101 research outputs found
Entrapment neuropathies II: carpal tunnel syndrome.
No full textDiagnostic tests in patients complaining of carpal tunnel syndrome (CTS) are based on physical examination, electrodiagnostic tests (EDTs), and diagnostic imaging. Timely diagnosis helps prevent permanent nerve damage and its sequelae in terms of functional impairment. Imaging provides additional information to that obtained from clinical tests and EDTs. By allowing direct visualization of the compressed median nerve (MN), ultrasound (US) and magnetic resonance imaging can depict the causes for secondary CTS and describe anatomical variants, such as a bifid MN or a persistent median artery of the forearm, as well as space-occupying lesions including tenosynovitis and ganglion cysts. In addition, diagnostic imaging is of value for postoperative patients presenting with persistent symptoms. Finally, US is able to add information for EDT-negative symptomatic patients. Over time, US has increased in its sensitivity and specificity so it can be used as the initial test in patients presenting with clinical symptoms of CTS because it is now equivalent to EDT. The use of US as a screening test may reduce the number of EDT examinations in patients with suspected CTS, providing additional valuable anatomical information
Tasks of mourning and the transtheoretical model of change: implications for grief therapy
No full textPlan BThis study examined 32 female, middle-aged bereaved subjects involved in a rural grief therapy group, applying the Transtheoretical Model of Change (Prochaska & DiClemente, 1982, 1983) to the tasks of mourning (Worden, 2002), with the purpose of extending the change model beyond pathological issues, while furthering the individualization of interventions for the bereaved. Individual volunteers were administered three self-report instruments including the Texas Revised Grief Inventory (Faschingbauer, Zisook, & DeVaul, 1987), the Tasks of Mourning: Self-Report Instrument (adapted by the researcher from Worden, 2002), and the University of Rhode Island Change Assessment (McCannaughty, Prochaska, & Velicer, 1983). The correlations between the individual stages of change and the sequential tasks of mourning were not statistically significant. Post hoc comparisons demonstrated a strong relationship between Precontemplation and Task Four and a minimal relationship with Tasks Two and Three. This may signify that Precontemplators exhibit a reluctance to express grief and to adapt to life without the deceased. The Action stage was related to Tasks Two, and Three with a limited association with Task Four of mourning. This may indicate that those involved in the mourning process actively express grief and modify their environments, and that the Action stage may be interrupted or discontinued upon fully integrating the loss. Discussion of implications for research and bereavement counseling are presented
Bifid Median Nerve in Carpal Tunnel Syndrome: Assessment with US Cross-sectional Area Measurement
No full textTo evaluate the accuracy of ultrasonography (US) in the diagnosis of carpal tunnel syndrome (CTS) in patients with a bifid median nerve on the basis of cross-sectional area (CSA) measurements of the median nerve at the level of the carpal tunnel (CSAc), with additional measurements obtained more proximally (CSAp) at the level of the pronator quadratus muscle.This HIPAA-compliant study was approved by the local institutional review board; informed oral and written consent were obtained. Fifty-three wrists in 49 consecutive patients with a bifid median nerve and CTS symptoms and 28 wrists in 27 healthy volunteers with a bifid median nerve were examined by using US. Two independent US examiners who were blinded to prior test results measured median nerve CSA at two levels, CSAc and CSAp. The difference between CSAc and CSAp (ΔCSA) was calculated for each wrist. Receiver operating characteristic (ROC) analysis was performed.The study population included 17 men and 32 women (mean age, 55.1 years; age range, 24-78 years). The control population included 13 men and 14 women (mean age, 52.6 years; age range, 24-86 years). Mean CSAc was approximately 5 mm(2) greater in patients with CTS than in healthy volunteers (P < .0001), while mean ΔCSA was 5.8-5.9 mm(2) greater in patients with CTS (P < .0001). A CSAc threshold of 12 mm(2) provided sensitivity and specificity of 84.9\% and 46.5\%, respectively, while a ΔCSA threshold of 4 mm(2) provided sensitivity and specificity of 92.5\% and 94.6\%, respectively. ROC analysis demonstrated a significant advantage of ΔCSA (area under ROC curve [A(z)] = 0.95-0.96) compared with CSAc (A(z) = 0.84-0.85) for the diagnosis of CTS (P < .003).The use of a ΔCSA parameter improves the diagnostic accuracy of US for the presence of CTS in patients with a bifid median nerve
Integrierte Modellierung heterogener Modellsysteme basierend auf dem Open Modelling Interface (OpenMI)
No full textBei der Erteilung einer wasserrechtlichen Erlaubnis für die Einleitung von Mischwasser in oberirdische Gewässer müssen die vorliegenden örtlichen Gewässerverhältnisse überprüft und bewertet werden. Im Rahmen eines vom Land Hessen finanzierten Forschungsprojektes wurde für die Nachweisführung eine simulationsgestützte Analyse- und Planungsmethodik entwickelt, die auf dem OpenMI-Framework als Schnittstellentechnologie aufbaut. Dazu wurden bestehende Modellsoftwarepakete zu Komponenten weiterentwickelt (Wrappertechnologie) und Schnittstellen des OpenMI-Frameworks implementiert. Ferner wurden Analysewerkzeuge entwickelt, die an die heterogenen Modellsysteme angebunden werden können und eine Auswertung während der Simulation ermöglichen
Preserving Linked Data Integrity on the Semantic Web by application of techniques from Hypermedia
No full textThis report presents a Literature Review of past work in Hypertext link integrity and current work in the emerging area of Semantic Web link integrity. A design and prototype for a system which applies some ideas from Hypertext link integrity to the Semantic Web is presented alongside plans for future enhancements of this system. In addition other possible avenues of research regarding ideas from traditional Hypertext link integrity are briefly discussed
- …
