Evaluation of rat thyroid gland morphophysiological status after three months exposure to 50 Hz electromagnetic field.

Objective of our study was to use morphophysiological criteria in order to determine the sensitivity of male rat thyroid gland to an extremely low frequency electromagnetic field (ELF-EMF) influence and the ability of the gland to repair after period of exposure. Animals were exposed to 50Hz, 50-500 microT ELF-EMF for 3 months when a part of them (group I) were sacrificed, while the rest of animals were subjected to recovery evaluation of the gland and sacrificed after 1 (group II), 2 (group III) and 3 (group IV) weeks. Histological and stereological analyses were performed on paraffin and semifine thyroid gland sections. Serum T3 and T4 were also determined. Histological and stereological analyses showed that the volume density of follicular epithelium and thyroid activation index decreased, while the volume density of colloid and capillary network increased in group I, II and III. The values of all these parameters in group IV were similar to corresponding controls. Serum T3 and T4 concentrations were significantly lower in all exposed animals, except in group I. Results of this study demonstrate that after significant morphophysiological changes caused by ELF-EMF exposure thyroid gland recovered morphologically, but not physiologically, during the investigated repair period.

Morphophysiological status of rat thyroid gland after subchronic exposure to low frequency electromagnetic field.

The objective of this study was to examine the impact of low-frequency electromagnetic field on male rat thyroid gland of Mill Hill strain. Animals were exposed to 50 Hz frequency, of decaying intensity from 500 microT to 50 microT and 10 V/m field, beginning 24 hours after birth, 7 hours a day, 5 days a week during three months. Results of histological and stereological analysis showed increased volume density of thyroid follicles, decreased thickness of the follicular epithelium, intrafollicular colloid content in lumen, decreased thyroid activation index, increased volume density of parafollicular cells, decreased volume of interfollicular connective tissue and increased number of degranulated mast cells in exposed animals in regard to control animals. Radioimmunologic assays were used to examine thyroid hormone concentrations in the blood serum revealing decrease of the total T4 as well as of total T3 in animals exposed to electromagnetic field in regard to controls. The obtained results show that a three month-exposition of animals to low frequency electromagnetic field led to morphofunctional alterations of the thyroid gland that can be referred to as reduced activity of the gland.

Applications of qualitative multi-attribute decision models in health care.

Hierarchical decision models are a general decision support methodology aimed at the classification or evaluation of options that occur in decision-making processes. They are also important for the analysis, simulation and explanation of options. Decision models are typically developed through the decomposition of complex decision problems into smaller and less complex subproblems; the result of such decomposition is a hierarchical structure that consists of attributes and utility functions. This article presents an approach to the development and application of qualitative hierarchical decision models that is based on DEX, an expert system shell for multi-attribute decision support. The distinguishing characteristics of DEX are the use of qualitative (symbolic) attributes, and 'if-then' decision rules. Also, DEX provides a number of methods for the analysis of models and options, such as selective explanation and what-if analysis. We demonstrate the applicability and flexibility of the approach presenting four real-life applications of DEX in health care: assessment of breast cancer risk, assessment of basic living activities in community nursing, risk assessment in diabetic foot care, and technical analysis of radiogram errors. In particular, we highlight and justify the importance of knowledge presentation and option analysis methods for practical decision-making. We further show that, using a recently developed data mining method called HINT, such hierarchical decision models can be discovered from retrospective patient data.

Hierarchical multi-attribute decision models and their application in health care.

Hierarchical decision models are developed through decomposition of complex decision problems into smaller and less complex subproblems. They are aimed at the classification or evaluation of options and can be used for analysis, simulation and explanation. This paper presents a set of methods for the construction and application of qualitative hierarchical decision models in health care. We present the results of four ongoing projects in oncology, radiology, community nursing and diabetic foot treatment.

The development and testing of information system for community nursing.

The paper presents the development and testing of information system (IS) for community nursing (CN). The goal of IS is to support CN practice and to encourage research and development in the field. The development was based on analysis of CN process. Principal functions of CN were analysed. The logical data model and corresponding user interface were designed. A special emphasis in the development process was put on testing in practice and users' training. The developed IS will: increase work efficiency, introduce process-oriented nursing doctrine, support integrated treatment of the subjects and enable data comparison and exchange. An important subsidary goal of the IS development and usage is the harmonisation of concepts and terminology used in Slovenia with those used in the EU. In this framework International Classification of Nursing Practice (ICNP) which was translated into Slovene was introduced and tested.

[Value of the fetal biophysical profile in intensive monitoring of high risk pregnancy]. / Pouzdanost biofizickog profila ploda u intenzivnoj kontroli visoko rizicnih trudnoca.

The fetal biophysical profile (FBP) is a combination of both acute and chronic condition markers of the fetus in the uterus (fetal movements, fetal breathing movements, amniotic fluid volume, maturity of the placenta, intestine distension, cardiotocographic "non stress test", cardiotocographic "oxytocin stress test" cardiotocographic "physical stress test") presented numerically, is an irreplaceable method for monitoring the condition of the fetus in the uterus. In 271 women with high risk pregnancies at the gestational age of 34-44 weeks, depending on the FBP value, the time and mode of pregnancy termination were chosen. There is a significant difference regarding the outcome of pregnancy (general bad outcome--p less than 0.001, mortality--p less than 0.004, low 5 min Apgar score--p less than 0.002, fetal distress during labour--p less than 0.001) depending on the FBP value (normal or pathological) and the connection of the pathological FBP values with the low fetal biochemical profile values (estriol in 24th urine less than 40,000 n mol/day and HPL less than 5 mg). Sensitivity (46.4%), specificity (99.2%), the prognostic value of the pathological test PVP (86.7%), and prognostic value of the normal test - PVN (94.1%) show a high FBP value as a diagnostic test. It is necessary to stick to the protocol while using this test which is very simple, cheap and not at all harmful.

[Induction of abortion in the 2nd trimester by intra-amniotic instillation of hypertonic sodium chloride solution]. / Provokacija pobacaja u drugom trimestru intraamnionskom instalacijom hipertonicnog rastvora natriujum hlorida

PIP: Second trimester pregnancy, of 16-24 weeks' gestation, was interrupt ed in 33 women by means of an instillation of 150-200 ml of a 25% solution of sodium chloride. 14 abortions were for psychiatric reasons and 16 for infectious problems. Full abortion occurred in all patients; time required was 32 hours and 8 minutes for primigravidas and 25 hours and 10 minutes for multiparous patients. The level of serum sodium did not exceed 350 mg% and was well tolerated. Serum potassium was within the normal range. This method was considered safe under the supervision of experienced obstetricians.^ieng