Medical University (medical + university)

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Distribution within Medical Sciences

Kinds of Medical University

  • george medical university
  • king george medical university

  • Terms modified by Medical University

  • medical university hospital

  • Selected Abstracts

    Addiction Research Centres and the Nurturing of Creativity The Chinese National Institute on Drug Dependence, Peking University: past, present and future

    ADDICTION, Issue 9 2010
    Xi Wang
    ABSTRACT In the 25 years since drug abuse re-emerged in China in the 1980s, the National Institute of Drug Dependence (NIDD) has made many contributions to China's antidrug campaign. This present paper offers an account of the history, current status and future of drug dependence research at NIDD. NIDD was originally a research centre at Beijing Medical University, founded by the Chinese Ministry of Health to address the rapid spread of drug abuse in China. Originally, the main task of NIDD was to complete the commissions assigned by the government and university. Further developments transformed NIDD into a national research institute in the field of drug addiction that began to conduct its own research. NIDD has now created a professional team spread across several independent departments involved in neurobiological mechanisms, epidemiological surveys and monitoring, pre-clinical and clinical evaluation of new drugs (mainly analgesic drugs and detoxification drugs) and informatics and data analysis. As a university-based research institute, NIDD's funding derives mainly from grants provided by the government and financial support from international organizations. Its past and present research has a gained NIDD a reputation with both practitioners and policy makers in the field of drug addiction. In the future, NIDD will continue to engage in various aspects of drug addiction research and will enter the field of brain function. [source]

    Long-term clinical outcome of living-donor liver transplantation for primary biliary cirrhosis

    Etsuko Hashimoto
    Aim:, We described the recurrence of primary biliary cirrhosis (PBC) after living donor liver transplantation (LDLT) (Liver Transplantation, 7, 2001: 588). However, since the follow-up period in that study was insufficiently long (median 35.5 months), we performed a long-term study to further characterize recurrence of PBC after LDLT. Patients:, From 1991 to 2006, 15 patients with end-stage PBC underwent LDLT at Tokyo Women's Medical University. Of these patients, we studied 8 PBC patients (age 29 to 51 years, all females) who survived LDLT for more than 5 years. The follow-up period for these patients ranged form 68 to 120 months. Immunosuppression was maintained with tacrolimus and prednisone. Laboratory examinations performed in every patient and donor before LDLT included routine biochemical studies, antimitochondrial antibody (AMA) by immunofluorescence (IF), anti-M2 by enzyme-linked immunosorbent assay as well as antinuclear antibody (ANA) by IF, and immunoglobulin. After LDLT, the same laboratory examinations were performed in patients every 6 months. Liver biopsy was performed when patients exhibited clinical or biochemical signs of graft dysfunction. In addition, protocol biopsy was performed every 1 to 2 years after LDLT. Results:, At the time of LDLT, all patients had end-stage cholestatic liver failure. Seven patients were positive for AMAand anti-M2 while 1 patient was negative for these markers but strongly positive for ANA. Donors were blood relatives in 6 cases, and 2 donors who were not blood relatives still exhibited multiple HLA matches with the recipients. At the end of the study in May 2006, all patients were doing well. On laboratory examination, mild abnormal liver function test results were found in 4 patients: 3 were probably due to recurrence of PBC, 1 resulted from nonalcoholic steatohepatitis. Comparison of the AMA titer between before LDLT and the most recent follow-up visit showed an increase in three patients, a decrease in two patients and no change in three patients. In contrast, the ANA titer increased in five patients. Histologically, strong evidence of recurrent PBC was found in 4 patients, and findings compatible with PBC were present in 2 additional patients. Conclusions:, Although the number of our patients is small, our findings confirm that PBC can recur at high frequency after LDLT. However, this complication has not developed to advanced stages and has not caused appreciable symptoms in our patients, all of whom have a good quality of life. [source]

    Neisser Lecture, Lower Silesian Dermatological Society, Medical University of Wroc,aw, June 2010

    Robert A. Schwartz md
    No abstract is available for this article. [source]

