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PubMed1972

Screening for bacteriuria in children: comparison of two dip-tests.

Two dip-tests, Testuria and Uricult, were studied as screening tests for bacteriuria in children. Both tests showed a very good correlation with a standard method of urine culture.Testuria is easier to read and more accurate; however, it shows more "doubtful" results. Uricult presents the advantages of showing fewer "doubtful" results, and of differentiating between gram-positive and gram-negative organisms.The use of both tests should be limited to screening for bacteriuria. Certainly they are no substitute for accepted methods of urine culture.

Adolescent↗

PubMed1981

Patient preference for a progressive addition multifocal lens (Varilux2) vs a standard multifocal lens design (ST-25).

Patient preference for the Varilux2 lens, a progressive addition multifocal lens, was compared to that of a standard straight-top 25 multifocal. Forty-eight first-time multifocal candidates were fitted with both lens designs, which were then each worn for two three-week periods in succession. The subjects were then asked to state their preference by choosing the lens design they would prefer to continue to wear. Twenty-five of the 48 subjects (52%) preferred the Varilux2 lens design (as compared to the ST-25). The results indicate that the Varilux2 progressive addition lens design is an acceptable method of correction for first time multifocal candidates. The study analyzes patient factors (sex, refractive error, addition power, etc.) in relation to final lens design selection.

Adult↗

PubMed2004

Comparing vaginal and buccal misoprostol when used after methotrexate for early abortion.

OBJECTIVE: The primary objective of this study was to determine if buccal misoprostol was as effective as vaginal misoprostol in medical abortions. The secondary objectives were to compare side effects and acceptability. METHODS: This was a randomized controlled trial of 600 microg misoprostol by the buccal or vaginal routes used 3 to 6 days after 50 mg/m2 methotrexate. The participants were women presenting for abortion at 49 days or less gestation. The outcome measures were the number of women who had aborted by Day 8, side effects and acceptability. RESULTS: Day 8 completion rate was 53.5% for the buccal route and 67.5% for the vaginal route (p = 0.012). Side effects were similar in the two groups except that there was more burning with the buccal route. Overall acceptability and route acceptability were similar in the two groups. CONCLUSIONS: When used after methotrexate for early abortion, the vaginal route for misoprostol is more effective and preferred to the buccal route.

Abortifacient Agents, Nonsteroidal↗

PubMed1989

[Vaginal sonography: a screening method for early detection of ovarian tumors and endometrial cancers?].

In total we performed a vaginosonographic measurement of 212 patients with or without a postmenopausal bleeding. Altogether 424 ovaries were sonographically examined. An endometrial thickness greater than 4 mm was histologically clarified by means of a curettage and all detectable ovarian tumors by means of a laparotomia. In total we found seven asymptomatic endometrial carcinomas, one cervical carcinoma and two ovarian cancers. The vaginosonography showed to be a very sensitive and acceptable method for the early detection of postmenopausal ovarian and endometrial tumors.

Female↗

PubMed1997

Intranasal diamorphine for paediatric analgesia: assessment of safety and efficacy.

OBJECTIVE: To evaluate the safety and efficacy of intranasal diamorphine as an analgesic for use in children in accident and emergency (A&E). METHODS: A prospective, randomised clinical trial with consecutive recruitment of patients aged between 3 and 16 years with clinically suspected limb fractures. One group received 0.1 mg/kg intranasal diamorphine, and the other group received 0.2 mg/kg intramuscular morphine. At 0, 5, 10, 20, and 30 minutes pain scores, Glasgow coma score, and peripheral oxygen saturations were recorded; parental acceptability was assessed at 30 minutes. RESULTS: 58 children were recruited, with complete data collection in 51 (88%); the median summed decrease in pain score was better for intranasal diamorphine than intramuscular morphine (9 v 8), though this was not significant (P = 0.4, Mann-Whitney U test). The episode was recorded as "acceptable" in all parents whose child received intranasal diamorphine, compared with only 55% of parents in the intramuscular morphine group (P < 0.0001, Fisher's exact test). There was no incidence of decreased peripheral oxygen saturation or depression in the level of consciousness in any patient. CONCLUSIONS: Intranasal diamorphine is an effective, safe, and acceptable method of analgesia for children requiring opiates in the A & E department.

Administration, Intranasal↗

PubMed1993

Accurate measurement of surface areas of anatomical structures by computer-assisted triangulation of computed tomography images.

