RESUMEN
Highly excited Rydberg states of excitons in Cu_{2}O semiconductors provide a promising approach to explore and control strong particle interactions in a solid-state environment. A major obstacle has been the substantial absorption background that stems from exciton-phonon coupling and lies under the Rydberg excitation spectrum, weakening the effects of exciton interactions. Here, we demonstrate that two-photon excitation of Rydberg excitons under conditions of electromagnetically induced transparency (EIT) can be used to control this background. Based on a microscopic theory that describes the known single-photon absorption spectrum, we analyze the conditions under which two-photon EIT permits separating the optical Rydberg excitation from the phonon-induced absorption background, and even suppressing it entir7ely. Our findings thereby pave the way for the exploitation of Rydberg blockade with Cu_{2}O excitons in nonlinear optics and other applications.
RESUMEN
BACKGROUND: The aim of this study was to evaluate the effect of photodynamic therapy (PDT) on Enterococcus faecalis biofilms in artificially infected root canals using modified photosensitizers and passive ultrasonic activation. METHODS: Two hundred and seventy extracted human teeth with one root canal were instrumented utilizing ProTaper files, autoclaved, infected with E. faecalis T9 for 72 h and divided into different groups: irrigation with 3% sodium hypochlorite (NaOCl), 20% ethylenediaminetetraacetic acid (EDTA), or 20% citric acid, PDT without irrigation, PDT accompanied by irrigation with NaOCl, EDTA, or citric acid, PDT using an EDTA-based photosensitizer or a citric-acid-based photosensitizer and PDT with ultrasonic activation of the photosensitizer. A 15 mg/ml toluidine blue served as the photosensitizer, activated by a 100 mW LED light source. Sterile paper points were used for sampling the root canals and dentin chips were collected to assess the remaining contamination after treatment. Samples were cultured on blood agar plates and colony forming units were quantified. RESULTS: PDT alone achieved a reduction in E. faecalis counts by 92.7%, NaOCl irrigation alone and combined with PDT by 99.9%. The antibacterial effects increased by the combination of irrigation using EDTA or citric acid and PDT compared to irrigation alone. More than 99% of E. faecalis were killed using PDT with the modified photosensitizers and ultrasonic activation. CONCLUSIONS: NaOCl based disinfection achieved the highest antimicrobial effect. Using PDT with an EDTA-based or citric-acid-based phozosensitizer or activating the photosensitizer with ultrasound resulted in a significantly higher reduction in E. faecalis counts compared to conventional PDT.
Asunto(s)
Biopelículas/efectos de los fármacos , Enterococcus faecalis/efectos de los fármacos , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Irrigación Terapéutica/métodos , Ultrasonido/métodos , Ácido Cítrico/uso terapéutico , Ácido Edético/uso terapéutico , Humanos , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/uso terapéutico , Cloruro de Tolonio/uso terapéuticoRESUMEN
An HIV/AIDS education and counseling program was integrated into the routine medical care of women attending the prenatal clinic of a major urban, inner-city, teaching hospital that serves mostly indigent minority women in an area hard hit by the HIV/AIDS epidemic. Pre- and post-intervention questionnaires were administered to a consecutive historical Control Group (n = 98) who did not receive the HIV/AIDS information and an Intervention Group (n = 515) who received all information. The data support our hypothesis that an HIV/AIDS education program would increase the level of general knowledge, but fail to support our hypothesis of a positive effect on attitudes around HIV-antibody testing and an increase in desire for voluntary testing. Our hypothesis that women reporting more risk behaviors would be more likely to agree to HIV-antibody testing was only partially supported.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Educación en Salud , Atención Prenatal/organización & administración , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Atención Ambulatoria , Consejo , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Ciudad de Nueva York/epidemiología , Pobreza , Embarazo , Factores de Riesgo , Conducta Sexual , Encuestas y Cuestionarios , Salud de la MujerRESUMEN
This article reports how a prenatal clinic in a major urban teaching hospital has developed and integrated an HIV education and counseling program into routine prenatal care. The patient population served are predominantly minority women living in an inner-city community that has been disproportionately affected by the AIDS epidemic. Implementation of the patient program has required training and support for all professional staff. Staff training served as a foundation for this comprehensive patient program, which has reached all prenatal patients regardless of risk behavior. The program has succeeded in involving a large population of women in an educational program, has identified HIV-1 seropositive pregnant women through voluntary testing, and has provided them with the necessary medical and social work services. Principles of program development are identified for use in other settings.
