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At least 1,009 records · Page 56Linked to original sources
PubMed2005

[Follow up of traumatic brain injury sequels in war victims].

Most evaluation scales used in the follow up of war victims with traumatic brain injury used to date have been focused on physical disability rather than psychological and social dimensions of the handicap. The aim of this study was to assess the applicability of the European Head Injury Evaluation Chart (EHIEC) in the follow up of traumatic brain injury in patients attending the War Veterans Rehabilitation Center in Osijek. The study included 20 patients with traumatic brain injury sustained during the war in Croatia and their families. The EHIEC form was filled out by a professional examiner using data from the patient's medical records and those obtained by evaluation of the patient's physical, mental and social status on his first visit to the Center. Study results showed the majority of these patients to suffer relatively moderate disability consequential to traumatic head injury (mild to moderate hemiparesis, moderate chronic pain, attention impairment, and frequent affective disorder such as depression and anxiety). The patients had significantly reduced capacity for work and impaired community adaptation. However, EHIEC questionnaire was found to suffer from some shortcomings, including time-consuming procedure, problems with interpretation of answers, and inadequate adaptability to local social service. Additional studies are needed to evaluate the questionnaire applicability to outpatient follow up of individuals with traumatic head injury.

Activities of Daily Living↗
PubMed2005

[Coronary reperfusion in acute myocardial infarction].

The efficacy of coronary reperfusion in acute myocardial infarction has been established for over twenty years. Its results can be further improved by refining both fibrinolytic therapy and angioplasty, but even more so by earlier treatment of larger numbers of patients thanks to the organisation and continuous evaluation of inter-disciplinary networks specially adapted to local needs.

Angioplasty, Balloon↗
PubMed2005

[Treatment and follow up protocol in differentiated thyroid carcinomas of follicular origin].

Differentiated thyroid carcinoma of follicular origin (DTCFO), although not very frequent, has registered a raising incidence in the last decades. In the majority of the cases, DTCFO is a curable disease when treated and monitored by experienced, multidisciplinary teams. These factors contribute to an increasing number of DTCFO survivors requiring life-long monitoring, due to the possibility of occurrence of recurrences many years after the initial treatment. Several aspects of the treatment and management of these patients are still controversial. The present protocol represents the consensus of the members of the Grupo de Estudo da Tiróide of the Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. It aims to define guidelines, in agreement with the current state of the art and contemplating the necessary adaptations to local constrains, that ensure decreased mortality and protection of patients' quality of life, avoiding unnecessarily aggressive or ineffective treatments, optimizing the use of the available resources.

Clinical Protocols↗
PubMed2005

Early intervention surveillance strategies (EISS) in dental student clinical performance: a mathematical approach.

Graduating dental practitioners requires the mastery of a number of skills and a significant body of basic information. Dental education is a complex combination of didactic and physical skill learning processes. It is necessary to develop appropriate tools to measure student clinical performance to allow the provision of interventional strategies at the right time targeted at the right individuals. In this study, an approach to early intervention surveillance strategies was developed that is cost-effective, transparent, and robust based on mathematical predictions of student clinical achievements. Using a cohort of students' clinical activity profile, a polynomial pair was developed that represents the predictive function of low and high achieving students. This polynomial pair can then be applied to students to predict their final achievement based on their current status. The polynomial methodology is adaptable to local variation such as access to clinical facilities. The early intervention surveillance strategy developed in this study provides a simple, cost-effective, predictive risk assessment system that relies on data sets already collected in most dental schools and can be completed without the need for significant human intervention. The mathematical approach allows the focusing of educational support towards students that require the assistance, thus augmenting the better use of resources.

Achievement↗
PubMed2006

Obstacles to the implementation of directly observed treatment in Ouagadougou, Burkina Faso.

