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Birido N, Brown KM, Olmo Ferrer D, Friedland R, Bailey SKT, Wawersik D, Charnetski M, Nair B, Kutzin JM, Gross IT, Palaganas JC. Health Care Simulation in Person and at a Distance: A Systematic Review. Simul Healthc 2024; 19:S65-S74. [PMID: 38240620 DOI: 10.1097/sih.0000000000000763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
ABSTRACT Distance simulation is a method of health care training in which the learners and facilitators are in different physical locations. Although methods of distance simulation have existed in health care for decades, this approach to education became much more prevalent during the COVID-19 pandemic. This systematic review studies a subset of distance simulation that includes combined in-person and distance simulation elements, identified here as "mixed- distance simulation." A review of the distance simulation literature identified 10,929 articles. Screened by inclusion and exclusion criteria, 34 articles were ultimately included in this review. The findings of this review present positive and negative aspects of mixed-distance simulation formats, a description of the most frequent configurations related to delivery, terminology challenges, as well as future directions including the need for faculty development, methodological rigor, and reporting details.
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Affiliation(s)
- Nuha Birido
- From the Royal College of Surgeons in Ireland-Medical University of Bahrain (N.B., B.N.), Busaiteen, Bahrain; Johns Hopkins University School of Nursing (K.M.B.), Baltimore, MD; Norfolk and Norwich University (D.O.-F.), Norfolk, UK; University of South Florida (S.K.T.B.), Tampa, FL; Nova Southeastern University (D.W.), Fort Lauderdale, FL; Dartmouth Health (M.C.), Lebanon, NH; The Mount Sinai Hospital (J.M.K.). New York, NY; Yale University School of Medicine (I.T.G.), New Haven, CT; and MGH Institute of Health Professions (J.C.P.), Boston, MA
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Rodseth R, Maslo C, Laubscher A, Friedland R. Readmission and inhospital death 1 year after COVID-19 hospitalization in South Africa. J Intern Med 2023; 294:370-372. [PMID: 37330991 DOI: 10.1111/joim.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
BACKGROUND Acute SARS-COVID-19 infection may increase readmission risk compared to other respiratory infections. We assessed the 1-year readmission and inhospital death rates of hospitalized SARS-COVID-19 patients compared to patients hospitalized with other types of pneumonia. METHODS We determined the 1-year readmission and inhospital death rate of adult patients initially hospitalized with a positive SARS-COVID-19 result, and subsequently discharged, between March 2020 and August 2021, at a Netcare private hospital in South Africa, and compared this to all hospitalized adult pneumonia patients in the 3 years prior to the COVID-19 pandemic (2017-2019). RESULTS The 1-year readmission rate in COVID-19 patients was 6.6% (328/50,067) versus 8.5% in pneumonia patients (4699/55,439; p < 0.001), with an inhospital mortality rate of 7.7% (n = 251) and 9.7% (n = 454; p = 0.002) for COVID-19 and pneumonia patients, respectively.
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Affiliation(s)
- Reitze Rodseth
- Netcare Ltd, Johannesburg, South Africa
- Department of Anaesthesiology and Critical Care, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - Anchen Laubscher
- Netcare Ltd, Johannesburg, South Africa
- Gordon Institute of Business Science (GIBS), University of Pretoria, Sandton, South Africa
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Maslo C, Friedland R, Toubkin M, Laubscher A, Akaloo T, Kama B. Characteristics and Outcomes of Hospitalized Patients in South Africa During the COVID-19 Omicron Wave Compared With Previous Waves. JAMA 2022; 327:583-584. [PMID: 34967859 PMCID: PMC8719272 DOI: 10.1001/jama.2021.24868] [Citation(s) in RCA: 324] [Impact Index Per Article: 162.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study describes the characteristics and clinical outcomes of patients hospitalized in South Africa during the Omicron wave compared with the same variables from earlier COVID-19 waves.
