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At least 469 records · Page 26Linked to original sources
PubMed2002

Effect of task context on reaching performance in children with spastic hemiparesis.

OBJECTIVE: To investigate the effect of task context on the quality of reaching movements in children with spastic hemiparesis. DESIGN: Randomized controlled experimental trial. SETTING: Institute for the Study of Education and Human Development (ISED). SUBJECTS: Twelve children (8-14 years of age) with spastic hemiplegic cerebral palsy. INTERVENTIONS: Subjects made fast reaching movements with the affected or nonaffected arm on a digitizer in three context conditions: (a) reach to press a light switch to turn on a red light (functional), (b) reach to press the light switch; no light (semi-functional), and (c) reach to a marker (nonfunctional). MAIN OUTCOME MEASURES: Kinematics of reaching movements of affected and nonaffected arms: movement time (MT), peak velocity (PV), time to PV, percentage of MT where peak velocity occurred (PPV), and smoothness (i.e. number of movement units (MU)). RESULTS: The functional condition elicited better quality of reaching for the nonaffected, but particularly the affected arm. Reaching of the affected arm was faster (larger MT; F = 10.21, p < 0.01), smoother (fewer MU; F = 19.95, p < 0.001), and better-controlled (right shift of PPV; F = 16.03, p < 0.001) compared with the semi- and nonfunctional condition. Reaching of the nonaffected arm was also faster (longer MT, F = 4.81, p < 0.05), and more smooth (fewer MU, F = 7.23, p < 0.05). CONCLUSIONS: These findings suggest that providing a functional context to perform a task may enhance the quality of reaching movements of the affected arm in children with spastic hemiparesis.

Adolescent↗
PubMed2002

The effect of a first vaginal delivery on the integrity of the pelvic floor musculature.

OBJECTIVE: To assess the specific effect of delivery of the first child on the integrity of the pelvic floor musculature. DESIGN: A prospective study of two groups of females with no symptoms of urinary incontinence. SETTING: Physiotherapy Department, Rotunda Lying In Hospital, Dublin. SUBJECTS: Two groups of healthy female physiotherapists (age range 20-28 years) were recruited for the study: group 1 consisted of nulliparous females (n = 10) and group 2 consisted of primiparous females who were 9-10 months post delivery (n = 10). INTERVENTION AND MAIN OUTCOME MEASURES: Assessment of the pelvic floor musculature was performed by digital assessment, electromyography and perineometry. RESULTS: For all data, the nulliparous group showed evidence of greater pelvic floor strength and endurance. Analysis of anterior and posterior electromyography data showed significantly stronger contractions in the nulliparous group (p = 0.0001 and 0.044). During a maximum contraction of the pelvic floor muscles, the anterior resting EMG activity increased by 9 +/- 6 microV (mean +/- SD) in the primiparous group compared with an increment of 22.3 +/- 4.74 microV in the nulliparous group. Posterior EMG resting activity increased by 19.7 +/- 7.65 microV (mean +/- SD) in the nulliparous group compared with 13.8 +/- 8.19 microV in the primiparous group. There were significant differences between the two groups for the four types of digital muscle assessment (p < 0.0013). In addition, there was a greater increase in perineometry readings in the nulliparous group (increment = 5.6 +/- 2.5, mean +/- SD) compared with the primiparous group (increment = 3.1 +/- 0.9; mean +/- SD). CONCLUSIONS: This study suggests that irrespective of lack of symptoms of urinary incontinence, it would appear advisable that all women should undertake a prescribed programme of pelvic floor rehabilitation exercises after childbirth.

Adult↗
PubMedDate not supplied

VHF digital ultrasound three-dimensional scanning in the diagnosis of myopic regression after corneal refractive surgery.

