Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 20
Filtrar
1.
Cancer Epidemiol ; 91: 102584, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38772062

RESUMEN

BACKGROUND: Individuals diagnosed with cancer via emergency admission are likely to have poor outcomes. This study aims to identify cancer diagnosed through an emergency hospital admission and examine predictors associated with mortality within 12-months. METHOD: A population-based retrospective 1:1 propensity-matched case-comparison study of people who had an emergency versus a planned hospital admission with a principal diagnosis of cancer during 2013-2020 in New South Wales, Australia using linked hospital, cancer registry and mortality records. Conditional logistic regression examined predictors of mortality at 12-months. RESULTS: There were 28,502 matched case-comparisons. Individuals who had an emergency admission were four times more likely to die within 12-months (Odds Ratio (OR) 3.93; 95 % confidence interval (CI) 3.75-4.13) compared to individuals who had a planned admission for cancer. Older individuals, diagnosed with lung (OR 1.89; 95 %CI 1.36-2.63) or digestive organ, excluding colorectal (OR1.78; 95 %CI 1.30-2.43) cancers, where the degree of spread was metastatic (OR 3.61; 95 %CI 2.62-4.50), who had a mental disorder diagnosis (OR 2.08; 95 %CI 1.89-2.30), lived in rural (OR 1.27; 95 %CI 1.17-1.37) or more disadvantaged neighbourhoods had a higher likelihood of death within 12-months following an unplanned admission compared to referent groups. Females (OR 0.87; 95 %CI 0.81-0.93) had an 13 % lower likelihood of mortality within 12-months compared to males. CONCLUSIONS: While some emergency cancer admissions are not avoidable, the importance of preventive screening and promotion of help-seeking for early cancer symptoms should not be overlooked as mechanisms to reduce emergency admissions related to cancer and to improve cancer survival.


Asunto(s)
Servicio de Urgencia en Hospital , Neoplasias , Humanos , Neoplasias/epidemiología , Neoplasias/diagnóstico , Neoplasias/mortalidad , Neoplasias/patología , Masculino , Femenino , Estudios Retrospectivos , Anciano , Persona de Mediana Edad , Estudios de Casos y Controles , Servicio de Urgencia en Hospital/estadística & datos numéricos , Adulto , Hospitalización/estadística & datos numéricos , Nueva Gales del Sur/epidemiología , Anciano de 80 o más Años , Adulto Joven , Australia/epidemiología , Tasa de Supervivencia , Sistema de Registros , Adolescente
2.
Glob Chall ; 7(12): 2300194, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38094865

RESUMEN

The negative environmental effects of global civil aviation growth since the 19th century lead to the emergence of the "sustainable aviation" concept. This study aims to determine the current status of sustainability discussions in developing Turkish civil aviation and its alignment with global sustainable aviation policies. The research data are collected through document analysis and key expert interviews. Document analysis is to review reports on sustainable aviation and to compare two cases of AirFrance-KLM and Turkish Airlines. Semi-structured interviews are conducted with key experts from airline companies, public institutions, and subsidiary services in the Turkish aviation sector. The analysis results are presented under the themes of "institutional, conceptual, Turkey's current situation, motivations, role of international organizations, cooperation and coordination, problems and obstacles." The results show that the Turkish civil aviation industry is enthusiastic about catching up with international standards and is successful in keeping up with the latest technologies. The private sector is leading the sector by targeting global competitiveness. Current deficiencies stem from legislation, incentives, obligations, resources, and environmental awareness. The main contribution is to be the first source and guide for future studies that aim to shed light on policymaking in Turkey as an emerging country case.

3.
Adm Soc ; 55(1): 158-183, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36606212

RESUMEN

Despite being the richest and most prepared nation in the world, the U.S. responded badly to the COVID-19 crisis. This paper examines the nature of political control and the essence of bureaucratic failure for the Centers for Disease Control and Prevention (CDC), an independent agency. In three case studies, we analyze the CDC's success in handling H1N1 and Ebola, and its failures on COVID-19. We find that the CDC suffered not only from political interference by the Trump Administration but also internal organizational problems that muted its ability to respond effectively. We conclude by offering policy prescriptions for addressing concerns of bureaucratic autonomy and success at the CDC.

