[Discussion on Technical Evaluation of Tongue Diagnosis Equipment of Traditional Chinese Medicine].

This study briefly introduces the tongue diagnostic equipment of traditional Chinese medicine. It analyzes and discusses the key points of technical evaluation of tongue diagnostic equipment from the aspects of product name, performance parameters, image processing functions, product use methods, clinical evaluation, etc. It analyzes the safety risks and effectiveness indicators of tongue diagnostic equipment, hoping to bring some help to the gradual standardization of tongue diagnostic equipment and the registration of enterprises.

Discussion on Technical Evaluation of Tongue Diagnosis Equipment of Traditional Chinese Medicine / 中国医疗器械杂志

This study briefly introduces the tongue diagnostic equipment of traditional Chinese medicine. It analyzes and discusses the key points of technical evaluation of tongue diagnostic equipment from the aspects of product name, performance parameters, image processing functions, product use methods, clinical evaluation, etc. It analyzes the safety risks and effectiveness indicators of tongue diagnostic equipment, hoping to bring some help to the gradual standardization of tongue diagnostic equipment and the registration of enterprises.

Reliability and diagnostic performance of a new blood ketone and glucose meter in humans.

BACKGROUND: Accurate and reliable monitoring of blood ketone and glucose levels is useful for athletes adhering to a ketogenic diet who want to verify that they are in a state of ketosis and, therefore, accruing performance adaptations. However, the cost of devices and testing materials may prohibit their use. More affordable field testing systems are available, but their accuracy and reliability remain in question. The objectives of this study were to evaluate the agreement between a previously validated ketone and glucose meter (Meter 1 - Precision Xtra) and a more affordable meter that has not been validated (Meter 2 - Keto-Mojo), and also to assess the diagnostic performance of Meter 2 for identifying nutritional ketosis. METHODS: Thirteen participants (7 females and 6 males; 21.6 ± 3.0 years old) visited the laboratory three times in this randomized, double-blind cross-over design study. Ketone and glucose levels were measured with Meter 1 and Meter 2 twice before and twice after ingestion of a racemic ketone, natural ketone, or maltodextrin supplement. Intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated to evaluate interrater reliability for Meter 1 and Meter 2. Bland-Altman plots were constructed to visually assess the agreement between devices. Area under the ROC curve analysis was performed to evaluate the diagnostic ability of Meter 2 to detect nutritional ketosis at a threshold ketone level of 0.5 mM as identified by Meter 1. RESULTS: Reliability between the meters was excellent for measuring ketones (ICC = .968; .942-.981) and good for measuring glucose (ICC = .809; .642-.893), though the Bland-Altman plot revealed substantial differences in agreement for measuring glucose. Area under the ROC curve (Area = 0.913; 0.828-0.998) was excellent for diagnosing nutritional ketosis. CONCLUSIONS: Both Meter 1 and Meter 2 displayed excellent agreement between each other for ketone measurement. Meter 2 also displayed an excellent level of accuracy for diagnosing nutritional ketosis at a threshold value of 0.5 mM, making it an effective and affordable alternative to more expensive testing devices.

Measurement of Lumbar Lordosis: A Comparison of 2 Alternatives to the Cobb Angle.

OBJECTIVE: The purpose of this study was to compare 2 alternative methods, the radiologic Harrison Posterior Tangent Method (HPTM) and the nonradiologic Spinal Mouse (SM), to the Cobb angle for measuring lumbar lordosis. METHODS: Sixteen participants with previously existing lateral lumbopelvic radiographs underwent nonradiographic lordosis assessment with a Spinal Mouse. Then 2 investigators analyzed each radiograph twice using the Harrison Posterior Tangent Method and Cobb angle. Correlations were analyzed between HPTM, the Cobb angle, and SM using the Spearman rank correlation coefficient; intraexaminer and interexaminer agreement were analyzed for HPTM and the Cobb angle using intraclass correlation coefficients. RESULTS: The HPTM correlated highly with the Cobb angle (Spearman ρ = 0.936, P < .001); SM had moderate to strong correlations with the Cobb angle (ρ = 0.737, P = .002) and HPTM (ρ = 0.707, P = .003). Intraexaminer and interexaminer agreement for the Cobb angle and HPTM were excellent (all intraclass correlation coefficients > 0.90). One participant had slight kyphosis according to HPTM and SM analyses (which consider the entire lumbar region), whereas the Cobb angle, based only on L1 and L5, reported mild lordosis for that participant. CONCLUSION: In this sample, HPTM measurements showed high correlation with the commonly used Cobb angle, but this method requires more time and effort, and normal values have not been established. The SM may be an alternative when radiographs are inappropriate, but it measures soft tissue contours rather than lordosis itself.

