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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
81

DeterminaÃÃo do perfil de pacientes e avaliaÃÃo do tratamento da tuberculose latente em candidatos ao uso de bloqueadores do TNFâα no Hospital UniversitÃrio Walter CantÃdio (HUWC/UFC). / Determining of the profile of patients and evaluation of treatment of latent tuberculosis infection in candidates for the use of tumor necrosis factor-alpha blockers in University Hospital Walter CantÃdio (HUWC/UFC).

Diana Maria de Almeida Lopes 17 March 2010 (has links)
nÃo hà / A introduÃÃo na prÃtica clÃnica dos agentes bloqueadores do TNF-α representou uma revoluÃÃo no tratamento das doenÃas inflamatÃrias crÃnicas: artrite reumatÃide (AR), espondilite anquilosante (EA), doenÃa de Crohn (DC) e psorÃase. Desde entÃo, seu uso tem sido ampliado, contudo essa terapia de alto custo econÃmico elevou o risco de desenvolvimento das doenÃas infecciosas entre elas, à tuberculose (TB). Por este motivo recomenda-se a investigaÃÃo da Tuberculose latente (TBL) antes do inÃcio da terapÃutica com os bloqueadores do TNF-α. O objetivo do nosso estudo foi traÃar o perfil clÃnico-epidemiolÃgico dos pacientes nessa condiÃÃo clÃnica e avaliar os desfechos de tratamento de pacientes submetidos ao tratamento da TBL por indicaÃÃo do uso de bloqueadores do TNF-α no AmbulatÃrio de Tisiologia do Hospital UniversitÃrio Walter CantÃdeo (HUWC/UFC). MÃtodo: Foi realizada no perÃodo de 2008-2009 uma anÃlise descritiva prospectiva desse grupo de pacientes seguido de um estudo analÃtico observacional do tipo transversal do desfecho. Resultados: Foram estudados 45 pacientes classificados como portadores de TBL por apresentarem teste tuberculÃnico (TT) ≥ 5 mm e radiografia de tÃrax normal ou com lesÃes residuais mÃnimas. A maioria era do sexo feminino (56%), cerca da metade estava na faixa etÃria de 40 a 49 anos (45%). Em relaÃÃo à doenÃa de base tivemos diagnÃsticos reumatolÃgicos â artrite reumatÃide e espondilite (49,0%), dermatolÃgicos â psorÃase (37,7%) e doenÃa de Chron (13,3%). A presenÃa de 01 comorbidades foi observada em15/45 (33,3%) e em 6/45 (13,3%) pacientes apresentavam mais de uma doenÃa associada. Contato com paciente de TB foi relatado em 9/45 (20%) dos indivÃduos estudados. Dois pacientes referiram TB pulmonar tratada anteriormente. A maioria (88,9%) era de assintomÃticos respiratÃrios. O resultado mÃdio do TT foi 14,6mm, variando de 5 a 30 mm, sendo que 30/45 (66,7%) apresentou TT >10 mm. O uso de medicaÃÃo antiinflamatÃria nÃo influiu no resultado do TT. A anÃlise radiolÃgica do tÃrax foi normal em 64,4% e em 35,6 % foram observadas alteraÃÃes radiolÃgicas mÃnimas. Dos 45 pacientes estudados 37 utilizaram fÃrmacos para tratamento da doenÃa de base, 20 (54,0%) usaram corticosterÃides (prednisona) e 36 (97,3%) relataram o uso de imunossupressores, principalmente o Metrotexato. A isoniazida 300mg/dia foi utilizada no tratamento da TBL e os efeitos colaterais ocorreram em 15,6 % dos pacientes. Em relaÃÃo ao desfecho foi observado que 41 completaram o tratamento. Houve 01 abandono, 01 transferÃncia e 02 suspensÃes de tratamento por hepatite medicamentosa. ConclusÃo: A determinaÃÃo do perfil do paciente candidato ao tratamento da TBL pode contribuir para a uniformizaÃÃo dos procedimentos de rastreio e prevenÃÃo da TB, bem como para estabelecer os protocolos clÃnicos de uso e acompanhamento dos fÃrmacos anti-TNF. Todos os pacientes continuam em acompanhamento no ambulatÃrio de tisiologia do HUWC/UFC por um perÃodo mÃnimo de 5 anos.
82

Novel predictors of cardiovascular disease in peritoneal dialysis patients.

