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At least 163 records · Page 9Linked to original sources
PubMed2003

Dental caries and periodontal status of 12-year-old school children in rural Qinghai, China.

OBJECTIVES: To describe the dental caries and periodontal status of 12-year-old children in rural Qinghai and to compare the oral health status between the Han and ethnic minority children. METHOD: Children aged 12-years in three primary schools in Hexi Townships, Guide County, Hainan Tibetan Autonomous State, Qinghai Province, China, were invited to participate in the survey conducted during July 2001. Each child was interviewed and clinically examined in the schools, using portable equipment. World Health Organization (WHO) examination procedures and diagnostic criteria were used. SPSS 11.0 was used for data compilation and statistical analysis. RESULTS: All 196 12-year-olds (118 Han and 78 from ethnic minorities, i.e. Muslims and Tibetans) were surveyed. 48% of the children reported never brushing their teeth, while 12% brushed only every 2-3 days. Over ninety per cent (n=182) of the children had never visited a dentist. The DMFT scores in Han and in minority groups were found to be 0.12 and 0.23 respectively. A larger proportion of children in Han group (94%) had no caries experience (DMFT = 0) than that of Muslim and Tibetan (82%) groups (p<0.01). None of the children had healthy gingiva (i.e. highest CPI score=0) and 85% had calculus. CONCLUSION: The prevalence of caries experience in Han children is significantly lower than that in Muslim and Tibetan children in rural Qinghai. Dental caries and caries treatment needs of Han and minority rural schoolchildren in Qinghai are low but their periodontal health status is unsatisfactory. Basic dental health care and preventive education for the children in this part of China is needed.

Child↗
PubMed2005

Evaluation of a point-of-care blood analyzer and determination of reference ranges for blood parameters in rockfish.

OBJECTIVE: To compare values of blood parameters in rockfish obtained by use of a point-of-care portable blood analyzer with values determined by a veterinary diagnostic laboratory, calculate reference ranges for various blood parameters in black rockfish, and compare values of blood parameters in clinically normal fish with those of fish with clinical abnormalities. DESIGN: Prospective study. ANIMALS: 41 captive adult black rockfish (Sebastes melanops) and 4 captive adult blue rockfish (Sebastes mystinus). PROCEDURE: Rockfish were anesthetized with tricaine methanesulfonate for collection of blood samples. Heparinized blood samples were immediately analyzed with a point-of-care analyzer. Blood sodium, potassium, chloride, urea nitrogen, and glucose concentrations; Hct; pH; partial pressure of carbon dioxide; total carbon dioxide concentration; bicarbonate concentration; base excess; and hemoglobin concentration were determined. A microhematocrit technique was used to determine PCV, and a refractometer was used to estimate total plasma protein concentration. Paired heparinized blood samples were transported to a veterinary diagnostic laboratory for analyses. RESULTS: Data obtained with the point-of-care analyzer were reproducible; however, values for most blood parameters were significantly different from those obtained by the veterinary diagnostic laboratory. Fish with poor body condition had several blood parameter values that were lower than corresponding values in clinically normal fish. CONCLUSIONS AND CLINICAL RELEVANCE: Point-of-care blood analyses may prove useful in rockfish. Point-of-care data for a large number of clinically normal fish must be obtained for reference ranges to be calculated, and further assessments of clinically abnormal fish are necessary to determine the relevance of the data.

Animals↗
PubMed1999

Transtelephonic ECG in Slovenia.

Transtelephonic ECG has been introduced in Slovenia in 1996. It has been operating on a regular basis since September 1997. Users of the system are health institutions and patients with CV diseases. They use portable 12-channel ECG weighing less then 200 grams. Diagnostic center is located in medical ICU in Clinical Center Ljubljana. In the first 20 months of regular operation we have received 852 calls, 450 of them being diagnostic. The most common reasons for calling were: ischaemic chest pain, atypical chest pain, palpitations and dyspnoea. Most common diagnoses made on the basis of history and ECG were: AMI, angina pectoris, paroxysmal tachycardias and atypical chest pain. In 186 cases the cardiologist's advice sufficed, 171 patients were referred to the ER, 142 immediately and 29 only if suggested therapy hadn't been successful. To 82 patients new medication or changed dosage of previous medication was suggested. With the intent to evaluate accuracy of the diagnoses made on the basis of history and transtelephonic ECG evaluation we followed up the patients who were sent to ER in Ljubljana upon our cardiologists' advice. On the basis of preliminary results we can conclude that TTE is as diagnostic as the conventional ECG and its' use shortens time from onset of symptoms to initiation of treatment, it lowers disability and mortality due to CV diseases and improves cost benefit.