A Prospective Pilot Study on Use of Liquid Crystal Thermography to Detect Early Breast Cancer.

Background: Breast cancer is the most common cancer in women. While mammography is the standard for early detection in women older than 50 years of age, there is no standard for younger women. The aim of this prospective pilot study was to assess liquid crystal contact thermography, using the Braster device, as a means for the early detection of breast cancer. The device is intended to be used as a complementary tool to standard of care (sonography, mammography, etc). Patients and Methods: A total of 274 consecutive women presenting at Polish breast centers for prophylactic breast examination were enrolled to receive thermography; 19 were excluded for errors in thermographic image acquisition. The women were divided according to age (n = 135, <50 years; n = 120, ≥50 years). A control population was included (n = 40, <50 years; n = 23, ≥50 years). The primary endpoint, stratified by age group, was the C-statistic for discrimination between breast cancer and noncancer. Results: In women with abnormal breast ultrasound (n = 95, <50 years; n = 87, ≥50 years), the C-statistic was 0.85 and 0.75, respectively (P = .20), for discrimination between breast cancer and noncancer. Sensitivity did not differ (P = .79) between the younger (82%) and older women (78%), while specificity was lower in the older women (60% vs 87%, P = .025). The false-positive rate was similar in women with normal and abnormal breast ultrasound. Positive thermographic result in women with Breast Imaging Reporting and Data System (BIRADS) 4A on ultrasound increased the probability of breast cancer by over 2-fold. Conversely, a negative thermographic result decreased the probability of cancer more than 3-fold. Breast size and structure did not affect the thermography performance. No adverse events were observed. Conclusions: Thermography performed well in women <50 years of age, while its specificity in women ≥50 years was inadequate. These promising findings suggest that the Braster device deserves further investigation as a supporting tool for the early detection of breast cancer in women younger than 50 years of age.

The effect of manual therapy on gastrocnemius muscle stiffness in healthy individuals.

STUDY DESIGN: Randomized clinical trial. BACKGROUND: Muscle stiffness is a potential complication after injury and has been shown to be a risk factor for injury in healthy individuals. OBJECTIVES: The primary purpose of this study was to assess the short-term effects of manual therapy (MT) on muscle stiffness of the gastrocnemius in both a relaxed and contracted state. The secondary purpose was to assess the reliability of a novel clinical tool (MyotonPRO) to measure muscle stiffness in the gastrocnemius in both a passive and contracted state. METHODS: Eighty-four consecutive healthy individuals were randomized to receive Manual Therapy (MT group) directed at the right-side ankle and foot or no treatment (CONTROL group). Muscle stiffness of the gastrocnemius was assessed bilaterally in all participants at baseline and then immediately after intervention in a relaxed and contracted state. Group (MT vs. CONTROL) by side (ipsilateral vs. contralateral) by time (pre vs. post) effects were compared through a 3-way interaction utilizing mixed model ANOVA. Reliability of the MyotonPRO was assessed with two-way mixed model intraclass correlation coefficients. RESULTS: There was a significant 3-way interaction for muscle stiffness of the gastrocnemius in a relaxed state (p<0.01), but not contracted state (p=0.54). All conditions had increased resting muscle stiffness from pre to post measures except for the ipsilateral limb of the MT group. There was not a significant interaction for muscle stiffness in a contracted state. Reliability estimates (ICC) for muscle stiffness measures ranged between 0.898 and 0.986. CONCLUSION: The change in muscle stiffness of the gastrocnemius in a relaxed state depended upon whether individuals received MT. Muscle stiffness measures were highly reliable based on single measurements. LEVEL OF EVIDENCE: Therapy, level 2.