PIP: The process of incorporating HIV education and counseling into the Mount Sinai Medical Center's prenatal clinic in New York City is provided in terms of background, the patient program, evaluation, and conclusions. There have been endorsements for inclusion of HIV testing and education in the practice of prenatal care and reported effectiveness in delaying the onset of AID's associated infections. The prenatal clinic provides health care to predominantly minority women (36% African American and 55% Hispanic) of whom 10-12% report intravenous or nonintravenous drug use; clinic births are about 1600 a year. Early attempts in 1986-7 to provide anonymous testing and counseling demonstrated the need to reach a large audience. Observations were that considerable staff training and support was needed for an effective patient program. Encouragement and support was also needed by patients. 8 one hour training sessions were provided to the nurses, as well as a 21 hour state certification program for the social workers, both groups of whom worked directly with patients. Intense reactions to caring for HIV infected persons occurs and emotional support must be included in the training. Additional staff support was provided through an AIDs prevention grant for a year. Continuous staff training is required. Another grant provided a clinical social worker and program coordinator who worked closely with the clinic director. The target was to integrate the HIV/AIDs information into routine clinic services; specifically, a 45 minute orientation session during patient's first medical visit. The groups discussion session is lead by the nurse's introduction to the clinic, patient care, and screening, and followed by the social worker's comments on voluntary HIV screening. Nonambiguous language which is understood by various educational levels was used. Patients needed more time to discuss the concerns for dealing with their partners about STD's and contraception. Testing was available throughout the prenatal clinic period. Posttest counseling is also provided as a review, and for those seropositive or high risk patients as initial crisis intervention and case management. There was nonjudgemental discussion about termination of pregnancy. 1453 patients out of 1600 were involved in the orientation, with 20% (297) rather than the preceding years 40 screened. Success is attributed to strong collaborative working relationships with medical, nursing, social work, and clerical staffs, and extensive prior education. Those identified as seropositive were followed up in a separate clinic.
Asunto(s)
Infecciones por VIH/prevención & control , Educación en Salud , Atención Prenatal , Evaluación de Programas y Proyectos de Salud , Atención Ambulatoria , Consejo , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Humanos , Intercambio Materno-Fetal , Ciudad de Nueva York/epidemiología , Embarazo , Apoyo Social , Servicio Social , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/epidemiología , Salud de la MujerRESUMEN
The transurethral ultrasound tomography represents an important addition to the spectrum of diagnostic means for vesical tumors. On the basis of the comparisons between sonographic and histopathologic staging of 26 cystectomy specimens there was agreement in 20 cases. So far, limiting factors have proved to be the restricted penetration depth of the ultrasound probe used and the evaluation of the bladder outlet, which is possible to only a limited extent, even with retrograde transducers.
Asunto(s)
Estadificación de Neoplasias/métodos , Ultrasonografía/métodos , Neoplasias de la Vejiga Urinaria/patología , Femenino , Humanos , Masculino , Uretra , Vejiga Urinaria/anatomía & histologíaRESUMEN
Deep structures of the bladder wall can be examined by intravesical ultrasonic tomography. Therefore this technique is an ideal supplement to cystoscopy. Typical ultrasonic findings of 58 patients with different lesions of the bladder wall are presented.
Asunto(s)
Tomografía/métodos , Ultrasonografía , Enfermedades de la Vejiga Urinaria/diagnóstico , Carcinoma de Células Transicionales/diagnóstico , Cistitis/diagnóstico , Cistoscopía , Diverticulitis/diagnóstico , Femenino , Humanos , Leiomioma/diagnóstico , Masculino , Neoplasias de la Vejiga Urinaria/diagnósticoAsunto(s)
Gasto Cardíaco , Procedimientos Quirúrgicos Cardíacos , Técnicas de Dilución del Indicador , Temperatura , Animales , Computadores , Circulación Coronaria , Perros , Fenómenos Electromagnéticos , Estudios de Evaluación como Asunto , Glucosa , Atrios Cardíacos , Métodos , Arteria Pulmonar , Reología , Cloruro de Sodio , TermómetrosAsunto(s)
Riñón/cirugía , Prolapso Visceral/cirugía , Adulto , Femenino , Humanos , Masculino , Complicaciones Posoperatorias/etiologíaRESUMEN
A practical example shows that the rehabilitation of a single, dependent paraplegic cannot be terminated with the completion of the medical rehabilitation phase and the provision of an adequate job. The complete integration necessitates well organized care and assistance. In the described case this has been achieved by personal initiative, because for this problem complex there is a gap in the state rehabilitation system. Private care by conscentious objectors is described and put to discussion.