4.
Endosc Ultrasound ; 11(5): 383-392, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36255026

RESUMEN

Background and Objectives: Data on the clinical efficacy of EUS-guided ablation using the HybridTherm-Probe (EUS-HTP) in locally advanced pancreatic ductal adenocarcinoma (LA-PDAC) are lacking. The aim of the study was to assess the impact of EUS-HTP added to chemotherapy (CT) on overall survival (OS) and progression-free survival (PFS) of LA-PDAC patients with local disease progression (DP) after first-line therapy, compared to CT alone in controls. Methods: LA-PDAC cases, prospectively treated by EUS-HTP, were retrospectively compared to matched controls (1:2) receiving standard treatment. Study endpoints were the OS and PFS from local DP after first-line therapy, compared through log-rank test calculating hazard ratios and differences in restricted mean OS/PFS time (RMOST/RMPFST) within prespecified time points (4, 6, and 12 months). Results: Thirteen cases and 26 controls were included. Clinical, tumor, and therapy features before and after first-line therapy were case-control balanced. The median OS and PFS were not significantly improved in cases over controls (months: 7 vs. 5 and 5 vs. 3, respectively). At 4 and 6 months, the RMPFST difference was in favor of cases (P = 0.0001 and P = 0.003, respectively). In cases and controls not candidate to further CT (N = 5 and N = 9), the median OS and PFS were not significantly improved in cases over controls (months: 6 vs. 3 and 4 vs. 2, respectively), but the RMPFST difference was in favor of cases at 4 months (P = 0.002). Conclusions: In locally progressive PDAC patients experiencing failure of first-line therapy, EUS-HTP achieves a significantly better RMPFST up to 6 months compared to standard treatment, although without a significant impact on OS.

5.
BMC Pregnancy Childbirth ; 20(1): 697, 2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-33198668

RESUMEN

BACKGROUND: Under the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers. METHODS: Anonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used. RESULTS: Half of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% < 21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%). CONCLUSION: This novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women's needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal.


Asunto(s)
Servicios de Salud Materna , Resultado del Embarazo , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Salud Mental , Evaluación de Necesidades , Embarazo , Complicaciones del Embarazo/epidemiología , Web Semántica/estadística & datos numéricos , Fumar/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Salud de la Mujer , Adulto Joven
6.
Front Psychol ; 11: 122, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32116927

RESUMEN

We performed a case comparison study to investigate the nature of interpersonal patterns in childhood trauma and the process of change therein. We analyzed three matching cases of childhood trauma that followed a psychodynamic treatment via a mixed-methods design. We found that (1) the core tendency to avoid negative reactions from others through passive behaviors emerged in all three cases, both in childhood and adulthood, (2) core interpersonal patterns transpired in the interaction between patient and therapist and thereby affected the therapeutic relationship, and (3) change ensued when a repetition of core interpersonal patterns was avoided and a new relational experience occurred. The accumulated findings across cases further resulted in several clinical implications and recommendations, such as the importance of the assessment of patients' (covert) conditions, responsiveness, supervision and facilitating patients' agency, and provided several avenues for further research.

7.
Front Psychol ; 10: 2509, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31798492

RESUMEN

Episodic memory is essential to effectively perform a number of daily activities, as it enables individuals to consciously recall experiences within their spatial and temporal environments. Virtual Reality (VR) serves as an efficacious instrument to assess cognitive functions like attention and memory. Previous studies have adopted computer-simulated VR to assess memory, which realized greater benefits compared to traditional procedures (paper and pencil). One of the most recent trends of immersive VR experiences is the 360° technology. In order to evaluate its capabilities, this study aims to compare memory performance through two tasks: immersive task and non-immersive task. These tasks differ based on the participant's view of the 360° picture: (1) head-mounted display (HMD) for immersive task and (2) tablet for non-immersive task. This study seeks to compare how memory is facilitated in both the 360° immersive picture as well as the non-immersive 360° picture. A repeated measure design was carried out in a sample of 42 participants, randomized into two groups of 21. Group 1 first observed Picture A (immersive) followed by Picture B (non-immersive) while Group 2 began with Picture B and then looked at Picture A. Each 360° picture contains specific items with some items appearing in both. Memory evaluation is assessed immediately after the exposure (recall task), then again after a 10-min delay (recognition task). Results reveal that Group 1, which began with the immersive task, demonstrated stronger memory performance in the long term as compared to Group 2, which began with the non-immersive task. Preliminary data ultimately supports the efficacy of the 360° technology in evaluating cognitive function.

