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At least 469 records · Page 26Linked to original sources
PubMed1996

[Intrauterine copper contraceptive implants].

GyneFix, conceived in 1985, was developed to minimize three major problems frequently associated with discontinuation of IUD use: expulsion, bleeding and pain. Since the initial clinical investigations, over 10,000 women years of experience and up to 8 years of follow-up in international, multicenter, non-comparative and comparative clinical trials, including a large proportion of nulligravid/nulliparous women, have been collected. The following conclusions were reached: 1. The unique design characteristics of GyneFix (frameless, flexible and fixed to the fundus of the uterus) have resulted in optimal tolerance and almost complete absence of expulsion. The result is enhanced effectiveness (comparable to OCs and male/female sterilization) and a high rate of continued use. GyneFix reduces the IUD-failure rate to a minimum and is, therefore, a welcome reversible alternative to OCs and female surgical contraception. 2. Frameless and flexibility explain the absence of side-effects and adverse events caused by dimensional incompatibility between the frame of conventional IUDs and the uterine cavity and may also explain the absence of PID and ectopic pregnancies in any of the clinical studies. 3. Insertion of GyneFix, with or without local anaesthesia, is easily accomplished in the office of a few minutes. Removal is easy, quick and painless. 4. GyneFix is an equally effective and well accepted method fro nulliparous women.

Equipment Design↗
PubMed1991

Applicability of industrial sampling techniques to epidemiologic investigations: examination of an underutilized resource.

In carrying out surveys to estimate disease prevalence or health services coverage in a region, investigators are often interested in identifying communities or other subareas in which the problem of interest is especially severe. In view of the large number of subareas to be examined, the investigator seeks rapid methods of assessment that require minimum sampling in each. Lot quality assurance sampling, developed more than 60 years ago to meet industrial quality control needs, has been found to serve public health purposes as well. Curiously, other more recent and more powerful industrial techniques have not received the recognition they deserve. Several of them are discussed in this paper and likely applications are cited. They fall into two categories: 1) lot acceptance methods to depict static conditions in a population and 2) more dynamic process monitoring methods for continuous surveillance. Under the first category, techniques of double sampling and sequential sampling are described. Reduced and tightened scrutiny, control charts, and exponential smoothing are highlighted as especially promising approaches under the process control category.

Decision Trees↗
PubMed2003

[Depot medroxyprogesterone acetate (DMPA) injectable contraception--safe, effective but neglected method of family planning in Poland].

As it is known from demographical prognosis for Poland, in the nearest years significant increase of the number of women in the childbearing age is expected (reflecting high, postwar, demographical wave). In spite of that, the prognosis of the number of live births is low, and does not exceed 450 thousands. The reason for this phenomenon is the change of life style among young people. They postpone delivery of the first baby, and use modern contraceptives. It is also expected that the number of women using modern contraceptives (especially combined oral contraceptives: estrogen + progestin) should significantly rise. It is well known, that with the age of a woman, there is an increasing number of contraindications for the estrogen use. It is the sufficient reason to think about alternate methods of contraception. DMPA (DEPO-PROVERA-150) is the very effective and safe method of family planning. It is used in many countries all over the world, since the sixties, but it is almost unknown in Poland. The use of DMPA is not reserved only for special cases. After many years of experience, it is possible to select the best candidates for this injectable contraception (patients with contraindications for estrogens, lactating women, smokers--especially over 35 years of age etc). DMPA appears to be acceptable method of fertility regulation. Clinical evidence after more than 30 years of use shows no additional adverse effects and possibly fewer than in the case of other hormonal methods of contraception. The particular advantages of DMPA, as a highly effective, long-lasting and reversible contraceptive, make it important option for Polish women, desiring a modern method of fertility regulation.

Adult↗
PubMed2006

Simultaneous determination of methyl tert-butyl ether, its degradation products and other gasoline additives in soil samples by closed-system purge-and-trap gas chromatography-mass spectrometry.

