Evaluation of the risk of postoperative pulmonary complications

Ten of 40 patients who underwent major thoracic or abdominal operations developed postoperative pulmonary complications, consisting of six massive atelectasis, three pneumonias and one edema. They were mostly thoracotomy cases and cigarette smokers. Many of these complications would have been prevented, if reliable pulmonary function tests are available to predict preoperatively such occurrence. Flow-volume curve tracing and closing volume measurement were evaluated in this respect. Both flow at the point of functional residual capacity on flow-volume curve, and the closing capacity subtracted from functional residual capacity were found to be well correlated with the occurrence of postoperative complications and can be used to evaluate the risk of pulmonary complications developing in postoperative period.     

Evaluation of the obstetrical risks of the antiphospholipid syndrome and therapeutic management

In experiments using ferric nitrilotriacetate (Fe-NTA) as a renal carcinogen, multiple renal cysts are often observed in addition to renal tumours. In the present study, we used 3-week-old male ddY mice and examined the relation between renal cysts and cancer development. Four months after the start of Fe-NTA administration, we observed cysts in the renal cortex in all Fe-NTA-treated mice, but not in Fe-free NTA-treated mice. Three types of cysts were observed, but only those which originated from the renal proximal tubules showed multilayered or papillary growth of cyst epithelial cells. Using histochemical staining, we found a cyst formation-tumour induction sequence, and the supposed cystic-papillary tumour induced by Fe-NTA was of proximal tubular cell origin. We also found that the minimum dose of Fe-NTA capable of inducing renal tumours in ddY mice was 10 mg of iron/kg/day, four times in 2 weeks.     

Therapists at risk: The perils of the intimacy of the therapeutic relationship.

Review of book: Therapists at Risk: The Perils of the Intimacy of the Therapeutic Relationship by Lawrence E. Hedges, Robert Hilton, Virginia Wink Hilton, and O. Brandt Caudill, Jr., Northvale, NJ: Jason Aronson, 1997, 317 pp. Reviewed by Alma H. Bond. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of factors of female urinary incontinence and therapeutic indications

A good understanding of the factors involved in female urinary incontinence is essential for the therapeutic management of incontinent women. Urinary stress incontinence involves three variables which participate in the pressure equilibrium during effort: mobility of the urethrovesical junction, urethral resistance and the intensity of effort. The most appropriate treatment for each patient can only be selected by investigating all three of these factors and by determining their respective roles in incontinence. Urge incontinence is also multifactorial, but, very often, no cause can be found on the aetiological assessment, leading to the diagnosis of idiopathic instability. The factors of detrusor motor instability are discussed and their aetiological treatment is proposed.     

Evaluation of the therapeutic and protective efficacy of doramectin against psoroptic scabies in cattle

Arenaviruses are enveloped viruses with a genome composed of two ssRNA species, designated L and S. The arenaviruses were divided in two major groups (Old World and New World), based on serological properties and genetic data, as well as geographic distribution. A sequence alignment analysis of all reported arenavirus S RNAs yielded 17 conserved regions in addition to a reported conserved region at the end of both RNAs. The consensus sequences of these regions were used to design generalized primers suitable for RT-PCR amplification of a set of overlapping nucleotide sequence fragments comprising the complete S RNA of any arenavirus. A restriction analysis (RFLP) was designed to rapidly typify the amplified fragments. This RT-PCR-RFLP approach was tested with Old World (LCM) and New World (Junin and Tacaribe) arenaviruses. Furthermore, using this procedure the whole S RNA of a novel arenavirus isolate obtained from a rodent trapped in central Argentina, was amplified and characterized. Partial nucleotide sequence data were used for phylogenetic analyses that showed the relationships between this arenavirus and the rest of the members of the family. This relatively simple methodology will be useful both in basic studies and epidemiological survey programs.     

Evaluation of risk factors for fatal neonatal sepsis

OBJECTIVE: To evaluate risk factors for fatal neonatal sepsis. DESIGN: Prospective study. SETTING: Referral neonatal unit of a teaching hospital. SUBJECTS: 171 neonates admitted with sepsis. METHODS: Clinical examination and investigations on the day of admission were recorded and the neonates followed up to determine the final outcome. RESULTS: The overall fatality was 48.5%. In the univariate analysis, the factors significantly associated with death were weight, gestational age, age at onset of sepsis, hypothermia, requirement of IPPV, presence of refractory septic shock, neutropenia, metabolic acidosis and raised prothrombin time. However, in the multivariate analysis, only neutropenia, metabolic acidosis, increased prothrombin time and refractory septic shock retained their significance. The adjusted odd's ratio (95% confidence interval) were 0.095 (0.04 = 0.22), 1.14 (1.04-1.25), 1.04 (1.002-1.08) and 11.82 (5.47-69.40), respectively. CONCLUSION: Even in a setting with high fatality rates, high risk of mortality in neonatal sepsis can be identified and targeted for intensive intervention.     

