scholarly journals Perioperative Acupuncture and Related Techniques

2005 ◽  
Vol 102 (5) ◽  
pp. 1031-1049 ◽  
Author(s):  
Grigory V. Chernyak ◽  
Daniel I. Sessler ◽  
David C. Warltier
Keyword(s):  
Clinical Medicine ◽  
Volatile Anesthetic ◽  
Postoperative Nausea And Vomiting ◽  
Medical Settings ◽  
Number Of Patients ◽  
Considerable Controversy ◽  
Promising Application ◽  
Important Amount ◽  
High Level

Acupuncture and related techniques are increasingly practiced in conventional medical settings, and the number of patients willing to use these techniques is increasing. Despite more than 30 yr of research, the exact mechanism of action and efficacy of acupuncture have not been established. Furthermore, most aspects of acupuncture have yet to be adequately tested. Therefore, considerable controversy remains about the role of acupuncture in clinical medicine. Acupuncture apparently does not reduce volatile anesthetic requirement by a clinically important amount. However, preoperative sedation seems to be a promising application of acupuncture in perioperative settings. Acupuncture may be effective for postoperative pain relief but requires a high level of expertise by the acupuncture practitioner. Acupuncture and related techniques can be used for treatment and prophylaxis of postoperative nausea and vomiting in routine clinical practice in combination with or as an alternative to conventional antiemetics when administered before induction of general anesthesia.

scholarly journals Systematic Screening of Retinopathy in Diabetes (REaD Project): An Italian Implementation Campaign

2016 ◽  
Vol 27 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Massimo Porta ◽  
Francesco Boscia ◽  
Paolo Lanzetta ◽  
Edoardo Mannucci ◽  
Ugo Menchini ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Systematic Screening ◽  
Fundus Camera ◽  
Number Of Patients ◽  
Retinal Screening ◽  
Level Of Training ◽  
High Level ◽  
Digital Color Images ◽  
New Onset

Purpose To evaluate the use of telemedicine retinal screening in Italy and to identify potential elements of implementation of this system. Methods Patients with either new-onset diabetes or no ophthalmologic visit over the previous 2 years and attending 33 referral diabetic centers between mid-April 2013 and mid December 2015 were screened. Two partially overlapping nonstereoscopic 45° digital color images were captured from each eye using a fully automated nonmydriatic digital fundus camera. Factors limiting the assessment of retinopathy were explored. Results Out of 24,473 eligible individuals, 22,466 had complete data. Among them, good-quality images enabling appropriate evaluation of at least one eye were obtained from 19,712 patients (both eyes, n = 18,887). Although nonmydriatic retinographs were provided, 39% of patients were evaluated using mydriasis. The rate of low-quality images in each center was inversely associated with the number of patients assessed. This was more evident for screening in mydriasis: adjusted odds ratio (OR) 0.79 (95% confidence interval (CI) 0.76-0.82) (p<0.001) vs 0.96 (95% CI 0.94-0.97) (p<0.001). Finally, both the number of patients assessed and use of mydriasis were inversely related to the presence of diabetic retinopathy (DR): adjusted OR 0.93 (95% CI 0.92-0.93) (p<0.001) and 0.88 (95% CI 0.82-0.96) (p<0.001), respectively. Conclusions This program confirmed a role for teleophthalmology in the systematic screening of DR and provided important suggestions to improve the system deployed. A high level of training is required for operators to optimize imaging. The role of mydriasis should be evaluated further.

Update on Femoroacetabular Impingement: What Is New, and How Should We Assess It?