Arrhythmias, Cardiac↗
PubMed2003

[Epidemiological features of severe acute respiratory syndrome in Beijing].

OBJECTIVE: To describe the epidemiologic features of severe acute respiratory syndrome (SARS) in Beijing. METHOD: Database of the 2 521 probable cases of SARS in Beijing Center for Disease Prevention and Control was used. RESULTS: The course of SARS epidemic in Beijing could be divided into five phases: import and spreading-from 1 to 31 in March, rising-from April 1 to April 15, peak-from April 16 to May 4, declining-from 5 to 18 in May, terminating-from 19 to 28 in May. The proportions of portable cases of SARS in each phase were 2.7%, 13.6%, 71.0%, 11.6% and 1.1%, respectively. Totally, 2 521 portable cases were diagnosed and verified according to the diagnostic criteria of SARS issued by the Ministry of Health. Among them, 192 died from SARS. The incidence and mortality rates of SARS were 18.57 per 100,000 and 1.41 per 100,000 with the fatality of 7.6%. The ratio of male to female with SARS was 1:0.97. The highest incidence rate of SARS was in the group of 20 - 29 years (30.85 per 100,000), and the lowest was in the group of 0 - 14 years (2.54 per 100,000). People aged 20 - 49 accounted for 72.3% of all SARS cases. The incidence rates in urban, suburb and far-suburb were 32.25/100,000, 20.57/100,000 and 8.90/100,000, respectively, decreasing according to the population density. Health care providers (17.3%), staff (12.9%), retirees (11.4%), workers (9.7%) and house-hold unemployees (8.8%) appeared to be at the five top risk populations being infected. The fatality increased significantly with age. CONCLUSION: Beijing was the most severe epidemic region of SARS in the world, but the fatality was the lowest.

Adolescent↗
PubMed1993

Sonography of the chest in children.

Sonography is an extremely important tool in the evaluation of the chest in children. Its easy availability, versatility, and portability make it an obvious choice as the next diagnostic examination after an abnormal chest radiograph. Patience and meticulous technique coupled with good anatomic knowledge will produce useful studies. Sonography is equivalent and sometimes superior to CT because of its Doppler ability and superior fluid and tissue characterization. It is most helpful in the assessment of anterior and middle mediastinal masses, opaque chest, and pleural and juxta-diaphragmatic abnormalities; in the classification of perplexing radiographs; and in the assessment of peripheral chest lesions. Sonography provides guidance for diagnostic and therapeutic aspiration, providing not only excellent anatomic demonstration, tissue characterization, and vascular information but also immediate access to bacteriologic and tissue diagnosis when required.

Child↗
PubMed1996

Telemedicine: caring for patients across boundaries.

Telemedicine combines computer, video and telecommunications to provide healthcare to patients at distant sites. With the improved camera and transmission technologies of the 1990s, telemedicine can be used in a variety of situations. There are two basic technological systems: live interactive video and still image ("store and forward"). Potential users include patients who live in rural or difficult to reach geographic areas, who are confined (i.e. prison inmates), Telemedicine can allow ambulatory patients to continue living at home rather than moving into costly nursing facilities. Home telemedicine also allows greater responsiveness and higher frequency of visits by home care nurses, potentially reducing future hospital visits and costs. Two home telemedicine models are the personal telemedicine unit and the enhanced personal telemedicine module with pc-based video. Telemedicine technologies developed by the military for use on the battlefield that could be adapted for civilian use include medical simulations, individual monitoring devices and biosensors, portable retinal display monitors, life support for trauma/transport, and diagnostic ultrasound imagery. Ultimately, the benefits of telemedicine will be consistency of care, easy access to specialized consultants, higher responsiveness to patient needs, and lower overall healthcare costs.

Home Care Services↗
PubMed2004

Comparative study of two portable systems for oral anticoagulant monitoring.

Portable prothrombin time (PT) monitors offer the potential for both simplifying and improving oral anticoagulation management. It is necessary to evaluate their concordance and correlation with other PT systems. Our objective was to evaluate the concordance and clinical correlation of two portable PT determination systems, ProTime (ITC) and CoaguChek S (Roche Diagnostics). In all, 20 healthy individuals and 60 anticoagulated patients stabilized over 3 months in a therapeutic International Normalized Ratio (INR) range between 2-3.5 were studied. A drop of capillary blood was obtained simultaneously from two different fingers of each patient and applied to the monitor's application zone. The mean INR of the patients' blood samples of the two monitors differed by 0.01 units (2.32+/-0.63 for Pro Time and 2.33+/-0.68 for CoaguChek). The percentage of simple concordance and the kappa index were 88.3 and 75.9%, respectively. The coefficient of correlation was 0.922. The mean difference (bias) between the monitors was 0.01. The portable PT monitors evaluated presented a high percentage of concordance in INR results.

