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Search Results: 1 - 10 of 7215 matches for " Alex Kiss "
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Newly developed histological tray for the application of identifying exact lymph node dissections in uro-logical surgical oncology  [PDF]
Istvan Buzogany, Laszlo Vaczi, Zsolt Domjan, Fariborz Bagheri, Attila Kiss, Dakay Alex, Tamas Ferenc Molnar
Health (Health) , 2013, DOI: 10.4236/health.2013.510219

In any urologic cancer surgery, lymph node dissection and its processing play a significant role in staging and management of the patients. Accordingly, precise handling of the dissected lymph nodes is important for histopathological work-up. The authors have developed a lymph node plastic tray shaping the abdomen and pelvis in which the dissected lymph nodes are placed in its determined location. This can be applied for any urologic cancer surgery. The research was designed to test the usage of a new histological tray. The objective was to assess how helpful it was for the surgical team and in the pathological process. The newly developed lymph node tray has been applied in 150 urological cancer surgeries and its efficacy and outcome have been evaluated in all these cases by involved doctors and assistants. This new tray simplifies lymph node removing and identification (staging), making it safer and quicker in any uro-oncological surgery. It facilitates the work of the pathologist and the flow of reliable information along the surgeon—pathologist-oncologist team. With usage of the tray, lymph node dissections are more structured by methodical means compared to any of the present methods.

A cluster randomized trial evaluating electronic prescribing in an ambulatory care setting
Merrick F Zwarenstein, Katie N Dainty, Sherman Quan, Alex Kiss, Neill KJ Adhikari
Trials , 2007, DOI: 10.1186/1745-6215-8-28
Abstract: This study was designed as a 65-week, cluster randomized, parallel study.The trial was conducted within ambulatory outpatient clinics in an academic tertiary care centre in Ontario, Canada. The electronic prescribing software for the study is a Canadian electronic prescribing software package which provides physician prescription entry with decision support at the point of care. Using a handheld computer (PDA) the physician selects medications using an error minimising menu-based pick list from a comprehensive drug database, create specific prescription instructions and then transmit the prescription directly and electronically to a participating pharmacy via facsimile or to the physician's printer using local area wireless technology. The unit of allocation and randomization is by 'week', i.e. the system is "on" or "off" according to the randomization scheme and the unit of analysis is the prescription, with adjustment for clustering of patients within practitioners.This paper describes the protocol for a pragmatic cluster randomized trial of point-of-care electronic prescribing, which was specifically designed to overcome the limitations associated with traditional study design.This trial has been registered with clinicaltrials.gov (ID: NCT00252395)A medication error, as defined by the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), is a preventable event that may cause or lead to inappropriate medication use or patient harm. Such events may be related to practice, products, procedures, and systems, including prescribing, order communication, product labelling, packaging, nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use [1].Medication errors, adverse drug events (ADEs), and potential adverse drug events impose substantial harms and costs on patients and the health system. The largest study [2] of the prevalence of ADEs and potential ADEs suggests rates of 6.5 ADEs and 5.5 pot
The Use of Mosquito-Net Cloths as Prosthesis in Inguinal Hernia Repair: An Experience in Southern Sudan  [PDF]
Alberto Kiss, Daniele Corona, Oscar Kiss
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.33030
Abstract: Inguinal hernia is one of the commonest medical problems in Africa and the treatment via open repair is considered as one of the most affordable and secure procedures. In the industrialized countries, the gold standard treatment is represented by placing a prosthesis which is usually a mesh, made of alloplastic material, such as polypropylene. In developing countries, a piece of nylon mosquito-net without insecticide is a cheaper and safe alternative as prosthesis. This study shows the security of implant of nylon mosquito-net in 70 patients, operated on with Lichtenstein’s tension-free technique, and performed in rural hospitals of Southern Sudan. The easy use of analyzed low-cost material and the demonstrated safety of these sterilized prostheses are two important factors that make them excellent solutions in poor and rural areas such as Southern Sudan. Objective: the aim of this article is to demonstrate that prostheses, made of well analyzed low-cost material, can be cost-effective and a valid solution for surgical inguinal hernia repair in both poor and rural developing areas.
Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status
Michelle N Grinman, Shirley Chiu, Donald A Redelmeier, Wendy Levinson, Alex Kiss, George Tolomiczenko, Laura Cowan, Stephen W Hwang
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-94
Abstract: Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses.Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)).Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status.Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals [1,2]. Substance use may increase the risk of homelessness by undermining their social ties and economic stability [3]. Drug users also suffer from numerous adverse health effects, including overdoses, psychiatric conditions, and infectious diseases [4,5].Drug use patterns vary regionally and often change over time [6]. However, few recent studies in the peer-reviewed literature have examined patterns of drug use among homeless individuals in a major Canadian city. This study's goal was to determine the prevalence and characteristics
Enhancing breast milk production with Domperidone in mothers of preterm neonates (EMPOWER trial)
Elizabeth V Asztalos, Marsha Campbell-Yeo, Orlando P daSilva, Alex Kiss, David C Knoppert, Shinya Ito
BMC Pregnancy and Childbirth , 2012, DOI: 10.1186/1471-2393-12-87
Abstract: EMPOWER is a multicenter, double masked, randomized controlled phase-II trial to evaluate the safety and effectiveness of domperidone in those mothers identified as having difficulty in breast milk production. Eligible mothers will be randomized to one of two allocated groups: Group A: domperidone 10?mg orally three times daily for 28?days; and Group B: identical placebo 10?mg orally three times daily for 14?days followed by domperidone 10?mg orally three times daily for 14?days. The primary outcome will be determined at the completion of the first 2-week period; the second 2-week period will facilitate answering the secondary questions regarding timing and duration of treatment. To detect an estimated 30% change between the two groups (from 40% to 28%, corresponding to an odds ratio of 0.6), a total sample size of 488 mothers would be required at 80% power and alpha?=?0.05. To account for a 15% dropout, this number is increased to 560 (280 per group). The duration of the trial is expected to be 36–40?months.The use of a galactogogue often becomes the measure of choice for mothers in the presence of insufficient breast milk production, particularly when the other techniques are unsuccessful. EMPOWER is designed to provide valuable information in guiding the practices for this high-risk group of infants and mothers. The results of this trial will also inform both mothers and clinicians about the choices available to increase and maintain sufficient breast milk.Clinical Trials.gov Identifier: NCT01512225Despite the recent perinatal and neonatal technological advances, at least 8.2% of births in Canada are preterm (<37?weeks gestation), a figure that has continued to rise [1,2]. The very preterm infant is often growth restricted because of the concurrent illnesses and difficulties in optimizing energy and nutrient intake for normal growth [3]. Studies have suggested that early nutritional intervention (breast milk and preterm formula) that will support growth, in parti
Feedback GAP: study protocol for a cluster-randomized trial of goal setting and action plans to increase the effectiveness of audit and feedback interventions in primary care
Noah M Ivers, Karen Tu, Jill Francis, Jan Barnsley, Baiju Shah, Ross Upshur, Alex Kiss, Jeremy M Grimshaw, Merrick Zwarenstein
Implementation Science , 2010, DOI: 10.1186/1748-5908-5-98
Abstract: Two-arm cluster trial was conducted with participating primary care practices allocated using minimization to simple feedback or enhanced feedback group. The simple feedback group receives performance feedback reports every six months for two years regarding the proportion of their patients with diabetes and/or ischemic heart disease who are meeting quality targets. The enhanced feedback group receives these same reports as well as a theory-informed worksheet designed to facilitate goal setting and action plan development in response to the feedback reports. Participants are family physicians from across Ontario who use electronic medical records; data for rostered patients are used to produce the feedback reports and for analysis.The primary disease outcomes are the blood