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Preferred Method (prefer + method)
Selected AbstractsLong chain polyunsaturated fatty acids (LC-PUFA) and perinatal developmentACTA PAEDIATRICA, Issue 4 2001B Koletzko This paper reports on the conclusions of a workshop on the role of long chain polyunsaturated fatty acids (LC-PUFA) in maternal and child health The attending investigators involved in the majority of randomized trials examining LC-PUFA status and functional outcomes summarize the current knowledge in the field and make recommendations for dietary practice. Only studies published in full or in abstract form were used as our working knowledge base. Conclusions: For healthy infants we recommend and strongly support breastfeeding as the preferred method of feeding, which supplies preformed LC-PUFA. Infant formulas for term infants should contain at least 0.2% of total fatty acids as docosahexaenoic acid (DHA) and 0.35% as arachidonic acid (AA). Since preterm infants are born with much less total body DHA and AA, we suggest that preterm infant formulas should include at least 0.35% DHA and 0.4% AA. Higher levels might confer additional benefits and should be further investigated because optimal dietary intakes for term and preterm infants remain to be defined. For pregnant and lactating women we consider it premature to recommend specific LC-PUFA intakes. However, it seems prudent for pregnant and lactating women to include some food sources of DHA in their diet in view of their assumed increase in LC-PUFA demand and the relationship between maternal and foetal DHA status. [source] Results of a Survey of 5,700 Patient Monopolar Radiofrequency Facial Skin Tightening Treatments: Assessment of a Low-Energy Multiple-Pass Technique Leading to a Clinical End Point AlgorithmDERMATOLOGIC SURGERY, Issue 8 2007FRCP, FRCPC, JEFFREY S. DOVER MD INTRODUCTION Monopolar radiofrequency is an effective means of nonsurgical facial skin tightening. OBJECTIVE The objective of this study was to determine whether using larger tips at lower energy and multiple passes, using patient feedback on heat sensation and treating to a clinical end point of visible tightening, would yield better results than single passes with small tips at high energy, as measured by patient and physician satisfaction. METHODS Fourteen physicians from four specialties were surveyed to determine the answers to the following three questions. (1) Is patient's feedback on heat sensation a valid and preferred method for optimal energy selection? (2) Do multiple passes at moderate energy settings yield substantial and consistent efficacy? (3) Is treating to a clinical end point of visible tightening predictable of results? RESULTS A total of 5,700 patient treatments were surveyed. Comparisons were made using the original algorithm of high-energy, single pass to the new algorithm of lower energy and multiple passes with visible tightening as the end point of treatment. Using the original treatment algorithm, 26% of patients demonstrated immediate tightening, 54% observed skin tightening 6 months after treatment, 45% found the procedure too painful, and 68% of patients found the treatment results met their expectations. With the new multiple-pass algorithm, 87% observed immediate tightening, 92% had the tightening six months after treatment, 5% found the procedure too painful, while 94% found the treatment results met their expectations. CONCLUSIONS Patient feedback on heat sensation is a valid, preferable method for optimal energy selection in monopolar radiofrequency skin-tightening treatments. [source] Retrospective Review of Reconstructive Methods of Conchal Bowl Defects Following Mohs Micrographic SurgeryDERMATOLOGIC SURGERY, Issue 5 2001Nina Wines BSc Background. Mohs micrographic surgery has consistently been demonstrated to be the most effective method for excision of potentially aggressive lesions of the conchal bowl. A variety of techniques are employed to reconstruct the conchal bowl following surgery. Objective. To explore the type and frequency of reconstruction techniques used and the factors influencing the surgeons choice of reconstruction method. Method. Retrospective analysis of 272 patients with conchal bowl tumors. Results. Split thickness skin grafting was the preferred method of reconstruction. The histopathology of the lesions and the size of the post-Mohs defect did not influence the choice of technique, except for lesions less than 1 cm in which healing by secondary intention was favored. Conclusion. Tumor size, type, and aggressiveness did not influence repair technique choice. Surgeon preference was therefore the principle factor dictating method of reconstructive technique following Mohs micrographic surgery. [source] Fractional CO2 laser: a novel therapeutic device upon photobiomodulation of tissue remodeling and cytokine pathway of tissue repairDERMATOLOGIC THERAPY, Issue 2009F. Prignano ABSTRACT Minimally ablative fractional laser devices have gained acceptance as a preferred method for skin resurfacing. Notable improvements in facial rhytides, photodamage, acne scarring, and skin laxity have been reported. The aim of the present work was to compare how different CO2 laser fluences, by modulating the secretory pathway of cytokines, are able to influence the wound-healing process, and how these fluences are associated with different clinical results. Eighteen patients, all with photodamaged skin, were treated using a fractional CO2 laser (SmartXide DOT, Deka M.E.L.A., Florence, Italy) with varying laser fluences (2.07, 2.77, and 4.15 J/cm2). An immunocytochemical study was performed at defined end points in order to obtain information about specific cytokines of the microenvironment before and after treatment. The secretory pathway