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PubMed2002

Laparoscopic pancreatic surgery: its indications and techniques: from the viewpoint of limiting the indications.

Indications in the field of pancreatic surgery should be limited considering the technical difficulties and the characteristics of pancreatic diseases. Benign or low-grade malignant tumors, including pseudocysts, islet tumors, and cystic tumors, are indications for distal pancreatectomy. Islet tumors such as insulinomas are good candidates for this procedure when they are located near splenic vessels or the main pancreatic duct and enucleation is considered inappropriate. Techniques of laparoscopic distal pancreatectomy with/without splenectomy and laparoscopy-assisted distal pancreatectomy indicated in low-grade malignant tumors such as mucinous cystadenoma are described. Insulinoma is one of the best candidates for enucleation because many of the cases are solitary and benign. The technique of enucleation is also described.

Humans↗
PubMed2002

Indications for full prosthetic disc arthroplasty: a correlation of clinical outcome against a variety of indications.

In this prospective study, a total of 134 prosthetic discs were replaced in 108 patients undergoing total disc replacement surgeries for degenerative disc disease. It was the aim of this study to correlate the clinical findings and the outcome of our patients treated with Prodisc II prostheses for various indications and to formulate indication criteria for disc replacement surgeries. The discs were implanted at L5/S1 in 61 patients, L5/L6 in 3 patients, L4/L5 in 31 patients, L3/L4 in 7 patients, and L2/L3 in 3 patients. There were 12 patients with two-level implants: from L4 to S1 in 11 of them and from L2 to L5 in the remaining one. Two patients also had three-level implants, from L3 to S1. Follow-up evaluation included plain radiographs, physical evaluation, and subjective evaluation by the patient using the Oswestry scale, the visual analog pain scale, and the SF-36V2 well-being questionnaire. The evaluation exercise showed that 90.8% of patients had excellent results, 7.4% had good results and 1.8% had fair results, with no poor results seen. Postoperatively, the average vertebral motion was increased in all patients at the operated level. Progression of disc degeneration at the adjacent levels was noted in ten patients. The average time to resuming activities of daily living unaided was 2.3 weeks. No implant failures or complications due to surgery were encountered in this study. Total prosthesis disc replacement for degenerative disc disease was found to be a good treatment modality, provided proper patient selection and criteria are adhered to. We were able to formulate indication criteria based on this.

Adult↗
PubMed2006

Comparing the response of biochemical indicators (biomarkers) and biological indices to diagnose the ecological impact of an oil spillage in a Mediterranean river (NE Catalunya, Spain).

Three biomarkers of hydrocarbon exposure, liver 7-ethoxyresourfin-O-deethylase activity (EROD), fluorescent hydrocarbon compounds (FACs) in bilis, and the liver antioxidant enzyme catalase (CAT) were examined in the autochthonous fish species Barbus meridionalis collected in the river Fluvià (NE Catalunya, Spain) after an oil spillage. Four different locations were sampled, including the impacted site, upstream and downstream sites and a reference site. Biomarker responses were compared with diatom and macroinvertebrate community assemblage metrics (Specific Pollution Sensitivity index - IPS, and Iberian Biological Monitoring Working Party - IBMWP, respectively). Chemical analyses denoted that polycyclic aromatic hydrocarbon levels in sediment were much higher at the impacted site than in downstream reaches. Four fold increase of EROD activity together with increased levels of biliary FACs in barbs collected at the spilled site indicated exposure of inhabiting fish to the oil. Additionally, CAT activity was significantly depressed (four fold) when compared to other stations, thus suggesting that fish collected from the impacted sites could be more susceptible to suffer oxidative stress. Biological indices (particularly that of the diatom community IPS) showed slight significant effects between control and impacted sites, indicating that more tolerant taxa were favoured because of the oil spillage. These results support the need to include biochemical responses measured in local species in monitoring programmes aimed to diagnose specific pollution effects in stressed river ecosystems.

