C23 | assessment biliary tract liver transplantation tube cholangiography iodida scanning biliary tract obstruction anastomotic leakage common problems following liver transplantation sequential study , 31 patients liver transplant investigated 99mtc iodida \( iodida \) scanning tube cholangiography \( ttc \) results compared clinical outcome seven patients extrahepatic biliary obstruction one patient biliary leak detection biliary complications ttc iodida scanning similar terms sensitivity \( 63 per cent \) ttc better specificity \( 79 per cent versus 60 per cent \) accuracy \( 74 per cent versus 60 per cent \) iodida scanning liver function taken account , diagnostic efficacy tests patients bilirubin levels less 200 mumol l similar levels greater 200 mumol l greater number false positive results iodida scanning \( 12 per cent versus 54 per cent \) significant biliary leak clearly detected ttc iodida scanning ttc remains effective way evaluating biliary tract transplantation iodida scanning limited value bilirubin levels elevated , may provide additional information blood supply , hepatocyte function intrahepatic cholestasis |
C23 | patterns dyspepsia patients clinical evidence organic diseases studied 2000 dyspeptic patients obvious signs organic disease first examination , order \( 1 \) verify many diagnoses idiopathic dyspepsia really made diagnostic procedures \( 2 \) evaluate diagnostic power symptoms distinguishing organic idiopathic dyspepsia latter considered structural abnormalities found cases , distinction made related associated organic dyspepsia according whether certain relationship abnormalities dyspeptic symptoms patients referred us follows \( 1 \) spontaneously , \( 2 \) sent physicians us , \( 3 \) referred open access endoscopic service results show frequency idiopathic dyspepsia 26 , whereas associated structural abnormalities present 45 4 obvious organic causes dyspepsia seen 28 6 \( 24 benign 4 6 malignant diseases \) considered separately , symptom alone allows correct diagnosis simultaneous evaluation symptoms linear discriminant analysis distinguishes idiopathic organic dyspeptic patients 70 cases higher discrimination percentage 70 cases higher discrimination percentage could probably obtained using wider range clinical parameters complex statistical analysis interrelationships exist clinical symptoms final diagnosis |
C23 | evaluation 13c urea breath test detection helicobacter pylori monitoring effect non ulcer dyspepsia sixty nine patients non ulcer dyspepsia studied endoscopy , biopsy , quick urease \( \) test , helicobacter pylori culture , 13c urea breath test treatment \( \) two tablets twice daily four weeks symptoms non ulcer dyspepsia recorded using standard questionnaire using h pylori culture gold standard , sensitivity 13c urea breath test 90 , specificity 98 6 , accuracy 94 8 positive predictive value 98 2 negative predictive value 92 5 conversion rate h pylori positive negative status treatment 17 9 symptoms non ulcer dyspepsia improved appreciably treatment irrespective h pylori status 13c urea breath test accurate research tool suitable serial testing population surveys |
C23 | demonstration area slow conduction human atrial flutter ten patients chronic atrial flutter studied prospectively using electrophysiologic mapping pacing techniques assess mechanism atrial flutter presence area slow conduction atria electrograms recorded greater equal 30 right atrial sites patient atrial flutter demonstrated right atrial free wall activation interatrial septum activation , consistent reentrant circuit involving right atrium six patients , slow conduction occurred atrial flutter inferior right atrium spatially associated fractionated recordings four patients , missing interval electrical activity occurred inferior right atrium average 40 atrial flutter cycle transient criteria demonstrated patient rapid high right atrial pacing mean activation time high right atrial pacing site coronary sinus \( inferior left atrial \) recording site long \( 228 ms \) consistent activation area slow conduction rapid pacing atrial flutter coronary sinus site , transient criteria could demonstrated mean activation time coronary sinus pacing site high right atrial recording site relatively short \( 134 ms \) consistent activation high right atrium area slow conduction high right atrial pacing sinus rhythm rates similar atrial flutter demonstrated short activation time coronary sinus low right atrial sites \( mean 169 88 ms , respectively \) , indicating activation area slow conduction coronary sinus pacing sinus rhythm demonstrated phenomena low right atrial electrograms recorded sinus rhythm rapid pacing sinus rhythm fractionated , although atrial flutter thus , atrial mapping pacing data complementary , indicating human atrial flutter patients studied generated reentrant circuit right atrium , area slow conduction low right atrium present atrial flutter |
C23 | analysis base station morphine orders assessment physician consistency paramedic contact base station consistent recommendations reflecting consensus base station physician care urban ems system , paramedics must contact single base station provide morphine sulfate \( ms \) patient chest pain performed retrospective cohort analysis prehospital ms requests chest pain determine consistency circumstances paramedic team refused ms ms requests represented 123 1 , \( 7 \) line physician consultations 6 month study 15 123 \( 12 \) ms requests refused neither mean patient age , sex distribution , presenting vital signs correlated ms refusal maximum estimate transport time hospital less equal 5 minutes noted 7 15 \( 47 \) medication compared 11 96 \( 11 \) documented estimated transport times \( p less equal 0 005 \) simultaneous request nitroglycerin \( \) noted 6 15 \( 40 \) medication 15 108 \( 14 \) \( p less 0 05 \) found refusal ms administration uncommon physicians tended ms transport time short requested concomitant administration also noted physician inconsistencies refusal findings guide physician consensus development avoid mixed paramedics |
C23 | predictors smoking nhanes followup experience published prospective studies predictors spontaneously cigarette smoking nationally representative u population paper describes study , using cohort taken first national health nutrition examination survey \( nhanes , 1971 1975 \) traced nhanes epidemiologic followup survey \( 1982 1984 \) successful \( least 1 year time followup \) ascertained among adults \( age 25 74 years \) smokers time nhanes disabled followup independent predictors \( proportional hazards multiple regression \) \( 1 \) older age \( 2 \) white race \( 3 \) fewer cigarettes smoked day \( 4 \) higher household income \( 5 \) hospitalization followup period predictors relapse \( ex smokers nhanes smoking time followup \) \( 1 \) younger age \( 2 \) urban residence \( 3 \) female gender findings implications intervention strategies , public health projections research |