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At least 829 records · Page 46Linked to original sources
PubMed2004

Rhinopharynx endoscopy in the diagnosis of chronic otitis media with effusion in infancy.

Chronic otitis media with effusion is an inflammatory process of the mucosa of the middle ear persisting for more than 3 months, being most frequent in infancy, and is correlated with marked tube obstruction. In infancy, the most frequent cause of this obstruction is adenoid hypertrophy and diagnosis, clinical or radiological, is often not confirmed by rhinopharynx fiberendoscopy. Since, in these cases, treatment is often surgical, it is possible that small patients may be submitted, unnecessarily, to adenoidectomy. In collaboration with the Paediatric Clinic, the present study on an infant outpatient population with nasal respiratory difficulty, associated with chronic otitis media with effusion, was, therefore, aimed at standardizing the endoscopic diagnosis of patients with suspected adenoid hypertrophy. Between October and December 2002, 32 consecutive patients, aged between 4 and 11 years, all oral breathers with OME, were sent to our attention from the Paediatric Clinic. All those patients, with indication for adenoidectomy, have been enrolled in the study and submitted to fiberendoscopic examination of the external ear and nose. Nasal respiration was confirmed with active anterior rhinomanometry. Endoscopic evaluation of the rhinopharynx, aimed at assessing adenoid dimensions and their relationship with the auditory tube, has been expressed in four degrees of increasing severity and adenoidectomy was indicated in those cases, classified, by us, as third and fourth degree. In our experience, endoscopic examination of the rhinopharynx has, however, shown that only 9 children (28.2%) presented an absolute need to undergo adenoidectomy since they were carriers of massive adenoid hypertrophy with tubal obstruction and consequent bilateral glue ear (3rd and 4th degree) while, in all other cases (71.8%), the clinical and radiological findings did not correspond to endoscopic data. Diagnostic accuracy that characterizes rhinopharyngeal fiberendoscopy is, therefore, in our opinion, of fundamental importance to avoid these errors, as far as possible, and in establishing an appropriate therapeutic programme.

Adenoidectomy↗
PubMed2005

An outbreak of leptospirosis, Thailand--the importance of the laboratory.

The reported incidence of leptospirosis increased 30-fold in Thailand between 1995 and 2000. Despite many hypotheses to explain the increase, the true etiology remains unknown. We conducted a review of the national surveillance system for leptospirosis, examining the reporting practices, system attributes, and utilization of laboratory confirmation in two northeastern provinces. Using standard guidelines for evaluation of public health surveillance systems, we assessed the timeliness, completeness, and accuracy of data; the sensitivity and specificity of case ascertainment; and the overall usefulness of the Thai leptospirosis surveillance system. Physicians were interviewed to assess compliance and understanding of the case definition. Capacity for confirmation of leptospirosis by a Thai latex agglutination test was assessed. Completeness for variables critical for linking epidemiologic and laboratory data for leptospirosis was 69%. Twenty-eight percent of 208 provincial surveillance reports were considered timely. Interviewed physicians indicated that the national case definition was difficult to understand and apply, and that laboratory confirmation was infrequently used. Compared to a standardized microscopic agglutination test (MAT) panel, the Thai test was specific, but relatively insensitive. We found that a lack of a standardized case definition for leptospirosis, the infrequent use of confirmatory laboratory testing, and the inability to link clinical, epidemiologic, and laboratory data hindered system utility. This surveillance system for leptospirosis highlights difficulties with surveillance of febrile illnesses in general, and the importance of laboratory confirmation for infections that are difficult to diagnose clinically.

Centers for Disease Control and Prevention, U.S.↗
PubMed2005

A Multi-Source Information System via the Internet for End-Stage Renal Disease: Scalability and Data Quality.

