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Biomedical subjects

P Neff

Publications and source records attributed to P Neff.

13 recordsLinked to original sources
PubMed2006

[Long-term follow-up after surgery for thoracic outlet syndrome (TOS)].

This is a long-term follow-up analysis of patients who have been operated on for Thoracic Outlet Syndrome (TOS) at our clinic in order to evaluate the quality of therapy and the criteria of indications for surgery. 39 patients with a total of 45 surgical procedures were examined after a median follow-up of 8.8 years. The results in this study are based exclusively on the subjective outcome assessment by the patients themselves. Assessment of the long-term result in the "vascular TOS" group (13 cases = 29 %) was good in ten cases (77 %), fair in two cases (15 %) and poor in one case (8 %). In agreement with the literature, we were able to achieve the best results in this group. In the "true neurological TOS" group (28 cases = 62 %), assessment of the long-term result was good in 19 cases (68 %), fair in six cases (21 %) and poor in three cases (11 %). A clear tendency to a poor prognosis could be seen in women with a combination of cervical rib and fibrous band and a long delay between onset of symptoms and surgery. Assessment of long-term result in the "disputed TOS" group (four cases = 9 %) showed good results in three cases and a fair result in one case. In the absence of objective pathologies, only few and carefully selected patients were operated upon. The presented long-term results confirm the use of individual therapeutic concepts with special consideration of anatomy and clinical picture.

Adolescent↗
PubMed2004

Baseline staging in cutaneous malignant melanoma.

BACKGROUND: Baseline staging in patients with primary cutaneous malignant melanoma (MM) is routine, but the diagnostic accuracy and the impact on clinical outcome are still unclear. OBJECTIVES: To evaluate the sensitivity and specificity of baseline staging in the early detection of regional lymph node metastases or distant metastases in patients with MM. METHODS: One hundred consecutive patients with MM of Breslow's tumour thickness over 1.0 mm were enrolled. All patients had an extensive baseline staging including physical examination, ultrasound (US) of the abdomen and regional lymph nodes, chest X-ray, whole-body positron emission tomography (PET) and sentinel lymph node biopsy. The sensitivity and specificity of detection of macroscopic or microscopic metastases in the regional lymph nodes or at distant sites were calculated for each method. RESULTS: Sentinel lymph node biopsy was positive in 26 patients. US detected two of 26 histologically tumour-positive sentinel nodes (sensitivity 8%, specificity 88%) and PET two of 26 (sensitivity 8%; specificity 100%). There were three lymph node metastases with a diameter > 4 mm. All of them were found suspect at physical examination. Two of them were detectable with US, two with PET, and all were identified with either US or PET. Nine patients had suspect findings at distant sites, which were all false positive on further investigation (specificity of the combined staging procedures 91%). At 18 (6-37) months' follow-up, five of 26 (19%) patients with a positive sentinel node and four of 74 (5%) of patients with a negative sentinel node had recurrent or progressive disease. CONCLUSIONS: The combination of physical examination and lymph node US detects the great majority of patients with macroscopic lymph node metastasis (approximately 3% of patients at baseline). Only 10% of patients who have a histologically tumour-positive sentinel node are macroscopically detectable. Altogether, approximately 25% of patients have a positive sentinel node biopsy, among 90% microscopic. The value of whole body staging at baseline remains limited, since distant metastases can hardly ever be detected. The survival benefit of baseline staging and surveillance in patients with cutaneous MM remains to be established by comparative prospective trials.

Abdomen↗
PubMed2003

An FDA phase I clinical trial of quinacrine sterilization (QS).

OBJECTIVE: To review the significance of a United States Food and Drug Administration (FDA) approved Phase I clinical trial of a new use for an old drug, quinacrine. To discover whether ultrasound may have utility in quinacrine sterilization (QS). METHOD: This clinical trial began on 16 September 2000 at the Women's and Children's Hospital of Buffalo (WCHOB) in Buffalo, New York. Ten patients volunteered to have QS. These subjects were carefully followed with regularly scheduled examinations, including extensive laboratory blood tests. In addition, each patient had a trans-abdominal ultrasound examination six weeks or later past the date of the second insertion of quinacrine. The trial was completed on 30 April 2003. RESULTS: Laboratory results fell within normal limits, thus providing additional evidence to affirm the lack of toxic effects of QS. With ultrasound, we were able to see scars in both oviducts on all of our patients. One patient with a small scar as seen on ultrasound became pregnant. CONCLUSION: QS was found to be safe and effective. Ultrasound holds the promise of reducing the failure rate.

Adult↗
PubMed1997

Toward optimizing a preshaped catheter and system parameters to achieve single lead DDD pacing.

