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‣ Intra-arterial calcium stimulation test in the investigation of hyperinsulinaemic hypoglycaemia

Abernethy, L; Davidson, D; Lamont, G; Shepherd, R; Dunne, M
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /04/1998 Português
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OBJECTIVE—To investigate the use of a calcium infusion test in the diagnosis and localisation of insulin secreting tumours in children.
PATIENTS—Three patients with persistent hypoglycaemia of infancy (PHHI).
PROCEDURE—During planned selective coeliac and mesenteric arteriography, serial samples were taken from a catheter in the right hepatic vein for insulin measurement following the injection of calcium gluconate.
RESULTS—In all three children, selective intra-arterial calcium stimulation produced a significant rise in plasma insulin and was of value in localising the pancreatic abnormality in one child. In vitro studies on islets of Langerhans isolated from this patient following partial pancreatectomy showed unresponsive intracellular calcium signalling of the cells when stimulated with high extracellular concentrations of glucose and potassium or with sulphonylurea drugs (tolbutamide), but normal responsiveness to increasing extracellular calcium concentrations.
CONCLUSIONS—The findings suggest a functional abnormality of the calcium channel in PHHI and provide a rationale for the reported efficacy of channel blocking drugs in this condition. The role of selective intra-arterial calcium stimulation in the diagnosis of hyperinsulinaemic hypoglycaemia in childhood warrants further investigation.



‣ Investigation and management of iron deficiency anaemia in general practice: a cluster randomised controlled trial of a simple management prompt

Logan, E; Yates, J; Stewart, R; Fielding, K; Kendrick, D
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /09/2002 Português
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Background: Iron deficiency anaemia (IDA) remains the most common cause of anaemia and is frequently secondary to occult gastrointestinal blood loss requiring further investigation. The study was designed to prospectively assess the adequacy of investigation of IDA and to establish whether a simple computerised prompt would increase the completeness of investigation of patients presenting to their general practitioners.

‣ Role of computed tomographic scanning of the thorax prior to bronchoscopy in the investigation of suspected lung cancer

Laroche, C.; Fairbairn, I.; Moss, H.; Pepke-Zaba, J.; Sharples, L.; Flower, C.; Coulden, R.
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /05/2000 Português
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BACKGROUND—Fibreoptic bronchoscopy (FOB) is the usual initial investigation of choice in patients with suspected endobronchial carcinoma, but it is often non-diagnostic. Once a positive diagnosis has been made, many patients undergo staging by computed tomographic (CT) scanning to assess the extent of the disease and its suitability for radical treatment. To determine whether initial CT scanning before FOB is a cost effective way of reducing subsequent unnecessary or unhelpful invasive diagnostic procedures, a study was undertaken in 171 patients with suspected endobronchial carcinoma.
METHODS—A randomised two group study was performed with all patients undergoing an initial CT staging scan. In group A the CT scans were reviewed before FOB, allowing cancellation or a change to an alternative invasive procedure if considered appropriate. In group B all patients proceeded to FOB with the bronchoscopist blinded to the result of the CT scan until after the procedure.
RESULTS—In group A six of 90 patients (7%) required no further investigations as the CT scan was either normal, consistent with benign disease, or consistent with widespread metastatic disease. Of the remainder, bronchoscopy was diagnostic in 50 of 68 (73%) in group A compared with 44 of 81 (54%) in group B (p = 0.015). Overall...

‣ Resource utilisation, length of hospital stay, and pattern of investigation during acute medical hospital admission

McMullan, R; Silke, B; Bennett, K; Callachand, S
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /01/2004 Português
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Objectives: To describe the patient demographic characteristics and organisational factors that influence length of stay (LOS) among emergency medical admissions. Also, to describe differences in investigation practice among consultant physicians and to examine the impact of these on LOS.

‣ Severe hyponatraemia: investigation and management in a district general hospital

Saeed, B O; Beaumont, D; Handley, G H; Weaver, J U
Fonte: Copyright 2002 Journal of Clinical Pathology Publicador: Copyright 2002 Journal of Clinical Pathology
Tipo: Artigo de Revista Científica
Publicado em /12/2002 Português
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Aims: To study the incidence, investigation, and management of severe hyponatraemia (serum sodium < 120 mmol/litre) over a period of six months in a district general hospital.

‣ The investigation of short stature: a survey of practice in Wales and suggested practical guidelines

Evans, C; Gregory, J W;
Fonte: Copyright 2004 Journal of Clinical Pathology Publicador: Copyright 2004 Journal of Clinical Pathology
Tipo: Artigo de Revista Científica
Publicado em /02/2004 Português
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Aim: To survey the investigation of short stature in Wales and suggest guidelines to improve practice.