2017 ◽  
Vol 21 (05) ◽  
pp. 518-528 ◽  
Author(s):  
Christian Pfirrmann ◽  
Reto Sutter
Keyword(s):  
Clinical Practice ◽  
Femoroacetabular Impingement ◽  
Skeletal Maturation ◽  
Femoral Torsion ◽  
Current State ◽  
Number Of Patients ◽  
High Level ◽  
Crucial Part ◽  
Sports Activities

AbstractIt is almost 20 years since the concept of femoroacetabular impingement (FAI) was introduced, and by now a large number of orthopaedic surgeons, sports physicians, and radiologists have implemented this concept in clinical practice, as is evident in the steady rise in the number of patients diagnosed and treated for FAI. However, this trend has been accompanied by some criticism and concerns about overdiagnosing FAI. Imaging continues to play a crucial part in the evaluation of patients with suspected FAI. This review looks at the current state of FAI: Which parts of the FAI concept have become widely accepted, which ideas have been abandoned, and how should we assess patients with suspected FAI today? Although cam- and pincer-type morphology remain two central pillars of the FAI concept, the important role of abnormal femoral torsion in the development of FAI has now been recognized. High-level sports activities during skeletal maturation have been proven to increase the risk of developing FAI.

Putting the Content Into Context

2011 ◽  
pp. 105-115 ◽  
Author(s):  
Henning Müller ◽  
Jayashree Kalpathy-Cramer
Keyword(s):  
Image Retrieval ◽  
Information Needs ◽  
Multimedia Data ◽  
Free Text ◽  
Medical Settings ◽  
Multiple Images ◽  
Digital Management ◽  
High Level ◽  
Case Based

Digital management of medical images is becoming increasingly important as the number of images being created in medical settings everyday is growing rapidly. Content-based image retrieval or techniques based on the query-by-example paradigm have been studied extensively in computer vision. However, the global, low level visual features automatically extracted by these algorithms do not always correspond to high level concepts that a user has in his mind for searching. The role of image retrieval in diagnostic medicine can be quite complex, making it difficult for the user to express his/her information needs appropriately. Image retrieval in medicine needs to evolve from purely visual retrieval to a more holistic, case-based approach that incorporates various multimedia data sources. These include multiple images, free text, structured data, as well as external knowledge sources and ontologies.

Searching for ‘success’: generation, gender and onward migration in the Iranian diaspora

2017 ◽  
Vol 14 (1) ◽  
pp. 101-112 ◽  
Author(s):  
Melissa Kelly
Keyword(s):  
Life History ◽  
Young Age ◽  
Onward Migration ◽  
Social Fields ◽  
Transnational Social Fields ◽  
High Level ◽  
Iranian Diaspora

This article uses the concepts of ‘transnational social fields’ and ‘habitus’ to explore the multifaceted role families play in shaping the aspirations of onward migrating youth. The article draws on biographical life history interviews conducted with the children of Iranian migrants who were raised in Sweden but moved to London, UK as adults. The findings of the study suggest that from a young age, all the participants were pressured by their parents to perform well academically, and to achieve high level careers. These goals were easier to achieve in London than in Sweden for several reasons. Interestingly, however, participants’ understandings of what constituted success and their motivations for onward migration were nuanced and varied considerably by gender. The study contributes to an understanding of the role of multi-sited transnational social fields in shaping the aspirations of migrant youths, as well as the strategies taken up by these migrants to achieve their goals.

The Use of Posterior Pericardiotomy Technique to Prevent Postoperative Pericardial Effusion in Cardiac Surgery

2012 ◽  
Vol 15 (2) ◽  
pp. 84 ◽  
Author(s):  
Canturk Cakalagaoglu ◽  
Cengiz Koksal ◽  
Ayse Baysal ◽  
Gokhan Alici ◽  
Birol Ozkan ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Pericardial Tamponade ◽  
Anxiety Level ◽  
Control Group ◽  
Echocardiographic Study ◽  
Number Of Patients ◽  
Hospital Stays

