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Biomedical subjects

A Martin

Publications and source records attributed to A Martin.

At least 1,027 records · Page 57Linked to original sources
PubMedDate not supplied

Psychometric evaluation of the Program Evaluation Instrument.

Most continuing education program evaluations are developed informally with little attention paid to psychometric properties. Rigorous evaluation of continuing education programs should measure quality and allow valid comparisons across programs. The Program Evaluation Instrument (PEI), which evaluates continuing education programs, was tested in this study to further evaluate its psychometric properties. The 19-item instrument consists of four theoretical subscales: program objectives, learner objectives, teacher behavior, and program satisfaction. Participants (N = 566) completed the instrument after a variety of hospital continuing education programs. Principal components factor analysis with Varimax rotation revealed two interpretable factors, Preparation and Presentation, and Usefulness. Coefficient alphas for the two factors were .94 and .70 respectively. The findings suggest item revision and further psychometric evaluation.

Education, Nursing, Continuing↗
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[Soft tissue sarcoma in childhood: local treatment in patients under 3 years of age. Analysis of the RMS-88 multicenter study].

The purpose of this report is to describe the treatment and the outcome of patients affected by soft tissue sarcomas and enrolled in the Italian Cooperative Study RMS 88, whose age was less than 36 months. In particular the role of local treatment is discussed, considering that RT was not recommended by the protocol. The 104 patients, 70 affected by RMS and 34 by NR-STS, were grouped according to the Intergroup Rhabdomyosarcoma Staging (IRS) system. The general guidelines of the study for the local treatment included surgery in Gr I, surgery + radiotherapy (40 Gy) in Gr II, surgery (1 or more procedures) + radiotherapy (45-54 Gy) in Gr III, but RT was not recommended for patients < 3 years. RMS: The 5 patients in Gr I did not receive RT: 4/5 are alive NED and 1 is lost at FU. Among the 5 patients in Gr II, 5 did not receive RT and are alive NED; 4 were given RT and 2 of these died of disease. In the 56 patients in Gr III, RT was utilized in 25: 5 died of disease and 6 manifested distant sequelae due to RT. 10/31 patients who were not given RT, did not undergo any other local treatment and died of disease; 4 patients died after surgery only. NRSTS: 7/9 Gr I patients are alive (1 was treated with RT and did not present sequelae); 1/9 died and 1 is lost at FU. 3/6 Gr II patients are alive (1 after RT), 2 died of disease and 1 is lost at FU. 2/19 Gr III patients were given RT and 1 died of disease; 3 of the not irradiated patients died without any local treatment, 4 after surgery only. CONCLUSION: The local treatment was important for patients' outcome: only 28% of the RMS and 36% of the NRSTS patients who were not treated with surgery a/o RT are in CR. Surgery was not particularly aggressive (6 mutilating procedures). RT was utilized in 33/104 patients and sequelae were 7. The difference in overall survival between patients less than 3 and patients more than 3 is not statistically significant.

Child, Preschool↗
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What do patients want to know about their inflammatory bowel disease?

Being informed is not only a patient's right, it is also important in order to improve compliance and management. Apart from verbal consultations, informative material is often produced without prior analysis of what patients consider important to know. Patient information needs were defined in order to plan future educational programmes. A 44-item questionnaire was given to 100 Inflammatory Bowel Disease (IBD) out-patients (50 Crohn's Disease (CD) and 50 Ulcerative Colitis (UC). Sixty-two per cent of those with UC and 78% of those with CD consider themselves insufficiently informed about their disease. CU and CD patients indicated different priorities concerning areas where further information is requested: CD patient needs were aetiology, diet, symptoms, history, new treatments, risks deriving from treatment, cancer risk and consequences on work. UC patients indicated a different priority order: risk of cancer, new treatments, symptoms, psychological and diet factors and aetiology. The media preferred by patients were: specifically prepared books (73%), video-cassettes (20%) and leaflets (25%). Ninety per cent think that educational material prepared according to their needs could be very useful; however 35% think that knowledge of the possible severity of their disease might increase their anxiety.

