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The paper considers the state-of-the-art, problems, and prospects for development of interventional and surgical arrhythmology in Russia, which is a multidisciplinary specialty which integrates present-day achievements of medicine and new technologies in the diagnosis and treatment of cardiac arrhythmias.
OBJECTIVE: The purpose of this study is to explore the infiltration arts of MIC and study the effects of different packing density of Al2O3 matrix on the properties of MIC. METHODS: alpha-Al2O3 specimens were fabricated by pouring alpha-Al2O3 slip with different powder/liquid ratios(P/L = 3.5, 7.5, 10.5) into a mold, and subsequently pre-fired at 1160 degrees C for 6 hours to form Al2O3 matrix. The packing density of the matrices were measured. Infiltration concepts were introduced into this study by infiltrating molten mica micro-crystalline glass into the porous Al2O3 matrix at 1160 degrees C for 6 hours to form a continuous interpenetrating composite. The composite then underwent micro-crystallization by nucleating at 550 degrees C for 1 hour and crystallizing at 900 degrees C for 1 hour, which resulted in the MIC. Mechanical properties including three point flexural strength, elastic modulus, Vicker's hardness, indentation fracture toughness and Weibull's modulus of flexural strength were determined. Parameters of machinability(H/KIC)2 of MIC were calculated. XRD and SEM were employed to study its microstructure. RESULTS: The resulted matrices reached packing densities of 63%, 76%, 78% with P/L of 3.5, 7.5 and 10.5. The MIC attained high strength and good machinability after infiltration. Three-point flexural strength and indentation fracture toughness were 342, 431, 374 MPa and 4.05, 4.14, 5.02 MPa m1/2 for MIC with packing density of 63%, 76%, 78% separately. And parameters of machinability were 5.41, 6.84 and 7.39 respectively. Packing density of Al2O3 matrix significantly influenced the mechanical properties. Maximum properties were obtained with a matrix packing density of 75%(P/L = 7.5), with a Weibull's modulus of flexural strength of 6.8. Machinability decreased with the increase of P/L ratio. Micro-crystallizing treatment resulted in the formation of evenly distributed mica crystalline in the composite, which contributed to the high strength of this composite material. CONCLUSION: MIC is a new infiltrated ceramic with favorable strength and machinability which can satisfy the prosthodontic requirements as all ceramic crown and bridge materials, it also shows promising outlook for future developments and clinical usage.
U.S. AIDS rates have declined among same population groups; however, African-Americans and other ethnic minorities have experienced the least amount of decline. As a result medical and public health authorities are tasked with developing strategies to help eliminate the disparity in HIV/AIDS incidence rate and clinical outcomes. Thus, in 1999, the National Minority AIDS Education and Training Center (NMAETC) was developed to facilitate training, clinical consultation and technical assistance to clinicians that provide care to HIV-infected minority patients. Its initial activities were designed solely to increase providers' clinical capacity to use state-of-art anti-retroviral therapies to treat and manage the disease. However, through focused discussions with target providers and a survey of medical care service sites, the NMAETC confirms that provider' training and assistance needs extend into non-medical domains.
The terms health education, patient education, self-care education, school health education, and health promotion are distinguished from each other as follows. Health education is a subset or strategy within each of these but is the primary and dominant strategy in health promotion. Health education occurs through the health care providers in various settings: worksites, medical, community agencies and schools. Nurses and midwives are the most important health care providers to train people for health promotion and cancer prevention. We appreciate the importance of the "Fight against Cancer" movement in the primary health care centre and its health care providers who inform people about cancer and its symptoms, how to find lesions and early stages, and how to avoid hazardous factors. This is as process of continuous information transfer by in-service education. Primary prevention should encompass all actions aimed to reducing the occurrence of cancer. In reviewing recent advances in science and how the art of health education has been applied in practical ways within medical and other settings for prevention and public health, we can point ot the necessity for facilities like an APOCP Training Centre as a venue for scientific courses.
