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At least 1,369 records · Page 76Linked to original sources
PubMed1999

Successful management of Crohn's disease of the ileoanal pouch with infliximab.

This study reports the clinical benefit and safety of the murine chimeric anti-tumor necrosis factor (TNF)-alpha monoclonal antibody, infliximab, in the treatment of patients who developed findings compatible with Crohn's disease after undergoing colectomy with ileal-pouch anal anastomosis (IPAA) for an original diagnosis of ulcerative colitis. Medical records of 7 patients with Crohn's disease and an IPAA treated with infliximab were reviewed. Clinical response was classified as complete response, partial response, and no response. Concurrent treatment with immune modifier agents and/or antibiotics was recorded. Seven patients with active inflammatory or fistulizing Crohn's disease and an IPAA performed for diagnosis of ulcerative colitis were treated with infliximab after they had no response to conventional therapies. Patients received 1-4 infliximab infusions at a dose of 5 mg/kg. All patients improved clinically. Six patients had a complete response, and 1 had a partial response. Four of the 5 patients with complex perianal and fistulizing disease had closure of all fistula tracts, and 1 patient improved temporarily. Six of the 7 patients underwent concurrent treatment with immune modifier drugs. One patient had myalgias and malaise after the first infliximab infusion and flu-like symptoms after the second one. No other adverse effects were observed. This case series demonstrates that the murine chimeric anti-TNF-alpha monoclonal antibody, infliximab, can be used successfully to treat patients with Crohn's disease involving an IPAA who are refractory to conventional therapies.

Adult↗
PubMed2004

[Measuring preferences of psychiatric patients].

OBJECTIVE: Economic evaluation of health care interventions may require preference-based valuations of health outcomes or health effects. This paper provides an overview of the use of standard gamble (SG), time trade-off (TTO) and contingent valuation (CV) to elicit preferences of patients with depression or schizophrenia. METHODS: A systematic search of the literature was conducted covering the use of SG, TTO and CV in patients with depression or schizophrenia. Practicability, measurement results, construct and concurrent validity as well as test-retest-reliability formed the criteria for reviewing the performance of these measures of preference. RESULTS: SG, TTO and CV were rarely used in the two diagnostic groups considered. The reviewed studies mostly showed good practicability as well as some evidence for validity and reliability. Measured SG und TTO values point to substantial losses in utility caused by these diseases. CONCLUSIONS: Elicitation of patient preferences for the economic evaluation of mental health care seems possible.

Cost Allocation↗
PubMed2005

Endotoxin-like reactions with intravenous gentamicin: results from pharmacovigilance tools under investigation.

OBJECTIVE: To apply two data mining algorithms (DMAs) to Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) reports that involved endotoxin-like reactions with intravenous gentamicin to determine whether a signal of disproportionate reporting of these events would have been generated concurrently with surveillance based on clinical observation. DESIGN: Multi-item gamma-Poisson shrinker (MGPS) and proportional reporting ratios (PRRs) were used. Data used for data mining consisted of an extract of the FDA AERS database. Previously published details of clusters of endotoxin-like reactions to intravenous gentamicin were used to select adverse events for data mining. RESULTS: The first signal of disproportionate reporting with any relevant event occurred in 1998, the year in which the outbreak was identified and evaluated by the Centers for Disease Control and Prevention and the FDA. In 1997, there were only 6 reports of rigors in the AERS; this jumped to 68 in 1998. In 1998, a signal was generated for endotoxic shock with PRRs but not with MGPS, based on one case. CONCLUSIONS: The two DMAs generated signals concurrently with the influx of reports. It would have been difficult for safety reviewers to ignore an increase in rigors by traditional methods of safety surveillance; therefore, DMAs might not have had a great deal to offer in this instance. If data mining were considered as a second-line defense to diligent clinical observations under similar circumstances, simple disproportionality methods such as PRRs might be more useful than DMAs such as MGPS when commonly cited thresholds are used.

