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At least 145 records · Page 8Linked to original sources

Decision support systems in nuclear emergencies: a scenario-based comparison of domestic and reference tools.

The article reports selective results of a comparison between RODOS-an emerging decision support system for the management of nuclear emergencies in Europe developed by an international research consortium under EEC aegis, and a resident software package developed and maintained for similar purposes at IFIN-HH, Bucharest. Reproducible similarity patterns obtained in the output data distributions provide for simple normalising procedures that may ensure convergent radiological assessments. When properly consolidated on a sufficient scenario casuistry, such procedures could lend a certain resilience to domestic decision support tools over the interim lead time required by the full implementation of RODOS, or other major league, internationally accepted reference systems.

Decision Support Techniques↗

Nematode infection of the liver mimicking metastasis of malignant melanoma.

BACKGROUND: The differential diagnoses of a circumscribed mass of the liver are varied. Especially if a malignant tumor, capable of setting metastases to the liver, is known in a patient's medical history, there might be difficulties in differentiating the tumor's entity. CASUISTRY: We report a case of a 40-year-old male with a history of malignant melanoma in whom follow-up investigations revealed a mass in the liver. RESULTS: The histopathological and microbiological results, however, showed an infestation of liver tissue with nematodes. Malignant tumor cells could not be detected. CONCLUSIONS: Roundworm-infections of the liver can present as lesions suspicious of being malignant. Therefore, along with e.g. microhamartoma, microabscesses and hepatocellular carcinoma, infestation with nematodes should be taken into consideration.

Adult↗

Basilar impression and the so-called 'associated anomalies'.

Analysing the casuistry of 210 patients with basilar impression, the author has enumerated the type and frequency of the associated anomalies and looked for correlations between them and the various clinical syndromes. An attempt is made to divide the anomalies into pathogenetic groups on the basis of these findings.

Adolescent↗

An approach of ultrasound diagnostic techniques of the skin and subcutaneous tissue.

The authors have examined ultrasound echograms and photographs of the skin and subcutaneous tissue changes in some skin diseases, reporting their findings. In spite of the preliminary clinical casuistry, this quick, simple and painless technique without irradiation hazard to the patient shows the advantage relating to the other techniques, routine roentenography especially. In conclusion, it is the authors' opinion that the improved scanning technique and greater experience should offer such valuable results, used as an additional method in dermatological diagnostics.

Aged↗

Disability: an agenda for bioethics.

Contemporary bioethics has been somewhat skewed by its focus on high-tech medicine and the resulting development of ethical frameworks based on an acute-care model of healthcare. Research and scholarship in bioethics have payed only cursory attention to ethical issues related to disability. I argue that bioethics should concern itself with the full range of theoretical and practical issues related to disability. This encounter with the disability community will enrich bioethics and, potentially, society as well. I suggest a number of items that the bioethics agenda should include, such as the development of a casuistry of the right to healthcare and to community integration and an advocacy role in fostering an understanding among the public and policy makers of the need to reform research and treatment related to disability.

Bioethical Issues↗

Principles and theory in bioethics.

The following citations were selected from BIOETHICSLINE, the online database prepared at the Kennedy Institute of Ethics for the National Library of Medicine's MEDLARS system. Searching the keywords autonomy, beneficence, casuistry, justice, and virtues, as well as the text word principlism produced more than 400 citations. Only the citations concerned with theory and principle in the practice of bioethics are included here -- e.g., works about justice in resource allocation have been deleted.

Bioethics↗

Amenable to reason: Aristotle's rhetoric and the moral psychology of practical ethics.

An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in is Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. an important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this feature enables us to understand casuistry, narrative, and principlism as mutually supportive modes of moral inquiry, rather than divergent and mutually exclusive methods of ethics. As a result, an Aristotelian conception of practical ethics clears the conceptual common ground upon which practical ethicists can forge a stable and realistic self-understanding.

Bioethics↗

Angular analysis of corpus callosum in 18 patients with frontonasal dysplasia.

Considering the rarity of the frontonasal dysplasia (FD) and the few reports about it in a large casuistry using magnetic resonance image (MRI), we describe the results of the angular analysis of the corpus callosum of 18 individuals with FD (7 male, 11 female), using an easily-reproductive method. Group I had 12 individuals with isolated form and Group II had 6 individuals with FD syndromic with unknown etiology. The results are presented in set. Comparing with the control group, patients with FD presented alpha angle increase and beta and gamma angles reduction (p<0.05). Alpha and gamma angles express the relationship between the anterior portion of corpus callosum and the floor of 4th ventricle. Considering the embryonary development, these findings would occur secondarily to failure during the development of nasal capsula. Thus, angular anomaly in corpus callosum would be a usual finding, and not fortuitous in patients with FD.

Abnormalities, Multiple↗

[Importance of the clinical genetics evaluation on hydrocephalus].

