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At least 775 records · Page 43Linked to original sources
PubMed1995

Lumbar discography. Position statement from the North American Spine Society Diagnostic and Therapeutic Committee.

STUDY DESIGN: A comprehensive review of the literature dealing with lumbar discography was conducted. OBJECTIVE: The purpose of the review was to generate a position statement addressing criticisms of lumbar discography, identify indications for its use, and describe a technique for its performance. SUMMARY OF BACKGROUND DATA: Lumbar discography remains a controversial diagnostic procedure. There are concerns about its safety and clinical value, although others support its use in specific applications. METHODS: Articles dealing with lumbar discography were reviewed and summarized in this report. RESULTS: Most of the recent literature supports the use of discography in select patients. Although not to be taken lightly, many of the serious and high complication rates were reported before 1970 and have decreased since because of improvement in injection technique, imaging, and contrast materials. CONCLUSIONS: Most of the current literature supports the use of discography in select situations. Particular applications include patients with persistent pain in whom disc abnormality is suspect, but noninvasive tests have not provided sufficient diagnostic information or the images need to be correlated with clinical symptoms. Another application is assessment of discs in patients in whom fusion is being considered. Discography's role in such cases is to determine if discs within the proposed fusion segment are symptomatic and if the adjacent discs are normal. Discography appears to be helpful in patients who have previously undergone surgery but continue to experience significant pain. In such cases, it can be used to differentiate between postoperative scar and recurrent disc herniation and to investigate the condition of a disc within, or adjacent to, a fused spinal segment to better delineate the source of symptoms. When minimally invasive discectomy is being considered, discography can be used to confirm a contained disc herniation, which is generally an indication for such surgical procedures. Lumbar discography should be performed by those well experienced with the procedure and in sterile conditions with a double needle technique and fluoroscopic imaging for proper needle placement. Information assessed and recorded should include the volume of contrast injected, pain response with particular emphasis on its location and similarity to clinical symptoms, and the pattern of dye distribution. Frequently, discography is followed by axial computed tomography scanning to obtain more information about the condition of the disc.

Humans↗
PubMed1996

The testimonial value of the statements of minors in a criminal trial.

There is no doubt that a child is capable of making statements just as any other person is, nevertheless, in addition to the need, which takes priority in some cases, of knowing how to correctly understand his way of expressing himself in order to avoid distorted interpretations, one cannot ignore the fact that his testimony may often imply delicate psychological problems for which the law must bear responsibility, on one hand to adequately protect the emotional integrity of the child and on the other to safeguard the defendant from accusations that could be the result of imagination or biased knowingly or unknowingly by third parties, particularly from within the family circle.

Adolescent↗
PubMed1996

Evolution of the American Nurses' Association Code for Nurses with interpretive statements: explications for perioperative nurses.

Although the need for ethical standards in the nursing profession has been recognized since as early as 1903, not until 1950 was a code of ethical principles adopted by American Nursing Association (ANA) members. The AORN Special Committee on Ethics was formed in 1991 to identify ethical issues in perioperative nursing and recommend educational strategies for addressing them. Formulation, publication, and distribution of the ANA Code for Nurses with Interpretive Statements--Explications for Perioperative Nurses resulted from the work of this committee.

American Nurses' Association↗
PubMed1996

Influencing health care policy: nursing research and the ANA social policy statement.

This paper describes policy formation and its relationship to nursing research, examining ways in which nursing's disciplinary research can have greater influence on American health care policy. The American Nurses Association's Social Policy Statement (1995) is discussed in its role as a guide for nursing research efforts in a health care reform environment where favorable patient outcomes are key.

American Nurses' Association↗
PubMed1997

General principles of self psychology: a position statement.

In the more than twenty-five years since Kohut formulated a psychology of the self, the basic theory has undergone many revisions and additions. In the course of broadening from a focus on narcissism and empathy into a general theory of normal and pathological development, self psychology has taken so many different directions that the question can be asked, Does self psychology remain essentially a single theory with different descriptors--a theory of a self-selfobject matrix, a theory of intersubjectivity, a theory of motivational systems, and so on? A concise statement of general principles is intended to contribute to a dialogue between advocates of the views presented here and those who hold different views of theory and practice, within and withoutself psychology.

Adolescent↗
PubMed1997

Cross-institutional reuse of a problem statement knowledge base.

This article describes client and server applications for a problem statement knowledge base derived from a large corpus of provider entered terminology. The current status and potential for integration of the server into the Vanderbilt University Medical Center computing environment are discussed. Finally, an experiment in multiple dimensions of reuse for problem list terms is introduced, and possible strategies to mediate between free text and coded data are examined.

Artificial Intelligence↗
PubMed1997

The development of outcome statements for burn care.

This article chronicles the development of an American Burn Association consensus document reflecting optimal goals for the delivery of burn care for use in clinical pathways and other quality improvement efforts. Outcome statements can measure progress toward meeting patient goals and can identify barriers in delivering optimal patient care.

Burns↗
PubMed1996

Smoking and health: a physician's responsibility. A statement of the Joint Committee on Smoking and Health. American College of Chest Physicians, American Thoracic Society, Asian Pacific Society of Respirology, Canadian Thoracic Society, European Respiratory Society, International Union against Tuberculosis and Lung Disease.