Determination of Bitterness of Andrographis Herba Based on Electronic Tongue Technology and Discovery of the Key Compounds of Bitter Substances.

Andrographis Herba (AH), the dry aerial segments of Andrographis paniculata (Burm.f.) Nees, is a common herbal remedy with bitter properties in traditional Chinese medicine (TCM) theory. Although bitterness is one of the features representing Chinese medicine, it has not been implemented as an index to assess the quality and efficacy of TCM because of peoples' subjectivity to taste. In this study, 30 batches of AH with different commercial classifications (leaves, stems, or mixtures of both) were collected. Bitterness of AH was quantified by electronic tongue technology. Meanwhile, chemical compositions were characterized through establishing high-performance liquid chromatography fingerprints. The result indicated that the radar curves of the bitterness from different AH commercial classifications displayed different taste fingerprint information. Based on six taste factors, a Principal Component Analysis (PCA) score three-dimensional (3D) plot exhibited a clear grouping trend (R²X, 0.912; Q², 0.763) among the three different commercial classifications. Six compounds (Peaks 2, 3, 4, 6, 7, 8) with positive correlation to bitterness were discovered by a Spearman correlation analysis. Peaks 2, 6, 7, 8 were identified as andrographolide, neoandrographolide, 14-deoxyandrographolide, and dehydroandrographolide, respectively. The electronic tongue can be used to distinguish AH samples with different commercial classifications and for quality evaluation.

Chemical Sensing at the Robot Fingertips: Toward Automated Taste Discrimination in Food Samples.

The development of robotic sensors that mimic the human sensing capabilities is critical for the interaction and cognitive abilities of modern robots. Though robotic skin with embedded pressure or temperature sensors has received recent attention, robotic chemical sensors have long been unnoticed due to the challenges associated with realizing chemical sensing modalities on robotic platforms. For realizing such chemically sensitive robotic skin, we exploit here the recent advances in wearable chemical sensor technology and flexible electronics, and describe chemical sensing robotic fingers for rapid screening of food flavors and additives. The stretchable taste-sensing finger electrochemical devices are printed on the robotic glove, which simulates the soft skin, and are integrated with a wireless electronic board for real-time data transmission. The printed middle, index, and ring robotic fingers allow accurate discrimination between sweetness, sourness, and spiciness, via direct electrochemical detection of glucose, ascorbic acid, and capsaicin. The sweet-sensing ability has been coupled with a caffeine-sensing robotic finger for rapid screening of the presence of sugar and caffeine in common beverages. The "sense of taste" chemically sensitive robotic technology thus enables accurate discrimination between different flavors, as was illustrated in numerous tests involving a wide range of liquid and solid food samples. Such realization of advanced wearable taste-sensing systems at the robot fingertips should pave the way to automated chemical sensing machinery, facilitating robotic decision for practical food assistance applications, with broad implications to a wide range of robotic sensing applications.

El papel de la autopsia en la práctica clínica actual / The current role of autopsy in current clinical practice

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[Taking a look at the characteristics of the diagnostic methods of Traditional Chinese Medicine (TCM) from the periodical literature in the republican period of China].

Compiling 198 pieces of literature related to TCM diagnostic method in 210 kinds of medical periodicals during the republican period of China, they can be divided into three categories by different characteristics: theoretical research, popular common sense, works and lectures etc. Taking a look at the contents of the articles, there were 74 pieces of comprehensive literature (37%) 20 pieces of inspection literatures (10%) 6 pieces of auscultation and olefaction literature (3%) 11 pieces of inquiry literature (6%) 87 pieces of palpation literature (44%) Pulse diagnosis is a traditional distinguishing diagnostic method which involves much research. The literature on pulse diagnosis was in the majority The articles about theoretical research mostly explained the TCM principles with western medical knowledge and advocated diagnosing the disease with western medical apparatus, which was the characteristic of that time.

Treatment satisfaction and quality of life for an integrated continuous glucose monitoring/insulin pump system compared to self-monitoring plus an insulin pump.

