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At least 181 records · Page 10Linked to original sources
PubMed1997

Patients' assessment of sensory levels during epidural analgesia in labour.

Thirty women in established labour and with epidurals in situ were asked to assess the sensory level of the epidural using loss of light touch sensation with their own finger. This dermatomal level was then compared to the sensory level assessed by an anaesthetist using loss of cold sensation with ethyl chloride spray. A total of 88 assessments were made. The mean dermatomal difference was 0.20 and 95% of the differences lay between 3.5 and -3.1 dermatomes. This large variation in dermatomal differences between the two methods of sensory assessment means that patient light touch is not an acceptable method of assessing epidural sensory level when compared to ethyl chloride.

Journal Article↗
PubMed2003

Impact evaluation of efforts to eliminate iodine deficiency disorders in Nigeria.

OBJECTIVE: : The objective of the present review is to assess the impact of universal salt iodisation in Nigeria during the last five years, with reference to some of the sentinel sites studied previously during a 1995 multi-centre study. DESIGN, SETTING AND SUBJECTS: : The method of goitre classification by palpation was employed using the new internationally accepted method in which the classification is simply graded as 0, 1 or 2. The multistage random sampling method was used and states and local government areas were already selected by virtue of their known status for iodine deficiency disorders (IDD). Schools were randomly chosen in each local government area and children aged 8-12 years in each school were determined. A percentage of the children was then included in the study to give a sample size greater than the minimum number allotted to the school. A total of 2372 schoolchildren (1420 males and 952 females) in 11 local government areas were examined; urine samples were collected from 537 children and analysed for urinary excretion of iodine. The method known as the Sandell-Kolthoff reaction was adopted, in which the iodide in the urine samples catalyses the reduction of ceric ammonium sulphate (yellow colour) to the cerous form (colourless) in the presence of arsenious acid. The degree of reduction in colour intensity of the yellow ceric ammonium sulphate is proportional to the iodine content in the urine sample. RESULTS: : The results from this study show that the median urinary iodine excretion for this sampled population in Nigeria, drawn mostly from IDD-endemic areas, is 14.65 microgram dl-1 with a mean value of 13.39 microgram dl-1. CONCLUSION: : This finding would suggest that Nigeria, in general terms, has achieved the goal of universal salt iodisation and should now focus its attention on constant monitoring in order to sustain this iodisation level.

Child↗
PubMed1998

Automated Left Ventricular Endocardial Border Detection Using Acoustic Quantification in Children.

OBJECTIVES: The purpose of this study was to determine the reliability and accuracy of automated border detection using acoustic quantification in children. BACKGROUND: Acoustic quantification has shown promise in adult patients as a method for on-line estimation of left ventricular size and function. However, in children, the smaller ventricular size might magnify the importance of measurement error. METHODS: We compared the cross-sectional area and fractional area change of the left ventricle as measured on line by acoustic quantification with the area and fractional area change derived by hand-digitizing the endocardial border of the left ventricle off line, both with and without the papillary muscles included in the left ventricular cavity. RESULTS: The areas and area change fractions from the two methods were highly correlated, both with inclusion and exclusion of the papillary muscles for off-line analysis. However, the regression slope was closer to unity when the papillary muscles were excluded from the left ventricular cavity during off-line digitization of the endocardial border. Analysis of agreement between the two methods showed good agreement for area measurements and fair agreement for function measurements. The magnitude of the difference between the two methods for area measurement was directly proportional to the size of the ventricle. That is, the larger the ventricle the larger the difference between the area measurements by the two methods. DISCUSSION: Automatic border detection using acoustic quantification appears to be an acceptable method for estimating the cross-sectional area and fractional area change of the left ventricle in children.

Journal Article↗
PubMed1997

The effect of chlorhexidine/xylitol chewing-gum on cariogenic salivary microflora: a clinical trial in elderly patients.