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Affiliation(s)
| | | | - Mande Toubkin
- Netcare Ltd South Africa, Johannesburg, South Africa
| | | | | | - Boniswa Kama
- Netcare Ltd South Africa, Johannesburg, South Africa
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Friedland R, Reiss-Huss S, Sabbah F, Ben Amitai D. Clinical clues and trends in epidemiology and pathogens in paediatric tinea capitis: a retrospective cohort study. Clin Exp Dermatol 2021; 47:50-56. [PMID: 34236716 DOI: 10.1111/ced.14831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Tinea capitis is the most common dermatophyte infection in children. Pathogens differ between populations. During the past few decades pathogen shifts have been reported in many countries around the world. This study aimed to characterize the pathogens involved in tinea capitis in a large tertiary paediatric medical centre in Israel. METHODS The electronic medical records of the dermatology unit were searched for patients diagnosed with tinea capitis from 2010 to 2019, and demographic, clinical and mycological data were retrieved. A stepwise logistic regression was performed to determine the variables most significantly associated with positive cultures. RESULTS The prevalence of Trichophyton tonsurans isolates was found to be significantly increased during 2019. In the logistic regression analysis, alopecia was most significantly associated with a positive culture (OR = 8.72, 95% CI 4.29-17.7, P < 0.001) while positive culture was also associated with age (OR = 1.11 per year of age, 95% CI 1.02-1.22, P = 0.01) and Ethiopian ethnicity (OR = 3.67, 95% CI 1.42-9.45, P = 0.01). The presentation of alopecia was significantly related to having a positive culture. This symptom was more prevalent in boys than in girls, and the diagnosis of tinea capitis was delayed by an average of 2 months in girls. CONCLUSION The results of this study may herald a pathogen shift in Israel. Physicians should be aware that rates of alopecia are lower in girls and this can result in delayed diagnosis and the development of complications, including chronicity, scarring alopecia and kerion formation.
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Affiliation(s)
- R Friedland
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Reiss-Huss
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - F Sabbah
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Ben Amitai
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Grizzetti B, Vigiak O, Udias A, Aloe A, Zanni M, Bouraoui F, Pistocchi A, Dorati C, Friedland R, De Roo A, Benitez Sanz C, Leip A, Bielza M. How EU policies could reduce nutrient pollution in European inland and coastal waters. Glob Environ Change 2021; 69:102281. [PMID: 34471331 PMCID: PMC8386246 DOI: 10.1016/j.gloenvcha.2021.102281] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 05/23/2023]
Abstract
Intensive agriculture and densely populated areas represent major sources of nutrient pollution for European inland and coastal waters, altering the aquatic ecosystems and affecting their capacity to provide ecosystem services and support economic activities. Ambitious water policies are in place in the European Union (EU) for protecting and restoring aquatic ecosystems under the Water Framework Directive and the Marine Strategy Framework Directive. This research quantified the current pressures of point and diffuse nitrogen and phosphorus emissions to European fresh and coastal waters (2005-2012), and analysed the effects of three policy scenarios of nutrient reduction: 1) the application of measures currently planned in the Rural Development Programmes and under the Urban Waste Water Treatment Directive (UWWTD); 2) the full implementation of the UWWTD and the absence of derogations in the Nitrates Directive; 3) high reduction of nutrient, using best technologies in wastewaters treatment and optimal fertilisation in agriculture. The results of the study show that for the period 2005-2012, the nitrogen load to European seas was 3.3-4.1 TgN/y and the phosphorus load was 0.26-0.30 TgP/y. Policy measures supporting technological improvements (third scenario) could decrease the nutrient export to the seas up to 14% for nitrogen and 20% for phosphorus, improving the ecological status of rivers and lakes, but widening the nutrient imbalance in coastal ecosystems (i.e. increasing nitrogen availability with respect to phosphorus), affecting eutrophication. Further nutrient reductions could be possible by a combination of measures especially in the agricultural sector. However, without tackling current agricultural production and consumption system, the reduction might not be sufficient for achieving the goals of EU water policy in some regions. The study analysed the expected changes and the source contribution in different European regional seas, and highlights the advantages of addressing the land-sea dynamics, checking the coherence of measures taken under different policies.
