55,998 research outputs found
Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR Study): recruitment list evaluation. Study report no. 2
No full textBACKGROUND: Accompanying the patient recruitment within the "Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment multicentre trial (SPR)", all patients with primary rhegmatogenous retinal detachment (RRD) had to be documented in a detailed recruitment list. The main goal of this analysis was to estimate the prevalence of "medium-severe" RRD (SPR Study eligible) as defined by the SPR Study inclusion criteria. In addition, the detailed anatomical situation of medium-severe RRD is investigated. METHODS: SPR Study recruitment was evaluated via a standardised questionnaire, which contained a coloured fundus drawing and information regarding possible reasons for exclusion from the SPR Study in each case. A team of three experienced vitreoretinal surgeons evaluated all fundus drawings from a 1-year period. The review led to a decision on SPR Study eligibility on the pure basis of anatomical assessment. The main outcome measures were assessment of feasible inclusion into the SPR Study by the evaluation team based on the fundus drawing and anatomical details. RESULTS: A total of 1,115 patients with RRD from 13 European centres were prospectively enrolled in the year 2000. The quality of the drawings sufficed for assessment in 1,107 cases (99.3%). Three hundred and twelve fundus drawings (28.2%) met the anatomic inclusion criteria of the SPR Study. RRD of medium severity is characterised by an average number of 2.6 (SD 2.4) retinal breaks, 5.8 (SD 2.8) clock hours of detached retina, unclear hole situation in 15.1% of cases (n=47), attached macula in 42.9% (n=134), bullous detachment in 15.1% (n=47) and vitreous haemorrhage/opacity in 7.7% (n=24). CONCLUSIONS: In the recruitment lists of the SPR Study of the year 2000, RRD of medium severity was present in nearly one third of the patients with primary RRD. These findings emphasise the clinical relevance of the SPR Study
The UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factors
No full textThe UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factor
Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study (SPR study): Risk assessment of anatomical outcome. SPR study report no. 7
No full textPurpose: The 'Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment study' (SPR study) is a randomized multicentre trial comparing primary vitrectomy (PV) and scleral buckling surgery (SB) for rhegmatogenous retinal detachment (RRD). This subanalysis was conducted to identify risk factors associated with anatomical outcomes. Methods: Relating the anatomical success results at the 1-year follow-up visit to pre- and intraoperative findings using multivariate statistical methods. Results: In the phakic subtrial, anatomical success was negatively associated with the number of breaks (p 1 clock hour (p = 0.0005) and intraoperative use of cryotherapy (p = 0.0484). It was positively associated with retinal breaks with irregular edges (p = 0.0353) and subretinal fluid drainage (p = 0.0155). In the pseudophakic/aphakic subtrial, anatomical success was negatively associated with the number of retinal breaks (p = 0.0004) and previous YAG capsulotomy (p = 0.0256), and the combined effect of the surgical procedure and intraoperative use of laser (p = 0.0229). Conclusion: Primary anatomical success is an important result for patients undergoing RRD surgery. Our data demonstrate that the final anatomical outcome is related to a higher preoperative number of breaks and cryotherapy in phakic eyes. Additional risk factors varied between phakic and pseudophakic subgroups. Our findings may be used to facilitate the prognosis of future patients with RRD
Preparation of Stable Gold Colloids for Sensitivity Enhancement of Progesterone Immunoassay using Surface Plasmon Resonance
No full textThe purpose of this study was to prepare concentrated and stable gold colloids for the enhancement of the signal response of the SPR technique for detecting small molecules such as progesterone. The gold colloids developed in this study were prepared by hydrazine hydrate, sodium borohydride, and tri-potassium citrate reduction routes. The study revealed that the sodium borohydride reduced gold colloids were extremely stable and it was able to be utilised in the progesterone immunoassay developed previously by Mitchell et al. The experiment was carried out on BIAcore 3000 using two different sensor surfaces (CM5 and SAM). The results showed that the enhancement species prepared from the borohydride-reduced gold colloids were able to improve the SPR signal response by 13 times higher than SPR signal produced without the enhancement species on the CM5 surface. The signal enhancement on the SAM surface using the same enhancement species was even greater at 29 times higher. The sensitivity of the assay was, however, unable to be determined due to time constraint. The limit of detection (LOD) of the progesterone assay using the CM5 chip was estimated to be ca. 5-20 pg/mL. Whilst for the SAM chip, the LOD of the progesterone assay was estimated to be ca. 5-20 fg/mL. Further work is required to confirm these estimated LOD values