8.
Sci Justice ; 58(4): 258-263, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29895457

RESUMEN

In 2015 and 2016 the Central Unit of the Dutch National Police created and submitted 21 cartridge case comparison tests as real cases to the Netherlands Forensic Institute (NFI), under supervision of the University of Twente (UT). A total of 53 conclusions were drawn in these 21 tests. For 31 conclusions the underlying ground truth was "positive", in the sense that it addressed a cluster of cartridge cases that was fired from the same firearm. For 22 conclusions the ground truth was "negative", in the sense that the cartridge cases were fired from different firearms. In none of the conclusions, resulting from examinations under casework conditions, misleading evidence was reported. All conclusions supported the hypothesis reflecting the ground truth. This article discusses the design and results of the tests in more detail.

9.
BMJ Open Diabetes Res Care ; 5(1): e000421, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29225892

RESUMEN

OBJECTIVE: Past research provides insufficient evidence to inform second-line diabetes medication prescribing when metformin is no longer sufficient. We evaluated patient, prescriber, and health plan characteristics associated with selection of second-line diabetes medications in the USA. RESEARCH DESIGN AND METHODS: We used a multiple case-comparison study design to identify characteristics associated with the probability of starting each of six second-line diabetes medication alternatives within 77 744 adults enrolled in commercial or Medicare Advantage health plans from 2011 to 2015. National administrative data were provided by a large commercial health payer. Multinomial logistic regression models were used to identify characteristics independently associated with selecting each diabetes drug class. RESULTS: From 2011 to 2015, sulfonylureas still represented 47% of all second-line drug starts, with proportionately higher use in patients ≥75 years of age (63% of drug starts). Basal insulin was more likely to be selected when a past A1c test result was >10% (13.0% vs 4.5% for those with A1c <8%; p<0.001). Initiation of a glucagon-like peptide-1 receptor agonist was associated with being female (10.1% vs 6.0% for male; p<0.001) and having a diagnosis code for obesity (10.8% vs 6.9% for no diagnosis; p<0.001). For all drug classes, the recent prescribing behavior of the provider was a strong correlate of subsequent second-line drug selection. CONCLUSIONS: Sulfonylureas continue to represent almost half of second-line diabetes medication starts in the USA. This could reflect overuse for some groups such as older adults, for whom some alternatives may be safer, although more costly and potentially less effective. Future research should compare outcomes of medication choices and conditions under which particular classes are most effective.

10.
J Mix Methods Res ; 10(3): 251-272, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27429602

RESUMEN

Qualitative comparative analysis (QCA) was developed over 25 years ago to bridge the qualitative and quantitative research gap. Upon searching PubMed and the Journal of Mixed Methods Research, this review identified 30 original research studies that utilized QCA. Perceptions that QCA is complex and provides few relative advantages over other methods may be limiting QCA adoption. Thus, to overcome these perceptions, this article demonstrates how to perform QCA using data from fifteen institutions that implemented universal tumor screening (UTS) programs to identify patients at high risk for hereditary colorectal cancer. In this example, QCA revealed a combination of conditions unique to effective UTS programs. Results informed additional research and provided a model for improving patient follow-through after a positive screen.

