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At least 1,585 records · Page 88Linked to original sources
PubMed2006

[Documentation of endonasal changes in blood volume using optical rhinometry].

BACKGROUND: In optical rhinometry, the nose is transilluminated with light and the light absorption by the nasal tissue is measured continuously. Using this method, a real time documentation of changes in nasal blood volume is possible. The method has been evaluated using the nasal allergen provocation test. In this study, the ability of optical rhinometry to detect changes in the nasal blood volume due to various posture changes is examined. METHODS: Optical rhinometry was tested on ten healthy probands, with several examinations being performed on each. RESULTS: By bending the neck, lying down or stopping breathing, stronger light extinction was found. Standing up quickly caused a sudden but short decrease in light extinction. A small amount of exercise, such as making a fist several times, decreased light extinction. Harder exercise on an ergometer led to a stronger decrease in light extinction. In the Valsalva maneuver, an increase in light extinction for the duration of the maneuver was observed. Changes in breathing through the nose or mouth or counting from 1 to 100 had no influence. CONCLUSIONS: Using the new method of optical rhinometry, it is possible to detect changes in endonasal blood volume caused by changes of intrathoracic pressure, changes in posture or physical exercise, non-invasively and in real time. This technique can therefore be used for further research on the regulation of the nasal blood flow.

Adult↗
PubMed1996

[Acoustic voice analysis. On documentation of voice rehabilitation after laser surgery laryngeal carcinoma resection].

Following curative minimal-invasive laser resection of T1-T3 laryngeal carcinomas, patients were subjected to an intensive voice rehabilitation. Therapy was effected twice a day for approximately 2 months, utilizing the concept of functional voice therapy. Before and after rehabilitation, acoustic analyses were made by using two different computer-supported measuring systems: (1) the "multidimensional voice program" (Kay Elementrics Corp.) and (2) a novel software program developed in Göttingen that includes a new voice quality parameter based on correlations between frequency bands. Acoustic analyses showed superiority of the glottal versus supraglottal compensatory phonation. Findings showed that not all acoustic parameters equally documented voice improvement after rehabilitation. The standard deviation of fundamental frequency was the only parameter showing a significant post-therapeutic improvement. A further suitable acoustic method proved to be the voice quality parameter that has been newly introduced by us. In contrast to analogous parameters of other methods, this approach is independent of the exact periodicity of the glottal excitation function, thus permitting reliable results to be obtained even with aphonic or heavily dysphonic voices.

Aged↗
PubMed2001

Images of the invisible-prospection methods for the documentation of threatened archaeological sites.

To understand the development of prehistoric cultural and economic activities, archaeologists try to obtain as much relevant information as possible. For this purpose, large numbers of similar sites must be identified, usually by non-destructive prospection methods such as aerial photography and geophysical prospection. Aerial archaeology is most effective in locating sites and the use of digital photogrammetry provides maps with high accuracy. For geophysical prospection mainly geomagnetic and geoelectrical methods or the ground-penetrating radar method are used. Near-surface measurements of the respective contrasts within physical properties of the archaeological structures and the surrounding material allows detailed mapping of the inner structures of the sites investigated. Applying specially developed wheeled instrumentation, high-resolution magnetic surveys can be carried out in a standard raster of 0.125 x 0.5 m covering up to 5 ha per day. Measurements of ground resistivity or radar surveys in a raster of 0.5 or 0.5 x 0.05 m, respectively, are used to gain information on archaeological structures and on the main stratigraphic sequence of sites covering up to 0.5 ha per day. Data on intensities of the Earth's magnetic field, apparent resistivities of the ground or amplitudinal information of radar reflections are processed using a digital image processing technique to visualize the otherwise invisible archaeological structures or monuments buried in the ground. Archaeological interpretation, in the sense of detecting, mapping and describing the archaeological structures, is done using GIS technology by combining all relevant prospection data. As most of the Middle European archaeological heritage is under a massive threat of destruction, dramatically accelerated by intensive agriculture or industrial transformation of the landscape, the prospection techniques presented here represent an approach towards an efficient documentation of the disappearing remains of our ancestors.

