A combined infrared/heat pump drying technology applied to a rotary dryer

Selostus: Yrttien ja vihannesten infrapunakuivaus rumpukuivurissa

Sclerotherapy of telangiectasias: a painless two-step technique.

BACKGROUND: Sclerotherapy of telangiectasias and reticular leg veins can be unpleasant and painful for some patients. OBJECTIVE: To determine pain level with two different sclerotherapy techniques in a prospective randomized trial. METHODS: Patients with symmetrical telangiectasias and reticular veins on both legs (C(1A) or (S)E(P)A(S)P(N1) were randomized to the standard (successive injections of chromated glycerin mixed with one-third lidocaine-epinephrine 1%) or two-step technique (first treating only reticular veins with a single injection at the base of each cluster of telangiectasias and then successively injecting all remaining telangiectasias a few minutes later. Pain was assessed using a 100-point visual analogue scale (0 = no pain, 100 = maximum pain). RESULTS: Data from 53 consecutive patients could be evaluated. The two-step technique was significantly less painful (28.2) than the standard technique (40.6, p < .001). CONCLUSION: The two-step technique with chromated glycerin mixed with one-third lidocaine-epinephrine 1% significantly reduces sclerotherapy pain. This may be a useful technique for patients who are particularly sensitive or afraid of sclerotherapy.

Solid-phase microextraction as short-term sampling technique for BTEX occupational exposure

Solid phase microextraction (SPME) has been widely used for many years in various applications, such as environmental and water samples, food and fragrance analysis, or biological fluids. The aim of this study was to suggest the SPME method as an alternative to conventional techniques used in the evaluation of worker exposure to benzene, toluene, ethylbenzene, and xylene (BTEX). Polymethylsiloxane-carboxen (PDMS/CAR) showed as the most effective stationary phase material for sorbing BTEX among other materials (polyacrylate, PDMS, PDMS/divinylbenzene, Carbowax/divinylbenzene). Various experimental conditions were studied to apply SPME to BTEX quantitation in field situations. The uptake rate of the selected fiber (75 μm PDMS/CAR) was determined for each analyte at various concentrations, relative humidities, and airflow velocities from static (calm air) to dynamic (>200 cm/s) conditions. The SPME method also was compared with the National Institute of Occupational Safety and Health method 1501. Unlike the latter, the SPME approach fulfills the new requirement for the threshold limit value-short term exposure limit (TLV-STEL) of 2.5 ppm for benzene (8 mg/m3).

Magnetism of isolated Mn12 single-molecule magnets detected by magnetic circular dichroism: Observation of spin tunneling with a magneto-optical technique

We report magnetic and magneto-optical measurements of two Mn12 single-molecule magnet derivatives isolated in organic glasses. Field-dependent magnetic circular dichroism (MCD) intensity curves (hysteresis cycles) are found to be essentially identical to superconducting quantum interference device magnetization results and provide experimental evidence for the potential of the optical technique for magnetic characterization. Optical observation of magnetic tunneling has been achieved by studying the decay of the MCD signal at weak applied magnetic field

15-OR: Multi-phase postmortem CT angiography of pulmonary embolism: technique-related artefacts or real findings?

Multi-phase postmortem CT angiography (MPMCTA) is recognized as a valuable tool to explore the vascular system, with higher sensitivity than conventional autopsy. However, a limitation is the impossibility to diagnose pulmonary embolism (PE) due to post-mortem blood clots situated in pulmonary arteries. The purpose of this study was to explore an eventual possibility to distinguish between real PE and artefacts mimicking PE. Our study included 416 medico-legal cases. All of them underwent MPMCTA, conventional autopsy and histological examination. We selected cases presenting arterial luminal filling defects in the pulmonary arteries. Their radiological interpretation was confronted to the one of autopsy and histological examination. We also investigated an eventual correlation between artefacts in pulmonary arteries and those in other parts of the vascular system. In 123 cases, filling defects of pulmonary arteries were described during MPMCTA. In 57 cases, this was interpreted as artefact and in 4 cases as suspected PE. In 62 cases only a differential diagnosis was made. Autopsy and histology could clearly identify the artefacts as such. Only one case of real PE was radiologically misinterpreted as artefact. In 6 of the 62 cases with no interpretation a PE was diagnosed. In 3 out of 4 suspected cases, PE was confirmed. We found out that filling defects in pulmonary arteries are nearly always associated to other vascular artefacts. Therefore, we suggest following some rules for radiological interpretation in order to allow a reliable diagnosis of pulmonary embolism after MPMCTA.

