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Results for “match monitoring”

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PubMed1994

Perinatal results of hemodynamic and conservative temporizing treatment in severe pre-eclampsia.

OBJECTIVE: To evaluate maternal and perinatal outcome of hemodynamic temporizing management in severe pre-eclampsia. DESIGN: Study group of 57 pre-eclamptic women, gestational age 35 weeks or less, treated with plasma volume expansion and vasodilatation under invasive hemodynamic monitoring, retrospectively matched with a control group treated in another center without volume expansion and invasive monitoring. RESULTS: In both groups pregnancy was prolonged with 10-11 days. Maternal morbidity was low in both groups. No complications of hemodynamic monitoring were observed. Perinatal mortality was not significantly different between the study group (7.1%) and the control group (14.3%). SGA-infants were significantly less frequent in the study group (9%) than in controls (33%). CONCLUSION: Temporizing treatment of patients with early severe pre-eclampsia, with or without plasma volume expansion and invasive hemodynamic monitoring, may reduce neonatal mortality and morbidity. The difference in birthweight between study group and control group may be an effect of the therapy or may be caused by selection bias. The perinatal outcome in the study group suggests that there may be a subgroup of patients who might benefit from hemodynamic treatment.

Cerebral Hemorrhage↗

PubMed2001

Weekly quizzes in extended-matching format as a means of monitoring students' progress in gross anatomy.

We compared weekly quizzes in extended-matching format with multiple-choice questions and oral examinations as means of monitoring students' progress in gross anatomy. Students' performance on 19 weekly oral examinations or 10-question quizzes based on extended-matching or multiple-choice formats were correlated with their success on 3 interim examinations and the final comprehensive examination. The Kuder-Richardson formula 20, an estimate of precision of the test, was 0.64 for extended-matching quizzes. Students' performance on interim examinations did not differ significantly. There was a significant correlation between students' mean scores on weekly quizzes and mean scores on interim examinations in both the extended-matching (r = 0.516) and multiple-choice group (r = 0.823). The mean grades (ranging from 2 to 5) on the final exam, based on understanding of anatomical concepts and their application in clinical practice, were significantly higher in extended-matching group (4.8) than in the multiple-choice (4.1) and orally examined groups (3.9) (p < 0.05). We conclude that extended-matching quizzes were at least as effective as multiple-choice quizzes and oral examinations and may be better for acquiring synthetic understanding of anatomical concepts especially in combination with other means of knowledge assessment. We recommend them as a reliable and objective means of monitoring students' performance during a gross anatomy course.

Anatomy↗

PubMed2005

Topiramate pharmacokinetics in children and adults with epilepsy: a case-matched comparison based on therapeutic drug monitoring data.

OBJECTIVE: To compare the steady-state pharmacokinetics of topiramate in a large population of children and adults with epilepsy in a therapeutic drug monitoring setting. STUDY DESIGN: Retrospective, case-matched pharmacokinetic evaluation. PATIENTS: Seventy children (aged 1-17 years) with epilepsy and 70 adult controls (aged 18-65 years) with epilepsy, matched for sex and comedication. METHODS: Topiramate apparent oral clearance (CL/F) values were calculated from steady-state serum concentrations in children and compared with those determined in controls. Comparisons were made by means of the Mann-Whitney's U-test, or the Kruskal-Wallis test in the case of multiple comparisons. A linear regression model was used to assess potential correlation of CL/F values with age. To investigate the influence of different variables on the variability in topiramate CL/F values, a multiple regression model was developed. RESULTS: In the absence of enzyme-inducing comedication, mean topiramate CL/F was 42% higher in children than in adults (40.3 +/- 21.0 vs 28.4 +/- 15.3 mL/h/kg; p < 0.01). In children and adults comedicated with enzyme-inducing antiepileptic drugs (AEDs), topiramate CL/F values were approximately 1.5- to 2-fold higher than those observed in the absence of enzyme inducers, and the elevation in topiramate CL/F in children compared with adults was also present in the subgroups receiving enzyme inducers (66%; 76.6 +/- 35.1 vs 46.1 +/- 16.7 mL/h/kg; p < 0.0001). In the paediatric population, a negative correlation between CL/F and age was demonstrated, both in the absence (p < 0.01) and in the presence (p < 0.001) of enzyme induction. The independent influence of age and enzyme-inducing AEDs on topiramate CL/F was confirmed by multiple regression analysis. CONCLUSION: Topiramate CL/F is highest in young children and decreases progressively with age until puberty, presumably due to age-dependent changes in the rate of drug metabolism. As a result of this, younger patients require higher dosages to achieve serum topiramate concentrations comparable with those found in older children and adults. Enzyme-inducing comedication decreases serum topiramate concentration by approximately one-half and one-third in children and adults, respectively.

