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Selected AbstractsImpoverished Children With Asthma: A Pilot Study of Urban Healthcare AccessJOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 2 2004Andrea Wallace ND ISSUES AND PURPOSE Using Andersen's Behavioral Model of Health Care Use, this pilot study was conducted to better understand the experiences of children with asthma as they access an urban healthcare system. DESIGN AND METHODS This descriptive study used a convenience sample of 34 families of pediatric asthma patients who participated in semistructured interviews and closed medical record review. RESULTS Only one patient reported having a written exacerbation management plan. Beliefs regarding medication addiction and side effects were frequently reported as barriers to medication adherence, and children seeking asthma care in primary care settings saw many care providers. PRACTICE IMPLICATIONS Exploring how expanded nursing roles can help address both family and system factors serving as barriers to health care ought to be a key priority for nursing. [source] Airway Management After Maxillectomy: Routine Tracheostomy Is Unnecessary,THE LARYNGOSCOPE, Issue 6 2003Ho-Sheng Lin MD Abstract Objectives/Hypothesis There is a paucity of data to guide the optimal management of the airway in patients after maxillectomy. The decision on whether a concomitant tracheostomy is needed is often dictated by the surgeon's training and experience. We reviewed our experience with maxillectomy to assess the need for tracheostomy in postoperative airway management. Study Design Retrospective analysis at a university hospital. Methods We identified 121 patients who underwent 130 maxillectomies between October 1990 and September 2001. Twenty-four of these were total (all six walls removed), 45 were subtotal (two or more walls removed), and 61 were limited (only one wall removed). Reconstruction ranged from none to microvascular free flap, with split-thickness skin graft being the most common reconstructive option. Results Only 10 tracheostomies (7.7%) were performed at the time of maxillectomy. These included four tracheostomies in patients who underwent bulky flap reconstruction, two tracheostomies in patients who underwent both flap reconstruction and mandibulectomy, one tracheostomy in a patient who underwent mandibulectomy, one tracheostomy in a patient with mucormycosis in anticipation of prolonged ventilatory support postoperatively, and two tracheostomies at the surgeons' discretion because of concern for upper airway edema. Among the 111 patients who underwent 120 maxillectomies without concomitant tracheostomy, 1 patient (0.9%), a 74 year-old man with oxygen-dependent chronic obstructive pulmonary disease, required repeat intubation on day 3 and again on day 10 after the surgery, because of respiratory failure; fiberoptic examination confirmed the absence of upper airway compromise. Conclusions The routine performance of tracheostomy in patients undergoing maxillectomy is unnecessary. Selective use of tracheostomy may be indicated in situations in which mandibulectomy or bulky flap reconstruction is performed or a concern for postoperative oropharyngeal airway obstruction because of edema or packing exists. [source] Pulmonary Function After Pectoralis Major Myocutaneous Flap HarvestTHE LARYNGOSCOPE, Issue 3 2002FACS, Yoav P. Talmi MD Abstract Objective The pectoralis major myocutaneous flap is widely used in the reconstruction of surgical defects in the head and neck region. Pulmonary atelectasis has been reported in patients undergoing these procedures, and many of these patients are heavy smokers and drinkers and have associated cardiopulmonary disorders. Flap harvest and donor site closure may lead to impairment of pulmonary function before and after the use of pectoralis major myocutaneous (PMC) in surgical reconstruction in patients with cancer of the head and neck. Methods Patients undergoing extirpation of head and neck tumors with PMC reconstruction were prospectively evaluated. Patient age, smoking history (pack-years), anesthesia duration, percentage predicted pre- and postoperative FEV1, percentage-predicted pre- and postoperative FVC (forced vital capacity), and preoperative SaO2 (oxygen saturation) were evaluated. Preoperative FEV1/FVC ratio was calculated. Chest x-rays were reviewed. Results Only 11 patients, 5 of whom smoked, could be evaluated