WorldWideScience

Sample records for underwent standard procedures

  1. Assessment of quality of life in patients who underwent minimally invasive cosmetic procedures.

    Science.gov (United States)

    de Aquino, Marcello Simão; Haddad, Alessandra; Ferreira, Lydia Masako

    2013-06-01

    There are increasingly more patients seeking minimally invasive procedures, which have become more effective and safer in reducing the signs of facial aging. This study included 40 female adult patients who voluntarily underwent selected minimally invasive procedures (filling with hyaluronic acid and botulinum toxin injection) for facial rejuvenation. All patients were followed for a period of 6 months. They were evaluated with the use of questionnaires, a quality-of-life questionnaire (DLQI), the self-esteem scale of Rosenberg (EPM/Rosenberg), and a pain scale. The minimally invasive procedures resulted in improvement in quality of life and self-esteem, which were stronger the first 3 months after the procedures but remained at a higher level than that before treatment, even after 6 months. Hyaluronic acid with lidocaine in the formula is more comfortable for the patient as it makes the injection less painful. 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 .

  2. Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures

    Directory of Open Access Journals (Sweden)

    Zeba Snježana

    2007-01-01

    Full Text Available Background. Hypothermia in the surgical patients can be the consequence of long duration of surgical intervention, general anesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition, but some investigations reported that infusion of aminoacids during surgery can induce thermogenesis and prevent postoperative hypothermia. Case report. We reported two males who underwent major colorectal surgery for rectal carcinoma. One patient received Aminosol 15% solution, 125 ml/h, while the other did not. The esophageal temperatures in both cases were measured every 30 minutes during the operation and 60 minutes after in Intensive Care Unit. We were monitoring blood pressure, heart rate, ECG, and shivering. Patient who received aminoacids showed ameliorated postoperative hypothermia without hypertension, arrhythmia, or shivering, while the other showed all symptoms mentioned above. Conclusion. According to literature data, as well as our findings, we can conclude that intraoperative intravenous treatment with amino acid solution ameliorates postoperative hypothermia along with its complications. .

  3. Comparison of Standard Catheters Versus Radial Artery-Specific Catheter in Patients Who Underwent Coronary Angiography Through Transradial Access.

    Science.gov (United States)

    Chen, On; Goel, Sunny; Acholonu, Michael; Kulbak, Guy; Verma, Shivani; Travlos, Efstratios; Casazza, Richard; Borgen, Elliot; Malik, Bilal; Friedman, Michael; Moskovits, Norbert; Frankel, Robert; Shani, Jacob; Ayzenberg, Sergey

    2016-08-01

    In this prospective, randomized controlled study, we aim to compare the performance outcomes of standard catheters with the radial artery-specific catheter. Over the past decade, transradial cardiac catheterization has gained widespread popularity because of its low complication rates compared with transfemoral access. Operators have the choice of using either standard catheters (used for both transfemoral and transradial approach, with need for separate catheter use for either right or left coronary artery engagement) or a dedicated radial artery catheter, which is specifically designed to engage both coronary arteries through radial artery access. A total of 110 consecutive patients who underwent coronary angiography at our institution from March 2015 to April 2015 were prospectively randomized to either radial artery-specific Tiger catheter (5Fr; Terumo Interventional Systems, Somerset, New Jersey) versus standard Judkins left and right catheters (5Fr R4, L4; Cordis Corporation, Miami, Florida). The end points of the study included fluoroscopy time, dose-area product, contrast volume used, and total procedure time for the coronary angiography. A total of 57 patients (52%) were randomized to radial artery-specific catheter and 53 (48%) to the standard catheter. Tiger catheter was associated with significantly lower fluoroscopy time (184 ± 91 vs 238 ± 131 seconds, p = 0.015), which was statistically significant. Other outcome measures such as dose-area product (2,882.4 ± 1,471.2 vs 3,524.6 ± 2,111.7 Gy·cm(2), p = 0.07), total contrast volume (48.1 ± 16.1 vs 53.4 ± 18.5 ml, p = 0.114), and total procedure time (337 ± 382 vs 434 ± 137 seconds, p = 0.085) were also lower in single-catheter group, but it did not reach statistical significance. A total of 8 patients (14%) were crossed over from radial-specific catheter arm to standard catheter arm because of substandard image quality and difficulty in coronary engagement. Six patients had to be

  4. Radiation control standards and procedures

    Energy Technology Data Exchange (ETDEWEB)

    1956-12-14

    This manual contains the Radiation Control Standards'' and Radiation Control Procedures'' at Hanford Operations which have been established to provide the necessary control radiation exposures within Irradiation Processing Department. Provision is also made for including, in the form of Bulletins'', other radiological information of general interest to IPD personnel. The purpose of the standards is to establish firm radiological limits within which the Irradiation Processing Department will operate, and to outline our radiation control program in sufficient detail to insure uniform and consistent application throughout all IPD facilities. Radiation Control Procedures are intended to prescribe the best method of accomplishing an objective within the limitations of the Radiation Control Standards. A procedure may be changed at any time provided the suggested changes is generally agreeable to management involved, and is consistent with department policies and the Radiation Control Standards.

  5. Clinical Outcome of a Prospective Case Series of Patients With Ketamine Cystitis Who Underwent Standardized Treatment Protocol.

    Science.gov (United States)

    Yee, Chi-hang; Lai, Pui-tak; Lee, Wai-man; Tam, Yuk-him; Ng, Chi-fai

    2015-08-01

    To assess the outcome of a prospective cohort of patients with ketamine-associated uropathy after standardized treatment. This is a prospective case series of patients with ketamine-related urologic problems. Management for the patients includes a 4-tier approach, namely anti-inflammatory or anti-cholinergic drugs, opioid analgesics or pregabalin, intravesical hyaluronic acid, and finally, surgical intervention including hydrodistension and augmentation cystoplasty. Outcome was assessed with functional bladder capacity, pelvic pain and urgency or frequency (PUF) symptom scale, and the EuroQol visual analog scale. Between December 2011 and June 2014, 463 patients presented with ketamine-associated uropathy. All were managed by the same standardized protocol. Among these patients, 319 patients came back for follow-up assessment. Overall mean follow-up duration was 10.7 ± 8.5 months. For those patients who received first-line treatment (290 patients), there was a significant improvement in PUF scores, the EuroQol visual analog scale, and functional bladder capacity. Both abstinence from ketamine usage and the amount of ketamine consumed were factors predicting the improvement of PUF scores. For those patients who required second-line oral therapy (62 patients), 42 patients (67.7%) reported improvement in symptoms. Eight patients have completed intravesical therapy. There was a significant improvement in voided volume for the patients after treatment. The study demonstrated the efficacy of managing ketamine-associated uropathy using a 4-tier approach. Both anti-inflammatory drugs and analgesics could effectively alleviate symptoms. Being abstinent from ketamine abuse and the amount of ketamine consumed have bearings on treatment response. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Standardized procedure for tsunami PRA by AESJ

    International Nuclear Information System (INIS)

    Kirimoto, Yukihiro; Yamaguchi, Akira; Ebisawa, Katsumi

    2013-01-01

    After Fukushima Accident (March 11, 2011), the Atomic Energy Society of Japan (AESJ) started to develop the standard of Tsunami Probabilistic Risk Assessment (PRA) for nuclear power plants in May 2011. As Japan is one of the countries with frequent earthquakes, a great deal of efforts has been made in the field of seismic research since the early stage. To our regret, the PRA procedures guide for tsunami has not yet been developed although the importance is held in mind of the PRA community. Accordingly, AESJ established a standard to specify the standardized procedure for tsunami PRA considering the results of investigation into the concept, the requirements that should have and the concrete methods regarding tsunami PRA referring the opinions of experts in the associated fields in December 2011 (AESJ-SC-RK004:2011). (author)

  7. Standard manufacturing procedure of Tamra Bhasma.

    Science.gov (United States)

    Jagtap, Chandrashekhar Y; Prajapati, Pradeep Kumar; Patgiri, Biswajyoti; Shukla, Vinay J

    2012-10-01

    Tamra Bhasma (incinerated copper) is one of the main weapons in the archery of Ayurvedic practitioners. Though several methods of preparation of Tamra Bhasma (TB) are found in Rasashastra classics, several difficulties occur during the preparation of a good-quality Bhasma. In this study, TB was prepared and analyzed to develop the standard manufacturing procedure. Each unit operative procedure was considered as an independent processing and an attempt was made to validate each procedure. Wire used for the purpose of electrical earthing was taken for the preparation of Bhasma. Procedures of Shodhana, Marana, and Amritikarana were followed as per the classical references. Specific temperature pattern was adopted for Puta in the electrical muffle furnace. From 500 g of Tamra, 483.4 g of black colored TB was obtained after subjecting to three Putas. Final product was detected to be cupric sulfide in X-ray diffraction. In particle size distribution analysis 10% of the material was below the size of 2 μm, while in inductive coupled plasma - atomic absorption spectrometry 58.56 wt% copper and 22.48 wt% of sulfur were found present in the final product along with the elements such as arsenic, lead, zinc, mercury, and manganese in traces.

  8. 42 CFR 493.1251 - Standard: Procedure manual.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Procedure manual. 493.1251 Section 493... Systems § 493.1251 Standard: Procedure manual. (a) A written procedure manual for all tests, assays, and.... (b) The procedure manual must include the following when applicable to the test procedure: (1...

  9. 21 CFR 120.6 - Sanitation standard operating procedures.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Sanitation standard operating procedures. 120.6... Provisions § 120.6 Sanitation standard operating procedures. (a) Sanitation controls. Each processor shall have and implement a sanitation standard operating procedure (SSOP) that addresses sanitation...

  10. 40 CFR 761.79 - Decontamination standards and procedures.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Decontamination standards and..., AND USE PROHIBITIONS Storage and Disposal § 761.79 Decontamination standards and procedures. (a) Applicability. This section establishes decontamination standards and procedures for removing PCBs, which are...

  11. Standard-E hydrogen monitoring system shop acceptance test procedure

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T.C.

    1997-10-02

    The purpose of this report is to document that the Standard-E Hydrogen Monitoring Systems (SHMS-E), fabricated by Mid-Columbia Engineering (MCE) for installation on the Waste Tank Farms in the Hanford 200 Areas, are constructed as intended by the design. The ATP performance will verify proper system fabrication.

  12. Standard manufacturing procedure of Teekshna lauha bhasma

    Directory of Open Access Journals (Sweden)

    Thakur Rakesh Singh

    2016-04-01

    Conclusion: Pharmaceutical procedures given in Ayurvedic texts are necessary to prepare pakwa jambu phala varna T. lauha bhasma that complies with all the classical bhasma pariksha and modern analytical parameters in 20 puta at a temperature of 650 °C maintained for 1 h in EMF.

  13. 77 FR 12454 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2012-03-01

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 97 [Docket No. 30829; Amdt. No. 3467] Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final rule...

  14. 42 CFR 493.1256 - Standard: Control procedures.

    Science.gov (United States)

    2010-10-01

    ... results are used, statistical parameters (for example, mean and standard deviation) for each batch and lot... 42 Public Health 5 2010-10-01 2010-10-01 false Standard: Control procedures. 493.1256 Section 493... (CONTINUED) STANDARDS AND CERTIFICATION LABORATORY REQUIREMENTS Quality System for Nonwaived Testing Analytic...

  15. JSC Design and Procedural Standards, JSC-STD-8080

    Science.gov (United States)

    Punch, Danny T.

    2011-01-01

    This document provides design and procedural requirements appropriate for inclusion in specifications for any human spaceflight program, project, spacecraft, system, or end item. The term "spacecraft" as used in the standards includes launch vehicles, orbital vehicles, non-terrestrial surface vehicles, and modules. The standards are developed and maintained as directed by Johnson Space Center (JSC) Policy Directive JPD 8080.2, JSC Design and Procedural Standards for Human Space Flight Equipment. The Design and Procedural Standards contained in this manual represent human spacecraft design and operational knowledge applicable to a wide range of spaceflight activities. These standards are imposed on JSC human spaceflight equipment through JPD 8080.2. Designers shall comply with all design standards applicable to their design effort.

  16. Demographic And Technical Risk Factors Of 30-Day Stroke, Myocardial Infarction, And/Or Death In Standard And High Risk Patients Who Underwent Carotid Angioplasty And Stenting

    Directory of Open Access Journals (Sweden)

    Samaneh Yousefi

    2017-02-01

    Full Text Available Background: Carotid angioplasty and stenting (CAS is an accepted treatment to prevent stroke in patients with carotid artery stenosis. The purpose of this study is to identify risk factors for major complications after carotid angioplasty and stenting. Methods and Material: This is a prospective study conducted at Shiraz University of Medical Sciences in southern Iran from March 2011 to June 2014. Consecutive patients undergoing carotid angioplasty and stenting were enrolled. Both standard risk and high risk patients for endarterectomy were enrolled. Demographic data, atherosclerotic risk factors, site of stenosis, degree of stenosis, and data regarding technical factors were recorded. 30-day stroke, myocardial infarction, and/or death were considered as the composite primary outcome of the study. Results:  two hundred and fifty one patients were recruited (mean age: 71.1+ 9.6 years, male: 65.3%.  One hundred and seventy eight (70.9% patients were symptomatic; 73 (29.1%, 129 (51.4%, 165 (65.7% and 62 (24.7% patients were diabetic, hyperlipidemic, hypertensive and smoker respectively. CAS performed for left ICA in 113 (45.4% patients. 14 (5.6% patients had Sequential bilateral stenting. Mean stenosis of operated ICA was 80.2 +13.8 %. Embolic protection device was used in 203 (96.2% patients. Predilation and post-dilation were performed in 39 (18.5% and 182 (86.3% patients respectively. Composite outcome was observed in 3.6% (3.2% stroke, 0% myocardial infarction and 1.2% death. Left sided lesions and presence of DM was significantly associated with poor short term outcome. (P value: 0.025 and 0.020, respectively Conclusion: There was a higher risk of short term major complications in diabetic patients and left carotid artery intervention.

  17. Standard Review Plan Maintenance Program implementing procedures document

    International Nuclear Information System (INIS)

    1996-11-01

    The implementing Procedures Document (IPD) was developed by the Inspection Program Projects Branch, Office of Nuclear Reactor Regulation, with assistance from Pacific Northwest National Laboratory, for the Standard Review Plan Maintenance Program (SRP-MP). The SRP-MP was established to maintain the Standard Review Plan (SRP) on an on-going basis. The IPD provides guidance, including an overall approach and procedures, for SRP-MP tasks. The objective of the IPD is to ensure that modifications to SRP need to reflect current NRC requirements and guidance are identified and that a consistent methodology is used to develop and revise SRP sections

  18. Standard Review Plan Update and Development Program. Implementing Procedures Document

    Energy Technology Data Exchange (ETDEWEB)

    1992-05-01

    This implementing procedures document (IPD) was prepared for use in implementing tasks under the standard review plan update and development program (SRP-UDP). The IPD provides comprehensive guidance and detailed procedures for SRP-UDP tasks. The IPD is mandatory for contractors performing work for the SRP-UDP. It is guidance for the staff. At the completion of the SRP-UDP, the IPD will be revised (to remove the UDP aspects) and will replace NRR Office Letter No. 800 as long-term maintenance procedures.

  19. Standardized methods for photography in procedural dermatology using simple equipment.

    Science.gov (United States)

    Hexsel, Doris; Hexsel, Camile L; Dal'Forno, Taciana; Schilling de Souza, Juliana; Silva, Aline F; Siega, Carolina

    2017-04-01

    Photography is an important tool in dermatology. Reproducing the settings of before photos after interventions allows more accurate evaluation of treatment outcomes. In this article, we describe standardized methods and tips to obtain photographs, both for clinical practice and research procedural dermatology, using common equipment. Standards for the studio, cameras, photographer, patients, and framing are presented in this article. © 2017 The International Society of Dermatology.

  20. 21 CFR 58.81 - Standard operating procedures.

    Science.gov (United States)

    2010-04-01

    ... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Standard operating procedures. 58.81 Section 58.81 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL GOOD...

  1. Incidence of postoperative implant-related bacterial endocarditis in dogs that underwent trans-catheter embolization of a patent ductus arteriosus without intra- and post-procedural prophylactic antibiotics.

    Science.gov (United States)

    Szatmári, Viktor

    2017-08-01

    Intra- and post-procedural prophylactic antibiotics are routinely administered by veterinary cardiologists to dogs that undergo trans-catheter embolization of a patent ductus arteriosus for prevention of implant-related infective endocarditis. The hypothesis of our study was that primary antibiotic prophylaxis is not necessary to prevent bacterial endocarditis. In this retrospective case series 54 client-owned dogs that underwent trans-catheter occlusion of a patent ductus arteriosus in a single tertiary veterinary referral center between 2004 and 2016 were evaluated. Follow-up information was gained by telephone interviews with the owners or the referring veterinarians, or from the digital archives of the authors' clinic. Inclusion criteria were that at least one metal implant (a coil or an Amplatz duct occluder) had to be delivered in the ductal ampulla, no local or systemic antibiotics were given on the day of the intervention or the week thereafter, at least 3 months of postoperative follow-up information was available, and the author was performing the procedure either as the primary or as the supervising cardiology specialist. None of the 54 dogs developed infective endocarditis in the postoperative 3 months. A study describing a similar population reports 2 of the included 47 dogs having developed infective endocarditis in the postoperative period despite the administration of intra- and post-procedural prophylactic antibiotics. We conclude that intra- and post-procedural antibiotic prophylaxis is not justified in dogs that undergo trans-catheter closure of a patent ductus arteriosus. Proper surgical technique and the use of new sterile catheters and implants are sufficient to prevent infective endocarditis in these dogs. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Hip arthroplasty in obese patients: rising prevalence – standard procedures?

    Directory of Open Access Journals (Sweden)

    Michael Skutek

    2016-06-01

    Full Text Available We examined our experience and, in particular, complications associated with total hip arthroplasty in obese and morbidly obese patients. We prospectively gathered 50 patients in a matched control series including 25 obese and morbidly obese patients. All patients were operated using the direct lateral approach and standard postoperative protocols. Operating room time, complications, dislocations, blood loss, cup position and clinical parameters using the Harris Hip Score and the Western Ontario and McMaster Universities Arthritis Index results were compared. Although there were some significant differences in clinical outcomes, standard procedures yielded good overall results and an acceptable rate of complications. Details approaching this patient entity are being discussed.

  3. The European Stroke Organisation Guidelines: a standard operating procedure

    DEFF Research Database (Denmark)

    Ntaios, George; Bornstein, Natan M; Caso, Valeria

    2015-01-01

    In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published...... pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important...... cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical...

  4. Quality assurance: Importance of systems and standard operating procedures

    OpenAIRE

    Kishu Manghani

    2011-01-01

    It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality...

  5. Standard operating procedures for serum and plasma collection: early detection research network consensus statement standard operating procedure integration working group.

    Science.gov (United States)

    Tuck, Melissa K; Chan, Daniel W; Chia, David; Godwin, Andrew K; Grizzle, William E; Krueger, Karl E; Rom, William; Sanda, Martin; Sorbara, Lynn; Stass, Sanford; Wang, Wendy; Brenner, Dean E

    2009-01-01

    Specimen collection is an integral component of clinical research. Specimens from subjects with various stages of cancers or other conditions, as well as those without disease, are critical tools in the hunt for biomarkers, predictors, or tests that will detect serious diseases earlier or more readily than currently possible. Analytic methodologies evolve quickly. Access to high-quality specimens, collected and handled in standardized ways that minimize potential bias or confounding factors, is key to the "bench to bedside" aim of translational research. It is essential that standard operating procedures, "the how" of creating the repositories, be defined prospectively when designing clinical trials. Small differences in the processing or handling of a specimen can have dramatic effects in analytical reliability and reproducibility, especially when multiplex methods are used. A representative working group, Standard Operating Procedures Internal Working Group (SOPIWG), comprised of members from across Early Detection Research Network (EDRN) was formed to develop standard operating procedures (SOPs) for various types of specimens collected and managed for our biomarker discovery and validation work. This report presents our consensus on SOPs for the collection, processing, handling, and storage of serum and plasma for biomarker discovery and validation.

  6. 75 FR 72942 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2010-11-29

    ...: Harry J. Hodges, Flight Procedure Standards Branch (AFS-420), Flight Technologies and Programs Divisions..., SD, Rapid City Rgnl, ILS OR LOC RWY 32, Amdt 19 Newport News, VA, Newport News/Williamsburg Intl, ILS OR LOC RWY 7, Amdt 33 Newport News, VA, Newport News/Williamsburg Intl, ILS OR LOC RWY 25, Amdt 1...

  7. Standardization of SMP procedure and its impact on outcome

    Directory of Open Access Journals (Sweden)

    Rachita S Dhurat

    2017-01-01

    Full Text Available Background: Cosmetic deformities can result from various types of alopecia or even post hair transplantation procedures. Patients with such deformities seek aesthetically appealing longer-lasting options. Scalp concealers are commonly used by men and women to camouflage these deformities. Scalp micropigmentation (SMP is one of the concealers recently gaining popularity. Objectives: SMP is a novel technique wherein microdot tattoos are placed in a stippling pattern to mimic hair follicles that are cut close to the scalp and various variables affecting its outcome were evaluated. Methods: Forty-five subjects were recruited for the study. The various factors affecting outcome of SMP—angle of needle against the scalp, depth of needle into the scalp, time of the needle contact in scalp, speed of the rotor, resistance of scalp, color of pigment, viscosity of dye, needle number, needle thickness, and pattern of dot placement—were systematically studied in 15 patients through clinical photographs and trichoscopy. Ideal depth of pigment deposition was assessed through histopathological examination. After using these optimum variables, standardized SMP was performed in 30 patients with hair loss (3 patients with cicatricial and 27 patients with diffuse non-cicatricial alopecia. SMP was also used to create an aesthetically denser hairline. The outcome of the procedure was evaluated using standardized global photographs. Results: The ideal parameters were established to achieve standard reproducible results. There were great patient satisfaction and acceptance of the procedure. All the patients showed moderate to great improvement after the procedure with satisfactory scalp coverage. Adverse events were transient which were seen in the form of edema and redness. Conclusion: SMP offers a non-medical, tattoo-based cosmetically appealing and effective “cover-up” that hides the unsightly conditions. The cosmetic tattoo placement creates an illusion of

  8. Standard working procedures in production of traditionally fermented Sremska sausage

    Directory of Open Access Journals (Sweden)

    Vesković-Moračanin Slavica

    2011-01-01

    Full Text Available Investigations conducted within project "Techonological and protective characteristics of autochthonous strains of lactic acid bacteria isolated from traditional fermented sausages and possibilities for their implementation in the meat industry" (Project Number: 20127, financed on behalf of the Ministry for Science and Technology of the Republic of Serbia, have provided an answer on the characteristics of the quality of the used raw materials for the production of Sremska sausage - one of the most well-known Serbian traditionally fermented sausages (choice of meat, fatty tissue, additives and spices, and data have been registered in connection with the procedures of their processing, microclimatic conditions have been established (temperature, relative humidity, and air circulation during the entire process of production and fermentation, as well as the presence and types of microorganisms, primarily lactic acid bacteria (BMK, the carrier of lactic fermentation. The most important characteristics of the filling have been established, the smoking regimen, the regimens of fermentation, maturing, drying, as well as the parameters for quality and safety of the finished product. At the same time, the standard working procedure has been determined for the preparation of the meat, fatty tissue, the forming and inserting of the filling into the wrappers, as well as the characteristics of the finished products. The given standard working procedure should serve as a guideline for the meat industry in the production process of this traditional fermented sausage.

  9. Environmental Sciences Division Toxicology Laboratory standard operating procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kszos, L.A.; Stewart, A.J.; Wicker, L.F.; Logsdon, G.M.

    1989-09-01

    This document was developed to provide the personnel working in the Environmental Sciences Division's Toxicology Laboratory with documented methods for conducting toxicity tests. The document consists of two parts. The first part includes the standard operating procedures (SOPs) that are used by the laboratory in conducting toxicity tests. The second part includes reference procedures from the US Environmental Protection Agency document entitled Short-Term Methods for Estimating the Chronic Toxicity of Effluents and Receiving Waters to Freshwater Organisms, upon which the Toxicology Laboratory's SOPs are based. Five of the SOPs include procedures for preparing Ceriodaphnia survival and reproduction test. These SOPs include procedures for preparing Ceriodaphnia food (SOP-3), maintaining Ceriodaphnia cultures (SOP-4), conducting the toxicity test (SOP-13), analyzing the test data (SOP-13), and conducting a Ceriodaphnia reference test (SOP-15). Five additional SOPs relate specifically to the fathead minnow (Pimephales promelas) larval survival and growth test: methods for preparing fathead minnow larvae food (SOP-5), maintaining fathead minnow cultures (SOP-6), conducting the toxicity test (SOP-9), analyzing the test data (SOP-12), and conducting a fathead minnow reference test (DOP-14). The six remaining SOPs describe methods that are used with either or both tests: preparation of control/dilution water (SOP-1), washing of glassware (SOP-2), collection and handling of samples (SOP-7), preparation of samples (SOP-8), performance of chemical analyses (SOP-11), and data logging and care of technical notebooks (SOP-16).

  10. The European Stroke Organisation Guidelines: a standard operating procedure.

    Science.gov (United States)

    Ntaios, George; Bornstein, Natan M; Caso, Valeria; Christensen, Hanne; De Keyser, Jacques; Diener, Hans-Christoph; Diez-Tejedor, Exuperio; Ferro, Jose M; Ford, Gary A; Grau, Armin; Keller, Emanuella; Leys, Didier; Russell, David; Toni, Danilo; Turc, Guillaume; Van der Worp, Bart; Wahlgren, Nils; Steiner, Thorsten

    2015-10-01

    In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations on the related module rather swiftly; with the previous approach of a single large Guideline Document, its entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines. After discussion within the European Stroke Organisation Guidelines Committee and significant input from European Stroke Organisation members as well as methodologists and analysts, this document presents the official standard operating procedure for

  11. "Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education.

    Science.gov (United States)

    Nikendei, C; Ganschow, P; Groener, J B; Huwendiek, S; Köchel, A; Köhl-Hackert, N; Pjontek, R; Rodrian, J; Scheibe, F; Stadler, A-K; Steiner, T; Stiepak, J; Tabatabai, J; Utz, A; Kadmon, M

    2016-01-01

    The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.

  12. Standard Operating Procedures for Female Genital Sexual Pain

    DEFF Research Database (Denmark)

    Fugl-Meyer, Kerstin S; Bohm-Starke, Nina; Damsted Petersen, Christina

    2012-01-01

    and psychological disorders are highlighted, and different somatic and psychological assessment and treatment modalities are discussed. Methods.  The Standard Operating Procedures (SOP) committee was composed of a chair and five additional experts. No corporate funding or remuneration was received. The authors...... therapeutic interventions. However, this international expert group will recommend guidelines for management of female GSP. Conclusions.  GSP disorders are complex. It is recommended that their evaluation and treatment are performed through comprehensive somato-psychological multidisciplinary approach. Fugl......Introduction.  Female genital sexual pain (GSP) is a common, distressing complaint in women of all ages that is underrecognized and undertreated. Definitions and terminology for female GSP are currently being debated. While some authors have suggested that GSP is not per se a sexual dysfunction...

  13. Quality assurance: Importance of systems and standard operating procedures.

    Science.gov (United States)

    Manghani, Kishu

    2011-01-01

    It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company.

  14. Standard procedures for pooling health physics data for epidemiologic studies

    International Nuclear Information System (INIS)

    Strom, D.J.; Beck, W.L.; Stansbury, P.S.; Tankersley, W.G.; Watson, J.E. Jr.

    1983-01-01

    The objectives of the study are: (1) to determine the availability of dosimetry data and supporting documentation at multiple facilities; (2) to develop criteria and methods for optimally retrieving data; (3) to evaluate and document the quality and completeness of data and dosimetry programs; (4) to put dosimetry data (e.g., external, whole body counting, and bioassay data) from various facilities in a single format for epidemiologic analysis; and (5) to document all work for peer review. To achieve these objectives, a ''Dosimetry Records and Radiation Hazards Questionnaire'' was developed to send to the facilities under study. Responses to this questionnaire are used to develop data retrieval criteria and methods, and to retrieve data. Dose data are reformatted into Standard Intermediate Dosimetry Files for editing and characterization. Evaluations of dosimetry programs are performed concurrently. Results of these steps are brought together and analysis files created. Status of this work in the context of the Department of Energy 5-Rem Study is reported. The standard procedures are applicable to single- as well as multiple-facility studies

  15. Measuring and diagnosing unilateral neglect: a standardized statistical procedure.

    Science.gov (United States)

    Toraldo, Alessio; Romaniello, Cristian; Sommaruga, Paolo

    Unilateral neglect is usually investigated by adminstering stimuli (targets) in different positions, with targets being responded to by the patient (Hit) or omitted. In spite of this homogeneity of data type, neglect indices and diagnostic criteria vary considerably, causing inconsistencies in both clinical and experimental settings. We aimed at deriving a standard analysis which would apply to all tasks sharing this data form. A-priori theoretical reasoning demonstrated that the mean position of Hits in space (MPH) is an optimal index for correctly diagnosing and quantifying neglect. Crucially MPH eliminates the confounding effects of deficits that are different from neglect (non-lateral) but which decrease Hit rate. We ran a Monte Carlo study to assess MPH's (so far overlooked) statistical behavior as a function of numbers of targets and Hits. While average MPH was indeed insensitive to non-lateral deficits, MPH's variance (like that of all other neglect indices) increased dramatically with increasing non-lateral deficits. This instability would lead to alarmingly high false-positive rates (FPRs) when applying a classical diagnostic procedure that compares one patient with a control sample. We solved the problem by developing an equation that takes into account MPH instability and provides correct cut-offs and close-to-nominal FPRs, even without control subjects. We developed a computerized program which, given the raw data, yields the MPH, a z-score and a p-value. We provided a standard method that allows clinical and experimental neuropsychologists to diagnose and measure neglect in a consistent way across the vast majority of tasks.

  16. Standard formatted data units-control authority procedures

    Science.gov (United States)

    1991-01-01

    The purpose of this document is to establish a set of minimum and optional requirements for the implementation of Control Authority (CA) organizations within and among the Agencies participating in the Consultative Committee for Space Data Systems (CCSDS). By satisfying these requirements, the resultant cooperating set of CA organizations will produce a global CA service supporting information transfer with digital data under the Standard Formatted Data Unit (SFDU) concept. This service is primarily accomplished through the registration, permanent archiving, and dissemination of metadata in the form of Metadata Objects (MDO) that assist in the interpretation of data objects received in SFDU form. This Recommendation addresses the responsibilities, services, and interface protocols for a hierarchy of CA organizations. The top level, consisting of the CCSDS Secretariat and its operational agent, is unique and primarily provides a global coordination function. The lower levels are Agency CA organizations that have primary responsibility for the registration, archiving, and dissemination of MDOs. As experience is gained and technology evolves, the CA Procedures will be extended to include enhanced services and their supporting protocols. In particular, it is anticipated that eventually CA organizations will be linked via networks on a global basis, and will provide requestors with online automated access to CA services. While this Recommendation does not preclude such operations, it also does not recommend the specific protocols to be used to ensure global compatibility of these services. These recommendations will be generated as experience is gained.

  17. Quality assurance: Importance of systems and standard operating procedures

    Directory of Open Access Journals (Sweden)

    Kishu Manghani

    2011-01-01

    Full Text Available It is mandatory for sponsors of clinical trials and contract research organizations alike to establish, manage and monitor their quality control and quality assurance systems and their integral standard operating procedures and other quality documents to provide high-quality products and services to fully satisfy customer needs and expectations. Quality control and quality assurance systems together constitute the key quality systems. Quality control and quality assurance are parts of quality management. Quality control is focused on fulfilling quality requirements, whereas quality assurance is focused on providing confidence that quality requirements are fulfilled. The quality systems must be commensurate with the Company business objectives and business model. Top management commitment and its active involvement are critical in order to ensure at all times the adequacy, suitability, effectiveness and efficiency of the quality systems. Effective and efficient quality systems can promote timely registration of drugs by eliminating waste and the need for rework with overall financial and social benefits to the Company.

  18. Manual of Standard Operating Procedures for Veterinary Drug Residue Analysis

    International Nuclear Information System (INIS)

    2016-01-01

    Laboratories are crucial to national veterinary drug residue monitoring programmes. However, one of the main challenges laboratories encounter is obtaining access to relevant methods of analysis. Thus, in addition to training, providing technical advice and transferring technology, the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has resolved to develop clear and practical manuals to support Member State laboratories. The Coordinated Research Project (CRP) on Development of Radiometric and Allied Analytical Methods to Strengthen Residue Control Programs for Antibiotic and Anthelmintic Veterinary Drug Residues has developed a number of analytical methods as standard operating procedures (SOPs), which are now compiled here. This publication contains SOPs on chromatographic and spectrometric techniques, as well as radioimmunoassay and associated screening techniques, for various anthelmintic and antimicrobial veterinary drug residue analysis. Some analytical method validation protocols are also included. The publication is primarily aimed at food and environmental safety laboratories involved in testing veterinary drug residues, including under organized national residue monitoring programmes. It is expected to enhance laboratory capacity building and competence through the use of radiometric and complementary tools and techniques. The publication is also relevant for applied research on residues of veterinary drugs in food and environmental samples

  19. 49 CFR 1111.9 - Procedural schedule in cases using simplified standards.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Procedural schedule in cases using simplified... PROCEDURES § 1111.9 Procedural schedule in cases using simplified standards. (a) Procedural schedule. Absent a specific order by the Board, the following general procedural schedules will apply in cases using...

  20. Estimating the Standard Error of the Judging in a modified-Angoff Standards Setting Procedure

    Directory of Open Access Journals (Sweden)

    Robert G. MacCann

    2004-03-01

    Full Text Available For a modified Angoff standards setting procedure, two methods of calculating the standard error of the..judging were compared. The Central Limit Theorem (CLT method is easy to calculate and uses readily..available data. It estimates the variance of mean cut scores as a function of the variance of cut scores within..a judging group, based on the independent judgements at Stage 1 of the process. Its theoretical drawback is..that it is unable to take account of the effects of collaboration among the judges at Stages 2 and 3. The..second method, an application of equipercentile (EQP equating, relies on the selection of very large stable..candidatures and the standardisation of the raw score distributions to remove effects associated with test..difficulty. The standard error estimates were then empirically obtained from the mean cut score variation..observed over a five year period. For practical purposes, the two methods gave reasonable agreement, with..the CLT method working well for the top band, the band that attracts most public attention. For some..bands in English and Mathematics, the CLT standard error was smaller than the EQP estimate, suggesting..the CLT method be used with caution as an approximate guide only.

  1. International standards and quality control procedures applied to nuclear instruments

    International Nuclear Information System (INIS)

    Urbanski, P.

    2008-01-01

    The survey of international standards related to Nuclear Instrumentation and QC tests was presented. From among the 29'336 active international standards published by such organizations as ISO, IEC, CEN and CENELEC, only 582 are devoted to nuclear instruments. The international classification of standards (ICS) is shown. Also, the list of 582 international standards related to nuclear instruments is attached. (author)

  2. Incidence of postoperative implant-related bacterial endocarditis in dogs that underwent trans-catheter embolization of a patent ductus arteriosus without intra- and post-procedural prophylactic antibiotics

    NARCIS (Netherlands)

    Szatmári, Viktor

    2017-01-01

    Intra- and post-procedural prophylactic antibiotics are routinely administered by veterinary cardiologists to dogs that undergo trans-catheter embolization of a patent ductus arteriosus for prevention of implant-related infective endocarditis. The hypothesis of our study was that primary antibiotic

  3. Standard interface files and procedures for reactor physics codes. Version IV

    International Nuclear Information System (INIS)

    O'Dell, R.D.

    1977-09-01

    Standards, procedures, and recommendations of the Committee on Computer Code Coordination for promoting the exchange of reactor physics codes are updated to Version IV status. Standards and procedures covering general programming, program structure, standard interface files, and file management and handling subroutines are included

  4. Manual for the GAW Precipitation Chemistry Programme: Guidelines, Data Quality Objectives and Standard Operating Procedures

    National Research Council Canada - National Science Library

    Allan, Mary A

    2004-01-01

    This is a manual for the Global Atmosphere Watch Precipitation Chemistry (GAW-PC) Programme. Where possible, it describes standard operating procedures and otherwise provides guidance on methods and procedures...

  5. Standardization of the time for the execution of HANARO start-up and shutdown procedures

    International Nuclear Information System (INIS)

    Choi, H. Y.; Lim, I. C.; Hwang, S. R.; Kang, T. J.; Youn, D. B.

    2003-01-01

    For the standardization of the time to execute HANARO start-up and shutdown procedures, code names were assigned to the individual procedures and the work time were investigated. The data recorded by the operators during start-up and shutdown were statistically analyzed. The analysis results will be used for the standardization of start-up and shutdown procedures and it will be reflected in the procedure document

  6. 21 CFR 606.100 - Standard operating procedures.

    Science.gov (United States)

    2010-04-01

    ... blood and blood components for transfusion and further manufacturing purposes. Such procedures shall be... the site of phlebotomy to give maximum assurance of a sterile container of blood. (4) Method of... precautions taken to measure accurately the quantity of blood removed from the donor. (6) Methods of component...

  7. Creating Royal Australian Navy Standard Operating Procedures using Flow Diagrams

    Science.gov (United States)

    2015-08-01

    set it is important to determine writing and approval responsibilities, storage methods and publishing details before SOPs are written. This...5 4.1.1 Brainstorming ...managed accordingly. Key activities include scoping the set of SOPs, creating a team, developing a plan, writing , reviewing and approving procedures, and

  8. Item Disordinality with the Bookmark Standard Setting Procedure.

    Science.gov (United States)

    Skaggs, Gary; Tessema, Aster

    This paper presents an application of the bookmark procedure to a test comprised of increasing text difficulty levels. The Test of English Proficiency for Adults (TEPA) was used for this study. Three forms of the TEPA were field tested in 1999 with approximately 1,000 non-native English speaking students enrolled in English-as-a-Second-Language…

  9. Policy, Procedures and Standards for Enterprise Information Management

    Science.gov (United States)

    This policy establishes a standard approach for managing information produced by, funded by, or received per regulated reporting and/or federal-wide requirements and subsequently held or cataloged in information management systems by EPA.

  10. Standard Operating Procedure for Accelerated Corrosion Testing at ARL

    Science.gov (United States)

    2017-11-01

    to scribe nonferrous materials so as to prevent contamination of the substrate during the process. The "X" scribe is made by scribing 2 intersecting...may include GMW14872 Cyclic Corrosion Testing (typically Exterior, Exposure C), ASTM B117 Neutral Salt Fog Testing, ASTM G50 Atmospheric Corrosion...using the same cleaning procedures, contamination of the substrate is minimized during the scribe process. All partners adhering to guidelines and

  11. Standardization of the Romanowsky staining procedure: an overview.

    Science.gov (United States)

    Bentley, S A; Marshall, P N; Trobaugh, F E

    1980-01-01

    Commerically available Romanowsky blood stains are variable mixtures of thiazein dyes and brominated fluorescein derivatives with varying degrees of metallic salt contamination in a number of different solvent systems. There is a need for standardized Romanowsky stains of constant composition, which, when used in conjunction with a carefully controlled specimen preparation technique, should give consistent performance. Such a preparation system would be of great value to hematologists in general and would be essential to the validity of data obtained by the digital processing of blood cell images. It is possible to prepare standardized Romanowsky stains as mixtures of two or three dye components, namely, eosin Y, azure B and methylene blue, although azure B has only recently become commercially available at an acceptable degree of purity. The logistic problems of stain standardization are discussed.

  12. Planning and evaluating prescribed fires--a standard procedure

    Science.gov (United States)

    William C. Fischer

    1978-01-01

    Provides a standard format and checklist to guide the land manager through the important steps for prescribed burning. Describes the kind of information needed to prepare fire prescriptions and burning plans. Identifies the elements of a fire prescription, a burning plan, and a prescribed fire evaluation. A plan written for an actual prescribed burning is included as...

  13. Standardized Procedures for Use of Nucleic Acid-Based Tools

    Science.gov (United States)

    2008-08-01

    Madigan, M., J. Martinko, P. Dunlap and D. Clark (2006). Brock Biology Of Microorganisms , Benjamin Cummings. Mailloux, B. J. and M. E. Fuller...Methods for Enumeration of Microorganisms and Development of a Dhc Reference Standard...Dehalococcoides (Dhc) and other environmentally relevant microorganisms . The results of these analyses are increasingly used by site owners

  14. 12 CFR 616.6300 - Leasing policies, procedures, and underwriting standards.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Leasing policies, procedures, and underwriting standards. 616.6300 Section 616.6300 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM LEASING § 616.6300 Leasing policies, procedures, and underwriting standards. The board of each institution...

  15. 7 CFR 201.67 - Seed certifying agency standards and procedures.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Seed certifying agency standards and procedures. 201...) FEDERAL SEED ACT FEDERAL SEED ACT REGULATIONS Certified Seed § 201.67 Seed certifying agency standards and procedures. In order to qualify as a seed certifying agency for purposes of section 101(a)(25) of the Federal...

  16. Procedures and Standards Handbook. Version 3.0. What Works Clearinghouse

    Science.gov (United States)

    What Works Clearinghouse, 2014

    2014-01-01

    This "What Works Clearinghouse Procedures and Standards Handbook (Version 3.0)" provides a detailed description of the standards and procedures of the What Works Clearinghouse (WWC). The remaining chapters of this Handbook are organized to take the reader through the basic steps that the WWC uses to develop a review protocol, identify…

  17. A Comparison of Standard-Setting Procedures for an OSCE in Undergraduate Medical Education.

    Science.gov (United States)

    Kaufman, David M.; Mann, Karen V.; Muijtjens, Arno M. M.; van der Vleuten, Cees P. M.

    2000-01-01

    Compared four standard-setting procedures for an objective structure clinical examination (OSCE) in medical education. Applied Angoff, borderline, relative, and holistic procedures to the data used to establish a cutoff score for a pass/fail decision. The Angoff and borderline procedures gave similar results; however, the relative and holistic…

  18. Operational procedure standard for occurrences involving radioactive materials

    Energy Technology Data Exchange (ETDEWEB)

    Piekarz, Leonardo, E-mail: leonardopbm@yahoo.com.br [Academia de Bombeiros Militar de Minas Gerais, Belo Horizonte, MG (Brazil); Rezende, Talita C.; Pinheiro, Christiano J.G., E-mail: talitacolombi@yahoo.com, E-mail: christrieste@yahoo.it [Universidade Federal do Espirito Santo (CCA/UFES), Alegre, ES (Brazil). Programa de Pós-Graduação em Engenharia Química

    2017-07-01

    This study has as objective to analyze more deeply the actions of response to emergencies involving radioactive materials, in the intent to establish a pattern to the actions performed by the military fire fighters of the Military Fire Brigade of Minas Gerais. To met these goals, it has been attempted to analyze the procedures utilized and recommended, nowadays, for the military fire fighters of CBMMG, and through directed studies, to suggest new actions possible to be executed in the local of the emergency in a way that will not expose the garrison to doses of ionizing radiation that may prejudice them. It is a study of bibliographic, exploratory, and also descriptive nature, realized through a qualitative approach. The techniques used for the research were the analysis of institutional documents, norms and other literature produced by renamed entities in the radiologic and biosafety areas. It was then concluded that CBMMG, through simple actions of response, can provide higher quality and safety in the operations involving radiologic accidents, standing out that the implemented actions nowadays are very beneath the capacity of the corporation, due to the lack of knowledge of the matter by the fire fighters. It was proposed, then, that new actions be implemented and instituted as operational procedures to be used on those emergencies, with the objective of provide a higher safety and professionalism in the attendance to emergencies involving radioactive materials. (author)

  19. Operational procedure standard for occurrences involving radioactive materials

    International Nuclear Information System (INIS)

    Piekarz, Leonardo; Rezende, Talita C.; Pinheiro, Christiano J.G.

    2017-01-01

    This study has as objective to analyze more deeply the actions of response to emergencies involving radioactive materials, in the intent to establish a pattern to the actions performed by the military fire fighters of the Military Fire Brigade of Minas Gerais. To met these goals, it has been attempted to analyze the procedures utilized and recommended, nowadays, for the military fire fighters of CBMMG, and through directed studies, to suggest new actions possible to be executed in the local of the emergency in a way that will not expose the garrison to doses of ionizing radiation that may prejudice them. It is a study of bibliographic, exploratory, and also descriptive nature, realized through a qualitative approach. The techniques used for the research were the analysis of institutional documents, norms and other literature produced by renamed entities in the radiologic and biosafety areas. It was then concluded that CBMMG, through simple actions of response, can provide higher quality and safety in the operations involving radiologic accidents, standing out that the implemented actions nowadays are very beneath the capacity of the corporation, due to the lack of knowledge of the matter by the fire fighters. It was proposed, then, that new actions be implemented and instituted as operational procedures to be used on those emergencies, with the objective of provide a higher safety and professionalism in the attendance to emergencies involving radioactive materials. (author)

  20. Comparison of the efficacy of standard bariatric surgical procedures on Saudi population using the bariatric analysis and reporting outcome system

    Directory of Open Access Journals (Sweden)

    Azzam Al Kadi

    2017-03-01

    Full Text Available Objectives: To compare the efficacy of various standard bariatric surgical procedures using the Bariatric Analysis and Reporting Outcome System (BAROS. Methods: This is a prospective, descriptive analytical study conducted in 2 medical institutions in Saudi Arabia. A total of 270 patients who had different bariatric surgery during the period between March 2010 and December 2012 were included. The data was analyzed and scored against 3 outcomes, excess weight loss, cure or improvement of comorbidities, and quality of life changes. Results: All patients who had different bariatric procedures were included in our study. Seventy-nine (29.3% underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP, 159 (58.9% had laparoscopic sleeve gastrectomy (LSG, and 32 (11.9% had laparoscopic adjustable gastric banding (LAGB. Complete remission of at least one comorbidity was reported in 36% of LRYGBP, 51% in LSG, and 42% in LAGB. While all other patients have improved comorbidities. The BAROS score was good or higher in 78.5% of LRYGBP, 83.6% for the LSG, and 84.4% of LAGB patients. The average excess weight loss was 67.9% in LRYGBP, 75.8% in LSG, and 81.7% LAGB patients. Conclusion: Bariatric surgery provides a substantial reduction in excess weight, improvement and cure of comorbidities, and improvement in quality of life. Standard bariatric procedures have different degrees of outcomes that can be beneficial in selecting appropriate procedure for appropriate indications and patients.

  1. Muscle sparing lateral thoracotomy: the standard incision for thoracic procedures

    Directory of Open Access Journals (Sweden)

    Mihai Dumitrescu

    2017-05-01

    Full Text Available Lateral thoracotomy is a versatile approach with many variations and is currently the most widely used incision in thoracic surgery. In the current article we are presenting the muscle-sparing lateral thoracotomy in the lateral decubitus position which we consider to be the “standard” for lateral thoracotomies. Indications, surgical technique and pitfalls are described alongside our experience with thoracic drainage. Although there is no consensus regarding the name of this incision, some authors call it “axillary thoracotomy” while others call it a “modified lateral thoracotomy”, they all agree on one aspect – the importance of muscle sparing – which makes it the go-to thoracotomy for both small and large procedures involving the lung. Lateral muscle sparing thoracotomy allows for good exposure of the pulmonary hilum, fissures, apex and diaphragm. The approach is easy and quick to perform while at the same time ensuring faster postoperative recovery by sparing the latissimus dorsi muscle, better cosmetics and lower postoperative pain score when compared to the posterolateral or classical lateral thoracotomies.

  2. Standard-C hydrogen monitoring system acceptance test procedure

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T.C.

    1994-09-02

    The primary function of the standard-C hydrogen monitoring system (SHMS) is to monitor specifically for hydrogen in the waste tank atmosphere which may also contain (but not be limited to) unknown quantities of air, nitrous oxide, ammonia, water vapor, carbon dioxide, carbon monoxide, and other gaseous constituents. The SHMS will consist of hydrogen specific monitors, a grab sampler to collect samples for laboratory analysis, a gas chromatograph, and the gas sample collection system necessary to support the operation of the instrumentation. This system will be located in a cabinet placed at the tank of interest. The purpose of this document is to demonstrate that the SHMS is constructed as intended by design.

  3. 78 FR 14010 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2013-03-04

    ...). Issued in Washington, DC, on February 15, 2013. John M. Allen, Director, Flight Standards Service..., RNAV (GPS) RWY 36, Orig Siren, WI, Burnett County, Takeoff Minimums and Obstacle DP, Orig BILLING CODE...

  4. 75 FR 63712 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2010-10-18

    ... 1, 2010. John M. Allen, Director, Flight Standards Service. Adoption of the Amendment 0 Accordingly..., Takeoff Minimums and Obstacle DP, Amdt 3 Siren, WI, Burnett County, VOR OR GPS RWY 5, Amdt 2B Solon...

  5. 76 FR 40600 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2011-07-11

    ... Navigation (air). Issued in Washington, DC, on June 24, 2011. John M. Allen, Director, Flight Standards... Corinth, MS, Roscoe Turner, RNAV (GPS) RWY 36, Amdt 1 Harvey, ND, Harvey Muni, RNAV (GPS) RWY 29, Orig-A...

  6. 75 FR 25760 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2010-05-10

    .... John M. Allen, Director, Flight Standards Service. Adoption of the Amendment 0 Accordingly, pursuant to... Muni, Takeoff Minimums and Obstacle DP, Amdt 3 Galliano, LA, South Lafourche Leonard Miller Jr, LOC/DME...

  7. 75 FR 9098 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2010-03-01

    ... 19, 2010. John M. Allen, Director, Flight Standards Service. Adoption of the Amendment 0 Accordingly... GALLIANO SOUTH LAFOURCHE 0/3269 2/3/10 RNAV (GPS) RWY 18, AMDT 1. LEONARD MILLER JR. 8-Apr-10 LA JENNINGS...

  8. 16 CFR 1610.35 - Procedures for testing special types of textile fabrics under the standard.

    Science.gov (United States)

    2010-01-01

    ... textile fabrics under the standard. 1610.35 Section 1610.35 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY OF CLOTHING TEXTILES Rules and Regulations § 1610.35 Procedures for testing special types of textile fabrics under the standard. (a) Fabric...

  9. Standardization of figures and assessment procedures for DTM verticalaccuracy

    Directory of Open Access Journals (Sweden)

    Vittorio Casella

    2015-07-01

    Full Text Available Digital Terrain Models (DTMs are widely used in many sectors. They play a key role in hydrological risk prevention, risk mitigation and numeric simulations. This paper deals with two questions: (i when it is stated that a DTM has a given vertical accuracy, is this assertion univocal? (ii when DTM vertical accuracy is assessed by means of checkpoints, does their location influence results? First, the paper illustrates that two vertical accuracy definitions are conceivable: Vertical Accuracy at the Nodes (VAN, the average vertical distance between the model and the terrain, evaluated at the DTM's nodes and Vertical Accuracy at the interpolated Points (VAP, in which the vertical distance is evaluated at the generic points. These two quantities are not coincident and, when they are calculated for the same DTM, different numeric values are reached. Unfortunately, the two quantities are often interchanged, but this is misleading. Second, the paper shows a simulated example of a DTM vertical accuracy assessment, highlighting that the checkpoints’ location plays a key role: when checkpoints coincide with the DTM nodes, VAN is estimated; when checkpoints are randomly located, VAP is estimated, instead. Third, an in-depth, theoretical characterization of the two considered quantities is performed, based on symbolic computation, and suitable standardization coefficients are proposed. Finally, our discussion has a well-defined frame: it doesn't deal with all the items of the DTM vertical accuracy budget, which would require a much longer essay, but only with one, usually called fundamental vertical accuracy.

  10. 78 FR 37452 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Science.gov (United States)

    2013-06-21

    ..., 2013. John M. Allen, Director, Flight Standards Service. Adoption of the Amendment Accordingly..., Amdt 1. 7/25/13 FL Tampa Tampa Executive. 3/0405 6/6/13 ILS OR LOC RWY 23, Amdt 1. 7/25/13 FL Milton...

  11. The philosophy and limitations of FAA aeromedical standards, policies and procedures.

    Science.gov (United States)

    1971-06-01

    Designated Aviation Medical Examiners need available basic information concerning the FAA medical certification system, the philosophy which underlies standards, policy and procedures, and certain limitations of the system. It is through such informa...

  12. Trends and the determination of effective doses for standard X-ray procedures

    International Nuclear Information System (INIS)

    Johnson, H.M.; Neduzak, C.; Gallet, J.; Sandeman, J.

    2001-01-01

    Trends in the entrance skin exposures (air kerma) for standard x-ray imaging procedures are reported for the Province of Manitoba, Canada. Average annual data per procedure using standard phantoms and standard ion chambers have been recorded since 1981. For example, chest air kerma (backscatter included) has decreased from 0.14 to 0.09 mGy. Confounding factors may negate the gains unless facility quality control programs are maintained. The data were obtained for a quality assurance and regulatory compliance program. Quoting such data for risk evaluation purposes lacks rigor hence a compartment model for organ apportioning, using organ absorbed doses and weighting factors, has been applied to determine effective dose per procedure. The effective doses for the standard procedures are presented, including the value of 0.027 mSv (1999) calculated for the effective dose in PA chest imaging. (author)

  13. Development of a standard operating procedure for analysis of ammonia concentrations in coal fly ash.

    Science.gov (United States)

    2015-04-01

    Research was performed to support the development and recommendation of a standard operating : procedure (SOP) for analyzing the ammonia content in fly ash intended for use in concrete. A review : of existing ash producers found that several differen...

  14. Licensing procedure, nuclear codes and standards in the Federal Republic of Germany

    International Nuclear Information System (INIS)

    Schultheiss, G.F.

    1980-01-01

    The present paper deals with legal background of licensing in nuclear technology and atomic energy use, licensing procedures for nuclear power plants and with codes, standards and guidelines in the Federal Republic of Germany. (orig./RW)

  15. 9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

  16. 40 CFR 75.38 - Standard missing data procedures for Hg CEMS.

    Science.gov (United States)

    2010-07-01

    ... Hg CEMS. 75.38 Section 75.38 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Standard missing data procedures for Hg CEMS. (a) Once 720 quality assured monitor operating hours of Hg... substitute data for Hg concentration in accordance with the procedures in ( 75.33(b)(1) through (b)(4...

  17. Standard testing procedures for optical fiber and unshielded twisted pair at Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Adams, R.L.

    1993-11-01

    This document will establish a working standard for testing optical fiber and unshielded twisted pair cables included in the Lab-wide telecommunications cabling system. The purpose of these standard testing procedures is to deliver to all Sandians a reliable, low-maintenance, state-of-the-art, ubiquitous telecommunications cabling infrastructure capable of satisfying all current and future telecommunication needs.

  18. EVALUASI SANITATION STANDARD OPERATING PROCEDURES KERUPUKAMPLANG DI UD SARINA KECAMATAN KALIANGET KABUPATEN SUMENEP

    Directory of Open Access Journals (Sweden)

    Ach Triharjono

    2016-11-01

    Full Text Available Industri pangan untuk menghasilkan produk yang memenuhi standar keamanan pangan. Standar tersebut dapat dipenuhi dengan menerapkan 8 aspek kunci Sanitation Standard Operating Prosedures (SSOP. Tujuan dari penelitian ini adalah untuk memperoleh hasil penerapan 8 aspek kunci Sanitation Standard Operating Procedures (SSOP dan mengevaluasi penerapan Sanitation Standard Operating Procedures (SSOP Di UD Sarina Kecamatan Kalianget Kabupaten Sumenep. Jenis penelitian ini bersifat deskriptif dengan lokasi penelitian di UD Sarina Kecamatan Kalianget Kabupaten Sumenep. Hasil penelitian diketahui bahwa penerapan 8 aspek kunci Sanitation Standard Operating Procedures (SSOP di UD Sarina sudah terlaksana tapi terdapat 3 tahapan kunci yang belum terlaksana dengan baik yaitu pencegahan kontaminasi silang, pengawasan kondisi kesehatan personil dan menghilangkan hama dari unit pengolahan. Hal yang perlu ditingkatkan terkait dengan penerapan SSOP di UD Sarina yaitu masih perlu adanya manual prosedur untuk berbagai pelaksanaan sanitasi yang dilakukan oleh UD Sarina ini

  19. Improving the review of standard operating procedures: a novel electronic system for compounding pharmacies.

    Science.gov (United States)

    Brensel, Robert; Brensel, Scott; Ng, Amy

    2013-01-01

    Since the New England Compounding Center disaster in 2012, the importance of following correct procedures during every phase of customized pharmacy has been a focus of governmental interest and action as well as public scrutiny. Many pharmacies rely on the rote review of standard operating procedures to ensure that staff members understand and follow protocols that ensure the safety and potency of all compounds prepared, but that approach to continuing education can be cumbersome and needlessly time-consuming. In addition, documenting and retrieving evidence of employee competence can be difficult. In this article, we describe our use of online technology to improve our methods of educating staff about the full range of standard operating procedures that must be followed in our pharmacy. The system we devised and implemented has proven to be effective, easy to update and maintain, very inexpensive, and user friendly. Its use has reduced the time previously required for a read-over review of standard operating procedures from 30 or 40 minutes to 5 or 10 minutes in weekly staff meetings, and we can now easily document and access proof of employees' comprehension of that content. It is our hope that other small compounding pharmacies will also find this system of online standard operating procedure review helpful.

  20. The primary exposure standard for Co-60 gamma radiation: characteristics and measurements procedures

    International Nuclear Information System (INIS)

    Laitano, R.F.; Toni, M.P.

    1983-01-01

    A description is given of a cavity ionization chamber used, as a primary exposure standard, at the Laboratorio di Metrologia delle Radiazioni Ionizzanti of the ENEA in Italy. The primary standard is designed to make absolute measurements of exposure due to the Co-60 gamma radiation. The procedures for the realizationof the exposure unit are also described. Finally results of some international comparisons are reported

  1. Standard operating procedures for female orgasmic disorder: consensus of the International Society for Sexual Medicine

    NARCIS (Netherlands)

    Laan, Ellen; Rellini, Alessandra H.; Barnes, Tricia

    2013-01-01

    As the field of sexual medicine evolves, it is important to continually improve patient care by developing contemporary "standard operating procedures" (SOPs), reflecting the consensus view of experts in sexual medicine. Few, if any, consensus SOPs have been developed for the diagnosis and treatment

  2. Procedure-related mortality of endovascular abdominal aortic aneurysm repair using revised reporting standards.

    NARCIS (Netherlands)

    Konig, G.G.; Vallabhneni, S.R.; Marrewijk, C.J. van; Leurs, L.J.; Laheij, R.J.F.; Buth, J.

    2007-01-01

    OBJECTIVE: The aim of this study was to evaluate the definition of Procedure-related mortality after endovascular aneurysm repair (EVAR) as defined by the Committee for Standardized Reporting Practices in Vascular Surgery. METHODS: Data on patients with an AAA were taken from the EUROSTAR database.

  3. Evolution of standardized procedures for adjusting lumber properties for change in moisture content

    Science.gov (United States)

    David W. Green; James W. Evans

    2001-01-01

    This paper documents the development of procedures in American Society for Testing and Materials standards for adjusting the allowable properties of lumber for changes in moisture content. The paper discusses the historical context of efforts to establish allowable properties on a consensus basis, beginning in the 19th century. Where possible, the reasons for proposed...

  4. Procedures and Standards for Residential Ventilation System Commissioning: An Annotated Bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, J. Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wray, Craig P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2013-04-01

    Beginning with the 2008 version of Title 24, new homes in California must comply with ANSI/ASHRAE Standard 62.2-2007 requirements for residential ventilation. Where installed, the limited data available indicate that mechanical ventilation systems do not always perform optimally or even as many codes and forecasts predict. Commissioning such systems when they are installed or during subsequent building retrofits is a step towards eliminating deficiencies and optimizing the tradeoff between energy use and acceptable IAQ. Work funded by the California Energy Commission about a decade ago at Berkeley Lab documented procedures for residential commissioning, but did not focus on ventilation systems. Since then, standards and approaches for commissioning ventilation systems have been an active area of work in Europe. This report describes our efforts to collect new literature on commissioning procedures and to identify information that can be used to support the future development of residential-ventilation-specific procedures and standards. We recommend that a standardized commissioning process and a commissioning guide for practitioners be developed, along with a combined energy and IAQ benefit assessment standard and tool, and a diagnostic guide for estimating continuous pollutant emission rates of concern in residences (including a database that lists emission test data for commercially-available labeled products).

  5. Standard operating procedures improve acute neurologic care in a sub-Saharan African setting.

    Science.gov (United States)

    Jaiteh, Lamin E S; Helwig, Stefan A; Jagne, Abubacarr; Ragoschke-Schumm, Andreas; Sarr, Catherine; Walter, Silke; Lesmeister, Martin; Manitz, Matthias; Blaß, Sebastian; Weis, Sarah; Schlund, Verena; Bah, Neneh; Kauffmann, Jil; Fousse, Mathias; Kangankan, Sabina; Ramos Cabrera, Asmell; Kronfeld, Kai; Ruckes, Christian; Liu, Yang; Nyan, Ousman; Fassbender, Klaus

    2017-07-11

    Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p process quality of neurologic emergency management in under-resourced settings. This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  6. Standard procedures for adults in accredited sleep medicine centres in Europe

    DEFF Research Database (Denmark)

    Fischer, Jürgen; Dogas, Zoran; Bassetti, Claudio L

    2012-01-01

    The present paper describes standardized procedures within clinical sleep medicine. As such, it is a continuation of the previously published European guidelines for the accreditation of sleep medicine centres and European guidelines for the certification of professionals in sleep medicine, aimed...... and quality assurance of sleep medicine in Europe....... at creating standards of practice in European sleep medicine. It is also part of a broader action plan of the European Sleep Research Society, including the process of accreditation of sleep medicine centres and certification of sleep medicine experts, as well as publishing the Catalogue of Knowledge...... and Skills for sleep medicine experts (physicians, non-medical health care providers, nurses and technologists), which will be a basis for the development of relevant educational curricula. In the current paper, the standard operational procedures sleep medicine centres regarding the diagnostic...

  7. A Guide for Developing Standard Operating Job Procedures for the Pump Station Process Wastewater Treatment Facility. SOJP No. 3.

    Science.gov (United States)

    Perley, Gordon F.

    This is a guide for standard operating job procedures for the pump station process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up procedures, continuous routine operation procedures, and shut-down procedures. A general description of the equipment used in the process is given. Two…

  8. Appearance of discontinuities in spectra transformed by the piecewise direct instrument standardization procedure.

    Science.gov (United States)

    Gemperline, P J; Cho, J; Aldridge, P K; Sekulic, S S

    1996-09-01

    Several years ago, we noted that spectra transformed by the piecewise direct standardization (PDS) method may contain discontinuities. Having noticed that the problem was a recurring one, we studied it and recently diagnosed its source. Our investigations suggest that this problem also occurs in applications of window factor analysis, evolving factor analysis, and any other procedure that uses piecewise principal component models. In this work, we report the source of the problem and illustrate it with one example. A procedure is presented for eliminating the problem that is effective in PDS pattern recognition applications. Further work is needed to develop modified algorithms suitable for calibration applications.

  9. Standardizing the classification of abortion incidents: the Procedural Abortion Incident Reporting and Surveillance (PAIRS) Framework.