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Affiliation(s)
- B. Grizzetti
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
| | - O. Vigiak
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
| | - A. Udias
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
| | | | | | - F. Bouraoui
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
| | - A. Pistocchi
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
| | | | - R. Friedland
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
| | - A. De Roo
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
| | | | - A. Leip
- European Commission Joint Research Centre (JRC), Ispra, VA, Italy
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Fogel I, Ollech A, Zvulunov A, Valdman‐Greenshpon Y, Atar Snir V, Friedland R, Lapidoth M, Ben‐Amitai D. Safety profile during initiation of propranolol for treatment of infantile haemangiomas in an ambulatory day‐care hospitalization setting. J Eur Acad Dermatol Venereol 2018; 32:2004-2009. [DOI: 10.1111/jdv.14955] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/26/2018] [Indexed: 12/01/2022]
Affiliation(s)
- I. Fogel
- Department of Dermatology Northwestern University Chicago IL USA
| | - A. Ollech
- Department of Dermatology Northwestern University Chicago IL USA
| | - A. Zvulunov
- Pediatric Dermatology Unit Schneider Children's Medical Center of Israel Petach Tikva Israel
- Ben Gurion University of the Negev Be'er Sheva Israel
| | - Y. Valdman‐Greenshpon
- Dermatology Unit Kaplan Hospital Rehovot Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - V. Atar Snir
- Pediatric Dermatology Unit Schneider Children's Medical Center of Israel Petach Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - R. Friedland
- Pediatric Dermatology Unit Schneider Children's Medical Center of Israel Petach Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - M. Lapidoth
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Laser Unit Rabin Medical Center ‐ Hasharon Hospital Petach Tikva Israel
| | - D. Ben‐Amitai
- Pediatric Dermatology Unit Schneider Children's Medical Center of Israel Petach Tikva Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
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Vaishnav R, Rebolledo-Mendez J, Raha-Chowdhury R, Nandi S, Roberts A, Palmer K, Cooper N, Friedland R. Progranulin Regulator miR-107 Shows Cross-Species Homology with Plant Viruses (P05.054). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Afgin A, Massarwa M, Schechtman E, Israeli-Korn S, Strugatsky R, Abuful A, Farrer L, Friedland R, Inzelberg R. Conversion from Mild Cognitive Impairment to Alzheimer's Disease in an Elderly Arab Population (P01.088). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Friedland R, David M, Feinmesser M, Barzilai A, Hodak E. NB-UVB (311-312 nm)-induced lentigines in patients with mycosis fungoides: a new adverse effect of phototherapy. J Eur Acad Dermatol Venereol 2011; 26:1158-62. [DOI: 10.1111/j.1468-3083.2011.04189.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Friedland R, David M, Feinmesser M, Fenig-Nakar S, Hodak E. Idiopathic guttate hypomelanosis-like lesions in patients with mycosis fungoides: a new adverse effect of phototherapy. J Eur Acad Dermatol Venereol 2010; 24:1026-30. [PMID: 20180893 DOI: 10.1111/j.1468-3083.2010.03571.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Idiopathic guttate hypomelanosis (IGH) is a common pigmentary disorder, the aetiology and pathogenesis of which are largely unknown. The appearance of IGH-like lesions during phototherapy has been reported previously in only one patient. OBJECTIVE To describe the clinical and histological features of phototherapy-induced IGH-like lesions, their relation to ultraviolet dosimetry and the course of this eruption in patients with mycosis fungoides (MF). METHODS The files of all patients with MF who underwent phototherapy in our centre from 1992 to 2008 were searched to identify those in whom IGH-like lesions appeared during treatment. Results Among 87 patients with early-stage MF who underwent phototherapy, seven acquired IGH-like lesions during monotherapy with narrow-band ultraviolet B (NB-UVB; four patients) or psoralen and ultraviolet A (PUVA; three patients). All but one had a light complexion. The lesions appeared in areas exposed to ultraviolet light, and not exclusively on the skin previously involved by the disease. The mean number of exposures until appearance of the lesions was 92 for NB-UVB and 137 for PUVA. Biopsy study showed a decreased number of melanocytes. Phototherapy was discontinued in four patients, of whom three showed a partial or complete disappearance of the IGH-lesions. The other three patients are still receiving phototherapy, with no change in their IGH-like lesions. CONCLUSIONS Phototherapy may induce an eruption bearing similar clinical and histopathological features to IGH. The eruption is rare, appears to emerge only after prolonged therapy and seems to be reversible upon discontinuation of phototherapy. IGH-like eruption should be added to the list of side-effects of phototherapy.