    Hereditary benign telangiectasia: first case in Iran

    Zari Javidi
    A 14-year-old boy was referred to the Dermatology Clinic of the Medical University of Mashhad, Iran, with numerous cutaneous telangiectasias on the face, ears, lips, and back of the hands, with lesions in the temporal region being the first to appear (Figs 1,3). His mother stated that the lesions had been present for 10 years with an increase in the past 6 months. He had no history of bleeding from the nose, mouth, gastrointestinal tract, and other mucosal surfaces, and there was no sign of organ involvement. On inspection, no lesions were detected on the nasal mucosa, external ear, over the tympanic membrane, or mouth. Figure 1. Numerous telangiectasias affecting the cheeks, nose, and perioral areas Figure 2. Lateral view of Fig. 1 Figure 3. Telangiectasias affecting the dorsal aspect of the hands The patient is one member of a family of six. His mother is healthy, but similar lesions were seen in his father, sister and one of his brothers with similar distributions. Lesions were also seen in his aunt and paternal grandmother, showing disease distribution in six members of this family from three generations. The oldest brother is 20 years of age and mentioned the onset of disease from the age of 10 years. The sister is 18 years of age and lesions started to appear 7 years ago; she claims that the lesions regress during her menstrual period. The youngest brother is 4 years of age and shows no sign of cutaneous lesions as yet. The parents are not consanguineous. Generalized telangiectasia with a predominant distribution on light-exposed skin, an autosomal dominant inheritance, and no sign of systemic or mucosal involvement and bleeding disorders indicates a diagnosis of hereditary benign telangiectasia. Our patient did not consent to biopsy. [source]

    Spoke-wheel-like enhancement as an important imaging finding of chromophobe cell renal carcinoma: A retrospective analysis on computed tomography and magnetic resonance imaging studies

    Abstract Aim:, Little information has been reported with regard to the radiological features of chromophobe cell renal carcinomas (CCRC). The aim of the present study was to identify imaging characteristics which lead to the histological diagnosis of CCRC. Methods:, The imaging findings of computed tomography (CT) and magnetic resonance imaging (MRI) were retrospectively analyzed in 11 patients with CCRC operated on at Tokyo Women's Medical University, Tokyo, Japan. Results:, None of the factors studied were significant in distinguishing the two variants, typical and eosinophilic variants. Enhanced CT scans showed a spoke-wheel-like enhancement with a central scar in 3 patients (27%). The radiological patterns were classified into two groups. Seven patients (64%) showed pattern 1 in which: (i) a hypodense to isodense enhancement compared to the renal medulla in the corticomedullary phase during dynamic CT; (ii) an isodense mass compared to the renal medulla in unenhanced CT scan; and (iii) a lobulated appearance were typically observed. Four patients (36%) showed pattern 2 that seemed to be similar to the features of clear cell carcinoma, having an alveolar structure including a hyperdense enhancement in the corticomedullary phase and an inhomogeneous appearance. A spoke-wheel-like enhancement was observed only in patients with pattern 1, and was more clearly demonstrated in larger tumors. Conclusions:, The CT and MRI findings in CCRC patients were not uniform, but it was noted that a spoke-wheel-like enhancement with a central stellate scar, which might have been mistaken for oncocytoma, was one of important findings of CCRC. Tumors demonstrating a spoke-wheel-like enhancement with a central scar should be carefully managed, because they could be malignant. [source]

    Guidelines Abstracted from the Department of Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Stroke Rehabilitation

    Miriam Rodin MD
    OBJECTIVES: To assist facilities in identifying those evidence-based processes of poststroke care that enhance measurable patient outcomes. The guideline(s) should be used by facilities (hospitals, subacute-care units and providers of long-term care) to implement a structured approach to improve rehabilitative practices and by clinicians to determine best interventions to achieve improved patient outcomes. OPTIONS: The guideline considers five elements of poststroke rehabilitation care: interdisciplinary teams; use of standardized assessments; intensity, timing, and duration of therapy; involvement of patients' families and caregivers in decision-making; and educational interventions for patients, families, and caregivers. Evidence, benefits, harms, and recommendations for each of the five designated elements and specific annotated recommendations for poststroke managements are presented separately. OUTCOMES: The overall guideline considers improvement in functional status measures as the primary outcome. Achieving community-dwelling status and preventing complications, death, and rehospitalization are also important outcomes. Costs are not specifically addressed. PARTICIPANTS: The Department of Veterans Affairs/Department of Defense (VA/DoD) Stroke Rehabilitation Working Group consisted of 28, largely VA and military hospital, representatives of medical and allied professions concerned with stroke diagnosis, management, and rehabilitation. Nine additional members with similar credentials served as the editorial committee. Technical consultation was contracted from ACS Federal Health Care, Inc., and the Center for Evidence-Based Practice, State University of New York,Upstate Medical University, Department of Family Medicine conducted evidence appraisal. Consensus was achieved over several years of facilitated group discussion and iterative evaluation of draft documents and supporting evidence. SPONSOR: The guideline was prepared under the auspices of the VA/DoD. No other source of support was identified in the document, or supporting documents. [source]