of cytokines changed depending on the re-epithelization and the different laser fluences. Different but significant improvements in wrinkles, skin texture, and hyperpigmentation were definitely obtained when using 2.07, 2.77, and 4.15 J/cm2, indicating fractional CO2 laser as a valuable tool in photorejuvenation with good clinical results, rapid downtime, and an excellent safety profile. [source] Skin rejuvenation with microthermal fractional photothermolysisDERMATOLOGIC THERAPY, Issue 2007Vic A. Narurkar ABSTRACT:, Fractional resurfacing is gaining acceptance as a preferred method for skin resurfacing. Experience in treating photoaging, acne scars, and melasma is reviewed. [source] Pregnancy rates in mares after a single fixed time hysteroscopic insemination of low numbers of frozen-thawed spermatozoa onto the uterotubal junctionEQUINE VETERINARY JOURNAL, Issue 2 2003L. H. A. MORRIS Summary Reasons for performing study: To compensate for the wide variation in the freezability of stallion spermatozoa, it has become common veterinary practice to carry out repeated ultrasonography of the ovaries of oestrous mares in order to be able to inseminate them within 6,12 h of ovulation with a minimum of 300,500 × 106 frozen-thawed spermatozoa. Furthermore, in order to achieve satisfactory fertility, this requirement for relatively high numbers of spermatozoa currently limits our ability to exploit recently available artificial breeding technologies, such as sex-sorted semen, for which only 5,20 × 106 spermatozoa are available for insemination. Objectives: This study was designed to evaluate and compare the efficacy of hysteroscopic vs. conventional insemination when low numbers of spermatozoa are used at a single fixed time after administration of an ovulation-inducing agent. Methods: In the present study, pregnancy rates were compared in 86 mares inseminated once only with low numbers of frozen-thawed spermatozoa (3,14 × 106) at 32 h after treatment with human chorionic gonadotrophin (hCG), either conventionally into the body of the uterus or hysteroscopically by depositing a small volume of the inseminate directly onto the uterotubal papilla ipsilateral to the ovary containing the pre-ovulatory follicle. Results: Pregnancy rates were similarly high in mares inseminated conventionally or hysteroscopically with 14 × 106 motile frozen-thawed spermatozoa (67% vs. 64%). However, when the insemination dose was reduced to 3 × 106 spermatozoa, the pregnancy rate was significantly higher in the mares inseminated hysteroscopically onto the uterotubal junction compared to those inseminated into the uterine body (47 vs. 15%, P<0.05). Conclusions: When inseminating mares with <10 × 106 frozen-thawed stallion spermatozoa, hysteroscopic uterotubal junction deposition of the inseminate is the preferred method. Potential clinical relevance: Satisfactory pregnancy rates are achievable after insemination of mares with frozen-thawed semen from fertile stallions 32 h after administration of human chorionic gonadotrophin (Chorulon)1. Furthermore, these results were obtained when mares were inseminated with 14 × 106 progressively motile frozen-thawed spermatozoa from 2 stallions of proven fertility. [source] Feasibility and acceptability of CD-ROM-based cognitive-behavioural treatment for binge-eating disorderEUROPEAN EATING DISORDERS REVIEW, Issue 3 2007Jennifer R. Shapiro Abstract We compared preliminary feasibility and acceptability of CD-ROM-delivered CBT for overweight individuals with binge-eating disorder (BED) to 10 weekly group CBT sessions (Group) and to a waiting list control (WL). Attrition was numerically greater in the Group than the CD-ROM condition; although only Group differed significantly from WL in dropout rates. Those in the CD-ROM condition reported continued use of their CD-ROM after treatment. Also, the majority of WL participants elected to receive CD-ROM over Group treatment at the end of the waiting period. Preliminarily, no significant differences emerged across the active treatment groups on most outcome measures. However, there was a significantly greater decline in binge days in the two active groups relative to WL. CD-ROM appears to be an acceptable and at least initially preferred method of CBT delivery for overweight individuals with BED. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Flow cytometric analysis of the localization of Helicobacter pylori antigens during different growth phasesFEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY, Issue 3 2001Kristina Blom Abstract Previous studies on the localization of several different Helicobacter pylori antigens have been contradictory. We have therefore examined by using both one- and two-color flow cytometry (FCM), immunofluorescence (IF), and immunoelectron microscopy (IEM), the possible surface localization of some H. pylori antigens that may be important virulence factors. All four methods detected the lipopolysaccharide and the N -acetyl-neuroaminyllactose-binding hemagglutinin protein (HpaA) as surface-exposed, while the urease enzyme was not detected at all and the neutrophil activating protein only in low concentration on the surface of the H. pylori bacteria during culture of H. pylori in liquid broth for 11 days. The FCM analysis was found to be quite sensitive and specific and also extremely fast compared with IF and IEM, and therefore the preferred method for detection of surface-localized antigens of H. pylori. [source] A Method for Predicting Chloride Concentrations in Leachate at Natural Attenuation Landfills in the Precambrian Shield Regions of Ontario, CanadaGROUND WATER MONITORING & REMEDIATION, Issue 3 2000Jim Gehrels Natural attenuation landfill sites continue to be the preferred method of domestic waste disposal in the Precambrian