Home About us Contact
|
Home About us Contact | ||
|
|
||
Final Analysis (final + analysis)
Selected AbstractsIncorporating Data Received after a Sequential Trial Has Stopped into the Final Analysis: Implementation and Comparison of MethodsBIOMETRICS, Issue 3 2003Marina Roshini Sooriyarachchi Summary. In a sequential clinical trial, accrual of data on patients often continues after the stopping criterion for the study has been met. This is termed "overrunning." Overrunning occurs mainly when the primary response from each patient is measured after some extended observation period. The objective of this article is to compare two methods of allowing for overrunning. In particular, simulation studies are reported that assess the two procedures in terms of how well they maintain the intended type I error rate. The effect on power resulting from the incorporation of "overrunning data" using the two procedures is evaluated. [source] Determination of nonsteroidal antiinflammatory drugs in water samples using liquid chromatography coupled with diode-array detector and mass spectrometryJOURNAL OF SEPARATION SCIENCE, JSS, Issue 17 2005Jolanta Debska Abstract An analytical method for the determination of trace levels of six different nonsteroidal antiinflammatory drugs (NSAIDs) in water samples has been developed and validated. Environmentally relevant pharmaceuticals were chosen according to human consumption in Poland. Final analysis of the target compounds was performed by RP LC,diode-array detection,MS, whereas sample preparation included an SPE step. For this SPE step, a number of packing materials, such as LiChrolut RP-18, calixarene, Strata-X, BAKERBOND Narc-2, BAKERBOND Polar Plus, BAKERBOND styrene divinylbenzene-1, and Discovery DSC-18, were used, and their respective advantages and disadvantages in this study were discussed. The RP-18 phase was found to be the most retentive for all analytes. The detection limits for compounds in surface waters were varied from 0.005 for diflunisal to 0.095 ,g/L for ibuprofen. The average recoveries of NSAIDs from the surface water samples ranged from 80 up to 103%. RSD value is relatively low (from 4% for fenoprofen up to 8% for ibuprofen). The performance of the method was tested with several environmental water samples. [source] Enhanced adherence to HCV therapy with higher dose ribavirin formulation: final analyses from the ADHERE registryALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2010I. Alam Aliment Pharmacol Ther 2010; 32: 535,542 Summary Background, Poor adherence to Hepatitis C virus (HCV) treatment is an important cause of treatment failure. Traditional ribavirin 200 mg (RBV) treatment is associated with a significant daily pill burden. RibaPak (RBP), available as 400 mg and 600 mg ribavirin tablets, offers simplified dosing at two pills daily. Aim, To examine whether improved adherence was associated with RBP vs. RBV. Methods, Accurate Dosing in Hepatitis C: Examining the RibaPak Experience (ADHERE) was a U.S., multi-centre, prospective registry capturing data on adherence with RBP vs. RBV in adults with HCV. Adherence was measured by the proportion of subjects remaining on treatment at weeks 4, 12 and 24; by pill counts; and by the proportion of subjects who took ,80% of their prescribed dose. Results A total of 503 patients (RBP = 346, RBV = 157) from 33 sites were included. A greater proportion of RBV vs. RBP subjects prematurely discontinued treatment. At 12 and 24 weeks, a greater proportion of RBP vs. RBV subjects took ,80% of their prescribed doses (P < 0.05). For patients who remained on treatment, the mean milligrams missed per day was significantly greater for RBV vs. RBP at 24 weeks. Conclusions, First line treatment with RBP may offer the best prospect for less discontinuation and improved treatment adherence. [source] Routine and adaptive expert strategies for resolving ICT mediated communication problems in the team settingMEDICAL EDUCATION, Issue 7 2009Lara Varpio Context, The use of information and communication technologies (ICTs) for supporting interprofessional communication is becoming increasingly common in health care. However, little research has explored how ICTs affect interprofessional communication, or how novices are trained to be effective interprofessional ICT users. This study explores the interprofessional communication strategies of nurses and doctors (trainees and experts) when their communications were mediated by a specific ICT: an electronic patient record (EPR). Methods, A total of 72 doctors and nurses participated in this 8-month study on a paediatric in-patient ward. Eighty hours of non-participant observations and 20 semi-structured interviews were conducted. All data were rendered anonymous prior to analysis. Using a constructivist grounded theory approach, one researcher read and analysed all data recursively. As emergent themes were identified, exemplary portions of the data were discussed with three additional researchers to resolve discrepancies and confirm the coding structure. Expertise literatures informed the final analyses. Results, Three interprofessional communication strategies were identified: (i) all participants routinely formulated ,workarounds' to circumvent problematic EPR-mediated communications; (ii) workarounds were classifiable as instances of Abandoning, Forcing or Submitting to the EPR, and (iii) novices learned workaround strategies through an informal curriculum, but they did not learn to manage the interprofessional effects of these workarounds. Conclusions, Trainees relied on workarounds as simplified routines, demonstrating routine expertise. Staff members, demonstrating adaptive expertise, used workarounds as part of a broader network of people and communication tools. Explicit training regarding this network and the ways in which workarounds conceal this network may help trainees develop adaptive expertise. [source] Maternal use of folic acid supplements during pregnancy and four-year-old neurodevelopment in a population-based birth cohortPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2009Jordi Julvez Summary The use of folic acid supplements during very early pregnancy is recommended in order to reduce the incidence of neural tube defects. Little is known about the possible benefits of folic acid on child neurodevelopment. A total of 420 children (87% of those eligible) from a birth cohort had complete data for final analyses at age 4 years. Information about folic acid and other over-the-counter dietary supplements was obtained prospectively using interviewer-administered questionnaires at the end of the first trimester of pregnancy. Psychological