SEARCH · PubMed Health

Results for “Protocol”

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 1,009 records · Page 56Linked to original sources

PubMed2002

Selecting chemical substances for the UN-ECE POP protocol.

In 1998 the UN-ECE POP Protocol was signed. Sixteen substances are included in the protocol. They can be characterised as persistent, bioaccumulating and toxic organic substances prone to long-range atmospheric transport. The Dutch Ministry of Housing, Physical Planning and the Environment started a project to select possible candidates for the protocol. In the first phase of the project possible candidates were selected using the so-called 'PTB-database' applying the criteria from the protocol. From the 12 substances that met the criteria four substances were selected for which preliminary risk profiles were drafted: polychlorinated naphthalenes, dicofol, hexachlorobutadiene and pentachlorobenzene. These profiles are presented. Revised profiles have to be prepared for the UN-ECE LRTAP Ad hoc Expert Group on persistent organic pollutants (POPs). Ultimately, the process should lead to a proposal to include additional POPs to the UN-ECE POP Protocol.

Biological Availability↗

PubMed2003

Morbidity does not influence the T-cell immune risk phenotype in the elderly: findings in the Swedish NONA Immune Study using sample selection protocols.

A critical issue in our understanding of ageing and the immune system refers to the health status of the population from which inferences are drawn. The commonly used SENIEUR protocol, selecting individuals representing 'normal ageing' has recently been under debate because a substantial amount of individuals with various health problems are excluded. The aim of the present study was to investigate the influence of morbidity on immune parameters and to evaluate the associations with the T-cell immune risk phenotype (IRP), related to cytomegalovirus (CMV) seropositivity by applying the SENIEUR protocol and the OCTO-Immune protocol in the unselected population based sample (n=138) of oldest-olds, participating in the Swedish NONA Immune Study. The SENIEUR protocol excluded over 90% of the sample whereas the OCTO-Immune protocol excluded almost 65% of the sample. Three independent groups, very healthy (SENIEUR), moderately healthy (OCTO-Immune) and frail (non-SENIEUR/non-OCTO-Immune) were created. Flow cytometry studies on lymphocyte sub-populations revealed no significant difference in CD4/CD8 ratio, CD3+CD4-CD8+, CD3+CD4+CD8-, CD8+CD57+CD28-, CD8+CD56+CD57- or CD8+CD56+CD57+ between the very healthy, moderately healthy and the frail subsamples. Our findings indicate that morbidity does not significantly influence the T-cell immune risk profile in the elderly, and we suggest the inclusion of broader samples in future immunogerontological studies.

Aged↗

PubMed1997

Mouse paw preference: effects of variations in testing protocol.

Two experiments using two inbred strains of mice were conducted to study mouse paw preference. In the first study, 250 (50 x 5) paw reaches from each of 12 male and 12 female C57BL/6J mice were observed over an 8-week period using the Collins paw preference apparatus to investigate questions relating to the independence of reaches, the size of the tube into which the animals reach for flakes of food, and practise effects. Animals appeared to be much more highly lateralized when two independent reaches per day for 25 days (I protocol) were observed than when 50 reaches were observed in a single session (S protocol). Paradoxically, however, we found no evidence for the lack of independence of reaches when we examined the sequences of reaches performed by animals under the S protocol conditions. With practise, animals became slightly more lateralized, but there were no effects of sex, and approximately equal numbers of mice were left-pawed as were right-pawed. The size of the tube had no effect. The second study used 30 BALB mice, each of which was tested with both the I and S protocols, with order of testing counterbalanced. There was a significant protocol x order interaction such that those doing S first were more highly lateralized on the I task, but those doing I first were highly lateralized on both tasks.

Animals↗

PubMed1999

Proton dosimetry intercomparison based on the ICRU report 59 protocol.