The aim of this study was to characterize the possibility of genetic etiology in a group of individuals with congenital hydrocephalus in which the etiology was indeterminate and to confirm that earlier diagnosed. The casuistry was composed by 16 individuals with congenital hydrocephalus. Investigation protocol included anamnesis, familial investigation, physical examination, computerized tomography or magnetic resonance image of head, vertebral column X-ray, karyotype and dysmorphological study. Results were analyzed in two groups. In Group I (3M:9F) was composed by hydrocephalus associated with unspecific signs. Group II (7 males) had findings of epectrum of L1 disease. Genetic counseling could be offered in 11 cases. These results demonstrate the great etiological heterogeneity of congenital hydrocephalus and reinforce the importance of dysmphology evaluation as an important complementary investigation.

Adolescent↗

[Episodic tension-type headache: clinical evaluation of 50 patients].

A case series study of 50 consecutive patients with episodic tension type headache (ETTH) was conducted. Clinical aspects, family history and impact on work activities were studied. The casuistry was made up of 40 women and 10 men. The average age was 30 (+/-12) years. Constrictive pain was present in 40 patients (80%). Sickness was the most commonly reported related phenomenon (20%). As expected, bilateral pain predominated; however, unilateral location was also present (10%). Although classically described as a mild pain, we observed that ETTH can come in intense crisis (16%). Family history of tension type headache was positive in 12 patients. The impact on work activities was substantial (14%). Our findings regarding to clinical aspects are in agreement with the literature. It is important to mention that the impact of ETTH on the individual and society should be reconsidered, and is more substantial than has been reported to date.

Adolescent↗

[Family and risk factors related to alcohol consumption and smoking among children and adolescents (Guayaquil-Ecuador)].

The present investigation had as objective identifying in a family the possible factors of risk related to the use of alcohol and tobacco in the children and adolescents. It is important to emphasize that study of this nature within a social and culture perspective expresses the attempt to include/understand the factors of risk for the use of tobacco and to drink alcoholic the environmental influences in the familiar surroundings views to prevent futures cases with dependency. For the study used a sample of one hundred families, to that applied to an instrument pre to them established with the people in charge of the respective families. As result were obtained 51% of the schooling level are low, 54% has inferior wage to the basic one, 61% to drink alcoholic. To emphasize that unquestionable the reduction of the casuistry of alcoholism and/or tabaquismo to influence significantly in the quality of the individuals life.

Adolescent↗

[Neoplasms associated with esophageal epidermoid carcinoma].

INTRODUCTION: The esophageal epidermoid cancer has an important association with aerodigestive tract neoplasms and possibly share the same risk factors. Furthermore, other neoplasms can be associated with esophagus cancer. OBJECTIVE: To analyze retrospectively the patients with esophageal epidermoid cancer (EEC) and associated neoplasms, treated by the Esophagus Stomach and Small Intestine Group of Surgery at Hospital de Clinicas de Porto Alegre from January 1988 to June 1995. PATIENTS AND METHODS: Nineteen (7.28%) of the 261 studied patients had associated neoplasms to the EEC. Ten patients presented synchronic tumours and 9 metachronic ones. The predominant sex was the masculine with 17 cases. The mean age was 62.52 years in the moment of the esophageal cancer diagnostic. RESULTS: The aerodigestive tumours, squamous carcinomas in totality, represented the predominant associated neoplasm histological type in 68.42% of the cases. The most frequent associated aerodigestive tumours site was the respiratory tract (53.8%), followed by the oral cavity and oropharynx (23%) and larynx (23%). In our sample, twelve patients were smokers and 9 were alcohol abusers. In relation to the EEC treatment, surgery was performed in 6 patients. The associated neoplasm was treated with radical surgery in 11 patients and radiotherapy in 5. Surprisingly 4 cases (21%) of gastric adenocarcinoma associated to the EEC were diagnosed, treated with radical surgery in 3 patients. CONCLUSION: The authors call attention to the importance of a criterial staging as well as the follow up in patients with EEC owing to the significant association with others neoplasms, principally with aerodigestive tumours, and discuss the common risk factors possibility: tobacco and alcohol use. Important association with gastric neoplasms were found in this casuistry.

Adult↗

[Rhabdomyosarcomas in the naso-paranasal area].