11.
BMC Cancer ; 16: 334, 2016 05 26.
Artículo en Inglés | MEDLINE | ID: mdl-27229687

RESUMEN

BACKGROUND: To assess the importance of heredity in the etiology of inflammatory breast cancer (IBC), we compared IBC patients to several carefully chosen comparison groups with respect to the prevalence of first-degree family history of breast cancer. METHODS: IBC cases (n = 141) were compared to non-inflammatory breast cancer cases (n = 178) ascertained through George Washington University (GWU) with respect to the prevalence of first-degree family history of breast cancer and selected environmental/lifestyle risk factors for breast cancer. Similar comparisons were conducted with subjects from three case-control studies: breast cancer cases (n = 1145) and unaffected controls (n = 1142) from the Cancer Genetic Markers of Susceptibility (CGEMS) study, breast cancer cases (n = 465) and controls (n = 9317) from the Women's Health Initiative (WHI) study, and ovarian cancer cases (n = 260) and controls (n = 331) from a study by University of Toronto (UT). RESULTS: The frequency of first-degree breast cancer family history among IBC cases was 17.0 % compared to 24.4 % for GWU breast cancer cases, 23.9 % and 17.9 % for CGEMS breast cancer cases and controls, respectively, 16.9 % and 12.6 % for WHI breast cancer cases and controls, respectively, and 24.2 % and 11.2 % for UT ovarian cancer cases and controls, respectively. IBC cases had a significantly lower prevalence of parous women than WHI breast cancer cases (OR = 0.46, 95 % CI:0.27-0.81) and controls (OR = 0.31, 95 % CI:0.20-0.49). Oral contraceptive use was significantly higher among IBC cases compared to WHI breast cancer cases (OR = 7.77, 95 % CI:4.82-12.59) and controls (OR = 8.14, 95 % CI:5.28-12.61). IBC cases had a significantly higher frequency of regular alcohol consumption (≥1 drink per day) compared to WHI controls (OR = 1.84, 95 % CI:1.20-2.82) and UT controls (OR = 1.86, 95 % CI:1.07-3.22) and higher (statistically non-significant) prevalence (21.3 %) compared to breast cancer cases from GWU (18.2 %) and WHI (15.2 %). CONCLUSIONS: The prevalence of first-degree breast cancer family history among IBC cases was lower compared to breast and ovarian cancer cases but higher than unaffected individuals. Our multiple-case inflammatory and non-inflammatory breast cancer families may reflect aggregation of common genetic and/or environmental factors predisposing to both types of breast cancer. Our findings that oral contraceptive use and regular alcohol consumption may be associated with IBC warrant further investigations.


Asunto(s)
Neoplasias Inflamatorias de la Mama/etiología , Estudios de Casos y Controles , Femenino , Interacción Gen-Ambiente , Humanos , Neoplasias Inflamatorias de la Mama/epidemiología , Persona de Mediana Edad , Prevalencia , Factores de Riesgo
12.
Front Public Health ; 4: 77, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27148521

RESUMEN

A growing body of evidence supports the association between the built environment and children walking to school (WTS), but few studies have compared WTS behaviors in cities of different sizes. This case-comparison study utilized WTS data from fourth graders in the small city of Manhattan, KS, USA (N = 171, from all eight schools) and data from fourth graders in the large city of Austin, TX, USA (N = 671 from 19 stratified-sampled schools). The same survey instrument was used in both locations. After controlling for socioeconomic and demographic variables, built environment, neighborhood, and attitudinal differences were demonstrated by the odds ratios for WTS in the small city vs. the large city. WTS in the small city was more likely to be associated with walking paths/trails and sidewalk landscape buffers en route to school despite lower perceived neighborhood social cohesion, school bus availability, and parental concerns about crime, compared to WTS in the large city. Also, the small city lacked key pedestrian infrastructure elements that were present in the large city. This study highlights important differences related to WTS behaviors and, thus, provides key insights for encouraging WTS in cities of different sizes.

13.
Int J Fertil Steril ; 10(1): 11-21, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27123195

RESUMEN

BACKGROUND: Endometriosis affects women's physical and mental wellbeing. Symptoms include dyspareunia, dysmenorrhea, pelvic pain, and infertility. The purpose of this study is to assess the correlation between some relevant factors and symptoms and risk of an endometriosis diagnosis in infertile women. MATERIALS AND METHODS: A retrospective study of 1282 surgical patients in an infertility Institute, Iran between 2011 and 2013 were evaluated by laparoscopy. Of these, there were 341 infertile women with endometriosis (cases) and 332 infertile women with a normal pelvis (comparison group). Chi-square and t tests were used to compare these two groups. Logistic regression was done to build a prediction model for an endometriosis diagnosis. RESULTS: Gravidity [odds ratio (OR): 0.8, confidence interval (CI): 0.6-0.9, P=0.01], parity (OR: 0.7, CI: 0.6-0.9, P=0.01), family history of endometriosis (OR: 4.9, CI: 2.1-11.3, P<0.001), history of galactorrhea (OR: 2.3, CI: 1.5-3.5, P=0.01), history of pelvic surgery (OR: 1.9, CI: 1.3-2.7, P<0.001), and shorter menstrual cycle length (OR: 0.9, CI: 0.9-0.9, P=0.04) were associated with endometriosis. Duration of natural menstruation and age of menarche were not correlated with subsequent risk of endometriosis (P>0.05). Fatigue, diarrhea, constipation, dysmenorrhea, dyspareunia, pelvic pain and premenstrual spotting were more significant among late-stage endometriosis patients than in those with early-stage endometriosis and more prevalent among patients with endometriosis than that of the comparison group. In the logistic regression model, gravidity, family history of endometriosis, history of galactorrhea, history of pelvic surgery, dysmenorrhoea, pelvic pain, dysparaunia, premenstrual spotting, fatigue, and diarrhea were significantly associated with endometriosis. However, the number of pregnancies was negatively related to endometriosis. CONCLUSION: Endometriosis is a considerable public health issue because it affects many women and is associated with the significant morbidity. In this study, we built a prediction model which can be used to predict the risk of endometriosis in infertile women.