Administration, Oral↗

PubMed2007

The influence of preferred coping style and cognitive strategy on laboratory-induced pain.

OBJECTIVE: To evaluate the effects of matching an individual's coping style (low, mixed, or high monitoring) to an appropriate cognitive strategy (distraction or sensation monitoring) to improve pain management. DESIGN: This study used a split-plot factorial design in a laboratory setting. MAIN OUTCOME MEASURES: Main outcomes were pain threshold, pain tolerance, pain intensity, pain affect, and anxiety. RESULTS: The results of the 2 x 3 x 3 (Experimental Condition x Coping Style x Trial) analysis of variance (ANOVA) interaction were significant for pain threshold scores, F(4, 178) = 2.95, p < .01. Low monitors in the matched distraction trial had higher pain threshold scores than during baseline, t(15) = -2.68, p = .017, and the mismatched sensation monitoring trial, t(15) = 2.80, p = .014. High monitors' pain threshold scores were higher than baseline only during the matched sensation monitoring trial, t(27) = -2.75, p = .010. The results of the 2 x 3 x 3 ANOVA interaction were not significant for pain tolerance scores; however, when the mixed monitors were excluded, the 3-way interaction was significant, F(2, 124) = 3.48, p < .05. The results were nonsignificant for pain intensity, pain affect, and anxiety. CONCLUSION: Results demonstrate that matching coping style to the appropriate cognitive strategy is important for improving pain threshold and pain tolerance; however, matching did not reduce pain intensity, pain affect, or anxiety. Future studies should explore the explanation for differential responses of high and low monitors and should test these hypotheses in a clinical setting.

Adaptation, Psychological↗

PubMed2004

Is the association of airborne particles with daily deaths confounded by gaseous air pollutants? An approach to control by matching.

Although particulate air pollution has been associated with increased numbers of daily deaths in dozens of cities around the world, issues still remain about the association. Some have questioned the complex modeling used to control for season in Poisson regression or the role of gaseous air pollutants as potential confounders of the association. I examined the association between deaths and particulate matter with an aerodynamic diameter less than or equal to 10 microm (PM10) using a case-crossover design. In this approach, the pollution on the day of each death is contrasted with the pollution level on control days when the subject did not die. Season and gaseous air pollutants were controlled by matching. Control days were chosen within the same month of the same year to control for season, and matched on either sulfur dioxide (SO2; within 1 ppb), nitrogen dioxide (within 1 ppb), maximum ozone (within 2 ppb), or carbon monoxide (within 0.03 ppm). The analysis was conducted in 14 U.S. cities that have daily PM10 monitoring. After matching, there were about 400,000 deaths in each analysis. Results were combined across cities using a maximum likelihood method. PM10 was a significant predictor of mortality when controlling for gaseous air pollutants, with effect sizes ranging from a 0.45% increase per 10 microg/m3 increment of PM10 [95% confidence interval (CI), 0.12-0.79%] when matched on maximum hourly ozone levels, to a 0.81% increase per 10 microg/m3 increment of PM10 (95% CI, 0.47-1.16%) when matched on 24-hr average SO2.

Air Pollution↗

PubMed1998

[Importance of hygienic monitoring in detection of etiological mechanisms of chronic lead poisoning in battery production plants].

The authors demonstrate importance of hygienic monitoring for describing the course of chronic lead intoxication among workers of storage battery production. The authors specify and describe the principles of hygienic monitoring program, grouped and individual parameters (hygienic, medical and biologic) that are risk factors for chronic lead intoxication and subjects of control. The article contains some examples demonstrating possibilities of hygienic monitoring for matching the occupational morbidity parameters of storage battery production workers with work conditions and other parameters influencing the disease.

Environmental Monitoring↗

PubMed1984

Diagnostic concepts in clinical organ transplantation: histocompatibility testing and T cell monitoring.