    Science.gov (United States)

    Taylor, Diana; Upadhyay, Ushma D; Fjerstad, Mary; Battistelli, Molly F; Weitz, Tracy A; Paul, Maureen E

    2017-07-01

    To develop and validate standardized criteria for assessing abortion-related incidents (adverse events, morbidities, near misses) for first-trimester aspiration abortion procedures and to demonstrate the utility of a standardized framework [the Procedural Abortion Incident Reporting & Surveillance (PAIRS) Framework] for estimating serious abortion-related adverse events. As part of a California-based study of early aspiration abortion provision conducted between 2007 and 2013, we developed and validated a standardized framework for defining and monitoring first-trimester (≤14weeks) aspiration abortion morbidity and adverse events using multiple methods: a literature review, framework criteria testing with empirical data, repeated expert reviews and data-based revisions to the framework. The final framework distinguishes incidents resulting from procedural abortion care (adverse events) from morbidity related to pregnancy, the abortion process and other nonabortion related conditions. It further classifies incidents by diagnosis (confirmatory data, etiology, risk factors), management (treatment type and location), timing (immediate or delayed), seriousness (minor or major) and outcome. Empirical validation of the framework using data from 19,673 women receiving aspiration abortions revealed almost an equal proportion of total adverse events (n=205, 1.04%) and total abortion- or pregnancy-related morbidity (n=194, 0.99%). The majority of adverse events were due to retained products of conception (0.37%), failed attempted abortion (0.15%) and postabortion infection (0.17%). Serious or major adverse events were rare (n=11, 0.06%). Distinguishing morbidity diagnoses from adverse events using a standardized, empirically tested framework confirms the very low frequency of serious adverse events related to clinic-based abortion care. The PAIRS Framework provides a useful set of tools to systematically classify and monitor abortion-related incidents for first

  10. Standard guidelines of care: Performing procedures in patients on or recently administered with isotretinoin

    Directory of Open Access Journals (Sweden)

    Venkataram Mysore

    2017-01-01

    Full Text Available Background: Currently, the standard protocol regarding the performance of procedures on patients receiving or having recently received isotretinoin (13-cis-retinoic acid states that the procedures should not be performed. The recommendations in standard books and drug insert require discontinuation of isotretinoin for 6 months before performing cosmetic procedures, including waxing, dermabrasion, chemical peels, laser procedures, or incisional and excisional cold-steel surgery. These recommendations have been followed for over two decades despite little evidence for the stated increased risk of scarring. Objective: The Association of Cutaneous Surgeons (I constituted a task force to review the evidence and to recommend consensus guidelines regarding the safety of skin procedures, including resurfacing, energy-device treatments, and dermatosurgical procedures in patients with concurrent or recent isotretinoin administration. Materials and Methods: Data were extracted from the literature through a PubMed search using the keywords “isotretinoin,” “safety,” “scarring,” “keloids,” “hypertrophic scarring,” and “pigmentation.” The evidence was then labeled and circulated to all members of task force for review. Results: The task force is of the opinion that there is insufficient evidence to support the current protocol of avoiding and delaying treatments in the patient group under consideration and recommends that the current practice should be discontinued.The task force concludes that performing procedures such as laser hair removal, fractional lasers for aging and acne scarring, lasers for pigmented skin lesions, fractional radio-frequency microneedling, superficial and medium-depth peels, microdermabrasion, dermaroller, biopsies, radio-frequency ablation, and superficial excisions is safe in patients with concurrent or recent isotretinoin administration.

  11. Standard operating procedure changed pre-hospital critical care anaesthesiologists’ behaviour: a quality control study

    Science.gov (United States)

    2013-01-01

    Introduction The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists’ behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region prospectively registered pre-hospital advanced airway-management data according to the Utstein-style template. We collected pre-intervention data from February 1st 2011 to January 31st 2012, implemented the standard operating procedure on February 1st 2012 and collected post intervention data from February 1st 2012 until October 31st 2012. We included transported patients of all ages in need of controlled ventilation treated with pre-hospital endotracheal intubation or the insertion of a supraglottic airways device. The objective was to evaluate whether the development and implementation of a standard operating procedure for controlled ventilation during transport could change pre-hospital critical care anaesthesiologists’ behaviour and thereby increase the use of automated ventilators in these patients. Results The implementation of a standard operating procedure increased the overall prevalence of automated ventilator use in transported patients in need of controlled ventilation from 0.40 (0.34-0.47) to 0.74 (0.69-0.80) with a prevalence ratio of 1.85 (1.57-2.19) (p = 0.00). The prevalence of automated ventilator use in transported traumatic brain injury patients in need of controlled ventilation increased from 0.44 (0.26-0.62) to 0.85 (0.62-0.97) with a prevalence ratio of 1.94 (1.26-3.0) (p = 0.0039). The prevalence of automated ventilator use in patients transported after return of spontaneous circulation following pre-hospital cardiac arrest increased from 0.39 (0

  12. Standard Evaluation Procedures (SEPs) and Data Entry Spreadsheet Templates (DESTs) for Endocrine Disruptor Screening Program (EDSP) Tier 1 Assays

    Science.gov (United States)

    This page provides information and access to Standard Evaluation Procedures (SEPs) and Data Entry Spreadsheet Templates (DESTs) developed by EPA's Office of Chemical Safety and Pollution Prevention (OCSPP).

  13. Worldwide review of existing standards and procedures for monitoring and analysing dam deformations

    International Nuclear Information System (INIS)

    Chrzanowski, A.; Avella, S.; Frodge, S.L.

    1993-01-01

    A study was carried out of existing standards and procedures for dam monitoring worldwide. The survey covers worldwide distribution of large dams, dam failures and dam safety legislation, required accuracy and frequency of monitoring surveys, and geometrical analysis of dam deformations. Information is tabulated, on a per-country basis, of number of dam types, actual or preferred method of monitoring, dam safety legislation in place, standards and specifications for monitoring, whether automation of monitoring is included, whether geodetic systems have been designed, and sample specifications for monitoring concrete dams as recommended by the Swiss National Committee on Large Dams. 29 refs., 3 tabs

  14. Procedure and reference standard to determine the structural resolution in coordinate metrology

    Science.gov (United States)

    Illemann, Jens; Bartscher, Markus; Jusko, Otto; Härtig, Frank; Neuschaefer-Rube, Ulrich; Wendt, Klaus

    2014-06-01

    A new procedure and reference standards for specifying the structural resolution in coordinate metrology traceable to the SI unit the metre are proposed. With the definition of the structural resolution, a significant gap will be closed to complete ‘acceptance and verification tests’ of the coordinate measuring systems (CMSs) which are specified in the ISO 10360 series dealing with tactile sensors, optical sensors, and x-ray computed tomography measurement systems (CTs). The proposed new procedure uses reference standards with circular rounded edges. The idea is to measure the radius of curvature on a calibrated round edge structure. From the deviation between the measured and the calibrated radius, an analogue Gaussian broadening of the measurement system is determined. This value is a well-defined and easy-to-apply measure to define the structural resolution for dimensional measurements. It is applicable to CMSs which are based on different sensing principles, e.g. tactile, optical and CT systems. On the other hand, it has a physical meaning similar to the classical optical point-spread function. It makes it possible to predict which smallest details the CMS is capable of measuring reliably for an arbitrary object shape. The theoretical background of the new procedure is given, an appropriate reference standard is described and comparative, quantitative measurement data of CMSs featuring different sensors are shown.

  15. Paving the way for a gold standard of care for infertility treatment: improving outcomes through standardization of laboratory procedures.

    Science.gov (United States)

    Schoolcraft, William; Meseguer, Marcos

    2017-10-01

    Infertility affects over 70 million couples globally. Access to, and interest in, assisted reproductive technologies is growing worldwide, with more couples seeking medical intervention to conceive, in particular by IVF. Despite numerous advances in IVF techniques since its first success in 1978, almost half of the patients treated remain childless. The multifactorial nature of IVF treatment means that success is dependent on many variables. Therefore, it is important to examine how each variable can be optimized to achieve the best possible outcomes for patients. The current approach to IVF is fragmented, with various protocols in use. A systematic approach to establishing optimum best practices may improve IVF success and live birth rates. Our vision of the future is that technological advancements in the laboratory setting are standardized and universally adopted to enable a gold standard of care. Implementation of best practices for laboratory procedures will enable clinicians to generate high-quality gametes, and to produce and identify gametes and embryos of maximum viability and implantation potential, which should contribute to improving take-home healthy baby rates. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. 40 CFR 75.33 - Standard missing data procedures for SO2, NOX, Hg, and flow rate.

    Science.gov (United States)

    2010-07-01

    ... SO2, NOX, Hg, and flow rate. 75.33 Section 75.33 Protection of Environment ENVIRONMENTAL PROTECTION... Procedures § 75.33 Standard missing data procedures for SO2, NOX, Hg, and flow rate. (a) Following initial...—Missing Data Procedure for SO2 CEMS, CO2 CEMS, Moisture CEMS, Hg CEMS, and Diluent (CO2 or O2) Monitors...

  17. Standardization of specifications and inspection procedures for LEU plate-type research reactor fuels

    International Nuclear Information System (INIS)

    1988-06-01

    With the transition to high density uranium LEU fuel, fabrication costs of research reactor fuel elements have a tendency to increase because of two reasons. First, the amount of the powder of the uranium compound required increases by more than a factor of five. Second, fabrication requirements are in many cases nearer the fabrication limits. Therefore, it is important that measures be undertaken to eliminate or reduce unnecessary requirements in the specification or inspection procedures of research reactor fuel elements utilizing LEU. An additional stimulus for standardizing specifications and inspection procedures at this time is provided by the fact that most LEU conversions will occur within a short time span, and that nearly all of them will require preparation of new specifications and inspection procedures. In this sense, the LEU conversions offer an opportunity for improving the rationality and efficiency of the fuel fabrication and inspection processes. This report focuses on the standardization of specifications and inspection processes of high uranium density LEU fuels for research reactors. However, in many cases the results can also be extended directly to other research reactor fuels. 15 refs, 1 fig., 3 tabs

  18. Addendum to the procedure of KWU standard calculation for PWR fuel assembly with gadolinium

    International Nuclear Information System (INIS)

    Andrade, E.P. de

    1993-01-01

    The objective of this work is to solve a doubt appeared in the standard procedure of KWU/Siemens for fuel assembly (FA) with gadolinium. In this procedure, the σ's and form functions of such assembly are modified by his effective heterogeneity factor factor (f eff ), which is defined as the ratio between the heterogeneity factors (f het ) of FA's with and without poison. The doubt appeared at the time to calculated the f het of FA without poison: should one consider the pure FA or the FA with poison in which the concentration of gadolinium would be set to zero, but one should keep that of natural uranium? The best results were obtained considering the second hypothesis. (author)

  19. Refractory Metal Heat Pipe Life Test - Test Plan and Standard Operating Procedures

    Science.gov (United States)

    Martin, J. J.; Reid, R. S.

    2010-01-01

    Refractory metal heat pipes developed during this project shall be subjected to various operating conditions to evaluate life-limiting corrosion factors. To accomplish this objective, various parameters shall be investigated, including the effect of temperature and mass fluence on long-term corrosion rate. The test series will begin with a performance test of one module to evaluate its performance and to establish the temperature and power settings for the remaining modules. The performance test will be followed by round-the-clock testing of 16 heat pipes. All heat pipes shall be nondestructively inspected at 6-month intervals. At longer intervals, specific modules will be destructively evaluated. Both the nondestructive and destructive evaluations shall be coordinated with Los Alamos National Laboratory. During the processing, setup, and testing of the heat pipes, standard operating procedures shall be developed. Initial procedures are listed here and, as hardware is developed, will be updated, incorporating findings and lessons learned.

  20. Assessment of organ doses by standard X-ray procedures in the GDR

    International Nuclear Information System (INIS)

    Tautz, M.; Brandt, G.A.

    1986-01-01

    A modern method has been described to assess the radiation burden by X-ray procedures with consideration of the standards of our Society for Medical Radiology in the GDR. The underlying methodology is a Monte Carlo computer technique, which simulates stochastically the energy deposition of X-ray photons in a mathematically described heterogeneous anthropomorphic phantom by Rosenstein (US Department of Health, Education and Welfare). To apply the procedure specific values for the following parameters must be determined for each dose estimation: projection and view, X-ray field size and location entrance exposure at skin surface, beam quality, source-to-image receptor distance. The base data are obtained in terms of tissue-air ratio. Organ doses were calculated for chest, urography, skull, cervical spine, thoracic spine, lumbar spine, pelvis and lymphography. Concluding possibilities have been discussed for reduction of radiation burden. 9 refs., 6 figs., 9 tabs. (author)

  1. Chinese consensus statement on standard procedure and perioperative management of bronchial thermoplasty.

    Science.gov (United States)

    Lin, Jiangtao; Nong, Ying; Yang, Dong; Li, Shiyue; Wang, Guangfa; Su, Nan; Zhong, Nanshan

    2017-12-01

    Bronchial thermoplasty (BT) is a non-pharmacologic therapy for severe asthma. The proper procedure and perioperative management are very important for the effectiveness and safety of BT. China Asthma Alliance assembled a group of experts in asthma and BT to review the literature, drew on their own experiences, discussed, and then finalized by consensus to establish this standard practice guideline. This practice guideline is designed to guide clinicians as to proper patients' selection, preoperative assessment, postoperative management and follow-up. This practice guideline also proposed "China Alair System Registry Study (NCT02206269)" as the real-world study to enhance clinical utility of BT.

  2. New Serbian criminal procedure: New reasons for harmonization with European legal standards

    Directory of Open Access Journals (Sweden)

    Đurđić Vojislav

    2014-01-01

    Full Text Available The new criminal procedure, set forth in 2011, represents a compilation of the inquisitive model of preliminary proceedings, on the one hand, and adversarial trial of the Anglo-American type of criminal procedure on the other. Introduction of the public prosecutor's investigation required a subtle legislative approach to the protection of human rights in criminal proceedings, in order to establish equilibrium between efficient and just procedure. Instead of the expected, the erroneous conception based on the ideas that the public prosecutor's investigation should be strictly formal as that of a court, that evidence taken by the non-judicial authorities should have the same bearing as those taken by the courts, and that the court should have no role in conducting investigation, resulted in an overly inferior position of the accuses compared to that of the public prosecutor. Beside the fact that such conception can not pass the ECJ test, the specific legal solutions referring the investigation open the question of harmonization with the European legal standards. The provisions on initiation of this phase of the proceedings, not being legally sanctioned, put in question the right of the accused to access justice, as well as his right to an effective legal remedy, and the introduced investigation against the unknown perpetrator, the right to be present at one's own trial is being jeopardized. Neither do all procedural rules pertaining to the trial support the fair procedure principle: the indirect extortion of evidence from the defense is discordant with the rule that the burden of proof lies on the prosecutor, as one of the main pillars of the assumption of innocence; as well as the broad opportunity to use non-judicial evidence at the hearing without any major legal obstacles, have demolished the principles of directness and contradictoriness. Even some of the minimal right of the defense as well as the guarantees of personal freedom in the course

  3. Federal standards and procedures for the National Watershed Boundary Dataset (WBD)

    Science.gov (United States)

    ,; ,; ,

    2013-01-01

    The Watershed Boundary Dataset (WBD) is a comprehensive aggregated collection of hydrologic unit data consistent with the national criteria for delineation and resolution. This document establishes Federal standards and procedures for creating the WBD as seamless and hierarchical hydrologic unit data, based on topographic and hydrologic features at a 1:24,000 scale in the United States, except for Alaska at 1:63,360 scale, and 1:25,000 scale in the Caribbean. The data within the WBD have been reviewed for certification through the 12-digit hydrologic unit for compliance with the criteria outlined in this document. Any edits to certified data will be reviewed against this standard prior to inclusion. Although not required as part of the framework WBD, the guidelines contain details for compiling and delineating the boundaries of two additional levels, the 14- and 16-digit hydrologic units, as well as the use of higher resolution base information to improve delineations. The guidelines presented herein are designed to enable local, regional, and national partners to delineate hydrologic units consistently and accurately. Such consistency improves watershed management through efficient sharing of information and resources and by ensuring that digital geographic data are usable with other related Geographic Information System (GIS) data.Terminology, definitions, and procedural information are provided to ensure uniformity in hydrologic unit boundaries, names, and numerical codes. Detailed standards and specifications for data are included. The document also includes discussion of objectives, communications required for revising the data resolution in the United States and the Caribbean, as well as final review and data-quality criteria. Instances of unusual landforms or artificial features that affect the hydrologic units are described with metadata standards. Up-to-date information and availability of the hydrologic units are listed at http:// www

  4. Improving International Standards in Surgical and Procedural Training through Comparative Operative Log Growth Charts

    Directory of Open Access Journals (Sweden)

    Vannipa Vathanophas, M.D.

    2018-03-01

    Full Text Available Objective: To use these growth charts to critically assess sufficiency of cases and parity of cases between residents, and to compare these growth charts to available international standards for minimum case numbers. Methods: Operative Log Growth Charts were developed for key indicator procedures for graduating otolaryngology residents in 2012-2014 at a large teaching hospital in the capital city of a newly industrialized country. Comparisons were made between years of training and required minimum case numbers published by the ACGME RRC for Otolaryngology. Results: Data was available to create 7 key indicator operative log growth charts to include all available data from 2012-2014 residents. These growth charts were used to assess growth in operative procedures for residents in the program compared to historical norms in the program. Graduating residents surpassed ACGME minimum case numbers in Bronchoscopy only and were below the minimum numbers for the other key indicators tested. Conclusion: There is significant heterogeneity in the standards for otolaryngology training between countries. It is possible to develop program-specific and country-specific operative log growth charts.

  5. The Cox-maze IV procedure in its second decade: still the gold standard?

    Science.gov (United States)

    Ruaengsri, Chawannuch; Schill, Matthew R; Khiabani, Ali J; Schuessler, Richard B; Melby, Spencer J; Damiano, Ralph J

    2018-04-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia and the treatment options include medical treatment and catheter-based or surgical interventions. AF is a major cause of stroke, and its prevalence is increasing. The surgical treatment of AF has been revolutionized over the past 2 decades through surgical innovation and improvements in endoscopic imaging, ablation technology and surgical instrumentation. The Cox-maze (CM) procedure, which was developed by James Cox and introduced clinically in 1987, is a procedure in which multiple incisions are created in both the left and the right atria to eliminate AF while allowing the sinus impulse to reach the atrioventricular node. This procedure became the gold standard for the surgical treatment of AF. Its latest iteration is termed the CM IV and was introduced in 2002. The CM IV replaced the previous cut-and-sew method (CM III) by replacing most of the incisions with a combination of bipolar radiofrequency and cryoablation. The use of ablation technologies, made the CM IV technically easier, faster and more amenable to minimally invasive approaches. The aims of this article are to review the indications and preoperative planning for the CM IV, to describe the operative technique and to review the literature including comparisons of the CM IV with the previous cut-and-sew method. Finally, this review explores future directions for the surgical treatment of patients with AF.

  6. Development of a standard operating procedure for mammography equipment used in calibration of ionized chambers

    International Nuclear Information System (INIS)

    Rodrigues, Yklys Santos; Potiens, Maria da Penha Albuquerque

    2011-01-01

    Mammography is one widely used technique in the detection of breast cancer. In order to optimize the results achieving better images with lower dose rates, a quality assurance programme must be applied to the equipment. Some control tests use ionization chambers to measure air kerma and other quantities. These tests can only be reliable if the ionization chambers used on them are correctly calibrated. In the present work, it was developed a standard operating procedure (SOP) for quality control tests in a commercial mammography equipment installed in the Calibration Laboratory (LCI) at IPEN - Brazilian Institute for energy and nuclear research). Seven tests were performed in the equipment: Tube voltage and exposition time accuracy and reproducibility, linearity and reproducibility of Air kerma and Half Value Layer (HVL). Then, it was made a measurement of the air kerma in the mammography equipment, using a reference ionization chamber with traceability to a primary laboratory in Germany (Physikalisch-Technische Bundesanstalt - PTB), that was later compared with the air kerma measured in an industrial irradiator. This industrial X-ray generator was recently used in the implementation of X-radiation Standards beams, mammography level, following the Standard IEC 61267. The HVL values varied from 0.36 (25kV) to 0.41 mmA1 (35kV), and the measured air kerma rates were between 9.78 and 17.97 mGy/min. (author)

  7. Primary calibration of TXRF in comparison with the standard droplet procedure

    International Nuclear Information System (INIS)

    Dobler, M.; Reus, U.; Knoth, J.; Schwenke, H.

    2000-01-01

    For the determination of contamination on wafer surfaces with total reflection x-ray fluorescence spectrometry (TXRF) normally external 1 ng Ni droplet standards were used for calibration. This method is based on several assumptions about the properties of the standard droplet which are strongly affected by the preparation of the samples. In this paper a study is resented which compares the external droplet method with a calibration procedure using the fundamental physical background of total reflection x-ray fluorescence spectrometry and the properties of Ni bulk material. The particular features of the two methods will be discussed and the obtained results compared to each other. It is demonstrated in this study that the calibration with Ni bulk material is a primary method which offers several advantages compared to the calibration based on droplet standards. These advantages are unique and enable a more reliable and reproducible quantification of contamination on wafer surfaces. This is caused by the fact that the method is standardless and only based on fundamental parameters and natural constants. It is also demonstrated that effects which could be caused by especial features of the measured samples (particle or film, e.g.) or by the degradation of the calibration sample could be excluded. (author)

  8. Influence of new customs procedures and logistic security standards on companies competiveness – a Croatian company case study

    Directory of Open Access Journals (Sweden)

    Aleksandar Erceg

    2014-12-01

    Full Text Available In today’s global market, companies are constantly confronted with the competition on the local, national and international level. Companies therefore use a variety of strategies and tools to become and/or remain competitive. Potential areas for cost reduction in companies are supply chain management and logistic and customs procedures. Implementation of various logistic standards in supply chain management can provide significant cost savings for the company’s daily operations and thus reduce overall costs and improve the competitiveness. Using different customs procedures and logistic standards to reduce their costs and become more competitive in the market is necessary for Croatian companies. The method of using these tools is not a one-time process and requires constant efforts. Companies therefore have to be ready to improve daily to be and remain competitive. Using a variety of modern customs procedures can save their money and time, not only through these procedures, but also through better use of their employee’s time, their own vehicles and other equipment. The paper analyzes various customs procedures and logistic standards that can help companies save time and money and improve their competitiveness. In the example of Croatian company, which uses various available procedures and standards the benefits of their use are shown. Apart from bringing savings in operations, all these procedures and standards allow the company to be better, cheaper and more attractive to buyers.

  9. Calibration of photon and beta ray sources used in brachytherapy. Guidelines on standardized procedures at Secondary Standards Dosimetry Laboratories

    International Nuclear Information System (INIS)

    2004-03-01

    It has generally been recognized that international harmonization in radiotherapy dosimetry is essential. Consequently, the IAEA has given much effort to this, for example by publishing a number of reports in the Technical Reports Series (TRS) for external beam dosimetry, most notably TRS-277 and more recently TRS-398. Both of these reports describe in detail the steps to be taken for absorbed dose determination in water and they are often referred to as 'dosimetry protocols'. Similar to TRS-277, it is expected that TRS-398 will be adopted or used as a model by a large number of countries as their national protocol. In 1996, the IAEA established a calibration service for low dose rate (LDR) 137 Cs brachytherapy sources, which is the most widely used source for treatment of gynecological cancer. To further enhance harmonization in brachytherapy dosimetry, the IAEA published in 1999 IAEA-TECDOC-1079 entitled 'Calibration of Brachytherapy Sources. Guidelines on Standardized Procedures for the Calibration of Brachytherapy Sources at Secondary Standard Dosimetry Laboratories (SSDLs) and Hospitals'. The report was well received and was distributed in a large number of copies to the members of the IAEA/WHO network of SSDLs and to medical physicists working with brachytherapy. The present report is an update of the aforementioned TECDOC. Whereas TECDOC-1079 described methods for calibrating brachytherapy sources with photon energies at or above those of 192 Ir, the current report has a wider scope in that it deals with standardization of calibration of all the most commonly used brachytherapy sources, including both photon and beta emitting sources. The latter sources have been in use for a few decades already, but their calibration methods have been unclear. Methods are also described for calibrating sources used in the rapidly growing field of cardiovascular angioplasty. In this application, irradiation of the vessel wall is done in an attempt to prevent restenosis after

  10. A Guide for Developing Standard Operating Job Procedures for the Grit Removal Process Wastewater Treatment Facility. SOJP No. 2.

    Science.gov (United States)

    Deal, Gerald A.; Montgomery, James A.

    This guide describes standard operating job procedures for the grit removal process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up, continuous operation, and shut-down procedures. A description of the equipment used in the process is given. Some theoretical material is presented. (BB)

  11. Standard manufacturing procedure for syrup and tablet forms of Jwarahara Dashemani

    Science.gov (United States)

    Kalsariya, Bharat D.; Patgiri, B. J.; Prajapati, P. K.

    2010-01-01

    Jwarahara Dashemani (JHD) is mentioned by Acharya Charaka under the different categories of Mahakashayas (groups of drugs having similar pharmacological actions). For the present study, syrup and tablet forms of JHDs were prepared and analyzed. The formulations were prepared in various batches by following the standard manufacturing procedure (SMP). JHD Kwatha (2200 ml) and 1430 g sugar candy powder were heated (80–90°C) together for 3.10 hours and 2200 ml syrup was obtained, whereas an average of 446 g of tablet was obtained from the mixture of 285 g Ghana and powder of sugar candy (125 g), JHD Dravyas (55 g) and talc (18 g). These formulations were subjected to various analytical parameters and the results were observed on the basis of preparation. PMID:22131721

  12. The CIPM list of recommended frequency standard values: guidelines and procedures

    Science.gov (United States)

    Riehle, Fritz; Gill, Patrick; Arias, Felicitas; Robertsson, Lennart

    2018-04-01

    A list of standard reference frequency values (LoF) of quantum transitions from the microwave to the optical regime has been recommended by the International Committee for Weights and Measures (Comité international des poids et mesures, CIPM) for use in basic research, technology, and for the metrology of time, frequency and length. The CIPM LoF contains entries that are recommended as secondary representations of the second in the International System of Units, and entries that can be used to serve as realizations of the definition of the metre. The historical perspective that led to the CIPM LoF is outlined. Procedures have been developed for updating existing, and validating new, entries into the CIPM LoF. The CIPM LoF might serve as an entry for a future redefinition of the second by an optical transition.

  13. Standardization of the Action Verbs used in Emergency Operating Procedures of NPPs

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Tong Il; Lee, Yong Hee; Park, Jae Chang [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Jeong, Yeon Seop; Chu, Gang Il [Korea Hydro and Nuclear Power, Daejeon (Korea, Republic of)

    2010-05-15

    The action verbs used in Emergency Operating Procedures (EOPs) for each nuclear power plant are translated respectively from the action verbs used in Emergency Recovery Guidelines (ERG) of the reference plants. The action verbs used in each plant are not largely different with one another. There are, however, some cases that the meanings of the same action verbs used in different plants are not consistent with each other and translations are not exact. In this study, the original English expressions of the action verbs and the translated verbs were compared and their accepted meanings analyzed. And then, standardization for the action verbs which are not exactly translated or which are used with different meanings among the plants was proposed

  14. Constructing an exposure chart: step by step (based on standard procedures)

    International Nuclear Information System (INIS)

    David, Jocelyn L; Cansino, Percedita T.; Taguibao, Angileo P.

    2000-01-01

    An exposure chart is very important in conducting radiographic inspection of materials. By using an accurate exposure chart, an inspector is able to avoid a trial and error way of determining correct time to expose a specimen, thereby producing a radiograph that has an acceptable density based on a standard. The chart gives the following information: x-ray machine model and brand, distance of the x-ray tube from the film, type and thickness of intensifying screens, film type, radiograph density, and film processing conditions. The methods of preparing an exposure chart are available in existing radiographic testing manuals. These described methods are presented in step by step procedures, covering the actual laboratory set-up, data gathering, computations, and transformation of derived data into Characteristic Curve and Exposure Chart

  15. Development of a standard test procedure for devices on thermal weed control

    Directory of Open Access Journals (Sweden)

    Verschwele, Arnd

    2016-02-01

    Full Text Available In contrast to the standard evaluation of the efficacy of pesticides and the testing of spraying equipment there are no comparable testing procedure for equipment of thermal weed control. It is the aim of the investigations described here to develop a standard procedure for assessing temperature distribution and biological efficacy. This will be the basis for quality testing which can be directly used by practical users. Also it can help engineers to improve devices if constructive gaps will be identified by these tests. The results from testing a flaming device (Green-Flame 850 E demonstrated such a potential for technical improvement: The temperature decreased from 159 °C to 89 °C by increasing driving speed from 0.35 m/s to 0.81 m/s. The variation of the temperature related to the working width was extremely high: The range was 60 °C at highest speed and 79 °C at lowest speed, respectively. The biological efficacy against the test plant species Sinapis arvensis was also affected by the driving speed and the corresponding temperature. A driving speed not higher than 0.53 m/s resulted in efficacy rates of almost 95%. However, the efficacy was only 66% at the highest tested speed of 0.81 m/s. Thus, the needed effective temperature is between 89 °C und 106 °C. In contrast, Lolium perenne was controlled by only 72% under the tested conditions. Here a dose-response relationship was not observed. The variation of the temperature, as well as the biological efficacy, was extremely heterogeneous and not satisfying in terms of an economic and safe use. Similar results were found for other devices on thermal weed control.

  16. Standard Operating Procedure (SOP) for Rapid and Efficient Production of Stevia Tissue Culture Seedlings

    International Nuclear Information System (INIS)

    Norazlina Noordin; Peng, C.S.; Rusli Ibrahim

    2015-01-01

    Stevia rebaudiana Bertoni is a non-caloric natural sweetener which is 300 times sweeter than cane sugar. Extracts from stevia leaves has vast application in food and beverages based industries, can be added to tea and coffee, cooked or baked goods, processed foods and confectionary goods. Recently, stevia attained awareness owing to its natural, non-caloric sweetness by diet/ health conscious and diabetic persons (Arpita et al., 2011). This natural sweetener has high commercial value in global market, it was estimated that global market value for stevia is be around USD11 billion by year 2015. Although stevia is being largely popularized in Malaysia and other countries but large-scale propagation procedures for the continuous supply of planting materials in commercial plantation has yet to be established, optimized and standardized. Furthermore, propagation through stevia seeds is often very difficult due to self-incompatibility which results in sterile seeds (Sakaguchi et al., 1982). Tissue culture is the only rapid process for the mass propagation of stevia and there have been few reports of in vitro growth of stevia (Miyagaya et al., 1986) and in vitro micropropagation from shoot tip and leaf (Uddin et al., 2006). Hence, study was carried out to establish a suitable protocol for in vitro propagation of S. rebaudiana Bertoni that can be further up-scaled for mass propagation of stevia seedlings. The established Standard Operating Procedure (SOP) will ensure rapid and efficient production of stevia tissue culture seedlings for continuous supply of planting materials for commercial stevia plantations in Malaysia. Preparation of growth medium, multiplication of shoots, rooting of plant lets and hardening of ex-vitro rooted plant lets is discussed in this paper. (author)

  17. The importance of strong evaluation standards and procedures in training residents.

    Science.gov (United States)

    Short, J P

    1993-07-01

    A strong evaluation process in a residency offers faculty an opportunity to strengthen the educational program, to help residents know what is expected of them, and to remove with minimum difficulties those residents who are not progressing satisfactorily and do not appear to be salvageable. Despite these advantages, the evaluation of residents during their training is often done poorly or not at all. The author describes the kinds of standards and procedures that constitute a sound, strong evaluation process, proposes criteria for academic probation and due process when a resident is performing unacceptably, and describes the role that the medical school administration should play in the evaluation process, one that is flexible enough to allow each program to comply and still have program-specific procedures. The author closes with statistics on how few residents are dismissed for incompetency or unacceptable behaviors, and inquires how many more might be found if strong evaluation processes were more widely used. Even so, in the attempt to evaluate residents and to foster protection from legal problems, residency program directors must keep in mind the importance of letting residents make mistakes and learn from them; a good evaluation system strikes a balance that fosters the learning process and benefits the residents, the medical school, and the community.

  18. Collection of Pyrethroids in Water and Sediment Matrices: Development and Validation of a Standard Operating Procedure

    Science.gov (United States)

    Hladik, Michelle; Orlando, James L.; Kuivila, Kathryn

    2009-01-01

    Loss of pyrethroid insecticides onto surfaces during sample collection can confound the interpretation of analytical and toxicity test results. Sample collection devices, container materials, and water matrix composition have a significant influence on the association of pyrethroids to container walls, which can be as high as 50 percent. Any sample collection method involving transfer through multiple containers or pieces of equipment increases the potential for pyrethroid loss. This loose 'surface-association' with container walls can be reversed through agitation. When sampling water matrices with pumps or autosamplers, no pyrethroids were lost as long as the water was moving continuously through the system. When collecting water matrices in containers, the material with the least amount of pyrethroid sorption is as follows: glass less than (pyrethroids were easier to re-suspend from the glass container walls. Since the amount of surface-association is proportional to the ratio of volume-to-contact-area of the sample, taking larger-volume field samples (greater than 3 liters) reduced pyrethroid losses to less than 10 percent. The amount of surface-association cannot be predicted easily because of the dependence on water matrix composition; samples with higher dissolved organic carbon or suspended-sediment concentrations were observed to have lower percent loss. Sediment samples were not affected by glass-container sorption (the only containers tested). Standardized sample-collection protocols are critical to yield accurate pyrethroid concentrations for assessment of potential effects, and have been summarized in an accompanying standard operating procedure.

  19. Enhanced Sanitation Standard Operating Procedures Have Limited Impact on Listeria monocytogenes Prevalence in Retail Delis.

    Science.gov (United States)

    Etter, Andrea J; Hammons, Susan R; Roof, Sherry; Simmons, Courtenay; Wu, Tongyu; Cook, Peter W; Katubig, Alex; Stasiewicz, Matthew J; Wright, Emily; Warchocki, Steven; Hollingworth, Jill; Thesmar, Hilary S; Ibrahim, Salam A; Wiedmann, Martin; Oliver, Haley F

    2017-10-20

    In a recent longitudinal surveillance study in 30 U.S. retail delicatessens, 9.7% of environmental surfaces were positive for Listeria monocytogenes, and we found substantial evidence of persistence. In this study, we aimed to reduce the prevalence and persistence of L. monocytogenes in the retail deli environment by developing and implementing practical and feasible intervention strategies (i.e., sanitation standard operating procedures; SSOPs). These SSOPs were standardized across the 30 delis enrolled in this study. SSOP implementation was verified by systems inherent to each retailer. Each deli also was equipped with ATP monitoring systems to verify effective sanitation. We evaluated intervention strategy efficacy by testing 28 food and nonfood contact surfaces for L. monocytogenes for 6 months in all 30 retail delis. The efficacy of the intervention on the delis compared with preintervention prevalence level was not statistically significant; we found that L. monocytogenes could persist despite implementation of enhanced SSOPs. Systematic and accurate use of ATP monitoring systems varied widely among delis. The findings indicate that intervention strategies in the form of enhanced daily SSOPs were not sufficient to eliminate L. monocytogenes from highly prevalent and persistently contaminated delis and that more aggressive strategies (e.g., deep cleaning or capital investment in redesign or equipment) may be necessary to fully mitigate persistent contamination.

  20. Leptospirosis in a small animal veterinarian: reminder to follow standardized infection control procedures.

    Science.gov (United States)

    Baer, R; Turnberg, W; Yu, D; Wohrle, R

    2010-06-01

    A small animal veterinarian in Washington State developed leptospirosis after an occupational exposure. Approximately 10 days prior to the onset of illness, he examined a healthy appearing pet rat for fleas, which urinated on his un-gloved hands. Although the veterinarian washed his hands after the examination, his hands had abrasions from gardening. The veterinarian was hospitalized for 12 days and was able to return to work part-time 1 month following discharge. This illness may have been prevented if the veterinarian had been wearing gloves during the examination as recommended by the National Association of State Public Health Veterinarians (NASPHV), Veterinary Infection Control Committee, in its Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel (2008). This case alerts us to the need for small animal veterinarians to minimize their infection risk by practising recommended infection control procedures. Veterinarians should establish and follow a written infection control plan based on the standardized infection control approach adopted by the NASPHV to minimize their risk of occupational zoonotic infections.

  1. CSNI international standard problem procedures - CSNI Report No. 17 - Revision 4

    International Nuclear Information System (INIS)

    Micaelli, J.C.

    2004-01-01

    . Careful consideration and planning is therefore required. After a brief recall of the ISPs' objectives, this document provides guidelines to be followed during the different phases of an ISP. Two phases are considered. The first one consists in proposing and selecting an ISP, the second one consists in performing an ISP. This revised document was prepared under the Leadership of J.-C. Micaelli (IRSN). It was reviewed and endorsed in September 2003 by the Working Group on the Analysis and Management of Accidents (GAMA), GAMA performed in 2003 a survey on updating CSNI Report No. 17, 'CSNI Standard Problem Procedures', first published in 1977, last updated in 1989. The objective of this activity was to collect proposals regarding the improvement of ISP efficiency with respect to their objectives and the improvement of the quality of the procedures document. Eleven series of questions were asked in the survey, related to: - General structure of the procedures document; - ISP objectives; - Six phases: ISP proposal, ISP specification, ISP results reporting, Preparation of the preliminary data comparison and interpretation report, Post-ISP analysis, Preparation of the final comparison and interpretation report; - Updating of the procedures; - Support to be provided by the participants

  2. A standard operating procedure for the surgical implantation of transmitters in juvenile salmonids

    Science.gov (United States)

    Liedtke, T.L.; Beeman, J.W.; Gee, L.P.

    2012-01-01

    Biotelemetry is a useful tool to monitor the movements of animals and is widely applied in fisheries research. Radio or acoustic technology can be used, depending on the study design and the environmental conditions in the study area. A broad definition of telemetry also includes the use of Passive Integrated Transponder (PIT) tags, either separately or with a radio or acoustic transmitter. To use telemetry, fish must be equipped with a transmitter. Although there are several attachment procedures available, surgical implantation of transmitters in the abdominal cavity is recognized as the best technique for long-term telemetry studies in general (Stasko and Pincock, 1977; Winter, 1996; Jepsen, 2003), and specifically for juvenile salmonids, Oncorhynchus spp. (Adams and others, 1998a, 1998b; Martinelli and others, 1998; Hall and others, 2009). Studies that use telemetry assume that the processes by which the animals are captured, handled, and tagged, as well as the act of carrying the transmitter, will have minimal effect on their behavior and performance. This assumption, commonly stated as a lack of transmitter effects, must be valid if telemetry studies are to describe accurately the movements and behavior of an entire population of interest, rather than the subset of that population that carries transmitters. This document describes a standard operating procedure (SOP) for surgical implantation of radio or acoustic transmitters in juvenile salmonids. The procedures were developed from a broad base of published information, laboratory experiments, and practical experience in tagging thousands of fish for numerous studies of juvenile salmon movements near Columbia River and Snake River hydroelectric dams. Staff from the Western Fisheries Research Center's Columbia River Research Laboratory (CRRL) frequently have used telemetry studies to evaluate new structures or operations at hydroelectric dams in the Columbia River Basin, and these evaluations typically

  3. 77 FR 65823 - Control of Air Pollution From Aircraft and Aircraft Engines; Emission Standards and Test Procedures

    Science.gov (United States)

    2012-10-31

    ... Control of Air Pollution From Aircraft and Aircraft Engines; Emission Standards and Test Procedures... titled ``Table 3 to Sec. 87.23--Tier 6 NO X Standards for New Subsonic Turbofan or Turbojet Engines with... for New Subsonic Turbofan or Turbojet Engines With Rated Output Above 26.7 kN and the rated output (in...

  4. Acucise™ endopyelotomy in a porcine model: procedure standardization and analysis of safety and immediate efficacy

    Directory of Open Access Journals (Sweden)

    Andreoni Cássio

    2004-01-01

    Full Text Available PURPOSE: The study here presented was done to test the technical reliability and immediate efficacy of the Acucise device using a standardized technique. MATERIALS AND METHODS: 56 Acucise procedures were performed in pigs by a single surgeon who used a standardized technique: insert 5F angiographic catheter bilaterally up to the midureter, perform retrograde pyelogram, Amplatz super-stiff guidewire is advanced up to the level of the renal pelvis, angiographic catheters are removed, Acucise catheter balloon is advanced to the ureteropelvic junction (UPJ level, the super-stiff guide-wire is removed and the contrast medium in the renal pelvis is aspirated and replaced with distilled water, activate Acucise at 75 watts of pure cutting current, keep the balloon fully inflated for 10 minutes, perform retrograde ureteropyelogram to document extravasation, remove Acucise catheter and pass an ureteral stent and remove guide-wire. RESULTS: In no case did the Acucise device present malfunction. The electrocautery activation time was 2.2 seconds (ranging from 2 to 4 seconds. The extravasation of contrast medium, visible by fluoroscopy, occurred in 53 of the 56 cases (94.6%. In no case there was any evidence of intraoperative hemorrhage. CONCLUSIONS: This study revealed that performing Acucise endopyelotomy routinely in a standardized manner could largely preclude intraoperative device malfunction and eliminate complications while achieving a successful incision in the UPJ. With the guidelines that were used in this study, we believe that Acucise endopyelotomy can be completed successfully and safely in the majority of selected patients with UPJ obstruction.

  5. Manual of Standard Operating Procedures for Veterinary Drug Residue Analysis (French Edition)

    International Nuclear Information System (INIS)

    2017-01-01

    Laboratories are crucial to national veterinary drug residue monitoring programmes. However, one of the main challenges laboratories encounter is obtaining access to relevant methods of analysis. Thus, in addition to training, providing technical advice and transferring technology, the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has resolved to develop clear and practical manuals to support Member State laboratories. The Coordinated Research Project (CRP) on Development of Radiometric and Allied Analytical Methods to Strengthen Residue Control Programs for Antibiotic and Anthelmintic Veterinary Drug Residues has developed a number of analytical methods as standard operating procedures (SOPs), which are now compiled here. This publication contains SOPs on chromatographic and spectrometric techniques, as well as radioimmunoassay and associated screening techniques, for various anthelmintic and antimicrobial veterinary drug residue analysis. Some analytical method validation protocols are also included. The publication is primarily aimed at food and environmental safety laboratories involved in testing veterinary drug residues, including under organized national residue monitoring programmes. It is expected to enhance laboratory capacity building and competence through the use of radiometric and complementary tools and techniques. The publication is also relevant for applied research on residues of veterinary drugs in food and environmental samples

  6. Standard operating procedures for quality audits of 60Co external beam radiotherapy facilities

    International Nuclear Information System (INIS)

    Larrinaga Cortina, E.F.; Dominguez Hung, L.; Campa Menendez, R.

    2001-01-01

    The use of radiotherapy implies the necessity of rigorous quality standards in its different components, aimed to provide the best possible treatment and avoid potential patients' risks, that could even cause him death. Projects of technical cooperation developed in Cuba and supported by the International Atomic Energy Agency address the implementation of Programs of Quality Assurance (PGC) in radiotherapy services. The establishment of the National Quality Audit Program (PNAC) is a superior stage. The National Control Center for Medical Devices, as the national regulator entity for the control and supervision of medical devices in the National Health System, is responsible for the making and execution of the PNAC. The audit modality selected was the inspection visit in situ due to its intrinsic advantages, our geographical extension and the number of radiotherapy services. This paper presents the methodology for the execution of the PNAC, in form of a Normalized Procedure of Operation (PNO) that defines the objectives, scope, terms and definitions, responsibilities, composition and selection of the auditor team, security's conditions, materials and equipment, steps of the audit execution, results calculation and interpretation, records, etc. (author)

  7. Manual of Standard Operating Procedures for Veterinary Drug Residue Analysis (Spanish Edition)

    International Nuclear Information System (INIS)

    2017-01-01

    Laboratories are crucial to national veterinary drug residue monitoring programmes. However, one of the main challenges laboratories encounter is obtaining access to relevant methods of analysis. Thus, in addition to training, providing technical advice and transferring technology, the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture has resolved to develop clear and practical manuals to support Member State laboratories. The Coordinated Research Project (CRP) on Development of Radiometric and Allied Analytical Methods to Strengthen Residue Control Programs for Antibiotic and Anthelmintic Veterinary Drug Residues has developed a number of analytical methods as standard operating procedures (SOPs), which are now compiled here. This publication contains SOPs on chromatographic and spectrometric techniques, as well as radioimmunoassay and associated screening techniques, for various anthelmintic and antimicrobial veterinary drug residue analysis. Some analytical method validation protocols are also included. The publication is primarily aimed at food and environmental safety laboratories involved in testing veterinary drug residues, including under organized national residue monitoring programmes. It is expected to enhance laboratory capacity building and competence through the use of radiometric and complementary tools and techniques. The publication is also relevant for applied research on residues of veterinary drugs in food and environmental samples

  8. Qualitative research within trials: developing a standard operating procedure for a clinical trials unit

    Science.gov (United States)

    2013-01-01

    Background Qualitative research methods are increasingly used within clinical trials to address broader research questions than can be addressed by quantitative methods alone. These methods enable health professionals, service users, and other stakeholders to contribute their views and experiences to evaluation of healthcare treatments, interventions, or policies, and influence the design of trials. Qualitative data often contribute information that is better able to reform policy or influence design. Methods Health services researchers, including trialists, clinicians, and qualitative researchers, worked collaboratively to develop a comprehensive portfolio of standard operating procedures (SOPs) for the West Wales Organisation for Rigorous Trials in Health (WWORTH), a clinical trials unit (CTU) at Swansea University, which has recently achieved registration with the UK Clinical Research Collaboration (UKCRC). Although the UKCRC requires a total of 25 SOPs from registered CTUs, WWORTH chose to add an additional qualitative-methods SOP (QM-SOP). Results The qualitative methods SOP (QM-SOP) defines good practice in designing and implementing qualitative components of trials, while allowing flexibility of approach and method. Its basic principles are that: qualitative researchers should be contributors from the start of trials with qualitative potential; the qualitative component should have clear aims; and the main study publication should report on the qualitative component. Conclusions We recommend that CTUs consider developing a QM-SOP to enhance the conduct of quantitative trials by adding qualitative data and analysis. We judge that this improves the value of quantitative trials, and contributes to the future development of multi-method trials. PMID:23433341

  9. Qualitative research within trials: developing a standard operating procedure for a clinical trials unit.

    Science.gov (United States)

    Rapport, Frances; Storey, Mel; Porter, Alison; Snooks, Helen; Jones, Kerina; Peconi, Julie; Sánchez, Antonio; Siebert, Stefan; Thorne, Kym; Clement, Clare; Russell, Ian

    2013-02-21

    Qualitative research methods are increasingly used within clinical trials to address broader research questions than can be addressed by quantitative methods alone. These methods enable health professionals, service users, and other stakeholders to contribute their views and experiences to evaluation of healthcare treatments, interventions, or policies, and influence the design of trials. Qualitative data often contribute information that is better able to reform policy or influence design. Health services researchers, including trialists, clinicians, and qualitative researchers, worked collaboratively to develop a comprehensive portfolio of standard operating procedures (SOPs) for the West Wales Organisation for Rigorous Trials in Health (WWORTH), a clinical trials unit (CTU) at Swansea University, which has recently achieved registration with the UK Clinical Research Collaboration (UKCRC). Although the UKCRC requires a total of 25 SOPs from registered CTUs, WWORTH chose to add an additional qualitative-methods SOP (QM-SOP). The qualitative methods SOP (QM-SOP) defines good practice in designing and implementing qualitative components of trials, while allowing flexibility of approach and method. Its basic principles are that: qualitative researchers should be contributors from the start of trials with qualitative potential; the qualitative component should have clear aims; and the main study publication should report on the qualitative component. We recommend that CTUs consider developing a QM-SOP to enhance the conduct of quantitative trials by adding qualitative data and analysis. We judge that this improves the value of quantitative trials, and contributes to the future development of multi-method trials.

  10. Validity evidence for procedural competency in virtual reality robotic simulation, establishing a credible pass/fail standard for the vaginal cuff closure procedure.

    Science.gov (United States)

    Hovgaard, Lisette Hvid; Andersen, Steven Arild Wuyts; Konge, Lars; Dalsgaard, Torur; Larsen, Christian Rifbjerg

    2018-03-30

    The use of robotic surgery for minimally invasive procedures has increased considerably over the last decade. Robotic surgery has potential advantages compared to laparoscopic surgery but also requires new skills. Using virtual reality (VR) simulation to facilitate the acquisition of these new skills could potentially benefit training of robotic surgical skills and also be a crucial step in developing a robotic surgical training curriculum. The study's objective was to establish validity evidence for a simulation-based test for procedural competency for the vaginal cuff closure procedure that can be used in a future simulation-based, mastery learning training curriculum. Eleven novice gynaecological surgeons without prior robotic experience and 11 experienced gynaecological robotic surgeons (> 30 robotic procedures) were recruited. After familiarization with the VR simulator, participants completed the module 'Guided Vaginal Cuff Closure' six times. Validity evidence was investigated for 18 preselected simulator metrics. The internal consistency was assessed using Cronbach's alpha and a composite score was calculated based on metrics with significant discriminative ability between the two groups. Finally, a pass/fail standard was established using the contrasting groups' method. The experienced surgeons significantly outperformed the novice surgeons on 6 of the 18 metrics. The internal consistency was 0.58 (Cronbach's alpha). The experienced surgeons' mean composite score for all six repetitions were significantly better than the novice surgeons' (76.1 vs. 63.0, respectively, p negatives). Our study has gathered validity evidence for a simulation-based test for procedural robotic surgical competency in the vaginal cuff closure procedure and established a credible pass/fail standard for future proficiency-based training.

  11. 24 CFR 200.942 - Supplementary specific procedural requirements under HUD building product standards and...

    Science.gov (United States)

    2010-04-01

    ... the following standards: (i) AATCC 20A-81—Fiber Analysis: Quantitative; (ii) AATCC 16E-82... Energy Source; (viii) ASTM D2646-79—Standard Methods of Testing Backing Fabrics; (ix) ASTM D3936-80...-81—Standard Methods for Rubber Products—Chemical Analysis; (xi) ASTM D418-82—Standard Methods of...

  12. Staging in Patients with Small-Cell Lung Carcinoma; PET-CT versus Standard Staging Procedures

    Directory of Open Access Journals (Sweden)

    Burcu Yalçın

    2016-12-01

    Full Text Available Objective: The most important factor for accurate treatment of patients with small cell lung carcinoma (SCLC is accuracy of the initial staging. The aim of this study was to determine how often patients, staged as local or local-advanced disease by standard staging procedures (SSPs, would be staged to have a metastatic disease based on the findings of the positron emission tomography–computed tomography (PET-CT scan. Methods: Patients with SCLC who were staged as I, II, or III disease by SSPs (according to the American Joint Committee on Cancer Staging, 7th edition formed the study population. SSPs included computed tomography of chest, abdomen, brain (or magnetic resonance imaging of brain, and bone scintigraphy. These patients were re-staged with 18F-FDG PET-CT scan. Results: Between 2013 and 2015, 27 patients were prospectively studied. Of these patients, 92.5% were male and the median age was 61. Among 27 patients, distant metastasis was detected by PET-CT in 7 (25.9% patients. Two of 7 patients were determined as stage IIIA by SSPs and 5 of 17 patients that were determined as stage IIIB by SSPs were upstaged to metastatic disease by PET-CT. All of the 7 patients had bone metastasis by PET-CT. But bone metastasis could not be detected with bone scintigraphy. Conclusion: PET-CT detected distant metastasis in one quarter of SCLC stage III patients by SSPs. Patients who staged local-advanced SCLC with CT of the chest have to be assessed by PET-CT for extracranial distant metastasis.

  13. Evaluation of the surface free energy of plant surfaces: toward standardizing the procedure.

    Science.gov (United States)

    Fernández, Victoria; Khayet, Mohamed

    2015-01-01

    Plant surfaces have been found to have a major chemical and physical heterogeneity and play a key protecting role against multiple stress factors. During the last decade, there is a raising interest in examining plant surface properties for the development of biomimetic materials. Contact angle measurement of different liquids is a common tool for characterizing synthetic materials, which is just beginning to be applied to plant surfaces. However, some studies performed with polymers and other materials showed that for the same surface, different surface free energy values may be obtained depending on the number and nature of the test liquids analyzed, materials' properties, and surface free energy calculation methods employed. For 3 rough and 3 rather smooth plant materials, we calculated their surface free energy using 2 or 3 test liquids and 3 different calculation methods. Regardless of the degree of surface roughness, the methods based on 2 test liquids often led to the under- or over-estimation of surface free energies as compared to the results derived from the 3-Liquids method. Given the major chemical and structural diversity of plant surfaces, it is concluded that 3 different liquids must be considered for characterizing materials of unknown physico-chemical properties, which may significantly differ in terms of polar and dispersive interactions. Since there are just few surface free energy data of plant surfaces with the aim of standardizing the calculation procedure and interpretation of the results among for instance, different species, organs, or phenological states, we suggest the use of 3 liquids and the mean surface tension values provided in this study.

  14. A Guide for Developing Standard Operating Job Procedures for the Sludge Conditioning & Dewatering Process Wastewater Treatment Facility. SOJP No. 11.

    Science.gov (United States)

    Schwing, Carl M.

    This guide describes standard operating job procedures for the sludge conditioning and dewatering process of wastewater treatment facilities. In this process, sludge is treated with chemicals to make the sludge coagulate and give up its water more easily. The treated sludge is then dewatered using a vacuum filter. The guide gives step-by-step…

  15. A Guide for Developing Standard Operating Job Procedures for the Primary Sedimentation Process Wastewater Treatment Facility. SOJP No. 4.

    Science.gov (United States)

    Charles County Community Coll., La Plata, MD.

    This guide describes standard operating job procedures for the primary sedimentation process of wastewater treatment plants. The primary sedimentation process involves removing settleable and suspended solids, in part, from wastewater by gravitational forces, and scum and other floatable solids from wastewater by mechanical means. Step-by-step…

  16. A Guide for Developing Standard Operating Job Procedures for the Screening & Grinding Process Wastewater Treatment Facility. SOJP No. 1.

    Science.gov (United States)

    Deal, Gerald A.; Montgomery, James A.

    This guide describes standard operating job procedures for the screening and grinding process of wastewater treatment facilities. The objective of this process is the removal of coarse materials from the raw waste stream for the protection of subsequent equipment and processes. The guide gives step-by-step instructions for safety inspection,…

  17. A Guide for Developing Standard Operating Job Procedures for the Sludge Thickening Process Wastewater Treatment Facility. SOJP No. 9.

    Science.gov (United States)

    Schwing, Carl M.

    This guide describes standard operating job procedures for the screening and grinding process of wastewater treatment facilities. The objective of this process is the removal of coarse materials from the raw waste stream for the protection of subsequent equipment and processes. The guide gives step-by-step instructions for safety inspection,…

  18. A Guide for Developing Standard Operating Job Procedures for the Tertiary Multimedia Filtration Process Wastewater Treatment Facility. SOJP No. 7.

    Science.gov (United States)

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary multimedia filtration process of wastewater treatment plants. The major objective of the filtration process is the removal of suspended solids from the reclaimed wastewater. The guide gives step-by-step instructions for pre-start up, start-up, continuous operation, and…

  19. A Guide for Developing Standard Operating Job Procedures for the Digestion Process Wastewater Treatment Facility. SOJP No. 10.

    Science.gov (United States)

    Schwing, Carl M.

    This guide describes standard operating job procedures for the digestion process of wastewater treatment facilities. This process is for reducing the volume of sludge to be treated in subsequent units and to reduce the volatile content of sludge. The guide gives step-by-step instructions for pre-startup, startup, continuous operating, shutdown,…

  20. 78 FR 4060 - Manufactured Home Construction and Safety Standards, Test Procedures for Roof Trusses

    Science.gov (United States)

    2013-01-18

    ..., such as metal connector plates or wood gussets or their equivalents, uplift testing in Wind Zone I is.... SUMMARY: This final rule amends the roof truss testing procedures in the Federal Manufactured Home... testing procedures in 2003. In response to public comments, HUD returned the proposal to MHCC for further...

  1. Calibration of brachytherapy sources. Guidelines on standardized procedures for the calibration of brachytherapy sources at Secondary Standard Dosimetry Laboratories (SSDLs) and hospitals

    International Nuclear Information System (INIS)

    1999-04-01

    Today, irradiation by brachytherapy is considered an essential part of the treatment for almost all the sites of cancer. With the improved localization techniques and treatment planning systems, it is now possible to have precise and reproducible dose delivery. However, the desired clinical results can only be achieved with a good clinical and dosimetric practice, i.e. with the implementation of a comprehensive quality assurance (QA) programme which includes detailed quality control procedures. As summarized in the present report, accidents in brachytherapy treatments have been caused due to the lack of traceable calibration of the sources, due to the incorrect use of quantities and units, or errors made in the dose calculation procedure. The International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources has established a requirement on the calibration of sources used for medical exposure. For sources used in brachytherapy treatments, a calibration traceable to a standards dosimetry laboratory is required. The present report deals with the calibration of brachytherapy sources and related quality control (QC) measurements, QC of ionization chambers and safety aspects related to the calibration procedures. It does not include safety aspects related to the clinical use of brachytherapy sources, which have been addressed in a recent IAEA publication, IAEA-TECDOC-1040, 'Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects'. The procedures recommended in this report yield traceability to internationally accepted standards. It must be realized, however, that a comprehensive QA programme for brachytherapy cannot rest on source calibration alone, but must ensure QC of all the equipment and techniques that are used for the dose delivery to the patient. The present publication incorporates the reports of several consultants meetings in the field of

  2. [Orthotopic cardiac transplantation with caval anastomosis: a comparative randomized study with standard procedure in 81 cases].

    Science.gov (United States)

    Deleuze, P; Benvenuti, C; Mazzucotelli, J P; Perdrix, C; Le Besnerais, P; Mourtada, A; Hillion, M L; Patrat, J F; Loisance, D Y

    1996-01-01

    Complete resection of the right atrium with conservation of a strip of left atrium around the 4 pulmonary veins followed by direct anastomosis on the vena cava has recently been proposed as an alternative to the standard orthotopic cardiac transplantation described by Shumway and Lower. In order to determine whether this "anatomical" transplantation should now be considered to be the procedure of choice, a prospective randomised study was undertaken in 1991 including 78 patients undergoing 81 cardiac transplantations by one of the two techniques: gr. I: classical transplantation (n = 40), gr. II: "anatomical" transplantation (n = 41). The groups were comparable in age, sex, weight, nature of the underlying cardiac disease and clinical status at the time of transplantation. Similarly, the parameters of the donors were comparable with respect to age, sex, weight and dosage of inotropic drugs at the time of explantation. All patients came of cardiopulmonary bypass with comparable ischaemia time of the graft (gr. I: 136 +/- 46 min; gr. II: 138 +/- 51 min). Immediate return to sinus rhythm occurred in 20 cases in gr. I and 36 cases in gr. II. Atrial arrhythmia persisted in 5 cases in gr. I but in no cases of gr. II. These differences were very significant (p < 0.001). There were 13 early deaths in gr. I and 8 in gr. II. Doppler echocardiography was performed two to three months after transplantation. The right atrial surface was significantly decreased in gr. II (18 +/- 4.7 cm2) compared with gr. I (24 +/- 7 cm2): the same difference was observed for the left atrium (gr. I: 24 +/- 4.5 cm2; gr. II: 20 +/- 5 cm2), p = 0.001. Tricuspid regurgitation was observed in 82% of patients in gr. I compared with 57% in gr. II (p < 0.005). Exercise stress tests during the same period showed no difference in peak oxygen consumption between the groups. Holter ECG monitoring led to permanent pacing in 2 patients of gr. I (5%). The technical simplicity and reduction of postoperative

  3. SURF: Taking Sustainable Remediation from Concept to Standard Operating Procedure (Invited)

    Science.gov (United States)

    Smith, L. M.; Wice, R. B.; Torrens, J.

    2013-12-01

    Over the last decade, many sectors of industrialized society have been rethinking behavior and re-engineering practices to reduce consumption of energy and natural resources. During this time, green and sustainable remediation (GSR) has evolved from conceptual discussions to standard operating procedure for many environmental remediation practitioners. Government agencies and private sector entities have incorporated GSR metrics into their performance criteria and contracting documents. One of the early think tanks for the development of GSR was the Sustainable Remediation Forum (SURF). SURF brings together representatives of government, industry, consultancy, and academia to parse the means and ends of incorporating societal and economic considerations into environmental cleanup projects. Faced with decades-old treatment programs with high energy outputs and no endpoints in sight, a small group of individuals published the institutional knowledge gathered in two years of ad hoc meetings into a 2009 White Paper on sustainable remediation drivers, practices, objectives, and case studies. Since then, SURF has expanded on those introductory topics, publishing its Framework for Integrating Sustainability into Remediation Projects, Guidance for Performing Footprint Analyses and Life-Cycle Assessments for the Remediation Industry, a compendium of metrics, and a call to improve the integration of land remediation and reuse. SURF's research and members have also been instrumental in the development of additional guidance through ASTM International and the Interstate Technology and Regulatory Council. SURF's current efforts focus on water reuse, the international perspective on GSR (continuing the conversations that were the basis of SURF's December 2012 meeting at the National Academy of Sciences in Washington, DC), and ways to capture and evaluate the societal benefits of site remediation. SURF also promotes and supports student chapters at universities across the US

  4. Interim radiological safety standards and evaluation procedures for subseabed high-level waste disposal

    Energy Technology Data Exchange (ETDEWEB)

    Klett, R.D.

    1997-06-01

    The Seabed Disposal Project (SDP) was evaluating the technical feasibility of high-level nuclear waste disposal in deep ocean sediments. Working standards were needed for risk assessments, evaluation of alternative designs, sensitivity studies, and conceptual design guidelines. This report completes a three part program to develop radiological standards for the feasibility phase of the SDP. The characteristics of subseabed disposal and how they affect the selection of standards are discussed. General radiological protection standards are reviewed, along with some new methods, and a systematic approach to developing standards is presented. The selected interim radiological standards for the SDP and the reasons for their selection are given. These standards have no legal or regulatory status and will be replaced or modified by regulatory agencies if subseabed disposal is implemented. 56 refs., 29 figs., 15 tabs.

  5. Interim radiological safety standards and evaluation procedures for subseabed high-level waste disposal

    International Nuclear Information System (INIS)

    Klett, R.D.

    1997-06-01

    The Seabed Disposal Project (SDP) was evaluating the technical feasibility of high-level nuclear waste disposal in deep ocean sediments. Working standards were needed for risk assessments, evaluation of alternative designs, sensitivity studies, and conceptual design guidelines. This report completes a three part program to develop radiological standards for the feasibility phase of the SDP. The characteristics of subseabed disposal and how they affect the selection of standards are discussed. General radiological protection standards are reviewed, along with some new methods, and a systematic approach to developing standards is presented. The selected interim radiological standards for the SDP and the reasons for their selection are given. These standards have no legal or regulatory status and will be replaced or modified by regulatory agencies if subseabed disposal is implemented. 56 refs., 29 figs., 15 tabs

  6. Evaluation of the ISO Standard 11063 DNA Extraction Procedure for Assessing Soil Microbial Abundance and Community Structure

    Science.gov (United States)

    Griffiths, Robert; Dequiedt, Samuel; Lelievre, Mélanie; Regnier, Tiffanie; Nowak, Virginie; Bailey, Mark; Lemanceau, Philippe; Bispo, Antonio; Chabbi, Abad; Maron, Pierre-Alain; Mougel, Christophe; Ranjard, Lionel

    2012-01-01

    Soil DNA extraction has become a critical step in describing microbial biodiversity. Historically, ascertaining overarching microbial ecological theories has been hindered as independent studies have used numerous custom and commercial DNA extraction procedures. For that reason, a standardized soil DNA extraction method (ISO-11063) was previously published. However, although this ISO method is suited for molecular tools such as quantitative PCR and community fingerprinting techniques, it has only been optimized for examining soil bacteria. Therefore, the aim of this study was to assess an appropriate soil DNA extraction procedure for examining bacterial, archaeal and fungal diversity in soils of contrasting land-use and physico-chemical properties. Three different procedures were tested: the ISO-11063 standard; a custom procedure (GnS-GII); and a modified ISO procedure (ISOm) which includes a different mechanical lysis step (a FastPrep ®-24 lysis step instead of the recommended bead-beating). The efficacy of each method was first assessed by estimating microbial biomass through total DNA quantification. Then, the abundances and community structure of bacteria, archaea and fungi were determined using real-time PCR and terminal restriction fragment length polymorphism approaches. Results showed that DNA yield was improved with the GnS-GII and ISOm procedures, and fungal community patterns were found to be strongly dependent on the extraction method. The main methodological factor responsible for differences between extraction procedure efficiencies was found to be the soil homogenization step. For integrative studies which aim to examine bacteria, archaea and fungi simultaneously, the ISOm procedure results in higher DNA recovery and better represents microbial communities. PMID:22984486

  7. Evaluation of the ISO standard 11063 DNA extraction procedure for assessing soil microbial abundance and community structure.

