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At least 127 records · Page 7Linked to original sources
PubMed1987

Complications of ureteroscopy in relation to experience: report of survey and author experience.

During the last 4 years we performed ureteroscopy for diagnostic evaluation in 20 patients and for removal of mid or distal ureteral stones in 127. All of the diagnostic studies were successful. In the stone removal cases the success rate increased from 71 per cent for the 24 procedures done during the first 2 years to 92 per cent for the 60 procedures done in the first 9 months of 1985. The rate of ureteral injury in the entire series was 2 per cent and in only 9 of the 23 failures was an open operation necessary. The benefit of experience also was evident in the results reported by 28 medical centers, with a 78 per cent success rate at the 11 centers that had performed less than 20 procedures each and an 84 per cent success rate at the 9 centers that had done more than 50. Despite early frustration with ureteroscopy, the value of mastering the technique allows the urologist to proceed endourologically with minimum morbidity and without precluding further interventional procedures.

Adult↗
PubMed1999

Mass mailing and staff experience in a total recruitment program for a clinical trial: the SHEP experience. Systolic Hypertension in the Elderly Program. Cooperative Research Group.

The Systolic Hypertension in the Elderly Program (SHEP) staff contacted 447,921 screenees, of whom 11,919 (2.7%) were originally eligible and 4,736 (1.1%) maintained eligibility and were randomized. The total number of participants enrolled at the 16 clinical centers ranged from 133 to 559. The low yield of screenees to randomizations resulted from the study design, not from low levels of agreement to participate, and required the employment of a variety of recruitment strategies in a prudent overall plan. SHEP was one of the first clinical trials to use mass mailing as a primary strategy of recruitment. The study used mailing lists from seven generic sources. More than 3.4 million letters of invitation were mailed; they yielded an overall response rate of 4.3%. Motor vehicle and voter registration lists provided the greatest numbers of names. Mailings to members of health maintenance organizations (HMOs) and registrants of the Health Care Finance Administration (HCFA) provided the greatest response rates. Considerable variability in response rates existed among clinical centers using generically similar mailing lists. Generally, the number of hours spent on recruitment showed a positive, but not statistically significant, association with randomization yields. The recruitment yield was statistically significantly higher in clinics with experienced recruitment coordinators than in clinics with inexperienced ones (p = 0.0008). From these findings we conclude that mass mailing is an important strategy in an overall recruitment program, that the involvement of experienced recruitment staff is important, and that although the total time spent by staff on recruitment may also improve results, it matters less than the staff's level of recruiting experience.

Aged↗
PubMed1998

The experience of people awaiting coronary artery bypass graft surgery: the Icelandic experience.

Prolonged waiting for major elective surgery has been a problem in several Western countries for many years. In Iceland coronary artery bypass graft (CABG) surgery was installed in 1986 and this descriptive study was conducted to describe systematically the experience of Icelandic people waiting for CABG surgery with the purpose of gaining information about what nursing services these people need during the waiting period. The survey used a mailed questionnaire developed by the authors. The target population consisted of people awaiting coronary artery bypass graft surgery at the National University Hospital in Iceland, at two predetermined days with a 10-month interval. The return rate was 81.8% (n = 72). Mean time on the waiting list was 5 to 6 months. The waiting for surgery had negative effects on the work and daily life of the majority of the subjects and they were dissatisfied with their health status. Prominent symptoms were fatigue, shortness of breath, chest pain, anxiety and depression. Most patients (86.6%) experienced stress with 28.4% of them reporting a serious level of stress. The majority reported considerable negative influences of their illness on their spouse and family, particularly on their emotional condition. The conclusion drawn is that shortening the waiting period for CABG surgery should be a primary objective; however, that may be unlikely with the present Icelandic health care system. Therefore, helping the individuals and their families live with the lengthy wait is a necessity.

Adult↗
PubMed2000

Recent changes in the workload and clinical experience of pre-registration house officers: experiences over four years in south-west England.

