SEARCH · PubMed Health

Results for “Exploration”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources

PubMed1985

Penetrating neck wounds. Mandatory versus selective exploration.

We reviewed the records of 257 patients (ages, 16-83 years) with penetrating neck wounds (119 gunshot and 138 stab) managed at Harlem Hospital Center. Among the first 148 patients, 134 were managed by mandatory neck exploration; 42 had injuries (31%), and 92 (69%) had no injury. There were four deaths (3%) and seven (5%) morbidities. Because of the high rate of unnecessary operations, the following 109 patients were managed selectively, 40 by exploration, and nine of the 40 (22%) had no injury; 69 were observed and did not require subsequent operative intervention. There were six deaths (5.5%) and six morbidities (5.5%) among the second group. Morbidity and mortality were unrelated to the method of management but related to the type and severity of injuries, associated injuries, preexisting illnesses, and age of the patients. The frequency of operations for penetrating neck wounds without structural injuries was minimized in the selective exploration group.

Adolescent↗

PubMed2001

Visual exploration of emotion eliciting images by patients with schizophrenia.

To examine the relationship between emotional activation and information gathering in schizophrenia, the eye movements and emotional responses of 20 patients with schizophrenia and 10 patients without history of psychosis were recorded while viewing 30 images varying in pleasantness. Emotionally activating pictures were more extensively explored than neutral pictures by both groups but especially by schizophrenia patients. Comparison patients explored pictures more extensively during the early part of image exposure, whereas patients with schizophrenia took longer to engage in informative exploration. The scan path lengths and the proportions of fixation time spent in regions of interest did not differ between groups, although persons with schizophrenia had longer fixations and looked at fewer regions of interest in neutral pictures. Emotion reports did not differ between groups. Schizophrenia patients' results are consistent with the hypothesized normalizing effects of emotional activation on the distribution of attention.

Adult↗

PubMed1977

Evaluation of peritoneal lavage and local exploration in lower chest and abdominal stab wounds.

One hundred twenty-three patients with lower chest and abdominal stab wounds were evaluated. If chest wounds were located between the two anterior axillary lines and abdominal examination was negative, peritoneal lavage was performed. If abdominal wounds were located between the two anterior axillary lines and physical examination was negative, local exploration was performed followed by lavage if local exploration was positive. Patients with negative lavage were observed and those with positive lavage were operated upon. Of the patients in this selected series 69.9% were spared an operative procedure. The incidence of negative laparotomy was 4.1%. It is concluded that the combination of local exploration and peritoneal lavage will increase diagnostic accuracy, eliminate unnecessary hospitalization, and reduce the number of negative laparotomies.

Abdominal Injuries↗

PubMed1984

Routine versus selective exploration of penetrating neck injuries: a randomized prospective study.

In an effort to settle the controversy regarding the optimal management of penetrating trauma to the neck, a randomized prospective study was conducted in which 160 patients with penetrating neck injuries admitted to Kings County Hospital between 1977 and 1982 were placed, by protocol, into two groups. Group A patients were explored routinely for all injuries to the neck violating the platysma muscle. Group B patients were managed selectively with operation based on clinical or radiographic evidence of major vascular, visceral, or airway injury. Data were collected retrospectively. Length of hospital stay, morbidity, and mortality were compared between groups A and B, as well as between patients explored or not, and no statistical difference was noted. Since there is no clear advantage to either routine or selective exploration in the management of penetrating neck wounds, we conclude that surgeons should base their treatment on their own experience, house staff and nursing support, and radiologic and operating room availability.

Adult↗

PubMed1996

Comparative study of functional recovery for surgically explored and conservatively managed spinal cord missile injuries.

