PURPOSE: To compare the relative effects of random versus blocked practice schedules in treatment for childhood apraxia of speech (CAS). Although there have been repeated suggestions in the literature to use random practice in CAS treatment, no systematic studies exist that have directly compared random with blocked practice in this ...

PURPOSE OF REVIEW: Although there are extensive studies of postoperative and postdischarge nausea and vomiting (PONV/PDNV) up to 24 h, few investigate 'delayed PDNV'. With an increasing outpatient surgical population, specific 'delayed PDNV' risk identification and management is necessary for improving outcomes and helping patients after discharge. This review will discuss ...

Atrioventricular (AV) block comprises a spectrum of cardiac conduction delays with varying clinical presentations. It is commonly encountered in both hospital as well as ambulatory settings, and recognition of the type of AV conduction delay is essential for appropriate subsequent management. The electrocardiogram is a key tool for identification of ...

Background. Chronic pancreatitis (CP) is defined as a continuing inflammatory disease of the pancreas characterised by irreversible morphological changes, often associated with pain and with the loss of exocrine and/or endocrine function that may be clinically relevant. Alcohol is the predominant cause of CP in the western world and is ...

After marketing tactics resulted in $1.2 billion fines, the 2002 PhRMA Code attempted to standardize marketing and sales practices. Self-regulation had varied success by other industries and by pharmaceutical industries in other countries. Similarly, the Code addressed negative responses about pharmaceutical's practices but had no provisions for monitoring violations. Representative's ...

European legislation for medicines places the emphasis on an assessment of quality, safety and efficacy during the procedure for the granting of marketing authorisations for medicines, in order to protect patient health. The integrated European regulatory system involves the participation of a network of experts from the agencies of the ...

Transthoracic echocardiography is an established means of diagnosing a pericardial effusion and has become the reference guidance modality for drainage of symptomatic collections. However, echocardiographic drainage is not feasible in all patients for a variety of technical and patient-related factors. Computed tomography (CT)-directed pericardiocentesis using a standard Seldinger technique is ...

As the market for nanomedicines in the EU is growing, the development of regulatory guidance in this area assumes priority. Currently, the nanomedicine market is poised at a critical stage wherein clear regulatory guidance is imperative in providing for clarity and legal certainty to manufacturers of nanomedicine. The regulation of ...

BACKGROUND: This study evaluated a clinical audit and evidence based practice guide designed to improve general practitioners' assessment and management of erectile dysfunction. METHOD: A self selected sample of 25 GPs audited their assessment and management of 1354 patients at risk of, or being treated for, erectile dysfunction. RESULTS: General ...

Chronic venous leg ulcers account for the majority of lower extremity ulcers and represent a serious health and financial burden. Although several clinical practice guidelines and systematic reviews are available to guide treatment decisions, healing rates have not improved over the last decade. This research study illustrates some of the ...

BACKGROUND: The objective of the study was to determine the general public's level of awareness of and degree of concern about the interactions between pharmaceutical manufacturers and doctors in Melbourne. This Internet was survey administered using Survey Monkey. METHODS: The participants in the study were employees of The Age Newspaper ...

BACKGROUND: Administrative data from the Australian Pharmaceutical Benefits Scheme (PBS) showed rapid growth of esomeprazole dispensing when it was launched. Australia has universal prescription medicine coverage (the PBS), which included esomeprazole from August 2002. Free samples of new medicines are commonly provided to doctors. OBJECTIVES: To determine if a relationship ...

This paper offers an economic rationale for compulsory licensing of needed medicines in developing countries. The patent system is based on a trade-off between the "deadweight losses" caused by market power and the incentive to innovate created by increased profits from monopoly pricing during the period of the patent. However, ...

PURPOSE: Physical therapists are encouraged to use the Guide to Physical Therapist Practice (Guide) in their practice. The purpose of this study was to determine whether and how pediatric physical therapists (PTs) use the Guide. SUBJECTS AND METHODS: A nationwide electronic survey was sent to pediatric physical therapists. Four hundred ...

Glucosamine and chondroitin sulfate are the most well-marketed dietary supplements directed toward managing symptoms associated with osteoarthritis. The presumption of their benefit in the ankle is based largely on promising results from their use in knee osteoarthritis. Likewise, viscosupplementation has proved to be efficacious in the management of osteoarthritis of ...

Chronic venous leg ulcers account for the majority of lower extremity ulcers and represent a serious health and financial burden. Although several clinical practice guidelines and systematic reviews are available to guide treatment decisions, healing rates have not improved over the last decade. This research study illustrates some of the ...