The effects of 14-day use of either a chlorhexidine/xylitol or a xylitol chewing gum on salivary levels of mutans streptococci, lactobacilli, and yeasts were determined for 53 subjects (mean age 79.49 +/- 7.7 years) participating in this randomised, double-blind, placebo-controlled trial. Salivary flow rates and enamel staining were measured and the attitudes of the subjects to gum chewing were evaluated by the use of structured questionnaires. The chlorhexidine/xylitol gum significantly reduced the salivary levels of mutans streptococci (p < 0.0001) lactobacilli (p < 0.05) and yeasts (p < 0.05) while the xylitol placebo gum produced significant reductions in mutans streptococci (p < 0.01) only. The study population found chewing gum twice per day for 10 min an acceptable method of receiving medication and improving oral health. Prior to gum use participants recognised persistent symptoms of dry mouth and their subjective evaluation of dry mouth was significantly (p < 0.001) related to the number of prescribed medications with xerostomic side-effects. The desire to continue gum use was significantly related to the subjects' evaluation of their oral dryness at baseline and to their perceived oral health gain from gum usage. Only those participants with stained enamel at baseline exhibited increased enamel staining following chlorhexidine/xylitol gum usage.

Aged↗
PubMed2000

Accuracy and precision of the i-STAT portable clinical analyzer: an analytical point of view.

The introduction of a new point-of-care testing (POCT) instrument into the market affects medical practice and laboratory services. The i-STAT is designed to improve the speed in the decision making of the medical profession. However, reliability of results would ensure the quality of laboratory data. We, therefore, made an evaluation of the performance of i-STAT using a disposable cartridge EG7 + which is capable of measuring pH, pO2, pCO2 (blood gas), Sodium, Potassium (Electrolytes), Ionized calcium and Hematocrit with only 10 microliters of lithium heparinized blood in 2 minutes. The results were compared with those obtained from routine methods. The results were found to be accurate, precise and correlated with acceptable methods used routinely in the laboratory.

Blood Chemical Analysis↗
PubMed2004

Applying an artificial neural network to warfarin maintenance dose prediction.

BACKGROUND: Oral anticoagulation with warfarin can lead to life-threatening events as a result of either over-anticoagulation or undertreatment. One of the main contributors to an undesirable warfarin effect is the need to adjust its daily dose for a specific patient. The dose is adjusted empirically based on the experience of the clinician, a method that is often imprecise. There is currently no other well-accepted method for predicting the maintenance dose of warfarin. OBJECTIVE: To describe the application of an artificial neural network to the problem of warfarin maintenance dose prediction. METHODS: We designed a neural network that predicts the maintenance dose of warfarin. Data on 148 patients attending a large anticoagulant clinic were collected by file review. Using correlational analysis of the patients' data we selected the best input variables. The network was trained by using the back-propagation algorithm on a subset of our data and the results were validated against the rest of the data. We used a multivariate linear regression to create a comparable model. RESULTS: The neural network generated reasonable predictions of the maintenance dose (r = 0.823). The results of the linear regression model were similar (r = 0.800). CONCLUSION: Neural networks can be applied successfully for warfarin maintenance dose prediction. The results are promising, but further investigation is needed.

Adolescent↗
PubMedDate not supplied

Making cancer prevention effective for African-Americans.

In order to reduce the racial disparities in cancer death rates, prevention programs designed for minorities must concentrate on the cancer sites and intervention methods which offer the greatest promise for closing the mortality gap. Generally accepted methods to achieve these results were recently published by the U.S. Preventive Services Task Force. Effective intervention recommendations will be increased when researchers understand the cultural differences of minorities, communicate clearly, collaborate with other programs, and treat the program participants with respect.

Adult↗
PubMed1988

Nurses' attitudes toward conventional and automated vital signs measurement methods.