Asunto(s)
Conciencia , Principios Morales , Paraplejía/rehabilitación , Actividades Cotidianas , Adulto , Cuidados Posteriores , Servicios de Salud Comunitaria , Alemania Occidental , Humanos , Masculino , Planificación de Atención al Paciente , GuerraRESUMEN
Perinatal social work is a recent field of practice with expanding opportunities and responsibilities for social workers in direct practice, research and education. This paper discusses the emergence of high technology in the perinatal field and the specialization of social work knowledge, skills and roles which are developing in tandem with bio-medical advances. The need to reconcile compelling needs for preventive social work practice with those of specialization are examined.
Asunto(s)
Técnicas Reproductivas/psicología , Apoyo Social , Intervención en la Crisis (Psiquiatría) , Femenino , Fertilización In Vitro , Humanos , Recién Nacido , Infertilidad Femenina/psicología , Embarazo , Embarazo Múltiple/psicologíaRESUMEN
Postpartum depression is a common and treatable clinical syndrome which effects up to fifty percent of all women and which can best be considered as a triad of disorders. Postpartum blues, postpartum affective disorders or major depressions, and postpartum psychosis have distinct symptoms with corresponding implications for social work interventions and treatment strategies. The role of prevention can be pivotal in terms of reducing negative impacts of psychological problems after birth and minimizing adverse consequences for the new baby and all family members.
Asunto(s)
Depresión Posparto/psicología , Servicio Social/métodos , Trastornos de Adaptación/psicología , Trastornos de Adaptación/terapia , Depresión Posparto/prevención & control , Depresión Posparto/terapia , Trastorno Depresivo/psicología , Trastorno Depresivo/terapia , Familia/psicología , Femenino , Humanos , Masculino , Trastornos Psicóticos/psicología , Trastornos Psicóticos/terapiaRESUMEN
Among the imaging techniques for the morphologic diagnosis of the prostate and seminal vesicles transrectal sonography has assumed a foremost position. With the aid of longitudinal sectional images of the prostate and seminal vesicles obtained by means of a newly developed transrectal linear scanner the typical sonic characteristics associated with morphologic alterations of these organs were well demonstrated in 58 patients. For clarifying sonographic findings suggestive of carcinomas this approach can be used for precisely guided transperineal and above all transrectal puncture. Sonographic imaging of the prostatic urethra has opened new aspects in the assessment of functional processes on the basis of morphologic changes.
Asunto(s)
Enfermedades de la Próstata/diagnóstico , Vesículas Seminales , Ultrasonido/instrumentación , Enfermedades de la Vejiga Urinaria/diagnóstico , Adulto , Anciano , Biopsia con Aguja/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Hiperplasia Prostática/diagnóstico , Neoplasias de la Próstata/diagnóstico , Prostatitis/diagnóstico , Recto , UltrasonografíaRESUMEN
Childhood asthma is a chronic health condition that affects more than 1 million school-age children and their families. Asthma is the leading cause of school absences and accounts for a substantial amount of activity limitation in children. A small pilot study of caretakers of African American and Hispanic school-age children with asthma explored the effects of the illness on families and the coping strategies used by caretakers. Large and significant correlations were found between the perceived impact in the areas of financial burden, social and familial isolation, and personal strain. Caretakers reported using active coping, planning, religion, and acceptance of the illness most frequently. The authors suggest the value of making conceptual distinctions between the burden imposed by the illness and the coping skills used by caretakers.
Asunto(s)
Adaptación Psicológica , Asma/psicología , Negro o Afroamericano/psicología , Cuidadores/psicología , Costo de Enfermedad , Hispánicos o Latinos/psicología , Rol del Enfermo , Asma/etnología , Niño , Familia/psicología , Femenino , Humanos , Masculino , Área sin Atención Médica , Ciudad de Nueva York , Proyectos Piloto , Aislamiento Social , Apoyo SocialRESUMEN
This paper describes the development of consultancy groups in behavioral science, epidemiology and biostatistics, and information science in a required community medicine rotation with a twenty year history. The addition of consultants to individual student tutors and field preceptors has led to a structure which promotes student-project flexibility, development of critical assessment skills and independent learning while maximizing faculty expertise and effectiveness.
