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PubMed1990

Perfusion and function at rest and treadmill exercise using technetium-99m-sestamibi: comparison of one- and two-day protocols in normal volunteers.

The purpose of this study was to explore the feasibility of performing rest and exercise technetium-99m-sestamibi (99mTc-sestamibi) studies on the same day. We prospectively studied 34 asymptomatic volunteers using two different protocols (17 patients studied using one-day protocol and 17 patients studied using two-day protocol). For the one-day protocol, the rest study was performed first. For the two-day protocol, the exercise study was performed first followed by a second-day rest study. Left and right ventricular ejection fractions, myocardium/lung, myocardium/liver, myocardium/spleen, and myocardium/gallbladder count ratios were similar for the one- and two-day groups. No significant difference was observed in any variable measured. These data suggest that 99mTc-sestamibi can be used for rest and treadmill exercise studies performed on the same day to provide assessment of ventricular function and perfusion similar to studies performed on separate days.

Abdomen↗

PubMed1988

Isokinetic strength training protocols: do they induce skeletal muscle fiber hypertrophy?

Sedentary subjects were submitted to repeated concentric isokinetic strength training protocols separated by a 50-day detraining period. Peak torque output of the quadriceps muscle group increased by 54% after the first ten-week training protocol. No significant changes in mean skeletal muscle fiber area were observed while a significant increase in percent fiber type and percent fiber area was noticed for type IIa fibers. The activities of the enzymes hexokinase, malate dehydrogenase, 3-hydroxyacyl CoA dehydrogenase, and oxoglutarate dehydrogenase were also increased significantly. Fifty days without training induced a significant decline in peak torque output. All the enzymes that responded to the first training protocol maintained their elevated activities over the detraining period except for the enzyme oxoglutarate dehydrogenase. A second training protocol administered to the same subjects following the 50-day inactivity period did not result in any significant increase in maximum torque output and fiber area. It is concluded that the isokinetic strength training protocol used can increase the functional capacity of skeletal muscle, but this effect does not appear to be related to skeletal muscle fiber hypertrophy.

Adult↗

PubMed1986

Interaction of test protocol and horizontal run training on maximal oxygen uptake.

Twenty-seven untrained college-age males (mean age = 23.1 yr) volunteered for this 12-wk training study, which investigated potential interactions between training specificity and treadmill protocol specificity. The study was designed to analyze the interaction between a subject's maximal oxygen uptake (VO2max) on an inclined protocol (IP) vs a horizontal protocol (HP) before and after training exclusively on flat terrain. Experimental subjects (E, N = 17) trained by running on flat terrain for 12 wk, 4 d/wk, 37 min/d at an intensity equal to 65 to 85% of their heart rate reserve while control subjects (C, N = 10) remained sedentary. All subjects underwent a minimum of four maximal treadmill tests (two with an IP and two with a HP) prior to training and two maximal treadmill tests (one IP and one HP) post-training. Multivariate analysis of variance and post-hoc t-tests using a pooled variance-covariance matrix were used to analyze the data. Alterations in E, consequent to training, included significant increases in VO2max [mean IP = 53.6 to 58.4 (+8.9%) and mean HP = 51.7 to 56.2 ml. kg-1 . min-1 (+8.7%)]. C showed a significant pre- to post-training decrease on the HP for VO2max [mean HP = 52.4 to 50.7 ml . kg-1 . min-1 (-3.2%)], but showed no significant change on the IP. There was no significant pre- to post-training interaction between protocols for VO2max. It was concluded that the post-training results do not support the concept of protocol specificity when evaluating VO2max in subjects trained exclusively on flat terrain.

Adult↗

PubMed1986

Interaction of test protocol and inclined run training on maximal oxygen uptake.

Twenty-two men, 17 to 27 years of age, volunteered to participate in an inclined terrain running program. Men were randomly assigned to a control (N = 10) or an experimental (N = 12) group. The experimental group ran on inclined terrain 4 times/wk for 35 min a session at an intensity of 65 to 85% of maximal aerobic power for 12 wk. The purpose of this study was to analyze the interaction between a subject's VO2max on an inclined protocol (IP) vs a horizontal protocol (HP) before and after training on incline terrain. VO2max, HRmax, VEmax, Rmax, and maximum treadmill time were evaluated on both treadmill protocols (IP and HP). Prior to training, results indicated no difference in VO2max values between protocols. Following training, VEmax, maximum treadmill time, and VO2max increased 8.7, 9.1, and 8.5%, respectively, on the IP and 5.8, 6.8, and 5.3% on the HP respectively. All increases were statistically significant at the 0.05 level. The post-training VO2max on the IP was significantly greater than the value on the HP. These results support the concept of specificity of training and indicate the importance of careful selection of both the test protocol as well as the test mode.