BACKGROUND: Little is known about how the most advanced technology affects treatment satisfaction and health-related quality of life (HRQOL) in adults with diabetes. This study was designed to assess treatment satisfaction and HRQOL among users of an integrated real-time (RT) continuous glucose monitoring (CGM)/continuous subcutaneous insulin infusion (CSII) system compared with those using self-monitoring of blood glucose (SMBG) with CSII. METHODS: Participants were 311 adult respondents to an Internet survey, 162 using RT-CGM/CSII, 149 using SMBG + CSII (median age 43 years; type 1 diabetes 94%; diabetes duration >15 years 61%; median insulin use 15 years). Respondents completed instruments assessing glucose monitoring system and insulin delivery system convenience, interference, burden, glucose control efficacy, cost satisfaction, overall satisfaction, and treatment preference, as well as quality of life (diabetes-related worries, social burden, and psychological well-being). Real-time CGM/CSII users also assessed specific elements of the RT-CGM/CSII system. Group differences were assessed using analysis of covariance controlling for respondent characteristics. RESULTS: The RT-CGM/CSII group gave significantly better ratings than the SMBG + CSII group for their glucose monitoring system's glucose control efficacy, overall satisfaction, desire to switch, and willingness to recommend, and significantly worse ratings for interference with daily activities. The RT-CGM/CSII group gave significantly better ratings than the SMBG + CSII group for their insulin delivery system's convenience and glucose control efficacy, overall satisfaction, desire to switch, and willingness to recommend. Real-time CGM/CSII users gave positive ratings of all system features. CONCLUSIONS: Users of the integrated RT-CGM/CSII system reported more benefits of treatment, higher treatment satisfaction and quality of life, and greater preference for this system than SMBG + CSII users.

Análise da dose do laser de baixa potência em equipamentos nacionais / Analysis of low-level laser therapy doses in Brazilian equipment

CONTEXTUALIZAÇÃO: A laserterapia de baixa potência vem sendo cada vez mais utilizada, e o crescente interesse por seus efeitos relaciona-se com a grande quantidade de publicações científicas. Muitos terapeutas e pesquisadores têm-se baseado na definição da dose do laser pela densidade energética (deltaE); porém, a grande variedade de equipamentos de laser pode levar a diferença nos resultados terapêuticos encontrados, por fornecerem parâmetros que variam de acordo com o fabricante. OBJETIVO: Analisar a energia final transmitida ao tecido ao aplicar-se a mesma deltaE em equipamentos de diferentes marcas nacionais. MATERIAIS E MÉTODOS: Foram avaliados sete equipamentos nacionais, com potência média (Pm) diferentes, e foram realizadas simulações aplicando deltaE de 1J/cm² em cada aparelho, para avaliar possíveis diferenças na energia final. RESULTADOS: A mesmadeltaE aplicada em diferentes aparelhos nacionais forneceu energia final que variou entre 10 e 90mJ. Esta variação na energia deveu-se principalmente a diferenças na Pm, sendo encontrados valores entre 5,4 e 75mW. CONCLUSÃO: Esta variabilidade na energia final, que é transmitida ao tecido, indica que a deltaE parece não ser o parâmetro que melhor descreve a dose a ser utilizada. É preciso mencionar não só a deltaE, mas também a energia final, para que se possa estabelecer a dose para obtenção do melhor resultado terapêutico.

INTRODUCTION: Low-level laser therapy is becoming more popular and there is a growing interest in its effects, as reflected in the increased number of articles published about the subject. Many therapists and researchers have used a laser dose definition based on energy density (deltaE). However, the variety of laser equipments may lead to differences in the therapeutic results found, since the parameters supplied by these equipments vary according to the manufacturer. OBJECTIVE: To analyze the final energy transmitted to the tissue when applying the same deltaE using equipment of different Brazilian brands. MATERIAL AND METHODS: Seven brands of Brazilian equipment with different mean power (Pm) were evaluated by means of simulations. deltaE of 1J/cm² was applied using each brand of equipment, in order to evaluate possible differences in the final energy. RESULTS: The same deltaE applied using different brands of Brazilian equipment supplied final energy that ranged from 10 to 90mJ. This variation in the energy was mainly due to differences in Pm. These values ranged between 5.4 and 75mW. CONCLUSIONS: This variability in the final energy that is transmitted to the tissue indicates that deltaE may not be the best parameter for describing the dose to be used. In addition to deltaE, the final energy needs also to be stated, in order to establish the dose for obtaining the best therapeutic results.

