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At least 199 records · Page 11Linked to original sources
PubMed1997

Urinary thromboxane B2 in cardiac transplant patients as a screening method of rejection.

Noninvasive methods for regular monitoring of cardiac transplant patients for acute rejection are preferable to the only currently accepted method involving frequent endomyocardial biopsies. Thromboxane A2 (TXA2) is synthesized in large amounts by monocytes/macrophages during organ graft rejection. It enhances T-lymphocyte clonal expansion and cytotoxic function as well as upregulating the major histocompatibility class II expression on antigen presenting cells. Experimentally increased urinary excretion of TXA2 metabolites is associated with cardiac transplant rejection. We therefore compared urinary immunoreactive thromboxane B2 (i-TXB2) levels to the rejection score of the endomyocardial biopsies. In addition we graded the degree of activated lymphocytes in peripheral blood. Urinary i-TXB2 was significantly higher in patients exhibiting medium to severe rejection than in patients without rejection (1236 +/- 372 vs. 526 +/- 57 pg/mL). The urine i-TXB2 (704 +/- 48 pg/mL) of all patients who participated in this study, whose endomyocardial biopsy indicated rejection, was also significantly higher than in the non-rejecting group. Increased levels of urine i-TXB2 were associated with increased biopsy scores. Circulating activated lymphocytes was also significantly increased in patients with moderate/severe rejection compared to patients with no rejection (66 +/- 11 vs. 39 +/- 4 per mm (3)) (p < 0.01). Further, this study shows that urine i-TXB2 is associated with increased endomyocardial biopsy scores (acute rejection scores) and blood lymphocyte activation. Thus we conclude that urine i-TXB2 may be of potential value as a diagnostic screening test for helping identify cardiac transplant patients undergoing acute rejection.

Enzyme-Linked Immunosorbent Assay↗
PubMedDate not supplied

Why is the standardization of prothrombin time a problem?

The standardization of prothrombin time (PT) has been a problem for more than 50 years; by applying the methods to the same clinical material the analysis may explain why. The initial standardization by 2--3 times normal clotting time by Quick's PT assay did not standardize presently used PT assays. The ratio method accepted by the WHO in 1977 was not satisfactory because the intercept was neglected. The revised ratio method (WHO 1983) recommended calibration between log clotting times of normal and abnormal plasmas and a simplified conversion into ratios. However, by including a high proportion of normal plasmas (up to 1/3 of abnormal) an erroneous calibration material was introduced; the conversion from clotting times into ratios was also more complex than predicted. The international sensitivity index, which is based on the simplified method, produced international normalized ratios (INR) that were not more standardized than not corrected ratios. Not corrected coagulation activities showed poor standardization due to the different sensitivity of assays for the protein induced by vitamin K absence (Pivka) inhibitor. The corresponding therapeutic ranges of INR and coagulation activities covered 70 and 10--20% of their scales, respectively. Standardization by Pivka-corrected coagulation activities against an international reference assay may be the preferable method.

Blood Coagulation Tests↗
PubMed1975

A long term follow-up of Moore arthroplasty in femoral neck fractures.

Moore arthroplasty was performed for medial femoral neck fractures in 169 patients. The mortality rate was 21.3 per cent within 3 months. The general postoperative complication rate (39.6 per cent) was dominated by cardiopulmonary (17.2 per cent) and thromboembolic (16.0 per cent) events. Of local complications, wound infection was found in 4.7 per cent and osteitis in 3.0 per cent of cases. A total of 60 patients were followed up with a mean observation time of 4.9 years. Of these, 8.3 per cent sustained femoral fractures during this period. The results classified according to the criteria of the American Academy of Orthopedic Surgeons showed 52 per cent excellent or good, 43 per cent fair and 5 per cent poor results. The roentgenological finding of settling or osteolysis along the prosthesis was significantly correlated to reduced hip mobility. Ossification in the prosthetic fenestres gave significantly diminished settling, and was correlated to better hip mobility and less pain. In our opinion, Moore arthroplasty has proved to be an acceptable method for the treatment of femoral neck fractures in elderly patients, as 73 per cent had an acceptable range of motion, 40 per cent managed walking distances of more than 500 m and 70 per cent had minimal or no pain. Although 25 per cent became nursing home patients, this reduction of vitality could be related to the hip arthroplasty in only two cases.

Aged↗
PubMed1989

[Serum determination of N-terminal peptide of type III procollagen as a marker of fibrotic activity].

Among the noninvasive methods proposed for the study of collagen metabolism as an of fibrosis and inflammation, the most widely accepted method is quantitation in serum of the N-terminal peptide of type III procollagen (P-III-Ps). We measured this variable in 87 subjects classified into five study groups: 19 controls (C), 18 alcoholics (E), 15 patients diagnosed as liver cirrhosis (CH), 11 chronic liver disease (HC) and 24 pregnant women (EMB). In our environment, the serum level of P-III-P in the healthy population was 9.12-12.8 ng/ml. In 27.77% of the alcoholics studied (5 cases) the mean value exceeded this level, 19.35 +/- 3.05 ng/ml. Forty percent of the cirrhotics (6 cases) presented the highest values, 26.54 +/- 11.45 ng/ml, while 83.33% of the patients with chronic active hepatitis presented a mean value of 18.53 +/- 3.8 ng/ml. Of the 24 pregnant women, 95.83% (23 cases) had higher than normal values, and concentrations roses in the last trimester of gestation with respect to the previous trimesters. Analysis of the correlations of all the biochemical parameters of liver function with P-III-Ps disclosed a relationship between P-III-Ps and alkaline phosphatase in the groups of cirrhotics and chronic persistent hepatitis (p less than 0.05). We conclude that the N-terminal peptide of type III procollagen is a useful marker of active fibrosis.

