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At least 181 records · Page 10Linked to original sources

Notifying patients exposed to blood products associated with Creutzfeldt-Jakob disease: theoretical risk for real people.

BACKGROUND: In July 1995 the Canadian Red Cross Society recalled blood products because of the hypothetical risk of transmission of Creutzfeldt-Jakob disease (CJD) through those blood products. The authors undertook a survey to determine the views of patients and parents of patients about being notified that they or their child had received such blood products. METHODS: The study population consisted of 528 transfusion recipients, of whom 453 (85.8%) were under 16 years of age, notified by the Hospital for Sick Children, Toronto, of the CJD recalls in 1995 and 1996. Families attending an information session were asked to complete a self-administered questionnaire (85 cases). Ninety-seven families randomly selected from those who did not attend the session were interviewed by telephone. The questionnaire was adapted from a questionnaire used to evaluate families' responses to notification of transfusion and risk of HIV infection. RESULTS: More than 80% of the respondents said they wanted to be notified and would want to be notified if there were another recall. On initial receipt of the notification about two-thirds of the respondents had been anxious, fearful or angry. There was no one method of conveying the information that suited all, but a personalized letter was seen as the most acceptable method. INTERPRETATION: Most parents of children who have received blood products are in favour of being informed about the risk of CJD, despite the uncertainty of the information on risk and the anxiety that such information causes.

Adolescent↗

Comparison of two methods of bedside blood glucose screening in the NICU: evaluation of accuracy and reliability.

Bedside whole blood glucose screening in the NICU has been an accepted method of care for several years. Meters or visually read reagent strips are used in bedside screening, but the reliability and accuracy of these methods are not always established before they are implemented as routine practice in the NICU. A study was conducted to determine which method of bedside whole blood glucose screening was the more accurate: visually read Chemstrip bG reagent strips or the One Touch II meter method. The values obtained were compared with lab analysis of serum glucose, and a correlation study was performed to compare the accuracy and reliability of the values produced by the two methods. One hundred samples were obtained from 38 NICU infants; 63 percent of the 100 samples were compared with lab values. Results revealed that the One Touch II method was more reliable (r = .92) than the Chemstrip bG method (r = .87). Furthermore, the One Touch II results correlated better with lab values when the meter was not operated in the neonatal mode. This study revealed that the One Touch II method appears to provide safe and accurate screening of bedside blood glucose in a high-risk neonatal population.

Blood Glucose↗

Use of the Round Ligament as a Natural Living Gastric Band for Weight Loss Surgery: a preliminary report.

With non-operative methods of treatment being notoriously refractory and prone to failure, gastric partitioning and banding surgery has become a more acceptable method of treating morbid obesity. The present method of simple gastric banding has developed with modifications over several years, with the present fashionable procedure creating an upper gastric pouch of about 50 ml by applying a restrictive band of a suitable material just below the fundus of the stomach. This article describes the development of this band which previously used synthetic material, by using a live natural material, ligamentum fares (round ligament), and thus finding a solution to the theoretical and actual problems of infection and erosion from such synthetics.

Journal Article↗

Repair of zygomaticomalar complex fractures. The Swiss method.

The zygomaticomalar complex fracture, also known as the trimalar, tripod, or tetrapod fracture, is a fracture commonly encountered by facial plastic surgeons. Failure to correctly reduce these fractures can lead to facial asymmetry, trismus, diplopia, enophthalmos, and parasthesias. Approaches to the zygomaticomalar complex have been well documented in the literature and include the transconjunctival lateral canthotomy, subciliary blepharoplasty, brow, gingivobuccal, and coronal incisions, or some combination thereof. Fracture fixation is accomplished by the internal placement of miniplates and microplates across properly reduced fracture lines to resist torsional rotation and masticatory distraction. The method of fracture reduction and fixation employed at the University Hospital of Bern, Switzerland, shares much with previously published and accepted methods of medial and lateral buttress reconstruction, but it introduces several original concepts in an attempt to maximize functional and aesthetic outcomes.

