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At least 505 records · Page 28Linked to original sources
PubMed2002

Moving from CFC aerosol to HFA aerosol or dry powder inhalers: what do patients think?

BACKGROUND/OBJECTIVES: Environmentally friendly hydrofluoroalkane (HFA) pressurised metered-dose inhalers are currently being marketed to replace chlorofluorocarbon (CFC)-driven devices. It is uncertain whether these new formulations with different properties are acceptable to patients. Similarly, switching a patient to a dry powder inhaler (DPI) carries the risk of non-acceptance. METHODS: One hundred patients with obstructive airway disease on regular CFC aerosol inhaler medication underwent a standardised, structured interview. During the interview patients were asked to use a new HFA aerosol inhaler and three DPIs in random order. Patients' notions were recorded. RESULTS: Most patients (96) agreed to change from their CFC to the HFA inhaler, of those, only 12 did so with some reservation. Properties (taste, user-friendliness, design) of the HFA inhaler were rated favourably. DPIs represented an acceptable alternative to aerosol inhalers. In fact, 57 patients preferred a DPI over the HFA inhaler. Not all powder devices were equally acceptable. Replacing the CFC inhaler with patients' preferred alternative devices resulted in a more than 3-fold increase in costs. CONCLUSION: Concerns about the acceptability of reformulated CFC-free aerosol inhalers are ill founded. However, if given the choice, many patients prefer a DPI over the HFA inhaler. The transition offers an opportunity to review patients' current treatment and the proficiency of their inhaling technique. Moving to CFC-free inhalers will have revenue implications.

Adolescent↗
PubMed1979

[Contraception using a progestagen-only minipill in cardiac patients].

The choice of method of contraception in cardiac patients is often peremptory, as combined oestrogen-progesterone preparations and intra uterine devices are often contraindicated. A pure progesterone mini-pill, lynoestrenol (500 microgram) has been used in our department for several years, and would appear to be a possible solution. Its daily, uninterrupted administration for 6 to 30 months in 40 cardiac patients, many considered to be high risk cases (28 cases), has confirmed its contraceptive action: totally effective, excellent reversibility and satisfactory acceptability despite definite menstrual changes. Above all, it was almost totally innocuous, an essential factor in cardiac patients. No haemodynamic, hypersensitive or thromboembolic side effects were observed in any pateint. No changes were observed in glucose or lipid metabolism, hepatic function or blood coagulation after 3 to 6 months, in 6 to 14 patients at high risk. Platelet aggregation, factors II, V, VII and X, fibrinogen and anti thrombin II were normal. Although this is a small series of patients, the use of microdosage lynoestrenol seems an acceptable method of oral contraception for cardiac patients, providing they collaborate and are closely followed up from the cardiac point of view.

Adolescent↗
PubMed2003

Analysis of clinical isolates of Propionibacterium acnes by optimised RAPD.

Random amplification of polymorphic DNA (RAPD) was evaluated as a genotypic method for typing clinical strains of Propionibacterium acnes. RAPD can suffer from problems of reproducibility if parameters are not standardised. In this study the reaction conditions were optimised by adjusting template DNA concentration and buffer constituents. All isolates were typeable using the optimised RAPD protocol which was found to be highly discriminatory (Simpson's diversity index, 0.98) and reproducible. Typing of P. acnes by optimised RAPD is an invaluable tool for the epidemiological investigation of P. acnes for which no other widely accepted method currently exists.

Buffers↗
PubMed2004

Immediate loading of dental implants in the edentulous mandible.

BACKGROUND: The authors review the literature regarding immediate implant loading in the anterior edentulous mandible, demonstrate the technique they currently use, review preliminary results and present an illustrative case. MATERIALS AND METHODS: The authors conducted a literature search using PUBMED and Ovid databases. They considered for review 31 articles in English from 1969 to 2003 that pertained to immediate loading of the anterior mandible. The authors developed a technique to provide a bar-supported prosthesis on the day of surgery. They treated five patients and followed them up for at least six months. The preliminary results are presented. RESULTS: This literature review demonstrated that immediate loading of anterior mandibular implants is an acceptable method, with predictable results. This case series demonstrates the potential for delivering a final bar on the day of surgery, based on the current evidence and clinical application. CONCLUSIONS AND PRACTICE IMPLICATIONS: The method described provides patients with immediate prosthetic restorations and a decreased treatment time compared with that for the traditional two-stage implant approach.

Dental Implantation, Endosseous↗
PubMed1994

Physical activity and colon cancer.