    Directory of Open Access Journals (Sweden)

    Pierre Plassart

    Full Text Available Soil DNA extraction has become a critical step in describing microbial biodiversity. Historically, ascertaining overarching microbial ecological theories has been hindered as independent studies have used numerous custom and commercial DNA extraction procedures. For that reason, a standardized soil DNA extraction method (ISO-11063 was previously published. However, although this ISO method is suited for molecular tools such as quantitative PCR and community fingerprinting techniques, it has only been optimized for examining soil bacteria. Therefore, the aim of this study was to assess an appropriate soil DNA extraction procedure for examining bacterial, archaeal and fungal diversity in soils of contrasting land-use and physico-chemical properties. Three different procedures were tested: the ISO-11063 standard; a custom procedure (GnS-GII; and a modified ISO procedure (ISOm which includes a different mechanical lysis step (a FastPrep ®-24 lysis step instead of the recommended bead-beating. The efficacy of each method was first assessed by estimating microbial biomass through total DNA quantification. Then, the abundances and community structure of bacteria, archaea and fungi were determined using real-time PCR and terminal restriction fragment length polymorphism approaches. Results showed that DNA yield was improved with the GnS-GII and ISOm procedures, and fungal community patterns were found to be strongly dependent on the extraction method. The main methodological factor responsible for differences between extraction procedure efficiencies was found to be the soil homogenization step. For integrative studies which aim to examine bacteria, archaea and fungi simultaneously, the ISOm procedure results in higher DNA recovery and better represents microbial communities.

  8. Standard Operating Procedures for Preparing and Handling Sterile Male Tsetse flies for Release

    International Nuclear Information System (INIS)

    Argiles-Herrero, Rafa; Leak, Stephen G.A.

    2016-01-01

    The purpose of this SOP is to describe the procedures involved in preparing tsetse flies reared in a breeding facility for release in the field for the sterile insect technique (SIT) as a component of Area-Wide Insect pest Management (AW-IPM). Following the procedures which are outlined will help to ensure that the released sterile male tsetse flies are of optimal quality.

  9. Standard operating procedure for combustion of 14C - samples with OX-500 biological material oxidizer

    International Nuclear Information System (INIS)

    Nashriyah Mat.

    1995-01-01

    This procedure is for the purpose of safe operation of OX-500 biological material oxidizer. For ease of operation, the operation flow chart (including testing the system and sample combustion) and end of day maintenance flow chart were simplified. The front view, diagrams and switches are duly copied from operating manual. Steps on sample preparation are also included for biotic and a biotic samples. This operating procedure is subjected to future reviews

  10. A Meta-Analytic Assessment of Empirical Differences in Standard Setting Procedures.

    Science.gov (United States)

    Bontempo, Brian D.; Marks, Casimer M.; Karabatsos, George

    Using meta-analysis, this research takes a look at studies included in a meta-analysis by R. Jaeger (1989) that compared the cut score set by one standard setting method with that set by another. This meta-analysis looks beyond Jaeger's studies to select 10 from the research literature. Each compared at least two types of standard setting method.…

  11. Malpractice claims and unintentional outcome of tonsil surgery and other standard procedures in otorhinolaryngology

    Science.gov (United States)

    Windfuhr, Jochen P.

    2015-01-01

    of malpractice after LN (16; 57%), TE (10; 37%), SP (8; 57%) and AE (2; 100%). There were 16 cases of PTH amongst 27 trials after TE resulting either in death (5) or apallic syndrome (5). Bleeding complications had occurred on the day of surgery in only 2 patients. 16 trials were based on malpractice claims following SP encompassing lack of informed consent (6), anosmia (4), septal perforation (2), frontobasal injury (2) and dry nose (2). Trials after LN procedures were associated exclusively with a lesion of the spinal accessory nerve (28), including lack of informed consent in 19 cases. 49 cases (69%) were decided for the defendant, 22 (31%) were decided for the plaintiff with monetary compensation in 7 of 29 AE/TE-trials, 9 of 28 LN-trials and 6 of 14 SP-trials. Lack of informed consent was not registered for AE/TE but LN (11) and SP (2). Conclusion: Complicated cases following TE, TT, ATE, SP and LN are not systematically collected in Germany. It can be assumed, that not every complicated case is published in the medical literature or law journals and therefore not obtainable for scientific research. Alleged medical malpracice is proven for less than 6% before trial stage. Approximately half of all cases result in a plaintiff verdict or settlement at court. Proper documentation of a thourough counselling, examination, indication, informed consent and follow-up assists the surgeon in litigation. An adequate complication management of PTH is essential, including instructions for the patients/parents, instructions for the medical staff and readily available surgical instruments. Successful outcome of life-threatening PTH is widely based on a proper airway management in an interdisciplinary approach. Electrosurgical tonsillectomy techniques were repeatedly labeled as a risk factor for bleeding complications following TE. Institutions should analyse the individual PTH rate on a yearly basis. Contradictory expert opinions and verdicts of the courts concerning spinal

  12. Extended device profiles and testing procedures for the approval process of integrated medical devices using the IEEE 11073 communication standard.

    Science.gov (United States)

    Janß, Armin; Thorn, Johannes; Schmitz, Malte; Mildner, Alexander; Dell'Anna-Pudlik, Jasmin; Leucker, Martin; Radermacher, Klaus

    2018-02-23

    Nowadays, only closed and proprietary integrated operating room systems (IORS) from big manufacturers are available on the market. Hence, the interconnection of components from third-party vendors is only possible with increased time and costs. In the context of the German Federal Ministry of Education and Research (BMBF)-funded project OR.NET (2012-2016), the open integration of medical devices from different manufacturers was addressed. An integrated operating theater based on the open communication standard IEEE 11073 shall give clinical operators the opportunity to choose medical devices independently of the manufacturer. This approach would be advantageous especially for hospital operators and small- and medium-sized enterprises (SME) of medical devices. Actual standards and concepts regarding technical feasibility and the approval process do not cope with the requirements for a modular integration of medical devices in the operating room (OR), based on an open communication standard. Therefore, innovative approval strategies and corresponding certification and test procedures, which cover actual legal and normative standards, have to be developed in order to support the future risk management and the usability engineering process of open integrated medical devices in the OR. The use of standardized device and service profiles and a three-step testing procedure, including conformity, interoperability and integration tests are described in this paper and shall support the manufacturers to integrate their medical devices without disclosing the medical devices' risk analysis and related confidential expertise or proprietary information.

  13. CTEPP STANDARD OPERATING PROCEDURE FOR CONDUCTING INTERNAL FIELD AUDITS AND QUALITY CONTROL (SOP-2.25)

    Science.gov (United States)

    This SOP describes the method for conducting internal field audits and quality control procedures. Internal field audits will be conducted to ensure the collection of high quality data. Internal field audits will be conducted by Field Auditors (the Field QA Officer and the Field...

  14. Effects of Computer-Based Training on Procedural Modifications to Standard Functional Analyses

    Science.gov (United States)

    Schnell, Lauren K.; Sidener, Tina M.; DeBar, Ruth M.; Vladescu, Jason C.; Kahng, SungWoo

    2018-01-01

    Few studies have evaluated methods for training decision-making when functional analysis data are undifferentiated. The current study evaluated computer-based training to teach 20 graduate students to arrange functional analysis conditions, analyze functional analysis data, and implement procedural modifications. Participants were exposed to…

  15. 42 CFR 493.1255 - Standard: Calibration and calibration verification procedures.

    Science.gov (United States)

    2010-10-01

    ... least a minimal (or zero) value, a mid-point value, and a maximum value near the upper limit of the... the number, type, and concentration of calibration materials, as well as acceptable limits for and the... acceptable limits for calibration verification. (b) Perform and document calibration verification procedures...

  16. HUBUNGAN ANTARA GAYA KEPEMIMPINAN PATH GOAL SUPERVISOR PABRIK BAJA DENGAN TINGKAT KEPATUHAN SOP (STANDARD OPERATIONAL PROCEDURE) PEKERJA

    OpenAIRE

    Ridho, Wahyu Fahrul

    2017-01-01

    ABSTRACTEmployee ignorance on Standard Operational Procedures (SOP) is one of the main causes of workplace accidents. This study was conducted to analyze the correlation between path goal leadership implemented by Gresik steel factory supervisors and employee obedience on company SOP. This study applied quantitative approach and cross-sectional research design. The data were collected through observation and interview on 52 respondents consisting of employees working led by 4 different superv...

  17. Clinical outcomes for 14 consecutive patients with solid pseudopapillary neoplasms who underwent laparoscopic distal pancreatectomy.

    Science.gov (United States)

    Nakamura, Yoshiharu; Matsushita, Akira; Katsuno, Akira; Yamahatsu, Kazuya; Sumiyoshi, Hiroki; Mizuguchi, Yoshiaki; Uchida, Eiji

    2016-02-01

    The postoperative results of laparoscopic distal pancreatectomy for solid pseudopapillary neoplasm of the pancreas (SPN), including the effects of spleen-preserving resection, are still to be elucidated. Of the 139 patients who underwent laparoscopic pancreatectomy for non-cancerous tumors, 14 consecutive patients (average age, 29.6 years; 1 man, 13 women) with solitary SPN who underwent laparoscopic distal pancreatectomy between March 2004 and June 2015 were enrolled. The tumors had a mean diameter of 4.8 cm. Laparoscopic spleen-preserving distal pancreatectomy was performed in eight patients (spleen-preserving group), including two cases involving pancreatic tail preservation, and laparoscopic spleno-distal pancreatectomy was performed in six patients (standard resection group). The median operating time was 317 min, and the median blood loss was 50 mL. Postoperatively, grade B pancreatic fistulas appeared in two patients (14.3%) but resolved with conservative treatment. No patients had postoperative complications, other than pancreatic fistulas, or required reoperation. The median postoperative hospital stay was 11 days, and the postoperative mortality was zero.None of the patients had positive surgical margins or lymph nodes with metastasis. The median follow-up period did not significantly differ between the two groups (20 vs 39 months, P = 0.1368). All of the patients are alive and free from recurrent tumors without major late-phase complications. Laparoscopic distal pancreatectomy might be a suitable treatment for patients with SPN. A spleen-preserving operation is preferable for younger patients with SPN, and this study demonstrated the non-inferiority of the procedure compared to spleno-distal pancreatectomy. © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  18. Aircrew Compliance with Standard Operating Procedures as a Component of Airline Safety.

    Science.gov (United States)

    1980-01-01

    typical operating environment, the crew activity associated with it is thought to be representative of habitual behavior. In contrast, the second...Most of the participants were assigned to a single aircrew domicle. The one captain who came from a different domicile is subjectively ranked between...initiations lies in the sweeping Command and Management Procedures. They affirm that responsibility for all operational activity resides in the

  19. Proposal evaluation tool of standards and procedures for breast cancer in the province of Cienfuegos

    International Nuclear Information System (INIS)

    Fraga Suarez, Omayda; Sabates Llerandi, Teresita; Arnot Silvera, Rogelio; Torres Aja, Lidia

    2009-01-01

    Breast cancer is one of the most frequent malignancies Although Cuba and be a program with rules and procedures established a high number of women will die from cause. Objectives, design an instrument to assess compliance with the rules and procedures of breast cancer in Cienfuegos Province. Methodological design, a study was conducted descriptive, during the time period from January 2007 to January 2008, whose study group consisted of 55 women diagnosed with breast cancer at the 'Hospital Universitario Dr. Gustavo Lima Aldereguia' of Cienfuegos, the research was divided into three stages: general characterization, design of an assessment tool, criterion validation by external evaluators. Methods were used theoretical, empirical and mathematical statistics. Results, the stadiums most representative were II and III, there are delays in the performance definitive surgery, radical surgical treatments prevail, delays in the initiation of chemotherapy. Findings, there difficulties in adherence and compliance and therapeutic procedures established in the province of Cienfuegos, by which an instrument was designed for evaluation. (Author)

  20. The advantages of using standardized review procedures in certifying type B radioactive material packages

    International Nuclear Information System (INIS)

    Easton, E.P.; Faille, S.

    2004-01-01

    This paper presents the advantages of adopting well-documented standardized review practices for reviewing Type B package designs. The US experience using standardized review plans and guidance has shown them to be a valuable tool in achieving more consistent and efficient package reviews, in training and qualifying technical reviewers, and in enhancing public and industry understanding of the package certification process. In addition, the standardized review practices, as living documents, have proven to be an effective method of incorporating new technical advances into the review process, and have provided a vehicle to make that knowledge widely available to fellow reviewers, the public and industry. Canada implemented a new internal review process in early 2003 to standardize the review of applications for certification of Type B Packages. Based on the similarity of these approaches, the United States and Canada have started discussions on a A North American System for the unilateral approval of Type B (U) packages. This initiative is looking into how each country is currently reviewing transportation package applications to see if agreement can be reached on accepting Type B certifications on a reciprocal basis, i.e., without additional review. Based on the experience in Canada and the United States, the authors believe that the use of standardized review processes, coupled with the knowledge and experience resident in IAEA's Transportation Advisory Material (TS-G-1.1) and series of TECDOCS, could also be used to develop a standard internationally accepted review process that could enhance the acceptance of unilateral approvals for Type B packages

  1. 78 FR 54655 - Center for Devices and Radiological Health: Draft Standard Operating Procedure for Level 1...

    Science.gov (United States)

    2013-09-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... challenging for the Center to communicate the change and its basis to all affected parties in a meaningful and... communication on regulatory matters, including establishing a standard practice for communicating to all...

  2. Study on Design and Implementation of JAVA Programming Procedural Assessment Standard

    Science.gov (United States)

    Tingting, Xu; Hua, Ma; Xiujuan, Wang; Jing, Wang

    2015-01-01

    The traditional JAVA course examination is just a list of questions from which we cannot know students' skills of programming. According to the eight abilities in curriculum objectives, we designed an assessment standard of JAVA programming course that is based on employment orientation and apply it to practical teaching to check the teaching…

  3. Preliminary Guidelines and Standard Operating Procedure for Drainage and Erosion Control at McMurdo Station

    Science.gov (United States)

    2014-12-01

    along the impermeable frozen soil layer. Soil freeze–thaw action disrupts soil structures, displaces soils particles, and creates voids both in...appropriate culvert replacement type (e.g., metal or plastic or concrete , etc.) and to try to standardize culverts around the Station. ER D C

  4. CTEPP STANDARD OPERATING PROCEDURE FOR HANDLING SAMPLE AND DATA CUSTODY (SOP-2.26)

    Science.gov (United States)

    This SOP describes the method for handling sample custody. A standardized Chain-of-Custody (CoC) Record is used to document the sample/data custody. Each participant is assigned one CoC Record for the samples/data collected at their home and/or day care center.

  5. Incorporation of biomagnification in procedures for environmental risk assessment and standard setting

    NARCIS (Netherlands)

    Luttik R; Traas TP; de Greef J

    1992-01-01

    Recently methods have been developed in the Netherlands to assess quality standards for the environment. Maximum permissible concentrations have been derived for direct exposure to environmental media. In 1991 two simple foodchains were analyzed at the RIVM. - Water --> Fish --> Fish-eating

  6. Documentation for assessment of modal pushover-based scaling procedure for nonlinear response history analysis of "ordinary standard" bridges

    Science.gov (United States)

    Kalkan, Erol; Kwong, Neal S.

    2010-01-01

    The earthquake engineering profession is increasingly utilizing nonlinear response history analyses (RHA) to evaluate seismic performance of existing structures and proposed designs of new structures. One of the main ingredients of nonlinear RHA is a set of ground-motion records representing the expected hazard environment for the structure. When recorded motions do not exist (as is the case for the central United States), or when high-intensity records are needed (as is the case for San Francisco and Los Angeles), ground motions from other tectonically similar regions need to be selected and scaled. The modal-pushover-based scaling (MPS) procedure recently was developed to determine scale factors for a small number of records, such that the scaled records provide accurate and efficient estimates of 'true' median structural responses. The adjective 'accurate' refers to the discrepancy between the benchmark responses and those computed from the MPS procedure. The adjective 'efficient' refers to the record-to-record variability of responses. Herein, the accuracy and efficiency of the MPS procedure are evaluated by applying it to four types of existing 'ordinary standard' bridges typical of reinforced-concrete bridge construction in California. These bridges are the single-bent overpass, multi span bridge, curved-bridge, and skew-bridge. As compared to benchmark analyses of unscaled records using a larger catalog of ground motions, it is demonstrated that the MPS procedure provided an accurate estimate of the engineering demand parameters (EDPs) accompanied by significantly reduced record-to-record variability of the responses. Thus, the MPS procedure is a useful tool for scaling ground motions as input to nonlinear RHAs of 'ordinary standard' bridges.

  7. Standardization of solvent extraction procedure for determination of uranium in seawater

    International Nuclear Information System (INIS)

    Sukanta Maity; Sahu, S.K.; Pandit, G.G.

    2015-01-01

    Solvent extraction procedure using ammonium pyrolidine dithiocarbamate complexing agent in methyl isobutyl ketone organic phase and acid exchange back-extraction is described for the simultaneous quantitative pre-concentration of uranium in seawater followed by its determination by differential pulse adsorptive stripping voltammetry. Solvent extraction time is optimized for extraction of uranium from seawater. Solvent extraction efficiency for uranium in seawater at different pH was carried out. The method gives a recovery of 98 ± 2 % for 400 mL sample at pH 3.0 ± 0.02, facilitating the rapid and interference free analysis of seawater samples. (author)

  8. Comparative analysis of pain in patients who underwent total knee replacement regarding the tourniquet pressure

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leão

    Full Text Available ABSTRACT OBJECTIVES: To evaluate through the visual analog scale (VAS the pain in patients undergoing total knee replacement (TKR with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard and the other with systolic blood pressure plus 100 mmHg (P + 100. These patients had their pain assessed by VAS at 48 h, and at the 5th and 15th days after procedure. Secondarily, the following were also measured: range of motion (ROM, complications, and blood drainage volume in each group; the data were subjected to statistical analysis. RESULTS: After data analysis, there was no statistical difference regarding the incidence of complications (p = 0.612, ROM (p = 0.202, bleeding after 24 and 48 h (p = 0.432 and p = 0.254 or in relation to VAS. No correlation was observed between time of ischemia compared to VAS and bleeding. CONCLUSIONS: The use of the pneumatic tourniquet pressure at 350 mmHg or systolic blood pressure plus 100 mmHg did not influence the pain, blood loss, ROM, and complications. Therefore the pressures at these levels are safe and do not change the surgery outcomes; the time of ischemia must be closely observed to avoid major complications.

  9. A Standardized Procedure for a Pre-evaluation of the IED Instance

    Science.gov (United States)

    Panepinto, Deborah; Ruffino, Barbara; Zanetti, Mariachiara; Genon, Giuseppe

    2016-04-01

    This study presents a procedure, called EICS (Enterprise IPPC Compatibility Study) aimed at evaluating, by means of the calculation of three indexes, the compliance of the processes performed in an industrial plant with the guidelines provided by BREFs (BAT References) Documents. In fact, according to European Directive 2010/75/EU (concerning the Integrated Pollution Prevention and Control and repealing European Directive 2008/01/EC), industrial plants must require authorizations to the competent authority stating the conformity of their activity, in order to obtain this conformity they are advised to Best Available Technologies (BAT). The aim of the BATs is to avoid or minimize the impact of an industrial activity on the environment through the prevention of the atmospheric emissions, wastewater discharge and energetic consumption, and the correct waste management thus improving the efficiency of the plant. The procedure shown in the present paper has been tested on several types of industrial plant (cement plants, secondary smelt foundries, paper-mill, and automotive industries as regards their paint lines). In this paper, the application of EICS method to a cement plant is presented: the obtained results highlight a good correlation between the index values and the real situation of the plant.

  10. Developing standard performance testing procedures for MC and A components at a site

    International Nuclear Information System (INIS)

    Scherer, Carolynn

    2010-01-01

    The condition of a nuclear material control and accountability system (MC and A) and its individual components, as with any system combining technical elements, documentation and the human factor, may be characterized through an aggregate of values for the various parameters that determine the system's ability to perform. The MC and A system's status may be functioning effectively, marginally or not functioning based on a summary of the values of the individual parameters. This work included a review of the following elements and subsystems or components for a material control and accountability system: (1) MC and A Elements: Information subsystem, Measurement subsystem, NM access subsystem, including a tamper-indicating device (TID) program, and Automated information-gathering subsystem; and (2) Detecting NM Loses Elements: Inventory differences, Shipper/receiver differences, Confirmatory measurements and differences with accounting data, and TID or seal violations. In order to detect the absence or loss of nuclear material there must be appropriate interactions among the elements and their respective subsystems (from the list above). Additionally this work includes a review of the status of regulatory requirements for the MC and A system components and potential criteria that support the evaluation of the performance of the listed components. The listed components had performance testing algorithms and procedures developed that took into consideration the regulatory criteria. The developed MC and A performance-testing procedures were the basis for a pilot Guide for MC and A Performance Testing at the MBAs of SSC RF IPPE.

  11. Biobanking human endometrial tissue and blood specimens: standard operating procedure and importance to reproductive biology research and diagnostic development.

    Science.gov (United States)

    Sheldon, Elizabeth; Vo, Kim Chi; McIntire, Ramsey A; Aghajanova, Lusine; Zelenko, Zara; Irwin, Juan C; Giudice, Linda C

    2011-05-01

    To develop a standard operating procedure (SOP) for collection, transport, storage of human endometrial tissue and blood samples, subject and specimen annotation, and establishing sample priorities. The SOP synthesizes sound scientific procedures, the literature on ischemia research, sample collection and gene expression profiling, good laboratory practices, and the authors' experience of workflow and sample quality. The National Institutes of Health, University of California, San Francisco, Human Endometrial Tissue and DNA Bank. Women undergoing endometrial biopsy or hysterectomy for nonmalignant indications. Collecting, processing, storing, distributing endometrial tissue and blood samples under approved institutional review board protocols and written informed consent from participating subjects. Standard operating procedure. The SOP addresses rigorous and consistent subject annotation, specimen processing and characterization, strict regulatory compliance, and a reference for researchers to track collection and storage times that may influence their research. The comprehensive and systematic approach to the procurement of human blood and endometrial tissue in this SOP ensures the high quality, reliability, and scientific usefulness of biospecimens made available to investigators by the National Institutes of Health, University of California, San Francisco, Human Endometrial Tissue and DNA Bank. The detail and perspective in this SOP also provides a blueprint for implementation of similar collection programs at other institutions. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Effectiveness of facilitated introduction of a standard operating procedure into routine processes in the operating theatre: a controlled interrupted time series.

    Science.gov (United States)

    Morgan, Lauren; New, Steve; Robertson, Eleanor; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; Pickering, Sharon P; Hadi, Mohammed; Griffin, Damian; McCulloch, Peter

    2015-02-01

    Standard operating procedures (SOPs) should improve safety in the operating theatre, but controlled studies evaluating the effect of staff-led implementation are needed. In a controlled interrupted time series, we evaluated three team process measures (compliance with WHO surgical safety checklist, non-technical skills and technical performance) and three clinical outcome measures (length of hospital stay, complications and readmissions) before and after a 3-month staff-led development of SOPs. Process measures were evaluated by direct observation, using Oxford Non-Technical Skills II for non-technical skills and the 'glitch count' for technical performance. All staff in two orthopaedic operating theatres were trained in the principles of SOPs and then assisted to develop standardised procedures. Staff in a control operating theatre underwent the same observations but received no training. The change in difference between active and control groups was compared before and after the intervention using repeated measures analysis of variance. We observed 50 operations before and 55 after the intervention and analysed clinical data on 1022 and 861 operations, respectively. The staff chose to structure their efforts around revising the 'whiteboard' which documented and prompted tasks, rather than directly addressing specific task problems. Although staff preferred and sustained the new system, we found no significant differences in process or outcome measures before/after intervention in the active versus the control group. There was a secular trend towards worse outcomes in the postintervention period, seen in both active and control theatres. SOPs when developed and introduced by frontline staff do not necessarily improve operative processes or outcomes. The inherent tension in improvement work between giving staff ownership of improvement and maintaining control of direction needs to be managed, to ensure staff are engaged but invest energy in appropriate change

  13. The use of faces as stimuli in neuroimaging and psychological experiments: a procedure to standardize stimulus features.

    Science.gov (United States)

    Gronenschild, Ed H B M; Smeets, Floortje; Vuurman, Eric F P M; van Boxtel, Martin P J; Jolles, Jelle

    2009-11-01

    In psychological experiments involving facial stimuli, it is of great importance that the basic perceptual or psychological characteristics that are investigated are not confounded by factors such as brightness and contrast, head size, hair cut and color, skin color, and the presence of glasses and earrings. Standardization of facial stimulus materials reduces the effect of these confounding factors. We therefore employed a set of basic image processing techniques to deal with this issue. The processed images depict the faces in grayscale, all at the same size, brightness, and contrast, and confined to an oval mask revealing only the basic features such as the eyes, nose, and mouth. The standardization was successfully applied to four different face databases, consisting of male and female faces and including neutral as well as happy facial expressions. An important advantage of the proposed standardization is that featural as well as configurational information is retained. We also consider the procedure to be a major contribution to the development of a de facto standard for the use of facial stimuli in psychological experiments. Such methodological standardization would allow a better comparison of the results of these studies.

  14. Developing standard performance testing procedures for material control and accounting components at a site

    International Nuclear Information System (INIS)

    Scherer, Carolynn P.; Bushlya, Anatoly V.; Efimenko, Vladimir F.; Ilyanstev, Anatoly; Regoushevsky, Victor I.

    2010-01-01

    The condition of a nuclear material control and accountability system (MC and A) and its individual components, as with any system combining technical elements and documentation, may be characterized through an aggregate of values for the various parameters that determine the system's ability to perform. The MC and A system's status may be functioning effectively, marginally or not functioning based on a summary of the values of the individual parameters. This work included a review of the following subsystems, MC and A and Detecting Material Losses, and their respective elements for the material control and accountability system: (a) Elements of the MC and A Subsystem - Information subsystem (Accountancy/Inventory), Measurement subsystem, Nuclear Material Access subsystem, including tamper-indicating device (TID) program, and Automated Information-gathering subsystem; (b) Elements for Detecting Nuclear Material Loses Subsystem - Inventory Differences, Shipper/receiver Differences, Confirmatory Measurements and differences with accounting data, and TID or Seal Violations. In order to detect the absence or loss of nuclear material there must be appropriate interactions among the elements and their respective subsystems from the list above. Additionally this work includes a review of regulatory requirements for the MC and A system component characteristics and criteria that support the evaluation of the performance of the listed components. The listed components had performance testing algorithms and procedures developed that took into consideration the regulatory criteria. The developed MC and A performance-testing procedures were the basis for a Guide for MC and A Performance Testing at the material balance areas (MBAs) of State Scientific Center of the Russian Federation - Institute for Physics and Power Engineering (SSC RF-IPPE).

  15. [Nomenclature and classification of complications. Standard procedure at the Heidelberg University Orthopedic Clinic].

    Science.gov (United States)

    Krämer, K L; Clauss, M

    1999-03-01

    In order to get a better data management of complications in orthopedic surgery and in order to get comparable statistics a standardisation of nomenclature and classification of complications is demanded since 1.1.1997. The Orthopedic University Clinic of Heidelberg started with a register of all early complications of all inpatients. According to a standardized nomenclature all occurred complications the doctors put in the data of complications in a database. These data were controlled, complemented and classified by members of the quality management group. This guideline consists of five parts: catalogue of diagnoses, general and special definitions, classification and an allocation table of diagnoses to grades of severity.

  16. Assessment of modal-pushover-based scaling procedure for nonlinear response history analysis of ordinary standard bridges

    Science.gov (United States)

    Kalkan, E.; Kwong, N.

    2012-01-01

    The earthquake engineering profession is increasingly utilizing nonlinear response history analyses (RHA) to evaluate seismic performance of existing structures and proposed designs of new structures. One of the main ingredients of nonlinear RHA is a set of ground motion records representing the expected hazard environment for the structure. When recorded motions do not exist (as is the case in the central United States) or when high-intensity records are needed (as is the case in San Francisco and Los Angeles), ground motions from other tectonically similar regions need to be selected and scaled. The modal-pushover-based scaling (MPS) procedure was recently developed to determine scale factors for a small number of records such that the scaled records provide accurate and efficient estimates of “true” median structural responses. The adjective “accurate” refers to the discrepancy between the benchmark responses and those computed from the MPS procedure. The adjective “efficient” refers to the record-to-record variability of responses. In this paper, the accuracy and efficiency of the MPS procedure are evaluated by applying it to four types of existing Ordinary Standard bridges typical of reinforced concrete bridge construction in California. These bridges are the single-bent overpass, multi-span bridge, curved bridge, and skew bridge. As compared with benchmark analyses of unscaled records using a larger catalog of ground motions, it is demonstrated that the MPS procedure provided an accurate estimate of the engineering demand parameters (EDPs) accompanied by significantly reduced record-to-record variability of the EDPs. Thus, it is a useful tool for scaling ground motions as input to nonlinear RHAs of Ordinary Standard bridges.

  17. A case that underwent bilateral video-assisted thoracoscopic ...

    African Journals Online (AJOL)

    No Abstract Available A case that underwent bilateral video-assisted thoracoscopic surgical (VATS) biopsy combined with pneumonectomy is presented. The patient developed hypoxia during the contralateral VATS biopsy. His hypoxia was treated with positive expiratory pressure (PEEP) to the dependent lung and apneic ...

  18. Microspectrophotometric studies of Romanowsky stained blood cells. I. Subtraction analysis of a standardized procedure.

    Science.gov (United States)

    Galbraith, W; Marshall, P N; Bacus, J W

    1980-08-01

    This paper describes a microspectrophotometric study of blood smears stained by a simple, standardized Romanowsky technique, using only the dyes azure B and cosin. Absorbance spectra are presented for twenty-two classes of cellular object, and for the two dyes in solution, together with tabulations of spectral maxima, and suitable wavelengths for use in automated image processing. The colours of objects stained with azure B/eosin are discussed in terms of absorbance spectra. By a spectral subtraction technique, it is shown that the differential colouration of various cell structures may be explained satisfactorily in terms of the varying proportions of only four dye components. These are the monomers and dimers of azure B and eosin. Polymerization was found to occur both in solution and on binding to biopolymers. A similar analysis of a conventional Romanowsky stain would present much greater difficulties, due to the greater number of dye components, which, however, contribute little to the colours observed.

  19. STANDARDIZATION OF PROCEDURES OF Plasmodium falciparum ANTIGEN PREPARATION FOR SEROLOGIC TESTS

    Directory of Open Access Journals (Sweden)

    Sandra L.M. AVILA

    1998-09-01

    Full Text Available The objective of the present study is to standardize the technical variables for preparation and storage of Plasmodium falciparum and of antigen components extracted with the amphoteric detergent Zwittergent. P. falciparum obtained from in vitro culture was stored at different temperatures and for different periods of time. For each variable, antigen components of the parasite were extracted in the presence or absence of protease inhibitors and submitted or not to later dialysis. Products were stored for 15, 30 and 60 days at different temperatures and immunological activity of each extract was determined by SDS-PAGE and ELISA using positive or negative standard sera for the presence of IgG directed to blood stage antigens of P. falciparum. Antigen extracts obtained from parasites stored at -20oC up to 10 days or at -70oC for 2 months presented the best results, showing well-defined bands on SDS-PAGE and Western blots and presenting absorbance values in ELISA that permitted safe differentiation between positive and negative sera.O objetivo deste estudo foi padronizar variáveis técnicas para o armazenamento de Plasmodium falciparum e de seus componentes antigênicos. Sedimentos de parasitas foram obtidos do cultivo in vitro de P.falciparum e estocados em diferentes temperaturas por diferentes períodos de tempo. De cada variável, foram extraídos os componentes antigênicos com detergente anfótero Zwittergent na presença e na ausência de inibidores de proteases e submetidos ou não a posterior diálise. Os produtos foram estocados por 15, 30 e 60 dias em diferentes temperaturas e caracterizados por SDS-PAGE. A atividade antigênica de cada extrato foi determinada por ELISA e Western blotting usando soros positivos e negativos para anticorpos IgG anti-formas eritrocitárias de P.falciparum. Os extratos antigênicos obtidos de parasitas estocados até 10 dias a _20ºC ou por 2 meses a _70ºC e tratados com inibidores de proteases, sob as

  20. Two-loop renormalization in the standard model, part II. Renormalization procedures and computational techniques

    Energy Technology Data Exchange (ETDEWEB)

    Actis, S. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany); Passarino, G. [Torino Univ. (Italy). Dipt. di Fisica Teorica; INFN, Sezione di Torino (Italy)

    2006-12-15

    In part I general aspects of the renormalization of a spontaneously broken gauge theory have been introduced. Here, in part II, two-loop renormalization is introduced and discussed within the context of the minimal Standard Model. Therefore, this paper deals with the transition between bare parameters and fields to renormalized ones. The full list of one- and two-loop counterterms is shown and it is proven that, by a suitable extension of the formalism already introduced at the one-loop level, two-point functions suffice in renormalizing the model. The problem of overlapping ultraviolet divergencies is analyzed and it is shown that all counterterms are local and of polynomial nature. The original program of 't Hooft and Veltman is at work. Finite parts are written in a way that allows for a fast and reliable numerical integration with all collinear logarithms extracted analytically. Finite renormalization, the transition between renormalized parameters and physical (pseudo-)observables, are discussed in part III where numerical results, e.g. for the complex poles of the unstable gauge bosons, are shown. An attempt is made to define the running of the electromagnetic coupling constant at the two-loop level. (orig.)

  1. OIE philosophy, policy and procedures for the development of food safety standards.

    Science.gov (United States)

    Droppers, W F G L

    2006-08-01

    Food safety was identified as a high priority area in the 2001-2005 World Organisation for Animal Health (OIE) Strategic Plan. Member Countries of the OIE considered that the organisation should be more active in issues of public health and consumer protection and that this should include more involvement in the area of diseases or pathogens transmissible through food, whether or not animals are affected by such diseases or pathogens. A permanent Working Group on Animal Production Food Safety was established in 2002 to coordinate the OIE's activities in food safety. The Working Group was requested to focus on food safety measures applicable at farm level and to monitor the ongoing cooperation between the OIE and Codex Alimentarius. More emphasis is now placed on the public health aspects of a disease when OIE standards are developed or revised. For example, the revised chapter on bovine tuberculosis in the Terrestrial Animal Health Code includes food safety recommendations for meat and meat products and for milk and milk products. The revised chapter was approved by the OIE International Committee of Member Countries at their 73rd General Session in May 2005. More chapters will follow, beginning with a chapter addressing bovine brucellosis.

  2. Novel femoral artery terminology: integrating anatomy and clinical procedures leading to standardized intuitive nomenclature.

    Science.gov (United States)

    Benninger, Brion

    2014-10-01

    The objective of this study is to investigate the terminology of the femoral artery and recommended alternative terminology that satisfies both anatomy and clinical arenas.The femoral artery (FA) is often defined as the continuation of the external iliac artery. Specifically, when the external iliac artery reaches directly beneath the inguinal ligament, it becomes the FA. Currently, Terminologia Anatomica (TA) records the profunda femoris or deep femoral as a terminal branch. Clinicians often use superficial femoral artery (SFA) rather than FA and profunda or deep FA. SFA is actually very deep and well protected for most of its journey. On observation, the terminology in current use is not intuitive. The objective of this study was to investigate the terminology associated with the anatomical and clinical anatomical interpretations of the FA and its terminal branches and to suggest a more appropriate terminology that addresses the points of view of the macro anatomist, as well as that of the clinician. Literature search was conducted regarding the nomenclature of the FA and its terminal branches. Dissection of 89 embalmed cadavers (49F, 40M, ages 47-89) was conducted to analyze the morphology of the FA and its branches. Perusal of the literature revealed a difference in terminology between anatomical and clinical textbooks/atlases/journals regarding the FA and its terminal branch. Our dissections suggested that the FA may be better defined vis-à-vis its relationship to the anterior and posterior compartments of the thigh. A difference in terminology exists between the anatomical and clinical arenas. A need for a standardized terminology is necessary because clinicians and their publishers have not adopted TA. This study suggests that the current FA be considered the common FA and the continuation of the FA, the SFA be renamed the anterior FA and the current profunda (the deep FA) be renamed the posterior FA, respectively. The proposed terminology mirrors the lower

  3. NUTRITION SUPPORT COMPLICATIONS IN PATIENT WHO UNDERWENT CARDIAC SURGERY

    OpenAIRE

    Krdžalić, Alisa; Kovčić, Jasmina; Krdžalić, Goran; Jahić, Elmir

    2016-01-01

    Background: The nutrition support complications after cardiac surgery should be detected and treated on time. Aim: To show the incidence and type of nutritional support complication in patients after cardiac surgery. Methods: The prospective study included 415 patients who underwent cardiac surgery between 2010 and 2013 in Clinic for Cardiovascular Disease of University Clinical Center Tuzla. Complications of the delivery system for nutrition support (NS) and nutrition itself were analy...

  4. Standardization and optimization of core sampling procedure for carbon isotope analysis in eucalyptus and variation in carbon isotope ratios across species and growth conditions

    CSIR Research Space (South Africa)

    Raju, M

    2011-11-01

    Full Text Available 13C is a well established surrogate for water use efficiency (WUE). However, variation due to aspect, length of branch and position In canopy can cause potential errors. Hence, experiments were conducted to standardize the sampling procedures...

  5. A Guide for Developing Standard Operating Job Procedures for the Tertiary Chemical Treatment - Lime Precipitation Process Wastewater Treatment Facility. SOJP No. 6.

    Science.gov (United States)

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary chemical treatment - lime precipitation process of wastewater treatment plants. Step-by-step instructions are given for pre-start up, start-up, continuous operation, and shut-down procedures. In addition, some theoretical material is presented along with some relevant…

  6. Powered bone marrow biopsy procedures produce larger core specimens, with less pain, in less time than with standard manual devices

    Directory of Open Access Journals (Sweden)

    Larry J. Miller

    2011-07-01

    Full Text Available Bone marrow sampling remains essential in the evaluation of hematopoietic and many non-hematopoietic disorders. One common limitation to these procedures is the discomfort experienced by patients. To address whether a Powered biopsy system could reduce discomfort while providing equivalent or better results, we performed a randomized trial in adult volunteers. Twenty-six subjects underwent bilateral biopsies with each device. Core samples were obtained in 66.7% of Manual insertions; 100% of Powered insertions (P=0.002. Initial mean biopsy core lengths were 11.1±4.5 mm for the Manual device; 17.0±6.8 mm for the Powered device (P<0.005. Pathology assessment for the Manual device showed a mean length of 6.1±5.6 mm, width of 1.0±0.7 mm, and volume of 11.0±10.8 mm3. Powered device measurements were mean length of 15.3±6.1 mm, width of 2.0±0.3 mm, and volume of 49.1±21.5 mm3 (P<0.001. The mean time to core ejection was 86 seconds for Manual device; 47 seconds for the Powered device (P<0.001. The mean second look overall pain score was 33.3 for the Manual device; 20.9 for the Powered (P=0.039. We conclude that the Powered biopsy device produces superior sized specimens, with less overall pain, in less time.

  7. Sexual Desire and Hypoactive Sexual Desire Disorder in Women. Introduction and Overview. Standard Operating Procedure (SOP Part 1)

    DEFF Research Database (Denmark)

    Bitzer, Johannes; Giraldi, Annamaria; Pfaus, Jim

    2013-01-01

    Introduction.  Hypoactive sexual desire disorder (HSDD) is defined in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as persistent or recurrent deficiency (or absence) of sexual fantasies/thoughts, and/or desire for or receptivity to sexual activity, which causes personal......-factor models (e.g., excitation-inhibition, appetitive-consummatory) or more specific multifactorial models (in which the different components of sexual activity and their interaction are delineated). The etiology of the disorder is generally considered as multifactorial. Biomedical factors like diseases, drugs...... must be based on a biopsychosocial, multidimensional, and integrative perspective. Bitzer J, Giraldi A, and Pfaus J. Sexual desire and hypoactive sexual desire disorder in women. Introduction and overview. Standard operating procedure (SOP part 1). J Sex Med **;**:**-**....

  8. Removal of foot-and-mouth disease virus infectivity in salted natural casings by minor adaptation of standardized industrial procedures.

    Science.gov (United States)

    Wijnker, J J; Haas, B; Berends, B R

    2007-04-10

    Intestines are used for the production of natural casings as edible sausage containers. Derived from animals (pigs and sheep) experimentally infected with FMDV (initial dosage 10(7.3) PFU/ml, strain O(1Kaufbeuren)), these natural casings were treated with sodium chloride or a phosphate salts/sodium chloride mixture and the residual FMDV titres measured. After storage at about 20 degrees C, no remaining infectivity was found after either treatment, whereas casings stored at 4 degrees C still contained infectivity. Storage of salted casings at about 20 degrees C for 30 days is already part of the Standard Operating Procedures (included in HACCP) of the international casing industry and can therefore be considered as a protective measure for the international trade in natural casings.

  9. Design of standard operating procedure production proceses (case study on the home industry Bedugul Baturiti Tabanan Bali)

    Science.gov (United States)

    Kasiani; Suhantono, Djoko; Mirah Kencanawati, AAA

    2018-01-01

    Candikuning is part of the district of Baturiti, tourism village, better known by the name of Bedugul. No less interesting is the variety of chips produced by two partner groups as a souvenir after the tour, such as Chips: Spinach; beans; Tempeh. The purpose of this research were to design a Standard Operating Procedure (SOP): Production Processes on the Home Industry Bedugul Baturiti Tabanan Bali. The data technic collected use: observation; Documentation; and then interview to collect information. The data analysis technic done by using the Miles & Huberman. Result this research that the draft SOP: Production Processes Chips (Menu). The conclusion in this research SOP Production Processes use with flowchart and description on the Home Industry Bedugul Baturiti Tabanan Bali.

  10. Assessment of macrofungal diversity in a Silver Fir plantation in Sardinia (Italy using a standardized sampling procedure

    Directory of Open Access Journals (Sweden)

    Elia Ambrosio

    2015-12-01

    Full Text Available The knowledge of macrofungal diversity associated with Silver Fir forests in Italy is quite scarce. Only a little information is available about macrofungal communities from some Ligurian and Tuscan Silver Fir sites. This study aims to assess the macrofungal diversity of a Silver Fir plantation in Sardinia by the application of a standardized sampling procedure. A total of 606 sporomata were collected and 52 Basidiomycota were identified. The high value of the Shannon Index indicated a considerable level of macrofungal diversity in this plantation. The results were also compared with the diversity indices obtained by a previous 3-years long sampling methodology in the same site. The comparison of the macrofungal diversity values of the Sardinian site with those of the Ligurian Silver Fir forest revealed interesting similarities among natural versus planted coniferous forests.

  11. Standardization of digestion procedure for the determination of heavy metals in biological materials by atomic absorption spectrometry

    International Nuclear Information System (INIS)

    Khalid, N.; Chaudhri, S.A.

    1999-01-01

    Proper decomposition of the sample is one of the basic requirements of the atomic absorption spectroscopic analysis. In the present studies, heavy metals (Cu, Fe, Mn and Zn) were determined in biological samples by designating them in a mixture of nitric acid and perchloric acid. The quantification was made with atomic absorption spectrometry using an air-acetylene flame. The reliability of the procedure used was checked by analysing standard reference materials from NBS and IAEA, such as Rice flour (NBS-SRM-1568), Horse Kidney (IAEA H-8), Mixed Human diet(IAEA H-9), Copepod (IAEA MA-A-1) and fish flesh (IAEA MA-A-2) under identical conditions. A good agreement was observed between determined and the certified values reported by NBS and IAEA. (author)

  12. Validation of standard operating procedures in a multicenter retrospective study to identify -omics biomarkers for chronic low back pain.

    Directory of Open Access Journals (Sweden)

    Concetta Dagostino

    Full Text Available Chronic low back pain (CLBP is one of the most common medical conditions, ranking as the greatest contributor to global disability and accounting for huge societal costs based on the Global Burden of Disease 2010 study. Large genetic and -omics studies provide a promising avenue for the screening, development and validation of biomarkers useful for personalized diagnosis and treatment (precision medicine. Multicentre studies are needed for such an effort, and a standardized and homogeneous approach is vital for recruitment of large numbers of participants among different centres (clinical and laboratories to obtain robust and reproducible results. To date, no validated standard operating procedures (SOPs for genetic/-omics studies in chronic pain have been developed. In this study, we validated an SOP model that will be used in the multicentre (5 centres retrospective "PainOmics" study, funded by the European Community in the 7th Framework Programme, which aims to develop new biomarkers for CLBP through three different -omics approaches: genomics, glycomics and activomics. The SOPs describe the specific procedures for (1 blood collection, (2 sample processing and storage, (3 shipping details and (4 cross-check testing and validation before assays that all the centres involved in the study have to follow. Multivariate analysis revealed the absolute specificity and homogeneity of the samples collected by the five centres for all genetics, glycomics and activomics analyses. The SOPs used in our multicenter study have been validated. Hence, they could represent an innovative tool for the correct management and collection of reliable samples in other large-omics-based multicenter studies.

  13. Standard operating procedures for pre-analytical handling of blood and urine for metabolomic studies and biobanks

    International Nuclear Information System (INIS)

    Bernini, Patrizia; Bertini, Ivano; Luchinat, Claudio; Nincheri, Paola; Staderini, Samuele; Turano, Paola

    2011-01-01

    1 H NMR metabolic profiling of urine, serum and plasma has been used to monitor the impact of the pre-analytical steps on the sample quality and stability in order to propose standard operating procedures (SOPs) for deposition in biobanks. We analyzed the quality of serum and plasma samples as a function of the elapsed time (t = 0−4 h) between blood collection and processing and of the time from processing to freezing (up to 24 h). The stability of the urine metabolic profile over time (up to 24 h) at various storage temperatures was monitored as a function of the different pre-analytical treatments like pre-storage centrifugation, filtration, and addition of the bacteriostatic preservative sodium azide. Appreciable changes in the profiles, reflecting changes in the concentration of a number of metabolites, were detected and discussed in terms of chemical and enzymatic reactions for both blood and urine samples. Appropriate procedures for blood derivatives collection and urine preservation/storage that allow maintaining as much as possible the original metabolic profile of the fresh samples emerge, and are proposed as SOPs for biobanking.

  14. Standard operating procedures for pre-analytical handling of blood and urine for metabolomic studies and biobanks

    Energy Technology Data Exchange (ETDEWEB)

    Bernini, Patrizia; Bertini, Ivano, E-mail: bertini@cerm.unifi.it; Luchinat, Claudio [University of Florence, Magnetic Resonance Center (CERM) (Italy); Nincheri, Paola; Staderini, Samuele [FiorGen Foundation (Italy); Turano, Paola [University of Florence, Magnetic Resonance Center (CERM) (Italy)

    2011-04-15

    {sup 1}H NMR metabolic profiling of urine, serum and plasma has been used to monitor the impact of the pre-analytical steps on the sample quality and stability in order to propose standard operating procedures (SOPs) for deposition in biobanks. We analyzed the quality of serum and plasma samples as a function of the elapsed time (t = 0-4 h) between blood collection and processing and of the time from processing to freezing (up to 24 h). The stability of the urine metabolic profile over time (up to 24 h) at various storage temperatures was monitored as a function of the different pre-analytical treatments like pre-storage centrifugation, filtration, and addition of the bacteriostatic preservative sodium azide. Appreciable changes in the profiles, reflecting changes in the concentration of a number of metabolites, were detected and discussed in terms of chemical and enzymatic reactions for both blood and urine samples. Appropriate procedures for blood derivatives collection and urine preservation/storage that allow maintaining as much as possible the original metabolic profile of the fresh samples emerge, and are proposed as SOPs for biobanking.

  15. Revisiting olfactory classical conditioning of the proboscis extension response in honey bees: a step toward standardized procedures.

    Science.gov (United States)

    Matsumoto, Yukihisa; Menzel, Randolf; Sandoz, Jean-Christophe; Giurfa, Martin

    2012-10-15

    The honey bee Apis mellifera has emerged as a robust and influential model for the study of classical conditioning thanks to the existence of a powerful Pavlovian conditioning protocol, the olfactory conditioning of the proboscis extension response (PER). In 2011, the olfactory PER conditioning protocol celebrated its 50 years since it was first introduced by Kimihisa Takeda in 1961. In this protocol, individually harnessed honey bees are trained to associate an odor with sucrose solution. The resulting olfactory learning is fast and induces robust olfactory memories that have been characterized at the behavioral, neuronal and molecular levels. Despite the success of this protocol for studying the bases of learning and memory at these different levels, innumerable procedural variants have arisen throughout the years, which render comparative analyses of behavioral performances difficult. Moreover, because even slight variations in conditioning procedures may introduce significant differences in acquisition and retention performances, we revisit olfactory PER conditioning and define here a standardized framework for experiments using this behavioral protocol. To this end, we present and discuss all the methodological steps and details necessary for successful implementation of olfactory PER conditioning. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. Standard Operating Procedure

    National Research Council Canada - National Science Library

    1997-01-01

    ...) plastic collection bag system. Red blood cell concentrates stored at 4 C in the 800 ml primary plastic collection bag can be biochemically modified to increase the red cell 2,3 DPG and ATP levels...

  17. Design reinforced concrete structures: Differences in procedure, formula, and results between Eurocode 2 and British Standard 8110

    Science.gov (United States)

    Rahim, Mustaqqim Abdul; Ying, Lum Chui; Shahidan, Shahiron; Ghazaly, Zuhayr Md.; Anudai, Shamilah; Bawadi, Nor Faizah; Isa, Nur Fitriah; Hassan, Zulkarnain; Habulat, Afifuddin; Ismail, Zul-Atfi

    2017-09-01

    This research is mainly about comparisons of reinforced concrete structure design based on Eurocode 2 and British Standard 8110. The reinforcement concrete element is designed by referring Eurocode 2 (EN1992-1-1) and British Standard 8110 (BS8110-1:1997) for comparing purpose. The work examples of the structural elements has been done in this research to obtain the area of reinforcement required. The differences in procedure, formula and result of area of steel required for the elements based on both of the codes are compared and tabulated. In this research, there are five part of reinforced concrete structure elements are designed which are continuous beams, one way slabs, braced and short column, pile cap, and cantilever retaining wall. From the result acquired, it shows that area of reinforcement required based on EC 2 is lesser than BS 8110 and the dimension required based on BS8110 is larger than EC 2. Meanwhile, the design based on Eurocode 2 came out with more economical structural elements compare to BS 8110 as lesser steel and concrete volume required.

  18. Assessment of the standard forensic procedure for the evaluation of psychological injury in intimate-partner violence.

    Science.gov (United States)

    Fariña, Francisca; Arce, Ramón; Vilariño, Manuel; Novo, Mercedes

    2014-01-01

    In judicial terms, a victim refers to any person who has suffered injury arising from an action or omission of an action that constitutes an offence, and the burden of proof lies with the prosecution. A review of Spanish judicial judgements underscored that the lack of evidence of psychological injury in cases of intimate-partner violence (IPV) accounted for approximately 40% of acquittals. Thus, the Spanish standard of proof for the forensic evaluation of psychological injury i.e., the MMPI-2 and the unstructured interview were assessed in order to determine if they met the statutory requirement for the assessment of psychological injury and the differential diagnosis of feigning. The results of the comparison of 51 women victims of IPV with firm convictions against their aggressors, and 54 women mock victims of IPV showed that the F, K, Fb, Fp and Ds scales, and the F-K index discriminated significantly and with medium and large effect sizes, between adjudicated and mock victims. However, the results did not provide a valid decision criterion for forensic settings i.e., false negatives (identifying feigner as honest protocols) were not classified correctly. In conclusion, the standard forensic procedure for the evaluation of psychological injury in cases of IPV did not constitute valid proof for judges who acquitted defendants on the grounds of not proven due to the lack of evidence of psychological injury.

  19. Raising the quality of rheumatology management recommendations: lessons from the EULAR process 10 years after provision of standard operating procedures.

    Science.gov (United States)

    Colebatch-Bourn, Alexandra N; Conaghan, Philip G; Arden, Nigel K; Cooper, Cyrus; Dougados, Maxime; Edwards, Christopher J

    2015-08-01

    To increase understanding of how to raise the quality of rheumatology guidelines by reviewing European League Against Rheumatism (EULAR) management recommendations, using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, 10 years after publication of the EULAR standardized operating procedures (SOP) for the production of recommendations. It was hoped that this work could help inform improvements in guideline development by other societies and organizations. The SOP were published in 2004 to ensure the quality of EULAR-endorsed recommendations. We reviewed 27 published EULAR recommendations for management using the AGREE II tool. This provides a framework to assess the quality of guidelines across six broad domains using 23 specific questions. Overall the EULAR recommendations reviewed have been performed to a high standard. There are particular strengths in the methodology and presentation of the guidelines; however, the results indicate areas for development in future recommendations: in particular, stakeholder involvement and applicability of the recommendations. Improvements in quality were evident in recent years, with patient representation in 9 of 15 (60.0%) recommendations published 2010-14 compared with 4 of 12 (33.3%) published 2000-09. In the last 10 years the overall quality of recommendations was good, with standards improving over the decade following publication of the SOP. However, this review process has identified potential areas for improvement, especially in patient representation and provision of implementation tools. The lessons from this work can be applied to the development of rheumatology guidelines by other societies and organizations. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. External quality assurance programs as a tool for verifying standardization of measurement procedures: Pilot collaboration in Europe.

    Science.gov (United States)

    Perich, C; Ricós, C; Alvarez, V; Biosca, C; Boned, B; Cava, F; Doménech, M V; Fernández-Calle, P; Fernández-Fernández, P; García-Lario, J V; Minchinela, J; Simón, M; Jansen, R

    2014-05-15

    Current external quality assurance schemes have been classified into six categories, according to their ability to verify the degree of standardization of the participating measurement procedures. SKML (Netherlands) is a Category 1 EQA scheme (commutable EQA materials with values assigned by reference methods), whereas SEQC (Spain) is a Category 5 scheme (replicate analyses of non-commutable materials with no values assigned by reference methods). The results obtained by a group of Spanish laboratories participating in a pilot study organized by SKML are examined, with the aim of pointing out the improvements over our current scheme that a Category 1 program could provide. Imprecision and bias are calculated for each analyte and laboratory, and compared with quality specifications derived from biological variation. Of the 26 analytes studied, 9 had results comparable with those from reference methods, and 10 analytes did not have comparable results. The remaining 7 analytes measured did not have available reference method values, and in these cases, comparison with the peer group showed comparable results. The reasons for disagreement in the second group can be summarized as: use of non-standard methods (IFCC without exogenous pyridoxal phosphate for AST and ALT, Jaffé kinetic at low-normal creatinine concentrations and with eGFR); non-commutability of the reference material used to assign values to the routine calibrator (calcium, magnesium and sodium); use of reference materials without established commutability instead of reference methods for AST and GGT, and lack of a systematic effort by manufacturers to harmonize results. Results obtained in this work demonstrate the important role of external quality assurance programs using commutable materials with values assigned by reference methods to correctly monitor the standardization of laboratory tests with consequent minimization of risk to patients. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Pigmented Villonodular Synovitis in a Patient who Underwent Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Nevzat Dabak

    2014-09-01

    Full Text Available Pigmented villonodular synovitis (PVNS is a rare, benign, but a locally aggressive tumor. It is characterized by the proliferation of synovial membrane, but it can also be seen in tendon sheaths and bursae. Clinical presentation of solitary lesions include compression and locking of the joint suggesting loose bodies in the joint and a subsequent findings of an effusion, whereas diffuse lesions manifest with pain and chronic swelling. In this article, we presented a curious case of PVNS in a female patient who have been followed up due to an acetabular cystic lesion. She underwent total hip arthroplasty for severe osteoarthritis of the hip joint and associated pain. The diagnosis of PVNS was established intraoperatively. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 235-7

  2. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  3. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2013-01-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  4. Comparison of Test Procedures and Energy Efficiency Criteria in Selected International Standards & Labeling Programs for Copy Machines, External Power Supplies, LED Displays, Residential Gas Cooktops and Televisions

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Nina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Zhou, Nan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fridley, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-03-01

    This report presents a technical review of international minimum energy performance standards (MEPS), voluntary and mandatory energy efficiency labels and test procedures for five products being considered for new or revised MEPS in China: copy machines, external power supply, LED displays, residential gas cooktops and flat-screen televisions. For each product, an overview of the scope of existing international standards and labeling programs, energy values and energy performance metrics and description and detailed summary table of criteria and procedures in major test standards are presented.

  5. Frequency of Helicobacter pylori in patients underwent endoscopy

    Directory of Open Access Journals (Sweden)

    Ahmet Tay

    2012-06-01

    Full Text Available Objectives: The aim of this study was to investigate thefrequency of Helicobacter pylori in patients underwent endoscopyeastern Anatolia.Materials and methods: The patients whose endoscopicantral biopsies were taken for any reason in our endoscopyunit in February-June 2010 period were includedand retrospectively investigated. The frequency of Helicobacterpylori was determined as separating the patientsaccording to general, sex and the age groups. Antral biopsieswere stained with hematoxylin-eosin and modified giemsamethod and examined under light microscope andreported as (+ mild, (++ moderate, (+++ severe positiveaccording to their intensities.Results: Biopsy specimens of 1298 patients were includedinto the study. The mean age was 47.5 ± 17.5 years(range 14-88 and 607 of these patients (47% were male.Histopathological evaluation revealed that, 918 of the patientswere (71% positive and 379 (29% were negativefor Helicobacter pylori. Approximately 60% of our patientshad mild, 29% had moderate and 11% had severe positivityfor Helicobacter pylori. No significant difference wasfound in the frequency of Helicobacter pylori betweenwomen and men. The frequencies of Helicobacter pyloriwere 73.2%, 71.5%, 68.6% and 70.4%, respectively, inthe age groups of 14-30 years, 31-45 years, 46-60 yearsand 61-88 years.Conclusion: The frequency of Helicobacter pylori was71% in Eastern Anatolia Region. No statistically significantdifference was found between genders and agegroups in term of the frequency of Helicobacter pylori.

  6. Standard Operating Procedures, ethical and legal regulations in BTB (Brain/Tissue/Bio) banking: what is still missing?

    Science.gov (United States)

    Ravid, Rivka

    2008-06-01

    The use of human biological specimens in scientific research is the focus of current international public and professional concern and a major issue in bioethics in general. Brain/Tissue/Bio banks (BTB-banks) are a rapid developing sector; each of these banks acts locally as a steering unit for the establishment of the local Standard Operating Procedures (SOPs) and the legal regulations and ethical guidelines to be followed in the procurement and dissemination of research specimens. An appropriat Code of Conduct is crucial to a successful operation of the banks and the research application they handle. What are we still missing ? (1) Adequate funding for research BTB-banks. (2) Standard evaluation protocls for audit of BTB-bank performance. (3) Internationally accepted SOP's which will facilitate exchange and sharing of specimens and data with the scientific community. (4) Internationally accepted Code of Conduct. In the present paper we review the most pressing organizational, methodological, medico-legal and ethical issues involved in BTB-banking; funding, auditing, procurement, management/handling, dissemination and sharing of specimens, confidentiality and data protection, genetic testing, "financial gain" and safety measures. Taking into consideration the huge variety of the specimens stored in different repositories and the enormous differences in medico-legal systems and ethics regulations in different countries it is strongly recommend that the health-care systems and institutions who host BTB-Banks will put more efforts in getting adequate funding for the infrastructure and daily activities. The BTB-banks should define evaluation protocols, SOPs and their Code of Conduct. This in turn will enable the banks to share the collected specimens and data with the largest possible number of researchers and aim at a maximal scientific spin-off and advance in public health research.

  7. Enumeration of heterotrophs, fecal coliforms and Escherichia coli in water: comparison of 3M Petrifilm plates with standard plating procedures.

    Science.gov (United States)

    Schraft, H; Watterworth, L A

    2005-03-01

    A total of 177 naturally contaminated water samples were analyzed by membrane filtration according to the Standard Methods for the Examination of Water and Wastewater published by the American Public Health Association. Filters were incubated in parallel on mHPC-agar and 3M Petrifilm Aerobic Count Plates (Petrifilm AC plates) for heterotrophic counts. Fecal coliforms and Escherichia coli were enumerated on mFC-agar and 3M Petrifilm E. coli/Coliform Count Plates (Petrifilm EC plates). Typical colonies on each media type were confirmed following standard procedures. Heterotrophic counts were between 10(3) and 10(4) CFU/mL and the average log10 counts obtained on Petrifilm AC plates were about two-fold lower than on mHPC-agar. Counts for fecal coliforms and E. coli were between 10(2) and 10(3) CFU/mL. Average log10 counts for confirmed fecal coliforms obtained on Petrifilm EC plates were slightly lower than on mFC agar with a correlation coefficient of 0.949. The average log10 counts for confirmed E. coli on Petrifilm EC plates and on mFC agar were statistically not different (P=0.126) with a correlation coefficient of 0.879. Specificity of Petrifilm EC plates and mFC agar was evaluated by comparing typical colony counts with confirmed counts. On mFC agar, counts for typical colonies were by 2 log10 CFU higher than the actual confirmed counts. In contrast, on Petrifilm EC plates typical colony counts were almost identical to confirmed colony counts for both fecal coliforms and E. coli. This comparison illustrates the high specificity of Petrifilm EC plates for enumeration of both fecal coliforms and E. coli in water.

  8. Standard Operating Procedures, ethical and legal regulations in BTB (Brain/Tissue/Bio) banking: what is still missing?

    Science.gov (United States)

    Ravid, Rivka

    2008-09-01

    The use of human biological specimens in scientific research is the focus of current international public and professional concern and a major issue in bioethics in general. Brain/Tissue/Bio banks (BTB-banks) are a rapid developing sector; each of these banks acts locally as a steering unit for the establishment of the local Standard Operating Procedures (SOPs) and the legal regulations and ethical guidelines to be followed in the procurement and dissemination of research specimens. An appropriat Code of Conduct is crucial to a successful operation of the banks and the research application they handle. What are we still missing ? (1) Adequate funding for research BTB-banks. (2) Standard evaluation protocls for audit of BTB-bank performance. (3) Internationally accepted SOP's which will facilitate exchange and sharing of specimens and data with the scientific community. (4) Internationally accepted Code of Conduct. In the present paper we review the most pressing organizational, methodological, medico-legal and ethical issues involved in BTB-banking; funding, auditing, procurement, management/handling, dissemination and sharing of specimens, confidentiality and data protection, genetic testing, "financial gain" and safety measures. Taking into consideration the huge variety of the specimens stored in different repositories and the enormous differences in medico-legal systems and ethics regulations in different countries it is strongly recommend that the health-care systems and institutions who host BTB-Banks will put more efforts in getting adequate funding for the infrastructure and daily activities. The BTB-banks should define evaluation protocols, SOPs and their Code of Conduct. This in turn will enable the banks to share the collected specimens and data with the largest possible number of researchers and aim at a maximal scientific spin-off and advance in public health research.

