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At least 343 records · Page 19Linked to original sources
PubMed2006

Revision total knee arthroplasty: 1990 through 2002. A review of the Finnish arthroplasty registry.

BACKGROUND: National and regional arthroplasty registries have been used to study the results of primary total knee arthroplasties. The purpose of this paper was to present the results of revision total knee replacements and describe predictors of survival of those replacements, with repeat revision as the end point. METHODS: The nationwide Finnish Arthroplasty Registry included 2637 revision total knee arthroplasties from 1990 through 2002. Survivorship of the revision total knee arthroplasties was analyzed, with repeat revision as the end point. The survivorship analyses comprised evaluations of the proportional hazards assumption followed by calculations of univariate and multivariate statistics and model diagnostics as appropriate. RESULTS: The survival rate following the revision total knee arthroplasties was 95% (95% confidence interval, 94% to 96%) at two years (1874 knees), 89% (95% confidence interval, 88% to 90%) at five years (944 knees), and 79% (95% confidence interval, 78% to 81%) at ten years (141 knees). Multivariate regression analysis showed the most significant predictors of prosthetic survival to be the age of the patient and the life in service of the primary total knee replacement (that is, the time between the primary total knee replacement and the revision). Survivorship was also significantly predicted by the year of the first revision total knee arthroplasty and the reason for the revision. CONCLUSIONS: An age greater than seventy years, revision five years or more after the primary arthroplasty, and absence of patellar subluxation are positive indicators of survival of a revision total knee replacement. We believe that normal aging as well as the deconditioning effect of disease (osteoarthritis and rheumatoid arthritis) and its treatment (primary total knee replacement) may lead to a reduced activity level, which, together with a presumed reluctance to operate on elderly patients, protects against repeat revisions. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.

Adolescent↗
PubMed1993

Estimating pattern similarity for correlation matrices from differing neuropsychiatric populations.

The present example illustrates a method for assessing pattern similarity for correlation matrices from populations known to differ in clinically important respects. The data underlying previously published confirmatory factor analyses of neuropsychological traits are presented in two methods for assessing whether the matrices are similar enough to justify their aggregation into a single composite matrix. The significance of this procedure for research in applied neuropsychology is commented upon in terms of the benefits to model diagnostics.

Brain Damage, Chronic↗
PubMed2006

Dynamic obstructions of the equine upper respiratory tract. Part 2: comparison of endoscopic findings at rest and during high-speed treadmill exercise of 600 Thoroughbred racehorses.

REASONS FOR PERFORMING STUDY: The reliability of diagnoses of obstructive conditions of the upper respiratory tract (URT) based on examinations performed at rest vs. at exercise is controversial. OBJECTIVE: To compare diagnosis of URT by endoscopy at rest with that achieved during high-speed treadmill exercise (HSTE). HYPOTHESIS: Endoscopy of URT at rest, when performed in isolation from other simpler techniques is unreliable in the prediction of dynamic respiratory obstructions. METHODS: Endoscopic findings of 600 Thoroughbred racehorses during quiet breathing were compared with findings during high-speed treadmill exercise. Other parameters were also assessed for their specificity in diagnosis. RESULTS: Endoscopy of the resting horse showed low sensitivity (0.15) in the diagnosis of dorsal displacement of the soft palate (DDSP) and palatal instability (PI). When endoscopy and reported noises were taken together there was still a 35% misdiagnosis rate. Although there was significant association between resting laryngeal function score (LFS) and dynamic vocal cord and/or arytenoid cartilage collapse at exercise, 19% of horses with a grade 4/5 LFS were able to attain and maintain full abduction during exercise and 7% of those with 'normal' grades 1 or 2 LFS at rest showed dynamic laryngeal collapse when exerted. Sensitivity of the diagnostic model was greatly increased (80%) when a history of inspiratory noise and palpable intrinsic muscle atrophy were included. CONCLUSIONS AND POTENTIAL RELEVANCE: Endoscopy of the upper respiratory tract of static horses is unreliable in the diagnosis of dynamic obstructions of the URT and should not be used in isolation in surgical decision-making or in the assessment of horses at the time of sale.