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Affiliation(s)
- R Friedland
- Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petah Tiqwa, Israel
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Sparks DL, Friedland R, Petanceska S, Schreurs BG, Shi J, Perry G, Smith MA, Sharma A, Derosa S, Ziolkowski C, Stankovic G. Trace copper levels in the drinking water, but not zinc or aluminum influence CNS Alzheimer-like pathology. J Nutr Health Aging 2006; 10:247-54. [PMID: 16886094 PMCID: PMC3899576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Mounting evidence suggests copper may influence the progression of Alzheimer's disease by reducing clearance of the amyloid beta protein (Abeta) from the brain. Previous experiments show that addition of only 0.12 PPM copper (one-tenth the Environmental Protection Agency Human consumption limits) to distilled water was sufficient to precipitate the accumulation of Abeta in the brains of cholesterol-fed rabbits (1). Here we report that addition of copper to the drinking water of spontaneously hypercholesterolemic Watanabe rabbits, cholesterol-fed beagles and rabbits, PS1/APP transgenic mice produced significantly enhanced brain levels of Abeta. In contrast to the effects of copper, we found that aluminum- or zinc-ion-supplemented distilled water did not have a significant effect on brain Ab accumulation in cholesterol-fed rabbits. We also report that administration of distilled water produced a reduction in the expected accumulation of Ab in three separate animal models. Collectively, these data suggest that water quality may have a significant influence on disease progression and Ab neuropathology in AD.
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Affiliation(s)
- D L Sparks
- Roberts aboratory for NeurodegenerativeDisease Research, Sun Health Research Institute, Sun City, AZ, USA
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Abstract
The authors aimed to examine the difference in 24-hour rhythms of sleep-wake cycle and temperature between Alzheimer's disease (AD) patients and elderly comparison subjects. The continuous measuring of wrist activity and skin temperature was conducted for 96 hours in seven AD patients (age: 77.0 +/- 4.3) and 11 normal comparison subjects (age: 74.2 +/-5.2). The mean acrophases and amplitudes of the two rhythms in the AD group were not different from those in the comparison group. The mean phase difference between the two rhythms, however, was significantly lower in the AD group than in the comparison group.
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Affiliation(s)
- J H Lee
- Department of Psychiatry, Kangwon National University Hospital, Chunchon, Korea
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Demissie S, Green RC, Mucci L, Tziavas S, Martelli K, Bang K, Coons L, Bourque S, Buchillon D, Johnson K, Smith T, Sharrow N, Lautenschlager N, Friedland R, Cupples LA, Farrer LA. Reliability of Information Collected by Proxy in Family Studies of Alzheimer’s Disease. Neuroepidemiology 2001; 20:105-11. [PMID: 11359077 DOI: 10.1159/000054768] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The study evaluated the reliability of data obtained from proxy informants. The index subjects in this study were 81 nondemented participants in the Multi-Institutional Research in Alzheimer Genetic Epidemiology (MIRAGE) study. These index subjects and 159 proxy informants, identified by the index subjects, participated in the study. The kappa statistic with multiple raters per subject (for dichotomous variables) and the intraclass correlation coefficient (for continuous variables) were used to measure reliability. Among proxy respondents who provided answers, there was excellent agreement between proxy responses and the responses of the index subjects (0.7 < or = kappa < or =0.9), with the exception of questions about head injury (kappa = 0.4). A large proportion (>90%) of the proxy informants in this study were able to provide information on most items. Higher nonresponse rates (as high as 30%) were observed for medication history and women's health questions. This study supports the reliability of proxy responses for most categories of questions that are elicited in typical epidemiological studies, including the MIRAGE study.