postoperatively. Preoperative FEV1/FVC was more than 70 and FEV1 more than 75% predicted in all patients. A decrease in FVC was observed in 7 of the 11 patients, which ranged between 2% and 27% without any clinically obvious respiratory manifestations. A baseline SaO2 of more than 96% was noted in all patients. Four of 9 postoperative chest x-rays demonstrated atelectasis. Conclusions PMC harvest and donor site closure may lead to the recorded decrease in FVC measurements. These changes did not manifest clinically. Nevertheless, alternative methods of surgical defect closure should be considered in patients with severe preexisting pulmonary disorders. [source] Assessment of the potential of dogs and cats as urban reservoirs of Ross River and Barmah Forest virusesAUSTRALIAN VETERINARY JOURNAL, Issue 1-2 2002AM BOYD Objective To determine whether dogs and cats are potential reservoirs of Ross River (RR) and Barmah Forest (BF) viruses Method Young seronegative female dogs and cats were experimentally exposed to the viruses using Ochlerotatus vigilax(Skuse) mosquitoes. Results Only one of the 10 dogs and one of the 10 cats exposed to RR developed neutralising antibody. None of the animals developed detectable viraemia or clinical signs. One dog and three cats exposed to BF developed neutralising antibody. In addition, a serological survey of sera obtained from domestic dogs and cats residing in the Brisbane region indicated that 23.7% and 1.3% of dogs, and 14% and 2% of cats, had neutralising antibodies to RR and BF respectively. Conclusions Although dogs and cats are exposed naturally to these viruses, and can become infected, they are unlikely to be important urban reservoirs of either virus. [source] Assessment of the potential of dogs and cats as urban reservoirs of Ross River and Barmah Forest virusesAUSTRALIAN VETERINARY JOURNAL, Issue 1 2002AM BOYD Objective To determine whether dogs and cats are potential reservoirs of Ross River (RR) and Barmah Forest (BF) viruses Method Young seronegative female dogs and cats were experimentally exposed to the viruses using Ochlerotatus vigilax(Skuse) mosquitoes. Results Only one of the 10 dogs and one of the 10 cats exposed to RR developed neutralising antibody. None of the animals developed detectable viraemia or clinical signs. One dog and three cats exposed to BF developed neutralising antibody. In addition, a serological survey of sera obtained from domestic dogs and cats residing in the Brisbane region indicated that 23.7% and 1.3% of dogs, and 14% and 2% of cats, had neutralising antibodies to RR and BF respectively. Conclusions Although dogs and cats are exposed naturally to these viruses, and can become infected, they are unlikely to be important urban reservoirs of either virus. [source] Cross sectional study of automated blood pressure measurements throughout pregnancyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2004N. Ochsenbein-Kölble Objective To generate reliable new reference ranges for pregnancy blood pressure from a large population. Design A prospective cross sectional study. Setting Obstetric outpatient clinic, Zurich University Hospital. Sample Accurately dateable singleton pregnancies (Caucasian: n= 3234; Asian [predominantly from Sri Lanka, Thailand and the Philippines]: n= 577; Black n= 212). Methods Between January 1996 and February 2000 blood pressure was determined in 4023 pregnant women using an oscillometric automated device (Dinamap) according to British Hypertension Society recommendations. Women receiving antihypertensive medication were excluded. Main outcome measure Blood pressure. Results Only the means of duplicate measures at the booking visit (5,42 weeks) were used in the analysis. Mean blood pressure decreased from early to mid pregnancy before increasing to levels 4 mmHg higher at term than in early pregnancy. Values >130/80 and <90/50 mmHg were above the 95th and below the 5th centiles, respectively. Parity, age and body mass index were significant determinants in Caucasians. Blood pressure was slightly lower in Asians and Blacks. Conclusions The current World Health Organisation definition of high diastolic blood pressure (,90 mmHg on two occasions) reflects values >2 standard deviations from the mean. This may be too conservative as threshold for detecting women at risk of pre-eclampsia. Further studies are required to determine the prognostic implications of gestational values ,95th centile (,130/80 mmHg) and ,5th centile (,90/50 mmHg). [source] Outcome of the distal ureteric stump after (hemi)nephrectomy and subtotal ureterectomy for reflux or obstructionBJU INTERNATIONAL, Issue 6 2001P.A. Androulakakis Objective To assess the outcome of the distal ureteric stump (DUS) after (hemi)nephrectomy with subtotal ureterectomy. Patients and methods The records of 89 patients (median age 2.7 years, range 0.25,12) who underwent nephrectomy (24) or heminephrectomy (65) with subtotal ureterectomy between 1982 and 1996 were reviewed retrospectively for symptoms caused by the DUS. The mean follow-up was 9.8 years. Nephrectomy was undertaken for a poorly functioning dysplastic (in nine), scarred (in 10) or hydronephrotic (in five) kidney, and heminephrectomy for a poorly functioning upper moiety associated with ectopic ureterocele (in 26) or stenotic hydroureter (in 15), or for a poorly functioning lower moiety associated with reflux (in 24). There were 38 refluxing and 51 non-refluxing ureteric stumps. Two additional patients primarily operated elsewhere were referred with DUS symptoms. Results Only one patient had a symptomatic DUS, with recurrent haematuria and bacteriuria. The two patients referred from elsewhere presented with febrile UTIs. The first had been left with a long refluxing stump opening ectopically into the urethra, and the second with a long stump which was converted from nonrefluxing to a refluxing stump when he developed dysfunctional voiding. Surgical excision of the distal stump was curative in each case. Conclusions The risk of a symptomatic DUS in patients who undergo subtotal ureterectomy in conjunction with (hemi)nephrectomy is very low, with no difference between refluxing and nonrefluxing stumps. Long ureteric stumps and dysfunctional voiding may cause symptoms. Because of the low morbidity associated with a short ureteric stump, we recommend subtotal ureterectomy in children who undergo (hemi)nephrectomy for reflux, vesico-ureteric obstruction or ectopic ureterocele associated with a poorly functioning kidney or kidney moiety. [source] A gene's eye view of epistasis, selection and speciationJOURNAL OF EVOLUTIONARY BIOLOGY, Issue 3 2002M. J. Wade In this mini-review, I discuss the effects of gene interaction or epistasis from a `gene's eye view.' By a `gene's eye view' of epistasis, I mean that I will consider a single, bi-allelic locus, A, whose effects on fitness result only from its interactions with alleles of another, unknown locus, X. I will show how changes in the frequencies of alleles at the background locus affect the relationship of alleles at the A -locus to fitness. Changing the genetic background changes the fundamental characteristics of the A -locus, such as the magnitude and sign of allelic effects on fitness, and, consequently, it changes the strength and pattern of selection. I consider each of the four kinds of pair,wise interactions between two loci and show that some kinds of epistasis are more sensitive than others to population genetic subdivision. Lastly, I show that some kinds of epistasis are more likely than others to affect the process of speciation and contribute to or be responsible for general genetic features of interspecific hybrids, such as Haldane's rule. [source] Joint effects of coffee consumption and serum gamma-glutamyltransferase on the risk of liver cancer,HEPATOLOGY, Issue 1 2008Gang Hu Only three Japanese prospective studies have suggested an inverse association between coffee drinking and liver cancer risk. No prospective studies on the association between serum gamma-glutamyltransferase (GGT) and liver cancer risk have been reported. We aimed to determine the single and joint associations of coffee consumption and serum GGT with the risk of primary liver cancer. Study cohorts included 60,323 Finnish participants who were 25-74 years of age and free of any cancer at baseline. During a median follow-up period of 19.3 years (interquartile range: 9.3-29.2 years), 128 participants were diagnosed with an incident liver cancer. The multivariable-adjusted (age, sex, alcohol consumption, education, smoking, diabetes and chronic liver disease at baseline and during follow-up, and body mass index) hazards ratios of liver cancer in participants who drank 0-1, 2-3, 4-5, 6-7, and ,8 cups of coffee daily were 1.00, 0.66, 0.44, 0.38, and 0.32 (P for trend = 0.003), respectively. Further adjustment