The nasoparanasal region rhabdomyosarcoma belongs to the group of the rare malignant diseases, however it nevertheless represents major diagnostic and therapeutic problem. The study is aimed at presenting clinical casuistry of the nasoparanasal region rhabdomyosarcoma in adults and children, for the purpose of assessment of modern diagnostic and therapeutic possibilities. The study was retrospective and included the patients with evidenced and pathohistologically verified rhabdomyosarcoma of the nasoparanasal region diagnosed and treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia, during the period 1988-2001, and subsequently at the Institute of Oncology in Belgrade. The total of 9 patients aged 3-50 years (median 15) were assessed, with the female to male ratio being 4:5. Seven patients were previously hospitalized in other health institutions. The following parameters were analyzed: sex, age group, number of hospitalizations, diagnostic procedures, histological tumour types, mode of treatment and disease outcome. In 7 patients, the tumour spread beyond the nasoparanasal region--in 6 into the orbit, in 5 into the epipharynx, in 3 intracranially, in 1 into the pterygopalatine pit and in another 1 into the parapharyngeal space. Regional lymph nodes were affected only in one patient, while distant bone metastases were evidenced on another one. Embryonal type of the rhabdomyosarcoma was verified in 7 patients, while two had the alveolar type. In the affected children mean survival was significantly longer (76.3 months) in comparison to the one observed in adults (11.5 months). Therapeutic procedure included combined application of the chemotherapeutic protocols (adjusted with respect to the age group and stage of the disease) and radiotherapy. Radical surgical procedures were applied on in case of stage I tumours, and they may also be used in rest-relapse cases subsequent to the applied chemo-, i.e., radiotherapy.

Adolescent↗

[Juvenile angiofibroma of the nasopharynx--clinical diagnosis and therapy].

Juvenile nasopharyngeal angiofibroma is an infrequent epipharyngeal tumour necessitating particular diagnostic and therapeutic procedures in comparison to other benign epipharyngeal tumours due to its expansive growth tendency. Our retrospective study is aimed at presenting clinical casuistry of the tumour in order to evaluate modern diagnostic and therapeutic possibilities. The study included 13 male patients, aged 13-24 years, who were hospitalized, diagnostically assessed and surgically treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia over the period 1990-June 2001. The following parameters were analyzed: sex, age groups, preoperative symptoms of the disease, diagnostic methods, embolization, local tumour spreading, number and time of tumour relapses and surgical approach.

Adolescent↗

["Teruel feet". Care and treatment of frostbite wounds in the hospitals of Navarra during the civil war].

The care of combatants with lesions caused by frostbite during the battle of Teruel, which was fought in extreme weather conditions and in temperatures as low as twenty degrees below zero, was the period of greatest medical activity and the highest rates of occupation in the military hospitals of Navarre during the civil war of 1936-1939. From November 1937 to March 1938, 375 cases of frostbite were registered in the provincial establishments, amongst which there was a predominance of cases of dry gangrene partially affecting the lower extremity, which was popularly known as "Teruel feet". Some of the medical staff, conscious of the exceptional nature of the casuistry, registered statistics, clinical cases and personal impressions of the evolution of the lesions and the effectiveness of the treatments. In treating this affectation they employed medicines, surgical techniques and novel therapeutic procedures that were not widely used in the medical milieu of the time. However, the limited duration of the problem, the inconclusive results of the treatments and the differing opinions on their effectiveness -questions that are considered in this article- restricted the subsequent medical repercussion of the experiences of frostbite developed during the wartime period in Teruel.

Foot↗

[Natural history of unstable angina. Observations on 157 cases (author's transl)].

157 cases affected with "unstable angina" and hospitalized were observed over a period of from 8 to 24 months (average observation time: 16 1/2 months). The patients were treated with: nitroderivates, beta blocking drugs (when not contra-indicated); treatment of side affects (hypertension; arrhythmias, decompensation, associated pathology, correction of risk factors of coronary heart disease). 9 cases were lost and 148 were studied for the course of the illness. 10.6% died from cardiopathy (2.8% through sudden death; 7.4% from myocardial infarction); there was a 12.1% total incidence of myocardial infarction; 50% of the cases were alive but with sumptoms of stabilized angina, whilst 32.4% were completely asymptomatic. Coronographic alterations and myocardial contractility negatively affect the course of the illness. Negative effects (disease or infarction) were not checked in the cases of stenosis of only one coronary branch. In the casuistry, there were no negative effects in patients with stenosis of one coronary branch, and in cases of two or more branches, negative effects were 28%. 41% of patients with alterations of ventrical contractility gave negative results. An asymptomatic course of the illness was checked more frequently in the intermediate stages than in angina cases.

Angina Pectoris↗

Spirituality and prayer research: a select annotated bibliography.

As the world has become more complex, so too have our ethical conceptualizations about it. In the 1970s, ethical theories and principle-based bioethics dominated. Then clinicians and scholars began to experience the limitations of these two approaches when used alone. In the 1980s, women's voices began to be heard through both feminist ethics and the ethic of care. In addition, virtue ethics and casuistry again gained recognition. During the 1990s and as we are about to enter the 21st century, ethics has expanded to capture the concepts of narrative ethics and spirituality. This select annotated bibliography focuses on spirituality and on prayer research.

Ethics, Nursing↗