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Same Criteria (same + criterion)
Selected AbstractsEvaluation of the skin sensitizing potency of chemicals by using the existing methods and considerations of relevance for elicitationCONTACT DERMATITIS, Issue 1 2005David A. Basketter The Technical Committee of Classification and Labelling dealing with harmonized classification of substances and classification criteria under Directive 67/548/EEC on behalf of the European Commission nominated an expert group on skin sensitization in order to investigate further the possibility for potency consideration of skin sensitizers for future development of the classification criteria. All substances and preparations should be classified on the basis of their intrinsic properties and should be labelled accordingly with the rules set up in the Directive 67/548/EEC. The classification should be the same under their full life cycle and in the case that there is no harmonized classification the substance or preparation should be self-classified by the manufacturer in accordance with the same criteria. The Directive does not apply to certain preparations in the finished state, such as medical products, cosmetics, food and feeding stuffs, which are subject to specific community legislation. The main questions that are answered in this report are whether it would be possible to give detailed guidance on how to grade allergen potency based on the existing methods, whether such grading could be translated into practical thresholds and whether these could be set for both induction and elicitation. Examples are given for substances falling into various potency groups for skin sensitization relating to results from the local lymph node assay, the guinea pig maximization test, the Buehler method and human experience. [source] Clustering of cardiovascular risk factors with diabetes in Chinese patients: the effects of sex and hyperinsulinaemiaDIABETES OBESITY & METABOLISM, Issue 3 2001Z. -R. SUMMARY Objective This study was designed to investigate factors which affect the clustering of cardiovascular risk factors with diabetes in Chinese patients. Research Design and Methods: Six hundred and fifty-four patients with diabetes were assessed comprehensively for diabetes complications and cardiovascular risk factors in a metropolitan hospital in Beijing, China. Insulin resistance and secretion were also evaluated by measurement of glucose and insulin levels before and after a meal tolerance test. Results were analysed according to patient groups stratified by the number of cardiovascular risk factors coexisting with diabetes. Results Cardiovascular risk factors were common in Chinese diabetic patients. The clustering of three or more of these factors with diabetes occurred more often than by chance alone and was associated with postprandial hyperinsulinaemia. Patients with a high number of risk factors were more prone to macrovascular events but did not have higher albuminuria. Using the commonly adopted lower threshold for diagnosing obesity and central obesity in women, there were more women with multiple risk factors. However, this disappeared if the same criteria were used for men and women. Even in the presence of diabetes, cardiovascular risk factors were inadequately controlled in most patients. Conclusions The concurrence of diabetes and other cardiovascular risk factors which constitute the metabolic syndrome is a common phenomenon in urban Chinese diabetic patients. It is associated with hyperinsulinaemia and possibly the female sex. This study emphasises the importance of public health measures to control cardiovascular risk factors in patients with diabetes. [source] Embedding knowledge management in the NHS south-west: pragmatic first steps for a practical conceptHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 2 2003Caroline Plaice Knowledge management, like clinical governance, is a practical science. Clinical governance, with its emphasis on creating an environment where clinical quality is monitored and acted upon, is one of the foundation stones of the new National Health Service (NHS). Both knowledge management and clinical governance need to share the same criteria in order to operate. Using these two pragmatic concepts and the premise of a practical approach, this article seeks to identify the drivers for knowledge management in the NHS, highlight national initiatives and focus on the steps libraries in the south-west of England have taken to make knowledge management a reality. In so doing, the central role of the library and information service has been reinforced and embedded and librarians have been recognized for their real worth to their organizations. [source] Interannual variability of atmospheric water balance over South Peninsular India and Sri Lanka during northeast monsoon seasonINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 