We aimed to measure changes in the training and workload of pre-registration house officers using a postal questionnaire. Two hundred and six pre-registration house officers in the south-western region of England were surveyed and asked to report on the education, training and workload of their posts. Results were compared with a survey conducted four years earlier. Since the previous survey, the number of hours on duty had reduced from a median of 80 h week-1 in 1992/3 to 72 h week-1 in 1996/7 (P < 0.0001). There were no statistically significant changes in the number of patients admitted or clerked in an average week, but house officers' clinical experience had fallen. All but five of 26 marker conditions showed a decline, which was statistically significant in seven cases. House officers were keener to include four months of general practice in the pre-registration year and were less adverse to extending the pre-registration year to two years. The reduction in hours of work for house officers has been accompanied by a decline in their clinical exposure to common medical and surgical emergencies. The long-term effects of these changes are unknown.

Emergency Medicine↗
PubMed1979

[Therapeutic embolisation of visceral arteries. Animal experiments, early clinical experience, introduction of a new embolising material (author's transl)].

Silicone elastomer was found to be suitable embolsing material in animal experiments and has been used in 16 patients. It produces permanent vascular occlusion, is easy to use, well tolerated and can be steam sterilised. The disadvantage of the method is the time taken to prepare it in the laboratory. Embolisation of tumours was successful in all cases; angiography nine months later showed that the vessels had remained occluded and that the tumours had ceased to grow or become smaller. The development of collateral vessels shows that this is only a palliative procedure and that surgery remains the main form of treatment. In ten of the 16 patients, the course of the disease was influenced beneficially.

Aged↗
PubMed2000

[Axis I "illness experience and treatment preconditions" of operational psychodynamic diagnosis (OPD). Experiences in clinical practice].

In a selective survey, results on psychometric properties and aspects of application of the axis I, "illness experience and treatment preconditions" of the Operational Psychodynamic Diagnoses (OPD) are described. Following remarks on the role of defense and coping theories in the conceptualisation of the axis, its structure and contents are outlined. After a brief summary of findings on its interrater reliability, several aspects of validity are discussed. Results on discriminative validity show that axis I items are useful in the statistical discrimination of subsamples differing in age, clinical diagnoses, and diagnostic setting (psychotherapy outpatient vs. psychosomatic consultation-liasion services). The contribution of axis I items to prediction of treatment outcomes, moreover, reveals high degree of predictive or treatment validity. After an integrative discussion of these findings, implications of patient personality and coping behaviour for axis I ratings are highlighted as important objectives for future OPD research.

Adaptation, Psychological↗
PubMed1998

[Stent placement with real time MRI guidance: initial animal experiment experiences].

PURPOSE: The aim of this study was to test the feasibility of iliac artery stent placement under MR guidance with real-time MR radial scanning in an animal model. MATERIALS AND METHODS: The experiments were performed on three pigs in a 1.5 T scanner. Radial scanning with a gradient echo technique (TR 8.4 ms, TE 3.6 ms, flip angle 10 degrees) was used. A dedicated backprojector performed the reconstruction of the raw data in real-time. The resulting MR-images were displayed on LCD screens beside the magnet. The sliding window reconstruction technique allowed image acquisition at a frame rate of 16 images per second. MR-compatible self-expanding stents with a diameter of 8 mm and a length of 3 cm were placed into the left iliac artery. Their positions were verified by digital subtraction angiography (DSA) and compared to MRI. RESULTS: All stents were successfully placed. Stent positions as monitored by real-time MR were identical to those seen on DSA images. The time needed for exact positioning of the scan plane ranged from 15 to 30 minutes. Stent placement itself took 8 minutes on average. CONCLUSION: Radial scanning applied together with the sliding window reconstruction technique allows placement of stents in iliac arteries under real-time MR control.

Angioplasty, Balloon↗
PubMed1987

[Historical retrospective. Lipamin (Agomensin) and luteolipoid (Sistomensin). Animal experiments and preliminary clinical experiences].

In 1914 "Lipamin" and "Luteolipoid", two extracts of corpus luteum, were developed at the University Gynaecological Hospital in Erlangen, Bavaria. The process of their preparation, protected by patents, was exploited soon after that by Ciba, Basel, who named their products Agomensin and Sistomensin. The history of their development, their effects in animal experiments, as well as their early therapeutical application to women are reported. Special reference is made to the patent specifications and to the lectures held at meetings of the Bavarian Society of Gynaecology and Obstetrics.

