scholarly journals Microcirculation: Physiology, Pathophysiology, and Clinical Application

2019 ◽  
Vol 49 (1-2) ◽  
pp. 143-150 ◽  
Author(s):  
Goksel Guven ◽  
Matthias P. Hilty ◽  
Can Ince
Keyword(s):  
Clinical Medicine ◽  
Point Of Care ◽  
Response To Therapy ◽  
Inadequate Response ◽  
Analysis Software ◽  
Paper Briefly ◽  
Central Function ◽  
Central Target ◽  
Instant Availability ◽  
Made In

This paper briefly reviews the physiological components of the microcirculation, focusing on its function in homeostasis and its central function in the realization of oxygen transport to tissue cells. Its pivotal role in the understanding of circulatory compromise in states of shock and renal compromise is discussed. Our introduction of hand-held vital microscopes (HVM) to clinical medicine has revealed the importance of the microcirculation as a central target organ in states of critical illness and inadequate response to therapy. Technical and methodological developments have been made in hardware and in software including our recent introduction and validation of automatic analysis software called MicroTools, which now allows point-of-care use of HVM imaging at the bedside for instant availability of functional microcirculatory parameters needed for microcirculatory targeted resuscitation procedures to be a reality.

Transoral Radiofrequency Treatment of Snoring

2002 ◽  
Vol 127 (3) ◽  
pp. 235-237 ◽  
Author(s):  
Jonas T. Johnson ◽  
Gabrielle L. Pollack ◽  
Robin L. Wagner
Keyword(s):  
Soft Palate ◽  
Average Energy ◽  
Response To Therapy ◽  
Inadequate Response ◽  
Significant Other ◽  
Viable Option ◽  
Insufficient Amount ◽  
Patient Tolerance ◽  
Before And After ◽  
Number Of Treatment

OBJECTIVES/HYPOTHESIS: Radiofrequency ablation (RFA) may effectively treat snoring with acceptable patient tolerance. STUDY DESIGN: A cohort of patients with unacceptable snoring underwent RFA to the soft palate between October 1997 and May 2000. Before the therapy, a family member or significant other person was interviewed to rate snoring loudness. METHODS: Snoring was rated on a visual analog scale of 0 to 10 (in which 0 was no snoring and 10 was horrific snoring) before and after therapy. All patients were treated with transoral RFA administered under local anesthesia at 6-week intervals. RESULTS: Complete data were available for 60 of the 75 treated patients. The average number of treatment sessions per patient was 1.8. These patients received an average energy of 1845 J. Overall the average snoring score was 8.9 before therapy and 3.5 after therapy. Fifty-one patients (85%) were considered to have major improvement in snoring loudness. A total of 9 patients (15%) were nonresponders. CONCLUSIONS: RFA to the soft palate is a viable option to treat socially unacceptable snoring. Inadequate response to therapy may reflect misdiagnosis or delivery of an insufficient amount of energy.

POCT Analysts’ Perspective: Practices and Wants for Improvement

2020 ◽  
Vol 5 (3) ◽  
pp. 480-493
Author(s):  
Sten A Westgard ◽  
Henk M J Goldschmidt ◽  
Sharon S Ehrmeyer
Keyword(s):  
Point Of Care ◽  
Healthcare Providers ◽  
Quality Improvements ◽  
Point Of Care Testing ◽  
Online Questionnaire ◽  
Testing Practices ◽  
Regulatory Mandates ◽  
Guidelines And Standards ◽  
And Function ◽  
Made In