January 2009 (has links)
Gao, Ni. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 133-153). / Abstracts also in Chinese. / ACKNOWLEDGEMENTS / TABLE OF CONTENT --- p.1 / LIST OF FIGURES AND TABLES --- p.4 / List of Figures --- p.4 / List of Tables --- p.5 / ABSTRACT --- p.6 / 中文摘要 --- p.9 / ABBREVIATIONS --- p.11 / Chapter CHAPTER 1 - --- BACKGROUND REVIEW AND HYPOTHESIS --- p.13 / Chapter 1.1 --- Overview of Peritoneal dialysis --- p.13 / Chapter 1.2 --- Peritoneal dialysis in Hong Kong --- p.16 / Chapter 1.3 --- Cardiovasular Disease in PD patients --- p.18 / Chapter 1.3.1 --- Arterial disease --- p.21 / Chapter 1.3.2 --- Left ventricular hypertrophy --- p.23 / Chapter 1.4 --- Malnutrition in PD patients --- p.26 / Chapter 1.5 --- Fluid overload in PD patients: a cause and a result of CVD --- p.28 / Chapter 1.5.1 --- Overview --- p.28 / Chapter 1.5.2 --- Fluid overload and residual renal function --- p.29 / Chapter 1.5.3 --- Fluid overload and hypertension --- p.30 / Chapter 1.5.4 --- Fluid overload and malnutrition --- p.32 / Chapter 1.5.5 --- Assessment of fluid status in PD patient --- p.33 / Chapter 1.6 --- Peritoneal transport as the cause of fluid overload --- p.36 / Chapter 1.6.1 --- Structure of peritoneum --- p.36 / Chapter 1.6.2 --- Structural alteration of peritoneal membrane in PD --- p.37 / Chapter 1.6.3 --- Ultrafiltration dysfunction --- p.38 / Chapter 1.6.4 --- Peritoneal transport and outcome of PD patients --- p.40 / Chapter 1.6.5 --- Fluid overload and peritoneal transport --- p.41 / Chapter 1.6.6 --- Peritoneal transport and malnutrition --- p.42 / Chapter 1.6.7 --- Assessment of peritoneal transport --- p.44 / Chapter 1.7 --- Closing the circle: Arterial stiffness as a cause of high peritoneal transport? --- p.47 / Chapter 1.7.1 --- Vascular function and anatomy --- p.47 / Chapter 1.7.2 --- Atherosclerosis --- p.49 / Chapter 1.7.3 --- Atherosclerosis and Endothelial Dysfunction --- p.50 / Chapter 1.7.4 --- Atherosclerosis and Extracellular Matrix --- p.53 / Chapter 1.7.5 --- Arterial stiffness and renal function --- p.54 / Chapter 1.7.6 --- Arterial stiffness in PD --- p.55 / Chapter 1.7.7 --- Arterial stiffness and clinical outcome --- p.55 / Chapter 1.7.8 --- Assessment of arterial stiffness --- p.57 / Chapter 1.8 --- An overall construct --- p.61 / Chapter 1.9 --- Hypothesis --- p.63 / Chapter CHAPTER 2 - --- GENERAL METHODOLOGY --- p.65 / Chapter 2.1 --- Radiographic Parameters of Intravascular Volume Status --- p.65 / Chapter 2.2 --- Pulse Wave Velocity Study --- p.69 / Chapter 2.3 --- Dialysis adequacy study --- p.72 / Chapter 2.4 --- Peritoneal equilibration test (PET) --- p.73 / Chapter 2.5 --- Assessment of nutritional status --- p.75 / Chapter CHAPTER 3 - --- Radiographic Parameters of Intravascular Volume Status as a Prognostic Marker in Chinese Peritoneal Dialysis Patients --- p.77 / Chapter 3.1 --- Introduction --- p.77 / Chapter 3.2 --- Patients and Methods --- p.78 / Chapter 3.3 --- Results --- p.81 / Chapter 3.4 --- Conclusion --- p.90 / Chapter CHAPTER 4 - --- Longitudinal Changes of Radiographic Parameters as the Prognostic Marker of Chinese Peritoneal Dialysis Patients --- p.91 / Chapter 4.1 --- Introduction --- p.91 / Chapter 4.3 --- Results --- p.95 / Chapter 4.4 --- Conclusions --- p.104 / Chapter CHAPTER 5 - --- "The Relation between Arterial Pulse Wave Velocity, Peritoneal Transport Characteristics, and Radiological Parameters of Intravascular Volume Status in Chinese peritoneal dialysis patients" --- p.105 / Chapter 5.1 --- Introduction --- p.105 / Chapter 5.2 --- Patients and Methods --- p.106 / Chapter 5.3 --- Results --- p.110 / Chapter 5.4 --- Conclusions --- p.119 / Chapter CHAPTER 6 - --- DISCUSSION --- p.120 / Chapter 6.1 --- Methodology --- p.120 / Chapter 6.2 --- Results --- p.123 / Chapter 6.3 --- Further Directions of Research --- p.131 / Chapter 6.4 --- Conclusions --- p.132 / REFERENCE --- p.133 / PUBLICATIONS RELATED TO THIS WORK --- p.154 / Index Publication --- p.154 / Abstract --- p.154
83