Animals↗
PubMed2004

State-to-state rotational relaxation rate constants for CO+Ne from IR-IR double-resonance experiments: comparing theory to experiment.

IR-IR double-resonance experiments were used to study the state-to-state rotational relaxation of CO with Ne as a collision partner. Rotational levels in the range Ji=2-9 were excited and collisional energy transfer of population to the levels Jf=2-8 was monitored. The resulting data set was analyzed by fitting to numerical solutions of the master equation. State-to-state rate constant matrices were generated using fitting law functions. Fitting laws based on the modified exponential gap (MEG) and statistical power exponential gap (SPEG) models were used; the MEG model performed better than the SPEG model. A rate constant matrix was also generated from scattering calculations that employed the ab initio potential energy surface of McBane and Cybulski [J. Chem. Phys. 110, 11 734 (1999)]. This theoretical rate constant matrix yielded kinetic simulations that agreed with the data nearly as well as the fitted MEG model and was unique in its ability to reproduce both the rotational energy transfer and pressure broadening data for Ne-CO. The theoretical rate coefficients varied more slowly with the energy gap than coefficients from either of the fitting laws.

Journal Article↗
PubMed2001

Eosinophilic gastroenteritis: our recent experience: one-year experience of atypical onset of an uncommon disease.

Eosinophilic gastroenteritis is an unusual entity that is rarely found in daily clinical practise. Its aetiology is unknown and diagnosis can be made microscopically with evidence of massive eosinophilic infiltration in patients with chronic gastrointestinal symptoms, excluding entities that may cause such findings (parasitic infestation, medical therapy, inflammatory bowel disease, and so on). Allergic processes are usually associated and these normally respond well to steroids. We present our last year's experience of four women with eosinophilic gastroenteritis with an extraordinary atypical clinical onset. Two of the women presented with an acute abdomen and two with isolated colonic involvement. The management of acute abdomen avoiding surgery and a complete response with azathioprine are the outstanding variables that make our recent cases of special interest. Demographic variables were similar to others reported from our medium, with the exception of a higher incidence of women. Our cases suggest the wide spectrum of clinical presentations and show the high suspicion index needed for a diagnosis that is made by pathologists.

Abdomen, Acute↗
PubMed2002

Magnetic resonance imaging (MRI) of sexual intercourse: second experience in missionary position and initial experience in posterior position.

Our objective was to confirm that it is feasible to take images of the male and female genitals during coitus and to compare this present study with previous theories and recent radiological studies of the anatomy during sexual intercourse. Magnetic resonance imaging was used to study the anatomy of the male and female genitals during coitus. Three experiments were performed with one couple in two positions and after male ejaculation. The images obtained confirmed that during intercourse in the missionary position, the penis reaches the anterior fornix with preferential contact of the anterior vaginal wall. The posterior bladder wall was pushed forward and upward and the uterus was pushed upward and backward. The images obtained from the rear-entry position showed for the first time that the penis seems to reach the posterior fornix with preferential contact of the posterior vaginal wall. In this position, the bladder and uterus were pushed forward. A different preferential contact of the penis with the female genitals was observed with each position. These images could contribute to a better understanding of the anatomy of sexual intercourse.

Coitus↗
PubMedDate not supplied

Methadone treatment: experiment and experience.

The relationship between public policy and scientific investigation is explored by a review of the experience with methadone maintenance treatment for narcotic addiction. The implementation of a widespread treatment effort in Hong Kong in the 1970s is contrasted with recent policies in regard to methadone treatment expansion in the United States. In neither case did research findings form the basis for public policy. In Hong Kong, rapid expansion of methadone treatment was initiated before scientific evidence was available to support this course, and in the United States treatment expansion has been rejected despite extensive evidence of its utility and safety. Decisions by government officials and health care providers, as in the case of addiction treatment, may be influenced more by philosophy and intuition than by scientific evidence. Scientists must recognize and address this reality if they are to play a meaningful role in shaping public health policy.

Health Policy↗
PubMedDate not supplied

"False positive" claims of near-death experiences and "false negative" denials of near-death experiences.

