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101.
102.
Pressure-controlled palpation: a new technique which increases the reliability of manual palpation 总被引:2,自引:0,他引:2
L Bendtsen R Jensen NK Jensen J Olesen 《Cephalalgia : an international journal of headache》1995,15(3):205-210
The objective of the present study was to investigate whether the reliability of tenderness evaluation can be increased by using a new technique called "pressure-controlled palpation" (pcp). The technique has been made possible by a newly invented piece of equipment called a palpometer, with which a pressure-sensitive plastic film attached to the index finger records the pressure exerted. In 15 patients with chronic tension-type headache and in 15 healthy volunteers, 2 investigators studied myofascial tenderness using conventional palpation and pressure-controlled palpation. Tenderness was scored on a 4-point scale in each of the examined pericranial regions. The sum of tenderness scores recorded by two observers using conventional palpation differed significantly ( p = 0.0003), while results did not differ between observers using pressure-controlled palpation ( p = 0.89). During palpation with seven different pressure intensities a positive and linear relation between pressure and pain intensity was found ( p = 0.00006). Pain intensity reported by the subjects correlated highly with tenderness scored by the observer ( rs = 0.95, p < 0.0001). These results demonstrate for the first time that tenderness scores can be compared between observers if palpation pressure is controlled. Pressure-controlled palpation represents a major improvement on current palpation techniques and should be standard in future research on myofascial pain disorders. 相似文献
103.
Branka Grskovi? Goran Ferencak Ana Stavijeni? Rukavina Monika Karija Ivana Furac Milovan Kubat 《Clinical chemistry and laboratory medicine》2002,40(6):559-562
We used single-strand conformation polymorphism analysis for mutational screening in two candidate genes, MPZ and PMP22, which have an important role in the pathogenesis of Charcot-Marie-Tooth disease (CMT) and related peripheral neuropathies. A novel Ser8Ser polymorphism was found in exon 1 of the MPZ gene in two heterozygous subjects, in a father with mild CMT2 phenotype and his daughter with normal clinical data. Thr118Met polymorphism was found in exon 5 of the PMP22 gene. The patient heterozygous for 118Met allele had CMT1 disease. We can conclude that the occurrence of the 118Met allele does not usually cause CMT1 and that it is not a clinically relevant disease marker. 相似文献
104.
Desirée H. J. L. M. Koopmanschap Alireza R. Bayat Bela Kubat Henri M. de Bakker Mathias W. M. Prokop Willemijn M. Klein 《Forensic science, medicine, and pathology》2016,12(3):248-256
Purpose
After death, a series of changes occur naturally in the human body in a fairly regular pattern. These postmortem changes are detectable on postmortem CT scans (PMCT) and may be useful in estimating the postmortem interval (PMI). The purpose of our study is to correlate the PMCT radiodensities of the cerebrospinal fluid (CSF) and vitreous humor (VH) to the PMI.Methods
Three patient groups were included: group A consisted of 5 donated cadavers, group B, 100 in-hospital deceased patients, and group C, 12 out-of-hospital forensic cadavers. Group A were scanned every hour for a maximum of 36 h postmortem, and the tympanic temperature was measured prior to each scan. Groups B and C were scanned once after death (PMI range 0.2–63.8 h). Radiodensities of the VH and CSF were measured in Hounsfield units. Correlation between density and PMI was determined using linear regression and the influence of temperature was assessed by a multivariate regression model. Results from group A were validated in groups B and C.Results
Group A showed increasing radiodensity of the CSF and VH over time (r 2 CSF, 0.65). PMI overruled the influence of temperature (r = 0.99 and p = 0.000). Groups B and C showed more diversity, with CSF and VH radiodensities below the mean regression line of Group A. The formula of this upper limit indicated the maximum PMI and was correct for >95 % of the cadavers.Conclusion
The results of group A showed a significant correlation between CSF radiodensity and PMI. The radiodensities in groups B and C were higher than in group A, therefore the maximum PMI can be estimated with the upper 95 % confidence interval of the correlation line of group A.105.