Administration, Oral↗
PubMedDate not supplied

Using STAT properly.

The misuse of the term STAT has long been a problem in many hospitals. Instead of being the universal word for "immediate," it has become a convenient phrase used, in some cases, to get what the physician wants now. Although the principles of this article may be applied to many modalities in the healthcare field, this article deals solely with portable chest x-rays performed at the University of Minnesota Medical Center, Fairview in Minneapolis. The diagnostic radiology department performed a 2-week analysis of orders in August 2004. The results showed that 74% of all portable chest x-rays were ordered as STAT. The manager, along with a staff radiologist, then created a list of clinical reasons that were appropriate for STAT, ASAP, or Routine orders. Then, there was a 2-week period of time delegated for education, during which the list was brought to the nurse managers of several patient care areas as well as some chief residents at the university's medical school. These individuals then shared the list with their staff. A second analysis conducted in November 2004 showed that an 11% decrease had been achieved. Given that 20,000 portable chest x-rays are performed at the medical center annually, the figure represents a 2,200 reduction in STAT portables per year. With the success of this endeavor, the radiology department piloted a second program to further decrease the number of STAT orders. Since the radiology department was using computed radiography (CR) and a picture archiving and communication system (PACS), research began to unearth the response times. The idea was to advertise to physicians how fast they could get their images, using the theory that if the times were quick enough, perhaps there would less of a tendency to order STATs. The results showed that a STAT order could be completed and viewable on PACS in an average of 17 minutes, and an ASAP in 28 minutes. A poster advertising these response times was generated and distributed to the nurse managers and residents to post in the inpatient units. The poster was well received. A two-week survey conducted in March 2005 showed that STATs now accounted for 54% of the portable chest x-rays. With this two-pronged approach, the radiology department was able to decrease the number of portable chest X-rays by 20%. Another 2-week survey conducted in May 2005 showed that number of portable chest x-rays ordered as STAT declined further to 52%.

Academic Medical Centers↗
PubMed2004

Development of an ultra-portable echo device connected to USB port.

In practical cardiology, a stethoscope based auscultation has been used to reveal the patient's clinical status. Recently, several hand-held echo devices are going on market and they are expected to play a role as "visible" auscultation instead of stethoscope. We have developed a portable and inexpensive echo device which can be used for screening of cardiac function. Two single element transducers were attached 180 degrees apart to a rotor with 14-mm diameter. The mechanical scanner, integrated circuits for transmitting and receiving ultrasonic signals and an A/D converter were encapsulated in a 150 x 40 mm probe weighing 200 g. The scan was started and the image was displayed on a Windows based personal computer (PC) as soon as the probe was connected to USB 2.0 port of the PC. The central frequency was available between 2.5 and 7.5 MHz, the image depth was 15 cm and the frame rate was 30/s. The estimated price of this ultra-portable ultrasound is about 3000 US dollars with software. For 69 cardiac patients with informed consent, image quality was compared with those obtained with basic range diagnostic echo machines. Left ventricular ejection fraction (EF) derived from normal M-mode image of standard machines (EFm) were compared with visual EF of the ultra-portable ultrasound device (EFv). The image quality was comparable to the basic range diagnostic echo machines although short axis view of aortic root was not clearly visualized because the probe was too large for intercostal approach. EFv agreed well with EFm. The ultra-portable ultrasound may provide useful information on screening and health care.

Echocardiography↗
PubMed1994

Detection of pooled secretions above endotracheal-tube cuffs: value of plain radiographs in sheep cadavers and patients.