Laparoscopic Gastric Banding Outcomes Do Not Depend on Device or Technique. Long-Term Results of a Prospective Randomized Study Comparing the Lapband® and the SAGB®.

BACKGROUND: Gastric banding still represents one of the most widely used bariatric procedures. It provides acceptable weight loss in many patients, but has frequent long-term complications. Because different types of bands may lead to different results, we designed a randomized study to compare the Lapband® with the SAGB®. We hereby report on the long-term results. METHODS: Between December 1998 and June 2002, 180 morbidly obese patients were randomized between Lapband® or SAGB®. Weight loss, long-term morbidity, and need for reoperation were evaluated. RESULTS: Long-term weight loss did not differ between the two bands. Patients who maintained their band had an acceptable long-term weight loss of between 50 and 60 % EBMIL. In both groups, about half the patients developed long-term complications, with about 50 % requiring major redo surgery. There was no difference in the overall rates of long-term complications or failures between the two groups, but patients who had a Lapband® were significantly more prone to develop band slippage/pouch dilatation (13.3 versus 0 %, p < 0,001). CONCLUSIONS: Although in the absence of complication, gastric banding leads to acceptable weight loss; the long-term complication and major reoperation rates are very high independently from the type of band used or on the operative technique. Gastric banding leads to relatively poor overall long-term results and therefore should not be considered the procedure of choice for the treatment of morbid obesity. Patients should be informed of the limited overall weight loss and the very high complication rates.

A practical right-sided incisional gastropexy technique for treatment or prevention of gastric dilatation volvulus

Yhteenveto: Käytännöllinen oikeanpuoleinen viiltogastropeksia mahalaukun laajentumisen ja kiertymisen hoitona tai ennaltaehkäisynä

Apport de la pH-impédancemétrie au diagnostic du reflux gastro- oesophagien et de la dysphagie [Advantages of pH-impedance monitoring in gastroesophageal reflux and dysphagia investigations]

Les manifestations ORL du reflux gastro-œsophagien sont fréquentes. La pH-impédancemétrie permet d’évaluer des reflux acides ou non acides et de déterminer leur extension proximale. A la lumière de deux patients de notre collectif, nous observons une corrélation entre reflux non acide et symptômes ORL dans le premier cas et une suppression acide insuffisante dans le deuxième cas. Ces résultats nous orientent vers un traitement spécifique complémentaire aux inhibiteurs de la pompe à protons. La pH-impédancemétrie détecte les reflux aussi bien acides que non acides, et analyse la concordance entre les symptômes et les épisodes de reflux. Elle permet ainsi une meilleure compréhension des manifestations ORL du reflux gastro-œsophagien et une prise en charge thérapeutique mieux adaptée. ENT symptoms of gastro-esophageal reflux are frequent. pH-impedance can detect acid and non-acid reflux and measure their proximal extension. The technique identifies the refluxate by changes in impedance. We discuss 2 clinical situations where correlation of symptoms could be explained by a non-acid reflux in the first case, and a lack of acid suppression in the second case, respectively. These results lead to a specific additional treatment to proton pump inhibitors (PPI). This technology provides a better understanding of the pathogenesis of reflux laryngitis, and affords the prescription of PPI on a proven diagnosis. Detection of non-acid reflux leads to an optimized medical treatment.

Is our heart a well-designed pump? The heart along animal evolution.