Colitis, Ulcerative↗
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Teaching gastroenterology using the problem-based learning method.

The need to change the methods of teaching medical students has become self-evident in the past two decades, and strategies for revision are indicated in the new course curriculum, Tabella XVIII. A modern teaching method is the problem-based learning (PBL) method, which has already been adopted by over 100 medical schools throughout the world. This method can also be a satisfactory tool for teaching gastroenterology to undergraduate students, and its implementation requires only a few resources that are available in most universities. The theoretical principles of the method are illustrated and practical suggestions are given to set up a course in gastroenterology using this method.

Education, Medical, Undergraduate↗
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Response to Eimeria tenella of chickens selected for high or low antibody response and differing in haplotypes at the major histocompatibility complex.

Sublines of chickens selected for high antibody (HA) or low antibody (LA) response that differed at the major histocompatibility complex (MHC) were tested for response to Eimeria tenella. In Expt. 1, the first exposure to E. tenella was natural (in floor pens), and chicks were challenged orally 21 days later with 0, 928, or 1855 oocysts. In Expt. 2, chicks were reared in wire-floored batteries, vaccinated orally with 928 oocysts, and challenged orally 12 days later with 15,844 oocysts. Corticosterone (20 mg/kg) was mixed with feed from 24 hr before vaccination to 120 hr after vaccination in Expt. 2. In Expt. 1, LA chicks had more-severe cecal lesions but gained relatively more body weight after challenge than did HA chicks. In Expt. 2, cecal lesions were least severe in HA chicks that had been fed corticosterone, most severe in LA chicks fed corticosterone, and intermediate in chicks that were not fed corticosterone. No differences in response to E. tenella occurred as a result of haplotypes at the MHC.

Animals↗
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[Leukotriene B4 in gastritis and peptic ulcer].

To contribute to a better understanding of the role of leukotrienes in inflammatory conditions of the upper gastrointestinal tract, leukotriene B4 (LTB4) levels were measured by specific radioimmunoassay in extracts of mucosal biopsies from the stomach and duodenum of control subjects and of patients with gastritis, benign gastric ulcer and duodenal ulcer. The control mucosa contained measurable levels of LTB4. Levels were 20% higher in gastritis than in controls and the lowest levels were found in the patients with no bile reflux. LTB4 levels were more than 3 times higher in duodenal ulcer (p less than 0.025) than in controls, whereas gastric ulcer margins had very low levels. No clear relationship was found between LTB4 levels and the drugs used in treatment. While these data do not explain the role of LTB4, they suggest that LTB4 may be an important mediator of the inflammation accompanying or leading to development of duodenal ulcer.

Analysis of Variance↗
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A resuscitation/selection system for rapid determination of Salmonella in foods.

A resuscitation medium was developed consisting of a trypticase soy broth base supplemented with 0.5% yeast extract, 0.25% sodium pyruvate, 0.01% sodium thioglycollate, and 0.1% chicken fat. After a resuscitation period of 4 h, the medium was made selective by addition of either sodium thiosulfate, bile salts and iodine, or sodium selenite and L-cystine. The now selective medium was incubated for 16 h. The presence or absence of Salmonella was determined by the Salmonella-Tek antibody-based detection kit. The present system was compared with a method of the Bacteriological Analytical Manual (BAM) for naturally contaminated foods. Nineteen egg products were screened; 3/19 were positive using the BAM method, 9/19 were positive using the present system. Seventeen chicken samples were assayed; 10/17 were positive using the BAM method; 13/17 were positive using the present system. Of 8 pepper samples, 4/8 were positive using the BAM method; 6/8 were positive using the present system. Of 8 spice samples, 6/8 were positive using the BAM method, 7/8 were positive using the present system. Of 6 onion products sampled, 5/6 were positive using the BAM method; 6/6 were positive using the present system.