Anatomic Success of Scleral Buckling for Rhegmatogenous Retinal Detachment - A Retrospective Study of 524 Cases
No full textBackground/Aim: Our purpose was to investigate the anatomic success of scleral buckling surgery for rhegmatogenous retinal detachment. Material and Methods: A total of 524 consecutive patients were retrospectively analysed. Several parameters including the lens status, number of breaks and extent of retinal detachment, preoperative proliferative vitreoretinopathy and refractive errors were examined. The minimum follow-up was 6 months. The primary success rate was defined as anatomic success being stable over a period of at least 6 months after surgery. The secondary success rate was defined as anatomic success after the second intervention if necessary. Besides an analysis over all patients, the patients were grouped according to the severity of the preoperative situation in simple, medium and severe cases. Results: The overall primary anatomic success rate was 84.7% and the secondary success rate 96.4% after 1 initial scleral buckling surgery and 1 additional surgery in case of persisting retinal detachment, and 19.1% of the patients with an initially attached retina after 1 scleral buckling surgery experienced a redetachment in the postoperative course and were successfully treated in 60/85 cases. In phakic patients (n = 359) the primary success rate was 89.7%, whereas in pseudophakic patients (n = 165) a primary success rate of 73.9% was obtained. The primary success was additionally influenced by the extent of the retinal detachment measured in clock hours (p <0.001), undetected holes (p = 0.004), small (p = 0.037) and no gas tamponade (p = 0.021). In simple, medium and severe cases, phakic patients always achieved better anatomic results (89.9, 89.1 and 90.2%) compared to pseudophakic ones (82.5, 70.3 and 36.4%). Conclusion: Scleral buckling is a very good surgical option in phakic patients irrespective of the preoperative severity and simple cases in pseudophakic patients. Scleral buckling represents a surgical technique worth being trained and performed in the light of favourable results especially in phakic eyes. Copyright (C) 2010 S. Karger AG, Base
All repair and reconstruction. Techniques from the SANTI study group
No full textBackground: Combining an anterior cruciate ligament (ACL) reconstruction with an anterolateral ligament (ALL) reconstruction results in significant advantages including reduced graft rupture rates, a lower risk of reoperation for secondary meniscectomy, improved knee stability, and higher rates of return to preinjury levels of sport. Indications: The previously reported indications for combined ACL and ALL reconstruction are as follows: ACL reconstruction revision; high-grade pivot shift test; long-term ACL rupture; young patients; pivoting activities; concomitant medial meniscus repair, and, specifically, regarding the ALL repair, it must be an acute surgery (within 15 days from injury). Technique Description: Several modern techniques have been described to repair and reconstruct the ALL. This technical note details a number of these techniques performed by the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group. Results: First, we describe a combined ACL reconstruction and double-bundle ALL reconstruction using hamstring autograft. Secondly, we describe a single-bundle ALL reconstruction using gracilis autograft. Thirdly, we describe an ALL reconstruction technique using a knotless soft anchor, which provides shallow fixation and prevents tunnel convergence. Finally, we describe a technique for ALL repair. Conclusion: Several techniques have been described to repair and reconstruct the ALL, all offering significant advantages over an isolated ACL reconstruction. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication
Robust automated detection of microstructural white matter degeneration in Alzheimer’s disease using machine learning classification of multicenter DTI data