The acceptance and assimilation of new medical technologies into the health-care arena is a complex process involving financial, humanistic, and clinical considerations. This experimental research compared nurses' attitudes regarding the clinical acceptability of conventional methods of measuring vital signs with their attitudes toward a new, automated method, using the IVAC Model 4000 Vital-Check. Two studies were conducted, at different university-affiliated hospitals, involving different nursing-care-delivery models. The 102 nurses who participated in the studies generally favored the automated method with respect to provider convenience, patient acceptance, and the opportunity to simultaneously perform other nursing assessments. Conventional techniques were preferred for patients on isolation precautions and in some very specific clinical situations such as those requiring detection of abnormalities in the heart rhythm. Interviews of patients were also conducted at both sites and their comments supplemented and supported the quantitative findings for the nurses. Patients seemed to adapt very well to the new technology. They were particularly interested in being better able to monitor their own measurements with the automated process.

Attitude of Health Personnel↗
PubMedDate not supplied

[Improved methods of controlling the purity and activity of inactivated influenza vaccines].

Rooster monospecific sera to influenza virus hemagglutinin free from antibodies to the host (chick embryo) admixture components were prepared and satisfactorily used in radial immunodiffusion test for control of the levels of hemagglutinin in influenza vaccines. The indirect hemagglutination test with erythrocytic antibody diagnosticum has been proposed for the detection of low ovalbumin concentrations. The sensitivity of this method is less than 0.003 micrograms/ml ovalbumin which significantly surpasses other currently accepted methods for control of this component in inactivated influenza vaccines. Immunochemical methods established the presence in influenza vaccines of other "nonovalbumin" multicomponent admixtures. Their sensitizing activity was characterized and found to be 4-5 times weaker than that of ovalbumin.

Allantois↗
PubMed1980

Conductometric titration of hydrochloric acid in gastric juice.

We describe a procedure for the determination of hydrochloric acid concentration in gastric juice by means of a conductometric titration of the 50-fold diluted sample with an aqueous ammonia solution. The conductometric method of endpoint indication leads to a definite location of the equivalence point in the titration of hydrochloric acid. The proposed method is simple and accurate and shows a good correlation with an accepted method for the measurement of gastric acidity.

Gastric Juice↗
PubMed1977

The calibration of automated instruments for accuracy in hemoglobinometry.

The surveys of the College of American Pathologists indicate a consistent bias between the manual "reference" method for hemoglobin determinations and the Coulter S measurements. The Coulter S hemoglobin values are invariably lower; the difference averages 0.3 g/dl. The commonly used calibration methods for the Coulter appear to be subobtimal. The hemoglobin calibration and quality assurance method proposed by Bull and colleagues is advocated as the presently most acceptable method. Commercial hemoglobin control materials should not be used for hemoglobin calibration.

Automation↗
PubMed2002

Primary stenting versus MIDCAB: preliminary report-comparision of two methods of revascularization in single left anterior descending coronary artery stenosis.

BACKGROUND: Percutaneous revascularization is a well-accepted method of treatment for a single left anterior descending coronary artery (LAD) stenosis. With the introduction of primary stenting, it has become the treatment of choice for a LAD lesion. In the last few years however, the introduction of minimally invasive cardiac surgery, video-assisted left internal thoracic artery (LITA) harvesting, and robotic surgery have raised the question as to whether minimally invasive surgical revascularization would be competitive with percutaneous coronary interventions in cases of single-vessel stenoses. METHODS: A group of 100 patients with Canadian Cardiovascular Society class II to IV, and angiographically confirmed single critical stenosis of the LAD (type A or B), were treated with direct primary stenting (group 1, n = 50), or with endoscopic atraumatic coronary artery bypass grafting (group 2, n =50). RESULTS: All patients in a group 1, obtained a very good angiographic and clinical effect. No acute postoperative complications were noted at 1 month of follow-up. However, at 1 month of follow-up, 3 patients (6%) developed restenosis of the LAD, and at 6 months follow-up, 6 patients (12%), developed restenosis of the LAD. In these cases, repeated percutaneous coronary interventions of the target vessel were successfully performed. In group 2, very good operative results were observed. In 1 and 6 months of follow-up, all patients remained asymptomatic. Critical stenosis of the left internal thoracic artery-LAD anastomosis was angiographically documented in 1 case (2%). This patient was successfully treated with balloon angioplasty. CONCLUSIONS: The study results document the superiority of endoscopic atraumatic coronary artery bypass grafting over direct primary stenting in LAD revascularization, along with the slightly higher costs of the surgical procedure.