Culture Media↗
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Recurrent Hodgkin's disease in the breast. Diagnosis of a case by fine needle aspiration and immunocytochemistry.

Recurrent Hodgkin's disease involving the breast in a 17-year-old girl was diagnosed by fine needle aspiration (FNA) biopsy of a solitary mass that developed one year after "curative" radiation. Benign breast disease and breast carcinoma were ruled out upon cytologic examination of the FNA smears, which contained diagnostic Reed-Sternberg cells and the characteristic polymorphic background elements. Follow-up immunoperoxidase staining for Leu-M1 on destained smears confirmed the diagnosis. Definitive therapeutic measures were initiated after the FNA diagnosis.

Adolescent↗
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[Development of gastric carcinoma at the site of a preceding peptic ulcer after 10 years].

We have observed an adenocarcinoma of the stomach which developed on the site where an apparently benign active gastric ulcer had been diagnosed radiologically 10 and 7 years previously. The patient had complained of recurrent episodes of epigastric pain over ten years, which were well controlled by the medical treatment. The length of clinical history in this patient makes it unlikely that his ulcer was neoplastic at the time of onset. This appears to be, therefore, one of the rare instances of development of a gastric carcinoma on the site of a previously benign peptic ulcer.

Adenocarcinoma↗
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[Systemically oriented family counseling (and treatment) within the scope of a social psychiatry service].

For the last 5 years the sociopsychiatric service of the public health administration of the city of Flensburg has been operating a kind of systemic family therapy. The theory of this method is described and placed in relationship with other family therapy theories. Some techniques of family therapy are demonstrated by means of a case. The legal background is shown. The system family treatment has improved as crisis intervention and short time therapy.

Adult↗
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[Contribution of indium-111 labelled polynuclear scintigraphy in the exploration of articular and bone infections].

Radionuclide imaging with Indium 111-labelled polymorphonuclears was performed on 90 occasions in 84 patients with suspected osteo-articular infection. The sensitivity of this technique was 70% and its specificity 87%. The Indium 111 technique is less sensitive than those using Technetium 99m and/or Gallium 67, but it is much more specific of infection. There are several causes of error when using this method: false-negative results due to the peculiarities of bone infection may occur, but false-positive results are rare, except in inflammatory diseases of peripheral joints. Among the best indications are infected articular prosthesis, spondylodiscitis, osteitis and osteomyelitis.

Bacterial Infections↗
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Gastric and duodenal ulcer in the same patient.

UNLABELLED: No extensive endoscopic studies have been performed on the prevalence and the clinical outcome of association of gastric ulcer (GU) and duodenal ulcer (DU). The present investigation, partially retrospective and partially prospective, takes into account 715 patients with active ulcer demonstrated by endoscopy, followed-up for a mean period of 3.8-years; 23 of them (3.2%) were found to have synchronous or asynchronous gastric and duodenal ulcers. The following characteristics were investigated: age of onset of both diseases, ulcer family history, cigarette and alcohol consumption, nonsteroidal anti-inflammatory drugs abuse, serum pepsinogen group I, ABO and Lewis blood groups, healing and relapse rate under H2-blocker treatment. The first diagnosis (by either X-Ray or endoscopy) was DU in 500 subjects (70%), GU in 210 (29.3%) and synchronous gastric and duodenal ulcers in 5 (0.7%). After a median period of 10 years, 2.8% of DU patients developed a GU; after 2-12 yrs 1.9% of GU patients developed a DU. The clinical and biochemical findings of our GU/DU patients suggest that the two ulcers are related by chance. IN CONCLUSION: asynchronous GU/DU patients do not seem to have a distinct disease in the large spectrum of ulcer disease. Larger studies must be planned on synchronous GU/DU with the aim of assessing whether or not it represents a particular type of ulcer disease.

Blood Group Antigens↗