Immunological rejection is still the most important problem in clinical organ transplantation requiring the lifelong immuno-suppressive treatment of the allograft recipient. The clinical success rate however can be improved by a variety of diagnostic procedures: The reduction of the histocompatibility barrier between donor and recipient by HLA-typing and organ exchange in order to obtain the best possible match; posttransplant monitoring of donor specific immune responsiveness towards donor antigens; monitoring of T-cell subsets by monoclonal antibodies and cytofluometry. T-cell subset monitoring is a rapidly developing new technique with great potential. With the presently available first generation reagents already a detailed analysis of the major T-cell population in circulation is possible, which can markedly facilitate the diagnosis of rejection and viral infection. New monoclonal antibodies, defining certain activation stages of T-cells or permitting a more refined differentiation of functionally distinct subsets will lead to increased relevance of this diagnostic approach. A particularly interesting aspect of monoclonal antibodies against T-cell differentiation antigens is their potential therapeutic use as immunosuppressive drugs with a highly selective action on defined T-cell subsets.

Antibodies, Monoclonal↗

PubMed1978

Use of a new silylating agent for separation of bile acids and cholesterol by selected ion monitoring with the computer controlled intensity matching technique.

Dimethylethylsilyl ether derivatives of human biliary bile acid ethyl esters and cholesterol were separated completely by gas chromatography and selected ion monitoring by use of the mixed stationary liquid phase of OV-101 and Dexsil 300GC (1:1). These derivatives could be prepared easily and subjected directly to gas chromatography mass spectrometry. Dimethylethylsilyl ethers of bile acids ethyl esters were eluted in regular order according to the number of hydroxyl groups when used with the non-polar stationary liquid phases. Lithocholic acid, a minor component of human bile, was identified easily by selected ion monitoring with the computer controlled intensity matching technique.

Bile↗

PubMed2004

Physical and perceptual-cognitive demands of top-class refereeing in association football.

The aim of this study was to examine the physical and perceptual-cognitive demands imposed on UEFA top-class referees and assistant referees during the final round of the Euro 2000 Championship. To investigate the physical workload, the heart rates during matches were monitored by short-range radio telemetry and translated to different workloads expressed as a percentage of maximal heart rate. For measurement of the perceptual-cognitive workload, video-recordings of games were used to obtain the average number of observable decisions taken by a referee. On average, referees and assistant referees performed the matches at 85 +/- 5% and 77 +/- 7% of their maximal heart rate, respectively. Over the 31 games, the mean number of observable decisions was 137 (range 104-162), 64% of which were based on communication with the assistant referees and/or the fourth official. To optimize the physical preparation of top-class match officials, the results of this study support the application of intensive and intermittent training sessions, which should place priority on high-intensity aerobic stimuli. In addition, video training is discussed as an additional method for improving match officials' decision making.

Adult↗

PubMed1993

Children's sleep under the threat of attack by ballistic missiles.

The present paper reports on the influence of the Scud missile attacks during the Gulf War on the sleep of Israeli children. Two studies were performed. In the first, sleep habits and sleep disturbances of 61 (mean age 20 months) infants were assessed by questionnaires completed by their parents 5 months before the war and immediately after the end of the War. Comparison of pre- and post-war data revealed no major changes in sleep habits or in sleep quality. In the second study, sleep of 55 children was monitored at home by actigraphs during the last month of the War. All children were aroused during missile attacks, but returned to sleep immediately, with no evidence of carry-over effects once the 'all clear' sign was given. Comparison of sleep quality measures obtained during the War with those of age- and sex-matched children monitored a year before the war did not reveal any significant differences apart from the immediate response to the attack.

Journal Article↗

PubMed1982

Kidney transplantation in rhesus monkeys. Matching for D/DR antigens, pretransplant blood transfusions, and immunological monitoring before transplantation.

The effect of matching for D/DR antigens and of three pretransplant blood transfusions on kidney allograft survival was investigated in unrelated rhesus monkeys treated with standard immunosuppression. A control group consisting of host-donor combinations mismatched for one or two DR antigens (mixed lymphocyte culture (MLC) positive) and not receiving transfusions showed a MST of 13 +/- 1.2 days with a range from 9 to 22 days. The administration of pretransplant blood transfusions led to a MST of 28 +/- 5.4 days with 5 of 12 animals showing survival times of more than 22 days (i.e., a bimodal distribution of survival times). Recipients matched with their donors for two DR antigens and given transfusions showed an even better MST of 39 +/- 4.0 days. Under these conditions, MLC-negative combinations fared slightly better than MLC-positive ones: only 1 of 10 animals showed a survival time of less than 22 days and kidney function in the first weeks after transplantation was significantly better. When mixed lymphocyte reactions (MLC reactivity) between host and donor before and after the transfusions were compared, it was possible to predict to some extent the eventual fate of an allograft: increased mixed lymphocyte reaction predicted relatively short survival times, decreased mixed lymphocyte reaction relatively long ones (P less than 0.01).

