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At least 1,135 records · Page 63Linked to original sources
PubMed2004

World Health Organization systematic review of screening tests for preeclampsia.

OBJECTIVE: We sought to assess the usefulness of clinical, biophysical, and biochemical tests in the prediction of preeclampsia. DATA SOURCES: The sources of data we used to conduct this review included the computerized databases MEDLINE (1966 to February 2003), EMBASE, Popline, CINAHL, and LILACS plus reference lists, conference proceedings, textbooks, and contact with experts. METHODS OF STUDY SELECTION: All cohort or cross-sectional studies reporting data on the relationship between a predictive test that was performed during pregnancy and the development of preeclampsia were eligible for inclusion, whereas case-control studies were excluded. Eighty-seven (211,369 women) of 7,191 potentially relevant articles met inclusion criteria. We evaluated the methodologic quality for each included study. TABULATION, INTEGRATION, AND RESULTS: Using a standardized protocol, one reviewer selected and extracted data on study characteristics, quality, and accuracy. Data abstracted from each study were arranged in 2 x 2 tables to construct receiver operating characteristics plots (sensitivity against 1 - specificity) and pooled to produce summary likelihood ratios for positive and negative tests results. Moderate predictive accuracy of anticardiolipin antibodies, the presence of bilateral diastolic notches during Doppler ultrasonography, and urinary kallikrein were found in women at low risk of developing preeclampsia. Nevertheless, because the pretest probability of preeclampsia with a positive result was but minimally increased, the clinical use of these tests is limited. Other ultrasonography characteristics and the measurement of fetal and placental peptides showed low predictive accuracy. In populations that were deemed at high risk for preeclampsia, the use of Doppler ultrasonography had low predictive accuracy. No definitive conclusions were possible in the case of many other tests, because the number of studies that met the minimal inclusion criteria was limited. CONCLUSION: As of 2004, there is no clinically useful screening test to predict the development of preeclampsia. Further prospective, longitudinal studies are needed.

Blood Pressure Monitoring, Ambulatory↗
PubMed1999

Analysis and characterization of data from twinned crystals.

It is difficult but not impossible to determine a macromolecular structure using X-ray data obtained from twinned crystals, providing it is noticed and corrected. For perfectly twinned crystals, the structure can probably only be solved by molecular replacement. It is possible to detect and characterize twinning from an analysis of the intensity statistics and crystal packing density. Tables of likely twinning operators and some examples are discussed here.

Algorithms↗
PubMed2006

Validity of the "Community Periodontal Index of Treatment Needs" (CPITN) for population periodontitis screening.

The aim of the present study was to validate two versions of CPITN for periodontitis diagnosis. A sample of 400 individuals underwent full mouth periodontal examination including Clinical Attachment Loss, Periodontal Pocket Depth, and Sub-gingival Calculus. Full and partial CPITN versions were derived from this exam (gold standard). Contingency tables were constructed and operational characteristics obtained, as well as ROC curves. The results show 58% sensitivity for full CPITN and 80.6% specificity. Positive and negative predictive values were 87% and 46.3%, respectively. According to the test, estimated periodontitis prevalence was 46%, while the figure obtained with the gold standard was 69%. The partial version of the CPITN showed 50% sensitivity and 87.1% specificity. Positive and negative predictive values were 89.6% and 43.9%, respectively. Estimated periodontitis prevalence, through partial CPITN, was 30.5%. Adjusted global agreement (kappa) for partial and full CPITN was 0.32 and 0.29, respectively. Both CPITN versions disagreed significantly with gold standard results (chi-square p < 0.001). As a conclusion, both total and partial CPITN failed to reflect the real periodontal status of the sample.

Adolescent↗
PubMed1992

Results of pars plana vitrectomy in 62 cases of vitreous haemorrhage.

62 Cases with unresolving Vitreous Haemorrhage due to varied etiology, underwent pars plana Vitrectomy. A vitreous rebleed on the table and post-operatively, was the main complication encountered. Despite limited equipment, a visual improvement was obtained in 59.68% eyes with visual acuity greater than FC 6 meters in 33.87% eyes. This is far better than not being able to offer any treatment at all.