14.
Sci Justice ; 55(6): 514-9, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26654088

RESUMEN

In 2010, the Netherlands Forensic Institute (NFI) and the University of Amsterdam (UvA) started a series of tests for the NFI's Firearms Section. Ten cartridge case and bullet comparison tests were submitted by various external parties as regular cases and mixed in the flow of real cases. The results of the tests were evaluated with the VU University Amsterdam (VUA). A total of twenty-nine conclusions were drawn in the ten tests. For nineteen conclusions the submitted cartridge cases or bullets were either fired from the questioned firearm or from one and the same firearm, in tests where no firearm was submitted. For ten conclusions the submitted cartridge cases or bullets were either fired from another firearm than the submitted one or from several firearms, in tests where no firearm was submitted. In none of the conclusions misleading evidence was reported, in the sense that all conclusions supported the true hypothesis. This article discusses the design considerations of the program, contains details of the tests, and describes the various ways the test results were and could be analyzed.

15.
Braz. dent. j ; 26(6): 572-579, Nov.-Dec. 2015. tab, graf
Artículo en Inglés | LILACS | ID: lil-769550

RESUMEN

The aim of this study was to analyze the transplant efficiency of non-pedicled buccal fat pad graft (BFPG) for the treatment of Miller Class I or II gingival recessions (GRs) and to compare these results with those of subepithelial connective tissue graft (SCTG), which is considered the gold standard. Twelve patients with Miller Class I or II (≥2 mm) bilateral recessions in maxillary premolars or canines were selected. Recessions were randomly assigned to receive SCTG or BFPG. The clinical parameters evaluated at baseline and at 1, 3, and 6 months postoperatively included gingival index, plaque index, probing depth, GR, clinical attachment level, width of keratinized tissue, thickness of keratinized tissue and gingival margin to the acrylic guide. None of the evaluated clinical parameters differed significantly between the groups. At all evaluated postoperative time-points, both groups exhibited statistically significant differences in GR and gingival margin to the acrylic guide compared to baseline. Six months after surgery, the mean percentages of root coverage were 67.5% and 87.5% in the BFPG and SCTG groups respectively. In both groups, complete root coverage was observed in 50% of cases 6 months after surgery. The results presented herein indicate that the use of BFPG transplant has clinical similarities with SCTG and both may be considered as clinically successful methods for treating Miller Class I and II GRs.


Resumo O objetivo deste estudo foi analisar a eficiência do transplante do enxerto de tecido adiposo bucal não pediculado (ETAB) para o tratamento de recessões gengivais Classe I e II de Miller e comparar seus resultados com o enxerto de tecido conjuntivo (ETC), que é considerado o enxerto padrão ouro. Foram selecionados 12 pacientes com recessões gengivais bilaterais Classe I e II de Miller presentes em canino ou pré-molares maxilares. As recessões foram randomizadas para receber um dos dois tratamentos ETAB ou ETC. Os parâmetros clínicos avaliados no baseline e com 1, 3 e 6 meses de pós-operatório foram o índice gengival, índice de placa, profundidade de sondagem, recessão gengival (RG), nível clinico de inserção, espessura e largura de tecido queratinizado e a medida da margem gengival ao guia de acrílico (MG-GA). Os resultados mostraram que não houve diferença estatisticamente significativa entre os grupos em nenhum dos parâmetros clínicos avaliados. Os parâmetros clínicos de RG e MG-GA, em ambos os grupos, apresentaram diferença estatisticamente significativa nos 3 períodos pós-operatórios em relação ao baseline. Aos 6 meses de pós-operatório, a média percentual de recobrimento radicular foi de 67,5% e 87,5% para o grupo ETAB e ETC respectivamente. Em ambos os grupos o recobrimento radicular completo foi em 50% dos casos após 6 meses de pós-operatório. Pode-se concluir que o transplante do ETAB apresentou similaridades clínicas com o ETC e ambos os tratamentos podem ser considerados de sucesso clínico para o tratamento de RGs Classe I e II de Miller.