Injury mechanism of supination ankle sprain incidents in sports: kinematics analysis with a model-based image-matching technique.

January 2010 (has links)
Mok, Kam Ming. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 36-44). / Abstracts in English and Chinese. / Abstract --- p.ii / Chinese abstract --- p.iii / Acknowledgement --- p.iv / Table of contents --- p.V / List of figures --- p.vii / List of tables --- p.viii / Chapter Chapter 1: --- Introduction --- p.1 / Chapter Chapter 2: --- Review of literature --- p.3 / Chapter 2.1 --- Why prevent ankle ligamentous sprain? --- p.3 / Chapter 2.2 --- A sequence of injury prevention --- p.4 / Chapter 2.3 --- Biomechanical approaches in defining injury mechanism --- p.5 / Chapter 2.4 --- Injury mechanism of ankle ligamentous sprain in sports --- p.6 / Chapter 2.5 --- Model-Based Image-Matching motion analysis --- p.7 / Chapter Chapter 3: --- Development of an ankle joint Model-Based Image-Matching motion analysis technique --- p.9 / Chapter 3.1 --- Introduction --- p.9 / Chapter 3.2 --- Materials and method --- p.10 / Chapter 3.2.1 --- Cadaver test --- p.10 / Chapter 3.2.2 --- Model-Based Image-Matching motion analysis --- p.12 / Chapter 3.2.3 --- Statistical analysis --- p.14 / Chapter 3.3 --- Results --- p.15 / Chapter 3.3.1 --- Validity --- p.15 / Chapter 3.3.2 --- Intra-rater reliability --- p.16 / Chapter 3.3.3 --- Inter-rater reliability --- p.17 / Chapter 3.4 --- Discussion --- p.17 / Chapter 3.5 --- Conclusion --- p.21 / Chapter Chapter 4: --- Biomechanical motion analysis on ankle ligamentous sprain injury cases --- p.22 / Chapter 4.1 --- Introduction --- p.22 / Chapter 4.2 --- Materials and method --- p.24 / Chapter 4.2.1 --- Case screening --- p.24 / Chapter 4.2.2 --- Model-Based Image-Matching motion analysis --- p.24 / Chapter 4.3 --- Results --- p.28 / Chapter 4.3.1 --- High Jump Injury --- p.28 / Chapter 4.3.2 --- Field hockey Injury --- p.28 / Chapter 4.3.3 --- Tennis Injury --- p.29 / Chapter 4.4 --- Discussion --- p.30 / Chapter 4.5 --- Conclusion --- p.34 / Chapter Chapter 5: --- Summary and future development --- p.35 / References --- p.36 / List of publications --- p.42 / List of presentations at international and local conference --- p.43 / List of Awards --- p.44
84

Evaluating the effectiveness of a visual sign in reducing distraction during medication administration.