OBJECTIVE: In a retrospective study, the extent of functional recovery and the merits of surgical exploration versus conservative management for spinal cord injuries were evaluated for 145 casualties from the front lines of the Iran-Iraq conflict. METHODS: Eighty-seven patients who underwent surgical exploration and 58 patients who were conservatively treated were monitored for 6 to 140 months (average, 57 +/- 31 mo) for any changes from their baseline neurological status, using the Frankel Scoring System. RESULTS: Twenty-two of 90 patients (24.4%) with complete injuries (Frankel score A) and 53 of 55 (96.4%) with incomplete injuries (Frankel scores B, C, and D) experienced changes in their neurological status as they recovered. Improvement was noted for 42 of 87 surgically treated patients (13 of 55 with complete injuries and 29 of 32 with incomplete injuries). Among conservatively treated patients, improvement was noted for 32 of 58 (55%), including 25.7% of those with complete injuries and 100% of those with incomplete injuries. Independent walking (Frankel scores D and E) was achieved by 10 of 90 patients with complete injuries and by 52 of 55 patients with incomplete injuries. Surgery did not affect the final outcome. Thirteen of 17 (76%) cerebrospinal fluid fistulas, 13 of 15 (87%) meningitides, and 4 of 6 (67%) local septic complications were encountered in the surgically treated group. CONCLUSION: Surgery did not enhance functional recovery from spinal cord missile injuries but did correlate with an increased prevalence of complications (fistulas, meningitis, and local sepsis). With or without surgical exploration, patients with seemingly complete cauda equina injuries demonstrated better functional outcome than did those with spinal cord injuries.

Adolescent↗

PubMed1997

Transantral endoscopic orbital floor exploration: a cadaver and clinical study.

A cadaver and clinical study was performed to determine the value of transantral endoscopy in diagnosis and treatment of orbital floor fractures. Six fresh cadaver heads were dissected using a 30 degree, 4-mm endoscope through a 1 cm2 antrotomy. In the cadaver, the orbital floor and the course of the infraorbital nerve were easily identified. The infraorbital nerve serves as a reference point for evaluation of fracture size; three zones of the floor are described that are oriented relative to the infraorbital nerve. In the clinical study, nine patients with orbital floor fracture initially underwent endoscopy at the time of fracture repair: three patients had comminuted zygomatico-orbital fractures, five had monofragmented tetrapod fractures, and one had an isolated orbital blowout fracture. Endoscopic dissection of the orbital fractures revealed seven fractures with an area > 2 cm2 and two fractures with an area of < 2 cm2. The isolated orbital floor blowout fracture had entrapped periorbital tissue, which was completely reduced endoscopically. A separate patient with a < 2 cm2 displaced fracture also had stable endoscopic reduction. In the remaining seven patients, the endoscopic technique assisted with the floor reconstruction by identifying the precise fracture configuration as well as identifying the stable posterior ledge of the orbital floor fracture. There have been no complications in any of our patients to date. We conclude: (1) Transantral orbital floor exploration allows precise determination of orbital floor fracture size, location, and the presence of entrapped periorbita. The information obtained through endoscopic techniques may be used to select patients who would not benefit from lid approaches to the orbital floor and may possibly eliminate nontherapeutic exploration. (2) Transantral endoscopic orbital floor exploration assists the reduction of complex orbital floor fractures and allows precise identification of the posterior shelf for implant placement. (3) Transantral endoscopic techniques can completely reduce entrapped periorbital tissue caught in a trapdoor type of fracture.

Endoscopy↗

PubMed1980

Indications for exploring the retroperitoneal space.

The retroperitoneal space is an area that deserves consideration in patients with serious bleeding problems. This area should be explored in all patients with a history of previous reconstructive vascular surgery of the abdominal aorta and iliac vessels and who subsequently present with gastrointestinal hemorrhage. It should also be considered for exploration in patients presenting with serious bleeding problems when the bleeding site cannot be identified and the area in which blood is accumulating cannot be detected. We present three cases in which early adequate exploration of the retroperitoneal space would have been beneficial to the patients.

Aged↗

PubMed2002

Lumbosacral stability of consolidated anteroposterior fusion after instrumentation removal determined by roentgen stereophotogrammetric analysis and direct surgical exploration.