Asunto(s)
Humanos , Tejido Adiposo/trasplante , Mejilla , Recesión Gingival/cirugía
16.
Acad Radiol ; 22(10): 1226-35, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26254543

RESUMEN

RATIONALE AND OBJECTIVES: Radiologists commonly use comparison films to improve their differential diagnosis. Educational literature suggests that this technique might also be used to bolster the process of learning to interpret radiographs. We investigated the effectiveness of three comparison techniques in medical students, whom we invited to compare cases of the same disease (same-disease comparison), cases of different diseases (different-disease comparison), disease images with normal images (disease/normal comparison), and identical images (no comparison/control condition). Furthermore, we used eye-tracking technology to investigate which elements of the two cases were compared by the students. MATERIALS AND METHODS: We randomly assigned 84 medical students to one of four conditions and had them study different diseases on chest radiographs, while their eye movements were being measured. Thereafter, participants took two tests that measured diagnostic performance and their ability to locate diseases, respectively. RESULTS: Students studied most efficiently in the same-disease and different-disease comparison conditions: test 1, F(3, 68) = 3.31, P = .025, ηp(2) = 0.128; test 2, F(3, 65) = 2.88, P = .043, ηp(2) = 0.117. We found that comparisons were effected in 91% of all trials (except for the control condition). Comparisons between normal anatomy were particularly common (45.8%) in all conditions. CONCLUSIONS: Comparing cases can be an efficient way of learning to interpret radiographs, especially when the comparison technique used is specifically tailored to the learning goal. Eye tracking provided insight into the comparison process, by showing that few comparisons were made between abnormalities, for example.


Asunto(s)
Radiología/educación , Estudios de Casos y Controles , Competencia Clínica , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Aprendizaje Basado en Problemas , Radiografía Torácica , Distribución Aleatoria , Adulto Joven
17.
J Periodontol ; 85(10): 1361-70, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24694077

RESUMEN

BACKGROUND: In a previously reported split-mouth, randomized controlled trial, Miller Class II gingival recession defects were treated with either a connective tissue graft (CTG) (control) or recombinant human platelet-derived growth factor-BB + ß-tricalcium phosphate (test), both in combination with a coronally advanced flap (CAF). At 6 months, multiple outcome measures were examined. The purpose of the current study is to examine the major efficacy parameters at 5 years. METHODS: Twenty of the original 30 patients were available for follow-up 5 years after the original surgery. Outcomes examined were recession depth, probing depth, clinical attachment level (CAL), height of keratinized tissue (wKT), and percentage of root coverage. Within- and across-treatment group results at 6 months and 5 years were compared with original baseline values. RESULTS: At 5 years, all quantitative parameters for both treatment protocols showed statistically significant improvements over baseline. The primary outcome parameter, change in recession depth at 5 years, demonstrated statistically significant improvements in recession over baseline, although intergroup comparisons favored the control group at both 6 months and 5 years. At 5 years, intergroup comparisons also favored the test group for percentage root coverage and change in wKT, whereas no statistically significant intergroup differences were seen for 100% root coverage and changes to CAL. CONCLUSIONS: In the present 5-year investigation, treatment with either test or control treatments for Miller Class II recession defects appear to lead to stable, clinically effective results, although CTG + CAF resulted in greater reductions in recession, greater percentage of root coverage, and increased wKT.


Asunto(s)
Materiales Biocompatibles/uso terapéutico , Fosfatos de Calcio/uso terapéutico , Encía/trasplante , Recesión Gingival/cirugía , Proteínas Proto-Oncogénicas c-sis/uso terapéutico , Colgajos Quirúrgicos/cirugía , Adulto , Anciano , Becaplermina , Color , Tejido Conectivo/trasplante , Sensibilidad de la Dentina/clasificación , Femenino , Estudios de Seguimiento , Recesión Gingival/patología , Recesión Gingival/terapia , Humanos , Queratinas , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Pérdida de la Inserción Periodontal/clasificación , Bolsa Periodontal/clasificación , Proteínas Recombinantes , Raíz del Diente/patología , Resultado del Tratamiento
18.
Allergy Asthma Immunol Res ; 6(1): 75-82, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24404397

