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GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (4 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Language English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French Humans or Animals Humans Animals Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S. Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Results(1-25 of 25,000) Sort By: Publication Date Relevance Took: 3.441 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 1000 1 2 3 4 > Last >> (25000 articles found) Improving uptake of influenza vaccination among older people: A randomised controlled trial 2002 Arthur, A. J., Matthews, R. J., Jagger, C., Clarke, M., Hipkin, A., and Bennison, D. P. Background: The uptake of influenza vaccination among older people is suboptimal. Contact with a doctor or nurse is associated with older people deciding to accept influenza vaccination. Aim: To compare different forms of approach in improving uptake of influenza vaccination among patients aged 75 ... ( view more )years and over in primary care. Design of study: Randomised controlled trial. Setting: One large rural general practice serving the town and surrounding area of Melton Mowbray, Leicestershire. Method: All 2052 patients aged 75 years and over, registered with the practice and not living in nursing/residential homes or sheltered accommodation, were included in the study. One-third of patients were randomised to receive an offer of influenza vaccination as part of an over-75 health check administered by a practice nurse in the patient's home, and two-thirds of patients were randomised to receive a personal letter of invitation to attend an influenza vaccination clinic held at the surgery. The main outcome measure was uptake of influenza vaccination. Results: Six hundred and eighty patients were randomised to the health check arm of the trial and 1372 were randomised to receive a personal letter. Of those randomised to the health check arm, 468 received the health check from the nurse. Overall, the difference in influenza vaccination uptake was 6.4% (95% confidence interval [CI] = 2.2% to 10.4%) with 67.9% (n = 932) of those who were sent a personal letter actually receiving the vaccine, compared with 74.3% (n = 505) of those offered a combined health check and influenza vaccination (P = 0.003). Conclusion: Combining home-based over-75 health checks with influenza vaccination can improve uptake among older patients. However, this intervention is likely to be costly and its effect on influenza vaccination rates is modest. The difference in uptake is greater among those who do not routinely come forward for vaccination and a more viable option may be to target these patients ( view less ) View Full Abstract View Article Details View Coded Data Related Articles 18F-FDG uptake as a biologic prognostic factor for recurrence in patients with surgically resected non-small cell lung cancer 2002 Higashi, K., Ueda, Y., Arisaka, Y., Sakuma, T., Nambu, Y., Oguchi, M., Seki, H., Taki, S., Tonami, H., and Yamamoto, I. Among patients with resected non-small cell lung cancer (NSCLC), approximately 50% present with a recurrent tumor. The clinical or pathologic TNM staging does not always provide a satisfactory explanation for differences in relapse and survival. Thus, it is of major importance to be able to predict... ( view more ) these relapses and to prevent them with an active chemotherapy or radiotherapy program (or both). 18F-FDG uptake on PET could be of prognostic significance in patients with resected NSCLC. The goal of this study was to determine whether the level of metabolic activity observed with 18F-FDG uptake correlates with the probability of postoperative recurrence in patients with NSCLC. Methods: Fifty-seven patients with NSCLC were examined with 18F-FDG PET. For semiquantitative analysis, standardized uptake values (SUVs) were calculated. Patients were classified into high-SUV (>5.0) and low-SUV (<=5.0) groups. All patients underwent thoracotomy within 4 wk after the 18F -FDG PET study. Tumor 18F-FDG uptake (SUV), pathologic stage, and lesion size were analyzed for their possible association with disease-free survival. Results: Forty-six patients had pathologic stage I NSCLC and 11 had pathologic stage II or stage III NSCLC. In a univariate analysis, patients with an SUV of <=5 had a much better disease-free survival than did patients with an SUV of >5 (P < 0.0001). In patients with pathologic stage I and stage IA NSCLC, the SUV was also correlated with disease-free survival (P < 0.0001 and P = 0.0012, respectively). Patients with pathologic stage I disease had an expected 5-y disease-free survival rate of 88% if the SUV was <=5 and a survival rate of <=17% if the SUV was <=5. A multivariate Cox analysis identified the SUV as the most significant independent factor for diseasefree survival. Conclusion: We conclude that the 18F-FDG uptake in primary NSCLC determined by PET has a significant independent postoperative prognostic value for recurrence, especially in patients with pathologic stage I NSCLC. 18F-FDG uptake was superior to pathologic stage in predicting relapse of patients with NSCLC ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Is selectivity for serotonin uptake associated with a reduced emergence of manic episodes in depressed patients? 