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At least 91 records · Page 5Linked to original sources

PubMed1991

Postpartum tubal sterilization. A comparative study of the Hulka clip and modified Pomeroy technique.

To assess the feasibility of Hulka clip application for postpartum sterilization, 50 women were enrolled in a randomized, prospective study comparing modified Pomeroy tubal ligation and Hulka clip application. Hulka clip tubal occlusion in the postpartum period compared favorably with the commonly performed postpartum sterilization technique. Because of the simplicity of the technique and its greater potential reversibility, Hulka clip application may have advantages over standard postpartum sterilization techniques and should be considered for use in the postpartum period.

Adult↗

PubMed1992

Laser stapedotomy: a comparative study of prostheses and seals.

During the past 13 years, a number of prostheses of differing design and tissue seals have been used in laser stapedotomy for otosclerosis. This study compares the results of three different configurations of prostheses and tissue seals in a series of 53 patients. In 19, a platinum wire Teflon piston was placed in the laser stapedotomy fenestra and crimped on the long process of the incus; autologous venous blood was infiltrated into the oval window niche as a sealing mechanism. In 8 patients, a stainless steel bucket-handle-type prosthesis was used with a blood tissue seal. In 26 patients, a segment of autogenous vein was clad onto the bucket-handle-type prosthesis and placed into the laser fenestra. Two tissue seals (blood and vein) were also compared. The results were compared with regard to several audiometric parameters. It would appear that the bucket handle/vein configuration improves air-bone gap closure in the low- and mid-frequency speech range and also shows an advantage for air-bone gap closure to 10 dB or less compared to the other configurations in this study. Mean postoperative gaps were significantly less for vein compared to the blood tissue seal. Physiologic and surgical implications are discussed, and the vein-clad technique is illustrated.

Adolescent↗

PubMedDate not supplied

[A comparative study among different therapeutic approaches to portal hypertension and bleeding esophageal varices].

Recurrence of haemorrhage in patients with portal hypertension is the most feared life-threatening complication and the one which most often conditions patient survival. The present study compares the results obtained in two groups of patients treated by surgery and endoscopic sclerotherapy, respectively, and a control group treated with traditional medical therapy during bleeding episodes and subsequently given no further treatment. The patients in each group were subdivided into three different risk classes on the basis of the Child classification. Patients treated surgically mainly belonged to Child classes A and B, whereas those treated by endoscopic sclerotherapy belonged to Child class C. The long-term survival results show no significant differences between the two groups. On the other hand, both groups show better survival data than the untreated patients. On the basis of the results obtained, the authors believe that surgical treatment appears to most indicated in patients belonging to the lower risk classes (Child A and B), whereas endoscopic sclerotherapy is better suited to patients belonging to the higher risk class (Child C).

Aged↗

PubMed1990

Alkaline phosphatase and dipeptidylpeptidase IV staining of tissue components of skeletal muscle: a comparative study.

A combined alkaline phosphatase (AP) and dipeptidlypeptidase IV (DPP IV) staining reaction has demonstrated enzymatic heterogeneity of the arterial and venous segments of capillaries in rat skeletal muscle. This study compared the staining reactions of skeletal muscles in many commonly used laboratory animals, including the axolotl, chick, quail, Monodelphys, rat, mouse, hamster, guinea pig, rabbit, dog, monkey, and human. DPP IV activity was found in the venous ends of the capillaries and in the endothelium of some larger veins in many of the species but was never demonstrated in the arterial side of the circulation. AP was found in the arterial ends of capillaries in all species except the axolotl, and it was also found in the endothelium of larger arteries of most species. AP activity was absent in venous endothelium of all species except for birds and Monodelphys. DPP IV activity was found in the perineurium of intramuscular nerves of most species, and AP activity was commonly seen in tendons and intramuscular connective tissue. The interspecies variability found in this study shows that care must be taken in comparing experimental data involving this technique from one species to another, but within a species the technique allows a fine level of discrimination between functionally distinct compounds of skeletal muscle tissue.