P wave electrogram amplitudes and atrial stimulation thresholds were determined in eight Hanford miniature swine using a preshaped catheter with an "S" curve in the SVC, and a major lobe in the atrium to enhance electrode contact with the atrial wall. The catheter was designed for pacing and sensing in the DDD mode. P wave amplitudes were also ascertained with two commercially available VDD leads and compared to the data from the experimental catheters. The preshaped catheter used two 6-mm2 platinum iridium atrial electrodes with a 7-mm separation. Both atrial electrodes are on the same side of the catheter, facing outward on the major atrial lobe formed in the catheter. The P wave amplitudes were tested only in the differential bipolar configuration. For the eight preshaped catheters, the mean was 6.6 +/- 3.8 mV while for the conventional leads it was 2.9 +/- 1.6 mV. The mean atrial stimulation thresholds ranged from 1.1 +/- 0.2 V to 2.3 +/- 1.2 V, with still lower thresholds of 0.9-1.3 V when using the parallel unipolar atrial electrode configuration, in which both parts of the bipolar atrial electrode are configured as a unipolar electrode. The data suggest that bipolar simulation may be effective if sequential reverse polarity pulses are used to achieve cathodal stimulation from each electrode of the bipolar pair, on a beat-to-beat basis.

Animals↗
PubMed1995

Trauma from occlusion. Restorative concerns.

Trauma from occlusion and restorative concerns may affect the tooth itself, the supporting structures inside and around the tooth's immediate structures, and the total articulating system, which includes the neuromuscular system, the temporomandibular joints, and other systems such as the impairment of hearing or vision and many other peripheral conditions. A thorough examination and a differential diagnosis procedure is essential to restore the health of the articulating system and reverse peripheral condition. This includes the ability to restore the individual tooth in its best anatomic position as a complement to the articulating system using all individual disciplines of dentistry in the finest abilities of treatment and the ability to share and distinguish the possible parafunctional habits and the need for behavioral understanding, support, and management to limit or lessen the wear and destruction of the individual tissues and to restore a healthier physical support.

Bruxism↗
PubMed1994

Management of TMD caused by temporal head trauma.

This report followed the management of a 56-year-old female suffering from TMD caused by trauma to her temporal head area. The management consisted of occlusal devices until her condition stabilized followed by prosthodontic rehabilitation to obtain and maintain a physiologic maximum intercuspation.

Combined Modality Therapy↗
PubMed1993

Characterization of 86 bruxing patients with long-term study of their management with occlusal devices and other forms of therapy.

Of 353 patients screened, 86 answered positively to questions designed to identify bruxers. The bruxing patient profile revealed that 100% had working excursive interferences, 78% had balancing excursive interferences, and 95.4% had a premature contact into maximum intercuspation. Most of the bruxing patients had a chief complaint that related to pain, and 89.6% of the patients had a craniomandibular disorder. The patients were initially managed with an anterior deprogrammer and were later managed with other occlusal devices as signs and symptoms dictated. Definitive treatment was determined by the patient's maxillomandibular relationship.

Adult↗
PubMed1984

Mission to Peru.

Explore the source record for details and available documents.

Dental Care↗
PubMed1980

The effects of electrode position on the detection of the transvenous cardiac electrogram.

Adequate sensing of the cardiac electrogram is a necessary requisite for all demand cardiac pacemakers. In order to define better the effects of position of the sensing electrode on the ability of the pacer to detect the electrogram, a specially designed lead system with a movable, large surface area (50 mm2) proximal ring electrode and a small surface area distal tip electrode was placed transvenously in 12 mongrel dogs. As the sensing electrode was moved away from the right ventricular apex, there were slight but insignificant decreases in R wave amplitude. When the electrode was moved retrograde through the tricuspid valve into the atria there was a marked decrease in R wave sensing; however, this was accompanied by a significant increase in P wave amplitude. Therefore, with a large surface area electrode, direct contact with the myocardium is not needed for the detection of adequate P and R waves. In addition, a pacer lead system utilizing this sliding sensing electrode design could be used to optimize sensing position, either for atrial or ventricular sensing pacemakers.

Animals↗
PubMed1979

Productivity of respiratory therapy personnel.

An analysis was conducted of 630 periodic observations of work activities of 10 respiratory therapy personnel of a department during 14 consecutive days. It was found that the staff were spending about one-third of their working hours non-productively. The natures of the productive activities related to patient care were identified and each activity was categorized according to the level of difficulty and the skill required for performing it. The peak loads of the department were found to occur immediately before and after patients' meal hours and visiting hours. Nearly one-third of all the staff's productive time was spent administering IPPB. The personnel of various skill levels appeared to be performing different tasks regardless of their levels of difficulty.

Efficiency↗