BACKGROUND AND PURPOSE: A new protocol for calibration of proton beams was established by the ICRU in report 59 on proton dosimetry. In this paper we report the results of an international proton dosimetry intercomparison, which was held at Loma Linda University Medical Center. The goals of the intercomparison were, first, to estimate the level of consistency in absorbed dose delivered to patients if proton beams at various clinics were calibrated with the new ICRU protocol, and second, to evaluate the differences in absorbed dose determination due to differences in 60Co-based ionization chamber calibration factors. MATERIALS AND METHODS: Eleven institutions participated in the intercomparison. Measurements were performed in a polystyrene phantom at a depth of 10.27 cm water equivalent thickness in a 6-cm modulated proton beam with an accelerator energy of 155 MeV and an incident energy of approximately 135 MeV. Most participants used ionization chambers calibrated in terms of exposure or air kerma. Four ionization chambers had 60Co-based calibration in terms of absorbed dose-to-water. Two chambers were calibrated in a 60Co beam at the NIST both in terms of air kerma and absorbed dose-to-water to provide a comparison of ionization chambers with different calibrations. RESULTS: The intercomparison showed that use of the ICRU report 59 protocol would result in absorbed doses being delivered to patients at their participating institutions to within +/-0.9% (one standard deviation). The maximum difference between doses determined by the participants was found to be 2.9%. Differences between proton doses derived from the measurements with ionization chambers with N(K)-, or N(W) - calibration type depended on chamber type. CONCLUSIONS: Using ionization chambers with 60Co calibration factors traceable to standard laboratories and the ICRU report 59 protocol, a distribution of stated proton absorbed dose is achieved with a difference less than 3%. The ICRU protocol should be adopted for clinical proton beam calibration. A comparison of proton doses derived from measurements with different chambers indicates that the difference in results cannot be explained only by differences in 60Co calibration factors.

Algorithms↗

PubMed2003

Preston and Park-Sanders protocols adapted for semi-quantitative isolation of thermotolerant Campylobacter from chicken rinse.

Human campylobacteriosis has become the major cause of foodborne gastrointestinal diseases in several European countries. In order to implement effective control measures in the primary production, and as a tool in risk assessment studies, it is necessary to have sensitive and quantitative detection methods.Thus, semi-quantitative detection of thermophilic Campylobacter spp. in 20 naturally contaminated chicken rinse samples was carried out using the two most common standard protocols: Preston and Park-Sanders, as proposed by Nordic Committee on Food Analysis (NMKL) and International Standard Organization (ISO), respectively. For both protocols, the chicken rinse samples were prepared in 500 ml buffered peptone water, as recommended in the ISO protocol no. 6887-2. The results indicated that the Preston protocol was superior to the Park-Sanders protocol in supporting growth of Campylobacter spp. In conclusion, the established semi-quantitative assessment using Preston broth could be useful in monitoring the outcome of control programs or quantitative risk assessments.

Animals↗

PubMed1985

Evaluation of the use of a protocol in the antimicrobial treatment of intra-abdominal sepsis.

A protocol was established aimed at limiting the duration of antimicrobial therapy in two patient groups with peritonitis. One group had perforated or gangrenous appendicitis and the other non-appendiceal disease. The duration of treatment given to patients treated according to the protocol was compared retrospectively to that of similar patients treated without the protocol. Patients with perforated or gangrenous appendicitis required significantly less antimicrobial therapy than those with peritonitis due to non-appendiceal disease. In non-appendiceal intra-abdominal sepsis the use of the protocol was associated with a significantly reduced duration of antimicrobial therapy, compared with that observed without the protocol.

Adult↗

PubMed1998

Effect of a comprehensive quality management process on compliance with protocol in an emergency medical dispatch center.

STUDY OBJECTIVE: Modern emergency medical dispatch provides appropriate resource responses with the use of an emergency medical dispatch priority reference system (EMDPRS). The EMDPRS is a systematic protocol for all aspects of the dispatch process, including interrogating the caller, matching responses with severity, and providing pre-arrival care. We tested the hypothesis that appropriate performance feedback would increase dispatcher compliance with the protocol. METHODS: We examined how emergency medical dispatchers complied with the protocols contained in the Advanced Medical Priority Dispatch System, a commercially available EMDPRS. Six key areas and overall compliance were studied. Dispatchers performed for 2 months without feedback and for a further 2 months with performance feedback. We used statistical methods to compare the dispatchers' compliance with the protocols each month. RESULTS: The mean overall compliance score improved from 76.4%+/-10.2% (mean+/-SD) in the absence of performance feedback to 96.2%+/-4.0% (n=217; P <.001) when performance feedback was provided. Five of 6 key areas showed similar improvements. CONCLUSION: Providing emergency medical dispatchers with regular and objective feedback regarding their performance dramatically improves how rigorously they follow a systematized dispatch protocol.