Adverse Drug Reaction Reporting Systems↗
PubMed1999

Pneumonia in HIV-infected patients: a case-control survey of factors involved in risk and prevention.

OBJECTIVE: To assess the factors that increase or decrease the risk of pneumonia with particular attention to immunization with pneumococcal and influenza vaccines in a group of HIV-infected persons. DESIGN: A retrospective, case-control study based on information entered into a standard database and the medical record. SETTING: Patients attending a referral clinic specializing in AIDS/HIV care at a public hospital. PATIENTS: Among over 2000 subjects entered into a database in 8 years, 127 incidents of pneumonia were identified from the record. These cases were matched with 127 CD4 cell count matched, concurrent controls. INTERVENTIONS: None. MAIN OUTCOME MEASURE: The principal hypothesis was that chart review would find a decreased frequency of pneumococcal immunization in the pneumonia cases compared with matched controls. RESULTS: Pneumococcal immunization was associated with a reduction of the risk of pneumonia by nearly 70%. The effect was seen even when immunization was given with a CD4 cell count of less than 100/mm3. Injection drug users and African-Americans had a twofold increased risk of pneumonia. CONCLUSION: The study provides data to support the current recommendation for pneumococcal immunization of all HIV-infected persons. Although this conclusion could lead to renewed enthusiasm for increasing pneumococcal immunization rates in HIV-infected persons, it must be recognized that the study is observational and ascertainment bias cannot be excluded.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Congenital constriction band syndrome: a seventy-year experience.

Seventy-one cases of congenital constriction band syndrome (CCBS) were reviewed. The year of birth, sex, ethnic background, gestational history, family history, and concurrent diagnoses were obtained. The anatomic patterns of involvement, degree of impairment, and number and type of surgical interventions were recorded. The incidence of CCBS appears to be rising. The average patient had three involved limbs, with a predilection for distal, central digits of the upper extremity. Abnormal gestational histories were found in 60% of the cases; 50% had concurrent diagnoses, and nearly one-third had club-feet. The average patient had a 20% whole body impairment and required three reconstructive procedures. Distraction osteogenesis and free osteocutaneous transfer were useful. We feel that the term "early amnion rupture sequence" more accurately reflects the true pathogenesis of CCBS.

Abnormalities, Multiple↗
PubMed2007

Proteomics and systems biology in exercise and sport sciences research.

A systems biology approach toward biological research seeks to model all concurrent processes in a cell, tissue, or organism by global measurements. In this review, we describe recent advances in mass spectrometry-based proteomics and their application toward interpreting the physiological adaptations of skeletal muscle with exercise and obesity.

Biomedical Research↗
PubMed2006

Management of infants and young children with combined heart and kidney failure.

Most infants and children referred for cardiac transplantation have low cardiac output with concurrent renal hypoperfusion leading to renal insufficiency and failure. This article is a review of the literature of and a single center's experience with combined heart and kidney failure in infants and children less than 10 yr of age. While 39 infants less than 10 yr of age were dialyzed pre- or peri-operatively, none required dialysis support at the time of discharge or in 5-10 yr follow-up. Based on our experience we recommend heart transplant alone in infants and young children with primary heart disease even though they have renal dysfunction.

Child↗
PubMed1993

Histological re-evaluation of 101 intraoral salivary gland tumors by an EORTC-study group.

Tumors of the salivary glands constitute a heterogeneous group of lesions of great morphologic variation and for this reason present many difficulties in histologic classification. The histologic slides of 101 consecutive intraoral salivary gland tumors of the Department of Oral Pathology of the Free University in Amsterdam were reviewed, retrospectively, by an EORTC-study group on salivary gland tumors. Complete concurrence of diagnosis was reached in 54 cases. In 33 cases there were minor disagreements, mostly related to subclassification. Major disagreements, relating to benign versus malignant, occurred in eight cases (7.9 per cent).

Female↗
PubMed2001

Cytologic evaluation of inflammation in canine liver aspirates.