Bone Plates↗

Local immunotherapy for chronic respiratory allergic pathology with allergen aerosols. I. Treatment of allergic rhinitis.

For treatment of patients with chronic allergic rhinitis of pollen, dust, fungal and bacterial etiology two methods of specific therapy were employed. The first one consisted of projecting allergen aerosols into the nasal cavity on a special dosage schedule for a month or two; the second was the method of intradermal or subcutaneous injections of allergens. It was ascertained that local treatment has its advantages over a generally accepted method of injections. Good clinical effect combined with positive immunological shifts and decrease of nasal mucous membrane hypersensitivity to support this.

Aerosols↗

Cystic fibrosis heterozygote screening in 5,161 pregnant women.

A screening program for cystic fibrosis (CF) heterozygotes was conducted in a large HMO prenatal population, to evaluate the level of interest among eligible patients, the effectiveness of prescreening education, attitudes toward the screening process, psychological effects, and utilization of prenatal diagnosis and its outcomes. The heterozygote identification rate and frequency of specific CFTR mutations were also assessed. Identified carriers were offered genetic counseling and testing of male partners. Prenatal diagnosis was offered if both parents were identified as carriers. A total of 5,161 women underwent carrier testing; 947 others completed survey instruments only. The acceptance rate of screening was high (78%), and pretest education by videotape was generally effective. Adverse psychological effects were not reported. Participants generally found screening to be desirable and useful. Screening identified 142 female heterozygotes, 109 couples in which the male partner was not a carrier, and 7 high-risk couples. The incidence of R117H mutations was much higher than expected. The number of identified carriers was much lower in Hispanics than in Caucasians. We conclude that large-scale prenatal screening for CF heterozygotes in the absence of a family history of CF is an acceptable method for identifying couples at risk for affected fetuses. Sufficient pretest education can be accomplished efficiently, test insensitivity is well accepted, adverse psychological events are not observed, and general patient satisfaction is high.

Adult↗

Loss of lifetime due to radiation exposure-averaging problems.

A new method is presented for assessing a years of life lost (YLL) due to stochastic effects caused by the exposure to ionizing radiation. The widely accepted method from the literature uses a ratio of means of two quantities, defining in fact the loss of life as a derived quantity. We start from the real stochastic nature of the quantity (YLL), which enables us to obtain its mean values in a consistent way, using the standard averaging procedures, based on the corresponding joint probability density functions needed in this problem. Our method is mathematically different and produces lower values of average YLL. In this paper we also found certain similarities with the concept of loss of life expectancy among exposure induced deaths (LLE-EID), which is accepted in the recently published UNSCEAR report, where the same quantity is defined as years of life lost per radiation induced case (YLC). Using the same data base, the YLL and the LLE-EID are calculated and compared for the simplest exposure case-the discrete exposure at age a. It is found that LLE-EID overestimates the YLL, and that the magnitude of this overestimation reaches more than 15%, which depends on the effect under consideration.

Adolescent↗

The interplay between sagittal and vertical growth factors. An implant study of activator treatment.

Changes in sagittal jaw relationship are dependent on an interplay between a series of basal and dentoalveolar changes in both sagittal and vertical planes. The present article uses the implant method to examine and discuss this interrelationship as well as condylar growth and, in addition, comments on the relative value of accepted methods of expressing sagittal jaw relationship. The interplay between vertical and horizontal dentoalveolar, sutural, and condylar changes occurring relative to the occlusal plane in nineteen patients treated by means of activator was studied quantitatively by means of the implant method. Changes in the sagittal jaw relationship were evaluated by means of the change in ANB angle and utilizing the "Witts appraisal" with a modified occlusal plane construction. Change in sagittal jaw relationship was studied by means of a correlation analysis and shown to be largely dependent on the spatial development of the mandible; the latter was positively correlated to vertical condylar development and maxillary horizontal development but negatively correlated to increase in vertical sutural and dentoalveolar parameters. Vertical condylar development was also demonstrated to influence the rotational pattern of mandibular development. The clinical importance of controlling vertical development, sutural as well as dentoalveolar, in the treatment of sagittal discrepancies was stressed through the findings of the present study.