Alkaline Phosphatase↗

PubMed1991

Prospective comparative study in NIDDM patients of metformin and glibenclamide with special reference to lipid profiles.

Twenty-two NIDDM patients completed an open randomized cross-over study comparing metformin and glibenclamide over 1 year. The drugs had an equivalent effect on glycaemic control, but, in contrast to glibenclamide, metformin reduced body weight. Neither drug affected triglycerides, total- and LDL-cholesterol or C-peptide. Metformin caused a slight elevation of HDL-cholesterol (P less than 0.05). No serious adverse effects were observed. The results show that oral hypoglycaemic agents are not associated with undesirable effects on lipids and lipoproteins.

Administration, Oral↗

PubMed1992

Postoperative radiotherapy in head and neck carcinoma with extracapsular lymph node extension and/or positive resection margins: a comparative study.

In head and neck carcinoma, the finding of extracapsular lymph node extension and/or positive resection margins portends poor locoregional control and survival. The effectiveness of postoperative radiotherapy in these patients has been controversial due to insufficient studies comparing resected patients with those also receiving radiation. Between 1982 and 1988, 441 radical head and neck resections were performed at the Medical College of Virginia. Pathologic review of these cases identified 125 with extracapsular lymph node extension and/or positive resection margins. Of these, 43 had extracapsular lymph node extension only, 24 had both positive resection margins and extracapsular lymph node extension, and 58 demonstrated positive resection margins only. Surgery alone was performed in 71 of these patients while 54 cases received surgery and postoperative radiotherapy, (combined modality treatment) CMT. Radiotherapy doses ranged from 50 to 70 Gy. The surgery alone and combined modality treatment groups were comparable with respect to the distribution of positive resection margins and extracapsular lymph node extension. Slightly more CMT patients had clinical T4 disease compared with the surgery alone group (22% vs 14%). Slightly fewer combined modality treatment patients had clinical N0 necks than the surgery alone group (20% vs 29%). Multivariate analysis was performed with the variables T, N stages, radiotherapy, margin status, primary tumor sites, microscopic and macroscopic extracapsular lymph node extension, number of positive lymph nodes, number of nodes with extracapsular lymph node extension. Locoregional control was maintained at 5 years in 59% of the combined modality treatment group and 31% of the surgery alone group (p.0001). Subgroup analysis likewise reveals significant differences favoring the combined modality treatment group for positive resection margins only (49% vs 41%; p = .04), extracapsular lymph node extension only (66% vs 31%; p = .03) and extracapsular lymph node extension+positive resection margins (68% vs 0%; p = .001). Adjusted survival also shows a significant benefit of combined modality treatment vs surgery alone for the entire group (72% vs 41%; p = .001). Multivariate analysis revealed that the use of radiotherapy is a strongly favorable variable for local control and adjusted survival. Macroscopic extracapsular lymph node penetration and positive resection margins are unfavorable independent variables for local control. T-stage is the only variable predicting local control in the combined modality group. Extracapsular extension remains an important negative prognostic variable for survival in both treatment groups. In conclusion, this study demonstrates a locoregional control and survival benefit for postoperative radiotherapy in patients with the high risk pathologic findings of extracapsular lymph node extension and positive resection margins.

Carcinoma, Squamous Cell↗

PubMed1990

Comparative studies of pharmacotherapy for school refusal.

Two studies compared alprazolam and imipramine in the treatment of school refusal. In an open label study (N = 17), two-thirds of the subjects completing a trial in both the alprazolam and imipramine groups showed moderate to marked global improvement in symptoms of anxiety and depression. In the double-blind, placebo-controlled study (N = 24), posttreatment scores calculated as change from baseline on the Anxiety Rating for Children were significantly different (p = .03) among the three treatment groups, with the active medication groups showing the most improvement. Additionally, on all depression rating scales, similar trends were evident with the alprazolam and imipramine groups demonstrating greater improvement than the placebo group. However, analyses of covariance (with pretreatment scores as the covariates) showed no significant differences among the three treatment groups on change in anxiety and depression scales. Thus, additional research is needed to determine whether trends in this study are explained by drug effect or baseline differences on rating scales.