There have been several displays created at the Geoffrey Kaye museum over the last 20 years. The current display is the culmination of a new professional approach to the management of the collection. A timeline has been created to enhance conducted tours and to allow self-guided tours. The creation of ...

OBJECTIVE: The aim of this study was to discern the CT features of appendicoliths retained after appendectomy and evaluate the management options. CONCLUSION: Retained, or dropped, appendicolith most often presents as an area of high attenuation less than 1 cm in diameter with an associated abscess close to the cecum ...

The LAndscape Management Policy Simulator (LAMPS) model, version 1.1, is a spatial simulation model developed to provide forest landscape planning simulations for the Coastal Landscape Analysis and Modeling Study (CLAMS). It is designed to help policymakers, managers, and planners think through alternative management scenarios and their potential effects on the ...

The marketing of forest tree barks used for medicinal purposes were investigated in some markets in Abeokuta metropolis. This was to provide the much needed information on the sellers, buyers and producers of these products for sustainable production and maximum socio-economic benefits. This study identified 43 species being sold in ...

A new scoring system, the Basic Erosive Wear Examination (BEWE), has been designed to provide a simple tool for use in general practice and to allow comparison to other more discriminative indices. The most severely affected surface in each sextant is recorded with a four level score and the cumulative ...

For each medicinal product quality, safety and efficacy have to be proven to obtain a marketing authorisation. The national competent health authorities and the European Medicines Agency (EMEA) with support of the Heads of Medicines Agencies (HMA) work together to grant marketing authorisations for medicinal products. Several regulatory procedures to ...

The practice of regional anaesthesia will be probably forever changed by the introduction of ultrasonography into everyday clinical practice. The ability to now visualise directly the spread of local anaesthetic solution and its relationship with the nerve allows for immediate adjustments to needle position and/or local anaesthetic volume and spread ...

The University of Minnesota College of Veterinary Medicine incorporated a structured behavioral interview guide in its 2004 application cycle. This article presents the challenges associated with the incorporation of the guide, the methods used to ensure appropriate training for faculty and practicing veterinarians conducting interviews, and preliminary data regarding the ...

Percutaneous endoscopic-guided gastrostomy (PEG) is done routinely on patients who suffer from inability to feed by mouth. PEG is generally considered a safe procedure with a low complication rate. A commonly underreported complication of PEG is malposition. This manuscript is a guideline to diagnosis and management of PEG malposition. We ...

The concept of similar biological medicinal products ('biosimilar' medicinal products) allows pharmaceutical companies to develop products based on an abridged dossier once the marketing protection of the 'reference' biological medicinal product has expired. A biosimilar medicinal product can be granted a marketing authorization provided that its similarity to a reference ...

OBJECTIVE: To determine the effect on rhesus germinal vesicle-stage oocytes enclosed within cumulus cells (COCs) of cryopreservation either by slow, equilibrium cooling or by rapid, non-equilibrium cooling. DESIGN: Experimental study. SETTING: University primate research center. SUBJECT(S): Twelve female rhesus monkeys. INTERVENTION(S): Monkeys were stimulated with recombinant FSH, and COCs were ...

The guiding principle in managing trauma to the primary dentition is potential sequelae to the permanent tooth. If the risk to the permanent tooth is great, the primary tooth should be removed. If esthetics are a concern to the parent, a number of appliances can be fabricated to temporarily manage ...

Aesthetic Practice Trends is a periodic feature that will give readers updates on topics involving everyday clinical practice issues from how to run a successful dermatology practice to marketing and advertising ideas, and trends. It will also provide additional coverage on lasers, light sources, and other energy-based devices as well ...

D-Glyceraldehyde acetonide has been used as the starting point for accessing the enantiomeric cyclobutanols 11 in optically pure condition. The dextrorotatory enantiomer has been transformed in five steps into the [3.2.0] bicyclic lactone 22. While the deoxygenation of 22 proved to be problematical, the uncyclized variant 25 underwent the Barton ...

The primary goal of forecasting is to identify the full range of possibilities facing a company, society, or the world at large. In this article, Saffo demythologizes the forecasting process to help executives become sophisticated and participative consumers of forecasts, rather than passive absorbers. He illustrates how to use forecasts ...

In 2001, the Agency for Healthcare Research and Quality recommended the use of ultrasound for the placement of central venous catheters (CVCs) as one of their 11 practices to improve patient care. These recommendations were based on the results of several randomized clinical trials showing significantly improved overall success as ...

We report on a 65-year-old female with an aneurysmal subarachnoid hemorrhage (SAH) that was followed clinically, radiologically and electrophysiologically before and after converting from intracranial pressure (ICP)-guided to ICP wave-guided intensive care management. Intracranial pressure-guided management is aimed at keeping mean ICP < 15-20 mmHg, while ICP wave-guided management is ...