Animals↗

PubMed1998

The history and achievements of the National Confidential Enquiry into Perioperative Deaths.

The National Confidential Enquiry into Perioperative Deaths started in 1989 as a direct development of a Confidential Enquiry in the United Kingdom in 1984. Different samples from the 20,000 deaths in hospital within 30 days of a surgical operation are selected each year. Questionnaires about these are examined by groups of anaesthetists and surgeons, and lessons about the quality of perioperative care are derived. Causation is not emphasized but examples of potential for improvement are sought. Changes of consultant practice, increase in medical audit, improvement in physiological monitoring, appropriate matching of specialist experience to patients' medical conditions and increased awareness of the need for critical care areas are believed to have been influenced by this unique enquiry.

Adolescent↗

PubMed2000

Morphology discriminator feature for enhanced ventricular tachycardia discrimination in implantable cardioverter defibrillators.

The morphology discriminator (MD) feature is an electrogram template matching algorithm that intends to improve tachycardia discrimination in implantable cardioverter defibrillators (ICDs). The aim of this study was to evaluate the performance of this feature during spontaneously occurring ventricular and supraventricular tachyarrhythmias and exercise induced sinus tachycardia. Twenty-three patients (20 men, 3 women; mean age 54.3 +/- 13.8 years) with pectorally implanted Ventritex Contour MD, Angstrom MD, and Profile MD ICDs were studied. The stability of the acquired morphology template and performance of the algorithm during spontaneous tachyarrhythmias were evaluated at follow-up. A treadmill exercise test was performed in 16 patients along with continuous telemetric monitoring of matching scores. A satisfactory template could be acquired at baseline in 22 (96%) patients. Variations in electrogram morphology necessitated new template acquisition in seven (30%) patients at first follow-up (6-8 weeks postimplant). During a mean follow-up of 9.1 +/- 3.7 months, 56 ventricular tachycardia (VT) and 15 supraventricular tachycardia episodes (sinus tachycardia in two-thirds) in 11 patients were all appropriately discriminated by the MD feature. Exercise testing showed appropriate discrimination of sinus tachycardia in 15 (94%) of 16 patients. A common observation was postshock changes in electrogram morphology that resulted in transient mismatch with the template. In conclusion, the recently introduced MD feature in ICDs has a high sensitivity for detection of VT and high specificity for rejection of sinus tachycardia. Postshock changes in electrogram morphology have been observed that may cause inappropriate redetection. Marked variations of electrogram morphology over time may be a concern in some patients, especially during lead maturation.

Adult↗

PubMed2004

Alerts in mobile healthcare applications: requirements and pilot study.

Recent advances in mobile technologies have greatly extended traditional communication technologies to mobile devices. At the same time, healthcare environments are by nature "mobile" where doctors and nurses do not have fixed workspaces. Irregular and exceptional events are generated in daily hospital routines, such as operations rescheduling, laboratory/examination results, and adverse drug events. These events may create requests that should be delivered to the appropriate person at the appropriate time. Those requests that are classified as urgent are referred to as alerts. Efficient routing and monitoring of alerts are keys to quality and cost-effective healthcare services. Presently, these are generally handled in an ad hoc manner. In this paper, we propose the use of a healthcare alert management system to handle these alert messages systematically. We develop a model for specifying alerts that are associated with medical tasks and a set of parameters for their routing. We design an alert monitor that matches medical staff and their mobile devices to receive alerts, based on the requirements of these alerts. We also propose a mechanism to handle and reroute, if necessary, an alert message when it has not been acknowledged within a specific deadline.

Computer Communication Networks↗

PubMed2005

Influence of environmental exposure to PAHs on the susceptibility of lymphocytes to DNA-damage induction and on their repair capacity.