Emergency Medical Service Communication Systems↗

PubMed2002

Donor chimerism and stem cell function in a murine congenic transplantation model after low-dose radiation conditioning: effects of a retroviral-mediated gene transfer protocol and implications for gene therapy.

OBJECTIVE: We investigated low-dose radiation conditioning for the transplantation of retrovirus-transduced cells in a C57Bl6/J murine model. MATERIALS AND METHODS: The effect of low-dose radiation on stem cell function was investigated using a competitive repopulation assay. Stem cell function of marrow cells that underwent a retroviral-mediated gene transfer (RMGT) protocol was examined by this assay, and donor chimerism of these cells when transplanted into 160-cGy conditioned syngeneic hosts was compared to fresh marrow. RESULTS: Irradiation with 300 or 160 cGy substantially decreased stem cell function as measured by competitive repopulation. Animals conditioned with 160 cGy and transplanted with 20 x 10(6) fresh marrow cells permitted donor cell engraftment of 53.6% +/- 11.4% 6 months after transplant compared to 100% donor cell engraftment after 1100 cGy irradiation. Lymphoid and myeloid engraftment did not significantly differ from total engraftment in submyeloablated hosts. When transplanted into lethally irradiated hosts, the competitive repopulating activity of marrow treated with a single dose of 5-fluorouracil followed by ex vivo culture according to a standard RMGT protocol was equal to 5-fluorouracil-only treated marrow. However, cells treated with 5-fluorouracil or 5-fluorouracil plus ex vivo culture for RMGT repopulated less well than fresh marrow cells in 160 cGy conditioned hosts. CONCLUSIONS: Low-dose irradiation decreases host stem cell function, allowing engraftment of both fresh and RMGT protocol-treated marrow, although the engraftment of 5-fluorouracil-treated cells was reduced at least two-fold, and 5-fluorouracil plus RMGT protocol-treated cells at least three-fold, compared to fresh marrow. Modification of current RMGT protocols may be important for optimizing engraftment under these conditions.

Animals↗

PubMed1987

[Transfusion strategy for patients in therapeutic aplasia. Experience of the Henri Mondor Hospital apropos of 2 successive protocols].

Retrospective analysis of two transfusion protocols applied in our institution to the bone marrow transplanted patients was conducted. Granulocyte transfusions should be only proposed as a therapeutic treatment to patients with severe well documented bacterial infection resistant to an adapted antibiotherapy. Leukocyte-depleted blood products reduce the incidence of HLA-immunization but do not influence the frequency of CMV infections. Random single donor platelet concentrates (obtained by cytapheresis) could decrease the incidence of polyspecific HLA-antibodies in comparison with the use of random standard platelet concentrates. The best transfusion protocol should associate leukocyte-depleted blood products with transfusion of prophylactic single donor platelet concentrates. In our institution, this protocol is less expensive than the protocol with prophylactic white blood cell transfusions and has the same cost than other protocols using standard blood products.

Agranulocytosis↗

PubMed2002

A self consistent normalized calibration protocol for three dimensional magnetic resonance gel dosimetry.