Abstract Background Point-of-care testing (POCT) continues to expand worldwide. Concerns remain about result quality despite guidelines and standards that specify testing practices. To better understand POCT testing worldwide, we polled analysts to obtain their views on actual practices and needs for improvement. Methods An online questionnaire was constructed on SurveyMonkey, a commercially available website for conducting such surveys. POCT analysts were sought worldwide from a pool of healthcare providers subscribed to a westgard.com newsletter or visitors to westgard.com and/or LinkedIn to one of the authors. Results Seventy-three percent of testing occurred in hospitals with 64% conducted in specialty settings. Regulatory mandates were followed by 88%. For most, less than 100 tests were performed per day fewer less than 25 devices. Nurses top the list of analysts. All but 5% of analysts received some form of training primarily from manufacturers. Eighty-seven percent verified devices/methods prior to implementation. Five percent do not perform daily QC; all analyzed external QC at least once per month. When QC limits exceed acceptable limits, 92% stop testing. Expired materials were used by 5%. The majority collected data for quality improvements. Eleven percent thought their organization’s POCT is acceptable. The majority of respondents believe improvements need to be made in POCT. Conclusions Analysts' POCT practices have and are improving to contribute positively to patients’ healthcare and safety. Analysts do recognize problems and their wants/needs provide important information to improve their practices. Most participants desire more in-house and/or manufacturer training, explicit directions from manufacturers, manufacturer built-in quality and function checks, and oversight.

Diagnostic Biochemistry and Clinical Medicine: Facts and Fallacies

1963 ◽  
Vol 9 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Oscar Bodansky
Keyword(s):  
Clinical Medicine ◽  
Clinical Biochemistry ◽  
Hereditary Disease ◽  
Malignant Carcinoid ◽  
Laboratory Error ◽  
Interlaboratory Variability ◽  
Enzyme Defects ◽  
Precision And Accuracy ◽  
Clinical Biochemist ◽  
Made In

Abstract In this paper we have attempted to define the relationships between clinical medicine and diagnostic or, as it is more frequently termed, clinical biochemistry. We have indicated first, the role that general biochemistry has played in elucidating mechanisms of disease and in providing the clinician with procedures that aid him in the diagnosis of disease and in the care of the patient. We have illustrated this role by reviewing very briefly some of the recent contributions such as the expanded diagnostic use of serum enzymes; the correlation of subcellular structure in human tissues with function at enzymatic levels; the investigation of enzyme variants; the metabolism of epinephrine and norepinephrine in pheochromocytoma; the metabolism of tryptophan in malignant carcinoid; and enzyme defects in hereditary disease. We noted the reservations with which the clinician frequently views the specific results that he obtains from the diagnostic biochemistry laboratory and have attempted to analyze the bases for these reservations. In this connection we considered the phenomenon of interlaboratory variability, the nature of the random and the constant errors that may exist within a laboratory, and the measures that the clinical biochemist may take to counteract these errors. We have tried to indicate the steps the clinician may take in a fuller and more knowledgeable utilization of the data from the diagnostic biochemistry laboratory. These involve a recognition of the efforts and advances that are being made in increasing precision and accuracy within the laboratory and the role that the clinician himself can play in contributing to this precision and accuracy. The phenomenon of intraindividual and interindividual variability of biochemical parameters, and the significance of this phenomenon in diagnosis, are also worthy of the clinicians attention. Finally, the clinician should abjure the concept that a seeming discrepancy between his formulation and laboratory results usually means a laboratory error. Thoughtful review, in cooperation with the biochemist, of such discrepancies are of value both for clinical medicine and clinical biochemistry.

The Light Induced Changes in A-Si: H Materials and Solar Cells—Where We are Now

1997 ◽  
Vol 467 ◽  
Author(s):  
C. R. Wronski
Keyword(s):  
Solar Cells ◽  
Solar Cell ◽  
Paper Briefly ◽  
Cell Structures ◽  
Large Effort ◽  
Induced Changes ◽  
The Impact ◽  
Made In

ABSTRACTThe quest for understanding and especially controlling the reversible light induced changes in a-Si:H based materials has been ongoing for the last twenty years. This has been accompanied by a corresponding large effort in minimizing their effects on more efficient a-Si:H based solar cells. Despite the complexities in both the phenomena as well as the solar cells, progress has been made in both the scientific and technological arenas. This paper briefly reviews primarily studies on the characterization and reduction of the metastable changes in materials and the correlation of these changes with those in efficient solar cells. It will discuss the impact of studies on materials as well as the continuous advances made with “engineering” of solar cell structures on their improved stabilized performance.

