Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “INSTRUMENTS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2004

Effect of modified Hedstrom files on instrumentation area produced by ProFile instruments in oval canals.

OBJECTIVE: To study the effect of a modified Hedstrom file called IqFile on the instrumentation shape of oval canals prepared with ProFile instruments. STUDY DESIGN: Fifty extracted premolars were divided into 3 groups of 16 teeth each. Group 1 was subjected to ProFile 0.04 rotary instrumentation to a size 6. Group 2 followed the same technique, but also received buccolingual hand instrumentation with IqFiles to ISO size 70. Group 3 was instrumented similarly to group 2 but unmodified Hedstrom files were used. Teeth were sectioned at 1 and 3 mm from working length and photographed at 26x magnification. AutoCAD was used for measuring the percentage of instrumented area of the canal. RESULTS: ANOVA revealed that Group 2 was significantly better than Groups 1 (P=.00) and 3 (P=.00) at the 1 mm level. At the 3 mm level Group 2 was significantly better than Group 1 (P=.03), but no differences were found between Groups 2 and 3 (P=.15). CONCLUSION: The combination of ProFile and IqFile was found more effective in instrumenting oval canals at both the 1 and the 3 mm levels. However, at the 3 mm level no difference was detected between the use of IqFiles and the use of unmodified Hedstrom files.

Bicuspid↗
PubMed1997

A comparison of molar root canal preparations using six instruments and instrumentation techniques.

Six different instruments (Flexofile, Canal Master U, Heliapical, Flexogate, Ultraflex, and Lightspeed) were evaluated in 240 mesial canals of extracted mandibular molars (40 canals per instrument type). After instrumentation, the roots were cross-sectioned 2, 5, and 9 mm from the apex. The cross sections were evaluated to determine the quality of canal preparation (round, oval, irregular). The best results were obtained with nickel-titanium, a short cutting blade and a rotary rather than a filing motion. The Canal Master U, Flexogate, and Lightspeed instruments had significantly more round canals than the Flexofile, Heliapical and Ultraflex instruments at all levels. The Lightspeed had the largest number of round canals at all levels. Instrumentation time was also recorded. The Canal Master U and Flexogate were significantly slower than the Flexofile, heliapical, Ultraflex, and Lightspeed instruments. There were no statistically significant differences within the faster group.

Alloys↗
PubMed1996

Development of a musculoskeletal extremity health status instrument: the Musculoskeletal Function Assessment instrument.

Despite an increasing reliance on the use of health status measures to assess and evaluate medical care, no single instrument is currently available for use with the broad range of patients with musculoskeletal disorders of the extremities that is commonly seen in clinical practice. In this paper, we report on the development of the Musculoskeletal Function Assessment instrument, a 100-item self reported health status instrument that is designed to meet this need. The instrument was developed in two phases. During the first phase, items were selected on the basis of interviews with 135 patients and 12 clinicians and from reviews of existing health status instruments. The items then were grouped into categories. During the second phase, the instrument was tested for reliability and content validity using a sample of 327 patients with one of five musculoskeletal disorders of the upper and lower extremities (fractures, soft-tissue injuries, repetitive motion disorders, osteoarthritis, and rheumatoid arthritis). The patients were selected from both community and academic sites. Content validity also was demonstrated, based on a review of item selection procedures, expert opinion, and the distribution of scores on the instrument.

Adolescent↗
PubMed2003

Comparison of instrumented anterior interbody fusion with instrumented circumferential lumbar fusion.

