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20191885 | [Glaucoma--neurodegenerative disease]. | a is a specific optical neuropathy, with local nerve damage and pathogenesis pletely understood. The progressive death of retinal ganglion cells and optical neural loss suggests the following hypothesis: primary destructive event (ischemia, elevated intraocular pressure and genetic risk factors) and secondary degeneration (apoptosis and excitotoxicity). The concept of neuroprotection is a therapeutical paradigm for preventing and delaying neuronal cell death and maintaining the function of neurons. Other additional concept--neurorescue is used to prevent neuronal death by interrupting the biological cascade of secondary events. Most substances that can be found (glutamate, nitric oxide, a.o) in excess in extra cellular spaces induce damage of retinal ganglion cells, while others (memantine, gingko biloba, nicergoline, flavonoids, ascorbic acid) are used to restore these cells and their axons, i.e., neuroreparation and neuroregeneration in various degrees. This paper is an up-date of numerous studies which demonstrate that open-angle a is considered to be a neurodegenerative disease connected with alterations of the cardiovascular, central nervous, immune, endocrine, psychological systems and of sleep, requiring the introduction of a in general medical context. |
20191886 | [Quantification of the acute respiratory insufficiency of laryngo-tracheal origin]. | Acute respiratory insufficiency defines that status in which the respiratory system is not able to supply the metabolic requirements of the organism. The laryngo-tracheal segment plays an important role in the respiratory function, an obstruction at this level inducing an important limitation of oxygen intake. Due to the requirement of fast repermeabilisation of this segment, it is necessary to define all criteria (clinical and laboratory examination) required to diagnose and to evaluate the respiratory failure. The present paper depicts the clinical aspects, the acid-base equilibrium impairment induced by high level airway obstruction and the functional investigations available by ventilation tests. |
20191888 | Preoperative ultrasonography as a mean of predicting the conversion of mini cholecystectomy into classic cholecystectomy. | Cholecystectomy is considered to be the treatment of choice in symptomatic biliary lithiasis. Lately, due to medical progress, classic cholecystectomy has been gradually replaced by laparoscopic cholecystectomy and by mini cholecystectomy. Therefore, it is very important to determine certain preoperative factors which might predict the conversion of mini cholecystectomy (MC) into classic cholecystectomy (CC). |
20191889 | [Clinical study of sinus grafts and implants integration, in the posterior maxilla]. | In this study we have tried to evaluate the degree of integration for endosinusal grafting and implant placement in the posterior maxilla. |
20191887 | [Primary and secondary hepatic cancer--specifics of surgical treatment in correlation with disease stage]. | Given the necessity of increasing their resectability, there are evaluated the possibilities of surgical treatment for these types of hepatic cancer, in the context of dominant clinical presence of advanced hepatic tumors. |
20191891 | [Bilateral ureteroceles with bilateral secondary hydronephrosis and pelvic ureteral calculi. Case report]. | Bilateral ureterocele is a rare congenital condition that is usually diagnosed antenatally or in childhood. We present the case of a 64 year-old woman who was admitted for incidentally discovered microscopic hematuria. A bilateral ureterocele and secondary pelvic ureteral calculi were diagnosed by clinical examination (vaginal touch), ultrasound, plain radiography and intravenous urography. A transurethral incision of the ureterocele and extraction of calculi was performed by endoscopic approach. The postoperative recovery was uneventfull. Considering the risk for development of vesicoureteral reflux or recurrence of obstruction at the ureterovesical junction, a close long-term follow-up is required. |
20191890 | [Management of anxiety associated with oral surgery]. | General and practical training, knowing of safe methods of preanesthesia, pain and anxiety control and establishing a good relation with the patient are some of the most important methods of patient management in the dental office. The final goals of the methods are to obtain a calm patient, haemodinamic equilibrated and safely prepared for the surgery. |
20191896 | Using MLPA for large genomic rearrangements detection in breast cancer predisposition genes. | Breast and ovarian cancer mon pathologies in women, with increasing incidences worldwide. In hereditary breast and ovarian cancer (HBOC) families, a large percentage of cases are attributable to hereditary patibles with dominant autosomal transmission of a major tumour suppressor gene with plete penetrance. Screening for BRCA1 mutations is now standard practice for HBOC cases in western world, and permits medical follow-up and genetic counselling. Over 300 BRCA1 germinal mutations are stored in the Breast Cancer Information Core (BIC) mutation database. |
20191892 | [Py-Desmanet pinning in distal radius fractures]. | Internal fixation by pinning is one of the most used methods of surgical treatment in fractures of the distal extremity of the radius. As in stable fractures a styloid pinning is satisfactory, in unstable fractures however we must resort to different patterns of pin insertion, in order to effectively prevent the secondary displacement of the fractured fragments. The elastic pinning described by Py and Desmanet is one of the possibilities of inserting the pins. The principle of this method is to use the bending-induced tension in the pins to counteract the postero-lateral displacing forces. The authors have treated by this technique five patients with distal radius fractures (3 women and 2 men) about 56 years of average age, all with good-quality bone, all with Colles' fracture pattern (2-4 cm above the radio-carpal articulation, no articular involvement, posterior displacement of the distal fragment). The reduction of the fractures was achieved by closed manipulation and controlled intraoperatively with the C-arm. We preferred to reduce the fractures before inserting the pins, although this is pulsory, according to the authors of the technique. The approach was minimally-invasive, through two 1-cm long incisions. The pins, previously blunted and curved along the last centimeters, were introduced using a "T"-shaped handle. The plications, consisting of injuries of the many elements which cross the region, were avoided by sufficiently long incisions and identification and retraction of these elements (tendons, nervous branches) in order not to penetrate them with the pins. The aftertreatment consisted of immediate mobilization of the wrist in one patient, 21-day splinting in other two and 30-day splinting in the last two, depending on the intraoperative assessment of the stability of the fixation. The pins were removed at 45 days postoperatively in all cases. There were plications such as loss of reduction or pin migration. In all cases, there were good anatomic and functional results. |
20191893 | Micro- and nanoparticles--medical applications. | It is a long-standing need of the pharmaceutical industry, physicians, and patients to improve pharmaceutical formulations by establishing simpler, less expensive preparations and treatments, while reducing toxicity. This need can be met with the know-how of drug delivery science that has already made advance developments in improved delivery of injectibles, oral formulations, drug device implants, as well as topical and transdermal delivery formulations, especially in the case of drug delivery to the brain, an untouchable region by traditional drug delivery systems. The reason behind the failure of conventional delivery systems in reaching the brain is the blood brain barrier posed of tight tissues making it impervious to outside agents. Nanotechnology has the potential to address and resolve this challenge and make brain a reachable target for drug delivery systems, bining unique elements of size, surface activity and charge of nanostructures. Micro and nanoparticles have opened up unexpected ways in diagnostics and therapeutics in medicine. The previous treatment strategies in the fields of autoimmune diseases and cancer involved non-targeted treatment options with extensive "collateral damage." Nanodelivery of drugs is predicted to reduce this collateral damage, extend the drug's availability and effectiveness at the site, and reduce toxicity and cost with a high pay-off load. In this review we present the role of micro and nanoparticles in drug delivery and some applications in the health care fields. |