Liver aspiration cytology has been used routinely for more than a decade for the evaluation of canine and feline liver disease. However, the value of liver cytology in detecting inflammatory liver disease is poorly defined. We retrospectively reviewed 51 canine liver cytology reports and compared the conclusions with those from concurrent surgical biopsy reports. Overall sensitivity of cytology for diagnosis of inflammatory liver disease was 93% and specificity was 96%. For suppurative hepatitis (n = 14), the sensitivity of cytologic diagnosis was 100% and the specificity was 95%. For chronic active hepatitis (n = 13), the sensitivity of cytologic diagnosis was 100% and the specificity was 93%. For lymphocytic hepatitis (n = 3), the sensitivity of cytologic diagnosis was 33% and the specificity was 100%. We conclude that canine liver aspiration cytology is a highly sensitive test for the detection of suppurative and chronic active inflammation; however, it is insensitive for the detection of lymphocytic hepatitis.

Journal Article↗
PubMedDate not supplied

Does sex influence the impact that smoking, treatment interruption and impaired pulmonary function have on outcomes in limited stage small cell lung cancer treatment?

PURPOSE: To look for survival differences between men and women with limited stage small cell lung cancer (LS-SCLC) by examining stratified variables that impair treatment efficacy. METHODS: A retrospective review of 215 LS-SCLC patients treated from 1989 to 1999 with concurrent chemotherapy-radiotherapy modelled on the 'early-start' thoracic radiotherapy arm of a National Cancer Institute of Canada randomized trial. RESULTS: Of 215 LS-SCLC patients, 126 (58.6%) were men and 89 (41.4%) were women. Smoking status during treatment for 186 patients (86.5%) was: 107 (58%) nonsmoking (NS) (76 [71%] male [M]; 31 [29%] female [F]) and 79 (42%) smoking (S) (36 M [46%]; 43 F [54%]) (continuing-to-smoke F versus M, P=0.001). Fifty-six patients (26%) had radiotherapy interruptions (RTI) during chemotherapy-radiotherapy because of toxicity. Radiotherapy breaks were not associated with sex (P=0.95). Survival by sex and smoking status at two years was: F + NS = 38.7%; F + S = 21.6%; M + NS = 22.9%; and M + S = 9.1% (P=0.0046). Survival by sex and RTI status at two years was: F + no RTI = 32.4%; F + RTI = 23.6%; M + no RTI = 23.0%; and M + RTI = 3.8% (P=0.0025). Diffusion capacity for carbon monoxide (DLCO) was recorded for 86 patients (40%) and median survival by sex and DLCO was F = 16.7 months and M = 12.1 months for a DLCO less than 60%; and for a DLCO 60% or more, F = 15.1 months and M = 15.3 months. First relapses were recorded in 132 cases (61%), with chest failure in men (45%) greater than for women (35%) and cranial failure rates similar between sexes (48%). Upon multivariable analysis, continued smoking was the strongest negative factor affecting survival. CONCLUSIONS: In LS-SCLC, women overall do better than men, with or without a negative variable. The largest quantifiable improvement in survival for women came from smoking cessation, and for men from avoidance of breaks during treatment.

Adult↗
PubMed2001

Multiple epulides in 13 cats.

Epulides account for 0-7.8% of tumors in surveys of feline oral neoplasms. A review of the literature revealed no reports of multiple epulides in cats. Multiple, concurrent epulides were diagnosed microscopically in 13 cats. Fibromatous and ossifying epulides were diagnosed in 11 of 13 cats and fibromatous epulides were diagnosed in 2 of 13 cats. Microscopically, these epulides were nonencapsulated, well-vascularized, infiltrative, highly cellular neoplasms that expanded the gingiva and were composed of haphazardly arranged, spindle-shaped to stellate cells amid a dense, collagenous stroma. Osseous foci were a feature in the fibromatous and ossifying epulides. The mitotic rate was low and there was marked hyperplasia of the overlying gingiva with a prominent downgrowth of epithelial cords. These tumors recurred in 8 of 13 cats following surgical excision. While uncommon, multiple epulides in cats have a high incidence of recurrence but do not appear to have metastatic potential.

