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At least 37 records · Page 2Linked to original sources

PubMed2001

Dental procedures in children with severe congenital heart disease: a theoretical analysis of prophylaxis and non-prophylaxis procedures.

OBJECTIVE: To estimate the cumulative exposure to bacteraemia from dental procedures currently recommended for antibiotic prophylaxis and compare this with cumulative exposure from dental procedures not recommended for prophylaxis. DESIGN: Retrospective analysis. SETTING: University and teaching hospital maxillofacial and dental department. PATIENTS: 136 children with severe congenital cardiac disease attending for dental treatment between 1993 and 1998 and for whom full records were available. Each dental procedure was tallied. MAIN OUTCOME MEASURES: Cumulative exposure per annum to "non-prophylaxis procedures"; cumulative exposure per annum to "prophylaxis procedures". RESULTS: Cumulative exposure to bacteraemia from prophylaxis procedures was not significantly greater than from non-prophylaxis procedures. CONCLUSIONS: The data raise important questions about the appropriateness of current guidelines for antibiotic prophylaxis of bacterial endocarditis.

Adolescent↗

PubMed1995

Purine enzyme activities in peripheral blood mononuclear cells: comparison of a new non-radiochemical high-performance liquid chromatography procedure and a radiochemical thin-layer chromatography procedure.

Purine enzyme activities are usually assayed by radiochemical procedures and often TLC is part of the separation method. In screening patients with rheumatic diseases, these procedures have shown disadvantages like a relatively large coefficient of variation (C.V.) and time-instability. We describe a non-radiochemical reversed-phase HPLC micro-method with UV detection for measurement of activities of purine 5'-nucleotidase (5'NT; EC 3.1.3.5), purine nucleoside phosphorylase (PNP; EC 2.4.2.1) and hypoxanthine guanine phosphoribosyltransferase (HGPRT; EC 2.4.2.8) in human peripheral blood mononuclear cells (PBMC). The HPLC procedure is compared with the radiochemical TLC procedure by testing both with a 5'NT and a PNP assay. Reproducibility is tested with 14 healthy controls in each procedure. Short-term and long-term time-stability is tested by comparing enzyme activities measured immediately after preparation of the PBMC (week 0) with those found after freezing and storage at -20 degrees C for a maximum of 10 weeks. The HPLC procedure is preferable to the radiochemical TLC procedure because it shows significantly better reproducibility and better time-stability and in addition is non-radiochemical and less time-consuming.

Adult↗

PubMed2002

Teaching procedural skills to medical students: one institution's experience with an emergency procedures course.

STUDY OBJECTIVE: We examine the effect of a preclinical emergency procedures course on students' clinical procedural skills and medical knowledge. METHODS: This is a retrospective review of evaluation forms for a cohort of 86 students graduating from medical school at an academic center. A cross section of students (n=57) taking a clinical emergency medicine rotation over a 4-year period was also studied. Numeric scores (1 to 9 on a Likert scale) in procedural skills and medical knowledge categories were extracted from evaluations for internal medicine, surgery, obstetrics and gynecology, and emergency medicine rotations. Scores of students who had taken an elective course, Essential Procedures in Emergency Medicine (EPEM), were compared with scores of students who did not take this course. US Medical Licensing Examination Step I scores for both groups were also compared. RESULTS: Students who took EPEM scored significantly higher in the procedural skills category during the emergency medicine rotation (P =.04) and during both months of the internal medicine rotation (P =.02; P =.02). Students scored on average higher in the surgery and obstetrics and gynecology rotations, but these differences were not statistically significant. Students who took EPEM scored significantly higher in the medical knowledge category for emergency medicine (P =.01; P =.002), both months of internal medicine (P =.03; P =.006), and 1 of 2 months of surgery (P =.01) rotations. Students in obstetrics and gynecology rotations scored higher, although not significantly. US Medical Licensing Examination Step I scores were not different between students taking or not taking EPEM. CONCLUSION: Students taking EPEM achieved higher procedural skill and medical knowledge scores in clinical rotations. Emergency medicine is a specialty well suited to study procedures teaching and performance.

California↗

PubMed2002

IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C. Part 3. Reference procedure for the measurement of catalytic concentration of lactate dehydrogenase.