20191897 | [Expression of CA-125 in ovarian cancer]. | Ovarian carcinoma is a heterogeneus disease. Pathologists classify it in serous, clear cell, endometrioid and mucinos subtypes. Each of these subtypes is associated with different genetic risk factors and molecular events during oncogenesis and it is characterised by distinct mRNA expression profiles. |
20191895 | [Prognostic significance of leukemia-associated phenotype in correlation with other biologic markers in acute myeloid leukemia patients]. | Leukemic cells have unique aberrant phenotypes, which permit identification of this cells at diagnose and in evolution of the disease. Signaling molecules with other cells and bone marrow stroma are part of the leukemic cells phenotype. Genetic and molecular abnormalities have the main prognostic significance and confer the leukemic cell status. The main aim of the current study is to identify correlation between recognized prognostic factors in acute myeloid leukemia (AML) patients and other phenotypic markers. |
20191894 | The protective effect of superoxide dismutase on isolated human mammary arteries preincubated with triglyceride-rich remnant lipoproteins. | The main changes of the plasma lipid profile in patients with endothelial dysfunction are the increased triglyceride content of the lipoprotein remnant particles, the presence of the small and dense LDL particles and the decreasing of the HDL-cholesterol level. |
20191901 | [Cross-sectional study to evaluate the development and risk factors in premature children]. | Prematurity represents an important medical problem due to the increased incidence plex treatment measures. |
20191898 | Biogenic amines determination in some Romanian meat products. | Biogenic amines pounds synthesized in human body which in high concentration e toxic and lead to a wide range of symptoms as palpitations, nausea and headache. Meat products can contain high levels of biogenic amines. Ingestion of such product can cause severe illness. For these reason it es necessary to determine the biogenic amines levels in meat products. In our work we have determined the amount of some biogenic amines and the ration in which they are present in different type of fresh and processed meat products made by several producers. |
20191905 | [Management of emergency cases, hospitalized in Romania in 2007]. | We evaluated the main aspects of the management of emergency cases, hospitalized in Romania in 2007, by following the frequency of main diagnosis, their distribution by place and hospital and hospital indicators. |
20191903 | [Retrospective clinical epidemiology research on a sample of 277 patients with viral hepatitis A, 20-70 aged, from the Suceava County, between 2001-2008]. | Authors present some results of clinical epidemiological research carried out on a sample of 277 patients with viral hepatitis A (VHA), hospitalized in Suceava County, during 8 years. |
20191900 | [Enhanced molecular techniques for the diagnosis of human papillomavirus infections]. | optimisation of Real Time PCR technique for quantifying oncogenic types 16 and 18 of Human Papilloma Viruses, genotyped through classic PCR, followed by hybridisation. |
20191904 | [Average vegetable intake in a group of schoolchildren from Iaşi]. | Nutritional guidance must take into account the existing situation in order to obtain the desired effects. |
20191902 | [Specifics of individual risks in a group of women with genital neoplasms]. | Genital cancers represent an important issue regarding women health, as they produce a large number of cases, invalidities and deaths. |
20191899 | Effects of dietary flaxseed supplementation on renal oxidative stress in experimental diabetes. | Previous results demonstrate that experimental diabetes mellitus is panied by increased oxidant stress within glomeruli. Evidence are emerging that dietary flaxseed supplementation can have beneficial effects on oxidative stress. |
20191906 | [The monitoring of Neisseria gonorrhoeae infection incidence and its resistance in Suceava County]. | Neisseria gonorrhoeae infection is one of the most frequent infections transmitted on sexual intercourse. In the last decades, a significant numbers of gonococcus strains were resistant to penicillin, tetracycline, quinolones and, in the last period, resistant to 3rd generation cephalosporines too. The purpose of this study was to monitor the trend of N. gonorrhoeae isolates from 2004-2008, in Suceava County, North-East region of Romania. |
20191909 | [Correlation between the lower first permanent molar axis and the premature loss of temporary molars]. | The aim of our study was to determine the impact of premature loss of temporary molars upon the longitudinal axis of the first permanent molar. |
20191908 | [Microbial involvement in oral abscesses: update]. | Perioral abscesses mon manifestations of acute oral infections and microbiological studies has shown that they are polymicrobial infections, most often with the involvement of 3.5 different bacterial species. Microbial virulence, biocoenosis of oral cavity is elements which contribute to the emergence of oral infections. Although it may seem outside interest of dentist or oral surgeon updating related microbiological pathogens identified in perioral abscess, a brief and modest information about the profile of the pathogens involved is particularly beneficial and useful. The fact that this "explosive army" is not in sight, this not mean that it doesn't exist, so we believe that the holding of general notions of microbiological culture is necessary for prevention and treatment measures. |
20191907 | Contribution towards developing a new semi-selective medium for Streptococcus anginosus group. | The aim of this study was to develop a new selective medium for isolation of Streptococcus anginosus group (SAG) strains, by adding sulphamethazine and aztreonam as selective agents at Mitis-Salivarius agar (MSA), the monly used for recovery of oral streptococci from oral samples. |
20191911 | [Clinical aspects of therapeutic options in oral rehabilitation of partially edentulous patients]. | This study aims at identifying practical ways of approaching social cases, and creating a hierarchy of the final functions of restauration. |
20191912 | [Study on noninvasive paraclinical evaluation methods according to particular aspects in patients diagnosed with partial dentition]. | The aim of this study quantifies the contribution of the non invasive and minimally invasive methods of paraclinic evaluation corroborated with the clinical aspects, a particularly important element being represented by the inter-relation between the general condition--oral pathology. |
20191920 | Stroke prevention: awareness of risk factors for stroke among African American residents in the Mississippi delta region. | Compared to whites, African Americans have almost a 2-fold increased risk of first-ever stroke. Our study sought to determine awareness of stroke risk factors and management, symptoms, and risk reduction strategies in African Americans in Mississippi, which is part of the "stroke belt. |
20191915 | [Comparative data regarding two HPLC methods for determination of isoniazid]. | For the determination of isoniazide (isonicotinic acid hydrazide - HIN) two different HPLC methods were developed and validated. |
20191913 | [Contributions to the comparative study of the antioxidant potential of some extracts obtained from chamomile flowers]. | Within plex research regarding the pharmaceutical quality of Chamomillae mercialized in the Romanian pharmaceutical network (as well as the food chain), we investigated 9 samples of chamomile "tea" purchased in April/May 2005 pliance to the European Pharmacopoeia. |
20191910 | [The bony modifications in the periodontal pockets]. | The aim of this study was to demonstrate the bony structural changes in deep periodontal pockets. |
20191914 | [Contributions to the study of the chemical variability of some Galium album Mill. Populations harvested from wild flora in northern Moldavia]. | Within plex research regarding the chemical intra- and inter-specific variability of some medicinal plants, pared two species of Galium: Galium verum L. and Galium album Mill. |
20191916 | [Design considerations for clinical data management in an integrated remote medical system]. | In this paper, we present a proposal for the design of a telemedicine system. The system (called SIMPA) will be used for noninvasive monitoring of some vital parameters of patients with chronic diseases. |
20191917 | [Hip joint force evaluation to patients with hip prosthesis]. | Gait biomechanical parameters is essential to establish the loosening of a hip prosthesis and provide important information about gait analyses from different orthopedics pathologies. |
20191923 | Racial disparities in urologic health care. | In the United States, disparities in health care delivery and access are apparent between different racial and ethnic groups. Minorities, including African Americans, often suffer disproportionately from pared to Caucasians. In the urologic arena, this is apparent in urologic cancer screening, treatment choices, and survival, as well as in the arena of chronic kidney disease, transplant allocation, and transplant es. Latino men also seem to be affected more often by erectile dysfunction than Caucasian counterparts. Disparities such as these have been identified as a problem in the delivery of health care in the United States, and resources have been allocated to help allay the disparity. Through organizations such as the Cleveland Clinic Minority Men's Health Center, policy initiatives, and increased cultural awareness by physicians, steps can be made to reduce and eliminate health care disparities. |
20191921 | Does coping mediate the relationship between personality and cardiovascular health in African Americans? | Few studies have examined traits or behaviors that may predispose some African Americans to poor cardiovascular health es. While several models of personality exist, the 5-factor model (FFM) is arguably the best representation of personality and provides a useful framework for the study of personality and health. Among personality characteristics associated with health risks among African Americans, a high-effort coping style called John Henryism is among the most thoroughly examined. It is not clear if personality coping and health are connected in a meaningful way. The present study utilized data from the Baltimore Study of Black Aging (BSBA) to examine whether personality was linked to John Henryism, how personality might be linked to cardiovascular health, and how John Henryism might mediate the relationship between personality and cardiovascular health. The sample consisted of 234 older African Americans (mean age, 67 years), 28% of which were men. Regressions were used to examine the questions. The results indicated that those who are more neurotic report more cardiovascular health problems, and that openness and conscientiousness were significant predictors of active coping. The mediation analysis results suggest that coping style did not mediate the relationship between personality and reports of cardiovascular health problems. These findings highlight the importance of personality in accounting for cardiovascular health in African Americans. |
20191918 | [Changes of spirographic parameters in type 2 diabetes mellitus]. | Diabetes mellitus (DM), metabolic disease with chronic evolution, affects various organs through its macro- and plications which it causes, one of this target organs for diabetes being the lungs. |
20191924 | Perception of weight and threat to health. | To examine African American women's perception of their risk for orbid pared to their weight category. |
20191922 | Recruitment of rural physicians in a diabetes internet intervention study: overcoming challenges and barriers. | This paper highlights a descriptive study of the challenges and lessons learned in the recruitment of rural primary care physicians into a randomized clinical trial using an Internet-based approach. |
20191925 | Predictors for survival of penetrating trauma using emergency department thoracotomy in an urban trauma center: the Cardiac Instability Score. | Emergency department thoracotomy (EDT) is a procedure used in an attempt to save lives of patients in extremis. This study aims to determine predictors of survival and futility by proposing a scoring scale that measures cardiac instability and its use in predicting survival of victims of penetrating trauma undergoing EDT. |
20191926 | Late-onset Fanconi anemia in an African-Caribbean patient. | A 38-year-old female of African-Caribbean origin presented with symptomatic anemia and was found to have hypoplastic thumbs and patchy hypopigmentation. Peripheral blood examination revealed pancytopenia and the bone marrow biopsy confirmed marrow hypoplasia. Fanconi anemia was later confirmed by flow cytometry and diepoxybutane testing. Treatment was limited to transfusions after development of toxicity with cyclosporine and androgen therapy. She manifested classical features of transfusion-related hemosiderosis and died 12 years after initial presentation. |
20191927 | Concomitant anterior and posterior infantile perianal protrusions. | Infantile perianal protrusion is characterized by asymptomatic pyramidal protrusion with a rose-red or purplish red surface along the midline, usually anterior to the anus. The protrusion is usually solitary. Two girls are reported with itant anterior and posterior infantile perianal pyramidal protrusions and a history of constipation. The occurrence of itant anterior and posterior infantile perianal pyramidal protrusions has not been reported previously. |
20191928 | A woman with back pain. | The Editorial Board of JNMA is proud to launch yet another reader-oriented monthly column entitled "Radiology Rounds", which will be orchestrated by Dr. James Collins, longtime NMA member and professor of radiology at UCLA. Dr Collins and his colleagues across the country will endeavor to bring us a variety of interesting cases with both an educational and clinical message that will undoubtedly prove useful to our primary care physicians and many specialists as well. It is anticipated that this will evolve into a continuing medical education initiative going forward. We would like for this to be an interactive column, so please feel free to forward your views and opinions of the cases being presented to Dr Collins for follow-up in JNMA. If you have an interesting case with excellent radiologic images, please feel free to contact Dr Collins directly so that we can share your experience with all of our NMA colleagues and friends. |
20191932 | A twin study of sleep duration and body mass index. | To determine the relative importance of genetic and environmental contributions to the association between sleep duration and body mass index (BMI). |
20191934 | Home is where sleep is: an ecological approach to test the validity of actigraphy for the assessment of insomnia. | This study tested the ecological validity of actigraphy (ACT) for estimating objective sleep parameters in participants' homes. We also examined how well ACT and polysomnography (PSG) measures discriminated (1) individuals with and without insomnia; and (2) nights participants rated worse, the same as, or better than average. |
20191935 | Effect of gaboxadol on patient-reported measures of sleep and waking function in patients with Primary Insomnia: results from two randomized, controlled, 3-month studies. | To evaluate the efficacy and safety of gaboxadol in the treatment of Primary Insomnia. |
20191936 | Sleep quality and motor vehicle crashes in adolescents. | plaints mon in adolescents, but their impact on the rate of motor vehicle crashes accidents is poorly known. We studied subjective sleep quality, driving habits, and self-reported car crashes in high-school adolescents. |
20191937 | Normative heart rate parameters during sleep for children aged 6 to 11 years. | Normative values for pediatric heart rates during sleep are not known. The purpose of this study was to describe the average sleeping heart rate of children and to determine if age, sex, body mass index (BMI) or ethnicity is related to sleeping heart rate. |
20191940 | Can a single cephalometric measurement predict obstructive sleep apnea severity? | To look for an association between the vertical position of the hyoid, as measured by the sella-hyoid (S-H) distance and the severity of obstructive sleep apnea (OSA). A previously published study on this subject showed a significant correlation between S-H distances more than 120 mm and severe OSA. |
20191939 | An automated sleep-analysis system operated through a standard hospital monitor. | Sleep disordered breathing (SDB), a cause of clinically important orbidity, is often not recognized and diagnosed. An automated system that detects SDB using signals from a standard hospital monitor might provide useful information about the presence and severity of SDB without the need to evaluate the patient in a sleep laboratory and without additional hardware. The aim of this study was to examine the feasibility and accuracy of routine overnight sleep testing for SDB detection by an automated analysis system that operates by analyzing signals derived from standard hospital monitors. |
20191942 | A case of narcolepsy with strictly unilateral cataplexy. | I report a case of a 50-year-old African American woman who presented for a sleep medicine plaining of excessive daytime sleepiness of greater than 10 years' duration. She reported falling asleep while driving, talking with friends, and eating. Her Epworth Sleepiness Scale score was 21/24. Her history was positive for the presence of sleep paralysis. She denied visual or auditory hallucinations in the peri-sleep period. |
20191938 | Impact of clinical assessment on use of data from unattended limited monitoring as opposed to full-in lab PSG in sleep disordered breathing. | We examined agreement among multiple sleep clinicians when presented with clinical data plus the full tracings and data obtained from unattended limited monitoring (ULM) or a full polysomnography (PSG). |
20191941 | The nightmares of sleep apnea: nightmare frequency declines with increasing apnea hypopnea index. | To clarify the association of reported nightmare recall with polysomnographically defined obstructive sleep apnea (OSA) in a sleep laboratory population. |
20191943 | A novel approach to treating morning sleep inertia in narcolepsy. | We describe an adolescent with narcolepsy who presented with inability to awaken from sleep to attend early morning classes at school. After he did not respond to traditional therapies, a nicotine patch was prescribed with success. We present our experience with this unconventional treatment, which may benefit others with inability to awaken from sleep that is refractory to standard treatments. |
20191947 | Re-examining respect for human research participants. | The demands of respect for persons when conducting clinical research are often reduced to respect for autonomy. In this paper, I re-examine the concept of respect for persons in light of important intuitions from our ordinary language usage of respect. I propose that there are many ways to respect persons as persons and that the core elements of respect for persons are: appreciating what is valuable or important about a person, recognizing the constraints or demands that such a valuation places on one's own conduct, and acting in a way that expresses that recognition. On this account, in addition to autonomous agency, respect demands attention to important subjective experiences, persons' existence as part munities, and considerations portment. This account has important implications for the conduct of clinical research with persons who are autonomous as well as with those who are not. Its implications, however, are different for these two populations, particularly with regard to concerns about well-being. |
20191944 | Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM behavior disorder/REM sleep without atonia: literature review, qualitative scoring, and comparative analysis. | Pharmacologically induced/exacerbated restless legs syndrome (RLS), periodic limb movements in sleep (PLMS), and REM behavior disorder/REM sleep without atonia (RSWA) are increasingly recognized in clinical sleep medicine. A scoring system to evaluate the literature was created and implemented. The aim was to identify the evidence with the least amount of confound, allowing for more reliable determinations of iatrogenic etiology. |
20191945 | Best practice guide for the treatment of REM sleep behavior disorder (RBD). | Modifying the sleep environment is mended for the treatment of patients with RBD who have sleep-related injury. Level A Clonazepam is suggested for the treatment of RBD but should be used with caution in patients with dementia, gait disorders, or itant OSA. Its use should be monitored carefully over time as RBD appears to be a precursor to neurodegenerative disorders with dementia in some patients. Level B Clonazepam is suggested to decrease the occurrence of sleep-related injury caused by RBD in patients for whom pharmacologic therapy is deemed necessary. It should be used in caution in patients with dementia, gait disorders, or itant OSA, and its use should be monitored carefully over time. Level B Melatonin is suggested for the treatment of RBD with the advantage that there are few side effects. Level B Pramipexole may be considered to treat RBD, but efficacy studies have shown contradictory results. There is little evidence to support the use of paroxetine or L-DOPA to treat RBD, and some studies have suggested that these drugs may actually induce or exacerbate RBD. There are limited data regarding the efficacy of acetylcholinesterase inhibitors, but they may be considered to treat RBD in patients with a itant synucleinopathy. Level C. |
20191948 | Respect for rational autonomy. | The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy. |
20191949 | Mandatory autopsies and organ conscription. | Laws requiring autopsies have generated little controversy. Yet it is considered unconscionable to take organs without consent for transplantation. We think an organ draft is justified if mandatory autopsies are. We reject the following five attempts to show why a mandatory autopsy policy is legitimate, but organ conscription is not: (1) The social contract gives the state a greater duty to protect its citizens from each other than from disease. (2) There is a greater moral obligation to prevent murders than disease-caused deaths because killing people is morally worse than allowing people to die. (3) Autopsies do not confiscate body parts, but organ transplants do. (4) The citizenry's knowledge that their organs are very likely to be taken will generate more anxiety than the remote possibility of a mandatory autopsy. (5) A religious conviction that one's organs will be needed in order to be resurrected is threatened by organ transplantation but not by autopsies that "return" body parts. |
20191951 | What is affordable health insurance? The reasonable tradeoff account of affordability. | The reform of the health care system will include a mandate: Individuals are required to purchase health insurance provided that affordable options are available. But what is affordable health insurance? Three accounts of affordability of health coverage have been advanced. The first two accounts are empirical. The third account is needs-based. All three accounts are inadequate. I propose a fourth, the reasonable tradeoff account, according to which individuals should only be required to make reasonable tradeoffs in order to pay for their health coverage. That is, health insurance is affordable if in order to pay for it one does not to have to sacrifice other benefit(s) that parable in importance to the benefits of health coverage. |
20191950 | Commentary on "The incoherence of determining death by neurological criteria". | mentary challenges the conclusions reached by Franklin Miller and Robert Truog in their criticism of the President's Council's White Paper, "Controversies in the Determination of Death." I agree with much of Miller and Truog's criticism of the rationale offered by the President's Council for accepting neurological criteria for determining death but argue that they too quickly dismiss the alternative rationale of determining death by neurological criteria-i.e., the destruction of the psychophysical integrity of the human being that occurs when the potential for consciousness and every other mental function is lost due to catastrophic injury to the brain. By focusing on the death of bodies instead of human beings, their view absurdly implies that decapitation would not necessarily result in one's death. Since total brain failure is a form of physiological decapitation, the neurological criterion coheres perfectly well with the ordinary understanding of decapitation as death. |
20191952 | [Clinical application of continuous douche and vacuum sealing drainage in refractory tissue, bone and joint infections after debridement]. | To explore effect and the application value of continuous douche and vacuum sealing drainage (VSD) in refractory tissue, and joint infections plete debridement. |
20191954 | [Comparison of clinical effects between locking intramedullary nail fixation and skeletal traction in treating tibiofibula fractures]. | pare and evaluate clinical effects between locking intramedullary nail fixation and skeletal traction in order to provide the best therapeutic choice for tibiofibula fractures. |
20191953 | [Establishment and analysis of a three-dimensional finite element model of human cervicotnoracic junction (C6-T1)]. | To establish the cervicothoracic spine finite element model with three-dimensional finite element method, verify the effectiveness of this model and explore the stress distribution. |
20191958 | [The prevention and treatment of cerebrospinal fluid leakage following cervical spine surgery]. | To investigate curative effect of the prevention and treatment in cerebrospinal fluid leakage (CFL) after cervical surgery. |
20191957 | [Correlation studies between MRI and the symptom scores of patients with LDH before and after manipulative therapy]. | To study the correlation between the MRI and some symptom scores of the patients with lumbar disc herniation (LDH), such as VAS (visual analogue scale), JOA (Japanese orthopedic association scale),and SLR (straight leg raising test) before and after manipulative therapy. |
20191955 | [Clinical application of extracorporeal shock wave to repair and reconstruct osseous tissue framework in the treatment of avascular necrosis of the femoral head (ANFH)]. | To investigate the application value of extracorporeal shock wave to repair and reconstruct osseous tissue for the treatment of avascular necrosis of the femoral head (ANFH). |
20191959 | [In vitro induction studies of YouGui drink on culture of steroid induced necrosis of femoral head rat osteoblast]. | On the basis of YouGui drink ([Chinese characters: see text]) to act on the normal rats in vitro osteoblast proliferation and differentiation, further observe YooGui drink ([Chinese characters: see text]) inductive effect for steroid induced necrosis of femoral head rats in vitro on cultivation of osteoblast proliferation and differentiation. |
20191960 | [Experiment of rhBMP-2 in posterolateral spinal fusion in aged rabbits]. | Posterolateral intertransverse process fusion was performed in aged and young adult female rabbits lumbar spine using binant human bone morphogenetic protein-2 (rhBMP-2) and autograft to reveal the function of rhBMP-2 on spinal fusion on aged animals. |
20191962 | [The influence of rotary manipulation on the internal pressure of cervical nucleus pulposus]. | To measure the pressure changes inside the cervical nucleus pulposus in fresh human cervical specimen by imitating different rotary manipulations. |
20191963 | [Exploring the mechanism of children elbow joint injury led to elbow varus]. | To explore the causes and mechanisms of children elbow joint injury led to elbow varus. |
20191964 | [Clinical apprehension on application of metal on metal total hip arthroplasty with large diameter heads]. | To approach the short-term result and clinical application of metal on metal total hip arthroplasty with large diameter heads and evaluate its safety and efficacy clinically. |
20191965 | [Minimally invasive surgery to treat severe acromioclavicular dislocation combined with coracoid process fracture]. | To discuss the diagnosis and minimally invasive surgical treatment on severe acromioclavicular bined with coracoid process fracture. |
20191966 | [Treatment of complex fracture--dislocation of elbow with external fixator with joint and limited internal fixation]. | To discuss the method and the effect of external fixator and limited internal fixation with joint applied plex fracture-dislocation of elbow. |
20191967 | [Clinical analysis of preoperative deep venous thrombosis (DVT) complicated lower extremity close fractures]. | To study the instance of deep venous plicated by preoperative lower extremity close fracture. |
20191977 | [Current situation and progression in the treatment of spinal cord injury]. | Spinal cord injuries include original injury and secondary injury. The aim of therapy is to prevent and reduce the secondary injury. The traditional therapy can alleviate the secondary injury of spinal cord through surgery that can both relieve the pressure of spinal cord and maintain the spinal stability with the internal fixation, medicine and hyperbaric oxygen therapy were applied together. But, the effect of neuroprotection and neurotization of traditional therapy is worse and the most of all is the environment in the spinal cord injury that make against the repairing. At present, the treatment of spinal cord injury with cell transplantation and gene therapy have made achievements in the animal experiment and have been simply tested in clinical. Cell transplantation and gene therapy have a great clinical utilization. |
20191978 | [Operative treatment of metastatic tumors of spine]. | The spine is the mon site of metastatic tumors. The highest incidence of metastatic tumors on the spine is in the lumbar region, followed by the thoracic and cervical levels. Most associated spinal cord lesions, however, are located in the thoracic spine. The goals of surgery is pression of the neural tissues, prevention of neural injury by stabilization of the unstable spinal column,or pain control. When there is a need to press the neurologic tissues,the most direct approach is anterior because the mon site of metastatic tumors is in the vertebral body. Laminectomy alone is not effective in improving neurologic function. Nevertheless,the posterior approach is more accessible, less hazardous, and effective in the correction of deformity bined with instrumentation. plete vertebrectomy is feasible in anterior bone bined with anterior and posterior stabilization is necessary following the vertebrectomy. |
20191983 | [Evaluation of the function and ventricular synchrony in patients with latency stage of Chagas' disease]. | pare the left ventricular function and the ventricular synchrony in patients with Chagas disease in latency stage respect to a control group. |
20191984 | [Effects of the combined treatment with Metformin/Glimepiride on endothelial function of patients with type 2 diabetes mellitus. A positron emission tomography (PET) evaluation study]. | The purpose of this study was to determine the effect of treatment, with Metformin alone or with bination of Glimepiride/Metformin, on coronary endothelial function in asymptomatic patients with recently diagnosed type 2 diabetes mellitus (DM) Methods: 16 asymptomatic patients with type DM2 and 15 healthy controls (HC) were studied. At baseline and after treatment, myocardial blood flow (MBF) was measured with 13N-ammonia Possitron Emission Tomography (PET) at rest, during cold pressor testing (CPT) and during pharmacologic stress with adenosine. The endothelial dependent vasodilation index (EDVI), myocardial flow reserve (MFR) and the percentage of the change between rest MBF and CPT MBF (%deltaMBF) were calculated as markers of endothelial function. MBF was normalized to the rate pressure product (RPP). |
20191985 | [Psychopathology and personality of patients with heart disease]. | To know the psychological aspects involved in cardiac ailments and whether there was a distinctive personality profile of each disorder. |
20191988 | Anomalous origin of the left coronary artery from the pulmonary artery. Echocardiographic diagnosis. | The experience with echocardiographic diagnosis of five cases of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) is reviewed. |
20191986 | [Clinical predictors of ventricular arrhythmia storms in Chagas cardiomyopathy patients with implantable defibrillators]. | To define the predictive factors of electrical storm (ES) in patients with Chronic Chagas Heart Disease (CCh) with an implantable cardioverter defibrillator (ICD). |
20191987 | [Severe myocardial damage caused by leptospirosis. Report of a fatal case in Mexico]. | Chagasic cardiomyopathy is mon disease in Latin America, however similar clinical pictures exist that can be confused with this, as they give negative results to the tests that detects T. cruzi, like non Chagasic rural endemic chronic cardiopathy, mon in Venezuela. Using histopathology techniques, "idiopathic cardiomyopathy" is frequently found as the cause of death when the etiology of this disease is not known. This paper presents the case of a man of 26-years-old who died of dilated cardiomyopathy secondary to leptospirosis. Clinically, in addition to the cardiac failure, jaundice, hyperbilirubinemia, transaminases increase, proteinuria and hematuria were present. Initially it was suspected Chagasic cardiomyopathy but the epidemiologic background and the parasitologic and serologic tests for T. cruzi gave negative results. The dark field microscopy videorecording of blood and urine samples, argentic impregnation and immunohistochemistry tests as well as haemoculture in EMJH medium were positive for L. interrogans serovar Pomona. Postmortem we confirmed the presence of leptospira in different tissues through of histopathology, argentic impregnation, indirect immunofluorescence and immunohistochemistry. |
20191989 | [Coronary artery disease and cardiac ischemic disease: two different pathologies with different diagnostic procedures]. | Coronary artery disease (CAD) remains the leading cause of death in the Western world, and early detection of CAD allows optimal therapeutic management. The gold standard has always been invasive coronary angiography, but over the years various non-invasive techniques have been developed to detect CAD, including cardiac SPECT and puted tomography (Cardiac CT). Cardiac SPECT permitted visualization of myocardial perfusion and have focused on the assessment of the hemodynamic consequences of obstructive coronary lesions as a marker of CAD. Cardiac CT focuses on the detection of atherosclerosis rather than ischemia, and permit detection of CAD at an earlier stage. Objectives of this manuscript are to discuss the clinical experience with both modalities and to provide a critical review of the strengths and limitations of Cardiac SPECT and Cardiac CT for the diagnostic and management of patients with suspected CAD or cardiac ischemic disease. |
20192019 | Enamel defects in standard poodle dogs in Sweden. | Several disturbances can occur in enamel formation. Amelogenesis imperfecta is an inherited enamel malformation that has not previously been reported in dogs. The aims of this study were to investigate amelogenesis imperfecta-like tooth discoloration in standard poodle dogs by histopathological characterization of discolored teeth from affected dogs, investigating whether these dogs have mon genetic background, and assessing mon this problem is in the breed. Histologically, a defect of enamel mineralization was documented. Affected enamel contained a large residual amount of organic matrix, showing that the enamel was not fully mineralized. In some sections, the enamel appeared intact, but with excessively well-defined enamel prisms which is an additional sign of poor mineralization. The abnormal enamel was identical to that seen in humans with amelogenesis imperfecta. Five of 27 standard poodle dogs present at a dog show had discolored teeth. A four-generation pedigree was available containing an example of parents also having discolored teeth one of which had amelogenesis imperfecta confirmed histologically. In all subsequent litters from these dogs, there was at least one dog with discolored teeth, and two histologically confirmed cases of amelogenesis imperfecta four generations later. Histological examination and the apparent familial occurrence indicates that amelogenesis imperfecta is mon cause of discolored teeth in standard poodle dogs in Sweden. |
20192020 | Measurement of the Curve of Spee in horses. | The Curve of Spee is well known, yet hardly understood in the horse, as there is a striking lack of biometrically related data which could help to explain its biomechanical significance. Older horses display drastic alterations of the Curve of Spee in routine clinical examinations. Since the Curve of Spee is known to be biomechanically related to the masticatory forces in humans, the same may apply to the equine, and masticatory deficits can be expected in the geriatric horse. Quantitative data of the Curve of Spee cannot be obtained directly by means of measurements in the horse's long and narrow oral cavity. Instead, the radiographs of 24 heads and 6 skulls of horses of different age were used to develop a geometrical procedure facilitating a quantitative analysis of the height of the Curve of Spee. The geometrical values gave clear evidence that the height of the Curve of Spee was smaller in groups of older pared with those of younger horses. This finding was in accordance with biomechanical studies which reported decreased masticatory forces in older horses. |
20192021 | Endodontic treatment of dens invaginatus in a dog. | Dens invaginatus or dens in dente is a developmental dental malformation that has the radiographic appearance of a separate tooth inside the pulp chamber or canal of another tooth. This report describes endodontic treatment of a variation of dens invaginatus in the maxillary canine tooth of a dog. |
20192022 | Computed tomography and partial coronoidectomy for open-mouth jaw locking in two cats. | Open-mouth jaw locking in the cat has traditionally been minimally evaluated with diagnostic imaging. Multiple methods have been described for surgical management of this problem. This report describes the use puted tomography to diagnose open-mouth jaw locking in 2 cats secondary to ventrolateral displacement of the coronoid process in relation to the zygomatic arch. In these 2 cases, a previously unreported surgical approach whereby the coronoid was not reduced before partial coronoidectomy was used with successful es. |
20192030 | [Brain-machine interface--current status and future prospects]. | Recent advances in brain activity analysis putational algorithms have enabled people with severe motor disorders to control external devices via brain activity. Brain-machine interface puter interface has gained importance as the ultimate strategy for pensation because it improves impaired neuromuscular systems. Invasive BMI performed using needle arrays can best control robotic arms puter cursors because it records neural activity in the primary motor cortex in detail. The extensive and validated physiological background of recorded signals enables researchers to develop highly accurate BMI systems with needle electrodes. Less invasive neural recording with an electrocorticogram (ECoG)-electrode array provides good temporal and spatial information for use in prosthetic control. ECoG electrodes have wide clinical applications in pain control and epilepsy; therefore, techniques for electrode implantation are well pared to those for needle arrays. These electrodes may find wide clinical applications if their accuracy level reaches that suitable for practical use. Noninvasive BMI involving neural recording by electroencephalography (EEG) is the most widely used technique because of a convenient experimental setup, although it provides a limited range of decodable motor outputs. In EEG, arc-shaped mu rhythms of 8-12 Hz appear around the sensorimotor area in the resting state and diminish in amplitude during motor imagery. Thus, the mu rhythm amplitude may correlate with cortical excitability of the sensorimotor area, and EEG-BMI may be useful in the neurorehabilitation of patients with stroke-induced hemiplegia. Research on BMI as a therapeutic tool though emergent, may widen the scope of conventional BMI. |
20192031 | [Novel functional electrical stimulation for neurorehabilitation]. | Our understanding of motor learning, neuroplasticity, and functional recovery after the occurrence of brain lesions has increased considerably. New findings in basic neuroscience have provided an impetus for research in motor rehabilitation. Several prospective studies have shown that repeated motor practice and motor activity in a real world environment have a favorable effect on motor recovery in stroke patients. Electrical stimulation can be applied in a variety of ways to the hemiparetic upper extremity following a stroke. In particular, electromyography (EMG)-triggered electrical muscle stimulation improves the motor function of the hemiparetic arm and hand. Triggered electrical stimulation is reported to be more effective than non-triggered electrical stimulation in facilitating upper extremity motor recovery after stroke. Power-assisted functional electrical stimulation (FES) induces greater muscle contraction by electrical stimulation that is in proportion to voluntary integrated EMG signals. Daily power-assisted FES home-program therapy with novel equipment has been shown to effectively improve wrist, finger extension, and shoulder flexion. Combined modulation of voluntary movement, proprioceptive sensory feedback, and electrical stimulation might play an important role in improving impaired sensory-motor integration by power-assisted FES therapy. A multi-channel near-infrared spectroscopy (NIRS) studies in which the hemoglobin levels in the brain were non-invasively and dynamically measured during functional activity found that the cerebral blood flow in the injured sensory-motor cortex area is greater during a power-assisted FES session than during simple active movement or simple electrical stimulation. A novel power-assisted FES sleeve (Cyberhand) has been developed for the rehabilitation of hemiplegic upper extremities. |
20192032 | [Clinical application of functional near-infrared spectroscopy in rehabilitation medicine]. | Functional near-infrared spectroscopy (fNIRS) is an effective tool to non-invasively investigate cerebral oxygenation and hemodynamics. fNIRS as well as other functional neuroimaging techniques including functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) have been used for investigating the neural mechanisms of functional recovery after a stroke or a traumatic brain injury. fNIRS has several advantages over other neuroimaging techniques in terms of clinical application in the field of rehabilitation medicine. In addition to its portability and low equipment cost, fNIRS does not require strict motion restriction during measurement, unlike other functional imaging techniques. Therefore, this technique enables the examination of cortical activation during physically dynamic activities, like gait or balance perturbation. Studies using fNIRS have revealed several implications for gait recovery after stroke. These studies have shown that the medial sensorimotor cortex (SMC) and the supplementary motor area (SMA) are mainly involved in steadying gait and that the prefrontal cortex (PFC) is involved in the adjustment of walking speed. In hemiparetic patients, lateralization of SMC activation during gait is reduced, and additional cortical activations in the premotor cortex and PFC during gait became evident after focused rehabilitation for several months. The cortical activation pattern may be modified after different types of rehabilitative interventions. These results imply that fNIRS data is a potential biomarker for functional recovery and the response to rehabilitative interventions. Although further studies are required, fNIRS might provide useful information for customizing rehabilitation programs in order to enhance functional recovery. |
20192033 | [Robot-aided training in rehabilitation]. | Recently, new training techniques that involve the use of robots have been used in the rehabilitation of patients with hemiplegia and paraplegia. Robots used for training the arm include the MIT-MANUS, Arm Trainer, mirror-image motion enabler (MIME) robot, and the assisted rehabilitation and measurement (ARM) Guide. Robots that are used for lower-limb training are the Rehabot, Gait Trainer, Lokomat, LOPES Exoskeleton Robot, and Gait Assist Robot. Robot-aided therapy has enabled the functional training of the arm and the lower limbs in an effective, easy, fortable manner. Therefore, with this type of therapy, the patients can repeatedly undergo sufficient and accurate training for a prolonged period. However, evidence of the benefits of robot-aided training has not yet been established. |
20192034 | [Neuroimaging and neurorehabilitation for aphasia]. | With the development of neuroimaging techniques such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), many reports revealing the underlying mechanisms of functional recovery from aphasia have been published. Three types pensatory mechanisms seem to operate in aphasic patients with left hemisphere damage: (1) functional recovery of the damaged area in the left hemisphere, (2) activation of the perilesional area in the left hemisphere, and (3) activation of the right frontal area (area homologous to the language-relevant area). Although there are some pitfalls in the interpretation of neuroimaging, it is mended that the areas pensate for impaired language function should be clarified prior to the initiation of neurorehabilitation for aphasia. The clinical effectiveness of repetitive transcranial magnetic stimulation (rTMS) and pharmacotherapy for aphasia has been recently studied. We administered low-frequency rTMS and language therapy to 4 stroke patients with motor-dominant aphasia for 6 consecutive days. The application site of rTMS was determined on the basis of the findings of pretreatment fMRI during word repetition tasks. Our novel approach resulted in significant improvement in language functions. The results of some double-blind placebo-controlled trials on aphasic patients have indicated that levodopa, dextroamphetamine, and donepezil play a critical role in the recovery from aphasia. We anticipate limitless future possibilities for the intensive neurorehabilitation of aphasic patients, including constraint-induced language therapy, rTMS application, and pharmacotherapy. The application of newly developed neuroimaging techniques may provide additional important information for improving neurorehabilitative intervention for aphasia. |
20192035 | [A new system for the quantitative evaluation of motor commands for neurorehabilitation]. | In this study, we introduce a new method to analyze the functional significance of mands based on the causal relationship between muscle activities and movement kinematics. We asked 4 healthy subjects to perform 2 movement tasks involving movements of the wrist joint with a manipulandum: (1) a step-tracking movement, and (2) a smooth pursuit movement to follow a smoothly moving target with a cursor. We recorded the movements of the wrist joint and the electromyography (EMG) signals from 4 prime movers of the wrist. We then identified the causal relationship between the muscle activities and the movement kinematics in terms of the torque at the wrist joint torque. Correlation coefficients (R) between the muscle activities and the movement kinematics were surprisingly high for both the step-tracking movement (0.88-0.96) and the smooth pursuit movement (0.89-0.98). Nevertheless, the ratio of the viscosity coefficient B and the elastic coefficient K for the of the causal relationship was systematically different for the 2 movement tasks. For the step-tracking movement, the elastic coefficient K was much higher than the viscosity coefficient B (K>>B, B/K ratio = 0-0.25), suggesting that the muscle activities were correlated mainly with position of the wrist joint. In other words, the central nervous system (CNS) mainly controls the target position during the step-tracking movement. In contrast, for the smooth pursuit movement, the elastic coefficient K and the viscosity coefficient B were similar (B approximately equal to K, B/K ratio = 1.0-2.1), suggesting that the muscle activities were correlated both with the position and velocity of the wrist joint. In other words, the CNS controls the velocity as well as position of the target during the smooth pursuit movement. Overall, the controller for the wrist movement can switch between the position-control mode and the position/velocity-control mode depending on the requirement of the task. Our new method is a unique noninvasive tool for the bedside evaluation of the condition of motor controllers in the CNS. Thus, it is useful for finding evidence of neurorehabilitation. |
20192036 | [The association of age and tracer clearance determined radionuclide cisternography]. | We aimed to study tracer kinetics in radioisotope (RI) cisternography. For this purpose, we analyzed the RI images of 36 individuals in whom absence of cerebrospinal fluid (CSF) leakage was confirmed. For the semiquantitative assessment of tracer clearance, the geometric mean of the RI count in the anterior and posterior images was obtained for the entire head as well as for the whole spinal axis. After correcting for the radioactive decay of the tracer, tracer clearance was expressed as a ratio of the count in the range of the whole CSF space at different time points to that at the time of tracer delivery. Tracer clearance from the CSF space was not related to the degree of cranial transport of the tracer in 1 hour, but was significantly related with the age of the patients. At 24 hours after the injection, tracer clearance was significantly faster in the younger patients (Group I: age < 40 years) than in the older patients (Group II: age > or = 40 years). The cranial transport of the tracer appeared to be rapid in group I; however, the difference between these 2 groups was not significant. These results indicate that age should be taken in account while establishing the reference values for tracer kinetics in normal individuals. |
20192037 | [A case of common femoral artery occlusion after homeostasis using device at carotid artery stenting]. | The hemostatic puncture closure device Angio-Seal is a quick and easy-to-use system, allowing rapid sealing of the vascular access site after interventional procedure. The rate plications associated with the use of this device has been reported to be low; nonetheless, certain plications may arise. In the present study, we describe a case of vascular occlusion that occurred because of the use of the Angio-Seal device. A 59-year-old man with no sign of peripheral arterial occlusive disease underwent carotid artery stenting. The mon femoral artery was closed with the Angio-Seal device. After 7 days, the plained of intermittent claudication, especially while climbing up the stairs. Angiography of the left iliac artery at 2 months after carotid artery stenting revealed occlusion of the mon femoral artery. Deep and superficial femoral arteries were fed by the collateral flow from the muscle branch. Because the patient's symptom was mild and his daily life was not affected, he was treated conservatively. In conclusion, arterial closure performed using a hemostatic device is associated with a risk of vascular occlusion. |
20192043 | Implementing the eight high impact actions to transform healthcare and boost efficiency. | Nurses and midwives could improve care and save billions of pounds a year by implementing the eight high impact actions unveiled by the chief nursing officer for England Dame Christine Beasley in 2009. We explore how staff can implement the actions through leadership and knowledge of change management processes. |
20192042 | Using ideas management to identify ways to improve care in the NHS and in organisations. | Nurses and midwives have been asked to implement eight high impact actions, announced by the chief nursing officer for England Dame Christine Beasley in November 2009. Here we describe the process of ideas management that led to the actions being selected for the final list, and suggest ways in which nurses can use this process to implement changes in practice. |
20192050 | A statistical segmentation method for measuring age-related macular degeneration in retinal fundus images. | Day by day, huge amount of information is collected in medical databases. These databases include quite interesting information that could be exploited in diagnosis of illnesses and medical treatment of patients. Classification of these data is getting harder as the databases are expanded. On the other hand, automated image analysis and processing is one of the most promising areas puter vision used in medical diagnosis and treatment. In this context, retinal fundus images, offering very high resolutions that are sufficient for most of the clinical cases, provide many indications that could be exploited in diagnosing and screening retinal degenerations or diseases. Consequently, there is a strong demand in developing automated evaluation systems to utilize the information stored in the medical databases. This study proposes an automatic method for segmentation of ARMD in retinal fundus images. The method used in the automated system extracts lesions of the ARMD by employing a statistical method. In order to do this, the statistical segmentation method is first used to extract the healthy area of the macula that is more familiar and regular than the unhealthy parts. Here, characteristic images of the patterns of the macula are extracted and used to segment the healthy textures of an eye. In addition to this, blood vessels are also extracted and then classified as healthy regions. Finally, the inverse image of the segmented image is generated which determines the unhealthy regions of the macula. The performance of the method is examined on various quality retinal fundus images. Segmented images are pared with consecutive images of the same patient to follow up the changes in the disease. |
20192051 | Design and construction of a low cost dsPIC controller based repetitive transcranial magnetic stimulator (rTMS). | In this work, a digital signal peripheral interface controller (dsPIC) based repetitive transcranial magnetic stimulator (rTMS) was designed and tested under low voltages. In addition, some limited knowledge of TMS, especially design parameters and notions concerned with it, also were investigated. The reason employing the dsPIC in the design is that design parameters can effectively be controlled. Pulse width modulation and switching output of the control unit, which is necessary to control the rTMS device, were controlled in a more effective way. The other novelty is that developed system can be used for therapeutic or diagnostic purposes in future work provided by digital signal processing performance of dsPIC. Bounded-cylindrical in shape head model made from nonmagnetic material, was used during the tests of the system. Spectrum analyses of clicking sounds were performed with FFT by using MATLAB. The effectiveness of the designed system have been proved by its' measurement pared with previous works. |
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