  9. Calibration of photon and beta ray sources used in brachytherapy. Guidelines on standardized procedures at Secondary Standards Dosimetry Laboratories (SSDLs) and hospitals

    International Nuclear Information System (INIS)

    2002-03-01

    It has generally been recognized that international harmonization in radiotherapy dosimetry is essential. Consequently, the IAEA has given much effort to this, for example by publishing a number of reports in the Technical Reports Series (TRS) for external beam dosimetry, most notably TRS-277 and more recently TRS-398. Both of these reports describe in detail the steps to be taken for absorbed dose determination in water and they are often referred to as 'dosimetry protocols'. Similar to TRS-277, it is expected that TRS-398 will be adopted or used as a model by a large number of countries as their national protocol. In 1996, the IAEA established a calibration service for low dose rate (LDR) 137 Cs brachytherapy sources, which is the most widely used source for treatment of gynecological cancer. To further enhance harmonization in brachytherapy dosimetry, the IAEA published in 1999 IAEA-TECDOC-1079 entitled 'Calibration of Brachytherapy Sources. Guidelines on Standardized Procedures for the Calibration of Brachytherapy Sources at Secondary Standard Dosimetry Laboratories (SSDLs) and Hospitals'. The report was well received and was distributed in a large number of copies to the members of the IAEA/WHO network of SSDLs and to medical physicists working with brachytherapy. The present report is an update of the aforementioned TECDOC. Whereas TECDOC-1079 described methods for calibrating brachytherapy sources with photon energies at or above those of 192 Ir, the current report has a wider scope in that it deals with standardization of calibration of all the most commonly used brachytherapy sources, including both photon and beta emitting sources. The latter sources have been in use for a few decades already, but their calibration methods have been unclear. Methods are also described for calibrating sources used in the rapidly growing field of cardiovascular angioplasty. In this application, irradiation of the vessel wall is done in an attempt to prevent restenosis after

  10. Evaluasi Penerapan Standard Operating Procedure-Good Agriculture Practice (SOP-GAP pada Usahatani Padi Organik di Kabupaten Bantul

    Directory of Open Access Journals (Sweden)

    Sriyadi Sriyadi

    2016-02-01

    Full Text Available Food security has meaning not only the availability of adequate food, but also providing security for producers and consumers and ensuring environmental sustainability for sustainable production. Organic farming systems are expected to solve the problem for realizing food security and enhancement of people's welfare. The results of research indicated that, (1 The implementation level of Standard Operating Procedure-Good Agriculture Practice (SOP-GAP of Organic Rice Farming in Bantul district was quite high, (2 The implementation level of SOP-GAP of Organic Rice Farming related to the availability of capital, the selling price and the purchase price of inputs (seeds and fertilizers, (3 The level of the farmer's decision related to the implementation level of SOP-GAP of organic rice farming, and (4 development of organic rice farming required availability of sufficient capital. In this regard the government, particularly the agriculture authority and food security agency need to disburse or facilitate capital for farmers in revolving as well as low interest loans.

  11. Standard operating procedure for air quality stationary source management at Air Force installations in the Air Force Materiel Command

    Energy Technology Data Exchange (ETDEWEB)

    Powell, C.M.; Ryckman, S.J. [Headquarters Air Force Materiel Command, Wright-Patterson AFB, OH (United States). Environmental Compliance Branch

    1997-12-31

    To sustain compliance and avoid future enforcement actions associated with air quality stationary sources and to provide installation commanders with a certification process for Title V permitting, and Air Force Materiel Command (AFMC) Standard Operating Procedure (SOP) for Stationary Source Management has been developed. The SOP consists of two major sections: Stationary Source Planning and Administration, and Stationary Source Operations These two main sections are further subdivided into twelve subsections which delineate requirements (e.g. maintaining inventories, applying for and maintaining permits, keeping records, reporting and certifying compliance) and assign ownership of processes and responsibilities (e.g. appointing a manager/alternate for each identified stationary air source). In addition, the SOP suggests training that should be provided from operator to commander levels to ensure that all personnel involved with a stationary air source are aware of their responsibilities. Implementation of the SOP should provide for the essential control necessary for installation commanders to eliminate stationary air source non-compliance and to certify compliance in accordance with the Title V Operating Permit requirements. This paper will discuss: the background and purpose for the SOPs content, the twelve subsections of the SOP, the success of implementation at various installations, the relevance or the recommended training, the success of negotiating with various labor unions for SOP implementation and the success of the SOP in reference to its intended purpose.

  12. Test Standard Revision Update: JESD57, "Procedures for the Measurement of Single-Event Effects in Semiconductor Devices from Heavy-Ion Irradiation"

    Science.gov (United States)

    Lauenstein, Jean-Marie

    2015-01-01

    The JEDEC JESD57 test standard, Procedures for the Measurement of Single-Event Effects in Semiconductor Devices from Heavy-Ion Irradiation, is undergoing its first revision since 1996. In this talk, we place this test standard into context with other relevant radiation test standards to show its importance for single-event effect radiation testing for space applications. We show the range of industry, government, and end-user party involvement in the revision. Finally, we highlight some of the key changes being made and discuss the trade-space in which setting standards must be made to be both useful and broadly adopted.

  13. Final Rule for Control of Air Pollution from Aircraft and Aircraft Engines: Emission Standards and Test Procedures

    Science.gov (United States)

    EPA is amending the existing emission standards for oxides of nitrogen (NOx) for new commercial aircraft engines. These standards are equivalent to the NOx emission standards of the United Nations International Civil Aviation Organization (ICAO).

  14. Direct Final Rule for Control of Air Pollution From Aircraft and Aircraft Engines; Emission Standards and Test Procedures

    Science.gov (United States)

    This rule will adopt the current voluntary NOx and CO emissions standards of the United Nations International Civil Aviation Organization (ICAO), bringing the United States aircraft standards into alignment with the international standards.

  15. Development and operation of a quality assurance system for deviations from standard operating procedures in a clinical cell therapy laboratory.

    Science.gov (United States)

    McKenna, D; Kadidlo, D; Sumstad, D; McCullough, J

    2003-01-01

    Errors and accidents, or deviations from standard operating procedures, other policy, or regulations must be documented and reviewed, with corrective actions taken to assure quality performance in a cellular therapy laboratory. Though expectations and guidance for deviation management exist, a description of the framework for the development of such a program is lacking in the literature. Here we describe our deviation management program, which uses a Microsoft Access database and Microsoft Excel to analyze deviations and notable events, facilitating quality assurance (QA) functions and ongoing process improvement. Data is stored in a Microsoft Access database with an assignment to one of six deviation type categories. Deviation events are evaluated for potential impact on patient and product, and impact scores for each are determined using a 0- 4 grading scale. An immediate investigation occurs, and corrective actions are taken to prevent future similar events from taking place. Additionally, deviation data is collectively analyzed on a quarterly basis using Microsoft Excel, to identify recurring events or developing trends. Between January 1, 2001 and December 31, 2001 over 2500 products were processed at our laboratory. During this time period, 335 deviations and notable events occurred, affecting 385 products and/or patients. Deviations within the 'technical error' category were most common (37%). Thirteen percent of deviations had a patient and/or a product impact score > or = 2, a score indicating, at a minimum, potentially affected patient outcome or moderate effect upon product quality. Real-time analysis and quarterly review of deviations using our deviation management program allows for identification and correction of deviations. Monitoring of deviation trends allows for process improvement and overall successful functioning of the QA program in the cell therapy laboratory. Our deviation management program could serve as a model for other laboratories in

  16. PFGE standard operating procedures for Listeria monocytogenes: harmonizing the typing of food and clinical strains in Europe.

    Science.gov (United States)

    Michelon, Damien; Félix, Benjamin; Vingadassalon, Noemie; Mariet, Jean-François; Larsson, Jonas T; Møller-Nielsen, Eva; Roussel, Sophie

    2015-03-01

    Listeria monocytogenes is a foodborne pathogen responsible for a severe disease known as listeriosis. The European Centre for Disease Prevention and Control (ECDC) coordinates a network of national public health laboratories (NPHLs) in charge of typing clinical strains. In food, it is the European Union Reference Laboratory for L. monocytogenes (EURL Lm), which manages a network of National Reference Laboratories (NRLs). A pulsed-field gel electrophoresis (PFGE) standard operating procedure (EURL SOP) has been used routinely at the EURL Lm since 2007. The EURL Lm has recommended that NRLs use the EURL SOP, whereas the Statens Serum Institut (SSI), under contract for ECDC, requested that NPHLs use Halpins' SOP (HSOP) published in 2010 for the PulseNet USA network. An update of Halpins' SOP (uHSOP) was published in 2013. To facilitate the exchange of profiles among human and food European reference laboratories, it is crucial to ensure that the PFGE profiles obtained with these different SOPs are comparable. The aim here was to compare the EURL SOP with HSOP and uHSOP. The panel comprised 114 well-characterized SSI/EURL strains. All were characterized at the EURL using both the EURL SOP and uHSOP. Seventy of the 114 strains were also characterized at the SSI using HSOP. The EURL SOP and uHSOP produced indistinguishable combined (ApaI/AscI) profiles for the 114 strains tested. The EURL SOP and HSOP produced indistinguishable combined profiles for 69 of the 70 strains tested. One strain displayed for the AscI profile an additional low-intensity band at 184 kbp with HSOP. For this strain, SSI and EUR Lm had already observed the same profile from NPHLs and NRLs. However, this deviation is minor as it accounted for about 1% of all the 114 combined profiles. This study should facilitate the exchange of reproducible PFGE profiles among human and food reference laboratories.

  17. Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Alain Moré Duarte

    2016-01-01

    Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

  18. [Falling Short of Minimum Volume Standards, Exemptions and Their Consequences from 2018 Onwards. Complex Procedures on Oesophagus and Pancreas in German Hospitals from 2006 to 2014].

    Science.gov (United States)

    de Cruppé, Werner; Geraedts, Max

    2018-03-16

    The minimum volume standards for hospitals in Germany, in force since 2004, provide four exemptions for non-complying hospitals. This study investigates the extent and importance of these exemptions for complex procedures on the oesophagus and pancreas for all non-complying hospitals and for the revised minimum volume regulations in force since the beginning of 2018. Longitudinal, descriptive analyses of data on minimum volume standards and their exemptions for complex procedures on the oesophagus and pancreas, as presented by the hospital quality report cards of the reporting years from 2006 to 2014. For each year and both procedures, about 120 hospitals with some 500 cases report non-compliance with the minimum volume standards. Of these a third report no exemptions (with 180 procedures), a third state emergencies (110), and another third report exemptions due to internal hospital restructuring (210). Ensuring geographical access to care as an exemption is of no importance. After the three year exemption period for installation of a new service line, 20% of the hospitals with procedures on the oesophagus and 30% on the pancreas complied with the minimum volume standards. After the two-year period for staff realignment, the figures were 40 and 50%, respectively. Exemptions do not entirely explain all procedures performed by hospitals not complying with the minimum volume standards. The revised minimum volume regulations' restructuring of exemptions to "emergencies" and "new or renewed service lines" with a two year exemption period, are concordant with the empirical findings of this study. Georg Thieme Verlag KG Stuttgart · New York.

  19. The tsunami probabilistic risk assessment (PRA). Example of accident sequence analysis of tsunami PRA according to the standard for procedure of tsunami PRA for nuclear power plants

    International Nuclear Information System (INIS)

    Ohara, Norihiro; Hasegawa, Keiko; Kuroiwa, Katsuya

    2013-01-01

    After the Fukushima Daiichi nuclear power plant (NPP) accident, standard for procedure of tsunami PRA for NPP had been established by the Standardization Committee of AESJ. Industry group had been conducting analysis of Tsunami PRA for PWR based on the standard under the cooperation with electric utilities. This article introduced overview of the standard and examples of accident sequence analysis of Tsunami PRA studied by the industry group according to the standard. The standard consisted of (1) investigation of NPP's composition, characteristics and site information, (2) selection of relevant components for Tsunami PRA and initiating events and identification of accident sequence, (3) evaluation of Tsunami hazards, (4) fragility evaluation of building and components and (5) evaluation of accident sequence. Based on the evaluation, countermeasures for further improvement of safety against Tsunami could be identified by the sensitivity analysis. (T. Tanaka)

  20. U.S. Geological Survey Noble Gas Laboratory’s standard operating procedures for the measurement of dissolved gas in water samples

    Science.gov (United States)

    Hunt, Andrew G.

    2015-08-12

    This report addresses the standard operating procedures used by the U.S. Geological Survey’s Noble Gas Laboratory in Denver, Colorado, U.S.A., for the measurement of dissolved gases (methane, nitrogen, oxygen, and carbon dioxide) and noble gas isotopes (helium-3, helium-4, neon-20, neon-21, neon-22, argon-36, argon-38, argon-40, kryton-84, krypton-86, xenon-103, and xenon-132) dissolved in water. A synopsis of the instrumentation used, procedures followed, calibration practices, standards used, and a quality assurance and quality control program is presented. The report outlines the day-to-day operation of the Residual Gas Analyzer Model 200, Mass Analyzer Products Model 215–50, and ultralow vacuum extraction line along with the sample handling procedures, noble gas extraction and purification, instrument measurement procedures, instrumental data acquisition, and calculations for the conversion of raw data from the mass spectrometer into noble gas concentrations per unit mass of water analyzed. Techniques for the preparation of artificial dissolved gas standards are detailed and coupled to a quality assurance and quality control program to present the accuracy of the procedures used in the laboratory.

  1. Random access procedures and radio access network (RAN) overload control in standard and advanced long-term evolution (LTE and LTE-A) networks

    DEFF Research Database (Denmark)

    Kiilerich Pratas, Nuno; Thomsen, Henning; Popovski, Petar

    2015-01-01

    In this chapter, we describe and discuss the current LTE random access procedure and the Radio Access Network Load Control solution within LTE/LTE-A. We provide an overview of the several considered load control solutions and give a detailed description of the standardized Extended Access Class B...

  2. Diagnosis and dosimetry of exposure to sulfur mustard: Development of a standard operating procedure for hemoglobin adducts: Exploratory research on albumin and keratin adducts

    NARCIS (Netherlands)

    Noort, D.; Fidder, A.; Jong, L.P.A. de; Schans, G.P. van der; Benschop, H.P.

    2000-01-01

    A standard operating procedure (SOP) for determination of the sulfur mustard adduct to the N-terminal valine in hemoglobin was developed. By using this SOP, it was found that the Nterminal valine adduct in globin of hairless guinea pigs and marmosets which had been exposed to sulfur mustard (0.5

  3. An umbrella protocol for standardized data collection (SDC) in rectal cancer: a prospective uniform naming and procedure convention to support personalized medicine.

    Science.gov (United States)

    Meldolesi, Elisa; van Soest, Johan; Dinapoli, Nicola; Dekker, Andre; Damiani, Andrea; Gambacorta, Maria Antonietta; Valentini, Vincenzo

    2014-07-01

    Predictive models allow treating physicians to deliver tailored treatment moving from prescription by consensus to prescription by numbers. The main features of an umbrella protocol for standardizing data and procedures to create a consistent dataset useful to obtain a trustful analysis for a Decision Support System for rectal cancer are reported. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Diagnosis and dosimetry of exposure to sulfur mustard: Development of a standard operating procedure for mass spectrometric analysis of haemoglobin adducts - Exploratory research on albumin and keratin adducts

    NARCIS (Netherlands)

    Noort, D.; Fidder, A.; Hulst, A.G.; Jong, L.P.A. de; Benschop, H.P.

    2000-01-01

    Experiments were carried out to develop a standard operating procedure for analysis of sulfur mustard adducts to the N-terminal valine in haemoglobin and to explore adduct formation with albumin and keratin. In the first approach, gas chromatography-negative chemical ionization/mass spectrometry

  5. A Guide for Developing Standard Operating Job Procedures for the Activated Sludge - Aeration & Sedimentation Process Wastewater Treatment Facility. SOJP No. 5.

    Science.gov (United States)

    Mason, George J.

    This guide for developing standard operating job procedures for wastewater treatment facilities is devoted to the activated sludge aeration and sedimentation process. This process is for conversion of nonsettleable and nonfloatable materials in wastewater to settleable, floculated biological groups and separation of the settleable solids from the…

  6. Transfer of near-infrared calibration model for determining fiber content in flax: effects of transfer samples and standardization procedure.

    Science.gov (United States)

    Sohn, Miryeong; Barton, Franklin E; Himmelsbach, David S

    2007-04-01

    The transfer of a calibration model for determining fiber content in flax stem was accomplished between two near-infrared spectrometers, which are the same brand but which require a standardization. In this paper, three factors, including transfer sample set, spectral type, and standardization method, were investigated to obtain the best standardization result. Twelve standardization files were produced from two sets of the transfer sample (sealed reference standards and a subset of the prediction set), two types of the transfer sample spectra (raw and preprocessed spectra), and three standardization methods (direct standardization (DS), piecewise direct standardization (PDS), and double window piecewise direct standardization (DWPDS)). The efficacy of the model transfer was evaluated based on the root mean square error of prediction, calculated using the independent prediction samples. Results indicated that the standardization using the sealed reference standards was unacceptable, but the standardization using the prediction subset was adequate. The use of the preprocessed spectra of the transfer samples led to the calibration transfers that were successful, especially for the PDS and the DWPDS correction. Finally, standardization using the prediction subset and their preprocessed spectra with DWPDS correction proved to be the best method for transferring the model.

  7. 16 CFR 1616.35 - Use of alternate apparatus, procedures, or criteria for testing under the standard.

    Science.gov (United States)

    2010-01-01

    ... SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY OF CHILDREN'S SLEEPWEAR... converter) initially introducing items subject to the Standard into commerce to group items into production units, and to test samples from each production unit. See 16 CFR 1616.4. The Standard prescribes an...

  8. 16 CFR 1615.35 - Use of alternate apparatus, procedures, or criteria for testing under the standard.

    Science.gov (United States)

    2010-01-01

    ... SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD FOR THE FLAMMABILITY OF CHILDREN'S SLEEPWEAR... converter) initially introducing items subject to the Standard into commerce to group items into production units, and to test samples from each production unit. See 16 CFR 1615.4 (b), (c) and (d). The Standard...

  9. PENYUSUNAN DRAFT STANDARD OPERATING PROCEDURE (SOP PENGOLAHAN KERIPIK PISANG (STUDI KASUS DI SALAH SATU INDUSTRI RUMAH TANGGA KERIPIK PISANG BANDAR LAMPUNG

    Directory of Open Access Journals (Sweden)

    Didit Haryanto

    2013-09-01

    Full Text Available Standard operating procedure (SOP is a procedure or steps which is standardized and must be passed to complete a particular work process. Arranging SOP draft is based on a review of Good Manufacture Practice. SOP is made for being a guide line in doing process in an industry. Purposes of this research is arranging SOP draft for home industries of banana chips making, so the product will meet the standard. In this research, drafting standard operating procedure (SOP of the banana chips industry was begun with observating and recording every detail process. The research was conducted through four steps. Firstly, field observation to observate  process, including sanitation, tools specification, and description about step of processing banana chips. Second step was determining the critical point and optimating the condition. The next step was arranging the SOP draft. The last was the testing of SOP draft. Then the data were compared and discussed descriptively.  The result was a SOP draft which was used as in processing banana chips the products consistenly had meet the standard quality of SNI 01-4315-1996, they include moisture content, ash content, fat content, wholeness, with flavor, aroma, color, and texture.  The analysis data are, Moisture content (0,17%, ash content (1,35%, fat content (27,90% and wholeness (88,00%. Otherwise the data analysis for banana chips that produce without SOP are, moisture content (0,15%, ash content (1,88%, fat content (39,41% and wholeness (83,00%. Keywords: standard operating procedure (SOP, banana chips, consistency of quality

  10. Diagnosis and Dosimetry of Exposure to Sulfur Mustard: Development of Standard Operating Procedures; Further Exploratory Research on Protein Adducts

    National Research Council Canada - National Science Library

    Benschop, H

    1999-01-01

    .... Both procedures could be substantially shortened, while their sensitivities were improved. Furthermore, exploratory research is performed aiming at the development of a fieldable immunochemical assay for sulfur mustard adducts with proteins, i.e...

  11. Effective reduction of fluoroscopy duration by using an advanced electroanatomic-mapping system and a standardized procedural protocol for ablation of atrial fibrillation: 'the unleaded study'.

    Science.gov (United States)

    Knecht, Sven; Sticherling, Christian; Reichlin, Tobias; Pavlovic, Nikola; Mühl, Aline; Schaer, Beat; Osswald, Stefan; Kühne, Michael

    2015-11-01

    It is recommended to keep exposure to ionizing radiation as low as reasonably achievable. The aim of this study was to determine whether fluoroscopy-free mapping and ablation using a standardized procedural protocol is feasible in patients undergoing pulmonary vein isolation (PVI). Sixty consecutive patients were analysed: Thirty consecutive patients undergoing PVI using Carto3 were treated using a standardized procedural fluoroscopy protocol with X-ray being disabled after transseptal puncture (Group 1) and compared with a set of previous 30 consecutive patients undergoing PVI without a specific recommendation regarding the use of fluoroscopy (Group 2). The main outcome measures were the feasibility of fluoroscopy-free mapping and ablation, total fluoroscopy time, total dose area product (DAP), and procedure time. Sixty patients (age 60 ± 10 years, 73% male, ejection fraction 0.55 ± 0.09, left atrium 42 ± 8 mm) were included. In Group 1, total fluoroscopy time was 4.2 (2.6-5.6) min and mapping and ablation during PVI without using fluoroscopy was feasible in 29 of 30 patients (97%). In Group 2, total fluoroscopy time was 9.3 (6.4-13.9) min (P fluoroscopy after transseptal puncture using a standardized procedural protocol is feasible in almost all patients and is associated with markedly decreased total fluoroscopy duration and DAP. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  12. Assessing the reliability of the borderline regression method as a standard setting procedure for objective structured clinical examination

    Directory of Open Access Journals (Sweden)

    Sara Mortaz Hejri

    2013-01-01

    Full Text Available Background: One of the methods used for standard setting is the borderline regression method (BRM. This study aims to assess the reliability of BRM when the pass-fail standard in an objective structured clinical examination (OSCE was calculated by averaging the BRM standards obtained for each station separately. Materials and Methods: In nine stations of the OSCE with direct observation the examiners gave each student a checklist score and a global score. Using a linear regression model for each station, we calculated the checklist score cut-off on the regression equation for the global scale cut-off set at 2. The OSCE pass-fail standard was defined as the average of all station′s standard. To determine the reliability, the root mean square error (RMSE was calculated. The R2 coefficient and the inter-grade discrimination were calculated to assess the quality of OSCE. Results: The mean total test score was 60.78. The OSCE pass-fail standard and its RMSE were 47.37 and 0.55, respectively. The R2 coefficients ranged from 0.44 to 0.79. The inter-grade discrimination score varied greatly among stations. Conclusion: The RMSE of the standard was very small indicating that BRM is a reliable method of setting standard for OSCE, which has the advantage of providing data for quality assurance.

  13. Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

    Directory of Open Access Journals (Sweden)

    Alessandro Varrica

    2015-01-01

    Full Text Available Background. S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB, has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. Methods. We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN measurement were drawn at five perioperative time-points. Results. S100B showed a significant increase from hospital admission up to 24 h after procedure reaching its maximum peak (P0.05 have been found all along perioperative monitoring. ADN/S100B ratio pattern was identical to S100B alone with the higher peak at the end of CPB and remained higher up to 24 h from surgery. Conclusions. The present study provides evidence that, in CHD infants, S100B protein is not affected by an extra-source adipose tissue release as suggested by no changes in circulating ADN concentrations.

  14. Comparison of Test Procedures and Energy Efficiency Criteria in Selected International Standards and Labeling Programs for Clothes Washers, Water Dispensers, Vending Machines and CFLs

    Energy Technology Data Exchange (ETDEWEB)

    Fridley, David; Zheng, Nina; Zhou, Nan

    2010-06-01

    Since the late 1970s, energy labeling programs and mandatory energy performance standards have been used in many different countries to improve the efficiency levels of major residential and commercial equipment. As more countries and regions launch programs covering a greater range of products that are traded worldwide, greater attention has been given to harmonizing the specific efficiency criteria in these programs and the test methods for measurements. For example, an international compact fluorescent light (CFL) harmonization initiative was launched in 2006 to focus on collaboration between Australia, China, Europe and North America. Given the long history of standards and labeling programs, most major energy-consuming residential appliances and commercial equipment are already covered under minimum energy performance standards (MEPS) and/or energy labels. For these products, such as clothes washers and CFLs, harmonization may still be possible when national MEPS or labeling thresholds are revised. Greater opportunity for harmonization exists in newer energy-consuming products that are not commonly regulated but are under consideration for new standards and labeling programs. This may include commercial products such as water dispensers and vending machines, which are only covered by MEPS or energy labels in a few countries or regions. As China continues to expand its appliance standards and labeling programs and revise existing standards and labels, it is important to learn from recent international experiences with efficiency criteria and test procedures for the same products. Specifically, various types of standards and labeling programs already exist in North America, Europe and throughout Asia for products in China's 2010 standards and labeling programs, namely clothes washers, water dispensers, vending machines and CFLs. This report thus examines similarities and critical differences in energy efficiency values, test procedure specifications and

  15. Development and evaluation of Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in a Nuclear Medicine Service

    International Nuclear Information System (INIS)

    Krempser, Alexandre R.; Soares, Alexandre B.; Corbo, Rossana

    2011-01-01

    The quality management in Nuclear Medicine Services is a requirement of national and international standards. The Brazilian regulatory agency in health surveillance, the Agencia Nacional de Vigilancia Sanitaria (ANVISA), in its Resolucao de Diretoria Colegiada (Collegiate Directory Resolution) no. 38, requires the elaboration of documents describing the technical and clinical routine activities. This study aimed to elaborate, implement and evaluate Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in the Nuclear Medicine Service of a university hospital. Eighteen SOPs were developed, involving tasks related to dose calibrator, gamma camera, Geiger-Muller detectors and radiological protection activities. The performance of its application was evaluated for a period of six months. It was observed a reduction in 75% of reported operational errors and 42% of the number of reported incidents with contamination by radioactive material. The SOPs were adequate and successful in its application. New procedures involving clinical activities will also be developed and evaluated. (author)

  16. Coracoid bone graft osteolysis after Latarjet procedure: A comparison study between two screws standard technique vs mini-plate fixation

    Science.gov (United States)

    Giacomo, Giovanni Di; Costantini, Alberto; de Gasperis, Nicola; De Vita, Andrea; Lin, Bernard K. H.; Francone, Marco; Beccaglia, Mario A. Rojas; Mastantuono, Marco

    2013-01-01

    Aims: One of the reason for Latarjet procedure failure may be coracoid graft osteolysis. In this study, we aimed to understand if a better compression between the coracoid process and the glenoid, using a mini-plate fixation during the Latarjet procedure, could reduce the amount of coracoid graft osteolysis. Materials and Methods: A computed tomography scan analysis of 26 prospectively followed-up patients was conducted after modified Latarjet procedure using mini-plate fixation technique to determine both the location and the amount of coracoid graft osteolysis in them. We then compared our current results with results from that of our previous study without using mini-plate fixation to determine if there is any statistical significant difference in terms of corcacoid bone graft osteolysis between the two surgical techniques. Results: The most relevant osteolysis was represented by the superficial part of the proximal coracoid, whereas the deep part of the proximal coracoid graft is least involved in osteolysis and has best bone healing. The current study showed a significant difference only for the deep part of the distal coracoid with our previous study (P Latarjet procedure. Conclusion: Our study suggests that there is a significant difference only for the deep part of the distal coracoid in terms of osteolysis. At clinical examination, this difference did not correspond with any clinical findings. Level of Evidence: Level 4. Clinical Relevance: Prospective case series, Treatment study. PMID:23858288

  17. Enhancing Title Ix Due Process Standards in Campus Sexual Assault Adjudication: Considering the Roles of Distributive, Procedural, and Restorative Justice

    Science.gov (United States)

    Harper, Shannon; Maskaly, Jon; Kirkner, Anne; Lorenz, Katherine

    2017-01-01

    Title IX prohibits sex discrimination--including sexual assault--in higher education. The Department of Education Office for Civil Rights' 2011 "Dear Colleague Letter" outlines recommendations for campus sexual assault adjudication allowing a variety of procedures that fail to protect accused students' due process rights and victims'…

  18. 40 CFR 1045.515 - What are the test procedures related to not-to-exceed standards?

    Science.gov (United States)

    2010-07-01

    ... emissions with one of the following procedures: (1) Remove the selected engines for testing in a laboratory....075 (5) For two-stroke engines not equipped with a catalyst, the NTE zone described in paragraph (c)(3... cycle: (i) Mode 1: Operate the engine at wide open throttle. For laboratory testing, this may involve...

  19. Final Rule for Control of Air Pollution From Aircraft and Aircraft Engines; Emission Standards and Test Procedures

    Science.gov (United States)

    EPA adopted emission standards and related provisions for aircraft gas turbine engines with rated thrusts greater than 26.7 kilonewtons. These engines are used primarily on commercial passenger and freight aircraft.

  20. Patient Recall of Informed Consent at 4 Weeks After Total Hip Replacement With Standardized Versus Procedure-Specific Consent Forms.

    Science.gov (United States)

    Pomeroy, Eoghan; Shaarani, Shahril; Kenyon, Robert; Cashman, James

    2017-08-25

    Informed consent plays a pivotal role in the operative process, and surgeons have an ethical and legal obligation to provide patients with information to allow for shared decision-making. Unfortunately, patient recall after the consent process is frequently poor. This study aims to evaluate the effect of procedure-specific consent forms on patient's recall four weeks after total hip replacement (THR). This is a prospective study using a posttest-only control group design. Sixty adult patients undergoing total hip replacement were allocated to be consented using either the generic or the surgery-specific consent form. Four weeks after surgery, a phone interview was conducted to assess patient's recall of risk of surgical complications. Patient demographic characteristics and educational attainment were similar in both groups. There was a statistically significant increase in the mean number of risks recalled in the study group at 1.43 compared with 0.67 in the control group (P = 0.0131). Consent is a complex process, and obtaining informed consent is far from straightforward. A statistically significant improvement in patient's recall with the use of procedure-specific consent forms was identified, and based on this, we would advocate their use. However, overall patient recall in both groups was poor. We believe that improving the quality of informed consent may require the sum of small gains, and the use of procedure-specific consent forms may aid in this regard.

  1. A proposal of Brazilian Society of Surgical Oncology for standardizing cytoreductive surgery plus hypertermic intraperitoneal chemotherapy procedures in Brazil: pseudomixoma peritonei, appendiceal tumors and malignant peritoneal mesothelioma

    Directory of Open Access Journals (Sweden)

    Thales Paulo Batista

    Full Text Available ABSTRACT Cytoreductive surgery plus hypertermic intraperitoneal chemotherapy has emerged as a major comprehensive treatment of peritoneal malignancies and is currently the standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome as well as malignant peritoneal mesothelioma. Unfortunately, there are some worldwide variations of the cytoreductive surgery and hypertermic intraperitoneal chemotherapy techniques since no single technique has so far demonstrated its superiority over the others. Therefore, standardization of practices might enhance better comparisons between outcomes. In these settings, the Brazilian Society of Surgical Oncology considered it important to present a proposal for standardizing cytoreductive surgery plus hypertermic intraperitoneal chemotherapy procedures in Brazil, with a special focus on producing homogeneous data for the developing Brazilian register for peritoneal surface malignancies.

  2. A Randomized Controlled Trial to Compare e-Feedback Versus "Standard" Face-to-Face Verbal Feedback to Improve the Acquisition of Procedural Skill.

    Science.gov (United States)

    Al-Jundi, Wissam; Elsharif, Mohamed; Anderson, Melanie; Chan, Phillip; Beard, Jonathan; Nawaz, Shah

    Constructive feedback plays an important role in learning during surgical training. Standard feedback is usually given verbally following direct observation of the procedure by a trained assessor. However, such feedback requires the physical presence of expert faculty members who are usually busy and time-constrained by clinical commitments. We aim to evaluate electronic feedback (e-feedback) after video observation of surgical suturing in comparison with standard face-to-face verbal feedback. A prospective, blinded, randomized controlled trial comparing e-feedback with standard verbal feedback was carried out in February 2015 using a validated pro formas for assessment. The study participants were 38 undergraduate medical students from the University of Sheffield, UK. They were recorded on video performing the procedural skill, completed a self-evaluation form, and received e-feedback on the same day (group 1); observed directly by an assessor, invited to provide verbal self-reflection, and then received standard verbal feedback (group 2). In both groups, the feedback was provided after performing the procedure. The participants returned 2 days later and performed the same skill again. Poststudy questionnaire was used to assess the acceptability of each feedback among the participants. Overall, 19 students in group 1 and 18 students in group 2 completed the study. Although there was a significant improvement in the overall mean score on the second performance of the task for all participants (first performance mean 11.59, second performance mean 15.95; p ≤ 0.0001), there was no difference in the overall mean improvement score between group 1 and group 2 (4.74 and 3.94, respectively; p = 0.49). The mean overall scores for the e-feedback group at baseline recorded by 2 independent investigators showed good agreement (mean overall scores of 12.84 and 11.89; Cronbach α = 0.86). Poststudy questionnaire demonstrated that both e-feedback and standard verbal feedback

  3. 77 FR 36341 - Control of Air Pollution From Aircraft and Aircraft Engines; Emission Standards and Test Procedures

    Science.gov (United States)

    2012-06-18

    ... normally expressed as shaft horsepower (hp) or shaft kilowatt (kW). \\5\\ This includes turbofan and turbojet... Organization (ICAO). The requirements contained in this final rule bring the United States into alignment with... brought the U.S. standards closer to alignment with ICAO CAEP/4 requirements that were effective in 2004...

  4. 20 CFR 627.604 - Alternative procedure for handling labor standards violations under section 143 of the Act...

    Science.gov (United States)

    2010-04-01

    ... standards violations under section 143 of the Act-binding arbitration. 627.604 Section 627.604 Employees... UNDER TITLES I, II, AND III OF THE ACT Federal Handling of Noncriminal Complaints and Other Allegations...—binding arbitration. (a) A person alleging a violation of section 143 of the Act, as an alternative to...

  5. Standard Procedure for Dose Assessment using the film holder NRPB/AERE and the film AGFA Monitoring 2/10

    International Nuclear Information System (INIS)

    Guillen, J.A.

    1998-07-01

    This paper describes the calculation method to assess dose and energy using the film holder from NRPB/AERE and the film Agfa Monitoring 2/10. Also includes all the steps since preparing the standard curve, fitting of calibration curve, dose assesment, description of filtration of the film holder and the form of the calibration curve

  6. Conscious sedation for endoscopic and non-endoscopic interventional gastrointestinal procedures: meeting patients' expectations, missing the standard

    Energy Technology Data Exchange (ETDEWEB)

    Marriott, P.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F. E-mail: derrick.martin@smtr.nhs.uk

    2004-02-01

    AIM: To assess the level of sedation, patient satisfaction and frequency of unplanned events with conscious sedation for interventional procedures. MATERIALS AND METHODS: One hundred and seventeen patients were assessed prospectively before, during and after procedures. Blood pressure, pulse, oxygen saturation and sedation level were monitored and patients followed up after 24 h. Sedation was scored after drugs were given in accordance with an established protocol. Doses were recorded, as were patients' weight, age and ASA grade and any unplanned events and their management. RESULTS: Seventy-six of the 117 patients (65%) had no unplanned event, 20 (17.1%) became agitated, 15 (12.8%) hypotensive, three (2.6%) hypoxic and three (2.6%) had more than one response. Twelve patients required active management. Fifty-two (44.4%) had a sedation level of {<=}3 (responsive to verbal commands), but 39 (33.3%) reached level 6. Median doses were midazolam 6 mg (1-20 mg) and pethidine 50 mg (12.5-100 mg). Ninety-three percent were satisfied with their sedation. No adverse effects were observed after 24 h. CONCLUSION: Despite using a sedation protocol, unplanned events occurred in 35% (95% CI=27-44%) of patients, although not all required active management. The sedation levels reached in some exceeded guidelines. Unplanned events were commoner with increased sedation level. Patient satisfaction was high and no permanent damage was observed.

  7. Conscious sedation for endoscopic and non-endoscopic interventional gastrointestinal procedures: meeting patients' expectations, missing the standard

    International Nuclear Information System (INIS)

    Marriott, P.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F.

    2004-01-01

    AIM: To assess the level of sedation, patient satisfaction and frequency of unplanned events with conscious sedation for interventional procedures. MATERIALS AND METHODS: One hundred and seventeen patients were assessed prospectively before, during and after procedures. Blood pressure, pulse, oxygen saturation and sedation level were monitored and patients followed up after 24 h. Sedation was scored after drugs were given in accordance with an established protocol. Doses were recorded, as were patients' weight, age and ASA grade and any unplanned events and their management. RESULTS: Seventy-six of the 117 patients (65%) had no unplanned event, 20 (17.1%) became agitated, 15 (12.8%) hypotensive, three (2.6%) hypoxic and three (2.6%) had more than one response. Twelve patients required active management. Fifty-two (44.4%) had a sedation level of ≤3 (responsive to verbal commands), but 39 (33.3%) reached level 6. Median doses were midazolam 6 mg (1-20 mg) and pethidine 50 mg (12.5-100 mg). Ninety-three percent were satisfied with their sedation. No adverse effects were observed after 24 h. CONCLUSION: Despite using a sedation protocol, unplanned events occurred in 35% (95% CI=27-44%) of patients, although not all required active management. The sedation levels reached in some exceeded guidelines. Unplanned events were commoner with increased sedation level. Patient satisfaction was high and no permanent damage was observed

  8. Standard procedure for testing acute toxic effects on bioluminescent bacteria; Saggio di tossicita` acuta con batteri bioluminescenti

    Energy Technology Data Exchange (ETDEWEB)

    Guzzella, L. [CNR, Brugherio, Milan (Italy). Istituto di Ricerca Sulle Acque

    1996-06-01

    A standardized method for the determination of 15-30 min toxicity of `Vibrio fisheri` bioluminescent bacteria is evaluated. The proposed method can be applied for the analysis of liquid (superficial and drinking waters, eluates and wastes) and solid (sediments and muds) samples and permits the quantification of the EC50 and EC20 values and of the no-effective sample dilution. The results of a interlaboratory ring tests conducted with reference substances are illustrated.

  9. [Patients with astigmatism who underwent cataract surgery by phacoemulsification: toric IOL x asferic IOL?].

    Science.gov (United States)

    Torres Netto, Emilio de Almeida; Gulin, Marina Carvalho; Zapparoli, Marcio; Moreira, Hamilton

    2013-01-01

    Compare the visual acuity of patients who underwent cataract surgery by phacoemulsification with IOL AcrySof(®) toric implantation versus AcrySof(®) IQ and evaluate the reduction of cylindrical diopters (CD) in the postoperative period. Analytical and retrospective study of 149 eyes with 1 or more diopters of regular symmetrical keratometric astigmatism, which underwent cataract surgery by phacoemulsification. The eyes were divided into two groups: the toric group with 85 eyes and the non-toric group with 64 eyes. In the pre-operative phase, topographic data and refraction of each eye to be operated were assessed. In the postoperative phase, refraction and visual acuity with and without correction were measured. The preoperative topographic astigmatism ranged from 1.00 to 5.6 DC in both groups. Average reduction of 1.37 CD (p<0.001) and 0.16 CD (p=0.057) was obtained for the toric and non-toric group when compared to the refractive astigmatism, respectively. Considering visual acuity without correction (NCVA), the toric group presented 44 eyes (51.7%) with NCVA of 0 logMAR (20/20) or 0.1 logMAR (20/25) and the toric group presented 7 eyes (10.93%) with these same NCVA values. The results show that patients with a significant keratometric astigmatism presented visual benefits with the toric IOL implantation. The reduction of the use of optical aids may be obtained provided aberrations of the human eye are corrected more accurately. Currently, phacoemulsification surgery has been used not only for functional improvement, but also as a refraction procedure.

  10. MATLAB-implemented estimation procedure for model-based assessment of hepatic insulin degradation from standard intravenous glucose tolerance test data.

    Science.gov (United States)

    Di Nardo, Francesco; Mengoni, Michele; Morettini, Micaela

    2013-05-01

    Present study provides a novel MATLAB-based parameter estimation procedure for individual assessment of hepatic insulin degradation (HID) process from standard frequently-sampled intravenous glucose tolerance test (FSIGTT) data. Direct access to the source code, offered by MATLAB, enabled us to design an optimization procedure based on the alternating use of Gauss-Newton's and Levenberg-Marquardt's algorithms, which assures the full convergence of the process and the containment of computational time. Reliability was tested by direct comparison with the application, in eighteen non-diabetic subjects, of well-known kinetic analysis software package SAAM II, and by application on different data. Agreement between MATLAB and SAAM II was warranted by intraclass correlation coefficients ≥0.73; no significant differences between corresponding mean parameter estimates and prediction of HID rate; and consistent residual analysis. Moreover, MATLAB optimization procedure resulted in a significant 51% reduction of CV% for the worst-estimated parameter by SAAM II and in maintaining all model-parameter CV% MATLAB-based procedure was suggested as a suitable tool for the individual assessment of HID process. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. PLAN-TA9-2443(U), Rev. B Remediated Nitrate Salt (RNS) Surrogate Formulation and Testing Standard Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Geoffrey Wayne [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-16

    This document identifies scope and some general procedural steps for performing Remediated Nitrate Salt (RNS) Surrogate Formulation and Testing. This Test Plan describes the requirements, responsibilities, and process for preparing and testing a range of chemical surrogates intended to mimic the energetic response of waste created during processing of legacy nitrate salts. The surrogates developed are expected to bound1 the thermal and mechanical sensitivity of such waste, allowing for the development of process parameters required to minimize the risk to worker and public when processing this waste. Such parameters will be based on the worst-case kinetic parameters as derived from APTAC measurements as well as the development of controls to mitigate sensitivities that may exist due to friction, impact, and spark. This Test Plan will define the scope and technical approach for activities that implement Quality Assurance requirements relevant to formulation and testing.

  12. The ageing and myasthenic thymus: a morphometric study validating a standard procedure in the histological workup of thymic specimens.

    Science.gov (United States)

    Ströbel, Philipp; Moritz, Regina; Leite, Maria Isabel; Willcox, Nick; Chuang, Wen-Yu; Gold, Ralf; Nix, Wilfred; Schalke, Berthold; Kiefer, Reinhard; Müller-Hermelink, Hans-Konrad; Jaretzki Iii, Alfred; Newsom-Davis, John; Marx, Alexander

    2008-09-15

    The thymus is believed to play an important role in the pathogenesis of myasthenia gravis (MG). The 80% of MG patients with anti-acetylcholine receptor autoantibodies fall into three clinical subgroups: 1) thymoma; 2) early-onset MG (standardized histological workup and reporting system used in this trial.

  13. Randomized trial of one-hour sodium bicarbonate vs standard periprocedural saline hydration in chronic kidney disease patients undergoing cardiovascular contrast procedures.

    Science.gov (United States)

    Kooiman, Judith; de Vries, Jean-Paul P M; Van der Heyden, Jan; Sijpkens, Yvo W J; van Dijkman, Paul R M; Wever, Jan J; van Overhagen, Hans; Vahl, Antonie C; Aarts, Nico; Verberk-Jonkers, Iris J A M; Brulez, Harald F H; Hamming, Jaap F; van der Molen, Aart J; Cannegieter, Suzanne C; Putter, Hein; van den Hout, Wilbert B; Kilicsoy, Inci; Rabelink, Ton J; Huisman, Menno V

    2018-01-01

    Guidelines advise periprocedural saline hydration for prevention of contrast induced-acute kidney injury (CI-AKI). We analysed whether 1-hour sodium bicarbonate hydration administered solely prior to intra-arterial contrast exposure is non-inferior to standard periprocedural saline hydration in chronic kidney disease (CKD) patients undergoing elective cardiovascular diagnostic or interventional contrast procedures. We performed an open-label multicentre non-inferiority trial between 2011-2014. Patients were randomized to 1 hour pre-procedure sodium bicarbonate hydration (250 ml 1.4%, N = 168) or 4-12 hours saline hydration (1000 ml 0.9%, N = 165) prior to and following contrast administration (2000 ml of saline total). Primary outcome was the relative serum creatinine increase (%) 48-96 hours post contrast exposure. Secondary outcomes were: incidence of CI-AKI (serum creatinine increase>25% or >44μmol/L), recovery of renal function, the need for dialysis, and hospital costs within two months follow-up. Mean relative creatinine increase was 3.1% (95%CI 0.9 to 5.2%) in the bicarbonate and 1.1% (95%CI -1.2 to 3.5%) in the saline arm, mean difference 1.9% (95%CI -1.2 to 5.1%, p-non-inferiority sodium bicarbonate and 12 (7.5%) to saline (p = 0.79). Renal function did not fully recover in 40.0% and 44.4% of CI-AKI patients, respectively (p = 0.84). No patient required dialysis. Mean costs for preventive hydration and clinical preparation for the contrast procedure were $1158 for sodium bicarbonate vs. $1561 for saline (p sodium bicarbonate prior to elective cardiovascular diagnostic or therapeutic contrast procedures is non-inferior to standard periprocedural saline hydration in CKD patients with respect to renal safety and results in considerable healthcare savings. Netherlands Trial Register (http://www.trialregister.nl/trialreg/index.asp), Nr NTR2699.

  14. Mortalidade relacionada ao tratamento endovascular do aneurisma da aorta abdominal com o uso dos modelos revisados Procedure-related mortality of endovascular abdominal aortic aneurysm repair using revised reporting standards

    Directory of Open Access Journals (Sweden)

    Gosen Gabriel Konig

    2007-03-01

    Full Text Available OBJETIVO: O objetivo do estudo foi avaliar a definição da mortalidade relacionada ao procedimento após tratamento endovascular do aneurisma de aorta abdominal (EVAR como definido pelo Committee for Standardized Reporting Practices in Vascular Surgery. MÉTODO: Dados de pacientes com aneurisma de aorta abdominal foram analisados do banco de dados EUROSTAR. Os pacientes foram submetidos ao EVAR entre junho de 1996 a fevereiro de 2004 e foram estudados retrospectivamente. A probabilidade explicita da causa de morte foi registrada. O intervalo entre a operação, alta hospitalar ou intervenção secundária até a morte foi registrado. RESULTADOS: De um total de 5612 pacientes, 589 (10,5% faleceram após o EVAR em acompanhamento total e qualquer causa de morte foi inclusa. Cento e quarenta e um pacientes (12,5% morreram devido a causa relacionada ao aneurisma, sendo que 28 (4,8% foram rupturas, 25 (4,2% infecções do implante e 88 (14,9% foram pacientes que morreram num prazo de 30 dias após o procedimento inicial (definição atualmente utilizada, também conhecido como resultado clínico a curto prazo. Além disso, 25 pacientes faleceram após 30 dias, mas continuavam ainda hospitalizados (ou transferidos a home-care para reavaliação posterior, ou necessitaram intervenção secundária. Levando em conta a duração da admissão ao hospital e a mortalidade imediata após o procedimento relacionada a intervenções secundárias, 49 mortes tardias também podem ser relacionadas ao EVAR. CONCLUSÃO: Morte tardia compõe uma proporção considerável da mortalidade relacionada ao EVAR dentro do tempo de análise revisado.OBJECTIVE: The aim of this study was to evaluate the definition of Procedure-related mortality after endovascular aneurysm repair (EVAR as defined by the Committee for Standardized Reporting Practices in Vascular Surgery. METHODS: Data on patients with an AAA were taken from the EUROSTAR database. The patients underwent EVAR

  15. Standardization of a Protocol for Obtaining Platelet Rich Plasma from blood Donors; a Tool for Tissue Regeneration Procedures.

    Science.gov (United States)

    Gómez, Lina Andrea; Escobar, Magally; Peñuela, Oscar

    2015-01-01

    To develop a protocol for obtaining autologous platelet rich plasma in healthy individuals and to determine the concentration of five major growth factors before platelet activation. This protocol could be integrated into the guidelines of good clinical practice and research in regenerative medicine. Platelet rich plasma was isolated by centrifugation from 38 healthy men and 42 women ranging from 18 to 59 years old. The platelet count and quantification of growth factors were analyzed in eighty samples, stratified for age and gender of the donor. Analyses were performed using parametric the t-test or Pearson's analysis for non-parametric distribution. P platelet counts from 1.6 to 4.9 times (mean = 2.8). There was no correlation between platelet concentration and the level of the following growth factors: VEGF-D (r = 0.009, p = 0.4105), VEGF-A (r = 0.0068, p = 0.953), PDGF subunit AA (p = 0.3618; r = 0.1047), PDGF-BB (p = 0.5936; r = 0.6095). In the same way, there was no correlation between donor gender and growth factor concentrations. Only TGF-β concentration was correlated to platelet concentration (r = 0.3163, p = 0.0175). The procedure used allowed us to make preparations rich in platelets, low in leukocytes and red blood cells, and sterile. Our results showed biological variations in content of growth factors in PRP. The factors influencing these results should be further studied.

  16. Evaluation and assessment methodology, standards, and procedures manual of the United States Federal Radiological Monitoring and Assessment Center

    International Nuclear Information System (INIS)

    Kerns, K.C.; Burson, Z.G.; Smith, J.M.; Blanchard, R.L.

    2000-01-01

    In the event of a major radiological emergency, the U.S. Federal Radiological Emergency Response Plan authorises the creation of the Federal Radiological Monitoring and Assessment Center (FRMAC). The FRMAC is established to co-ordinate the Federal off-site monitoring and assessment activities, and is comprised of representatives from several Federal agencies and Department of Energy contractors who provide assistance to the state(s) and Lead Federal Agency. The Evaluation and Assessment (E and A) Division of the FRMAC is responsible for receiving, storing, and interpreting environmental surveillance data to estimate the potential health consequences to the population in the vicinity of the accident site. The E and A Division has commissioned the preparation of a methodology and procedures manual which will result in a consistent approach by Division members in carrying out their duties. The first edition of this manual is nearing completion. In this paper, a brief review of the structure of the FRMAC is presented, with emphasis on the E and A Division. The contents of the E and A manual are briefly described, as are future plans for its expansion. (author)

  17. International Cooperation to Establish Standard Operating Procedure (SOP) for Quarantine Management of Irradiated Foods in International Trade

    International Nuclear Information System (INIS)

    Lee, J. W.; Byun, M. W.; Kim, J. H.; Choi, J. I.; Song, B. S.; Yoon, Y. H.; Kim, D. H.; Kim, W. G.; Kim, K. P.

    2010-02-01

    · Development of SOPs through various research activities such as building international cooperation, and analysing current status of food irradiation in domestic and international markets, export and import, international market size, and of R and D - Analysis of examples for quarantine management in agricultural product exporting countries and use of irradiation technology for agricultural product quarantine, and changes in international quarantine management - Analysis of SOPs for food irradiation quarantine in international organization (CODEX, IPPC, WHO). U.S, EU, China, India, and Australia. - Collaborative researches of India/Korea and China/Korea entered into an agreement for market trials · Publishment of irradiation quarantine management SOPs agreed to CODEX standards - Collaborative researches for quarantine management, avoiding Technical Barrier to Trade (TBT), and Sanitary Phytosanitary Measures were conducted, and advanced SOPs agreed with WTO/FTA system were published

  18. Surgical outcomes of 380 patients with double outlet right ventricle who underwent biventricular repair.

    Science.gov (United States)

    Li, Shoujun; Ma, Kai; Hu, Shengshou; Hua, Zhongdong; Yang, Keming; Yan, Jun; Chen, Qiuming

    2014-09-01

    The study objective was to report the outcomes of biventricular repair in patients with double outlet right ventricle. Patients with double outlet right ventricle who underwent biventricular repair at Fuwai Hospital from January 2005 to December 2012 were included. Patients were excluded if double outlet right ventricle was combined with atrioventricular septal defect, heterotaxy syndrome, atrioventricular discordance, or univentricular physiology. A total of 380 consecutive patients with a mean age of 1.9 ± 2.1 years (range, 1 month to 6 years) were included. Varied types of biventricular repair were customized individually. Follow-up was 90.4% complete, and the mean follow-up time was 3.4 ± 3.9 years. There were 17 (4.5%) early deaths and 7 (2.1%) late deaths. Preoperative pulmonary hypertension was the only risk factor for early mortality. Postoperative significant left ventricular outflow tract obstruction was present in 9 survivors. Patients with noncommitted ventricular septal defect had a longer crossclamp time, longer cardiopulmonary bypass time, and higher incidence of postdischarge left ventricular outflow tract obstruction. There were 4 reoperations, all of which were caused by subaortic left ventricular outflow tract obstruction. All of the pressure gradients were decreased to less than 20 mm Hg after the modified Konno procedure with an uneventful postoperative course. Optimal results of varied types of biventricular repair for double outlet right ventricle have been acquired. Although noncommitted ventricular septal defect is technically difficult, the outcomes of patients are favorable. Late-onset left ventricular outflow tract obstruction is the main reason for reoperation but can be successfully relieved by the modified Konno procedure. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  19. Mutagenic treatments towards increasing the frequency of day-neutral mutations and standardization of procedures for tissue culture, in potato

    International Nuclear Information System (INIS)

    Upadhya, M.D.; Chandra, R.; Abraham, M.J.

    1976-01-01

    Various chemical mutagens and gamma radiation have been used on single dormant eyes and true seeds with a view to finding effective mutagenic treatment for the induction of day-length neutral mutants in potato using an effective screening technique for the isolation of day-length neutral mutants. Sodium meta bisulphite (SMS) was found to be an efficient mutagen in inducing mutations for this trait in true seeds although the same concentrations, when used for treating the single tuber eyes proved lethal. Pre-soaking the seeds for 24 hrs prior to treatment with 0.0025M SMS gave highest frequency of the mutants followed by 48 hrs presoaking, indicating a sensitive stage during the cell cycle in true seeds. Other mutagen treatments gave different frequencies of mutations. The highest frequency of day-length neutral mutants was observed when seeds irradiated with 40 Kr of gamma radiation were treated with 0.05M hydrazinium dichloride solution. Screening procedures have also been standardised with the development of synethetic media for the isolation of biochemical mutants at the true seed level. Initial efforts have yielded mutants resistant to LD 100 doses of ethionine. Another aspect of the study was to develop a proper potato callus culture technique. A medium has been developed to produce and maintain callus from potato leaf strips. Efforts on the regeneration of shoot and roots from callus, have so far lead to differentiation of callus to form roots. The ultimate aim of these studies is to develop plantlets from single cell which would form the units of mutation induction and isolation. (author)

  20. Assessment of Patients Who Underwent Nasal Reconstruction After Non-Melanoma Skin Cancer Excision.

    Science.gov (United States)

    Uzun, Hakan; Bitik, Ozan; Kamburoğlu, Haldun Onuralp; Dadaci, Mehmet; Çaliş, Mert; Öcal, Engin

    2015-06-01

    Basal and squamous cell carcinomas are the most common malignant cutaneous lesions affecting the nose. With the rising incidence of skin cancers, plastic surgeons increasingly face nasal reconstruction challenges. Although multiple options exist, optimal results are obtained when "like is used to repair like". We aimed to introduce a simple algorithm for the reconstruction of nasal defects with local flaps, realizing that there is always more than one option for reconstruction. We retrospectively reviewed 163 patients who underwent nasal reconstruction after excision of non-melanoma skin cancer between March 2011 and April 2014. We analyzed the location of the defects and correlated them with the techniques used to reconstruct them. There were 66 males and 97 females (age, 21-98 years). Basal cell carcinoma was diagnosed in 121 patients and squamous cell carcinoma in 42. After tumor excision, all the defects were immediately closed by either primary closure or local flap options such as Limberg, Miter, glabellar, bilobed, nasolabial, V-Y advancement, and forehead flaps. Obtaining tumor-free borders and a pleasing aesthetic result are major concerns in nasal reconstruction. Defect reconstruction and cosmesis are as important as rapid recovery and quick return to normal daily activities, and these should be considered before performing any procedure, particularly in elderly patients.

  1. Philosophy, policy and procedures of the World Organisation for Animal Health for the development of standards in animal welfare.

    Science.gov (United States)

    Petrini, A; Wilson, D

    2005-08-01

    Animal welfare was identified as a priority for the World Organisation for Animal Health (OIE) in the 2001-2005 OIE Strategic Plan. Member Countries recognised that, as animal protection is a complex, multi-faceted public policy issue which includes important scientific, ethical, economic and political dimensions, the OIE needed to develop a detailed vision and strategy incorporating and balancing these dimensions. A permanent working group on animal welfare was established in order to provide guidance to the OIE in its work on the development of science-based standards and guidelines. The Working Group decided to give priority to the welfare of animals used in agriculture and aquaculture, and that, within those groups, the topics of transportation, slaughter for human consumption and killing for disease control purposes would be addressed first. Some guiding principles were approved by the International Committee of OIE Member Countries during the 72nd General Session in May 2004, and these have been followed by four specific guidelines on the priority topics listed above.

  2. Preparation procedure and certification of uranous-uranic oxide and nitric acid solution of neptunium as standard specimens of plant

    International Nuclear Information System (INIS)

    Bulyanitsa, L.S.; Lipovskij, A.A.; Ryzhinskij, M.V.; Preobrazhensskaya, L.D.; Aleksandruk, V.M.; Alekseeva, N.A.; Gromova, E.A.; Solntseva, L.F.; Shereshevskaya, I.I.

    1981-01-01

    Two techniques of certification of standard specimens of plant (SSP) are considered. The first technique-comparison with initial SS-metallic uranium NBS-960 - is used for certification of uranium. protoxide-oxide. The mass part of the sum of analyzed impurities in prepared initial SS is (8.4+-0.8)x10 -3 %. For certification according to mass uranium part the method of gravimetric potentiometric titration with semiautomatic titrator is used; the mean quadratic deviation of the method is s=0.0002-0.0003, certified value of uranium mass part in SSP (taking account of the error of initial SS) is (84.80+-0.02)%. The second technigue - a simplified circular experiment - is used for certification of SSP-nitric acid solution of neptunium as to Np mass part. Coulometry at controlled potential and coulometry at controlled current and two variants of potentiometric titration are used as certification methods of analysis. Relative mean quadratic deviations of the methods are ssub(r)=0.0014-0.0023. When calculating total error of certified value of neptunium mass part constituents of both accidental and unremoved systematic errors of the methods were included. The final certification result of SSP is (5.707+-0.018)% [ru

  3. Chapter 1. Introduction. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

    Science.gov (United States)

    Sprung, Charles L; Cohen, Robert; Adini, Bruria

    2010-04-01

    In December 2007, the European Society of Intensive Care Medicine established a Task Force to develop standard operating procedures (SOPs) for operating intensive care units (ICU) during an influenza epidemic or mass disaster. To provide direction for health care professionals in the preparation and management of emergency ICU situations during an influenza epidemic or mass disaster, standardize activities, and promote coordination and communication among the medical teams. Based on a literature review and contributions of content experts, a list of essential categories for managing emergency situations in the ICU were identified. Based on three cycles of a modified Delphi process, consensus was achieved regarding the categories. A primary author along with an expert group drafted SOPs for each category. Based on the Delphi cycles, the following key topics were found to be important for emergency preparedness: triage, infrastructure, essential equipment, manpower, protection of staff and patients, medical procedures, hospital policy, coordination and collaboration with interface units, registration and reporting, administrative policies and education. The draft SOPs serve as benchmarks for emergency preparedness and response of ICUs to emergencies or outbreak of pandemics.

  4. Changes in the biochemical oxygen demand procedure in the 21st edition of Standard Methods for the Examination of Water and Wastewater.

    Science.gov (United States)

    Young, James C; Clesceri, Lenore S; Kamhawy, Sabry M

    2005-01-01

    The dilution biochemical oxygen demand (BOD) test has widespread application for design and operation of wastewater treatment processes, evaluating the quality of natural waters, and assessing the effect of wastewater discharges on these waters. While standardization of the BOD-measuring method has become of prime importance in maintaining dependable data acquisition, changes are made as needed in response to questions raised by analysts and to accommodate new applications. The purpose of this article is to describe changes that have been incorporated in the 20th and 21st editions of Standard Methods for the Examination of Water and Wastewater (APHA et al., 1998 and 2004). These changes include changes in text format to clarify the procedural steps, allowance for use of bottle sizes ranging from 60 mL or larger, improvements in quality-control procedures, and improvements in the method of calculating BOD. Other changes include allowance for the use of allylthiourea for nitrification inhibition and broadening the source of seed that can be used for inoculation of BOD samples.

  5. [Advantages and disadvantages of different methods for the implementation and the support of standard operating procedures: From PDF files to an app- and webbased SOP management system].

    Science.gov (United States)

    Bauer, M; Riech, S; Brandes, I; Waeschle, R M

    2015-11-01

    The quality assurance of care and patient safety, with increasing cost pressure and performance levels is of major importance in the high-risk and high cost area of the operating room (OR). Standard operating procedures (SOP) are an established tool for structuring and standardization of the clinical treatment pathways and show multiple benefits for quality assurance and process optimization. An internal project was initiated in the department of anesthesiology and a continuous improvement process was carried out to build up a comprehensive SOP library. In the first step the spectrum of procedures in anesthesiology was transferred to PDF-based SOPs. The further development to an app-based SOP library (Aesculapp) was due to the high resource expenditure for the administration and maintenance of the large PDF-based SOP collection and to deficits in the mobile availability. The next developmental stage, the SOP healthcare information assistant (SOPHIA) included a simplified and advanced update feature, an archive feature previously missing and notably the possibility to share the SOP library with other departments including the option to adapt each SOP to the individual situation. A survey of the personnel showed that the app-based allocation of SOPs (Aesculapp, SOPHIA) had a higher acceptance than the PDF-based developmental stage SOP form. The SOP management system SOPHIA combines the benefits of the forerunner version Aesculapp with improved options for intradepartmental maintenance and administration of the SOPs and the possibility of an export and editing function for interinstitutional exchange of SOPs.

  6. Abdominoplasty combined with other intraabdominal procedures.

    Science.gov (United States)

    Gemperli, R; Neves, R I; Tuma, P; Bonamichi, G T; Ferreira, M C; Manders, E K

    1992-07-01

    One hundred three patients underwent abdominoplasty combined with other intraabdominal procedures including 67 tubal ligations, 34 total abdominal hysterectomies and 2 cholecystectomies, from January 1983 to July 1991. The patients were divided into two groups, those undergoing the standard or total abdominoplasty and those undergoing limited abdominoplasty with or without liposuction in delimited areas. In this series of 103 patients, we found only two minor complications and only three patients were transfused with autologous units of blood. When performed by well-schooled surgical teams, abdominoplasty may be combined with intraabdominal procedures with gratifying results.

  7. Evaluation of patients who underwent resympathectomy for treatment of primary hyperhidrosis.

    Science.gov (United States)

    de Campos, José Ribas Milanez; Lembrança, Lucas; Fukuda, Juliana Maria; Kauffman, Paulo; Teivelis, Marcelo Passos; Puech-Leão, Pedro; Wolosker, Nelson

    2017-11-01

    Video thoracoscopic sympathectomy is the recommended surgical treatment for primary hyperhidrosis and has a high success rate. Despite this high success rate, some patients are unresponsive and eventually need a resympathectomy. Few studies have previously analysed exclusively the results of these resympathectomies in patients with primary hyperhidrosis. None of the studies have objectively evaluated the degree of response to surgery or the improvement in quality of life after resympathectomies. This is a retrospective study, evaluating 15 patients from an initial group of 2300 patients who underwent resympathectomy after failure of the primary surgical treatment. We evaluated sympathectomy levels of resection, technical difficulties, surgical complications preoperative quality of life, response to treatment and quality-of-life improvement 30 days after each surgery. Regarding gender, 11 (73.3%) patients were women. The average age was 23.2 with SD of 5.17 years, and the mean body mass index was 20.9 (SD 2.12). Ten patients had major complaints about their hands (66%) and 5 (33%) patients about their forearms. A high degree of response to sympathectomy occurred in 73% of patients. In 11 of these patients, the improvement in quality of life was considered high, 3 showed a mild improvement and 1 did not improve. No major complications occurred; the presence of adhesions was reported in 11 patients and pleural drainage was necessary in 4 patients. Resympathectomy is an effective procedure, and it improves the quality of life in patients with primary hyperhidrosis who failed after the first surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  8. Evaluation and standardization of different purification procedures for fish bile and liver metallothionein quantification by spectrophotometry and SDS-PAGE analyses.