Potential interventions for gastroesophageal reflux disease include lifestyle modifications, antacids, mucosal protectants, prokinetic (promotility) agents, H2 receptor antagonists (H2RAs) and, the agents of choice in 2003, proton pump inhibitors (PPIs). This article reviews the current state of the art in use of these agents. Lifestyle changes, though sound in their intent and in many cases based on solid laboratory research, can today be considered only adjuncts to pharmacologic therapy. The mainstay of pharmacologic therapy in 2003 is antisecretory therapy. Both H2RAs and PPIs inhibit acid secretion and raise intragastric pH. H2RAs only block one receptor, have limited effect on acid reduction, and are relatively weak inhibitors of meal-stimulated acid secretion. PPIs provide superior control of intragastric pH over a 24-hour period compared with H2RAs and effect greater symptom relief and healing.
The XVIII Congress of the International Society on Thrombosis and Haemostasis, held July 6-12, 2001, in Paris, France, covered the latest advances in the field of thrombosis and hemostasis, including vascular biology. Plenary conferences, state-of-the-art lectures, symposia, and oral and poster presentations focused most of the attention on the current research on the pathogenesis and treatment of thrombotic and hemorrhagic disorders and provided updates on trials currently under way or already completed.
This article discusses the state of the art and the prospects of evolution of ultrasonic immersion mammographs. It is shown that ultrasonic immersion mammography for diagnostics of surface organs has a preference over existing ultrasonic scanning devices of contact type. An immersion mammograph has been developed, a characteristic of which is the use of compact ring multielement antenna with the electronic dynamic focusing block.
Radioimmunoscintigraphy (RIS) of colorectal carcinomas is under investigation in controlled clinical studies in Germany since 1985. With the availability of 99mTc labelled monoclonal antibodies against the carcinoembryonic antigen (CEA), there is an increasing acceptance of this new technique; nevertheless, the merits of RIS in comparison to established methods of staging and restaging of patients with colorectal carcinomas as computed tomography, endoscopy and sonography are still under discussion. In this review the current "State of the Art" of radioimmunoscintigraphy of colorectal carcinomas is given in respect of whether there is additional information which can be gained only by Ris but not by the established diagnostic procedure.
In Singapore, 1 in 5 pregnancies occur in mothers > 35 years old and genetic diseases, such as thalassaemia, are common. Current methods for the diagnosis of aneuploidy and monogenic disorders require invasive testing by amniocentesis, chorion villus biopsy or fetal blood sampling. These tests carry a procedure-related risk of miscarriage that is unacceptable to many couples. Development of non-invasive methods for obtaining intact fetal cells would allow accurate prenatal diagnosis for aneuploidy and single gene disorders, without the attendant risks associated with invasive testing, and would increase the uptake of prenatal diagnosis by women at risk. Isolation of fetal erythroblasts from maternal blood should allow accurate non-invasive prenatal diagnosis of both aneuploidies and monogenic disorders. Expression of gamma-globin in maternal erythroblasts and the inability to locate fetal erythroblasts reliably in all pregnancies have prevented its clinical application. In the absence of a highly specific fetal cell marker, enrichment, identification and diagnosis--the 3 components of non-invasive prenatal diagnosis--have clearly defined objectives. Since fetal cells are rare in maternal blood, the sole purpose of enrichment is yield--to recover as many fetal cells as possible--even if purity is compromised at this stage. In contrast, the primary goal of identification is specificity; absolute certainty of fetal origin is required at this stage if the ultimate objective of diagnosis, accuracy, is to be achieved. This review summarises the current state of the art of non-invasive prenatal diagnosis using fetal erythroblasts enriched from maternal blood.
Laparoscopic hepatic surgery has recently claimed its place among the minimally invasive techniques. Adequate technologies and experience both in laparoscopy and liver surgery are essential for its correct use. A review of the English literature on this subject is presented and the present state of the art discussed. Various topics are considered: staging, treatment of cystic lesions and treatment of benign and malignant primary and secondary tumours. Over the past five years various groups have published papers regarding case series, mainly concerning hepatic resection. More correct indications for the use of laparoscopy in liver surgery have been defined. In particular, laparoscopy is of great importance in the staging of primary and secondary liver cancer and in the treatment of cystic and benign lesions, mainly of the anterior segments. Less univocal are surgeons' attitudes towards the treatment of primary and secondary liver cancers. Laparoscopic liver surgery is gradually gaining wider and clearer acceptance in the treatment of hepatic lesions, while it has now virtually consolidated its role in the treatment of cystic lesions and in the staging of primary and secondary liver cancer.