There is a need for accurate surface area measurement of internal irregular anatomical structures in order to define light dosimetry in adjunctive intraoperative photodynamic therapy (AIOPDT). No satisfactory preoperative method exists of measuring this parameter. We have investigated whether computer-assisted triangulation of serial sections generated by computed tomography (CT) scanning can give an accurate assessment of the surface area of the walls of the true pelvis after anterior resection and before colorectal anastomosis. We have shown that the technique of paper density tessellation is an acceptable method of measuring the surface areas of phantom objects, with a maximum error of 0.5%, and is used as the gold standard. Computer-assisted triangulation of CT images of standard geometric objects and accurately-constructed pelvic phantoms gives a surface area assessment with a maximum error of 2.5% compared with the gold standard. The CT images of 20 patients' pelves have been analysed by computer-assisted triangulation and this shows that the surface area of the walls varies from 143 cm2 to 392 cm2. Simple step-like analysis of images and approximation to geometric shapes with subsequent calculation give unacceptably high errors. The surface area of an internal, rigid, irregular surface area for illumination in AIOPDT can be accurately measured preoperatively by computer-assisted triangulation of CT images.

Anthropometry↗

PubMed1988

A comparison of disc agar diffusion and agar dilution for the detection of methicillin resistant staphylococci.

Ninety two consecutively occurring clinical isolates of Staphylococcus aureus and 71 coagulase negative staphylococci (CONS) were tested by disc agar diffusion (DAD) and agar dilution (Mueller Hinton agar with 4% sodium chloride and 6 mcg/ml oxacillin) for methicillin resistance. There were 6 S. aureus and 33 CONS which were resistant to oxacillin. Five discrepancies (CONS) occurred between the two methods, with all indicating susceptibility by DAD and resistance by agar dilution. Four discrepancies were resolved by minimal inhibitory concentration (MIC) tests. In two of the CONS, the MIC agreed with the DAD results, and in the other two, the MIC agreed with the agar dilution results. Results of this study indicate that DAD is an accurate and acceptable method of detecting methicillin resistance in staphylococci (especially S. aureus) at this institution.

Agar↗

PubMed1988

Vaginal cones: a conservative method of treating genuine stress incontinence.

A set of weighted vaginal cones designed to exercise the pelvic floor muscles was used by a group of 39 premenopausal patients with genuine stress incontinence who were awaiting corrective surgery. The effectiveness of the exercises in reducing urinary loss was assessed with a standard urine pad test before and after 1 month of training. Of the 30 women who completed 1 month of the exercises 70% felt they were improved or cured and 90% found it an acceptable method of treatment. Of the 30 women only 11 (37%) opted for surgery after training. There was a highly significant correlation (P less than 0.001, rs = -0.21) between decreased urine loss and increase in retained cone weight.

Adolescent↗

PubMed1978

Kidney transplantation.

Since 1954, more than 26,000 kidney transplants have been performed and transplantation is now an accepted method for the treatment of end-stage renal disease. Recent advances in transplantation include operation not only on ideal recipients, but also on a much broader group of patients; an improved understanding of rejection mechanisms; better employment of standard immunosuppressive drugs; identification of an additional major histocompatibility antigen system; appreciation that blood transfusions prior to transplantation may facilitate acceptance of cadaver kidneys; and development of intracellular washout solutions for kidney preservation. Although the overall functional survival rates of kidney transplants have not improved recently, there has been a significant improvement in patient survival, especially after transplantation of cadaver kidneys.

Graft Rejection↗

PubMedDate not supplied

Enumeration of coliform bacteria in wastewater solids using defined substrate technology.

Commercially available defined substrate technology for the enumeration of coliform bacteria was investigated for its applicability to waste activated sludge (WAS) solids. The defined substrate, Colilert, in conjunction with the QuantiTray enumeration system, was compared with multiple-tube fermentation (MTF). Multiple-tube fermentation analyses (U.S. Environmental Protection Agency [U.S. EPA]-accepted methods for the enumeration of coliforms in wastewater solids) were conducted on settled wastewater solids using lauryl tryptose broth as the presumptive phase and brilliant-green lactose bile broth for the confirmed phase of total coliform enumeration. Both EC medium for fecal coliform identification and EC-4-methyl-umbelliferyl-beta-D-glucuronide (MUG) media for Escherichia coli for the MTF completed phase were also conducted on the WAS. Samples analyzed included raw WAS and WAS that had been pasteurized at 70 degrees C for 15 and 30 minutes, respectively. Twenty replicates of each sample were measured to demonstrate statistical equivalence of the total coliform numbers for all three WAS samples (raw, 15-minute pasteurization, and 30-minute pasteurization). Results show that both systems provided statistically equal total coliform most probable numbers (MPNs) for all samples tested. As expected, fecal coliform numbers identified by the MTF technique were statistically higher than E. coli enumerated by Colilert-QuantiTray. However, the E. coli MPN generated by the MTF method was found to be statistically equal to the Colilert-QuantiTray numbers. Because of its ease of use and reduced time to obtain the analysis, the Colilert-QuantiTray system can be useful in enumerating coliforms in WAS. However, more data are required to definitively show equivalence of the commercially available defined substrate technology to the U.S.-EPA accepted protocol. It is hoped that the results of this study will help form a database for the acceptance of the Colilert-QuantiTray system for WAS bacterial analyses.