In a clinical setting, mixed and inconsistent results have been reported using Magnetic Resonance Relaxation imaging of irradiated aqueous polymeric gels as a three-dimensional dosimeter, for dose verification of conformal radiation therapy. The problems are attributed to the difficulty of identifying an accurate dose calibration protocol for each delivered gel at the radiation site in a clinical setting. While careful calibration is done at the gel manufacturing site in a controlled laboratory setting, there is no guarantee that the dose sensitivity of the gels remains invariant upon delivery, irradiation, magnetic resonance imaging and storage at the clinical site. In this study, we have compared three different dose calibration protocols on aqueous polymeric gels for a variety of irradiation scenarios done in a clinical setting. After acquiring the three-dimensional proton relaxation maps of the irradiated gels, the dose distributions were generated using the off-site manufacturer provided calibration curve (Cal-1), the on-site external tube gel calibration (Cal-2) and the new on-site internal normalized gel calibration (Cal-3) protocols. These experimental dose distributions were compared with the theoretical dose distributions generated by treatment-planning systems. We observed that the experimental dose distributions generated from the Cal-1 and Cal-2 protocols were off by 10% to 40% and up to 200% above the predicted maximum dose, respectively. On the other hand, the experimental dose distributions generated from the Cal-3 protocol matched reasonably well with the theoretical dose distributions to within 10% difference. Our result suggests that an independent on-site normalized internal calibration must be performed for each batch of gel dosimeters at the time of MR relaxation imaging in order to account for the variations in dose sensitivity caused by various uncontrollable conditions in a clinical setting such as oxygen contamination, temperature changes and shelf life of the delivered gel between manufacturing and MR acquisitions.

Calibration↗

PubMed1999

Idiopathic condylar resorption: diagnosis, treatment protocol, and outcomes.

Idiopathic condylar resorption is a poorly understood progressive disease that affects the TMJ and that can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain. This article presents the diagnostic criteria for idiopathic condylar resorption and a new treatment protocol for management of this pathologic condition. Idiopathic condylar resorption most often occurs in teenage girls but can occur at any age, although rarely over the age of 40 years. These patients have a common facial morphology including: (1) high occlusal and mandibular plane angles, (2) progressively retruding mandible, and (3) Class II occlusion with or without open bite. Imaging usually demonstrates small resorbing condyles and TMJ articular disk dislocations. A specific treatment protocol has been developed to treat this condition that includes: (1) removal of hyperplastic synovial and bilaminar tissue; (2) disk repositioning and ligament repair; and (3) indicated orthognathic surgery to correct the functional and esthetic facial deformity. Patients with this condition respond well to the treatment protocol presented herein with elimination of the disease process. Two cases are presented to demonstrate this treatment protocol and outcomes that can be achieved. Idiopathic condylar resorption is a progressive disease that can be eliminated with the appropriate treatment protocol.

Adolescent↗

PubMed2004

Schizophrenia research participants' responses to protocol safeguards: recruitment, consent, and debriefing.

OBJECTIVE: To examine the perspectives and preferences regarding ethically important aspects of recruitment, consent, and debriefing of people with schizophrenia who volunteered for research protocols. METHOD: A structured interview to assess research-related views of people with schizophrenia was developed and piloted. Data collection occurred at three sites. For this analysis, we examined the subset of responses from schizophrenia patients currently enrolled in a protocol. RESULTS: Data from 28 schizophrenia research volunteers were analyzed. Of these, 22 were men and 11 were voluntary inpatients. Most (n=23) recalled speaking with someone before enrolling in the protocol, and most (n=26) reported trusting the person who told them about it. Participants reported a moderate understanding of their protocols. All but one person (n=27) remembered signing a consent form. Twenty-one volunteers indicated that consent forms are meant to help both the patient and the researcher. Most (n=23) reported making the enrollment decision alone, with 22 making this decision prior to reviewing the consent form. The decision was described as relatively easy. Respondents felt some pressure to enroll, with women experiencing more pressure. Debriefing practices were strongly endorsed by participants. All 28 of the volunteers wished to be informed if a health problem (i.e., "something wrong") was discovered during the protocol. CONCLUSION: The persons living with schizophrenia who were interviewed for this project expressed interesting perspectives and preferences regarding ethically important aspects of recruitment, consent, and debriefing in clinical research that may help guide efforts to make research processes more attuned to participants and merit further inquiry.

Adult↗

PubMed2004

State-of-the-Art computed tomography of primate skulls--comparison of different scan-protocols.

