Adequacy and quality of abdominal echographies requested by primary care professionals

<p>Abstract</p> <p>Background</p> <p>The value of abdominal echography in primary care is great because it is innocuous, inexpensive, easy to perform and provides a great deal of information making this the first examination to be requested in cases of probable abdominal disease. <b>However, too many abdominal echographies are probably requested overcrowding the Departments of Radiodiagnosis with not always justified petitions or with repetition of tests based on little clinical criteria</b>.</p> <p>Methods/Design</p> <p><b>The aim of the study is </b>to evaluate the adequacy and quality of abdominal echographies requested by primary care physicians in the Maresme County (North of Barcelona), develop guidelines for indicating echographies and reevaluate this adequacy after implementing these guidelines.</p> <p>We will perform a two-phase study: the first descriptive, and retrospective evaluating the adequacy and quality of petitions for abdominal echographies, and in the second phase we will evaluate the impact of recommendations for indicating abdominal echographies for PC physicians on the adequacy and quality of echography petitions thereafter.</p> <p><b>This study will be carried out in 10 primary care centres </b>in the Maresme (Barcelona).</p> <p>1067 abdominal echographies requested by primary care physicians from the above mentioned centres from January 2007 to April 2010 and referred to the Department of Radiology and the same number of applications after the intervention.</p> <p>All the petitions for abdominal echographies requested will be analysed and the clinical histories will be obtained to determine demographic variables, the reason for the visit and for the echography petition and diagnostic orientation, clinical and echographic data, evaluation of the echographies according to the quality and variables characterising the professionals requesting the echographies including: age, sex, laboral situation, length of time in work post, formation, etc.</p> <p>To achieve a consensus of the adequacy of abdominal echography, a work group including gastroenterologists, radiologists and general practitioners will be created following the nominal group. This will allow the design of guidelines for the indication of abdominal echography and posterior evaluation of their impact among physicians by diffusion and posterior reevaluation of the adequacy of the petitions.</p

A theoretical study of potassium cation-glycine (K+-Gly) interactions

The structures and binding affinities of potassium cation (K+) bound complexes of glycine (Gly) are established using a B3-LYP density functional based energetic protocol 'EP(K+)'. Ten stable isomers on the potential energy surface have been located and the most stable mode of binding involves a bidentate interaction between the cation with O=C and -OH. The dipole moment of the glycine ligand plays a dominant role in governing the relative stability of binding modes, while the effect of ligand polarizability plays a less important role. We found that the stabilization energies (raw interaction energies) of these complexes can be well approximated by a linear function of the 'dipole interaction parameter' and 'polarizability interaction parameter'. © 2002 Elsevier Science B.V. All rights reserved.link_to_subscribed_fulltex

Interaction of Ca2+ with mannose: A density functional study

Five stable binding modes between Ca2+ and β-D-mannose have been identified using hybrid density functional method. The most stable mode of binding involves the simultaneous interaction of Ca2+ with four oxygen atoms on the mannose, while some bidentate interactions are of comparable strength to the tridentate interaction. By partitioning the total interaction energy into "stabilization" and "deformation" energies, the effect of Ca2+ co-ordinate number, Ca2+-O bonding distances, intramolecular hydrogen bonding and conformational strain upon complexation on the relative stability of different binding modes are analyzed. Biological relevance of our present study is also discussed. © 2001 Elsevier Science B.V.link_to_subscribed_fulltex

Absolute potassium cation affinities (PCAs) in the gas phase

The potassium cation affinities (PCAs) of 136 ligands (20 classes) in the gas phase were established by hybrid density functional theory calculations (B3-LYP with the 6-311 + G(3df,2p) basis set). For these 136 ligands, 70 experimental values are available for comparison. Except for five specific PCA values - those of phenylalanine, cytosine, guanine, adenine (kinetic-method measurement), and Me2SO (by high-pressure mass spectrometric equilibrium measurement) - our theoretical estimates and the experimental affinities are in excellent agreement (mean absolute deviation (MAD) of 4.5 kJ mol -1). Comparisons with previously reported theoretical PCAs are also made. The effect of substituents on the modes of binding and the PCAs of unsubstituted parent ligands are discussed. Linear relations between Li +/Na + and K + affinities suggest that for the wide range of ligands studied here, the nature of binding between the cations and a given ligand is similar, and this allows the estimation of PCAs from known Li + and/or Na + affinities. Furthermore, empirical equations relating the PCAs of ligands with their dipole moments, polarizabilities (or molecular weights), and the number of binding sites were established. Such equations offer a simple method for estimating the PCAs of ligands not included in the present study.link_to_subscribed_fulltex

Effective personal protective clothing for health care workers attending patients with severe acute respiratory syndrome

Background: Optimal usability is crucial in providing protection for health care workers who are exposed to severe acute respiratory syndrome day and night while taking care of patients with the virus. No research study has yet tested the usability of personal protective clothing (PPC). Method: The study was carried out in 3 stages. PPC available in Hong Kong were sorted by their physical properties in the first stage. The second stage was a single-blinded study examining the different usability aspects of the PPC. The third stage was a simulated viral load test. Results: Four types were identified: good water repellency and water resistance, poor air permeability (Type A PPC); good water repellency and air permeability, poor water resistance (Type B PPC); poor water repellency, poor water resistance, and fair air permeability (Type C PPC); and good water repellency, poor air permeability and fair water resistance (Type D PPC). Type D PPC had a significantly higher number of contamination sites on the subjects' dorsum and palm. Type C PPC had the highest contamination over the trunk. Findings in the viral load test showed that there was a significant difference in the contamination of the face (t = 4.69, df = 38. P <.00) between 1 and 2 strokes. Conclusion: Type A PPC is effective in providing a desirable protective function against droplet splash, if a disposable PPC is required. Type C PPC, the surgical gown, is also appropriate, as the cost is low, air permeability is fair, and the level of possible hand contamination is lowest among the 4 groups in the current study.Institute of Textiles and ClothingSchool of Nursin

Modulation of N400 in chronic non-fluent aphasia using low frequency Repetitive Transcranial Magnetic Stimulation (rTMS)

Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43. months post stimulation. The present study aimed to investigate the electrophysiological correlates associated with the application of rTMS through measurement of the semantic based N400 Event-related brain potentials (ERP) component. Low frequency (1. Hz) rTMS was applied to the anterior portion of the homologue to Broca's area (pars triangularis), for 20. min per day for 10. days, using a stereotactic neuronavigational system. Twelve non-fluent persons with aphasia, 2-6. years post stroke were stimulated. Six participants were randomly assigned to receive real stimulation and six participants were randomly assigned to receive a blind sham control condition. ERP measures were recorded at baseline, 1. week and 2. months subsequent to stimulation. The findings demonstrate treatment related changes observed in the stimulation group when compared to the placebo control group at 2. months post stimulation indicating neuromodulation of N400 as a result of rTMS. No treatment related changes were identified in the stimulation group, when compared to the sham group from baseline to 1. week post stimulation. The electrophysiological results represent the capacity of rTMS to modulate neural language networks and measures of lexical-semantic function in participants with non-fluent aphasia and suggest that time may be an important factor in brain reorganization subsequent to rTMS. © 2010 Elsevier Inc

A problem by a different name? A review of research on trafficking in South-East Asia and Oceania

10.1111/j.0020-7985.2005.00318.xInternational Migration431-2203-23