outcomes were assessed by two psychologists and teachers 4 years later. Low maternal socio-economic status, smoking, high parity and short duration of breast feeding were associated with lower prevalence of folic acid supplement use. Verbal (b = 3.98, SE = 1.69), motor (b = 4.54, SE = 1.66) and verbal-executive function (b = 3.97, SE = 1.68) scores, social competence (b = 3.97, SE = 1.61) and inattention symptom [OR = 0.46; 95% CI 0.22, 0.95] scores were associated with reported folic acid use. Reported folic acid supplement use during pregnancy was associated with improved neurodevelopment in children after adjusting for a number of sociodemographic and behavioural factors. [source] Outcomes After Intravenous Opioids in Emergency Patients: A Prospective Cohort AnalysisACADEMIC EMERGENCY MEDICINE, Issue 6 2009Alec B. O'Connor MD Abstract Objectives:, Pain management continues to be suboptimal in emergency departments (EDs). Several studies have documented failures in the processes of care, such as whether opioid analgesics were given. The objectives of this study were to measure the outcomes following administration of intravenous (IV) opioids and to identify clinical factors that may predict poor analgesic outcomes in these patients. Methods:, In this prospective cohort study, emergency patients were enrolled if they were prescribed IV morphine or hydromorphone (the most commonly used IV opioids in the study hospital) as their initial analgesic. Patients were surveyed at the time of opioid administration and 1 to 2 hours after the initial opioid dosage. They scored their pain using a verbal 0,10 pain scale. The following binary analgesic variables were primarily used to identify patients with poor analgesic outcomes: 1) a pain score reduction of less than 50%, 2) a postanalgesic pain score of 7 or greater (using the 0,10 numeric rating scale), and 3) the development of opioid-related side effects. Logistic regression analyses were used to study the effects of demographic, clinical, and treatment covariates on the outcome variables. Results:, A total of 2,414 were approached for enrollment, of whom 1,312 were ineligible (658 were identified more than 2 hours after IV opioid was administered and 341 received another analgesic before or with the IV opioid) and 369 declined to consent. A total of 691 patients with a median baseline pain score of 9 were included in the final analyses. Following treatment, 57% of the cohort failed to achieve a 50% pain score reduction, 36% had a pain score of 7 or greater, 48% wanted additional analgesics, and 23% developed opioid-related side effects. In the logistic regression analyses, the factors associated with poor analgesia (both <50% pain score reduction and postanalgesic pain score of ,7) were the use of long-acting opioids at home, administration of additional analgesics, provider concern for drug-seeking behavior, and older age. An initial pain score of 10 was also strongly associated with a postanalgesic pain score of ,7. African American patients who were not taking opioids at home were less likely to achieve a 50% pain score reduction than other patients, despite receiving similar initial and total equianalgesic dosages. None of the variables we assessed were significantly associated with the development of opioid-related side effects. Conclusions:, Poor analgesic outcomes were common in this cohort of ED patients prescribed IV opioids. Patients taking long-acting opioids, those thought to be drug-seeking, older patients, those with an initial pain score of 10, and possibly African American patients are at especially high risk of poor analgesia following IV opioid administration. [source] Preoperative blood sugar and C-reactive protein associated with persistent discharge after incision and drainage for patients with deep neck abscessesCLINICAL OTOLARYNGOLOGY, Issue 4 2009S.-A. Liu Objectives:, The aim of this study was to investigate whether preoperative C-reactive protein (CRP) and blood sugar correlated with persistent discharge after incision and drainage for patients with deep neck abscesses. Study design:, Retrospective data analysis. Setting:, Tertiary referral centre. Participants:, A total of 204 patients who underwent operation for deep neck abscess. Main outcome measures:, Persistent discharge after operation. Results:, One hundred seventy patients were included for final analyses. Most of the patients were male (n = 115; 68%) and the average age was 54 years. Using logistic regression analyses, age >55 years [odds ratio (OR): 3.053; P = 0.002], preoperative CRP >15 mg/dL (OR: 2.174; P = 0.027), and preoperative blood sugar >8.3 mmol/L (OR: 3.280; P = 0.001) were independent factors correlated with persistent discharge. Conclusions:, Older age, elevated preoperative CRP level and blood sugar had a statistically significant association with persistent discharge after operation in deep neck abscesses patients. [source] Survival probability of zirconia-based fixed dental prostheses up to 5 yr: a systematic review of the literatureEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 5 2010Jaana-Sophia Schley Schley J-S, Heussen N, Reich S, Fischer J, Haselhuhn K, Wolfart S. Survival probability of zirconia-based fixed dental prostheses up to 5 yr: a systematic review of the literature. Eur J Oral Sci 2010; 118: 443,450. © 2010 Eur J Oral Sci The purpose of this systematic review was to calculate the 5-yr survival rates of all-ceramic zirconia-based fixed dental prostheses (FDPs) and to analyze technical and biological complications. An electronic literature search of MEDLINE (PubMed) was conducted independently by three reviewers to identify clinical studies from 1999 to 2009 and was completed by a manual search. Keywords and inclusion and exclusion criteria were well-defined. The search revealed 399 titles and led to the final analysis of 18 full-text articles. Nine studies met the inclusion criteria. Extracted data were statistically calculated into 5-yr survival rates and 5-yr complication-free rates by using Poisson regression analysis. In total, 310, 3- to 4-unit FDPs and 20 FDPs with more than 4 units were included. The estimated 5-yr survival rate for all FDPs was 94.29% (95% CI: 58.98,99.32); 19 FDPs were lost as a result of catastrophic failures. The 5-yr complication-free rate regarding technical complications was 76.41% (95% CI: 42.42,91.60) with chipping being the most frequent complication. Regarding biological complications, the 5-yr complication-free rate was 91.72% (95% CI: 59.19,98.53). The survival rates of zirconia-based short-unit FDPs are promising. However, an important improvement of the veneering systems is required, and