Adjustment Disorders↗

PubMed1991

A comparative study between Michel and Proximate clips for the closure of neck incisions.

A prospective study comparing two types of surgical clip, the Proximate II (Ethicon) staple and the Michel clip, was performed on 30 thyroidectomy (horizontal) and 50 carotid endarterectomy (vertical) incisions with reference to their ease of handling, patient comfort, complication rate, cosmetic result and cost. In each patient half of the wound was approximated with one type of clip and half with the other. The Proximate II staple was more comfortable for the patient in the vertical wounds (P less than 0.02), easier to remove as judged by the nurse in both horizontal (P less than 0.001) and vertical (P less than 0.02) wounds, and by the patient in the horizontal wounds (P less than 0.02) only. The incidence of inflammation was significantly higher with the Michel clip (P less than 0.001). In both the horizontal (P less than 0.05) and the vertical (P less than 0.001) wounds, when the scar was assessed at the time of discharge from hospital, the Proximate II staple achieved a significantly better result. However, assessment of the wounds by patient and researcher 6 weeks postoperatively, revealed no significant difference between the wounds with regard to cosmetic outcome. The Proximate II design, however, costs between seven and ten times more than the Michel clip depending on the size of the dispenser used, and since the late cosmetic result offers no advantage over the latter design, we feel these financial variables deserve consideration.

Adult↗

PubMed1990

Prospective comparative study of cefotetan with piperacillin for prophylaxis against infection in elective colorectal surgery.

This study compared one dose of cefotetan with three doses of piperacillin as prophylaxis against wound infection in 153 patients undergoing elective colorectal surgery. The patients were randomized into two groups: the first received 2 g cefotetan intravenously with induction of anaesthesia (n = 75), and the second received three doses of 2 g piperacillin (n = 78). Wound infection was defined as the presence of an abscess or discharging pus from the wound. In the cefotetan group there were 14 (19%) wound infections and 13 (17%) in the piperacillin group. There were three septic deaths, one in the cefotetan group and two in the piperacillin group. Both groups were comparable with regard to age, sex, nature of pathology and pre- and perioperative risk factors. No significant haematological or biochemical abnormalities were detected. The only adverse reaction was one patient who had an allergic reaction (rash) to piperacillin. These data suggest that single-dose cefotetan is as effective as triple-dose piperacillin in prophylaxis against infection in elective colorectal surgery.

Cefotetan↗

PubMed1992

Information flow in the hospital: a comparative study of the Hungarian and the Dutch situation using a two axes model of hospital information flow.

This study compares the organization and structure of information flow in a Dutch and in a Hungarian hospital. The study was carried out as a field orientation part of a Health Care Management project of the Hogeschool van Amsterdam. The host of the field orientation was the BAZIS Foundation, the Central Development and Support Group Hospital Information System, Leiden. The visited hospitals were equipped with the BAZIS Hospital Information System. The method of study consisted of series of formalized interviews with all-level actors of a hospital; the interpretation of data was enhanced by a two axes (patient and management) model of information flow defined by the authors. In summary, Dutch hospitals show a more elaborate information flow system, with more information flow channels sideways among equal levels, less bureaucracy in organization of information flow, and significantly more benefits of automation, compared to the Hungarian situation.

Computer Systems↗

PubMed1990

[Comparative studies on several indices of nuclear damage in human peripheral lymphocytes].