Age Factors↗
PubMedDate not supplied

Human deposition and clearance of 6-micron particles inhaled with an extremely low flow rate.

In human experimental data, tracheobronchial deposition reaches its maximum for particles of about 6 microns inhaled at 0.5 L/s. The purpose of the present study was to investigate if tracheobronchial deposition of 6-microns particles could be increased, especially in the smaller bronchi, using an extremely slow inhalation rate. Six healthy nonsmokers inhaled monodisperse 6-microns (aerodynamic diameter) Teflon particles labeled with 111In at 0.04 L/s. Radioactivity in mouth and throat, lung, and stomach was measured immediately after inhalation by profile scanning and in the lung also after 24, 48, 72, and 96 h. There was a substantial clearance between 24 and 72 h; around 20% of the total clearance occurred between 24 and 72 h. This is in contrast to earlier studies in which only around 1% of 6-microns particles inhaled at 0.5 L/s cleared between 24 and 72 h. This indicates a markedly higher deposition in the smaller bronchi at 0.04 L/s than at 0.5 L/s. The total tracheobronchial deposition was 50%, compared to about 30% when particles were inhaled at 0.5 L/s. These findings could be therapeutic use. They also implicate the possibility of developing a diagnostic model that can separate between bronchial reactivity in large and small bronchi.

Adult↗
PubMed1996

Incidence of seizures after surgery for supratentorial meningiomas: a modern analysis.

The authors have assessed the incidence of postoperative seizures in 158 patients with supratentorial meningiomas diagnosed by computerized tomography (CT) and/or magnetic resonance (MR) imaging, which theoretically should lead to early diagnosis and treatment and the potential for improved seizure outcome. Univariate chi-square and logistic regression analyses were performed 24 independent variables against the outcome variable of occurrence of a postoperative seizure. The median duration of preoperative seizures was 1 month, considerably shorter than that found in studies conducted prior to the advent of CT and MR imaging. Of 63 patients with a history of preoperative seizures, 40 (63.5%) had complete cessation of seizures after surgery. Twelve (92.3%) of 13 patients with one to three postoperative seizures eventually achieved complete seizure control, whereas only four (40%) of 10 patients with more than three postoperative seizures achieved this result. Overall 88.9% of patients with preoperative seizures achieved complete seizure control postoperatively. Multivariate analysis was used to identify six variables that were predictive of the occurrence of postoperative seizures: preoperative seizure history preoperative language disturbance, extent of tumor removal, parietal location of tumor, postoperative anticonvulsant medication status, and postoperative hydrocephalus. These variables were incorporated into a diagnostic model designed to predict the risk of a postoperative seizure following meningioma surgery. On the basis of their findings, the authors conclude that earlier detection and treatment of supratentorial meningiomas improve seizure outcome in patients with preoperative epilepsy. Furthermore an assessment of the risk of postoperative seizures may help guide decisions concerning weaning patients from anticonvulsant medications postoperatively.

Aged↗
PubMed2004

[The optimal combination of serum tumor markers with bioinformatics in diagnosis of colorectal carcinoma].

OBJECTIVE: To identify the optimal combination of serum tumor markers with bioinformatics in diagnosis of colorectal cancer. METHODS: The serum levels of CEA, AFP, NSE, CA199, CA242, CA724, CA211 and TPA were detected in 128 patients with colorectal carcinoma and 113 health subjects. The serum tumor markers were evaluated with the area under curves. The optimal combination of serum tumor markers was selected and the diagnostic model with artificial neural network was established. RESULTS: CEA, CA199, CA242, CA211, CA724 were selected for the optimal combination and the artificial neural network was built. The model was evaluated by a 5-cross validation approach. The model had a specificity of 95%, sensitivity of 83% and positive predictive value of 95% in diagnosis of colorectal carcinoma. CONCLUSION: The combination of optimal serum tumor markers has a high sensitivity and specificity in diagnosis of colorectal carcinoma.