Activator Appliances↗

The diagnostics and prevalence of genital human papillomavirus (HPV) infection in Hungary.

OBJECTIVE: To show the prevalence and determine the type of human papillomavirus (HPV) in healthy women of reproductive age in Hungary. STUDY DESIGN: We determined HPV nucleic acid using the Digene Hybrid Capture HPV-DNA assay from endocervical swabs of 1121 volunteer women of reproductive age. With the help of the hybridization antibody capture test we determined 14 HPV types (low risk, intermediate and high risk). RESULTS: HPV prevalence was 17.5% considering the whole material. At the Szeged center 27.6% of the women screened were HPV positive, whereas at the three centers in Budapest, HPV prevalence did not exceed 15% in either of them. With a cytological examination out of 1100 cases, 117 (10.6%) were found to be HPV infected. The virus infection could be shown out of 1018 non-malignant cytologies in 60 (5.9%) cases and from 82 epithelial lesions 57 (69.5%) were infected. The cytological and molecular HPV diagnoses showed a significant relation to each other (P<0.001). The cytological method showed HPV infections with a low degree of efficiency (sensitivity: 23.8%). On the other hand, the specificity (92.2%) is an acceptable method for the real negativity of the light microscopic HPV infection. CONCLUSIONS: These facts mean regarding the detection of HPV-DNA genoms that HPV positive cytological reports are false negative and in dysplasias are false positive. Since in HPV infected women the development of CIN is a great risk, it is advisable to carry out the HPV determination and typing in the so-called "endangered" groups.

Adult↗

Management of knee arthroscopy portals.

Although the use of suture material for closure of knee arthroscopy portals has decreased, many surgeons continue to use adhesive tape, assuming this is superior to leaving them open. We have investigated two modalities of portal management after knee arthroscopy, the open method and the use of adhesive tape, documenting wound healing, complications and patient satisfaction. Eighty-seven patients (92 knees) were included in this study, 183 portals were involved. Sixty portals (30 knees) were closed with adhesive tape and 123 portals (62 knees) were left open. Follow up was at 2 weeks and at a further 6 weeks post operatively for those with a complication. In the adhesive tape group there were 6 portals with a complication (10%). In the open group there were 13 portals with a complication (10.56%). There were no major or long term complications and no significant difference between the two methods of treatment (P = 0.908 for portals, P = 0.954 for knees). We concluded that leaving knee athroscopy wounds open is an acceptable method of management when compared to adhesive tape.

Arthroscopy↗

General method validation guidelines for pharmaceutical samples.

Method validation guidelines, which provide an organizational structure for the design and evaluation of a validation procedure, are presented for a wide range of pharmaceutical applications. The validation guidelines are based on the analyte concentration/sample matrix combination to which the method will be applied. These guidelines include the selection of appropriate validation parameters, design considerations for evaluation, and a discussion of acceptance guidelines for the determination of acceptable method performance. A set of tables is included which illustrates the selection and testing procedure and tailors the entire validation process to the specific characteristics of the determination to be made.

Chemistry, Pharmaceutical↗

Use of plasma clearance of inulin for estimating glomerular filtration rate in cats.