    Pediatric Homicides Related to Burn Injury: A Retrospective Review at the Medical University of South Carolina

    William F. Zaloga D.O.
    ABSTRACT: Many burn injuries are mistakenly referred to as "accidents" because they occur suddenly and seem unpredictable and uncontrollable; however, injuries often occur in predictable patterns. We reviewed all pediatric forensic cases referred to the Medical University of South Carolina Forensic Pathology Section over a 28-year period from January 1975 to December 2002. There were 124 cases with 121 fire-related fatalities and three scald fatalities. Ninety of the burn victims were in the 0,5-year age group. The manner of deaths showed 108 accidents and 12 homicides (four undetermined). Eleven of 12 burn-related homicides occurred at the home with all of the victims in the 1,8-year age group. The perpetrator of the home fire homicides was the mother in five cases and the sister in one case (two undetermined). Homicide involved a vehicle fire in one case in which the father caused an explosion with an accelerant. The three scald death perpetrators were the father, mother's boyfriend, and an aunt. This retrospective study and review of the literature may reveal patterns useful for evaluation of manner of death. By recognizing scene characteristics, potential perpetrators, and children at risk, we can better classify pediatric burn-related fatalities. [source]

    What cause of mortality can we predict by cholesterol screening in the Japanese general population?

    T. Okamura
    Abstract., Okamura T, Kadowaki T, Hayakawa T, Kita Y, Okayama A, Ueshima H (Shiga University of Medical Science, Shiga, Japan; Iwate Medical University, Morioka, Iwate, Japan). What cause of mortality can we predict by cholesterol screening in the Japanese general population? J Intern Med 2003; 253: 169,180. Objective., In a population with a markedly lower coronary mortality such as in Japan, the benefit of cholesterol screening may be different from Western populations. We attempted to assess the importance of cholesterol screening in Japan. Design., A 13.2-year cohort study for cause-specific mortality. Setting., Three hundred randomly selected districts throughout Japan in which the National Survey on Circulatory Disorders 1980 was performed. Subjects., A total of 9216 community dwelling persons aged 30 years and over, with standardized serum cholesterol measurement and without a past history of cardiovascular disease. Results., There were 1206 deaths, which included 462 deaths due to cardiovascular disease with 79 coronary heart diseases. Hypercholesterolemia (>6.21 mmol L,1) showed a significant positive relation to coronary mortality (relative risk; 2.93, 95% confidence interval; 1.52,5.63) but not to stroke. Although hypocholesterolemia (<4.14 mmol L,1) was significantly associated with an increased risk of liver cancer, noncardiovascular, noncancer disease and all-cause mortality, these associations, except for liver cancer, disappeared after excluding deaths in the first 5 years of the follow-up. The multivariate adjusted attributable risk of hypercholesterolaemia for coronary disease was 0.98 per 1000 person-years, which was threefold higher than that of hypocholesterolemia for liver cancer: 0.32 per 1000 person-years. The attributable risk percentage of hypercholesterolaemia was 66% for coronary heart disease. Conclusion., Similar to Western populations, it is recommended to provide screening for hypercholesterolaemia in Japan, especially for males, although its attributable risk for coronary disease might be small. [source]

    Evaluation of pregnant women with scarred uterus in a low resource setting

    Anjoo Agarwal
    Abstract Aim:, Management of post cesarean pregnancy continues to be a dilemma. The present study was undertaken to evaluate the outcome of such pregnancies in a resource constrained setting so that an appropriate management protocol can be decided. Methods:, An observational study was conducted in the Department Of Obstetrics And Gynecology, King George's Medical University, Lucknow, India. The outcome of all of the women admitted with pregnancy with a previous cesarean section was noted. Results:, A total number of 447 women with a post cesarean pregnancy underwent delivery. These comprised 13.7% of total deliveries over the same period. 124 women (27.7%) had successful vaginal delivery while 323 (72.3%) had a repeat cesarean section. Maternal morbidity and perinatal mortality were both significantly higher in the vaginal delivery group (P = 0.00211 and P = 0.0426, respectively). Conclusions:, Vaginal birth after cesarean (VBAC) is associated with higher maternal morbidity and perinatal mortality. Therefore the decision for VBAC must be taken only after proper consideration and counseling of the couple. [source]