Archaeology↗
PubMed1998

[Basic documentation: inpatient management in a region by a psychiatric hospital and a psychiatric department. Results of a joint evaluation].

A mental hospital and a psychiatric department of a general hospital in the region of Kassel have jointly analysed their basic documentation to produce an overview of hospital treatment of psychiatric patients in the region. Patients from the urban population occupy twice as many beds as those from the rural population which is a hint that standard bed-ratios per population are inadequate. Instead of the unsuitable official definition of duration of stay in hospital we used "days in hospital per person per year". Making allowance for groups of diagnoses this made possible interesting comparisons about the contributions of the two hospitals to the treatment of the psychiatric patients in the region. The two hospitals are not similar and the results show how the patients make use of the possibility of choosing the various specialities of the two hospitals.

Adult↗
PubMed1999

[Wish and reality in installation of a clinic-wide system for image and documentation access].

PROBLEM: This report describes the problems that can occur in the representation of the radiological workplace in a digital environment. On one hand the radiologist can sometimes access good equipment in "stand-alone" surroundings (CT, laser printer, workstations,...); on the other hand, the existing insufficient communication between different components is only rarely qualified to support the radiological workflow. This unsatisfactory framework handicaps the required clinic-wide distribution of radiological information. METHODS: From the beginning we defined user groups requiring different radiological data closely associated with specific hard- and software: The radiological workstation in the department for reporting and image processing. The demonstration workstation in wards/outpatient departments for clinicians involved in treatment. Standard PCs with access to the digital medical document for clinicians involved in treatment. At all workstations the medical as well as the legal unity of digital radiological images and the corresponding report is ensured. RESULTS: Only the first two user groups have unrestricted access to the RIS database and to the PACS archive. We have decided that the RIS should be the master of the RIS/PACS-System. For an effective master/slave relationship between RIS and PACS archive and PACS workstations we suggest to mark images and/or series of images. CONCLUSION: The third user group depends on the information exported by the radiologist from PACS. After the report is written and signed by the radiologist, the digital report is transferred from the RIS to the HIS. The report is automatically attached to these images. Authorized personnel at the wards and outpatient are able to read the combination of validated report and exported radiological images as part of the digital medical record with an intranet browser on standard PCs.

Computer Systems↗
PubMed2003

Forensic pathological aspects of postmortem imaging of gunshot injury to the head: documentation and biometric data.

To determine the value of imaging procedures such as computer tomography (CT) and magnetic resonance imaging (MRI) of the head in providing additional information of forensic relevance, we examined 17 cadavers of human victims of gunshot wounds to the head. Three of the victims briefly survived the gunshot wound. The weapons involved were all guns with low muzzle energy (<550 J), i.e., handguns and low-velocity rifles. In the majority of cases ( n=15) a penetrating wound to the head was found, only two cases showed the bullet lodged in the brain. In some cases, imaging of the skull and brain was performed prior to autopsy; in others imaging took place after autopsy on the isolated, formalin-fixed brain. The imaging findings were correlated with the criminological data and the results of macroscopic and microscopic examination of the brain. The findings on the bony structures of the head provided imaging criteria for differentiation between entrance and exit of the gunshot wounds, which corresponded to the forensic pathological findings at autopsy. CT scans and MRI of the cerebral parenchyma revealed lanes of opaque bone and missile fragments along the course of the missile, which allowed recognition of the missile track in 3D reconstruction. Biometric reconstruction allowed easy determination of the angle of the missile track in all three planes. Examination of the parenchymal structures and imaging of the isolated, formalin-fixed brain enabled tracking of the missile path directly along the zone of destruction as well as demonstration of secondary changes such as air bubbles along the bullet course, hemorrhage and edema. The significance of a translucent zone surrounding the missile track in several cases remains unclear; it probably represents tissue destruction secondary to temporary cavitation. The imaging procedures described here allowed excellent documentation of in situ conditions, while the storing of data enabled biometric reconstruction for determination of the angle of trajectory, of entrance and exit wounds, and the extent of tissue damage along the missile track and, possibly, in the zone of temporary cavitation.

Adult↗
PubMedDate not supplied

Clinical procedures performed by emergency medicine resident physicians: a computer-based model for documentation.

To facilitate documentation and assess the number and types of clinical procedures actually performed by resident physicians, we developed a microcomputer-based recording process. After completing a procedure, including resuscitations, residents recorded in a precoded book issued for each monthly rotation. At the end of each rotation, the books were collected and the information was transferred to a database program by the clerical staff. During 1989, 17 emergency medicine resident physicians at PGY levels 1 through 3 utilized this system. Completed procedure record books were submitted for 124 of 148 clinically active months for a compliance rate of 84%. Of 1,857 procedures recorded, the most frequent were resuscitation (20%), orotrachael intubation (12%), and percutaneous central vein cannulation (12%). Commonly recorded were lumbar puncture (7%), diagnostic peritoneal lavage (5%), nasotrachael intubation (4%), and newborn delivery (4%). The high compliance rate suggests resident physicians acceptance. This system enables residency directors to closely monitor individual and group procedure experiences and to make curriculum changes based on objective findings. It also provides a means of storing and retrieving data for review organizations and credentials committees.

Documentation↗
PubMed2006

Pilot study of methods to document quantity and variation of independent patient exercise and activity after total knee arthroplasty.

Variation in patients' independent exercise and activity after total knee arthroplasty (TKA) surgery may contribute to variable functional gains but have never been quantified. We pilot tested daily exercise logs and step activity monitors to quantify exercise and general home activity post-TKA. Patients successfully maintained logs and wore activity monitors. Logs documented significant variation in quantity of daily exercises. Women with poor emotional health recorded fewer repetitions and greater variation. More daily exercise repetitions correlated with larger 6-month functional improvement. Activity peaks on step monitors correlated with logged exercise sessions. However, most step activity was in addition to exercise sessions. Further research is needed to validate these findings and to clarify the relationship among post-TKA exercise, activity, and functional gain.

Aged↗
PubMed2004

Italian version of the International Knee Documentation Committee Subjective Knee Form: cross-cultural adaptation and validation.

PURPOSE: Patient-oriented measures, represented by self-administered questionnaires, have become an important aspect of clinical outcome assessment. To be used with different language groups and in different countries, questionnaires must be translated and adapted to new cultural characteristics, and then validated by a widely accepted process to evaluate reliability and validity, fundamental characteristics for each measure. The aim of the study was to perform the cross-cultural adaptation and to assess the reliability and validity of the Italian version of the International Knee Documentation Committee (IKDC) Subjective Knee Form. TYPE OF STUDY: A cross-cultural adaptation and cross-sectional study of a sample of patients undergoing anterior cruciate ligament (ACL) reconstruction with a subsample followed up prospectively for retest reliability. METHODS: The IKDC Subjective Knee Form was culturally adapted for Italian-speaking people, following the simplified Guillemin criteria. Reliability and validity were assessed in a cross-sectional study of 50 consecutive patients undergoing ACL reconstruction. A subsample of 20 patients was followed up prospectively for retest reliability. RESULTS: The results were compared with other validated patient-oriented measures. The principal IKDC scale showed a high correlation with other patient-oriented measures as hypothesized, and it also showed good values with regard to reproducibility, consistency, and validity, compared with the versions of IKDC published in other languages. CONCLUSIONS: These findings suggest that the evaluation capacities of the IKDC Italian version are equivalent to those of other language versions of the IKDC. LEVEL OF EVIDENCE: Level II.