This paper is the third in a series dealing with reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C and the certification of reference preparations. Other parts deal with: Part 1. The Concept of Reference Procedures for the Measurement of Catalytic Activity Concentrations of Enzymes; Part 2. Reference Procedure for the Measurement of Catalytic Concentration of Creatine Kinase; Part 4. Reference Procedure for the Measurement of Catalytic Concentration of Alanine Aminotransferase; Part 5. Reference Procedure for the Measurement of Catalytic Concentration of Aspartate Aminotransferase; Part 6. Reference Procedure for the Measurement of Catalytic Concentration of gamma-Glutamyltransferase; Part 7. Certification of Four Reference Materials tamyltransferase, Lactate Dehydrogenase, Alanine Aminotransferase and Creatine Kinase at 37 degrees C. A document describing the determination of preliminary upper reference limits is also in preparation. The procedure described here is deduced from the previously described 30 degrees C IFCC reference method (1). Differences are tabulated and commented on in Appendix 1.

Body Temperature↗

PubMed2002

IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C. International Federation of Clinical Chemistry and Laboratory Medicine. Part 4. Reference procedure for the measurement of catalytic concentration of alanine aminotransferase.

This paper is the fourth in a series dealing with reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C and the certification of reference preparations. Other parts deal with: Part 1. The Concept of Reference Procedures for the Measurement of Catalytic Activity Concentrations of Enzymes; Part 2. Reference Procedure for the Measurement of Catalytic Concentration of Creatine Kinase; Part 3. Reference Procedure for the Measurement of Catalytic Concentration of Lactate Dehydrogenase; Part 5. Reference Procedure for the Measurement of Catalytic Concentration of Aspartate Aminotransferase; Part 6. Reference Procedure for the Measurement of Catalytic Concentration of Gamma-Glutamyltransferase; Part 7. Certification of Four Reference Materials for the Determination of Enzymatic Activity of Gamma-Glutamyltransferase, Lactate Dehydrogenase, Alanine Aminotransferase and Creatine Kinase at 37 degrees C. A document describing the determination of preliminary upper reference limits is also in preparation. The procedure described here is deduced from the previously described 30 degrees C IFCC reference method. Differences are tabulated and commented on in Appendix 2.

Alanine Transaminase↗

PubMed2002

IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C. International Federation of Clinical Chemistry and Laboratory Medicine. Part 5. Reference procedure for the measurement of catalytic concentration of aspartate aminotransferase.

This paper is the fifth in a series dealing with reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C and the certification of reference preparations. Other parts deal with: Part 1. The Concept of Reference Procedures for the Measurement of Catalytic Activity Concentrations of Enzymes; Part 2. Reference Procedure for the Measurement of Catalytic Concentration of Creatine Kinase; Part 3. Reference Procedure for the Measurement of Catalytic Concentration of Lactate Dehydrogenase; Part 4. Reference Procedure for the Measurement of Catalytic Concentration of Alanine Aminotransferase; Part 6. Reference Procedure for the Measurement of Catalytic Concentration of Gamma-Glutamyltransferase; Part 7. Certification of Four Reference Materials for the Determination of Enzymatic Activity of Gamma-Glutamyltransferase, Lactate Dehydrogenase, Alanine Aminotransferase and Creatine Kinase at 37 degrees C. A document describing the determination of preliminary upper reference limits is also in preparation. The procedure described here is deduced from the previously described 30 degrees C IFCC reference method. Differences are tabulated and commented on in Appendix 3.

Aspartate Aminotransferases↗

PubMed2002

IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C. International Federation of Clinical Chemistry and Laboratory Medicine. Part 6. Reference procedure for the measurement of catalytic concentration of gamma-glutamyltransferase.

This paper is the sixth in a series dealing with reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 degrees C and the certification of reference preparations. Other parts deal with: Part 1. The Concept of Reference Procedures for the Measurement of Catalytic Activity Concentrations of Enzymes; Part 2. Reference Procedure for the Measurement of Catalytic Concentration of Creatine Kinase; Part 3. Reference Procedure for the Measurement of Catalytic Concentration of Lactate Dehydrogenase; Part 4. Reference Procedure for the Measurement of Catalytic Concentration of Alanine Aminotransferase; Part 5. Reference Procedure for the Measurement of Catalytic Concentration of Aspartate Aminotransferase; Part 7. Certification of Four Reference Materials for the Determination of Enzymatic Activity of Gamma-Glutamyltransferase, Lactate Dehydrogenase, Alanine Aminotransferase and Creatine Kinase at 37 degrees C A document describing the determination of preliminary upper reference limits is also in preparation. The procedure described here is deduced from the previously described 30 degrees C IFCC reference method. Differences are tabulated and commented on in Appendix 1.