for serum GGT in subgroup analysis affected the results only slightly. The multivariable-adjusted and coffee-adjusted hazard ratio of liver cancer for the highest versus the lowest quartile of serum GGT was 3.13 (95% confidence interval = 1.22-8.07). The multivariable-adjusted inverse association between coffee consumption and liver cancer risk persisted when stratified by baseline factors: age more/less than 50 years, current smoker/never smoked/ever smoked, alcohol drinker/never drinker, obese/nonobese, and the highest/lowest three quartiles of serum GGT. A combination of very low coffee consumption and high level of serum GGT was associated with nearly nine-fold increased risk. Conclusion: Coffee drinking has an inverse and graded association with the risk of liver cancer. High serum GGT is associated with an increased risk of liver cancer. (HEPATOLOGY 2008.) [source] Particle surface temperature measurements with multicolor band pyrometryAICHE JOURNAL, Issue 1 2009Hong Lu Abstract A noncontact, color-band pyrometer, based on widely available, inexpensive digital imaging devices, such as commercial color cameras, and capable of pixel-by-pixel resolution of particle-surface temperature and emissivity is demonstrated and described. This diagnostic instrument is ideally suited to many combustion environments. The devices used in this method include color charge-coupled device (CCD), or complementary metal oxide semiconductor (CMOS) digital camera, or any other color-rendering camera. The color camera provides spectrally resolved light intensity data of the image, most commonly for three color bands (Red, Green, and Blue,), but in some cases for four or more bands or for a different set of colors. The CCD or CMOS sensor-mask combination has a specific spectral response curve for each of these color bands that spans the visible and often near infrared spectral range. A theory is developed, based on radiative heat transfer and camera responsivity that allows quantitative surface temperature distribution calculation, based on a photograph of an object in emitted light. Particle surface temperature calculation is corrected by heat transfer analysis with reflection between the particle and reactor wall for particles located in furnace environments, but such corrections lead to useful results only when the particle temperature is near or below the wall temperatures. Wood particle-surface temperatures were measured with this color-band pyrometry during pyrolysis and combustion processes, which agree well with thermocouple measured data. Particle-surface temperature data simultaneously measured from three orthogonal directions were also mapped onto the surface of a computer generated 3-D (three-dimensional) particle model. © 2008 American Institute of Chemical Engineers AIChE J, 2009 [source] Eignung eines großen Flüssigkeits- und eines Luftpyknometers zur Bestimmung des Rohvolumens von Feststoffen unterschiedlicher Art und GrößeJOURNAL OF PLANT NUTRITION AND SOIL SCIENCE, Issue 2 2005Berthold Deller Abstract Das Feststoffvolumen von Materialien, die sowohl relativ große als auch spezifisch leichte Bestandteile enthalten, kann nach DIN ISO 11508 (mit relativ kleinen Flüssigkeitspyknometern (FP) und submerser Wägung in Wasser) nicht bestimmt werden. Deshalb wurde geprüft, ob es ohne Zerkleinerung des Untersuchungsmaterials in einem größeren FP (ca. 280,cm3) oder einem Luftpyknometer (LP) genau genug zu ermitteln ist. Materialien mit gröberen Bestandteilen bzw. Feststoffe mit sehr unterschiedlicher Rohdichte ergaben mit dem FP größere Differenzen zwischen Parallelansätzen als die wiederholte Befüllung mit Wasser und die Untersuchung von feinkörnigen Mineralböden erwarten ließ. Die wesentliche Ursache dafür wird in der materialspezifischen Inhomogenität gesehen. Das FP scheint somit für die Untersuchung von Materialien mit Partikeldurchmessern von bis zu 3,cm grundsätzlich geeignet. Die Bestimmung muss jedoch jeweils an mindestens zwei Parallelproben erfolgen und ggf. erweitert werden, um verlässliche Mittelwerte zu erhalten. Die gleiche Bestimmung mit einem selbst gebauten LP ergab zu niedrige Werte für das Rohvolumen, wenn die Materialien ofentrocken, lufttrocken und feucht waren (Ausnahme: solche mit kompakten und relativ großen Partikeln). Die Fehler traten sowohl bei der Messung durch Luftdrucksenkung (ca. ,300 hPa) als auch unter Druckerhöhung (ca. 100,hPa) auf. Das