<p><b>Aim:</b> The goal was to determine the effectiveness of the posterior pericardiotomy technique in preventing the development of early and late pericardial effusions (PEs) and to determine the role of anxiety level for the detection of late pericardial tamponade (PT).</p><p><b>Materials and Methods:</b> We divided 100 patients randomly into 2 groups, the posterior pericardiotomy group (n = 50) and the control group (n = 50). All patients undergoing coronary artery bypass grafting surgery (CABG), valvular heart surgery, or combined valvular and CABG surgeries were included. The posterior pericardiotomy technique was performed in the first group of 50 patients. Evaluations completed preoperatively, postoperatively on day 1, before discharge, and on postoperative days 5 and 30 included electrocardiographic study, chest radiography, echocardiographic study, and evaluation of the patient's anxiety level. Postoperative causes of morbidity and durations of intensive care unit and hospital stays were recorded.</p><p><b>Results:</b> The 2 groups were not significantly different with respect to demographic and operative data (<i>P</i> > .05). Echocardiography evaluations revealed no significant differences between the groups preoperatively; however, before discharge the control group had a significantly higher number of patients with moderate, large, and very large PEs compared with the pericardiotomy group (<i>P</i> < .01). There were 6 cases of late PT in the control group, whereas there were none in the pericardiotomy group (<i>P</i> < .05). Before discharge and on postoperative day 15, the patients in the pericardiotomy group showed significant improvement in anxiety levels (<i>P</i> = .03 and .004, respectively). No differences in postoperative complications were observed between the 2 groups.</p><p><b>Conclusion:</b> Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.</p>

Decision making power of college girls in relation to clothing

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Parul Gill ◽  
Poonam Malik ◽  
Pankaj Gill
Keyword(s):  
Decision Making ◽  
Satisfaction Level ◽  
College Going ◽  
Level Of Satisfaction ◽  
High Level ◽  
Garment Design ◽  
Structured Questionnaire

The present study was undertaken to explore the decision making patterns of college girls in relation to clothing and their satisfaction level with these decision making patterns. Thirty under graduate college girls from Panipat city were approached to record their responses regarding decision making in relation to clothing and satisfaction level through a well structured questionnaire. It was found that most of the girls (56.66%) themselves made the decisions about the type of garment (Indian, western or both) they wear and majority of girls (70%) were highly satisfied with this decision making. Parents performed the role of buyers for their college going daughters' garments in most of the cases (63.33%) and the 73.33% girls had high level of satisfaction with this. In most of the cases (60%) the decision about the garment design was made by the girls themselves and they were highly satisfied with it. Keywords: clothing, college, girls, decision making.

Сирия (аш-Шам) в системе османских владений (XVI – начало XX в.)

2019 ◽  
Author(s):  
D.R. Zhantiev
Keyword(s):  
Ottoman Empire ◽  
19Th Century ◽  
Social Mechanisms ◽  
Checks And Balances ◽  
Local Elites ◽  
The Balkans ◽  
The Face ◽  
High Level ◽  
The 19Th Century