STUDY DESIGN: The intervertebral stability of bony consolidated anteroposterior lumbosacral spondylodesis is evaluated by roentgen stereophotogrammetric analysis and direct surgical exploration before and after removal of the internal fixator. OBJECTIVES: To determine the remaining in vivo stability of spinal arthrodesis solely retained by a bony integrated carbon fiber cage. SUMMARY OF BACKGROUND DATA: Roentgen stereophotogrammetric analysis studies on posterolateral lumbar fusions demonstrate primary spinal stability after additional dorsal instrumentation, which is retained during bony fusion healing. Animal models show a persistent stabilizing effect of the fixator despite the presence of bony fusion. Although direct surgical inspection is the most reliable method to evaluate fused vertebrae, roentgen stereophotogrammetric analysis has also proven to be a highly accurate method to evaluate spinal stability. METHODS: In 10 patients lumbosacral fusion was performed using carbon interbody implants and an internal fixator. Ten months after initial surgery (range 7-15 months) the internal fixation was removed to reduce local soft tissue impingement as soon as bony fusion was achieved. Fusion site exploration in the course of instrumentation removal was performed by applying distraction, compression, and torque to the grafted area under fluoroscopic control. Any motion indicated a pseudarthrosis. Lumbosacral stability was evaluated by serial roentgen stereophotogrammetric analysis after fusion and after instrumentation removal. RESULTS: During instrumentation removal the mechanical stress test under fluoroscopic control did not indicate pseudarthrosis. After instrumentation removal, roentgen stereophotogrammetric analysis measurements revealed a nonsignificant increase in lumbosacral micromotions within the fused segment with 0.14, 0.31, and 0.44 mm in the transverse, vertical, and sagittal axes, respectively. CONCLUSIONS: The internal fixator could be removed without endangering the stability of the fusion. Direct surgical exploration confirmed the adequacy of roentgen stereophotogrammetric analysis as a reliable in vivo method to evaluate lumbosacral stability after anteroposterior fusion.

Adult↗

PubMedDate not supplied

Interactive point-based isosurface exploration and high-quality rendering.

We present an efficient point-based isosurface exploration system with high quality rendering. Our system incorporates two point-based isosurface extraction and visualization methods: edge splatting and the edge kernel method. In a volume, two neighboring voxels define an edge. The intersection points between the active edges and the isosurface are used for exact isosurface representation. The point generation is incorporated in the GPU-based hardware-accelerated rendering, thus avoiding any overhead when changing the isovalue in the exploration. We call this method edge splatting. In order to generate high quality isosurface rendering regardless of the volume resolution and the view, we introduce an edge kernel method. The edge kernel upsamples the isosurface by subdividing every active cell of the volume data. Enough sample points are generated to preserve the exact shape of the isosurface defined by the trilinear interpolation of the volume data. By employing these two methods, we can achieve interactive isosurface exploration with high quality rendering.

Algorithms↗

PubMedDate not supplied

MatrixExplorer: a dual-representation system to explore social networks.

MatrixExplorer is a network visualization system that uses two representations: node-link diagrams and matrices. Its design comes from a list of requirements formalized after several interviews and a participatory design session conducted with social science researchers. Although matrices are commonly used in social networks analysis, very few systems support the matrix-based representations to visualize and analyze networks. MatrixExplorer provides several novel features to support the exploration of social networks with a matrix-based representation, in addition to the standard interactive filtering and clustering functions. It provides tools to reorder (layout) matrices, to annotate and compare findings across different layouts and find consensus among several clusterings. MatrixExplorer also supports Node-link diagram views which are familiar to most users and remain a convenient way to publish or communicate exploration results. Matrix and node-link representations are kept synchronized at all stages of the exploration process.

Algorithms↗

PubMed1990

The importance of distinguishing familial hypocalciuric hypercalcaemia from asymptomatic primary hyperparathyroidism prior to neck exploration.