Animals↗
PubMed2004

Surgical reduction and stabilization for repair of femoral capital physeal fractures in cats: 13 cases (1998-2002).

OBJECTIVE: To evaluate anatomic reduction and surgical stabilization of femoral capital physeal fractures in cats. DESIGN: Retrospective study. ANIMALS: 13 cats. PROCEDURE: Medical records of cats with unilateral or bilateral femoral capital physeal fractures evaluated from 1998 to 2002 were reviewed. Age and weight of cats at the time of surgery; breed; sex; concurrent injuries; severity of lameness before and 1, 2, 4, 6, and 8 weeks after surgery; the amount of fracture reduction achieved and number of Kirschner wires (K-wires) used; degree of degenerative joint disease of the hip joint and lysis of the femoral neck and head observed after surgery; whether K-wires were removed after surgery; and complications after surgery were evaluated. RESULTS: Thirteen cats with 16 capital physeal fractures were identified. There was significant improvement in the severity of clinical lameness in all cats from weeks 1 through 4 after surgery. There was no correlation between the scores of the individuals who evaluated radiographs for fracture reduction and placement of K-wires. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that surgical stabilization and repair of femoral capital physeal fractures facilitate a short recovery period and a good prognosis for return to normal function in cats.

Animals↗
PubMed2001

Bone morphogenetic protein in spinal fusion: overview and clinical update.

The widespread use of fusion procedures in the management of spinal disorders has led investigators to explore the use of growth and differentiation factors in such procedures. As an adjuvant to allograft bone or as a replacement for harvested autograft, bone morphogenetic proteins (BMPs) appear to improve fusion rates after spinal arthrodesis in both animal models and humans, while reducing the donor-site morbidity previously associated with such procedures. The use of recombinant genetic technology in the production of BMP has improved the efficiency, cost effectiveness, and safety of producing and using such materials. Recombinant human BMP-2 (rhBMP-2), as one of the first factors identified in the process of endochondral bone formation, has been extensively researched over the past decade. The efficacy and dose profile of this differentiation factor in the context of various carrier substrates has been investigated. Based on the encouraging results of preliminary studies, the future role of rhBMP-2 may lie in its replacement of autologous bone grafting and, consequently, the reduced need for instrumented fixation, while concurrently improving overall fusion rates. The authors provide an overview of BMP and review its use in clinical and laboratory settings.

Animals↗
PubMedDate not supplied

Late corneal scarring after photorefractive keratectomy concurrent with development of systemic lupus erythematosus.

PURPOSE: To report a case of late-onset corneal haze following previous photorefractive keratectomy (PRK) concurrent with the development of systemic lupus erythematosus. METHODS: Single case report and review of medical literature. RESULTS: A 41-year-old woman underwent uneventful bilateral, non-simultaneous photorefractive keratectomy (PRK) with retreatment of the right eye after 1 year. Two months after retreatment, the patient presented with headaches and mental status changes and was diagnosed with systemic lupus erythematosus. Severe reticular corneal scarring developed in the right eye 1 year after retreatment. After the patient's disease was well controlled on a maintenance dose of hydroxychloroquine 200 mg twice a day, mechanical debridement was performed on the right cornea with a marked decrease in corneal haze and improved best spectacle-corrected vision. CONCLUSION: Patients who manifest with autoimmune disorders such as systemic lupus erythematosus may be at greater risk for developing dense, reticular corneal scars after PRK.

Adult↗
PubMed1984

Examining the reliability and validity of the Play History.

Few occupational therapy tools exist that evaluate play totally and systematically. The purpose of this study was to examine the Play History Interview and establish its value as a scientific clinical tool. The parents of 15 disabled and 15 nondisabled children between the ages of 1 and 7 1/2 years were interviewed about their children's play behaviors using the Play History Interview. Children were rated on an ordinal scale according to the criteria outlined on the Play History Chart and Taxonomy for Diagnosis. Interrater and test-retest reliabilities were determined by two independent raters. The scores from the Play History and Minnesota Child Development Inventory were correlated to examine concurrent validity of the Play History. Content validity was studied via a literature review. Significant results suggest that the Play History is a reliable and valid interview in occupational therapy for assessing children's play behavior.