Heart disease and cancer, the major causes of mortality and morbidity in Western countries, have common risk factors. Exercise appears to reduce the risk of cardiovascular disease, but its role with respect to primary prevention of cancer has not been emphasized. Here we evaluate the epidemiological studies dealing with exercise and colon cancer. Despite the fact that different methods of assessing the amount of typical exercise of individuals and the different types of physical activity measured (occupational and recreational), there is remarkably consistent evidence that people who are highly physically active could be at a reduced risk of cancer of the colon. An analysis of case-control and cohort studies suggests that exercise might reduce the risk, at least in men, by up to one-third. We conclude that exercise has been overlooked as a potentially useful, effective, and acceptable method for reducing the risk of colon cancer.

Case-Control Studies↗
PubMed2001

The impact of side effects on family planning use among female clients of the public health services in Jamaica.

A one-year longitudinal study was undertaken in Kingston, Jamaica, to examine (i) the experience of side effects among female contraceptive users, (ii) the role of side effects in method continuation, and (iii) counselling regarding side effects. The study consisted of 463 women who utilized public health centres in Kingston and were either new users of contraceptives or who were switching contraceptive methods. They were recruited over a two-month period in 1998 and followed up for one year. All follow-up, interviews were done at the women's homes and complete interviews were obtained for 323 women. Information was collected about socio-economic characteristics, contraceptive history, service factors, experience with method and length of use. Forty-eight per cent of the women experienced side effects with the method accepted on recruitment to the study. Common side effects were irregular bleeding no period, headaches, nausea/dizziness and weight gain/loss. These side effects occurred mainly among pill and injection users. The occurrence of side effects had a negative impact on continuation rates. Forty-seven per cent of the women stated that they had received counselling regarding side effects. The level and impact of side effects among family planning acceptors at public health centres in Jamaica is of significance to the family planning programme. Method options need to be widened and counselling needs to be improved to ensure that women fully understand the issue of side effects and make informed choices about contraception.

Ambulatory Care Facilities↗
PubMed1995

The free vascularised fibular transfer as a definitive treatment in femoral septic non-unions.

Free vascularised bone transfer (fibula, iliac crest, or rib) is an accepted method of bone grafting in malignant and non-union bone surgery. The vascular microanastomoses have transformed the bone healing by creeping substitution seen after non-vascularised grafting (a long and often insufficient process) into normal healing of the fracture site. The presence of its own vascular support allows bone healing in such compromised circumstances as sclerosis and infection. We present the clinical history of five patients with septic femoral non-unions, in which only the final vascular fibular graft provided an acceptable outcome. Discussion about the indication and timing of this microsurgical salvage procedure is still controversial.

Adult↗
PubMed1984

Bioluminescent determination of free fatty acids.

A simple, highly specific, and sensitive bioluminescent method for determination of free fatty acids in unextracted plasma or serum has been developed. The method is based on the activation of free fatty acids by acyl-CoA synthetase (EC 6.2.1.3). The pyrophosphate formed is used to phosphorylate fructose 6-phosphate in a reaction catalyzed by the enzyme pyrophosphate-fructose-6-phosphate phosphotransferase (EC 4.1.2.13). The triosephosphates produced from fructose 1,6-bisphosphate by aldolase are oxidized by NAD in the presence of arsenate to 3-phosphoglycerate. The NADH is detected via the bacterial NADH-linked luciferase system. Excellent agreement has been obtained by comparison with accepted methods. In addition, for the determination of serum free fatty acids, the method is particularly applicable for following lipolysis of isolated adipocytes.

Adipose Tissue↗
PubMed1996

Distal movement of buccal segments with the "en masse" removable appliance: its value in treating patients with mild Class II, Division 1 malocclusion. Part II: the model measuring system and results.

The model of 25 children with mild Class II, Division 1 malocclusions who had their upper buccal segments moved distally with an en masse appliance were measured at the beginning of treatment and at the completion of buccal segment retraction. A reflex microscope, interfaced to a personal computer, was adapted for this purpose. A custom-made jig and linear stepping motor permitted the recording of both buccal and incisal measurements of the teeth in occlusion, as well as individual arch parameters. Software was designed to record and calculate the required measurements. The method error associated with this approach ranged from 0.01 to 0.5 mm. Results indicated that mean distal movement of the buccal segments approximated 6 mm, equivalent to a full cusp of buccal segment retraction. A small spontaneous reduction in overjet was seen. The upper arch showed spontaneous alignment and increases in width, length, and perimeter. In the lower jaw, transverse expansion was accompanied by a small increase in arch perimeter. Arch length, however, was slightly reduced. It was concluded that the system was an acceptable method of recording occlusal changes during orthodontic treatment, supplementing routine cephalometry. Furthermore, a full unit of buccal segment retraction could be expected, by using a removable appliance/headgear technique.