Animals↗
PubMed2003

Occurrence and densities of bacteriophages proposed as indicators and bacterial indicators in river waters from Europe and South America.

AIMS: To evaluate the feasibility of bacteriophages as a complementary tool for water quality assessment in surface waters from different parts of the globe. METHODS AND RESULTS: Faecal coliform bacteria, enterococci, spores of sulphite-reducing clostridia, somatic coliphages, F-specific RNA bacteriophages and bacteriophages infecting Bacteroides fragilis were determined by standardized methods in raw sewage and in 392 samples of river water from 22 sampling sites in 10 rivers in Argentina, Colombia, France and Spain, which represent very different climatic and socio-economic conditions. The results showed that the indicators studied maintained the same relative densities in the raw sewage from the different areas. Classifying the river water samples according to the content of faecal coliform bacteria, it can be observed that the relative densities of the different bacterial indicators and bacteriophages changed according to the concentration of faecal coliform bacteria. There was a relative increase in the densities of all groups of bacteriophages and sulphite-reducing clostridia with respect to faecal coliforms and enterococci in the samples with low counts of faecal coliform bacteria. CONCLUSIONS: The numbers of bacterial indicators and bacteriophages were similar in the different geographical areas studied. Once released in rivers, the persistence of the different micro-organisms differed significantly. Bacteriophages and spores of sulphite-reducing clostridia persisted longer than faecal coliforms and enterococci. SIGNIFICANCE AND IMPACT OF THE STUDY: Bacteriophages in river water samples provide additional information to that provided by bacteria about the fate of faecal micro-organisms in river water. The easy, fast and cheap methods for phage determination are feasible both in industrialized and developing countries.

Bacteriophages↗
PubMed1995

Balancing science and practice in indicator development: the Maryland Hospital Association Quality Indicator (QI) project.

This paper describes the technical and conceptual aspects in the development of an indicator project to measure hospital performance. Almost a decade ago, a research based--hence explorative, series of inpatient and ambulatory care indicators were developed. This paper describes some of the most fundamental technical and applied knowledge gleaned from the study and applicable to all quality assurance/quality improvement activities. These findings, and the resulting indicator development guiding principles, are based on more than 900 hospitals' experience in the US, Japan, and England. Although this paper presents the necessary scientific underpinning for a valid and reliable analysis, its principal emphasis is on the practical applicability of this decade old research project aimed at measuring select outputs of performance and identifying and explaining the determinants of these outputs.

England↗
PubMed2000

A retrospective analysis of pharmacokinetic/pharmacodynamic indices as indicators of the clinical efficacy of ciprofloxacin.

A retrospective analysis of the relationship between estimated pharmacokinetic/pharmacodynamic indices and the reported efficacy of ciprofloxacin has been carried out using different correlation models. f1.gif" BORDER="0">, T(ss) > MIC, f2.gif" BORDER="0"> and AUIC(ss) were calculated for each clinical case included in the study, from simulated plasma level curves corresponding to the dosage regimen administered. A univariate correlation analysis was performed considering efficacy (%) as the dependent variable and indices as the independent variables according to linear and non-linear pharmacokinetic-pharmacodynamic models (PK-PD models). The results prove that log-transformation of the independent variable improves the data fitting to linear model. The four estimated indices show a log-linear relationship with outcome, T(ss) > MIC and AUIC(ss) being the parameters best correlated with percentage efficacy. The E(max) model with intrinsic response is an additional correlation strategy for T(ss) > MIC, leading to estimated values of E(max) and E(0) of 100.34 +/- 25.09% and 24.40 +/- 11.7%, respectively. The wide range of bacteria responsible for the infections considered, including Gram-positive pathogens such as staphylococci, might explain the good correlation between T(ss) > MIC and percentage efficacy found for ciprofloxacin in this study.

Algorithms↗
PubMed1981

Indices of serum androgens in normal puberty: correlations of two indices with chronological age, bone age and pubertal development in boys and girls.

Two indices of free serum androgenic activity, the normalized androgen ration (NAR) and the free androgen index (FAI) were determined in 218 normal children aged 8-17.9 years. Before the onset of puberty and between chronological age 8 and 11.9 years, NAR and FAI were similar in both sexes, the NAR being less than 0.8 and FAI less than 0.1. In boys mean NAR value increased from 0.87 to 1.39 between 12.5 and 17.5 years, and mean FAI from 0.14 to 1.85 between 12.5 and 17.5 years. In girls mean NAR increased from 0.79 to 0.85 between 12.5 and 15.5 years, and mean FAI from 0.11 to 0.23, between 12.5 and 15.5 years. Both indices did not change significantly between 15.5 and 17.5 years in girls. A rapid increase in NAR and FAI occurred in boys from a mean testicular volume of 4.1 to greater than 20 ml and from genital stage G2+ to 5+. In girls a gradual increase in NAR and FAI occurred from breast stage B2+ to 5+ . Although the androgen indices increased in both sexes between pubic hair stages PH2+ and 6+, the values in girls were always less than in boys at corresponding stages suggesting an increased androgen sensitivity of the female pubic hair follicle during adolescence. The peak rise in NAR and FAI in boys between 13 and 15 years correlated closely with the timing of the pubertal growth spurt in this sex. A similar rise was not seen in girls at the time of their peak growth velocity between 11 and 13 years and suggested that androgens play only a minor or complementary part in the female growth spurt.

Adolescent↗
PubMed1992

Short- and long-term variability of selected indices related to nutritional status. II. Vitamins, lipids, and protein indices.

Five free-living women (ages 23-38 years) who consumed a self-selected diet and five women (ages 23-44 years) residing in a metabolic unit who were fed constant diet were assessed for variation in vitamin and general chemistry indices. Blood was drawn from these women once a month for five months, once a week for five weeks, and once a day for five days to assess analytical and biological variability of the indices. Analytical variability was determined by concurrently analyzing control samples prepared from plasma and serum pools. All samples were analyzed in duplicate. Of the measured indices, vitamins and lipids seemed to be the most variable. Diet had a significant effect only on ascorbic acid. We were unable to show any seasonal change for these analytes. Estimations of analytical variability, along with estimates of biological variability, and knowledge of dietary practices are essential when interpreting differences in analytes.

Adult↗
PubMedDate not supplied

[Is a radial nerve paralysis in a humeral shaft fracture an indication for surgery? Indications].

Surgery for humeral shaft fractures. A series of 78 operative treated humeral shaft fractures was studied retrospectively. Sixteen times we found a radial nerve palsy, preoperatively. In this group we evaluated the type of fracture, the operation indication, the time of treatment and the postoperative recovery of the radial nerve palsy. Fourteen times we did an early exploration. The indication to operate was 9 times the conducting polytrauma, 5 times the radial nerve palsy itself and 2 times a pseudarthrosis. In 13 of the 16 patients nerve function recovered either clinically and/or electromyographically. This study confirms that radial nerve palsy is found especially in fractures located at the junction of the middle and the lower third of the humeral shaft. Because we found nearly always a macroscopically lesion of the nerve in this type of fracture, we recommend an early exploration in spiroid fractures at that junction. For the same reason we advise an early exploration in cases of secondary radial nerve palsy. If no other indication to operate occurs, we accept a conservative treatment of the humeral fracture with radial palsy.

Adult↗
PubMed1986

[Induced labor. Indications and contra-indications].

The authors report all present and future indications of the induction of a term delivery, as well as their contra-indications. They present their experience in prophylactic delivery, and propose a comparative study of the incidence in the recent literature of the main indications of induction.

Female↗
PubMedDate not supplied

[The main indications for crenotherapy, its contra-indications].

The current and recent development in indications for the thermal treatment is linked with certain characteristics of current therapeutics, the appearance of new clinical motives for prescribing the treatment, the quantitative and qualitative increase in the pathological symptoms known as "civilizational disorders", the extension of life-span and thus an increase in the number of sage-linked complaints. The author also mentions the time to be appointed for the treatment, its ultimately preventive nature, and the problem of indication with regard to age. Crenotherapy is still the treatment indicated in the case of the sequels to certain acute disorders, the initial period of chronic organic disorders, functional troubles, and morbid or allergic predispositions.

Balneology↗
PubMed1994

A new colorimetric breath indicator (Colibri). A comparison of the performance of two carbon dioxide indicators.

Colorimetric carbon dioxide indicators are designed for the verification of satisfactory tracheal tube placement. However, widespread use of the device in this and other applications is hampered by limitations in its performance characteristics. A new colorimetric breath indicator (Colibri) has been developed that overcomes major shortcomings of current technology. A simple method is described that can be used to evaluate the properties of colorimetric carbon dioxide indicators in a quantitative way.

Breath Tests↗
PubMed1999

1997 Peritoneal Dialysis-Core Indicators Study: Dialysis Adequacy and Nutritional Indicators Report.

The 1997 Peritoneal Dialysis-Core Indicators Study: Dialysis Adequacy and Nutritional Indicators Report documents the current status of peritoneal dialysis within the United States. A national random sample of adult peritoneal dialysis (PD) patients participating in the United States End Stage Renal Disease (ESRD) program was surveyed. PD subjects were large, with a mean body weight of 76 +/- 18.9 kg (mean +/- 1 SD) and a body mass index (BMI) of 27 +/- 6.4. The dialysis prescriptions documented achieved a mean weekly Kt/Vurea (wKt/V) and weekly creatinine clearance (wCrCl) of 2. 45 +/- 2.29 and 65.5 +/- 35.2 L/wk/1.73m2, respectively. The serum albumin of these patients was 3.5 +/- 0.48 g/dL, their normalized protein equivalent of nitrogen appearance (nPNA) 1.0 +/- 0.63 g/kg/d, and their normalized creatinine appearance rate (nCAR) 14 +/- 6.0 mg/kg/d. Serum albumin correlated meagerly but in a positive fashion with BMI, nPNA, and nCAR, and negatively with wCrCl. Among adult US PD patients, serum albumin values appear to correlate poorly with alternative measures of nutritional status and are inversely related to the intensity of renal replacement therapy. The presumptive dietary protein intake (nPNA) and creatinine appearance rate (nCAR) derived for PD patients do correlate in a positive fashion with dialysis delivery, at least up to a wCrCl of 60 to 80 L/wk/1.73 m2 and wKt/V = 2.1, but their values suggest that 30% to 50% of PD patients have marginal nutritional status.

Adolescent↗
PubMed1990

[The effect of pesticides on health indices and the test indicators for their determination].

It is suggested that causal-sequel relationships of the levels of morbidity and functional changes in the health condition of the population reflect the intensity in the use of pesticides and are locally manifested in conditions of extreme loads of pesticides. The authors distinguish priority unspecific tests-indicators according to nosological entities of pathology and indices of the functional state of the body that may be recommended for systemic evaluation of links with territorial loads of pesticides and for providing information in the monitoring of the health of the population in regions of intensive use of agrochemical agents.

Adolescent↗
PubMedDate not supplied

DNA adduct formation by mineral oils and their fractions as indicated by 32P-postlabelling: is adduct formation truly indicative of carcinogenic potential?

Oils of differing types, physical properties and carcinogenic activity were tested for ability to produce epidermal DNA adducts 24 h after application to the skin of mice, using the 32P-postlabelling method. Two studies were carried out, the first on three oils to identify the adduct-forming components, and the second on nine oils to investigate whether the nature of the oils affected their adduct-forming potential. In addition to the whole oils, fractions of the oils containing saturated hydrocarbons, 2-6-ring aromatic compounds and polar compounds were tested in both studies in proportion to their concentration in the original oil. In addition, a further examination of the aromatic fractions from two carcinogenic oils was carried out in the first study by testing 2-3-ring and 4-6-ring subfractions (the latter containing carcinogenic polycyclic aromatic compounds (PACs)). Results from the first study indicated that carcinogenic oils do produce adducts and that the adduct-forming components were mainly in the aromatic fraction. When, however, subfractions of the aromatic fraction were examined, it was found that slightly higher adduct levels were produced by the 2-3-ring aromatic fraction than with the 4-6-ring PAC fraction. This was contrary to expectation from published work on the skin carcinogenicity of oils and suggested that some non-carcinogenic PACs may produce adducts. The second study indicated that although most carcinogenic oils produced adducts, some non-carcinogenic oils can also do so.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Simulation of titration curves indicated with two indicator electrodes (biamperometry).

A rigorous method to simulate titration curves with indication using two indicator electrodes (biamperometry) is presented. Computer simulations can be carried out for reversible as well as for irreversible systems. The different parameters like the area of the individual electrodes, applied potential difference, heterogeneous rate constant, and the kinetic parameter alpha were varied and investigated as to their influence upon the shape of the titration curves. The theoretically derived effects match with the effects obtained by experiment. Considering the effects described here, it is possible to tailor the shape of the titration curve by the experimental conditions for specific applications in order to get an optimum shape at the end point of the titration.

Journal Article↗
PubMed2003

Indications for surgical repair of funnel chest based on indices of chest wall deformity and psychological state.

PURPOSE: We examined the surgical indications for funnel chest, taking psychological factors into consideration. METHODS: We assessed 36 young people with funnel chest who were seen as outpatients, including 31 boys and 5 girls aged from 1 to 22 years old. Respondents were asked whether they suffered psychological distress, and if they wanted surgery. The severity of the deformity was evaluated using the Vertebral Index (VI) and the Frontosagittal Index (FSI) calculated from chest roentgenograms. RESULTS: The VI in 11 patients without distress (23.7 +/- 4.1) was lower than that in 25 patients with distress (32.8 +/- 8.2), and the FSI in the patients without distress (33.5 +/- 5.3) was higher than that in the patients with distress (23.6 +/- 8.6). The VI in 19 patients who did not want surgery (26.9 +/- 7.9) was lower than that in 17 patients who did (33.5 +/- 7.5), and the FSI in the patients who did not want surgery (30.4 +/- 8.1) was higher than that in the patients who did (22.4 +/- 8.1). The distressed patients suffered many psychological problems, such as being the object of bullying. CONCLUSION: The severity of the deformity affected the patient's psychological state. We consider that a VI >28 or an FSI <28 are indications for surgery, based on the mean VI + SD and the mean FSI-SD of patients not suffering distress.

Adolescent↗
PubMed2003

Stapled haemorrhoidopexy: a consensus position paper by an international working party - indications, contra-indications and technique.

An international working party with experience in the performance of an alternative haemorrhoid operation through the use of the circular stapler was convened for the purpose of developing a consensus as to the criteria for undertaking this procedure. The agenda consisted of first, naming the operation; second, the indications and contra-indications for its performance; and third, the preferred surgical technique. Among the recommendations for individuals who plan to embark on this surgery are that experience with anorectal surgery and an understanding of anorectal anatomy are requisites; experience with circular stapling devices is essential; and the surgeon must attend a formal course which should include lectures, videos, the application of the instrument in models, and observation of the operation as performed by a surgeon recognized by his or her peers-leading ultimately to undertaking the procedure while being observed by an experienced surgeon. Following satisfactory completion of the above, independent responsibility should be determined by an individual's department of surgery.

Digestive System Surgical Procedures↗