    Significance of incidental mesangial IgA deposition in minimal change nephrotic syndrome

    NEPHROLOGY, Issue 2001
    M Tsukada
    Background: Incidental IgA deposition in glomerular mesangium exists in 10,20% of autopsy kidneys1,2 or renal allograft donors.3 In the present study, we examined the clinicopathological features of incidental mesangial IgA deposition in renal biopsy from patients with minimal change nephrotic syndrome (MCNS) to understand the significance of mesangial IgA deposition in MCNS and pathogenesis of IgA nephropathy. Patients and Methods: From January 1994 to September 2000, 63 patients were diagnosed with MCNS by renal biopsy at Kidney Center, Tokyo Women's Medical University. Mesangial IgA and C3 deposition was examined by immunofluorescence staining using frozen sections. The frequency of IgA and C3 deposition in MCNS and clinicopathological features of IgA-positive patients with MCNS were investigated. Results: The mesangial IgA deposition was present in 15 out of 63 patients (23.8%). Among these 15 patients, codeposition of C3 was present in 10 patients (66.7%) (Fig. 1). The serum IgA concentration was significantly higher in the IgA-positive patients than in the IgA-negative patients (309 ± 75 mg/dL versus 245 ± 106 mg/dL, P = 0.043) (Fig. 2). The urinary red blood cell count was higher in IgA-positive patients than in IgA-negative patients, although not significantly different (11.7 ± 12.7 counts/HPF versus 5.3 ± 4.0 counts/HPF, P = 0.067) (Fig. 3). Other clinical parameters (age, sex, amount of proteinuria, serum creatinine and creatinine clearance) were not significantly different. Histologically, no significant differences were observed between IgA-positive and IgA-negative patients in following parameters: grade of mesangial cell proliferation and mesangial matrix increase, extents of tubular atrophy and interstitial fibrosis and grade of vascular sclerosis. After steroid treatment, all 15 patients with mesangial IgA deposition had become complete remission, although three patients once relapsed proteinuria. The haematuria also disappeared after steroid treatment in these patients. Figure 1. The frequency of mesangial IgA and C3 deposition in MCNS patients (n = 63). The mesangial IgA deposition was present in 15 out of 63 patients (23.8%). Among these 15 patients, codeposition of C3 was present in 10 patients (66.7%). Figure 2. The serum IgA concentration of the MCNS patients with and without mesangial IgA deposition. The serum IgA concentration was significantly higher in IgA-positive patients (n = 15) than in IgA-negative patients (n = 48) (309 ± 75 mg/dL vs 245 ± 106 mg/dL, P = 0.043). Figure 3. The urinary red blood cell counts of the MCNS patients with and without mesangial IgA deposition. The urinary red blood cell count was higher in IgA-positive patients (n = 15) than in IgA-negative patients (n = 48), although not significantly different (11.7 ± 12.7 counts/HPF vs 5.3 ± 4.0 counts/HPF, P = 0.067). Conclusion: The incidental mesangial IgA deposition was frequently observed in MCNS patients (15/60 patients, 23.8%). The phenomenon of mesangial IgA deposition in MCNS patients was related to higher serum IgA concentration and might cause slight haematuria. However, no influence of mesangial IgA deposition was found on the renal function and the clinical outcome of MCNS after treatment. [source]

    Mandibular reconstruction after resection of benign tumours using non-vascularised methods in a series of patients that did not undergo radiotherapy