Análisis de equipo médico instalado para la detección precoz de cáncer de mama / Analysis of medical equipment installed for the early detection of breast cancer

OBJETIVOS: El objetivo general de este estudio fue describir la capacidad instalada de los equipos médicos para la detección precoz de cáncer de mama en el Uruguay en el 2008, así como la evolución de la mortalidad por dicha causa, a fin de contribuir a regular y desarrollar políticas de tecnología médica en nuestro país en consonancia con el Sistema Nacional Integrado de Salud. MÉTODOS: Estudio de tipo transversal descriptivo con recolección de datos por parte de la Autoridad Sanitaria Nacional (MSP), mediante un cuestionario postal, a todos los Servicios de Salud del país pasibles de disponer equipos de alta tecnología médica, incluidos los mamógrafos. Se recabaron datos acerca de la localización del equipo, estado, historial de uso, utilización, funcionamiento y mantenimiento. Asimismo se utilizaron como fuentes secundarias los datos de Tasas ajustadas de mortalidad por cáncer de mama de la CHLCC de los últimos tres quinquenios disponibles y datos del INE (datos de población del censo Fase I del 2004) para la construcción de indicadores. RESULTADOS : Se encuestó por correo postal a 219 instituciones de todo el país, con una tasa de respuesta global de 90,1%. De las 176 instituciones que tenían equipos, 52 (29,5%) poseen mamógrafos. El número total de mamógrafos en el país es de 62, con una disponibilidad promedio de 0.9 mamógrafos cada 10 000 mujeres mayores de 40 años, con grandes diferencias entre el Interior del país (1,2) y la capital (0,7). Casi la mitad de los equipos posee más de 10 años de fabricados, con un elevado porcentaje de equipos usados y también sin registro en el MSP. A pesar de que existe mayor disponibilidad de equipos en el Interior del país, la productividad es mayor en Montevideo. Se utiliza en el país solo el 24,1% del potencial de los equipos y en el año 2006 se logró una cobertura aproximada en mamografía de 26,2%. La reducción de la mortalidad en los períodos considerados fue de 6,09%, aunque no se encontró asociación con la cobertura en mamografía. CONCLUSIONES: Aunque el número de mamógrafos en el país es suficiente para llevar adelante el programa de screening de cáncer de mama, si consideramos a cada Departamento, existen algunos que no podrían llegar a cubrir a la población objetivo junto con otros departamentos que podrían cubrirla hasta 2,5 veces. Dada la baja cobertura en mamografía en el país, no es esperable un cambio en la mortalidad por cáncer de mama asociado a la misma.(AU)

OBJETIVE: The general objective of the present study is to describe the installed facilities of medical equipment for early detection of breast cancer in Uruguay in 2008. Moreover, mortality changes associated to the condition will also be described, in order to contribute to regulation and development of medical technology policies alongside the National Integrated Health System. METHODOLOGY: The study was designed as a cross-sectional descriptive study collecting information from the Ministry of Public Health (MSP), information obtained from postal questionnaires sent to all Health Services likely to have high technology medical equipment, including mammography units. Data collected included location of the equipment, condition, history of use, utilization, functioning and maintenance. Furthermore, secondary data information needed to derive indicators included: adjusted mortality rates due to breast cancer from the Cancer Commission (Comisión honoraria de lucha contra el cancer) covering the last 15 years, and data supplied by the National Statistical Institute (population census phase I, 2004). RESULTS: 219 medical centres all over the country were contacted and received questionnaires. The overall response rate reached 90,1%. From 176 centres having high technology medical equipment, 52 had mammography units (29,5% ). Total number of mammography units in the country was 62, with a mean availability of 0.9 units per 10,000 women older than 40 years of age. There were large differences between Montevideo (0.7/10,000 women) and the countryside (1.2/10,000 women), Close to 50% of the units have been produced 10 years or more ago. There was a high percentage of second-hand equipment and also, equipment not registered by MSP. Despite the availability of units in the countryside, productivity was higher in Montevideo. Only 24,1% of the whole country ́s mammography units potential was used. Data from 2006 indicated a whole mammography coverage of the women aged 40 or more was only 26,2%. The decrease in mortality rate in the considered period was 6,09%, although no association was found with mammography coverage of the population. CONCLUSIONS: Even though the number of mammography units in Uruguay as a whole would be enough to take forward a programme of breast cancer screening, existent differences between each Department would leave some areas without enough population coverage while others could cover it 2.5 times over. Due to the low mammography coverage in Uruguay, a change in mortality rate associated to the mammography units is not expected.(AU)