Adult↗
PubMed1992

[Early weight-bearing after osteosynthesis by THS hip screw in cervico-trochanteric fractures].

A second generation hip screw was designed in the laboratory to allow unlimited immediate weight-bearing in elderly patients with cervico-trochanteric fractures. The use of this device in 300 operated patients demonstrated that it provided the same capacity for weight-bearing as total hip prostheses, but with a lower morbidity and better and longer lasting functional results. Thus, in patients with a mean age of 77 years, one half of whom suffered from an unstable fracture: the operation was minimally traumatic (reduction on an orthopaedic table, no surgical access to the fracture site, operating time less than one hour); complications were consequently rare (no deep sepsis, no dislocation) in contrast with 5 to 10% of deep sepsis or dislocation with prostheses; early unlimited weight-bearing was permitted by the 5th day in every case and was achieved by the 10th day in more than 80% of cases (30% of whom were able to walk unassisted with crutches); an essential point, the design of the material prevented dismantling on weight-bearing and preserved the morphology of the hip (telescoping of the fracture site never exceeded 20 mm, mean:11 mm). Consolidation was obtained in every case by 6 to 8 weeks. The mortality at 3 months was identical to that observed with prostheses (18%, related to physiological age). The length of hospital stay and the duration of rehabilitation were considerably shortened, as 37% of patients returned to their previous residence by the 45th postoperative day. This resulted in a marked saving in medical costs for each patient (as patients previously returned home after an average of 145 days).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

An extended SQL for temporal data management in clinical decision-support systems.

We are developing a database implementation to support temporal data management for the T-HELPER physician workstation, an advice system for protocol-based care of patients who have HIV disease. To understand the requirements for the temporal database, we have analyzed the types of temporal predicates found in clinical-trial protocols. We extend the standard relational data model in three ways to support these querying requirements. First, we incorporate timestamps into the two-dimensional relational table to store the temporal dimension of both instant- and interval-based data. Second, we develop a set of operations on timepoints and intervals to manipulate timestamped data. Third, we modify the relational query language SQL so that its underlying algebra supports the specified operations on timestamps in relational tables. We show that our temporal extension to SQL meets the temporal data-management needs of protocol-directed decision support.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Management of frontal sinus fractures. Changing concepts.

Since the turn of the century, surgeons have handled frontal sinus fractures with a variety of different procedures. The optimal management procedure remains controversial. We have presented a graduated anatomic algorithm for treatment of frontal sinus fractures based on the degree of fracture displacement and nasofrontal duct involvement and presence of CSF leak. Nondisplaced fractures are best handled conservatively, without operative intervention. However, the majority of frontal sinus fractures require operative correction. Uncomplicated anterior table displacement with an aesthetic deformity is treated by fragment reduction and stabilization with miniplates or microplates or wires. Nasofrontal duct obstruction is usually managed by sinus obliteration with spontaneous osteoneogenesis or autologous bone grafting. Finally, comminuted, displaced anterior and posterior table fractures, especially those with persistent CSF leakage and associated nasofrontal duct involvement, are best handled with frontal sinus cranialization. The presented algorithm is simply a treatment guideline. Frontal sinus fracture management must be individualized. However, this graduated anatomic approach provides a pragmatic framework for decision making and understanding this complex and controversial topic.

Bone Transplantation↗
PubMed2004

Service level web monitoring in the field management of emergencies.

Cardiologic Emergency Project is based on a hospital network in Milan, Italy, in order to provide patients with more efficient first aid immediately after the occurrence of an Acute Coronary Syndrome. The Project includes ECG transmission from running ambulances to the 118 telephone central help desk, and from there to the suitable hospital. Since the maximum total transfer time should stay within a few tens of minutes, and given that a number of different factors may cause very dangerous delays, the effective coordination of several healthcare systems, devices and organizations is critical. Monitoring of the activities on each component is a must. Cardiologic Emergency Project uses a Web application devoted to the monitoring and evaluation of the service levels. Web applications allow the quantitative monitoring of the durations of extra-hospital operations. Several types of tables and graphics are automatically filled for the best care of the patient. For example, given a lengthy total time request by a satisfactory full ECG transmission, the system allows analysis of the ECG machine, of the cellular phone partial-only coverage along the ambulance pathway, of the transfer time in rush hours, etc., to determine which elements in the process can be improved to avoid future delays.