    ORAL SURGERY, Issue 1 2009
    D. Mehrotra
    Abstract Aim:, A case series analysis of 52 consequent subjects of immediate mandibular reconstruction after tumour resection using non-vascularised methods, undertaken at U.P. King George's University of Dental Sciences and King George's Medical University, is being reported. To assess the success of reconstruction on subjective and objective evaluation based upon Mandibular Reconstruction Assessment Scale (MRAS) questionnaire. Methods:, Patients with benign mandibular tumours irrespective of age, sex, site and socio-economic status were included. Primary reconstruction was carried out after resection in two surgical units on surgeon's choice using stainless steel wire (6/52; 12%), stainless steel reconstruction plate (10/52; 19%) or titanium reconstruction plate (36/52; 69%) without bone graft (23/52; 44%) or with bone graft (29/52; 56%). Bone grafts were harvested from iliac crest (21/52; 40%), rib (2/52; 4%) and an additional pectoralis major myocutaneous flap with iliac crest bone graft (6/52; 12%) to provide cover to the reconstruction plate was also used. Results:, The primary outcome measurements were wound healing, mouth opening, chewing efficiency, jaw movements, cosmetic achievement and speech on a five-point scale, all of which improved significantly after surgery. The overall complication rate was 17%. Three patients (6%) had loosening of the screw, two (4%) showed dehiscence of the plate, two (4%) showed tumour recurrence and one (2%) had infection of the graft that was subsequently removed. Conclusion:, Titanium reconstruction plates with iliac crest graft provided good result in the absence of microvascular reconstruction because of unavailable long operating time and lack of expertise. Long-term satisfactory rehabilitation can be achieved using removable dentures or prosthesis on dental implants on the contraption provided by the non-vascularised tissue despite non-calcified bone visible on the skiagram. [source]

    Preliminary experience with arterial chemoembolization for hepatoblastoma and hepatocellular carcinoma in children

    PEDIATRIC BLOOD & CANCER, Issue 7 2006
    Piotr Czauderna MD
    Abstract The objective of this work was to test feasibility and efficacy of hepatic artery chemoembolization (HACE) in unresectable malignant liver tumors. Five patients aged from 1,12 years were treated in the Medical University of Gdansk from 1999 to 2002. All had locally advanced tumors, which did not respond to systemic chemotherapy: four, hepatoblastoma (HB) and one, hepatocellular carcinoma (HCC). Arteriography was performed and chemoembolization suspension (cisplatin,+,doxorubicin,+,mitomycin mixed with lipiodol) was injected, followed by gelatin foam particles. The procedure was performed one to three times in each patient. In four patients (three, HB, one, fibrolamellar HCC), tumor response was observed, with decrease in the diameter of the mass of 25,33% and fall in the AFP level of 83,99%. One child with HB was non-evaluable due to early death caused by systemic myelotoxicity. Two patients (2 HB) underwent macroscopically complete tumor resection, 1 is alive and well, and 1 died at the end of surgery for an unknown reason (possibly related to cardiotoxicity of earlier systemic chemotherapy). One HB patient was successfully transplanted after two HACE courses. The only HCC patient died because of pulmonary oil embolism immediately after the third HACE course. HACE can lead to tumor regression in most cases and may be considered an alternative for patients with unresectable liver tumors who do not respond to primary systemic chemotherapy and are not candidates for liver transplantation for various reasons. © 2005 Wiley-Liss, Inc. [source]

    Short- and long-time effects of pediatric liver transplantation on serum cholesterol and triglyceride levels , The Vienna Cohort

    Julia Becker
    Abstract:, Hyperlipidemia is common in patients after LTX. Although immunosuppressive protocols have changed, there are only few data after pediatric LTX. Aim of our study was to evaluate short- and long-time effects of LTX on serum cholesterol and triglycerides in children with different immunosuppressive regimen. We retrospectively analyzed 24 children (seven boys) who underwent LTX since 1987 and were followed for at least one yr at the Medical University of Vienna. Serum lipids, liver function and records of immunosuppressive therapy were evaluated at first referral, shortly before and three, six, nine and 12 months after LTX, and at last visit (mean 6.6 yr after LTX). At first referral, serum lipids were significantly related to underlying disease and age. Following LTX, prevalence of hypercholesterolemia was 25% and of hypertriglyceridemia 90% after the first year. Long-term follow-up showed an overall decrease of serum lipids. Significant decreases in serum triglycerides were directly related to discontinuation of steroids. There was no effect of calcineurin inhibitiors. Our study confirms the high prevalence of hyperlipidemia before and after pediatric LTX and suggests a major role of steroid-withdrawal for the control of post-transplant hypertriglyceridemia. [source]