A Multi-Source Information System (MSIS), has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease (ESRD). MSIS aims at providing reliable follow-up data for ESRD patients. It is based on an n-tier architecture, made out of a universal client, a dynamic Web server connected to a production database and to a data warehouse. MSIS is operational since 2002 and progressively deployed in 9 regions in France. It includes 11,500 patients. MSIS facilitates documenting medical events which occur during the course of ESRD patient' health care and provides means to control the quality of each patient's record and reconstruct the patient trajectory of care. Consolidated data are made available to a data warehouse and to a geographic information system for analysis and data representation in support of public-health decision making.

Data Accuracy↗
PubMed1990

Reviewing the research process for postanesthesia care unit studies.

Research studies are needed by and for nurses to validate nursing practice. PACU nurses are in an excellent position to validate PACU nursing practice through research studies that seek solutions to patient problems. Research ideas also may be derived from formal and informal discussions at professional meetings, by testing new products, and reviewing the literature; however, precise steps must be followed to assure accuracy of data collection and the interpretation of the results.

Clinical Nursing Research↗
PubMed1991

The relationship between fetal biophysical assessment, umbilical artery velocimetry, and fetal acidosis.

In a prospective study of 62 patients undergoing cesarean delivery before the onset of labor, fetal biophysical assessment and umbilical artery systolic-diastolic ratios (S/Ds) were performed within 3 hours of delivery. There was a significant relationship between the fetal biophysical profile score and cord arterial as well as cord venous pH. However, there was no identifiable relationship between S/D and cord arterial or venous pH. The efficacies of the biophysical components alone (nonstress test [NST] and fetal biophysical profile) and in combination with S/D to predict fetal acidosis were determined. The NST had the best sensitivity (100%) and negative predictive value (100%). The fetal biophysical profile had the best specificity (91%), positive predictive value (62%), and overall efficiency (90%). The S/D had the lowest sensitivity (66%), specificity (42%), positive predictive value (16%), negative predictive value (88%), and overall efficiency (45%). The addition of S/D to the NST or fetal biophysical profile did not improve diagnostic accuracy. These data suggest that the NST should be used as a primary test for the antepartum detection of fetal acidosis, whereas the fetal biophysical profile is a reasonable adjunct test. The umbilical artery S/D, as determined by continuous-wave Doppler velocimetry, has no value as a primary method or an adjunct in the antepartum detection of fetal acidosis.

Acidosis↗
PubMedDate not supplied

[Analysis of the serum concentration of pregnancy protein-1 (SP-1) offers no advantage in comparison with menstrual anamnesis and ultrasound biometry in determining gestational age].

In 69 patients with normal pregnancy the estimated day of confinement (EDC) was determined by three different methods (last menstrual period = LMP, ultrasound, and determination of Schwangerschaftsprotein-1 (SP-1) serum concentration). Ultrasound and LMP were shown to predict the EDC with approximately the same accuracy. While data obtained by LMP were scattered a little bit more around the mean value, data obtained by ultrasound tended to underestimate the EDC slightly. Determination of SP-1 serum concentration had the lowest predictive value in assessing the EDC. Accordingly, we don't consider routine SP-1 determinations to be a useful test in antenatal care.

Female↗
PubMed1989

Computerizing the intensive care unit: current status and future directions.

Computers are serving intensive care patients by simplifying and improving the accuracy of data acquisition, facilitating communications, storing and organizing patient records, and providing expert suggestions. The future will bring many changes in the way nurses practice in intensive care. The computer should be considered an evolutionary tool to help effect these changes.

Communication↗
PubMed1989

[Basic study on MRI guided stereotaxic surgery].