for FDPs with more units in function, further randomized, controlled clinical trials are necessary. [source] The Institutionalised Participation of Management and Labour in the Legislative Activities of the European Community: A Challenge to the Principle of Democracy under Community LawEUROPEAN LAW JOURNAL, Issue 1 2000Gabriele Britz The legislative procedure established by Articles 138-139 of the Amsterdam Treaty is sensitive with regard to democratic prerequisites, but does not, in the final analysis, breach the formal principle of democracy established under Community law. Although the establishment of a parliamentary right of consultation is desirable, sufficient democratic legitimation is nonetheless supplied by virtue of Council and Commission participation within the legislative procedure and by their unlimited right to examine and reject substantive provisions designed by management and labour. By the same measure, the participation of management and labour in the Articles 138-139 legislative process is not of itself sufficient to create democratic legitimation. However, although management and labour organisations might never claim to represent the public of Europe as a whole, they can contribute to the ,substantive' legitimacy of European social law-making where they are adequately representative of persons and groups affected by EC legislative acts and take positive steps to ensure that the interests of such persons are reflected in secondary EC law. Accordingly, the Commission and the Council should review the representative nature of organisations engaged in European social law-making, paying particular attention to under-represented interests and, if necessary, should also make use of their right of rejection where privately negotiated agreements neglect these interests. [source] Immunohistochemical study of epidermal growth factor receptor in adenoid cystic carcinoma of salivary gland originHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2002Marilena Vered DMD Abstract Background Epidermal growth factor (EGF) and its receptor (EGFR) are involved in the development of salivary gland tumors. Recently, treatment modalities for EGFR inhibition have shown an enhanced clinical response in carcinomas of different locations. Adenoid cystic carcinoma (ACC) of salivary gland origin is a malignant tumor with a poor long-term outcome. If salivary gland ACC does exhibit EGFR, then immunotherapy could have a major impact on improving its prognosis. Methods The study consisted of 34 samples of formalin-fixed, paraffin-embedded specimens of salivary gland ACC. Specimens were stained with a mouse antihuman monoclonal antibody for immunohistochemical detection of EGFR. Overlying oral mucosa and adjacent normal salivary ducts served as internal controls. Both membrane and cytoplasmic staining were evaluated. Staining score was calculated by multiplying the percentage of positively stained tumor cells by the intensity of the staining. The highest score for a given tumor was equal to 2. Results In the final analysis, 27 of the 34 specimens were included; 7 were excluded, because the internal control did not reveal any staining. Of these 27 specimens, 23 (85%) stained positively for EGFR with a staining score of 0.05 to 1.8. Three palatal tumors attained the highest scores (one tumor, 1.2, and the remaining two, 1.8). Conclusions Most salivary gland ACC stained positively for EGFR, and in some the staining was quite intense. On the basis of the already proven antitumoral effect of agents acting as EGFR inhibitors, it is suggested that patients with ACC might benefit from these agents, especially when surgery has failed or in those with recurrent or metastatic disease. © 2002 Wiley Periodicals, Inc. Head Neck 24: 632,636, 2002 [source] Favorable Response to Analgesics Does Not Predict a Benign Etiology of HeadacheHEADACHE, Issue 6 2008Jennifer V. Pope MD Background., Distinguishing between primary and secondary headaches (HAs) is essential for the safe and effective management of patients with HA. A favorable response to analgesics may be observed with both classes of HAs and therefore is not a good predictor of who needs further evaluation. Objective., To systematically review the data that a favorable response to analgesics including triptans should not be used to exclude a serious secondary cause of HA. Design., PubMed search of English-language articles between 1980 and 2007 and reference lists of these articles. Two authors independently reviewed articles for study results and quality. Inclusion was based on 100% agreement between authors. We included articles that described secondary HAs as (1) having a favorable response to analgesics and/or (2) having a favorable response to sumatriptan. Of the 548 studies identified by our search strategy, 18 were included in our final analysis. Results., Seven of the 18 studies found that 46/103 patients (44%) described a significant or complete resolution of secondary HA from medications such as anti-emetics and nonsteroidal anti-inflammatory drugs (NSAIDs). Eleven of the 18 articles including 25/25 patients (100%) described a significant or complete resolution of secondary HA from sumatriptan, a serotonin 5HT agonist. Conclusions., A favorable response to analgesics including triptans should not be used to exclude a serious secondary cause of HA. [source] Factors Related to Helicobacter pylori Prevalence in an Adult Population in BrazilHELICOBACTER, Issue 1 2007Schlioma Zaterka Abstract Background:, The prevalence of Helicobacter pylori is higher in developing countries. Sanitary facilities, crowding and ethnic group are some of the factors related to H. pylori infection. The aim of this study was to investigate in blood donors, free of dyspeptic symptoms, the prevalence and factors influencing H. pylori infection. Materials and Methods:, This study was conducted in São Paulo, a city known to have a mixed population coming from all over the country. A total of 1008 blood donors were initially included in the study. After a final revision of all the questionnaires, 993 were included in the final analysis (746 males). H. pylori status was checked by an ELISA test. The following associations to infection were analyzed: sex, age, ethnic group, previous upper gastrointestinal (GI) endoscopy, smoking, alcoholism, drug addiction, type of drinking water, crowding, sanitary facilities, and family income. Results:, Infection was observed in 496 of 746 male (66.5%) and in 156 of 247 female (63.2%) blood donors. Infection prevalence increased according to age group, regardless of sex. Prevalence was lower in White population than in non-White. No