Coronary Angiography↗
PubMed1988

A new method of measuring the cross-sectional area of connective tissue structures.

There appears to be no generally accepted method of measuring in-situ the cross-sectional area of connective tissues, particularly small ones, before mechanical testing. An instrument has therefore been devised to measure the cross-sectional area of one such tissue, the rabbit medial collateral ligament, directly and nondestructively. However, the methodology is general and could be applied to other tissues with appropriate changes in detail. The concept employed in the instrument is to measure the thickness of the tissue as a function of position along the width of the tissue. The plot obtained of thickness versus width position is integrated to provide the cross-sectional area. This area is accurate to within 5 percent, depending mainly on alignment of the instrument and pre-load of the ligament. Results on the mid-substance of the rabbit medial collateral ligaments are repeatable and reproducible. Values of maximum width and thickness are less variable than those obtained with a vernier caliper. The measured area is considerably less than that estimated assuming rectangular cross-section and slightly less than that estimated on the assumption of elliptical cross-section.

Animals↗
PubMed2004

Validation of a new ultrasound method for the measurement of carotid artery intima medial thickness and plaque dimensions.

BACKGROUND: Carotid ultrasound is an accepted method for the detection of subclinical atherosclerosis. Valid methods that allow quantitation of carotid atheroma burden may be useful for stratifying risk. OBJECTIVE: To validate the results of intima medial thickness (IMT) and plaque measurements using a newly created software algorithm by comparing them with those obtained using a previously validated method. METHODS: Carotid ultrasound videotapes (n=24) were analyzed by experienced observers using a validated method and a new method. Ultrasound parameters were compared by measuring the difference +/- SD to yield indexes of accuracy and precision. Performance was also assessed using correlation and Bland-Altman analyses. RESULTS: Average IMT (n=24), plaque area (n=46), and several indexes that integrate IMT and plaque measurements were all found to be comparable with measurements obtained using the previously validated method. For example, the plaque area showed excellent accuracy and precision (-0.17+/-2.0 mm2, P=0.56), excellent correlation (r=0.98, standard error of the estimate = 2.01 mm2, P<0.001) and no evidence of bias using Bland-Altman analyses (Spearman's rho = 0.04, P=0.82). CONCLUSIONS: A new algorithm for the quantitation of carotid atheroma burden yields results that are comparable with those of a previously validated and widely used method. Availability of valid tools for measuring carotid ultrasound should facilitate the incorporation of this procedure into clinical risk stratification paradigms.

British Columbia↗
PubMed1990

Acceptability of abortion methods.

This chapter has reported the findings of acceptability of prostaglandin pessaries compared with vacuum aspiration as methods for inducing abortion in a very early stage of pregnancy. Acceptability has been defined by the WHO as the degree with which a treatment method has attributes that make it perceived by a user or potential user to be consonant with his or her own sense of well-being and therefore will be used or preferred. The acceptability of the medical and surgical procedures for inducing abortion was studied in Swedish abortion patients using a pre- and post-abortion design for obtaining observations. Methods used included interview schedules, questionnaires, rating scales and attitude measuring techniques. Patients consenting to take part in the acceptability study had agreed to be randomly assigned to prostaglandin treatment, given at the clinic or self-administered by the patient at home, or to vacuum aspiration. A high degree of acceptability for the prostaglandin treatment was obtained in this group of patients who had applied for an abortion very soon after one missed menstrual period. This was indicated from the finding that the very high preference for this procedure remained unchanged in the group randomly assigned to it. Other measures of attitudes to prostaglandin treatment also indicated the unchanged positive attitude. There was a significant change in the attitude to vacuum aspiration among those assigned to this treatment, indicating that post-abortion it was more acceptable to these patients. However, 30% of them would still prefer the prostaglandin treatment, especially self-administered, in the event of another abortion. There were consistent and significant relationships found between the degree of negative emotional arousal before and after abortion and preference for the medical or surgical procedure and also the amount of complaints after abortion. Those patients who pre-abortion had preferred the self-administered procedure were, regardless of which treatment they had been assigned to, those who were least emotionally upset both before and after the treatment and also complained the least. This chapter also reported on findings of how acceptable the medical and surgical procedures can be inferred to be from comparisons of preferences and attitude measures obtained from abortion patients before treatment and from women in the same age group (who would not exclude an abortion if pregnant) in samples from outside the clinical setting. In the non-patient groups about half the subjects would prefer the medical alternative.(ABSTRACT TRUNCATED AT 400 WORDS)