‣ Rare variation at the TNFAIP3 locus and susceptibility to rheumatoid arthritis

Bowes, John; Lawrence, Robert; Eyre, Stephen; Panoutsopoulou, Kalliope; Orozco, Gisela; Elliott, Katherine S.; Ke, Xiayi; Morris, Andrew P.; ; Thomson, Wendy; Worthington, Jane; Barton, Anne; Zeggini, Eleftheria
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Português
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Genome-wide association studies (GWAS) conducted using commercial single nucleotide polymorphisms (SNP) arrays have proven to be a powerful tool for the detection of common disease susceptibility variants. However, their utility for the detection of lower frequency variants is yet to be practically investigated. Here we describe the application of a rare variant collapsing method to a large genome-wide SNP dataset, the Wellcome Trust Case Control Consortium rheumatoid arthritis (RA) GWAS. We partitioned the data into gene-centric bins and collapsed genotypes of low frequency variants (defined here as MAF ≤0.05) into a single count coupled with univariate analysis. We then prioritised gene regions for further investigation in an independent cohort of 3,355 cases and 2,427 controls based on rare variant signal p value and prior evidence to support involvement in RA. A total of 14,536 gene bins were investigated in the primary analysis and signals mapping to the TNFAIP3 and chr17q24 loci were selected for further investigation. We detected replicating association to low frequency variants in the TNFAIP3 gene (combined p = 6.6 × 10−6). Even though rare variants are not well-represented and can be difficult to genotype in GWAS...

‣ Phytochemical investigation and diuretic activity of Cyclea peltata leaf extracts

Hullatti, K. K.; Gopikrishna, U. V.; Kuppast, I. J.
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
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Ayurvedic system of medicine is well known for treating renal problems. A vast number of medicinal plants mentioned in Ayurvedic system of medicine are known to possess diuretic properties. Present study reports the preliminary phytochemical investigation of petroleum ether and ethanolic extracts of Cyclea peltata and their diuretic activity. Preliminary phytochemical screening reveals the presence of phytosterols and alkaloids as major phytoconstituents in petroleum ether extract. The ethanolic extract showed the presence of alkaloids, flavonoids, tannins, diterpenes and saponins. Pharmacological investigation revealed that ethanolic extract of C. peltata leaves possessed significant diuretic activity in a given dose of 200 and 300 mg/kg body weight (Diuretic action 1.7 and 2.6, respectively). Where as petroleum ether extract has shown moderate diuresis at a dose of 300 mg/kg body weight (Diuretic action 1.1). The present study justifies the use of C. peltata in the Ayurvedic system of medicine as a diuretic drug.

‣ Modern contact investigation methods for enhancing tuberculosis control in Aboriginal communities

Cook, Victoria J.; Shah, Lena; Gardy, Jennifer
Fonte: Co-Action Publishing Publicador: Co-Action Publishing
Tipo: Artigo de Revista Científica
Publicado em 25/05/2012 Português
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The Aboriginal communities in Canada are challenged by a disproportionate burden of TB infection and disease. Contact investigation (CI) guidelines exist but these strategies do not take into account the unique social structure of different populations. Because of the limitations of traditional CI, new approaches are under investigation and include the use of social network analysis, geographic information systems and genomics, in addition to the widespread use of genotyping to better understand TB transmission. Guidelines for the routine use of network methods and other novel methodologies for TB CI and outbreak investigation do not exist despite the gathering evidence that these approaches can positively impact TB control efforts, even in Aboriginal communities. The feasibility and efficacy of these novel approaches to CI in Aboriginal communities requires further investigation. The successful integration of these novel methodologies will require community involvement, capacity building and ongoing support at every level. The outcome will not only be the systematic collection, analysis, and interpretation of CI data in high-burden communities to assess transmission but the prioritization of contacts who are candidates for treatment of LTBI which will break the cycle of transmission. Ultimately...