A new protocol for the simultaneous determination of methyl tert-butyl ether (MTBE); its main degradation products: tert-butyl alcohol (TBA) and tert-butyl formate (TBF); other gasoline additives, oxygenate dialkyl ethers: ethyl tert-butyl ether (ETBE), tert-amyl methyl ether (TAME) and diisopropyl ether (DIPE); aromatics: benzene, toluene, ethylbenzene and xylenes (BTEX) and other compounds causing odour events such as dicyclopentadiene (DCPD) and trichloroethylene (TCE) in soils has been developed. On the basis of US Environmental Protection Agency (EPA) method 5035A, a fully automated closed-system purge-and-trap coupled to gas chromatography/mass spectrometry (P&T-GC/MS) was optimised and permitted to detect microg/kg concentrations in solid matrices avoiding losses of volatile compounds during operation processes. Parameters optimised were the sampling procedure, sample preservation and storage, purging temperature, matrix effects and quantification mode. Using 5 g of sample, detection limits were between 0.02 and 1.63 microg/kg and acceptable method precision and accuracy was obtained provided quantification was performed using adequate internal standards. Soil samples should be analysed as soon as possible after collection, stored under -15 degrees C for not longer than 7 days if degradation products have to be analysed. The non-preservative alternative (empty vial) provided good recoveries of the most analytes when freezing the samples up to 7 day holding time, however, if biologically active soil are analysed the preservation with trisodium phosphate dodecahydrate (Na(3)PO(4).12H(2)O or TSP) is strongly recommended more than sodium bisulphate (NaHSO(4)). The method was finally applied to provide threshold and background levels of several gasoline additives in a point source and in sites not influenced by gasoline spills. The proposed method provides the directions for the future application on real samples in current monitoring programs at gasoline pollution risk sites where till now little monitoring data for MTBE in soils are available.

Benzene↗
PubMed2003

The assessment of flexor tendon function after primary tendon repair.

Because the actual methods of assessment and the grading of these methods in favor at any one time have changed so much over the last 50 years, the usefulness of the considerable experience in this field for practitioners today is much reduced. Agreement on the systems of assessment to be used for the different parts of the flexor system would allow a better exchange of knowledge worldwide at this time and a more useful cumulative experience for the next 50 years. If an acceptable method of assessment of any particular injury and its treatment can be agreed on by all, two stages remain for us to audit our work. The first is identifying how much we must downgrade the expectations of the assessment to accommodate the imperfections of our treatments. Most patients would consider an "excellent" result to be a return to normal. Currently, using, for example, the first Strickland system of assessment, we are happy to call any result of primary repair of a zone 2 flexor tendon division greater than 85% of normal, "excellent." How much we should reasonably downgrade our assessments is a variable that one hopes would reduce with accumulated experience, but one that makes repeated adjustment of our methods of assessment essential. Having set the level of the "excellent," "good," "fair," and "poor" qualifying bands relative to normal digital function, it only remains to take our measuring instruments out of their boxes and measure!

Finger Injuries↗
PubMed2005

Comparison of two methods for evaluating the quality of stored drinking water in Abidjan, Côte d'lvoire, and review of other comparisons in the literature.

Membrane filtration, multiple tube fermentation (the standard methods) and Colilert are techniques available for assessing drinking water quality, but there are no published comparisons of Colilert to standard methods in a developing country laboratory. We reviewed the published literature on Colilert and standard methods and conducted a study to compare Colilert with membrane filtration for the detection and enumeration of total coliforms and fecal coliforms (Escherichia coli bacteria) using 35 stored drinking water samples from households in Abidjan, Côte d'lvoire. Our study results are consistent with previous published studies conducted in developed countries. Results from Colilert and membrane filtration correlated for both total coliforms (r2 = 0.81) and E. coli (r2 = 0.93). Colilert is an acceptable method to measure the presence and quantity of coliforms in water samples in a developing country setting.

Cote d'Ivoire↗
PubMed1997

[Radioimmunologic targeting and therapy with antihuman primary hepatic cancer monoclonal antibodies (Hepama I) in patients].

