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PubMedDate not supplied

Anesthesia-assisted procedures in a burn intensive care unit procedure room: benefits and complications.

A retrospective review of 109 procedures was performed to evaluate the safety and efficacy of anesthesiologist-administered anesthesia in the burn intensive care unit treatment room. Intraprocedural and postprocedural complications, impact on patient activity, and nutritional goals were evaluated. The review suggested that these procedures can be performed safely with appropriate supervision and monitoring without detrimental effects on patient activity level or nutritional status.

Adult↗
PubMed2006

Endovascular and interventional procedures in obese patients: a review of procedural technique modifications and radiation management.

As the prevalence of obesity in the United States continues to increase, the volume of endovascular and fluoroscopically guided procedures is also increasing. With obese patients, it often seems the only consideration is whether the table weight tolerance can accommodate the patient. This is a naive approach to performing procedures in obese patients, as there are multiple considerations involved in providing state-of-the-art endovascular and interventional care to obese patients. A growing collection of literature is beginning to surface regarding the appropriate modifications in the interventional care of these patients. This article reviews the relevant literature on this important subject.

Fluoroscopy↗
PubMed1986

Comparison of the standard pour plate procedure and the ATP and Limulus amebocyte lysate procedures for the detection of microbial contamination in intravenous fluids.

The intrinsic and extrinsic microbial contamination of large-volume parenterals has been associated with bacteremias in hospitalized patients. When epidemiologic data suggest the association of contaminated intravenous (i.v.) fluids with disease, appropriate laboratory methods must be devised to analyze quickly the suspect fluid. A study was undertaken to compare three laboratory test methods (standard pour plate [SPP] technique, ATP procedure, and Limulus amebocyte lysate [LAL] assay) for detecting the presence of microorganisms in artificially contaminated i.v. fluid. SPP proved the most sensitive of the assay techniques used, but a 24-h period was required for microbial growth. The LAL assay appeared more sensitive in detecting i.v. contamination than the ATP method. These studies suggest that the LAL and ATP methods can be used for the rapid detection of microbial contamination in i.v. fluid. SPP and LAL procedures would have practical laboratory application when the contamination of i.v. fluids is suspected, and they are more sensitive in detecting microbial contamination in these solutions than the ATP method.

Adenosine Triphosphate↗
PubMed1983

A new biometrical procedure for testing the equality of measurements from two different analytical methods. Application of linear regression procedures for method comparison studies in clinical chemistry, Part I.

Procedures for the statistical evaluation of method comparisons and instrument tests often have a requirement for distributional properties of the experimental data, but this requirement is frequently not met. In our paper we propose a new linear regression procedure with no special assumptions regarding the distribution of the samples and the measurement errors. The result does not depend on the assignment of the methods (instruments) to X and Y. After testing a linear relationship between X and Y confidence limits are given for the slope beta and the intercept alpha; they are used to determine whether there is only a chance difference between beta and 1 and between alpha and 0. The mathematical background is amplified separately in an appendix.

Biometry↗
PubMed1991

A comparison between two different procedures for bone marrow processing: a semiautomated procedure vs manual starch sedimentation.

After high-dose chemotherapy, autologous cryopreserved bone marrow infusion is employed to restore rapidly the compromised hematopoietic function. An efficient bone marrow processing reduces the infusion toxicity produced by hemolized red cells, granulocytes and platelets clumping and DMSO amount; moreover it increases freezing efficacy, a critical step in autologous bone marrow grafting techniques. Gravity sedimentation technique with 6% hydroxyethyl-starch (HES) or a semiautomated procedure using a blood cell processor were used in our center to manipulate ex-vivo the collected bone marrow. In our experience we compared these two different procedure and we evaluated their efficiency.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Current status of bioassay procedures to detect and quantify previous exposures to radioactive materials. Bioassay Procedures Working Group.