Posterior lumbar interbody fusion (PLIF) restores disc height, the load bearing ability of anterior ligaments and muscles, root canal dimensions, and spinal balance. It immobilizes the painful degenerate spinal segment and decompresses the nerve roots. Anterior lumbar interbody fusion (ALIF) does the same, but could have complications of graft extrusion, compression and instability contributing to pseudarthrosis in the absence of instrumentation. The purpose of this study was to assess and compare the outcome of instrumented circumferential fusion through a posterior approach [PLIF and posterolateral fusion (PLF)] with instrumented ALIF using the Hartshill horseshoe cage, for comparable degrees of internal disc disruption and clinical disability. It was designed as a prospective study, comparing the outcome of two methods of instrumented interbody fusion for internal disc disruption. Between April 1994 and June 1998, the senior author (N.R.B.) performed 39 instrumented ALIF procedures and 35 instrumented circumferential fusion with PLIF procedures. The second author, an independent assessor (S.M.), performed the entire review. Preoperative radiographic assessment included plain radiographs, magnetic resonance imaging (MRI) and provocative discography in all the patients. The outcome in the two groups was compared in terms of radiological improvement and clinical improvement, measured on the basis of improvement of back pain and work capacity. Preoperatively, patients were asked to fill out a questionnaire giving their demographic details, maximum walking distance and current employment status in order to establish the comparability of the two groups. Patient assessment was with the Oswestry Disability Index, quality of life questionnaire (subjective), pain drawing, visual analogue scale, disability benefit, compensation status, and psychological profile. The results of the study showed a satisfactory outcome (score< or =30) on the subjective (quality of life questionnaire) score of 71.8% (28 patients) in the ALIF group and 74.3% (26 patients) in the PLIF group (P>0.05). On categorising Oswestry Index scores into "excellent", "better", "same", and "worse", we found no difference in outcome between the two groups: 79.5% (n=31) had satisfactory outcome with ALIF and 80% (n=28) had satisfactory outcome with PLIF. The rate of return to work was no different in the two groups. On radiological assessment, we found two nonunions in the circumferential fusion (PLIF) group (94.3% fusion rate) and indirect evidence of no nonunions in the ALIF group. There was no significant difference between the compensation rate and disability benefit rate between the two groups. There were three complications in ALIF group and four in the PLIF (circumferential) group. On the basis of these results, we conclude that it is possible to treat discogenic back pain by anterior interbody fusion with Hartshill horseshoe cage or with circumferential fusion using instrumented PLIF.

Adult↗
PubMed2006

Apheresis instrument settings influence infused absolute lymphocyte count affecting survival following autologous peripheral hematopoietic stem cell transplantation in non-Hodgkin's lymphoma: the need to optimize instrument setting and define a lymphocyte collection target.

Autograft absolute lymphocyte count (A-ALC) is an independent prognostic factor for survival after autologous peripheral blood hematopoietic stem cell transplantation (APHSCT) for non-Hodgkin's lymphoma (NHL). Factors enhancing A-ALC collections are unknown. We hypothesize that apheresis instrument settings could affect A-ALC. Data from 127 NHL patients collected from 15 January 1999 to 30 July 2004 using a single apheresis instrument (COBE Spectra (SP), Baxter Amicus (AM), and CS3000 Plus (CS)) were analyzed. The primary end point of the study was to assess the correlation between apheresis instrument settings and A-ALC. The secondary end point was to determine the effect of apheresis instrument on survival post-APHSCT. Patients collected using SP achieved higher A-ALC compared to AM (with modified settings) or CS (P<0.05) and demonstrated superior overall (OS) and progression-free survival (PFS) (P<0.03). Multivariate analysis demonstrated A-ALC and not the apheresis instrument as an independent prognostic factor for OS and PFS, cancelling the prognostic effect of the apheresis instruments observed in the univariate analysis. The survival advantage observed by SP was from the higher A-ALC collected compared to AM and CS. These data suggest that apheresis instrument settings should be optimized to collect CD34(+) cells as well as an A-ALC target, with direct impact on survival post-APHSCT.

Adult↗
PubMed2005

Leisure Time Physical Activity Instrument and Physical Activity at Home and Work Instrument. Development, face validity, construct validity and test-retest reliability for subjects with fibromyalgia.