relationship was observed between infection and smoking, drug addiction, and alcohol. A positive relation was observed between infection and previous upper GI endoscopy, and type of drinking water, regardless if currently or during childhood. Crowding and lack of toilet in the house during childhood resulted in a higher infection rate. Lower familial income and educational level showed a positive association to infection. Conclusions:, Prevalence of H. pylori is higher in non-White population, independent of gender. A positive association was observed in aging, previous upper GI endoscopy, crowding, type of drinking water, lack of toilet during childhood, lower family income, and lower educational level. [source] Improvement in social competence in patients with schizophrenia: a pilot study using a performance-based measure using virtual reality,HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2009Kyung-Min Park Abstract Objective The objective of this study was to explore the possibility of the use of Virtual Reality Functional Skills Assessment (VRFSA) in a future regular clinical trial, as well as to report a preliminary result about effectiveness of atypical antipsychotics to social competence in schizophrenia. Methods We developed the VRFSA that measured subjects' performances automatically and used analogue scale rather than Likert scale. Twenty-four female patients with paranoid schizophrenia and 15 healthy females were recruited. This was a 6-week, randomized, open-label, and flexible dose study, and 2 treatments (baseline versus post-treatment),×,2 skills phases (receptive versus expressive),×,2 patient groups (aripiprazole versus risperidone) analysis of variance was used in the final analysis. Results There was a significant difference in the VRFAS between the patients and the healthy subjects (p,<,0.05). Eighteen patients were included in the final analysis. We found larger treatment effect than those found in previous studies, and significant treatment,×,skills phase,×,group interaction effect on the VRFAS. Conclusions Our results suggest that the VRFAS is strongly sensitive to changes in social competence and thus especially beneficial in short-term clinical trials. In addition, atypical antipsychotics can improve social competence and differentially improve receptive skills and expressive skills in schizophrenia. Copyright © 2009 John Wiley & Sons, Ltd. [source] The potential impact of human papillomavirus vaccination in contemporary cytologically screened populations may be underestimated: An observational retrospective analysis of invasive cervical cancersINTERNATIONAL JOURNAL OF CANCER, Issue 10 2009Ned Powell Abstract The aim of this study was to determine the proportion of invasive cervical cancers attributable to human papillomavirus (HPV) types 16 and 18 in a contemporary, cytologically well-screened UK population. This was achieved in a retrospective observational analysis by HPV typing 453 archival invasive cervical cancers diagnosed between January 1, 2000 and September 1, 2006. Pathological material was collected from 9 hospitals across Wales (UK), and HPV typing and pathology review was conducted at a central laboratory. Genotyping for high-risk HPV DNA was performed by PCR-enzyme immunoassay using the GP5+/6+ primer set. DNA was successfully extracted from 297 cases. Two hundred and eighty cases were included in the final analysis. The proportion of cases which had only HPV 16 and/or 18 was 219 of 280 (78.2%, 95% CI = 73.0,82.7); the proportion of cases which had HPV 16 or 18 and another HPV type was 230 of 280 (82.1%, 95% CI = 77.2,86.2). The proportion of cervical cancers associated with infection with HPV types 16 and 18 has previously been estimated at around 70%. The appropriate figure for a cytologically well-screened UK population appears to be approximately 80%. Hence, the potential impact of the current vaccination programme may be underestimated. © 2009 UICC [source] Theorizing Diaspora: Perspectives on "Classical" and "Contemporary" DiasporaINTERNATIONAL MIGRATION, Issue 2 2004Michele Reis Cohen (1997) employed the term "classical" diaspora in reference to the Jews. Indeed, a vast corpus of work recognizes the Jewish people as examples of quintessential diasporic groups. However, a broader conceptualization of the term diaspora allows for the inclusion of immigrant communities that would be otherwise sidelined in the conventional literature on diaspora. This study is therefore a departure from the traditional diasporic literature, which tends to use the Jewish Diaspora as the archetype. It favours, rather, the classification of three principal broad historical waves in which the Jewish Diaspora can be interpreted as part of a classical period. The historicizing of diasporization for the purpose of this paper is achieved by an empirical discussion of the three major historical waves that influenced the diasporic process throughout the world: the Classical Period, the Modern Period, and the Contemporary or Late-modern Period. The paper discusses these three critical phases in the following manner: first, reference is made to the Classical Period, which is associated primarily with ancient diaspora and ancient Greece. The second historical phase analyses diaspora in relation to the Modern Period, which can be interpreted as a central historical fact of slavery and colonization. This section can be further subdivided into three large phases: (1) the expansion of European capital (1500,1814), (2) the Industrial Revolution (1815,1914), and (3) the Interwar Period (1914,1945). The final major period of diasporization can be considered a Contemporary or Late-modern phenomenon. It refers to the period immediately after World War II to the present day, specifying the case of the Hispanics in the United States as one key example. The paper outlines some aspects of the impact of the Latin American diaspora on the United States, from a socio-economic and politico-cultural point of view. While the Modern and Late-modern periods are undoubtedly the most critical for an understanding of diaspora in a modern, globalized context, for the purpose of this paper, more emphasis is placed on the latter period, which illustrates the progressive effect of globalization on the phenomenon of diasporization. The second period, the Modern Phase is not examined in this paper, as the focus is on a comparative analysis of the early Classical Period and the Contemporary or Late-modern Period. The incorporation of diaspora as a unit of analysis in the field of international relations has been largely neglected by both recent and critical scholarship on the subject matter. While a