‣ Effects of sleep bruxism on functional and occlusal parameters: a prospective controlled investigation

Alicia Ommerborn, Michelle; Giraki, Maria; Schneider, Christine; Michael Fuck, Lars; Handschel, Jörg; Franz, Matthias; Hans-Michael Raab, Wolfgang; Schäfer, Ralf
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Português
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This study was conducted to verify the results of a preceding retrospective pilot study by means of a prospective controlled investigation including a larger sample size. Therefore, the aim of this clinical investigation was to analyze the relationship between sleep bruxism and several functional and occlusal parameters. The null hypothesis of this study was that there would be no differences among sleep bruxism subjects and non-sleep bruxism controls regarding several functional and occlusal parameters. Fifty-eight sleep bruxism subjects and 31 controls participated in this study. The diagnosis sleep bruxism was based on clinical criteria of the American Academy of Sleep Medicine. Sixteen functional and occlusal parameters were recorded clinically or from dental study casts. Similar to the recently published retrospective pilot study, with a mean slide of 0.77 mm (s.d., 0.69 mm) in the sleep bruxism group and a mean slide of 0.4 mm (s.d., 0.57 mm) in the control group, the evaluation of the mean comparison between the two groups demonstrated a larger slide from centric occlusion to maximum intercuspation in sleep bruxism subjects (Mann–Whitney U-test; P=0.008). However, following Bonferroni adjustment, none of the 16 occlusal and functional variables differed significantly between the sleep bruxism subjects and the non-sleep bruxism controls. The present study shows that the occlusal and functional parameters evaluated do not differ between sleep bruxism subjects and non-sleep bruxism subjects. However...

‣ Contact investigation for tuberculosis: a systematic review and meta-analysis

Fox, Gregory J.; Barry, Simone E.; Britton, Warwick J.; Marks, Guy B.
Fonte: European Respiratory Society Publicador: European Respiratory Society
Tipo: Artigo de Revista Científica
Português
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Investigation of contacts of patients with tuberculosis (TB) is a priority for TB control in high-income countries, and is increasingly being considered in resource-limited settings. This review was commissioned for a World Health Organization Expert Panel to develop global contact investigation guidelines.

‣ Investigation of dmyc Promoter and Regulatory Regions

Kharazmi, Jasmine; Moshfegh, Cameron
Fonte: Libertas Academica Publicador: Libertas Academica
Tipo: Artigo de Revista Científica
Publicado em 15/05/2013 Português
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Products of the myc gene family integrate extracellular signals by modulating a wide range of their targets involved in cellular biogenesis and metabolism; the purpose of this integration is to regulate cell death, proliferation, and differentiation. However, understanding the regulation of myc at the transcription level remains a challenge. We performed rapid amplification of dmyc cDNA ends (5′ RACE) and mapped the transcription start site at P1 promoter, 18 base pairs upstream of the start of the known EST GM01143 and within the 5′ UTR. Our data show that the first TATA box, previously computationally predicted, is utilized to generate dmyc full length mRNA. The largest transcript contains all three exons, generated after the removal of the introns by constitutively regulated splicing events. Further investigation of Downstream Promoter Element (DPE) was achieved by studying lacZ reporter activity; investigation revealed that this element and its upstream cluster of binding sites are required for the dmyc intron 2 activity. These findings may provide valuable tools for further analysis of dmyc cis-elements.

‣ ABCG2-overexpressing S1-M1-80 cell xenografts in nude mice keep original biochemistry and cell biological properties

Wang, Fang; Liang, Yong-Ju; Wu, Xing-Ping; Su, Xiao-Dong; Fu, Li-Wu
Fonte: Sun Yat-sen University Cancer Center Publicador: Sun Yat-sen University Cancer Center
Tipo: Artigo de Revista Científica
Publicado em /03/2012 Português
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S1-M1-80 cells, derived from human colon carcinoma S1 cells, are mitoxantrone-selected ABCG2-overexpressing cells and are widely used in in vitro studies of multidrug resistance (MDR). In this study, S1-M1-80 cell xenografts were established to investigate whether the MDR phenotype and cell biological properties were maintained in vivo. Our results showed that the proliferation, cell cycle, and ABCG2 expression level in S1-M1-80 cells were similar to those in cells isolated from S1-M1-80 cell xenografts (named xS1-M1-80 cells). Consistently, xS1-M1-80 cells exhibited high levels of resistance to ABCG2 substrates such as mitoxantrone and topotecan, but remained sensitive to the non-ABCG2 substrate cisplatin. Furthermore, the specific ABCG2 inhibitor Ko143 potently sensitized xS1-M1-80 cells to mitoxantrone and topotecan. These results suggest that S1-M1-80 cell xenografts in nude mice retain their original cytological characteristics at 9 weeks. Thus, this model could serve as a good system for further investigation of ABCG2-mediated MDR.