To evaluate the image quality of different scan-protocols on 3 different CT-scanners for data acquisition of skulls of apes and monkeys with special respect on imaging the paranasal sinuses, we compared CT image quality in 452 skulls on either the Philips "Mx8000" Multi-Slice CT, the "Aura" Spiral CT or the "T omoscanM" CT scanner. Therefore, we used sequential and volume scanning as well as different slice thickness, table feed, voltage and X-ray current intensity. Representative axial scans of the anonymized studies as well as three-dimensional reconstructions were independently analyzed by an experienced radiologist and an anthropologist, using a study protocol covering relevant anatomical findings. Low-Dose protocols at 40 mAs demonstrated an equal diagnostic value with better CT-performance due to lower overheatening of the X-ray tube in all studies. Resolution, especially in small anatomical structures, was best with multi-slice CT. On both single-slice scanners resolution was significantly better with sequential-protocols (slice 2-5 mm; feed 1:1) than with volume-protocols. Volume scans are required for 3D-reconstruction. Best 3D results were achieved with "M x8000" due to its better spatial resolution, followed by the "Aura" scanner. Multi-slice CT (MSCT) was found to be the superior method for the radiographic evaluation of small anatomical structures. However, there is no significant loss of information with thin sequential scans in LD technique on a single-slice spiral CT scanner. Volume-data aquisition is required for 3D reconstruction.

Animals↗

PubMed1999

Spreadsheet calculations of absorbed dose to water for photons and electrons according to established dosimetry protocols.

The calculation of absorbed dose to water according to a Code of Practice demands a strict adherence to the rules and data of the protocol. To ease the calculations and to avoid computational and methodological errors, we have developed a number of spreadsheets to perform the calculations in accordance with an established dosimetry protocol-in our case those of the International Atomic Energy Agency (IAEA) and the Institution of Physics and Engineering in Medicine and Biology (IPEMB). The spreadsheets are implemented as Microsoft Excel V5.0 worksheets. Only a limited selection of dosimetry equipment is used for calibration, which is performed according to only one of the methods allowed by the protocol. This voluntary limitation of equipment and methods is reflected in a spreadsheet that is beam-specific, compact, focused, and very practical. There are four main spreadsheets: high-energy photons (IAEA), high-energy electrons (IAEA), medium energy X rays (IPEMB), and low-energy X rays (IPEMB). The sheets allow the input of setup and measured data, but tabulated data and formulas are protected. Parameter values are copied from the protocols, and the relevant value is found by linear interpolation. Once the spreadsheets are drawn up correctly and thoroughly checked, protocol calculations are performed easily and accurately. The spreadsheets presented are tailored to suit our specific needs but can easily be modified to conform to the practices of any other institution. They are not intended as "cookbooks" but need to be filled in by a radiation physicist with the input data checked by a second professional. The same method is also used for calculating the Reference Air Kerma Rate of brachytherapy sources.

Calibration↗

PubMed2001

Evaluation of an oral care protocol intervention in the prevention of chemotherapy-induced oral mucositis in paediatric cancer patients.

Oral mucositis is the most frequent and severe complication of chemotherapy in children with cancer that can aggravate the child's clinical condition and increase the risk of infection. This prospective comparative study was designed to determine the effectiveness of a preventive oral care protocol in reducing chemotherapy-induced oral mucositis in children with cancer. During an 8-month period, 42 children aged 6 to 17 years with haematological malignancies or solid tumours were evaluated. The 21 children who were included in the first 4-month period of the study constituted the control group. Another 21 children were enrolled in the subsequent 4 months and were assigned to the experimental group, in which they were given an oral care protocol intervention. The oral care protocol consisted of tooth brushing, 0.2% chlorhexidine mouth rinse and 0.9% saline rinse. Children in both groups were evaluated twice a week for 3 weeks. The incidence of ulcerative lesions, severity of oral mucositis and the related pain intensity were used as the main outcome variables. A 38% reduction in the incidence of ulcerative mucositis was found in children using the oral care protocol compared with children in the control group. The severity of oral mucositis (P=0.000002) and the related pain (P=0.0001) were significantly reduced with the intervention. These results support the preventive use of the oral care protocol in paediatric cancer patients who undergo chemotherapy for cancer treatment.

Adolescent↗

PubMedDate not supplied

Osteosarcoma nursing care guidelines: a tool to enhance the nursing care of children and adolescents enrolled on a medical research protocol.