January 2008 (has links)
Kan, Ka Lai Carrie. / "May 2008." / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 118-125). / Abstracts in English and Chinese, some text in appendix also in Chinese. / Chapter CHAPTER 1: --- INTRODUCTION --- p.1 / Chapter CHAPTER 2: --- LITERATURE REVIEW / Introduction --- p.3 / Medication error --- p.4 / Definition of medication error --- p.4 / Incidents of medication error --- p.6 / The issues of defining medication error --- p.7 / The issue of medication error reporting --- p.8 / Near miss --- p.9 / Factors associated with medication error --- p.10 / System factors --- p.10 / Environmental factors --- p.12 / Human factors --- p.13 / Slips and lapses and medication error --- p.14 / "Distraction, slips and lapses and medication error" --- p.15 / Distraction --- p.15 / Definition of distraction --- p.15 / Consequences of distraction --- p.16 / Factors associated with distraction --- p.16 / Cognitive factors --- p.17 / Personality factors --- p.18 / Environmental factors --- p.18 / Studies on distraction during medication administration --- p.19 / Distraction and medication error --- p.21 / Strategies to reduce distraction --- p.22 / Visual Sign --- p.23 / Definition of visual sign --- p.23 / Nature of visual sign --- p.24 / Studies on visual sign to reduce distraction --- p.25 / Summary of literature review --- p.25 / Chapter CHAPTER 3: --- METHODOLOGY / Introduction --- p.27 / Aims and objectives --- p.27 / Operational definitions --- p.28 / Research design --- p.28 / Setting --- p.31 / Stage one --- p.32 / Setting --- p.32 / Sampling --- p.33 / Instrument --- p.35 / Data collection method --- p.36 / Data analysis --- p.37 / Stage two --- p.38 / Stage three --- p.40 / Pilot study --- p.40 / Validity and reliability of methodology --- p.41 / Interview --- p.41 / Observation --- p.42 / Ethical considerations --- p.43 / Chapter CHAPTER 4: --- FINDINGS / Introduction --- p.44 / Stage one --- p.44 / Baseline interview --- p.44 / Informants' characteristics --- p.44 / Categories and sub-categories --- p.45 / Feelings of medication error --- p.46 / Causes of medication error --- p.47 / Causes of distraction --- p.49 / Perception of distraction --- p.50 / Feelings about distraction --- p.52 / Strategies to reduce distraction --- p.53 / Strategies to reduce medication error --- p.54 / Baseline observation --- p.56 / Findings of stage one --- p.59 / Stage two --- p.60 / One week after implementation observation --- p.60 / Findings of stage two --- p.63 / Stage three / Three months after implementation observation --- p.63 / Follow-up interview --- p.66 / Informants' characteristics --- p.66 / Categories and sub-categories --- p.67 / Conflicting feelings --- p.68 / Different effects on nursing service --- p.69 / Feelings about wearing the red vest --- p.70 / Enhanced a non-distractive culture --- p.72 / Improved cognitive process --- p.73 / Improved performance --- p.75 / Findings of stage three --- p.76 / Comparison of the three stages of quantitative observational data --- p.77 / "Lapse time, items given, and number of patients" --- p.77 / Comparison of lapse time and total distraction --- p.78 / Comparison of the ten items on distraction --- p.78 / Comparison of total distraction --- p.79 / Comparison of near misses --- p.80 / Overall Summary of the findings --- p.80 / Chapter CHAPTER 5: --- DISCUSSION / Introduction --- p.82 / Characteristics of informants and observational data --- p.82 / Nurseśة perception of distraction as a cause of medication administration error --- p.83 / Causes of distraction during medication administration --- p.87 / Evaluation outcome --- p.91 / Evaluation process --- p.98 / Chapter CHAPTER 6: --- "LIMITATIONS, IMPLICATIONS AND RECOMMEDATIONS" / Limitations --- p.111 / Setting --- p.111 / Population and sampling --- p.111 / Observer's influence --- p.112 / Interviewer's influence --- p.112 / Implications for nursing practice --- p.113 / Recommendations for future studies --- p.114 / Conclusion --- p.116 / REFERENCES --- p.118 / APPENDICES / Chapter 1: --- Literature search --- p.126 / Chapter 2: --- Medication Administration Distraction Observation Sheet (MADOS) --- p.127 / Chapter 3: --- Adapted MADOS --- p.128 / Chapter 4: --- Baseline interview guide --- p.129 / Chapter 5: --- Interview consent form --- p.130 / Chapter 6: --- Observation consent form --- p.136 / Chapter 7: --- Informal letter to nursing staff --- p.142 / Chapter 8: --- Follow-up interview guide --- p.144 / Chapter 9: --- Rationale for pilot study --- p.145 / Chapter 10: --- Ethical approval (CUHK) --- p.147 / Chapter 11: --- Ethical approval ( Hospital Administrative Council) --- p.148 / Chapter 12: --- Baseline interview (1) --- p.149 / Chapter 13: --- Baseline observation (MAC 4) --- p.154 / Chapter 14: --- One week after observation (MAC 01) --- p.155 / Chapter 15: --- Three months after observation (MAC 005) --- p.156 / Chapter 16: --- Follow-up interview (08) --- p.157 / TABLES / Chapter 1: --- Different units and the approximate numbers of nurses --- p.30 / Chapter 2: --- Proposed sample size for baseline interview --- p.33 / Chapter 3. --- Medication administration at different scheduled time --- p.35 / Chapter 4. --- Informantśة characteristics at baseline interview --- p.45 / Chapter 5: --- Categories and subcategories: baseline interview --- p.46 / Chapter 6: --- "Elapse time, items given, number of patients, distractions and near misses at baseline observation" --- p.57 / Chapter 7: --- Frequency of the ten items of distraction at baseline observation --- p.57 / Chapter 8: --- Ranking of the ten items on distraction at baseline observation --- p.58
85