PURPOSE: To perform VHF digital ultrasound scanning and analysis of a case of high-myopic undercorrection in an eye that had undergone multiple surgical interventions for the correction of an initial refraction of -12.00 diopters (D). METHODS: A 49-year-old woman was evaluated after undergoing three surgical interventions for correction of an initial refraction of -12.00 D in the left eye. Automated lamellar keratoplasty (ALK) was followed by arcuate keratotomy (for induced astigmatism) and surface photorefractive keratectomy (PRK). The residual ametropia on presentation was -6.75 -3.50 x 95 degrees. VHF digital ultrasound scanning and analysis was performed. RESULTS: On ultrasound, the ALK interface was clearly visible. Residual stromal thickness beneath the cap was at least 275 microm. The absence of Bowman's layer indicated the region of PRK. New stroma and nascent stromal layers were differentiated within the flap. Neo stromal deposition and central epithelial hyperplasia were determined to be responsible for the myopic shift, as opposed to biomechanical changes. CONCLUSIONS: In this case, refraction, slit-lamp examination, and topography were unable to provide a diagnosis for regression following multiple corneal refractive procedures. By providing layered anatomical mapping, VHF digital ultrasound scanning was able to exclude a diagnosis of ectasia and provide anatomical diagnostic information to explain the clinical observations.

Astigmatism↗
PubMed2006

Metastatic prostate carcinoma presenting as supraclavicular lymphadenopathy - is it unusual?

Prostate carcinoma presenting initially as supraclavicular lymphadenopathy has been increasingly reported as an uncommon presentation of the disease. The diagnosis is often made on lymph node biopsy as these patients rarely undergo digital rectal examination or serum prostate-specific antigen level measurement as part of their initial investigations. A 74-year-old man presented with supraclavicular lymphadenopathy and subsequently deteriorated with severe shortness of breath associated with venous congestion of the head and neck. The diagnosis of metastatic prostate adenocarcinoma was made only after cervical lymph node biopsy. Following the diagnosis, he was confirmed as having an abnormal prostate on digital rectal examination and a raised serum prostate-specific antigen level. The authors propose that a digital rectal examination and a serum prostate specific antigen level be included in the initial investigation process of male patients with persistent supraclavicular lymphadenopathy. This would prevent delay in diagnosis, allow early intervention and decrease patient morbidity.

Adenocarcinoma↗
PubMed1999

In vitro models of intracranial arteriovenous fistulas for the evaluation of new endovascular treatment materials.

BACKGROUND AND PURPOSE: The purpose of this study was to create and test an in vitro model of intracranial arteriovenous fistulas (AVFs) that simulates the geometry of human vasculature and allows realistic testing of devices used in endovascular therapy. METHODS: The models were derived from corrosion casts of the main cervicocranial arteries and veins obtained from two nonfixed human specimens. Wax copies of the casts were produced and combined to create complex models simulating various types of intracranial AVFs. Wax assemblies were embedded with liquid silicone solidified into transparent blocks containing, after wax evacuation, hollow reproductions of the original vascular trees. The models were connected to a pulsatile pump and their compatibility with various imaging techniques and endovascular treatment materials was evaluated. RESULTS: The models were compatible with digital subtraction angiography, CT, MR imaging, and transcranial Doppler sonography. They provided a realistic endovascular environment for the simulation of interventional neuroradiologic procedures. CONCLUSION: Anatomically accurate and reproducible in vitro models of intracranial AVFs provide a valuable method for evaluating new endovascular treatment materials and for teaching purposes.

Aged↗
PubMed2002

Clinical benefits of rotational 3D angiography in endovascular treatment of ruptured cerebral aneurysm.