growing number of studies focus on the increasing phenomenon of diasporic communities, from the vantage of social sciences, the issue of diaspora appears to be inadequately addressed or ignored altogether. Certain key factors present themselves as limitations to the understanding of the concept, as well as its relevance to the field of international relations and the social sciences as a whole. This paper is meant to clarify some aspects of the definition of diaspora by critiquing the theories in the conventional literature, exposing the lacunae in terms of interpretation of diaspora and in the final analysis, establishing a historiography that may be useful in comparing certain features of "classical" diaspora and "contemporary" diaspora. The latter part of the paper is intended to provide illustrations of a contemporary diasporic community, using the example of Hispanics in the United States. [source] The historical biogeography of co-evolution: emerging infectious diseases are evolutionary accidents waiting to happenJOURNAL OF BIOGEOGRAPHY, Issue 8 2005Daniel R. Brooks Abstract Ecological fitting refers to interspecific associations characterized by ecologically specialized, yet phylogenetically conservative, resource utilization. During periods of biotic expansion, parasites and hosts may disperse from their areas of origin. In conjunction with ecological fitting, this sets the stage for host switching without evolving novel host utilization capabilities. This is the evolutionary basis of emerging infectious diseases (EIDs). Phylogenetic analysis for comparing trees (PACT) is a method developed to delineate both general and unique historically reticulated and non-reticulated relationships among species and geographical areas, or among parasites and their hosts. PACT is based on ,Assumption 0', which states that all species and all hosts in each input phylogeny must be analysed without modification, and the final analysis must be logically consistent with all input data. Assumption 0 will be violated whenever a host or area has a reticulated history with respect to its parasites or species. PACT includes a Duplication Rule, by which hosts or areas are listed for each co-evolutionary or biogeographical event affecting them, which satisfies Assumption 0 even if there are reticulations. PACT maximizes the search for general patterns by using Ockam's Razor , duplicate only enough to satisfy Assumption 0. PACT applied to the host and geographical distributions of members of two groups of parasitic helminths infecting anthropoid primates indicates a long and continuous association with those hosts. Nonetheless, c. 30% of the host associations are due to host switching. Only one of those involves non-primate hosts, suggesting that most were constrained by resource requirements that are phylogenetically conservative among primates (ecological fitting). In addition, most of the host switches were associated with episodes of biotic expansion, also as predicted by the ecological fitting view of EIDs. [source] Periodontal growth factors and tissue carriers: Biocompatibility and mitogenic efficacy in vitroJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2006Claudio Cesari Clinical research has long been testing techniques of integrating biomaterials with many external factors, such as simple proteins or more complicated devices, in order to achieve the restitutio ad integrum of periodontium. This study assessed the in vitro effectiveness of platelet derivate growth factor-BB (PDGF) and insulin growth factor I (IGF); the biocompatibility of materials like Paroguide, Oclastim membranes, Gingistat sponges, Surgiplaster, and Capset; and their efficacy as carriers for the platelet derivate growth factor-BB (PDGF) and insulin growth factor I (IGF). Fibroblasts from the human periodontal ligament were incubated with growth factors free or vehiculated. Mitogenic effect was evaluated by measuring the growth rate and biocompatibility by observing cell morphology at SEM. PDGF was the most effective in stimulating cell proliferation both in solution (p < 0.001) and vehiculated (p < 0.01). Surgiplaster and Capset were more biocompatible; however, final analysis to assess their efficacy as carriers failed to disclose significant differences between experimental findings and control. © 2005 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2006 [source] A systematic review of professional support interventions for breastfeedingJOURNAL OF CLINICAL NURSING, Issue 9 2008Leena Hannula PhD Objectives., The objectives of this systematic review were first, to describe how breastfeeding is professionally supported during pregnancy, at maternity hospitals and during the postnatal period. Secondly, to find out how effective interventions are in supporting breastfeeding. Background., Breastfeeding is an effective way to promote the health of infants. In many countries, the rates for breastfeeding remain lower than recommended. Many studies have examined breastfeeding promotion interventions; some of them are successful and some fail. It is important to find effective combinations of support. Design. Systematic review. Methods., Search of CINAHL, Medline and Cochrane Central Register databases were conducted for data collection. The search was limited to articles published in Finnish, Swedish and English between the year 2000 and March 2006, focusing on breastfeeding and breastfeeding support interventions. Two reviewers independently analysed 36 articles in the final analysis. Results., Interventions expanding from pregnancy to the intrapartum period and throughout the postnatal period were more effective than interventions concentrating on a shorter period. In addition, intervention packages using various methods of education and support from well-trained professionals are more effective than interventions concentrating on a single method. Conclusions., During pregnancy, the effective interventions were interactive, involving mothers in conversation. The Baby Friendly Hospital Initiative (BFHI) as well as practical hands off -teaching, when combined with support and encouragement, were effective approaches. Postnatally effective were home visits, telephone support and breastfeeding centres combined with peer support. Relevance to clinical practice., Professionals need breastfeeding education and support of their organisations to act as breastfeeding supporters. The BFHI -programme is effective and it would be wise to include the core components of the programme in breastfeeding promotion interventions. Mothers benefit from breastfeeding encouragement and guidance that supports their self-efficacy and feelings of being capable and empowered, and is tailored to their individual needs. [source] Distribution trends of colorectal adenoma and cancer: A colonoscopy database analysis of 11 025 Chinese patientsJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2010Yu Bai Abstract Background and Aim:, A left-to-right shift of colorectal cancer (CRC) has been reported in Western studies. However, few Asian studies have investigated the anatomic distribution of colorectal adenoma and CRC. We aimed to describe the time trends in the distribution of colorectal adenoma and CRC in a Chinese population. Methods:, A colonoscopy database was reviewed, and all consecutive patients with lower gastrointestinal symptoms who underwent colonoscopy from 1998 to 2009 were identified. Data, including patients' sex, age, symptoms, and the number and anatomic locations of colorectal adenoma and CRC, were documented. Results:, A total of 11 025 patients were included in the final analysis; 1012 and 363 patients were diagnosed with colorectal adenoma and CRC, respectively. Overall, there were more distal than proximal adenomas (54.4% vs 37.9%), and the proportion of proximal adenomas remained stable from 1998,2006 to 2007,2009 (38.2% vs 37.6%). Similarly, there were more distal than proximal CRC (56.5% vs 42.4%), and the proportion of proximal CRC declined from 45.8% in 1998,2006 to 38.4% in 2007,2009. Colorectal adenoma and CRC were equally distributed among both sexes. For elderly patients (> 50 years), there was a non-significant trend towards more proximal adenoma and CRC. Conclusions:, The present study suggests no distal-to-proximal shift of colorectal adenoma and CRC among the Chinese population in Shanghai over the past 12 years. The distribution pattern of colorectal adenoma and CRC of Chinese patients is different from that of Western patients, who had more colorectal lesions located in the distal part. [source] Prevalence of celiac disease among school children in Punjab, North IndiaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2006Ajit Sood Abstract Background:, Celiac disease, as of today, is said to exist in almost all parts of the world, although it is rare among people of purely African,Caribbean, Japanese and Chinese background. The disease has also been considered uncommon in India until recently. Hospital records have revealed an increasing trend of the disease in predominantly wheat-eating areas of North India. The aim of the present study was to determine the prevalence of celiac disease among school children in Punjab, North India. Methods:, The study was carried out in the Ludhiana district of Punjab, Northern India. A total of 4347 children aged 3,17 years attending different schools were enrolled. A structured questionnaire was used to collect sociodemographic data and symptoms and signs related to celiac disease and various sociodemographic factors. The screening for celiac disease for the suspected celiacs was done by testing for antitissue transglutaminase (anti-tTG) by indirect solid-phase immunometric assay (ELISA). All children with high anti-tTG whose parents consented underwent upper gastrointestinal endoscopy for small bowel biopsy from the second part of the duodenum. Histopathology was expressed according to the Marsh classification of 1992. Follow up was carried out among children who were put on a gluten-restricted diet, at monthly intervals for 3 months and every 3 months thereafter. The diagnosis of celiac disease was established on the basis of the revised European Society of Paediatric Gastroenterologists and Nutritionists (ESPGAN) criteria (confirmed cases). Results:, A total of 4347 school children (1967 girls, 2380 boys, age range 3,17 years) were screened for celiac disease. Out of these, 198 suspected children were identified for further evaluation. Twenty-one children tested positive for anti-tTG assay (10.6%, 95% confidence interval: 16.91,34.79). Seventeen of these 21 children agreed to undergo biopsy; of these, 14 had histological changes consistent with celiac disease and all these 14 children had clinical response to gluten restriction. Three children with high anti-tTG had normal mucosa on duodenal biopsy and were not labelled as being in the celiac disease group. In the final analysis the disease prevalence was one in 310 children. Conclusions:, This is the first study on celiac disease prevalence among school children from India. Although this disease frequency of one in 310 is thought to be an under-assessment, it clearly shows that celiac disease is not rare in wheat-eating areas of North India. [source] Increased Dosage during Intracoronary Irradiation Due to Overlapped Source Stepping Shows No Long-Term Adverse Changes in Vessel MorphologyJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2004BONNI SYEDA M.Sc., M.D. Purpose: The purpose of this analysis was to evaluate if overdosage during intracoronary irradiation due to overlapped source stepping may result in long-term morphologic changes in vessel anatomy. Methods: Baseline angiograms of patients with in-stent restenosis undergoing coronary reintervention followed by intracoronary irradiation with source stepping were analyzed. Overlapping was considered present for the segment with overlapped reference isodose length (RIL) (RIL = segment with ,90% of reference dose at 1 mm vessel wall depth). Baseline and 6-months follow-up volumetric intravascular ultrasound (IVUS) analysis were performed for the overlapped segment and for proximal and distal segments of equal length. Results: Overlapping was found in six patients (three patients: 32P treatment; three patients: 90Sr/Y treatment); final analysis was performed in four patients. Comparison of the baseline and follow-up IVUS volumetric parameters revealed no significant change in lumen or vessel volumes at segments of overlaps in comparison to proximal and distal reference segments. Conclusion: Increased dosage due to overlapping during source stepping is not associated with morphologic changes in vessel anatomy at follow-up. (J Interven Cardiol 2004;17:143,149) [source] Factors influencing job satisfaction of front line nurse managers: a systematic reviewJOURNAL OF NURSING MANAGEMENT, Issue 7 2008HOW LEE BScN Aim, The purpose of this study was to systematically review the research literature that examined the determinants of front line nurse managers' job satisfaction. Background, Front line managers are the vital link between senior management and clinical nurses. They influence organizational culture and outcomes for patients and staff so their job satisfaction and ultimately retention is of importance. Evaluations, A review of research articles that