    Science.gov (United States)

    Tenório-Daussat, Carolina Lyrio; Resende, Marcia Carolina Martinho; Ziolli, Roberta L; Hauser-Davis, Rachel Ann; Schaumloffel, Dirk; Saint'Pierre, Tatiana D

    2014-03-01

    Fish bile metallothioneins (MT) have been recently reported as biomarkers for environmental metal contamination; however, no studies regarding standardizations for their purification are available. Therefore, different procedures (varying centrifugation times and heat-treatment temperatures) and reducing agents (DTT, β-mercaptoethanol and TCEP) were applied to purify MT isolated from fish (Oreochromis niloticus) bile and liver. Liver was also analyzed, since these two organs are intrinsically connected and show the same trend regarding MT expression. Spectrophotometrical analyses were used to quantify the resulting MT samples, and SDS-PAGE gels were used to qualitatively assess the different procedure results. Each procedure was then statistically evaluated and a multivariate statistical analysis was then applied. A response surface methodology was also applied for bile samples, in order to further evaluate the responses for this matrix. Heat treatment effectively removes most undesired proteins from the samples, however results indicate that temperatures above 70 °C are not efficient since they also remove MTs from both bile and liver samples. Our results also indicate that the centrifugation times described in the literature can be decreased in order to analyze more samples in the same timeframe, of importance in environmental monitoring contexts where samples are usually numerous. In an environmental context, biliary MT was lower than liver MT, as expected, since liver accumulates MT with slower detoxification rates than bile, which is released from the gallbladder during feeding, and then diluted by water. Therefore, bile MT seems to be more adequate in environmental monitoring scopes regarding recent exposure to xenobiotics that may affect the proteomic and metalloproteomic expression of this biological matrix. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Methodology of Isochronal and Isothermal Anneals applied to Irradiated MOS Structures. Application to Post-Irradiation Effects (in Space, Accelerators) and Standard Test Procedures

    International Nuclear Information System (INIS)

    Chabrerie, Christian

    1997-01-01

    We report the development of a methodology using isochronal and isothermal anneals for the characterization of MOS (Metal - Oxide - Semiconductor) Transistors irradiated electronic components. We study the recovery kinetics of the post-irradiation effects and the modeling of the recovery temperature activated phenomena. This allows us to understand the basic physical mechanisms that have led to the definition of standard test procedures. The fields of application are numerous (space, military, accelerators for high energy physics, civilian nuclear and harsh environment robotics). We begin by outlining the context of our study and by presenting the actual standard test procedures (TM1019.4 and BS22900) used for the qualification of integrated circuits. We then review the different theories of the temperature activated phenomena. The link between the foundations of the normalized procedures and the thermally activated phenomena is clarified. From this analysis, we propose a new approach, mainly based on the use of isochronal anneals. During this work, we have developed two tools with this aim: - the first tool is software, it is a numerical simulation program for thermally activated phenomena. - The second is composed of a specific automated annealing bench (in particular isochronal), that we have designed. The applications and results are then presented in four parts: - the first presents simulation results computed using our calculation code, - the second concerns experimental results obtained with thin oxides from different rad-hard technologies and their application to study gate oxides of transistors, - the third develops results on non-hardened technological thick oxides and their consequences on the lateral leakage currents due to parasitic MOS structures in the 'commercial' components, - the fourth concerns the post-irradiation evolution of interface states during isochronal anneals. We conclude with a number of recommendations concerning the post

  10. A prospective case control comparison of the ZeroGravity system versus a standard lead apron as radiation protection strategy in neuroendovascular procedures.

    Science.gov (United States)

    Haussen, Diogo C; Van Der Bom, Imramsjah Martijn John; Nogueira, Raul G

    2016-10-01

    We aimed to compare the performance of the ZeroGravity (ZG) system (radiation protection system composed by a suspended lead suit) against the use of standard protection (lead apron (LA), thyroid shield, lead eyeglasses, table skirts, and ceiling suspended shield) in neuroangiography procedures. Radiation exposure data were prospectively collected in consecutive neuroendovascular procedures between December 2014 and February 2015. Operator No 1 was assigned to the use of an LA (plus lead glasses, thyroid shield, and a 1 mm hanging shield at the groin) while operator No 2 utilized the ZG system. Dosimeters were used to measure peak skin dose for the head, thyroid, and left foot. The two operators performed a total of 122 procedures during the study period. The ZG operator was more commonly the primary operator compared with the LA operator (85% vs 71%; p=0.04). The mean anterior-posterior (AP), lateral, and cumulative dose area product (DAP) radiation exposure as well as the mean fluoroscopy time were not statistically different between the operators' cases. The peak skin dose to the head of the operator with LA was 2.1 times higher (3380 vs 1600 μSv), while the thyroid was 13.9 (4460 vs 320 μSv), the mediastinum infinitely (520 vs 0 μSv), and the foot 3.3 times higher (4870 vs 1470 μSv) compared with the ZG operator, leading to an overall accumulated dose 4 times higher. The ratio of cumulative operator received dose/total cumulative DAP was 2.5 higher on the LA operator. The ZG radiation protection system leads to substantially lower radiation exposure to the operator in neurointerventional procedures. However, substantial exposure may still occur at the level of the lens and thyroid to justify additional protection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Procedimientos Comunes de Operacion Para Juntas Responsabilidades y Derechos del Presidente, Vice Presidente, Secretaria, y Miembros (Standard Procedures of Operation for Meetings, Rights, and Responsibilities of the President, Vice President, Secretary, and Members).

    Science.gov (United States)

    Gonzalez, Ramon

    Of use to Parent Advisory Committees, this Spanish-English handout briefly describes the standard procedures used to conduct meetings and outlines the duties of committee officers and members. The pamphlet describes the standard order of business at a meeting, including calling a meeting to order, roll call, minutes, reports, unfinished and new…

  12. Sepsis and Critical Illness Research Center investigators: protocols and standard operating procedures for a prospective cohort study of sepsis in critically ill surgical patients.

    Science.gov (United States)

    Loftus, Tyler J; Mira, Juan C; Ozrazgat-Baslanti, Tezcan; Ghita, Gabriella L; Wang, Zhongkai; Stortz, Julie A; Brumback, Babette A; Bihorac, Azra; Segal, Mark S; Anton, Stephen D; Leeuwenburgh, Christiaan; Mohr, Alicia M; Efron, Philip A; Moldawer, Lyle L; Moore, Frederick A; Brakenridge, Scott C

    2017-08-01

    Sepsis is a common, costly and morbid cause of critical illness in trauma and surgical patients. Ongoing advances in sepsis resuscitation and critical care support strategies have led to improved in-hospital mortality. However, these patients now survive to enter state of chronic critical illness (CCI), persistent low-grade organ dysfunction and poor long-term outcomes driven by the persistent inflammation, immunosuppression and catabolism syndrome (PICS). The Sepsis and Critical Illness Research Center (SCIRC) was created to provide a platform by which the prevalence and pathogenesis of CCI and PICS may be understood at a mechanistic level across multiple medical disciplines, leading to the development of novel management strategies and targeted therapies. Here, we describe the design, study cohort and standard operating procedures used in the prospective study of human sepsis at a level 1 trauma centre and tertiary care hospital providing care for over 2600 critically ill patients annually. These procedures include implementation of an automated sepsis surveillance initiative, augmentation of clinical decisions with a computerised sepsis protocol, strategies for direct exportation of quality-filtered data from the electronic medical record to a research database and robust long-term follow-up. This study has been registered at ClinicalTrials.gov, approved by the University of Florida Institutional Review Board and is actively enrolling subjects. Dissemination of results is forthcoming. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Standard procedure of operation for the accomplishment of audit of quality in facilities of teletherapy with isotopic units of 60Co

    International Nuclear Information System (INIS)

    Larrinaga Cortina, Eduardo F.; Dominguez Hung, Lourdes; Campa Menendez, Raudel

    2001-01-01

    The use of the radiotherapy implies the necessity of rigorous quality standards in its different components, aiming to provide the best possible treatment and avoid potential patient's risks, that could even cause his/her death. Projects of technical cooperation have been developed in Cuba support by the International Atomic Energy Agency addresses to the implementation of Programs of Quality Assurance in radiotherapy services. The establishment of the National Quality Audit Program (PNAC) is a superior stage. The National Control Center for Medical Devices as the national regulator entity for the control and supervision of medical devices in the National Health System is the responsible for the making and execution of the PNAC. The audit modality selected was the inspection visit in situ due to its intrinsic advantages, our geographical extension and the number of radiotherapy services. This paper presents the methodology for the execution of the PNAC, in form of a Normalized Procedure of Operation that defines the objectives, scope, terms and definitions, responsibilities, composition and selection of the auditor team, security's conditions, materials and equipment, steps of the audit execution, results calculation and interpretation, records, etc. (author)

  14. 65. Impact of focused echocardiography in clinical decision of patients presented with STMI, underwent primary percutenouse angioplasty

    Directory of Open Access Journals (Sweden)

    M. Qasem

    2016-07-01

    Full Text Available Echocardiography in coronary artery diseases is an essential, routine echocardiography prior to primary percutaneous angioplasty is not clear. In our clinical practice in primary angioplasty we faced lots of complications either before or during or after the procedure. Moreover, lots of incidental findings that discovered after the procedure which if known will affect the plan of management. One-hundred-nineteen consecutive underwent primary angioplasty. All patients underwent FE prior to the procedure in catheterization lab while the patient was preparing for the procedure. FE with 2DE of LV at base, mid and apex, and apical stander views. Diastology grading, E/E′ and color doppler of mitral and aortic valve were performed. (N = 119 case of STMI were enrolled, mean age 51 ± 12 year. Eleven cases (9.2% had normal coronary and normal LV function. Twenty cases (17% of MI complication detected before the procedures: RV infarction 8.4% (5.1% asymptomatic and 3.3% symptomatic, ischemic MR (8.4%, LV apical aneurysm (0.8%, significant pericardial effusion (0.80%. Acute pulmonary edema in 17 cases (14.3%: six cases (5.1% developed acute pulmonary edema on the cath lab with grade 3 diastolic dysfunction and E/E ′  >20, 9 cases (7.6% develop acute pulmonary edema in CCU with grade 2–3 diastolic dysfunction and E/E′ 15–20. 2 cases (2.7% develop acute pulmonary in CCU with grade 1–2 diastolic dysfunction and E/E′ 9–14. One case (0.8% presented cardiac tamponade 2 h post PCI. Incidental finding not related to STMI were as follow: 2 cases (1.7% with severe fibro degenerative MR, 2 cases (1.7% with mild to moderate AR and 2 cases (1.7% with mild to moderate AS. Isoled CABG 5/4.2% and CABG and MVR 2/1.7%. FE play an important role in guiding the management, early detection the incidental findings and complication post PCI.

  15. Postoperative pain medication requirements in patients undergoing computer-assisted (“Robotic”) and standard laparoscopic procedures for newly diagnosed endometrial cancer.

    Science.gov (United States)

    Leitao, Mario M; Malhotra, Vivek; Briscoe, Gabriel; Suidan, Rudy; Dholakiya, Priyal; Santos, Kevin; Jewell, Elizabeth L; Brown, Carol L; Sonoda, Yukio; Abu-Rustum, Nadeem R; Barakat, Richard R; Gardner, Ginger J

    2013-10-01

    patients who had undergone an RBT hysterectomy compared to a standard total LSC hysterectomy for benign indications.13 A recent cost analysis suggested that patients experienced less pain and required less pain medication use after RBT procedures compared to LSC for endometrial cancer.14 Based on these reports, we sought to analyze postoperative pain and the use of pain medication in patients undergoing RBT compared to standard transperitoneal LSC procedures for newly diagnosed endometrial cancer during a concurrent time period. Of note, current RBT surgery is not truly robotic in that it is not autonomous. A more appropriate term is “computer-assisted surgery,” but to satisfy current convention, we refer to it as “robotic surgery” in this manuscript.

  16. Standard operating procedures for collection of soil and sediment samples for the Sediment-bound Contaminant Resiliency and Response (SCoRR) strategy pilot study

    Science.gov (United States)

    Fisher, Shawn C.; Reilly, Timothy J.; Jones, Daniel K.; Benzel, William M.; Griffin, Dale W.; Loftin, Keith A.; Iwanowicz, Luke R.; Cohl, Jonathan A.

    2015-12-17

    An understanding of the effects on human and ecological health brought by major coastal storms or flooding events is typically limited because of a lack of regionally consistent baseline and trends data in locations proximal to potential contaminant sources and mitigation activities, sensitive ecosystems, and recreational facilities where exposures are probable. In an attempt to close this gap, the U.S. Geological Survey (USGS) has implemented the Sediment-bound Contaminant Resiliency and Response (SCoRR) strategy pilot study to collect regional sediment-quality data prior to and in response to future coastal storms. The standard operating procedure (SOP) detailed in this document serves as the sample-collection protocol for the SCoRR strategy by providing step-by-step instructions for site preparation, sample collection and processing, and shipping of soil and surficial sediment (for example, bed sediment, marsh sediment, or beach material). The objectives of the SCoRR strategy pilot study are (1) to create a baseline of soil-, sand-, marsh sediment-, and bed-sediment-quality data from sites located in the coastal counties from Maine to Virginia based on their potential risk of being contaminated in the event of a major coastal storm or flooding (defined as Resiliency mode); and (2) respond to major coastal storms and flooding by reoccupying select baseline sites and sampling within days of the event (defined as Response mode). For both modes, samples are collected in a consistent manner to minimize bias and maximize quality control by ensuring that all sampling personnel across the region collect, document, and process soil and sediment samples following the procedures outlined in this SOP. Samples are analyzed using four USGS-developed screening methods—inorganic geochemistry, organic geochemistry, pathogens, and biological assays—which are also outlined in this SOP. Because the SCoRR strategy employs a multi-metric approach for sample analyses, this

  17. The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

    Directory of Open Access Journals (Sweden)

    Abdurrahim Çolak

    Full Text Available Abstract Objetive: Saline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed. Methods: Forty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74 underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90% were in NYHA class III; 34 (85% patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months. Results: While the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination. Conclusion: Radiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.

  18. Technical Note: Anatomic identification of isolated modern human molars: testing Procrustes aligned outlines as a standardization procedure for elliptic fourier analysis.

    Science.gov (United States)

    Corny, Julien; Détroit, Florent

    2014-02-01

    The determination of the precise position of permanent first and second modern human molars, following standard tooth identification criteria, is often difficult because of their morphological similarities. Here, we proposed to evaluate the suitability of two-dimensional crown contour shape analysis in achieving this objective. The method was tested separately on 180 first and second maxillary molars (UM) and 180 first and second mandibular molars (LM) securely identified (in anatomical position in their sockets). Generalized Procrustes superimposition is used to normalize the outlines prior to applying elliptic Fourier analyses ("EFAproc" method). Reliability and effectiveness of this morphometric procedure was evaluated by comparing the results obtained for the same dataset with four other morphometric methods of contour analysis. Cross-validated ("leave one individual out") percentages of misclassification yielded by linear discriminant analyses were used for determining the anatomic position of modern human molars. The percentages of misclassifications obtained from every method of contour analysis were low (1.67% to 3.33% for the UM, 5.56% to 6.67% for the LM) indicating the high suitability of crown contour analyses in correctly identifying molars. A reliable protocol, based on predictive linear discriminant analyses, was then proposed for identification of isolated molars. In addition, our results confirmed that the EFAproc method is suitable for normalizing outlines prior to undertaking elliptic Fourier analyses, especially in the case of nearly circular outlines: it obtained better classification than the classic method of normalization of Fourier descriptors for UM and provided also some advantages over the three landmarks-based methods tested here. Copyright © 2013 Wiley Periodicals, Inc.

  19. Systematic review with network meta-analysis: comparative efficacy of different enteral immunonutrition formulas in patients underwent gastrectomy.

    Science.gov (United States)

    Song, Guo-Min; Liu, Xiao-Ling; Bian, Wei; Wu, Jing; Deng, Yong-Hong; Zhang, Hui; Tian, Xu

    2017-04-04

    Optimal enteral immunonutrition (EIN) regime for gastric cancer (GC) patients underwent gastrectomy remains uncertainty. To assess comparative efficacy of different EIN formulas in GC patients underwent gastrectomy, we performed network meta-analysis. We included 11 RCTs enrolling 840 patients. Pairwise meta-analysis indicated that EIN (RR 0.56, 95% CI 0.36-0.86; MD -0.42, 95% CI -0.74-0.10), Arg+RNA+ω-3-FAs (RR 0.37, 95% CI 0.22-0.63; MD -0.42, 95% CI -0.75-0.07), Arg+Gln+ω-3-FAs (RR 0.22, 95% CI 0.05-0.94; MD -0.69, 95% CI -1.22-1.07) reduced ICs and LOS. Network meta-analysis confirmed the potential of Arg+RNA+ω-3-FAs for ICs (OR 0.27, 95% Crl 0.12-0.49) and Arg+Gln+ω-3-FAs for CIs (OR 0.22, 95% Crl 0.02-0.84) and LOS (SMD -0.63, 95% Crl -1.07-0.13), and indicated that Arg+RNA+ω-3-FAs was superior to Arg+RNA and Arg+Gln for ICs as well. We performed direct and network meta-analyses for randomized controlled trials comparing EIN formulas with each other or standard enteral nutrition (SEN) in reducing infectious complications (ICs), noninfectious complications (NICs) and length of hospital stay (LOS), through January 2016. The surface under the cumulative ranking curve (SCURA) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to rank regimes and rate qualities of evidences respectively. As for GC patients underwent gastrectomy, Arg+RNA+ω-3-FAs and Arg+Gln+ω-3-FAs are the optimal regimes of reducing ICs and LOS.

  20. Chapter 2. Surge capacity and infrastructure considerations for mass critical care. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster

    NARCIS (Netherlands)

    Hick, John L.; Christian, Michael D.; Sprung, Charles L.; Camargo, Ruben; Ceraso, Daniel; Azoulay, Elie; Duguet, Alexandre; Guery, Benoit; Reinhart, Konrad; Adini, Bruria; Barlavie, Yaron; Benin-Goren, Odeda; Cohen, Robert; Klein, Motti; Leoniv, Yuval; Margalit, Gila; Rubinovitch, Bina; Sonnenblick, Moshe; Steinberg, Avraham; Weissman, Charles; Wolff, Donna; Kesecioglu, Jozef; de Jong, Menno; Moreno, Rui; An, Youzhong; Du, Bin; Joynt, Gavin M.; Colvin, John; Loo, Shi; Richards, Guy; Artigas, Antonio; Pugin, Jerome; Amundson, Dennis; Devereaux, Asha; Beigel, John; Danis, Marion; Farmer, Chris; Maki, Dennis; Masur, Henry; Rubinson, Lewis; Sandrock, Christian; Talmor, Daniel; Truog, Robert; Zimmerman, Janice; Brett, Steve; Montgomery, Hugh; Rhodes, Andrew; Sanderson, Frances; Taylor, Bruce; Monrgomery, Hugh

    2010-01-01

    To provide recommendations and standard operating procedures for intensive care unit (ICU) and hospital preparations for a mass disaster or influenza epidemic with a specific focus on surge capacity and infrastructure considerations. Based on a literature review and expert opinion, a Delphi process

  1. Effect of using pump on postoperative pleural effusion in the patients that underwent CABG

    Directory of Open Access Journals (Sweden)

    Mehmet Özülkü

    2015-08-01

    Full Text Available Abstract Objective: The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods: A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results: The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump as compared to Group 2 (off-pump. But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893, P>0.05 for bilateral pleural effusion (P=0.780]. Left pleural effusion was encountered to be lower in Group 2 (off-pump. The difference was found to be statistically significant (P<0.05, P=0.006. Conclusion: Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting.

  2. Dysphagia among Adult Patients who Underwent Surgery for Esophageal Atresia at Birth

    Directory of Open Access Journals (Sweden)

    Valérie Huynh-Trudeau

    2015-01-01

    Full Text Available BACKGROUND: Clinical experiences of adults who underwent surgery for esophageal atresia at birth is limited. There is some evidence that suggests considerable long-term morbidity, partly because of dysphagia, which has been reported in up to 85% of adult patients who undergo surgery for esophageal atresia. The authors hypothesized that dysphagia in this population is caused by dysmotility and/or anatomical anomalies.

  3. Acute myocardial infarctation in patients with critical ischemia underwent lower limb revascularization

    Directory of Open Access Journals (Sweden)

    Esdras Marques Lins

    2013-12-01

    Full Text Available BACKGROUND: Atherosclerosis is the main cause of peripheral artery occlusive disease (PAOD of the lower limbs. Patients with PAOD often also have obstructive atherosclerosis in other arterial sites, mainly the coronary arteries. This means that patients who undergo infrainguinal bypass to treat critical ischemia have a higher risk of AMI. There are, however, few reports in the literature that have assessed this risk properly. OBJECTIVE: The aim of this study was to determine the incidence of acute myocardial infarction in patients who underwent infrainguinal bypass to treat critical ischemia of the lower limbs caused by PAOD. MATERIAL AND METHODS: A total of 64 patients who underwent 82 infrainguinal bypass operations, from February 2011 to July 2012 were studied. All patients had electrocardiograms and troponin I blood assays during the postoperative period (within 72 hours. RESULTS: There were abnormal ECG findings and elevated blood troponin I levels suggestive of AMI in five (6% of the 82 operations performed. All five had conventional surgery. The incidence of AMI as a proportion of the 52 conventional surgery cases was 9.6%. Two patients died. CONCLUSION: There was a 6% AMI incidence among patients who underwent infrainguinal bypass due to PAOD. Considering only cases operated using conventional surgery, the incidence of AMI was 9.6%.

  4. Do English NHS Microbiology laboratories offer adequate services for the diagnosis of UTI in children? Healthcare Quality Improvement Partnership (HQIP) Audit of Standard Operational Procedures.

    Science.gov (United States)

    McNulty, Cliodna A M; Verlander, Neville Q; Moore, Philippa C L; Larcombe, James; Dudley, Jan; Banerjee, Jaydip; Jadresic, Lyda

    2015-09-01

    The National Institute of Care Excellence (NICE) 2007 guidance CG54, on urinary tract infection (UTI) in children, states that clinicians should use urgent microscopy and culture as the preferred method for diagnosing UTI in the hospital setting for severe illness in children under 3 years old and from the GP setting in children under 3 years old with intermediate risk of severe illness. NICE also recommends that all 'infants and children with atypical UTI (including non-Escherichia coli infections) should have renal imaging after a first infection'. We surveyed all microbiology laboratories in England with Clinical Pathology Accreditation to determine standard operating procedures (SOPs) for urgent microscopy, culture and reporting of children's urine and to ascertain whether the SOPs facilitate compliance with NICE guidance. We undertook a computer search in six microbiology laboratories in south-west England to determine urine submissions and urine reports in children under 3 years. Seventy-three per cent of laboratories (110/150) participated. Enterobacteriaceae that were not E. coli were reported only as coliforms (rather than non-E. coli coliforms) by 61% (67/110) of laboratories. Eighty-eight per cent of laboratories (97/110) provided urgent microscopy for hospital and 54% for general practice (GP) paediatric urines; 61% of laboratories (confidence interval 52-70%) cultured 1 μl volume of urine, which equates to one colony if the bacterial load is 106 c.f.u. l(-1). Only 22% (24/110) of laboratories reported non-E. coli coliforms and provided urgent microscopy for both hospital and GP childhood urines; only three laboratories also cultured a 5 μl volume of urine. Only one of six laboratories in our submission audit had a significant increase in urine submissions and urines reported from children less than 3 years old between the predicted pre-2007 level in the absence of guidance and the 2008 level following publication of the NICE guidance. Less than a

  5. Comparison of IEEE383-2003 and IEC60505-2004 standards for harmonization of environmental qualification procedure of electric cable

    International Nuclear Information System (INIS)

    Kim, Jong Seog; Jeong, Sun Chul; Park, Kyung Heum; Jang, Kyung Nam

    2010-01-01

    Needs for harmonization of international equipment qualification(EQ) standards have been raised several years due to purchasing problem of nuclear equipment supplied from abroad country. To meet the regulatory requirement of domestic nuclear power plant, manufacturers have to qualify their equipment in accordance with each standard such as IEEE, IEC and RCC-E. Double qualification increase the equipment cost, which result in high construction cost. Even the unification of each standard have been discussed several years, we have got the long way to go yet. Comparison and harmonization of each international standard will give help to purchase the equipment qualified by not endorsed standard. Environmental qualification, seismic qualification and EMI/EMC qualification are major targets for harmonization. Since concern about cable qualification of 60 years life has been raised recently, harmonization of cable qualification standard also needs to be discussed. KEPRI launched a project for harmonization of EQ relative standards such as IEEE, IEC and RCC-E. A study for harmonization of IEEE323 and IEC60780 is known in progress by IEEE committee. In this paper, harmonization of international standards for cable qualification will be discussed. IEEE383 standard is qualification standard for electric cable broadly used in Asian pacific area while IEC60505 is mostly used in European area. Since these two standards have different requirements for environmental qualification of cable, problem can be happened in the plant site when they purchase cable qualified by not endorsed standard. IEEE383-2003 and IEC60505-2004 is the latest version of each standard. Comparison results and recommendations for harmonization of these two standards are introduced herein

  6. Standards for holdup measurement

    International Nuclear Information System (INIS)

    Zucker, M.S.

    1982-01-01

    Holdup measurement, needed for material balance, depend intensively on standards and on interpretation of the calibration procedure. More than other measurements, the calibration procedure using the standard becomes part of the standard. Standards practical for field use and calibration techniques have been developed. While accuracy in holdup measurements is comparatively poor, avoidance of bias is a necessary goal

  7. Voiding patterns of adult patients who underwent hypospadias repair in childhood.

    Science.gov (United States)

    Jaber, Jawdat; Kocherov, Stanislav; Chertin, Leonid; Farkas, Amicur; Chertin, Boris

    2017-02-01

    This study aimed at evaluating the voiding patterns of adult patients who underwent hypospadias repair in childhood. Following IRB approval 103 (22.7%) of 449 adult patients who underwent hypospadias repair between 1978 and 1993 responded to the following questionnaires: International Prostate Symptom Score (I-PSS) and Short Form 12 questionnaire (SF-12). Uroflowmetry (UF) was performed for all patients. The patients were divided into three groups according to the primary meatus localization. Group I had 63 patients (61.5%) treated for glanular hypospadias, group II had 19 patients (18.4%) treated for distal hypospadias, and group III comprised the remaining 21 patients (20.4%) treated for proximal hypospadias. The mean ± SD I-PSS score for all patients who responded to the questionnaire was 2.3 ± 2.4, and UF was 21.1 ± 4.3 mL/s. The patients from groups I and III had fewer urinary symptoms compared with those of the group II: 1.3 ± 1.5, 5.5 ± 2.4, and 1.6 ± 1.4, respectively (p hypospadias repair in childhood had normal or mild voiding disturbance, with no effects on their physical or mental status. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  8. [Prognostic Analysis of Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy Using QOL-ACD].

    Science.gov (United States)

    Fukui, Yasuhiro; Kashiwagi, Shinichiro; Takada, Koji; Goto, Wataru; Asano, Yuka; Morisaki, Tamami; Noda, Satoru; Takashima, Tsutomu; Onoda, Naoyoshi; Hirakawa, Kosei; Ohira, Masaichi

    2017-11-01

    We investigated into association of quality of life(QOL)and prognosis of breast cancer patients who underwent neoadjuvant chemotherapy(NAC). We retrospectively studied 228 patients with breast cancer who were performed NAC during a period between 2007 and 2015. TheQ OL score was measured with"The QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs(QOL-ACD)". We evaluate association between QOL score with antitumor effect and prognosis. Changes in the QOL score between before and after NAC were compared as well. We divided 2 groups by QOL-ACD scoreinto high and low groups. Therapeautic effect of NAC on 75 patients were pathological complete response(pCR). QOL-ACD score was not significantly associated with pCR rate in both high and low groups(p=0.199). High group was significantly associated with higher survival rate in both of disease free survival(p=0.009, logrank)and overall survival(p=0.040, logrank). QOLACD score decreased after NAC in both of pCR and non-pCR patients. In conclusion, QOL evaluation using QOL-ACD could be an indicator of breast cancer patients' prognosis who underwent NAC.

  9. HLA-G regulatory haplotypes and implantation outcome in couples who underwent assisted reproduction treatment.

    Science.gov (United States)

    Costa, Cynthia Hernandes; Gelmini, Georgia Fernanda; Wowk, Pryscilla Fanini; Mattar, Sibelle Botogosque; Vargas, Rafael Gustavo; Roxo, Valéria Maria Munhoz Sperandio; Schuffner, Alessandro; Bicalho, Maria da Graça

    2012-09-01

    The role of HLA-G in several clinical conditions related to reproduction has been investigated. Important polymorphisms have been found within the 5'URR and 3'UTR regions of the HLA-G promoter. The aim of the present study was to investigate 16 SNPs in the 5'URR and 14-bp insertion/deletion (ins/del) polymorphism located in the 3'UTR region of the HLA-G gene and its possible association with the implantation outcome in couples who underwent assisted reproduction treatments (ART). The case group was composed of 25 ART couples. Ninety-four couples with two or more term pregnancies composed the control group. Polymorphism haplotype frequencies of the HLA-G were determined for both groups. The Haplotype 5, Haplotype 8 and Haplotype 11 were absolute absence in ART couples. The HLA-G*01:01:02a, HLA-G*01:01:02b alleles and the 14-bp ins polymorphism, Haplotype 2, showed an increased frequency in case women and similar distribution between case and control men. However, this susceptibility haplotype is significantly presented in case women and in couple with failure implantation after treatment, which led us to suggest a maternal effect, associated with this haplotype, once their presence in women is related to a higher number of couples who underwent ART. Copyright © 2012. Published by Elsevier Inc.

  10. Sarcopenia: a new predictor of postoperative complications for elderly gastric cancer patients who underwent radical gastrectomy.

    Science.gov (United States)

    Zhou, Chong-Jun; Zhang, Feng-Min; Zhang, Fei-Yu; Yu, Zhen; Chen, Xiao-Lei; Shen, Xian; Zhuang, Cheng-Le; Chen, Xiao-Xi

    2017-05-01

    A geriatric assessment is needed to identify high-risk elderly patients with gastric cancer. However, the current geriatric assessment has been considered to be either time-consuming or subjective. The present study aimed to investigate the predictive effect of sarcopenia on the postoperative complications for elderly patients who underwent radical gastrectomy. We conducted a prospective study of patients who underwent radical gastrectomy from August 2014 to December 2015. Computed tomography-assessed lumbar skeletal muscle, handgrip strength, and gait speed were measured to define sarcopenia. Sarcopenia was present in 69 of 240 patients (28.8%) and was associated with lower body mass index, lower serum albumin, lower hemoglobin, and higher nutritional risk screening 2002 scores. Postoperative complications significantly increased in the sarcopenic patients (49.3% versus 24.6%, P sarcopenia (odds ratio: 2.959, 95% CI: 1.629-5.373, P Sarcopenia, presented as a new geriatric assessment factor, was a strong and independent risk factor for postoperative complications of elderly patients with gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Effect of different pneumoperitoneum pressure on stress state in patients underwent gynecological laparoscopy

    Directory of Open Access Journals (Sweden)

    Ai-Yun Shen

    2016-10-01

    Full Text Available Objective: To observe the effect of different CO2 pneumoperitoneum pressure on the stress state in patients underwent gynecological laparoscopy. Methods: A total of 90 patients who were admitted in our hospital from February, 2015 to October, 2015 for gynecological laparoscopy were included in the study and divided into groups A, B, and C according to different CO2 pneumoperitoneum pressure. The changes of HR, BP, and PetCO2 during the operation process in the three groups were recorded. The changes of stress indicators before operation (T0, 30 min during operation (T1, and 12 h after operation (T2 were compared. Results: The difference of HR, BP, and PetCO2 levels before operation among the three groups was not statistically significant (P>0.05. HR, BP, and PetCO2 levels 30 min after pneumoperitoneum were significantly elevated when compared with before operation (P0.05. PetCO2 level 30 min after pneumoperitoneum in group B was significantly higher than that in group A (P0.05. Conclusions: Low pneumoperitoneum pressure has a small effect on the stress state in patients underwent gynecological laparoscopy, will not affect the surgical operation, and can obtain a preferable muscular relaxation and vision field; therefore, it can be selected in preference.

  12. Analysis of Ulcer Recurrences After Metatarsal Head Resection in Patients Who Underwent Surgery to Treat Diabetic Foot Osteomyelitis.

    Science.gov (United States)

    Sanz-Corbalán, Irene; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; García-Morales, Esther; Molines-Barroso, Raúl; Alvaro-Afonso, Francisco Javier

    2015-06-01

    Metatarsal head resection is a common and standardized treatment used as part of the surgical routine for metatarsal head osteomyelitis. The aim of this study was to define the influence of the amount of the metatarsal resection on the development of reulceration or ulcer recurrence in patients who suffered from plantar foot ulcer and underwent metatarsal surgery. We conducted a prospective study in 35 patients who underwent metatarsal head resection surgery to treat diabetic foot osteomyelitis with no prior history of foot surgeries, and these patients were included in a prospective follow-up over the course of at least 6 months in order to record reulceration or ulcer recurrences. Anteroposterior plain X-rays were taken before and after surgery. We also measured the portion of the metatarsal head that was removed and classified the patients according the resection rate of metatarsal (RRM) in first and second quartiles. We found statistical differences between the median RRM in patients who had an ulcer recurrence and patients without recurrences (21.48 ± 3.10% vs 28.12 ± 10.8%; P = .016). Seventeen (56.7%) patients were classified in the first quartile of RRM, which had an association with ulcer recurrence (P = .032; odds ratio = 1.41; 95% confidence interval = 1.04-1.92). RRM of less than 25% is associated with the development of a recurrence after surgery in the midterm follow-up, and therefore, planning before surgery is undertaken should be considered to avoid postsurgical complications. © The Author(s) 2015.

  13. Comparising the Succinylcholine onset effect with Atracurium - Alfentanyl in patient underwent rapid sequence Induction

    Directory of Open Access Journals (Sweden)

    hasan Teimouri

    2005-12-01

    Conclusion: According to results, use of Atra + Alfen method can replace the standard method (succinylcholine for contraindicated condition. Mild vocal cord movement and mild bucking in the Atracurium + Alfentanyl can be control by that a increase in Atracurium dose.

  14. A Pregnant Woman Who Underwent Laparoscopic Adrenalectomy due to Cushing’s Syndrome

    Directory of Open Access Journals (Sweden)

    Halit Diri

    2014-01-01

    Full Text Available Cushing’s syndrome (CS may lead to severe maternal and fetal morbidities and even mortalities in pregnancy. However, pregnancy complicates the diagnosis and treatment of CS. This study describes a 26-year-old pregnant woman admitted with hypertension-induced headache. Hormonal analyses performed due to her cushingoid phenotype revealed a diagnosis of adrenocorticotropic hormone- (ACTH- independent CS. MRI showed a 3.5 cm adenoma in her right adrenal gland. After preoperative metyrapone therapy, she underwent a successful unilateral laparoscopic adrenalectomy at 14-week gestation. Although she had a temporary postoperative adrenal insufficiency, hormonal analyses showed that she has been in remission since delivery. Findings in this patient, as well as those in previous patients, indicate that pregnancy is not an absolute contraindication for laparoscopic adrenalectomy. Rather, such surgery should be considered a safe and efficient treatment method for pregnant women with cortisol-secreting adrenal adenomas.

  15. Enteral nutrition is superior to total parenteral nutrition for pancreatic cancer patients who underwent pancreaticoduodenectomy.

    Science.gov (United States)

    Liu, Changli; Du, Zhi; Lou, Cheng; Wu, Chenxuan; Yuan, Qiang; Wang, Jun; Shu, Guiming; Wang, Yijun

    2011-01-01

    To determine the effects of total parenteral nutrition (TPN) and enteral nutrition (EN) on biochemical and clinical outcomes in pancreatic cancer patients who underwent pancreaticoduodenectomy. From the year 2006 to 2008, 60 patients who underwent pancreaticoduodenectomy in Tianjin Third Central Hospital were enrolled in this study. They were randomly divided into the EN group and the TPN group. The biochemical and clinical parameters were recorded and analyzed between the two groups. There was no significant difference in the nutritional status, liver and kidney function, and blood glucose levels between the TPN and EN groups on the preoperative day, the 1st and 3 rd postoperative days. However, on the 7th postoperative day, there was significant difference between the two groups in 24 h urinary nitrogen, serum levels of, total protein (TP), transferrin (TF), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transpeptadase (GGT), blood urea nitrogen (BUN) and creatinine (Cr). On the 14th postoperative day, there was a significant difference between the two groups in terms of urinary levels of 24 h nitrogen, TP, TF, retinol binding protein, ALT, AST, ALP, GGT, total bilirubin, direct bilirubin, BUN, Cr, and glucose. The incidence of delayed gastric emptying in the EN and TPN groups was 0% and 20%, respectively. Moreover, the incidence of pancreatic fistulas and hemorrhages in the EN group were 3.6% and 3.6%, versus 26.7% and 30% in the TPN group, respectively. EN is better than TPN for pancreatic cancer patients who received pancreaticoduodenectomy.

  16. Tools, harmonization and standardization procedures of the impact and outcome evaluation indices obtained during a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study.

    Science.gov (United States)

    Mouratidou, T; Miguel, M L; Androutsos, O; Manios, Y; De Bourdeaudhuij, I; Cardon, G; Kulaga, Z; Socha, P; Galcheva, S; Iotova, V; Payr, A; Koletzko, B; Moreno, L A

    2014-08-01

    The ToyBox-intervention is a kindergarten-based, family-involved intervention targeting multiple lifestyle behaviours in preschool children, their teachers and their families. This intervention was conducted in six European countries, namely Belgium, Bulgaria, Germany, Greece, Poland and Spain. The aim of this paper is to provide a descriptive overview of the harmonization and standardization procedures of the baseline and follow-up evaluation of the study (and substudies). Steps related to the study's operational, standardization and harmonization procedures as well as the impact and outcome evaluation assessment tools used are presented. Experiences from the project highlight the importance of safeguarding the measurement process to minimize data heterogeneity derived from potential measurement error and country-by-country differences. In addition, it was made clear that continuing quality control and support is an important component of such studies. For this reason, well-supported communication channels, such as regular email updates and teleconferences, and regular internal and external meetings to ensure smooth and accurate implementation were in place during the study. The ToyBox-intervention and its harmonized and standardized procedures can serve as a successful case study for future studies evaluating the efficacy of similar interventions. © 2014 World Obesity.

  17. Comparison of Healthcare Costs Among Commercially Insured Women in the United States Who Underwent Hysteroscopic Sterilization Versus Laparoscopic Bilateral Tubal Ligation Sterilization.

    Science.gov (United States)

    Carney, Patricia I; Yao, Jianying; Lin, Jay; Law, Amy

    2017-05-01

    This study evaluated healthcare costs of index procedures and during a 6-month follow-up of women who had hysteroscopic sterilization (HS) versus laparoscopic bilateral tubal ligation (LBTL). Women (18-49 years) with claims for HS and LBTL procedures were identified from the MarketScan commercial claims database (January 1, 2010, to December 31, 2012) and placed into separate cohorts. Demographics, characteristics, index procedure costs, and 6-month total healthcare costs and sterilization procedure-related costs were compared. Multivariable regression analyses were used to examine the impact of HS versus LBTL on costs. Among the study population, 12,031 had HS (mean age: 37.0 years) and 7286 had LBTL (mean age: 35.8 years). The majority (80.9%) who had HS underwent the procedure in a physician's office setting. Fewer women who had HS versus LBTL received the procedure in an inpatient setting (0.5% vs. 2.1%), an ambulatory surgical center setting (5.0% vs. 23.8%), or a hospital outpatient setting (13.4% vs. 71.9%). Mean total cost for the index sterilization procedure was lower for HS than for LBTL ($3964 vs. $5163, p women who had HS versus LBTL. Multivariable regression results confirmed that costs were lower for women who had HS versus LBTL. Among commercially insured women in the United States, HS versus LBTL is associated with lower average costs for the index procedure and lower total healthcare and procedure-related costs during 6 months after the sterilization procedure.

  18. Study of verification and validation of standard welding procedure specifications guidelines for API 5L X-70 grade line pipe welding

    Directory of Open Access Journals (Sweden)

    Qazi H. A. A.

    2017-12-01

    Full Text Available Verification and validation of welding procedure specifications for X-70 grade line pipe welding was performed as per clause 8.2, Annexure B and D of API 5L, 45th Edition to check weld integrity in its future application conditions. Hot rolled coils were imported from China, de-coiling, strip edge milling, three roller bending to from pipe, inside and outside submerged arc welding of pipe, online ultrasonic testing of weld, HAZ and pipe body, cutting at fixed random length of pipe, visual inspection of pipe, Fluoroscopic inspection of pipe, welding procedure qualification test pieces marking at weld portion of the pipe, tensile testing, guided bend testing, CVN Impact testing were performed. Detailed study was conducted to explore possible explanations and variation in mechanical properties, WPS is examined and qualified as per API 5L 45th Edition.

  19. Study of the seroma volume changes in the patients who underwent Accelerated Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Ho; Son, Sang Jun; Mun, Jun Ki; Seo, Seok Jin; Lee, Je Hee [Dept. of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-06-15

    By analyzing seroma volume changes in the patients who underwent Partial breast radiation therapy after breast conserving surgery, we try to contribute to the improvement of radiotherapy effect. Enrolled 20 patients who underwent partial breast radiation therapy by ViewRay MRIdian System were subject. After seeking for the size of the removed sample in the patients during surgery and obtained seroma volume changes on a weekly basis. On the Basis of acquired volume, it was compared with age, term from start of the first treatment after surgery, BMI (body mass index) and the extracted sample size during surgery. And using the ViewRay MRIdian RTP System, the figure was analyzed by PTV(=seroma volume + margin) to obtain a specific volume of the Partial breast radiation therapy. The changes of seroma volume from MR simulation to the first treatment (a week) is 0~5% in 8, 5~10% in 3, 10 to 15% in 2, and 20% or more in 5 people. Two patients(A, B patient) among subjects showed the biggest change. The A patient's 100% of the prescribed dose volume is 213.08 cc, PTV is 181.93 cc, seroma volume is 15.3 cc in initial plan. However, while seroma volume decreased 65.36% to 5.3 cc, 100% of the prescribed dose volume was reduced to 3.4% to 102.43 cc and PTV also did 43.6% to 102.54 cc. In the case of the B patient, seroma volume decreased 42.57% from 20.2 cc to 11.6 cc. Because of that, 100% of the prescribed dose volume decreased 8.1% and PTV also did to 40%. As the period between the first therapy and surgery is shorter, the patient is elder and the size of sample is smaller than 100 cc, the change grow bigger. It is desirable to establish an adaptive plan according to each patient's changes of seroma volume through continuous observation. Because partial breast patients is more sensitive than WBRT patients about dose conformity in accordance with the volume change.

  20. Development and Monte Carlo Study of a Procedure for Correcting the Standardized Mean Difference for Measurement Error in the Independent Variable

    Science.gov (United States)

    Nugent, William Robert; Moore, Matthew; Story, Erin

    2015-01-01

    The standardized mean difference (SMD) is perhaps the most important meta-analytic effect size. It is typically used to represent the difference between treatment and control population means in treatment efficacy research. It is also used to represent differences between populations with different characteristics, such as persons who are…

  1. The procedure of evaluating the practical adhesion strength of new biocompatible nano- and micro-thin films in accordance with international standards

    Czech Academy of Sciences Publication Activity Database

    Kutílek, P.; Mikšovský, Jan

    2011-01-01

    Roč. 13, č. 3 (2011), s. 87-94 ISSN 1509-409X Institutional research plan: CEZ:AV0Z10100522 Keywords : practical adhesion * strength * nano-layer * micro-layer * international standards * scratch test Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 0.449, year: 2011 http://382.indexcopernicus.com/abstracted.php?level=5&ICID=962671

  2. Procedure for the standardized measure of the detective quantum efficiency in digital mammography; Procedimiento para la medida estandarizada de la Eficiencia Cuantica de Deteccion en un mamografo digital

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Martin, G.; Garcia Castano, P.; Bermudez Luna, R.; Fernandez Bedoya, V.; Espana Lopez, M. L.; Miquelez Alonso, S.

    2011-07-01

    The objective of this work is to develop a simple guide for determining the DQE, according to the CEI, in those having mammography flat panel detectors, and highlight the main difficulties that may be in the process of the standardized measurement.

  3. [A survey of perioperative asthmatic attack among patients with bronchial asthma underwent general anesthesia].

    Science.gov (United States)

    Ie, Kenya; Yoshizawa, Atsuto; Hirano, Satoru; Izumi, Sinyuu; Hojo, Masaaki; Sugiyama, Haruhito; Kobayasi, Nobuyuki; Kudou, Kouichirou; Maehara, Yasuhiro; Kawachi, Masaharu; Miyakoshi, Kouichi

    2010-07-01

    We investigated the risk factor of perioperative asthmatic attack and effectiveness of preventing treatment for asthmatic attack before operation. We performed retrospective chart review of one hundred eleven patients with asthma underwent general anesthesia and surgical intervention from January 2006 to October 2007 in our hospital. The rate of perioperative asthmatic attack were as follows; 10.2% (5 in 49 cases) in no pretreatment group, 7.5% (3 in 40 cases) in any pretreatments except for systemic steroid, and 4.5% (1 in 22 cases) in systemic steroid pretreatment group. Neither preoperative asthma severity nor duration from the last attack had significant relevancy to perioperative attack rate. The otolaryngological surgery, especially those have nasal polyp and oral surgery had high perioperative asthma attack rate, although there was no significant difference. We recommend the systemic steroid pretreatment for asthmatic patients, especially when they have known risk factor such as administration of the systemic steroid within 6 months, or possibly new risk factor such as nasal polyp, otolaryngological and oral surgery.

  4. Congenital hydrocele: prevalence and outcome among male children who underwent neonatal circumcision in Benin City, Nigeria.

    Science.gov (United States)

    Osifo, O D; Osaigbovo, E O

    2008-06-01

    To determine the prevalence and spontaneous resolution of congenital hydrocele diagnosed in male neonates who underwent circumcision at our centre. All male neonates presented for circumcision at the University of Benin Teaching Hospital, Benin City, Nigeria between January 2002 and December 2006 were examined for the presence of hydrocele. Those diagnosed with this condition were recruited and followed up in a surgical outpatient clinic for 2 years. The number of cases of spontaneous resolution and age at which this occurred were documented on a structured pro forma. A total of 2715 neonates were circumcised and 128 (4.7%) were diagnosed with 163 cases of hydrocele, while 27 cases in 25 (0.9%) children failed to resolve at the age of 2 years. Neonatal hydrocele was bilateral in 112 (68.7%), and there were 20 (12.3%) right and 31 (19.0%) left. Among those with hydrocele, 28.1% were delivered preterm and resolution was spontaneous in many of them, with no observed significant statistical difference to those delivered full term (P=0.4740). Of the 163 hydrocele cases, 136 (83.4%) resolved spontaneously by age 18 months with peak resolution at 4-6 months. No spontaneous resolution occurred after 18 months and no hydrocele-related complication occurred during follow up. Neonates with congenital hydrocele should be observed for spontaneous resolution for at least 18 months before being subjected to surgery.

  5. Stress and Quality of Life for Taiwanese Women Who Underwent Infertility Treatment.

    Science.gov (United States)

    Cheng, Ching-Yu; Stevenson, Eleanor Lowndes; Yang, Cheng-Ta; Liou, Shwu-Ru

    2018-04-28

    To describe the psychological stress and quality of life experienced by women who underwent fertility treatment in Taiwan. Cross-sectional, correlational study. Recruitment was conducted and questionnaires administered at a reproductive medicine center in Chiayi City, Taiwan. Informed consent to participate was obtained from 126 women who sought fertility treatment at the center. The Chinese Fertility Problem Inventory and Fertility Quality of Life scale were used to measure participants' levels of fertility-related stress and fertility-related quality of life. Descriptive statistics, correlation, and regression analysis were used. Overall, participants reported low levels of fertility-related stress and fertility-related quality of life; however, they had relatively high levels of stress related to need for parenthood. Women who were older, had greater body mass indexes, and consumed coffee regularly had lower fertility-related quality of life. Social and relationship concerns and stress related to need for parenthood were significant predictors of low fertility-related quality of life. In a culture in which childbearing is generally an expectation and an important part of family life, women who experience infertility are at risk to experience fertility-related stress. Social support and family consultation might be offered to improve women's fertility-related quality of life. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  6. Relevant Standards

    Indian Academy of Sciences (India)

    .86: Ethernet over LAPS. Standard in China and India. G.7041: Generic Framing Procedure (GFP). Supports Ethernet as well as other data formats (e.g., Fibre Channel); Protocol of ... IEEE 802.3x for flow control of incoming Ethernet data ...

  7. Developing policies and procedures.

    Science.gov (United States)

    Randolph, Susan A

    2006-11-01

    The development of policies and procedures is an integral part of the occupational health nurse's role. Policies and procedures serve as the foundation for the occupational health service and are based on its vision, mission, culture, and values. The design and layout selected for the policies and procedures should be simple, consistent, and easy to use. The same format should be used for all existing and new policies and procedures. Policies and procedures should be reviewed periodically based on a specified time frame (i.e., annually). However, some policies may require a more frequent review if they involve rapidly changing external standards, ethical issues, or emerging exposures.

  8. The Effects of Functional Knee Brace on Postural Control in Patients Who Underwent Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Salehi

    2016-09-01

    Full Text Available Background The current study aimed to evaluate the postural control in patients underwent anterior cruciate ligament reconstruction pre and post wearing functional knee brace. Methods Eighteen athletes undergone unilateral anterior cruciate ligament reconstruction included in the study. They had unilateral anterior cruciate ligament reconstruction at least six months before session test. Postural control was assessed pre and post wearing custom-fit functional knee brace using a posturographic platform prokin 254. The balance tests included: 1 standing on prokin platform with eyes open/closed on anterior cruciate ligament reconstruction limb, 2 standing on prokin platform with eyes open/closed on both limbs. The standard deviation (SD of body sway along the anteroposterior (AP and mediolateral (ML axis, mean velocity of center of pressure (COP along AP/ ML axis and the area ellipse (measured in 2 mm were calculated. Results Results of the paired T-test revealed a significant effect on selected postural control variables for the brace conditions especially in low challengeable conditions (double leg, eyes open test situations (P < 0.05. But in high challengeable conditions this effect was not significant. Conclusions Functional knee brace improved postural control in the simple balancing task in the subjects with anterior cruciate ligament reconstruction. But this improvement in more difficult balancing task was limited.

  9. The Effect of Prazosin and Oxybutynin on the Symptoms Due to Using Double J Catheter in Patients Underwent TUL

    Directory of Open Access Journals (Sweden)

    K. Tavakkoli Tabassi

    2014-01-01

    Full Text Available Background & Aims: Double J catheter has been used for years as an independent practice or a part of other urological practices. Although these catheters have solved many patients’ problems but those can cause symptoms and problems for patients. The aim of this study was the investigation the effect of prazosin and oxybutynin on the degree of symptoms due to using Double J catheter. Methods: In this interventional study, patients who underwent TUL from July 2008 to march 2008 in the lithotripsy ward of Imam Reza hospital were entered to the study and randomly divided in 3 groups randomly. In the first group, placebo, in the second group, oxybutynin, in the third group prazosin were prescribed. Three weeks later standard questionnaire Ureteric Stent Symptom Questionnaire (USSQ was completed. After collecting data, was analyzed using SPSS software. Results: A total of 113 patients (70 men 43 women were included to the study. The mean age was 39 years. There were no significance difference among urinary symptoms score pain of body and physical activity problems in three groups (P>0.05, but there was a significant difference in general health and work problems among them (P<0.05. Conclusion: Oxybutynin caused a low effect on improvement of general health and work problems in patients who were studied. It might Prazosin does not has a sufficient time to affect on urinary symptoms, because of shortness of usage.

  10. Consent for routine neonatal procedures: A study of practices in Irish neonatal units. How do we compare with the gold standard BAPM guidelines?

    LENUS (Irish Health Repository)

    Ryan, M A

    2017-06-01

    The Irish National Consent Policy (NCP)¹ proposes that the legal requirement for consent extends to all forms of interventions, investigations and treatment, carried out on or behalf of the Health Service Executive (HSE). This study employs a quantitative descriptive approach to investigate the practices for obtaining consent for an identified group of routine neonatal procedures in neonatal facilities throughout Ireland. The BAPM (British Association of Perinatal Medicine)² guidelines were identified as ‘gold standard’ for the purposes of this study. The results indicated a lack of consistency between participating units pertaining to the modes of consent utilised and notable variances from ‘gold standard’ guidelines. Unanimity was evident for 3 procedures only (administering BCG, 6-in-1, and donor breast milk to infant). Significant findings related to EEG with video recordings, MRI\\/CT and gastro intestinal imaging, screening of an infant with suspected substance abuse or retinopathy of prematurity screening (ROP), administration of Vitamin K, and the carrying out of a lumbar puncture.

  11. Long-term outcomes of four patients with tracheal agenesis who underwent airway and esophageal reconstruction.

    Science.gov (United States)

    Tazuke, Yuko; Okuyama, Hiroomi; Uehara, Shuichiro; Ueno, Takehisa; Nara, Keigo; Yamanaka, Hiroaki; Kawahara, Hisayoshi; Kubota, Akio; Usui, Noriaki; Soh, Hideki; Nomura, Motonari; Oue, Takaharu; Sasaki, Takashi; Nose, Satoko; Saka, Ryuta

    2015-12-01

    The aim of this study was to evaluate the long-term outcomes of four patients with tracheal agenesis who underwent airway and esophageal/alimentary reconstruction. We reviewed the medical records of four long-term survivors of tracheal agenesis and collected the following data: age, sex, type of tracheal agenesis, method of reconstruction, nutritional management, and physical and neurological development. The patients consisted of three boys and one girl, who ranged in age from 77 to 109months. The severity of their condition was classified as Floyd's type I (n=2), II (n=1), or III (n=1). Mechanical respiratory support was not necessary in any of the cases. Esophageal/alimentary reconstruction was performed using the small intestine (n=2), a gastric tube (n=1), and the esophagus (n=1). The age at esophageal reconstruction ranged from 41 to 55months. All of the cases required enteral nutrition via gastrostomy. Three of the patients were able to swallow a small amount of liquid and one was able to take pureed food orally. The physical development of the subjects was moderately delayed-borderline in childhood. Neurological development was normal in two cases and slightly delayed in two cases. None of the long-term survivors of tracheal agenesis required the use of an artificial respirator, and their development was close to normal. Future studies should aim to elucidate the optimal method for performing esophageal reconstruction to allow tracheal agenesis patients to achieve their full oral intake. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Shantavasinkul, Prapimporn Chattranukulchai; Omotosho, Philip; Corsino, Leonor; Portenier, Dana; Torquati, Alfonso

    2016-11-01

    Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for obesity and results in long-term weight loss and resolution of co-morbidities. However, weight regain may occur as soon as 1-2 years after surgery. This retrospective study aimed to investigate the prevalence of weight regain and possible preoperative predictors of this phenomenon after RYGB. An academic medical center in the United States. A total of 1426 obese patients (15.8% male) who underwent RYGB during January 2000 to 2012 and had at least a 2-year follow-up were reviewed. We included only patients who were initially successful, having achieved at least 50% excess weight loss at 1 year postoperatively. Patients were then categorized into either the weight regain group (WR) or sustained weight loss (SWL) group based upon whether they gained≥15% of their 1-year postoperative weight. Weight regain was observed in 244 patients (17.1%). Preoperative body mass index was similar between groups. Body mass index was significantly higher and percent excess weight loss was significantly lower in the WR group (Pweight regain was 19.5±9.3 kg and-.8±8.5 in the WR and SWL groups, respectively (Pweight loss. Moreover, a longer duration after RYGB was associated with weight regain. Multivariate analysis revealed that younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The present study confirmed that a longer interval after RYGB was associated with weight regain. Younger age was a significant predictor of weight regain even after adjusting for time since RYGB. The findings of this study underscore the complexity of the mechanisms underlying weight loss and regain after RYGB. Future prospective studies are needed to further explore the prevalence, predictors, and mechanisms of weight regain after RYGB. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  13. Newly Developed Sarcopenia as a Prognostic Factor for Survival in Patients who Underwent Liver Transplantation.

    Directory of Open Access Journals (Sweden)

    Ja Young Jeon

    Full Text Available The relationship between a perioperative change in sarcopenic status and clinical outcome of liver transplantation (LT is unknown. We investigated whether post-LT sarcopenia and changes in sarcopenic status were associated with the survival of patients.This retrospective study was based on a cohort of 145 patients from a single transplant center who during a mean of 1 year after LT underwent computed tomography imaging evaluation. The cross-sectional area of the psoas muscle of LT patients was compared with that of age- and sex-matched healthy individuals. The Cox proportional hazards regression model was used to determine whether post-LT sarcopenia and changes in sarcopenic status affect post-LT survival.The mean age at LT of the 116 male and 29 female patients was 50.2 ± 7.9 years; the mean follow-up duration was 51.6 ± 32.9 months. All pre-LT patients with sarcopenia still had sarcopenia 1 year after LT; 14 (15% patients had newly developed sarcopenia. The mean survival duration was 91.8 ± 4.2 months for non-sarcopenic patients and 80.0 ± 5.2 months for sarcopenic patients (log-rank test, p = 0.069. In subgroup analysis, newly developed sarcopenia was an independent negative predictor for post-LT survival (hazard ratio: 10.53, 95% confidence interval: 1.37-80.93, p = 0.024.Sarcopenia in LT recipients did not improve in any of the previously sarcopenic patients and newly developed within 1 year in others. Newly developed sarcopenia was associated with increased mortality. Newly developed sarcopenia can be used to stratify patients with regard to the risk of post-LT mortality.

  14. The Effectiveness of Adjuvant Hyperbaric Oxygen Therapy in Adults who Underwent Hypospadias Surgery

    Directory of Open Access Journals (Sweden)

    Onder Kara

    2017-01-01

    Full Text Available Aim: To evaluate the role of hyperbaric oxygen therapy (HBO2T with buccal mucosal tube urethroplasty in adult patients with hypospadias. Material and Method: Sixteen adult patients with hypospadias were included in our study. Patients with a short urethra and penile curvature were treated in two stages (orthoplasty buccal mucosal tube urethroplasty. Buccal mucosa was taken and prepared for tube urethroplasty around a 16 French (Fr nelaton catheter and the urethral tube was introduced between the urethral meatus and glans penis. Beginning the 1st postoperative day (HBO2T was applied for 10 sessions during weekdays in 13 patients. Results: The mean age was 21 (±1.23 years and mean follow-up time was 10.1 (±2.1 months. In the group who received HBO2T postoperatively (n=13, a two-stage (orthoplasty buccal mucosal tube urethroplasty procedure was performed in 6 (46%, and the mean length of graft was 5.4 (±1.23 cm. In this group of 13 the success rate without any additional manipulations (urethrotomy intern, fistula repair was 54% (7/13. After additional manipulations, complete healing was achieved in 11 out of 13 patients (84.6%. In the group who did not receive HBO2T postoperatively (n=3, a two-stage procedure was performed in 1 patient (33%, and the mean length of graft was 8 (±5 cm. In this group of 3, complete healing was not achieved in any of these patients as a result of the hypospadias surgery. However, after the additional manipulations, complete healing was achieved in 1 patient (33%. Discussion: Given the promising rates of surgical success, postoperative HBO2T might be considered as a supportive treatment modality for adult patients with hypospadias who undergo buccal mucosal tube urethroplasty. Randomized controlled studies are needed.

  15. Elaboration and implementation of standard operational procedure for quality assurance of cone beam CT image in radiotherapy; Elaboracao e implementacao de procedimentos operacionais padrao para controle de qualidade da imagem CBCT em radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Bonatto, Larisse N.; Estacio, Daniela R.; Lopes, Juliane S.; Sansson, Angela; Duarte, Lucas O.; Sbaraini, Patricia; Silva, Ana M. Marques da; Streck, Elaine E., E-mail: larisse.neumann@pucrs.br [Pontificia Universidade Catolica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS (Brazil)

    2016-07-01

    The objective of this article is to present the implementation of the quality Control of Cone Beam Computed Tomography (CBCT) image, generated by the On-Board Imager, integrated with the linear accelerator Trilogy. Standard operating procedures (POPs) have been developed based on the literature and manuals of the simulator object Catphan 504 and the On-Board Imager. The following POPs were developed: acquisition of the CBCT image; linearity of CT number; uniformity; spatial resolution; low contrast resolution; spatial linearity; thickness of the cut. The validation of the elaborated procedures was done from an experimental acquisition of the simulator object. The results obtained in the validation of the POPs are in compliance with the parameters established by the manufacturer of the simulator object, as well as those obtained in the acceptance of the On-Board Imager device.

  16. Elaboration and implementation of standard operational procedure for quality assurance of cone beam CT image in radiotherapy; Elaboracao e implementacao de procedimentos operacionais padrao para controle de qualidade da imagem CBCT em radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Bonatto, Larisse N.; Estacio, Daniela R.; Lopes, Juliane S.; Sansson, Angela; Duarte, Lucas O.; Sbaraini, Patricia, E-mail: larisse.neumann@pucrs.br [Hospital Sao Lucas (PUC-RS), Porto Alegre, RS (Brazil). Servico de Radioterapia; Silva, Ana M. Marques da; Streck, Elaine E. [Pontificia Universidade Catolica do Rio Grande do Sukl (PUC-RS), Porto Alegre, RS (Brazil). Faculdade de Fisica

    2016-07-01

    The aim of this paper is to present the implementation of image quality control of the computed tomography cone beam (CBCT), generated by the On-Board Imager device, and integrated into the linear accelerator Trilogy. To this end, standard operating procedures (SOP) based on the literature and Catphan 504 phantom and On-Board Imager manuals were drafted. The following SOPs were prepared: acquisition of CBCT image; CT number linearity; uniformity; spatial resolution; low contrast resolution; spatial linearity; slice thickness. The validation of the procedures from an experimental acquisition of the phantom was performed. The results, obtained in the SOP validation, are in accordance with the parameters established by the phantom manufacturer, as well as those obtained in the On-Board Imager device acceptance. (author)

  17. Balancing energy conservation and occupant needs in ventilation rate standards for Big Box stores and other commercial buildings in California. Issues related to the ASHRAE 62.1 Indoor Air Quality Procedure

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Apte, Mike G. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2010-10-31

    This report considers the question of whether the California Energy Commission should incorporate the ASHRAE 62.1 ventilation standard into the Title 24 ventilation rate (VR) standards, thus allowing buildings to follow the Indoor Air Quality Procedure. This, in contrast to the current prescriptive standard, allows the option of using ventilation rate as one of several strategies, which might include source reduction and air cleaning, to meet specified targets of indoor air concentrations and occupant acceptability. The research findings reviewed in this report suggest that a revised approach to a ventilation standard for commercial buildings is necessary, because the current prescriptive ASHRAE 62.1 Ventilation Rate Procedure (VRP) apparently does not provide occupants with either sufficiently acceptable or sufficiently healthprotective air quality. One possible solution would be a dramatic increase in the minimum ventilation rates (VRs) prescribed by a VRP. This solution, however, is not feasible for at least three reasons: the current need to reduce energy use rather than increase it further, the problem of polluted outdoor air in many cities, and the apparent limited ability of increasing VRs to reduce all indoor airborne contaminants of concern (per Hodgson (2003)). Any feasible solution is thus likely to include methods of pollutant reduction other than increased outdoor air ventilation; e.g., source reduction or air cleaning. The alternative 62.1 Indoor Air Quality Procedure (IAQP) offers multiple possible benefits in this direction over the VRP, but seems too limited by insufficient specifications and inadequate available data to provide adequate protection for occupants. Ventilation system designers rarely choose to use it, finding it too arbitrary and requiring use of much non-engineering judgment and information that is not readily available. This report suggests strategies to revise the current ASHRAE IAQP to reduce its current limitations. These

  18. BTS statistical standards manual

    Science.gov (United States)

    2005-10-01

    The Bureau of Transportation Statistics (BTS), like other federal statistical agencies, establishes professional standards to guide the methods and procedures for the collection, processing, storage, and presentation of statistical data. Standards an...