Child↗
PubMedDate not supplied

Candida spp. urinary tract infections in 13 dogs and seven cats: predisposing factors, treatment, and outcome.

Records from 20 animals (13 dogs, seven cats) with Candida spp. urinary tract infections were reviewed. Six Candida spp. were isolated; Candida albicans was the most common isolate. Concurrent diseases or nonantifungal drugs administered within 1 month of isolation included antibiotics (n=16), corticosteroids (n=6), diabetes mellitus (n=4), nonurogenital neoplasia (n=3), and noncandidal urogenital disease (n=14). All animals had sources of local or systemic immune compromise that likely predisposed to infection. Of five animals with resolution of infection, three did not receive specific antifungal treatment. The authors conclude that correction of predisposing conditions is likely critical for management of Candida spp. urinary tract infection.

Animals↗
PubMed1994

Practice-based training in nurse management development: a case study.

One hundred and twenty nurse managers within the Central Sydney Area Health Service completed a program designed to concurrently strengthen professional skills and management systems. The program was based on functional review of work practices. It required consultation with the unit staff and collaboration with other sections of the organisation in designing and implementing quality improvement projects. The success of the program supports the idea that adult learners benefit from the opportunity to reflect on their experience at work. The program demonstrated that nurse managers will make major contributions to improvements in an organisation when the review process is legitimised, when they can participate in developing a framework for the review, and when organisational support is provided.

Education, Nursing, Continuing↗
PubMedDate not supplied

The evil twins of chronic pelvic pain syndrome: endometriosis and interstitial cystitis.

OBJECTIVE: To determine the value in the initial laparoscopic and cystoscopic evaluation of avoiding the unnecessary delay in diagnosing the "evil twins" of chronic pelvic pain syndrome, endometriosis and interstitial cystitis. METHODS: We performed a retrospective review of 60 women ranging in age from 19 to 62. They underwent concurrent laparoscopy, cystoscopy, and hydrodistentions from January 1999 to October 2000. A gynecology and urology team performed these procedures in these 60 patients at a regional pelvic pain center in Northwest Ohio. RESULTS: Fifty-eight patients (96.6%) were diagnosed with interstitial cystitis by the presence of glomerulation and terminal hematuria according to National Institutes of Health criteria. A diagnosis of (active and inactive) endometriosis was found in 56 patients (93.3%). Biopsy-confirmed active endometriosis was found in 48 patients (80%). In the interstitial cystitis patient group (58), 54 patients had a diagnosis of (active and inactive) endometriosis (93.1%), and 47 patients had biopsy-confirmed active endometriosis (81%). In the group of 56 patients with a diagnosis of (active and inactive) endometriosis, 54 patients were found to have interstitial cystitis (96.4%). In the group of 48 patients with active biopsy-confirmed endometriosis, 47 have interstitial cystitis (97.7%). CONCLUSION: Patients with chronic pelvic pain syndrome are very difficult to manage. Eighty percent were found to have endometriosis and had numerous previous operations. Many patients failed to respond to multiple therapies. In many cases, pain persists even after a hysterectomy. Through our study, we showed the high prevalence and association of interstitial cystitis and endometriosis, the evil twins of chronic pelvic pain syndrome. It is absolutely necessary to perform both laparoscopic and cystoscopic examinations concurrently with the patient anesthetized in the initial evaluation and treatment of chronic pelvic pain syndrome to avoid unnecessary delay in making the diagnosis of the evil twins, because chronic pelvic pain syndrome can be caused by either or both of these entities. It is very important to have the gynecologists and urologists working as a team in making an early diagnosis to resolve these chronic debilitating diseases.

Adult↗