Comparing the effect of polyurethane endotracheal tube and polyurethane subglottic secretion drainage endotracheal tube on fluid leakage across endotracheal tube cuff as a measure for preventing microaspiration to reduce ventilator associated pneumonia: a laboratory study / CUHK electronic theses & dissertations collection

January 2015 (has links)
Chan, Wing Keung David. / Thesis D.Nurs. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 115-119). / Abstracts also in Chinese. / Title from PDF title page (viewed on 26, October, 2016).
86

Identification of ankle sprain motion from normal activities by dorsal foot kinematics data.

January 2008 (has links)
Chan, Yue Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 36-40). / Abstracts in English and Chinese. / Abstract --- p.i / Chinese abstract --- p.ii / Acknowledgement --- p.iii / Table of Contents --- p.iv / List of figures --- p.vi / List of tables --- p.vii / Chapter Chapter 1: --- Introduction --- p.1 / Chapter Chapter 2: --- Review of literature --- p.4 / Chapter 2.1 --- Chapter introduction --- p.4 / Chapter 2.2 --- Anatomy and kinematics of the ankle --- p.4 / Chapter 2.3 --- Epidemiology of ankle sprain --- p.6 / Chapter 2.4 --- Grading system for classification of ankle sprain --- p.7 / Chapter 2.5 --- Previous measures of protecting ankle from sprain injury --- p.7 / Chapter 2.6 --- Usage of motion sensors in human motion detection --- p.9 / Chapter Chapter 3: --- A mechanical supination sprain simulator for studying ankle supination sprain kinematics --- p.11 / Chapter 3.1 --- Chapter Introduction --- p.11 / Chapter 3.2 --- Methods --- p.12 / Chapter 3.3 --- Results --- p.17 / Chapter 3.4 --- Discussion --- p.17 / Chapter Chapter 4: --- Identification of simulated ankle supination sprain from other normal motions by gyrometers and accelerometers --- p.19 / Chapter 4.1 --- Chapter introduction --- p.19 / Chapter 4.2 --- Methods --- p.20 / Chapter 4.2.1 --- Data collection --- p.20 / Chapter 4.2.2 --- Support Vector Machine for classification of human motion --- p.22 / Chapter 4.2.3 --- Training the Support Vector Machine --- p.23 / Chapter 4.2.4 --- Support Vector Machine verification --- p.24 / Chapter 4.2.5 --- Choose the optimal position of motion sensor --- p.25 / Chapter 4.3 --- Results --- p.25 / Chapter 4.4 --- Discussion --- p.29 / Chapter Chapter 5: --- Summary and future development --- p.34 / References --- p.36 / List of publications --- p.41 / List of presentations at international and local conferences --- p.41 / Appendix I: --- p.42 / Related publication: / "Chan, Y. Y., Fong, D. T. P., Yung, P. S. H., Fung, K. Y., & Chan, K. M (1998). A mechanical supination sprain simulator for studying ankle supination sprain kinematics. Journal of Biomechanics. 41(11), 2571-2574." / Appendix II: --- p.46 / Ethical approval of the investigation of ankle torque and motion signal pattern in foot segment during simulate sprain and other motion
87