In 1987, we started MRI guided stereotaxic surgery using BRW-MRI apparatus. As distortion of image had been noted around the periphery of MRI due to the characteristic static magnetic field, we examined accuracy of data before clinical application. The MRI machine was a MRT-15A, 0.15 Tesla resistive type made by Toshiba. The stereotaxic apparatus consisted of a head ring, which was fixed to the patient's head, a cubical localizer frame which was attached to the head ring for the scanning phase, and a programmed computer. The localizer frame had multitubular channels, which could be fixed and drained easily with whatever paramagnetic fluid was desired. Since the beginning of our use of the instrument, we have used petroleum jelly. This material produced sufficient localizer image for us to fully determine any MRI scan plane. Once the MRI scan target had been identified, it could be approached stereotaxically in a same way as was done in the CT-related one. In the examination, at first, we studied the MRI image of a grid phantom, or the localizer frame placed on the center of the magnetic field. In the MRI, distortion of the image was seen only at the periphery of the Z axis. Secondly, we calculated the three-dimensional coordinates of the center of tumors in axial, coronal and sagittal images for correlation. But, the target values did not differ by over 5.1 mm. Therefore we concluded that the distortion of the image had minimum effect on surgery. Thirteen surgical operations were performed for brain tumors. Among these surgical interventions biopsy alone was performed in 8 cases, and biopsy combined with brachytherapy was performed in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Brachytherapy↗
PubMed1987

Effects of varying geometry on dose calibrator response: cobalt-57 and technetium-99m.

A joint project between the National Bureau of Standards (NBS) and Biomedical Products Department, E.I. du Pont de Nemours and Company, Inc. compared the indicated activity of (a) cobalt-57 samples in NBS 5-ml ampoules, plastic syringes, Du Pont 27-ml Vial E epoxy- and solution-filled containers, and (b) technetium-99m solutions in NBS 5-ml ampoules, elution vials, and syringes. The measurements were made in ionization chambers from two manufacturers, Capintec and Radcal. The main objective was to examine the use of radionuclides in NBS ampoules and Du Pont Vial E containers as suitable reference sources for ionization chambers used to assay radiopharmaceuticals in elution vials and syringes. The exercise illustrated that regardless of the brand of dose calibrator used, a calibration factor for each geometry should be determined to ensure the highest accuracy. The data show that as much as a 9% difference from the correct activity can be observed for these radionuclides, even when the ampoule reference source gives the appropriate reading.

Calibration↗
PubMed1985

Statistical software packages for physical therapists. STATPAK for the IBM PC.

If you have modestly sized files, modest computing requirements, and only a modest budget, look into STATPAK. Despite the limitations of STATPAK's computational accuracy, data-entry capabilities, and file-size restrictions. It is a package that provides many of the more frequently required statistical routines in physical therapy research. Besides, who knows when you'll need Fourier-transformed nonlinear correlations! Be prepared to spend an evening or two getting used to the cryptic program descriptions. Perhaps a future version will contain a tutorial with sample data to help the beginner get started; a general linear-model routine to permit ANOVAs on unbalanced Ns, assess multivariate hypotheses, and test the compound-symmetry assumption of repeated measured ANOVA would also be welcome. I would first recommend, however, that the documentation problems be addressed; at least let us find "Graphics" or "Chart" in the index, without having to guess that we should look under "Plot"!

Computers↗
PubMed1986

4 p.m. baseline cortisol level as a predictor of DST results in depression.

To assess the relationship of baseline cortisol to the 1 mg dexamethasone suppression test (DST), 4 p.m. baseline and 4 p.m. postdexamethasone blood samples were drawn on 52 consecutive depressed outpatients. Baseline cortisol correlated significantly with post-DST values, and baseline levels above 15 micrograms/dl predicted DST nonsuppression with 90.4% accuracy. These data lend some support to the usefulness of baseline cortisol determination in depressed outpatients in whom a full DST may be difficult.

Ambulatory Care↗
PubMed1985

Reproductive efficiency and calf survival in Ontario beef cow-calf herds: a cross-sectional mail survey.

A survey of the efficiency of production of Ontario beef cow-calf herds was conducted using a stratified systematic random sample of Ontario producers. In general, about 87% of females exposed to breeding produced a live calf and 6% of these died before reaching four weeks of age. The herd to herd variation in these rates was quite large, the coefficient of variation being about 17%. The stillbirth rate was 1.7% and the abortion rate 1.2%. In general, herds in northern Ontario and herds whose owners kept breeding and calving records, had reduced livebirth rates, the latter probably reflecting accuracy of data. Herds with a restricted (less than three months) breeding season had increased livebirth rates. Herds using injectable vitamins ADE, and prophylactic antibiotics, had increased neonatal losses. Herds with a restricted calving season (less than or equal to 3 months) and/or feeding free choice salt to cows had decreased neonatal losses. Herdsize and calf mortality rate were directly related, but this did not appear to be due to increased density of cows at calving time. In herds, where calving occurred during the spring, using scour vaccines in calves was associated with increased calf mortality.