This report was prepared by a working group established by the Oak Ridge Associated Universities (ORAU) for the purpose of assessing the current capabilities of bioassay methods that can be used to determine the occurrence and magnitude of a previous internal deposition of one or more radionuclides. The first five sections discuss general features of the use of in-vitro bioassay samples to achieve this purpose. The remainder of the report is focused on the possible use of urine bioassay procedures to detect and quantify internal depositions of radionuclides that may have occurred in United States occupation troops in Hiroshima or Nagasaki, Japan, prior to 1 July 1946, or to personnel who participated in atmospheric nuclear weapons tests conducted between 1945 and 1962. Theoretical calculations were made to estimate the quantities of various radionuclides produced in a 20-kiloton (kt) nuclear detonation that might still be present in measurable quantities in people today if they were exposed 25 to 40 y ago. Two radionuclides that emerged as good choices for this type of bioassay analysis were 90Sr, which emits beta particles, and 239,240Pu, which emits alpha particles. The current status and future prospects of chemical procedures for analyzing in-vitro urine bioassay samples for these two radionuclides were examined to determine the minimum amounts that could be detected with current methods and how much one might expect the sensitivity of detection to improve in the near future. Most routine 239,240Pu bioassay analyses involve detection by alpha spectrometry. The current minimum detectable amount (MDA) is about 0.74 mBq L-1 (20 fCi L-1), but this could be lowered to 74 muBq L-1 (2 fCi L-1). An MDA of 0.74 mBq L-1 (20 fCi L-1) is adequate for routine bioassay analyses but is too high to detect most uptakes of 239,240Pu that may have occurred 25 to 40 y ago. Methods under development that are or can be much more sensitive and have lower MDAs than alpha spectrometry for 239Pu are fission track analysis and mass spectrometry. Currently, the fission track analysis method has an MDA of about 19 muBq L-1), and this may eventually be lowered to 1.9 muBq L-1 (0.005 fCi L-1). The current MDA for 239Pu by mass spectrometry is about 7.4 mBq L-1 (200 fCi L-1), but the potential exists that it could be lowered to a value of about 0.37 muBq L-1 (0.01 fCi L-1).(ABSTRACT TRUNCATED AT 400 WORDS)

Feces↗
PubMed2006

Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures.

PURPOSE: To compare the clinical outcome of anatomic double-bundle anterior cruciate ligament (ACL) reconstruction with that of nonanatomic single- and double-bundle reconstructions. TYPE OF STUDY: Prospective comparative cohort study. METHODS: Seventy-two patients with unilateral ACL-deficient knees were randomly divided into 3 groups. Concerning all background factors, there were no statistical differences among the 3 groups. In group S (n = 24), single-bundle ACL reconstruction was performed. In group N-AD (n = 24), nonanatomic double-bundle reconstruction was carried out. In group AD (n = 24), anatomic double-bundle reconstruction was performed. One surgeon performed all operations using hamstring tendon autografts. Each patient underwent clinical examinations, before surgery and at 2 years. RESULTS: No intraoperative and postoperative complications were experienced in each group. There were no significant differences concerning the time for operation among the 3 groups. The statistical analysis showed a significant difference in the postoperative side-to-side anterior laxity among the 3 groups (P = .006). The laxity was significantly less (P = .002) in group AD (1.1 mm) than in group S (2.8 mm), while there was no significant difference (P = .072) between groups AD and N-AD. Concerning the pivot-shift test, group AD was significantly superior to group S (P = .025). There were no significant differences in the range of knee motion, the muscle torque, and the International Knee Documentation Committee evaluation. CONCLUSIONS: On the basis of the KT-2000 measurement, the side-to-side anterior laxity of our anatomic double-bundle ACL reconstruction was significantly better than that of the single-bundle reconstruction with the hamstring tendon graft, although there were no significant differences in the other clinical measures among any of the 3 procedures. LEVEL OF EVIDENCE: Level II.

Adolescent↗
PubMed2001

Touch contamination levels during anaesthetic procedures and their relationship to hand hygiene procedures: a clinical audit.