A carrier system for gases and nutrients became mandatory when primitive animals grew larger and developed different organs. The first circulatory systems are peristaltic tubes pushing slowly the haemolymph into an open vascular tree without capillaries (worms). Arthropods developed contractile bulges on the abdominal aorta assisted by accessory hearts for wings or legs and by abdominal respiratory motions. Two-chamber heart (atrium and ventricle) appeared among mollusks. Vertebrates have a multi-chamber heart and a closed circulation with capillaries. Their heart has two chambers in fishes, three chambers (two atria and one ventricle) in amphibians and reptiles, and four chambers in birds and mammals. The ventricle of reptiles is partially divided in two cavities by an interventricular septum, leaving only a communication of variable size leading to a variable shunt. Blood pressure increases progressively from 15 mmHg (worms) to 170/70 mmHg (birds) according to the increase in metabolic rate. When systemic pressure exceeds 50 mmHg, a lower pressure system appears for the circulation through gills or lungs in order to improve gas exchange. A four-chamber heart allows a complete separation of systemic and pulmonary circuits. This review describes the circulatory pumping systems used in the different classes of animals, their advantages and failures, and the way they have been modified with evolution.

Evaluation of the inhalation technique in asthmatic children visiting a specialised outpatient clinic

Background and objective: Asthma is one of the most frequent chronic diseases affecting children and adolescents. Good compliance is indispensable for effective treatment since a suboptimal use of inhalation devices can result in decreased therapeutic efficacy and increased morbidity. The objective of this work was to evaluate the inhalation technique of paediatric patients visiting a specialized consultation clinic of a university hospital. Design: Observational prospective study during a 3-month period. Setting Specialized consultation clinic of a university hospital. Main outcome measures: This study involved 40 outpatient infants, children and adolescents visiting alone or with their parent(s). Patients' data (age, sex, weight, diagnostic, reason for consulting, previous consultations) and their medicines were compiled using an ad hoc form. Filmed sequences of the inhalation procedure used by each child were reviewed independently by members of an interdisciplinary team consisting in a physician, a pharmacist, a nurse and a physiotherapist. A score of 1 was assigned to each correct step in the procedure, and a score of 0 to an incorrect step. A perfect procedure implied 12 correct steps. Results: Thirty patients were treated with a metered-dose inhaler and an inhalation chamber (Babyhaler or AeroChamber Plus); ten other patients were treated with a dry powder inhaler (Diskus or Turbuhaler). The agreement between the members of the interdisciplinary team was considered satisfactory. Nine patients (22.5%) reached an average score lower than 7, 18 patients (45%) a score between 7 and 10 and 13 (32.5%) a score equal to or better than 10. No patient reached the maximum score of 12. Users of the metered-dose inhalers (average score = 9.2) showed a better technique than users of the dry powder inhalers (average score = 7.4). Disappointingly, the score was not improved during a second consultation or following regular consultations. Conclusions: Video recording is a simple method to evaluate the degree of mastery of an inhalation procedure in paediatric patients. The method allows a convenient and efficient identification of suboptimal procedure steps by the hospital staff, and opens the way to patient-specific teaching. In two-thirds of juvenile patients, their inhalation technique was suboptimal despite initial training. This study shows conclusively that the inhalation technique in paediatric patients must be monitored during each examination, and teaching measures taken to improve it when necessary.

Technique de reconstruction itérative VEO : évaluation en tomodensitométrie thoracique chez l'enfant.

Objectifs: Evaluer la technique de reconstruction itérative VEO en tomodensitométrie (TDM) du thorax chez l'enfant. Matériels et méthodes: Etude prospective, basée sur 20 patients (7-18 ans), suivis pour mucoviscidose et adressés pour TDM de suivi. Dix patients (groupe A) ont eu une acquisition basse-dose habituelle (BD). Dix patients (groupe B) ont eu une acquisition très-basse-dose (TBD) et ultra-basse-dose (UBD). Les acquisitions BD étaient reconstruites par rétroprojection filtrée (RPF), les acquisitions TBD et UBD étaient reconstruites par RPF et VEO. L'évaluation de VEO était basée sur la réduction de dose et la qualité des images (mesures de bruit et scores de visualisation des structures pulmonaires). Résultats: Une réduction de dose d'environ 50% était obtenue dans le groupe B. La réduction du bruit en VEO par rapport aux RPF était de 55% en TBD et de 75% en UBD. En VEO, une amélioration des scores de visualisation des structures pulmonaires était obtenue en TBD et UBD. Cependant, en VEO-UBD, la visualisation des structures distales demeuraient parfois insuffisante et celle des structures proximales était altérée par une modification de texture de l'image. Conclusion: Malgré une altération possible de la texture de l'image en UBD, la technique de reconstruction VEO est performante en réduction de dose et amélioration des images.