No full textDiffusion tensor imaging (DTI) based assessment of white matter fiber tract integrity can support the diagnosis of Alzheimer’s disease (AD). The use of DTI as a biomarker, however, depends on its applicability in a multicenter setting accounting for effects of different MRI scanners. We applied multivariate machine learning (ML) to a large multicenter sample from the recently created framework of the European DTI study on Dementia (EDSD). We hypothesized that ML approaches may amend effects of multicenter acquisition. We included a sample of 137 patients with clinically probable AD (MMSE 20.6±5.3) and 143 healthy elderly controls, scanned in nine different scanners. For diagnostic classification we used the DTI indices fractional anisotropy (FA) and mean diffusivity (MD) and, for comparison, gray matter and white matter density maps from anatomical MRI. Data were classified using a Support Vector Machine (SVM) and a Naïve Bayes (NB) classifier. We used two cross-validation approaches, (i) test and training samples randomly drawn from the entire data set (pooled cross-validation) and (ii) data from each scanner as test set, and the data from the remaining scanners as training set (scanner-specific cross-validation). In the pooled cross-validation, SVM achieved an accuracy of 80% for FA and 83% for MD. Accuracies for NB were significantly lower, ranging between 68% and 75%. Removing variance components arising from scanners using principal component analysis did not significantly change the classification results for both classifiers. For the scanner-specific cross-validation, the classification accuracy was reduced for both SVM and NB. After mean correction, classification accuracy reached a level comparable to the results obtained from the pooled cross-validation. Our findings support the notion that machine learning classification allows robust classification of DTI data sets arising from multiple scanners, even if a new data set comes from a scanner that was not part of the training sample
Effectiveness of brief schema group therapy for borderline personality disorder symptoms : a randomized pilot study
No full textBackground and objectives Schema group therapy is a potentially cost-effective treatment for borderline personality disorder (BPD). We piloted the feasibility and effectiveness of a 20-session schema group therapy without individual therapy among psychiatric BPD outpatients in a randomized pilot study registered as a clinical trial (ISRCTN76381242). Methods Altogether 42 psychiatric outpatients diagnosed with BPD were randomized 2:1 to a 20-session weekly schema group therapy plus treatment as usual (TAU) (n = 28) vs. a control group with TAU alone (n = 14). The primary outcome was decline of BPD symptoms in the short Borderline Symptom List (BSL-23) score. Secondary outcomes were decline in symptoms of anxiety, depression, alcohol use, and improvement in functioning and schema modes. Two external experts evaluated validity of the intervention based on videotaped sessions. Results Overall, 23 schema group therapy patients (82%) and 12 controls (86%) completed their treatment. Treatment validity good or very good. However, no significant differences emerged in the primary outcome mean BSL-23 decline (6.95 [SE 5.91] in group schema therapy vs. 12.55 [4.85] in TAU) or in any of the secondary outcome measures. Limitations Despite randomization, the TAU subgroup had non-significantly higher baseline scores in most measures. Small sample size predisposing to type II errors; reliance on self-reported outcomes. Conclusions Schema group therapy was feasible for psychiatric outpatients with BPD. However, in this small pilot study we did not find it more effective than TAU. Effectiveness of this short intervention remains open.Peer reviewe
«inclusive plus» : group psychotherapy for young people and emerging adults in work integration programs
No full textBackground: Many of unemployed adolescents and young adults in work integration programs have mental health issues. In a previous study, we found that almost 70% of these persons suffered from at least one mental disorder (Sabatella & von Wyl, 2014). Nevertheless, to date there is no appropriate treatment option as part of the work integration program. Usually, the transitional programs focus on school and social deficits without offering psychotherapeutic services. In the pre-study “inclusive” we therefore developed a group psychotherapy with elements of Positive Peer Culture (PPC) for this group of people. For the project “Inclusive plus” we adapted the treatment concept: the group therapy is still the most important part. Additionally, we offer individual sessions for the young clients as well as supervision for the staff of the work integration program.
Method: A pragmatic trial was conducted to examine the effectiveness of the intervention in a pre-post-follow up design in 10 different work integration programs. Primary outcome measures focus on aspects of work ability. Secondary outcome are symptom severity and personality functioning. Results and discussion: Just over 200 youths and emerging adults aged 16-29 participate in “inclusive plus”. Preliminary results will be presented at the conference. Discussion and recommendations will focus on strengths and difficulties for group psychotherapy for youths and emerging adulthood in a non-clinical setting
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