OBJECTIVE: Mechanical ventilation is thought to increase the risk of nosocomial pneumonia by permitting leakage of bacteria-laden gastro-oropharyngeal secretions into the upper airways. The goal of this study was (a) to validate radiographic signs of pooled secretions above endotracheal-tube cuffs (supracuff liquid) in an animal model and (b) to determine whether suctionable pooled supracuff liquid can be identified on bedside radiographs of intubated patients. MATERIALS AND METHODS: Diagnostic criteria for supracuff liquid were initially validated by three radiologists interpreting 162 randomized radiographs made in an intubated sheep cadaver. The primary criteria included (a) replacement of the normal supracuff lucency with liquid opacity and (b) the formation of a sharp interface between the lucency of the upper edge of the cuff below and the liquid above. Graded infusions of 0, 3, 8, 13, and 23 ml of saline were made in triplicate into the space above the cuff, and radiographs were evaluated for the presence or absence of saline. The validated diagnostic criteria were used by two radiologists to estimate the frequency with which pooled liquid was seen on portable chest radiographs of 47 patients undergoing elective short-term postanesthetic mechanical ventilation. RESULTS: In the sheep-cadaver model, the diagnostic criteria for supracuff liquid allowed successful differentiation between no liquid, a small amount of liquid (3-8 ml), and a large amount of liquid (13-23 ml; c2, p < .0001). In a clinical study, radiographic signs of supracuff liquid were identified in 57% of 47 patients. In a small subset of patients (n = 18), the estimated liquid volume (mean +/- SEM) was calculated to be 7.8 +/- 1.1 ml (range = 2.1-18.4 ml). CONCLUSIONS: Radiography is a sensitive means of identifying small volumes of supracuff liquid above the inflated cuffs of endotracheal tubes. Potentially contaminating liquid pooled above the cuff of an endotracheal tube can be identified in about half of patients undergoing short-term mechanical ventilation. Our results suggest the suction of the supracuff space may be a reasonable prophylactic maneuver against nosocomial pneumonia. A much larger study is suggested to investigate the actual relation between pooled supracuff liquid and the development of nosocomial pneumonia.

Adult↗
PubMed2005

Electrochemical biosensors: towards point-of-care cancer diagnostics.

Wide-scale point-of-care diagnostic systems hold great promise for early detection of cancer at a curable stage of the disease. This review discusses the prospects and challenges of electrochemical biosensors for next-generation cancer diagnostics. Electrochemical biosensors have played an important significant role in the transition towards point-of-care diagnostic devices. Such electrical devices are extremely useful for delivering the diagnostic information in a fast, simple, and low cost fashion in connection to compact (hand-held) analyzers. Modern electrochemical bioaffinity sensors, such as DNA- or immunosensors, offer remarkable sensitivity essential for early cancer detection. The coupling of electrochemical devices with nanoscale materials offers a unique multiplexing capability for simultaneous measurements of multiple cancer markers. The attractive properties of electrochemical devices are extremely promising for improving the efficiency of cancer diagnostics and therapy monitoring. With further development and resources, such portable devices are expected to speed up the diagnosis of cancer, making analytical results available at patient bedside or physician office within few minutes.

Biomarkers, Tumor↗
PubMed1983

A simplified method of esophageal pH monitoring for assessment of gastroesophageal reflux.

We have found that 24-hour esophageal pH monitoring is clinically useful in the evaluation of reflux-related symptoms but that the application of this diagnostic tool is limited by lack of simplicity and easy portability of equipment, a time-consuming method for data analysis, and the necessity to hospitalize patients for the study. We have resolved the first two problems with the development of a lightweight, portable, solid-state system for recording and analyzing the data. To assess the feasibility of utilizing an 8-hour study applicable to outpatients, we studied 30 unselected patients referred for 24-hour pH monitoring. We separately analyzed the data from the first 8 hours of the study and the data from the entire 24-hour period. The correlation between the results obtained with each analysis was excellent, indicating that the 8-hour study can be used to quantitate reflux accurately. An 8-hour outpatient protocol was developed and applied to 25 healthy volunteers to determine the normal range of values. From this, a simplified scoring system was created for assessing the results of 8-hour pH studies.

Adult↗
PubMed2001

Accuracy and precision of point-of-care testing for glucose and prothrombin time at the critical care units.

The use of point-of-care testing (POCT) in critical care patient units has continued to increase since the 1980s. This increase is due to the need for prompt therapeutic interventions that may impact mortality and morbidity, and reduce the overall cost of healthcare for critically ill patients. The diagnostic manufacturing industry has risen to this challenge by introducing portable and/or handheld analyzers for use at the point-of-care. In order to ensure the public safety in the USA, the Food and Drug Administration (FDA) must approve the use of each POCT analyzer. The FDA approval is based on established performance criteria that includes relative accuracy and precision documentation. This study evaluated the precision and accuracy of the POCT prothrombin time and glucose analyzers relative to the manufacturers' specifications, to the internal QC in the main laboratory, and to the results of the external proficiency-testing program. The QC for the prothrombin time had a precision that ranged from 2.84% to 3.45% (POCT) and from 1.27-1.66% (main laboratory). The precision for the glucose QC ranged from 5% to 5.2% (POCT) and 0.9-2.7% (main laboratory). Using the results of the external proficiency testing, the inter-laboratory CV% for the POCT prothrombin time ranged from 3.5% to 5.0% and the main laboratory had a range of 2.5-2.9%. The inter-laboratory CV% ranges for glucose POCT and the main laboratory were 4.9-10.6% and 1.8-3.5%, respectively. The main laboratory analyzers proved to be more accurate than the POCT analyzers as indicated by comparison to the mean prothrombin time and glucose results of all participating laboratories in the proficiency testing program.