Abortion, Induced↗
PubMed2001

Temporary discontinuation: a compliance issue in injectable users.

This study examined compliance in injectable users and followed women post-discontinuation to document their contraceptive practices. A cohort of 189 predominantly new users of depot-medroxyprogesterone acetate and norethisterone oenanthate were recruited and followed for 2 years regardless of whether or not they continued the method. Continuation rates were 42% at 1 year and 21% at 2 years. Of the 78 women who discontinued the method, 31 reported that they were "taking a break." For 20 of these women, this break (nonuse segment) occurred within the 2-year period, and 15 of them returned to the injection before the end of study period. The other five switched methods after the nonuse segment. The mean length of the nonuse segment was 7 months (range 2-13 months). In all 20 women, no other contraceptive method was used, they remained sexually active, and started the break within 6 months of commencing use of the injectable. In addition, 11 women were in a self-reported nonuse segment at the end of the study and stated their intention to return to the method at a later date. Menstrual disturbances were cited as the main reason for the break. Strengthened counseling at method acceptance was identified as a strategy to decrease the frequency of breaks in injectable method use.

Adult↗
PubMed1998

Errors in quantitative backscattered electron analysis of bone standardized by energy-dispersive x-ray spectrometry.

Backscattered electron (BSE) imaging has proven to be a useful method for analyzing the mineral distribution in microscopic regions of bone. However, an accepted method of standardization has not been developed, limiting the utility of BSE imaging for truly quantitative analysis. Previous work has suggested that BSE images can be standardized by energy-dispersive x-ray spectrometry (EDX). Unfortunately, EDX-standardized BSE images tend to underestimate the mineral content of bone when compared with traditional ash measurements. The goal of this study is to investigate the nature of the deficit between EDX-standardized BSE images and ash measurements. A series of analytical standards, ashed bone specimens, and unembedded bone specimens were investigated to determine the source of the deficit previously reported. The primary source of error was found to be inaccurate ZAF corrections to account for the organic phase of the bone matrix. Conductive coatings, methylmethacrylate embedding media, and minor elemental constituents in bone mineral introduced negligible errors. It is suggested that the errors would remain constant and an empirical correction could be used to account for the deficit. However, extensive preliminary testing of the analysis equipment is essential.

Animals↗
PubMed1969

A survey of non-linear optimization techniques.

Optimization means the provision of a set of numerical parameter values which will give the best fit of an equation, or series of equations, to a set of data. For simple systems this can be done by differentiating the equations with respect to each parameter in turn, setting the set of partial differential equations to zero, and solving this set of simultaneous equations (as for exwnple in linear regression). In more complicated cases, however, it may be impossible to differentiate the equations, or very difficultly soluble non-linear equations may result. Many numerical optimization techniques to overcome these difficulties have been developed in the least ten years, and this review explains the logical basis of most of them, without going into the detail of computational procedures.The methods fall naturally into two classes - direct search methods, in which only values of the function to be minimized (or maximized) are used - and gradient methods, which also use derivatives of the function. The author considers all the accepted methods in each class, although warning that gradient methods should not be used unless the analytical differentiation of the function to be minimized is possible.If the solution is constrained, that is, certain values of the parameters are regarded as impossible or certain relations between the parameter values must be obeyed, the problem is more difficult. The second part of the review considers methods which have been proposed for the solution of constrained optimization problems.

Journal Article↗