Tobacco use, particularly cigarette smoking, is widely recognized by the medical community and the general public as a major public health problem. Physicians and medical organizations share a public health duty to address this problem. Physicians and their professional organizations must contribute effectively to measures undertaken to deal with cigarette smoking. The issues involved are complex and affect medical practice in a number of ways. The following statement developed by six international organizations--the American College of Chest Physicians, the American Thoracic Society, the European Respiratory Society, the Asian Pacific Society of Respirology, the Canadian Thoracic Society, and the International Union Against Tuberculosis and Lung Disease--is intended to state the physician's responsibilities both to patients and to the community with regard to these general issues.

Adult↗
PubMed1997

Breast Cancer Screening For Women Ages 40-49--NIH Consensus Statement.

For 2 days, January 21 and 22, a panel of experts representing specialties in women's health, oncology, radiology, epidemiology, and public health listened to presentations by researchers and to public discussion and debate designed to reach a consensus on 5 questions: (1) Is there a reduction in breast cancer mortality due to screening women ages 40-49 with mammography, with or without physical examination? (2) What are the risks associated with screening women ages 40-49 with mammography and with physical examination? (3) Are there other benefits? If so, what and how do they change with age? (4) What is known about how the benefits and risks of breast cancer screening differ based on known risk factors for breast cancer? (5) What are the directions for future research? On January 23, the panel issued a consensus statement concluding that, while mammography has been shown to be clearly effective in reducing cancer mortality in women ages 50-69, there is no difference in breast cancer death within 7 years between 40- to 49-year-old women assigned to receive or not receive screening. For women in their 40s, the potential benefits of earlier diagnosis and breast-conserving therapy must be weighed against the potential risks of mammograms, including discomfort, inconvenience, radiation, and false reassurance given to women with false-negative screens. At the present time, the available data do not warrant a single recommendation for mammography for all women in their 40s. Each woman should decide for herself whether to undergo mammography.

Journal Article↗
PubMed1998

Estimating costs of programme services and products using information provided in standard financial statements.

The financial viability of programme services and product offerings requires that revenue exceeds expenses. Revenue includes payments for services and products as well as donor cash and in-kind contributions. Expenses reflect consumption of purchased or contributed time and materials and utilization (depreciation) of physical plant facilities and equipment. Standard financial reports contain this revenue and expense information, complemented when necessary by valuation and accounting of in-kind contributions. Since financial statements are prepared using consistent and accepted accounting practices, year-to-year and organization-to-organization comparisons can be made. The use of such financial information is illustrated in this article by determining the unit cost of cataract surgery in two hospitals in Nepal. The proportion of unit cost attributed to personnel, medical supplies, administrative materials, and depreciation varied significantly by institution. These variations are accounted for by examining differences in operational structure and capacity utilization.

Accounting↗
PubMed2005

Recommended standard of cerebrospinal fluid analysis in the diagnosis of multiple sclerosis: a consensus statement.

New criteria for the diagnosis of multiple sclerosis (MS) were published as the result of an internationally formed committee. To increase the specificity of diagnosis and to minimize the number of false diagnoses, the committee recommended the use of both clinical and paraclinical criteria, the latter involving information obtained from magnetic resonance imaging, evoked potentials, and cerebrospinal fluid (CSF) analysis. Although rigorous magnetic resonance imaging requirements were provided, the "new criteria paper" fell short in terms of guidelines as to how the CSF analysis should be performed and simply equated the IgG index with isoelectric focusing, without any justification. The spectrum of parameters analyzed and methods for CSF analysis differ worldwide and often yield variable results in terms of sensitivity, specificity, accuracy, and reliability, with no decided "optimal" CSF test for the diagnosis of MS. To address this question specifically, an international panel of experts in MS and CSF diagnostic techniques was convened and the result was this article, representing a consensus of all the participants. These recommendations for establishing a standard for the evaluation of CSF in patients suspected of having MS should greatly complement the new criteria in ensuring that a correct diagnosis of MS is being made.

Consensus Statements as Topic↗
PubMed2002

Consensus statements from the Second International Lung Cancer Molecular Biomarkers Workshop: a European strategy for developing lung cancer molecular diagnostics in high risk populations.

The Second Molecular Biomarkers Workshop was held at the Roy Castle International Centre for Lung Cancer Research in Liverpool, in June 2001 and it brought together experts in the clinical, epidemiological and molecular-pathology of lung cancer from Europe and the USA, to address issues surrounding the development of a European strategy for early lung cancer detection. The 2001 Workshop Breakout Groups concentrated on the current challenges in the early detection of lung cancer which need to be addressed in the light of the recent surge in interest in many countries for mounting new clinical trials to evaluate the utility of Spiral CT in early lung cancer detection. If population-based trials of CT screening are mounted it will also be a favorable clinical environment in which to evaluate efficiently recent advances in molecular screening and genotyping. The Workshop focused specifically on: a) clinical and molecular biomarkers, b) sputum as an early detection and diagnostic tool, c) validation of molecular markers prior to their use in early detection trials and d) ethical issues that have to be considered in early lung cancer detection trials. A distillation of the Workshop discussions is given in this article.

Biomarkers, Tumor↗