After different methods of hand preparation, volunteers rolled segments of sterile central venous catheter between their fingertips, and bacterial transfer was evaluated by standardized quantitative culture. The number of bacteria transferred differed between methods (P<0.001). Comparisons were made with the control group (no preparation at all; median, third quartile and maximum count=6.5, 24, 55). Bacterial transfer was greatly increased with wet hands (1227, 1932, 3254; P<0.001). It was reduced with a new rapid method, based on thorough drying with a combination of 10 s using a cloth towel followed by either 10 or 20 s with a hot-air towel (0, 3, 7 and 0, 4, 30, respectively; P=0.007 and 0.004, respectively). When asked to follow their personal routines, 10 consultant anaesthetists used a range of methods. Collectively, these were not significantly better than control (7.5, 15, 55; P=0.73), and neither was an air towel alone (2.5, 15, 80; P=0.176) nor the hospital's standard procedure (0, 1, 500; P=0.035). If hand preparation is needed, an adequate and validated method should be used, together with thorough hand drying.

Bacteria↗
PubMed1999

Clinical update--the teeth and the maxillary sinus: the mutual impact of clinical procedures, disease conditions and their treatment implications. Part 2. Odontogenic sinus disease and elective clinical procedures involving the maxillary antrum: diagnosis and management.

Although odontogenic sinusitis is a rare entity when compared to sinus disease of rhinogenic origin, it is extremely important to identify a dental aetiology when it occurs. The offending tooth or teeth would thus require endodontic treatment or extraction, and the sinus disease carefully assessed and appropriately managed. Aetiology and presentation of oro-antral fistulae are also discussed and guidelines for the management of this complication are recommended. Certain lesions such as cysts and tumours may involve the jaws and hence the maxillary antrum; some of these, such as a radicular cyst are quite common, but the rarer ones are included for completeness. Surgical techniques are continuously evolving to optimise form and function of the jaws, and when applied to the maxilla there may be some impact on nasal and sinus function. The advent, and now proven success, of osseointegrated jaw implants have brought with them innovations and refinements of bone grafting techniques, and more recently distraction osteogenesis for augmentation. Maxillary osteotomies for surgical orthodontics, and to facilitate prosthodontic treatment are briefly mentioned, as most of these inevitably involve the antrum and/or nose. This paper discusses, in summary form, important aspects of clinical dental practice which may involve the maxillary antrum. It is thus a broad overview of certain pathologic conditions and elective surgical procedures which have relevance to both medical and dental practitioners.

Bone Transplantation↗
PubMed1992

Prosthodontic procedures for implant reconstruction. 1. Diagnostic procedures.

The University of Sydney Dental School and more recently the Implant Centre have been treating patients with the Brånemark Osseointegration Implant System since 1981. Success depends on close cooperation between surgeon and prosthodontist. This paper describes specific prosthodontic treatment planning procedures based on a general knowledge of prosthodontics, and detailed methods for determining the position, length and alignments of the implants for a specific case by the use of radiographic and surgical templates.

Dental Articulators↗
PubMed1996

A preliminary procedure for predicting the positive and negative effects of reinforcement-based procedures.

In the current investigation, a modification was made to the preference assessment described by Pace, Ivancic, Edwards, Iwata, and Page (1985) to predict the effects of stimuli when used in a differential-reinforcement-of-other-behavior (DRO) schedule for 2 clients with severe self-injurious behavior (SIB) and profound mental retardation. Based on the results of the preference assessment, three types of stimuli were identified: (a) high-preference stimuli associated with high rates of SIB (HP/HS), (b) high-preference stimuli associated with relatively lower rates of SIB (HP/LS), and (c)low-preference stimuli associated with low rates of SIB (LP/LS). Consistent with the results of the preference assessment, the DRO schedule with HP/HS stimuli resulted in increased SIB, and the DRO schedule with LP/LS stimuli resulted in no change in SIB when used in a DRO schedule. Thus, the stimulus preference assessment may be useful clinically in some situations for predicting both the beneficial and the negative side effects of stimuli in DRO procedures.

Adult↗
PubMed1999

[General characteristics, basis and procedures for high dose chemotherapy procedures supported by hemopoietic stem cell transplantation].