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Affiliation(s)
- S Demissie
- Data Coordinating Center, Boston University Schools of Medicine and Public Health, Boston, Mass., USA
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Chow V, Burbridge B, Friedland R, Kudel B, Chappell B, Tan L. Interobserver variability in the measurement of internal carotid stenosis. Can Assoc Radiol J 1999; 50:37-40. [PMID: 10047749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE To assess interobserver variability in the measurement of carotid stenoses from digital subtraction angiograms displayed in different ways (nonmagnified or magnified, white or black arteries); and to compare human readers with computer-generated densitometric measurements of vessel stenosis. METHODS Digital subtraction angiograms of 20 proximal internal carotid artery stenoses were laser printed in the following ways: (1) Nonmagnified white artery on a black background; (2) Magnified white artery on a black background; (3) Nonmagnified black artery on a white background; (4) Magnified black artery on a white background. This resulted in 80 images of internal carotid artery stenoses. These stenoses were independently measured by 4 radiologists using the North American Symptomatic Carotid Endarterectomy Trial method. A computer-generated densitometric measurement of the black nonmagnified images was also obtained. RESULTS The most reliable stenosis measurements were obtained from the nonmagnified black and white artery images. The interobserver variability in the measurement of internal carotid stenoses using these images was quite small. Variability increased with the use of magnification. The computer-generated stenosis measurements were consistently much higher than those of the radiologists. CONCLUSION There was significant variability in measurements made from magnified images and between human readers and computer-generated measurements. This has great clinical significance. Readers of digital angiographic images must determine the most reliable, reproducible images generated by their equipment, as these measurements significantly affect treatment of patients with symptomatic internal carotid artery stenosis.
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Affiliation(s)
- V Chow
- Department of Medical Imaging, Royal University Hospital, Saskatoon, Sask
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Haacke EM, Hopkins A, Lai S, Buckley P, Friedman L, Meltzer H, Hedera P, Friedland R, Klein S, Thompson L. 2D and 3D high resolution gradient echo functional imaging of the brain: venous contributions to signal in motor cortex studies. NMR Biomed 1994; 7:54-62. [PMID: 8068526 DOI: 10.1002/nbm.1940070109] [Citation(s) in RCA: 118] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Recent emphasis on high resolution gradient echo studies in functional imaging has led to the conclusion that there are likely three domains of response to the blood circulation in the brain when considering field inhomogeneity effects of the venous blood pre- and during activation. The first is a coherent effect due to large or macroscopic vessels on the order of the size of the voxel (ca 200-500 microns in most studies). These can lead to very large signal changes (up to 100%). The second is at the venule level (ca 50-200 microns) and is associated with smaller parenchymal changes (usually ca 10% or less). The third is at the capillary level and is associated with much smaller signal changes at 1.5 T and even up to 4 T. The actual signal changes depend on field strength and sequence design. In this paper, we present our experience in detecting the first two domains with 2D and 3D gradient echo imaging at 1.5 T. We find that high resolution enables visualization of the larger small veins in motor cortex studies and that, on occasion, it is possible to see the venule effects as well. We suggest a simple model to explain the large signal changes based on susceptibility changes and partial volume effects. Comparisons of the functional imaging data to this model and to MR angiographic studies are also shown as evidence of the venous sources of the susceptibility changes.
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Affiliation(s)
- E M Haacke
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
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Lai S, Hopkins AL, Haacke EM, Li D, Wasserman BA, Buckley P, Friedman L, Meltzer H, Hedera P, Friedland R. Identification of vascular structures as a major source of signal contrast in high resolution 2D and 3D functional activation imaging of the motor cortex at 1.5T: preliminary results. Magn Reson Med 1993; 30:387-92. [PMID: 8412613 DOI: 10.1002/mrm.1910300318] [Citation(s) in RCA: 328] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We have measured the T2* signal response associated with cortical activation due to finger motion at 1.5 Tesla. Both thin slice 2D and 3D images show signal intensity changes which vary from 2% to 32% depending on volunteer, echo time, slice thickness, and in-plane resolution. The largest signal change occurred for the thinnest slices and highest resolution (2 mm3). This is consistent with reducing partial volume effects and a simple difference in phase between the intravascular signal and surrounding parenchyma. No inflow enhancement was seen on the 2D or 3D scans, confirming the nature of the signal difference for this approach was due to local field inhomogeneity effects. Using 3D imaging, multiple effects can be seen simultaneously. With a 3D MRA method, it was possible to locate the vessel that was the source of the T2* behavior; it was in each case a vein on the surface of the cortical parenchyma.