OBJECTIVE: To evaluate utility of a method for estimating glomerular filtration rate after a single i.v. injection of inulin. ANIMALS: Cats that were renal intact (n = 3) or had renal mass reduced by partial nephrectomy (n = 6). PROCEDURE: Plasma clearance of inulin (PCln) was taken as the quotient of the administered dose of inulin (150 mg) divided by the area under the plasma inulin concentration versus time curve determined by 3 methods (PCln1-PCln3). Results for PCln were compared with simultaneously obtained values for urinary clearance of exogenous creatinine (CCr), an accepted method for the estimation of glomerular filtration rate (GFR) in cats. RESULTS: Values for PCln were closely related (R2 ranged from 0.951 to 0.972, P < 0.0001 in all instances) to CCr. However, PCln3 provided an estimate of GFR that consistently overestimated CCr. CONCLUSION: Determination of PCln by use of PCln1 and PCln2 provided a reliable estimate of GFR in cats of this study. CLINICAL RELEVANCE: Determination of PCln appears to provide a reliable estimate of GFR in cats with early-stage renal disease and no evidence of derangement of body fluid status. In particular, PCln2, which requires only 3 determinations of plasma inulin concentration, should be considered when an estimate of GFR is sought in a cat with suspected early-stage renal disease.

Animals↗

[Studies of arrhythmia incidence and heart rate variability in patients suffering from cerebral stroke].

Patients with cerebral stroke develop electrocardiographic changes concerning the period of ventricular muscle repolarization and cardiac arrhythmias, which may results in the possibility of acute circulatory arrest. ECG monitoring by means of Holter method provides not only information concerning arrhythmias, episodes of ischaemia of the cardiac muscle, but it is also a recognised and generally accepted method of investigation of the autonomic system. The aim of the study was to assess the incidence of arrhythmias and heart rate variability in patients suffering from recent cerebral stroke. The studies involved 36 patients, in that 22 women (mean age 67.7 +/- 7.2 years) and 14 men (mean age 66.5 +/- 11.3 years) within first 24 hours after cerebral stroke confirmed by computerised tomography (CT). One the basis of CT scan haemorrhagic stroke was diagnosed in 7 patients and ischaemic stroke, after ruling out haemorrhagic stroke and neurological consultations, in 29 patients. Moreover, all patients revealed hypertension, 12 of them mild degree (1 degree), and 21 of moderate degree (2 degrees), and 3 of severe degree (3 degrees). The control group comprised 65 patients suffering from primary hypertension without concomitant cerebral stroke, matching the study group as to sex and age as well as the degree of hypertension. All of them were submitted to 24-hour Holter monitoring on tape by means of 3-channel registrator MR45, analysis of ECG tracings was carried out according to Optima Jet system manufactured by Oxford. In order to facilitate further analysis, the automatic recording was verified visually and next heart rate variability (HRV) was estimated within 24 hours and separately for day hours 6:00-22:00 and night hours 22:00-6:00. In comparison to patients with hypertension, but without stroke, subjects with hypertension and accompanying cerebral stroke more often reveal premature supraventricular beats, pairs of ventricular beats as well as episodes of nonsustained ventricular tachycardia; they also reveal lower 24-hours heart rate variability.

Aged↗

A new MRI ratio method for in-vivo estimation of signal hypointensity in aging and Alzheimer's disease.

1. Alzheimer's Disease (AD) is accompanied by a disruption in iron metabolism. There is no universally accepted method for detecting brain iron. 2. The authors have developed a novel "ratio" method which uses the red nucleus as an internal reference. We postulated that this method would improve our sensitivity in detecting differences in MRI signal intensities and that it would allow us to measure brain iron deposition. 3. The ratio method reasonably reproduced previous reports of the normal deposition of iron in brain that occurs with aging. It failed to distinguish any differences in three brain areas: putamen, left frontal lobe and whole slice in AD patients versus age and sex matched controls. 4. It also failed to detect differences with AD progression or severity. 5. The ratio method itself warrants further investigation.

Aged↗

A new one-step method for the isolation of human mononuclear cells.