Аннотация В статье рассматривается роль и место Сирии (включая Ливан и Палестину) в системе османских владений на протяжении нескольких веков от османского завоевания до периода правления султана Абдул-Хамида II. В течение четырех столетий османского владычества территория исторической Сирии (Билад аш-Шам) была одним из важнейших компонентов османской системы и играла роль связующего звена между Анатолией, Египтом, Ираком и Хиджазом. Необходимость ежегодной организации хаджа с символами султанской власти и покровительства над святынями Мекки и Медины определяла особую стратегическую важность сирийских провинций Османской империи. Несмотря на ряд серьезных угроз во время общего кризиса османской государственности (конец XVI начало XIX вв.), имперскому центру удалось сохранить контроль над Сирией путем создания сдержек и противовесов между местными элитами. В XIX в. и особенно в период правления Абдул- Хамида II (18761909 гг.), сохранение Сирии под османским контролем стало вопросом существования Османской империи, которая перед лицом растущего европейского давления и интервенции потеряла большую часть своих владений на Балканах и в Северной Африке. Задача укрепления связей между имперским центром и периферией в сирийских вилайетах в последней четверти XIX в. была в целом успешно решена. К началу XX в. Сирия была одним из наиболее политически спокойных и прочно связанных со Стамбулом регионов Османской империи. Этому в значительной степени способствовали довольно высокий уровень общественной безопасности, развитие внешней торговли, рост образования и постепенная интеграция местных элит (как мусульман, так и христиан) в османские государственные и социальные механизмы. Положение Сирии в системе османских владений показало, что процесс ослабления и территориальной дезинтеграции Османской империи в эпоху реформ не был линейным и наряду с потерей владений и влияния на Балканах, в азиатской части империи в течение XIX и начала XX вв. происходил параллельный процесс имперской консолидации.Abstract The article examines the role and place of Greater Syria (including Lebanon and Palestine) in the system of Ottoman possessions over several centuries from the Ottoman conquest to the period of the reign of Abdul Hamid II. For four centuries of Ottoman domination, the territory of historical Syria (Bilad al-Sham) was one of the most important components in the Ottoman system and played the role of a link between Anatolia, Egypt, Iraq and Hijaz. The need to ensure the Hajj with symbols of Sultan power and patronage over the shrines of Mecca and Medina each year determined the special strategic importance of the Syrian provinces of the Ottoman Empire. Despite a number of serious threats during the general crisis of the Ottoman state system (late 16th early 19th centuries), the imperial center managed to maintain control over Syria by creating checks and balances between local elites. In the 19th century. And especially during the reign of Abdul Hamid II (18761909), keeping Syria under Ottoman control became a matter of existence for the Ottoman Empire, which, in the face of increasing European pressure and intervention, lost most of its possessions in the Balkans and North Africa. The task of strengthening ties between the imperial center and the periphery in Syrian vilayets in the last quarter of the 19th century was generally successfully resolved. By the beginning of the 20th century, Syria was one of the most politically calm and firmly connected with Istanbul regions of the Ottoman Empire. This was greatly facilitated by a fairly high level of public safety, the development of foreign trade, the growth of education and the gradual integration of local elites (both Muslims and Christians) into Ottoman state and social mechanisms. Syrias position in the system of Ottoman possessions clearly showed that the process of weakening and territorial disintegration of the Ottoman Empire during the era of reform was not linear, and along with the loss of possessions and influence in the Balkans, in the Asian part of the empire during the 19th and early 20th centuries there was a parallel process of imperial consolidation.

Changing Role of Agriculture in Income and Employment, and Trends of Agricultural Worker Productivity in Indian States

2020 ◽  
pp. 183-189
Keyword(s):  
Green Revolution ◽  
Positive Trend ◽  
Worker Productivity ◽  
Indian States ◽  
Agricultural Worker ◽  
The Sixties ◽  
High Level ◽  
The Cost ◽  
Changing Role

The productivity of land has been often discussed and deliberated by the academia and policymakers to understand agriculture, however, very few studies have focused on the agriculture worker productivity to analyze this sector. This study concentrates on the productivity of agricultural workers from across the states taking two-time points into consideration. The agriculture worker productivity needs to be dealt with seriously and on a time series basis so that the marginal productivity of worker can be ascertained but also the dependency of worker on agriculture gets revealed. There is still disguised unemployment in all the states and high level of labour migration, yet most of the states showed the dependency has gone down. Although a state like Madhya Pradesh is doing very well in terms of income earned but that is at the cost of increased worker power in agriculture as a result of which, the productivity of worker has gone down. States like Mizoram, Meghalaya, Nagaland and Tripura, though small in size showed remarkable growth in productivity and all these states showed a positive trend in terms of worker shifting away from agriculture. The traditional states which gained the most from Green Revolution of the sixties are performing decently well, but they need to have the next major policy push so that they move to the next orbit of growth.

STEROID RECEPTOR PHENOTYPE, EXPRESSION OF HER-2/NEU, PD-1, PD-L1 AND LYMPHOCYTIC-MACROPHAGAL INFILTRATION OF ENDOMETRIAL CARCINOMAS: COMPARISON OF MODERN MOLECULAR BIOLOGICAL TYPES OF THE DISEASE (THE ROLE OF BODY MASS INDEX)