examined the determinants of front line nurse managers' job satisfaction was conducted. These managers supervise staff nurses and have direct responsibility for the management of a nursing unit or team in any type of healthcare facility. Fourteen studies were included in the final analysis. Key issues, Evidence of significant positive relationships were found between span of control, organizational support, empowerment and the job satisfaction of front line nurse managers. Conclusion, The review suggests that job satisfaction of front line managers may be improved by addressing span of control and workload, increasing organizational support from supervisors and empowering managers to participate in decision-making. Implications for Nursing Management, Healthcare organizations may enhance the recruitment, retention and sustainability of future nursing leadership by addressing the factors that influence job satisfaction of front line managers. [source] Preventable but not prevented: the reality of cervical cancer,JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2003Usha B. Saraiya Abstract Introduction: The incidence of invasive cervical cancer has decreased in the last 50 years in the developed countries substantially due to the use of routine pap smears. However, in the Asia,Oceanic region it continues to be high as screening programs are not established. Credit for starting cytology services in India goes to Professor P.N. Wahi of Agra. He became Founder President when about 34 cytologists got together in 1970 to form the Indian Academy of Cytologists. Since then cytology has spread through all parts of India. The Cytology Clinic in Cama & Albless Hospital was started in the same year. Since then over 100 000 women have been screened. Approximately 1200 cases of pre- and early cancers have been detected and treated. Since 1982 we are aware of the important role of human papillomavirus infection. We diagnose it by cytology and colposcopy and histology. Facilities for polymerase chain reaction, in-situ hybridization and other virology studies are not available to us. CO2 laser treatment is found particularly useful in multicentric human papillomavirus disease. Screening for the State of Maharashtra: Since 1984 we have planned for a screening program for our State. We have a population of 78.9 million. Approximately 15 million women in the age group of 35,64 years have to be screened. The health care infrastructure is good with 36 medical colleges and over 35 district hospitals. Screening is planned in phases. Trained personnel are the key to a successful program. In the final analysis, cervical cancer is not just a biomedical disease. It has socio-cultural and economic implications. [source] Hollow-fibre supported liquid membrane extraction for determination of fluoxetine and norfluoxetine concentration at ultra trace level in sewage samplesJOURNAL OF SEPARATION SCIENCE, JSS, Issue 15 2007Saioa Zorita Abstract In this study, a method was developed for determining the concentration of the pharmaceutical fluoxetine and its metabolite, norfluoxetine, in sewage water samples. Sample preparation was performed by hollow-fibre supported liquid membrane (HF-SLM) extraction with final analysis using liquid chromatography with UV detection. Several parameters were studied including type of organic solvent, sample and acceptor pH, and salt and humic acid content. The optimised method allowed determination of the analyte at the ng/L level in sewage water. A linear plot gave a correlation coefficient better than 0.991 for both analytes and resulted in limits of detection in sewage water of 11 and 12 ng/L, for fluoxetine and norfluoxetine, respectively. The enrichment factor was over 1700 for both analytes in sewage water. The repeatability and reproducibility were better than 8% and 17%, respectively. The developed methodology was used to study daily variations of fluoxetine and norfluoxetine in municipal sewage streams. Norfluoxetine has been detected for the first time in sewage water and a preliminary analysis gave average concentrations of 150 and 225 ng/L for norfluoxetine and fluoxetine, respectively. [source] Extended multiorgan resection for T4 gastric carcinoma: 25-year experienceJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2005Fabio Carboni MD Abstract Background and Objectives In locally advanced gastric carcinoma infiltrating adjacent organs, an extended resection including invaded organs is required to improve the prognosis. We retrospectively analyzed our experience with extended multiorgan resection (EMR) in patients with advanced gastric cancer. Methods Between December 1979 and April 2004, 65 patients were resected for extended gastric carcinoma macroscopically invading other organs. Various clinicopathologic factors influencing early and late results were evaluated. Survival rates were calculated according to the Kaplan,Meier method. Prognostic factors were evaluated by univariate and multivariate analysis. Results The majority of patients (61.5%) did receive a R0 curative resection. In 52 (80%) of the 65 presumed T4 cancers, histologic final analysis confirmed invasion. Postoperative morbidity and mortality was 27.7% and 12.3%, respectively. Actuarial 5-year overall survival (OS) rate was 21.8%. It was significantly better in R0 versus R+ (30.6% vs. 0%, P,=,0.001). Multivariate analysis identified curative resection as the strongest predictor of survival (P,=,0.002). Conclusions Patients with locally advanced gastric carcinoma invading adjacent organs can benefit from aggressive surgical treatment with acceptable morbidity and mortality. However, curative resection is mandatory to improve prognosis. J. Surg. Oncol. 