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Affiliation(s)
- S Lai
- Department of Physics, Case Western Reserve University, Cleveland, Ohio
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Swedo SE, Schapiro MB, Grady CL, Cheslow DL, Leonard HL, Kumar A, Friedland R, Rapoport SI, Rapoport JL. Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. Arch Gen Psychiatry 1989; 46:518-23. [PMID: 2786402 DOI: 10.1001/archpsyc.1989.01810060038007] [Citation(s) in RCA: 422] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The cerebral metabolic rate for glucose was studied in 18 adults with childhood-onset obsessive-compulsive disorder (OCD) and in age- and sex-matched controls using positron emission tomography and fludeoxyglucose F 18. Both groups were scanned during rest, with reduced auditory and visual stimulation. The group with OCD showed an increased glucose metabolism in the left orbital frontal, right sensorimotor, and bilateral prefrontal and anterior cingulate regions as compared with controls. Ratios of regional activity to mean cortical gray matter metabolism were increased for the right prefrontal and left anterior cingulate regions in the group with OCD as a whole. Correlations between glucose metabolism and clinical assessment measures showed a significant relationship between metabolic activity and both state and trait measurements of OCD and anxiety as well as the response to clomipramine hydrochloride therapy. These results are consistent with the suggestion that OCD may result from a functional disturbance in the frontal-limbic-basal ganglia system.
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Affiliation(s)
- S E Swedo
- Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892
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Jenkins RR, Friedland R, Howald H. The relationship of oxygen uptake to superoxide dismutase and catalase activity in human skeletal muscle. Int J Sports Med 1984; 5:11-4. [PMID: 6607896 DOI: 10.1055/s-2008-1025872] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A considerable amount of evidence now makes it clear that aerobic tissues require an elaborate enzyme system to remove the harmful reaction products of oxygen reduction. A portion of this protective system has been studied in human muscle and rat tissues. The VO2 max as well as the superoxide dismutase and catalase activity of vastus lateralis muscle of 12 healthy, male subjects was measured. The subjects with a high aerobic capacity (VO2 max greater than 60 ml . kg-1 . min-1) had significantly greater levels of both superoxide dismutase and catalase. There was also a linear relationship between both superoxide dismutase and catalase and VO2 max. The tissue oxygen consumption, and enzyme activity of the liver, heart, lung, and gastrocnemius from 24 rats was also studied. There VO2 and tissue enzyme activity of both superoxide dismutase and catalase.
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Ehrengut W, Friedland R. [Indications and implementation of preventive vaccination in the inland]. Internist (Berl) 1979; 20:273-82. [PMID: 378890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Friedland R. Introduction to the theme--state intervention and the social wage: the politics of social services expansion. Int J Health Serv 1979; 9:191-206. [PMID: 437933 DOI: 10.2190/6eyy-6412-gc7l-m51y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
State intervention in the consumption process has become increasingly critical to economic growth on the one hand and to real family income on the other. The social wage thus tends to become a conflictual political issue. As a result, the articulation of state intervention with the changing requirements of economic growth is subject to continuous political challenge. This special issue examines the problematic relationship between state intervention in social services and the organization of the capitalist economy. Some contributors study the ways in which state inter ventions are structured so as to be consonant with the requirements of economic growth and profitability, as well as the difficulties such structures pose. Feshbach's analysis of the Hill-Burton Hospital Construction Program and Mollenkopf's study of San Francisco's public transit system both reflect this concern. Other contributors study the ways in which the organization of the economy constrains the development of democratically responsive social services. Sbragia's study of the capital market and public housing in Italy and Taylor's study of free medical clinics in the U.S. both reflect this concern. Finally, contributors study macroscopic transformations in the relationship between state intervention and the organization of the capitalist economy. Esping-Andersen's study of the political logic of increasing state intervention in production and Hirschhorn's analysis of the defunctionalization of social services attendent upon the disaccumulative tendencies in capitalism both reflect this concern. This introductory paper reviews four theories which attempt to explain how state intervention is insulated from democratic controls. For each theory, the mechanisms specified to perform this function are subject to weaknesses. An attempt is made to position the contributions to this volume with respect to these theoretical traditions.
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Abstract
We report a case of infectious mononucleosis in which central nervous system involvement was the presenting and sole manifestation of the disorder. The major symptomatology consisted of stupor, chorea, and signs of aseptic meningitis. We also discuss the clinical and laboratory features of the neurological manifestations of infectious mononucleosis and the theories as to its pathogenesis.
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