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Chest Mar 2019Continuous renal replacement therapy (CRRT) is commonly used to provide renal support for critically ill patients with acute kidney injury, particularly patients who are... (Review)
Review
Continuous renal replacement therapy (CRRT) is commonly used to provide renal support for critically ill patients with acute kidney injury, particularly patients who are hemodynamically unstable. A variety of techniques that differ in their mode of solute clearance may be used, including continuous venovenous hemofiltration with predominantly convective solute clearance, continuous venovenous hemodialysis with predominantly diffusive solute clearance, and continuous venovenous hemodiafiltration, which combines both dialysis and hemofiltration. The present article compares CRRT with other modalities of renal support and reviews indications for initiation of renal replacement therapy, as well as dosing and technical aspects in the management of CRRT.
Topics: Acute Kidney Injury; Continuous Renal Replacement Therapy; Critical Illness; Humans; Patient Selection
PubMed: 30266628
DOI: 10.1016/j.chest.2018.09.004 -
Current Protocols in Cytometry Mar 2020In light microscopy, illuminating light is passed through the sample as uniformly as possible over the field of view. For thicker samples, where the objective lens does...
In light microscopy, illuminating light is passed through the sample as uniformly as possible over the field of view. For thicker samples, where the objective lens does not have sufficient depth of focus, light from sample planes above and below the focal plane will also be detected. The out-of-focus light will add blur to the image, reducing the resolution. In fluorescence microscopy, any dye molecules in the field of view will be stimulated, including those in out-of-focus planes. Confocal microscopy provides a means of rejecting the out-of-focus light from the detector such that it does not contribute blur to the images being collected. This technique allows for high-resolution imaging in thick tissues. In a confocal microscope, the illumination and detection optics are focused on the same diffraction-limited spot in the sample, which is the only spot imaged by the detector during a confocal scan. To generate a complete image, the spot must be moved over the sample and data collected point by point. A significant advantage of the confocal microscope is the optical sectioning provided, which allows for 3D reconstruction of a sample from high-resolution stacks of images. Several types of confocal microscopes have been developed for this purpose, and each has different advantages and disadvantages. This article provides a concise introduction to confocal microscopy. © 2019 by John Wiley & Sons, Inc.
Topics: Animals; Drosophila; HeLa Cells; Humans; Larva; Microscopy, Confocal; Microtubules; Sample Size; Time Factors
PubMed: 31876974
DOI: 10.1002/cpcy.68 -
Urologic Oncology May 2019Clinical trials organization can be daunting especially when orienting to a new system. The steps to a successful clinical trial are not concrete and vary based on the... (Review)
Review
BACKGROUND AND PURPOSE
Clinical trials organization can be daunting especially when orienting to a new system. The steps to a successful clinical trial are not concrete and vary based on the system.
METHODS
In this section the discussion centers on how to shape the question for the clinical trial which is rational and feasible to answer within the planned study design.
FINDINGS
Senior mentorship, collaboration and early involvement of stakeholders can help shape a successful clinical trial. Keeping in mind ethics and the processes within a system will make planning easier. Questions about key elements of the trial should be answered early to prevent delays of study initiation.
CONCLUSION
Clinical trial development and implementation can be very rewarding, but successful outcomes require careful planning and considerations.
Topics: Clinical Trials as Topic; Humans; Research Design
PubMed: 29395953
DOI: 10.1016/j.urolonc.2017.12.017 -
Journal of Translational Medicine Nov 2020Publishing articles in international scientific journals is the primary method for the communication of validated research findings and ideas. Journal articles are... (Review)
Review
Publishing articles in international scientific journals is the primary method for the communication of validated research findings and ideas. Journal articles are commonly used as a major input for evaluations of researchers and institutions. Few articles have been published previously about the different aspects needed for writing high-quality articles. In this manuscript, we provide an updated and brief guide for the multiple dimensions needed for writing manuscripts in the health and biological sciences, from current, international and interdisciplinary perspectives and from our expertise as authors, peer reviewers and editors. We provide key suggestions for writing major sections of the manuscript (e.g. title, abstract, introduction, methods, results and discussion), for submitting the manuscript and bring an overview of the peer review process and of the post-publication impact of the articles.
Topics: Communication; Publishing; Research Design; Writing
PubMed: 33167977
DOI: 10.1186/s12967-020-02596-2 -
Indian Journal of Dental Research :... 2017The effectiveness of ProTaper Universal and ProTaper Retreatment rotary instruments was compared to the Hedström files in the removal of filling material from root...