Adult↗
PubMed1999

[Development of a method for alkaline extraction of DNA from Brucella for diagnosing brucellosis using the polymerase chain reaction].

Several methods of alkaline extraction of chromosome DNA from Brucella in the presence of 50 microliters model diagnostic material blood serum are developed for the diagnosis of brucellosis by the polymerase chain reaction (PCR). These methods are based on the capacity of NaOH to effectively denature proteins and destroy Brucella cell wall, thus isolating the genome DNA without exposure to proteolytic enzymes, detergents, deproteinization, or pH neutralization. The first method consists in alkaline lysis by 0.2-1.0 M NaOH followed by DNA precipitation with two ethanol volumes in the presence of 0.1 M NaCl, washing of the resultant precipitate in 80% ethanol, drying of the precipitate, and dissolving in distilled water. The second method includes alkaline lysis in the presence of 0.3 M NaCl with NaOH concentrations of 0.5-4.3 M and the stages of DNA sedimentation, washing of precipitate, its drying and dissolving similar to those in alkaline lysis. The third method consists in alkaline lysis-precipitation by 0.2-05 M NaOH in the presence of 0.1 M NaCl and 64% ethanol, followed by DNA preparation stages similar to those in alkaline lysis. The best results were achieved by alkaline lysis in the presence of 0.3 M NaCl at NaOH concentrations of 0.7 and 2.1 M, which meant theoretical levels of sensitivity 140 and 86 Brucella cells, respectively.

Alkalies↗
PubMed1999

Anterior single-tooth replacement: clinical examination and treatment planning.

The replacement of a single anterior tooth is a complex, challenging procedure that can be accomplished with implant-supported restorations as well as conventional porcelain-fused-to-metal and resin-bonded fixed partial dentures. A comprehensive diagnostic form may be beneficial in determining the most effective means of rendering treatment for each patient. This article demonstrates the use of this form, diagnostic models, and radiographs to diagnose and restore three patients who presented for the replacement of a single tooth in the anterior maxilla.

Adult↗
PubMedDate not supplied

[Nocturnal enuresis in children. II--Diagnosis and treatment of nocturnal enuresis].

The classification of the various types of urination disorders among children as well as the latest theories explaining the causes of nocturnal enuresis were presented in the first part of the article entitled "Nocturnal Enuresis in Children" (in "Medycyna Wieku Rozwojowego" 1998, II, 1 pp. 55-69). The second part of this article concentrates on the differential diagnostics of urination disorders amongst patients seeking help for nocturnal enuresis. The diagnostic model developed by the Urodynamic Unit at the Department of Paediatric Surgery, National Research Institute of Mother and Child can be applied in an outpatient clinic. Hospitalization of the patient is not necessary to carry out the study, meaning that the child is spared any additional stress. Currently applied methods for treating nocturnal enuresis by non-pharmacological methods are also discussed in this text.

Child↗
PubMed2000

Nuclear size and shape in fine needle aspiration biopsy samples of the prostate.

OBJECTIVE: To study the potential of nuclear size and shape estimates in interpreting fine needle aspiration biopsy (FNAB) samples of the prostate. STUDY DESIGN: Morphometry was used to outline nuclei of prostate cells. Cell groups were selected by an experienced cytologist. RESULTS: The mean area of nuclei in the most atypical cell groups among definitely malignant samples (n = 17) varied from 26.3 to 93.3 micron 2 and in normal prostate cells (n = 10) from 15.6 to 33.7 micron 2. Perfect distinction of definitely benign and slightly atypical samples (n = 13) from definitely malignant samples was possible when the samples were characterized by the weighted means of the mean nuclear areas of the cell groups in the samples. The means of individual cell groups allowed correct distinction in only 84.8% of cell groups. Shape factors did not have any diagnostic value. CONCLUSION: Morphometric nuclear size estimates from ethanol-fixed FNAB samples of the prostate are of diagnostic value and can potentially be used as part of multivariate diagnostic models when selected by an experienced cytologist according to strict criteria. However, measurement should be done from several cell groups (at least three of the most-atypical cell groups) in each sample.