This paper describes a radical new, one-step method for the routine isolation of the mononuclear cells from human blood in high yield and purity. In this procedure the blood sample is mixed with a Nycodenz separation medium prior to centrifugation. Erythrocytes and polymorphogranulocytes are pelleted during centrifugation leaving the mononuclear cells in the supernatant. The method can be used for a wide range of blood sample volumes and can be carried out with greater ease than the currently accepted methods.

Cell Separation↗

Single daily dose of carbimazole in the treatment of hyperthyroidism.

BACKGROUND: The antithyroid drugs, methimazole and carbimazole, are conventionally used in divided daily doses. However, these drugs have a longer intrathyroidal than a plasma half-life. We undertook this prospective, controlled study, in an area of mild iodine deficiency, to compare the efficacy of a single daily dose of carbimazole with divided doses in the treatment of hyperthyroidism. METHODS: Nineteen patients with hyperthyroidism received 30 mg of carbimazole daily at bed time (group A) while 14 received 10 mg of carbimazole every 8 hours (group B). These patients were assessed clinically and biochemically by estimation of serum total thyroxine, total triiodothyronine and thyrotropin before and 1, 2, 3, 4 and 6 weeks after treatment. RESULTS: There was no significant difference between mean baseline concentrations of thyroxine and triiodothyronine. After 1, 2, 3, 4 and 6 weeks there was a decline in their concentrations which was similar in both groups (p > 0.05). Euthyroidism was achieved in 4.6 +/- 1.4 weeks (range 2-6 weeks) in group A and in 3.8 +/- 1.2 weeks (range 3-6 weeks) in group B (p > 0.05). CONCLUSIONS: We conclude that carbimazole in a single daily dose is an effective method for treating hyperthyroidism in an area of mild iodine deficiency and its efficacy is comparable to divided dose therapy. This practical and acceptable method of treatment can be specially useful in patients who find it difficult to remember to take divided doses.

Adolescent↗

In search of effective programs to address students' emotional distress and behavioral problems part III: student assessment of school-based support groups.

Emotional distress and behavioral problems are common in high schools. This report describes the efficacy of an in-school program based on participation in volunteer-facilitated peer support groups in addressing these problems. Two hundred and fifty students who experienced such problems participated in weekly 50-minute peer support groups led by adult nonmental health professional volunteers. The students anonymously evaluated their progress and program acceptability using an instrument developed specifically to evaluate the group experience. Analysis of the evaluation of the 131 respondents documented the reliability of a proposed Self-Assessment Questionnaire which showed that participation led to improvement in school, interpersonal, and internal domains. The program was highly accepted and showed other signs of success: half of the alcohol and substance users reduced their intake, and 60% of those who considered dropping out of school continued their education. The results provide preliminary evidence that peer support groups show promise as an economical and well-accepted method for early recognition and management of emotional and behavioral problems in high schools. For some adolescents, these groups may be the only acceptable or available therapeutic modality.

Adolescent↗

Prehospital pediatric endotracheal intubation: a survey of the United States.

INTRODUCTION: The standard of practice and teaching for prehospital pediatric endotracheal intubation (PETI) in the United States currently is unknown. The accepted practice of prehospital PETI is of interest because it has contradictory support in the medical literature. HYPOTHESIS: PETI is an accepted method of prehospital airway control in the United States. METHODS: Nationwide mail survey (June 1991 to March 1992) of each state emergency medical service (EMS) agency and all known paramedic training sites. RESULTS: The use of PETI is supported by 100% of state EMS agencies and the American Virgin Islands. Ninety-seven percent (339 of 349) of the responding (349 of 523) paramedic training sites reported that PETI was taught in their programs. The results of the survey did not identify a predominate method for instructing paramedics in PETI. Lectures, mannequins, operating room demonstration, animal models, and cadavers were used in various ways for teaching the skill. CONCLUSION: Endotracheal intubation is an accepted standard in prehospital pediatric care. This standard exists with marginal support in published literature and study of prehospital PETI is needed to define the benefits, risks, and optimal instruction methods for the procedure.

Emergency Medical Services↗