Bicuspid↗
PubMed2004

Improvement of anaerobic digestion of sludge.

Anaerobic digestion improvement can be accomplished by different methods. Besides optimization of the process conditions, pretreatment of input sludge and increase of process temperature is frequently used. The thermophilic process brings a higher solids reduction and biogas production, a high resistance to foaming, no problems with odour, better pathogens destruction and an improvement of the energy balance of the whole treatment plant. Disintegration of excess activated sludge in a lysate centrifuge was proved to cause increase of biogas production in full-scale conditions. The rapid thermal conditioning of digested sludge is an acceptable method of particulate matter disintegration and solubilization.

Anaerobiosis↗
PubMedDate not supplied

Determination of chlormequat and mepiquat in foods by liquid chromatography/mass spectrometry or liquid chromatography/tandem mass spectrometry: interlaboratory study.

Interlaboratory validation studies have been performed on 2 methods for the determination of chlormequat (CLQ) and mepiquat (MPQ). Both methods used identical extraction procedures and stable isotope internal standardization but differed in the use of liquid chromatography/mass spectrometry (LC/MS) or LC/tandem mass spectrometry (LC/MS/MS) for the determination, the amount of internal standard used, and the expected limit of detection. After addition of deuterated internal standards, CLQ and MPQ were extracted with methanol-water and determined by LC//MS or LC/MS/MS with positive electrospray ionization. Eight European laboratories participated in the LC/MS method study, analyzing mushroom, pear, wheat flour, and fruit puree with residues of CLQ in the range 0.040-1.19 mg/kg and of MPQ in the range 0.041-0.39 mg/kg. For CLQ, the Horwitz ratio (HoRat) values for individual test materials/levels were in the range 0.85-1.13 with a mean of 1.00, showing good method performance. For MPQ, the Ho values for mushroom, pear (both levels), and wheat flour were in the range 0.83-0.94, again indicating good method performance. For the determination of MPQ in infant food (fruit puree) at 0.041 mg/kg, the Ho was 1.7 when a value of 0 reported by one participant was excluded. In the LC/MS/MS study, in which 11 laboratories participated, a separate sample set was analyzed with residues of CLQ in the range 0.007-1.03 mg/kg and of MPQ in the range 0.008-0.72 mg/kg. Ho values for CLQ were in the range 0.27-1.36 and for MPQ in the range 0.51-2.10, all corresponding to acceptable method performance.

Calibration↗
PubMed2001

[Osteogenesis imperfecta. The effect of intramedullary nails in long tubular bones].

INTRODUCTION: The aim of the study was to describe the clinical, radiological, and functional results of intramedullary nailing of deformities in the lower extremities of children with osteogenesis imperfecta after the use of multiple osteotomies and non-telescoping rods (rush pins). MATERIAL AND METHODS: Eight children with osteogenesis imperfecta, who consecutively underwent surgery during 1991-1994, were entered in the study. RESULTS: Sixteen operations were performed on eight children: 12 on the femur and four on the tibia. Like others, we found a high complication rate, 50%. Radiological correction of angular deformities was good. The functional outcome was satisfactory and the patients were satisfied. CONCLUSION: Correction and stabilisation of deformities in the lower extremities in children with osteogenesis imperfecta with the use of non-telescoping rods is an acceptable method of decreasing fractures and allowing most formerly non-ambulatory children to walk. Furthermore, the cosmetics were improved.

Adolescent↗
PubMed1999

Comparison of VIDAS with direct immunofluorescence for the detection of respiratory syncytial virus in clinical specimens.