15 2008Venkatraman Prasanna Abstract In this study we have investigated atmospheric water balance over South Peninsular India and Sri Lanka during the months October to December (OND) using computed moisture convergence (C) and residual evaporation (E) from National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR) reanalysis data and Global Precipitation and Climatology Project (GPCP) precipitation data. The interannual signatures of OND precipitation, moisture convergence and evaporation over the South Peninsular India and Sri Lanka have been captured. The spatial and temporal characteristics of the hydrological cycle and the contribution of evaporation (E) and convergence (C) to precipitation (P) are discussed in detail. Over the South Peninsular India and Sri Lanka, evaporation (E) dominates during the entire monsoon months (OND). However, the interannual variability of precipitation over the domain is not necessarily influenced by the same criteria which influences the mean seasonal precipitation. The moisture from the Indian Ocean (IO) sector also modulates the precipitation over this region on a year-to-year basis. It has been noted that the positive northeast monsoon rainfall (NEMR) is associated with El Nino coupled with IO dipole, but negative NEMR is weakly associated only with La Nina over South Peninsular India and Sri Lanka. There also exists a significant land-atmospheric interaction over the region in modulating the hydrological cycle on a year-to-year basis. Copyright © 2008 Royal Meteorological Society [source] Quality of institutional care of older people as evaluated by nursing staffJOURNAL OF CLINICAL NURSING, Issue 18 2008Arja Isola Aims., The aim of this paper was to report on the quality of institutional nursing of older people as evaluated by nursing staff in 2001 and to compare the responses with those obtained in 1998. Background., The healthcare division of one Finnish city authorised an outside survey of long-term geriatric care in the hospitals providing such care in 1998. Based on the results, recommendations concerning the development of care of older people were issued. A re-survey was conducted in 2001, using the same criteria of quality assessment. Methods., A survey research method was used. All the seven institutions providing long-term geriatric care, including a total of 53 wards, participated. In 1998, a total of 607 questionnaires was returned. The response percentage was 78·6%. In 2001, a total of 573 questionnaires was returned. The response percentage was 76·8%. Results., The staff considered their possibilities to help geriatric patients best in the domain of physical care and slightly less good in the domain of psychosocial care. The differences in staff estimates between the two years were very small. More than 90% of the respondents considered their knowledge of physical care adequate. The nursing staff's evaluations were roughly similar in 1998 and 2001. More than 98% of the respondents considered the helping of older people important or moderately important in the other subdomains except sexual expression. According to the nursing staff, intentional or unintentional negligence in care was more common than physically or psychically offensive conduct. Observations concerning maltreatment had increased from 1998 to 2001. The staff reported both physical and mental fatigue. Nevertheless, the nursing staff appeared to be quite content with their current workplaces. Relevance to clinical practice., The findings indicated that geriatric care mostly aims to respond to the physical needs of older people. Nursing should, therefore, be developed and improved because mere satisfaction of physical needs is not enough to guarantee a good quality of life for older people in long-term institutional care. [source] Two new cases of rank reversals when the AHP and some of its additive variants are used that do not occur with the multiplicative AHPJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 1 2001Evangelos Triantaphyllou Abstract Many researchers have long observed some cases in which certain ranking irregularities can occur when the original analytic hierarchy process (AHP), or some of its variants, are used. This paper presents two new categories of ranking irregularities which defy common intuition. These ranking irregularities occur when one decomposes a decision problem into a set of smaller problems each defined on two alternatives and the same criteria as the original problem. These irregularities are possible when the original AHP, or some of its additive variants, are used. Computational experiments on random test problems and an examination of some real-life case studies suggest that these ranking irregularities are dramatically likely to occur. This paper also proves that these ranking irregularities are not possible when a multiplicative variant of the AHP is used. Copyright © 2001 