Bacteriological Techniques↗

PubMed1998

The changes in main pulmonary artery pressure after bilateral lung autotransplantation in dogs.

In the Respiratory Center, Yongdong Severance Hospital, Yonsei University, we performed 10 cases of bilateral lung autotransplantation in mongrel dogs from July 1994 to June 1996, and we have analyzed the hemodynamic changes. Autotransplantation was performed in order to avoid postoperative rejection. The lung was flushed with an Euro-Collins(E-C) solution containing PGE1 which passed through a 10 French catheter inserted into an incision on the anterior half of the pulmonary artery to pulmonary parenchyme, and the vertical incision was made on the anterior half of the left atrium near the proximal part of the pulmonary vein. However, the bronchus was totally divided after clamping both sides. The lung was kept cold (4 degrees C) in the thoracic cavity for an hour by using slushed ice made from an E-C solution. After an hour of cold ischemia, the pulmonary artery was sutured with Prolene 5-0. The pulmonary vein was sutured with Prolene 6-0 by using the continuous everting mattress method. The main bronchus was anastomosed using the telescope method. The arterial oxygen concentration and the pressures in the femoral and pulmonary arteries were measured both preoperatively and postoperatively. There were no significant hemodynamic differences between the preoperative and postoperative mean pulmonary artery pressure (MPAP) (paired t-test, P = 0.05). Lung preservation using a cold (4 degrees C) E-C solution containing PGE1 may be an acceptable method for short-term storage of a lung (for about an hour) in bilateral lung autotransplantation in dogs.

Animals↗

PubMed1983

A new method of management using the Kim-Ray Greenfield filter for deep venous thrombosis and pulmonary embolism in spinal cord injury.

In this study, it is documented that the proper location of the Kim-Ray Greenfield filter offers excellent protection against PE in patients with SCI and DVT. The device has been associated with thrombosis of the IVC in two of 21 patients, and the thrombosis was well tolerated. The incidence of complications has been quite low. We believe that this is a most acceptable method of managing patients with SCI and DVT or PE when heparin is either inadequate or contraindicated.

Adult↗

PubMed2006

Circulating endothelial cells in cardiovascular disease.

Quantification of circulating endothelial cells (CECs) in peripheral blood is developing as a novel and reproducible method of assessing endothelial damage/dysfunction. The CECs are thought to be mature cells that have detached from the intimal monolayer in response to endothelial injury and are a different cell population to endothelial progenitor cells (EPCs). The EPCs are nonleukocytes derived from the bone marrow that are believed to have proliferative potential and may be important in vascular regeneration. Currently accepted methods of CEC quantification include the use of immunomagnetic bead separation (with cell counting under fluorescence microscopy) and flow cytometry. Several recent studies have shown increased numbers of CECs in cardiovascular disease and its risk factors, such as unstable angina, acute myocardial infarction, stroke, diabetes mellitus, and critical limb ischemia, but no change in stable intermittent claudication, essential hypertension, or atrial fibrillation. Furthermore, CEC quantification at 48 h after acute myocardial infarction has been shown to be an accurate predictor of major adverse coronary events and death at both 1 month and 1 year. This article presents an overview of the pathophysiology of CECs in the setting of cardiovascular disease and a brief comparison with EPCs.

Cardiovascular Diseases↗

PubMed1986

Prescription of diabetic diets in the 1980s.

A method is described to aid the prescription of diabetic diets, derived from newly available data for computation of metabolic rates of individuals. Absolute daily amounts of the main nutrients required to formulate a patient's diet are obtained from simple nomograms based on the patient's height and activity level. This system is more accurate and more flexible than currently accepted methods of dietary assessment and should lead to improved use of dietetic resources.

Adolescent↗

PubMed2004

Computerized symptom and quality-of-life assessment for patients with cancer part II: acceptability and usability.