Emergencies↗
PubMed1991

[Note on the lessons of rinderpest control in Chad since 1935].

The policy of rinderpest control in Chad has passed through various phases over sufficiently long periods to validate certain concepts such as that of the usefulness of perifocal vaccination of populations which have not been previously vaccinated. After studying the reliability of data regarding livestock, vaccinations and pathology and after having reviewed the various types of vaccine used, it can be concluded that perifocal vaccination, even in conjunction with the systematic vaccination of young, has not enabled rinderpest to be brought under control in Chad. Only systematic livestock vaccination can control and eradicate the disease. A table illustrates the vaccination operations and monitoring systems used.

Animals↗
PubMed1987

[Prenatal pharmacology of low molecular weight heparin and pentosan polysulfate].

The aim of prenatal pharmacology is to evaluate the biologic effects to the fetus of a drug taken during pregnancy. Development of a new technic for collection of fetal blood samples in utero under ultrasound guidance allowed, by evaluation of maternal and fetal hemostasis, study of two low molecular weight heparins, PK 10169 (Lovenox) (table I) and CY 216 (Fraxiparine) (tableau II) and of pentosan polysulfate (Hemoclar) (table III). Under the operating conditions applied, the three molecules failed to diffuse across placenta during 2nd and 3rd pregnancy trimesters. This permitted treatment of eleven women at risk for eclampsia or thromboembolism with good clinical results, white confirming absence of circulating heparinemia at birth (umbilical cord blood).

Anticoagulants↗
PubMedDate not supplied

The Corneal EyeSys System: accuracy analysis and reproducibility of first-generation prototype.

The EyeSyS Corneal Topography System manufactured by EyeSys Laboratories, Inc., Houston, Tex utilizes a unique data-acquisition design to perform rapid, cost-effective quantitative photokeratoscopy. We evaluated a first-generation prototype system. Repeated testing with this prototype demonstrated an accuracy and reproducibility to within 0.25 D on spherical surfaces. Similar results were obtained in testing aspherical surfaces without refocusing. Data from preliminary clinical studies are displayed for the following corneal conditions: normal, keratoconus, post-keratoplasty, and post-keratoplasty with wound ectasia. Advantages of the EyeSys System include rapid data analysis and display, ease of operation, and compact table-top size.

Adult↗
PubMedDate not supplied

[Surgical treatment of peripheral nerve compression syndromes].

Among 12,476 patients with diseases of the peripheral nervous system 54.3% had radical syndromes, 16.3% had acute injuries of the nerves, 25.2% had entrapment syndromes, 3.8% suffered from polyneuropathies and other diseases. Entrapment syndromes were encountered in 3143 patients. Carpal, ulnar, and tarsal canal syndromes, thoracic outlet syndrome, and syndromes of entrapment of the radial and peroneal nerves prevailed. A total of 763 operations were performed for the entrapment syndromes. The distribution of the syndromes and operations is shown in the table. From 10 to 20% of patients with tunnel syndromes needed surgical treatment. From 12 to 34 upper extremities were operated on annually per 100,000 population for the carpal tunnel syndrome; 90% of the operations were performed at out-patient clinics. Interfascicular neurolysis by means of microsurgical techniques was conducted mainly in the cubital tunnel syndrome. Operations in entrapment lesions are marked by high efficacy.

Humans↗
PubMed1994

[Treatment of the ipsilateral femur shaft and femur neck fractures with the Russell-Taylor reconstruction nail].