2000 Barak, Y., Kimhi, R., and Weizman, R. To determine whether selectivity for serotonin reuptake plays a role in antidepressant-associated mania (AAM)), we evaluated the frequency of treatment-emergent mania in patients with unipolar depression who received either citalopram, a highly selective serotonin uptake inhibitor, or the adrenergi... ( view more )c tetracyclic antidepressants (TTCAs) maprotiline and mianserin, or placebo. Data were collected from post-marketing reports of adverse events, three placebo-controlled trials and four double-blind comparative trials. Of the total 4004 depressed patients treated with citalopram (2482 from post-marketing data, 840 from placebo-controlled studies and 682 from TTCAs comparative studies), 25 (0.62%) had manic episodes. The rate of AAM in the comparative trials was significantly lower in the citalopram-treated patients (1/682, 0.15%) than in the TTCA-treated patients (5/389, 1.29%) (P = 0.03). In the placebo-controlled studies, no manic episodes were reported in the patients given placebo, but one manic episode occurred in a citalopram-treated patient (1/840, 0.12%). The citalopram-treated patients in whom AAM developed were significantly older than those in whom it did not (about 10 years, P < 0.001); gender distribution was similar. In conclusion, despite its limitations, our study apparently indicates that citalopram, a highly selective serotonin reuptake inhibitor, is associated with a significantly lower rate of treatment emergent manic episodes than TTCAs, which have noradrenergic activity, but a similar rate to that reported for less selective SSRIs. (C) 2000 Lippincott Williams and Wilkins ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Predictive accuracy of a model of volatile anesthetic uptake 2002 Kennedy, R. R., French, R. A., and Spencer, C. A computer program that models anesthetic uptake and distribution has been in use in our department for 20 yr as a teaching tool. New anesthesia machines that electronically measure fresh gas flow rates and vaporizer settings allowed us to assess the performance of this model during clinical anesth... ( view more )esia. Gas flow, vaporizer settings, and end-tidal concentrations were collected from the anesthesia machine (Datex S/5 ADU) at 10-s intervals during 30 elective anesthetics. These were entered into the uptake model. Expired anesthetic vapor concentrations were calculated and compared with actual values as measured by the patient monitor (Datex AS/3). Sevoflurane was used in 16 patients and isoflurane in 14 patients. For all patients, the median performance error was -0.24%, the median absolute performance error was 13.7%, divergence was 2.3%/h, and wobble was 3.1%. There was no significant difference between sevoflurane and isoflurane. This model predicted expired concentrations well in these patients. These results are similar to those seen when comparing calculated and actual propofol concentrations in propofol infusion systems and meet published guidelines for the accuracy of models used in target-controlled anesthesia systems. This model may be useful for predicting responses to changes in fresh gas and vapor settings ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Aortic enhancement during abdominal CT angiography: Correlation with test injections, flow rates, and patient demographics 1999 Platt, J. F., Reige, K. A., and Ellis, J. H. OBJECTIVE. The goal of our study was to determine the effect of contrast material injection rate and patient demographic variables on vascular enhancement for abdominal CT angiography and compare test injection results with actual patterns of vascular enhancement. SUBJECTS AND METHODS. One hundred ... ( view more )twenty-five patients underwent abdominal CT angiography. For each patient, CT attenuation values (Hounsfield units) of the aorta were determined before and after IV contrast administration, every 3 sec between 21 and 60 sec. A peak aortic enhancement value and the time needed to reach peak and aortic enhancement thresholds of 150 and 200 H were determined. All patients received 150 ml of nonionic contrast material at 3 ml/sec in 25 patients and 4 ml/sec in 100 patients. A test injection of 15 ml was used to compute a scan delay in 46 patients. Patient age, sex, weight, injection rate, and test injection results were compared with vascular enhancement patterns. RESULTS. For the 125 patients, the mean aortic enhancement at each time point was greater than 150 H. Patient weight was inversely correlated (r2 = -.62) with aortic enhancement. The test injection did not accurately predict actual aortic enhancement peak value or time. Test injection delay time was significantly correlated with time to reach aortic enhancement thresholds of 150 and 200 H. The 4 ml/sec rate resulted in a higher peak aortic enhancement (320 +/- 58 H versus 281 +/- 49 H) (mean +/- SD, p < .01) that was reached quicker than with the 3 ml/sec injection rate (45 +/- 5 sec versus 52 +/- 5 sec) (p < .01). Injecting at 4 ml/sec resulted in greater aortic enhancement values at 24-45 sec, whereas 3 ml/sec produced significantly better aortic enhancement at 54-60 sec. CONCLUSION. The test injection correlated better with time to reach specific aortic enhancement thresholds than with time to peak aortic enhancement. For a given amount of contrast material, faster injection rates resulted in greater vascular enhancement that occurred earlier ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A physiologically based pharmacokinetic