World's first magnetic resonance imaging/x-ray/operating room suite: a significant milestone in the improvement of neurosurgical diagnosis and treatment.

OBJECT: In February 2006, the magnetic resonance/x-ray/operating room (MRXO) suite opened at the authors' institution. This is the first hybrid neurosurgical procedure suite to combine magnetic resonance (MR) imaging, computed tomography (CT), and angiography within a neurosurgical operating room (OR). In the present paper the authors describe the concept of the MRXO as well as their first 10 months of experience using this suite, and discuss its advantages and limitations. METHODS: In the MRXO suite, the combined OR and angiography (OR-angiography) station is located in the middle of the suite, and the MR imaging and CT scanning stations are each installed in an adjoining bay connected to the OR-angiography station by shielded sliding doors. The surgical, MR imaging, angiography, and CT tables are positioned in order of use. The patient lies on a fully MR imaging- and radiography-compatible mobile patient tabletop that is used to move the patient quickly and safely among the tables in the imaging and operating components of the MRXO suite. RESULTS: The authors performed all interventional procedures safely. The specially designed operating tabletop of the MRXO suite reduced the limitations on neurosurgeons during standard neurosurgical procedures. This hybrid suite helps to provide high-quality intraoperative imaging, greatly reducing the risk of unexpected events during the procedure. CONCLUSIONS: The MRXO suite, which combines OR and imaging equipment, represents a significant milestone in the improvement of neurosurgical diagnosis and treatment and other interventional procedures. Another advantage of the MRXO suite is its cost-effectiveness, which is partly due to its streamlined imaging procedure.

Impact of topical anesthesia on acoustic characteristics of voice during laryngeal telescopic examination.

OBJECTIVE: The purposes of this study are to investigate the impact of topical anesthetic alone and with concurrent laryngeal telescopic examination on acoustic characteristics of vocal fold function. Comparison with phonation in controlled conditions may imply diagnostic information from the examination. STUDY DESIGN: Thirty males evaluated as having a normal voice were included in the study. The subjects were asked to phonate sustained /i/ with a naturally comfortable pitch and loudness in three consecutive experimental sequences as "control condition," "anesthetic condition," and "telescopic condition." Acoustic analysis of fundamental frequency, jitter, shimmer, and harmonic to noise ratio in the three different conditions were executed. RESULTS: The mean and standard deviation of Fo in control condition, anesthetic condition, and telescopic condition were 130.1 +/- 18.5 Hz, 125.7 +/- 19.7 Hz, and 173.2 +/- 35.1 Hz, respectively. The telescopic condition showed more negative change than that in control condition and anesthetic condition in other parameters. There was a significant difference (P < 0.001) between control condition and telescopic condition in all four parameters. CONCLUSIONS: This study showed that anesthesia has little effect on voice performance for subjects with a normal voice. On the other hand, the acoustic characteristics changed significantly during telescopic performance. When doing interpretation of acoustic data, the abnormality of the acoustic characteristics might be the result of the procedures and not reflect vocal pathology. Laryngeal variations due to manipulation of telescope should be ruled out.