    Clinicopathological study of bronchogenic carcinoma

    RESPIROLOGY, Issue 4 2004
    Rajendra PRASAD
    Objective: The present study was undertaken to explore the clinicopathological profile of bronchogenic carcinoma. Methodology: Four hundred consecutive patients with histopathologically proven bronchogenic carcinoma, hospitalized between 1985 and 1999 at a large teaching and tertiary care referral hospital at King George's Medical University in Lucknow, India, were analysed. Results: The average age of the bronchogenic carcinoma patients was 57 years; 9.8% of patients were less than 40 years of age; the ratio of male to female patients was 4.3:1.0; 71% were smokers; and 87% of the smoking patients were bidi smokers. The most common histological type was squamous-cell carcinoma (46.5%), followed by adenocarcinoma (18.5%) and small-cell carcinoma (18.2%). The majority of patients (74.2%) were diagnosed in the late stages of the disease (IIIb and IV). Conclusion: Bidi smoking is an important contributory factor in the development of bronchogenic carcinoma in India, and approximately 25% of patients with bronchogenic carcinoma are non-smokers. [source]

    Need for syphilis screening and counselling in HIV counselling and testing centres: A curtain raiser study from north India

    Vijaya Lakshmi Nag
    Abstract Background:,Voluntary counselling and testing centres (VCTC) are important HIV screening points for the population with suspicion or apprehension for HIV, because of high-risk exposures. Theoretically, these are also at the risk of having co-infections, commonest being syphilis. The present short-term study was aimed at knowing the sero-reactivity of syphilis among a study cohort attending the VCTC in King George's Medical University, Lucknow, India. Method:,During a 2.5-month period, 49 HIV-positive and 171 HIV-negative sera were tested for venereal disease research laboratory (VDRL). The positive sera were further tested for treponema pallidum haemagglutination (TPHA). Result:,Eleven (22.4%) HIV-positive sera and 104 (60.8%) HIV-negative sera were VDRL-reactive (,1:8 dilutions). Of these, TPHA was reactive in three (27.3%) and four (3.9%), respectively. Conclusion:,The result might suggest the need for routine screening and counselling for syphilis at VCTC. Studies from other centres on larger population are required. [source]

    Evaluation of modern pathological criteria for positive margins in radical prostatectomy specimens and their use for predicting biochemical recurrence

    BJU INTERNATIONAL, Issue 3 2009
    Gary W. Bong
    OBJECTIVES To assess the interpretation of modern criteria for evaluating surgical margins (SMs), by examining the incidence of positive SMs (PSMs) and subsequent biochemical recurrence in a single-surgeon series of radical prostatectomy (RP) at two institutions, as the criteria for determining PSMs after RP are subject to individual interpretation, and this might explain some of the variability in biochemical recurrence rates with different rates of PSMs. PATIENTS AND METHODS We reviewed 301 consecutive perineal RPs by one surgeon (T.K.) at Emory University Hospital (EUH) and the Medical University of South Carolina (MUSC), with each pathology department using modern criteria to evaluate the SMs. The SM status and biochemical recurrence (BCR) were analysed, the latter defined as a prostate-specific antigen level of ,0.2 ng/mL. RESULTS There were 158 perineal RPs at EUH followed by 143 at MUSC. PSMs were reported in 39 patients (24.7%) at EUH, whereas six (4.2%) were positive at MUSC. The overall BCR rates were similar between the groups, but BCR within margin-positive cases was 100% at MUSC vs 25.6% at EUH (P < 0.01). The presence of tumour at <1 mm from the margin did not increase the rate of BCR compared to those with obvious negative SMs (P = 0.731). CONCLUSION In this single-surgeon series, using the same criteria to evaluate the SMs resulted in significantly different PSM rates and margin-positive BCR rates between the institutions. Although the reason for these differences is difficult to determine, the study shows clearly that tumour within 1 mm of the margin should not be classified as margin-positive. [source]

    3424: Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy

    Purpose To study the correlation between posterior capsule opacification (PCO) and intraocular straylight and visual acuity. Methods We measured visual acuity (VA) (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) under photopic conditions before and 2 weeks after YAG capsulotomy in 41 patients (53 eyes) from the Centro de Oftalmología Barraquer in Barcelona and the University Eye Clinic, Paracelsus Medical University in Salzburg. Photopic pupil diameter was also measured. To document the level of opacification, pupils were dilated, and photographs were taken with a slit lamp, using retroillumination and the reflected light of a wide slit beam at an angle of 45º. PCO was subjectively graded on a scale of 0 to 10 and using the POCOman system. A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy. Results Straylight correlated well with retroillumination and reflected-light PCO scores, whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values varied widely after capsulotomy. Multiple regression analysis showed that older age, large ocular axial length, hydrophobic acrylic intraocular lenses (IOLs), and small capsulotomies are factors that increased intraocular straylight. Conclusion Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity scoring methods. When performing a posterior capsulotomy, factors such as age, IOL material, axial length, and capsulotomy size must be taken into consideration, as they influence intraocular straylight. [source]