model for fluoride uptake by bone 1995 Rao, H. V., Beliles, R. P., Whitford, G. M., and Turner, C. H. A sex-specific, physiologically based pharmacokinetic (pbpk) model has been developed to describe the absorption, distribution, and elimination of fluorides in rats and humans. Growth curves generated by plotting mean body weights (kg) against age (weeks or years) are included in the simulation mod... ( view more )el to allow the integration of chronic fluoride exposure from birth to old age. The model incorporates age and body weight dependence of the physiological processes that control the uptake of fluoride by bone and the elimination of fluoride by the kidneys. Six compartments make up the model. These are lung, liver, kidney, bone, and slowly and rapidly perfused compartments. The model also includes two bone subcompartments: a small, flow-limited, rapidly exchangeable surface bone compartment and a bulk virtually nonexchangeable inner bone compartment. The inner bone compartment contains nearly all of the whole body content of fluoride, which, in the longer time frame, may be mobilized through the process of bone modeling and remodeling. The model has been validated by comparing the model predictions with experimental data gathered in rats and humans after drinking water and dietary ingestion of fluoride. This physiological model description of absorption, distribution, and elimination of fluoride from the body permits the analysis of the combined effect of ingesting and inhaling fluorides on the target organ, bone. Estimates of fluoride concentrations in bone are calculated and related to chronic fluoride toxicity. The model is thus useful for predicting some of the long-term metabolic features and tissue concentrations of fluoride that may be of value in understanding positive or negative effects of fluoride on human health. In addition, the pbpk model provides a basis for across-species extrapolation of the effective fluoride dose at the target tissue, bone, in the assessment of risk from different exposure conditions ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Poor uptake of influenza vaccinations in patients receiving cytotoxic chemotherapy 2003 Ring, A., Marx, G., Steer, C., Prendiville, J., and Ellis, P. This audit was designed to assess whether existing UK vaccination programmes mean that patients receiving chemotherapy are being vaccinated against influenza. One hundred and ten adult patients receiving chemotherapy at a south London tertiary referral centre were interviewed when they attended for... ( view more ) their chemotherapy. Thirty-six of the 110 (33%) patients had received their influenza vaccination at the time of the study. Vaccination rates were significantly higher in those patients older than 65 years (53% vs 17%, p<0.001), and in those with co-morbidities (49% vs 25%, p<0.05). The vaccination rate in this at-risk population is lower than the overall national uptake in those aged 65 and over. Those patients most likely not to receive their influenza vaccination are those who have no indication for vaccination other than the fact they are receiving chemotherapy. Increased awareness of the benefits of influenza vaccine and its safety is needed among general practitioners, patients and oncologists ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Rheumatoid arthritis: epidural enhancement as an underestimated cause of subaxial cervical spinal stenosis 2004 Kroft, L. J., Reijnierse, M., Kloppenburg, M., Verbist, B. M., Bloem, J. L., and van, BuchemMA PURPOSE: To assess the frequency and site of subaxial spinal canal stenosis due to enhancing tissue in patients with rheumatoid arthritis. MATERIALS AND METHODS: Data from 33 consecutive patients with rheumatoid arthritis were evaluated; these patients had undergone 1.5-T magnetic resonance imaging... ( view more ) following gadolinium chelate administration, in combination with a frequency selective fat-suppression technique. Stenosis and enhancement were scored for each of six cervical spinal levels and were compared with results in a control population consisting of 16 patients with degenerative disease. Enhancement was scored as superficial or deep on the anterior and posterior sides from the cervical spinal cord. Differences between patient groups were tested by using the chi(2) test for trend and the Fisher exact test. RESULTS: No significant difference was found in the frequency or severity of subaxial stenosis between rheumatoid arthritis and degenerative disease. Deep epidural enhancement was observed more often with rheumatoid arthritis than with degenerative disease both anterior (25 of 33 patients vs seven of 16 patients, respectively; P <.001) and posterior (24 of 33 patients vs two of 16 patients, respectively; P =.001) to the spinal cord. Enhancing stenosing tissue in rheumatoid arthritis frequently occurred anterior and posterior at the same time and at the same level, with segmental cufflike extension of enhancing tissue around the dural sac. Stenosing tissue enhanced more frequently with rheumatoid arthritis than with degenerative disease (22 of 33 vs four of 16 patients, respectively; P =.008). CONCLUSION: In patients with rheumatoid arthritis, subaxial stenosis is frequently caused by enhancing epidural tissue. This enhancing tissue presumably represents pannus. Copyright RSNA, 2004 ( view less ) View Full Abstract View Article Details   Related Articles Computer-assisted