BACKGROUND AND PURPOSE: Recent neurointerventional and neurosurgical technologies require an understanding of lesions and adjacent structures in three dimensions. To clarify the clinical benefits of rotational 3D digital subtraction angiography (DSA), we retrospectively analyzed its advantages and disadvantages at the time of interventional procedures for ruptured cerebral aneurysms. METHODS: From January 1998 through September 2000, 85 patients with a ruptured cerebral aneurysm were treated with Guglielmi detachable coils in the acute phase. Data for the patients treated before availability of 3D DSA (group A, 52 patients) were compared with data for patients treated after availability of 3D DSA (group B, 33 patients). Variables analyzed were age, sex, location of aneurysm, size of aneurysm, number of implanted coils, number of DSA exposures, and total amount of contrast medium used. RESULTS: No statistically significant differences between the groups were noted when we compared the age, sex, aneurysm location, aneurysm size, and number of implanted coils. The number of DSA exposures was decreased in total by using 3D DSA (P <.0001), not only to determine the working projection (P <.0001) but also during the procedure (P <.0002). However, no statistically significant difference was noted in the comparison of total amount of contrast medium. CONCLUSION: Three-dimensional DSA allows acquisition of high-quality 3D images of cerebral arteries and also allows observation and analysis from multiple directions to determine the appropriate working projection for embolization. Three-dimensional DSA is essential for optimal diagnosis and embolization of cerebral aneurysms and can reduce the number of exposures.

Adolescent↗
PubMed1992

Potential of digital flashing tomosynthesis for angiocardiographic evaluation.

A system for digital flashing tomosynthesis (DFTS) consists of four electrocardiogram-gated and simultaneously flashed x-ray tubes, a 14" image intensifier, a unit for digital subtraction angiography (DSA), a personal computer-hosted transputer network for three-dimensional (3D) reconstruction as well as for quantitative coronary angiography and ventriculography, a display unit and an individual digital archive. DFTS-tomoangiograms may be presented in single slice mode or as multiple slices of arbitrary thickness, using rotating and stereographic presentation of 3D images. DFTS represents a configuration for standardized digital angiocardiography with digital archiving and assures optimal reproducibility and safety. This angiographic configuration is feasible for both ambulatory angiography to allow high volume cardiovascular angiographic screening and for the quantitative assessment of natural progression or potential regression of coronary artery disease resulting from interventional or pharmacological therapy.

Angiocardiography↗
PubMed2001

Risk factors for improper vaccine storage and handling in private provider offices.