An Analytical Approach Regarding Some Radiometric Problems during the Detection on the Sea Surface with a Thermal Camera

2013 ◽  
Vol 436 ◽  
pp. 318-325 ◽  
Author(s):  
Catalin Spulber ◽  
Octavia Violeta Borcan
Keyword(s):  
Atmospheric Pollution ◽  
System Performance ◽  
Analytical Approach ◽  
Sea Surface ◽  
Thermal Camera ◽  
Analysis Software ◽  
Surface Detection ◽  
Thermal Signature ◽  
Radiometric Characteristics ◽  
Made In

The paper presents some methods to evaluate a thermal signature acquired with a thermal camera from some targets in marine background. Using a simulation interface made in MAVIIS 1,5 [ and with the ImageJ [ analysis software, the authors reveal the dependence between the atmospheric pollution, geometrical and radiometric characteristics of the targets and their backgrounds used during the sea surface detection, and the system performance of the thermal camera sensor.

Development of a Bead-Based Optoelectrokinetic Immunosensing Technique for Detection of Low-Abundance Analytes

2017 ◽  
Author(s):  
Han-Sheng Chuang ◽  
Hsiao-Neng Lin ◽  
Hu-Yao Ku
Keyword(s):  
Limit Of Detection ◽  
Point Of Care ◽  
Particle Manipulation ◽  
Great Flexibility ◽  
Point Of Care Diagnostics ◽  
Combined Use ◽  
Tnf Α ◽  
Rapid Electrokinetic Patterning ◽  
Sample Droplet ◽  
Made In

Bead-based immunosensing has been growing as a promising technology in the point-of-care diagnostics because of great flexibility. For dilute samples, functionalized particles can be used to collect dispersed analytes and act as carriers for particle manipulation. To carry out rapid and selective diagnosis, a bead-based optoelectrokinetic immunosensing technique was developed herein to detect biomarkers, lipocalin 1 (LCN1) and TNF-α, for diabetic retinopathy (DR). The measurement was made in a sample droplet sandwiched between two parallel electrodes. With an electric field and a focused laser beam simultaneously applying on the microchip, the immunocomplexes in the droplet were further concentrated within the region of irradiation to enhance the fluorescent signal. The optoelectrokinetic platform, termed rapid electrokinetic patterning (REP), is excellent in dynamic and programmable particle manipulation. Therefore, the detection could be complete in roughly 10 s. With an appropriate frequency modulation, the two DR biomarkers were detected at a time. The limit of detection (LOD) of the REP-enabled measurement reached as low as 100 pg/mL. The combined use of bead-based immunoassays and the optoelectrokinetic platform therefore provides an insightful measure to the early diagnosis of diseases.

scholarly journals A Study of Traditional Toy Making in Channapatna, and Proposal of an Artisan Village

2021 ◽  
Vol 10 (4) ◽  
pp. 191-195
Author(s):  
Ar. Uma S.M ◽  
◽  
Dr. B. Shankar ◽  
Aparna Agaram Krishnan ◽  
◽  
...  
Keyword(s):  
Social Development ◽  
Working Conditions ◽  
Raw Materials ◽  
International Market ◽  
Research Paper ◽  
Paper Briefly ◽  
Made In

Toys are objects made for a child to play with and explore their surroundings. Toys aid in the physical, emotional, cognitive and social development of children. Channapatna toys are soft-wood toys that are made in Channapatna, about 60 km southwest of Bangalore. The toys are eco-friendly, non-toxic and child safe and have been recognized as GI tagged commodities. Artisans majorly acquire the skills from their families who are into toy making since generations, or from a master craftsmen who acts as a head of a group of artisans. It is a craft that is passed on from generation to generation. The toys are also exported and have buyers in an international market. In this research paper, the process of traditional toy making, raw materials required, and methods have been studied in detail, along with the challenges faced by artisans. The artisans engaged in the craft form are mostly dependent on middle-men, and are unaware of benefits and facilities that are available. The paper briefly outlines possible architectural interventions that can improve the working conditions of artisans, and preserve the traditional craft form.

scholarly journals Granulocyte transfusions: current status

Blood ◽  
1980 ◽  
Vol 55 (1) ◽  
pp. 2-8 ◽  
Author(s):  
DJ Higby ◽  
D Burnett
Keyword(s):  
Bone Marrow ◽  
Acute Leukemia ◽  
Clinical Medicine ◽  
Bone Marrow Failure ◽  
Current Status ◽  
Granulocyte Transfusion ◽  
Transfusion Therapy ◽  
Neutropenic Patients ◽  
Ongoing Evaluation ◽  
Made In