Adult↗

PubMed1986

Effect of different incremental exercise protocols on the determination of lactate and ventilatory thresholds.

The aerobic threshold (AeT) determined from ventilatory curves occurs at the same oxygen uptake and is independent of the rate of increase of power output in an incremental exercise test. On the other hand, it has been proposed that the AeT determined from blood lactate curves and the anaerobic threshold (AnT) determined from ventilatory curves may vary depending on the exercise protocol. Seven healthy subjects performed two incremental exercise tests to evaluate the effect of the rate of power increment on the AeT and the AnT determined from the break points in both ventilatory and venous blood lactate curves. The protocols on the cycle ergometer consisted of increments of 15 W every min (slow) or every 0.25 min (fast). When the results were expressed as the corresponding oxygen uptake, neither the lactate AeT (slow = 2.662 +/- 0.395 1/min; fast = 2.577 +/- 0.392 1/min; P greater than 0.05) nor the ventilatory AeT (slow = 2.737 +/- 0.426 1/min; fast = 2.583 +/- 0.555 1/min; P greater than 0.05) was significantly affected by the protocols. The lactate AnT (slow = 3.675 +/- 0.610 1/min; fast = 3.683 +/- 0.610 1/min; P greater than 0.05) and the ventilatory AnT (slow = 3.635 +/- 0.665 1/min; fast = 3.823 +/- 0.645 1/min; P greater than 0.05) were also not significantly affected by the protocols. The oxygen uptake corresponding to a blood lactate concentration of 2 mM was significantly higher for the fast protocol (slow = 3.235 +/- 0.735 1/min; fast = 4.005 +/- 0.643 1/min; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1985

Pharmacist-directed heparin therapy using a standard dosing and monitoring protocol.

Use of a protocol for pharmacist determination of heparin sodium dosages administered by continuous i.v. infusion was evaluated by retrospective chart review in a California hospital. Charts of adult medical-surgical patients who received heparin infusions between June 1982 and December 1983 were reviewed for the following information: patient sex, age, and reason for receiving heparin; times, dates, numbers, and values of coagulation tests before and during heparin therapy; times, dates, and values of prothrombin time determinations during conversion to warfarin therapy; and times, number, and costs of heparin infusions. Charts were divided into two groups: those of patients for whom physicians prescribed heparin doses empirically and those of patients for whom physicians requested heparin dosing by the pharmacy department. Data were evaluated for 62 patients in the physician-dosed group and 26 patients in the pharmacy protocol group. Pulmonary embolism was the reason for heparin therapy in 34% of the physician-dosed patients and only 15% of the pharmacist-dosed patients. Pharmacists using the protocol ordered fewer anticoagulation tests and fewer heparin infusions per patient. Time from the start of heparin therapy to therapeutic anticoagulation was shorter in patients whose heparin dose was determined by the protocol, and values in the therapeutic range were achieved in a greater percentage of these patients than in the empirically dosed patients. Pharmacists using a standard dosing protocol effectively initiated and maintained heparin therapy that compared favorably with physician-dosed empiric therapy.

Adolescent↗

PubMed1985

Optimization of an immunotherapeutic protocol with poly(I,C)-LC.

The development of successful immunotherapeutic protocols requires new therapeutic strategies as well as the development of clinically predictive tumor models and protocols. A bell-shaped response curve is observed with many biological response modifiers (BRMs), not only for immunomodulation, but also for therapeutic activity. Although most BRMs, including poly(I,C)-LC, are toxic at high doses, the administration of nontoxic doses by an optimal protocol and route of injection results in significant therapeutic benefit and increased immunomodulation in tumor-bearing animals compared to the administration of a maximum tolerated dose (MTD). We suggest that Phase II clinical trials using an optimal immunomodulatory protocol may result in increased therapeutic activity compared to protocols based on the MTD.

Animals↗

PubMed1982

Survey of North American air carriers regarding protocol for dental identification of in-flight personnel.

