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PubMed1993

Reduced failure rate in knee prosthetic surgery with improved implantation technique.

From the Swedish Knee Arthroplasty project, started in 1975, types of relatively unmodified knee prostheses were chosen for analysis of time-dependent changes in the failure rate. One thousand nine hundred sixty-nine Marmor unicompartmental and 376 Total Condylar arthroplasties, all cemented, were followed until the end of 1989. The cumulative revision rates calculated with survival statistics showed a continuous improvement with time. The five-year revision rate was reduced from 11% to 5% for the Marmor prosthesis and from 10% to 2% for the Total Condylar prosthesis. This indicates that factors other than improved design are important. Such factors could include improved guide instruments, better surgical and cementing technique, influence of a learning curve, and patient selection.

Follow-Up Studies↗

PubMed1993

[Systematic control of claw health in cows raised in loose housing systems for the total year].

Claw health was systematically checked and recorded in the dairy herd of the experimental and teaching unit at Oberschleissheim. The project started in March 1988 and ended in July 1989. In total 158 dairy cows and 50 heifers of the breeds German Black and White as well as German Simmental were examined for claw health at intervals of six weeks. Heel erosion was diagnosed most frequently, followed by interdigital dermatitis and contusion of the sole. Contusions and ulcerations of the sole were located especially in the claws of the hindleg. More than 90 percent of lameness occurred in the hindleg. Frequency and severity of claw disorders were reduced significantly over the 1.5 year period of systematic veterinary supervision of claw health. Thirty percent of dairy cows were diagnosed as having not any claw disorder at the end of the investigation period. The percentage of dairy cows without any claw disorder was increased by 5-10 percent. Cows of the breed German Simmental in their first lactation were a high risk group for contusions of the sole. The repeatability of the claw measurements of angle of the dorsal wall, length of the dorsal wall and of the heel, height of the heel, diagonal length of the claw and ground surface was usually 0.5 and higher. For the claw disorders heel erosion, interdigital hyperplasia and in part contusions of the sole, fairly high correlations were estimated between heifers and cows as well as between consecutive lactations.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1995

[Development and validation of QPD 32, a specific questionnaire for measuring the quality of life of patients with peptic ulcer].

Drugs need to be evaluated both in terms of efficacy, safety and regarding the patient's perception of his own health status. For these reasons, sensible, reliable and patient-oriented instruments are needed, besides the methodologies for evaluation of drug efficacy and safety. Such instruments substantially evaluate Health related Quality of Life (HrQoL). Concerning gastric acid hypersecretion few papers are available, based on HrQoL questionnaires, both general and specific. A research project led us to develop through patients and physicians involvement, a specific instrument to evaluate HrQoL as to the various aspects of the peptic disease. The project started in 1993 through a series of 4 focus groups with gastroenterologists and patients, followed by the preparation of a questionnaire named QPD48. Such instrument was psychometrically validated through a study named Herqules 1, involving 176 gastroenterologists and 1774 patients. The psychometric analysis on QPD48 led to the re-issue of a questionnaire named QPD32 with Chronbach's alfa equal to 0.91, based on 3 factor-referenced subscales evaluating pain, induced anxiety, constrained daily living and awareness of symptoms and agents. Concerning the concurrent validity a one-way analysis of variance showed highly significant differences associated with attack frequency with substantial effect sizes ranging from 0.46 to 1.27 of a standard deviation in the full scale. QPD 32 is patent protected and will be used in clinical trials.

Adult↗

PubMed1999

The AAMFT-Head Start Training Partnership Project: enhancing MFT capacities beyond the family system.

This paper summarizes the experience of a two-year project to promote partnerships between 12 graduate Marriage and Family Therapy (MFT) training programs and their 12 local Head Start partners. The American Association for Marriage and Family Therapy (AAMFT) awarded 9 grants to MFT-Head Start partnerships that had established relationships with each other prior to the project. Three MFT-Head Start pairs that had no preexisting relationship but wanted to develop one received planning grants. The partnership project provided an exciting opportunity for MFT faculty and interns to integrate family systems theory into larger organizational settings and to enhance the capacity of MFTs to serve disadvantaged, low-income, culturally diverse families and the community agencies that work with them. Preparing MFT students to intervene and respond systemically both in organizations and with the families they serve represents a viable alternative to more traditional approaches to MFT that limit the focus to the family system. Survey results and interview data reflect the rich experiences of MFT faculty and supervisors, MFT interns, and Head Start staff. Implementation issues are discussed and recommendations are made to improve the collaboration between MFTs and community-based agencies such as Head Start.

Child, Preschool↗

PubMed2001

Japanese experience of telemedicine in oncology.

We started telemedicine projects from 1990 with a telepathology system within Tsukiji Campus of National Cancer Center. In 1994, we connected Tsukiji Campus and Kashiwa Campus by 6 Mbps optical fiber leased line using IP protocol for data transmission, for teleconference, telepathology, and teleradiology projects. We also started connection of regional cancer centers and are now forming a cancer center network of 14 cancer centers. We are at present organizing 130 teleconferences per year with an attendance of more than 16000 people as summary. We have also used a high-resolution image transferring system, such as SHD (2000 pixelsx2000 pixels resolution) system on one side, and an economical telemedicine system using JAVA and a WWW browser (NCC_image) on the other side. We think that providing information is another field of telemedicine. We began the experimental gopher and WWW service in 1993. We are now providing official up-to-date cancer information for patients and healthcare professionals. We are getting more than 400000 hits per month. We are also providing a teleconference video session which is held every week on the Internet using a Real Video system with synchronized slide presentation on the WWW browser. We are also organizing a Cancer Image Reference Database System including DICOM images with viewer software. This paper is a summary of the telemedicine projects performed at the National Cancer Center.

Community Networks↗

PubMed2005

[Three patients with pneumonia due to Legionella associated with a sauna, a cooling tower and a caravan in The Netherlands].

In three male patients with lower respiratory disease, aged 51, 32 and 63 years, Legionnaires' disease was diagnosed by urinary antigen test and culture of the respiratory-tract fluid. In the second patient, the bronchoalveolar fluid also contained Streptococcus pneumoniae and Haemophilus influenzae. All three patients recovered after treatment with azithromycin in the first, cefotaxime, vancomycin and levofloxacin in the second, and erythromycin and ciprofloxacin in the third, respectively. Legionella pneumophila pneumonia is clinically not clearly distinct from other pneumonias and has a high mortality rate when not treated with the proper antibiotics. For that reason, adequate and swift diagnosis is of great importance. The urinary antigen test meets both of these criteria. Still, it is advisable to use culture and serology as well if Legionnaires' disease is suspected in a patient, since the urinary antigen test has limitations. In addition, patient isolates are ofepidemiological importance for public health. By comparing available patient isolates with Legionella strains from water sources, it is possible to identify sources of infection. In 2002, based on this principle, a project was started in The Netherlands aimed at identifying sources of infection, thereby preventing outbreaks of Legionnaires' disease by swift elimination of the source. Since the start of the project, 29 sources have been identified. In the cases described above these were a sauna, a cooling tower and a caravan, respectively. In suspected cases, respiratory-tract fluid must be collected to make possible such a source investigation.

Adult↗

PubMed2006