In order to use appropriately NAT and explore possibility of use of the test in human cells, the authors used gamma-rays as mutagenic and carcinogenic irradiated whole blood in vitro, prepared directly smears of isolated lymphocytes, and studied comparatively dose-response relationship of 4 types of nuclear damage. Main results of the study are given as follows: 1. In doses from 0 to 3 Grays MNF (Frequency of micronucleus), INF (Frequency of irregular nucleus), KNF (Frequency of karyorrhetic nucleus), and PNF (Frequency of pyknotic nucleus) increase along with increase of irradiated doses. At 5 grays INF still increases, but MNF, KNF and PNF decrease. 2. In doses from 0 to 3 grays regression equation of 4 indices of nuclear damage are as follows (D means dose, r means correlative coefficient): MNF: y = 0.3433 + 0.1052D, r = 0.9128, p less than 0.05; INF: y = 7.2178 + 2.1817D, r = 0.8846, p less than 0.05; KNF: y = 0.6462 + 0.2014D, r = 0.7286, p greater than 0.05; PNF: y = 0.2774 + 0.0728D, r = 0.5484, p greater than 0.05. 3. In doses from 0 to 3 grays MNF is linear with INF and KNF. Regression equation are as follows (x means MNF): MNF-INF: y = 2.0598 + 16.6545x, r = 0.778 p greater than 0.05; MNF-KNF: y = 0.2235 + 1.426x, r = 0.5945, p greater than 0.05. Finally according to synthetic analysis of correlative coefficient, intercept, regression coefficient and feasibility of indices of nuclear damage, we could consider it suitable that nuclear anomalies in human peripheral lymphocytes include micronucleus, irregular nucleus and karyorrhexis.

Adolescent↗

PubMed1991

Intraoperative surgical specimen evaluation: frozen section analysis, cytologic examination, or both? A comparative study of 206 cases.

Having recently become aware of the merits of cytologic preparations, histopathologists are focusing their attention on cytologic examination as a means of intraoperatively evaluating surgical specimens. This study compares the diagnostic accuracy and quality of frozen-section (FS) and cytologic preparations from 206 surgical specimens. The quality of cytologic preparations was significantly superior to that of FSs (P = 0.0001). With the use of a three-level accuracy scale suited to the practical demands of intraoperative evaluation, there was no significant difference between the accuracy of diagnosis by FS analysis compared with that achieved by cytologic examination (P = 0.35). More importantly--except in one case--whenever one technique did not correctly distinguish benign from malignant disease, the other technique yielded an essentially correct diagnosis. With the use of both techniques, 99.5% of cases were interpreted correctly, at least in regard to benign versus malignant diagnoses. Because significant additional time, equipment, stains, laboratory space, or personnel are not needed to implement intraoperative cytologic studies in a routine anatomic pathology laboratory, the authors advocate the simultaneous use of FS and cytologic studies in the specified context.

Diagnostic Errors↗

PubMedDate not supplied

[Current role of the Zeiss extractor catheter. Comparative study with other methods. Presentation of 80 personal cases and a comprehensive review].

The present study compared the Zeiss and Dormia type extractors for ureteral calculi with the new methods of treatment (shock waves and laser) to determine the place of these extractors in our urological armamentarium today. The results and the complications in our series comprised of 80 cases are presented and the literature available on this subject reviewed. We discuss briefly the methods commonly used today, i. e., shock waves and laser, with special reference to the good results and scant complications. We can conclude from this study that these catheters continue to be useful in current urological practice.

Adolescent↗

PubMed1976

Pass/fail versus A-F grading: a comparative study.

This study compared achievement when one half of a class was assigned to take a course on a pass/fail basis and the other half received a letter grade. The unique characteristics were as follows: (1) students were assigned to A-F and pass/fail groups rather than allowed to choose the grading system, (2) virtually no other course competed for study time, and (3) the course constituted a major field of study for the student. The results showed no significant difference between the two groups in achievement on three separate examinations.

Education, Dental↗

PubMed1992

A comparative study of controlled-release morphine (CRM) suspension and CRM tablets in chronic cancer pain.