CONTEXT: Preventing loss of vaccine potency during storage and handling is increasingly important as new, more expensive vaccines are introduced, in at least 1 case requiring a different approach to storage. Little information is available about the extent to which staff in private physicians' offices meet quality assurance needs for vaccines or have the necessary equipment. Although the National Immunization Program at the Centers for Disease Control and Prevention (CDC) in 1997 developed a draft manual to promote reliable vaccine storage and to supplement published information already available from the CDC and the American Academy of Pediatrics, the best ways to improve vaccine storage and handling have not been defined. OBJECTIVES: To estimate the statewide prevalence of offices with suboptimal storage and handling, to identify the risk factors for suboptimal situations in the offices of private physicians, and to evaluate whether the distribution of a new National Immunization Program draft manual improved storage and handling practices. DESIGN: Population-based survey, including site visits to a stratified, random sample of consenting private physicians' offices. At least 2 months before the site visits, nearly half (intervention group) of the offices were randomly selected to receive a draft CDC manual entitled, "Guideline for Vaccine Storage and Handling." The remainder was considered the control group. Trained graduate students conducted site visits, all being blinded to whether offices were in the intervention or control groups. Each site visit included measurements of refrigerator and freezer temperatures with digital thermometers (Digi-thermo, Model 15-077-8B, Control Company, Friendswood, TX; specified accuracy +/- 1 degrees C). Their metal-tipped probes were left in the center shelf of cold storage compartments for at least 20 minutes to allow them to stabilize. The type of refrigerator/freezer unit, temperature-monitoring equipment, and records were noted, as were the locations of vaccines in refrigerator and freezer, and the presence of expired vaccines. Other information collected included the following: staff training, use of written guidelines, receipt of vaccine deliveries, management of problems, number of patients, type of office, type of medical specialty, and the professional educational level of the individual designated as vaccine coordinator. PARTICIPANTS: Two hundred twenty-one private physicians' offices known by the Georgia Immunization Program in 1997 to immunize children routinely with government-provided vaccines. OUTCOME MEASURES: Estimates (prevalence, 95% confidence interval [CI]) of immunization sites found to have a suboptimally stored vaccine at a single point in time, defined as: vaccine past expiration date, at a temperature of </=1 degrees C or >/=9 degrees C in a refrigerator or >/=-14 degrees C (recommended for varicella vaccine) in freezer, and odds ratios (ORs) for risk factors associated with outcomes. We performed chi(2) analysis and Student's t tests to compare the administrative characteristics and quality assurance practices of offices with optimal vaccine storage with those with suboptimal storage, and to compare the proportion of offices with suboptimal storage practices in the groups that did and did not receive the CDC manual. RESULTS: Statewide estimates of offices with at least 1 type of suboptimal vaccine storage included: freezer temperatures measuring >/=-14 degrees C = 17% (95% CI: 10.98, 23.06); offices with refrigerator temperatures >/=9 degrees C = 4.5% (95% CI: 1.08, 7.86); offices with expired vaccines = 9% (95% CI: 4.51, 13.37); and offices with at least 1 documented storage problem, 44% (95% CI: 35.79, 51.23). Major risk factors associated with vaccine storage outside recommended temperature ranges were: lack of thermometer in freezer (OR: 7.15; 95% CI: 3.46, 14.60); use of freezer compartment in small cold storage units (OR: 5.46; 95% CI = 2.70, 10.99); lack of thermometer in refrigerator (OR: 3.07; 95% CI: 1.15,8.20); and failure to maintain temperature log of freezer (OR: 2.70; 95% CI: 1.40, 5.23). Offices that adhered to daily temperature monitoring for all vaccine cold storage compartments, compared with those that did not, were 2 to 3 times more likely to assign this task to staff with higher levels of training, have received a recent visit from the state immunization program, and be affiliated with a hospital or have Federally Qualified Health Center status. In addition, sites using >1 refrigerator/freezer for vaccine storage were more likely to have at least 1 cold storage compartment outside recommended temperature ranges. We found no significant differences in the data reported above between the intervention group (received copy of the draft manual) and the control group (did not receive copy of draft manual), even when controlling for the annual number of immunizations given or the type of office. (ABSTRACT TRUNCATED)

Child↗
PubMed1994

Predictors of survival after a positive post-irradiation prostate biopsy.

PURPOSE: Considerable debate persists in the urologic oncology literature with regard to the optimum management of patients with a positive post-irradiation prostate biopsy. This analysis characterizes a group of such patients who have had a favorable course without intervention. METHODS AND MATERIALS: Between 1956 and 1991, 116 patients have had a positive prostate biopsy 12 or more months post-irradiation without hormonal intervention or evidence of distant relapse. The population had an age range of 42 to 82 years (median - 61). American Joint Committee on Cancer stages included 1 T1, 70 T2, 44 T3, and 1 T4. Median actuarial survival for the entire population was 14.4 years (range = 2.2-21.5 years) from presentation and 5.2 years from re-biopsy. RESULTS: Fifty-one of the 116 patients developed metastases subsequent to re-biopsy and 65 remain free from distant relapse. Among these 65 patients, 50 remain alive and otherwise well, 11 have died of other causes, and only four have succumbed to their local disease. The best predictor of distant relapse subsequent to re-biopsy was digital rectal exam. Forty-one of the 51 patients later developing metastases had an abnormal digital rectal exam compared to 37 of 65 with sustained distant control (p = .01). CONCLUSION: These data demonstrate that long-term, disease-free (other than re-biopsy) survival is common following a "positive" post-irradiation biopsy without intervention especially among patients with a normal digital rectal exam. Therefore, routine re-biopsy without clinical indications is not a useful practice.