Abortion, Veterinary↗
PubMed1985

Bar codes and their potential applications in hospital pharmacy.

The technology and terminology of bar codes, the Health Industry Bar Code (HIBC) Standard, issues facing the pharmaceutical industry with respect to bar codes, and potential applications of bar codes in hospital pharmacy are reviewed. Bar codes consist of a series of parallel alternating dark lines and empty spaces. Commonly used bar codes include UPC (Universal Product Code), Interleaved 2 of 5, Codabar, Code 93, Code 128, and Code 39. There are several different types of scanners that may be used for scanning bar codes. Some of the variable features are portability, contact and noncontact, autodiscrimination, and the presence of numeric keypads. The HIBC Council (HIBCC) is a steering committee charged with developing bar-code standards for health care, assigning identification numbers to manufacturers, and providing information to interested individuals. The HIBCC Board includes representatives from health-care providers, equipment manufacturers, drug manufacturers, and wholesalers. Drug manufacturers are concerned about several issues with regard to bar codes; for example, who will pay for the cost of implementation, on what level of packaging will the bar codes be required, and are there legal implications if a poor scan results in patient harm? Bar codes have already been applied in some hospitals for coding blood containers, roentgenogram jackets, medical records, and capital equipment. The potential applications in hospital pharmacy include inventory control, verifying the accuracy of dispensing to both inpatients and outpatients, and record keeping for drug product expiration or disposal. Bar codes also offer pharmacists the ability to perform in-process dispensing controls that are not practical to perform manually. Bar-code technology offers health-care personnel the opportunity to improve work efficiency and increase the accuracy of data entry into automated systems.

Computers↗
PubMedDate not supplied

Investigational trials of anticancer drugs: establishing safeguards for experimentation.

The National Cancer Institute since 1955 has been charged with responsibility for discovering new anti-cancer agents and bringing them to clinical trial. These activities are carried out by NCI's Developmental Therapeutics Program, which has established systems for discovery, experimental testing, bulk synthesis, formulation, and toxicological testing of candidate drugs, and by the Cancer Therapy Evaluation Program, which conducts initial trials to establish safe doses of new agents and to determine their utility in treating specific forms of cancer. These clinical trials are conducted both at NCI in Bethesda, Md., and at selected cancer centers throughout the United States. This paper describes the safeguards that NCI has built into the clinical trials system in the past decade-safeguards that ensure the safety of patients and the accuracy of data collected and at the same time allow efficient testing of each promising new agent in the fight against cancer. Recent improvements in cancer survival leave little doubt that patients are indeed benefiting from extensive efforts to discover and develop new drugs for cancer treatment.

Antineoplastic Agents↗
PubMedDate not supplied

Dynamic auditory localization by normal and learning disability children.

Twenty children from regular classrooms and 20 children from self-contained, learning disability classrooms tracked four different acoustic stimuli through three fixed paths in space. An apparatus specifically designed to provide objective data on accuracy of tracking was used. The results showed that learning disability children as a group were inferior in their abilities to follow a moving speech signal and a moving white noise. The position of the target with respect to the listeners' midlines affected accuracy of tracking, but this was not a function of the hand used to control the pointer.

Acoustic Stimulation↗
PubMed1983

A computerized dietary order entry system.

The Dietary Order Entry System is a computerized system which instantaneously communicates orders/messages from the patient care units to the floor diet offices. The system also produces up-to-date management reports such as diet lists and diet census at pre-determined times and on demand. Dietary and nursing personnel believe it is an extremely beneficial system in terms of both increased accuracy of data and time savings in transmission of information. We believe that improved patient care will result from this improved method of diet ordering.

Computers↗