A survey of North American air carriers regarding the protocol for dental identification of their in-flight personnel in the event of a disaster was accomplished in July 1980. Initial evaluation of this survey indicates that few air carriers have such a protocol or forensic odontology consultants. Many of the air carriers indicated the need for the development and implementation of such a protocol individualized for their company. Statistical evaluation of the survey is presented with discussion centered on the role of the forensic odontologist consulting with respective air carriers in establishing such protocols. The survey documents areas of need in such protocols.

Accidents, Aviation↗

PubMed1995

[Usefulness of a protocol for carotid sinus massage in supine and erect postures in patients with syncope without other cardiovascular or neurological diseases].

BACKGROUND: Carotid sinus massage is a first level test when investigating the cause of syncope. It is normally performed in the supine and erect positions. However, there is no standard complete protocol. So we have devised a new protocol to evaluate the utility of carotid sinus massage in different postures and the influence of patients age on the response. METHODS: Two groups of subjects were selected: a group of 167 patients (mean age 50 ys +/- 18, 105 males, 62 females) with a history of syncope without cardiovascular and neurological disease and 20 asymptomatic control subjects (mean age 52 ys +/- 13, 11 males, 9 females). Carotid sinus massage was performed supine, just after passive tilt, after 5 minutes of tilt and just after passive return to supine. If a pause > 3" was detected, the protocol was repeated after atropine i.v. injection. DEFINITIONS: Borderline vasodepressor: blood pressure reduction > 30 but < 50 mm Hg without symptoms; vasodepressor: blood pressure reduction > 50 mm Hg or > 30 mm Hg with symptoms like dizziness, vertigo or syncope; cardioinhibitory: pause > 3"; mixed: cardioinhibitory with blood pressure reduction > 30 mm Hg after atropine. RESULTS: Carotid sinus massage gave all informations in the supine position in 14 (12%) patients, after passive tilt in 67 (57%), after 5 minutes of tilt in 30 (26%), and after return to supine in 6 (5%). The responses were: 13 (8%) borderline vasodepressor, 32 (19%) vasodepressor, 2 (1%) cardioinhibitory, 70 (42%) mixed, 50 (30%) negative. Positive responses were more frequent in patients over 45 years (90% versus 43%). In the control group only 3 (15%) positive responses were elicited (2 borderline vasodepressor, and 1 vasodepressor, all in subjects over 45). CONCLUSIONS: This protocol for carotid sinus massage evidenced positive responses in 70% of patients with syncope without cardiovascular and neurological disease; cardioinhibitory responses are rare (2%); positive responses are more frequent in patients over 45 years; the protocol specificity was 85%.

Adolescent↗

PubMed1994

An optimized electroporation protocol applicable to a wide range of cell lines.

A number of transfection methods for mammalian cells are available; however, many cell lines may appear resistant to efficient transfection, or at best, necessitate lengthy optimization procedures in recommended protocols. We describe here an electroporation protocol that yields highly efficient gene transfer (20%-100% of surviving cells) in all 19 cell lines tested so far, including lymphoid, myeloid, glial, fibroblast and COS cells. Unlike earlier electroporation protocols, adaptation of this protocol to a cell line of interest only requires the optimization of a single parameter, i.e., the voltage, and can be performed within a day. Furthermore, it is also superior to transfection protocols for other methods (calcium phosphate precipitation, lipofection, DEAE-dextran transfection and transferrinfection) in terms of reproducibility, economy and average transfection efficiency for a wide variety of cell lines.

Animals↗

PubMed1994

Perioperative diabetes regulation with the help of a standard protocol.

According to a standard protocol 115 patients (96 type 2 DM, 19 type 1 DM) were treated with a 3 litre glucose 5%/day infusion, KCl and insulin, with the aim of obtaining near-normoglycaemia perioperatively. Blood glucoses of 6.7-10.0 mmol/l were scored as ideal, 3.5-15.0 mmol/l as acceptable, and the remaining values as unacceptable. In 32 patients (28%) the protocol was followed in all aspects, whereas in 45 patients (39%) the protocol was followed in therapeutic aspects (total n = 77.67%, Group 1). In the remaining 38 patients (33%) protocol violations occurred (Group 2). In 48 patients (62%) of Group 1 ideal or acceptable control was obtained perioperatively versus 11 patients (29%) of Group 2 (p < 0.05). In patients with good preoperative long-term regulation (HbA1 < or = 8.0%; n = 81) ideal or acceptable perioperative control was achieved in 58% (n = 47) versus 13% (n = 4) of those (n = 31) with preoperative HbA1 > 8.0% (p < 0.05). Stepwise multiple logistic regression analysis showed that preoperative long-term regulation (HbA1; p < 0.001) and adherence to the protocol (p = 0.022) were the only independent variables with prognostic significance for perioperative blood glucose control. In 17 patients (15%) minor electrolyte disturbances occurred. No patient had frank ketosis. Duration of disease, presence of complications, type of anaesthesia and operation did not affect perioperative diabetes control.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Chlamydia latex agglutination antigen and protocol improvement and psittacine bird anti-chlamydial immunoglobulin reactivity.