PURPOSE: A new instrument measuring leisure time physical activity (LTPAI) in populations predominately engaging in low intensity activities and a new instrument measuring the Physical Activity at Home and Work (PAHWI) were designed. METHODS: Patients with long-lasting pain and expert physiotherapists participated in the development of the two instruments. Test-retest reliability was evaluated for the LTPAI and the PAHWI. Construct validity was evaluated for the LTPAI by comparing it with an instrument measuring physical activities for older people, six-minute walk test and aerobic capacity. POPULATION: 37 women with FM, with the mean age of 46 years (SD 8.4) and mean symptom duration of 11 years (SD 5.9) were recruited to the study. RESULTS: The mean time that the study population spent in physical activities during leisure time was 5.2 hours (SD 4.0) a week. Satisfactory test-retest reliability was found for the total score of LTPAI (ICC 0.86, CI 0.79 - 0.93) and for the PAHWI (ICC 0.91, CI 0.82 - 9.96). A significant association between the LTPAI and the six-minute walk test (rs 0.40, p = 0.02) and another physical activity instrument (rs 0.39, p = 0.02) was found. As expected, LTPAI did not have any association with aerobic capacity. CONCLUSIONS: Face validity of the instruments was ensured during the development process. Satisfactory test-retest reliability was found for the LTPAI and the PAHWI. Significant but low associations were found between the LTPAI and the six-minute walk test and an instrument designed for older people, respectively, while no association was found between the LTPAI and aerobic capacity.

Adult↗
PubMed1997

Persistently electrified pedicle stimulation instruments in spinal instrumentation. Technique and protocol development.

STUDY DESIGN: A prospective review was done of a new intraoperative technique developed to detect and prevent neurologic compromise during pedicle screw insertion. OBJECTIVES: To describe in sufficient detail the technique of persistently electrified pedicle stimulation instruments, so that this technique will be available generally to all clinical neurophysiologists and spine surgeons; and to demonstrate the use, typical results, interpretation, and protocol of the technique. SUMMARY AND BACKGROUND DATA: Fusion techniques that use pedicle instrumentation have the potential to cause nerve root injury. Several authors have proposed imaging and neurophysiologic methods to improve outcome. The present method represents a significant theoretical departure and advance from previously reported methods. METHODS: All relevant instruments used during pedicle instrumentation were converted easily, inexpensively, and quickly into monopolar stimulators with appropriate stimulus voltages to identify broaches of pedicle bone via evoked-electromyograms from relevant muscle groups. RESULTS: The persistently electrified pedicle stimulation instrument technique provided accurate intraoperative neurophysiologic information concerning pedicle, integrity in the patients studied. The protocol is standardized and adaptable easily, inexpensively, and quickly to most clinical applications. CONCLUSIONS: The persistently electrified pedicle stimulation instrument technique described here is useful for monitoring instrumented lumbar fusion procedures. The use of this protocol may help confirm intraosseous placement of pedicle screws and prevent neurologic injury.

Bone Screws↗
PubMed2000

Adaptation of WHOQOL as health-related quality of life instrument to develop a vision-specific instrument.

The WHOQOL instrument was adapted as a health-related QOL instrument for a population-based epidemiologic study of eye diseases in southern India, the Andhra Pradesh Eye Disease Study (APEDS). A follow-up question was added to each item in WHOQOL to determine whether the decrease in QOL was due to any health reasons including eye-related reasons. Modifications in WHOQOL and translation in local language were done through the use of the focus groups including health professionals and people not related to health care. The modified instrument has 28 items across 6 domains of the WHOQOL and was translated into the local language, Telugu, using the pragmatic approach. It takes 10-20 minutes to be administered by a trained interviewer. Reliability was within acceptable range. This health-related QOL instrument is being used in the population-based study APEDS to develop a vision-specific QOL instrument which could potentially be used to assess the impact of visual impairment on QOL across different cultures and for use in evaluating eye-care interventions. This health-related QOL instrument could also be used to develop other disease-specific instruments as it allows assessment of the extent to which various aspects of QOL are affected by a variety of health problems.

Adult↗
PubMedDate not supplied

Microsurgical instrument handling systems. A new approach to instrument budget control.