Botulinum toxin type A injection have become commonplace and are an essential part of the aesthetic management of the upper face. A through understanding of the interrelationships between relevant facial muscles allows clinicians to use Botox for a wide range of conditions in addition to those for which it was ...

Miniscrew placement has achieved widespread acceptance in orthodontic practice. However, selecting a suitable miniscrew system from among the available brands is not easy. The aim of this article is to help the clinician better understand the features of miniscrew systems currently available on the market and provide a useful guideline ...

AIMS: To investigate the availability of information about premarketing randomized active-control trials (RaCTs) involving medicines with a new active substance at the moment of market authorization in the European Union. METHODS: Information was obtained from the EMEA European Public Assessment Reports and the MEDLINE and EMBASE databases. RESULTS: Between 1999 ...

Methods to manage twins after fixation include natural reduction,dietary reduction, transvaginal ultrasound-guided aspiration,surgical removal, craniocervical dislocation, and transabdominal ultrasound-guided injection. Of these, results have been inconsistent with regard to producing a single healthy foal, except for craniocervical dislocation. This new technique enables the twin to be reduced before complete placenta ...

BACKGROUND: The authors provide a suggested framework for completing a comprehensive evaluation of practice processes and routines. Their approach focuses on improving the professional image of dentists and the methods they use to market themselves. CONCLUSIONS: A practice can benefit by implementing a program to understand the strengths and weaknesses ...

The NHS spends over pound10 billion each year on medicines. The use of generic (patent-expired) medicines rather than branded equivalents has a key role in containing this expenditure and ensuring best value for money. On average, 4 years after the patent of a branded medicine has expired in the UK, ...

OBJECTIVE: To present a clinical classification of the lip-cheek groove. DESIGN: The clinical classification, which is based on years of analysis, will provide optimal management options for achieving the greatest degree of correction and rejuvenation of the lip-cheek groove. RESULTS: The use of the clinical classification of the lip-cheek groove ...

In the following pilot study, we compared conventional laryngoscope-guided tracheal intubation (tracheal intubation) and laryngoscope-guided, gum elastic bougie-guided ProSeal laryngeal mask airway insertion (guided ProSeal) for airway management by first-month anesthesia residents after brief manikin-only training. Five first-month residents with no practical experience of airway management were observed performing these ...

The healthcare outside hospitals white paper is part of a continuing drive to involve non-NHS bodies in patient care. This means an unfamiliar working environment for migrating managers; with different motivations, less job security and increased entrepreneurial freedom. Managers in Partnership has called on managers to develop self-marketing skills to ...

The Society of Radiologists in Ultrasound convened a panel of specialists from a variety of medical disciplines to come to a consensus on the management of thyroid nodules identified with thyroid ultrasonography (US), with particular focus on which nodules should be subjected to US-guided fine needle aspiration and which thyroid ...

Excellent clinicians have a solid knowledge base and use sound principles to guide their practice. Most of us work in dynamic and, at times, uncontrolled settings. To succeed, you must follow some established guidelines. As you grow in your chosen career, also continue to improve your airway knowledge and strive ...

OBJECTIVES: The aims of this paper are to review and compare existing techniques for creation of interdental/interimplant papillae, to address factors that may influence its appearance and to present an approach that authors developed that could help clinicians to manage and recreate the interproximal papillae. METHODS: Papers related to interdental ...

Leaders tend to be so immersed in the specifics of strategy that they rarely stop to think how much of their reasoning is done by analogy. As a result, they miss useful insights that psychologists and other scientists have generated about analogies' pitfalls. Managers who pay attention to their own ...

INTRODUCTION: In 1999, a statement of best practice in primary total hip replacement was approved by the Council of the British Orthopaedic Association (BOA) and by the British Association for Surgery of the Knee (BASK) to provide a basis for regional and national auditable standards: we have compared practice in ...

BACKGROUND: Melanoma skin cancer affects many young adults, yet few practice skin self-examination (SSE). We collected detailed information about young adult SSE practices, which can be used to guide the development of SSE interventions that target this age group. METHODS: We surveyed 190 US university students to assess their SSE ...

The utilization of microsystems technology (MST) in medical applications is instrumental in opening up new market segments, in the creation of novel, more effective diagnosis and therapy options in medicine, as well as in the further development of MST. However, the players in the healthcare industry are faced with technical ...

Tactical displays can quickly become cluttered with large numbers of symbols that can compromise effective monitoring. Here, we studied how heuristic automation can aid users by intelligently "decluttering" the display. In a realistic simulated naval air defense task, 27 experienced U.S. Navy users monitored a cluttered airspace and executed defensive ...