Inhibition of ErbB2 and Thymidylate Synthase by a Multi-Targeted Small-Interfering RNA in Human Breast Cancer Cell Lines

Hunter, Rebecca Stephanie 14 February 2008 (has links)
The therapeutic potential of a novel multi-targeted small-interfering RNA (siRNA) was investigated in human breast cancer cells. Previous studies had identified an siRNA that specifically and potently inhibited expression of thymidylate synthase (TS) by directly targeting human TS mRNA. TS is a folate-dependent enzyme that catalyzes the key reaction involved in synthesizing nucleotide precursors for DNA biosynthesis, and as such, it plays a critical role in maintaining cell growth. The goal of this thesis was to design and develop a novel siRNA molecule that targeted TS mRNA as well as a cellular mRNA that encodes a different cellular protein involved in cancer cell growth and proliferation, such as a member of the ErbB family. Gene sequence analysis was performed and identified an overlapping sequence between TS and ErbB2 mRNAs. An siRNA duplex was then designed to simultaneously target human TS and ErbB2 mRNA. Transfection of the multi-targeted siRNA (TS1M17) revealed that both ErbB2 and TS proteins were significantly suppressed in a time and dose-dependent manner in ErbB2-overexpressing human breast cancer SKBR3 cells. The corresponding mRNA levels, as determined by RT-PCR, were also decreased. Protein levels of other ErbB family members, including ErbB1 and ErbB3, remained unchanged with siRNA treatment. An ErbB2-specific siRNA (B2450) inhibited ErbB2, but had no effect on TS expression demonstrating the specificity of the multi-targeted siRNA against both TS and ErbB2. Mismatched (TS1-Mismatch) and control (GL2) siRNAs had no inhibitory effects on expression of the two target proteins. Suppression of activated ErbB2, as determined by expression of phosphorylated ErbB2 protein, was observed with transfection of TS1M17 siRNA. In addition, the expression of downstream signaling proteins, such as phosphorylated mitogen activated protein kinase (p-MAPK), p27Kip1, p21Cip1, cyclin D1, and survivin were significantly changed. In contrast, control siRNAs did not exert any inhibitory effects on downstream signaling. Taken together, these findings suggest that TS1M17 siRNA inhibits signaling of the ErbB2 pathway. The effect of TS1M17 siRNA on cytotoxicity was analyzed by WST-1 assay. Upon transfection into SKBR3 cells, the TS1M17 siRNA significantly suppressed cell proliferation with an IC50 value of 0.65 nM, which is 154-fold more potent than ErbB2- and TS-specific siRNAs. This study suggests that targeting expression of ErbB2 and TS, two key proteins involved in distinct and critical pathways for cancer growth and proliferation, with a single siRNA molecule may provide a novel approach for cancer chemotherapy.
88

Preventive Behavior for Coronary Artery Disease Among Middle Eastern Immigrants

Elkashouty, Eman Elsayed, 1956- January 1996 (has links)
No description available.
89

Associations between pain intensity, functional status, and beliefs and attitudes towards pain in people with chronic pain, after a lidocaine infusion