  19. Preoperative evaluation of myocardial viability by thallium-201 imaging in patients with old myocardial infarction who underwent coronary revascularization

    International Nuclear Information System (INIS)

    Naruse, Hitoshi; Ohyanagi, Mitsumasa; Iwasaki, Tadaaki; Miyamoto, Takashi; Fukuchi, Minoru

    1992-01-01

    The myocardial uptake and redistribution in thallium scintigraphy and the regional wall motion by echocardiography were evaluated by a semi-quantitative method in 42 patients who previously had myocardial infarction (50 target vessels) and underwent coronary revascularization. The aim of this study was to elucidate the significance of the initial image, delayed image and redistribution on thallium-201 scintigraphy for clinical diagnosis of the myocardial viability. As a semi-quantitative analysis, we used a bull's-eye display for thallium image and centerline method for echocardiographic wall motion, and compared the results before and after revascularization. As a result, the thallium grade improved postoperatively in all 17 areas which preoperatively had showed redistribution, and also in 11 of the 32 areas without preoperative redistribution. The sensitivity, specificity and accuracy of preoperative thallium redistribution for predicting myocardial viability were 61%, 100% and 78%, respectively, when the postoperative improvement in the thallium grade was used as the standard. The postoperative probability of improvement in the thallium grade increased in proportion to the preoperative grade (delayed image)(p<0.01). There was no correlation between the preoperative thallium delayed image and postoperative improvement in wall motion. Postoperative improvement in thallium image and wall motion could not be predicted from the preoperative wall motion. Thus, postoperative improvement in thallium images can be anticipated if redistribution is present on the preoperative thallium image, and the preoperative thallium delayed image is useful for predicting myocardial viability. Improvement in wall motion could not be predicted preoperatively by these methods. (author)

  20. Accuracy of bone SPECT/CT for identifying hardware loosening in patients who underwent lumbar fusion with pedicle screws

    Energy Technology Data Exchange (ETDEWEB)

    Hudyana, Hendrah; Maes, Alex [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Hospital Leuven, Department of Morphology and Medical Imaging, Leuven (Belgium); Vandenberghe, Thierry; Fidlers, Luc [AZ Groeninge, Department of Neurosurgery, Kortrijk (Belgium); Sathekge, Mike [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Nicolai, Daniel [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Wiele, Christophe van de [AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Ghent, Department of Radiology and Nuclear Medicine, Ghent (Belgium)

    2016-02-15

    The aim of this retrospective study was to evaluate the accuracy of bone SPECT (single photon emission computed tomography)/CT (computed tomography) in diagnosing loosening of fixation material in patients with recurrent or persistent back pain that underwent lumbar arthrodesis with pedicle screws using surgery and clinical follow-up as gold standard A total of 48 patients (median age 49 years, range 21-81 years; 17 men) who had undergone lumbar spinal arthrodesis were included in this retrospective analysis. SPECT/CT results were compared to the gold standard of surgical evaluation or clinical follow-up. Positive SPECT/CT results were considered true positives if findings were confirmed by surgery or if clinical and other examinations were completely consistent with the positive SPECT/CT finding. They were considered false positives if surgical evaluation did not find any loose pedicle screws or if symptoms subsided with non-surgical therapy. Negative SPECT/CT scans were considered true negatives if symptoms either improved without surgical intervention or remained stable over a minimum follow-up period of 6 months. Negative SPECT/CT scans were determined to be false negatives if surgery was still required and loosening of material was found. The median length of time from primary surgery to bone SPECT/CT referral was 29.5 months (range 12-192 months). Median follow-up was 18 months (range 6-57) for subjects who did not undergo surgery. Thirteen of the 48 patients were found to be positive for loosening on bone SPECT/CT. Surgical evaluation (8 patients) and clinical follow-up (5 patients) showed that bone SPECT/CT correctly predicted loosening in 9 of 13 patients, while it falsely diagnosed loosening in 4 patients. Of 35 negative bone SPECT/CT scans, 12 were surgically confirmed. In 18 patients, bone SPECT/CT revealed lesions that could provide an alternative explanation for the symptoms of pain (active facet degeneration in 14 patients, and disc and sacroiliac

  1. The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital

    Directory of Open Access Journals (Sweden)

    Luciana Takata Pontes

    2015-11-01

    Full Text Available OBJECTIVE: Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal. METHODS: The records of patients who underwent Mohs micrographic surgery from October 2008 to November 2013 at the Dermatology Division of the Hospital of the Campinas University were assessed. The variables included were gender, age, anatomical location, histology, number of stages required and complications. RESULTS: Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications. CONCLUSION: Although superficial basal cell carcinoma is typically thought to represent a less-aggressive variant of these tumors, its propensity for demonstrating “skip areas” and clinically indistinct borders make it a challenge to treat. Its particular nature may result in the higher number of surgery stages required, which may, as a consequence, result in more complications, including recurrence. Recurrence likely occurs due to the inadequate excision of the tumors despite their clear margins. Further research on this subtype of basal cell carcinoma is needed to optimize treatments and decrease morbidity.

  2. The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital.

    Science.gov (United States)

    Takata Pontes, Luciana; Fantelli Stelini, Rafael; Cintra, Maria Leticia; Magalhães, Renata Ferreira; Velho, Paulo Eduardo N F; Moraes, Aparecida Machado

    2015-11-01

    Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal. The records of patients who underwent Mohs micrographic surgery from October 2008 to November 2013 at the Dermatology Division of the Hospital of the Campinas University were assessed. The variables included were gender, age, anatomical location, histology, number of stages required and complications. Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications. Although superficial basal cell carcinoma is typically thought to represent a less-aggressive variant of these tumors, its propensity for demonstrating "skip areas" and clinically indistinct borders make it a challenge to treat. Its particular nature may result in the higher number of surgery stages required, which may, as a consequence, result in more complications, including recurrence. Recurrence likely occurs due to the inadequate excision of the tumors despite their clear margins. Further research on this subtype of basal cell carcinoma is needed to optimize treatments and decrease morbidity.

  3. Lack of standardization in the procedures for mycological examination of sputum samples from CF patients: a possible cause for variations in the prevalence of filamentous fungi.

    Science.gov (United States)

    Borman, Andrew M; Palmer, Michael D; Delhaes, Laurence; Carrère, Jacqueline; Favennec, Loïc; Ranque, Stéphane; Gangneux, Jean-Pierre; Horré, Regine; Bouchara, Jean-Philippe

    2010-11-01

    Filamentous fungi and yeasts are increasingly isolated from respiratory secretions of patients with cystic fibrosis (CF), and persistent fungal colonization of the airways of such patients is thought to exacerbate lung damage. While many independent studies have identified Aspergillus fumigatus complex as the principal colonizing fungus in CF, increased awareness of the role of fungi in CF pathology coupled with improved mycological culture and identification methods have resulted in a number of other fungi being isolated and reported from CF sputum samples, including A. terreus, members of the Pseudallescheria boydii/Scedosporium apiospermum complex, Exophiala dermatitidis, Paecilomyces and Penicillium species. However, the range of fungal pathogens isolated and the relative prevalence of individual species vary widely between reports from different geographical CF centres, and as yet no standardized method for the mycological examination of CF sputum samples has been adopted. Here, we examine the potential contribution of the mycological methods employed to examine CF respiratory secretions relative to the variability in the fungal biota reported. The role of direct microscopic examination of respiratory samples and the impact of the culture conditions used on the detection of specific fungal pathogens are addressed, and the potential significance of isolation of yeast species from CF patient airways is discussed.

  4. Comparing efficacy of preemptively used dexketoprofen and tramadol for postoperative pain in patients underwent laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Süreyya Özkan

    2015-03-01

    Full Text Available Objective: In our study, we aimed to compare effects of preoperative dexketoprofen and tramadol administered by intravenous route on intraoperative and postoperative analgesic consumption, postoperative pain, durations of hospital stay and patient satisfaction in patients, undergoing laparoscopic cholecystectomy. Methods:After approval of ethic committee and written consent of patients were obtained, 60 patients between 18-70 years old with ASA I-II were included in the study. After routine monitorization and 20 minutes before induction of anesthesia, dexketoprofen 50 mg in 100 cc 0.9% NaCl was administered in Dexketoprofen Group and tramadol 100 mg in 100 cc 0.9% NaCl in Tramadol Group as intravenous infusion during 20 minutes. Intraoperative hemodynamic parameters, analgesic-anesthetic consumptions and complications of patients, on whom standard general anesthesia was applied, were recorded. Pain severity, degree of sedation, morphine consumptions and hemodynamic parameters were recorded at postoperative 30 th minute, and 4 th, 8th, 12th and 24 th hours. Additional analgesia requirement, times for requiring first analgesia, duration of hospital stay, postoperative complications and patient satisfactions were recorded. Results: Intraoperative analgesic-anesthetic consumptions, postoperative visual analogue scale (VAS scores, sedation degrees, intravenous patient controlled analgesia (PCA and morphine consumptions, times for requiring first analgesic, durations of hospital stay, intraoperative-postoperative complications developed and patient satisfactions were similar in both groups. Consequently, postoperative analgesic efficacy of pre-emptive dexketoprofen intravenous 50 mg and tramadol intravenous 100 mg administered was found to be similar in cases, who had laparoscopic cholecystectomy operation. Conclusion:Because VAS scores were low in our patients, morphine consumptions with intravenous PCA were similar in both groups, and there wasn

  5. NUTRITIONAL ASPECTS AND THE USE OF NUTRITIONAL SUPPLEMENTS BY WOMEN WHO UNDERWENT GASTRIC BYPASS.

    Science.gov (United States)

    Trindade, Elisangela Mara; Gebara, Telma Souza E Silva; Cambi, Maria Paula Carlini; Baretta, Giorgio Alfredo Pedroso

    2017-01-01

    Bariatric surgery is deemed one of the most effective procedures for the treatment of obesity and it aims at the reduction and maintenance of weight loss in long term, as the control of the related comorbidities. Quantify the occurrence of alterations of the gastrointestinal tract, suggestive signs of nutritional deficiencies and the use of supplements in a group of women undergoing bariatric surgery. The sample consisted of women aged 20-65 years submitted to Roux-en-Y gastric bypass with monitoring equal to or higher than 24 months. For the qualitative analysis, the Feeding Frequency Questionnaire was used. In the postoperative period, alopecia was the most reported (79.3%), followed by changes in the texture of the nails, both considered predictive of nutritional deficiencies. Changes in the gastrointestinal tract were described in 86.2%, and episodes of dumping were reported in 65.5%. Qualitative analysis has shown reduced daily consumption of sources of animal and plant proteins. After bariatric surgery can occur flatulence, vomiting and dumping syndrome as the most frequent representative symptoms of digestive functional disorders. Alopecia and nail changes are the most important signs of nutritional deficiency. The use of dietary supplements in the postoperative period is scarce and sporadic. A cirurgia bariátrica é considerada um dos procedimentos mais eficazes para tratamento da obesidade e objetiva a redução e manutenção da perda de peso em longo prazo, assim como, o controle das comorbidades associadas. Quantificar a ocorrência de alterações funcionais do trato gastrointestinal, sinais sugestivos de carências nutricionais e o uso de suplementos em um grupo de mulheres submetidas à cirurgia bariátrica. A amostra foi constituída por mulheres com idades entre 20-65 anos submetidas ao bypass gástrico em Y-de-Roux com seguimento igual ou superior a 24 meses. Para análise qualitativa foi utilizado o Questionário de Frequência Alimentar. No per

  6. Quantization Procedures

    International Nuclear Information System (INIS)

    Cabrera, J. A.; Martin, R.

    1976-01-01

    We present in this work a review of the conventional quantization procedure, the proposed by I.E. Segal and a new quantization procedure similar to this one for use in non linear problems. We apply this quantization procedures to different potentials and we obtain the appropriate equations of motion. It is shown that for the linear case the three procedures exposed are equivalent but for the non linear cases we obtain different equations of motion and different energy spectra. (Author) 16 refs

  7. [Standardizing the manipulation procedure of acupuncture-moxibustion, reinforcing the training of' clinical skill: learning experience of Acupuncture-moxibustion Clinical Skills Training: Chapter of Commonly Used Needling and Moxibustion Techniques].

    Science.gov (United States)

    Tian, Hongfang; Yang, Chao; Tang, Jie; Qin, Qiuguo; Zhao, Mingwen; Zhao, Jiping

    2015-07-01

    The book Acupuncture-moxibustion Clinical Skills Training is one of "Twelfth Five-Year Plan" in novative teaching materials, which is published by People's Medical Publishing House. Through learning the first half of the book commonly used needling and moxibustion techniques, it is realized that the selection of book content is reasonable and much attention is paid to needling and moxibustion techniques; the chapter arrangement is well-organized, and the form is novel, which is concise and intuitive; for every technique, great attention is paid to standardize the manipulation procedure and clarify the technique key, simultaneously the safety of acupuncture and moxibustion is also emphasized. The characteristics of the book, including innovativeness, practicability, are highlighted, and it greatly helps to improve students' clinical skills and examination ability.

  8. [Findings from Total Colonoscopy in Obstructive Colorectal Cancer Patients Who Underwent Stent Placement as a Bridge to Surgery(BTS)].

    Science.gov (United States)

    Maruo, Hirotoshi; Tsuyuki, Hajime; Kojima, Tadahiro; Koreyasu, Ryohei; Nakamura, Koichi; Higashi, Yukihiro; Shoji, Tsuyoshi; Yamazaki, Masanori; Nishiyama, Raisuke; Ito, Tatsuhiro; Koike, Kota; Ikeda, Takashi; Takayanagi, Yasuhiro; Kubota, Hiroyuki

    2017-11-01

    We clinically investigated 34 patients with obstructive colorectal cancer who underwent placement of a colonic stent as a bridge to surgery(BTS), focusing on endoscopic findings after stent placement.Twenty -nine patients(85.3%)underwent colonoscopy after stent placement, and the entire large intestine could be observed in 28(96.6%).Coexisting lesions were observed in 22(78.6%)of these 28 patients.The lesions comprised adenomatous polyps in 17 patients(60.7%), synchronous colon cancers in 5 patients(17.9%), and obstructive colitis in 3 patients(10.7%), with some overlapping cases.All patients with multiple cancers underwent one-stage surgery, and all lesions were excised at the same time.Colonoscopy after colonic stent placement is important for preoperative diagnosis of coexisting lesions and planning the extent of resection. These considerations support the utility of colonic stenting for BTS.

  9. Accreditation Criteria: Policies, Procedures, and Standards

    Science.gov (United States)

    Accrediting Council for Independent Colleges and Schools, 2010

    2010-01-01

    The Accrediting Council for Independent Colleges and Schools ("ACICS" or "Council") supports the concept that periodic evaluation entered into voluntarily by institutions and their peers enhances the quality of the educational process and demonstrates that self regulation of a profession is superior to outside regulation. This has been the…

  10. Adaptive Standard Operating Procedures for Complex Disasters

    Science.gov (United States)

    2017-03-01

    applies. Additionally, the predictive aspect of the SOP model provides policy makers and emergency planners a “ shopping list” for various types of...the complex crisis environment on September 11 as the needs of the moment inspired improvisational solutions in the absence of SOP guidance. The...three-minute window of opportunity for the military aircraft to intercept Flight 175 before it strikes the South Tower. In simulation terms, the goal

  11. Emergency Support Function 15 Standard Operating Procedures

    Science.gov (United States)

    2013-08-01

    offices, and various field offices to coordinate federal messaging.  Outreach materials were translated in 22 languages to ensure information was...effective formats. The function is also responsible for managing the translation of information into languages other than English which have been...of Defense and Deputy Secretary of Defense for public information, internal information, community relations, information training, and audiovisual

  12. MILSTRIP. MILitary, STandard, Requisitioning and Issue Procedures.

    Science.gov (United States)

    1987-05-01

    DTA Asset Support Request submitted for obsolete/inactive NSN which cannot be supported. (Applies to reference (cc) DZG trans- action rejects only...Republic of CV Cayman Islands CJ Chad CD Chile CI China (People’s Republic of) CH Colombia CO Colombia (International Narcotics Control) D5 Comoros CR...Liechtenstein LS Lithuania LH Luxembourg LX Macau MC Madagascar MA Malawi MI Malaysia MF Maldives MV Mali RM Malta MT Martinique MB Mauritania MR Mauritius

  13. Standardization of Code on Dental Procedures

    Science.gov (United States)

    1992-02-13

    such as dental implants . Credit one per patient examined. 0141 6.2 Postmortem Examination or Bite Mark Analysis for Identification. Postmortem dental ... endodontic therapy , or sensitivity testing. 0420 0.8 Oral Mucosal Smear. Credit one per specimen collected for cytological, DNA identification... Endodontic Interim Treatment. Treatment accomplished during the course of root canal therapy . Do not take credit for this code on the first or last

  14. Standard operating procedure for computing pangenome trees

    DEFF Research Database (Denmark)

    Snipen, L.; Ussery, David

    2010-01-01

    We present the pan-genome tree as a tool for visualizing similarities and differences between closely related microbial genomes within a species or genus. Distance between genomes is computed as a weighted relative Manhattan distance based on gene family presence/absence. The weights can be chose...

  15. Civil Procedure.

    Science.gov (United States)

    Byer, Robert

    1997-01-01

    Briefly reviews the historical development of civil procedure (the rules that dictate how a civil case can proceed through the courts) and identifies some of its main components. Discusses procedures such as subject matter jurisdiction, personal jurisdiction, venue, discovery, motions practice, pleadings, pretrial conference, and trials. (MJP)

  16. Photodigitizing procedures

    Science.gov (United States)

    Kilgore, P. D.; Gottbrath, J. H.

    1984-02-01

    This report documents procedures and programs for efficiently running the Photo Digitizing System at the Naval Biodynamics Laboratory. Procedures have been tested and have been found to be effective. Any future acquisitions of programs or changes to current programs should be incorporated in these procedures. On-going research programs use high speed instrumentation cameras to record the motion of test subjects during biodynamic experiments. The films are digitized and the 3-dimensional motion is reconstructed and analyzed. Experimental research is performed to determine the effects of aircraft crashes, ship motion, vibration, aircraft ejection and parachute opening forces on the health and performance of Navy personnel.

  17. APACHE II SCORING SYSTEM AND ITS MODIFICATION FOR THE ASSESSMENT OF DISEASE SEVERITY IN CHILDREN WHO UNDERWENT POLYCHEMOTHERAPY

    Directory of Open Access Journals (Sweden)

    А. V. Sotnikov

    2014-01-01

    Full Text Available Short-term disease prognosis should be considered for the appropriate treatment policy based on the assessment of disease severity in patients with acute disease. The adequate assessment of disease severity and prognosis allows the indications for transferring patients to the resuscitation and intensive care department to be defined more precisely. Disease severity of patients who underwent polychemotherapy was assessed using APACHE II scoring system.

  18. Atrioventricular septal defect (AVSD) : A study of 219 patients who underwent surgery for AVSD at Rikshospitalet from 1979 to 1999

    OpenAIRE

    Skraastad, Ingrid Birthe Bendixen; Skraastad, Berit Kristine

    2010-01-01

    Background: The present study evaluates 219 consecutive patients that underwent surgical repair for AVSD in a long term follow-up. Methods: The patients had a surgical correction for AVSD at Rikshospitalet from January 1979 to December 1999. The follow-up was closed in January 2009. AVSD with additional defects and syndromes were included. Results: Forty-two patients died during the observational period. Early mortality was 12.8% and late mortality was 6.4%. Early mortality declined f...

  19. Oculoplastic procedures

    Science.gov (United States)

    ... procedures may be done on the: Eyelids Eye sockets Eyebrows Cheeks Tear ducts Face or forehead These ... eyes. These lenses help protect your eyes and shield them from the bright lights of the surgical ...

  20. European Organisation for Research and Treatment of Cancer (EORTC) Pathobiology Group standard operating procedure for the preparation of human tumour tissue extracts suited for the quantitative analysis of tissue-associated biomarkers.

    Science.gov (United States)

    Schmitt, Manfred; Mengele, Karin; Schueren, Elisabeth; Sweep, Fred C G J; Foekens, John A; Brünner, Nils; Laabs, Juliane; Malik, Abha; Harbeck, Nadia

    2007-03-01

    With the new concept of 'individualized treatment and targeted therapies', tumour tissue-associated biomarkers have been given a new role in selection of cancer patients for treatment and in cancer patient management. Tumour biomarkers can give support to cancer patient stratification and risk assessment, treatment response identification, or to identifying those patients who are expected to respond to certain anticancer drugs. As the field of tumour-associated biomarkers has expanded rapidly over the last years, it has become increasingly apparent that a strong need exists to establish guidelines on how to easily disintegrate the tumour tissue for assessment of the presence of tumour tissue-associated biomarkers. Several mechanical tissue (cell) disruption techniques exist, ranging from bead mill homogenisation and freeze-fracturing through to blade or pestle-type homogenisation, to grinding and ultrasonics. Still, only a few directives have been given on how fresh-frozen tumour tissues should be processed for the extraction and determination of tumour biomarkers. The PathoBiology Group of the European Organisation for Research and Treatment of Cancer therefore has devised a standard operating procedure for the standardised preparation of human tumour tissue extracts which is designed for the quantitative analysis of tumour tissue-associated biomarkers. The easy to follow technical steps involved require 50-300 mg of deep-frozen cancer tissue placed into small size (1.2 ml) cryogenic tubes. These are placed into the shaking flask of a Mikro-Dismembrator S machine (bead mill) to pulverise the tumour tissue in the capped tubes in the deep-frozen state by use of a stainless steel ball, all within 30 s of exposure. RNA is isolated from the pulverised tissue following standard procedures. Proteins are extracted from the still frozen pulverised tissue by addition of Tris-buffered saline to obtain the cytosol fraction of the tumour or by the Tris buffer supplemented with

  1. Bioactivity and laundering resistance of five commercially available, factory-treated permethrin-impregnated fabrics for the prevention of mosquito-borne diseases: the need for a standardized testing and licensing procedure.

    Science.gov (United States)

    Faulde, Michael K; Pages, Frederic; Uedelhoven, Waltraud

    2016-04-01

    Personal protective measures against hematophagous vectors constitute the first line of defense against arthropod-borne diseases. In this regard, a major advance has been the development of residual insecticides that can be impregnated into clothing. Currently, however, information on specific treatment procedures, initial insecticide concentrations, arthropod toxicity, residual activity, and laundering resistance is either fragmentary or non-existent, and no World Health Organization Pesticides Evaluation Scheme or other guidelines exist for the standardized testing and licensing of insecticide-treated clothing. The aim of this study was to analyze the insecticide content, contact toxicity, laundering resistance, and residual activity of five commercially available and commonly used permethrin-treated fabrics-Insect Shield, ExOfficio, Sol's Monarch T-shirts, battle dress uniforms (BDUs), and Labonal socks-against vector-competent Aedes aegypti, Anopheles stephensi, and Culex pipiens mosquitoes under laboratory conditions. Prior to laundering, permethrin concentrations ranged from 4300 to 870 mg/m(2) whereas, after 100 defined machine launderings, the remaining permethrin content fell to between 1800 and 20 mg/m(2), a percentage permethrin loss of 58.1 to 98.5 %. The highest 99 % knockdown (KD99) efficacy of permethrin was detected in Ae. aegypti, followed by An. stephensi and Cx. pipiens demonstrating that Ae. aegypti is the most sensitive species and Cx. pipiens the least sensitive. After 100 launderings, the remaining biocidal efficacy differed markedly among the five brands, with KD99 times varying from 38.8 ± 2.9 to >360 min for Ae. aegypti, from 44 ± 3.5 to >360 min for An. stephensi, and from 98 ± 10.6 to >360 min for Cx. pipiens. Overall, the ranking of the residual biocidal efficacies within the five brands tested was as follows: BDU ≈ Labonal > Sol's Monarch > ExOfficio > Insect Shield. When applying German Armed Forces

  2. Comparison of libido, Female Sexual Function Index, and Arizona scores in women who underwent laparoscopic or conventional abdominal hysterectomy

    Science.gov (United States)

    Kayataş, Semra; Özkaya, Enis; Api, Murat; Çıkman, Seyhan; Gürbüz, Ayşen; Eser, Ahmet

    2017-01-01

    Objective: The aim of the present study was to compare female sexual function between women who underwent conventional abdominal or laparoscopic hysterectomy. Materials and Methods: Seventy-seven women who were scheduled to undergo hysterectomy without oophorectomy for benign gynecologic conditions were included in the study. The women were assigned to laparoscopic or open abdominal hysterectomy according to the surgeons preference. Women with endometriosis and symptomatic prolapsus were excluded. Female sexual function scores were obtained before and six months after the operation from each participant by using validated questionnaires. Results: Pre- and postoperative scores of three different quationnaires were found as comparable in the group that underwent laparoscopic hysterectomy (p>0.05). Scores were also found as comparable in the group that underwent laparotomic hysterectomy (p>0.05). Pre- and postoperative values were compared between the two groups and revealed similar results with regard to all three scores (p>0.05). Conclusion: Our data showed comparable pre- and the postoperative scores for the two different hysterectomy techniques. The two groups were also found to have similar pre- and postoperative score values. PMID:28913149

  3. Vaginal and pelvic recurrence rates based on vaginal cuff length in patients with cervical cancer who underwent radical hysterectomies.

    Science.gov (United States)

    Kim, K; Cho, S Y; Park, S I; Kim, B J; Kim, M H; Choi, S C; Ryu, S Y; Lee, E D

    2011-09-01

    The objective of this study was to determine the association of vaginal cuff length (VCL) with vaginal and pelvic recurrence rates in patients with cervical cancer who underwent radical hysterectomies. The clinicopathologic characteristics were collected from the medical records of 280 patients with cervical cancer who underwent radical hysterectomies. The association of VCL with 3-year vaginal and pelvic recurrence rates was determined using a Z-test. The association of VCL with other clinicopathologic characteristics was also determined. The VCL was not associated with 3-year vaginal and pelvic recurrence rates. The 3-year vaginal recurrence rate was 0%-2% and the 3-year pelvic recurrence rate was 7%-8%, independent of VCL. The VCL and the age of patients had an inverse relationship. However, the VCL was not associated with histologic type, FIGO stage, clinical tumor size, tumor size in the surgical specimen, depth of invasion, lymphovascular space invasion, parametrial involvement, lymph node involvement, and adjuvant therapy. One-hundred ninety of 280 patients (68%) underwent adjuvant therapies following radical hysterectomies. Although it is limited by the high rate of adjuvant therapy, the current study suggested that the VCL following radical hysterectomy in patients with cervical cancer was not associated with vaginal and pelvic recurrence rates. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Cerebrospinal fluid composition modifications after neuroendoscopic procedures.

    Science.gov (United States)

    Salvador, L; Valero, R; Carrero, E; Caral, L; Fernández, S; Marín, J L; Ferrer, E; Fábregas, N

    2007-02-01

    Normal saline solution is currently used as the ventricular irrigation fluid during neuroendoscopic procedures. The aim of this study is to determine the alterations in the cerebrospinal fluid (CSF) composition after neuroendoscopic interventions. Twenty nine patients who underwent a neuroendoscopic procedure under general anaesthesia were studied. Temperature inside the cerebral ventricle was measured and samples of CSF were taken to determinate oxygen and carbon dioxide partial pressures, pH, base excess, ionised calcium, standard bicarbonate, glucose, sodium, potassium, magnesium, total calcium, proteins, chlorine and osmolality before initiating the irrigation and after the neuronavigation. Patient demographics, neuronavigation time, total fluid volume used and temperature of the irrigation solution and complications that appeared in the first 24 hours were collected. Mean age of the patients was 42+/-18 years. The mean neuronavigation time was 21.5+/-15.4 minutes. The mean amount of saline solution used for irrigation was 919.6+/-994.7 mL. All the values studied in the CSF, except osmolality, showed significant variations. There was a significant correlation between the CSF variation of pH, oxygen and carbon dioxide partial pressures, base excess, standard bicarbonate, glucose and total calcium with respect to the total volume of irrigation solution, but not with respect to the neuronavigation time. A cut-off point of 500 mL of irrigation solution (sensitivity 0.7; specificity 0.87) was related with a CSF pH decrease greater than 0.2. The use of saline as irrigation solution during neuroendoscopic procedures produces important changes in CSF.

  5. Use of Low-Fidelity Simulation Laboratory Training for Teaching Radiology Residents CT-Guided Procedures.

    Science.gov (United States)

    Picard, Melissa; Nelson, Rachel; Roebel, John; Collins, Heather; Anderson, M Bret

    2016-11-01

    To determine the benefit of the addition of low-fidelity simulation-based training to the standard didactic-based training in teaching radiology residents common CT-guided procedures. This was a prospective study involving 24 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by low-fidelity simulation-based training on three common CT-guided procedures: random liver biopsy, lung nodule biopsy, and drain placement. Baseline knowledge, confidence, and performance assessments were obtained after the didactic session and before the simulation training session. Approximately 2 months later, all residents participated in a simulation-based training session covering all three of these procedures. Knowledge, confidence, and performance data were obtained afterward. These assessments covered topics related to preprocedure workup, intraprocedure steps, and postprocedure management. Knowledge data were collected based on a 15-question assessment. Confidence data were obtained based on a 5-point Likert-like scale. Performance data were obtained based on successful completion of predefined critical steps. There was significant improvement in knowledge (P = .005), confidence (P training to the standard didactic curriculum for all procedures. This study suggests that the addition of low-fidelity simulation-based training to a standard didactic-based curriculum is beneficial in improving resident knowledge, confidence, and tested performance of common CT-guided procedures. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Impact of gastrectomy procedural complexity on surgical outcomes and hospital comparisons.

    Science.gov (United States)

    Mohanty, Sanjay; Paruch, Jennifer; Bilimoria, Karl Y; Cohen, Mark; Strong, Vivian E; Weber, Sharon M

    2015-08-01

    Most risk adjustment approaches adjust for patient comorbidities and the primary procedure. However, procedures done at the same time as the index case may increase operative risk and merit inclusion in adjustment models for fair hospital comparisons. Our objectives were to evaluate the impact of surgical complexity on postoperative outcomes and hospital comparisons in gastric cancer surgery. Patients who underwent gastric resection for cancer were identified from a large clinical dataset. Procedure complexity was characterized using secondary procedure CPT codes and work relative value units (RVUs). Regression models were developed to evaluate the association between complexity variables and outcomes. The impact of complexity adjustment on model performance and hospital comparisons was examined. Among 3,467 patients who underwent gastrectomy for adenocarcinoma, 2,171 operations were distal and 1,296 total. A secondary procedure was reported for 33% of distal gastrectomies and 59% of total gastrectomies. Six of 10 secondary procedures were associated with adverse outcomes. For example, patients who underwent a synchronous bowel resection had a higher risk of mortality (odds ratio [OR], 2.14; 95% CI, 1.07-4.29) and reoperation (OR, 2.09; 95% CI, 1.26-3.47). Model performance was slightly better for nearly all outcomes with complexity adjustment (mortality c-statistics: standard model, 0.853; secondary procedure model, 0.858; RVU model, 0.855). Hospital ranking did not change substantially after complexity adjustment. Surgical complexity variables are associated with adverse outcomes in gastrectomy, but complexity adjustment does not affect hospital rankings appreciably. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Measurement of patient radiation doses in certain urography procedures

    International Nuclear Information System (INIS)

    Sulieman, A.; Barakat, H.; Zailae, A.; Abuderman, A.; Theodorou, K.

    2015-01-01

    Patients are exposed to significant radiation doses during diagnostic and interventional urological procedures. This study aimed to measure patient entrance surface air kerma (ESAK) and to estimate the effective dose during intravenous urography (IVU), extracorporeal shock-wave lithotripsy (ESWL), and ascending urethrogram (ASU) procedures. ESAK was measured in patients using calibrated thermo luminance dosimeters, GR200A). Effective doses (E) were calculated using the National Radiological Protection Board (NRPB) software. A total of 179 procedures were investigated. 27.9 % of the patients underwent IVU procedures, 27.9 % underwent ESWL procedures and 44.2 % underwent ASU procedures. The mean ESAK was 2.1, 4.18 and 4.9 mGy for IVU, ESWL, and ASU procedures, respectively. Differences in patient ESAK for the same procedure were observed. The mean ESAK values were comparable with those in previous studies. (authors)

  8. Bentall Procedure Using Cryopreserved Valved Aortic Homografts

    Science.gov (United States)

    Christenson, Jan T.; Sierra, Jorge; Trindade, Pedro T.; Didier, Dominique; Kalangos, Afksendiyos

    2004-01-01

    The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 ± 21 years (range, 15–74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 ± 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6–72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft. PMID:15745290

  9. The prognostic significance of preoperatively assessed AST/ALT (De Ritis) ratio on survival in patients underwent radical cystectomy.

    Science.gov (United States)

    Gorgel, Sacit Nuri; Kose, Osman; Koc, Esra Meltem; Ates, Erhan; Akin, Yigit; Yilmaz, Yuksel

    2017-09-01

    We aimed to evaluate prognostic significance of preoperatively assessed aspartate aminotransaminase (AST)/alanine aminotransferase (ALT) (De Ritis) ratio on survival in bladder cancer (BC) patients underwent radical cystectomy (RC). We, respectively, analysed clinical and pathological data of 153 patients who underwent RC for BC between February 2006 and December 2016 at a tertiary level hospital. The potential prognostic value of De Ritis ratio was assessed by using ROC curve analysis. The effect of the De Ritis ratio was analysed by the Kaplan-Meier method and Cox regression hazard models for patients' disease-specific survival (DSS) and overall survival (OAS). We had 149 BC patients, in total. Mean age was 61.65 ± 9.13 years. One hundred and thirty-nine (93.3%) of the patients were men. According to ROC analysis, optimal threshold of De Ritis ratio for DSS was 1.30. In Kaplan-Meier analyses, the high De Ritis ratio group showed worse progression in DSS and OAS (all parameters, p < 0.001). On Cox regression models of clinical and pathological parameters to predict DSS, De Ritis ratio (HR 5.79, 95% CI 2.25-15.13), pathological T stage (HR 15.89, 95% CI 3.92-64.33, in all p < 0.001); and to predict OAS, De Ritis ratio (HR 2.61, 95% CI 1.49-4.56; p < 0.001), pathological T stage (HR 5.42, 95% CI 2.63-11.64; p < 0.001) and age (HR 1.05, 95% CI 1.02-1.08; p = 0.001) were determined as independent prognostic factors. Preoperative elevated De Ritis ratio could be an independent prognostic factor in BC patients underwent RC. Our results should be confirmed by large and properly designed prospective, randomized trials.

  10. [Four patients with hepatitis A presenting with fulminant hepatitis and acute renal failure and who underwent liver transplantation].

    Science.gov (United States)

    Oh, Se Hoon; Lee, Joon Hyoek; Hwang, Ji Won; Kim, Hye Young; Lee, Chang Hoon; Gwak, Geum Youn; Choi, Moon Seok; Koh, Kwang Chul; Paik, Seung Woon; Yoo, Byung Chul

    2009-09-01

    Hepatitis A is generally known as a mild, self-limiting disease of the liver, but in rare instances it can progress to fulminant hepatitis, which may require liver transplantation for recovery. Such cases are known to be related to old age and underlying liver disease. We report four cases of hepatitis A in which patients presented with fulminant hepatitis and acute renal failure and underwent liver transplantation. The following common features were observed in our cases: (1) occurrence in relatively old age (>/=39 years old), (2) association with acute renal failure, (3) presence of hepatomegaly, and (4) microscopic features of submassive hepatic necrosis.

  11. Clinical Outcomes of patients with coronary artery disease who underwent FFR evaluation of intermediate coronary lesionS– COFFRS study

    Directory of Open Access Journals (Sweden)

    Srinivasa Prasad

    2017-07-01

    Conclusion: In our experience, MACE events were not higher in patients with FFR > 0.8 and kept under medical therapy and were similarly lower in patients with FFR ≤0.8 and underwent revascularisation (p = 0.73. Also MACE events were higher in patients with FFR ≤ 0.8 and did not undergo revascularisation compared to other two appropriately treated groups (p = 0.03. FFR based revascularization decision appears to be a safe strategy in Indian patients.

  12. Adequate procedures for specific exams

    International Nuclear Information System (INIS)

    Staevie, G.L.G.; Gattringer, D.K.; Dal Mas, C.R.; Tessman, M.

    1996-01-01

    Some ideal procedures for specific radiographic exams are briefly presented. The aim is to improve the quality standard, establishing a specific method for each exam in order to decrease films waste and reduce the patient dose exposure

  13. Environmental procedures

    International Nuclear Information System (INIS)

    1992-01-01

    The European Bank has pledged in its Agreement to place environmental management at the forefront of its operations to promote sustainable economic development in central and eastern Europe. The Bank's environmental policy is set out in the document titled, Environmental Management: The Bank's Policy Approach. This document, Environmental Procedures, presents the procedures which the European Bank has adopted to implement this policy approach with respect to its operations. The environmental procedures aim to: ensure that throughout the project approval process, those in positions of responsibility for approving projects are aware of the environmental implications of the project, and can take these into account when making decisions; avoid potential liabilities that could undermine the success of a project for its sponsors and the Bank; ensure that environmental costs are estimated along with other costs and liabilities; and identify opportunities for environmental enhancement associated with projects. The review of environmental aspects of projects is conducted by many Bank staff members throughout the project's life. This document defines the responsibilities of the people and groups involved in implementing the environmental procedures. Annexes contain Environmental Management: The Bank's Policy Approach, examples of environmental documentation for the project file and other ancillary information

  14. [Anesthetic Management of an Infant who Underwent Awake-intubation for Her Pharyngeal Injury Caused by a Toothbrush].

    Science.gov (United States)

    Nakano, Yoko; Suzuki, Hiroaki; Arai, Takero; Hashimoto, Yuichi; Okuda, Yasuhisa

    2016-04-01

    A 2-year-and-4-month-old female infant, 12 kg in weight and 90 cm in height fell off from a table, which was about 1 m height with a toothbrush in her mouth without her parents noticing. Urgent CT scan showed that it penetrated the left side of her oropharyngeal wall to the bifurcation of her right carotid artery. According to the initial assessment, carotid artery seemed intact and there seemed to be no sign of CNS involvement. She underwent general anesthesia for further investigation and operation. We could detect vocal code with ease by inserting Glidescope between her tongue and the toothbrush. After the intubation, we administered fentanyl 25 μg rocuronium 15 mg and sevoflulane 3-5% to her, and then she underwent arteriography. The neurosurgeon found no sign of major arterial injury nor traumatic aneurysm nor CNS involvement. She went to the ICU intubated after the removal of the toothbrush. She was extubated 5 days after operation. One of the benefits of the Glidescope is that we can share the visual image, and we chose it this time. When we expect a difficult airway during management for oropharyngeal trauma, we have to consider the way to manage the airway.

  15. Citrus aurantium Naringenin Prevents Osteosarcoma Progression and Recurrence in the Patients Who Underwent Osteosarcoma Surgery by Improving Antioxidant Capability

    Directory of Open Access Journals (Sweden)

    Lirong Zhang

    2018-01-01

    Full Text Available Citrus aurantium is rich in flavonoids, which may prevent osteosarcoma progression, but its related molecular mechanism remains unclear. Flavonoids were extracted from C. aurantium and purified by reparative HPLC. Each fraction was identified by using electrospray ionisation mass spectrometry (ESI-MS. Three main components (naringin, naringenin, and hesperetin were isolated from C. aurantium. Naringenin inhibited the growth of MG-63 cells, whereas naringin and hesperetin had no inhibitory function on cell growth. ROS production was increased in naringin- and hesperetin-treated groups after one day of culture while the level was always lowest in the naringenin-treated group after three days of culture. 95 osteosarcoma patients who underwent surgery were assigned into two groups: naringenin group (NG, received 20 mg naringenin daily, n=47 and control group (CG, received 20 mg placebo daily, n=48. After an average of two-year follow-up, osteosarcoma volumes were smaller in the NG group than in the CG group (P>0.01. The rate of osteosarcoma recurrence was also lower in the NG group than in CG group. ROS levels were lower in the NG group than in the CG group. Thus, naringenin from Citrus aurantium inhibits osteosarcoma progression and local recurrence in the patients who underwent osteosarcoma surgery by improving antioxidant capability.

  16. Prognostic Impact of the Geriatric Nutritional Risk Index on Long-Term Outcomes in Patients Who Underwent Percutaneous Coronary Intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Hassan, Ahmed; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-06-01

    Malnutrition has been identified as an important predictor of poor clinical outcomes in patients with heart failure. The aim of this study is to examine the prognostic impact of nutritional status in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). The impact of nutrition, assessed using the geriatric nutritional risk index (GNRI) calculated by serum albumin and body mass index, was evaluated in 2,853 patients with CAD who underwent their first PCI between 2000 and 2011. Patients were assigned to tertiles based on their GNRI levels. The incidences of all-cause death and cardiac death were assessed. The median GNRI values were 101 (interquartile range 95 to 106). Lower GNRI levels were associated with older age and higher prevalence of acute coronary syndrome and chronic kidney disease. During the median follow-up period of 7.4 years, Kaplan-Meier curves showed ongoing divergence in rates of mortality among tertiles (GNRI nutritional status was associated with long-term clinical outcomes in CAD patients after PCI. Evaluation of GNRI carries important prognostic information and may guide the therapeutic approach to such patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Electronic Procedures for Medical Operations

    Science.gov (United States)

    2015-01-01

    Electronic procedures are replacing text-based documents for recording the steps in performing medical operations aboard the International Space Station. S&K Aerospace, LLC, has developed a content-based electronic system-based on the Extensible Markup Language (XML) standard-that separates text from formatting standards and tags items contained in procedures so they can be recognized by other electronic systems. For example, to change a standard format, electronic procedures are changed in a single batch process, and the entire body of procedures will have the new format. Procedures can be quickly searched to determine which are affected by software and hardware changes. Similarly, procedures are easily shared with other electronic systems. The system also enables real-time data capture and automatic bookmarking of current procedure steps. In Phase II of the project, S&K Aerospace developed a Procedure Representation Language (PRL) and tools to support the creation and maintenance of electronic procedures for medical operations. The goal is to develop these tools in such a way that new advances can be inserted easily, leading to an eventual medical decision support system.

  18. Radiochemical procedures

    International Nuclear Information System (INIS)

    Lyon, W.S.

    1982-01-01

    The modern counting instrumentation has largely obviated the need for separation processes in the radiochemical analysis but problems in low-level radioactivity measurement, environmental-type analyses, and special situations caused in the last years a renaissance of the need for separation techniques. Most of the radiochemical procedures, based on the classic works of the Manhattan Project chemists of the 1940's, were published in the National Nuclear Energy Series (NNES). Improvements such as new solvent extraction and ion exchange separations have been added to these methods throughout the years. Recently the Los Alamos Group have reissued their collected Radiochemical Procedures containing a short summary and review of basic inorganic chemistry - 'Chemistry of the Elements on the Basis of Electronic Configuration'. (A.L.)

  19. A Case of Type 2 Amiodarone-Induced Thyrotoxicosis That Underwent Total Thyroidectomy under High-Dose Steroid Administration

    Directory of Open Access Journals (Sweden)

    Koshi Hashimoto

    2015-01-01

    Full Text Available Amiodarone is used commonly and effectively in the treatment of arrhythmia; however, it may cause thyrotoxicosis categorized into two types: iodine-induced hyperthyroidism (type 1 amiodarone-induced thyrotoxicosis (AIT and destructive thyroiditis (type 2 AIT. We experienced a case of type 2 AIT, in which high-dose steroid was administered intravenously, and we finally decided to perform total thyroidectomy, resulting in a complete cure of the AIT. Even though steroid had been administered to the patient (maximum 80 mg of prednisolone, the operation was performed safely and no acute adrenal crisis as steroid withdrawal syndrome was found after the operation. Few cases of type 2 AIT that underwent total thyroidectomy with high-dose steroid administration have been reported. The current case suggests that total thyroidectomy should be taken into consideration for patients with AIT who cannot be controlled by medical treatment and even in those under high-dose steroid administration.

  20. Infants with Atypical Presentations of Alveolar Capillary Dysplasia with Misalignment of the Pulmonary Veins Who Underwent Bilateral Lung Transplantation.

    Science.gov (United States)

    Towe, Christopher T; White, Frances V; Grady, R Mark; Sweet, Stuart C; Eghtesady, Pirooz; Wegner, Daniel J; Sen, Partha; Szafranski, Przemyslaw; Stankiewicz, Pawel; Hamvas, Aaron; Cole, F Sessions; Wambach, Jennifer A

    2018-03-01

    To describe disease course, histopathology, and outcomes for infants with atypical presentations of alveolar capillary dysplasia with misalignment of the pulmonary veins (ACDMPV) who underwent bilateral lung transplantation. We reviewed clinical history, diagnostic studies, explant histology, genetic sequence results, and post-transplant course for 6 infants with atypical ACDMPV who underwent bilateral lung transplantation at St. Louis Children's Hospital. We compared their histology with infants with classic ACDMPV and compared their outcomes with infants transplanted for other indications. In contrast with neonates with classic ACDPMV who present with severe hypoxemia and refractory pulmonary hypertension within hours of birth, none of the infants with atypical ACDMPV presented with progressive neonatal respiratory failure. Three infants had mild neonatal respiratory distress and received nasal cannula oxygen. Three other infants had no respiratory symptoms at birth and presented with hypoxemia and pulmonary hypertension at 2-3 months of age. Bilateral lung transplantation was performed at 4-20 months of age. Unlike in classic ACDMPV, histopathologic findings were not distributed uniformly and were not diffuse. Three subjects had apparent nonmosaic genetic defects involving FOXF1. Two infants had extrapulmonary anomalies (posterior urethral valves, inguinal hernia). Three transplanted children are alive at 5-16 years of age, similar to outcomes for infants transplanted for other indications. Lung explants from infants with atypical ACDMPV demonstrated diagnostic but nonuniform histopathologic findings. The 1- and 5-year survival rates for infants with atypical ACDMPV are similar to infants transplanted for other indications. Given the clinical and histopathologic spectra, ACDMPV should be considered in infants with hypoxemia and pulmonary hypertension, even beyond the newborn period. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

    Science.gov (United States)

    Punchick, Boris; Freud, Tamar; Press, Yan

    2016-01-01

    Abstract The prevalence of cognitive impairment and orthostatic hypotension (OH) increases with age, but the results of studies that assessed possible associations between them are inconsistent. The aim of this study is to assess possible associations between cognitive impairment and OH in patients ≥65 years of age who underwent a comprehensive geriatric assessment. A retrospective analysis was conducted of the computerized medical records of the study population from 2005 to 2013. Data collected included blood pressure measurements that enabled the calculation of OH, results of the mini-mental state examination (MMSE), results of the Montreal cognitive assessment (MoCA) test, and cognitive diagnoses that were determined over the course of the assessment. The rate of OH in the study population of 571 adults was 32.1%. The mean MMSE score was 22.5 ± 5.2 among participants with OH and 21.6 ± 5.8 among those without OH (P = 0.09). The absence of a significant association between OH and MMSE remained after adjusting the MMSE score for age and education level. The mean MoCA score was 16.4 ± 5.0 among participants with OH and 16.4 ± 4.8 among those without (P = 0.33). The prevalence of OH was 39% among participants without cognitive impairment, 28.9% among those with mild cognitive impairment (MCI), and 30.6% among those with dementia (P = 0.13). There was no association between OH and cognitive impairment in adults who underwent a comprehensive geriatric assessment. PMID:27442658

  2. Long-term prognosis and clinical characteristics of young adults (≤40 years old) who underwent percutaneous coronary intervention.

    Science.gov (United States)

    Konishi, Hirokazu; Miyauchi, Katsumi; Kasai, Takatoshi; Tsuboi, Shuta; Ogita, Manabu; Naito, Ryo; Katoh, Yoshiteru; Okai, Iwao; Tamura, Hiroshi; Okazaki, Shinya; Daida, Hiroyuki

    2014-09-01

    Limited data exist regarding the long-term prognosis of percutaneous coronary intervention (PCI) in young adults. The aim of this study was to retrospectively assess the long-term clinical outcomes in young patients who underwent PCI. Between 1985 and 2011, 7649 consecutive patients underwent PCI, and data from 69 young adults (age ≤40 years) and 4255 old adults (age ≧65 years) were analyzed. A Cox proportional hazards regression analysis was used to determine the independent predictors of a composite endpoint that included all-cause death and acute coronary syndrome (ACS) during the follow-up period. The mean age of the 69 young patients was 36.1±4.9 years, and 96% of them were men. Approximately 30% were current smokers, and their body mass index (BMI) was 26.7±5.0kg/m(2). The prevalence of diabetes and hypertension was 33% and 48%, respectively. All patients had ≥1 conventional cardiovascular risk factor. At a median follow-up of 9.8 years, the overall death rate was 5.8%, and new-onset ACS occurred in 8.7%. Current smoking was an independent predictor of the composite endpoint (hazard ratio 4.46, confidence interval 1.08-19.1, p=0.04) for young adults. Current smoking and obesity (high BMI) are the important clinical characteristics in young Japanese coronary heart disease patients who undergo PCI. The long-term prognosis in young patients is acceptable, but current smoking is a significant independent predictor of death and the recurrence of ACS in young Japanese coronary heart disease patients who are obese. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  3. [Evaluation of the antithrombotic strategy in low thrombotic risk patients who underwent aortic valve replacement with a bioprosthesis].

    Science.gov (United States)

    Aceves-Velázquez, Eduardo; Vieyra-Herrera, Gerardo; Rodríguez-Chávez, Laura; Herrera-Alarcón, Valentín

    2017-07-16

    According to current guidelines, in patients without additional risk factors who have undergone aortic valve replacement with a bioprosthesis, anticoagulation in the first 3 months after surgery is still a matter of debate. According to current evidence, aspirin in low doses is a reasonable alternative to vitamin K antagonists (VKA). A comparison is made between the incidence of thrombotic and haemorrhagic complications in patients with low thrombotic risk who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico. The hypothesis: aspirin as monotherapy has a beneficial effect compared to VKA. The studied patients were the low thrombotic risk patients who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico from 2011 to 2015. The groups studied were: aspirin only, VKA only, and the combination of VKA plus aspirin. The patients were retrospectively followed-up for 12 months, and the thrombotic and haemorrhagic complications were documented. Of the 231 patients included in the study, only one patient in the VKA only group presented with a haemorrhagic complication. No thrombotic complications were observed. In the present study no thrombotic complications were observed in patients who did not receive anticoagulation in the first 3 months after an aortic valve replacement with a bioprosthesis after a follow up period of 12 months. This suggests that the use of aspirin only is safe during this period. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  4. Autotransplantation of spleen tissue in children with mansonic schistosomiasis who underwent splenectomy: Evaluation of splenic residual functions

    Directory of Open Access Journals (Sweden)

    Brandt Carlos Teixeira

    1998-01-01

    Full Text Available Autotransplantation of spleen tissue is an attempt for maintenance of splenic functions when splenectomy is indicated in children. It minimizes the risks of overwhelming postsplenectomy infection and it has been done in children with severe portal hypertension due to hepatosplenic mansonic schistosomiasis that underwent splenectomy. The purposes of this investigation were to study the morphology of the residual splenic tissue; to evaluate the residual filtration function of this splenosis; and to assess the immune response to polyvalent pneumococcal vaccine of these patients. Twenty-three children with portal hypertension from mansonic schistosomiasis who underwent splenectomy, ligature of the left gastric vein, autotransplantation of spleen tissue into an omental pouch were evaluated for residual splenic parenchyma and functions. Tc-99m sulfur colloid liver-spleen scans were used for detection of splenic nodules. The search for Howell Jolly bodies were used for assessing the filtration function and Enzyme-linked immunosorbent assay was used for measuring the relative rise in titter of specific pneumococcal antibodies. Splenosis was evident in all children; however, in two there were less than five splenic nodules in the greater omentum, which was considered insufficient. Howell-Jolly bodies were found in the peripheral blood only in these two patients with less evident splenosis. The immune response was adequate in 15 patients; it was intermediate in 4 patients and inadequate in 4 patients. Autotransplantation of spleen tissue into an omental pouch is efficient in maintaining the filtration splenic function in more than 90% of the cases and the immune response to pneumococcal vaccination in approximately 65% of the children.

  5. Effect of advanced blood pressure control with nifedipine delayedrelease tablets on the blood pressure in patients underwent nasal endoscope surgery

    Directory of Open Access Journals (Sweden)

    Qing-Hua Xia

    2016-08-01

    Full Text Available Objective: To explore the effect of advanced blood pressure control with nifedipine delayedrelease tablets on the blood pressure in patients underwent nasal endoscope surgery and its feasibility. Methods: A total of 80 patients who were admitted in ENT department from June, 2012 to June, 2015 for nasal endoscope surgery were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the observation group were given nifedipine delayed-release tablets for advanced blood pressure control before operation, and were given routine blood pressure control during operation; while the patients in the control group were only given blood pressure control during operation. The changes of blood pressure, mean central arterial pressure, and heart rate before anesthesia (T0, after intubation (T1, during operation (T2, extubation when waking (T3, 30 min after extubation (T4, and 3 h after back to wards (T5 in the two groups were compared. The intraoperative situation and the surgical field quality in the two groups were compared. Results: SBP, DBP, and MAP levels at T1-5 in the two groups were significantly lower than those at T0. SBP, DBP, and MAP levels at T2 were significantly lower than those at other timing points, and were gradually recovered after operation, but were significantly lower than those at T0. The effect taking time of blood pressure reducing, intraoperative nitroglycerin dosage, and postoperative wound surface exudation amount in the observation group were significantly less than those in the control group. The surgical field quality scores in the observation group were significantly superior to those in the control group. Conclusions: Advanced blood pressure control with nifedipine delayed-release tablets can stabilize the blood pressure during the perioperative period in patients underwent nasal endoscope surgery, and enhance the surgical field qualities.

  6. Acute myocardial infarction in progressively elderly patients. A comparative analysis of immediate results in patients who underwent primary percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Mattos

    2001-01-01

    Full Text Available OBJECTIVE: Analysis of the in-hospital results, in progressively elderly patients who undergo primary percutaneous coronary intervention (PCI in the first 24 hours of AMI. METHODS: The patients were divided into three different age groups (60/69, 70/79, and > or = 80 years and were treated from 7/95 until 12/99. The primary success rate and the occurrence of major clinical events were analyzed at the end of the in-hospital phase. Coronary stent implantation and abciximab use were employed at the intervencionist discretion. RESULTS: We analyzed 201 patients with age ranging from 60 to 93 years, who underwent primary PCI. Patients with ages above 70 were more often female (p=.015. Those with ages above 80 were treated later with PCI (p=.054, and all of them presented with total occlusion of the infarct-related artery. Coronary stents were implanted in 30% of the patients. Procedural success was lower in > or = 80 year old patients (p=.022, and the death rate was higher in > or = 70 years olds (p=.019. Reinfarction and coronary bypass surgery were uncommon events. A trend occurred toward a higher combined incidence of major in-hospital events according to increased age (p=.064. CONCLUSION: Elderly patients ( > or = 70 years presented with adverse clinical and angiographic profiles and patients > or = 80 years of age obtained reduced TIMI 3 flow success rates after primary PTCA, and those > or = 70 years had a higher death rate.

  7. Acute myocardial infarction in progressively elderly patients. A comparative analysis of immediate results in patients who underwent primary percutaneous coronary intervention.

    Science.gov (United States)

    Mattos, L A; Zago, A; Chaves, A; Pinto, I; Tanajura, L; Staico, R; Centemero, M; Feres, F; Maldonado, G; Cano, M; Abizaid, A; Abizaid, A; Sousa, A G; Sousa, J E

    2001-01-01

    Analysis of the in-hospital results, in progressively elderly patients who undergo primary percutaneous coronary intervention (PCI) in the first 24 hours of AMI. The patients were divided into three different age groups (60/69, 70/79, and > or =80 years) and were treated from 7/95 until 12/99. The primary success rate and the occurrence of major clinical events were analyzed at the end of the in-hospital phase. Coronary stent implantation and abciximab use were employed at the interventionist discretion. We analyzed 201 patients with age ranging from 60 to 93 years, who underwent primary PCI. Patients with ages above 70 were more often female (p=.015). Those with ages above 80 were treated later with PCI (p=.054), and all of them presented with total occlusion of the infarct-related artery. Coronary stents were implanted in 30% of the patients. Procedural success was lower in > or =80 year old patients (p=.022), and the death rate was higher in > or =70 years olds (p=.019). Reinfarction and coronary bypass surgery were uncommon events. A trend occurred toward a higher combined incidence of major in-hospital events according to increased age (p=.064). Elderly patients (> or =70 years) presented with adverse clinical and angiographic profiles and patients > or =80 years of age obtained reduced TIMI 3 flow success rates after primary PTCA, and those > or =70 years had a higher death rate.

  8. Modified pediatric Bentall procedure: A novel technique in a rare case

    Directory of Open Access Journals (Sweden)

    Gananjay G Salve

    2016-01-01

    Full Text Available Aneurysms of ascending aorta are rarely seen in pediatric age group. Only few cases with Marfans syndrome have been reported in the literature. Preferred treatment for these children has been the standard Bentall procedure (aortic root replacement with composite graft prosthesis. We report a 4-year-old male child with huge aneurysm of ascending aorta and aortic root dilation with severe aortic regurgitation, having phenotypic features of Loeys-Dietz syndrome type I. He underwent Bentall procedure with a novel modification (medial trap-door technique for coronary reimplantation. Short-term result of this procedure is encouraging and he is asymptomatic for the last 14 months of follow-up.

  9. Laparoscopic reversal of Hartmann's procedure

    DEFF Research Database (Denmark)

    Svenningsen, Peter Olsen; Bulut, Orhan; Jess, Per

    2010-01-01

    INTRODUCTION: A change in procedure from open to laparoscopic reversal of Hartmann's colostomy was implemented at our department between May 2005 and December 2008. The aim of the study was to investigate if this change was beneficial for the patients. MATERIAL AND METHODS: The medical records...... of all patients who underwent reversal of a colostomy after a primary Hartmann's procedure during the period May 2005 to December 2008 were reviewed retrospectively in a case-control study. RESULTS: A total of 43 patients were included. Twenty-one had a laparoscopic and 22 an open procedure. The two...... groups matched with regard to age, sex, American Society of Anestheologists (ASA) score, body mass index and indication for Hartmann's operation. A significantly longer operation time was found for laparoscopic than for open surgery (median 285 versus 158 minutes, p

  10. Procedimiento experimental, innovador y establecido: Ética y ciencia en la introducción de la tecnología médica Experimental, innovative and standard procedures: Ethics and sciencie in the introduction of medical technology

    Directory of Open Access Journals (Sweden)

    J.M.V. Pons

    2003-10-01

    Full Text Available La frontera que delimita un procedimiento como experimental, innovador o establecido, dentro del proceso médico asistencial, suele ser imprecisa en gran parte de los casos. Aún lo es más en el campo quirúrgico y de los productos implantables que difieren sustancialmente de las intervenciones terapéuticas farmacológicas, que están mucho más reguladas. Sin embargo, tanto ética como científicamente, conviene delimitar al máximo el carácter de las distintas intervenciones médicas que se aplican en sujetos humanos, sin dejar a criterio individual el margen de discreción existente hoy en día, especialmente en la innovación quirúrgica. El examen de forma externa e independiente del cociente beneficio/riesgo de la innovación propuesta ha de permitir transparentar, en la relación médico-paciente, el carácter particular de la técnica, así como los requerimientos éticos y científicos para su evaluación más apropiada.The dividing lines between experimental, innovative and standard medical procedures are frequently blurred in current clinical practice. This is even more true in the fields of surgery and implantable devices. These differ substantially from pharmacological interventions, which are better regulated. However, the character of the various medical interventions applied in human subjects should be ethically and scientifically delimited as clearly as possible. This task cannot be abandoned to personal discretion and criteria, which are currently used, especially in the field of surgical innovation. External and independent review of the risk-benefit ratio of proposed innovations should enable specification of the particular features of a technique in the patient-doctor relationship, as well as the ethical and scientific requirements for more appropriate evaluation.

  11. Assessment of quality of life of patients who underwent anterior cruciate ligament reconstruction and a rehabilitation program

    Directory of Open Access Journals (Sweden)

    Moises Cohen

    2004-12-01

    Full Text Available Introduction: Quality of life can be defined as the expression of aconceptual model that tries to represent patient’s perspectivesand his/her level of satisfaction expressed by numbers. Theobjective of this study is to evaluate the parameters of quality oflife of 23 patients who underwent surgery for anterior cruciateligament reconstruction. Methods: We adopted SF-36, a generichealth-related evaluation questionnaire, to obtain informationregarding several aspects of patients’ health conditions, and theLysholm questionnaire, specific to evaluate the symptoms andfunction of the knee. The questionnaires were applied at two stagesof the treatment: pre- and postoperatively (after the rehabilitationprogram. Results: Before surgery, the Lysholm questionnairepresented the following results: excellent in 4% of the cases, goodin 22%, fair in 22%, and poor in 52%. After surgery (Lysholm e SF-36 the correlation level was approximately 44% (p = 0.041.Discussion: The correlation between the Lysholm and the SF-36questionnaires showed the following: the lower the level of pain,the higher the Lysholm score. The high scores presented by theLysholm questionnaire are directly proportional to physical andemotional aspects, and to functional capacity. Conclusion:Analysis of both questionnaires, as well as of their correlation,showed some improvement in patients´ quality of life. We werealso able to demonstrate the importance and usefulness of applyingthe two questionnaires at three different moments: before, duringand after physiotherapeutic intervention.

  12. The effect of anxiety and depression scores of couples who underwent assisted reproductive techniques on the pregnancy outcomes.

    Science.gov (United States)

    Terzioglu, Fusun; Turk, Rukiye; Yucel, Cigdem; Dilbaz, Serdar; Cinar, Ozgur; Karahalil, Bensu

    2016-06-01

    The aim of this study was to determine the effect of anxiety and depression scores of couples who underwent Assisted Reproductive Techniques (ART) on pregnancy outcomes. This study was conducted as a prospective and comparative study with 217 couples. The study data was collected by using a semi-structured questionnaire and the Turkish version of the State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). The questionnaire, STAI and BDI were applied to couples who initiated ART treatment. Couples' state anxiety scores were re-evaluated after embryo transfer (ET). A significant relationship was found between the depression score of women and pregnancy outcome (p 0.05) and lower depression scores (p positive pregnancy outcome. Study results indicated that the anxiety and depression scores of couples who had achieved a positive pregnancy result were lower than for couples with a negative result. The results of this study will contribute to the health professionals especially to the nurses who spend the most time with couples in providing consulting services and supporting psychological status of couples during ART process in Turkey.

  13. Factors associated with late specialized rehabilitation among veterans with lower extremity amputation who underwent immediate postoperative rehabilitation.

    Science.gov (United States)

    Kurichi, Jibby E; Xie, Dawei; Kwong, Pui L; Bates, Barbara E; Vogel, W Bruce; Stineman, Margaret G

    2011-05-01

    The aim of this study was to determine what patient- and facility-level characteristics drive late specialized rehabilitation among veterans who already received immediate postoperative services. Data were obtained from eight administrative databases for 2,453 patients who underwent lower limb amputation in Veterans Affairs Medical Centers in 2002-2004. A Cox proportional hazards model was used to determine the hazard ratios and 95% confidence intervals of the factors associated with days to readmission for late services after discharge from surgical hospitalization. There were 2304 patients who received only immediate postoperative services, whereas 152 also received late specialized rehabilitation. After adjustment, veterans who were less disabled physically, residing in the South Central compared with the Southeast region, and had their surgeries in facilities accredited by the Commission on Accreditation of Rehabilitation Facilities were all more likely to receive late services. The hazard ratios for type of immediate postoperative rehabilitation were not constant over time. At hospital discharge, there was no difference in receipt; however, after 3 mos, those who received early specialized rehabilitation were significantly less likely to receive late services. The factors associated with late specialized rehabilitation were due mainly to facility-level characteristics and care process variables. Knowledge of these factors may help with decision-making policies regarding units accredited by the Commission on Accreditation of Rehabilitation Facilities.

  14. Carotid intima-media thickness and ınsulin resistance changes in patients who underwent sleeve gastrectomy: A prospective study.

    Science.gov (United States)

    Yorulmaz, G; Cilekar, M; Bilge, U; Akcan, E; Akalin, A

    2016-01-01

    Our aim was to examine changes in insulin resistance, Carotid Intima-Media Thickness (CIMT), in morbid obese patients without any known associated chronic diseases who underwent sleeve gastrectomy. The subjects of this study were patients with minimum BMI of 40, who did not have any known chronic diseases. Sleeve gastrectomy was performed and perioperative control endoscopy was performed. The following values were measured before the operation and after follow-up period after the operation: Fasting blood glucose and insulin, lipid profile, BMI, liver function tests, right and left CIMT. Furthermore, the patients' insulin resistance was calculated by HOMA method, and the values of 2.7. Six-teen patients (14 women and 2 men, average age: 39.12 ± 10.63 years), who did not have a known additional chronic disease, took part in the study. There was a significant difference between baseline and follow-up values of the patients, and the mean weight loss was 20.5%. Given the statistical evaluation of baseline and follow-up values, there was a significant difference in BMI, insulin resistance rates and right and left CIMT values. Bariatric surgery may provide some additional advantages for the management of cardiovascular risks in obese patients. However, it should be kept in mind that the most important components of fight against obesity are appropriate diet and exercise programs.