OBJECTIVE: Effects of monoclonal antibody Hepama-I on targeting and therapy for primary hepatic cancer (PHC) were studied. METHODS: Thirty patients with veritified unresectable PHC were included in this study. For radioimmunoimaging (RII), 131I hepama was administered to 18 patients at a mean dose of 9.25 GBq. For radioimmunotherapy (RIT), 12 patients received a mean dose of 18.5 GBq by Seldinger's method via the hepatic artery. RESULTS: The optimum imaging time was 96 hours after injection. A decline in AFP level was found in 6/8 (75.0%). Reduction of tumor volume was observed as PR 66.6% and the survival time was prolonged in groups with 131I-Hepama-I treatment. CONCLUSION: Hepama I can recognized PHC cells in vivo and intra-hepatic arterial infusion of 131I-Hepama I is one of the acceptable methods of multimodality treatment for unresectable primary hepatic cancer in man.

Adult↗
PubMedDate not supplied

Laparoscopic treatment of superior mesenteric artery syndrome.

BACKGROUND: Superior mesenteric artery syndrome is caused by compression of the third portion of the duodenum by the superior mesenteric artery. Many disease states predispose one to this condition. METHODS: We present a case report of a young female patient who presented with gastro-duodenal obstruction from superior mesenteric artery syndrome and subsequently underwent surgical treatment with minimally invasive techniques. Pathophysiology of SMA syndrome is reviewed. RESULTS: The cause of superior mesenteric artery syndrome is variable but always results in duodenal obstruction. Surgery is one treatment option that is effective and can be performed laparoscopically. CONCLUSION: Laparoscopic duodenojejunostomy is an acceptable method of treating superior mesenteric artery syndrome.

Adult↗
PubMed2003

Attitudes and behaviour of general practitioners and their prescribing costs: a national cross sectional survey.

BACKGROUND: General practitioner (GP) prescribing accounts for about 10% of NHS expenditure. GPs at the top of the range have annual prescribing costs that are almost twice as much as those at the bottom of the range. This variation cannot be accounted for purely in terms of differences in underlying need for health care. OBJECTIVES: To describe the relationship between GPs' prescribing costs and their attitudes towards prescribing decisions and prescribing information sources, and to identify potentially modifiable attitudinal and behavioural factors associated with high cost prescribing. DESIGN: A postal questionnaire was designed on the basis of hypotheses developed from a literature search and an earlier qualitative survey. This questionnaire was sent to a national sample of GPs with equal numbers of practices in the upper, middle, and lowest quintile of prescribing costs. SETTING: GP practices in England. PARTICIPANTS: 1714 GPs in NHS practice. OUTCOME MEASURES: GPs' self-reported practices, attitudes and personal characteristics. RESULTS: There was a 64% response rate. Responders were more likely to be from larger practices, in less deprived areas, and with lower prescribing costs than were non-responders. Multivariable analysis showed that GPs with high prescribing costs were significantly more likely to work in dispensing practices, in practices with low income populations, in single handed practices, and in practices without a GP trainer. They were also significantly more likely to see drug company representatives more frequently, to prescribe newly available drugs more freely, to prescribe more readily to patients who expect a prescription, to report high levels of frustration from lack of time in the consultation, to find unsatisfactory those consultations which ended in advice only, and to express dissatisfaction with their review methods for repeat prescribing. They were significantly less likely to find useful criticism of prescribing habits by colleagues, and to check the BNF rather than other sources when uncertain about an aspect of drug treatment. CONCLUSIONS: While they cannot be held to have a causal relationship, the pattern of attitudes towards prescribing of GPs in the highest quintile of prescribing costs provide the basis for developing an educational intervention which may be an acceptable method of modifying the attitudes of GPs and consequently reducing their prescribing costs.

Attitude of Health Personnel↗
PubMed1992

A double stopcock technique for repeated sampling of venous blood.

Repeated sampling for measurement of venous blood levels of hemoglobin, hematocrit, plasma hemoglobin, potassium and ibuprofen with a novel method of phlebotomy, the double stopcock technique (DST), was compared to heparin lock (HPL), Angiocath with obturator (AOB) and direct venipuncture (DVP) techniques. There were 12 normal subjects in this randomized, three-way crossover trial. During each portion of the crossover, simultaneous samples for hemoglobin, hematocrit, plasma hemoglobin, potassium and ibuprofen were taken from each phlebotomy site prior to and after oral dosing with 400 mg ibuprofen. The DST was the best acceptable method based on the assessment of comfort by the subjects, followed by the AOB, HPL and DVP techniques. The least amount of blood waste was with the DST. The degree of hemolysis (as shown by plasma hemoglobin and potassium) was comparable across all techniques. Across all of the techniques, measurement of hemoglobin, hematocrit and ibuprofen levels using DST, HPL and AOB yielded lower levels than DVP. These changes were small and were not clinically significant, although statistically significant in some cases. The authors conclude that when there is need for frequent, rapid and repetitive venous blood sampling with minimal blood wastage and patient discomfort, the DST should be considered.

Blood Specimen Collection↗
PubMed1995

[Reduction of traumatic primary anterior shoulder dislocation under local analgesia].

The aim of the present study was to evaluate the value of local versus intravenous anaesthesia in the reduction of acute shoulder dislocations. Patients with a primary traumatic dislocation of the shoulder were randomized to either local lidocaine or intravenous anaesthesia with pethidine/diazepam. The local method was performed with 20 ml of 1% lidocaine. The intravenous method was performed with pethidine/diazepam injected intravenously. The patients were observed for any complication during and after the procedure and the used methods were evaluated using a Visual Analogue Scale (VAS). In the period from November 1991 to September 1993 81 patients were admitted to our departments and 68 patients were included. Average age was 48 years (range 15-79) with 29 men and 39 women. Thirty-five patients were randomized to intravenous anaesthesia, 33 had a successful reduction and two failed. Thirty-three patients received local anaesthesia, 32 succeeded and one failed. Ten patients treated with the intravenous method had respiratory depression and six required antidote. No systemic or local side effects and no neuro-vascular injuries were recorded with the use of lidocaine. We did not observe any superficial or deep infection in the lidocaine group. There was no statistical difference between the average VAS value in the two groups. Local anaesthesia used to reduce acute primary anterior dislocation of the shoulder is a simple, safe and well-accepted method with significantly fewer respiratory complications.

Adolescent↗
PubMed2005

Fast small molecule similarity searching with multiple alignment profiles of molecules represented in one-dimension.

Multiple sequence alignment has proven to be a powerful method for creating protein and DNA sequence alignment profiles. These profiles of protein families are useful tools for identifying conserved motifs, such as the catalytic triad of the serine protease family or the seven transmembrane helices of the G-protein coupled receptor family. Ultimately, the understanding of the critical motifs within a family is useful for identifying new members of the family. Due to the complexity of protein-ligand recognition, no universally accepted method exists for clustering small molecules into families with the same or similar biological activity. A combination of the concept of multiple sequence alignment and the 1-dimensional molecular representation described earlier offers a new method for profiling sets of small molecules with the same biological activity. These small molecule profiles can isolate key commonalities within the set of bioactive compounds much like a multiple sequence alignment can isolate critical motifs within a protein family. The small molecule profiles then make useful tools for searching small molecule databases for new compounds with the same biological activity. The technique is demonstrated here using the human ether-a-go-go potassium channel and the kinase SRC.

Algorithms↗
PubMed1994

Urinary screening for benzodiazepines with radioreceptor assay: comparison with EMIT d.a.u. benzodiazepine assay and high-performance liquid chromatography.

The radioreceptor assay (RRA) provides a total estimate of all pharmacologically active forms of benzodiazepines and their metabolites. We evaluated the method for urine drug screening. Detection limits of the most commonly used benzodiazepines and their major metabolites were determined. In all cases, the detection limits were lower than the cutoff values specified for the Syva EMIT d.a.u. benzodiazepine assay. Thirty-three urine samples for routine drug screening were tested for benzodiazepines by RRA and EMIT. Results were compared with those obtained by a highly specific high-performance liquid chromatographic (HPLC) method. Five commonly used benzodiazepines and their major metabolites were identified by use of a computerized multichannel photodetector. We obtained two false-negative results by RRA when compared with HPLC. These may be caused by conjugate formation. The inclusion of a simple enzymatic hydrolysis improves the detection of compounds excreted in the urine as glucuronide conjugates (e.g., oxazepam). We conclude that the combination of enzymatic hydrolysis and direct RRA provides a rapid and acceptable method for detection of the presence of benzodiazepines in urine samples.

Benzodiazepines↗
PubMed1991

Total coliform detection in drinking water: comparison of membrane filtration with Colilert and Coliquik.

The Colilert (CL) and Coliquik (CQ) systems were compared in a presence-absence format against the Standard Methods membrane filtration (MF) technique to determine whether differences existed in total coliform detection. Approximately 750 water samples were collected from distribution systems, covered and uncovered storage reservoirs, well sites, and the influent to drinking water treatment plants. Samples were analyzed for total coliforms and heterotrophic bacteria with MF, CL, and CQ. The agreements between CL and MF and between CQ and MF were both greater than 94.8%, which indicates that both may be acceptable methods for total coliform detection. Disagreement between the CL and CQ methods was primarily due to false-negative results. Furthermore, laboratory and field inoculation methods were compared for CL, more than 98% agreement was obtained. This finding indicates that sampling and immediate field inoculation may be an alternative to the traditional laboratory inoculation.

California↗
PubMed1991

The area under pH curve: a single-figure parameter representative of esophageal acid exposure.

This investigation aims at providing simpler methods for reading esophageal extended pH-metering tracings. Because the currently used parameters only quantify frequency and duration of acid exposure, we have measured the area between the pH curve and the pH 4 line (area under curve [AUC]) in an attempt to include in the evaluation the severity of acid exposure as well. We compared 20 control and 63 children with gastroesophageal reflux (GER). Extended pH metering curves were read according to currently accepted methods. In addition, we measured planimetrically total 24-hour AUC, AUC during daytime, AUC during sleep time, and total AUC excluding 2-hour postprandial periods. In spite of the very significant differences found between means of controls and GER patients for all variables considered, values overlapped widely. Receiver-operating characteristic (ROC) analysis indicated the best threshold values for differentiation of controls and GER patients and tested the diagnostic efficiency for each variable. We found that 24-hour AUC was the best comprehensive value (sensitivity = 1, specificity = 1) and that there was probably no use for fractional evaluation during selected periods of time. The optimum 24-hour AUC threshold value in the present conditions of measurement (paper speed, 0.25 cm/min; 1 pH unit, 2.5 cm) was 20 cm2. In order to facilitate comparison we propose using a pH-surface unit (pHSU) equal to recording speed (in cm/min) multiplied by vertical shift per 1 pH unit (in centimeters) (in this case, 0.25 x 2.5 = 0.625 cm2). A threshold value of 20 cm2 thus becomes 32 pHSU. A similar transformation will be adequate for any other recording conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Bayes Theorem↗
PubMedDate not supplied

Comparison of a colorimetric end-tidal CO2 detector and an esophageal aspiration device for verifying endotracheal tube placement in the prehospital setting: a six-month experience.

INTRODUCTION: Hand held, colorimetric, end-tidal CO2 detector devices are being used to verify correct endotracheal tube (ETT) placement. The accuracy of these devices has been questioned in situations of cardiac arrest. The use of the esophageal detector device (EDD) is an easy alternative for detection of ETT placement, and may be more accurate in situations of cardiac arrest. HYPOTHESIS: The use of the esophageal aspiration device in comparison with a colorimetric end-tidal CO2 detector is more accurate in detecting proper ETT placement and easier to use in the prehospital setting than is the colorimetric end-tidal CO2 detection device. METHODS: This was prospective alternating weeks, 6-month study in a prehospital setting. Participants included all patients older than 18 years who were intubated by the Portsmouth, Virginia Emergency Medical Services (EMS) personnel from 01 July 1993 through 31 December 1993. The aspiration device used, also known as an esophageal detector device (EDD), was a 60 ml, luer-lock syringe attached to a 15 mm ETT adapter. Its efficacy was compared with an already accepted method of ETT position detection, the colorimetric end-tidal CO2 detector. Each device was used on alternating weeks, and correct ETT placement was determined by the receiving emergency department physician using standard techniques. Chi-square analysis and Fisher's Exact test were used to compare parameters, time of device use, and ease of use. Sensitivity and specificity were calculated, and provider preference was assessed using a survey instrument administered following completion of the study. RESULTS: There were 49 patients who met the inclusion criteria, but six were excluded because of situational circumstances rendering use of the device a possible compromise of patient care. Twenty-five patients were in the EDD group, and 18 were in the end-tidal CO2 detector group. There was no statistically significant difference detected between groups for the gender ratio, underlying condition, CPR in progress, perceived difficulty of intubation, or percentage of nasotracheal intubation. The EDD was significantly easier to use (p < 0.005). There was no statistically significant difference in time required for use of end-tidal CO2 detector device versus the EDD. The sensitivity and specificity for correct tracheal placement using the EDD was 100%, and the sensitivity for correct tracheal placement using the end-tidal CO2 detector device was 78%. Use of the EDD was preferred over use of the end-tidal CO2 detector device by 75% of participating EMS providers. One case of nasotracheal intubation with an ETT placement above the cords raised the question of accuracy of this device in situations where direct visualization is not utilized. CONCLUSION: The EDD was accurate in all cases of orotracheal intubation, and was easier to use than was end-tidal CO2 detector device. It was preferred by 75% of participating EMS providers. In cases in which the ETT may be above the vocal cords, caution must be used with interpreting the results obtained by use of the EDD.

Carbon Dioxide↗
PubMed2026

Acceptability of alcohol-based hand rub during neonatal care in rural Ugandan households: a qualitative study nested within the BabyGel trial.

BACKGROUND: Poor access to water, sanitation and hygiene exacerbates the spread of infections among newborns. The BabyGel cluster randomised trial assessed the effectiveness of a community-level alcohol-based hand rub with a training component in reducing infection or death rates among newborns in Uganda. OBJECTIVE: Nested in the BabyGel trial, this study investigated the acceptability of the BabyGel intervention among mothers and household members in Eastern Uganda, using the Theoretical Framework of Acceptability. METHODS: In 2022, we conducted individual semistructured interviews with mothers, and group interviews with mothers and other household members, all recruited from intervention-arm clusters. Thematic analysis combined inductive and deductive coding, structured by the framework's seven constructs: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness and self-efficacy. RESULTS: Twenty mothers and 14&#xa0;household members participated in 10 individual and 10 small group interviews. Participants found the intervention generally acceptable, appreciating its convenience and perceived protection against infection. Many described hand hygiene changes that persisted beyond the intervention period. However, concerns related to its harmful effects, spiritual beliefs and social tensions with visitors occasionally influenced its use. CONCLUSION: Alcohol-based hand rub combined with a training component was generally well accepted, driven by perceived health and practical benefits, although concerns related to safety, belief systems and social dynamics remained. Because data collection coincided with the COVID-19 pandemic, a period of heightened hygiene awareness, the acceptability observed could differ in nonpandemic periods. Culturally adapted education, community engagement and reinforcement of correct use may enhance acceptability and sustainability in similar settings.

Humans↗
PubMed1998

Oral fluid therapy in paediatric burns (5-10%): an appraisal.

Fluid therapy by the oral route is the accepted method of treatment for smaller burns in children (less than 10%). [Settle JAD. Burns - the first five days. Essex: Smith and Nephew Pharmaceuticals Ltd, 1986.] A phone survey was carried out of all the hospitals in the United Kingdom that manage burns, to record their oral fluid therapy practices for burns (5-10% BSA) in paediatric patients. Included in the survey was an assessment of the uniformity of the contents of the fluids, their palatability and acceptance by patients and any side-effects from this form of treatment. There appears to be no uniformity in policies regarding fluid therapy in children with this percentage of burns. Treatment ranged from a formula guided resuscitation therapy (as practised generally with large burns) to a 'drink as you like' policy. Fluids used varied from electrolyte to non-electrolyte containing solutions and fruit juices and were, therefore, markedly different in content. The electrolyte solutions were reported as being non-palatable unless flavoured with fruit juices. No complication was reported although one unit queried a possible case of fluid overload. Potential complications from this mode of therapy are discussed. The cost implications of using various fluid types are also presented.

Administration, Oral↗