Shield regions of Ontario due to economic factors. The main challenge in siting these landfills is ensuring that there will be no adverse impact on off-site water resources. Impact risk assessments are generally based on estimated volumes and strengths of chloride in the leachate. While volumes can be estimated using simple water balances, peak chloride concentration predictions are based on judgment and are quite variable. Since design chloride strengths dictate the size of the required attenuation zone, overestimating concentrations will typically make it impossible to find a suitable site, while underestimating concentrations increases the potential for adverse off-site impacts occurring. Hydrogeological data from active and closed landfills in the Precambrian Shield region were collected to help develop a reliable method of predicting peak chloride concentrations in leachate. This study focused on 21 sites located on relatively permeable sandy soils since landfills underlain by low permeability clayey soils retain leachate similar to lined facilities. Linear regression analyses were conducted to determine if source chloride concentrations at the "sand" sites are significantly influenced by waste thickness, fill area, waste volume, waste deposition rate, hydraulic conductivity, upgradient flow length, depth to the water table, and moisture surplus. A strong relationship (R = 0.957) was found to exist between source chloride concentrations and waste volume. This empirical volume versus chloride regression equation can be used as the basis for establishing design chloride concentrations at new natural attenuation landfills developed over sandy soils in the Precambrian Shield regions of Ontario. An alternative risk assessment approach is required for sites developed over clay soils. [source] Simplifying head and neck microvascular reconstructionHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2004Eben Rosenthal MD Abstract Background. Free-tissue transfer has become the preferred method of head and neck reconstruction but is a technique that is considered to use excessive hospital resources. Methods. This study is a retrospective review of 125 consecutive free flaps in 117 patients over a 16-month period at a tertiary care university hospital. Results. Defects of the oral cavity/oropharynx (60%), midface (9%), hypopharynx (15%), or cervical and facial skin (16%) were reconstructed from three donor sites: forearm (70%), rectus (11%), and fibula (19%). Microvascular anastomoses were performed with a continuous suture technique or an anastomotic coupling device for end-to-end venous anastomoses. A single vein was anastomosed in 97% of tissue transfers. There were five flaps (4%) requiring exploration for vascular compromise, and the overall success rate was 97.6%. The major complication rate was 13%. Mean hospital stay was 7 days for all patients and 5 days for those with cutaneous defects. Combined ablative and reconstructive operative times were 6 hours 42 minutes, 7 hours 40 minutes, and 8 hours 32 minutes for forearm, rectus, and fibular free grafts, respectively. A subset of this patient series with oral cavity and oropharynx defects (76 patients; 58%) available for follow-up (74 patients) was assessed for deglutition. Forty-three patients (58%) had a regular diet, 22 patients (30%) had a limited diet or required supplemental tube feedings, and nine patients (12%) were dependent on tube feedings with a severely limited diet. Conclusions. This series suggests that most head and neck defects can be reconstructed by use of a simplified microvascular technique and a limited number of donor sites. Analysis of operative times and length of stay suggest improved efficiency with this approach to microvascular reconstruction. Complications and functional results are comparable to previously published results. © 2004 Wiley Periodicals, Inc. Head Neck26: 930,936, 2004 [source] The challenge of ST-segment elevation myocardial infarctionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 12 2007M. Cohen Summary Background/introduction:, Acute coronary syndromes (ACS) represent a spectrum of ischaemic myocardial events that share a similar pathophysiology. ST-segment elevation myocardial infarction (STEMI), the most severe form of ACS short of sudden cardiac death, is a significant public health problem with an estimated 500,000 STEMI events every year in the United States. Treatment/therapy:, The mortality and morbidity associated with STEMI is significant. Early reperfusion therapy is the most important aspect of the treatment of STEMI. There are two main methods of reperfusion therapy: percutaneous coronary intervention (PCI) and fibrinolytic therapy, with PCI being the preferred method. In addition to standard reperfusion therapy, antithrombotics (unfractionated heparin and low molecular weight heparins) and antiplatelet agents (aspirin, clopidogrel and glycoprotein IIb/IIIa inhibitors) are critical adjuncts, effective in the treatment of acute STEMI. Conclusions:, The survival of patients with STEMI depends on rapid diagnosis and optimal early treatment. Guidelines for the management of patients with STEMI recommend PCI within 90 min of presentation and that fibrinolytics are administered within 30 min. However, only a fraction of patients undergo reperfusion within the recommended time. Improvements in protocols for identifying STEMI cases are therefore required to allow reperfusion therapy to be initiated sooner. Secondary prevention is another important aspect of STEMI management, and patients should be encouraged to adopt strategies that reduce the risk of subsequent ischaemic events. [source] Simplified System for Absolute Fracture Risk Assessment: Clinical Validation in Canadian