‣ Monte Carlo-based investigation of water-equivalence of solid phantoms at 137Cs energy

Vishwakarma, Ramkrushna S.; Selvam, T. Palani; Sahoo, Sridhar; Mishra, Subhalaxmi; Chourasiya, Ghanshyam
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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Investigation of solid phantom materials such as solid water, virtual water, plastic water, RW1, polystyrene, and polymethylmethacrylate (PMMA) for their equivalence to liquid water at 137Cs energy (photon energy of 662 keV) under full scatter conditions is carried out using the EGSnrc Monte Carlo code system. Monte Carlo-based EGSnrc code system was used in the work to calculate distance-dependent phantom scatter corrections. The study also includes separation of primary and scattered dose components. Monte Carlo simulations are carried out using primary particle histories up to 5 × 109 to attain less than 0.3% statistical uncertainties in the estimation of dose. Water equivalence of various solid phantoms such as solid water, virtual water, RW1, PMMA, polystyrene, and plastic water materials are investigated at 137Cs energy under full scatter conditions. The investigation reveals that solid water, virtual water, and RW1 phantoms are water equivalent up to 15 cm from the source. Phantom materials such as plastic water, PMMA, and polystyrene phantom materials are water equivalent up to 10 cm. At 15 cm from the source, the phantom scatter corrections are 1.035, 1.050, and 0.949 for the phantoms PMMA, plastic water, and polystyrene...

‣ A prospective, proof-of-concept investigation of KPAX002 in chronic fatigue syndrome

Kaiser, Jon D
Fonte: e-Century Publishing Corporation Publicador: e-Century Publishing Corporation
Tipo: Artigo de Revista Científica
Publicado em 15/07/2015 Português
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Stimulant drugs and various micronutrient interventions have previously been studied in chronic fatigue syndrome (CFS) but they have never been studied in combination. This proof of concept investigation seeks to examine the clinical effects and safety profile of KPAX002 (a combination of methylphenidate hydrochloride and mitochondrial support nutrients) in patients with CFS. Fifteen patients diagnosed with CFS by 1994 Fukuda criteria were recruited and treated with KPAX002 to explore a potential synergistic effect of this combination. Fatigue and concentration disturbance symptoms were measured at baseline, 4 weeks, and 12 weeks using two clinically validated tools: Checklist Individual Strength (CIS) and Visual Analog Scale (VAS). The primary outcome objective was a decrease in the total CIS score of ≥25% in at least 50% of the subjects. The mean total CIS score decreased by 36.4 points (34%) at 12 weeks (P<0.0001), corresponding to a ≥25% decrease in 87% of the participants. Treatment with KPAX002 was well tolerated and significantly improved fatigue and concentration disturbance symptoms in greater than 50% of patients with CFS. These results were statistically significant. This combination treatment is worthy of additional investigation.

‣ Evaluation of stability and integrity of a steel truss bridge in a forensic investigation

BRANDO, FRANCESCA
Fonte: La Sapienza Universidade de Roma Publicador: La Sapienza Universidade de Roma
Tipo: Tese de Doutorado
Português
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The studies presented in this Thesis have been developed in the frame of the forensic investigation into the causes of the collapse of the I-35West Bridge (I-35W) in Minneapolis, Minnesota, USA that occurred on August 1 st, 2007. The failure of the I-35W represents a major case-study for the evaluation of stability and integrity of a steel truss bridge. The Thesis has been developed at Columbia University and at the engineering firm Thornton Tomasetti (TT) which was hired by a national law firm, Robins, Kaplan, Miller & Ciresi, to perform a forensic investigation into the cause of the catastrophic collapse. According to the findings of the forensic investigation, the collapse was triggered by the buckling of an element of the main truss bottom chord in the main span close to the pier. The Thesis focused on technical aspects and did not attempt to assign responsibility among the involved parties. In the first part of the thesis, the background and motivation for the forensic investigation are presented together with a description of the I-35W Bridge. The definition of bridge safety and related classifications are given. The concept of structural stability and integrity of steel structures are discussed. The nature of structures and their complexity are considered as well as the methodologies used to study them. An extensive description of the structural decomposition method is presented and detailed for the case study. In this work...

‣ Does Horner's syndrome in infancy require investigation?

George, N; Gonzalez, G; Hoyt, C
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/1998 Português
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AIMS—To evaluate whether isolated Horner's syndrome presenting in the first year of life warrants investigation.
METHOD—Retrospective review of 23 children presenting with Horner's syndrome in the first year of life.
RESULTS—In 16 patients (70%) no cause was identified. Birth trauma was the most common identifiable cause (four patients). Twenty one children (91%) had urinary vanillylmandelic acid (VMA) measured and 13 patients (57%) underwent either computed tomography or magnetic resonance imaging of the chest and neck. These investigations revealed previously undisclosed pathology in only two—one ganglioneuroma of the left pulmonary apex and one cervical neuroblastoma. A further patient was known to have abdominal neuroblastoma before presenting with Horner's syndrome. There were no cases of Horner's syndrome occurring after cardiothoracic surgery. Long term follow up of the patients (mean 9.3 years) has not revealed further pathology.
CONCLUSIONS—Routine diagnostic imaging of isolated Horner's syndrome in infancy is unnecessary. Infants should be examined for cervical or abdominal masses and involvement of other cranial nerves. If the Horner's syndrome is truly isolated then urinary VMA levels and follow up in conjunction with a paediatrician should detect any cases associated with neuroblastoma. Further investigation is warranted if the Horner's syndrome is acquired or associated with other signs such as increasing heterochromia...