2005;90:95,100. © 2005 Wiley-Liss, Inc. [source] Review article: permissive underfeeding in short-term nutritional supportALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2010A. E. Owais Aliment Pharmacol Ther 2010; 32: 628,636 Summary Background, The importance of adequate nutritional support in selected patient groups is well established. Traditionally, the amounts of macronutrients provided have been based on a perceived need to achieve, if not exceed, energy and protein balance. In recent years, there has been increasing interest in the concept of ,permissive underfeeding'. Aim, To determine whether or not there is evidence of benefit for permissive underfeeding in selected groups. Methods, Studies were identified from MEDLINE, Embase and PubMed databases and the Cochrane collaboration. The search was limited from January 1950 to January 2010. Further searches were made from the references of original articles. The literature search revealed 591 abstracts of relevant studies. All abstracts were initially reviewed by the primary author (AO) and those that did not fulfil the inclusion criteria were discarded. The remaining articles were requested and were reviewed independently by two authors (AO, JM). Results, Twelve studies were included in the final analysis. Eight of these were randomized interventional trials. Three were prospective cohort studies and one was a retrospective analysis. Conclusion, This review suggests that permissive underfeeding may be associated with improved outcomes and reduced morbidity in patients requiring short-term nutritional support. [source] Interventions for treating the posterior interosseus nerve syndrome: a systematic review of observational studiesJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2006Bionka M. A. Huisstede Abstract For the posterior interosseus nerve syndrome (PINS), no randomised controlled trials or controlled clinical trials about the effectiveness of interventions are available; only case series can be found. Although the validity of case series is inferior to controlled trials, they may provide valuable data about the efficacy of treatment options. Therefore, we systematically reviewed all available observational studies on treatment of PINS. A literature search and additional reference checking was done. On the basis of previous checklists, we constructed a quality assessment and rating system to analyse the included case series. Studies with less than 50% of the maximum points on the methodological quality assessment were excluded from the analysis. The results are summarised according to a rating system for the strength of the scientific evidence. Six eligible case series for this review were found. After the data extraction and methodological quality assessment, two higher quality studies that evaluated the effectiveness of surgical decompression of the PIN were included in the final analysis. There is a tendency for the effectiveness of surgical decompression of the PIN in patients with PINS. The effectiveness of a conservative treatment for PINS is unknown because no higher quality studies are available. Additional high-quality controlled studies are needed to assess the level of ,conclusive evidence' for surgical treatment. There is also a need for high-quality controlled trials into the effectiveness of conservative treatments for PINS. [source] A Bayesian model for longitudinal count data with non-ignorable dropoutJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES C (APPLIED STATISTICS), Issue 5 2008Niko A. Kaciroti Summary., Asthma is an important chronic disease of childhood. An intervention programme for managing asthma was designed on principles of self-regulation and was evaluated by a randomized longitudinal study. The study focused on several outcomes, and, typically, missing data remained a pervasive problem. We develop a pattern,mixture model to evaluate the outcome of intervention on the number of hospitalizations with non-ignorable dropouts. Pattern,mixture models are not generally identifiable as no data may be available to estimate a number of model parameters. Sensitivity analyses are performed by imposing structures on the unidentified parameters. We propose a parameterization which permits sensitivity analyses on clustered longitudinal count data that have missing values due to non-ignorable missing data mechanisms. This parameterization is expressed as ratios between event rates across missing data patterns and the observed data pattern and thus measures departures from an ignorable missing data mechanism. Sensitivity analyses are performed within a Bayesian framework by averaging over different prior distributions on the event ratios. This model has the advantage of providing an intuitive and flexible framework for incorporating the uncertainty of the missing data mechanism in the final analysis. [source] Allergic rhinitis: prevalence and possible risk factors in a Gulf Arab populationALLERGY, Issue 2 2010S. Alsowaidi To cite this article: Alsowaidi S, Abdulle A, Shehab A, Zuberbier T, Bernsen R. Allergic rhinitis: prevalence and possible risk factors in a Gulf Arab population. Allergy 2010; 65: 208,212 DOI: 10.1111/j.1398-9995.2009.02123.x. Abstract Background:, Epidemiological studies mainly from Europe, the USA and Asia indicate a high prevalence of allergic rhinitis (AR) in modern societies. However, little is known about AR among the heterogeneous population of the United Arab Emirates (UAE). Objectives: To estimate the prevalence of AR and its independent risk factors in Al-Ain City, UAE. Methods:, We used a validated, self-administered questionnaire modified from the ISAAC study to collect data from a two stage randomly selected sample of 10 000 school children. Overall, 7550 subjects (aged 13 years and above, siblings, and their parents) responded. We assessed the prevalence of AR (both crude and standardized prevalence of previous 12 months) as well as the independent relationship of AR with age, gender, education, nationality and family history by means of logistic regression. Results:, The response rate was 76%. A total of 6543 subjects (median age 30 years) were included in the final analysis. Self-reported prevalence of AR (having symptoms in the past 12 months) was 36%, while adjusted values for sex/age yielded a prevalence of 32%. Regression analysis revealed that AR was independently associated with family history, Arab origin, younger age, female gender and higher education. Conclusions:, The relatively high prevalence of AR found in this study may be attributable to modernization and genetic factors. Further studies on the impact of rapid environmental and cultural changes on AR in the Arab countries are needed and currently planned in conjunction with GA2LEN (Global Allergy and Asthma European Network). [source] ROBERT JENSON ON THE PRE-EXISTENCE OF CHRISTMODERN THEOLOGY, Issue 1 2007OLIVER D. CRISP In his recent two-volume Systematic Theology, Robert Jenson offers an account of Christ's pre-existence that is, in several important respects, an original contribution to the literature. In this article, I offer a critical interaction with Jenson's doctrine. In particular, I show that what Jenson has to say about (a) divine eternity and (b) the relationship between philosophy and theology, have important bearings on his construal of Christ's pre-existence and, in the final analysis, skew what he has to say on the matter. I conclude that Jenson's account of this doctrine, though suggestive and insightful in several respects, is unsuccessful, indeed, incoherent, as it stands. [source] | |||||||||||||||||||||||||||||||||||||||||||