Volumen von reinem Wasser konnte demgegenüber unter Druckerhöhung wesentlich genauer und richtiger bestimmt werden. Nach Kochen der Proben (wie für die Flüssigkeitspyknometrie) und Überdecken mit Wasser in der LP-Messkammer waren die Ergebnisse deutlich besser mit denen des FP vergleichbar und plausibler. Die Fehlerursachen werden darin gesehen, dass die Messung durch adsorbierte Luft (getrocknete und lufttrockene Proben) gestört wird bzw. Wasser von den Materialoberflächen während des Messvorganges verdampft. Suitability of a large liquid pycnometer and an air pycnometer to determine the raw volume of solids of different type and size The raw volume of materials, which contain constituents of relatively large size as well as of low density, can not be determined according to ISO 11508 without grinding. Therefore, this study should show if the analysis can be performed on original-sized materials with a large liquid pycnometer (LP, volume of about 280,cm3) or a self-made air pycnometer (AP). When materials of particle size up to 16,mm and/or of very different raw density were analyzed with the LP, the differences between parallel measurements were considerably greater than those of fine-textured soils and than those expected from repeated filling of the LP with water. They are ascribed mainly to the inhomogeneity of the samples and less to measuring errors. Consequently, the LP used seems to be suitable for the determination of particles with constituent size of up to 3,cm. However, the volume determination of every sample has to be performed at least twice. If the results do not meet the required precision, more repetitious measurements have to be performed, or the sample amount has to be enlarged. The same determination with the AP led to comparable and plausible results only in the case of water and of materials with compact constituents of relatively great size mainly (sand and fine gravel), when the samples were oven-dry, air-dry, or fairly moist. The results of the other materials were comparable, when the same sample preparation was performed as with liquid pycnometry (heating-up in water) and when they were covered by water in the measuring cell during measurement. The deviations from LP measurements were reduced, when measuring was performed by increasing air-pressure conditions (100 hPa) instead of lowering (,300 hPa), but to an insufficient degree. The reason for erroneous results was attributed to the existence of adsorbed air on particle surfaces (dry materials) and the evaporation of water during the measuring step (moist samples), respectively. [source] Partial lesion of thalamic ventral intermediate nucleus after chronic high-frequency stimulationMOVEMENT DISORDERS, Issue 6 2004Jasmine Henderson PhD Abstract A 73-year-old man with Parkinson's disease underwent thalamic stimulation for disabling tremor with excellent results only when stimulation on. Post-mortem neuropathology (7 years postoperatively) revealed 60% cell loss within 0.5 mm of the electrode tip. Tremor improvement was attributable to chronic stimulation, not microthalamotomy. © 2004 Movement Disorder Society [source] The phylogeny of Chinese indigenous pig breeds inferred from microsatellite markersANIMAL GENETICS, Issue 1 2005M. Fang Summary A genetic study of 32 local Chinese, three foreign pig breeds [Duroc (DU), Landrace and Yorkshire], and two types of wild boar (Hainan and Dongbei wild boar) based on 34 microsatellite loci was carried out to clarify the phylogeny of Chinese indigenous pig breeds. The allele frequencies, effective numbers of alleles, and the average heterozygosity within populations were calculated. The results showed that the genetic variability of the Lingao pig was the largest, while the Jiaxing pig was the lowest. The greatest distance between domestic pigs was found between Shanggao and DU pig and the shortest was found between Wuzhishan and Lingao pig, respectively. A neighbour-joining tree constructed from Modified Cavalli-Sforza genetic distances divided Chinese pigs into two clusters; four subclusters were also identified. Our results only partly agree with the traditional types of classification and also provide a new relationship among Chinese local pig breeds. Our data also confirmed that Chinese pig breeds have a different origin from European/American breeds and can be utilized in programmes that aim to maintain Chinese indigenous pig breeds. [source] |