Evaluation of the effects of diverse therapeutic treatments versus no treatment of patients with neurocardiogenic syncope

Head-up tilt test was introduced in clinical practice to assess vasovagal syncope and its use has further been extended to evaluate the efficacy of drug administration in these patients. Nevertheless, the effects of tilt test on vasovagal syncope have never been compared with those obtained by ethylephrine or propranolol administration. One hundred and sixty-nine consecutive patients with vasovagal syncope and positive baseline or nitrate-potentiated tilt test (60 degrees upright position for 45 min, or until syncope occurred; 5 mg sublingual isosorbide dinitrate administration if no symptoms occurred) were randomly distributed among three groups: Group A (57 control patients discharged without medical therapy); Group B (56 patients discharged with 75 mg/die ethylephrine); Group C (56 patients discharged with 80 mg/die propranolol). Tilt test was repeated after 1 month, while clinical outcome was evaluated monthly for a mean follow-up of 37.1 +/- 15.6 months. No significant differences in acute tilt-induced syncope recurrence rates were obtained among groups at test repetition since 70.2% of Group A, 69.6% of Group B and 62.5% of Group C experienced syncope. At 3-year follow-up 82.4% of Group A, 83.9% of Group B and 87.5% of Group C (NS among groups) remained symptom free, the most important clinical result being obtained in untreated patients. These data suggest that tilt test execution may prevent syncope recurrence as ethylephrine or propranolol administration. Irrespective of the therapeutical choice, the "controlled reproduction" of symptoms and some psychophysical training of patients to avoid precipitating circumstances, to recognize early symptoms promptly to be reverted by Trendelemburg position, may produce the same clinical improvement as (empiric) ethylephrine or propranolol therapy.     

Problems of occupational risk. Evaluation and social welfare

The authors suggested a complex evaluating occupational risk and tested it on enterprises belonging to various industries--machinery building, chemical, oil-processing, electronic, mining. The tests proved the complex to be useful in evaluation of health disorders probability. Integral parameters appeared to be the most valuable as considered not only occurrence, but also severity of the consequences. The study revealed high value of occupational morbidity, if assessed through morbidity with transitory disablement, in evaluation of occupational risk, as disability due to diseases associated with occupation is 2-4 times higher than occupational disability.     

The therapeutic personality in the therapeutic community.

Identified personality characteristics associated with the rated ability of various types of mental hospital support personnel to interact in a therapeutically beneficial manner with patients. The Gordon Personal Profile, the Gordon Personal Inventory, the Work Environment Preference Schedule, and an experimental mental health aptitude test were administered to the female support personnel in 6 state hospitals (N = 257). Ss judged by peers to be the more effective were inclined to take their responsibilities seriously, to be emotionally stable, to be cautious, to have trust and confidence in other people, to be nonbureaucratic in their work orientation, and to be aware of the therapeutically preferred procedures for handling patients. Few significant relationships were found with the supervisory ratings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of occupational diseases according to their risk and severity

Article covers approaches to evaluation and forecasting of occupational risk for workers exposed to occupational hazards, formulates a concept to evaluate occupational disease according to risk and severity categories, gives an integral parameter for qualitative and quantitative analysis of group risk for one occupational disease or their combination. Trials proved acceptability of the method for group risk evaluation according to WHO concept concerning occupational diseases.     

Evaluation of cow-level risk factors for the development of winter dysentery in dairy cattle

OBJECTIVE: To identify exposures to etiologic agents and to identify characteristics that could explain risk of disease for adult cattle in herds affected by winter dysentery (WD). ANIMALS: 229 lactating and nonlactating adult cattle (125 case and 104 control cattle) selected from 12 dairy herds. PROCEDURE: A case-control study, using multivariate conditional logistic regression and controlling for herd effects, was used to develop a model for risk factors associated with disease for each cow. RESULTS: Likelihood of developing disease increased as the ELISA value for bovine coronavirus (BCV) antigen detectable in feces increased (odds ratio [OR] = 2.94 for each 0.100 increase in BCV antigen ELISA value). Pregnant cattle were less likely to develop WD, compared with nonpregnant herdmates. Cows with high acute BCV antibody titers that seroresponded had greater odds of developing disease, compared with seroresponding cows with low acute titers. However, among those cows that did not serorespond, high acute antibody titers were associated with lower odds of developing the disease. CONCLUSION: In herds affected by WD, ill cows were more likely to shed detectable amounts of BCV antigen in their feces, and pregnancy appeared to protect cattle from the disease. The measured interaction between BCV seroresponse and acute BCV antibody titer may be evidence of an immunopathologic condition, but could also have been attributable to dynamics of the ELISA or study design. CLINICAL RELEVANCE: Factors that explained a cow's risk for illness within WD-affected herds may have been surrogate measures for that cow's nonspecific and BCV-specific immune profile.     

Evaluation of the risk of decompression disease during hypobaric decompression from the standpoint of the probability theory

Dentistry is a profession that enables us to combine adventure with the useful. By using our skill and knowledge we can, at least on a limited level, contribute to improving the health of people in third world countries. This article relates a dental volunteer trip into the heart of Africa. The rewards of this type of volunteer dentistry are lifelong memories and great satisfaction.     

Evaluation of coronary risk in patients with subrenal abdominal aortic aneurysm

Atheroma lesions are often found in multiple localizations. In addition, operative mortality for aneurysms of the non-ruptured sub-renal aorta is mainly related to coronary risk. In an attempt to reduce coronary risk, coronarography was performed in all patients (n = 297) from January 1989. Operation for the aneurysm was performed in 192 patients (reasons for not operating were small size of the aneurysm, other contraindication). There were 5 deaths, all related to coronary artery disease. Coronary bypass was performed in 42 patients either before (n = 38) or at the same time (n = 4) as the operation for the aneurysm of the aorta. There were no operative deaths. These results clearly demonstrate the importance of search and treatment of associated coronary lesions in all patients with an aneurysm of the subrenal abdominal aorta. Coronary lesions should be treated whenever morphology allows.