SEARCH · PubMed Health
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.
Explore the source record for details and available documents.
The operational feasibility of a congenital hypothyroidism (CH) screening programme was assessed. Cord blood spot specimens were collected at seven Teheran hospitals and within the Damavand District health network. Cord thyroid-stimulating hormone (TSH) levels > or = 20 mU/L were recalled and levothyroxine (L-T4) therapy was started immediately after diagnosis of CH. Of 20,107 acceptable specimens, 22 neonates had CH (1:914 births). The recall rate was 1.3%. Screening coverage was 90% of live births. Of all cord samples, only 0.2% were unacceptable either because of delay in transportation or improper specimen collection. Median ages at the time of diagnosis and starting treatment were 12 and 8 days respectively. Screening for CH is feasible and a national screening programme is a necessity.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The acoustic attenuation, relative sound pressure levels and the equivalent Nikuradse wall roughness under variable flow conditions in a 600 mm concrete sewer pipe are experimentally investigated. The values of the acoustic attenuation are obtained in the case of airborne sound propagation in the dry pipe. A range of values of the equivalent wall roughness is artificially generated by deploying a periodical array of engineering bricks. A novel method of rapid evaluation of the acoustic attenuation is proposed. The method relies upon sound reflections from the adjacent manholes. The results demonstrate that the acoustic attenuation depends strongly on the value of the equivalent wall roughness. This work can pave the way to the efficient methodology for the in-situ, physical evaluation of the equivalent hydraulic roughness of new and existing sewer networks.
Explore the source record for details and available documents.
The dismal prognoses suffered by malignant primary brain tumor (glioma) patients remain unchanged over the past two decades, despite significant improvements in the treatment of distinct tumors. Dendritic cell-based vaccine therapies represent a promising experimental approach to treat malignant gliomas, but major challenges still remain to render vaccination more effective. These challenges include diminishing the risk of pathological autoimmunity, identifying the cellular basis of clinical vaccine benefits and increasing the proportion of patients experiencing such benefits. Over the past three years, studies in glioma patients have characterized tumor antigens on human gliomas, identified some of the immune cells involved in beneficial anti-glioma immunity and examined how gliomas may be altered by sub-lethal immune influences, providing a glimpse of the strength with which immunity influences glioma clinical outcome. This progress promises to improve clinical vaccines for glioma, and perhaps for other cancers.
Pesticides are widely used inSenegal as in others africans countries. This situation facilitate occurrence of intoxications, whose management is limited by unavailability of antidotes. We report a case of acute pesticide intoxication in a suicide attempt by a girl of thirteen. The clinical evaluation showed a coma with advanced muscarinic and nicotinic syndrome. The absence of antidotes in the country limited the care management to atropine administration and reanimation measures. The evolution was positive in few days and the patient referred to pediatrics in order to be clinically and psychologically managed. The positive evolution should not hide the necessity for the country to make available all antidotes of toxic substances and to implement Poison Control Centre in order to improve medical management of poisoned people.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Article 8 of the Act Respecting the Protection of Persons Whose Mental State Presents a Danger to Themselves or to Others (Québec, 1997) introduced a new legal framework requiring a linkage between police departments and crisis intervention services to prevent involuntary hospitalizations. Through telephone interviews, observation sessions, and documentary analysis, the authors studied the implementation of article 8 in 16 Québec administrative regions. Results pertain to organizational consequences for the health and police sectors and methods of collaboration between the two sectors. They cast light on the difficulties of implementing article 8 and suggest conditions for the success of initiatives aimed at reducing unjustified recourse to the legal system and hospitalization in cases of persons with mental health problems.
Caring for the critically ill long-term patient is a challenge. Although such patients must remain in the critical care environment because of the nursing expertise they require, they are often viewed as low-priority patients by the staff because of two factors. One factor relates to the nurse. Critical care nurses, typically action-oriented, function best during crisis intervention and are rewarded for technical skills and efficiency. The other factor relates to the patient. The critically ill long-term patient's needs are different from those of patients most often seen in critical care units; therefore, required nursing interventions are different. These interventions may not be within the nurse's usual repertoire of knowledge and skills and may also be physically and psychologically draining. Implementation of appropriate strategies has the potential for reducing length of stay, cost to the patient and the hospital, and stress for the critical care staff.
A cringe response, born of fear of anticipated nipple pain, creates behaviours that undermine comfortable latch of baby at breast, resulting in the pain th women feared. Fear is an important response in human survival but sometimes the behaviours resulting from the fear are inappropriate. This case study discusses the psychological processes and specific physical responses observed in a woman who is experiencing nipple pain during breastfeeding. It describes steps that can be taken to assist the mother in identifying what she is doing, educating her about the processes involved, and providing her with strategies to override the inappropriate response.
Orientation programs for medical interns generally bombard new physicians with a barrage of information from the hospital director of medical education, the chief executive officer, and other hospital personnel, as well as from a number of outside speakers. Advanced cardiac life-support training and social events round out the orientation program, which typically lasts 3 to 4 days. The authors propose a three-phase orientation program that begins even before the intern reports for duty and continues for an estimated 6-month period thereafter. This seemingly long-term time investment will foster good relations between employer and employee, thereby helping to encourage the intern to stay on as a resident and staff physician. Such commitment can only enhance the growth of the osteopathic medical education programs.
INTRODUCTION: Blood pressure is one of the most prevalent risk factors for CVD. Despite the large arsenal of medications, the rate of BP control is not optimal. We studied the amount of attention family physicians pay to BP readings and treatment recommendations of hypertensive patients that were discharged from the hospital. METHODS: We included 98 consecutive hypertensive patients (mean age 68.5 +/- 1.1, 44% males) admitted to the hospital. Excluded were patients referred to the hospital from a nursing home. BP measurements were obtained at ER, admission to the ward, 2nd day of admission and day of discharge. Recommended treatment was obtained from the discharge letter. A phone call was made to each patient, 4-8 weeks after discharge, and data was obtained regarding recent BP levels and the current treatment. RESULTS: BP control was achieved in 48% of the patients at hospital discharge and 47% at follow-up. Among patients that received different treatment at follow-up because of the physician's advice or because they were considered to have a high BP (24 patients), BP control was reduced from 63% at discharge to 50% at follow-up. This reduction was attributed to decreased dosage of medications and to the replacement of medications with drugs from the same group, but given at nonequivalent doses. Ten patients that were controlled at discharge but not at follow-up were given fewer medications than recommended (2.7 vs. 3.2). Among the noncontrolled patients with BP > 140/90 at follow-up, treatment was not changed for 48%. CONCLUSION: The blood pressure treatment guidelines are not implemented, and the data regarding BP control that appears in the discharge letter is not adequately used by the family physicians. A better relationship between hospitals and family practice should be obtained to aid in controlling BP.