INTRODUCTION
The effectiveness of ProTaper Universal and ProTaper Retreatment rotary instruments was compared to the Hedström files in the removal of filling material from root canals.
MATERIALS AND METHODS
Thirty-six extracted human mandibular premolars with a single straight root canal were shaped and filled with gutta-percha and AH Plus. The specimens were stored for 6 months at 37°C and at 100% relative humidity, and then randomly divided into three groups: PTU - removal of filling material performed with ProTaper Universal instruments; PTR - removal of filling material performed with ProTaper Retreatment instruments; HF - removal of filling material performed with Gates-Glidden burs, Hedström files and solvent. After the filling material removal and diaphanization, the specimens were longitudinally sectioned and images of the canal surfaces were scanned. The remaining areas of filling material were measured (Image Tool 3.0), and data was analyzed statistically (Kruskal-Wallis and Dunn tests). The time required for filling removal in each group was also recorded (one-way ANOVA and Tukey's HSD test).
RESULTS
All groups presented remnants of filling material; PTU had the smallest amount and HF group presented the highest mean value (P< 0.05) in all the thirds. The cervical third had the smallest amount of material when compared with the other thirds (P< 0.05). HF group required a longer mean time, presenting significant difference (P< 0.05).
CONCLUSION
Considering the time required and the amount of the filling removal, ProTaper Retreatment were not superior to ProTaper Universal, but both rotary instruments were more effective and less time-consuming than Hedström manual files.
Topics: Bicuspid; Humans; In Vitro Techniques; Random Allocation; Retreatment; Root Canal Filling Materials; Root Canal Preparation; Treatment Outcome
PubMed: 28836531
DOI: 10.4103/ijdr.IJDR_89_16 -
Medical Care Jan 2022Pilot studies test the feasibility of methods and procedures to be used in larger-scale studies. Although numerous articles describe guidelines for the conduct of pilot...
BACKGROUND
Pilot studies test the feasibility of methods and procedures to be used in larger-scale studies. Although numerous articles describe guidelines for the conduct of pilot studies, few have included specific feasibility indicators or strategies for evaluating multiple aspects of feasibility. In addition, using pilot studies to estimate effect sizes to plan sample sizes for subsequent randomized controlled trials has been challenged; however, there has been little consensus on alternative strategies.
METHODS
In Section 1, specific indicators (recruitment, retention, intervention fidelity, acceptability, adherence, and engagement) are presented for feasibility assessment of data collection methods and intervention implementation. Section 1 also highlights the importance of examining feasibility when adapting an intervention tested in mainstream populations to a new more diverse group. In Section 2, statistical and design issues are presented, including sample sizes for pilot studies, estimates of minimally important differences, design effects, confidence intervals (CI) and nonparametric statistics. An in-depth treatment of the limits of effect size estimation as well as process variables is presented. Tables showing CI around parameters are provided. With small samples, effect size, completion and adherence rate estimates will have large CI.
CONCLUSION
This commentary offers examples of indicators for evaluating feasibility, and of the limits of effect size estimation in pilot studies. As demonstrated, most pilot studies should not be used to estimate effect sizes, provide power calculations for statistical tests or perform exploratory analyses of efficacy. It is hoped that these guidelines will be useful to those planning pilot/feasibility studies before a larger-scale study.
Topics: Feasibility Studies; Guidelines as Topic; Humans; Pilot Projects; Research Design
PubMed: 34812790
DOI: 10.1097/MLR.0000000000001664 -
Revista Paulista de Pediatria : Orgao... 2018To identify selection criteria for selective dorsal rhizotomy (SDR) in cerebral palsy, to analyze the instruments used for evaluation, and to describe the... (Review)
Review
OBJECTIVE
To identify selection criteria for selective dorsal rhizotomy (SDR) in cerebral palsy, to analyze the instruments used for evaluation, and to describe the characteristics of physical therapy in postoperative protocols.
DATA SOURCES
Integrative review performed in the following databases: SciELO, PEDro, Cochrane Library, and PubMed. The terms in both Portuguese and English for "cerebral palsy", "selective dorsal rhizotomy", and "physical therapy" were used in the search. Studies whose samples enrolled individuals with cerebral palsy who had attended physical therapy sessions for selective dorsal rhizotomy according to protocols and describing such protocols' characteristics were included. Literature reviews were excluded and there was no restriction as to period of publication.