Adenocarcinoma↗
PubMed2002

Treating alcohol problems with self-help materials: a population study.

OBJECTIVE: An experimental trial was used to assess the effectiveness of a self-help book and a personalized assessment-feedback intervention, both separately and in combination with each other, in a general population survey. METHOD: Participants (N = 86; 66.3% male) were recruited through a random digit dialing telephone survey conducted by the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Respondents were randomly assigned to one of four conditions in a two-by-two factorial design: "no-intervention" control group, "personalized feedback only," "self-help book only" and "both personalized feedback and self-help book." Respondents were followed up in 6 months' time, and differences in drinking status were compared between experimental conditions using a multivariate analysis of covariance with baseline drinking severity as the covariate. RESULTS: Support was provided for an interaction hypothesis in which respondents who received both interventions reported significantly improved drinking outcomes at 6-month follow-up, compared with respondents who received just one of the interventions or who received no intervention. CONCLUSIONS: Because respondents were recruited from a representative sample of the general population into a randomized trial with a no-intervention control group, this research design maximized both external and internal validity in examining the effectiveness of self-help interventions.

Alcohol Drinking↗
PubMedDate not supplied

Increased radiation dose by automatic exposure control system during fluoroscopy and angiography of pelvis due to contrast material in the bladder: experimental study.

PURPOSE: To evaluate the increase of radiation dose caused by contrast material excreted in the bladder during vascular interventional procedures of the pelvis. MATERIALS AND METHODS: A latex balloon filled with diluted contrast material, simulating the bladder, was placed in a water phantom. Entrance dose rates were measured under various conditions with and without the balloon. In animal experiments, skin doses during fluoroscopy and angiographic image acquisitions were measured at the pelvis of a swine before and after the contrast was excreted in the bladder. RESULTS: In phantom experiments, fluoroscopic dose rates increased 1.3- to 3.9-fold when the contrast-filled balloon was placed at the periphery of the phantom. The dose rates increased 3.0- to 4.0-fold when the balloon was placed at the center. In the animal experiment, dose rates increased 1.4- to 2.0-fold when the bladder was filled with contrast material. Skin doses during 10-second angiographic image acquisition also increased 1.1- to 2.3-fold when the bladder was filled with contrast. CONCLUSION: When the bladder is filled with excreted contrast material, skin doses delivered by fluoroscopy and angiography will increase. Removal of urine is recommended during vascular interventional procedures of the pelvis.

Angiography↗
PubMedDate not supplied

Factors affecting penetration of retrograde coronary venous injections into normal and ischemic canine myocardium: assessment by contrast echocardiography and digital angiography.

Ths experimental study described myocardial echo contrast enhancement through coronary venous injections. Retrograde administration of renografin was performed in 15 closed-chest dogs. Two-dimensional echocardiography was used to study myocardial echo contrast enhancement before and after coronary artery occlusion. Digital subtraction venography was used to assess delivery, drainage and shunting of the retrograde injectate. Systolic/diastolic blood pressure in the great cardiac vein measured 7 +/- 3/1 +/- 0.6 mm Hg and increased to 29 +/- 11/5 +/- 3 after coronary sinus occlusion and to 55 +/- 2.3/15 +/- 12 mm Hg during coronary sinus contrast injection. Myocardial contrast echo appearance in a midpapillary left ventricular short axis cross-section was limited to the anteroseptal region, extending to 28.4 +/- 11.3% of the section circumference after great cardiac vein injections and 35.3 +/- 17% after coronary sinus injections (difference NS). After occlusion of the left anterior descending coronary artery, great cardiac vein contrast injections resulted in opacification of 36.6 +/- 9.7% of the section circumference (N.S. vs preocclusion control) and opacified most, but not all asynergic segments. After occlusion of the circumflex coronary artery, myocardial echo contrast uptake was restricted to the septum and the anterior wall. The ischemic and asynergic posterolateral myocardial segments were not opacified. Digital subtraction coronary venography revealed rapid drainage of retrogradely injected contrast to the right atrium, in spite of coronary sinus balloon occlusion via venovenous anastomoses. Retrograde coronary venous contrast injections may help define myocardial regions which are accessible with retrograde coronary venous interventions.