106.
Inspite of spectacular technological advances made in the recent years, modern medicine has not been able to deny the inevitability of death. Slowly but surely, the approach towards death is changing with increasing emphasis on various end of life care decisions. Many of these decisions are being actively discussed, debated and practised all over the world. Palliative care in hospice has become an accepted mode of management of terminally ill patients, for whom the prognosis is limited. Increase in life expectancy of the Indian people and a strong movement to authorise ex-servicemen for treatment of malignant and other chronic diseases in service hospitals, requires the Armed Forces to consider these end of life care decisions and plan for terminal care in hospice.KEY WORDS: End of Life Care Decision, Hospice, Palliative Care 相似文献
107.
Costing a service product is a challenging but important tool for cost control. Different methods used for costing may provide varying costs and the choice of the method used becomes important. Use of absorption costing and marginal costing method and treatment of labour cost as variable and fixed cost provided different results in the present study of the cost of below knee patellar tendon bearing prosthesis. The study shows that marginal costing should also be done along with the absorption cost as it provides better indicator for cost control.Key Words: Absorption Costing, Cost Control, Marginal Costing, Prosthesis 相似文献
108.
Hospitals are by nature complex organisations and the complexity is compounded in service hospitals with perceived notion of service deficiencies. Quality has emerged as a major issue in health care sector and TQM has been accepted as a major long-term strategic initiative towards continuously improving quality of health care. Key concepts of TQM start with top management leadership with emphasis on process and customer focus. Implementation of TQM in service hospitals will require Quality Management awareness, training and framework development as well as development of customer awareness. TQM has been widely applied in clinical field with successful outcome. TQM is not a short-term solution, it has to be understood and practised as a long-term strategic commitment.Key Words: Quality in Health Care, Total Quality Management(TQM) 相似文献
109.
Rafet Basar Ayse Kubat Uzum Bulent Canbaz Sema Ciftci Dogansen Sevgi Kalayoglu-Besisik Senem Altay-Dadin Ferihan Aral Nese Colak Ozbey 《Archives of gynecology and obstetrics》2013,287(5):839-843
Introduction
During pregnancy, a progressive increase in serum triglyceride (TG) and cholesterol levels is observed whereas TG levels mostly remain <300 mg/dl. In women with genetic forms of hypertriglyceridemia, pregnancy may cause extremely elevated TG levels leading to potentially life-threatening pancreatitis attacks and chylomicronemia syndrome. The only safe medical treatment option during pregnancy is ω-3 fatty acids, which have moderate TG lowering effects. Therapeutic apheresis could be used as primary treatment approach during pregnancy.Materials and methods
We reported the effect of double filtration apheresis in one pregnant women with severe hypertriglyceridemia, therapeutic plasmapheresis and double filtration methods in the other severe hypertriglyceridemic pregnant woman; a 32-year-old pregnant woman (patient 1) with a history of hypertriglyceridemia-induced acute pancreatitis during pregnancy and a 30-year-old pregnant woman with extremely high TG levels (12,000 mg/dl) leading to chylomicronemia syndrome (patient 2). Medical nutrition therapy and ω-3 fatty acids were also provided. Double filtration apheresis (patient 1) and plasmapheresis + double filtration apheresis (patient 2) were used.Result and conclusion
When we calculated the TG levels before and after therapeutic apheresis, maximum decrease achieved with double filtration apheresis was 46.3 % for patient 1 and 37.3 % for patient 2. However, with plasmapheresis TG level declined by 72 % in patient 2. Plasmapheresis seemed to be more efficient to decrease TG levels. Iron deficiency anemia was the main complication apart from technical difficulties by lipemic obstruction of tubing system. Healthy babies were born. Delivery led to decreases in TG levels. It is concluded that during pregnancy therapeutic apheresis is an effective method to decrease extremely high TG levels and risks of its potentially life-threatening complications. 相似文献110.
Rambha Pathak Ravi C Sharma U C Parvan B P Gupta Rishi K Ojha NK Goel 《The Australasian medical journal》2011,4(1):15-21