‣ Forensic Investigation of mass disasters in Nigeria: A review

Obafunwa, John Oladapo; Faduyile, Francis Adedayo; Soyemi, Sunday Sokunle; Eze, Uwom Okereke; Nwana, Edmund J. C.; Odesanmi, William Olufemi
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2015 Português
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This paper is to establish the present state of things in the country in terms of legal framework and the availability of personnel with a view to presenting an overview of proper mass disaster investigations. This is a retrospective review of mass disasters in Nigeria that occurred within the last 20 years. The study therefore reviews the state of the forensic investigation of the mass disasters as well as the efforts made to identify the victims of the disaster. The process of proper forensic investigation from the stage of evaluation of the scene and recovery process to the final identification of victims are presented to serve as a protocol for the country. The assessment of the present state of preparedness in Nigeria is also examined with a view to improving the practice to international standards. Data were retrieved from official documents from the aviation industry as well as Nigeria news reports. The standard protocols for disaster victim identification were retrieved from the guide released by the INTERPOL. The state of preparedness of the country and recommendations for improvement are presented. The Federal government and the states of the federation should without further delay put in place the process of reviewing the law of Coroner's system and provide the enabling environment for the proper forensic investigation. The training curriculum of the first responders should incorporate mass disaster investigations in order to produce efficient officers and personnel. A functional disaster victim identification (DVI) team is strongly advocated to incorporate different professionals involved in mass disaster management.

‣ Clinical Investigation in Psychiatry

Sloane, R. Bruce; Payne, R. W.; Inglis, J.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 12/01/1963 Português
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A study involving correlations between personality and the fasting serum cholesterol level of normal volunteers on a fat-free diet was used to illustrate techniques of clinical investigation in psychiatry. Precise data were not quoted, but the procedure was described to show how behavioural studies differ from biological ones. Somatotyping (no significant correlation), excretion of catecholamines under stress (raised with high cholesterol levels) and classical conditioning (no significant correlation) were used as examples of simple biological functions. These were contrasted with trait ratings where one observer predicted cholesterol levels with a high degree of accuracy and another with a low and unreliable one. It seemed that the most important trait being rated was “aggressiveness”, and this was probably differentially elicited by the two observers, the one male and authoritarian, the other female and permissive. Such an interaction distorted the information obtained to a degree seldom seen in other data-gathering situations. Estimated and actual achievement on a competitive pin-ball game failed to show significant correlations with other traits. Questionnaires on the attitudes of the subjects' mothers suggested some correlation between severity of training and aggressivity. The techniques of personality investigation described embraced behavioural observations which...

‣ Construct Validity of the Holistic Complementary and Alternative Medicines Questionnaire (HCAMQ)—An Investigation Using Modern Psychometric Approaches

Kersten, Paula; White, P. J.; Tennant, A.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
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The scientific basis of efficacy studies of complementary medicine requires the availability of validated measures. The Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) is one such measure. This article aimed to examine its construct validity, using a modern psychometric approach. The HCAMQ was completed by 221 patients (mean age 66.8, SD 8.29, 58% females) with chronic stable pain predominantly from a single joint (hip or knee) of mechanical origin, waiting for a hip (40%) or knee (60%) joint replacement, on enrolment in a study investigating the effects of acupuncture and placebo controls. The HCAMQ contains a Holistic Health (HH) Subscale (five items) and a CAM subscale (six items). Validity of the subscales was tested using Cronbach alpha's, factor analysis, Mokken scaling and Rasch analysis, which did not support the original two-factor structure of the scale. A five-item HH subscale and a four-item CAM subscale (worded in a negative direction) fitted the Rasch model and were unidimensional (χ2 = 8.44, P = 0.39, PSI = 0.69 versus χ2 = 17.33, P = 0.03, PSI = 0.77). Two CAM items (worded in the positive direction) had significant misfit. In conclusion, we have shown that the original two-factor structure of the HCAMQ could not be supported but that two valid shortened subscales can be used...