The increasing detection of asymptomatic hypercalcaemic patients by biochemical screening has led to an increase in the number of patients referred for neck exploration. Familial Hypocalciuric Hypercalcaemia (FHH) has emerged as an important condition to distinguish from primary hyperparathyroidism as a cause of hypercalcaemia. Patients with FHH are usually asymptomatic, have similar biochemical findings to primary hyperparathyroidism, but fail to respond to parathyroid surgery. We have studied 15 members of a large kindred with FHH. The initial diagnosis was made in the propositus after a failed neck exploration for presumed primary hyperparathyroidism. Of the 7 affected members, 2 had recurrent acute pancreatitis and 2 had incidental malignant disease with no evidence of bony involvement. Measurement of the calcium: creatinine clearance ratio provides a good method of identifying hypercalcaemic patients who might have FHH. A ratio of less than 0.013 is an indication to screen first-degree relatives before considering neck exploration.

Adolescent↗

PubMed2005

Trust and managerialism: exploring discourses of care.

AIM: This paper reports a study that explored the relationship between trust and managerialism through an analysis of professional discourse. BACKGROUND: Managerialism is a distinct set of discourses and practices related to managerial effectiveness, flexibility and consumer responsiveness that have come to characterize debates over the provision of health and welfare services across the developed world. At the same time, trust has attracted increasing academic and political interest. Managerial discourses are critical of healthcare professions and the way they operate. Professional opinions are challenged as representing the interests of professions rather than service users; as a consequence trust is contested. However, where practitioners are both professionals and managers, the boundaries between these discourses become blurred. Moreover, paradoxical development occurs where increasing autonomy for practitioners is accompanied by a strengthening of managerial controls over their activity. METHOD: Discourse analysis was used to explore the text from two genres, academic literature and interviews (n = 17), in the context of community residential services for people with learning disabilities. The study was conducted in 2001. FINDINGS: Two broad themes were identified, each with a number of sub-themes. The first focuses on the relationship between managerialism and trust located around the management of expectations. The second, 'the politics of care', explores the way professional and managerial discourse articulate to produce complementary and contradictory positions. CONCLUSION: The colonization of professional activity by managerial discourse has produced a context where professional activity is defined by a series of managerial imperatives; trust, which was once the product of intimate social activity is now shaped through techniques based on distrust such as audits and quality monitoring. Nevertheless, the persistence of tensions between trust and managerialism suggest an ongoing struggle for professional autonomy in the face of increasing managerial controls.

Attitude of Health Personnel↗

PubMed2005

Is the reducing effect of the Staff Observation Aggression Scale owing to a learning effect? An explorative study.

Is the reducing effect of the Staff Observation Aggression Scale owing to a learning effect? An explorative study Abstract This study explores the decline in the amount of reported aggression incidents when using the Staff Observation Aggression Scale (SOAS). Because this decline could hold significant implications for practice or research, the objective of this study was to explore the plausible explanations for this phenomenon. The influence of systematic feedback of the gained data was also studied. The SOAS was introduced on a closed ward in a psychiatric institution in the Netherlands as a measuring instrument to assess the amount of aggression incidents during a 16-week period. The standard procedure for reporting general incidents was continued. After 10 weeks of registration, systematic feedback of the gathered data took place. Statistic analysis was used to determine significant changes in the total amount as well as on the various forms of aggression. During this observation period, qualitative data were collected to support the analysis of the quantitative data. A significant decrease in the total amount of reported aggression incidents as well as in the categories of 'verbal aggression' and 'remaining aggression' was found. However, the category 'physical aggression' was stable during the entire observation period. The number of standard procedure reports did not decrease when compared with the pre-test period. Nursing staff did not recognize a reduction in the amount of aggression incidents. The role of a learning effect in the reduction of reports on aggression incidents is not excluded but there are indications that the reduction is also the result of 'reporting fatigue' and 'shifting attention'.

Aggression↗

PubMed1995

Narrative and exploration: toward a poetics of knowledge in nursing.

The dualism of subject and object has been a traditional model for nursing knowledge. That model is portrayed here as an epistemological exile. Our self-imposed exile from the lived world of nursing can be remedied by inquiry based on engagement rather than distance. One model for engaged inquiry is explorers' journeys in remote regions. Knowledge of a region can be local or colonial, according to the explorer's stake in the region as homeland or territory. Nursing is an existential region where people live. In the exploration of nursing as homeland, knowledge takes the form of local narrative, the story of a place told by its inhabitants. Narrative inquiry offers nursing an epistemology that is both ethically and aesthetically congruent with its practice of engagement.