Women,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2009William D Leslie Abstract Absolute 10-yr fracture risk based on multiple factors is the preferred method for risk assessment. A simplified risk assessment system from sex, age, DXA, and two clinical risk factors (CRFs),prior fracture and systemic corticosteroid (CS) use-has been used in Canada since 2005. This study was undertaken to evaluate this system in the Canadian female population. A total of 16,205 women ,50 yr of age at the time of baseline BMD (1998,2002) were identified in a database containing all clinical DXA test results for the Province of Manitoba, Canada. Basal 10-yr fracture risk from age and minimum T-score (lumbar spine, femur neck, trochanter, total hip) was categorized as low (<10%), moderate (10,20%), or high (>20%). Health service records since 1987 were assessed for prior fracture codes (N = 5224), recent major CS use (N = 616), and fracture codes after BMD testing (mean, 3.1 yr of follow-up) for the hip, vertebrae, forearm, or humerus (designated osteoporotic, N = 757). Fracture risk predicted from age and minimum T-score alone showed a significant gradient in observed fracture rates (low 5.1 [95% CI, 4.1,6.4], moderate 11.5 [95% CI, 10.1,13.0], high 25.4 [95% CI, 23.2,27.9] per 1000 person-years; p -for-trend <0.0001). There was an incremental increase in incident fracture rates from a prior fracture (13.9 [95% CI, 11.3,16.4] per 1000 person-years) or major CS use (11.2 [95% CI, 4.1,18.2] per 1000 person-years). This simplified fracture risk assessment system provides an assessment of fracture risk that is consistent with observed fracture rates. [source] Temporary Epicardial Ventricular Stimulation in Patients with Atrial Fibrillation: Acute Effects of Ventricular Pacing Site on Bypass Graft FlowsJOURNAL OF CARDIAC SURGERY, Issue 4 2009Navid Madershahian M.D. This study aimed to evaluate the optimal epicardial ventricular pacing site in patients with AF following coronary artery bypass surgery (CABG). Methods: In 23 consecutive patients (mean age = 69.2 ± 1.9 years, gender = 62% male, ejection fraction [EF]= 50.4 ± 2.1%) monoventricular stimulations (VVI) were tested with a constant pacing rate of 100 bpm. The impact of ventricular pacing on bypass graft flow (transit-time flow probe) and pulsatility index (PI) were measured after lead placement on the mid paraseptal region of the right (RVPS) and the left (LVPS) ventricle, on the right inferior wall (RVIW), and on the right ventricular outflow tract (RVOT). In addition, hemodynamic parameters were measured. Patients served as their own control. Results: Comparison of all tested pacing locations revealed that RVOT stimulation provided the highest bypass grafts flows (59.9 ± 6.1 mL/min) and PI (2.2 ± 0.1) when compared with RVPS (51.3 ± 4.7 mL/min, PI = 2.6 ± 0.2), RVIW (54.0 ± 5.1 mL/m; PI = 2.4 ± 0.2), and LVPS (53.1 ± 4.5 mL/min; PI = 2.3 ± 0.1), respectively (p < 0.05). When analyzing patients according to their preoperative LV function (group I = EF > 50%; group II = EF < 50%), higher bypass graft flows were observed with RVOT pacing in patients with lower EF (p = n.s.). Conclusions: Temporary RVOT pacing facilitates optimal bypass graft flows when compared with other ventricular pacing sites and should be the preferred method of temporary pacing in cardiac surgery patients with AF. Especially in patients with low EF following CABG, RVOT pacing may improve myocardial oxygen conditions for the ischemic myocardium and enhance graft patency in the early postoperative period. [source] A Comparison of Cleaning Regimes for the Effective Removal of Fingerprint Deposits from BrassJOURNAL OF FORENSIC SCIENCES, Issue 1 2010Emma Paterson Abstract:, Effective removal of fingerprint deposits is crucial for experimentation related to the corrosion of metals by fingerprint deposits. Such removal is also necessary prior to deposition of test fingerprints. The effectiveness of four regimes in removing fingerprint deposits from brass is considered. Sustained wiping of the deposit with a tissue at applied pressures of up to c. 1430 Pa or rubbing while the brass was immersed in acetone both failed to remove completely all traces of fingerprint deposits. Heating the brass to 600°C was an effective remover; however, this also oxidized the surface of the metal except where inhibited by fingerprint deposits. The most effective regime, and the only one of the four that removed all traces of deposit without affecting the properties of the metal surface, was immersion in warm soapy water while rubbing with a tissue. We propose this as the preferred method for fingerprint removal. [source] Pyrotechnic Reaction Residue Particle AnalysisJOURNAL OF FORENSIC SCIENCES, Issue 2 2006Kenneth L. Kosanke Ph.D. ABSTRACT: Pyrotechnic reaction residue particle (PRRP) production, sampling and analysis are all very similar to that for primer gunshot residue. In both cases, the preferred method of analysis uses scanning electron microscopy to locate suspect particles and then uses energy dispersive x-ray spectroscopy to characterize the particle's constituent chemical elements. There are relatively few times when standard micro-analytical chemistry performed on pyrotechnic residues may not provide sufficient information for forensic investigators. However, on those occasions, PRRP analysis provides a greatly improved ability to discriminate between materials of pyrotechnic origin and other unrelated substances also present. The greater specificity of PRRP analysis is the result of its analyzing a large number of individual micron-sized particles, rather than producing only a single integrated result such as produced using standard micro-analytical chemistry. For example, PRRP analyses are used to demonstrate its ability to successfully (1) discriminate between pyrotechnic residues and unrelated background contamination, (2) identify that two different pyrotechnic compositions had previously been exploded within the same device, and (3) establish the chronology of an incident involving two separate and closely occurring explosions. [source] Failure to confirm HIV infection in two end-stage HIV/AIDS patients using a popular commercial line immunoassayJOURNAL OF MEDICAL VIROLOGY, Issue 9 2008Julian W. Tang Abstract Immunoassays using either viral lysate (Western blot) or recombinant/synthetic antigen (immunoblot) for anti-HIV capture are still the preferred method to confirm HIV infection. Two cases of HIV-1-infected patients presented with acquired immunodeficiency syndrome (AIDS)-defining illnesses. Laboratory tests were performed using multiple commercial HIV test kits on multiple sera from both patients over several weeks. Both patients were strongly positive on the anti-HIV/p24 antigen combined screening assay. Yet, HIV-1 infection could not be confirmed using a popular commercial immunoassay. Eventually, HIV infection was confirmed using an alternative commercial Western blot assay as well as an HIV quantitative PCR test. In laboratories without nucleic acid testing (NAT) for HIV, indeterminate results may delay confirmation of HIV infection, if commercial line immunoassays alone are available. Some end-stage HIV/AIDS patients may not produce antibodies to specific HIV antigens and may therefore give indeterminant or negative results on some immunoassays, depending on the type of antigen used. This report highlights the utility of having NAT available when diagnosing difficult cases of HIV infection, especially in light of the recent Centers for Disease Control and Prevention move towards more universal, routine, HIV testing. J. Med. Virol. 80:1515,1522, 2008. © 2008 Wiley-Liss, Inc. [source] Analysis of publications and citations from a geophysics research instituteJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 9 2001Cliff Frohlich We here perform an analysis of all 1128 publications produced by scientists during their employment at the University of Texas Institute for Geophysics, a geophysical research laboratory founded in 1972 that currently employs 23 Ph.D.-level scientists. We thus assess research performance using as bibliometric indicators such statistics as publications per year, citations per paper, and cited half-lives. To characterize the research style of individual scientists and to obtain insight into the origin of certain publication-counting discrepancies, we classified the 1128 publications into four categories that differed significantly with respect to statistics such as lifetime citation rates, fraction of papers never-cited after 10 years, and cited half-life. The categories were: mainstream (prestige journal) publications,32.6 lifetime cit/pap, 2.4% never cited, and 6.9 year half-life; archival (other refereed),12.0 lifetime cit/pap. 21.5% never cited, and 9.5 years half-life; articles published as proceedings of conferences,5.4 lifetime cit/pap, 26.6% never cited, and 5.4 years half-life; and "other" publications (news articles, book reviews, etc.),4.2 lifetime cit/pap, 57.1% never cited, and 1.9 years half-life. Because determining cited half-lives is highly similar to a well-studied phenomenon in earthquake seismology, which was familiar to us, we thoroughly evaluate five different methods for determining the cited half-life and discuss the robustness and limitations of the various methods. Unfortunately, even when data are numerous the various methods often obtain very different values for the half-life. Our preferred method determines half-life from the ratio of citations appearing in back-to-back 5-year periods. We also evaluate the reliability of the citation count data used for these kinds of analysis and conclude that citation count data are often imprecise. All observations suggest that reported differences in cited half-lives must be quite large to be significant. [source] Abandoned artisanal gold mines in the Brazilian Amazon: A legacy of mercury pollutionNATURAL RESOURCES FORUM, Issue 1 2002Marcello M. Veiga The modern gold rush in the Brazilian Amazon attracted millions of people to become artisanal miners in order to escape complete social marginalization. The rudimentary nature of artisanal mining activities often generates a legacy of extensive environmental degradation,both during operations and well after mining activities have ceased. One of the most significant environmental impacts is derived from the use of mercury (Hg), which is illegal for use in gold amalgamation in Brazil, but continues to be the preferred method employed by artisanal gold miners. The general population is unaware of the capricious nature of mercury and artisanal mining activities. Moreover, individuals in positions of political or economic infiuence tend to be negatively biased towards artisanal mining and government policies do not effectively address the realities of these activities. Affected communities have consequently been ignored,and mistrust towards outside parties is high. Not surprisingly, miners are suspicious of and unlikely to employ externally derived solutions to reduce mercury emissions. This article reviews the use of mercury in artisanal mining and highlights the role miners, governments and non-governmental organizations (NGOs) have played in communicating facts, perpetuating myths and deriving solutions for mercury pollution. This article also raises some key concerns that must be addressed to understand the behaviour of mercury in the environment and identifies solutions for problems facing communities where artisanal gold mining operations have been abandoned. [source] The treatment of oesophageal varices