  15. Anatomical location of metastatic lymph nodes: an indispensable prognostic factor for gastric cancer patients who underwent curative resection.

    Science.gov (United States)

    Zhao, Bochao; Zhang, Jingting; Zhang, Jiale; Chen, Xiuxiu; Chen, Junqing; Wang, Zhenning; Xu, Huimian; Huang, Baojun

    2018-02-01

    Although the numeric-based lymph node (LN) staging was widely used in the worldwide, it did not represent the anatomical location of metastatic lymph nodes (MLNs) and not reflect extent of LN dissection. Therefore, in the present study, we investigated whether the anatomical location of MLNs was still necessary to evaluate the prognosis of node-positive gastric cancer (GC) patients. We reviewed 1451 GC patients who underwent radical gastrectomy in our institution between January 1986 and January 2008. All patients were reclassified into several groups according to the anatomical location of MLNs and the number of MLNs. The prognostic differences between different patient groups were compared and clinicopathologic features were analyzed. In the present study, both anatomical location of MLNs and the number of MLNs were identified as the independent prognostic factors (p location of MLNs was considered (p location of MLNs had no significant effect on the prognosis of these patients, the higher number of MLNs in the extraperigastric area was correlated with the unfavorable prognosis (p location of MLNs was an important factor influencing the prognostic outcome of GC patients. To provide more accurate prognostic information for GC patients, the anatomical location of MLNs should not be ignored.

  16. Juveniles in criminal procedure

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    Lukić Tatjana

    2012-01-01

    Full Text Available Taking into consideration the importance and role of children in modern society, as well as their position, this article has as its focus juveniles in criminal procedure. The existence of a separate juvenile justice system independent of the criminal law applicable to the adult offenders and general criminal procedure, as well as the periodic changes of the dominant approach in theory and practice reflects the ascendancy of different theoretical perspectives in the juvenile justice. In this paper, the authors scrutinize the models of responding to juvenile crime - justice and welfare model - as two models of the greatest importance in the present reaction of the society to the crimes conducted by the youngest delinquents at the beginning of the new century and millennium. Furthermore, the paper deals with a matter of international legal standards which, to a large extent, give shape to the legal framework for juvenile offenders and provide their rights and position in the criminal procedure. The authors refer to the internationally accepted documents on several levels. From the (almost universally accepted multilateral conventions on human rights, through the field of recommendations, rules and guidelines which are obeyed and enforced in practice of the juvenile justice although they are of non-binding nature, via the regional European legislative to the national provisions in a particular number of countries. On all the levels mentioned above the rights of the juveniles are regulated having in mind their possible role in the criminal procedure as a perpetrator of a criminal act, as a victim or as a witness. This paper also analyzes the criminal procedure with respect to juvenile perpetrators of the criminal acts in the Republic of Serbia and compliance of the provisions currently in vigor with the international legal standards contained in the international conventions and other internationally accepted and recognized instruments.

  17. Management of antithrombotic therapy in patients with coronary artery disease or atrial fibrillation who underwent abdominal surgical operations.

    Science.gov (United States)

    Schizas, Dimitrios; Kariori, Maria; Boudoulas, Konstantinos Dean; Siasos, Gerasimos; Patelis, Nikolaos; Kalantzis, Charalampos; Carmen-Maria, Moldovan; Vavuranakis, Manolis

    2018-04-02

    Patients treated with antithrombotic therapy that require abdominal surgical procedures has progressively increased overtime. The management of antithrombotics during both the peri- and post- operative period is of crucial importance. The goal of this review is to present current data concerning the management of antiplatelets in patients with coronary artery disease and of anticoagulants in patients with atrial fibrillation who had to undergo abdominal surgical operations. For this purpose, incidence of major adverse cardiovascular events (MACE) and risk of antithrombotic use during surgical procedures, as well as the recommendations based on recent guidelines were reported. A thorough search of PubMed, Scopus and the Cochrane Databases was conducted to identify randomized controlled trials, observational studies, novel current reviews, and ESC and ACC/AHA guidelines on the subject. Antithrombotic use in daily clinical practice results to two different pathways: reduction of thromboembolic risk, but a simultaneous increase of bleeding risk. This may cause a therapeutic dilemma during the perioperative period. Nevertheless, careless cessation of antithrombotics can increase MACE and thromboembolic events, however, maintenance of antithrombotic therapy may increase bleeding complications. Studies and current guidelines can assist clinicians in making decisions for the treatment of patients that undergo abdominal surgical operations while on antithrombotic therapy. Aspirin should not be stopped perioperatively in the majority of surgical operations. Determining whether to discontinue the use of anticoagulants before surgery depends on the surgical procedure. In surgical operations with a low risk for bleeding, oral anticoagulants should not be discontinued. Bridging therapy should only be considered in patients with a high risk of thromboembolism. Finally, patients with an intermediate risk for thromboembolism, management should be individualized according to patient

  18. [Environmental investigation of ground water contamination at Wright-Patterson Air Force Base, Ohio]. Volume 3, Appendix A, Draft standard operating procedures and elements: Sampling and Analysis Plan (SAP): Phase 1, Task 4, Field Investigation, Draft

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    This report presents information concerning field procedures employed during the monitoring, well construction, well purging, sampling, and well logging at the Wright-Patterson Air Force Base. Activities were conducted in an effort to evaluate ground water contamination.

  19. Clinical and echocardiographic findings of patients with suspected acute pulmonary thromboembolism who underwent computed tomography pulmonary angiography

    Science.gov (United States)

    Adibi, Atoosa; Nouri, Shadi; Moradi, Maryam; Shahabi, Javad

    2016-01-01

    Background: The aim of the study was to determine the correlation between clinical and echocardiographic findings and risk factors of patients with suspected acute pulmonary thromboembolism (PTE) who underwent computed tomography pulmonary angiography (CTPA). Materials and Methods: In this cross-sectional study, 310 hospitalized patients aged >18 years with high clinical suspicion of PTE referred to imaging center of our hospital from different wards for CTPA were enrolled. The frequency of different clinical presentations, risk factors, items of Wells’ criteria, and echocardiographic findings was compared in patients with and without PTE, which have been diagnosed according to the CTPA results. Results: PTE was diagnosed in 53 (17.1%) of patients with suspected PTE. From clinical manifestations, tachypnea, pleuritic chest pain, and edema of lower extremities were significantly more frequent among patients with PTE (P < 0.05). Major surgery was the risk factor which was significantly more prevalent among patients with PTE (P < 0.05). Frequency of all criteria of Wells’ criteria, except hemoptysis, was significantly higher in patients with PTE (P < 0.05). The frequency of all studied echocardiographic variables was significantly higher in patients with PTE (P < 0.05). Conclusion: It is suggested that we could use the results of this study for utilizing the diagnostic process of PTE in patients with highly clinical suspicion of PTE and providing more validated decision. Using the results of this study, we could identify high-risk patients and made appropriate risk assessment for better management of patients with suspected PTE as well as reduce the rate of unnecessary CTPA and its related adverse consequences. PMID:28255326

  20. The effects of transfusion of irradiated blood upon cellular immune response in patients underwent open heart surgery

    International Nuclear Information System (INIS)

    Togashi, Ken-ichi; Nakazawa, Satoshi; Moro, Hisanaga; Yazawa, Masatomo; Kanazawa, Hiroshi; Hayashi, Jun-ichi; Yamazaki, Yoshihiko; Eguchi, Shoji

    1989-01-01

    The purpose of this paper is to demonstrate the effect of the transfusion of blood received 1500 rad exposure upon the immune response in 14 patients underwent various type of cardiac surgery. 13 patients received known amounts banked blood and irradiated fresh blood, while one patient received a lot of amounts of banked and irradiated and non-irradiated fresh blood. The authors studied the numbers of lymphocytes as well as lymphocyte subsets such as pan-T cells, B cells, helper/inducer T cells (T H/I ), cytotoxic/supressor T cells (T C/S ), active T cells, natural killer (NK) cells and NK cell activity during two weeks after surgeries. In all 14 patients, pan-T lymphocytes decreased markedly in a few days after surgeries, but increased to higher levels on the eight postoperative day than the levels preoperatively. T H/I and T C/S lymphocytes changed on the similar pattern as pan-T lymphocytes. Active T and B cells did not change significantly in two weeks. The number and activity of NK cells gave the lowest levels on the second postoperative day and did not recovery to the preoperative levels in two weeks. One patient received non-irradiated fresh blood showed the similar immune response as other 13 patients, while he gave the lower levels than others did. This patient died of graft-versus-host disease (GVHD)-like syndrome on the 36th postoperative day. It may be thought that the transfusion of irradiated blood would prevent the host from GVHD and gave the better effects on the immune response than that of non-irradiated blood following open-heart surgeries. (author)

  1. Clinical and echocardiographic findings of patients with suspected acute pulmonary thromboembolism who underwent computed tomography pulmonary angiography

    Directory of Open Access Journals (Sweden)

    Atoosa Adibi

    2016-01-01

    Full Text Available Background: The aim of the study was to determine the correlation between clinical and echocardiographic findings and risk factors of patients with suspected acute pulmonary thromboembolism (PTE who underwent computed tomography pulmonary angiography (CTPA. Materials and Methods: In this cross-sectional study, 310 hospitalized patients aged >18 years with high clinical suspicion of PTE referred to imaging center of our hospital from different wards for CTPA were enrolled. The frequency of different clinical presentations, risk factors, items of Wells' criteria, and echocardiographic findings was compared in patients with and without PTE, which have been diagnosed according to the CTPA results. Results: PTE was diagnosed in 53 (17.1% of patients with suspected PTE. From clinical manifestations, tachypnea, pleuritic chest pain, and edema of lower extremities were significantly more frequent among patients with PTE (P < 0.05. Major surgery was the risk factor which was significantly more prevalent among patients with PTE (P < 0.05. Frequency of all criteria of Wells' criteria, except hemoptysis, was significantly higher in patients with PTE (P < 0.05. The frequency of all studied echocardiographic variables was significantly higher in patients with PTE (P < 0.05. Conclusion: It is suggested that we could use the results of this study for utilizing the diagnostic process of PTE in patients with highly clinical suspicion of PTE and providing more validated decision. Using the results of this study, we could identify high-risk patients and made appropriate risk assessment for better management of patients with suspected PTE as well as reduce the rate of unnecessary CTPA and its related adverse consequences.

  2. Early prediction of treatment response by serum CRP levels in patients with advanced esophageal cancer who underwent definitive chemoradiotherapy

    International Nuclear Information System (INIS)

    Yoneda, Masayuki; Fujiwara, Hitoshi; Okamura, Shinichi

    2010-01-01

    Serum C reactive protein (CRP) has been shown to be associated with the progression of esophageal cancer. The purpose of this study was to examine the relationship between treatment response and serum CRP levels in time course during definitive chemoradiotherapy (CRT) in terms of early prediction of CRT response by serum CRP. The subjects of this study were 36 patients with cT3/cT4 esophageal squamous cell carcinoma who underwent definitive CRT in our hospital. Serum CRP levels during definitive CRT (pretreatment, 1W, 2W and 3W after CRT initiation) were compared between CR and non-CR group. In addition, partition model was constructed to discriminate CR with non-CR and the prediction accuracy was evaluated. The patients were consisted of 28 males and 8 females. At pretreatment diagnosis, tumors were categorized as T3 (n=21) and T4 (n=15). Thirty four patients received FP-based chemotherapy and 2 patients received docetaxel-based chemotherapy. Treatment responses were categorized as CR (n=8), partial response (PR) (n=14), no change (NC) (n=2) and progressive disease (PD) (n=12). Serum CRP levels at the time of 2W after CRT initiation (CRT2W) in CR group were low compared to those in non-CR group (p=0.071). The partition model was constructed based on CRP levels at CRT2W. The prediction accuracies to discriminate CR from non-CR by CRP ≤0.1 were 50%, 82%, and 75% in sensitivity, specificity and accuracy, respectively. Serum CRP is a useful biomarker for an early prediction of CRT response. (author)

  3. Posttraumatic Stress Disorder, Orientation to Pain, and Pain Perception in Ex-Prisoners of War Who Underwent Torture.

    Science.gov (United States)

    Tsur, Noga; Defrin, Ruth; Ginzburg, Karni

    Studies suggest that torture survivors often experience long-term chronic pain and increased pain perception. However, it is unclear whether the actual experience of torture or rather the subsequent posttraumatic stress disorder (PTSD) explains these pain problems. Furthermore, although catastrophic and fearful orientations to pain have been suggested to play a significant role in the association between trauma and pain, the underlying mechanisms remain unclear. This study examined whether chronic pain and pain perception among torture survivors are associated with torture experience or PTSD and whether catastrophic and fearful orientations mediate or moderate these associations. Fifty-nine ex-prisoners of war who underwent torture and 44 matched veterans participated in this study. Pain perception was evaluated by assessing pain threshold and reactivity to experimental suprathreshold noxious stimuli. Participants completed self-administered questionnaires assessing PTSD, chronic pain, pain catastrophizing, and fear of pain. Although chronic pain was associated with PTSD (0.44 < β < 0.49, p < .002), increased pain perception was correlated with torture (0.33 < β < 0.65, p < .05). Pain catastrophizing was found to mediate the association between PTSD and chronic pain (β = 0.18 and 0.19, respectively; p < .05). Fear of pain moderated the association between torture and pain perception (β = 0.41 and 0.42, respectively; p < .017). The findings suggest that chronic pain is contingent upon the psychological toll of torture, that is, PTSD. This study also indicates that PTSD exacerbates catastrophic orientation, which in turn may amplify chronic pain. Reactivity to experimental noxious stimuli was related to previous experiences of torture, which enhances perceived pain intensity when interacting with a fearful pain orientation. These findings highlight the significance of orientation to bodily experiences after trauma.

  4. CA-125–indicated asymptomatic relapse confers survival benefit to ovarian cancer patients who underwent secondary cytoreduction surgery

    Directory of Open Access Journals (Sweden)

    Wang Fang

    2013-02-01

    Full Text Available Abstract Background There is no consensus regarding the management of ovarian cancer patients, who have shown complete clinical response (CCR to primary therapy and have rising cancer antigen CA-125 levels but have no symptoms of recurrent disease. The present study aims to determine whether follow-up CA-125 levels can be used to identify the need for imaging studies and secondary cytoreductive surgery (CRS. Methods We identified 410 ovarian cancer patients treated at The University of Texas MD Anderson Cancer Center between 1984 and 2011. These patients had shown CCR to primary therapy. Follow-up was conducted based on the surveillance protocol of the MD Anderson Cancer Center. We used the Cox proportional hazards model and log-rank test to assess the associations between the follow-up CA-125 levels and secondary CRS and survival duration. Results The CA-125 level of 1.68 × nadir was defined as the indicator of recurrent disease (p  1.68 × nadir at relapse (55.7 and 10.4 months; p = 0.04 and 0.01, respectively. The overall and progression free survival duration of patients with asymptomatic relapse and underwent a secondary CRS was longer than that of patients with symptomatic relapse (p = 0.02 and 0.04 respectively. Conclusions The increase of serum CA-125 levels is an early warning of clinical relapse in ovarian cancer. Using CA-125 levels in guiding the treatment of patients with asymptomatic recurrent ovarian cancer, who have shown CCR to primary therapy, can facilitate optimal secondary CRS and extend the survival duration of the patients.

  5. Periodical assessment of genitourinary and gastrointestinal toxicity in patients who underwent prostate low-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Tanaka, Nobumichi; Asakawa, Isao; Anai, Satoshi; Hirayama, Akihide; Hasegawa, Masatoshi; Konishi, Noboru; Fujimoto, Kiyohide

    2013-01-01

    To compare the periodical incidence rates of genitourinary (GU) and gastrointestinal (GI) toxicity in patients who underwent prostate low-dose-rate brachytherapy between the monotherapy group (seed implantation alone) and the boost group (in combination with external beam radiation therapy (EBRT)). A total of 218 patients with a median follow-up of 42.5 months were enrolled. The patients were divided into 2 groups by treatment modality, namely, the monotherapy group (155 patients) and the boost group (63 patients). The periodical incidence rates of GU and GI toxicity were separately evaluated and compared between the monotherapy group and the boost group using the National Cancer Institute - Common Terminology Criteria for Adverse Events, version 3.0. To elucidate an independent factor among clinical and postdosimetric parameters to predict grade 2 or higher GU and GI toxicity in the acute and late phases, univariate and multivariate logistic regression analyses were carried out. Of all patients, 78.0% showed acute GU toxicity, and 7.8% showed acute GI toxicity, while 63.8% showed late GU toxicity, and 21.1% showed late GI toxicity. The incidence rates of late GU and GI toxicity were significantly higher in the boost group. Multivariate analysis showed that the International Prostate Symptom Score (IPSS) before seed implantation was a significant parameter to predict acute GU toxicity, while there were no significant predictive parameters for acute GI toxicity. On the other hand, combination with EBRT was a significant predictive parameter for late GU toxicity, and rectal volume (mL) receiving 100% of the prescribed dose (R100) was a significant predictive parameter for late GI toxicity. The boost group showed higher incidence rates of both GU and GI toxicity. Higher IPSS before seed implantation, combination with EBRT and a higher R100 were significant predictors for acute GU, late GU and late GI toxicity

  6. Comparison of quality of life between men and women who underwent Transforaminal Percutaneous Endoscopic Discectomy for lumbar disc herniation.

    Science.gov (United States)

    Kapetanakis, Stylianos; Gkasdaris, Grigorios; Thomaidis, Tryfon; Charitoudis, Georgios; Kazakos, Konstantinos

    2017-01-01

    Studies describing the efficacy of TPED on shortness of recovery and improvement of postoperative quality of life are limited, especially regarding gender something that has never been reported before in the literature. The purpose of this study is to evaluate possible differences of the health-related quality of life in patients who underwent TPED for LDH in accordance with sex. Seventy-six patients diagnosed and treated with TPED for LDH with 1 year follow-up were selected and divided into two groups of equal number depending on sex. Their quality of life was evaluated by using the SF-36 before the operation, six weeks, three, six and twelve months postoperatively. A statistical analysis was conducted, in order to compare the 8 scaled scores of the SF-36 combining each time two chronological phases in the total of patients, in each group and between groups. Fifty-two (68.4%) patients were ≤63 years old, while the rest 24 (31,4%) were >63 years old (mean ±SD = 56,5 ±12,1 years). Apart from the PF domain, the scores were higher in every visit for the two groups, but the change between groups was not significant. Women had a significantly higher increase of PF score in 3 months after TPED and in the interval 6 weeks-3 months comparing with men. However, in the intervals 3 months-6 months and 3 months-12 months men presented significantly higher increase compared to women. Statistically significant improvement of the quality of life for both men and women was observed. Generally, there was no significant difference between the two groups. As regards to the physical functioning, it appears to be a significant difference which is counterpoised over time. 2. TPED for LDH does not present major differences in the improvement of quality of life regarding gender.

  7. Comparison of a standardized procedure with current laboratory practices for the detection of lupus anticoagulant in France. Working Group on Hemostasis of the Société Française de Biologie Clinique.

    Science.gov (United States)

    1993-11-15

    A multicenter study involving 13 laboratories was designed to compare a common procedure for screening lupus anticoagulants (LA) to the different practices currently in use in these laboratories. The common procedure combined 3 phospholipid-dependent assays, including mixing studies and a phospholipid neutralizing test. Due to the heterogeneity of LA expression, an abnormal result in at least one of the tests was sufficient to classify a sample as positive for LA. Consecutive samples referred for LA diagnosis were evaluated in parallel by each participant and the data found using the common procedure were analyzed independently according to mutually agreed cut-offs and criteria for sample classification. Within a period of 3 months, 535 samples were included, of which 147 were judged LA positive, 29 undetermined and 359 negative by the respective laboratories using their current practice. When using the common procedure, 149 plasmas were said to be positive, 38 undetermined and 348 negative. Absolute concordance occurred for 81% of the specimen population and absolute discordance (positive versus negative) for 7%. The level of agreement between the common procedure and the current practices, assessed by kappa indexes, indicated noticeable variations in the rates of detection from laboratory to laboratory. Among the different tests used in the common procedure, regular APTT was the least sensitive (about 50% detection) but none of the other tests alone recognized more than 73% of specimens from the LA positive population. This yield increased to about 90% with any combination of 2 sensitive tests.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Estimation of absorbed dose of radiosensitive organs and effective sose in patients underwent abdominopelvic spiral CT scan using impact CT patient dosimetry

    Directory of Open Access Journals (Sweden)

    Ayoub Amirnia

    2017-05-01

    Full Text Available Background: Due to the presence of radiosensitive organs in the abdominopelvic region and increasing the number of requests for CT scan examinations, concerns about increasing radiation doses in patients has been greatly elevated. Therefore, the goal of this study was to determine the absorbed dose of radiosensitive organs and the effective dose in patients underwent abdominopelvic CT scan using ImPACT CT patient dosimetry Calculator (version 1.0.4, Imaging Performance Assessment on Computed Tomography, www.impactscan.org. Methods: This prospective cross-sectional study was conducted in Imam Reza Hospital from November to February 2015 February 2015 in the Imam Reza Hospital, in Urmia, Iran. The demographic and dosimetric information of 100 patients who underwent abdominopelvic CT scan in a 6-slice CT scanner were obtained through the data collection forms. The demographic data of the patients included age, weight, gender, and BMI. The dosimetric parameters included pitch value, CT dose volume index (CTDIvol, dose-length product (DLP, tube voltage, tube current, exposure time, collimation size, scan length, and scan time. To determine the absorbed dose of radiosensitive organs and also the effective dose in patients, ImPACT CT patient dosimetry calculator was used. Results: The results of this study demonstrated that the mean and standard deviation (SD of patients' effective dose in abdominopelvic CT scan was 4.927±0.164 mSv. The bladder in both genders had the greatest mean organ dose, which was 64.71±17.15 mGy for men and 77.56±18.48 mGy for women (P<0.001. Conclusion: The effective dose values of this examination are in the same range as previous studies, as well as International Commission on Radiological Protection (ICRP recommendations. However, the radiation dose from CT scan has the largest contribution to the medical imaging. According to the ALARA principle, it is recommended that the scan parameters, especially mAs, should be

  9. [Analysis of prevalence and risk factors of pelvic organ prolapse of women underwent gynecologic health care in Peking Union Medical College Hospital].

    Science.gov (United States)

    Zhu, Lan; Wang, Jing-yi; Lang, Jing-he; Xu, Tao; Li, Lin

    2010-07-01

    To investigate prevalence and risk factors of pelvic organ prolapse in women underwent routine gynecologic health care in Peking Union Medical College Hospital (PUMCH). From Jan. 2008 to Aug. 2009, 972 women underwent gynecological health care in PUMCH were enrolled in this study. Questionnaires and pelvic examinations were given. The pelvic organ prolapse quantitive examination (POP-Q) system was used as the assessment tool. (1) Among all participants, the mean ages were (42 ± 10) years (range 22 to 78 years), the mean height were (162 ± 5) cm (range 142 to 180 cm), and the mean weight were (59 ± 8) kg (range 42 to 91 kg). 83.8% (815/972) of women were multipara. The mean total vaginal length (TVL) of 972 women was 8.20 cm. No women met the standard of pelvic organ prolapse, while 35.5% (345/972) of women presented mild posterior vaginal descent and 96.7% (940/972) presented mild anterior vaginal descent, all of them were asymptomatic. (2) The length of genital hiatus (gh), TVL and C, D proximal to the hymen in nullipara were (2.26 ± 0.32), (8.08 ± 0.30), (-7.08 ± 0.24) and (-8.08 ± 0.30) cm, which were significantly less than (2.33 ± 0.39), (8.22 ± 0.35), (-7.14 ± 0.28) and (-8.22 ± 0.35) cm in multipara (P 0.05). However, those in women at group of 22 - 34 years and 35 - 49 years showed statistical difference when compared with women at group of more than 50 years (P < 0.05). When compared with women at group of 22 - 34 years, the incidence of posterior and anterior vaginal wall protrusion were increased (OR = 1.713, 3.765). (4) Menopause status was associated with severities of all kinds of descent (P < 0.05) and presence of posterior vaginal protrusion (OR = 3.354). Mild anterior and posterior vaginal descent by POP-Q were common among women in China. The risk of anterior vaginal descent is relatively higher than posterior vaginal descent. However, most of the women with descent are asymptomatic and need no treatment. The most important factors

  10. 49 CFR 192.225 - Welding procedures.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Welding procedures. 192.225 Section 192.225... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.225 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures...

  11. 46 CFR 154.665 - Welding procedures.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design temperature...

  12. 22 CFR 305.5 - Procedures.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Procedures. 305.5 Section 305.5 Foreign Relations PEACE CORPS ELIGIBILITY AND STANDARDS FOR PEACE CORPS VOLUNTEER SERVICE § 305.5 Procedures. Procedures for filing, investigating, and determining allegations of discrimination on the basis of race...

  13. CA-125–indicated asymptomatic relapse confers survival benefit to ovarian cancer patients who underwent secondary cytoreduction surgery

    Science.gov (United States)

    2013-01-01

    Background There is no consensus regarding the management of ovarian cancer patients, who have shown complete clinical response (CCR) to primary therapy and have rising cancer antigen CA-125 levels but have no symptoms of recurrent disease. The present study aims to determine whether follow-up CA-125 levels can be used to identify the need for imaging studies and secondary cytoreductive surgery (CRS). Methods We identified 410 ovarian cancer patients treated at The University of Texas MD Anderson Cancer Center between 1984 and 2011. These patients had shown CCR to primary therapy. Follow-up was conducted based on the surveillance protocol of the MD Anderson Cancer Center. We used the Cox proportional hazards model and log-rank test to assess the associations between the follow-up CA-125 levels and secondary CRS and survival duration. Results The CA-125 level of 1.68 × nadir was defined as the indicator of recurrent disease (p CA-125 biochemical progression prior to clinically-defined relapse was 31 days (ranging from 1 to 391 days). The median number of the negative imaging studies for the clinical relapse findings in patients with a CA-125 level of CA-125 level at relapse was an independent predictor of overall and progression free survival in patients who had shown CCR to primary therapy (p = 0.04 and 0.02 respectively). The overall and progression free survival durations in patients with a CA-125 level ≤ 1.68 × nadir at relapse (69.4 and 13.8 months) were longer than those with a CA-125 level > 1.68 × nadir at relapse (55.7 and 10.4 months; p = 0.04 and 0.01, respectively). The overall and progression free survival duration of patients with asymptomatic relapse and underwent a secondary CRS was longer than that of patients with symptomatic relapse (p = 0.02 and 0.04 respectively). Conclusions The increase of serum CA-125 levels is an early warning of clinical relapse in ovarian cancer. Using CA-125 levels in

  14. Scapular dyskinesis after Latarjet procedure.

    Science.gov (United States)

    Carbone, Stefano; Moroder, Philipp; Runer, Armin; Resch, Herbert; Gumina, Stefano; Hertel, Ralph

    2016-03-01

    Because of detachment of the pectoralis minor and variation of the vector of the conjoint tendons, we hypothesized that the Latarjet procedure may alter scapular position and motion. The purpose of this study was to evaluate scapular position and motion in patients who underwent a Latarjet or a modified iliac crest bone graft transfer (ICBGT) procedure (J-bone graft). Forty-six consecutive patients treated for recurrent anterior shoulder dislocation between 2010 and 2012 were retrospectively enrolled. Twenty-three were treated with a Latarjet and 23 with an ICBGT procedure. Twenty Latarjet and 20 ICBGT patients were available at a mean follow-up of 20 months (min, 12; max, 60). We recorded the Western Ontario Instability Index, the Rowe Score, and the Subjective Shoulder Value. Scapulothoracic position was studied according to the dyskinesis yes/no method. Intraobserver and interobserver reliability of the dyskinesis assessment was assessed. Intraobserver and interobserver reliability of scapula dyskinesis assessment was high (Latarjet: intratester, κ = 0.84; intertester, κ = 0.75; ICBGT: intratester, κ = 0.78; intertester, κ = 0.71). Scapular dyskinesis was observed after 5 of 20 Latarjet and after 0 of 20 ICBGT procedures (P = .047). Patients with dyskinesis had lower scores (Western Ontario Instability Index, P = .043; Rowe, P = .047; Subjective Shoulder Value, P = .046), but no statistically significant difference was found between the Latarjet and ICBGT groups. Two of the 5 scapular dyskinesis patients reached the SICK (Scapular malposition, Inferior medial scapular winging, Coracoid tenderness, and scapular dysKinesis) scapula syndrome definition. Scapular dyskinesis was found in 5 of 20 patients who underwent a Latarjet procedure. Dyskinesis may be related to the detachment of the pectoralis minor, and variation of the vector and the working length of the coracobrachialis and the short head of the biceps. Copyright © 2016 Journal of Shoulder and Elbow

  15. [Perioperative management of a child with central diabetes insipidus who underwent two surgeries before and after desmopressin administration].

    Science.gov (United States)

    Kiriyama, Keiji; Tachibana, Kazuya; Nishimura, Nobuyuki; Takeuchi, Muneyuki; Kinouchi, Keiko

    2013-03-01

    A 14-year-old girl weighing 32 kg was diagnosed with suprasellar tumor causing hydrocephalus, hypothyroidism, adrenal dysfunction and central diabetes insipidus. She was treated with levothyroxine and hydrocortisone and urged to take fluid to replace urine. She was scheduled to undergo ventricular drainage to relieve hydrocephalus prior to tumor resection. For the first surgery, desmopressin was not started and urine output reached 4,000 to 6,000 ml x day(-1), urine osmolality 64 mOsm x l(-1) and urine specific gravity 1.002. Anesthesia was induced with sevoflurane and maintained with propofol and remifentanil. Maintenance fluid was with acetated Ringer's solution and urine loss was replaced with 5% dextrose. Bradycardia and hypotension occurred after intubation, which was treated with volume load. Infusion volume was 750 ml and urine output was 1100 ml during 133 min of anesthesia. Postoperative day 1 nasal desmopressin was started. Ten days later, partial tumor resection was performed. Anesthesia was induced with propofol and fentanyl and maintained with sevoflurane and remifentanil. Infusion volume was 610 ml, urine output 380 ml, and blood loss 151 ml during 344 min of anesthesia. Hemodynamic parameters were stable throughout the procedure. Pathology of the tumor was revealed to be germinoma. Bradycardia and hypotension experienced during the first surgery was suspected to be caused by preoperative hypovolemia brought by polyuria. Desmopressin was proved to be effective to treat excessive urine output and to maintain good perioperative water balance.

  16. [Retrospective analysis of 856 cases with stage 0 to III rectal cancer underwent curative surgery combined modality therapy].

    Science.gov (United States)

    Chen, Pengju; Yao, Yunfeng; Zhao, Jun; Li, Ming; Peng, Yifan; Zhan, Tiancheng; Du, Changzheng; Wang, Lin; Chen, Nan; Gu, Jin

    2015-07-01

    To investigate the survival and prognostic factors of stage 0 to III rectal cancer in 10 years. Clinical data and follow-up of 856 rectal cancer patients with stage 0-III underwent curative surgery from January 2000 to December 2010 were retrospective analyzed. There were 470 male and 386 female patients, with a mean age of (58 ± 12) years. Kaplan-Meier method was used to analyze the overall survival and disease free survival. Log-rank test was used to compare the survival between groups. Cox regression was used to analyze the independent prognostic factors of rectal cancer. The patients in each stage were stage 0 with 18 cases, stage I with 209 cases, stage II with 235 cases, and stage III with 394 cases. All patients received curative surgery. There were 296 patients evaluated as cT3, cT4 and any T with N+ received preoperative radiotherapy. 5.4% patients got pathological complete response (16/296), and the recurrence rate was 4.7% (14/296). After a median time of 41.7 months (range 4.1 to 144.0 months) follow-up, the 5-year overall survival rate in stage 0 to I of was 91.0%, stage II 86.2%, and stage III 60.0%, with a significant difference (P=0.000). The cumulative local recurrence rate was 4.8% (41/856), of which 70.7% (29/41) occurred within 3 years postoperatively, 97.6% (40/41) in 5 years. The cumulative distant metastasis rate was 16.4% (140/856), of which 82.9% (129/140) occurred within 3 years postoperatively, 96.4% (135/140) in 5 years. The incidence of abnormal imaging findings was significantly higher in pulmonary than liver and other sites metastases (75.0% vs. 21.7%, χ² =25.691, P=0.000). The incidence of CEA elevation was significantly higher in liver than lung and other sites metastases (56.8% vs. 37.8%, χ² =25.691, P=0.000). Multivariable analysis showed that age (P=0.015, HR=1.385, 95% CI: 1.066 to 1.801), surgical approach (P=0.029, HR=1.337, 95% CI: 1.030 to 1.733), differentiation (P=0.000, HR=1.535, 95% CI: 1.222 to 1.928), TNM stage (P

  17. Comportamiento de los pacientesancianosoperados de cirugíacardíaca con circulaciónextracorpórea/ Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Alain Moré Duarte

    2015-10-01

    Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks. Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass. Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014. Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively. Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

  18. Robust procedures in chemometrics

    DEFF Research Database (Denmark)

    Kotwa, Ewelina

    -way chemometrical methods, such as PCA and PARAFAC models for analysing spatial and depth profiles of sea water samples, defined by three data modes: depth, variables and geographical location. Emphasis was also put on predicting fluorescence values, as being a natural measure of biological activity, by applying...... if contamination in the data is present. For this becoming a standard procedure, further work is required, aiming at implementing reliable robust algorithms into standard statistical programs.......The general aim of the thesis was to contribute to the improvement of data analytical techniques within the chemometric field. Regardless the multivariate structure of the data, it is still common in some fields to perform uni-variate data analysis using only simple statistics such as sample mean...

  19. Road safety audit tools, procedures, and experiences : a literature review and recommendations : research in the framework of the European research project Safety Standards for Road Design and Redesign SAFESTAR, Workpackage 8.

    NARCIS (Netherlands)

    Kooi, R.M. van der

    1999-01-01

    This report describes tools and procedures established in different countries which apply Road Safety Audits (RSA). These RSAs are utilized to identify potential safety problems and they concentrate on safety measures to overcome these problems. This technique is used to detect possible safety

  20. Procedures Manual: A Guide to Uniform Grant and Contract Management Standards and The Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments.

    Science.gov (United States)

    Conable, Sharon R.

    This manual has been compiled to provide consistent grant application and administrative procedures for state agencies which award grants or contracts to local governments. It provides a conceptual framework of information concerning the reporting, financial, contractual, and auditing requirements for recipients of Texas State Library grants…

  1. Effect of right ventricular electrode location (outflow tract vs. apex) on mechanical Ventricular synchrony in patients that underwent pacemaker implant therapy

    International Nuclear Information System (INIS)

    Rincon, Oscar S; Saenz, Luis C; Salazar, Gabriel; Hernandez, Edgar

    2008-01-01

    Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials And Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent trans thoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group). There was no structural cardiopathy, ejection fraction was ? 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler) and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages.Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25%) a pre-implant ventricular asynchrony was found; in seven (70%) ventricular asynchrony post-implant in the right ventricle outflow tract and in 5 (50%) in the apex. Mean interventricular pot-implant delay was 21,6 ms in the right ventricular outflow tract and 11,5 ms in the apex (p = 0,8); mean septal to lateral wall delay was 73 ms in the right ventricular outflow tract and 26 ms in the apex (p = 0,8). QRS post-implant delay was 134 ms in the right ventricular outflow tract and 140 ms in the apex (p = 0,1). No differences between implant parameters and device programming were found. Conclusions: presence of ventricular asynchrony was evidenced in patients with normal QRS and structurally healthy heart. Ventricular stimulation with pacemaker from the apex or the right ventricular outflow tract suggests acute ventricular asynchrony at least in 60% of the cases, without statistically significant difference between both groups.

  2. Proposed Rule and Related Materials for Control of Emissions of Air Pollution From Nonroad Diesel Engines Control of Air Pollution From Aircraft and Aircraft Engines; Proposed Emission Standards and Test Procedures

    Science.gov (United States)

    EPA is proposing to adopt emission standards and related provisions for aircraft gas turbine engines with rated thrusts greater than 26.7 kilonewtons. These engines are used primarily on commercial passenger and freight aircraft.

  3. Increased cartilage volume after injection of hyaluronic acid in osteoarthritis knee patients who underwent high tibial osteotomy.

    Science.gov (United States)

    Chareancholvanich, Keerati; Pornrattanamaneewong, Chaturong; Narkbunnam, Rapeepat

    2014-06-01

    High tibial osteotomy (HTO) is a surgical procedure used to correct abnormal mechanical loading of the knee joint; additionally, intra-articular hyaluronic acid injections have been shown to restore the viscoelastic properties of synovial fluid and balance abnormal biochemical processes. It was hypothesized that combining HTO with intra-articular hyaluronic acid injections would have benefit to improve the cartilage volume of knee joints. Forty patients with medial compartment knee osteoarthritis (OA) were randomly placed into 1 of 2 groups. The study group (n = 20) received 2 cycles (at 6-month intervals) of 5 weekly intra-articular hyaluronic acid injections after HTO operation. The control group (n = 20) did not receive any intra-articular injections after HTO surgery. Cartilage volume (primary outcome) was assessed by magnetic resonance imaging (MRI) pre-operatively and 1 year post-operatively. Treatment efficacy (secondary outcomes) was evaluated with the Western Ontario and McMaster Universities OA Index (WOMAC) and by the comparison of the total rescue medication (paracetamol/diclofenac) used (weeks 6, 12, 24, 48). MRI studies showed a significant increase in total cartilage volume (p = 0.033), lateral femoral cartilage volume (p = 0.044) and lateral tibial cartilage volume (p = 0.027) in the study group. Cartilage volume loss was detected at the lateral tibial plateau in the control group. There were significant improvements after surgery in both groups for all subscales of WOMAC scores (p hyaluronic acid injections may be beneficial for increasing total cartilage volume and preventing the loss of lateral tibiofemoral joint cartilage after HTO. Therapeutic study, Level I.

  4. NORMAL QUALITY OF LIFE AFTER THE COX MAZE PROCEDURE FOR ATRIAL FIBRILLATION.

    Science.gov (United States)

    Melby, Spencer J; Zierer, Andreas; Lubahn, Jordon G; Bailey, Marci S; Cox, James L; Schuessler, Richard B; Damiano, Ralph J

    2008-05-01

    BACKGROUND/OBJECTIVE: Atrial fibrillation(AF) has been shown in numerous studies to significantly decrease patient quality of life. The Cox-Maze procedure has excellent long-term efficacy in curing AF. However, it is unknown whether this procedure improves long-term quality of life in these patients. The purpose of this study was to examine late quality of life in patients that underwent a lone Cox-Maze procedure. METHODS: Between 1987 and 2003, 163 patients underwent a Cox-Maze procedure for lone AF at our institution. Of these, 68 patients agreed and completed the Medical Outcomes Study Short Form 36 Health Survey. Scores from the age-matched general US population were normalized to a mean of 50 and standard deviation of 10 to facilitate comparison. Collected data were compared to the norm-based score for each domain using a one-sample t-test. Four patients were removed from analysis because of AF recurrence. RESULTS: There were 52 males(81%). Mean age was 52.6±9.5 years. Preoperatively, 37 patients(58%) had paroxysmal and 25 patients(39%) had persistent or permanent AF. The mean duration of AF before surgery was 9.8±8.2 years. There was no statistical difference in norm-based scores between the Cox-Maze procedure group and the age-matched general US population in any of the eight health domains at a mean follow-up of 8.7±3.7 years. CONCLUSION: Our results suggest that the Cox-Maze procedure cures atrial fibrillation in the majority of patients, and that those patients that are cured obtain a normal quality of life as compared to the general population at late follow-up.

  5. Laparoscopic reversal of Hartmann's procedure

    DEFF Research Database (Denmark)

    Svenningsen, Peter Olsen; Bulut, Orhan; Jess, Per

    2010-01-01

    %). There was no difference in postoperative complications between the two groups (10 versus 14%), and no anastomotic leaks. The total mortality was 2% as one patient died postoperatively after an open operation. CONCLUSION: It is possible for trained laparoscopic colorectal surgeons to perform laparoscopic reversal...... of all patients who underwent reversal of a colostomy after a primary Hartmann's procedure during the period May 2005 to December 2008 were reviewed retrospectively in a case-control study. RESULTS: A total of 43 patients were included. Twenty-one had a laparoscopic and 22 an open procedure. The two...... groups matched with regard to age, sex, American Society of Anestheologists (ASA) score, body mass index and indication for Hartmann's operation. A significantly longer operation time was found for laparoscopic than for open surgery (median 285 versus 158 minutes, p

  6. Beyond the standard model

    International Nuclear Information System (INIS)

    Cuypers, F.

    1997-05-01

    These lecture notes are intended as a pedagogical introduction to several popular extensions of the standard model of strong and electroweak interactions. The topics include the Higgs sector, the left-right symmetric model, grand unification and supersymmetry. Phenomenological consequences and search procedures are emphasized. (author) figs., tabs., 18 refs

  7. Academic performance of students who underwent psychiatric treatment at the students’ mental health service of a Brazilian university

    Directory of Open Access Journals (Sweden)

    Cláudia Ribeiro Franulovic Campos

    Full Text Available ABSTRACT CONTEXT AND OBJECTIVE: University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students’ mental health service (SAPPE and to compare their academic performance with that of non-patient students. DESIGN AND SETTING: Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university. METHODS: Files of 1,237 students attended by psychiatrists at SAPPE from 2004 to 2011 were reviewed. Their academic performance coefficient (APC and status as of July 2015 were compared to those of a control group of 2,579 non-patient students matched by gender, course and year of enrolment. RESULTS: 37% of the patients had had psychiatric treatment and 4.5% had made suicide attempts before being attended at SAPPE. Depression (39.1% and anxiety disorders/phobias (33.2% were the most frequent diagnoses. Severe mental disorders such as psychotic disorders (3.7% and bipolar disorder (1.9% were less frequent. Compared with non-patients, the mean APC among the undergraduate patients was slightly lower (0.63; standard deviation, SD: 0.26; versus 0.64; SD: 0.28; P = 0.025, but their course completion rates were higher and course abandonment rates were lower. Regarding postgraduate students, patients and non-patients had similar completion rates, but patients had greater incidence of discharge for poor performance and lower dropout rates. CONCLUSION: Despite the inclusion of socially vulnerable people with severe mental disorders, the group of patients had similar academic performance, and in some aspects better, than, that of non-patients.

  8. Academic performance of students who underwent psychiatric treatment at the students' mental health service of a Brazilian university.

    Science.gov (United States)

    Campos, Cláudia Ribeiro Franulovic; Oliveira, Maria Lilian Coelho; Mello, Tânia Maron Vichi Freire de; Dantas, Clarissa de Rosalmeida

    2017-01-01

    University students are generally at the typical age of onset of mental disorders that may affect their academic performance. We aimed to characterize the university students attended by psychiatrists at the students' mental health service (SAPPE) and to compare their academic performance with that of non-patient students. Cross-sectional study based on review of medical files and survey of academic data at a Brazilian public university. Files of 1,237 students attended by psychiatrists at SAPPE from 2004 to 2011 were reviewed. Their academic performance coefficient (APC) and status as of July 2015 were compared to those of a control group of 2,579 non-patient students matched by gender, course and year of enrolment. 37% of the patients had had psychiatric treatment and 4.5% had made suicide attempts before being attended at SAPPE. Depression (39.1%) and anxiety disorders/phobias (33.2%) were the most frequent diagnoses. Severe mental disorders such as psychotic disorders (3.7%) and bipolar disorder (1.9%) were less frequent. Compared with non-patients, the mean APC among the undergraduate patients was slightly lower (0.63; standard deviation, SD: 0.26; versus 0.64; SD: 0.28; P = 0.025), but their course completion rates were higher and course abandonment rates were lower. Regarding postgraduate students, patients and non-patients had similar completion rates, but patients had greater incidence of discharge for poor performance and lower dropout rates. Despite the inclusion of socially vulnerable people with severe mental disorders, the group of patients had similar academic performance, and in some aspects better, than, that of non-patients.

  9. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1993-01-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes

  10. Uji Ketahanan Beberapa Varietas Dan Pengaruh Jarak Tanam Terhadap Penyakit Karat Daun (Puccinia Polysora Underw) Pada Tanaman Jagung (Zea Mays L.)

    OpenAIRE

    Aditya, Sukma

    2013-01-01

    Sukma Aditya, "Some Resistance Test Plant Varieties and Influence Distance Against Disease Leaf Rust (Puccinia polysora Underw) In the Corn Plantation (Zea mays l.) In the Lowlands". Supervised by Dr. Ir. Hasanuddin, MS, and Ir. Mukhtar Pinem Iskandar, M. Agr. This study aims to determine the resistance of some varieties of maize (Zea mays L.) and plant spacing influence on leaf rust disease (Puccinia polysora Underw.) In the lowlands. Research conducted in the village of Tanjung Selamat, Med...

  11. ['Gold standard', not 'golden standard'

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2005-01-01

    In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. In the same

  12. The standardized surgical approach improves outcome of gallbladder cancer

    Directory of Open Access Journals (Sweden)

    Igna Dorian

    2007-05-01

    Full Text Available Abstract Background The objective of this study was to examine the extent of surgical procedures, pathological findings, complications and outcome of patients treated in the last 12 years for gallbladder cancer. Methods The impact of a standardized more aggressive approach compared with historical controls of our center with an individual approach was examined. Of 53 patients, 21 underwent resection for cure and 32 for palliation. Results Overall hospital mortality was 9% and procedure related mortality was 4%. The standardized approach in UICC stage IIa, IIb and III led to a significantly improved outcome compared to patients with an individual approach (Median survival: 14 vs. 7 months, mean+/-SEM: 26+/-7 vs. 17+/-5 months, p = 0.014. The main differences between the standardized and the individual approach were anatomical vs. atypical liver resection, performance of systematic lymph dissection of the hepaticoduodenal ligament and the resection of the common bile duct. Conclusion Anatomical liver resection, proof for bile duct infiltration and, in case of tumor invasion, radical resection and lymph dissection of the hepaticoduodenal ligament are essential to improve outcome of locally advanced gallbladder cancer.

  13. Development of FWD procedures manual.

    Science.gov (United States)

    2010-04-01

    In this project, the state-of-practice in FWD testing and analysis procedures were examined : by looking at the standard protocols of a number of other highway agencies. The specific : needs of NJDOT were also examined and a protocol was developed th...

  14. Digital forensic standards: international progress

    CSIR Research Space (South Africa)

    Grobler, MM

    2010-05-01

    Full Text Available With the explosion of digital crime, digital forensics is more often applied. The digital forensic discipline developed rather rapidly, but up to date very little international standardization with regard to processes, procedures or management has...

  15. A standardized treatment regimen for patients with severe haemophilia A undergoing orthopaedic or trauma surgery: a single centre experience.

    Science.gov (United States)

    Hart, Christina; Heindl, Bernhard; Spannagl, Michael; Lison, Susanne

    2015-06-01

    Recommendations on the administration of clotting factor concentrates in patients with severe haemophilia undergoing surgery are usually determined by monitoring target clotting factor levels. In this retrospective cohort study, we enrolled patients with severe haemophilia A who underwent major orthopaedic or trauma surgery. We wanted to evaluate the feasibility and the safety of a standardized medical treatment procedure. Further on, we wanted to assess whether our standardized treatment regimen enables surgical procedures in certain situations in which measuring clotting factor VIII (FVIII) activity is not available. We created a standardized medical treatment procedure that included a medical protocol and close cooperation with the Haemophilic Treatment Centre. Thirteen surgical procedures in nine patients were examined. The feasibility and safety of this standardized treatment concept were assessed by identifying perioperative complications and by means of a questionnaire. Depending on the surgery, the amount of FVIII administered within the first 10 days ranged between 653 and 1027 units/kg body weight. No allogeneic blood transfusion was required. The measurement of FVIII activity was performed repeatedly in five patients. In all patients activated partial thromboplastin time monitoring was performed during the hospital stays. The surgeons and patients were satisfied with our treatment concept and adhered to the medical regimen protocol. By means of a detailed, standardized medical protocol and by ensuring close cooperation between the patient, the surgeons and the Haemophilic Treatment Centre, we could show that elective and emergency operations can be safely performed even in situations in which FVIII activity could not be monitored.

  16. Consistency Across Standards or Standards in a New Business Model

    Science.gov (United States)

    Russo, Dane M.

    2010-01-01

    Presentation topics include: standards in a changing business model, the new National Space Policy is driving change, a new paradigm for human spaceflight, consistency across standards, the purpose of standards, danger of over-prescriptive standards, a balance is needed (between prescriptive and general standards), enabling versus inhibiting, characteristics of success-oriented standards, characteristics of success-oriented standards, and conclusions. Additional slides include NASA Procedural Requirements 8705.2B identifies human rating standards and requirements, draft health and medical standards for human rating, what's been done, government oversight models, examples of consistency from anthropometry, examples of inconsistency from air quality and appendices of government and non-governmental human factors standards.

  17. Accounting standards

    NARCIS (Netherlands)

    Stellinga, B.; Mügge, D.

    2014-01-01

    The European and global regulation of accounting standards have witnessed remarkable changes over the past twenty years. In the early 1990s, EU accounting practices were fragmented along national lines and US accounting standards were the de facto global standards. Since 2005, all EU listed

  18. ISP-27 OECD/NEA/CSNI International Standard Problem n.27. Bethsy experiment 9.1 B. 2. cold leg break without HPSI and with delayed ultimate procedure. Comparison report. Volume 1 + 2

    International Nuclear Information System (INIS)

    1992-11-01

    This report is the final comparison report for ISP-27, a blind problem which is based on the BETHSY test 9.1b performed in december 1989 at the Nuclear Research Center in Grenoble (France). The BETHSY integral test facility is a scaled down model of a 3 loop 900 e MW FRAMATOME PWR; the overall scaling factor applied to every volume, mass flowrate and power level is close to 1/100, while elevations are 1/1 in order to preserve the gravitational heads. The cold leg break is combined with the High Pressure Injection System (HPIS) failure. In that case, the state oriented approach requires operators to start an Ultimate Procedure, which consists in fully opening the Steam Generator (SG) atmospheric dumps as soon as they are informed of the unavailability of the HPIS. The presently studied scenario assumes a delayed application of this procedure, which is started only when the core outlet temperature rises significantly higher than the saturation temperature. The BETHSY Test 9.1b addresses, besides typical problems relevant to Small Break Loss Of Coolant Accidents (SBLOCA) such as critical 2-phase flow, loop seal clearing, heat-transfer during boil-off or accumulator injection, specific aspects related to the fast depressurization (primary to secondary and structural heat transfer), uncovered core behavior when intense condensation takes place in the SG, and primary side refilling by the Low Pressure Injection System (LPIS)

  19. [Cox-maze III procedure for atrial fibrillation. A preliminary study].

    Science.gov (United States)

    García-Villarreal, Ovidio A

    2016-01-01

    To compare the efectiveness of the cut-and-sew Cox-maze III procedure against the Cox-maze IV peocedure by means of intraoperative bipolar radiofrequency delivery clamp. From January 2011 to October 2014, 50 patients were operated on with surgery for atrial fibrillation. All cases underwent mitral valve surgery as the first procedure, and secondarily a surgical procedure for atrial fibrillation was also performed. There were 2 groups. Group I (Cox-maze III «cut-and-sew»), and Group II (Cox-maze IV, intraoperative bipolar radiofrequency ablation). Group I was formed by 36 patients, and Group II by 14. All cases had atrial fibrillation longer than 1 year. The end-point was freedom of atrial fibrillation. There was no statistically significant difference between both groups regarding the basal and operative characteristics. Operative mortality was of 2 cases in the Group I, and no cases for Group II (P=0.9). A high tendency to eliminate atrial fibrillation in favour of Group I was observed (92% vs 53%, P<.001) in a 6 months follow-up. Classic standard Cox-maze III procedure showed superiority to eliminate atrial fibrillation over the Cox-maze IV procedure made with bipolar radiofrequency ablation clamp in patients with concomitant mitral valve disease. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  20. Pylorus drainage procedures in thoracoabdominal esophagectomy - a single-center experience and review of the literature.

    Science.gov (United States)

    Fritz, Stefan; Feilhauer, Katharina; Schaudt, André; Killguss, Hansjörg; Esianu, Eduard; Hennig, René; Köninger, Jörg

    2018-03-01

    Pylorotomy and pyloroplasty in thoracoabdominal esophagectomy are routinely performed in many high-volume centers to prevent delayed gastric emptying (DGE) due to truncal vagotomy. Currently, controversy remains regarding the need for these practices. The present study aimed to determine the value and role of pyloric drainage procedures in esophagectomy with gastric replacement. A retrospective review of prospectively collected data was performed for all consecutive patients who underwent thoracoabdominal resection of the esophagus between January 2009 and December 2016 at the Katharinenhospital in Stuttgart, Germany. Clinicopathologic features and surgical outcomes were evaluated with a focus on postoperative nutrition and gastric emptying. The study group included 170 patients who underwent thoracoabdominal esophageal resection with a gastric conduit using the Ivor Lewis approach. The median age of the patients was 64 years. Most patients were male (81%), and most suffered from adenocarcinoma of the esophagus (75%). The median hospital stay was 20 days, and the 30-day hospital death rate was 2.9%. According to the department standard, pylorotomy, pyloroplasty, or other pyloric drainage procedures were not performed in any of the patients. Overall, 28/170 patients showed clinical signs of DGE (16.5%). In the literature, the rate of DGE after thoracoabdominal esophagectomy is reported to be approximately 15%, even with the use of pyloric drainage procedures. This rate is comparable to that reported in the present series in which no pyloric drainage procedures were performed. Therefore, we believe that pyloric drainage procedures may be unwarranted in thoracoabdominal esophagectomy. However, future randomized trials are needed to ultimately confirm this supposition.

  1. Transtracheal puncture: a forgotten procedure

    Science.gov (United States)

    Almeida, E.P.; Almeida, A.C.; Almeida, F.F.; Montessi, J.; Gomes, C.A.; Ferreira, L.E.V.V.C.

    2015-01-01

    Transtracheal puncture has long been known as a safe, low-cost procedure. However, with the advent of bronchoscopy, it has largely been forgotten. Two researchers have suggested the use of α-amylase activity to diagnose salivary aspiration, but the normal values of this enzyme in tracheobronchial secretions are unknown. We aimed to define the normal values of α-amylase activity in tracheobronchial secretions and verify the rate of major complications of transtracheal puncture. From October 2009 to June 2011, we prospectively evaluated 118 patients without clinical or radiological signs of salivary aspiration who underwent transtracheal puncture before bronchoscopy. The patients were sedated with a solution of lidocaine and diazepam until they reached a Ramsay sedation score of 2 or 3. We then cleaned the cervical region and anesthetized the superficial planes with lidocaine. Next, we injected 10 mL of 2% lidocaine into the tracheobronchial tree. Finally, we injected 10 mL of normal saline into the tracheobronchial tree and immediately aspirated the saline with maximum vacuum pressure to collect samples for measurement of the α-amylase level. The α-amylase level mean ± SE, median, and range were 1914 ± 240, 1056, and 24-10,000 IU/L, respectively. No major complications (peripheral desaturation, subcutaneous emphysema, cardiac arrhythmia, or hemoptysis) occurred among 118 patients who underwent this procedure. Transtracheal aspiration is a safe, low-cost procedure. We herein define for the first time the normal α-amylase levels in the tracheobronchial secretions of humans. PMID:26176310

  2. Review Reviewing the values of a stabdard operating procedure ...

    African Journals Online (AJOL)

    The review further discusses shortcomings related to nonexistence of standard operating procedure including inconsistent quality of service; performance variation; procedural mix-ups; and misinterpretation or miscommunication of information. In conclusion, standard operating procedure, if realized and materialized as a ...

  3. Standardized quality audit procedures for on-site dosimetry visits to radiotherapy hospitals. Report of the IAEA consultants' meeting, IAEA, Vienna, 27 September - 1 October 1999; revised in 2001

    International Nuclear Information System (INIS)

    Izewska, Joanna; Dutreix, A.; Followill, D.S.; Nisbet, A.; Novotny, J.; Sipila, P.; Dam, J. van

    2002-01-01

    Since 1969 the International Atomic Energy Agency (IAEA), together with the World Health Organization (WHO), has performed postal TLD audits to verify the calibration of radiotherapy beams in developing countries. The IAEA over the past 30 years, has verified the calibration of more than 3500 clinical photon beams at approximately 1000 radiotherapy hospitals. Detailed follow-up procedures have been implemented since 1996. When the TLD result of a participating institution falls outside the acceptance limits of ±5%, the institution is initially informed that there is a discrepancy and requested to try to identify the reasons why it occurred. The institution is not informed of the actual magnitude of the discrepancy (blind conditions) but is offered a second TLD audit. If the deviation cannot be resolved by the local radiotherapy institution or the national SSDL, then an on-site visit is suggested which, if accepted, is made by an IAEA expert in clinical dosimetry. The on-site visit includes a review of the dosimetry data and techniques, corrective measurements and ad-hoc training. The reasons for the discrepancy are then traced, explained, corrected and reported. Until the discrepancies are resolved and changes have been implemented by hospitals to ensure that the discrepancies do not reoccur, the safe and effective delivery of radiation doses to patients is questionable. This document provides a standardised set of procedures for resolving discrepancies during onsite visits to radiotherapy hospitals by the IAEA experts. The table below summarises the acceptance criteria to be used by the IAEA experts for dosimetry and mechanical parameters of the hospital treatment units. If some of the parameters are outside the acceptance criterion, it will not be possible for an institution to assure the adequate quality of the dosimetry practices in radiotherapy. The criteria are based on analyses of clinical data and the measurement uncertainties for various dosimetry and

  4. EVALUATION OF OUTCOME OF VARIOUS SURGICAL PROCEDURES FOR UPPER EYELID PTOSIS

    Directory of Open Access Journals (Sweden)

    Nagaraju

    2015-02-01

    Full Text Available INTRODUCTION: There are various procedures available for ptosis correction. Successful outcome not only depends on correct technique but also choosing appropriate procedure for each patient. Selection of procedure is based on available levator function and also other factors like etiology, severity, Bell’s phenomenon etc. If such varied procedure s are performed in a group of patients based on standard criteria and results are evaluated systematically we can determine what works best for a given patient . AIM : Evaluation of outcome of various surgical procedures for upper eyelid ptosis . METHODOLOGY : 25 eyelids of 20 patients who presented to a tertiary centre in south India with complaint of drooping of upper lid were considered. All subjects underwent complete ocular examination corrected visual acuity and detailed ptosis evaluation with particular emphasis on measurement of levator muscle function, MRD1 (margin reflex distance - 1, palpebral fissure width in different gazes and margin crease distance. The effect of various factors like MRD1, MCD, levator function were assessed, the amount of correction required and appropriate surgical procedure was chosen. Surgical procedure of Levator resection, frontalis sling operation, anterior levator aponeurosis advancement, o r other ptosis correction procedures under appropriate anaesthesia were performed. Post - operative evaluation in terms of visual acuity, MRD, Interpalpebral fissure height, lid symmetry, lagophthalmos and complications (if any was done. RESULTS : Levator muscle resection was done in 28% of eyelids, frontal sling surgery in 60% of eyelids, Levator muscle plication in 8% eyelids and levator muscle disinsertion with frontal sling surgery in 4% eyes. Undercorrection was seen in about 44% of eyelids in varying degrees. 56% of the eyes had optimal correction. Symmetric correction was achieved in 76% of eyelids. CONCLUSION: The influence of various preoperative factors on the

  5. Prediction of Pathological Complete Response Using Endoscopic Findings and Outcomes of Patients Who Underwent Watchful Waiting After Chemoradiotherapy for Rectal Cancer.

    Science.gov (United States)

    Kawai, Kazushige; Ishihara, Soichiro; Nozawa, Hiroaki; Hata, Keisuke; Kiyomatsu, Tomomichi; Morikawa, Teppei; Fukayama, Masashi; Watanabe, Toshiaki

    2017-04-01

    Nonoperative management for patients with rectal cancer who have achieved a clinical complete response after chemoradiotherapy is becoming increasingly important in recent years. However, the definition of and modality used for patients with clinical complete response differ greatly between institutions, and the role of endoscopic assessment as a nonoperative approach has not been fully investigated. This study aimed to investigate the ability of endoscopic assessments to predict pathological regression of rectal cancer after chemoradiotherapy and the applicability of these assessments for the watchful waiting approach. This was a retrospective comparative study. This study was conducted at a single referral hospital. A total of 198 patients with rectal cancer underwent preoperative endoscopic assessments after chemoradiotherapy. Of them, 186 patients underwent radical surgery with lymph node dissection. The histopathological findings of resected tissues were compared with the preoperative endoscopic findings. Twelve patients refused radical surgery and chose watchful waiting; their outcomes were compared with the outcomes of patients who underwent radical surgery. The endoscopic criteria correlated well with tumor regression grading. The sensitivity and specificity for a pathological complete response were 65.0% to 87.1% and 39.1% to 78.3%. However, endoscopic assessment could not fully discriminate pathological complete responses, and the outcomes of patients who underwent watchful waiting were considerably poorer than the patients who underwent radical surgery. Eventually, 41.7% of the patients who underwent watchful waiting experienced uncontrollable local failure, and many of these occurrences were observed more than 3 years after chemoradiotherapy. The number of the patients treated with the watchful waiting strategy was limited, and the selection was not randomized. Although endoscopic assessment after chemoradiotherapy correlated with pathological response

  6. Lack of efficacy of an intradural somatic-to-autonomic nerve anastomosis (Xiao procedure) for bladder control in children with myelomeningocele and lipomyelomeningocele: results of a prospective, randomized, double-blind study.

    Science.gov (United States)

    Tuite, Gerald F; Polsky, Ethan G; Homsy, Yves; Reilly, Margaret A; Carey, Carolyn M; Parrish Winesett, S; Rodriguez, Luis F; Storrs, Bruce B; Gaskill, Sarah J; Tetreault, Lisa L; Martinez, Denise G; Amankwah, Ernest K

    2016-08-01

    OBJECTIVE Xiao et al. and other investigators have studied an intradural somatic-to-autonomic (e.g., L-5 to S3-4) nerve transfer as a method to create a reflex arc to allow bladder emptying in response to cutaneous stimulation (the Xiao procedure). In previous clinical studies of patients with spinal dysraphism who underwent the Xiao procedure, high success rates (70%-85%) were reported for the establishment of a "skin-CNS-bladder" reflex arc that allows spontaneous, controlled voiding in children with neurogenic bladder dysfunction. However, many of these studies did not use blinded observers, did not have control groups, and/or featured only limited follow-up durations. METHODS A randomized, prospective, double-blind trial was initiated in March 2009, enrolling children with myelomeningocele (MM), lipomyelomeningocele (LMM), and neurogenic bladder dysfunction who were scheduled for spinal cord detethering (DT) for the usual indications. At the time of DT, patients were randomized between 2 arms of the study: half of the patients underwent a standard spinal cord DT procedure alone (DT group) and half underwent DT as well as the Xiao procedure (DT+X group). Patients, families, and study investigators, all of whom were blinded to the surgical details, analyzed the patients' strength, sensory function, mobility, voiding, and urodynamic bladder function before surgery and at regular intervals during the 3-year follow-up. RESULTS Twenty patients were enrolled in the study: 10 underwent only DT and the other 10 underwent DT+X. The addition of the Xiao procedure to spinal cord DT resulted in longer operative times (p = 0.024) and a greater chance of wound infection (p = 0.03). Patients in both treatment arms could intermittently void or dribble small amounts of urine (bladder capacity) in response to scratching in dermatomes T-9 through S-2 using a standardized protocol, but the voiding was not reproducible and the volume voided was not clinically useful in any patient

  7. Feasibility of virtual 3-Fr percutaneous coronary intervention using standard guiding catheters.

    Science.gov (United States)

    Honda, Tsuyoshi; Fujimoto, Kazuteru; Miyao, Yuji

    2014-01-01

    Recent studies have reported the efficacy of sheathless percutaneous coronary intervention (PCI) using hydrophilic-coated 5-Fr guiding catheters that are one to two Fr sizes smaller in diameter than the corresponding introducer sheath (virtual 3-Fr PCI). However, the limited number of shapes of hydrophilic-coated guiding catheters occasionally makes them difficult to engage and control. To evaluate the efficacy and feasibility of virtual 3-Fr PCI using standard guiding catheters of various shapes. We identified 35 consecutive patients with stable angina, who underwent virtual 3-Fr PCI using either hydrophilic-coated guiding catheters (Works™, Medikit, Japan) or standard guiding catheters (Heartrail™, Terumo, Japan). Thirty-five patients were identified (63% men; mean age 70 ±13 years). In 2 cases, hydrophilic-coated guiding catheters were exchanged to standard guiding catheters because of difficulty in engaging the target coronary arteries. Ultimately, standard guiding catheters were used in 20 patients (57%) and hydrophilic-coated catheters were used in 15 (43%). One of 20 patients treated with standard guiding catheters and 1 of 15 treated with hydrophilic-coated guiding catheters underwent the 4-in-3 "slender mother and child" PCI technique due to difficulty of stent deployment. There were no differences between the two groups in PCI procedural variables such as procedural time, fluoroscopy time, radiation dose, or contrast dye volume. There were no access site-related complications in this study. These findings indicate that virtual 3-Fr PCI using standard guiding catheters is as efficient and safe as virtual 3-Fr PCI using hydrophilic-coated guiding catheters.

  8. Communications standards

    CERN Document Server

    Stokes, A V

    1986-01-01

    Communications Standards deals with the standardization of computer communication networks. This book examines the types of local area networks (LANs) that have been developed and looks at some of the relevant protocols in more detail. The work of Project 802 is briefly discussed, along with a protocol which has developed from one of the LAN standards and is now a de facto standard in one particular area, namely the Manufacturing Automation Protocol (MAP). Factors that affect the usage of networks, such as network management and security, are also considered. This book is divided into three se

  9. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1987-05-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes

  10. 5 CFR 179.308 - Accelerated procedures.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Accelerated procedures. 179.308 Section 179.308 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.308 Accelerated procedures. OPM may make an administrative...

  11. 5 CFR 179.304 - Notification procedures.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Notification procedures. 179.304 Section 179.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.304 Notification procedures. Before collecting any debt...

  12. 40 CFR 140.5 - Analytical procedures.

    Science.gov (United States)

    2010-07-01

    ... 140.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) MARINE SANITATION DEVICE STANDARD § 140.5 Analytical procedures. In determining the composition and quality of effluent discharge from marine sanitation devices, the procedures contained in 40 CFR part 136...

  13. Comparison of transition-matrix sampling procedures

    DEFF Research Database (Denmark)

    Yevick, D.; Reimer, M.; Tromborg, Bjarne

    2009-01-01

    We compare the accuracy of the multicanonical procedure with that of transition-matrix models of static and dynamic communication system properties incorporating different acceptance rules. We find that for appropriate ranges of the underlying numerical parameters, algorithmically simple yet high...... accurate procedures can be employed in place of the standard multicanonical sampling algorithm....

  14. Long-term psychological distress, and styles of coping, in parents of children and adolescents who underwent invasive treatment for congenital cardiac disease

    NARCIS (Netherlands)

    Spijkerboer, Alinda W.; Helbing, Willem A.; Bogers, Ad J. J. C.; van Domburg, Ron T.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2007-01-01

    To assess the level of psychological distress and styles of coping in both mothers and fathers of children who underwent invasive treatment for congenital cardiac disease at least 7 years and 6 months ago. The General Health Questionnaire and the Utrecht Coping List were completed by parents of

  15. Prognostic Impact of Combined Dysglycemia and Hypoxic Liver Injury on Admission in Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (from the INTERSTELLAR Cohort).

    Science.gov (United States)

    Jang, Ho-Jun; Oh, Pyung Chun; Moon, Jeonggeun; Suh, Jon; Park, Hyun Woo; Park, Sang-Don; Lee, Kyounghoon; Kim, Je Sang; Lee, Hyun Jong; Choi, Rak Kyeong; Choi, Young-Jin; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon

    2017-04-15

    Dysglycemia on admission is known to predict the prognosis of ST-segment elevation myocardial infarction (STEMI). Recently, hypoxic liver injury (HLI) has been proposed as a novel prognosticator for STEMI. We evaluated the prognostic impact of combined dysglycemia and HLI at the time of presentation in patients with STEMI who underwent primary percutaneous coronary intervention. From 2007 to 2014, 1,525 consecutive patients (79% men, mean age 61 years) who underwent primary percutaneous coronary intervention for STEMI in the INTERSTELLAR (Incheon-Bucheon Cohort of Patients Undergoing Primary PCI for Acute ST-Elevation Myocardial Infarction) cohort were analyzed retrospectively. Dysglycemia was defined as either hypoglycemia (serum glucose 250 mg/dl). HLI was defined as more than twofold increase of any serum aminotransferases above the upper normal limit. Patients were divided into 4 groups according to their dysglycemia and HLI status on admission: group 1, normoglycemia without HLI; group 2, dysglycemia without HLI; group 3, normoglycemia with HLI; and group 4, dysglycemia with HLI. Primary end point was inhospital death and secondary end point was all-cause mortality at 12 months after the index procedure. Of the 1,525 patients, there were 87 inhospital deaths (5.7%) and 113 all-cause deaths (7.4%) at 12 months after the index procedure. Both dysglycemia and HLI on admission were independent predictors of inhospital death. Inhospital mortality rate was the highest in group 4 (32.1%), followed by groups 2 and 3. Kaplan-Meier survival analysis at 12 months showed similar trends among the 4 groups. In conclusion, combined dysglycemia and HLI on admission predicts early prognosis for STEMI. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Measurement of patient radiation doses in certain urography procedures.

    Science.gov (United States)

    Sulieman, A; Barakat, H; Zailae, A; Abuderman, A; Theodorou, K

    2015-07-01

    Patients are exposed to significant radiation doses during diagnostic and interventional urologic procedures. This study aimed to measure patient entrance surface air kerma (ESAK) and to estimate the effective dose during intravenous urography (IVU), extracorporeal shock-wave lithotripsy (ESWL), and ascending urethogram (ASU) procedures. ESAK was measured in patients using calibrated thermo luminance dosimeters, GR200A). Effective doses (E) were calculated using the National Radiological Protection Board (NRPB) software. A total of 179 procedures were investigated. 27.9 % of the patients underwent IVU procedures, 27.9 % underwent ESWL procedures and 44.2 % underwent ASU procedures. The mean ESAK was 2.1, 4.18 and 4.9 mGy for IVU, ESWL, and ASU procedures, respectively. Differences in patient ESAK for the same procedure were observed. The mean ESAK values were comparable with those in previous studies. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Antimicrobial Testing Methods & Procedures Developed by EPA's Microbiology Laboratory

    Science.gov (United States)

    We develop antimicrobial testing methods and standard operating procedures to measure the effectiveness of hard surface disinfectants against a variety of microorganisms. Find methods and procedures for antimicrobial testing.

  18. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has......International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  19. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    competitive, national customs and regional economic organizations are seeking to establish a standardized solution for digital reporting of customs data. However, standardization has proven hard to achieve in the socio-technical e-Customs solution. In this chapter, the authors identify and describe what has......International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...... to be harmonized in order for a global company to perceive e-Customs as standardized. In doing so, they contribute an explanation of the challenges associated with using a standardization mechanism for harmonizing socio-technical information systems....

  20. Training Standardization

    International Nuclear Information System (INIS)

    Agnihotri, Newal

    2003-01-01

    The article describes the benefits of and required process and recommendations for implementing the standardization of training in the nuclear power industry in the United States and abroad. Current Information and Communication Technologies (ICT) enable training standardization in the nuclear power industry. The delivery of training through the Internet, Intranet and video over IP will facilitate this standardization and bring multiple benefits to the nuclear power industry worldwide. As the amount of available qualified and experienced professionals decreases because of retirements and fewer nuclear engineering institutions, standardized training will help increase the number of available professionals in the industry. Technology will make it possible to use the experience of retired professionals who may be interested in working part-time from a remote location. Well-planned standardized training will prevent a fragmented approach among utilities, and it will save the industry considerable resources in the long run. It will also ensure cost-effective and safe nuclear power plant operation

  1. Analgesic effect of breastfeeding for minor procedures in neonates: changing routines

    Directory of Open Access Journals (Sweden)

    Elisa Sánchez Torres

    2013-06-01

    Full Text Available With newborns often do you puncture to draw blood for diagnostic tests (hypoglycemia, hyperbilirubinemia, etc. as well as to conduct metabolic tests, causing pain during the procedure. Reduce and even eliminate pain in neonates is essential for them and their parents.Numerous studies have measured and analyzed the response to pain in neonates and as different techniques and use of drugs to reduce it.The aim of this study is to assess whether the pain is reduced in infants through breastfeeding simultaneously and skin contact, in order to change routines in the Obstetrics Unit of Hospital Universitario de Fuenlabrada. To do this, we designed a pilot study, establishing two groups of babies who are going to puncture and subsequent assessment of response to pain. The intervention group will be composed of infants who underwent simultaneous breast-feeding puncture skin and skin with the mother and the control group, infants who underwent the puncture in the nursing, the mother may accompany your child to the same (standard procedure.

  2. SAFE-P: System for Assurance of Flight Executable Procedures, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA operates manned spacecraft according to rigorously-defined standard operating procedures. Unfortunately, operating procedures are often written in different...

  3. Pollutant Assessments Group Procedures Manual: Volume 1, Administrative and support procedures

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    This manual describes procedures currently in use by the Pollutant Assessments Group. The manual is divided into two volumes: Volume 1 includes administrative and support procedures, and Volume 2 includes technical procedures. These procedures are revised in an ongoing process to incorporate new developments in hazardous waste assessment technology and changes in administrative policy. Format inconsistencies will be corrected in subsequent revisions of individual procedures. The purpose of the Pollutant Assessments Groups Procedures Manual is to provide a standardized set of procedures documenting in an auditable manner the activities performed by the Pollutant Assessments Group (PAG) of the Health and Safety Research Division (HASRD) of the Environmental Measurements and Applications Section (EMAS) at Oak Ridge National Laboratory (ORNL). The Procedures Manual ensures that the organizational, administrative, and technical activities of PAG conform properly to protocol outlined by funding organizations. This manual also ensures that the techniques and procedures used by PAG and other contractor personnel meet the requirements of applicable governmental, scientific, and industrial standards. The Procedures Manual is sufficiently comprehensive for use by PAG and contractor personnel in the planning, performance, and reporting of project activities and measurements. The Procedures Manual provides procedures for conducting field measurements and includes program planning, equipment operation, and quality assurance elements. Successive revisions of this manual will be archived in the PAG Document Control Department to facilitate tracking of the development of specific procedures.

  4. Standardization of a rearing procedure of Tetranychus urticae Koch (Acari: Tetranychidae) on bean (Phaseolus vulgaris): plant age and harvest time; Padronizacao da criacao de Tetranychus urticae Koch (Acari: Tetranychidae) em feijoeiro (Phaseolus vulgaris): idade da planta e tempo de colheita

    Energy Technology Data Exchange (ETDEWEB)

    Bustos, Alexander; Cantor, Fernando; Cure, Jose R; Rodriguez, Daniel [Universidade Militar Nueva Granada, Bogota (Colombia). Facutad de Ciencias. Programa de Biologia Aplicada], e-mail: fernando.cantor@unimilitar.edu.co

    2009-09-15

    A rearing technique was standardized to produce Tetranychus urticae Koch on Phaseolus vulgaris (ICA Cerinza variety) as a prey of the predatory mite Phytoseiulus persimilis Athias-Henriot. Two assays were conducted to assess the following variables: the most suitable plant age for mite infestation, and the best time to harvest the mites and re infest the plants. In the first experiment, four, five, six, and seven-week-old plants of P. vulgaris were infested with six T. urticae per foliole. The lower plant stratum exhibited the largest number of mites regardless of plant age. However, four-week old plants had the larger average number of individuals. In the second experiment four-week-old plants were infested with 0.5 female mite/cm{sup 2} of leaf. The number of individuals per instar of T. urticae was recorded weekly. The highest mite production occurred between four and five weeks after infestation, indicating this to be the most suitable for mite harvesting and for plant reinfestation. (author)

  5. The arthroscopic latarjet procedure for anterior shoulder instability: 5-year minimum follow-up.

    Science.gov (United States)

    Dumont, Guillaume D; Fogerty, Simon; Rosso, Claudio; Lafosse, Laurent

    2014-11-01

    The arthroscopic Latarjet procedure combines the benefits of arthroscopic surgery with the low rate of recurrent instability associated with the Latarjet procedure. Only short-term outcomes after arthroscopic Latarjet procedure have been reported. To evaluate the rate of recurrent instability and patient outcomes a minimum of 5 years after stabilization performed with the arthroscopic Latarjet procedure. Case series; Level of evidence, 4. Patients who underwent the arthroscopic Latarjet procedure before June 2008 completed a questionnaire to determine whether they had experienced a dislocation, subluxation, or further surgery. The patients also completed the Western Ontario Shoulder Instability Index (WOSI). A total of 62 of 87 patients (64/89 shoulders) were contacted for follow-up. Mean follow-up time was 76.4 months (range, 61.2-100.7 months). No patients had reported a dislocation since their surgery. One patient reported having subluxations since the surgery. Thus, 1 patient (1.59%) had recurrent instability after the procedure. The mean ± standard deviation aggregate WOSI score was 90.6% ± 9.4%. Mean WOSI domain scores were as follows: Physical Symptoms, 90.1% ± 8.7%; Sports/Recreation/Work, 90.3% ± 12.9%; Lifestyle, 93.7% ± 9.8%; and Emotions, 88.7% ± 17.3%. The rate of recurrent instability after arthroscopic Latarjet procedure is low in this series of patients with a minimum 5-year follow-up. Patient outcomes as measured by the WOSI are good. © 2014 The Author(s).

  6. Robot-assisted procedures in pediatric neurosurgery.

    Science.gov (United States)

    De Benedictis, Alessandro; Trezza, Andrea; Carai, Andrea; Genovese, Elisabetta; Procaccini, Emidio; Messina, Raffaella; Randi, Franco; Cossu, Silvia; Esposito, Giacomo; Palma, Paolo; Amante, Paolina; Rizzi, Michele; Marras, Carlo Efisio

    2017-05-01

    OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population. METHODS Between 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging. RESULTS The authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications. CONCLUSIONS To the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical

  7. 7 CFR 28.162 - Procedure.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Procedure. 28.162 Section 28.162 Agriculture..., TESTING, AND STANDARDS Regulations Under the United States Cotton Standards Act Adjustment of Contract... and in instituting and conducting arbitrations and appeals shall be as prescribed in the articles...

  8. An Evaluation of the Effects of the Transobturator Tape Procedure on Sexual Satisfaction in Women with Stress Urinary Incontinence Using the Libido Scoring System

    Science.gov (United States)

    Narin, Raziye; Nazik, Hakan; Narin, Mehmet Ali; Aytan, Hakan; Api, Murat

    2013-01-01

    Introduction and Hypothesis. Most women experience automatic urine leakage in their lifetimes. SUI is the most common type in women. Suburethral slings have become a standard surgical procedure for the treatment of stress urinary incontinence when conservative therapy failed. The treatment of stress urinary incontinence by suburethral sling may improve body image by reducing urinary leakage and may improve sexual satisfaction. Methods. A total of 59 sexually active patients were included in the study and underwent a TOT outside-in procedure. The LSS was applied in all patients by self-completion of questionnaires preoperatively and 6 months after the operation. General pleasure with the operation was measured by visual analogue score (VAS). Pre- and postoperative scores were recorded and analyzed using SPSS 11.5. Results. Two parameters of the LSS, orgasm and who starts the sexual activity, increased at a statistically significant rate. Conclusion. Sexual satisfaction and desire have partially improved after the TOT procedure. PMID:24288621

  9. Impact of baseline renal function on all-cause mortality in patients who underwent cardiac resynchronization therapy: A systematic review and meta-analysis.

    Science.gov (United States)

    Bazoukis, G; Letsas, K P; Korantzopoulos, P; Thomopoulos, C; Vlachos, K; Georgopoulos, S; Karamichalakis, N; Saplaouras, A; Efremidis, M; Sideris, A

    2017-10-01

    Cardiac resynchronization therapy (CRT) improves both morbidity and mortality in selected patients with heart failure and increased QRS duration. However, chronic kidney disease (CKD) may have an adverse effect on patient outcome. The aim of this systematic review was to analyze the existing data regarding the impact of baseline renal function on all-cause mortality in patients who underwent CRT. Medline database was searched systematically, and studies evaluating the effect of baseline renal function on all-cause mortality in patients who underwent CRT were retrieved. We performed three separate analyses according to the comparison groups included in each study. Data were analyzed using Review Manager software (RevMan version 5.3; Oxford, UK). We included 16 relevant studies in our analysis. Specifically, 13 studies showed a statistically significant higher risk of all-cause mortality in patients with impaired baseline renal function who underwent CRT. The remaining three studies did not show a statistically significant result. The quantitative synthesis of five studies showed a 19% decrease in all-cause mortality per 10-unit increment in estimated glomerular filtration rate (eGFR) [HR: 0.81, 95% CI (0.73-0.90), p <0.01, 86% I 2 ]. Additionally, we demonstrated that patients with an eGFR<60 mL/min/1.73 m 2 had an all-cause mortality rate of 66% [HR: 1.66, 95% CI (1.37-2.02), p <0.01, 0% I 2 ], which was higher than in those with an eGFR≥60 mL/min/1.73 m 2 . Baseline renal dysfunction has an adverse effect on-all cause mortality in patients who underwent CRT.

  10. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1983-10-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, these standards will be revised periodically to accommodate comments and reflect new information or experience

  11. Use of Bone Scan During Initial Prostate Cancer Workup, Downstream Procedures, and Associated Medicare Costs

    Energy Technology Data Exchange (ETDEWEB)

    Falchook, Aaron D. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Salloum, Ramzi G. [Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina (United States); Hendrix, Laura H. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Chen, Ronald C., E-mail: ronald_chen@med.unc.edu [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States)

    2014-06-01

    Purpose: For patients with a high likelihood of having metastatic disease (high-risk prostate cancer), bone scan is the standard, guideline-recommended test to look for bony metastasis. We quantified the use of bone scans and downstream procedures, along with associated costs, in patients with high-risk prostate cancer, and their use in low- and intermediate-risk patients for whom these tests are not recommended. Methods and Materials: Patients in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database diagnosed with prostate cancer from 2004 to 2007 were included. Prostate specific antigen (PSA), Gleason score, and clinical T stage were used to define D'Amico risk categories. We report use of bone scans from the date of diagnosis to the earlier of treatment or 6 months. In patients who underwent bone scans, we report use of bone-specific x-ray, computed tomography (CT), and magnetic resonance imaging (MRI) scans, and bone biopsy within 3 months after bone scan. Costs were estimated using 2012 Medicare reimbursement rates. Results: In all, 31% and 48% of patients with apparent low- and intermediate-risk prostate cancer underwent a bone scan; of these patients, 21% underwent subsequent x-rays, 7% CT, and 3% MRI scans. Bone biopsies were uncommon. Overall, <1% of low- and intermediate-risk patients were found to have metastatic disease. The annual estimated Medicare cost for bone scans and downstream procedures was $11,300,000 for low- and intermediate-risk patients. For patients with apparent high-risk disease, only 62% received a bone scan, of whom 14% were found to have metastasis. Conclusions: There is overuse of bone scans in patients with low- and intermediate-risk prostate cancers, which is unlikely to yield clinically actionable information and results in a potential Medicare waste. However, there is underuse of bone scans in high-risk patients for whom metastasis is likely.

  12. Program Baseline Change Control Procedure

    International Nuclear Information System (INIS)

    1993-02-01

    This procedure establishes the responsibilities and process for approving initial issues of and changes to the technical, cost, and schedule baselines, and selected management documents developed by the Office of Civilian Radioactive Waste Management (OCRWM) for the Civilian Radioactive Waste Management System. This procedure implements the OCRWM Baseline Management Plan and DOE Order 4700.1, Chg 1. It streamlines the change control process to enhance integration, accountability, and traceability of Level 0 and Level I decisions through standardized Baseline Change Proposal (BCP) forms to be used by the Level 0, 1, 2, and 3 Baseline Change Control Boards (BCCBs) and to be tracked in the OCRWM-wide Configuration Information System (CIS) Database.This procedure applies to all technical, cost, and schedule baselines controlled by the Energy System Acquisition Advisory Board (ESAAB) BCCB (Level 0) and, OCRWM Program Baseline Control Board (PBCCB) (Level 1). All baseline BCPs initiated by Level 2 or lower BCCBs, which require approval from ESAAB or PBCCB, shall be processed in accordance with this procedure. This procedure also applies to all Program-level management documents controlled by the OCRWM PBCCB

  13. A quality control procedure for seawater temperature data

    Digital Repository Service at National Institute of Oceanography (India)

    Ghosh, A; Pankajakshan, T.

    A three level quality check has been developed for seawater temperature data. The standards used in the procedure for the quality check are the characteristic property of vertical temperature distribution, watermass property and a standard...

  14. Standardization in measurement philosophical, historical and sociological issues

    CERN Document Server

    Schlaudt, Oliver

    2015-01-01

    The application of standard measurement is a cornerstone of modern science. In this collection of essays, standardization of procedure, units of measurement and the epistemology of standardization are addressed by specialists from sociology, history and the philosophy of science.

  15. Evaluation of endoscopic laser excision of polypropylene mesh/sutures following anti-incontinence procedures.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-11-01

    We reviewed our experience with and outcome of the largest series to our knowledge of patients who underwent endoscopic laser excision of eroded polypropylene mesh or sutures as a complication of previous anti-incontinence procedures.

  16. Audit of radiation dose during balloon mitral valvuloplasty procedure

    International Nuclear Information System (INIS)

    Livingstone, Roshan S; Chandy, Sunil; Peace, B S Timothy; George, Paul; John, Bobby; Pati, Purendra

    2006-01-01

    Radiation doses to patients during cardiological procedures are of concern in the present day scenario. This study was intended to audit the radiation dose imparted to patients during the balloon mitral valvuloplasty (BMV) procedure. Thirty seven patients who underwent the BMV procedure performed using two dedicated cardiovascular machines were included in the study. The radiation doses imparted to patients were measured using a dose area product (DAP) meter. The mean DAP value for patients who underwent the BMV procedure from one machine was 19.16 Gy cm 2 and from the other was 21.19 Gy cm 2 . Optimisation of exposure parameters and radiation doses was possible for one machine with the use of appropriate copper filters and optimised exposure parameters, and the mean DAP value after optimisation was 9.36 Gy cm 2

  17. Frequency standards

    CERN Document Server

    Riehle, Fritz

    2006-01-01

    Of all measurement units, frequency is the one that may be determined with the highest degree of accuracy. It equally allows precise measurements of other physical and technical quantities, whenever they can be measured in terms of frequency.This volume covers the central methods and techniques relevant for frequency standards developed in physics, electronics, quantum electronics, and statistics. After a review of the basic principles, the book looks at the realisation of commonly used components. It then continues with the description and characterisation of important frequency standards

  18. Human factoring administrative procedures

    International Nuclear Information System (INIS)

    Grider, D.A.; Sturdivant, M.H.

    1991-01-01

    In nonnuclear business, administrative procedures bring to mind such mundane topics as filing correspondence and scheduling vacation time. In the nuclear industry, on the other hand, administrative procedures play a vital role in assuring the safe operation of a facility. For some time now, industry focus has been on improving technical procedures. Significant efforts are under way to produce technical procedure requires that a validated technical, regulatory, and administrative basis be developed and that the technical process be established for each procedure. Producing usable technical procedures requires that procedure presentation be engineered to the same human factors principles used in control room design. The vital safety role of administrative procedures requires that they be just as sound, just a rigorously formulated, and documented as technical procedures. Procedure programs at the Tennessee Valley Authority and at Boston Edison's Pilgrim Station demonstrate that human factors engineering techniques can be applied effectively to technical procedures. With a few modifications, those same techniques can be used to produce more effective administrative procedures. Efforts are under way at the US Department of Energy Nuclear Weapons Complex and at some utilities (Boston Edison, for instance) to apply human factors engineering to administrative procedures: The techniques being adapted include the following

  19. Impact of high-density lipoprotein 3 cholesterol subfraction on periprocedural myocardial injury in patients who underwent elective percutaneous coronary intervention.

    Science.gov (United States)

    Harada, Kazuhiro; Kikuchi, Ryosuke; Suzuki, Susumu; Tanaka, Akihito; Aoki, Toshijiro; Iwakawa, Naoki; Kojima, Hiroki; Hirayama, Kenshi; Mitsuda, Takayuki; Sumi, Takuya; Negishi, Yosuke; Ishii, Hideki; Murohara, Toyoaki

    2018-02-02

    Periprocedural myocardial injury (PMI) is a major complication of percutaneous coronary intervention (PCI) and is associated with atherosclerotic coronary plaque and worse clinical outcomes. High-density lipoprotein cholesterol (HDL-C) is a protective factor for cardiovascular disease. However, the role of HDL-C subfractions, such as HDL2 cholesterol (HDL2-C) or HDL3 cholesterol (HDL3-C), in cardiovascular disease remains unclear. The purpose of the study was to investigate the relationship between HDL2-C and HDL3-C subfractions and the incidence of PMI in patients who underwent elective PCI. We enrolled 129 patients who underwent elective PCI for stable angina pectoris. PMI was defined as an increase in high-sensitivity troponin T levels > 5 times the upper normal limit (> 0.070 ng/mL) at 24 h after PCI. Serum HDL-C subfractions (HDL2-C and HDL3-C) were assessed using ultracentrifugation in patients with and those without PMI. HDL3-C levels were significantly lower in patients with PMI than in those without (15.1 ± 3.0 mg/dL vs. 16.4 ± 2.9 mg/dL, p = 0.016) and had an independent and inverse association with PMI (odds ratio, 0.86; 95% confidence interval, 0.74-0.99; p = 0.038). When divided by the cut-off value of HDL3-C for PMI (14.3 mg/dL), the incidence of PMI was significantly higher in low HDL3-C patients than in high HDL3-C patients (51.2% vs. 30.2%, p = 0.020). HDL3-C was an independent inverse predictor of PMI in patients who underwent elective PCI.

  20. Patterns and Timing of Failure for Diffuse Large B-Cell Lymphoma After Initial Therapy in a Cohort Who Underwent Autologous Bone Marrow Transplantation for Relapse

    Energy Technology Data Exchange (ETDEWEB)

    Dhakal, Sughosh; Bates, James E. [Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (United States); Casulo, Carla; Friedberg, Jonathan W.; Becker, Michael W.; Liesveld, Jane L. [Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (United States); Constine, Louis S., E-mail: louis_constine@urmc.rochester.edu [Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (United States)

    2016-10-01

    Purpose: To evaluate the location and timing of initial recurrence in patients with diffuse large B-cell lymphoma (DLBCL) who subsequently underwent high-dose chemotherapy with autologous stem cell transplant (HDC/ASCT), to direct approaches for disease surveillance, elucidate the patterns of failure of contemporary treatment strategies, and guide adjuvant treatment decisions. Methods and Materials: We analyzed consecutive patients with DLBCL who underwent HDC/ASCT between May 1992 and March 2014 at our institution. Of the 187 evaluable patients, 8 had incomplete data, and 79 underwent HDC/ASCT as a component of initial treatment for de novo or refractory DLBCL and were excluded from further analysis. Results: The median age was 50.8 years; the median time to relapse was 1.3 years. Patients were segregated according to the initial stage at diagnosis, with early stage (ES) defined as stage I/II and advanced stage (AS) defined as stage III/IV. In total, 40.4% of the ES and 75.5% of the AS patients relapsed in sites of initial disease; 68.4% of those with ES disease and 75.0% of those with AS disease relapsed in sites of initial disease only. Extranodal relapses were common (44.7% in ES and 35.9% in AS) and occurred in a variety of organs, although gastrointestinal tract/liver (n=12) was most frequent. Conclusions: Most patients with DLBCL who relapse and subsequently undergo HDC/ASCT initially recur in the previously involved disease site(s). Time to recurrence is brief, suggesting that frequency of screening is most justifiably greatest in the early posttherapy years. © 2016 Elsevier Inc.

  1. Operator licensing examiner standards

    International Nuclear Information System (INIS)

    1994-06-01

    The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes. Revision 7 was published in January 1993 and became effective in August 1993. Supplement 1 is being issued primarily to implement administrative changes to the requalification examination program resulting from the amendment to 10 CFR 55 that eliminated the requirement for every licensed operator to pass an NRC-conducted requalification examination as a condition for license renewal. The supplement does not substantially alter either the initial or requalification examination processes and will become effective 30 days after its publication is noticed in the Federal Register. The corporate notification letters issued after the effective date will provide facility licensees with at least 90 days notice that the examinations will be administered in accordance with the revised procedures

  2. Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery ?

    OpenAIRE

    Nunes, Viviane Regina Hernandez; Jacob, Charbel; Cardoso, Igor Machado; Batista, Jos? Lucas; Brazolino, Marcus Alexandre Novo; Maia, Thiago Cardoso

    2016-01-01

    ABSTRACT OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, an...

  3. The procedural egalitarian solution

    NARCIS (Netherlands)

    Dietzenbacher, Bas; Borm, Peter; Hendrickx, Ruud

    2017-01-01

    In this paper we introduce and analyze the procedural egalitarian solution for transferable utility games. This new concept is based on the result of a coalitional bargaining procedure in which egalitarian considerations play a central role. The procedural egalitarian solution is the first

  4. The Procedural Egalitarian Solution

    NARCIS (Netherlands)

    Dietzenbacher, Bas; Borm, Peter; Hendrickx, Ruud

    2016-01-01

    In this paper we introduce and analyze the procedural egalitarian solution for transferable utility games. This new concept is based on the result of a coalitional bargaining procedure in which egalitarian considerations play a central role. The procedural egalitarian solution is the first

  5. [Standardization of hospital feeding].

    Science.gov (United States)

    Caracuel García, Ángel Manuel

    2015-05-07

    Normalization can be understood as the establishing measures against repetitive situations through the development, dissemination, and application of technical design documents called standards. In Andalusia there are 45 public hospitals with 14,606 beds, and in which 11,700 full pensions / day are served. The Working Group on Hospital Food Standardization of the Andalusian Society for Clinical Nutrition and Dietetics, started in 2010, working on the certification of suppliers, product specifications, and meals technical card. - Develop a specific tool to help improving food safety through the certification of their suppliers. - Develop a standardized technical specifications of foodstuffs necessary for the development of menus established codes diets Andalusian hospitals document. - Develop a catalog of data sheets plates of hospital meals, to homogenize menus, respecting local and unifying criteria for qualitative and quantitative ingredients. - Providing documentation and studying of several public hospitals in Andalusia: • Product specifications and certification of suppliers. • International standards certification and distribution companies. • Legislation. • Data sheets for the menu items. • Specifications of different product procurement procedures. - Development of the draft standard HOSPIFOOD®, and approval of the version “0.0”. - Training course for auditors to this standard. - Development of a raw materials catalog as technical cards. - Meals Technical cards review and election of the ones which will be part of the document. After nearly three years of work, we have achieved the following products: - Standardized database of technical specifications for the production of food dietary codes for: fish, seafood, meat and meat products, meats and pates, ready meals, bread and pastries, preserves, milk and dairy products, oils, cereals, legumes , vegetables, fruits, fresh and frozen vegetables, condiments and spices. - Standardized database of

  6. Standardization of biodosimetry operations

    International Nuclear Information System (INIS)

    Dainiak, Nicholas

    2016-01-01

    Methods and procedures for generating, interpreting and scoring the frequency of dicentric chromosomes vary among cytogenetic biodosimetry laboratories (CBLs). This variation adds to the already considerable lack of precision inherent in the dicentric chromosome assay (DCA). Although variability in sample collection, cell preparation, equipment and dicentric frequency scoring can never be eliminated with certainty, it can be substantially minimized, resulting in reduced scatter and improved precision. Use of standard operating procedures and technician exchange may help to mitigate variation. Although the development and adoption of international standards (ISO 21243 and ISO 19238) has helped to reduce variation in standard operating procedures (SOPs), all CBLs must maintain process improvement, and those with challenges may require additional assistance. Sources of variation that may not be readily apparent in the SOPs for sample collection and processing include variability in ambient laboratory conditions, media, serum lot and quantity and the use of particular combinations of cytokines. Variability in maintenance and calibration of metafer equipment, and in scoring criteria, reader proficiency and personal factors may need to be addressed. The calibration curve itself is a source of variation that requires control, using the same known-dose samples among CBLs, measurement of central tendency, and generation of common curves with periodic reassessment to detect drifts in dicentric yield. Finally, the dose estimate should be based on common scoring criteria, using of the z-statistic. Although theoretically possible, it is practically impossible to propagate uncertainty over the entire calibration curve due to the many factors contributing to variance. Periodic re-evaluation of the curve is needed by comparison with newly published curves (using statistical analysis of differences) and determining their potential causes. (author)

  7. Association of Blood Fatty Acid Composition and Dietary Pattern with the Risk of Non-Alcoholic Fatty Liver Disease in Patients Who Underwent Cholecystectomy.

    Science.gov (United States)

    Shim, Poyoung; Choi, Dongho; Park, Yongsoon

    2017-01-01

    The relationship between diet and non-alcoholic fatty liver disease (NAFLD) in patients with gallstone disease and in those who have a high risk for NAFLD has not been investigated. This study was conducted to investigate the association between the risk of NAFLD and dietary pattern in patients who underwent cholecystectomy. Additionally, we assessed the association between erythrocyte fatty acid composition, a marker for diet, and the risk of NAFLD. Patients (n = 139) underwent liver ultrasonography to determine the presence of NAFLD before laparoscopic cholecystectomy, reported dietary intake using food frequency questionnaire, and were assessed for blood fatty acid composition. Fifty-eight patients were diagnosed with NAFLD. The risk of NAFLD was negatively associated with 2 dietary patterns: consuming whole grain and legumes and consuming fish, vegetables, and fruit. NAFLD was positively associated with the consumption of refined grain, meat, processed meat, and fried foods. Additionally, the risk of NAFLD was positively associated with erythrocyte levels of 16:0 and 18:2t, while it was negatively associated with 20:5n3, 22:5n3, and Omega-3 Index. The risk of NAFLD was negatively associated with a healthy dietary pattern of consuming whole grains, legumes, vegetables, fish, and fruit and with an erythrocyte level of n-3 polyunsaturated fatty acids rich in fish. © 2017 S. Karger AG, Basel.

  8. Prediction of vascular involvement and resectability by multidetector-row CT versus MR imaging with MR angiography in patients who underwent surgery for resection of pancreatic ductal adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Kyong [Department of Radiology, School of Medicine, Ewha Womans University, 911-1 Mok-dong, YangCheon-ku, Seoul 158-710 (Korea, Republic of); Kim, Ah Young [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnab-dong, Songpa-ku, Seoul 138-736 (Korea, Republic of)], E-mail: aykim@amc.seoul.kr; Kim, Pyo Nyun; Lee, Moon-Gyu; Ha, Hyun Kwon [Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnab-dong, Songpa-ku, Seoul 138-736 (Korea, Republic of)

    2010-02-15

    Purpose: To compare the diagnostic value of dual-phase multidetector-row CT (MDCT) and MR imaging with dual-phase three-dimensional MR angiography (MRA) in the prediction of vascular involvement and resectability of pancreatic ductal adenocarcinoma. Methods and materials: 116 patients with proven pancreatic adenocarcinoma underwent both MDCT and combined MR imaging prior to surgery. Of 116 patients, 56 who underwent surgery were included. Two radiologists independently attempt to assess detectability, vascular involvement and resectability of pancreatic adenocarcinoma on both images. Results were compared with surgical findings and statistical analysis was performed. Results: MDCT detected pancreatic mass in 45 of 56 patients (80.3%) and MR imaging in 44 patients (78.6%). In assessment of vascular involvement, sensitivities and specificities of MDCT were 61% and 96% on a vessel-by-vessel basis, respectively. Those of MR imaging were 57% and 98%, respectively. In determining resectability, sensitivities and specificities of MDCT were 90% and 65%, respectively. Those of MR imaging were 90% and 41%, respectively. There was no statistical difference in detecting tumor, assessing vascular involvement and determining resectability between MDCT and MR imaging (p = 0.5). Conclusion: MDCT and MR imaging with MRA demonstrated an equal ability in detection, predicting vascular involvement, and determining resectability for a pancreatic ductal adenocarcinoma.

  9. A New Risk Factor Profile for Contrast-Induced Acute Kidney Injury in Patients Who Underwent an Emergency Percutaneous Coronary Intervention.

    Science.gov (United States)

    Yuan, Ying; Qiu, Hong; Song, Lei; Hu, Xiaoying; Luo, Tong; Zhao, Xueyan; Zhang, Jun; Wu, Yuan; Qiao, Shubin; Yang, Yuejin; Gao, Runlin

    2017-01-01

    We developed a new risk factor profile for contrast-induced acute kidney injury (CI-AKI) under a new definition in patients who underwent an emergency percutaneous coronary intervention (PCI). Consecutive patients (n = 1061) who underwent an emergency PCI were divided into a derivation group (n = 761) and a validation group (n = 300). The rates of CI-AKI were 23.5% (definition 1: serum creatinine [SCr] increase ≥25% in 72 hours), 4.3% (definition 2: SCr increase ≥44.2 μmol/L in 72 hours), and 7.0% (definition 3: SCr increase ≥44.2 μmol/L in 7 days). Due to the high sensitivity of definition 1 and the high rate of missed cases for late diagnosis of CI-AKI under definition 2, definition 3 was used in the study. The risk factor profile included body surface area 15.00 × 10 9 /L ( P = .047), estimated glomerular filtration rate 133 μmol/L ( P = .007), intra-aortic balloon pump application ( P = .006), and diuretics administration ( P < .001), showing a significant predictive power in the derivation group and validation group. The new risk factor profile of CI-AKI under a new CI-AKI definition in emergency PCI patients is easily applicable with a useful predictive value.

  10. An evaluation of quality of life in women with endometriosis who underwent primary surgery: a 6-month follow up in Sabah Women & Children Hospital, Sabah, Malaysia.

    Science.gov (United States)

    M F, Ahmad; Narwani, Hussin; Shuhaila, Ahmad

    2017-10-01

    Endometriosis is a complex disease primarily affecting women of reproductive age worldwide. The management goals are to improve the quality of life (QoL), alleviate the symptoms and prevent severe disease. This prospective cohort study was to assess the QoL in women with endometriosis that underwent primary surgery. A pre- and post-operative questionnaire via ED-5Q and general VAS score used for the evaluation for endometrial-like pain such as dysmenorrhoea and dyspareunia. A total of 280 patients underwent intervention; 224 laparoscopically and 56 via laparotomy mostly with stage II disease with ovarian endometriomas. Improvements in dysmenorrhoea pain scores from 5.7 to 4.15 and dyspareunia from 4.05 to 2.17 (p <.001) were observed. The Self Rate Assessment was improved; 6.66-4.68 post-operatively (p < .05). In EQ-5 D Index, the anxiety and activities outcomes showed a significant worsening post-intervention. There was no correlation between the stage of disease and endometrial pain; (p = .289), method of intervention (p = .290) and usage of post-operative hormonal therapy (p = .632). This study concluded that surgical treatment improved the QoL with added hormonal therapy post-intervention, despite not reaching statistical significance, showed a promising result. Impact statement Surgical intervention does improve the QoL for women with endometriosis however post interventional hormonal therapy is remain inconclusive.

  11. Procedure generation and verification

    International Nuclear Information System (INIS)

    Sheely, W.F.

    1986-01-01

    The Department of Energy has used Artificial Intelligence of ''AI'' concepts to develop two powerful new computer-based techniques to enhance safety in nuclear applications. The Procedure Generation System, and the Procedure Verification System, can be adapted to other commercial applications, such as a manufacturing plant. The Procedure Generation System can create a procedure to deal with the off-normal condition. The operator can then take correct actions on the system in minimal time. The Verification System evaluates the logic of the Procedure Generator's conclusions. This evaluation uses logic techniques totally independent of the Procedure Generator. The rapid, accurate generation and verification of corrective procedures can greatly reduce the human error, possible in a complex (stressful/high stress) situation

  12. MILSTAMP: Military Standard Transportation and Movement Procedures. Volume 1

    Science.gov (United States)

    1987-03-15

    BAB MARYSVILLE, CA, BEALE AFB BCA BARACOA, CUBA BAC BARRANCA DE UPIA, COLOMBIA BCB BLACKSBURG, VA, VIRGINIA TECH AP BAD BOSSIER CITY, LA, BARKSDALE AFB...F20-14 CHR3 DoD 4500.32-R Vol. I 763 BAGS, SACKS BAGSAC 764 CLEANING SUPPLIES, OTHER THAN DETERGENTS AND SOAPS CLNSUP 765 MATCHES MATCHS 766 POLISHING

  13. Standards and Procedures for Application of Radiometric Sensors

    Science.gov (United States)

    2010-07-01

    anti-reflection. If the optical components are reflective, note the reflective material (such as aluminum or gold) and any coating material...are defined for different materials in Reference 8b and are typically for a certain wavelength range and temperature. For the indium antimonide (InSb...Condition 0.6 um* Solar 1.8 um* 1371 o C 3.6 um* 538 o C 5.4 um* 260 o C 9.3 um* 38 o C Aluminum Polished Oxidized Anodized at 1000

  14. Standard Operation Procedure of Gaharu Oil Extraction Process

    International Nuclear Information System (INIS)

    Peng, C.S.; Mohd Fajri Osman; Norella Bahari; Rusli Zakaria

    2015-01-01

    Gaharu oil extraction system developed by Nuclear Malaysia is a hydro-distillation system innovated from the tradition method and improvised with science and technology to enhance the process efficiency and safety. The main component of gaharu oil extraction system included the extraction vessel, condenser and collection decanter. Apart from the extraction unit, the gaharu oil extraction process also incorporated two major supporting systems. These systems are the liquefied petroleum gas (LPG) system and the water cooling system. The LPG system is solely used for heating the vessel, which contains a mixture of treated and grind gaharu bark and fluid, to produce steam. Meanwhile the water cooling system is used to supply the necessary cool water into the condenser unit and facilitate in the transformation of the mentioned steam into gaharu oil and distilled water. The dissipate water from this process will be channeled back into the water cooling ponds to let excess heat to be removed and allow the cool water to reuse again by the process. (author)

  15. Standard Test Procedures for Evaluating Various Leak Detection Methods

    Science.gov (United States)

    Learn about protocols that testers could use to demonstrate that an individual release detection equipment type could meet the performance requirements noted in the federal UST requirements for detecting leaks.

  16. Military Standard Transportation and Movement Procedures. Volume 1. Change 5

    Science.gov (United States)

    1994-08-12

    DCMINGO SDQ AWAN ADH ALMA ATA ALA EASTER ISLAND ANDER4A AW EASTER IS, MATAVERI INTL AP IPC ANAPA AAQ ARFBANGELSK ARM ECUADOR ASHKHABAD ASB AMBATO, CRACHOAN...ESK MONTEVIDEO, CARRASCO AIRPORT MVD ISTANBUL, ATATURK AIRPORT IST ZBR - ADNAN M ADB VANLTATA IZMIR, CIGLI MILITARY AIRPORT IGL AWIzTY AUY KAYSER ASR...MYANMAR AMZ ARDMORE, NEW ZEALAND ALA ALMA ATA, CIS ANA ANAHEIM, CA ALB ALBANY, NEW YORK, USA ANB ANNISTON, ALABAMA, USA ALC ALICANTE, SPAIN ANC

  17. Feasibility of Standard Evaluation Procedures for Ablating Materials

    National Research Council Canada - National Science Library

    Kiester, Nevin

    1966-01-01

    .... Teflon and high-density phenolic-nylon models having the same shape and size were supplied by Stanford Research Institute, and were evaluated at various enthalpies and heating rates under supersonic conditions...

  18. Integrating standard operating procedures with spacecraft automation, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Spacecraft automation has the potential to assist crew members and spacecraft operators in managing spacecraft systems during extended space missions. Automation can...

  19. Integrating Standard Operating Procedures with Spacecraft Automation, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Spacecraft automation can be used to greatly reduce the demands on crew member and flight controllers time and attention. Automation can monitor critical resources,...

  20. 40 CFR 51.357 - Test procedures and standards.

    Science.gov (United States)

    2010-07-01

    ... following steps: (i) Test equipment shall be connected to the fuel tank canister hose at the canister end... minutes and monitor for a sudden pressure drop, indicating that the fuel tank was pressurized. (v) The... be performed without repair or adjustment at the inspection facility, prior to the test, except as...

  1. Recommendations to reduce hand exposure for standard nuclear medicine procedures

    International Nuclear Information System (INIS)

    Sans-Merce, M.; Ruiz, N.; Barth, I.; Carnicer, A.; Donadille, L.; Ferrari, P.; Fulop, M.; Ginjaume, M.; Gualdrini, G.; Krim, S.; Mariotti, F.; Ortega, X.; Rimpler, A.; Vanhavere, F.; Baechler, S.

    2011-01-01

    The optimization of the extremity dosimetry of medical staff in nuclear medicine was the aim of the Work Package 4 (WP4) of the ORAMED project, a Collaborative Project (2008–2011) supported by the European Commission within its 7th Framework Programme. Hand doses and dose distributions across the hands of medical staff working in nuclear medicine departments were evaluated through an extensive measurement program involving 32 hospitals in Europe and 139 monitored workers. The study included the most frequently used radionuclides, 99m Tc- and 18 F-labelled radiopharmaceuticals for diagnostic and 90 Y-labelled Zevalin ® and DOTATOC for therapy. Furthermore, Monte Carlo simulations were performed in different predefined scenarios to evaluate separately the efficacy of different radiation protection measures by comparing hand dose distributions according to various parameters. The present work gives recommendations based on results obtained with both measurements and simulations. This results in nine practical recommendations regarding the positioning of the dosemeters for an appropriate skin dose monitoring and the best protection means to reduce the personnel exposure.

  2. 40 CFR 63.905 - Test methods and procedures.

    Science.gov (United States)

    2010-07-01

    ... secured in the closed position. (3) The detection instrument shall meet the performance criteria of Method... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Test methods and procedures. 63.905...) National Emission Standards for Tanks-Level 1 § 63.905 Test methods and procedures. (a) Procedure for...

  3. 40 CFR 63.945 - Test methods and procedures.

    Science.gov (United States)

    2010-07-01

    ... criteria of Method 21 of 40 CFR part 60, appendix A, except the instrument response factor criteria in... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Test methods and procedures. 63.945...) National Emission Standards for Surface Impoundments § 63.945 Test methods and procedures. (a) Procedure...

  4. 40 CFR 63.925 - Test methods and procedures.

    Science.gov (United States)

    2010-07-01

    ... secured in the closed position. (3) The detection instrument shall meet the performance criteria of Method... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Test methods and procedures. 63.925...) National Emission Standards for Containers § 63.925 Test methods and procedures. (a) Procedures for...

  5. 49 CFR 1111.10 - Meeting to discuss procedural matters.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Meeting to discuss procedural matters. 1111.10... § 1111.10 Meeting to discuss procedural matters. (a) Generally. In all complaint proceedings, other than... standards, the parties shall meet, or discuss by telephone, discovery and procedural matters within 12 days...

  6. Biometris GenStat Procedure Library Manual 12th Edition

    NARCIS (Netherlands)

    Goedhart, P.W.; Thissen, J.T.N.M.

    2009-01-01

    The Biometris GenStat Procedure Library contains procedures in which new and existing statistical methodology is implemented, as well as procedures to make GenStat more user-friendly. The Biometris library can be used and distributed freely. The Library is standardly distributed over the Dutch

  7. AN ANALYTICAL STUDY OF EFFICACY OF CORNEAL COLLAGEN CROSSLINKING C3R PROCEDURE IN PROGRESSIVE KERATOCONUS PATIENTS

    Directory of Open Access Journals (Sweden)

    Rajasekar K

    2017-10-01

    Full Text Available BACKGROUND Keratoconus affects a significant number of the general population with conical weakened protruded area from the cornea due to weakening of the corneal stroma by a genetically premeditated preponderance. We see keratoconus as a standalone disease or accompanying other syndrome manifestations in patients. Mainly, the inferotemporal cornea is affected and the conical protrusion causes profound high irregular myopic astigmatism as a refractive error, which is very difficult to correct in progressed advanced stages. Especially in economically productive age group patients, the poor vision becomes very difficult to live with. Corneal collagen crosslinking procedure is a novel tool in the armamentarium of treatment procedures against this malady. MATERIALS AND METHODS This analytical study was conducted at cornea services, Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai, for a period of 14 months. Forty five eyes of forty patients with early progressive keratoconus who presented to cornea services were subjected to riboflavin UVA collagen crosslinking procedures using a standard protocol after getting an informed consent. Further response to treatment were assessed in the follow up period. RESULTS Out of 40 patients in our series, 23 were males and 17 were females. The maximum patients in our series were in the age group between 10 to 25 yrs. Epi-off procedure was done in 31 eyes and epi-on procedure was done in 14 eyes. The patients with pachymetry 400-450 microns underwent epi-on procedure and more than 450 microns underwent epi-off C3R procedure. The K values in our series were between 49D to maximum 63D. The topographic flattening was seen in 52% in epi-on and epi-off procedures. Vision improvement in our series was 57% following epi-on and 65% following epi-off procedures. CONCLUSION C3R is a very promising therapeutic modality that may halt the progression of ectatic process. It is a less invasive mode

  8. Beyond the standard model; Au-dela du modele standard

    Energy Technology Data Exchange (ETDEWEB)

    Cuypers, F. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1997-05-01

    These lecture notes are intended as a pedagogical introduction to several popular extensions of the standard model of strong and electroweak interactions. The topics include the Higgs sector, the left-right symmetric model, grand unification and supersymmetry. Phenomenological consequences and search procedures are emphasized. (author) figs., tabs., 18 refs.

  9. Sphincter-saving procedure for radiation-injuried rectum

    International Nuclear Information System (INIS)

    Moriya, Yoshihiro; Koyama, Yasuo; Hojo, Keiichi

    1982-01-01

    Up to this time the sigmoid colostomy has been widely accepted and conventional treatment for radiation-injured rectum, but patients without residual malignancy strongly desire to live without colostomy. We have tried to remove the involved rectal segments by sphincter-saving procedures. Four patients underwent these procedures, pull-through procedure in three and low anterior resection in one. Among sphincter-saving procedures, pull-through procedure was most adequate. Provided the following five conditions are fulfilled, pull-through procedure should be considered for severe radiation-injured rectum. (1) No recurrence of initial malignancy in the pelvis. (2) More than 2 cm intact rectal segment above dentate line may be preserved. (3) No radiation-injured segment in upper sigmoid. (4) No severe radiation damage in small intestine. (5) Patients under 70 year-old, with normal tonus of anal sphincter. (author)

  10. Standard colonic lavage alters the natural state of mucosal-associated microbiota in the human colon.

    Directory of Open Access Journals (Sweden)

    Laura Harrell

    Full Text Available Past studies of the human intestinal microbiota are potentially confounded by the common practice of using bowel-cleansing preparations. We examined if colonic lavage changes the natural state of enteric mucosal-adherent microbes in healthy human subjects.Twelve healthy individuals were divided into three groups; experimental group, control group one, and control group two. Subjects in the experimental group underwent an un-prepped flexible sigmoidoscopy with biopsies. Within two weeks, subjects were given a standard polyethylene glycol-based bowel cleansing preparation followed by a second flexible sigmoidoscopy. Subjects in control group one underwent two un-prepped flexible sigmoidoscopies within one week. Subjects in the second control group underwent an un-prepped flexible sigmoidoscopy followed by a second flexible sigmoidoscopy after a 24-hour clear liquid diet within one week. The mucosa-associated microbial communities from the two procedures in each subject were compared using 16S rRNA gene based terminal restriction fragment length polymorphism (T-RFLP, and library cloning and sequencing.Clone library sequencing analysis showed that there were changes in the composition of the mucosa-associated microbiota in subjects after colonic lavage. These changes were not observed in our control groups. Standard bowel preparation altered the diversity of mucosa-associated microbiota. Taxonomic classification did not reveal significant changes at the phylum level, but there were differences observed at the genus level.Standard bowel cleansing preparation altered the mucosal-adherent microbiota in all of our subjects, although the degree of change was variable. These findings underscore the importance of considering the confounding effects of bowel preparation when designing experiments exploring the gut microbiota.

  11. 大型資料庫國小四年級自然科學習成就評量標準設定結果之效度評估 Validation of the Standard Setting Procedure for a Large Scale 4th Grade Science

    Directory of Open Access Journals (Sweden)

    謝進昌 Jin-Chang Hsieh

    2011-03-01

    Full Text Available 學習成就評量資料庫建置目的之一,在於描述學生於各學科的學習成就表現概況;而學習成就表現的描述,即牽涉到標準設定議題。隨著臺灣學生學習成就評量資料庫對於國小四年級自然科之評量架構調整,致使沿用的表現標準已多不符合實務運用,而興起重新修訂之舉。本研究主要目的在於評估2009 年自然科學習成就評量國小四年級標準設定結果之效度,以Kane(1994, 2001)的效度評估證據為依據,藉由效度的過程證據、內部證據以及外部證據,作為標準設定結果之效度證據來源。結果發現,從各項效度證據來看,國小四年級自然科標準設定可由標準設定成員的組成及其回應、設定結果的一致性,以及外推論於數學成就的效度外部證據得到支持。本研究最後提出數項建議,供未來標準設定研究者參考。 One of the main purposes for constructing an academic achievement database is to understand the students’ academic performance for each content area. Standard setting is the main issue in the academic achievement. Due to the adjustment of the test blueprint for Taiwan Assessment of Student Achievement 4th grade science, the previous performance level description is outmoded for practice. Therefore, modifying the standards is necessary. The purpose of this study is to validate a science standard setting procedure designed for 2009 4th grade science students. Based on Kane’s (1994, 2001 framework for validation, this study collected procedural evidence, internal evidence, as well as external evidence using mathematics academic performance. Several suggestions are provided in the conclusion for further studies.

  12. Safety and efficacy of dual-axis rotational coronary angiography vs. standard coronary angiography.

    Science.gov (United States)

    Klein, Andrew J; Garcia, Joel A; Hudson, Paul A; Kim, Michael S; Messenger, John C; Casserly, Ivan P; Wink, Onno; Hattler, Brack; Tsai, Thomas T; Chen, S Y James; Hansgen, Adam; Carroll, John D

    2011-05-01

    To determine the safety and efficacy of dual-axis rotational coronary angiography (DARCA) by directly comparing it to standard coronary angiography (SA). Standard coronary angiography (SA) requires numerous fixed static images of the coronary tree and has multiple well-documented limitations. Dual-axis rotational coronary angiography (DARCA) is a new rotational acquisition technique that entails simultaneous LAO/RAO and cranial/caudal gantry movement. This technological advancement obtains numerous unique images of the left or right coronary tree with a single coronary injection. We sought to assess the safety and efficacy of DARCA as well as determine DARCA's adequacy for CAD screening and assessment. Thirty patients underwent SA following by DARCA. Contrast volume, radiation dose (DAP) and procedural time were recorded for each method to assess safety. For DARCA acquisitions, blood pressure (BP), heart rate (HR), symptoms and any arrhythmias were recorded. All angiograms were reviewed for CAD screening adequacy by two independent invasive cardiologists. Compared to SA, use of DARCA was associated with a 51% reduction in contrast, 35% less radiation exposure, and 18% shorter procedural time. Both independent reviewers noted DARCA to be at least equivalent to SA with respect to the ability to screen for CAD. DARCA represents a new angiographic technique which is equivalent in terms of image quality and is associated with less contrast use, radiation exposure, and procedural time than SA. Copyright © 2011 Wiley-Liss, Inc.

  13. Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery.

    Science.gov (United States)

    Nunes, Viviane Regina Hernandez; Jacob, Charbel; Cardoso, Igor Machado; Batista, José Lucas; Brazolino, Marcus Alexandre Novo; Maia, Thiago Cardoso

    2016-01-01

    To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, and mean PI of 45. In patients with degenerative spondylolisthesis at the L4-L5 level, a mean tilt of 22.1, mean slope of 38.3, and mean PI of 61.4 were observed. This article reinforces the finding that the high mean tilt and PI are related to the onset of degenerative spondylolisthesis, and also concluded that the same angles, when low, increase the risk for disk herniation.

  14. Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery

    Directory of Open Access Journals (Sweden)

    Viviane Regina Hernandez Nunes

    Full Text Available ABSTRACT OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, and mean PI of 45. In patients with degenerative spondylolisthesis at the L4-L5 level, a mean tilt of 22.1, mean slope of 38.3, and mean PI of 61.4 were observed. CONCLUSION: This article reinforces the finding that the high mean tilt and PI are related to the onset of degenerative spondylolisthesis, and also concluded that the same angles, when low, increase the risk for disk herniation.

  15. Integration effects of underwing forward- and rearward-mounted separate-flow, flow-through nacelles on a high-wing transport

    Science.gov (United States)

    Lamb, M.; Abeyounis, W. K.

    1986-01-01

    An experimental investigation was conducted in the Langley 16-Foot Transonic Tunnel at free-stream Mach numbers from 0.70 to 0.82 and angles of attack from -2.5 to 4.0 degrees to determine the integration effects of pylon-mounted underwing forward and rearward separate-flow, flow-through nacelles on a high-wing transonic transport configuration. The results showed that the installed drag of the nacelle/pylon in the rearward location was slightly less than that of the nacelle/pylon in the forward location. This reduction was due to the reduction in calculated skin friction of the nacelle/pylon configuration. In all cases the combined value of form, wave, and interference drag was excessively high. However, the configuration with the nacelle/pylon in a rearward location produced an increase in lift over that of the basic wing-body configuration.

  16. Civil Procedure In Denmark

    DEFF Research Database (Denmark)

    Werlauff, Erik

    The book contains an up-to-date survey of Danish civil procedure after the profound Danish procedural reforms in 2007. It deals with questions concerning competence and function of Danish courts, commencement and preparation of civil cases, questions of evidence and burden of proof, international...... procedural questions, including relations to the Brussels I Regulation and Denmark's participation in this Regulation via a parallel convention with the EU countries, impact on Danish civil procedure of the convention on human rights, preparation and pronouncement of judgment and verdict, questions of appeal...... scientific activities conducted by the author, partly based on the author's experience as a member, through a number of years, of the Danish Standing Committee on Procedural Law (Retsplejeraadet), which on a continuous basis evaluates the need for civil procedural reforms in Denmark, and finally also based...

  17. Educational Standards for Chiropractic Colleges.

    Science.gov (United States)

    Council on Chiropractic Education, Des Moines, IA.

    The policy of accreditation for the chiropractic profession and educational standards for chiropractic colleges are presented. The following types are historical development of chiropractic accreditation; the structure and function of the Council on Chiropractic Education; and eligibility, procedures, and classifications for status as an…

  18. Functional Changes of Dendritic Cells in C6 Glioma-Bearing Rats That Underwent Combined Argon-Helium Cryotherapy and IL-12 Treatment.

    Science.gov (United States)

    Li, Ming; Cui, Yao; Li, Xiqing; Guo, Yanwu; Wang, Bin; Zhang, Jiadong; Xu, Jian; Han, Shuangyin; Shi, Xiwen

    2016-08-01

    The aim of this study was to explore changes in tumor tissues of glioma-bearing rats that underwent argon-helium cryoablation as well as changes in antitumor immunity before and after combined interleukin 12 treatment. Two hundred sixty Wistar rats were randomly divided into a blank control group, intravenous injection interleukin-12 group, cryotherapy group, and cryotherapy + intravenous injection group. C6 glioma cells proliferated in vitro were implanted subcutaneously on the backs of rats to establish C6 glioma-bearing animal models. Each group underwent the corresponding treatments, and morphological changes in tumor tissues were examined using hematoxylin-eosin staining. CD11c staining was examined using immunohistochemistry, and differences in dendritic cells and T-cell subsets before and after treatment were analyzed using flow cytometry. The control group showed no statistical changes in terms of tumor tissue morphology and cellular immunity, cryotherapy group, and cryotherapy + intravenous injection group, among which the count for the cryotherapy + intravenous injection group was significantly higher than those of all other groups. In the argon-helium cryotherapy group, tumor cells were damaged and dendritic cell markers were positive. The number of CD11c+ and CD86+ cells increased significantly after the operation as did the cytokine interferon-γ level (P < .01), suggesting a shift toward Th1-type immunity. Combined treatment of argon-helium cryoablation and interleukin 12 for gliomas not only effectively injured tumor tissues but also boosted immune function and increased antitumor ability. Therefore, this approach is a promising treatment measure for brain gliomas. © The Author(s) 2015.

  19. Analysis of 175 Cases Underwent Surgical Treatment in Our Hospital After Having Abdominal Wounding by Firearm in the War at Syria

    Directory of Open Access Journals (Sweden)

    Yusuf Yucel

    2016-04-01

    Full Text Available Aim: We aimed at analysing the patients, who underwent surgical treatment in our hospital after having abdominal wounding by firearm in the war at Syria, retrospectively. Material and Method: The files of Syrian patients, who applied to Emergency Service of Harran University Medical Faculty because of gunshot wounds and had operation after being hospitalized in General Surgery Clinic due to abdominal injuries between the years of 2011 and 2014, were analysed retrospectively. Results: 175 Syrian patients, who had abdominal injuries by firearms, underwent operation in our general surgery clinic. 99.4% (n=174 of the patients were male, and 0.6% (n=1 were female. Trauma-admission to hospital times of all cases were %u2265 6 hours. 62.8% (n=110 of the patients had isolated abdominal injuries, and 37.1% (n=65 had two or more system injuries. The frequency of more than one organ injuries in abdominal region was 44.5% (n=78 and the most frequent complication was wound infection (10%. Negative laparoscopy was 2.8% (n=5, support for intensive care was 38.2% (n=67, average duration of intensive care unit stay was 5.57 days and mortality was 9.7% (n=17. Discussion: In our study, it was seen that infectious morbidity and mortality increased for the patients, who applied to our hospital because of abdominal injuries by firearm, particularly the ones with gastrointestinal perforation, if trauma-admission to hospital times were %u2265 6 hours. And this shows us that the early intervention to injuries that perforate gastrointestinal tract was an important factor for decreasing morbidity and mortality.

  20. Lymphovascular invasion predicts poor prognosis in high-grade pT1 bladder cancer patients who underwent transurethral resection in one piece.

    Science.gov (United States)

    Ukai, Rinzo; Hashimoto, Kunihiro; Nakayama, Hirofumi; Iwamoto, Toshiyuki

    2017-05-01

    Lymphovascular invasion (LVI) in high-grade clinical T1 bladder cancer is usually considered a poor prognostic factor, but it is often difficult to achieve correct staging of T1 bladder cancer and diagnose the presence of LVI because of the inadequacy of conventional transurethral resection specimens. The aims of this study were to evaluate the prognostic value of LVI in patients with correctly staged high-grade pathological T1 (pT1) bladder cancer who initially underwent transurethral resection in one piece (TURBO). Eighty-six high-grade pT1 bladder cancer patients who underwent TURBO were enrolled. Risk of tumor understaging was avoided by examining the vertical resection margin of the TURBO specimen. Immunohistochemical staining using D2-40 and CD31 was performed to confirm LVI. We examined the association of LVI with other clinicopathological factors and the impact of LVI on progression-free survival and cancer-specific survival. The median follow-up period was 49 months (range, 6-142). In all patients, the tumors were accurately staged as pT1 at initial TURBO. LVI was detected in 15 patients (17%) and was significantly associated with tumor growth pattern (P = 0.001). Multivariate analysis identified LVI as the only independent predictor for reduced progression-free survival (HR, 4.48; 95% CI, 1.45-13.90; P = 0.009) and cancer-specific survival (HR, 4.35; 95% CI, 1.17-16.24; P = 0.029). The presence of LVI in TURBO specimens independently predicts poor clinical outcomes in patients with high-grade pT1 bladder cancer. This information may help urologists to counsel their patients when deciding whether to choose a bladder-preserving strategy or radical cystectomy.