1. Large portion of a hospital's supply budget is allocated for repair and replacement of surgical instruments. Microsurgical instrumentation can account for 18% or more of a total OR budget. 2. Managing the surgical instrument repair and replacement budgets with greater emphasis on accountability can help demonstrate effective cost containment. Cost savings may be experienced through appropriate use of surgical instrument management systems for handling, sterilization, and storage of microsurgical instruments. 3. Many facilities are implementing quality control programs to minimize replacement and repair costs, to ensure surgical instrument integrity, and to extend the life of their investment. Education, management information systems, improved communication, and appropriate use of instrument handling systems are some components of budget accountability in the operating room.

Budgets↗
PubMed1997

The Spanish Instrument Protocol: design and implementation of a study to evaluate treatment efficacy Instruments for Spanish-speaking patients with Alzheimer's disease. The Alzheimer's Disease Cooperative Study.

Development of improved outcome measures for Alzheimer's disease (AD) clinical trials is a major objective of the Alzheimer's Disease Cooperative Study (ADCS), an NIA-sponsored, multisite clinical trials consortium. The ADCS is committed to recruiting and following minority patients in clinical trials. At present, a serious impediment to recruiting non-English-speaking minorities is the lack of instruments with adequate translation. Because Spanish is the second most commonly spoken language in the United States and because persons of Hispanic origin represent approximately 10% of the population, we conducted an instrument development protocol for Spanish-speaking patients. Evaluating treatment efficacy in Spanish-speaking AD patients requires the development of assessments that are comparable to those used for English-speaking participants in clinical trials. The ADCS Instrument Development Project evaluated the sensitivity, reliability, and validity of new or improved measures in each of five assessment domains: (a) cognition (immediate and delayed memory, praxis, attention, and executive function); (b) clinical global change; (c) activities of daily living; (d) behavioral symptoms (agitation and other noncognitive symptoms); and (e) cognition in severely impaired patients. These new treatment efficacy instruments were translated for Spanish speakers and a Spanish Instrument Study was conducted in parallel with the English version of the study. This report describes instrument translation, entry criteria, and recruitment procedures. In addition, the demographic and clinical characteristics of the cohort at baseline are presented and compared to the English-speaking cohort. Implications for the development of comparably sensitive Spanish language instruments are discussed.

Aged↗
PubMed2006

Incidence of instrument separation using LightSpeed rotary instruments.

The use of nickel-titanium rotary instrument systems has gained popularity over the past 10 years. One of these instrument systems is the LightSpeed (LightSpeed Technology, Inc, San Antonio, TX). One drawback for all nickel-titanium rotary instruments is the incidence of instrument separation. The purpose of this study was to evaluate the incidence of nonretrievable instrument separation using the LightSpeed system in a clinical setting. A total of 3543 canals were treated over a 24 month period and during that time, 46 LightSpeed instruments were separated and found to be nonretrievable, resulting in a separation rate of 1.30%. This rate was lower than previous reported studies.

Dental Alloys↗
PubMed1999

[History of surgical instruments. 9. Surgical instruments and development of surgical technique of lithotomy incision].