Adult↗
PubMed1996

[The influence of psychological factors on the patient's management of diabetes. Critical survey of psychodynamic models on personal management of diabetes].

The authors have examined the currently accepted methods to face a chronic disease like diabetes. The person affected by this illness should learn to accept his/her limits and find a new identity. The aim of technical and scientific medicine is to teach the patient how to cope with the disease. However, in spite of the progress of the scientific research in this field, diabetes remains a poorly treated disease. A review of the literature shows that there is a deep interaction between diabetes and psychological states. Psychological disorders like depression and anxiety might be associated with the origin of diabetes and can affect its course. It seems that emotional factors have a more important role than education in diabetes care. The psychological aspect becomes even more important during adolescence, as the chronic illness can affect the normal development of the teen-ager who will deny it to protect himself. If the patient does not collaborate, his behaviour may be unconsciously aggressive and destructive. Some patients can use diabetes as a tool to act out aggressive feelings against themselves or the environment. Diabetes bad management becomes then the expression of their destructive narcissism which prevents them from finding a new identity. The collaboration of medical and psychological operators should help these patients to find a new identity which includes diabetes as an integrating part of their personality and enables them to cope with it under the guidance of the diabetes team.

Adaptation, Psychological↗
PubMed1998

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↗
PubMed2002

[Use of health services during the first year after stroke in community dwelling patients].

BACKGROUND: Stroke is the leading cause of disability in the elderly population, and inpatient rehabilitation is the most accepted method of providing rehabilitation to stroke survivors remaining with moderate to severe disability. It is also a major component of the large resources that this patient population demands. Since it is possible to develop alternatives to inpatient rehabilitation, it is important to make a long-term evaluation of its resource allocation, to enable comparison with the other alternatives. OBJECTIVES: To evaluate and classify the health services demanded during the first year after stroke by patients who had received inpatient rehabilitation. METHODS: A prospective follow-up of 75 consecutive stroke survivors who remained with moderate disability and were accepted for inpatient rehabilitation. Utilization of health services was recorded and evaluated considering the patients health status and success in returning to independent daily function. RESULTS: Inpatient rehabilitation lasted about fifty days, started relatively early and enabled participants to regain an acceptable level of basic functional independence. During the year of follow-up, about half of the patients were hospitalized, with stroke related causes contributing significantly. Not all patients were followed up regularly by community health services, and most suffered significant handicap and depression. CONCLUSIONS: This survey justifies the initial investment in inpatient rehabilitation for preparing stroke survivors to continue their lives at home. There is a need to improve continuity of services and to refine the methods of medical and psychosocial follow-up in the community.

Activities of Daily Living↗
PubMed1997

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↗
PubMed1992

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↗
PubMedDate not supplied

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↗
PubMedDate not supplied

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↗
PubMed1996

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↗
PubMed2001

Evaluation of ambulatory and self-initiated blood pressure monitors by pregnant and postpartum women.

OBJECTIVE: To investigate the acceptability of an ambulatory blood pressure (ABP) monitor (SpaceLabs 90207) and a self-initiated blood pressure monitor (Omron HEM-705CP) to pregnant women. METHODS: Acceptability of the SpaceLabs 90207 and Omron HEM- 705CP monitors was evaluated, using a modified British Hypertension Device assessment form, by () healthy, pregnant women at <15 weeks (n = 120), 35-37 weeks (n = 81), and 5-9 weeks postpartum (n = 86); and () women with preeclampsia (n = 52). MAIN OUTCOME MEASURES: A monitor was acceptable if a woman graded the overall impression as "good" or "very good." RESULTS: Healthy women at <15 and 35-37 weeks' gestation and preeclamptic women reported the SpaceLabs 90207 monitor caused discomfort in 54%, 52%, and 60%, interfered with activities in 38%, 40%, and 23%, and disturbed sleep in 62%, 52% and 31%, respectively. Fewer than 12% in any group reported these problems with the Omron HEM-705CP monitor. In the 78 women who evaluated both monitors at 35-37 weeks, the SpaceLabs 90207 and Omron HEM-705CP were acceptable to 78% and 95% of healthy women, respectively (p = 0.005). Women with preeclampsia rated the Space-Labs 90207 as "bad" or "fair" (14%), "good" (58%), and "very good" (28%) compared with "bad" or "fair" (8%), "good" (28%), and "very good" (64%) for the Omron HEM-705CP monitor (p = 0.009). CONCLUSIONS: Pregnant women found the less intensive blood pressure monitoring with the Omron HEM-705CP more acceptable than the 24-h ABP monitoring with the SpaceLabs 90207. If accurate self-initiated blood pressure devices become available, pregnant women would prefer this method of home blood pressure monitoring.

Blood Pressure Monitoring, Ambulatory↗
PubMed1997

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↗
PubMed1982

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↗
PubMed2002

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↗
PubMed2001

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↗
PubMed1987

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↗