using a Sengstaken,Blakemore tube: considerations for nursing practiceNURSING IN CRITICAL CARE, Issue 2 2004Teresa Christensen SUMMARY , The Sengstaken,Blakemore tube is slowly becoming the least preferred method for the treatment of oesophageal varices, possibly due to the potential complications that are inherent in its placement , Nursing practice pertaining to the care of this patient group appears ad hoc and reliant on local knowledge and experience, as opposed to recognized evidence of best practice [source] OLAV: Towards high-throughput tandem mass spectrometry data identificationPROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 8 2003Jacques Colinge Abstract Mass spectrometry combined with database searching has become the preferred method for identifying proteins in proteomics projects. Proteins are digested by one or several enzymes to obtain peptides, which are analyzed by mass spectrometry. We introduce a new family of scoring schemes, named OLAV, aimed at identifying peptides in a database from their tandem mass spectra. OLAV scoring schemes are based on signal detection theory, and exploit mass spectrometry information more extensively than previously existing schemes. We also introduce a new concept of structural matching that uses pattern detection methods to better separate true from false positives. We show the superiority of OLAV scoring schemes compared to MASCOT, a widely used identification program. We believe that this work introduces a new way of designing scoring schemes that are especially adapted to high-throughput projects such as GeneProt large-scale human plasma project, where it is impractical to check all identifications manually. [source] Comparison of flow injection analysis electrospray mass spectrometry and tandem mass spectrometry and electrospray high-field asymmetric waveform ion mobility mass spectrometry and tandem mass spectrometry for the determination of underivatized amino acidsRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 11 2006Margaret McCooeye Twenty proteinogenic amino acids (AAs) were determined without derivatization using flow injection analysis followed by electrospray ionization mass spectrometry and tandem mass spectrometry (ESI-MS and ESI-MS/MS) and electrospray ionization high-field asymmetric waveform ion mobility mass spectrometry and tandem mass spectrometry (ESI-FAIMS-MS and ESI-FAIMS-MS/MS), in positive and negative ionization modes. Three separate sets of ESI-FAIMS conditions were used for the separation and detection of the 20 AAs. Typically ESI-FAIMS-MS showed somewhat improved sensitivity and significantly better signal-to-noise ratios than ESI-MS mainly due to the elimination of background noise. However, the difference between ESI-FAIMS-MS and ESI-MS/MS was significantly less. ESI-FAIMS was able to partially or completely resolve all the isobaric amino acid overlaps such as leucine, isoleucine and hydroxyproline or lysine and glutamine. Detection limits for the amino acids in ESI-FAIMS-MS mode ranged from 2,ng/mL for proline to 200,ng/mL for aspartic acid. Overall, ESI-FAIMS-MS is the preferred method for the quantitative analysis of AAs in a hydrolyzed yeast matrix. Copyright © 2006 Crown in the right of Canada. Published by John Wiley & Sons, Ltd. [source] Outcomes of static and dynamic facial nerve repair in head and neck cancerTHE LARYNGOSCOPE, Issue 3 2010Tim A. Iseli MBBS Abstract Objectives/Hypothesis: Determine outcomes associated with nerve grafting versus static repair following facial nerve resection. Study Design: Retrospective chart review. Methods: Charts from 105 patients who underwent facial nerve reconstruction between January 1999 and January 2009 were reviewed. The majority had parotid malignancy (78.1%), most commonly squamous cell carcinoma (50.5%). Patients underwent static (n = 72) or dynamic (n = 33) reconstruction with nerve grafting. Facial nerve function was measured using the House-Brackmann (H-B) scale. Results: Patients receiving static reconstruction were on average 10.3 years older (P = .002). Mean overall survival for tumor cases was 61.9 months; parotid squamous cell carcinoma was associated with worse prognosis (P = .10). Median follow-up was 16.1 months (range, 4,96.1 months). Most (97%) patients receiving a nerve graft had some return of function at a median of 6.2 months postoperatively (range, 4,9 months) and the majority (63.6%) had good function (H-B score ,4). Patients having static reconstruction (29.2%) were more likely to have symptomatic facial palsy than those having a nerve graft (15.2%, P = .12). Conclusions: Where possible, nerve grafting is the preferred method of facial nerve reconstruction. Although elderly patients with parotid malignancy have traditionally been considered poor candidates for nerve grafting, we demonstrate good results within 9 months of facial nerve repair even with radiotherapy, the use of long grafts (>6 cm), and prolonged preoperative dysfunction. Laryngoscope, 2010 [source] Primary hydatid cysts of psoas muscleANZ JOURNAL OF SURGERY, Issue 6 2002Marcovalerio Melis Background:, Hydatid cysts may occur in any area of the body, but they usually localize to the liver and the lungs. Primary localization in muscle is not common, accounting for 2,3% of all sites; even rarer is the development of multiple cysts. Methods: The patient presented with a painless abdominal mass which gradually increased in size to a diameter of approximately 16 cm. Organ imaging scan revealed multiple hydatid cysts within the right psoas muscle. Because of the proximity of the lesions to the iliac vessels, ureter and nerves to the lower limb, percutaneous drainage and alcoholization under local anaesthesia were performed with the aim of reducing the size of the cysts and sterilizing them