quantitation of enhancing lesions in multiple sclerosis: correlation with clinical classification 1997 Miki, Y., Grossman, R. I., Udupa, J. K., Samarasekera, S., van, BuchemMA, Cooney, B. S., Pollack, S. N., Kolson, D. L., Constantinescu, C., Polansky, M., and Mannon, L. J. PURPOSE: To study the utility of a computer-assisted method of quantitating enhancing multiple sclerosis (MS) lesions and to correlate this quantitation with the type and duration of disease. METHODS: Forty untreated patients with MS were studied. The patients had been classified clinically as havi... ( view more )ng either relapsing-remitting (n = 27) or chronic-progressive (n = 13) disease. Postcontrast contiguous 3-mm-thick MR images of the brain were obtained for up to 3 years. The computer program selected potential lesion sites automatically on the basis of the theory of "fuzzy connectedness," which was incorporated into 3DVIEWNIX software. True lesions were selected from these previously detected potential lesions by means of yes/no responses to the program query. The number of enhancing lesions and the enhancing lesions volume were subsequently computed. RESULTS: The enhancing lesion volume in patients with relapsing-remitting disease was statistically significantly higher than that of patients with chronic-progressive disease. There was a strong positive correlation between the number of enhancing lesions and the enhancing lesion volume. No significant correlation was noted between the change in score on the expanded disability status scale (EDSS) and the change in the number of enhancing lesions, or between the change in EDSS score and the change in enhancing lesion volume. A negative correlation was found between enhancing lesion volume and duration of disease, and between the number of enhancing lesions and duration of disease in the patients who had enhancing lesions. CONCLUSIONS: Our data suggest that enhancing lesion volume reflects differences in the classification of clinical MS and in the disease activity over time. Computer-assisted quantitation of enhancing lesion volume is a robust, practical, and objective measure of MS activity ( view less ) View Full Abstract View Article Details   Related Articles Indulging anxiety: human enhancement from a Protestant perspective. Aug 1999 Mark J Hanson At the heart of any ethics of human enhancement must be some normative assumptions about human nature. The purpose of this essay is to draw on themes from a Protestant theological anthropology to provide a basis for understanding and evaluating the tension between maintaining our humanity and enhan... ( view more )cing it. Drawing primarily on the work of theologian Reinhold Niebuhr, I interpret enhancement as proceeding from the anxiety that characterizes human experience at the juncture of freedom and finiteness. Religious and moral dimensions of human sinfulness are considered in relation to cultural values that motivate human enhancement generally. I employ these dimensions in a series of benchmarks to suggest a background of theological, anthropological, and moral considerations against which enhancement is not to be condemmed but rather critically evaluated. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Approximal caries depth assessment with storage phosphor versus film radiography. Evaluation of the caries-specific Oslo enhancement procedure 2000 Svanaes, D. B., Moystad, A., and Larheim, T. A. OBJECTIVES: To study whether caries-specific enhancement of storage phosphor images might improve the observer performance of approximal caries depth assessments compared with film radiography. MATERIALS AND METHODS: 120 exposures were made of 120 extracted human teeth. To obtain geometrically iden... ( view more )tical images, Ektaspeed Plus films and storage phosphor plates were exposed simultaneously. The imaging plates were scanned in a Digora scanner and the files transferred to a different platform for image enhancement. Nine observers viewed films and storage phosphor images without provisions for adjustment of image intensity and contrast. For each imaging modality, 240 approximal surfaces were rated for caries on a 5-point confidence scale. Definite and probable caries lesions were also rated for lesion depth, and all ratings were compared with the histological state. Diagnostic accuracy was expressed as the area under the ROC curve (A(z) value). Paired t tests were used to compare the imaging modalities for diagnostic accuracy and F tests to compare observer variances. RESULTS: Enhanced storage phosphor images demonstrated significantly higher mean A(z) values than film (p = 0.0066). Significantly higher mean A(z) values were demonstrated in the outer half of enamel (p = 0.01), but no significant differences were found between the modalities for caries lesions penetrating beyond the outer half of the enamel. The number of correctly diagnosed true-positive surfaces with caries in outer enamel was significantly higher with storage phosphor images than with film (p = 0.00014). False-positive surfaces were most frequently registered in the outer enamel with both modalities, but in this region the number of false-positive surfaces was significantly higher with storage phosphor images than with film (p = 0.0038). Pooled sensitivity and specificity values were 0.48/0.94 and 0.61/0.86 for film and storage phosphor images, respectively. The interobserver variability was significantly