    Occurrence of human papillomavirus in pterygia

    Marta Piecyk-Sidor
    Abstract. Purpose:, The aim of the study was to assess the occurrence of human papillomavirus (HPV) DNA in pterygium. Methods:, The study involved 89 patients undergoing surgical procedures at the Department of Ophthalmology, Medical University of Lublin, Poland. Group 1 included 58 patients with clinically diagnosed pterygium. Group 2 consisted of 31 individuals with normal conjunctiva. The material was collected during elective surgical procedures. The presence of HPV genome was determined using polymerase chain reaction (PCR). Once the presence of HPV DNA was confirmed, 28 HPV genotypes were determined using reverse hybridization. Results:, The determinations confirmed the presence of HPV DNA in pterygium. In the material collected from 58 cases of pterygium (group 1), HPV DNA was identified in 16 patients (27.6%). In the material from 31 diagnostic specimens of normal conjunctiva (group 2), the presence of HPV was demonstrated in three cases (9.7%). A statistically significant difference was found in the presence of HPV DNA between the patients from groups 1 and 2 (p = 0.041). HPV type 16 was most common and was demonstrated in 56% of HPV-positive cases of pterygium. HPV 16 and HPV 6 co-infections were found in 19% of cases, while HPV 18 and HPV 6 co-infections were observed in 13%. In group 2, all three patients with HPV showed HPV 18. Conclusion:, It seems that HPV is not necessary to induce pterygium; however, it might play a synergistic role in the multi-stage process of its development. [source]

    Inflammation in AMD pathology

    Age-related macular degeneration (AMD) is a progressive retinal disease that leads to substantial irreversible vision loss in elderly patients. Two clinical categories of AMD are distinguished: the "dry" atrophic form and the exudative neovascular or "wet" form. There is neither a preventive therapy nor a cure for both forms, although recent efforts succeeded in a more effective treatment of the wet AMD with PDT and anti-VEGF drugs. AMD is a multifactorial pathology which involves complex interaction of metabolic, genetic and environmental factors, with major biochemical-clinical abnormalities seen in four functionally interrelated tissues: photoreceptors, retinal pigment epithelium, Bruch's membrane and choriocapilaries. Four processes specifically contribute to the development of AMD pathology: lipofuscinogenesis (in RPE cells), drusogenesis (with drusen located between RPE and Bruch's membrane), inflammation (local) and choroidal neovascularization (in wet form). Although the role of immune system and inflammation has been implicated in AMD pathogenesis for many years, an impetus to intensify the research in this direction gave a recent discovery of polymorphisms in genes that encode for elements of the complement system, including factor H (CFH; Y402H), factor B, and complement component 2. An increased activity of the complement alternative pathway due to the lack of or insufficient control by CFH appears to contribute to AMD progression via immunologic mechanism which drives inflammatory response. An arising question is whether blockade of overactive complement system will be a therapeutic strategy safe for patients and effective to prevent or slowing down the macula-devastating and vision-threatening disease. Supported by grant no. 503-1023-1 from Medical University of Lodz. [source]

    Long hospitalization is the most important risk factor for early weaning from breast milk in premature babies

    ACTA PAEDIATRICA, Issue 6 2009
    Lieselotte Kirchner
    Abstract Aim: To identify certain variables related to the infants' course that might have an impact on the mothers' decision to breastfeed. Patients and Method: Retrospective survey including all patients <1500 g birth weight (BW) treated between January 1, 2000 and December 31, 2005 at the Neonatal Intensive Care Unit of the Medical University of Vienna who were not transferred to another hospital. Multiple regression analysis of the following variables was carried out: gestational age (GA), BW, length of stay (LOS), parity, singleton or multiple gestation, sex and severe morbidity. Results: Of the 239 patients included, 142 (60%) were fed breast milk at the time of final discharge, 97 (40%) were fed formula. LOS was significantly correlated with the probability of being breastfed: the shorter it was, the higher was the probability of being breastfed at the time of final discharge (p = 0.0064 for singletons, p = 0.001 for multiples). Lower GA also increased the probability of being breastfed, but this was only statistically significant for multiples (p = 0.001). Conclusion: This study shows clearly that the most important influencing factor on the mothers' decision to continue breastfeeding is the LOS. Thus more emphasis should be put on encouraging mothers to continue lactation throughout their babies' hospital stay. [source]