Lithotomy, i.e. the surgical method of cutting for stone in the bladder, belongs to the oldest and, due to the high risk, most notorious operating techniques. Records of stone-cuttings date as far back as Ancient Greece. The first detailed description of the procedure and instrumentation of lithotomy is to be found by Celsus (1. century AD). The patient in the lithotomy position, the neck of the bladder is approached by a median incision of the perineum. Celsus is also the first to mention special stone-hooking instruments ("uncus") to aid in extracting the bladder-stones. Medico-historical development lead to constant changes in the technique as well as in the instrumentation, since the lack of analgesia and anaesthesia necessitated quick operations of only a few minutes. A key step in the progress of operation was the introduction of so-called path-finders and directing probes in the 16th century. The opening of the bladder from the perineal incision was now accompanied by the simultaneous admission of a metal catheter into the bladder via urethra, thus providing the "Lithotomist", through manual control of the catheter, with an enhanced orientation towards the position of urethra and bladder. At that time, the dissection was conducted bluntly and without direct view of the situation, i.e. without an exact representation of the structures to be separated. Thanks to the improved instrumentation, the instruments could now be guided along a probe directly into the bladder, thus alleviating the tedious search for the opening after changing instruments, all the while with an agitated, pressing patient. Famous names in the development of the lithotomy with an perineal incision are the medical doctor Mariano Santo (around 1488-1564), the barber-surgeon Frère Jacques de Beaulieu (1651-1719) and later Johann Jakob Rau M.D. (1668-1719). Only later, to avoid injury to the perineum, the suprasymphyseal approach ("Sectio alta") was adopted (primarily by Pierre Franco 1556). Due to the construction of arrow-like probe by the barber-surgeon Frère Come (Jean Baseilhac [1703-1781]), which was pushed through the urethra into the bladder and up and above the symphysis, the danger of damaging or penetrating the peritoneum was greatly reduced. In the 19th century the upper lithotomy prevailed as the standard operating method over the perineal approach, known even by the ancient Greeks, but marked by its high complication rate. Since the end of the 19th century, however, the upper lithotomy in ist turn, has been nearly completely replaced by the cystoscopic transurethral lithotripsy.

Cystostomy↗
PubMed2003

Pain 5 years after instrumented and non-instrumented posterolateral lumbar spinal fusion.

Pain drawings have been used in spine surgery for diagnostic use and psychological evaluation of fusion candidates; they have rarely been used to evaluate pain status after spinal fusion. This study is a 5-year follow-up on a randomised clinical trial assigning patients to posterolateral spinal fusion with or without pedicle screw instrumentation. Patients were mailed a pain drawing and questionnaires including questions regarding work, social status, smoking status, the Dallas Pain Questionnaire (DPQ), and the Low Back Pain Rating Scale (LBPRS). Pain drawings were scored using a visual inspection method and a surface-based point scoring and evaluated for the presence of donor site pain. Pain drawings from 109 patients (87% of the initially included patients), 56 men and 53 women, mean age at follow-up 51 years, were analysed. Fifty-three patients had undergone an instrumented fusion and 56 a non-instrumented fusion. Some presence of low back pain was marked by 79% and leg pain by 69%. Sixty-two percent of the pain drawings were classified as "organic" and 38% as "non-organic". There was no difference between the instrumented and the uninstrumented group. DPQ and LBPRS scores were higher in the non-organic group ( P=0.007). Using the point scoring, no difference between the instrumented and the uninstrumented group was seen. The results of the point scoring were found to correlate with the DPQ and LBPRS scores ( P=0.001). Working patients (39%) had significantly better scores than the rest. Ten percent of the patients had donor site pain. Twenty percent of spinal fusion patients are totally pain free at 5-year follow-up. Ten percent still experience donor site pain. In general, instrumentation does not affect the amount and localisation of pain 5 years after lumbar spinal fusion surgery. The pain drawing seems to be a valuable tool when following spinal fusion patients, but its use as prognostic marker in connection with fusion surgery needs further investigation.

Bone Transplantation↗
PubMed2006

The CarerQol instrument: a new instrument to measure care-related quality of life of informal caregivers for use in economic evaluations.

The societal perspective in economic evaluations dictates that costs and effects of informal care are included in the analyses. However, this incorporation depends on practically applicable, reliable and valid methods to register the impact of informal care. This paper presents the conceptualisation and a first test of the CarerQol instrument, aimed at measuring care-related quality of life in informal caregivers. The instrument combines the information density of a burden instrument (encompassing seven important burden dimensions) with a valuation component (a VAS scale for happiness). The instrument was tested in a Dutch sample of heterogeneous caregivers (n=175) approached through regional caregiver support centres. This first test describes the feasibility as well as convergent and clinical validity of the CarerQol instrument. The seven burden dimensions related well with differences in VAS scores. In all instances, the average CarerQol-VAS scores decreased as the severity of problems increased. Multivariate analyses showed that the seven burden dimensions explained 37-43% of the variation in CarerQol-VAS scores, depending on the model used. The CarerQol seems a promising new instrument to register the impact of informal caregivers in economic evaluations.