Latex agglutination detection of chlamydial antibody activity in psittacine bird sera was significantly more sensitive when an improved protocol was followed than was a test using the previously used protocol. Titers of antibody-positive sera were fourfold to 32-fold higher by the improved protocol than titers by the previously used protocol, whereas antibody-negative sera were negative by both protocols. Column chromatography was used to separate immunoglobulins in psittacine bird serum. Immunoglobulin M was reactive in latex agglutination (LA) but non-reactive in direct complement fixation (DCF). Immunoglobulin G was reactive in LA and DCF. The fifth supernatant fluid of serum multiply absorbed with latex beads was non-reactive in LA and DCF. The immunoglobulins reactive in LA had high avidity and affinity for latex beads. Prolonged storage at 4 C to 6 C preserved LA reactivity of absorbed immunoglobulins better than storage at 21 C to 23 C.

Animals↗

PubMed1993

A three-site programmed electrical stimulation protocol in patients with and without ventricular tachyarrhythmias.

Programmed electrical stimulation (PES) of the ventricle plays an important role in diagnosis and in testing the effect of pharmacological and non-pharmacological therapy of ventricular tachyarrhythmias. A stimulation protocol should reliably reproduce clinical ventricular tachyarrhythmia. The authors compared the results of the standard one-site protocol to those of a new test delivering extrastimuli alternately into the right and left ventricle. In group I (control group, n = 37), clinically without ventricular tachycardia, tachycardia could not be induced in any of the patients. In group II (n = 30), with clinical ventricular tachycardia, inducibility was in 22 patients using the standard test, and in 23 patients using the new test. The authors conclude that this modification of the PES protocol with alternate extrastimulus delivery into the right and left ventricle does not seem to contribute significantly to PES sensitivity compared to the standard one-site stimulation protocol. It is not clear whether or not another stimulation protocol with alternate stimulus delivery to both ventricles or to different sites in the right ventricle will raise the sensitivity, specificity and reproducibility of the PES test.

Amiodarone↗

PubMed1996

Testing the value of a measurement protocol for DNA image cytometry and comparing different cytologic preparations.

OBJECTIVE: To analyze the influence of measuring parameters on the quality of DNA histograms, and to compare the results of DNA image cytometry (ICM) and flow cytometry (FCM). STUDY DESIGN: Material from 20 breast cancer cases was analyzed. The protocol for ICM analyzed (1) measuring system and image analysis parameters, (2) the quality of fixation, and (3) the presence of cytoplasm around nuclei. In Feulgen-stained slides (both fresh imprints and cytocentrifuge preparations) at least 200 nuclei were examined using a commercially available ICM system. DNA FCM on disaggregates was performed, also. RESULTS: Strict adherence to the protocol gave reliable DNA ploidy profile results. In contrast, deviations from the protocol gave very broad histograms. With the protocol, similar results were found for imprints and cytocentrifuge samples. Duplicate "blind" assessments were highly reproducible. DNA indices measured by FCM and ICM (on cytocentrifuge samples) correlated highly as well. CONCLUSION: With the protocol used, DNA ploidy profiles obtained by ICM from fresh imprints and cytocentrifuge disaggregate cell preparations were comparable.

Breast Neoplasms↗

PubMed1997

The impact of water temperature on core body temperature of North American river otters (Lutra canadensis) during simulated oil spill recovery washing protocols.