Blood Glucose↗
PubMed2000

A miniature integrated device for automated multistep genetic assays.

A highly integrated monolithic device was developed that automatically carries out a complex series of molecular processes on multiple samples. The device is capable of extracting and concentrating nucleic acids from milliliter aqueous samples and performing microliter chemical amplification, serial enzymatic reactions, metering, mixing and nucleic acid hybridization. The device, which is smaller than a credit card, can manipulate over 10 reagents in more than 60 sequential operations and was tested for the detection of mutations in a 1.6 kb region of the HIV genome from serum samples containing as few as 500 copies of the RNA. The elements in this device are readily linked into complex, flexible and highly parallel analysis networks for high throughput sample preparation or, conversely, for low cost portable DNA analysis instruments in point-of-care medical diagnostics, environmental testing and defensive biological agent detection.

DNA↗
PubMed1994

Epidemiology of obstructive sleep apnea.

Sleep-disturbed breathing, which includes apneas, hypopneas, and oxygen desaturations, occurs in asymptomatic individuals and increases with age. Obstructive apnea is the most frequent type of respiratory disturbance documented by polysomonography, the gold standard test for assessing sleep-disturbed breathing. Many of the prevalence studies done to date have had one or more methodological weaknesses, including selection biases, varying definitions of obstructive sleep apnea, failure to distinguish types of apneas, failure to control for confounding variables, and small sample size. Although there is consensus on the definitions of sleep-disturbed breathing, the appropriate number of apneas and hypopneas for diagnosing clinically significant obstructive sleep apnea is uncertain. While the cutoff of five or more apneas and hypopneas per hour is historically considered abnormal, the origins of this number are vague, and the longevity of those who have this value on polysomnography is not necessarily reduced. This is particularly true among those without symptoms of obstructive sleep apnea syndrome, which include excessive daytime sleepiness, snoring, nocturnal awakenings, and morning headaches. Investigators should be careful to distinguish symptomatic study subjects from asymptomatic subjects, and to exclude central apneas in calculating their estimates. In addition, various studies have used different definitions of sleep apnea syndrome, making comparisons of point estimates difficult. It would be more appropriate for researchers to estimate morbidity and mortality indices with confidence intervals, using several different cutoff points. Subject selection in all studies should follow a two-stage sampling procedure. All subjects with symptoms compatible with obstructive sleep apnea syndrome and a subsample of asymptomatic individuals should be studied with all-night polysomnography. If portable monitoring is used, the validity and reproducibility of this diagnostic method should be assessed. Subjects with significant comorbidity should be excluded from prevalence studies. Factors that clearly increase the risk of sleep-disturbed breathing and obstructive sleep apnea and its related symptoms include age, structural abnormalities of the upper airway, sedatives and alcohol, and probably family history. Although endocrine changes such as growth hormone, thyroid hormone, and progesterone deficiency also have been suggested as risk factors for exacerbating obstructive sleep apnea syndrome, there is minimal epidemiologic evidence to support this. Case-control studies are recommended to assess the relation of endocrine factors to obstructive sleep apnea syndrome in a rigorous fashion. A limited number of mortality studies have suggested decreased survival in persons with the obstructive sleep apnea syndrome, possibly primarily due to vascular-related disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1983

Value of portable real-time ultrasound in the ICU.

A 2-yr retrospective analysis was undertaken of the value of portable real-time sonography on 107 patients in the ICU. A total of 88 abnormal findings were detected in 69 of 107 patients. Of these, 36 were clinically significant as the patients' therapy and clinical courses were modified by the ultrasound findings. In many instances, where the ultrasound findings were negative, this information had, nevertheless, important ramifications to the clinician and was frequently as helpful to him as a positive finding. A 20% yield of unsuspected abnormalities was also found, some of which were clinically significant and warranted specific action. We believe that the portable real-time ultrasound examination is, indeed, a valuable diagnostic tool to the ICU clinician and is most likely underutilized.

Adult↗