Aged↗
PubMed1989

A new root canal instrument and instrumentation technique: a preliminary report.

Cleaning and shaping the root canal system has been and continues to be a challenge for even the most experienced endodontist. Curved, narrow canals, in particular, cause difficulties for the beginner as well as the specialist. A new instrument designed to incorporate new concepts was developed to ameliorate the problems in cleaning and shaping root canal systems. This new instrument has been given the name of SW (Senia and Wildey). The new SW instrument uses controlled right and left rotational forces. This motion was used to clean and shape simulated root canals in plastic blocks and root canals in extracted teeth. Instrumentation appeared to be easier, faster, and more precise than with conventional instruments, especially in curved canals where there was remarkable reduction of canal transportation. A mechanical version of the SW instrument was also developed. It was used to flare the coronal portion of the root canal system.

Dental Pulp Cavity↗
PubMed1980

Comparison of four electrolyte instruments using the proposed NCCLS protocol for evaluation of precision and accuracy of automated instruments.

We compared four instruments, [Sequential Multiple Analyzer Computer (SMAC), AutoAnalyzer II (AAII), StatLyte and PVA-4] for the determination of Na, K, Cl and CO2 using the National Committee for Clinical Laboratory Standard's (NCCLS) protocol (PSEP-1) for evaluation of precision and accuracy of automated instruments. The protocol was applied concurrently to all four instruments. The repeatability results showed SMAC to have the highest precision among-days for K, Cl, and CO2 whereas StatLyte showed the highest precision among-days for Na. The PVA-4 had the best within-run precision for Na and Cl while the AAII and SMAC had the best within-run precision for K and CO2 respectively. Systematic biases among the instruments were small for Na and K. The AAII exhibited a nearly constant bias at all concentrations of Cl relative to the other three instruments. For CO2 the SMAC showed a large proportional bias compared with the other three instruments.

Autoanalysis↗
PubMed2003

Instrumental and Pavlovian incentive processes have dissociable effects on components of a heterogeneous instrumental chain.

Two experiments compared the effects of Pavlovian stimuli and incentive learning on the performance of a heterogeneous chain of instrumental actions. Using a Pavlovian-instrumental transfer design, the authors found that only a stimulus paired with the same outcome as that earned by performance of the chain produced positive transfer, an effect that was restricted to the action in the chain most proximal to reward delivery. In contrast, after a shift to a nondeprived state, only animals that had previously consumed the instrumental outcome when they were nondeprived decreased instrumental performance. Furthermore, this effect of the incentive learning treatment was limited to performance of the distal action. Together these data suggest that Pavlovian and instrumental incentive manipulations have dissociable effects on instrumental performance.

Animals↗
PubMedDate not supplied

Laboratory testing of segmental spinal instrumentation versus traditional Harrington instrumentation for scoliosis treatment.

The authors have tested 51 instrumented calf spines in vitro, using a scoliosis simulator, to evaluate the adequacy of fixation and nature of acute failure seen with various methods of scoliosis instrumentation. Tests were performed in compressive loading, rotation, and forward bending on the following instrumentation systems: (I) Harrington distraction, (II) Harrington distraction plus compression connected by transverse approximators, (III) Harrington distraction plus segmental laminar wires, and (IV) Luque double "L" rods plus segmental laminar wires. The study demonstrated that the addition of segmental fixation to scoliosis instrumentation provides improved stability because of (a) multiple fixation sites and (b) prevention of deformity, especially kyphosis, within the instrumented segment (an important contributor to hook cutout when a single Harrington distraction rod is tested). Failure with the Harrington rod was always by fracture at the metal-bone interface, while failure with the Luque method always occurred outside the instrumented segment.

Animals↗