This study compared the efficacy and the adverse effects of controlled-release morphine (CRM) suspension (SAR 213) and CRM tablets (Moscontin) in the treatment of cancer pain. This multicenter, randomized, double-blind, double-dummy, crossover study was carried out on 52 patients. Each patient received both study treatments given at an equivalent dosage of morphine during each of two 7-day periods. The primary outcome variable was the severity of pain assessed three times daily by means of a visual analogue scale. Secondary criteria of efficacy were the severity of pain assessed by verbal rating scale, the need for "rescue" doses of immediate-release morphine, treatment preference, and indices of quality of life (activity, mood, sleep). There were no statistically significant differences in the parameters assessed when comparing the two groups. This study shows that, when prescribed at the same doses, CRM suspension and CRM tablets have similar efficacy and adverse effects, as well as the same duration of action. The results of this first clinical study carried out on CRM suspension are especially relevant for patients with cancer pain who have difficulty swallowing.

Delayed-Action Preparations↗

PubMedDate not supplied

Prevalence of craniomandibular dysfunction in white children with different emotional states: Part III. A comparative study.

This study compared the prevalence of CMD between white children classified by the parents as calm and not calm, with twenty-six boys and twenty girls in each group (total, ninety-two children). They had been selected from a total of 386 white children examined for this study. The children were interviewed for symptoms, examined clinically for signs of CMD and malocclusion, and assigned to the study groups based on parents' responses to a questionnaire. The study showed significant differences in the prevalence of muscle and TMJ tenderness between children with different emotional states.

Child↗

PubMed1992

A comparative study of 0.25% ropivacaine and 0.25% bupivacaine for brachial plexus block.

The present study compares the effectiveness of 0.25% ropivacaine and 0.25% bupivacaine in 44 patients receiving a subclavian perivascular brachial plexus block for upper extremity surgery. The patients were assigned to two equal groups in this randomized, double-blind study; one group received ropivacaine 0.25% (112.5 mg) and the other, bupivacaine 0.25% (112.5 mg), both without epinephrine. Onset times for analgesia and anesthesia in each of the C-5 through T-1 brachial plexus dermatomes did not differ significantly between the two groups. The mean onset time for analgesia ranged from 11.2 to 20.2 min, and the mean onset time for anesthesia ranged from 23.3 to 48.2 min. The onset of motor block differed only with respect to paresis in the hand, with bupivacaine demonstrating a shorter onset time than ropivacaine. The duration of sensory and motor block also was not significantly different between the two groups. The mean duration of analgesia ranged from 9.2 to 13.0 h, and the mean duration of anesthesia ranged from 5.0 to 10.2 h. Both groups required supplementation with peripheral nerve blocks or general anesthesia in a large number of cases, with 9 of the 22 patients in the bupivacaine group and 8 of the 22 patients in the ropivacaine group requiring supplementation to allow surgery to begin. In view of the frequent need for supplementation noted with both 0.25% ropivacaine and 0.25% bupivacaine, we do not recommend using the 0.25% concentrations of these local anesthetics to provide brachial plexus block.

Adult↗

PubMed1991

Clinical features of breast cancer--Anglo-Japanese comparative study.

A comparative study was undertaken at Guy's Hospital in the UK and the Aichi Cancer Center in Japan of the clinical picture of breast cancer in the UK and Japan. Target patients were 221 UK and 200 Japanese primary operable patients who were recruited from April 1979 through August 1980. No difference was seen between the two countries in the side and site of the lesion and the size of the lesion. The localized tenderness of the tumor site was higher in Japanese patients than in UK patients (25.5% vs 0%). Difference was observed in tumor characteristics: breast cancers of the UK patients were irregular, ill-defined, and not so mobile, whereas those of the Japanese patients were round or oval, well-defined, and mobile. Skin fixation was higher in Japanese patients (71.0% vs 44.8%). Clinical node involvement was higher in UK patients (32.5% vs 19.0%).

Age Factors↗