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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.

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At least 91 records · Page 5Linked to original sources
PubMed2000

Microwave thermochemotherapy in the treatment of the bladder carcinoma--electromagnetic and dielectric studies--clinical protocol.

Microwave thermotherapy is currently used in clinical routines for benign prostatic hyperplasia treatments. The temperature increase is obtained using an endocavitary microwave applicator placed in the prostatic urethra. This urethral applicator after a technical modification can be placed inside the bladder in order to potentiate the effects of the treatment by chemotherapy of vesical carcinoma. This paper deals with electromagnetic studies of this new endocavitary applicator. First of all, the experimental determination of the dielectric permittivities for the propagation domain characterization is achieved in order to be used in the electromagnetic model. Compared to experimental results, these simulations obtained by the finite-difference time-domain formalism allow us to determine the electromagnetic performance of this applicator. Finally, the in vivo study realized on anesthetized dogs to determine the therapeutic protocol associating chemotherapy and thermotherapy in the treatment of the bladder cancer is presented.

Animals↗
PubMedDate not supplied

[The development of a clinical protocol for the study of peripheral facial paralysis. A computerized database version].

We present a protocol for the management and follow up of facial palsies, in which, the clinical, diagnosis and therapeutical informations are obtained in order to evaluate the clinical assessment and pathology of this cranial nerve. We also present a computerized database system in order to develop statistical analysis and further studies on this peripheral nerve lesion.

Clinical Protocols↗
PubMedDate not supplied

A computer-based flowcharting system for clinical protocols.

In medicine, scientific and technological developments for investigation and treatment are proceeding at an ever increasing rate. Protocols for patient management are becoming ever more complicated. Rational design and scientific evaluation of protocols requires precise documentation. We propose a notation based on a series of simple flowcharts which describe procedures in increasing detail. Each step in a flowchart is justified by a reasoned argument, possibly including reference to published articles. General correctness requirements of a protocol include, for example, conformity with known indications and contraindications for investigations and treatments. These correctness requirements can be specified declaratively in mathematical logic and justified by reasoned argument. This makes the correspondence between a protocol and its scientific foundation even more explicit. Flowcharts of this nature are more easily created and modified using a personal computer. Furthermore, use of the computer enables a protocol to be checked automatically against its specification for more rapid identification of errors during development and maintenance of the protocol. We present the structured design of our flowcharting system in the 'Z' specification language, and we examine the practicality of our approach by means of a case study; the management of infertility. Our flowcharting system may also have application outside medicine where it is necessary to describe formal protocols for complex procedures.

Algorithms↗
PubMed1997

Redesigning primary care processes to improve the offering of mammography. The use of clinic protocols by nonphysicians.

OBJECTIVE: To develop, within the framework of continuous quality improvement, new processes for offering mammography and determine whether protocols executed completely by nonphysicians would increase mammography utilization. DESIGN: A prospective follow-up study with patients from an intervention clinic and two control clinics. SETTING: Three general internal medicine clinics in a large, urban teaching hospital in Detroit, Michigan. PATIENTS/PARTICIPANTS: A total of 5,934 women, aged 40 through 75 years, making 16,546 visits to one of the clinics during the study period (September 1, 1992, through November 31, 1993). INTERVENTION: Medical assistants and licensed practical nurses in the intervention clinic were trained to identify women due for screening mammography, and to directly offer and order a mammogram if patients agreed. MEASUREMENTS AND MAIN RESULTS: Patients were considered up-to-date with screening if they had a mammogram within 1 year (if age 50-75) or 2 years (if age 40-49) prior to the visit or a mammogram within 60 days after the visit. The proportion of visits each month in which a woman was up-to-date with mammography was calculated using computerized billing records. Prior to the intervention, the proportion of visits in which women were up-to-date was 68% (95% confidence interval [CI] 63%, 73%) in the intervention clinic and 66% (95% CI 61%, 71%) in each of the control clinics. At the end of the evaluation, there was an absolute increase of 9% (95% CI 2%, 16%) in the intervention clinic, and a difference of 1% (95% CI -5%, 7%) in one of the control clinics and -2% (95% CI -3%, 5%) in the other. In the intervention clinic, the proportion of visits in which women were up-to-date with mammography increased over time and was consistent with a linear trend (p = .004). CONCLUSIONS: Redesigning clinic processes to make offering of mammography by medical assistants and licensed practical nurses a routine part of the clinic encounter can lead to mammography rates that are superior to those seen in physicians' usual practice, even when screening levels are already fairly high. Physicians need not be considered the sole, or even the primary, member of the health care team who can effectively deliver some preventive health measures.

Adult↗