Catalysis↗

PubMed2001

NAL-NL1 procedure for fitting nonlinear hearing aids: characteristics and comparisons with other procedures.

A new procedure for fitting nonlinear hearing aids (National Acoustic Laboratories' nonlinear fitting procedure, version 1 [NAL-NL1]) is described. The rationale is to maximize speech intelligibility while constraining loudness to be normal or less. Speech intelligibility is predicted by the Speech Intelligibility Index (SII), which has been modified to account for the reduction in performance associated with increasing degrees of hearing loss, especially at high frequencies. Prescriptions are compared for the NAL-NL1, desired sensation level [input/output], FIG6, and a threshold version of the Independent Hearing Aid Fitting Forum procedures. For an average speech input level, the NAL-NL1 prescriptions are very similar to those of the well-established NAL-Revised, Profound procedure. Compared with the other procedures, NAL-NL1 prescribes less low-frequency gain for flat and upward sloping audiograms. It prescribes less high-frequency gain for steeply sloping high-frequency hearing losses. NAL-NL1 tends to prescribe less compression than the other procedures. All procedures differ considerably from one another for some audiograms.

Acoustic Stimulation↗

PubMed2001

Interproximal papilla augmentation procedure: a novel surgical approach and clinical evaluation of 10 consecutive procedures.

Periodontal plastic surgery enables enhanced esthetics in the anterior maxillary region. Reconstruction of the interdental papilla is one of the most challenging and least predictable of treatments. Several surgical and nonsurgical procedures to rebuild lost papillae have been presented; however, good results have been elusive. The purpose of the present study was to evaluate a novel surgical procedure based on an advanced papillary flap combined with a gingival graft intended to augment the soft tissue in the interdental area. The study comprised 10 consecutive papilla augmentation procedures performed in nine patients. Previous to the surgical procedure and at least 3 months postoperative, papilla contour measurements were carried out based on a papilla index score (PIS). PIS ranged from 0 to 2 preoperative (mean 1.0) and between 1 and 3 postoperative (mean 2.2). In eight procedures, PIS increased. Differences between pre- and postoperative PIS ranged from 0 to 3 PIS units (mean 1.2). Among the 10 procedures, there was an increase of 1 PIS unit in five, an increase of 2 PIS units in two, 3 PIS units in one, and no increase in the remaining two. This procedure is relatively easy to perform and offers a reliable solution to an esthetic problem. However, larger clinical and histologic follow-up studies are necessary before its long-term predictability can be established.

Adult↗

PubMed1994

A prospective randomized trial comparing a modified needle suspension procedure with the vagina/obturator shelf procedure for genuine stress incontinence.

OBJECTIVE: To compare two procedures for the treatment of genuine stress incontinence in patients selected randomly. PATIENTS AND METHODS: Fifty patients with proven genuine stress incontinence were randomized prospectively over a 3 year period to be treated either by a modified needle suspension (MNS) (n = 26) or by a vagina/obturator shelf (VOS) (n = 24) procedure. RESULTS: In patients who had not undergone previous surgery for incontinence, the VOS procedure was superior with 12 of 14 patients achieving continence compared with eight of 15 patients in the MNS group (P < 0.05). In women who had undergone previous surgery seven of 11 were continent following MNS compared with five of 10 after a VOS procedure. Both techniques had a much lower continence rate when compared with a classical colposuspension operation which was reported in a previous series. CONCLUSION: As a primary procedure VOS was more successful than MNS. In patients who had undergone previous surgery for incontinence neither procedure gave acceptable results.

Female↗

PubMed1993

Comparison of demineralized allogeneic bone matrix grafting (the Urist procedure) and the Ilizarov procedure in large diaphyseal defects in sheep.