Angiography, Digital Subtraction↗
PubMed1999

Missed opportunities for prevention in general internal medicine.

BACKGROUND: According to the Canadian Society of Internal Medicine, the Canadian general internist is in the ideal position to promote patient health through disease prevention. To explore the general internist's contribution to disease prevention, the authors quantified the extent to which opportunities for prevention were addressed by the general internal medicine (GIM) service in an acute care teaching hospital in Calgary. METHODS: The authors interviewed 100 adult patients before discharge from the hospital's GIM service between May 14, 1997, and Dec. 2, 1997. The number of potential opportunities for preventive intervention were identified for each patient from 10 possible interventions recommended by the Canadian Task Force on the Periodic Health Examination (now the Canadian Task Force on Preventive Health Care): breast cancer screening, Papanicolaou smear for cervical cancer, counselling on menopausal hormone replacement therapy, digital rectal examination for prostate cancer, smoking cessation counselling, cholesterol measurement, therapy or monitoring for hypertension, influenza vaccination, pneumococcal vaccination and colorectal cancer screening. The authors determined which interventions the patient had undergone before the current admission to hospital and, using patient recall and postdischarge medical chart review, which opportunities for intervention were addressed by the GIM service during the current admission. An opportunity for preventive intervention was considered as addressed by the GIM service if it was performed during the current admission or if the general internist informed the patient or the patient's family physician of the need for such intervention in the near future. RESULTS: Among the 10 preventive interventions considered, a mean of 3.8 potential opportunities for prevention were identified for each patient. Of these, 46.5% had been addressed before the current admission, and 8.7% were addressed by the GIM service during the admission. Therefore, at the time of discharge, a mean of 55.2% of opportunities had been addressed. Among the opportunities not previously addressed, the GIM service most frequently addressed digital rectal examination for prostate cancer and cholesterol measurement. INTERPRETATION: General internists are discharging patients without sufficiently addressing opportunities for disease prevention. Preventive care protocols may be needed to limit the frequency of missed opportunities for prevention in patients admitted to tertiary care GIM services.

Acute Disease↗
PubMed2001

Three-dimensional cephalometry using individual skeletal laser technology models.

When planning operations on the facial skull, transversal asymmetries of the maxillo-mandibular complex cannot be adequately assessed using conventional two-dimensional (2D) x-ray cephalometry. On eight patients who presented with facial skull asymmetries, a three-dimensional (3D) laser technology model (LTM) using CT data was fabricated. Five sagittal plane points and six symmetry points were marked on the LTM, measured with the FlashPoint 3-D Digitizer and then geometrically converted, such that using the sagittal plane points, sella, basion, and nasion, a method could be developed that allowed the localization of each spatial point in the three symmetry planes. Thus one could quantitatively record a patient's specific facial skull asymmetry in all three planes and a 3D measurement became feasible. Based on the measurements, the asymmetry could be assessed with respect to the sagittal, vertical, and horizontal planes. With the 3-D LTM Digitizer measuring system, the surgeon now had precise numerical information regarding the symmetry ratios of the skull at his disposal, information that would have been difficult to evaluate solely using a model analysis. The results from this study show that our measuring system is applicable and useful for complex maxillofacial asymmetries. The planning of surgical interventions was optimized because precise numerical values regarding the degree of the asymmetry were available. With the 3-D LTM Digitizer measuring system, cephalometric analysis of complex asymmetries in the three spatial planes can be pragmatically supported.

Cephalometry↗
PubMed2004

Durability of cognitive remediation training in schizophrenia: performance on two memory tasks at 6-month and 12-month follow-up.

