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A community based study of urogenital chlamydia trachomatis in males aged fifteen years and above,Dembia District,northwest Ethiopia 总被引:1,自引:0,他引:1
Mitike G Genetu A Kassu A Aseffa A Woldemichael K Kebede Y Melesse T Dubisso B Admassu R Debebe A 《Ethiopian medical journal》2002,40(3):251-257
Chlamydia trachomatis is one of the most common causes of sexually transmitted diseases in sexually active males and females. Infertility is one of the serious complications of urogenital chlamydial infections. This study was carried out in Chuwahit town and the surrounding village, which is located southwest of Gondar town. The main objective was to estimate the prevalence of urogenital Chlamydia trachomatis among males aged fifteen years and above. The design used was a cross sectional survey. First catch urine was collected from males 15 years and above and interviews were made using a questionnaire. The urine samples were tested with an Enzyme Immuno-Assay (EIA), which is useful in rapid detection of chlamydia antigen. Among 199 males included in the study, thirty-three (16.6%) had laboratory evidence of urogenital Chlamydia trachomatis. The mean (SD) age of the study subjects was 29.3 (+/- 9) years. Students (8 out of 21, 38%) had the highest prevalence of urogenital Chlamydia compared to the other groups (OR = 4.10, 95% CI = 1.12, 14.48). The magnitude of urogenital chlamydia infection in males was high in the study area. Health professionals need to consider genital Chlamydial infections in the management and control of sexually transmitted diseases. Increasing the awareness of students towards urogenital Chlamydial trachomatis and teaching them about the benefits of using condoms is recommended. 相似文献
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Rajiv Agarwal Jennifer E. Bills Paulos M. Yigazu Terri Abraham Andinet B. Gizaw Robert P. Light Dagim M. Bekele Getachew G. Tegegne 《Clinical journal of the American Society of Nephrology》2009,4(1):77-85
Background and objectives: Measurement of GFR is important for the management of chronic kidney disease (CKD). Although bolus administration of radiocontrast agents is commonly used to measure GFR, the optimal duration of sampling to assess their plasma clearance is unknown. The purpose of this study was to evaluate whether the duration of plasma sampling influences precision and estimation of GFR.Design, setting, participants, & measurements: GFR was measured by sampling plasma 12 times over 5 h in 56 patients with CKD (mean age 64 yr, 98% men, 79% Caucasian, 34% diabetics, estimated GFR 31.8 ± 14.2 ml/min/1.73 m2). In a subset of 12 patients we measured GFR by sampling plasma 17 times over 10 h.Results: Short sampling intervals considerably overestimated GFR measured using total plasma iothalamate clearance, especially in larger patients. In the higher estimated GFR group (>30 ml/min/1.73m2), the 5-h GFR was 17% higher and 2-h GFR 54% higher compared with the 10-h GFR, which averaged 40.3 ml/min/1.73 m2. In the lower estimated GFR group (<30 ml/min/1.73m2), the 5-h GFR was 36% higher and 2-h GFR 126% higher compared with the 10-h GFR, which averaged 22.2 ml/min/1.73 m2. Short sampling duration also reduced the precision of the estimated GFR from 1.67% for 10-h GFR, to 3.48% for 5-h GFR, and to 7.07% for 2-h GFR.Conclusions: GFR measured over a longer duration with multiple plasma samples spanning the distribution and elimination phases may improve precision and provide a better measure of renal function.The clinical manifestations of chronic kidney disease (CKD) are heterogenous, but it is generally accepted that the staging of CKD rests upon an accurate knowledge of GFR (1). Although urinary clearance of radioactive iothalamate has been used as the reference method to measure GFR (2), many clinical and research laboratories now use plasma clearance of nonradioactive radiocontrast dyes instead (3–7). Plasma clearance of iothalamate can be measured either after continuous infusion of iothalamate to achieve steady state and measuring plasma iothalamate (4,5,7), or after an intravenous bolus (3,6,8). The latter technique involves administering a bolus dose of iothalamate or another radiocontrast dye and sampling blood at timed intervals to study its pharmacokinetics. We and others have reported that plasma iothalamate clearance provides improved precision over urinary clearances (8,9). Because of improved precision, the plasma iothalamate clearance technique appears attractive for longitudinal studies in which sample size can be reduced to detect a given change in GFR (9).The optimal duration of plasma sampling to best ascertain GFR remains undefined—no minimum duration of sampling is recommended. Accordingly, uncertainty exists when planning the optimal duration of GFR studies for the long-term follow-up renal function. Review of published work reveals that the duration of plasma iothalamate clearances measurement has varied anywhere between 2 to 10 h (8,10–12). In a study that measured plasma iothalamate concentration time profile over 10 h (12), plasma clearance was noted to be log-linear in all instances after 120 min, whereas another study reported that a 2-h time frame was perfectly adequate (10). A more recent multicenter study in children in the United States suggested 5 h as an adequate time frame for sampling (6).We sought to evaluate the optimal duration of measurement of plasma iothalamate clearance in a cohort of patients with CKD. We hypothesized that short studies would overestimate GFR and that longer studies would reduce this error. We reasoned that short studies in patients with lower GFR would be associated with greater discrepancy compared with studies with longer sampling duration and tested the hypothesis that shorter duration studies would sacrifice precision compared with longer studies. 相似文献
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Purpose A balanced fluid replacement strategy appears to be promising for correcting hypovolemia. The benefits of a balanced fluid
replacement regimen were studied in elderly cardiac surgery patients.
Methods In a randomized clinical trial, 50 patients aged >75 years undergoing cardiac surgery received a balanced 6% HES 130/0.42
plus a balanced crystalloid solution (n = 25) or a non-balanced HES in saline plus saline solution (n = 25) to keep pulmonary capillary wedge pressure/central venous pressure between 12–14 mmHg. Acid-base status, inflammation,
endothelial activation (soluble intercellular adhesion molecule-1, kidney integrity (kidney-specific proteins glutathione
transferase-alpha; neutrophil gelatinase-associated lipocalin) were studied after induction of anesthesia, 5 h after surgery,
1 and 2 days thereafter. Serum creatinine (sCr) was measured approximately 60 days after discharge.
Results A total of 2,750 ± 640 mL of balanced and 2,820 ± 550 mL of unbalanced HES were given until the second POD. Base excess (BE)
was significantly reduced in the unbalanced (from +1.21 ± 0.3 to −4.39 ± 1.0 mmol L−1 5 h after surgery; P < 0.001) and remained unchanged in the balanced group (from 1.04 ± 0.3 to −0.81 ± 0.3 mmol L−1 5 h after surgery). Evolution of the BE was significantly different. Inflammatory response and endothelial activation were
significantly less pronounced in the balanced than the unbalanced group. Concentrations of kidney-specific proteins after
surgery indicated less alterations of kidney integrity in the balanced than in the unbalanced group.
Conclusions A total balanced volume replacement strategy including a balanced HES and a balanced crystalloid solution resulted in moderate
beneficial effects on acid-base status, inflammation, endothelial activation, and kidney integrity compared to a conventional
unbalanced volume replacement regimen. 相似文献
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Andinet Enquobahrie David Gobbi Matthew W. Turek Patrick Cheng Ziv Yaniv Frank Lindseth Kevin Cleary 《International journal of computer assisted radiology and surgery》2008,3(5):395-403
Objective Many image-guided surgery applications require tracking devices as part of their core functionality. The Image-Guided Surgery
Toolkit (IGSTK) was designed and developed to interface tracking devices with software applications incorporating medical
images.
Methods IGSTK was designed as an open source C++ library that provides the basic components needed for fast prototyping and development
of image-guided surgery applications. This library follows a component-based architecture with several components designed
for specific sets of image-guided surgery functions. At the core of the toolkit is the tracker component that handles communication
between a control computer and navigation device to gather pose measurements of surgical instruments present in the surgical
scene. The representations of the tracked instruments are superimposed on anatomical images to provide visual feedback to
the clinician during surgical procedures.
Results The initial version of the IGSTK toolkit has been released in the public domain and several trackers are supported. The toolkit
and related information are available at .
Conclusion With the increased popularity of minimally invasive procedures in health care, several tracking devices have been developed
for medical applications. Designing and implementing high-quality and safe software to handle these different types of trackers
in a common framework is a challenging task. It requires establishing key software design principles that emphasize abstraction,
extensibility, reusability, fault-tolerance, and portability. IGSTK is an open source library that satisfies these needs for
the image-guided surgery community. 相似文献
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RATIONALE AND OBJECTIVES: The objective of this work was to develop and evaluate a robust algorithm that automatically detects small solid pulmonary nodules in whole lung helical CT scans from a lung cancer screening study. MATERIALS AND METHODS: We developed a three-stage detection algorithm for both isolated and attached nodules. The algorithm consisted of nodule search space demarcation, nodule candidates' generation, and a sequential elimination of false positives. Isolated nodules are nodules that are surrounded by lung parenchyma, whereas attached nodules are connected to large, dense structures such as pleural and/or mediastinal surface. Two large well-documented whole lung CT scan databases (Databases A and B) were created to train and test the detection algorithm. Database A contains 250 sequentially selected scans with 2.5-mm slice thickness that were obtained at Weill Medical College of Cornell University. With equipment upgrade at this college, a second database, Database B, was created containing 250 scans with a 1.25-mm slice thickness. A total of 395 and 482 nodules were identified in Databases A and B, respectively. In both databases, the majority of the nodules were isolated, comprising 72.1% and 82.3% of nodules in Databases A and B, respectively. RESULTS: The detection algorithm was trained and tested on both Databases A and B. For isolated nodules with sizes 4 mm or larger, the algorithm achieved 94.0% sensitivity and 7.1 false positives per case (FPPC) for Database A (2.5 mm). Similarly, the algorithm achieved 91% sensitivity and 6.9 FPPC for Database B (1.25 mm). The algorithm achieved 92% sensitivity with 17.4 FPPC and 89% sensitivity with 5.5 FFPC for attached nodules with sizes 3 mm or larger in the Database A (2.5 mm) and Database B (1.25 mm), respectively. CONCLUSION: The developed algorithm achieved practical performance for automated detection of both isolated and the more challenging attached nodules. The automated system will be a useful tool to assist radiologists in identifying nodules from whole lung CT scans in a clinical setting. 相似文献