BACKGROUND: requirements for infection control measures and the decision for treatment with antiviral agents make the rapid detection of respiratory syncytial virus (RSV) essential for hospitalized, pediatric and immunocompromised patients. Immunofluorescence is considered to be the most rapid and sensitive method for direct detection of RSV in clinical specimens, but several enzyme-linked immunoassays have also been commercially available. OBJECTIVES: to compare the performance of VIDAS RSV assay (Vitek ImmunoDiagnostic Assay System, BioMerieux Vitek), which is an automated enzyme-linked fluorescent immunoassay (ELFA) to direct immunofluorescence (DFA), in rapid detection of RSV in respiratory specimens. STUDY DESIGN: respiratory specimens collected during the 'RSV season', between the months of November 1997 and February 1998, were tested by both methods. DFA was performed upon receipt of the sample and an aliquot of the original specimen was stored in -70 degrees C for batch testing with VIDAS. RESULTS: from 238 samples that were tested, 231 could be evaluated by both methods. The two assays were in agreement for 213 specimens (92%), or 32 positive and 181 negative results. Eighteen discrepant results were generated; seven specimens were VIDAS-/DFA+ and 11 specimens were VIDAS+/DFA-. In addition, seven specimens had an inadequate number of cells for evaluation with DFA. One of these samples tested positive with VIDAS. VIDAS relative sensitivity and specificity were 82% and 94%, respectively, when compared to DFA. CONCLUSIONS: VIDAS is simple to perform, does not require expertise in interpretation and appears to be an acceptable method for the rapid detection of RSV.

Enzyme-Linked Immunosorbent Assay↗
PubMed2005

Constructs incorporating intralaminar C2 screws provide rigid stability for atlantoaxial fixation.

STUDY DESIGN: An in vitro biomechanical study of C1-C2 posterior fusion techniques using a cadaveric model. OBJECTIVES: To investigate the acute stability afforded across the atlantoaxial segment by a novel technique that uses intralaminar screws in C2, and to compare these results to the stability obtained using a C2 pedicle fixation technique. SUMMARY OF BACKGROUND DATA: There are numerous techniques available for rigidly coupling C1 and C2. It has been shown that screw techniques provide higher acute stability than wiring practices. However, many of these methods that use screw fixation in C2 can be technically difficult, especially in cases in which there is an aberrant vertebral artery course or if the C2 pedicle is not large enough to accommodate the instrumentation. A novel technique that uses intralaminar screws in C2 with C1 pedicle screws and bilateral longitudinal rods has been recently developed in an effort to overcome many of these issues. To date, there are no published reports as to whether this new technique provides equivalent (or better) fixation to the currently accepted methods. METHODS: Six fresh-frozen human cadaveric cervical spines (C0-C4) were used in this study. Specimens were tested in their intact condition after destabilization via odontoidectomy, and after implantation of 3 different fixation constructs: (1) the Harms technique, 2 pedicle screws in C2, (2) a single C2 pedicle screw and a single C2 intralaminar screw, and (3) a construct having bilateral intralaminar C2 screws. Pure moment loading in flexion/extension, lateral bending, and axial rotation was applied to the occiput. Subsequent relative intervertebral rotations were determined using a 3 camera system. Range of motion for the intact, destabilized, and 3 fixation scenarios was determined, and statistical analysis was performed using one-way analysis of variance Fisher least-significant-difference post hoc test for multiple comparisons. RESULTS: The data indicate that odontoidectomy significantly increased C1-C2 motion in flexion/extension and lateral bending. All 3 fixation techniques significantly reduced motion compared to the intact and destabilized cases. There were no statistically significant differences between the C2 intralaminar and pedicle screw techniques. CONCLUSIONS: The results clearly indicate the potential of the intralaminar screw technique to provide stability that is equivalent to methods currently used. Given the serious complications that can follow vertebral artery injury and the decreased likelihood of injury by avoiding placement of C2 pedicle screw(s) and C1-C2 transarticular screw(s), strong consideration should be given to using a construct that incorporates C2 intralaminar screw(s).

Atlanto-Axial Joint↗
PubMed2006

Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection.

BACKGROUND: Delayed gastric emptying (DGE) is one of the most troublesome postoperative complications following pancreatic resection. Not only does it contribute considerably to prolonged hospitalization, but it is also associated with increased postoperative morbidity and mortality. METHODS: We performed an electronic and manual search of the international literature for studies dealing with the treatment of DGE following pancreatic resection using the Medline database. The search items used were "delayed gastric emptying," "pancreaticoduodenectomy," "Whipple procedure," "pylorus-preserving pancreaticoduodenectomy," and "complications following pancreatic resection" in various combinations. RESULTS: A number of studies were identified regarding possible therapeutic alternatives for the treatment of DGE. From the class of prokinetic regimens, most studies seem to support the use of erythromycin. However, its use has not gained wide acceptance. Regarding the operative technique, both standard Whipple and pylorus-preserving pancreatic resection carry similar rates of DGE. Billroth II type-like gastrointestinal reconstruction is the most widely accepted method and is associated with lower rates of DGE. Reoperations for managing severe DGE were very rarely reported. CONCLUSIONS: The incidence of DGE in high-volume centers specialized in pancreatic surgery is well below 20%, thus following the improved rates that have been reported in the last decade regarding mortality and length of hospital stay after pancreatic surgery. DGE mandates a uniform definition and method of evaluation to achieve homogeneity among studies. Standardization of the operative technique, as well as "centralizing" pancreatic resections in high-volume centers, should aid to improve the occurrence of this bothersome postoperative complication.