Some persons who claim to have had near-death experiences (NDEs) fail research criteria for having had NDEs ("false positives"); others who deny having had NDEs do meet research criteria for having had NDEs ("false negatives"). The author evaluated false positive claims and false negative denials in an organization that promotes near-death research and in psychiatric outpatients. The frequency of false positives and negatives varied in samples that differed in prevalence of, and knowledge about, NDEs. The influence of participants' knowledge about NDEs on the findings of near-death research makes it critically important to use standardized criteria for identifying NDEs.

Death↗
PubMed1981

The psychological function of out-of-body experiences. So who needs the out-of-body experience?

What psychological needs are served by the out-of-body experience (OBE)? On the basis of a review of the literature in rather diverse areas several hypotheses on this issue are formulated in terms of Murray's conceptual system of manifest needs. A simple survey of the need profiles of students reporting OBEs provides support for only one of the hypotheses, namely, that such individuals are concerned with and attentive to their mental processes. Unanticipated by the literature was the finding that people reporting OBEs exhibit low levels of need for achievement and need for deference. If a sophisticated theory of the OBE is to be developed much more research must be conducted into the psychological, parapsychological, and neurophysiological correlates of the phenomenon.

Achievement↗
PubMed2006

What we learned from the experience of laparoscopic splenectomy in patients with idiopathic thrombocytopenic purpura (ITP)--single surgeon experiences.

From October 1994 to December 2004, 50 cases of laparoscopic splenectomy (LS) have been carried out by a single surgeon for treating patients with idiopathic thrombocytopenic purpura (ITP). This study was performed to analyze a single surgeon's experiences of LS in ITP and discuss lesions that we have learned and the technical changes based on perioperative outcomes of LS. It seems that strict right lateral decubitus is definitively the position of choice because it ensures good exposure of splenic vascular structure in hilum. We also found that a flexible scope or 45-degree angled telescope, not to mention a 30-degree one, allowed for optimal vision, and made laparoscopic procedures easy and secure. We could control the vascular structure safely by just applying 5-mm laparoscopic clips without using harmonic scalpel or endo-GIA. When delivering spleen, it maybe easy and safe way to remove the plastic pouch with spleen fragmented through the umbilical port after changing the patient's position to supine again.

Clinical Competence↗
PubMed1993

Alcohol and suicide in Denmark 1911-24--experiences from a 'natural experiment'.

In 1916-17, prices of alcoholic beverages increased dramatically in Denmark, and alcohol consumption decreased strongly. On the basis of this 'natural experiment', the effect of variations in per capita alcohol consumption on suicide rates is estimated, and compared to Norström's analysis of Danish data from the period 1931-80, as well as similar analyses from other countries. It is concluded that per capita alcohol consumption is probably related to the suicide rate in Denmark, but to a less extent than in some other countries.

Adolescent↗
PubMed1979

[Experiences in animal experiments with hydrogel keratoprosthesis of different water content].

Satisfactory results could be obtained in former animal experiments with keratoprostheses made by 38% hydrated hydrogel plastics (PHEMA). There still existed some doubts concerning alterations by aging of this material, possibly resulting in setting free toxic or allergenic substances as well as raising the risk of infection. Therefore, keratoprostheses containing 38 or 20% water were implanted in rabbit eyes. The follow-up period of 44 animals was 6 months. No essential differences in the postoperative course of both types of keratoprostheses could be observed. With the only exception of a growth of tissue over the optical cylinder in 1 case no serious complications, e.g., extrusion of the implant, occurred. Regarding the greater resistibility of the less hydrated hydrogel, this more durable plastic seems to be the more adapted material for keratoprotheses.

Animals↗
PubMed1996

From PTSD to voices in context: from an "experience-far" to an "experience-near" understanding of responses to war and atrocity across cultures.

This paper examines some of the difficulties of exporting the Western concept of Post Traumatic Stress Disorder (PTSD) to non-Western cultures. Using data drawn from Guatemala where I lived and worked among Quiché Mayan war widows, illustrates how culturally-specific understandings of events and reactions to them affect the well-being (or otherwise) of people exposed to extreme adverse events. The paper turns to the voices of the widows, who experienced and survived intense political conflict, explaining their experiences of violence within their particular context.

Cross-Cultural Comparison↗