Traumatismo craneoencefálico en niños revisión de casos, asociación entre la severidad del trauma y la morbi- mortalidad en la unidad de terapia intensiva HIMJR 1999- 2002 / Head injuries childs rvition of cases, association between to the severity of the injuries and morbi- mortality in the intensive care unit HIMJR 1999- 2002

El traumatismo craneoencefálico en niños se relaciona con un alto porcentaje de mortalidad y secuelas al punto que la OMS lo considera un grave problema para la salud pública tanto en el mundo desarrollado como en países pobres como el nuestro. La presente investigación es la primera realizada en nuestro centro sobre este importante tema. El objetivo propuesto fue conocer los factores asociados a la morbilidad y mortalidad de los pacientes con TCE hospitalizados en UTI del HIMJR. Método: Revisión de los pacientes ingresados en sala de cuidados intensivos pediátricos con traumatismo craneoencefálico en el período de 1999- 2002. Resultados: Fueron admitidos a UTI 23 pacientes con traumatismo craneoencefálico, siendo excluidos del estudio 2 por no habérseles realizado estudio de neuroimagen. La edad osciló entre 1- 12 años. La realización en cuanto al sexo fue de 2.5:1 a favor del masculino. La mayoría de los pacientes (81 porciento) llegaron del H.A.L.F centro neuroquirúrgico de referencia nacional, figurando el accidente automovilístico como la primera causa (52 porciento). El patrón de neuroimagen más frecuente fue la lesión axonal difusa (52.4 porciento) OR=2.29 para la mortalidad y OR=6 para las secuelas. El 91 porciento de los pacientes presentaron TCE severo OR= menor de 1 en relación a la mortalidad y OR=3.2 para las secuelas. El tratamiento que la mayoría de los pacientes recibieron fue hiperventilación, sedación y manitol; ameritando drenaje quirúrgico un tercio de los mismos. La mayoría de los pacientes tuvo una evolución favorable sin secuelas (33 porciento). De los 6 pacientes fallecidos, solamente 4(19 porciento) tuvieron como causa directa la hipertensión endocraneana secundaria al traumatismo craneoencefálico. Conclusiones: El Glasgow menor de 8 no se encontró asociado a la mortalidad y tiene un OR=3.2 para predecir secuelas. La lesión axonal difusa constituye un factor predictor para el pronostico...

A comparison of transcutaneous bilirubinometers: SpectRx BiliCheck versus Minolta AirShields.

BACKGROUND: Two devices are available for making transcutaneous estimates of serum bilirubin (SBR): the Minolta AirShields JM102 and the new SpectRx BiliCheck. OBJECTIVES: (a) To measure how well the readings produced by these devices agree with SBR measured in the laboratory; (b) to estimate for each device, the proportion of infants with clinical jaundice who would require blood sampling if the device was used as a screening tool to detect infants with SBR > or = 250 micromol/l. DESIGN: Prospective cohort study of jaundiced infants who required SBR at < or = 20 days of postnatal age. Those who had received phototherapy or exchange transfusion were excluded. SETTING: Tertiary neonatal service in South-East Scotland. INTERVENTIONS: Within 30 minutes of SBR sampling, transcutaneous bilirubinometry was performed using one Minolta and two SpectRx devices (designated A and B). RESULTS: Sixty-four neonates were enrolled, 19 of which were preterm (31-35 weeks). The 95% confidence intervals of a device reading corresponding to SBR were +/- 66.7, +/- 67.9, and +/- 66.4 micromol/l respectively. Using the devices to identify all SBR > or = 250 micromol/l would reduce SBR sampling by 23%, 16%, and 20% respectively. CONCLUSIONS: Given that SBR levels range from 50 to 400 micromol/l in jaundiced infants, the 95% confidence intervals of the devices are wide at +/- 67 micromol/l. The SpectRx can be used as a screening tool for hyperbilirubinaemia but there is no advantage in using it over the Minolta.

[The importation of the first X-ray diagnostic machine in China].

There are different opinions and controversies about the first importation of X - ray diagnostic machine, which was imported into China. Dian shi zhai hua bao (Pictorial of Dianshizhai), based on new historical materials, reported that Boxi Hospital of Suzhou imported the X - ray diagnosed machine before the last ten day of December, 1897.