How often do you see patients who appear headed for a chronic disease, but you feel powerless to intervene? A new center has opened its doors to provide alternatives to providers who want to establish their patients on a path toward prevention rather than disease. The approach combines state-of-the-art technology with the latest science on prevention, and it comes at a price. However, developers believe it is a price individual consumers should be willing to pay.
To date, several diagnostic tools allow an accurate non-invasive evaluation of coronary artery disease; this is due to the great progress in echocardiographic and nuclear imaging techniques in the last 10 years. The large availability of different stress imaging techniques allows to choose the most appropriate technique for each patient according to the clinical characteristics. This paper presents the state of the art of echocardiographic and nuclear stress imaging for the diagnosis of coronary artery disease and for the prognostic stratification of infarcted patients. Advantages and limits of the different techniques are described rather than putting in competition echo and nuclear cardiology as has often been done in the past. Cardiologists should select among the various techniques on the basis of clinical characteristics of single patients, center's experience and an objective evaluation of economical aspects.
Oral appliances have become established treatment devices for snoring and sleep apnea. Substantial scientific evidence has demonstrated that mandibular repositioning appliances (MRA) are effective. Patients prefer oral appliances above most other treatment options. In recent years a steady stream of reports on MRA has been published. This article gives an overview of the state-of-the-art.
State-of-the-art robotized systems developed for surgery are either remotely controlled manipulators that duplicate gestures made by the surgeon (endoscopic surgery applications), or automated robots that execute trajectories defined relatively to pre-operative medical imaging (neurosurgery and orthopaedic surgery). This generation of systems primarily applies existing robotics technologies (the remote handling systems and the so-called "industrial robots") to current surgical practices. It has contributed to validate the huge potential of surgical robotics, but it suffers from several drawbacks, mainly high costs, excessive dimensions and some lack of user-friendliness. Nevertheless, technological progress let us anticipate the appearance in the near future of miniaturised surgical robots able to assist the gesture of the surgeon and to enhance his perception of the operation at hand. Due to many in-the-body articulated links, these systems will have the capability to perform complex minimally invasive gestures without obstructing the operating theatre. They will also combine the facility of manual piloting with the accuracy and increased safety of computer control, guiding the gestures of the human without offending to his freedom of action. Lastly, they will allow the surgeon to feel the mechanical properties of the tissues he is operating through a genuine "remote palpation" function. Most probably, such technological evolutions will lead the way to redesigned surgical procedures taking place inside new operating rooms featuring a better integration of all equipments and favouring cooperative work from multidisciplinary and sometimes geographically distributed medical staff.
Many falls and injuries related to falls can be prevented with existing knowledge and technology. But effective fall prevention will require the collaborative efforts of many organizations as well as changes in the behavior of older adults and providers, and systematic changes in organizations. Many effective interventions currently exist, but improved access, additional resources, and coordination and commitment across systems are needed. In summary, we know how to prevent falls and reduce injuries, using proven intervention strategies aimed at both low-risk and high-risk older adults. There is a wide spectrum of screening and assessment tools available and effective intervention practices. The challenge now is to put into practice throughout California the state-of-the art knowledge that has already been compiled through innovative programs and rigorous research.
The system SureSmile (from Orametrix) has been developed on the basis of the Bending Art System (BAS) introduced in 1994 of which it is a manifold important evolution. It is a well considered combination of three-dimensional image processing, computer-assisted diagnosis, planning and realization of the treatment, which permits high quality orthodontia nevertheless capable of being reproduced in an objective manner. This article presents the system SureSmile.
Our understanding and management of chemotherapy-induced nausea and vomiting has progressed substantially in the past decade. We now have many effective single agents, which are even more beneficial when used in appropriate combinations. A new class of antiemetic agents, the serotonin antagonists, of which ondansetron is the first to be commercially available, promises significantly better control of the various emetic syndromes caused by cancer chemotherapy, with fewer side effects. This article summarizes the state of the art of antiemetic therapy.
Extracorporeal shock wave lithotripsy, percutaneous nephrolitholapaxy and retrograde ureterorenoscopy are modern urological procedures which have almost completely replaced open surgery of urolithiasis in the last decade. A review of techniques, management of clinical problems and differential indications is presented as a state of the art of these new treatment modalities in urinary stone disease.