Patients and Methods. Patients The study was approved by the hospital ethics committee and was conducted according to the principles stated in the Helsinki convention. Written informed consent was obtained the day before surgery. Fifteen patients (11 men and 4 women, mean age 73 years) scheduled to undergo elective cardiac surgery on cardiopulmonary bypass (11 patients with CAGB and 4 patients with mitral valve annuloplasty) were included in the study. Patients with significant valvular regurgitation and/or atrial fibrillation, aneurismal deformities to the aorta or symptomatic peripheral vascular disease were excluded. Patients were pre-medicated with sublingual lorazepam (0.05mg/kg). Radial arterial blood pressure was monitored via a 20 Gauge, 3.8 xx xxxx radial catheter inserted by Seldinger technique and connected to a pressure transducer (PX600F, Xxxxxxx Lifesciences). Central venous pressure was measured with a MultiCath 3 venous catheter (Vigon GmbH & Co, Aachen, Germany), connected to a pressure transducer (PX600F, Xxxxxxx Lifesciences). Anaesthesia during surgery was performed according to institutional standards. After transfer of the patients to the ICU, a second arterial pressure line was inserted with a Seldinger technique into the right femoral artery (4F, 16cm long thermistor- tipped arterial catheter PV2014L16; Pulsion Medical Systems, Munich, Germany) and connected to a cardiac output monitor (XxXXX, Pulsion). Pulse contour cardiac output was calibrated with 3 transpulmonary thermodilution measurements. For each thermodilution measurement, 20ml cold (3-8oC) saline was injected, via the central venous catheter. The results and calculated average of the 3 cardiac output measurements were documented. All patients were mechanically ventilated with an oxygen level of 40%, a respiratory frequency of 12-14 min-1, and positive end expiratory pressure of 5 cmH2O. Tidal volume (6-8 ml.kg-1) was adapted to maintain the arterial PCO2 between 40 and 45 mmHg. A hemodynamic stable status was achieved using fluids and catecholamines. The observation period started after introduction of the femoral artery catheter and stopped at the onset of weaning. During the observation period, up to 6 hours, the radial artery pressure, femoral artery pressure and central venous pressure were continuously stored on computer disk. The sample frequency was 100Hz and the resolution 0.2 mmHg. It should be noted that during this recording sessions great care was taken to flush, check, and if nece...
Patients and Methods. The PiKo-1 (Ferraris Cardiorespiratory, Louisville, CO, USA) is a lightweight, small, inexpensive electronic sensing device that can measure PEF and FEV1. The device can store 96 readings and report errors in the procedure. The reading itself is displayed along with a corresponding color zone, which can be adjusted according to the reference values. Data stored in the device can also be transferred to a computer or transmitted to other units1 (Figure 1). The Masterlab pneumotachograph (Xxxxxx XX, Würzburg, Germany) is a device that is widely used in clinical practice for measuring spirometric variables. However, the size of the device is a hindrance, and personnel with specific training are required. For these reasons, other devices, such as the PiKo-1 are under development. The aim is to make these devices easier to operate so that, once their readings have been shown to agree with those of the pneumotachograph, physicians can use them in the clinical practice. In clinical research, the reliability of a device is usually assessed by comparing the results with those of another one widely used in clinical practice for agreement or discrepancies. If a more practical alternative to the reference device becomes available, the agreement between systems should be determined. When a variable in a comparative analysis is continuous and quantitative, the intraclass correlation coefficient (ICC) is more appropriate than the Xxxxxxx correlation coefficient (r), as it can indicate general agreement between 2 or more methods of measurement or different observations.8 Another simple and visual method is the so-called Xxxxx-Xxxxxx analysis to assess agreement between 2 systems of measurement.9 We have undertaken a randomized, single-blind, cross- sectional study of agreement between 2 measurement devices in a specialist care setting—the lung function testing laboratory of the Hospital General Yagüe in Burgos, Spain, at 867 m above sea level. Population Patients were recruited from those attending our specialist laboratory between March 15 and April 24, 2004 for lung function testing. Patients aged between 20 years and 80 years were included, and those who did not understand the technique after a brief explanation were excluded in order to avoid procedural errors. Sample Size and Selection A table of random numbers was used to select patients from among those who attended the lung function testing laboratory and who met the inclusion criteria. A sample size of 40 patients...