2020 ◽  
Vol 66 (1) ◽  
pp. 71-78
Author(s):  
Lev Bershteyn ◽  
Aleksandr Ivantsov ◽  
Aglaya Ievleva ◽  
A. Venina ◽  
I. Berlev
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Tumor Tissue ◽  
Immunohistochemical Analysis ◽  
The Body ◽  
Molecular Profile ◽  
Total N ◽  
Number Of Patients ◽  
Her 2

The aim of this study was to evaluate steroid receptors’ status of tumor tissue in different molecular biological types of endometrial cancer (EC), subdivided according to the current classification, and their colonization by lymphocytic and macrophage cells, taking into account body mass index of the patients. Materials and methods: Material from treatment-naive patients with EC (total n = 229) was included; the number of sick persons varied depending on the method used. The average age of patients was close to 60 years, and about 90% of them were postmenopausal. It was possible to divide the results of the work into two main subgroups: a) depending on the molecular biological type of the tumor (determined on the basis of genetic and immunohistochemical analysis), and b) depending on the value of the body mass index (BMI). The latter approach was used in patients with EC type demonstrating a defective mismatch repair of the incorrectly paired nucleotides (MMR-D) and with a type without characteristic molecular profile signs (WCMP), but was not applied (due to the smaller number of patients) in EC types with a POLE gene mutation or with expression of the oncoprotein p53. According to the data obtained, when comparing various types of EC, the lowest values of Allred ER and PR scores were revealed for POLE-mutant and p53 types, while the “triple-negative” variant of the tumor (ER-, PR-, HER2/neu-) was most common in POLE-mutant (45.5% of cases) and WCMP (19.4%) types of EC. The p53+ type of EC is characterized by inclination to the higher expression of the macrophage marker CD68 and lymphocytic Foxp3, as well as mRNA of PD-1 and SALL4. In addition to the said above, for WCMP type of EC is peculiar, on the contrary, a decrease in the expression of lymphocytic markers CD8 (protein) and PD-L1 (mRNA). When assessing the role of BMI, its value of >30.0 (characteristic for obesity) was combined with an inclination to the increase of HER-2/neu expression in the case of MMR-D EC type and to the decrease of HER-2 /neu, FOXp3 and ER expression in WCMP type. Conclusions: The accumulated information (mainly describing here hormonal sensitivity of the tumor tissue and its lymphocytic-macrophage infiltration) additionally confirms our earlier expressed opinion that the differences between women with EC are determined by both the affiliation of the neoplasm to one or another molecular biological type (subdivided according to the contemporary classification), as well as by body mass value and (very likely) the associated hormonal and metabolic attributes.

Methyl mercury in the dutch rhine delta

1994 ◽  
Vol 30 (10) ◽  
pp. 213-219 ◽  
Author(s):  
Hendrik Pieters ◽  
Victor Geuke
Keyword(s):  
Suspended Matter ◽  
Methyl Mercury ◽  
Mercury Contamination ◽  
Benthic Organisms ◽  
Considerable Decrease ◽  
Continuous Sedimentation ◽  
Highly Correlated ◽  
High Level ◽  
Almost All

Samples of yellow eel from various locations in the Dutch Rhine area have been analyzed for trend monitoring of mercury since 1977. In the western Rhine delta mercury levels in eels have hardly changed since the seventies, whereas in the eastern part of the Dutch Rhine area a considerable decrease of mercury concentrations in eel has occurred. Because of continuous sedimentation of contaminated suspended matter transported from upstream regions, accumulation rates and concentrations of mercury in eel in the western Rhine delta remained at a relatively high level. Analyses of methyl mercury in biota have been performed to elucidate the role of methyl mercury in the mercury contamination of the Dutch Rhine ecosystem. Low percentages of methyl mercury were observed in zooplankton (3 to 35%). In benthic organisms (mussels) percentages of methyl mercury ranged from 30 to 57%, while in fish species and liver of aquatic top predator birds almost all the mercury was present in the form of methyl mercury (&gt; 80%). During the period 1970-1990 mercury concentrations of suspended matter in the eastern Rhine delta have drastically decreased. These concentrations seemed to be highly correlated with mercury concentrations of eel (R = 0.84). The consequences of this relation are discussed.

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