lower for storage phosphor images than for film. CONCLUSION: Enhancement of storage phosphor images with a caries-specific procedure significantly improved the accuracy of caries depth assessments in the outer half of the enamel compared with film radiography and reduced observer variability ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Comparison of two contrast materials with different iodine concentrations in enhancing the density of the the aorta, portal vein and liver at multi-detector row CT: A randomized study 2004 Suzuki, H., Oshima, H., Shiraki, N., Ikeya, C., and Shibamoto, Y. This work investigates differences in contrast enhancement of the aorta, portal vein and liver by two different concentrations of contrast materials using an automatic bolus tracking technique. Seventy patients were assigned randomly into one of two groups. Contrast materials with iodine concentrat... ( view more )ions of 300 and 370 mg/ml were administered to patients in groups A and B, respectively. The total iodine load (600 mg/kg) and injection time (30 s) were identical. Differences in the increase of the Hounsfield unit of the aorta, portal vein and liver between the two groups were examined by t test. There were no significant differences between the two groups in any of the contrast enhancements of the aorta, portal vein and liver parenchyma at all phases, except for enhancement of the portal vein at the late arterial phase. Females showed better contrast enhancement of the aorta and portal vein than males. With the same iodine dose and injection time, the concentration of contrast materials did not seem to influence the efficacy of contrast enhancement of the aorta, portal vein and liver, except for the portal vein at the late arterial phase. Planning of protocols for contrast media injection may be made irrespective of the iodine concentrations. copyright Springer-Verlag 2004 ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Comparison of two contrast materials with different iodine concentrations in enhancing the density of the the aorta, portal vein and liver at multi-detector row CT: a randomized study 2004 Suzuki, H., Oshima, H., Shiraki, N., Ikeya, C., and Shibamoto, Y. This work investigates differences in contrast enhancement of the aorta, portal vein and liver by two different concentrations of contrast materials using an automatic bolus tracking technique. Seventy patients were assigned randomly into one of two groups. Contrast materials with iodine concentrat... ( view more )ions of 300 and 370 mg/ml were administered to patients in groups A and B, respectively. The total iodine load (600 mg/kg) and injection time (30 s) were identical. Differences in the increase of the Hounsfield unit of the aorta, portal vein and liver between the two groups were examined by t-test. There were no significant differences between the two groups in any of the contrast enhancements of the aorta, portal vein and liver parenchyma at all phases, except for enhancement of the portal vein at the late arterial phase. Females showed better contrast enhancement of the aorta and portal vein than males. With the same iodine dose and injection time, the concentration of contrast materials did not seem to influence the efficacy of contrast enhancement of the aorta, portal vein and liver, except for the portal vein at the late arterial phase. Planning of protocols for contrast media injection may be made irrespective of the iodine concentrations ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Clinical evaluation of a computer simulated prediction model of contrast enhancement of the liver in spiral CT 2004 Schober, W., Kopp, A., Scherf, C., Mehnert, F., Heuschmid, M., Duda, S. H., Claussen, C. D., and Pereira, P. Objective: A software program was developed simulating a compartmental model of blood circulation based on differential equations. The aim of this study was to compare software-simulated levels of hepatic enhancement with the true values in patients and to test how many patients reach the simulated... ( view more ) hepatic enhancement level. Methods: As software program the CT application software CAREBOLUS 2(R) (Siemens, Forchheim, Germany) was used. Hepatic contrast-enhancement curves were simulated prior to CT examinations to evaluate a patient specific time delay after contrast application. At the time delay, when the simulation curve showed an enhancement threshold of 40 Hounsfield Units (HU), the CT spiral scan was started applying 120 ml contrast media with 2 ml/s. The simulated curves were compared with the empiric curves of each patient. Results: 25 of 28 patients (89%) achieved 40 HU. The mean enhancement of empiric patients curves was 46.32+/-11.9 HU, the mean simulated enhancement was 46.62+/-4.3 HU S.D. (P=0.48). 4.4 values per patient liver could be compared with the simulation curve (122 points for 28 patients): 50% of the patient curves were within a range of 5 HU compared with the simulation curve. Conclusion: Software simulation of contrast enhancement curves of the liver is a feasible and valuable method to predict individual liver enhancement curves. Improvements concerning the integration of cardiovascular parameters and preexisting liver parenchymal diseases into the simulation software have to be arranged. (C) 2003 Elsevier Ireland Ltd. All rights reserved ( view less ) View Full Abstract View Article Details   Related Articles Feasability of real time contrast enhanced ultrasound in renal disease. [French] 2004 Tranquart, F., Correas, J. M., Martegani, A., Greppi, B., and Bokor, D. Objectives. To evaluate feasability of real-time contrast enhanced ultrasound in renal disease Materials and methods. Eighteen patients (sex-ratio = 1: mean age 62.3+/-18.1 years) presenting with several renal diseases were enrolled in the present study. Real time contrast enhanced sonography was p... ( view more )erformed using an ultrasound dedicated system Esatune (Esaote, Firenze, Italy) with a very low mechanical index (MI < 0.1) and a dedicated contrast software CnTI after bolus injection of 2.4 ml Sonovue (Bracco, Milan, Italy). Detection, characterization and extension of renal masses as well as inflammatory and ischemic lesions were evaluated. The results were compared to those obtained by reference method such as contrast-enhanced CT-Scan or MRI. Results. This preliminary study gave some valuable results compared to baseline sonography: marked improvement in tumor delineation or internal microvasculature, detection of venous extension, improvement in cystic mass characterization. Diagnosis confidence was improved and reached 83% when diagnosis concordance with reference modality was improved by 50%. Conclusion. These preliminary results show that real-time contrast enhanced sonography could improve detection and characterization of renal masses by a complete assessment or arterial phase. Further studies are required to confirm these first results with possible advantages for the diagnosis of renal affections ( view less ) View Full Abstract View Article Details View Coded Data Related Articles MRI of extracranial masses in children: the usefulness of gadolinium-chelate enhancement 1998 Kidney, D. D., Dietrich, R. B., Goyal, A. K., Yan, K., and Bradley, W. G. J. OBJECTIVE: This study evaluated the usefulness of gadolinium (Gd) chelates in magnetic resonance imaging (MRI) of extracranial pediatric mass lesions. MATERIALS AND METHODS: Seventy-five MRI studies were obtained on 60 children (mean age 5.06 years) with pathologically proven mass lesions. Post-con... ( view more )trast T1-weighted (T1W) images were compared with pre-contrast T1-weighted, T2-weighted (T2W) and both T1W and T2W images. They were evaluated for their ability to demonstrate lesion margins and extent, to add additional information, and to increase confidence in or change a diagnosis. In all patients post-contrast images were also evaluated for degree and pattern of enhancement. RESULTS: Malignant lesions enhanced much more intensely than benign lesions (P<0.0005). Lack of enhancement was seen only in benign lesions. A heterogeneous pattern of enhancement was more frequently seen in malignancy (P<0.05). Additional information was provided on Gd-enhanced T1W images in 36% of cases compared to unenhanced T1 and T2W images. Diagnostic confidence was improved in 29%. The Gd-enhanced images changed the diagnosis correctly in 5% and incorrectly in 1%. CONCLUSION: Post-contrast images clarified specific issues, better defined lesion extent and margins in a majority of cases, and gave additional useful information in selected cases ( view less ) View Full Abstract View Article Details   Related Articles An Enhanced Role in Comprehensive Geriatric Assessment for Community-Nurse Case Managers. [References] 2003 Stolee, Paul, Patterson, Mary Lynne, Wiancko, Donna Crinklaw, Esbaugh, Jacquelin, Arcese, Zora A., Vinke, Anne Marie, Waddell, Sally, Hatt, Joanne, Wells, Karen, and Crilly, Richard G. We evaluated an enhanced role in comprehensive geriatric assessment for community-nurse case managers. Following practicum education in geriatric assessment, two community-nurse case managers conducted assessments of frail older clients and served as a resource for their case-manager teams. Impacts... ( view more ) on their colleagues' assessment skills were investigated in a non-randomized, controlled trial. Intervention-group case managers had higher confidence in assessing and managing the health and social concerns of older persons, greater use of standard assessment tools, and higher case-study assessment scores, than did control-group case managers. Case managers reported that interaction with the enhanced-role case managers had enhanced their skills and benefited clients; family physicians reported that improved patient outcomes had resulted from the assessment information received. Community case managers with enhanced training in geriatric assessment can have a valuable clinical and educational role. Issues include resource implications and integrating the enhanced role into home care operations. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract) ( view less ) View Full Abstract View Article Details View Coded Data Related Articles "Whose perfection is it anyway?": a virtuous consideration of enhancement. Aug 1999 James F Keenan Discussions of genetic enhancements often imply deep suspicions about human desires to manipulate or enhance the course of our future. These unspoken assumptions about the arrogance of the quest for perfection are at odds with the normally hopeful resonancy we find in contemporary theology. The aut... ( view more )hor argues that these fears, suspicions and accusations are misplaced. The problem lies not with the question of whether we should pursue perfection, but rather what perfection we are pursuing. The author argues that perfection, properly understood, has an enormously positive function in the Roman Catholic tradition. The author examines three sources: the Scriptures, the scholastic tradition, and ascetical theology. He examines contemporary criticisms of perfectionism and suggests that an adequate virtue theory keeps us from engaging perfectionism as such. The author then shows how a positive, responsible view of perfection is an asset to our discussion on enhancement technology. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Contrast enhanced computed tomography and magnetic resonance imaging in the diagnosis of recurrent disc herniation 1996 Albeck, M. J., Wagner, A., and Knudsen, L. L. A positive result of re-operation in patients with recurrent symptoms after lumbar disc surgery is likely only if a new disc herniation is present. An improved ability to differentiate between recurrent disc herniation and scar tissue by contrast enhanced CT and MRI is suggested in earlier studies.... ( view more ) In a prospective study 29 patients were selected for operation for suspected recurrent disc herniation. The inclusion of the patients was based on clinical symptoms and signs and myelography or non-enhanced CT. All patients were examined by CT and MRI both with and without intravenous contrast pre-operatively. The examinations were evaluated blind on a five point scale and statistical analysed by a regret function. Intravenous contrast improved the diagnostic power of both CT and MRI. MRI was superior to CT in both non-enhanced and enhanced examinations. MRI with intravenous contrast enhancement is proposed as the primary examination in patients with suspected recurrent disc herniation ( view less ) View Full Abstract View Article Details   Related Articles [Feasability of real time contrast enhanced ultrasound in renal disease]. [French] 2004 Tranquart, F., Correas, J. M., Martegani, A., Greppi, B., and Bokor, D. OBJECTIVES: To evaluate feasibility of real-time contrast enhanced ultrasound in renal disease. MATERIALS AND METHODS: Eighteen patients (sex-ratio=1: mean age 62.3 +/-18.1 years) presenting with several renal diseases were enrolled in the present study. Real time contrast enhanced sonography was p... ( view more )erformed using an ultrasound dedicated system Esatune (Esaote, Firenze, Italy) with a very low mechanical index (MI<0.1) and a dedicated contrast software CnTI after bolus injection of 2.4 ml Sonovue (Bracco, Milan, Italy). Detection, characterization and extension of renal masses as well as inflammatory and ischemic lesions were evaluated. The results were compared to those obtained by reference method such as contrast-enhanced CT-Scan or MRI. RESULTS: This preliminary study gave some valuable results compared to baseline sonography: marked improvement in tumor delineation or internal microvasculature, detection of venous extension, improvement in cystic mass characterization. Diagnosis confidence was improved and reached 83% when diagnosis concordance with reference modality was improved by 50%. CONCLUSION: These preliminary results show that real-time contrast enhanced sonography could improve detection and characterization of renal masses by a complete assessment or arterial phase. Further studies are required to confirm these first results with possible advantages for the diagnosis of renal affections ( view less ) View Full Abstract View Article Details   Related Articles Gd-DTPA enhancement of cranial nerves on MR imaging. Neoplastic lesions 1999 Kan, S. and Ikeda, T. This study describes a radiological finding - enhancement of cranial nerves and correlates patients' clinical findings and outcome. Seven patients with enhancement of cranial nerves on postcontrast MR were retrospectively reviewed. Cranial nerves having contrast enhancement were optic, oculomotor, ... ( view more )trigeminal, facial, acoustic, glossopharyngeal, vagus and accessory nerves. The patients' underlying diseases were malignant lymphoma (3), leukemia (1 patient) and metastatic tumor (2 lung, 1 rectum cancer). Most of the cases (4 out of 7) developed parenchymatous lesion later. Seven patients had CSF cytology study, positive in 3 cases, negative in 4 cases at first spinal tap. In 1 case (case 5) of negative cytology, elevated CEA (carcinogen antibody) was noted. In 2 cases, initial symptoms were sudden hearing loss. Autopsy was done for 1 case of metastatic tumor involving cranial nerves. Contrast MR is a useful examination for depicting cranial nerve involvement with neoplastic change ( view less ) View Full Abstract View Article Details   Related Articles Thinking theologically about reproductive and genetic enhancements: the challenge. Aug 1999 George Khushf Current philosophical and legal bioethical reflections on reprogenetics provides little more than a rationalization of the interests of science. There are two reasons for this. First, bioethicists attempt to address ethical issues in a "language of precision" that characterizes science, and this wo... ( view more )rks against analogical and narratological modes of discourse that have traditionally provided guidance for understanding human nature and purpose. Second, the current ethical and legal debate is framed by a public/private distinction that banishes robust norms to the private realm, and leaves a minimalist public discourse of harm avoidance that is insuffucient for regulating the science. In this essay, I argue that Mark Hanson's account of anxiety provides a valuable starting point for addressing deficiencies in the current philosophical and legal debate, and it highlights the need for a theological discourse on genetic enhancements. Through an assessment of Joel Shuman's criticism of the public/private distinction, I show how the needed theological discourse should be situated in the context of robust communities, and how such a communitarian inter-ethic is compatible with a variant of liberalism. Finally, I critically assess James Keenan's account of virtue and perfection, in order to outline what a sufficient discourse on reproductive and genetic enhancements requires. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Does justice require genetic enhancements? Apr 1999 N Holtug It is argued that justice in some cases provides a pro tanto reason genetically to enhance victims of the genetic lottery. Various arguments--both to the effect that justice provides no such reason and to the effect that while there may be such reasons, they are overridden by certain moral constrai... ( view more )nts--are considered and rejected. Finally, it is argued that justice provides stronger reasons to perform more traditional medical tasks (treatments), and that therefore genetic enhancements should not play an important role in a public health care system. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Systems theory and the ethics of human enhancement: a framework for NBIC convergence 2004 Khushf, G. Representatives from government and the private sector recommend a major, cooperative initiative directed toward using NBIC (nano-, bio-, info-, and cogno-) technologies for human enhancement. By appropriately seeding the convergence of NBIC domains, they believe that the rate of development can be... ( view more ) both accelerated and simultaneously channeled to avoid adverse risk and advance human good. However, to accomplish these goals, leaders of the convergence efforts identified as a major intellectual barrier the "development of a hierarchical architecture for integrating science across many scales, disciplines, and data modalities." Such a holistic framework requires a radical rethinking of the nature of science and engineering, and, beyond this, is also necessary for addressing their normative ethical and societal implications. In the first part of this essay, I consider the claim that a new view of science and engineering is needed. After reviewing the central features of a classical view of science, I consider aspects of the nano-revolution, showing why the classical conception is inappropriate and how a systems-oriented perspective is responsive to the character of this new science. I then consider how both science and engineering are transformed, calling into question older dichotomies between pure and applied domains. With the reworking of this distinction comes opportunities for rethinking the relation between science and the humanities more generally, which is necessary if we are to more appropriately address normative ethical aspects of the convergence initiative. After providing this groundwork for the needed hierarchical architecture, I consider a useful example of how a systems perspective might guide NBIC convergence. In the 1960s-1990s George Engel advocated a systems-theoretic model as an alternative to a more reductionistic "biomedical model" in medicine, and he did it for the exact same reasons as those advocated by the leaders of the NBIC convergence; namely, it embodies a more appropriate notion of science and enables one to address ethical aspects of medicine that were insufficiently addressed in the older model. By reviewing Engel's "biopsychosocial model" we can learn important lessons for developing the needed NBIC framework. I close by extending Engel's model so that it addresses all areas of enhancement envisioned as a part of NBIC convergence, and then identify areas where future research is still needed ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Enhanced external counterpulsation in the management of angina in the elderly 2003 Linnemeier, G., Michaels, A. D., Soran, O., and Kennard, E. D. This study was undertaken to determine whether enhanced external counterpulsation is a safe and effective treatment for angina in octogenarians. In this prospective observational study, demographic and clinical outcome data on patients consecutively enrolled in the International EECP Patient Regist... ( view more )ry was examined. Of the 3037 patients analyzed, 249 (8%) were >= 80 years old. Octogenarians were more likely to be female and have a history of congestive heart failure (41% vs. 29%; p<0.001). They were less likely to have had previous revascularization. Fewer patients in the octogenarian group (76% vs. 84%; p<0.01) completed a course of treatment. Of those octogenarian patients who completed treatment, 76% reported a reduction in angina and quality of life improved significantly. Adverse events related to treatment were low. At 6-month follow-up, 81% reported maintenance of angina improvement. Thus, enhanced external counterpulsation is a low-risk intervention that offers octogenarians the ability to return to more normal activity and a better quality of life. (C) 2003 Lejacq Communications, Inc ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Page 1 of 1000 1 2 3 4 > Last >> (25000 articles found)

      
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