Patients and Methods. Participants According to XXXXX committee recommendation we decided on a sample size of 3000 schoolchildren.4 In Iranian educational year 2001-2002, three thousand- fifty-three students aged 13-14 years completed Persian translated XXXXX written asthma questionnaire first followed by video asthma questionnaire (AVQ3.0) at schools.
Patients and Methods. To investigate agreement between indirect calorimetry and several REE estimating equations in 38 ESRD patients on peritoneal dialysis, we performed indirect calorimetry and compared the results with XXXx estimated using 5 equations [Xxxxxx-Xxxxxxxx (HBE), Mifflin, WHO, Xxxxxxxxx, and Xxxxxxxxxx]. Results: Xxxxxxxx XXX was 1393.2 ± 238.7 kcal/day. There were no significant differences between measured and estimated XXXx except Mifflin (1264.9 ± 224.8 kcal/day). Root mean square errors were smallest for HBE, followed by Xxxxxxxxx, Xxxxxxxxxx, and WHO, and largest for Mifflin (171.3, 171.9, 174.6, 175.3, and 224.6, respectively). In Xxxxx-Xxxxxx plot, correlation coefficients between mean values and differences were significant for HBE (r = 0.412, p = 0.012) and tended to be significant for Xxxxxxxxxx (r = 0.283, p = 0.086). In DM patients and patients with overhydration, HBE showed signi- ficant underestimation when REE increased.
Patients and Methods. 98 Patients Meeting all legal and ethical criteria set out by the local and ethical committees, fresh peripheral blood samples were obtained from 86 juvenile type 1 diabetic patients at diagnosis (mean ± SD; age 9.3 ± 3.5 years; 34 females). Diabetes was diagnosed according to the criteria set out by the World Health Association (19). Of every patient, a sibling control was included as control for serological assessment of MBL concentration and MBL complex activity (age 10.3 ± 4.8 years; 36 females). In order to avoid a parental selection bias, a control group of 69 healthy blood donors was included for allele frequency analysis. Serum was immediately aliquotted and frozen at -70°C. DNA was routinely isolated from heparinized blood. MBL genotyping
Patients and Methods. This randomized, single-blind study included 40 patients who attended the clinic for lung function testing. The 2 measurement devices were the Masterlab pneumotachograph and the PiKo-1. A correction factor estimated by the manufacturer was applied to the measurements taken with the PiKo-1. RESULTS: The values obtained with the 2 devices differed by a mean of 5.8218 L/min for PEF (95% confidence interval [CI], –9.4809 to 21.1387) and 0.001 L for FEV1 (95% CI, –0.0616 to 0.0636). The intraclass correlation coefficient was 0.9652 (95% CI, 0.9336-0.9819) for PEF and 0.9876 (95% CI, 0.9761-0.9936) for FEV1.