Adenocarcinoma↗
PubMedDate not supplied

[Current comprehensive diagnosis of pancreatobiliary cancer complicated by jaundice syndrome].

The study was undertaken to enhance the efficiency of diagnosis of pancreatobiliary cancer complicated by jaundice by using the potentialities of currently available instrumental studies at most. The data of examination of 256 patients with this disease are presented. Based on diagnostic findings, the authors have constructed a diagnostic model of precision recognition of cancer of the extrahepatic bile ducts, pancreatic head, Vater's papilla.

Ampulla of Vater↗
PubMed2000

[Experiences with development of morphological typology of the face].

On base of the component analysis of facial dimensions the original diagnostic model of definition of a morphological facial type in Russian males and females is developed. The first typological characteristic feature describes the variability of general face size, allocating extreme micro- and macrotypes. The second one describes the face shape as a ratio of frontal and mandibular parts. On poles of variability it demonstrates a type with massive frontal face part and rather reduced mandibular one, and a contrast type with a massive mandibular part at relative gracile frontal face part. Central position in this model is occupied by variants with equally proportional development of the top and bottom face parts. On the basis of seven traditional anthropometric facial dimensions the place of any individual in terms of face size and form can be easily found in the suggested model. The chosen contrast variants of the face form are comparable to the appropriate characteristics of cerebral and digestive Sigaud types. The offered morphotypology allows to estimate accurately individual and group features in the face form. The methods of multivariate analysis reveal steady connection between somatotypes and features of a facial structure. Though the level of correlation does not exceed 0.3-0.4 of correlation coefficients, it is statistically significant at the highest degree of probability. The basic direction of habitus variability in men is observed at general face size, in women at face shape.

Adult↗
PubMed2001

[Effectiveness of a clinical test in the preselection of children with suspected fragile X syndrome].

BACKGROUND: Fragile X syndrome (FXS) is the most frequent hereditary cause of mental retardation. It can be diagnosed by molecular genetic techniques, but clinical suspicion is made less likely by it variable expression. OBJECTIVE: To assess the effectiveness of a six-item checklist in the preselection of children who are candidates for FXS genetic study. MATERIAL AND METHODS: We studied 70 male patients aged between 2 and 10 years with mental retardation of unknown cause. In all patients a checklist with six clinical criteria (mental retardation, history of familial mental retardation, long face, large ears, autistic-like behaviour, and attention deficit disorder with hyperactivity) measured from 0-2 points was applied and molecular genetic studies using polymerase chain reaction and Southern-blot were performed. RESULTS: In 14 of the 70 children (20%) molecular study confirmed full mutation (200 CGG repeats). A score of six points in the test had the greatest discriminatory power and was reached by 14 patients (100%) with mutation, but only by 2of 56patients (3.5%) without mutation. The most accurate diagnostic model was the association of mental retardation, attention deficit disorder with hyperactivity, large ears and a history of familial mental retardation followed by long face and autistic-like behaviour. CONCLUSIONS: The six-item checklist improved the preselection of children with suspicion of FXS, which was later confirmed by molecular genetic techniques.

Child↗
PubMed2000

Analysis of the mandibular position in malocclusion patients.

OBJECTIVE: To study the changes of condyle position and occlusion between centric jaw relation (CR) and maximum intercuspation (MI) positions. METHODS: The power centric registration advocated by Roth was used to take centric relation bite registration for 50 patients (25 Angle Class I, and 25 Angle Class II). Diagnostic models were mounted and analyzed with Panadent articulator and condylar position indicator. RESULTS: Nearly all patients had CR-MI difference in all three spatial planes. Seventy percent of the sagittal displacement was within 2.0 mm and 87% of the transverse displacement was within 1.0 mm. Movement of most of the condyles was posterior and inferior. Sixty-five percent of the initial contacts in CR occurred on the most posterior molar on one side. When the mandible moved from CR to MI, overbite deepened, overjet decreased, and molar relationship became mesialized. Correlation was found between some variables of condylar displacement and occlusion changes. No significant difference between Angle Class I and Angle Class II patients was observed in condylar position and occlusion changes. CONCLUSION: The occlusion in centric jaw relation should be analyzed before treatment to reveal the disharmony between occlusion and jaw position.