The bone inductive capability of the Urist and Ilizarov procedures was compared in the repair of large diaphyseal defects in sheep. In 30 animals, a 4 cm segmental defect was created in the middle portion of the right femur and was stabilized with an external fixator. The sheep were divided into four groups according to the type of reconstruction of the defect. In group 1, a demineralized allogeneic bone matrix (DABM) cylinder was used; in group 2, DABM chips; and in group 3, gradual transport of a piece of bone detached from the proximal femoral fragment was used to fill the defect. Group 4 served as a control (the defect was left empty). New bone formation was assessed by serial radiographs until the time of death at 2 or 4 months. Postmortem specimens were analyzed with respect to bone mineral content, uptake of isotopes (45Ca and 3H-proline), and histology. The first signs of new bone formation were radiographically evident at 4 weeks. In the two groups in which reconstruction involved DABM (Urist procedures), new bone failed to form in eight of the 13 animals. Full bridging of the defect was observed at 8 weeks in one animal with a DABM cylinder and two with DABM chips. No decisive difference in bone yield could be demonstrated between the two Urist procedures. In the group treated with the Ilizarov procedure, new bone formation consistently occurred at a high rate; full bridging of the defect was observed in seven of the eight animals. Bone mineral scanning and histologic analysis essentially confirmed the radiographic results. Uptake of isotopes was selectively analyzed in two sheep from each experimental group in which new bone formation was exhibited in the defect; new bone formation was increased compared with that in the contralateral femur but was equal among the three experimental groups. Our study shows that gradual transport of a detached piece of autogeneic bone (Ilizarov procedure) is more effective than implantation of DABM (Urist procedure) in eliciting new bone formation in large diaphyseal defects in sheep. The variable bone induction by DABM may be explained by differences in host immune responses to the implants.

Animals↗

PubMedDate not supplied

Comparison of sight word training procedures with validation of the most practical procedure in teaching reading for daily living.

The effectiveness and efficiency (training trials and training errors through criterion) of stimulus fading, stimulus shaping, time delay, and a feedback only procedure were compared in teaching three adults with moderate developmental delays sight words encountered in activities of daily living. In Experiment 1, the four procedures were assessed during training in a controlled environment to identify the most effective and efficient procedure for each participant. All three adults acquired the target words, and the four procedures were found to be of comparable efficiency in total training sessions, whereas individual differences were found in training errors to criterion. In Experiment 2, the feedback only procedure was used to teach the three participants sight words in community settings. Participants learned new words in the community settings and used the previously trained words in daily living activities. The benefit of conducting a preliminary evaluation of instructional procedures during controlled training is discussed.

Activities of Daily Living↗

PubMed1993

Current procedural terminology coding of nuclear medicine procedures.

The future of nuclear medicine is dependent on payment for new procedures. Today, the basis of payment by the federal government is a relative value unit (RVU) system; the RVUS employed in this system are for medical services and procedures listed and described in Physicians' Current Procedural Terminology, fourth edition. Current procedural terminology (CPT) is maintained by the AMA; annual revisions include adding new codes or revised or deleted old codes. This process involves all national medical specialty societies. Starting in 1992 a new process, the Relative Updating Committee, which was initiated by the AMA, organized medicine to formalize a method for recommending relative values for physician procedures and services. In this rapidly changing scenario, all nuclear medicine procedure codes are under review by the coding and nomenclature committees of the medical societies interested in imaging. Significant CPT changes and additions were made in the cardiovascular nuclear medicine codes in 1992, reflecting the current imaging protocols and pharmacological agents for performing cardiac stress testing and new codes that recognize combinations of ventricular function measurements in patients undergoing myocardial perfusion imaging with technetium-99m agents.

American Medical Association↗

PubMed1989

Effects of sensory and procedural information on coping with stressful medical procedures and pain: a meta-analysis.

A meta-analysis of studies on preparation for medical procedures and pain evaluated the relative effects of sensory; procedural, and combined sensory-procedural preoperational information on coping outcomes. Results indicated that, in contrast to sensory information, procedural information provided no significant benefits over control group instruction. Combined sensory-procedural preparation, however, yielded the strongest and most consistent benefits in terms of reducing negative affect, pain reports, and other-rated distress. The meta-analytic results are consistent with the dual process preparation hypothesis, which proposes that the information combination is optimal because procedural details provide a map of specific events while sensory information facilitates their interpretation as nonthreatening. It is concluded that a combined preparation is the preferred clinical option.