DATA SYNTHESIS
Eighteen papers were selected, most of them being prospective cohort studies with eight-month to ten-year follow-ups. In most studies, the instruments of assessment encompassed the domains of functions, body structure, and activity. The percentage of posterior root sections was close to 50%. Primary indications for SDR included ambulatory spastic diplegia, presence of spasticity that interfered with mobility, good strength of lower limbs and trunk muscles, no musculoskeletal deformities, dystonia, ataxia or athetosis, and good cognitive function. Postoperative physical therapy is part of SDR treatment protocols and should be intensive and specific, being given special emphasis in the first year.
CONCLUSIONS
The studies underline the importance of appropriate patient selection to obatin success in the SDR. Postoperative physical therapy should be intensive and long-term, and must necessarily include strategies to modify the patient's former motor pattern.
Topics: Cerebral Palsy; Clinical Protocols; Humans; Patient Selection; Physical Therapy Modalities; Postoperative Care; Rhizotomy
PubMed: 29412426
DOI: 10.1590/1984-0462/;2018;36;1;00005 -
PLoS Genetics Feb 2019
Topics: Animals; Behavior, Animal; Female; Genetics, Behavioral; Humans; Male; Neurosciences; Research Design
PubMed: 30817793
DOI: 10.1371/journal.pgen.1008014 -
Journal of Medicine and Life 2021Postpartum depression is a common disabling psychosocial disorder that could have adverse effects on the life of the mother, infant, and family. The present study was... (Randomized Controlled Trial)
Randomized Controlled Trial
Postpartum depression is a common disabling psychosocial disorder that could have adverse effects on the life of the mother, infant, and family. The present study was conducted to evaluate the effect of ketamine on preventing postpartum depression in women undergoing caesarian sections considering the relatively known positive effect of ketamine on major depression. The present double-blind, randomized clinical trial was conducted on 134 women undergoing scheduled caesarian sections. Participants were randomly allocated into two groups of control and intervention. To induce anesthesia, 1-2 mg/kg of body weight of Nesdonal and 0.5 mg/kg of body weight of ketamine were used in the intervention group, while only 3-5 mg/kg of body weight Nesdonal was administered in the control group. Data were gathered using the Edinburgh Postnatal Depression Scale (EPDS) in three stages: before the caesarian section and two and four weeks after the caesarian section. Data were analyzed using variance analysis with repeated measures and the Chi-square test. Results of the present study showed that the mean (± standard deviation) of the depression score in the intervention and control groups were 13.78±3.87 and 13.79±4.78(p = 0.98) before the caesarian section, 11.82±3.41 and 14.34±4.29 (p < 0.001) two weeks after and 10.84±3.48 and 13.09±3.79 (p = 0.001) four weeks after the caesarian section, respectively. Using ketamine in the induction of general anesthesia could be effective in preventing postpartum depression. However, further studies are required to strengthen these findings.
Topics: Adult; Case-Control Studies; Depression, Postpartum; Double-Blind Method; Female; Humans; Ketamine; Mothers; Pregnancy
PubMed: 33767791
DOI: 10.25122/jml-2020-0116 -
Journal of Visualized Experiments : JoVE Jul 2016Understanding the role of factors that regulate intestinal epithelial homeostasis and response to injury and regeneration is important. The current literature describes...
Understanding the role of factors that regulate intestinal epithelial homeostasis and response to injury and regeneration is important. The current literature describes several different methodological approaches to obtain images of intestinal tissues for data validation. In this paper, we delineate a common protocol relating to the derivation and processing of mouse intestinal tissues. Proper fixation of intestinal tissues and Swiss-roll techniques that enhance intestinal epithelial morphology are discussed. Postresection processing and reorientation of embedded intestinal tissues are critical in obtaining paraffin-embedded blocks that display intact intestinal structural features after sectioning. The Swiss-rolling technique helps in histological assessment of the complete intestinal or colonic sections examined. An ability to differentiate intestinal structural features can be vital in quantitative measurements of intestinal inflammation and tumorigenesis along the entire length. Finally, paraffin-embedded sections are ideal for robust processing using both immunohistochemical and immunofluorescent detection methods. Nonfluorescent immunohistochemical sections provide a vibrant image of the tissue detailing different cellular structural features but do not provide flexibility for intracellular co-localization experiments. Multiple fluorescent channels can be appropriately utilized with immunofluorescent detection for co-localization experiments, lending support to mechanistic studies.
Topics: Animals; Colon; Fluorescent Antibody Technique; Histological Techniques; Immunohistochemistry; Intestines; Mice
PubMed: 27501188
DOI: 10.3791/54161