RESUMEN

PURPOSE: To evaluate airway changes in ovalbumin-induced asthmatic mice in terms of postmortem micro-CT images and pathological findings. METHODS: Asthma was induced in mice by intraperitoneal injection and nasal instillation of ovalbumin aluminium hydroxide into mice (experimental group, n=6), and another group of mice received intraperitoneal injection and nasal instillation of distilled phosphate-buffered saline (control group, n=6). Bronchial lumen area was measured in the main bronchial lumen of the distal third bronchial branch level (6 parts per each mouse) on axial scans of Micro-CT, using a Lucion's smart pen (semi-automated) and a curve pen (manual). Bronchial wall thickness was obtained in 4 sections (2 levels on either side) after the third bronchial branch by measuring the diameter which was perpendicular to the longitudinal axis of the main bronchus on curved Multi-planar reconstruction (MPR) images. Histologic slides were obtained from the lesion that was matched with its CT images, and bronchial wall thicknesses were determined. RESULTS: The mean bronchial lumen area was 0.196±0.072 mm(2) in the experimental group and 0.243±0.116 mm(2) in the control group; the difference was significant. Bronchial wall thickness on micro-CT images (mean, 0.119±0.01 vs. 0.108±0.013 mm) and in pathological specimens (mean, 0.066±0.011 vs. 0.041±0.009 mm) were thicker in the experimental group than in the control group; bronchial wall thickness on micro-CT images correlated well with pathological thickness (for the experimental group, r=0.712; for the control group, r=0.46). The thick bronchial wall in the experimental group demonstrated submucosal hypertrophy along with goblet cell hyperplasia and smooth muscle hyperplasia. CONCLUSIONS: The results of this study suggest that asthma may induce thickening of bronchial wall and narrowing of the lumen area on micro-CT images and that these results may significantly correlate with pathological findings.

19.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-164117

RESUMEN

PURPOSE: To evaluate airway changes in ovalbumin-induced asthmatic mice in terms of postmortem micro-CT images and pathological findings. METHODS: Asthma was induced in mice by intraperitoneal injection and nasal instillation of ovalbumin aluminium hydroxide into mice (experimental group, n=6), and another group of mice received intraperitoneal injection and nasal instillation of distilled phosphate-buffered saline (control group, n=6). Bronchial lumen area was measured in the main bronchial lumen of the distal third bronchial branch level (6 parts per each mouse) on axial scans of Micro-CT, using a Lucion's smart pen (semi-automated) and a curve pen (manual). Bronchial wall thickness was obtained in 4 sections (2 levels on either side) after the third bronchial branch by measuring the diameter which was perpendicular to the longitudinal axis of the main bronchus on curved Multi-planar reconstruction (MPR) images. Histologic slides were obtained from the lesion that was matched with its CT images, and bronchial wall thicknesses were determined. RESULTS: The mean bronchial lumen area was 0.196+/-0.072 mm2 in the experimental group and 0.243+/-0.116 mm2 in the control group; the difference was significant. Bronchial wall thickness on micro-CT images (mean, 0.119+/-0.01 vs. 0.108+/-0.013 mm) and in pathological specimens (mean, 0.066+/-0.011 vs. 0.041+/-0.009 mm) were thicker in the experimental group than in the control group; bronchial wall thickness on micro-CT images correlated well with pathological thickness (for the experimental group, r=0.712; for the control group, r=0.46). The thick bronchial wall in the experimental group demonstrated submucosal hypertrophy along with goblet cell hyperplasia and smooth muscle hyperplasia. CONCLUSIONS: The results of this study suggest that asthma may induce thickening of bronchial wall and narrowing of the lumen area on micro-CT images and that these results may significantly correlate with pathological findings.


Asunto(s)
Animales , Ratones , Remodelación de las Vías Aéreas (Respiratorias) , Asma , Vértebra Cervical Axis , Bronquios , Estudios de Casos y Controles , Estudios de Evaluación como Asunto , Células Caliciformes , Hiperplasia , Hipertrofia , Inyecciones Intraperitoneales , Músculo Liso , Ovalbúmina , Microtomografía por Rayos X
20.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-379713

RESUMEN

Objective To identify the compliance and influencing factors of colorectal cancer screening among urban communities. Methods People in urban communities are categorized as the case group, comparison group A and comparison group B, according to whether they receive questionnaire survey, FOBT test, intestine mirror, and different follow-up results in this screening test Results No significant differences (P>0.05) are found among people from different groups. In the survey for screening related knowledge, understanding of such knowledge is significantly higher than the comparison group(P>0.01), and the knowledge of comparison group A is higher than that of comparison group B. Conclusion The higher their knowledge in screening, the higher their compliance for screening.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA