A novel technique to measure severity of pediatric pectus excavatum using white light scanning.

Background/purpose

Computed tomography (CT) derived Haller Index (HI) remains the standard for quantifying severity in patient with pectus excavatum (PE). Optical scanning described in literature reports optimistic results and new indices that correlate with HI. This study assessed the feasibility of a handheld White Light Scanner (WLS) to obtain 3D measurements and indices of PE deformity.

Feasibility and reliability of a physical fitness tests battery for adults with intellectual disabilities: The SAMU DIS-FIT battery

BackgroundPeople with intellectual disability (ID) have lower performances in physical fitness (PF) tests than people without ID, a situation that exists during all the life stages. However, the assessment of the FP of persons with ID often uses instruments that were designed for non-disabled people.AimTo check the reliability and feasibility of 8 PF tests in adults with mild to moderate ID.MethodsA cross-sectional study was carried out with a test-retest design in a maximum interval of 2 weeks with 240 adults (160 men and 80 women) with mild to moderate ID in order to assess the feasibility and reliability of the following 8 tests: body mass index (BMI), waist circumference (WC), the timed up & go test (TUG), the deep trunk flexion test (DTF), the hand grip test (HG), the timed stand test (TST), the 30-s sit-up (SUP) test, and the 6-min walk test (6MWT). The complete battery was called the SAMU-Disability Fitness Battery (SAMU-DISFIT). The psychometric properties of the battery, feasibility, reliability, the standard error of the measurement (SEM) and the minimal detectable change (MDC) were calculated.ResultsThe TUG, DTF, HG, TST, and 6MWT showed an intraclass correlation coefficient (ICC) from fair to high reliability. Only the SUP test in men had an ICC lower than 0.7 and high SEM values.ConclusionThe psychometric properties provide robust data on the use of the SAMU-DISFIT battery in people with ID and can be considered a useful tool for assessing PF in adults with mild to moderate ID in future research.     

两种靶控方法输注异丙酚和瑞芬太尼的安全性和有效性比较

目的 比较靶控血浆浓度和效应室浓度输注异丙酚和瑞芬太尼的安全性及有效性。方法 选择44例腹腔镜胆囊切除的病人,年龄18～65岁,ASA Ⅰ～Ⅱ级,随机分为靶控血浆浓度组(P组)和效应室浓度组(E组)。设定异丙酚和瑞芬太尼的靶浓度分别为4 μg/ml和2 ng/ml。观察给药后意识消失时间、血液动力学变化以及听觉诱发电位指数(AAIs)的变化。术中调整两药靶浓度保持AAIS低于20。记录术毕停药后自主呼吸恢复和睁眼时间和AAIs的恢复。结果 E组意识消失的时间[(0.45±0.10)min]明显短于P组;此时两药的用量也明显高于P组。两组均能引起明显的低血压,但降低程度相似,且均未见严重的心血管副作用。AAIs在意识消失时P组为41±22;E组49±16:但插管时均在20以下。术中血液动力学保持较低水平(P<0.01)。两组的插管评分、麻醉质量评分相似。术后自主呼吸恢复时间和睁眼时间两组均无统计学差异。Aldrate评分及手术结束时疼痛评分差异均无显著性。结论靶控血浆和效应室浓度输注均可达到满意的麻醉效果,但靶控效应室诱导时间更短,且无明显心血管副作用。     

中国西部城市和农村开展面粉营养素强化的可行性分析

目的通过对甘肃农产区居民的饮食习惯、营养知识和态度的调查,从需方的角度对开展面粉营养素强化的可行性进行探讨。方法采用定性和定量调查相结合的方法,对4个地区的城市和农村的男性和女性分别进行现状和原因的调查分析。结果被调查地区多数城市(92.7%)和农村(60.7%)家庭日常饮食以面食为主,94.7%的城市家庭购买面粉,而在农村地区,多数家庭自己种植或购买小麦。城市居民较农村对营养和维生素有更多的了解和关注。农村男性对面粉营养素强化持怀疑态度,女性更加关注孩子的营养,认为目前的饮食单一,孩子可能营养不足。结论与农村地区相比,城市地区的社会经济条件和知识基础较利于开展面粉强化工作。     

Percepciones estudiantiles sobre las propiedades del examen clínico objetivo estructurado en Uruguay. Disponiendo un cuestionario válido para analizar la factibilidad del nuevo formato durante la transición curricular

Introduction

Although an objective structured clinical examination (OSCE) format has been applied in Uruguay since 2004, and providing reliable performance measures, perceptions of it properties and level of student satisfaction have not been determined.

腔镜肝切除术治疗肝内胆管结石的可行性和微创分析

目的：对腔镜肝切除治疗肝内胆管结石的可行性和微创进行分析，实现对胆结石的治疗。方法：选取本院的24例胆结石患者进行治疗，在腹腔镜下对患者进行胆结石的切除，患者在切除的过程中均无任何不适现象，患者的切除手术均成功完成。结果：24例患者整体上手术均顺利完成，手术中没有出现任何出血现象，患者没有术后并发症。结论：在宫腔镜下对患者肝内胆结石进行切除的效果显著。     

院内拓展训练在医院岗前培训中开展的可行性分析

院内拓展训练是一种全新的学习方式和训练方式。本文客观分析了院内拓展训练的优势和其在医院新员工岗前培训中开展的有利条件,认为院内拓展训练是对新员工岗前培训内容的有益补充,有利于推动传统岗前培训模式的转变,对全面提高新员工的综合素质具有重要意义。     

In vivo dosimetry in gynecological applications—A feasibility study

PurposeTo investigate the feasibility of in vivo dosimetry using microMOSFET dosimeters in patients treated with brachytherapy using two types of gynecological applicators.Methods and MaterialsIn this study, a microMOSFET was placed in an empty needle of an Utrecht Interstitial Fletcher applicator or MUPIT (Martinez Universal Perineal Interstitial Template) applicator for independent verification of treatment delivery. Measurements were performed in 10 patients, with one to three microMOSFETs per applicator and repeated for one to four fractions, resulting in 50 in vivo measurements. Phantom measurements were used to determine characteristics of the microMOSFETs.ResultsPhantom measurements showed a linear relationship between dose and microMOSFET threshold voltage, and a calibration coefficient (mV/cGy) was determined. Reproducibility of repeated 50 cGy irradiations was 2% (1 standard deviation). Distance and angle dependencies were measured and correction factors were determined. Subsequently, three microMOSFETs were placed in a phantom to measure a validation plan. The difference between predicted and measured dose was less than the measurement uncertainty (±9%, 2 standard deviations). In vivo measurements were corrected for distance and angle dependencies. Differences between predicted and measured dose in the patients were smaller than the measurement uncertainty for the majority of the measurements.ConclusionsIn vivo dosimetry using microMOSFETs in MUPIT and Utrecht Interstitial Fletcher applicators has proved to be feasible. Reimaging should be performed after detection of differences larger than 10% between predicted and measured dose to verify the applicator configuration. Movement of the applicator relative to the target or organs at risk is undetectable with this method.     

Feasibility,acceptability, and effectiveness of a decision aid versus an informational website to promote clinical trial decision-making among cancer patients: A pilot randomized controlled trial

ObjectiveTo assess intervention feasibility and acceptability, and compare the effectiveness of the CHOICES Decision Aid (DA) versus the National Cancer Institute (NCI) Cancer Clinical Trials (CCT) website to improve knowledge about CCTs and preparedness to make an informed decision.MethodsOncology patients (n = 101) with a scheduled clinic visit were enrolled and randomized. Decision-making variables were collected at two timepoints. Post-intervention scores were examined via paired t-tests and multivariate regression analyses. Predictors of the magnitudes of the change in scores were examined in multivariable regression analyses.ResultsThe interventions were feasible to implement and acceptable to participants. Both interventions increased objective and subjective knowledge, improved clarity of opinions, and reduced decisional conflict (p-values < 0.01). Improvements in the belief that one could find out about CCTs were observed in the CHOICES DA arm (p < 0.001). Multivariable analyses controlling for educational attainment showed no significant differences in the magnitude of change in outcome variables between intervention arms, but did find that improvements in some variables in the NCI arm – but not CHOICES DA arm – were associated with previous educational attainment.ConclusionsInterventions were feasible to implement and acceptable. Improvements in knowledge and decision-making outcomes were observed in both arms, supporting the view that interventions to improve CCT decision making are effective and feasible. Our results suggest that the CHOICES DA may be more effective than an informational website in improving decision-making outcomes regardless of participants’ educational attainment.Practice implicationsCCT resources should support informed decision-making among all cancer survivors, regardless of educational attainment.     

IL-6TNF-a用于高血压脑出血早期预警分级的可行性分析

目的分析白细胞介素-6(IL-6)、肿瘤坏死因子-a(TNF-a)用于高血压脑出血早期预警分级的可行性,为高血压脑出血的治疗及预防提供参考。方法选取2013-09—2015-03我院收治的高血压患者90例为研究对象,高血压伴脑出血者纳入A组(45例),单纯高血压者纳入B组(45例),采用双抗体夹心法(ELISA)测定发病后第1天、3天、7天、15天血清IL?6及TNF-a水平,并应用受试者工作特征曲线(ROC曲线)统计分析IL-6、TNF-a水平对高血压脑出血早期分级预测价值。结果发病后1d、3dA组IL-6、TNF-a水平较B组显著升高(P0.05),第7天、15天2组IL-6、TNF-a水平均下降(P0.05);ROC曲线分析显示血清IL-6、TNF-a浓度对高血压脑出血早期分级均具有显著预测价值,且其预测价值比较无显著差异(P0.05)。结论 IL-6、TNF-a可作为高血压脑出血早期预警分级指标,值得在临床广泛应用。