John Wiley & Sons, Ltd. [source] Does a change in obstetric management influence the incidence of traumatic birth lesions in mature, otherwise healthy newborn infants?JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2007Willibald Zeck Abstract Aim:, The incidence of lesions due to birth trauma can be generally regarded as a characteristic of obstetric management; since obstetric management has changed through the years, one might expect a decrease or increase of lesions due to birth trauma in mature newborn infants. Methods:, In a retrospective study, the incidence of lesions due to birth trauma was recorded in the year 2000. In 1989, an identical study had already been carried out in the same department, employing the same criteria. The new findings were compared with the historical data. Results:, In the year 1989 24.6% and in 2000 13.2% showed lesions due to obstetric trauma. The episiotomy rate and lesions due to birth trauma had significantly decreased. A decline regarding the traumas per se was noticed in caput succedaneum traumas, in hematomas due to birth trauma and in clavicle fracture. The cesarean section rate among the study group increased. The cesarean section rate among the traumatized newborns decreased. Conclusion:, Episiotomy does not prevent newborns from traumatic lesions. Gestational age and birthweight have not significantly changed throughout the years; therefore an increase in the cesarean section rate must have contributed to the decrease of birth traumas. Even during abdominal operative delivery, obstetric traumas in newborns do occur. However, an increase in cesarean sections alone can not thoroughly explain the reduction of birth lesion among newborns. Improvement in prenatal diagnostic tools and procedures, respectively, and a goal-oriented use of labor induction might also play a major role. [source] Clinical and biochemical abnormalities in endurance horses eliminated from competition for medical complications and requiring emergency medical treatment: 30 cases (2005,2006)JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 5 2009C. Langdon Fielding DVM, DACVECC Abstract Objective , To describe the clinical and clinicopathologic abnormalities in endurance horses eliminated from competition and requiring emergency medical treatment. Design , Retrospective study over a 2-year period (2005,2006). Ten horses that successfully completed the ride in 2006 were included for comparison. Setting , Temporary equine emergency field hospital. Animals , All horses (n=30) that were removed from endurance competition and treated for a metabolic abnormality were studied. Interventions , Horses were treated with IV fluids and analgesics. Monitoring included lab work (PCV, total protein, and electrolytes) and serial physical examinations. Statistical analysis included descriptive statistics and parametric and nonparametric comparisons (ANOVA, Friedman's test, and Kruskal-Wallis) where appropriate. Measurements and Main Results , The clinical diagnoses identified included colic, esophageal obstruction, poor cardiovascular recovery, myopathy, and synchronous diaphragmatic flutter. As a group, these sick horses had lower plasma chloride and potassium and higher total plasma protein concentrations as compared with 10 healthy horses that successfully completed the ride (P<0.05, <0.01, and <0.05 for chloride, potassium, and total protein, respectively). Horses with colic had a lower PCV as compared with horses with poor recovery and those with synchronous diaphragmatic flutter (P<0.05). All horses, including colics, were treated medically and discharged to owners. Conclusions , Based on the results of this study, the prognosis for horses requiring emergency veterinary treatment after being removed from endurance competition (for metabolic reasons) appears to be good if horses are withdrawn from competition under the same criteria outlined in this study. Biochemical abnormalities tend to be mild and do not necessarily aid in delineating sick horses from successfully completing horses. None of the horses with gastrointestinal disease required abdominal surgery. [source] Anemia in children after transplantation: etiology and the effect of immunosuppressive therapy on erythropoiesisPEDIATRIC TRANSPLANTATION, Issue 4 2003Amira Al-Uzri Abstract: Anemia in children after renal transplantation is more common than previously appreciated. Multiple factors appear to play roles in the development of post-transplant anemia, the most common of which is absolute and/or functional iron deficiency anemia. Most experts recommend that iron limited anemias in transplant patients should be diagnosed using the same criteria as for chronic renal failure patients. Serum erythropoietin (EPO) levels are expected to normalize after a successful renal transplantation with a normal kidney function, yet both EPO deficiency and resistance have been reported. While no large controlled trials comparing the effect of different immunosuppressive agents on erythropoiesis after transplantation have been performed, generalized bone marrow suppression attributable to azathioprine (AZA), mycophenolate mofetil (MMF), tacrolimus, antithymocyte preparations has been reported. Pure red cell aplasia (PRCA) occurs rarely after transplantation and is characterized by the selective suppression of erythroid cells in the bone marrow. PRCA has been reported with the use of AZA, MMF, tacrolimus, angiotensin converting enzyme inhibitors (ACEI), but not with cyclosporine (CSA) use. Post-transplant hemolytic uremic syndrome has been reported with orthoclone anti T-cell antibody (OKT3), CSA and tacrolimus therapy. Viral infections including cytomegalovirus, Epstein,Barr virus and human parvovirus B19 have been reported to cause generalized marrow suppression. Management of severe anemia associated with immunosuppressive drugs generally requires lowering the dose, drug substitution or, when possible, discontinuation of the drug. Because this topic has been incompletely studied, our recommendation as to the best immunosuppressive protocol after renal transplantation remains largely dependent on the clinical response of the individual patient. [source] Annotation: Childhood-onset schizophrenia: clinical and treatment issuesTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 2 2004Joan Rosenbaum Asarnow Background:, In the past 10 years, there has been increased research on childhood-onset schizophrenia and clear advances have been achieved. Method:, This annotation reviews the recent clinical and treatment literature on childhood-onset schizophrenia. Results:, There is now strong evidence that the syndrome of childhood-onset schizophrenia exists and there are several similarities between childhood- and later-onset schizophrenia. Schizophrenia in youth can be reliably diagnosed using the same criteria employed with adults, and childhood-onset schizophrenia is predictive of schizophrenia or schizophrenia spectrum disorders in adulthood. Data is accumulating to guide pharmacological treatment strategies, and practice parameters have been developed to guide clinical care. Conclusions:, Despite significant advances, there remains an urgent need for additional research on treatment and service delivery strategies. Promising work with adults highlights the importance of attending to psychosocial as well as pharmacologic treatment strategies, and the potential value of preventive interventions. [source] Evaluation of modern pathological criteria for positive margins in radical prostatectomy specimens and their use for predicting biochemical recurrenceBJU INTERNATIONAL, Issue 3 2009Gary 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] Prognosis for patients with thin cutaneous melanomaCANCER, Issue 6 2003Long-term survival data from the New South Wales Central Cancer Registry, the Sydney Melanoma Unit Abstract BACKGROUND Estimates of long-term survival for patients with thin (, 1 mm) primary cutaneous melanomas vary widely. Two separate methods were used to study the survival of patients with melanoma from New South Wales (NSW), Australia, and from the Sydney Melanoma Unit (SMU). METHODS The NSW Central Cancer Registry (NSWCCR) provided data on all patients who were diagnosed with cutaneous melanomas that measured , 1 mm thick between 1983 and 1998, inclusive. Patients with metastases at the time of diagnosis were not included, leaving 18,088 patients for analysis. The SMU data base was analyzed to extract data for all patients with thin melanomas who met the same criteria from 1979 to 1998, inclusive. All patients who had their primary tumors treated definitively elsewhere were excluded, leaving 2746 patients for analysis. Ten-year Kaplan,Meier survival rates were calculated, and significant differences were determined using log-rank analysis. Prognostic factors were evaluated with Cox proportional hazards analysis. RESULTS The NSWCCR analysis revealed a 10-year survival rate of 96.4%. The 10-year survival rate for patients at SMU was 92.7%. Among the patients at SMU who died, the median time to recurrence was 49.8 months, and the median time to death was 65.9 months. The 10-year survival for patients at SMU who had lesions that measured , 0.75 mm was 96.9% compared with 84.3% for patients who had lesions that measured 0.76,1.0 mm. For patients who had ulcerated melanomas measuring , 1 mm thick, the 10-year survival rate was 83%, compared with 92.3% for patients who had nonulcerated melanomas. CONCLUSIONS The results of the current study confirmed the excellent survival rate for patients with thin melanomas. Higher-risk subsets of patients who may warrant consideration for aggressive investigation and treatment are identifiable. Cancer 2003;98:1223,31. © 2003 American Cancer Society. DOI 10.1002/cncr.11624 [source] | ||||||||||