Adaptation, Psychological↗

PubMed2000

Procedures: do we really want to know them? An examination of the effects of procedural justice on self-esteem.

This study examined the effects of procedural justice on state-dependent self-esteem using the group-value model and attribution theory to present competing theoretical perspectives. The group-value model predicts a positive relationship between self-esteem and fair procedures. In contrast, attribution theory suggests procedural fairness interacts with outcome favorability to influence self-esteem. Thus, fair procedures will result in higher self-esteem ratings than unfair procedures when the outcome is positive but will result in lower self-esteem ratings than unfair procedures when the outcome is negative. The results of a laboratory and field study provide converging evidence to support the attribution theory predictions. The results of a 2nd laboratory study suggest that self-esteem is influenced by outcome expectancies, not actual outcomes.

Analysis of Variance↗

PubMed2001

Circular transanal stapled procedure for incomplete rectal prolapse associated with outlet obstruction versus conventional procedure.

The circular stapled procedure for mucosal prolapse of the rectum takes less time, is a less risky, less painful rectal procedure, and permits the preservation of more mucosa than conventional procedures. We compared retrospectively the early outcome of the circular transanal stapled procedure (n = 13), for incomplete rectal mucosal prolapse associated with outlet obstruction, with the current standard Milligan-Morgan procedure (n = 15). Under spinal anaesthesia, patients underwent a standardised diathermy perianal operation, or had a circumferential doughnut of mucosal prolapse at least 2 cm above the dentate line, using a circular end-to-end stapler (Ethicon Endosurgery SDH 33). All patients received the same preoperative analgesic and laxative regimens. The operating time for the stapled group was shorter (22-58 min, median 38) versus (42-79 min, median 68). The use of analgesics was significantly less, with 85% of the patients not using analgesics on and following the first postoperative day. The hospital stay was significantly shorter for the stapled group (3-5 days, median 3.2 versus 7-14 days, median 12.2). Constipation before procedure was improved in both groups. Early and late complications, and the functional outcome, measured by rectoanal manometry, appeared to be similar in short-term follow-up. However, the long-term results of recurrence, symptomatic and functional outcome, have yet to be evaluated in the extended follow-up.

Journal Article↗

PubMed1993

Comparative evaluation of the Rapid ID 32A kit system, miniaturized standard procedure and a rapid fermentation procedure for the identification of anaerobic bacteria.

The RAPID ID 32A and a rapid fermentation procedure were compared with a miniaturized standard procedure for the identification of 102 isolates of anaerobic bacteria belonging to 11 genera. The miniaturized standard procedure identified all 102 isolates at the genus level and 90 at the species level. The rapid fermentation procedure failed to identify 12 and 24 isolates at the genus and species levels respectively and is unsatisfactory. The RAPID ID 32A system misidentified 4 isolates (4%) at the genus level, 3 of which could have been avoided if the results of the Gram stain, the fundamental procedure in medical microbiology, had been taken into account. The system correctly identified 89 isolates at the species level. Since it does not produce species identifications within the genera Mobiluncus and Veillonella of which 7 and 2 isolates respectively were included in the study, the percentage of correct identifications at the species level is 96.7% (90/93). The RAPID ID 32A system is about 25 times more expensive than the miniaturized standard procedure if the investment for a gas chromatograph is not taken into account.

Bacteria, Anaerobic↗

PubMed1989

The superiority of the Goodwin procedure over the traditional procedure in measuring the loudness level of tinnitus.

The results of two procedures for measuring the loudness level of tinnitus will be presented. The traditional procedure yielded significantly smaller loudness matches, when expressed in decibel sensation level (i.e., dB SL), than did the Goodwin procedure. The Goodwin procedure is more sensitive to pharmacologically induced changes in tinnitus loudness than is the traditional procedure. The Goodwin method correlates well with changes in patient's subjective rating of tinnitus severity. The Goodwin match has a larger reliability coefficient. Nonlinear correlation also indicates that the Goodwin procedure is superior to the traditional method.

Aminooxyacetic Acid↗