prior to definitive surgery. This procedure was not effective. Two weeks after percutaneous treatment the patient underwent surgery. Results:, At operation the cysts were localized and successfully removed under ultrasound guidance. Postoperative stay was uneventful. Two years after surgery the patient has no evidence of recurrent hydatid disease. Conclusions:, Ultrasonography is the preferred method for detecting muscular hydatid cyst and for guiding the surgeon during resection. [source] Vascularity in thyroid neoplasms: a methodological investigation with a view to diagnostics,APMIS, Issue 11 2006KAREN KJÆR LARSEN The aim of the present study was to evaluate the reliability of four different methods (vascular grading, Chalkley count, microvessel density (MVD) and stereological estimation) for quantifying intratumoral microvascularity in thyroid neoplasms, by comparing the variability within and between observers. In addition, the diagnostic and prognostic potential of neovascularity expressed by the four methods was evaluated. The study had a retrospective design and involved 24 follicular adenomas (FA), 19 follicular carcinomas (FC), and 17 papillary carcinomas (PC). Chalkley count was reproducible both within and between observers. MVD was not reproducible. Within observer the reproducibility of vascular grading was substantial, between observers it was fair to moderate. Stereological estimation was a priori considered reproducible. Keeping time consumption, cost and reproducibility in mind, Chalkley count should be the preferred method for assessing microvascularity in thyroid neoplasms. The diagnostic evaluation revealed a tendency towards higher degree of vascularity in FA compared to both FC and PC for all methods. No statistically significant association was seen between vascular density and prognosis. [source] Randomized clinical trial comparing loop ileostomy and loop transverse colostomy for faecal diversion following total mesorectal excisionBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2002W. L. Law Background: The aim of this study was to compare loop ileostomy and loop transverse colostomy as the preferred mode of faecal diversion following low anterior resection with total mesorectal excision for rectal cancer. Methods: Patients who required proximal diversion after low anterior resection with total mesorectal excision were randomized to have either a loop ileostomy or a loop transverse colostomy. Postoperative morbidity, stoma-related problems and morbidity following closure were compared. Results: From April 1999 to November 2000, 42 patients had a loop ileostomy and 38 had a loop transverse colostomy constructed following low anterior resection. Postoperative intestinal obstruction and prolonged ileus occurred more commonly in patients with an ileostomy (P = 0·037). There was no difference in time to resumption of diet, length of hospital stay following stoma closure and incidence of stoma-related complications after discharge from hospital. A total of seven patients had intestinal obstruction from the time of stoma creation to stoma closure (six following ileostomy and one following colostomy; P = 0·01). Conclusion: Intestinal obstruction and ileus are more common after loop ileostomy than loop colostomy. Loop transverse colostomy should be recommended as the preferred method of proximal faecal diversion. © 2002 British Journal of Surgery Society Ltd [source] Outcome 1 year after aneurysmal subarachnoid hemorrhage: relation between cognitive performance and neuroimagingACTA NEUROLOGICA SCANDINAVICA, Issue 2 2005A. Egge Objective,,, To assess the cognitive impairment and the association between neuropsychological measures and neuroimaging 1 year after aneurysmal subarachnoid hemorrhage (SAH). Method,,, Forty-two patients were examined clinically according to Glasgow Outcome Scale (GOS). Computed tomography (CT), single photon emission computed tomography (SPECT) and neuropsychological examination were performed. Results,,, There were no association between GOS and cognitive impairment index based on the neuropsychological examination. CT showed no sign of cerebral ischemia in 17 (40%) and low attenuating areas indicating cerebral infarction(s) in 25 (60%) patients. A significant correlation (P = 0.01) was observed between the cognitive impairment index and the SPECT index (r = 0.6). SPECT measurement was the only independent predictor for cognitive impairment. Conclusion,,, GOS is a crude outcome measure and patients classified with good recoveries may have significant cognitive deficits. Neuropsychological examination is the preferred method for outcome evaluation as this method specifically addresses the disabilities affecting patients' everyday life. [source] 3335: New modalities for the treatment of corneal dystrophiesACTA OPHTHALMOLOGICA, Issue 2010I CLAERHOUT Purpose To give an overview of current treatment modalities of corneal dystrophies. Results New transplant techniques have changed the way that corneal dystrophies are being treated in the last few years. Phototherapeutic keratectomy is still a very valuable tool for superficial dystrophies. Depending on the layers involved the laser will be set to a depth of 5 to 100µm. DALK is now the preferred method of treatment of most stromal dystrophies, although macular dystrophy is an exception to this rule since there is evidence of endothelial involvement in this dystrophy. Endothelial dystrophies are now almost exclusively being treated by different types of endothelial grafts (DSAEK or DMEK). Conclusion Current treatment of corneal dystrophies has evolved from one size fits all to a more customised treatment schedule, still dependent on the layers involved in the disease. [source] Fine-needle aspiration biopsy and other biopsies