Clinical trials dominate the therapeutic approaches used in pediatric oncology with the majority of pediatric oncology patients receiving treatment on medical research protocols. These protocols detail the medical treatment that enrolled patients will receive. Nursing care is not described in these documents. However, nursing care must complement the medical care as written in the medical research protocol. Administering treatments safely, assessing treatment responses, educating patients and families, and communicating with the entire health care team are some of the essential nursing responsibilities that must be carefully orchestrated. Nursing care guidelines, as described here, were created to provide the careful balance between the medical research protocol and associated nursing care. These guidelines describe the nursing actions and considerations involved in caring for pediatric oncology patients enrolled on a particular medical research protocol. The purpose of this article is to describe the process used to create and evaluate nursing care guidelines.

Adolescent↗

PubMed1998

Standardized perioperative care protocols and reduced length of stay after colon surgery.

BACKGROUND: Recent studies have suggested that critical pathways and standard order sets decrease hospital length of stay and improve quality of care. A recently conducted prospective, randomized study at our institution found that patients undergoing elective colon resections had earlier return of bowel function if perioperative epidural anesthesia and analgesia were provided. All patients in the study were also placed on a standardized perioperative regimen. We hypothesized that the standardized perioperative protocol used in this study contributed to early return of bowel function and hospital discharge compared with similar patients managed off protocol. STUDY DESIGN: To test this hypothesis, we performed a case-controlled study comparing the hospital courses of 36 study patients to 36 control patients undergoing colorectal surgery by the same surgeons during the same calendar year. The distribution of types of operations and anesthetic techniques was similar in both groups. RESULTS: As dictated by the protocol, all study patients had their nasogastric tubes removed, were started on a low fat liquid diet, and ambulated in the first postoperative day. Nasogastric tubes were removed in control patients and study patients 2.2 +/- 0.9 (mean value +/- SD) and 1.0 +/- 0.0 days postoperatively, respectively. Control patients were started on an oral diet, usually clear liquids, an average of 2.9 +/- 1.1 days postoperatively, a specific liquid diet was started 1.0 day postoperatively in study patients (p < 0.001). Return of bowel function, as determined by bowel tones, flatus, and bowel movements, occurred approximately 1 day earlier in study patients. Study patients were discharged 1 day sooner than control patients. CONCLUSIONS: Our results suggest that the return of bowel function and the length of stay of patients undergoing colon surgery are improved if patients are entered into a standardized protocol that eliminates variation in intraoperative and postoperative anesthesia and postoperative surgical care. We believe these results can be reproduced in routine clinical surgery by having a clearly outlined protocol for perioperative care similar to that used in this study.

Analgesia, Epidural↗

PubMed2002

[First tier measures in the treatment of intracranial hypertension in the patient with severe craniocerebral trauma. Proposal and justification of a protocol].

The management of severe head injuries in general and that of high intracranial pressure (ICP) in particular are among the most challenging tasks in neurocritical care. One of the difficulties still faced by clinicians is that of reducing variability among centers when implementing management protocols. The purpose of this paper is to propose a standardized protocol for the management of high ICP after severe head injury, consistent with recently published clinical practice guidelines and other clinical evidence such as that provided by the systematic reviews of the Cochrane Collaboration. Despite significant advances in neuromonitoring, deeper insight into the physiopathology of severe brain trauma and the many therapeutic options available, standardized protocols are still lacking. Recently published guidelines provide sketchy recommendations without details on how and when to apply different therapies. Consequently, great variability exists in daily clinical practice even though different centers apply the same evidence-based recommendations. In this paper we suggest a structured protocol in which each step is justified and integrated into an overall strategy for the management of severe head injuries. The most recent data from both the preliminary and definitive results of randomized clinical trials as well as from other sources are discussed. The main goal of this article is to provide neurotraumatology intensive care units with a unified protocol that can be easily modified as new evidence becomes available. This will reduce variation among centers when applying the same therapeutic measures. This goal will facilitate comparisons in outcomes among different centers and will also enable the implementation of more consistent clinical practice in centers involved in multicenter clinical trials.

Adrenal Cortex Hormones↗