Abstract Since granulocyte transfusions first became widely used in clinical medicine, there have been advances in the treatment of acute leukemia and improvement in prevention and management of infection in neutropenic patients. Improved understanding now exists concerning prognosis of infections in such patients, and advances have been made in procurement of granulocytes. Granulocyte transfusions should be given for specific indications, and used adjunctively to other established antiinfective therapy. Once initiated, transfusions should be given in adequate doses at daily intervals (at least) with ongoing evaluation and periodic reassessment of the whole antiinfective program. Serious complications of granulocyte transfusion therapy are relatively rare, but the physician should be prepared to manage them intelligently. Research continues in discerning exactly how granulocyte transfusion work, in preservation of granulocytes, and in delineation of immunologic phenomena affecting the efficiacy of such therapy. Granulocyte transfusions will continue to be important in the management of acute leukemia, and other reversible bone marrow failure states, and in marrow transplantation and autotransplantation.

scholarly journals Redefining typhoid diagnosis: what would an improved test need to look like?

2019 ◽  
Author(s):  
Richard Mather ◽  
Heidi Hopkins ◽  
Christopher M. Parry ◽  
Sabine Dittrich
Keyword(s):  
Typhoid Fever ◽  
Diagnostic Test ◽  
Clinical Medicine ◽  
Point Of Care ◽  
Treatment Algorithm ◽  
Febrile Illness ◽  
Diagnosis And Treatment ◽  
Acute Febrile Illness ◽  
Next Generation ◽  
Antibiotic Overuse

IntroductionTyphoid fever is one of the most common bacterial causes of acute febrile illness in the developing world, with an estimated 10.9 million new cases and 116.8 thousand deaths in 2017. Typhoid point-of-care (POC) diagnostic tests are widely used but have poor sensitivity and specificity, resulting in antibiotic overuse that has led to the emergence and spread of multidrug resistant strains. With recent advances in typhoid surveillance and detection, this is the ideal time to produce a target product profile (TPP) that guides product development and ensure that a next-generation test meets the needs of users in the resource-limited settings where typhoid is endemic.MethodsA structured literature review was conducted to develop a draft TPP for a next-generation typhoid diagnostic test with minimal and optimal desired characteristics for 36 test parameters. The TPP was refined using feedback collected from a Delphi survey of key stakeholders in clinical medicine, microbiology, diagnostics and public and global health.ResultsA next-generation typhoid diagnostic test should improve patient management through the diagnosis and treatment of infection with acute Salmonella enterica serovars Typhi or Paratyphi with a sensitivity ≥90% and specificity ≥95%. The test would ideally be used at the lowest level of the healthcare system in settings without a reliable power or water supply and provide results in less than 15 minutes at a cost of <$1.00 USD.ConclusionThis report outlines the first comprehensive TPP for typhoid fever and is intended to guide the development of a next-generation typhoid diagnostic test. An accurate POC test will reduce the morbidity and mortality of typhoid fever through rapid diagnosis and treatment and will have the greatest impact in reducing antimicrobial resistance if it is combined with diagnostics for other causes of acute febrile illness in a treatment algorithm.

scholarly journals Mental health in Latin America and the Caribbean

2014 ◽  
Vol 11 (1) ◽  
pp. 6-8
Author(s):  
Jorge J. Rodriguez
Keyword(s):  
Mental Health ◽  
Latin America ◽  
Mental Illnesses ◽  
World Health ◽  
Paper Briefly ◽  
Mental Health Reform ◽  
Pan American ◽  
The Caribbean ◽  
Health Organization ◽  
Made In

Mental illnesses are a growing health problem and reducing the treatment gap in Latin America and the Caribbean is a great challenge. Evaluations conducted by the Pan American Health Organization (PAHO) and World Health Organization (WHO) have shown that the responsiveness of health services is still limited. Nonetheless, from an evaluation of how mental health reform has progressed in the region following the historical benchmark of the Caracas Declaration (1990), it is clear that – despite the limitations, shortcomings and challenges – significant progress has been made in most countries. This paper briefly reviews this progress.

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