SETTING: Five tuberculosis (TB) diagnosis and treatment centres in Ouagadougou, Burkina Faso. OBJECTIVE: To identify obstacles to the direct observation of anti-tuberculosis treatment (DOT) so that it can be adapted to local contexts. DESIGN: A cross-sectional study conducted between August and September 2002 among new and retreatment TB cases in the initial phase of treatment. Information and suggestions were collected on obstacles encountered in DOT. RESULTS: Among 74 patients interviewed, the main difficulties were the lack of assiduity among health personnel, the daily travel, the long distances, the high transportation costs and the high number of tablets. The main suggestions were a reduction in the number of tablets taken at a time, decentralisation of places where tablets are to be taken and weekly provision of drugs. CONCLUSION: Obstacles to DOT should be addressed to optimise the effectiveness of anti-tuberculosis treatment.

Adolescent↗
PubMed1991

[A new approach to polygene mapping. Localization of genes, controlling the adaptation level of closely related lines of Drosophila melanogaster].

The phenomenon of hitch-hiking of dispersed mobile elements (molecular markers) is proposed as a new approach to polygene mapping. Retrotransposons MDG1 and copia are used as molecular markers to reveal chromosome 2 segments controlling high fitness level in Drosophila melanogaster. Comparison of closely related Drosophila melanogaster stocks with different fitness level demonstrates the role of pericentromeric region of chromosome 2 in the control of adaptive value.

Animals↗
PubMed1995

Refocusing the adolescent preparticipation physical evaluation toward preventive health care.

The traditional preparticipation physical evaluation has come under much scrutiny by sports medicine physicians in recent years, following a number of studies that have found it to be of low yield and not cost effective. There is a general consensus among these researchers that a refocused preparticipation physical evaluation presents an excellent opportunity for health education. In this article, I review recent research that shows that the traditional "head-to-toe" physical exam is unnecessary and is more effectively replaced by a detailed history and focused physical exam. I present current epidemiologic and sociologic data that is pertinent to all health care professionals working with adolescents. Various methods to uncover potential problem areas in the young athletes' lives are also discussed. Each format may be adapted to local or community standards and needs. The approach to the preparticipation physical evaluation presented in the article allows athletic trainers to have an active role in the most important aspect of health care: the prevention of disease and injury.

Journal Article↗
PubMed2006

An analysis of continent-wide patterns of sexual selection in a passerine bird.

Patterns of selection are widely believed to differ geographically, causing adaptation to local environmental conditions. However, few studies have investigated patterns of phenotypic selection across large spatial scales. We quantified the intensity of selection on morphology in a monogamous passerine bird, the barn swallow Hirundo rustica, using 6495 adults from 22 populations distributed across Europe and North Africa. According to the classical Darwin-Fisher mechanism of sexual selection in monogamous species, two important components of fitness due to sexual selection are the advantages that the most attractive males acquire by starting to breed early and their high annual fecundity. We estimated directional selection differentials on tail length (a secondary sexual character) and directional selection gradients after controlling for correlated selection on wing length and tarsus length with respect to these two fitness components. Phenotype and fitness components differed significantly among populations for which estimates were available for more than a single year. Likewise, selection differentials and selection gradients differed significantly among populations for tail length, but not for the other two characters. Sexual selection differentials differed significantly from zero across populations for tail length, particularly in males. Controlling statistically for the effects of age reduced the intensity of selection by 60 to 81%, although corrected and uncorrected estimates were strongly positively correlated. Selection differentials and gradients for tail length were positively correlated between the sexes among populations for selection acting on breeding date, but not for fecundity selection. The intensity of selection with respect to breeding date and fecundity were significantly correlated for tail length across populations. Sexual size dimorphism in tail length was significantly correlated with selection differentials with respect to breeding date for tail length in male barn swallows across populations. These findings suggest that patterns of sexual selection are consistent across large geographical scales, but also that they vary among populations. In addition, geographical patterns of phenotypic selection predict current patterns of phenotypic variation among populations, suggesting that consistent patterns of selection have been present for considerable amounts of time.

Age Factors↗
PubMed2006

Human cortical bone: Computer method for physical behavior at nano scale constant pressure assumption.

It is well known that long term behavior of implants depends on bone remodeling. In the absence of a model of this phenomenon, few numerical simulations take into account bone remodeling. Some laws have been proposed but they cannot be used in the essential area surrounding the implant. We propose a multi-scale approach: cortical bone is structured in a hierarchical way consisting of five levels. The cortical part of a given bone is made up of various areas having different physical properties adapted to locally existing conditions. A Bony Elementary Volume denotes the elementary part of such a zone which constitutes our first level. The other levels are in conformity with our previous studies: osteon, lamella, fibre and fibril. This latter is composed by collagen and hydroxyapatite (Hap) occurring in a viscous liquid containing mineral ions. Mathematical homogenisation theory is used to determine equivalent macroscopic properties of a BEV, knowing the physical properties of collagen and Hap and the architectural description of this bony structure. For improving the performance of our simulation software, a new behavior law has been introduced with no continuity between the various levels. The effect of the fluid at the nanoscopic scale is modeled by a constant pressure. Recent developments allow us to determine the magnitude of various entities at nanoscopic scale from information at the macroscopic level. Realized simulations show that the assumption of constant pressure is not sufficient to characterize the nanoscopic mechanical behaviour. This point needs a more complex model with the introduction of a coupling between structure and fluid. This aspect is in development.

Biocompatible Materials↗
PubMed2006

With good Intentions.

The use of intentions in computer-based guidelines may help to make them more flexible, easier to adapt to local standards, easier to evaluate and to improve. We see possibilities of using intentions in several areas: as a generator of actions which could be performed and then compared with the decision of the physician, as a method for pruning proposed actions based on current and previous patient data. In this contribution we present our approach to intention-based guidelines.

Decision Support Systems, Clinical↗
PubMed1991

Serum hippurate and its excretion in conservatively treated and dialysed patients with chronic renal failure.

54 healthy volunteers or patients with normal kidney and liver function, 17 patients with decreased kidney function and 12 dialysed patients were evaluated for their serum hippurate accumulation and kidney excretion. It was found that there was an inverse relationship between serum hippurate and the clearance of endogenous creatinine (CCr) and a free relationship between fractional excretion of hippurate and CCr. The excretory capacity in residual nephrons was increased. This was caused by the greater glomerular filtration load which increased up to 25 times and tubular secretion which increased 7 times in dialysed patients. The relative contribution of glomerular filtration to hippurate excretion rose from about 20% in controls to almost 50% in dialysed patients. True kidney adaptation was localized in the organic anion transport system of proximal tubules.

Hippurates↗
PubMed1991

Health care in the developing world: need for appropriate laboratory technology.

Health care technology is rapidly advancing, and the development of equipment based on new principles has had a strong impact on laboratory services in Western countries. The use of such technologies frequently creates problems in countries of the Third World, because the effects of several interacting elements are not always taken into account. Not only technical factors but also socioeconomic and political factors, as well as differences in diseases in developing countries, must be considered. Standardization of equipment and methodology, and adaptation to local health systems, will facilitate improvement of laboratory services. Training and incentives for local initiatives are fundamental elements for the provision of cost-effective health care.

Africa↗
PubMed1991

[Repair surgery in the treatment of cancer of the cervical remnant].

The protocol recommended at the Centre Alexis Vautrin for the treatment of cancer of the cervical remnant is purely radiographic. The authors investigates repair surgery after the failure of radiotherapy in 8 cases, representing 9.3% of cases. He defines cancer of the cervical remnant by stressing the importance of a particularly difficult assessment of the extension and the methods of treatment. The series included 5 cases of cervicocolpectomies and 3 pelvic exenterations. The context was particularly unfavorable since the tumor had been irradiated and had developed a scarred region. Serious complications were not present in this series, but they should be recognized so that they can be prevented and some procedures adapted to local conditions, which include bladder, rectal and ureteral fistulae, occlusion and pelvic abscess. The rationale for surgery is based on the possibility of a cure and the prevention of locoregional progress which may be particularly painful and handicapping.

Adenocarcinoma↗
PubMed1990

[Stimulation at home and psychological profile of mothers of children with or without weight loss during the first 15 days of life].

OBJECTIVES: To determine the possible difference of the microenvironment of a group of children who lost weight in their first 15 days of life. DESIGN: Longitudinal ecological study of growth and development of a total cohort of all children born during a calendar year. SETTING: Rural village of Central Mexico. PARTICIPANTS: A group of sixteen children, who fifteen days after birth and without apparent reason, showed a decrease in weight as compared with weight at birth, they were compared with a control group from the same population and matched, case by case, according to gestation age, height at the time of birth, and body weight. MEASUREMENT AND MAIN RESULTS: To assess the influence of microenvironmental factors two indicators were used. Recording and scoring of maternal behavior was done by adaptation to local conditions by Cravioto et al, of the Maternal Behavior Profile developed by Nancy Bayley. The instrument used for estimating home stimulation was the inventory developed by Caldwell design to sample certain aspects of the quantity and/quality of social, emotional, and cognitive stimulation available to a young child within his home. No significant differences were found in relation to Maternal Behavior Profile and Home Stimulation in the two groups studied (statistical differences, P greater than 0.05). CONCLUSION: Data from present study contribute to the claim that systematic stimulation in the home and an adequate interrelation mother-child are among the main elements necessary for the proper development of the child.

Female↗
PubMed2026

PLayer-FL: A Principled Approach to Personalized Layer-wise Cross-Silo Federated Learning.

Non-identically distributed data is a major challenge in Federated Learning (FL). Personalized FL tackles this by balancing local model adaptation with global model consistency. One variant, partial FL, leverages the observation that early layers learn more transferable features by federating only early layers. However, current partial FL approaches use predetermined, architecture-specific rules to select layers, limiting their applicability. We introduce Principled Layer-wise-FL (PLayer-FL), which uses a novel federation sensitivity metric to identify layers that benefit from federation. This metric, inspired by model pruning, quantifies each layer's contribution to cross-client generalization after the first training epoch, identifying a transition point in the network where the benefits of federation diminish. We first demonstrate that our federation sensitivity metric shows strong correlation with established generalization measures across diverse architectures. Next, we show that PLayer-FL outperforms existing FL algorithms on a range of tasks, also achieving more uniform performance improvements across clients.

Journal Article↗
PubMed1981

[Burns in children in Africa (experience of the burns department at the Lomé University Hospital Center)].

Treatment of burns patients in the Lomé Teaching Hospital Centre has been reviewed and adapted to local conditions. The present study concerned 108 burned children, treated over a two year period. Burns in children are frequent. Boys are affected more frequently: 66.6 p. 100. Accidents are, above all, domestic and occur during the cooking of meals, at an age of 3 to 4 years (66.4 p. 100). Only thermal burns are seen, boiling fluids being involved in 71.3 p. 100 of cases. Superficial burns are the most common: 63.9 p 100, and intermediate 21.3 p. 100. Treatment is based upon water and electrolyte replacement and exposure to air. Infectious complications are the most frequent. Mortality involves 6.4 p. 100 of cases. All of these children were more than 35 p. 100 burnt. The cause of death is often infection. Results show 72.5 p. 100 of cases of cure without sequelae, 18.2 p. 100 of anesthetic sequelae and 9.3 p 100 of functional sequelae. If it were needed, these sequelae emphasize the fact that prevention remains and will remain the best form of treatment of burns.

Burns↗
PubMed1984

[Tactics and technic of abdominal closure in relaparotomy, abdominal dehiscence and peritonitis].

In cases of reexploration, abdominal wound dehiscence, and peritonitis closure of the abdomen calls for a flexible technique which can be adapted to local circumstances. Skin and the subcutaneous layer should be left open if contaminated from within the abdomen. If multi-layer closure becomes difficult, one should resort to one-layer closure sparing skin and subcutis. If approximation of wound edges becomes difficult or impossible, open stabilization of the abdomen is advocated, a simple method, applicable everywhere with an acceptable risk.

Abdominal Muscles↗