Indications for autologous and allogeneic bone marrow transplantation in hematological malignancies and solid tumours are summarised. AML treatment protocol including induction and consolidation chemotherapy followed by conventional maintenance chemotherapy or high dose chemotherapy with subsequent autologous or allogeneic stem cell transplant are presented. We compared elements and targets of autologous and allogeneic procedures pointing out the major differences regarding transplant related mortality, disease free survival and relapse rates.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

Modifications to the disability determination procedures; disability claims process redesign prototype. Social Security Administration. Notice of a prototype involving modifications to the disability determination procedures.

The Social Security Administration (SSA) is announcing a prototype involving a combination of modifications to the disability determination process. Before proceeding to national implementation, we expect that this prototype will provide a body of information about what impact these modifications may have on agency operations, notice and other procedures, as well as the resulting quality and timeliness of decisions for the public.

Disability Evaluation↗
PubMedDate not supplied

Evaluation of current compendial physiochemical test procedures for pharmaceutical elastomeric closures and development of an improved HPLC procedure.

The interaction between elastomeric container closures and the solutions they confine presents a potential hazard to the consumer due to extraction of closure ingredients into the dosage form. Each of the major Pharmacopeias, the United States, the European, and the Japanese, prescribe testing procedures for elastomeric closures. These consist of a series of non-specific wet chemical analyses performed on samples extracted into water or, in some cases, isopropanol (IPA) or the drug product vehicle. No consideration is given to the extracting potential of the drug product. Results from our testing on ten randomly selected closure samples indicated that these tests are not sensitive or specific enough to accurately measure the levels of extractables. Therefore, an HPLC gradient method was developed which had the required sensitivity and specificity. The prescribed compendial extractions, when performed on the various stopper types, proved inefficient and experiments were conducted in an attempt to improve them. These included increasing the time of the extractions, increasing the closure surface area, and increasing the strength of the extracting solvent (methylene chloride). The HPLC gradient method and the compendial wet chemical tests were then used to evaluate the stopper extractables. Results of the compendial analyses on the prescribed aqueous extractions were inconclusive as the number and relative amount of extractables in the closure could not be measured. The results of the compendial testing were only marginally improved using the stronger extraction conditions. Testing was dramatically improved, however, using the HPLC gradient method. As many as twenty extractables were detected in some of the samples and, unlike the compendial analysis, low level extractables were detected in the water samples. Identification of some of the extractables was accomplished via GC/MS.

Chemical Phenomena↗
PubMed2002

Bivalirudin, a bivalent, thrombin specific anticoagulant as an alternative to heparin in interventional procedures as an alternative to heparin in interventional procedures.

Among the antithrombotic therapies evaluated to date, the synthetic peptide bivalirudin is unique in its ability to reduce both ischemic and bleeding complications associated with percutaneous coronary intervention (PCI). Bivalirudin is a small peptide consisting of 20 amino acid residues that binds thrombin in a direct, reversible, and bivalent fashion. The agent is approved for use in the United States and New Zealand as an anticoagulant in patients with unstable angina undergoing PCI and may also prove beneficial in patients with acute coronary syndromes (ACS), acute myocardial infarction (AMI) and in patients undergoing coronary artery bypass graft (CABG) procedures. This article examines bivalirudin in more detail.

Angioplasty, Balloon, Coronary↗
PubMed1989

[Blood-saving procedures--anesthesiologic aspects. Autotransfusion procedures at a large clinic].

A major risc of blood transfusion is transmission of infectious diseases. The pattern of these diseases varies in different parts of the world. The fact, that diseases such as hepatitis or AIDS cannot completely be avoided has led to an increasing interest in autologous blood transfusion systems. In the Department of Anaesthesiology and Intensive Care Medicine of the Justus-Liebig-University Giessen the following methods of autotransfusion are performed: Acute normovolaemic haemodilution (ANH), intra- and postoperative autotransfusion (Cell-Saver, Haemonetics Corp.; Autotrans, Dideco Corp.), autologous donor-plasmapheresis and autologous predeposit. Using this methods the anaesthesiologic autotransfusion system in Giessen is capabel reducing bank blood requirements particularly in elective surgery such as cardiovascular surgery and orthopaedic surgery to a minimum. Most of these surgical procedures can be performed without transfusing any homologous blood substitutes.

Acquired Immunodeficiency Syndrome↗