Patients and Methods. Trial design The trial design and eligibility criteria are reported previously13 and therefore only the main features are summarised. Patients were randomised between preoperative RT or CRT and to either postoperative CT or no further treatment (Figure 1). Inclusion criteria were T3 or resectable T4 M0 adenocarcinoma of the rectum located within 15 cm from the anal verge, aged 80 years or less, and a WHO performance status of 0 or 1. The study Preoperative RT Preoperative CRT Preoperative RT Preoperative CRT Surgery Surgery Surgery Surgery Postoperative CT Postoperative CT Randomisation
Patients and Methods. This was a cross sectional study1 performed at Department of Oral and Maxillofacial Surgery, de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore. The duration of study was six months from 20th November 2016 to 19th May 2017. Total of 85 patients were recruited in the study. All the patients were treated on out- patient basis. Patients with ≥12 years and above age having white lesion in oral cavity for the duration ≥14 days and ≤6 months were a part of this study. Patients with any medical emergency as myocardial infarction, cerebro vascular accidents, an- xxxx pectoris, road traffic accidents, pregnant females and oral white lesions that were present since birth and greater than 4 cm in size were excluded from the study. The study was sent for approval to ethical com- mittee of de’Montmorency College of Dentistry and informed consent was taken from the patients in the understandable language by them, before their inclu- sion in the study. All the patients presented to the Oral & Maxillofacial Surgery department with white lesion of the mouth were subjected to complete history and clinical examination of oral cavity & maxillofacial region. Routine baseline investigations were advised and concerned radiographs were taken. All the patients were examined and treated by the same oral and max- illofacial surgeon. All patients were given local anesthesia.2,8 Local infiltration of lignocaine anesthesia (2%) with xxxxx- xxxxx 1:100,000 for hemostasis was used at the incision site under strict aseptic measures. Excisional biopsy was done for lesion less than 2cm,and incisional biop- sy was done for lesions greater than 2cm. All biopsy specimens were fixed in 10% formalin and sent for histopathological report to the histopathologist. After achieving the adequate haemostasis the incision was closed using 3-0 vicryl suture. All patients were given postoperative antibiotics and analgesics for 5 days. Oral hygiene measures were taken using 0.2% chlorhexidine mouthwash .1,4,5,6 All the data was entered and analyzed on SPSS version 17 software (SPSS, Inc.,Chicago, IL, USA). Continuous / Quantitative variables such as age of patient were presented in mean ± standard deviation. Categorical / qualitative variables such as agreement and gender of the patient, site of lesions, clinical and histopathological diagnosis were computed in the terms of frequency and percentages. Kappa statistics was calculated to determine the strength of agreement between clinical an...
Patients and Methods. We conducted a descriptive retrospective study on a series of all patients treated for WT in our institution between June 1991 and August 2017. Inclusion criteria were as follows: age under 18, avail- able and complete medical record, histologically proven diagnosis of WT. Medical records were analyzed, and data were collected on clinical, radiological, and histological characteristics, as well as treat- ment modalities (protocol SIOP9, SIOP 93-01, or SIOP 2001, type of chemotherapy, and indications of radiotherapy) and patients’ outcome (first complete remission [CR], date of tumor recurrence, second CR, or death). Clinical signs of suspected tumor rupture were defined as intense abdominal pain, history of recent abdominal trauma, and acute hemorrhage with rapid decrease in hemoglobin level. Radiological signs of suspected tumor rupture were defined as capsular breach, hemorrhage within the tumor or in the perirenal space, retroperi- toneal and/or intra-abdominal effusion (spontaneously hyperdense ascites, independently of their moderate or diffuse volume). They were assessed on CT scan evaluation at diagnosis and after neoad- juvant chemotherapy. All the CT scans of suspected cases have been reviewed for this study. Tumor rupture was assessed during surgery by direct visualization of a preoperative rupture, of metastatic peritoneal nodules or in case of an intraoperative rupture. Anatomopathological analysis of the piece of nephrectomy was performed by the local insti- tution pathologists, then was reviewed by a panel of leading pathology experts, according to the SIOP protocol guidelines. It included patho- logical stage, risk group, and existence of a histologically proven tumor rupture.
Patients and Methods. The liver intensive care unit (LITU) at King’s College Hospital is a tertiary referral centre for patients with acute liver failure (ALF). In a previous study from this unit, pregnancy related liver disease accounted for less than 5% of all admissions with ALF between 1986 to 1996. (74) All patients admitted to the LITU with pregnancy associated liver disease between 1997 and 2008 were reviewed and included in the current study. The diagnosis of HELLP syndrome was made using the following criteria; the presence of pre-eclampsia and a platelet count of less than 100x10³ cells/µl, a serum aspartate aminotransferase (AST) level of greater than 70 IU/L, a serum lactate dehydrogenase (LDH) level of greater than 600 IU/ml and/or a total bilirubin of greater than 1.2 mg/dl and the findings of a microangiopathic haemolytic anaemia with characteristic schistocytes on a blood film. (200) All patients met the Tennessee criteria for complete HELLP syndrome, with haemolysis on a peripheral blood film, a raised LDH >600IU/L, thrombocytopenia <100x109/L and elevated transaminases AST>70IU/L. (70)