Asunto(s)
Medicina Comunitaria/educación , Consultores , Educación de Pregrado en Medicina/métodos , Docentes Médicos/normas , Solución de Problemas , Ciencias de la Conducta/educación , Biometría , Educación de Pregrado en Medicina/organización & administración , Epidemiología/educación , Humanos , Bibliotecología/educación , Objetivos OrganizacionalesRESUMEN
The percutaneous nephrostomy-set described is a two-piece desposable set for temporary or permanent urine drainage. Under combined sonographic and radiologic control the thin but stabilised puncture needle, used alone, offers the advantage of permitting definitive establishment of the fistula in a fast and safe manner without changing of the guide instrument and without any troublesome bouginage.
Asunto(s)
Riñón/cirugía , Ultrasonografía , Derivación Urinaria/instrumentación , Humanos , Pelvis Renal , Instrumentos Quirúrgicos , Obstrucción Ureteral/cirugía , Cateterismo Urinario/instrumentaciónRESUMEN
Serum acid phosphatase activity is the most commonly measured biochemical marker for diagnosing prostatic cancer and monitoring responses of such patients to therapy. Increased total serum acid phosphatase activity has been detected in the serum of up to 75% of patients with advanced disease (Stage D) which has metastasized to the bone, whereas in early stages (Stage A and B) as few as 10% may have increased total serum acid enzyme phosphatase values that can be detected by conventional biochemical assays. Serum acid phosphatase is believed to be comprised of specific molecular variants (isoenzymes) from sources throughout the body. Unfortunately, biochemical tests may lack specificity and sensitivity for the prostatic acid phosphatase, which is, thought to enter the serum in early stages of prostatic cancer. This situation prompted the development of immunologic assays for the determination prostatic acid phosphatase (radioimmunoassays, enzyme-immunoassays) which, it is hoped, combine the specificity achieved with immunologic reagents and techniques with the sensitivity made available through the use of radioisotopes or spectrophotometers.
Asunto(s)
Fosfatasa Ácida/metabolismo , Neoplasias de la Próstata/enzimología , Ensayo de Inmunoadsorción Enzimática , Humanos , Masculino , Estadificación de Neoplasias , Próstata/enzimología , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/patología , RadioinmunoensayoRESUMEN
The study of a 66 year old woman's medical chart revealed many discordant elements, leading to the diagnosis of Munchausen's syndrome. The patient had been treated over a period of 20 years at the Medical polyclinic for a variety of symptoms concerning virtually all organs. Her son's chart similarly contains discordant elements, rising the suspicion of a Munchausen Syndrome "by proxy". With this case report, historical aspects and the therapeutic challenge of this syndrome are outlined.
Asunto(s)
Síndrome de Munchausen/diagnóstico , Adolescente , Adulto , Anciano , Niño , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Síndrome de Munchausen/psicología , Síndrome de Munchausen/terapia , Síndrome de Munchausen Causado por Tercero/diagnóstico , Síndrome de Munchausen Causado por Tercero/psicología , Síndrome de Munchausen Causado por Tercero/terapia , Grupo de Atención al Paciente , Trastorno Paranoide Compartido/diagnóstico , Trastorno Paranoide Compartido/psicología , Trastorno Paranoide Compartido/terapiaRESUMEN
A prerequisite for the therapeutic procedure in bladder carcinoma is the determination of the depth of infiltration and extent of the tumor. This is possible by means of intravesical ultrasonic tomography as studies in 19 patients with vesical tumors of different sizes and extent showed. Histologically verified infiltration depths correlated with the intravesical ultrasonic findings in all cases so far. A statement on the percentage accuracy of the sonographic findings is not yet possible because of the small number of cases so far.
Asunto(s)
Ultrasonografía , Neoplasias de la Vejiga Urinaria/diagnóstico , Humanos , Estadificación de Neoplasias , Tomografía Computarizada por Rayos X , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
New reproductive technologies such as in vitro fertilization (IVF) offer much hope to infertile couples, yet the odds for success are not high. In this study we examine the experiences of a cohort of women undergoing IVF or a related technology at three points in time: before technological intervention, approximately one month after the first failed cycle, and six months later. We consider the women's expectations and experiences and discuss implications of the findings for social work practice.