The influence of occupational exposure to environmental carcinogenic polycyclic aromatic hydrocarbons (c-PAHs) on DNA damage detected in lymphocytes of exposed people (city policemen) was studied. The cellular susceptibility to the induction of the DNA damage and the repair capacity of exposed donors are presented in comparison with matched controls. Monitoring was performed and blood samples (164 donors) were collected in Prague, Czech Republic, during the winter and summer seasons. The single-cell gel electrophoresis (SCGE) assay with an internal standard was applied to evaluate the DNA damage. A challenging dose of 2Gy of X-rays was used to study cellular capacities. In the results of studies of the DNA damage induced in vivo or as an immediate response to the challenging treatment no significant difference was found between exposed and unexposed subgroups. The percentage of non-repaired X-ray-induced DNA damage (residual damage, RD) overall in both seasons was significantly higher in lymphocytes of policemen exposed to c-PAHs than in matched controls (RD(T-DNA), %DNA in the comet tail: winter 36.4+/-22.1 versus 22.7+/-10.8, p < 0.001; summer 47.7+/-22.9 versus 34.7+/-15.2, p < 0.001). The results suggest that occupational exposure to environmental c-PAHs significantly reduces the cellular capacity to repair the DNA damage induced by a challenging treatment. A significant decrease of repair efficiency in donors occupationally exposed to environmental c-PAHs was also observed when subgroups were stratified according to smoking history. In conclusion, our results suggest that environmental exposure to c-PAHs affects the cellular repair processes and can lead to harmful effects hazardous to human health.

Adult↗

PubMed1995

Effect of magnesium on fetal heart rate variability using computer analysis.

We studied 16 women, at 32 weeks' or more gestation who required magnesium sulfate (MgSO4) therapy for preterm labor or preeclampsia. A 60-minute Doppler fetal heart rate (FHR) tracing, analyzed by the Oxford Sonicaid System 8000, was obtained for 1 hour before and 2 hours after each patient received intravenous MgSO4 therapy. Maternal serum Mg2+ levels were obtained at the second monitoring session. Matched paired measures of FHR parameters were compared with the Student's t test. After MgSO4 administration, we noted significant falls in long-term variability, short-term variability, and total acceleration (more than 10 beats/min) counts. Reduced short-term and overall variability occurred in all cases with maternal serum Mg2+ levels more than 4.6 mg/dL. Therapeutic maternal serum Mg2+ levels are linked with decreases in long-term and short-term FHR variability and acceleration counts. These findings should be considered when evaluating resting FHR baseline of patients thus treated.

Adult↗

PubMed1999

A study of injected dose for brain mapping on the ECAT HR+: activation maps for a parametric verbal working memory task.

The success of the 15O-water PET technique to localize statistically significant changes in regional cerebral blood flow is dependent on factors such as the activity level injected and the magnitude of the flow change. Undetectable changes may occur if insufficient activity is injected leading to high levels of statistical noise or the task performed results in only small changes in blood flow. To explore the relationship between injected activity and statistical significance, we performed a series of studies with the ECAT EXACT HR+, a high resolution PET tomograph. A parametric verbal working memory task (the N-back task) was selected to examine the relationship between regional cerebral blood flow and working memory load across a range of injected doses of 15O-water. At each activity level the volunteers were required to perform four different levels of the N-back task, a task in which a letter displayed on a monitor is matched with the letter displayed N letters previously. With increasing N, this task places increased load on working memory. For this study, 5, 10, and 15 mCi of 15O-water were injected into nine normal volunteers. The complete sequence of four tasks (N = 0, 1, 2, and 3) at three activity levels was repeated twice, for a total of 24 injections of 15O-water. We show that the peak count rate performance for the HR+ is approached at injected activity levels of 15O-water around 15 mCi. For this particular choice of N-back task, robust activation maps can nevertheless be obtained with as little as 5 mCi injected dose.

Adult↗

PubMedDate not supplied

Mechanism of action of Roter (bismuth subnitrate) in patients with duodenal ulcer disease and healthy volunteers.

The effects of Roter (compound bismuth subnitrate) on antacid activity and mucosal prostaglandin E2 (PGE2) synthesis were variously investigated in patients with duodenal ulcer disease and healthy volunteers. Roter had a significant but small antacid activity with a buffering capacity of 10.9 mmol per tablet. In healthy volunteers, this was assessed by 24 h gastric pH monitoring on matched days with and without Roter treatment. The percentage of time that gastric pH was above 3 and the time after a standard meal that the pH was above 3, were both significantly increased by treatment with Roter (II tds post-cibal) (P less than 0.01). Endogenous PGE2 synthesis was measured in endoscopic duodenal biopsies taken both before and after Roter treatment in patients with acute untreated duodenal ulceration. There was a significant deficiency of mucosal PGE2 synthesis in untreated patients compared with controls (P less than 0.005). However, following 4 weeks' treatment with Roter, there was a 90% rate of healing accompanied by a significant increase in PGE2 synthesis (P less than 0.05) up to control levels. These findings suggest that Roter heals by the combined effects of a modest antacid neutralizing capacity and the ability to restore mucosal prostaglandins to normal levels, thereby mediating prostaglandin-dependent defence mechanisms.

Adult↗