    Rare case of the inferior mesenteric artery and the common hepatic artery arising from the superior mesenteric artery

    CLINICAL ANATOMY, Issue 6 2004
    Tokuji Osawa
    Abstract We found a case in which inferior mesenteric artery and the common hepatic artery arose from the superior mesenteric artery, forming the common hepatomesenteric trunk, during a routine dissection carried out at Iwate Medical University in 2002. This variation is rare, but can be embryonically explained. A change in the positions of the disappearance of the ventral splanchnic arteries and the longitudinal anastomotic channel results in variations in the system of arteries distributed to the digestive organs. In the present case, the longitudinal anastomotic channel between the superior and the inferior mesenteric arteries survived to form the common mesenteric artery, which was joined by the common hepatic artery, forming the common hepatomesenteric trunk. Clin. Anat. 17:518,521, 2004. © 2004 Wiley-Liss, Inc. [source]

    Identifying challenges for academic leadership in medical universities in Iran

    MEDICAL EDUCATION, Issue 5 2010
    Ali Bikmoradi
    Medical Education 2010: 44: 459,467 Context, The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. Objectives, This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. Methods, A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. Results, The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). Conclusions, This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance. [source]

    Surgical site infection rate and associated risk factors in elective general surgery at a public sector medical university in Pakistan

    Ahmed Khan Sangrasi
    Abstract This prospective study aimed to determine the surgical site infection (SSI) rate and associated risk factors was carried in a general surgical ward at Liaquat University Hospital Jamshoro. A total of 460 patients requiring elective general surgery from July 2005 to June 2006 were included in this study. All four surgical wound categories were included. Primary closure was employed in all cases. Patients were followed up to 30th day postoperatively. All cases were evaluated for postoperative fever, redness, swelling of wound margins and collection of pus. Cultures were taken from all the cases with any of the above finding. Mean ± SD age of the patients was 38·8 ± 17·4 years with male to female ratio of 1·5:1. The overall rate of surgical site infection was 13·0%. The rate of wound infection was 5·3% in clean operations, 12·4% in clean-contaminated, 36·3% in contaminated and 40% in dirt-infected cases. Age, use of surgical drain, duration of operation and wound class were significant risk factors for increased surgical site infection (P < 0·05). Postoperative hospital stay was double in cases who had surgical site infection. Sex, haemoglobin level and diabetes were not statistically significant risk factors (P > 0·05). In conclusion, surgical site infection causes considerable morbidity and economic burden. The routine reporting of SSI rates stratified by potential risk factors associated with increased risk of infection is highly recommended. [source]

    Refuting patients' obligations to clinical training: a critical analysis of the arguments for an obligation of patients to participate in the clinical education of medical students

    MEDICAL EDUCATION, Issue 3 2001
    Jude T Waterbury
    Context The clinical teaching of medical students is essential to the continuation of medicine, but it has a major impact on the patient's health care and autonomy. Some people believe that there is a moral obligation for patients to participate in this training. Such an obligation, real or perceived, may endanger patients' autonomy. Objectives The author makes a critical analysis of the main arguments he encounters supporting such an obligation. These arguments are: (1) the furthering of medical education; (2) compensation when uninsured or unable to pay; (3) an equitable return for the care received in a teaching hospital, and (4) fulfilment of a student's need for (and some say right to) clinical training. Methods Related literature is reviewed in search of evidence and/or support for such arguments. Conclusions The review reveals that these arguments either cannot be verified or do not necessarily place any obligations on the patient. It is argued that, while a medical student may have a right to clinical education, the obligation to fulfil this right rests with the medical university and not on the patients of its teaching hospitals. Solutions Several proposals are made about how to satisfy this need without infringing on the patient's right to refuse participation, explaining the patient's rights and role in clinical teaching, and the use of standardized patients where necessary. [source]