Adolescent↗
PubMed2005

Social regulation, medicalisation and the nurse's role: insights from an analysis of nursing documentation.

BACKGROUND: Medicine is recognised as a dominant source of governmentality and social regulation, and although nursing has been implicated in the same process, analytical work in this area has been sparse. OBJECTIVES: The article aims to present an analysis of nursing records in order to understand the structural and social processes that mediate the texts. METHODS: 45 sets of nursing records drawn from four clinical sites in Ireland were subjected to a discourse analysis. RESULTS: This article focuses on two main themes that were derived from data: (i) the manner in which nurses controlled, regulated and invigilated patients' activities of daily living and (ii) the way in which activities of daily living were mediated by a biomedical worldview in the clinical settings. Through the organising framework of Activities of Daily Living (ADLs), normative social practices relating to hygiene, eating and drinking, sleeping and so forth were surveyed and monitored within clinical settings. We construct qualitative categories around a range of ways that nurses assessed and judged patients' capacities at ADLs. Furthermore, it is argued that the framework of ADLs epitomises the medicalisation of normative social practices, whereupon the most mundane of normal functions become redefined as an actual or potential clinical pathology, legitimating nursing interventions. According to the nursing documentation, biochemical interventions in the form of various medications were the most dominant means through which nurses attempted to restore or improve the functional capacity of an ADL. CONCLUSION: We conclude by proposing that nurses' invigilation of patients' ADLs is not necessarily a repressive feature of nursing practice, but rather has the potential to be used to advocate on patients' behalf in certain circumstances.

Activities of Daily Living↗
PubMed1995

Improving malnutrition documentation enhances reimbursement.

Diagnosis coding for malnutrition can positively affect hospital reimbursements. Our goal was to quantify the possible increase in reimbursements when the diagnosis of malnutrition was identified and appropriately coded. A sample of 234 cases representing 14% of Medicare patients seen from March 1991 through February 1992 at Allenmore Hospital in Tacoma, Wash, was retrospectively reviewed. Malnutrition diagnoses (using ICD-9-CM codes) were assessed according to established criteria. Ninety-four cases (39.7%) met the criteria for malnutrition. Seven demonstrated increased reimbursement, totaling $12,326 for the sample. Length of hospital stay was significantly longer in the malnourished group (P = .001). The results indicated a need for an improved system of documenting and coding malnutrition diagnoses for improved identification and reimbursement enhancement purposes. An example of criteria used for each malnutrition ICD-9-CM diagnosis code and a policy defining the criteria usage are shown. A nutrition assessment form, which includes each malnutrition ICD-9-CM code title for enhanced interdisciplinary communication leading to improved coding of malnutrition diagnoses, is also shown. We conclude that effective identification of malnutrition leading to enhanced reimbursement strengthens the leadership potential of hospital dietitians and improves hospital revenues. Additionally, we suggest that such a system initiates a process that may lead to improved, cost-effective treatment of persons identified as being malnourished and provide a foundation for surviving within the future health care reform environment.

Body Weight↗
PubMed1998

20 MHz ultrasonic imaging for quantitative assessment and documentation of early and late postradiation skin reactions in breast cancer patients.