3D coronary vessel wall imaging utilizing a local inversion technique with spiral image acquisition.

Current 2D black blood coronary vessel wall imaging suffers from a relatively limited coverage of the coronary artery tree. Hence, a 3D approach facilitating more extensive coverage would be desirable. The straightforward combination of a 3D-acquisition technique together with a dual inversion prepulse can decrease the effectiveness of the black blood preparation. To minimize artifacts from insufficiently suppressed blood signal of the nearby blood pools, and to reduce residual respiratory motion artifacts from the chest wall, a novel local inversion technique was implemented. The combination of a nonselective inversion prepulse with a 2D selective local inversion prepulse allowed for suppression of unwanted signal outside a user-defined region of interest. Among 10 subjects evaluated using a 3D-spiral readout, the local inversion pulse effectively suppressed signal from ventricular blood, myocardium, and chest wall tissue in all cases. The coronary vessel wall could be visualized within the entire imaging volume.

FAM-MDR: a flexible family-based multifactor dimensionality reduction technique to detect epistasis using related individuals

We propose a novel multifactor dimensionality reduction method for epistasis detection in small or extended pedigrees, FAM-MDR. It combines features of the Genome-wide Rapid Association using Mixed Model And Regression approach (GRAMMAR) with Model-Based MDR (MB-MDR). We focus on continuous traits, although the method is general and can be used for outcomes of any type, including binary and censored traits. When comparing FAM-MDR with Pedigree-based Generalized MDR (PGMDR), which is a generalization of Multifactor Dimensionality Reduction (MDR) to continuous traits and related individuals, FAM-MDR was found to outperform PGMDR in terms of power, in most of the considered simulated scenarios. Additional simulations revealed that PGMDR does not appropriately deal with multiple testing and consequently gives rise to overly optimistic results. FAM-MDR adequately deals with multiple testing in epistasis screens and is in contrast rather conservative, by construction. Furthermore, simulations show that correcting for lower order (main) effects is of utmost importance when claiming epistasis. As Type 2 Diabetes Mellitus (T2DM) is a complex phenotype likely influenced by gene-gene interactions, we applied FAM-MDR to examine data on glucose area-under-the-curve (GAUC), an endophenotype of T2DM for which multiple independent genetic associations have been observed, in the Amish Family Diabetes Study (AFDS). This application reveals that FAM-MDR makes more efficient use of the available data than PGMDR and can deal with multi-generational pedigrees more easily. In conclusion, we have validated FAM-MDR and compared it to PGMDR, the current state-of-the-art MDR method for family data, using both simulations and a practical dataset. FAM-MDR is found to outperform PGMDR in that it handles the multiple testing issue more correctly, has increased power, and efficiently uses all available information.

The International Universities Walking Project: Development of a Framework for Workplace Intervention Using the Delphi Technique

Background: This paper aimed to use the Delphi technique to develop a consensus framework for a multinational, workplace walking intervention. Methods: Ideas were gathered and ranked from eight recognized and emerging experts in the fields of physical activity and health, from universities in Australia, Canada, England, the Netherlands, Northern Ireland, and Spain. Members of the panel were asked to consider the key characteristics of a successful campus walking intervention. Consensus was reached by an inductive, content analytic approach, conducted through an anonymous, three-round, e-mail process. Results: The resulting framework consisted of three interlinking themes defined as “design, implementation, and evaluation.” Top-ranked subitems in these themes included the need to generate research capacity (design), to respond to group needs through different walking approaches (implementation), and to undertake physical activity assessment (evaluation). Themes were set within an underpinning domain, referred to as the “institution” and sites are currently engaging with subitems in this domain, to provide sustainable interventions that reflect the practicalities of local contexts and needs. Conclusions: Findings provide a unique framework for designing, implementing, and evaluating walking projects in universities and highlight the value of adopting the Delphi technique for planning international, multisite health initiatives.