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At least 487 records · Page 27Linked to original sources

Interpreting automated perimetry.

Visual field testing is mandatory for many ophthalmic conditions including glaucoma. The current gold standard for visual field testing is automated perimetry. In this article we familiarize the reader with the components of an automated perimetry printout. We describe a systematic approach that leads to a thorough interpretation of the printout. With the help of examples the reader should be able to learn to identify a normal field, detect the presence of a field defect, determine whether it is due to glaucoma, and establish progression, if any.

Humans↗

The surgical gowns and drapes of tomorrow. Specifying material performance and test methods.

A mandatory European standard is being developed to establish basic requirements and test methods for disposable and reusable materials used for surgical gowns and drapes. Once this standard has been adopted, the continued use of cotton textiles and conventional cotton-polyester-mixed textiles will become questionable. This article outlines the proposed requirements and looks at alternative methods that use liquid-repellent micro-filament textiles or liquid-proof textile laminates.

Equipment Reuse↗

Acceptance of genetic testing in a general population: age, education and gender differences.

The aim of the study was to analyze effects of age, education and gender on acceptance of genetic testing. Subjects, n = 1967 aged 15-69, were a stratified random sample of the Finnish population. One thousand, one hundred and sixty nine subjects, 530 men and 639 women, returned the questionnaire. The majority of the respondents approved of the availability of genetic testing. Young, aged 15-24, were more favourable towards testing and more willing to undergo suggested tests, but they were also more worried than others about the misuse of test results. Men aged 45-69 with only basic education were more in favour of mandatory genetic testing than other respondents. Respondents with university education were more critical towards genetic testing and expressed their worry about eugenics more often than other education groups. In conclusion, there are age, education and gender related differences in acceptance of genetic testing which need to be taken into account when considering screening programmes and informing the public.

Adolescent↗

Management of implantable cardioverter defibrillator patients: role of predischarge electrophysiologic testing and proper patient instruction before hospital discharge.

Routine postoperative testing of implanted defibrillators is still debated. While a high-risk subgroup of patients can be identified where this testing is mandatory, those with good results at implants may be less likely to benefit from further testing. Recent data suggests routine testing is justified due to a low, but potentially life-threatening, device failure rate found during postoperative testing. Additionally, patient education is important in the predischarge period. Patients must be knowledgeable regarding potential environmental electromagnetic interference with normal function of their device. Adequate discharge instructions will help reduce patient anxiety over returning to their normal daily activities, and help them adjust psychologically to their defibrillator.

Arrhythmias, Cardiac↗

How to detect pheochromocytomas?--the diagnostic relevance of plasma free metanephrines.

Pheochromocytomas are chromaffin cell tumors, mostly originating from the adrenal medulla, and represent a rare cause of hypertensiondue to excessive production of catecholamines (norepinephrine and/or epinephrine). More than 10% occur in families with multiple endocrine neoplasia type II, von Hippel-Lindau disease, neurofibromatosis type I, and familial carotid body tumors. Since approximately half of the afflicted patients present without or with only episodic hypertension, detailed clinical evaluation and sensitive biochemical tests are mandatory for the diagnosis, which relies on the detection of increased catecholamine production. Commonly employed tests such as the measurement of free catecholamines in plasma and urine or of their metabolites, vanillylmandelic acid and total metanephrines (= free + conjugated normetanephrine and metanephrine) in urine, suffer from interference from external factors and sometimes low clinical sensitivity and/or specificity. Recent technical advances now allow us to measure plasma free (unconjugated) metanephrines, thus increasing clinical sensitivity and specificity to close to 100%. Plasma free metanephrines offer the following advantages for the detection of pheochromocytomas: (i) independence of short-term changes in catecholamine secretion which may result from change of posture, exercise or intraoperative stress, (ii) information on long-term increase of catecholamine production, (iii) tight correlation with tumor mass, and (iv) only minor interference from drugs. This method does not need time-consuming standardized procedures for blood sampling, which are a prerequisite for the determination of free catecholamines. In conclusion, it is therefore recommended to use plasma free metanephrines--after meticulous clinical screening--as the first-line biochemical test for detecting pheochromocytomas.

Adrenal Gland Neoplasms↗