BACKGROUND AND PURPOSE: In dermatology high resolution ultrasonic systems proved to be valuable in following up genuine and experimental inflammatory dermatoses. The opportunities of 20 MHz ultrasonic imaging for quantitative assessment of early and late postradiation skin reactions are investigated. MATERIAL AND METHODS: Between April and November 1996, 96 high resolution ultrasound examinations of the skin in 29 patients treated for breast cancer at the University of Ulm were analyzed. Total doses between 46 and 60 Gy were applied. The time interval between the completion of radiotherapy and ultrasonic examination was < or =3 months in 18 patients and 6-135 months in 11 patients. For examinations we used a digital high resolution ultrasonic system with a ceramic 20 MHz transducer. Irradiated and non-irradiated skin were compared. RESULTS: A change of thickness and texture of the dermis depending on the time interval between the completion of radiotherapy and ultrasonic examination and on the administered radiation dose was found. There were significant differences between irradiated and non-irradiated skin regarding the dermal thickness in early (P < 0.001) as well as in late (P = 0.0018) reactions. Echogenicity of the upper and lower corium of irradiated skin decreased in early and late reaction. In upper corium the greatest reduction of signal intensity occurred in early reactions (P = 0.0001). Early reactions of the lower corium differed significantly from late changes (P = 0.001). Discrepancies between visible skin reactions described by examining physicians and ultrasonically proven changes were obvious mainly in late reactions. CONCLUSIONS: There are specific textures of early and late postradiation skin reactions in comparison to non-irradiated skin. High resolution digital 20 MHz ultrasound is non-invasive and quantitative, and in contrast to physical examination, an easy reproducible method for assessing and documenting early and late skin reaction during and after radiation therapy treatment.

Adult↗
PubMed1999

Improving understanding of the informed consent process and document.

OBJECTIVES: To review theoretical perspectives relating to the communication of informed consent and to describe research efforts and strategies to enhance the informed consent process and document. DATA SOURCES: Research studies review articles, education and communication models, and NCI National Working Group on Informed Consent Recommendations. CONCLUSIONS: Information communicated during the informed consent process is difficult to understand, raising ethical concerns about whether informed decision-making has taken place. Empirical research focuses on the nature of patient-provider interactions and the effectiveness of various delivery systems, a need exists to overcome conceptual and methodologic limitations. IMPLICATIONS FOR NURSING PRACTICE: Nurses must ensure that patients understand informed consent information. Several communication strategies are posited.

Clinical Trials as Topic↗
PubMedDate not supplied

Using Raman spectroscopy to solve crime: inks, questioned documents and fraud.

Raman microscopy is becoming a tool of major importance in forensic analysis, particularly of drugs and explosives. It is a non-invasive, non-destructive chemical probe allowing samples to be examined in their entirety without any preparation. This paper demonstrates the use of the technique as a general tool for inks analysis. Furthermore, it addresses two important issues that historically have been extremely difficult for the professional document examiner, namely, comparison of black ballpoint inks and the chronological sequencing of crossed ink lines. We show that Raman can successfully distinguish between a representative sample of commercially available black ballpoint inks. This data has been converted into a database for future reference. A method for chronological sequencing of crossed ink lines has been developed using confocal Raman microscopy. Case study work has shown the feasibility of this approach.

Databases, Factual↗
PubMedDate not supplied

An open source protein gel documentation system for proteome analyses.

Data organization and data mining represents one of the main challenges for modern high throughput technologies in pharmaceutical chemistry and medical chemistry. The presented open source documentation and analysis system provides an integrated solution (tutorial, setup protocol, sources, executables) aimed at substituting the traditionally used lab-book. The data management solution provided incorporates detailed information about the processing of the gels and the experimental conditions used and includes basic data analysis facilities which can be easily extended. The sample database and User-Interface are available free of charge under the GNU license from http://webber.physik.uni-freiburg.de/~fallerd/tutorial.htm.

Documentation↗
PubMed1976

Improvements in the coupling of SDI system output with document delivery systems.

A brief review is given of approaches used to couple SDI system output to the supporting document delivery systems. A coupling system is described which has been implemented for the nine campuses of the University of California to automatically annotate citations retrieved from a central SDI service with location and call number information. Many of the computer-printed citations sent to each UC user are annotated to show the one or more library locations and call numbers for those serial titles on that user's campus. In the event that a cited title is not held on a user's campus, the citations are annotated to identify the nearest UC library that has that title. The location-code segment of the SDI system has been in operation since mid-1974 for over 1500 profiles, and five data bases, and for users on nine UC campuses. This is the first instance of this kind of coupling on a operational basis for a large, multifile, geographically dispersed multilibrary system.

California↗