Masse, Julie. January 2009 (has links)
BACKGROUND: Pain intensity, functional status and beliefs and attitudes towards pain are dynamic elements involved in the experience of chronic pain. Lidocaine infusion (LI) is a therapeutic intervention used to relieve pain. OBJECTIVES: The primary objective of this study was to determine if people with chronic pain who received LI and reported a decrease in pain intensity at 4 days post-infusion differed from those who did not report a decrease in pain intensity with respect to the following: a) baseline beliefs and attitudes towards pain; b) changes in belief and attitudes towards pain; c) and changes in functional status. This study also investigated if these differences were associated with being a novel or repeat LI user. A secondary objective was to estimate the sample size required for a larger study. METHODS: This project was an exploratory study. Thirty-three subjects were monitored for pain intensity using the Visual Analogue Scale (VAS) just before the infusion, and then at four days, two weeks, and three weeks after the infusion. The subjects were separated into groups depending on the criteria of whether or not they had: a) criterion-based pain intensity decrease or not on the fourth day post infusion, and b) received a previous LI or not. Since no subjects who received their first LI reported pain intensity decrease four days later, three groups emerged from this classification: first time LI users with no pain decrease, repeat LI users with no pain decrease, and repeat LI users with pain decrease. The subjects completed two self-administered questionnaires the Survey of Pain Attitudes (SOPA-32) and the Short Musculoskeletal Function Assessment (SMFA) - before the infusion, and at two and three weeks post-infusion. The most important change at two or three weeks post-infusion was used for comparison purposes. RESULTS: No significant changes in function (SMFA) were found. However, changes in specific beliefs and attitudes towards pain (SOPA-32) were associated with the group variable as follows: 1) All three groups showed a significantly stronger belief that 'others, especially family members, should be solicitous in response to their experience of pain' after the infusion. 2) Those who received their first LI and did not report pain intensity decrease also showed a significantly stronger belief that 'medications are an appropriate treatment for chronic pain' after the infusion. 3) Subjects who had previous LI and did not report pain intensity decrease were the only ones to believe significantly less that 'medications are an appropriate treatment for chronic pain' and more 'in a medical cure for their pain problem' after the infusion. 4) Subjects who had previous LI and did report pain intensity decrease had a significantly stronger belief in the appropriateness of medications and that 'that they should avoid exercise' after the infusion. 5) Finally, subjects who believed more that 'medications are an appropriate treatment for chronic pain' and less 'that they should avoid exercise' at baseline, had significantly higher chances of experiencing decrease in pain intensity 4 days after a LI. CONCLUSION: The impact of a LI on the individuals' beliefs and attitudes towards pain differs depending if their pain intensity decreased or not four days after the infusion, and if they had previous LI or not. By contrast, their pre-infusion beliefs and attitudes profile impacts on the efficacy of this intervention. Because of the small sample size, the heterogeneity of the subjects in terms of the localization of their pain, and our choice of measurement tool, it is not possible to determine if LI impacts on function. Nevertheless, this exploratory study generated some novel observations and questions that are of great interest for future research. A particular question of interest would be to determine if repeated LI fosters a more passive attitude towards pain management. It was also determined that a sample size of 70 subjects per group would be necessary for future research on this question. / Keywords: Chronic pain, lidocaine, beliefs and attitudes towards pain, function, pain intensity.
90

Comparative numerical study of the intra-vessel flow characteristics between a flat and a cylindrical configuration in a stented wall region

Drapeau, Guy. January 2007 (has links)
Mechanical stresses and flow dynamics alteration in a stented artery region are known to stimulate intimal thickening and increase the risk of restenosis, the closure of a revascularized artery. Particle imaging velocimetry (PIV) is an optical flow visualization technique that can be used to characterize the local flow dynamics around different stent structures. However, the usual cylindrical stent geometries present visualization difficulties when using an optical measurement technique such as the PIV technique. Using a flat configuration of a stent model presents advantages over the usual cylindrical model. A planar stent model makes data acquisition easier in planes cutting through the model due to its flat geometry that is compatible with the PIV planar flow investigation technique. Furthermore, with the planar stent configuration model velocity measurements and their associated flow features can be done without inducing refraction of the laser light sheet occurring with the cylindrical model's curvature. The refraction of light should be avoided since measurement errors and reflections are the resulting effects of this laser light plane deviation when passing through the curvature of a cylindrical stent model. / The spatial and temporal distribution of the Wall Shear Stress (WSS), which is believed to be of primary importance in the development of restenosis should be comparable between the flat and the cylindrical stent configuration models. The velocity and shear strain rate distributions will be compared between the flat and cylindrical stent configurations using computational fluid dynamics (CFD) simulations in order to analyse the feasibility of using a flat instead of a cylindrical version of the stent model for PIV experiments. It will be shown that for a physiological pulsatile flow the flat model yields results in shear strain rate spatial and temporal distribution that is comparable to the cylindrical model. A more PIV compatible, efficient and less refractive error prone validated flat model would be advantageous when several stent designs influence on the local hemodynamics around the strut geometries have to be studied quantitatively and optimized.

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