Ten North American river otters (Lutra canadensis) were anesthetized with Telazol and instrumented with ingestable radiotelemetry temperature sensors for measuring core body temperature. The otters were then subjected to a washing protocol to simulate rehabilitation following an oil spill contamination. This protocol consisted of a 30-min wash in a 1:16 dilution of dishwashing liquid using either cold (24 degrees C) water or water near baseline core body temperature (38.4 degrees C), followed by a 30-min rinse with water of the same temperature, followed by 10 min of forced hot air drying. Core body temperatures of the otters washed in cold water fell at a median rate of 0.1 degrees C/min, whereas otters washed in warm water maintained stable core temperatures until the completion of the protocol, at which time their core temperatures began to drop at a similar rate. Core temperatures restabilized in both groups, and no statistical difference in core temperature between groups remained 180 min after initiation of the protocol. Efforts to examine the efficacy of supplemental squalene administration to speed the recovery of fur condition and waterproofing were unsuccessful because the washing protocol did not cause loss of coat waterproofing in 8 of the 10 subjects.

Aerosols↗

PubMed1976

A headache protocol for nurses: effectiveness and efficiency.

To test the effectiveness and efficiency of a nurse-administered protocol for headache in the primary care setting, we conducted a prospective controlled trial. Two hundred three randomly allocated patients were evaluated by nurses using the protocol who managed independently 55.2% of the patients and received physician consultation on the others. A total of 193 patients were randomly allocated to the physician-control group. Nurse-protocol group patients experienced equivalent symptomatic relief and expressed significantly greater satisfaction with the care they had received than did patients in the physician-control group. A retrospective study of the presenting findings in patients with serious diseases of the CNS provided evidence supporting the safety of the protocol logic. We conclude that nurse-protocol management of headache in this primary care practice was effective and efficient.

Ambulatory Care↗

PubMed1998

[Detection of human papillomavirus DNA by PCR in high-risk women. Validation of a protocol].

OBJECTIVE: To validate a protocol for HPV DNA detection using PCR (polymerase chain reaction). METHOD: HPV was investigated in cervical exfoliative specimens from 93 women at high risk for HPV infection Blind comparisons of HPV DNA detection using two PCR protocols were carried out in our laboratory and a widely accepted reference laboratory. RESULTS: HPV DNA prevalence varied according to the different protocols. A good agreement with the reference protocol was reached when a reduction of the cellular amount for DNA extraction was carried out. The prevalence of HPV DNA in this population was 50.5%. All cases with dysplasia were HPV DNA positive. The HPV type distribution was as follows: 29.8% HPV 16, 17% HPV 33, 12.7% HPV 11/6, 12.7%, HPV 18, 23.4% HPV 31, 3.6% HPV 39 y 4.3% HPV 51. An underestimation of the prevalence of HPV 51 was detected by our procedure in relation to the reference laboratory. CONCLUSIONS: HPV DNA detection by PCR may increase with simple protocol modifications. Regular validation studies are important to reach good sensitivity levels.

Adult↗

PubMed2001

Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01.

The Dana-Farber Cancer Institute (DFCI) acute lymphoblastic leukemia (ALL) Consortium Protocol 91-01 was designed to improve the outcome of children with newly diagnosed ALL while minimizing toxicity. Compared with prior protocols, post-remission therapy was intensified by substituting dexamethasone for prednisone and prolonging the asparaginase intensification from 20 to 30 weeks. Between 1991 and 1995, 377 patients (age, 0-18 years) were enrolled; 137 patients were considered standard risk (SR), and 240 patients were high risk (HR). Following a 5.0-year median follow-up, the estimated 5-year event-free survival (EFS) +/- SE for all patients was 83% +/- 2%, which is superior to prior DFCI ALL Consortium protocols conducted between 1981 and 1991 (P =.03). There was no significant difference in 5-year EFS based upon risk group (87% +/- 3% for SR and 81% +/- 3% for HR, P =.24). Age at diagnosis was a statistically significant prognostic factor (P =.03), with inferior outcomes observed in infants and children 9 years or older. Patients who tolerated 25 or fewer weeks of asparaginase had a significantly worse outcome than those who received at least 26 weeks of asparaginase (P <.01, both univariate and multivariate). Older children (at least 9 years of age) were significantly more likely to have tolerated 25 or fewer weeks of asparaginase (P <.01). Treatment on Protocol 91-01 significantly improved the outcome of children with ALL, perhaps due to the prolonged asparaginase intensification and/or the use of dexamethasone. The inferior outcome of older children may be due, in part, to increased intolerance of intensive therapy.

Adolescent↗