Patients with schizophrenia have consistently been found to exhibit cognitive deficits, particularly in memory, which have been suggested to mediate functional outcomes. Several recent reviews of cognitive retraining have concluded that these deficits respond to training, although the sustainability of cognitive improvement following completion of training has not been adequately evaluated. Most studies had small samples and very short follow-up periods. As part of a larger study, we examined performance on two memory tasks in two groups of participants: those who received computerized cognitive remediation training in addition to work therapy (n=45), vs. those who only received work therapy (n=49). Computerized cognitive remediation included hierarchical training on a computerized digit span task and a computerized words serial position task. Assessments using the same computerized tasks were made at three time points: baseline, end of active intervention, and 6-month follow-up. Compared to the active control condition (work therapy only), the group receiving computerized cognitive remediation in addition to work therapy showed significantly greater improvements on the trained digit span task following training. These improvements were maintained at the 6-month follow-up. There were no significant group differences on the word serial position task at any time point. Results indicate that computerized training can lead to sustained improvements on some, but not all, training tasks.

Adult↗
PubMed1988

[Digitalized angiography in coronary disease].

In cardiology, digital subtraction angiography after intravenous injection of contrast medium allows only the visualization of relative large structures as the ventricles and the great vessels. Subselective intra-arterial injections are attractive, but do not provide an appreciable reduction of the injected amount of contrast medium. A reduction is possible with selective injections, but good subtraction is only possible for non-moving arteries or for arteries with truly periodic movement (ECG gated subtraction). With the improvement of spatial and temporal resolution, digital angiography (without image subtraction) could replace conventional angiography, provided that the main problem of prohibitive costs associated to the stockage of image sequences with high spatial (1024 x 1024) and temporal (25 images/s) resolution is solved. At the present, however, the cinefilm 35 mm is still unbeaten in density of information, handling and costs. In interventional cardiology, the visualization of small coronary branches and of fine, fast moving guide-wires is improved by the digitalization of the images at the source, pulsed fluoroscopy, progressive scanning of the TV camera with temporary stockage of image sequences and the selective reinforcement of the image contrast in real time. Digital angiography is also more attractive than the cinefilm in view of a better exploitation of the information contained in angiographic sequences by sophisticated, computer assisted methods. For instance, parametric imaging for analysis of the contraction and relaxation of the left ventricle, or for the visualization of the progression of contrast medium to investigate the coronary circulation, condensing in one single image the information looked for, are fields where digital angiography has given new impulses to cardiologic research.

Coronary Angiography↗
PubMed2004

Attitudes, perceived norms, and intentions: a needs assessment study of the influenza immunization intentions of elderly citizens in Vermont.

CONTEXT: Influenza and pneumonia rank among the 5 leading causes of death among persons aged 65 and over. Although immunization has been demonstrated to prevent influenza or reduce its incidence and associated complications among the elderly, it has been largely underutilized. PURPOSE: This study examined the association of attitudes, perceived norms, and intention to obtain influenza immunization among community-dwelling rural elderly. The goal was to design an effective intervention program to increase the rate of flu immunization among the rural elderly. METHODS: In spring 2000, random-digit dialing selected 1,239 households in 2 rural Vermont counties. Telephone interviews were conducted with 799 persons aged 60 or older, resulting in a response rate of 65%. FINDINGS: Factor analyses revealed 2 dimensions underlying attitudes and perceived norms. Subsequent regression analyses confirmed that 1 attitude construct--perceived benefits--and both normative indices were significant predictors of immunization intention, explaining 45% of its variation. CONCLUSIONS: An intervention program targeting rural elderly should emphasize the benefits and perceived side effects of immunization. The program should publicize that most elderly believe that the advantages of influenza immunization outweigh the disadvantages. These findings will inform an intervention program designed to increase immunization coverage among rural seniors in Vermont.

Aged↗