Cisapride↗
PubMed2003

Functional imaging of the pelvic floor.

INTRODUCTION/OBJECTIVE: Pelvic floor dysfunction and associated pelvic organ prolapse represent a major problem in our present-day society, mostly afflicting parous women. Magnetic resonance imaging (MRI) is assuming an increasingly important role in the more accurate delineation of the extent of the problem. This article briefly reviews one of the main radiological methods for the dynamic evaluation of the pelvic floor: functional cine MRI. METHODS AND MATERIAL: Out of the literature the smallest common denominator for functional cine MRI can be defined as follows: high field system; patient either in supine or sitting position; fast gradient echo sequence; midsagittal slice orientation; either a stack of slices or repeated measurements at the same slice position with the patient at rest or straining; image analysis using the pubococcygeal reference line. RESULTS: All except two publications stress the usefulness of functional cine MRI in the evaluation of patients with organ descent and prolapse. This well accepted method allows for the visualization of all relevant structures in the anterior, middle and posterior compartment. It is especially useful in the detection of enteroceles, and provides a reliable postoperative follow-up tool. Isolated urinary or stool incontinence are not an indication for functional cine MRI, as is the case in patients with equivocal clinical findings. To date it does not allow for real 3D imaging of the pelvic floor or sufficient determination of fascial defects. DISCUSSION: Functional cine MRI of the pelvic floor is a promising new imaging method for the detection of organ descent and prolapse in patients with equivocal clinical findings. The combination of function and morphology allows for an innovative view of the pelvic floor, and thus adds to our understanding of the various interactions of the structures.

Female↗
PubMedDate not supplied

Application of a tri-enzyme extraction for total folate determination in foods.

A tri-enzyme digestion procedure using chicken pancreas conjugase, alpha-amylase, and Pronase was evaluated to determine its usefulness in the microbiological quantitation of total folate in foods. Folate values obtained by traditional conjugase digestion were compared to those obtained by the tri-enzyme method for 12 food products that represent diverse matrixes. The tri-enzyme treatment increased measurable folate from most foods when compared to levels found after conjugase digestion. Largest increases were noted for tuna fish (51%) and yogurt (33%) after tri-enzyme digestion. For the 12 foods, a mean increase of 19% in measurable folate was obtained with tri-enzyme treatment. The study shows that traditional conjugase treatment does not completely free folate from complex food matrixes before microbiological analysis. Further, as other investigations have suggested, current accepted methods for folate analysis may be underestimating folate levels in foods.

Animals↗
PubMed2000

[Cholecystectomy with microlaparotomy and innovation of the ROMICRO R-set].

Gallstone disease is a major health problem, 10-15% of the adult population of Hungary are afflicted, and each year about 20,000 cholecystectomies are undertaken. There are two essential and widely accepted methods for the removal of gallbladder: conventional open cholecystectomy and laparoscopic cholecystectomy. Since 1988 the authors worked on a new surgical technique and equipment (ROMICRO R-set) for cholecystectomy using a single 2-4 cm microlaparotomy inside the infrasternal triangle. They demonstrate the innovation's phases of this new technique and ROMICRO R-set. Till 1999 more than 7000 microlaparotomy cholecystectomy were undertaken in Hungary. The benefits of laparoscopic cholecystectomy can be achieved with less expense and risk by microlaparotomy cholecystectomy. Most patients are often not willing to accept conventional open cholecystectomy, but the microlaparotomy cholecystectomy alternative is unknown to the public and to most physicians. All countries have experienced a fast growth in their health care expenses over the last decades which will continue in the future. But spending an ever larger share of our nation's resources on health care cannot be afforded. As a consequence, making choices will became more and more unavoidable, also in galltree surgery. Therefore economic evaluation compares the different techniques of cholecystectomy necessary not only in terms on surgical and on patients aspect, but also in term of costs.

Adult↗