PURPOSE/OBJECTIVES: To determine the acceptability and usability of a computerized quality-of-life (QOL) and symptom assessment tool and the graphically displayed QOL and symptom output in an ambulatory radiation oncology clinic. DESIGN: Descriptive, cross-sectional. SETTING: Radiation oncology clinic located in an urban university medical center. SAMPLE: 45 patients with cancer being evaluated for radiation therapy and 10 clinicians, who submitted 12 surveys. METHODS: Acceptability of the computerized assessment was measured with an online, 16-item, Likert-style survey delivered as 45 patients undergoing radiation therapy completed a 25-item QOL and symptom assessment. Usability of the graphic output was assessed with clinician completion of a four-item paper survey. MAIN RESEARCH VARIABLES: Acceptability and usability of computerized patient assessment. FINDINGS: The patient acceptability survey indicated that 70% (n = 28) liked computers and 10% (n = 4) did not. The program was easy to use for 79% (n = 26), easy to understand for 91% (n = 30), and enjoyable for 71% (n = 24). Seventy-six percent (n = 25) believed that the amount of time needed to complete the computerized survey was acceptable. Sixty-six percent (n = 21) responded that they were satisfied with the program, and none of the participants chose the very dissatisfied response. Eighty-three percent (n = 10) of the clinicians found the graphic output helpful in promoting communication with patients, 75% (n = 9) found the output report helpful in identifying appropriate areas of QOL deficits or concerns, and 83% (n = 10) indicated that the output helped guide clinical interactions with patients. CONCLUSIONS: The computer-based QOL and symptom assessment tool is acceptable to patients, and the graphically displayed QOL and symptom output is useful to radiation oncology nurses and physicians. IMPLICATIONS FOR NURSING: Wider application of computerized patient-generated data can continue in various cancer settings and be tested for clinical and organizational outcomes.

Academic Medical Centers↗

PubMed1987

Testicular biopsy as an outpatient procedure in screening for carcinoma-in-situ: complications and the patient's acceptance.

Testicular biopsy has been performed as a simple outpatient procedure to facilitate screening purposes. The target population was men aged 20-30 years with previous cryptorchidism, and the aim of the study was to discover carcinoma-in-situ. When results from the first 209 consecutive males were assessed, very few and minor complications were encountered. Only three patients needed hospitalization for drainage of pus from the wound. The effects of the procedure as experienced by the patients were evaluated by a questionnaire. 72% of the patients found the method acceptable. The advantages were the patients' minimal absence from their jobs, and the low consumption of resources.

Adult↗

PubMed1985

Determination of cardiac output at rest and during exercise by carbon dioxide rebreathing method in obstructive airway disease.

We evaluated the accuracy of the CO2 rebreathing method (CO2rb) for measuring cardiac output at rest and during steady-state exercise in 15 patients (mean +/- SD age, 59.7 +/- 7.5 yr) with obstructive airway disease. At rest, there was a significant correlation between direct Fick and CO2rb methods using measured arterial PCO2 (r = 0.70; p = 0.002), but not with using end-tidal PCO2 (r = 0.38; p = NS). During exercise, there was greater correlation with CO2rb using arterial PCO2 (r = 0.79; p = 0.001) than using end-tidal PCO2 (r = 0.63; p = 0.007) compared with the direct Fick determination. Correlation between the CO2rb and direct Fick methods was greater with moderate air-flow obstruction (n = 6) than with severe airway disease (n = 9), and the CO2rb method was more accurate during exercise than at rest. The CO2rb method using either end-tidal or arterial PCO2 underestimated the direct Fick measurement in 13 of 15 patients at rest, which may reflect inadequate equilibration between alveolar and oxygenated mixed venous PCO2. However, no consistent error was observed during exercise when higher CO2 production and an increased venoarterial PCO2 difference would diminish potential inaccuracies. We concluded that the CO2rb technique is an acceptable method for measuring cardiac output during exercise in patients with moderate and severe obstructive airway disease as long as arterial PCO2 is directly measured rather than estimated from end-tidal PCO2.

Aged↗

PubMed1980

The use of a modified copper intrauterine device in nulliparous women with small uterine axial length.

In a preliminary study a highly selected group of 31 nulliparous patients with uterine axial length less than 6 cm underwent 32 insertions of a modified Gravigard device with reduced vertical and horizontal arms. After at least six months of use 26 patients (81%) continued to use this method of contraception. The six patients who discontinued are accounted for as follows: one became pregnant, two expelled the device, two requested removal of their devices because of pain and bleeding, and one device was removed accidentally. There was one further pregnancy at nine months of use. It is concluded that provided that the dimensions of the Gravigard are reduced, it is an acceptable method of contraception in nulliparae with small uterine axial length.

Adolescent↗