in suspected intraocular malignant disease: a reviewACTA OPHTHALMOLOGICA, Issue 6 2009Nils Eide Abstract. Ocular oncologists require a strong indication for intraocular biopsy before the procedure can be performed because it carries a risk for serious eye complications and the dissemination of malignant cells. The purpose of this review is to evaluate the extent to which this restricted practice is supported by evidence from previous reports and to outline our main indications and contraindications. The different intraocular biopsy techniques in the anterior and posterior segment are discussed with a focus on our preferred method, fine-needle aspiration biopsy (FNAB). In the literature, complications are typically under-reported, which reduces the possibilities of evaluating the risks correctly and of making fair comparisons with other biopsy methods. In FNAB, the exact placement of the needle is critical, as is an accurate assessment of the size of the lesion. Fine-needle aspiration biopsy is usually not a reliable diagnostic tool in lesions < 2 mm in thickness. It is very advantageous to have a cytopathologist present in the operating theatre or close by. This ensures adequate sampling and encourages repeated biopsy attempts if necessary. This approach reduces false negative results to < 3%. Adjunct immunocytochemistry is documented to increase specificity and is essential for diagnosis and management in about 10% of cases. In some rare pathological processes the diagnosis depends ultimately on the identification of specific cell markers. An accurate diagnosis may have a decisive influence on prognosis. The cytogenetic prognostications made possible after FNAB are reliable. Biopsy by FNA has a low complication rate. The calculated risk for retinal detachment is < 4%. Intraocular haemorrhage is frequently observed, but clears spontaneously in nearly all cases. Only a single case of epibulbar seeding of malignant cells at the scleral pars plana puncture site of transvitreal FNAB has been documented. Endophthalmitis has been reported and adequate standard preoperative preparation is obligatory. An open biopsy is still an option in the anterior segment, but has been abandoned in the posterior segment. Although vitrectomy-based procedures are becoming increasingly popular, we recommend using FNAB as part of a stepwise approach. A vitrectomy-assisted biopsy should be considered in cases where FNAB fails. In any adult patient with suspected intraocular malignancy in which enucleation is not the obvious treatment, the clinician should strive for a diagnosis based on biopsy. When the lesion is too small for biopsy or the risks related to the procedure are too great, it is reasonable to be reluctant to biopsy. The standards applied in the treatment of intraocular malignant diseases should be equivalent to those in other fields of oncology. Our view is controversial and contrary to opinion that supports current standards of care for this group of patients. [source] Malignant solitary fibrous tumour of the orbitACTA OPHTHALMOLOGICA, Issue 4 2009Leonard Girnita Abstract. Purpose:, We aimed to report a case of orbital solitary fibrous tumour (SFT) in a child and to review the relevant literature. Methods:, We describe an SFT in a 13-year-old boy with a 1-month history of painless proptosis in the left eye. Results:, Magnetic resonance imaging revealed a well circumscribed mass filling most of the left intraconal orbit. The lesion was excised and histopathological examination revealed a malignant SFT. Postoperative follow-up for 18 months was uneventful. Conclusions:, Malignant SFT of the orbit should be included in the differential diagnosis of paediatric orbital tumours. Complete surgical excision remains the preferred method of management and the longterm prognosis is guarded. [source] The relationships between learning outcomes and methods of teaching anatomy as perceived by professional anatomistsCLINICAL ANATOMY, Issue 2 2008K.M. Patel Abstract Changes in the teaching of gross anatomy have often involved decreasing student contact time alongside the use of new methods for teaching. However, there remains controversy over teaching methods and about whether cadaveric dissection by students should remain the preferred method. Furthermore, decisions concerning changes to curricula are more likely to be taken by choosing a method of teaching rather than by proper evaluation of what are the desired learning outcomes for a course in anatomy. The purpose of this study was to ascertain the attitudes of anatomists in Europe towards the methods of teaching best fitting a series of learning outcomes for anatomy and secondarily to test the hypothesis that, from evaluation of learning outcomes, anatomy is best taught by cadaveric dissection by the students. About 113 completed questionnaires were received from anatomists who are employed at higher education institutions that use various teaching methods. Most anatomists (69%) favored the use of cadaveric dissection above other teaching methods when considering the whole series of learning comes, this method seeming to achieve a range of different course aims/objectives, P < 0.001; Kruskal,Wallis). Consequently, these findings are consistent with our initial hypothesis. However, when individual learning outcomes were considered, the relationship was not so clear cut and, for example, little difference was discernible between teaching methods when considering learning outcomes related to the acquisition of anatomical knowledge. The use of human cadaveric dissection gained more approval when the skills-base was considered rather than just the content(knowledge)-base of an anatomical course. Clin. Anat. 21:182,189, 2008. © 2008 Wiley-Liss, Inc. [source] | ||||||||||||||||||||||||||||||||||