Existentialism↗

PubMed1995

Nurses, nursing and representation: an exploration of the effect of viewing positions on the textual portrayal of nursing.

Textual portrayals of nursing can be 'read' from a number of possible viewing positions, which play a very real part in the way that our reality is constructed and understood. The image depends on which viewing position is chosen by or constructed for the viewer, and how the viewer interacts with that position. Thus without the viewer the image is incomplete. This paper is a beginning exploration of the nature of texts that portray nursing, and what Kaplan has termed the 'delicate negotiation' between the reader and the text in producing, in this case, understandings of nursing. Consequently the discussion focuses on how texts represent nursing, not in terms of what they portray, but how understandings of that portrayal are arrived at. This is to move exploration of portrayals of nursing from the descriptive to the discursive realm. In so doing the aim is to begin to explore and uncover the way in which we are positioned, and position ourselves, as readers of portrayals of nursing in text.

Attitude↗

PubMed2004

Feasibility of laparoscopic common bile duct exploration in a rural centre.

BACKGROUND: Laparoscopic common bile duct exploration has emerged as a preferred option for the management of choledocholithiasis. The present study sought to review the feasibility of this technique in a rural centre. METHODS: A comprehensive retrospective review was undertaken of all patients who underwent surgical treatment of biliary calculi in Lismore, NSW (Australia), between January 1996 and December 2002. RESULTS: During the study period, 1567 consecutive patients underwent laparoscopic cholecystectomy, of whom 82 (5.2%) had choledocholithiasis identified at intraoperative cholangiography. A total of 86 laparoscopic common bile duct explorations were undertaken in these patients, 37 (43%) via a transcystic approach, and 49 (57%) via a laparoscopic choledochotomy. All common bile duct calculi were successfully removed in 78 cases, representing an overall duct clearance rate of 90.7%. Complications were noted in seven patients, a morbidity rate of 8.5%. Median operative time for the procedure over the study period was 173 min. Median hospital stay was 6 days for all patients. CONCLUSIONS: Laparoscopic common bile duct exploration can be successfully undertaken in a rural setting by general surgeons who have appropriate laparoscopic experience, and should be the procedure of choice for the management of choledocholithiasis in these patients. It should not be restricted to specialized surgical departments in major referral centres.

Cholecystectomy, Laparoscopic↗

PubMedDate not supplied

Qualitative differences in the exploration of upright and upside-down faces in four-month-old infants: an eye-movement study.

Four-month-old infants were habituated with an upright or an upside-down face. Eye-movement recordings showed that the upright and upside-down faces were not explored the same way. Infants spent more time exploring internal features, mainly in the region of the nose and mouth, when the face was upright. They also alternated as frequently between the face's internal features (eyes vs. nose/mouth) as between external and internal features. When the face was upside down, the infants spent half of their time exploring external features, and preferentially alternated between external features and internal features. The main effect of inversion was a decrease of the looking time to the nose/mouth region and of the number of shifts between the eye region and the nose/mouth region.

Attention↗

PubMed2005

Exploring clinician uncertainty in the diagnosis and treatment of attention deficit hyperactivity disorder.

Based upon analyses of interview data collected from twenty-six clinician respondents, this study explores two facets of clinician uncertainty related to the diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in children. First, this study explores clinician reservations about the diagnostic validity of ADHD as it is described by the American Psychiatric Association (1994) in DSM IV. Second, this study explores clinician ambivalence regarding the physical and social-psychological side-effects of stimulant medications, such as Ritalin. In applying the sociological discussions that address uncertainty in clinical settings and through reviewing a sizable cross-section of the popular and research-oriented literature demonstrating the contentious nature of the ADHD phenomenon, this study illustrates that clinicians do not practice within a vacuum, but are instead largely affected by the marked scepticism that surrounds ADHD. In being affected by this scepticism, it is concluded that clinicians who assess and treat ADHD are autonomous in how they interpret the diagnostic and treatment protocols for this mental disorder.

Attention Deficit Disorder with Hyperactivity↗