Eleven ipsilateral neck and shaft fractures of the femur in 11 patients (4 females, 7 males) were treated between May 1987 and December 1990 at the Department of Orthopedic Surgery. University of Louisville, Trauma center level one. The mean age was 34.5 (16-60) years. All patients sustained their injuries from high energy trauma (8 traffic accidents, 3 falls). All neck fractures were closed and there were 8 closed and 3 open (grade I, grade II, grade IIIA = one each) shaft fractures. All fractures were operated on the fracture table and all were stabilized with the Russell-Taylor reconstruction nail. Thus, antegrade reamed nailing of the shaft fracture was followed by internal fixation of the neck fracture with 8.0 mm and 6.4 mm lag screws. Those were placed with a targeting device through the proximal locking holes of the nail. Then, the distal locking bolts were implanted by free hand technique. The mean follow-up was 36.2 (18-71) months. All fractures of the neck and shaft healed. There was no necrosis of the femoral head. No infection was observed. The mean healing time for the neck fractures was 13.4 weeks and 16.8 weeks for the shaft fractures. In one case autogenous cancellous bone grafting was performed in delayed healing of a shaft fracture. There were no varus or valgus malangulations. Five patients had a minor limited ROM of the hip joint, another 6 patients an average shortening of 1.3 cm of he involved leg. In one case a locking bolt had to be removed due to loosening.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[The most frequent depressive disorders. Diagnosis, classification, symptoms and prognosis].

The most frequent depressive disorders--anxiety and panic syndrome, dysthymic (neurotic) illnesses and reactive depressive adjustment disorders--were classified according to the new international codes. It was also explained that theoretical aetiological assessment principles had to be replaced by duration and symptomatology as operational criteria. Further, a table was elaborated for diagnosing depressive syndromes from an intrapsychic, social and somatic standpoint. Epidemiological aspects of both German and international studies were discussed and prognostic factors highlighted.

Cross-Sectional Studies↗
PubMed1993

[Importance of surgical masks for peroperative asepsis].

For more than 70 years, the surgical mask has been used under operations as part of the maintenance of aseptic conditions in the operational field. Experiments with models and investigations of sources of infection carried out over the past 20 years have shown, however, that the bacterial flora of the upper respiratory tract do not contribute to airborne contamination of the surgical wound, but that persons who are situated directly beside the field may contaminate the wound directly by droplets released by speech, sneezing or coughing. Over the last ten years the usefulness of the surgical mask has been disputed several times, and a few controlled clinical trials have been able to confirm any benefits associated with use of surgical masks. There is therefore no reason from the point of view of preventing infection to maintain a general requirement for the use of surgical masks by others than those persons who may be situated within an arm's length of the operational field or instrument table.

Asepsis↗
PubMed1995

The role of discriminant functions in screening for beta-thalassaemia traits during pregnancy.

INTRODUCTION: The mean red cell volume (MCV) has been shown to be useful in a 2-stage screening process for beta-thalassaemia traits among pregnant women though associated with a large number of false positive results. We tested prospectively the ability of 5 discriminant functions (DF), (England & Fraser, Shine & Lal, Mentzer, Srivistava and Klee et al) to reduce the number of false positives when used as additional screening determinants for beta-thalassaemia in antenatal patients with red cell microcytosis. METHODS: The diagnostic performance of each DF was compared in 493 patients with microcytosis and known beta-thalassaemia status. Truth table analysis and Receiver Operation Characteristic curves for each function were determined. RESULTS: 11.4% of the patients with microcytosis were diagnosed to have beta-thalassaemia traits. DFs incorporating the red cell indices: haemoglobin or total red cell count are unsuitable during pregnancy. Shine & Lal's index [(0.01 x MCH x (< MCV)2] reduced the number of people recalled for confirmatory testing by 31.1% and increased the diagnostic yield to 38.7% while maintaining a negative predictive value for the test of 0.993. CONCLUSION: We conclude that a 3-stage screening process for beta-thalassaemia among pregnant women in Singapore involving the MCV, Shine & Lal's index and a confirmatory test to be both valid and cost-effective.

Diagnosis, Differential↗