Adolescent↗
PubMed2001

[Thyroid carcinoma--contemporary diagnostic principles and treatment].

Thyroid cancer, which is a rare neoplasm, is still controversial issue. References approved in Poland in 1995 caused unification of the extension of thyroid surgery to total resection of thyroid gland in case of cancer. For many surgeons such a radical treatment is still doubtful. On the other hand thyroid cancer is an object of many studies because of its heterogenous clinical course and prognosis depending of histological type. This article focuses on modern principles of diagnosis, treatment and follow-up according to obligatory references in Poland. The authors show current epidemiological data, prognosis according to histological type of cancer and explain pathogenesis of the disease. Preoperative diagnostic model has been described including role of ultrasound examination, biopsy, cytology and histology examination. Special interest was taken to follow-up patients after total thyroidectomy emphasising the role of thyreglobin in early detection of cancer recurrence. It is also important to observed patients for the rest of their life because cancer recurrences have been reported even 40 years after surgery. Preoperative diagnosis and treatment is a typical example of multi-disciplinary procedure which should be held in specialistic centres with proper equipment and experience.

Humans↗
PubMed2001

[Analysis of mandibular position of patients with angles Class I and Class II, division 1 malocclusion].

OBJECTIVE: To study changes of condyle position and occlusion between centric jaw relation and maximum intercuspation positions. METHODS: The power centric registration advocated by Roth was used to take centric relation bite registration for 50 patients (25 Class I and 25 Class II, Division 1) and diagnostic models were mounted and analysed with Panadent articulator and condyle position indicator. RESULTS: Nearly all patients had CR-MI differences in all three planes of space. 70% of the sagittal displacement was within 2.0 mm and 87% of the transverse displacement was within 1.0 mm. Most of the condyles moved posteriorly and inferiorly. 65% of the initial contacts in CR occured on the most posterior molar on single side. Correlation was found between some variables of condylar displacement and occlusion changes. No significant difference was observed in condylar position and occlusion changes between Class I and Class II, Dvision 1 patients. CONCLUSIONS: The occlusion in centric jaw relation should be analysed before treatment to reveal the disharmony between occlusion and jaw position.

Adolescent↗
PubMed2002

[Diagnostic and therapeutic guidelines for posttraumatic stress disorders].

Posttraumatic stress disorder (PTSD) presents an important medical and social problem in the Republic of Croatia with prevalence of 10-30% depending on the population. On the basis of our 8-year clinical experience in treating PTSD and detailed analysis of related literature a special team of the Department of Psychological Medicine, Zagreb University Hospital, compiled the proposed guidelines for diagnostics and treatment of PTSD. The established guidelines are independently developed, clinically proven at our Clinic and in terms of custom made procedure world wide unique. Their essential feature is psychoanalytic comprehension and approach to etiopathogenesis of PTSD, although it also applies to other psychotherapeutic techniques (cognitive-behavioral, relaxation, existential). The diagnostic model is based upon structured clinical interview (DSM-IV, ICD-10), but it also complies with the principles of psychotherapeutic interview. Therapeutic interventions as proposed are divided according to therapeutic goal into symptomatic and etiological.

Clinical Protocols↗
PubMedDate not supplied

[Craniometric diagnosis of skeletal and somatotype mass].

The paper presents diagnostic models for evaluation of ash mass (bone fragments, bone ashes), sex, length and mass of the burned body. Individual data by M. Warren and W. Maples (1997) on 85 adult Americans were used. On the basis of a canonical discriminant analysis and multiple linear regression equations the authors have developed models for diagnosis of ash residue mass as well as the burned body's sex, body length and mass. The above models can be used directly on the place of the criminal body cremation. They do not require determination of anatomic appurtenance of bone fragments and their osteometric examination.

Adult↗