pressure (BP), and low-density lipoprotein cholesterol (LDL) levels. The primary process measure is a composite score indicating the number of recommended activities (e.g., tests and prescriptions) conducted by the family physicians for their patients with diabetes and/or ischemic heart disease within the appropriate timeframe. Secondary outcomes are the proportion of patients whose results meet targets for glucose, LDL, and BP as well as the percent of patients receiving relevant prescriptions. A qualitative process evaluation using semi-structured interviews will explore perceived barriers to behaviour change in response to feedback reports and preferences with regard to feedback design.Intention-to-treat approach will be used to analyze the trial. Analysis will be performed on patient-level variables using generalized estimating equation models to adjust for covariates and account for the clustered nature of the data. The trial is powered to show small, but clinically important differences of 7 mmHG in systolic BP and 0.32 mmol/L in LDL.ClinicalTrials.gov NCT00996645Patients with diabetes or ischemic heart disease (IHD) are at elevated risk of cardiovascular events, especially if they have a hi
Heart and Stroke Foundation of Ontario (HSFO) high blood pressure strategy's hypertension management initiative study protocol
Sheldon W Tobe, Margaret Lum-Kwong, Nancy Perkins, Shirley Von Sychowski, Rolf J Sebaldt, Alex Kiss
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-251
Abstract: This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru ? automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs) and 1 Community Health Centre (CHC) and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150 community pharmacists across the 11 communities throughout the province of Ontario. The 11 primary care sites will be divided into immediate and delayed groups based on geography and the use of an electronic versus a traditional chart patient record.Initial consideration was given to randomizing the groups, however, for a number of reasons, this was deemed to not be possible. In order to ensure that the sites in the immediate intervention and delayed intervention groups are not different from each other, the sites will be assigned to the intervention groups manually to ensure a distribution of the variables as evenly as possible.Given that HS
Emergency department length of stay for patients requiring mechanical ventilation: a prospective observational study
Louise Rose, Sara Gray, Karen Burns, Clare Atzema, Alex Kiss, Andrew Worster, Damon C. Scales, Gordon Rubenfeld, Jacques Lee
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-30
Abstract: Prospective observational study of ED LOS for all patients receiving mechanical ventilation at four metropolitan EDs in Toronto, Canada over two six-month periods in 2009 and 2010.We identified 618 mechanically ventilated patients which represented 0.5% (95% CI 0.4%–0.5%) of all ED visits. Of these, 484 (78.3%) received invasive ventilation, 118 (19.1%) received NIV; 16 received both during the ED stay. Median Kaplan-Meier estimated duration of ED stay for all patients was 6.4?h (IQR 2.8–14.6). Patients with trauma diagnoses had a shorter median (IQR) LOS, 2.5?h (1.3–5.1), compared to ventilated patients with non-trauma diagnoses, 8.5?h (3.3–14.0) (p <0.001). Patients requiring NIV had a longer ED stay (16.6?h, 8.2–27.9) compared to those receiving invasive ventilation exclusively (4.6?h, 2.2–11.1) and patients receiving both (15.4?h, 6.4–32.6) (p <0.001). Longer ED LOS was associated with ED site and lower priority triage scores. Shorter ED LOS was associated with intubation at another ED prior to transfer.While patients requiring mechanical ventilation represent a small proportion of overall ED visits these critically ill patients frequently experienced prolonged ED stay especially those treated with NIV, assigned lower priority triage scores at ED presentation, and non-trauma patients.
Paediatric oncology in Hungary []
Kiss, Csongor
GMS Zeitschrift für Medizinische Ausbildung , 2007,
Some rare species of the genera Amphidelus and Aporcelaimellus (Nematoda: Dorylaimida) from Sas Hill, Budapest, Hungary
Kiss, M.
Opuscula Zoologica Instituti Zoosystematici et Oecologici Universitatis Budapestinensis , 2009,
Abstract: Four rare nematode species from Sas Hill in Budapest are described and illustrated. They are Amphidelus lagrecai Vinciguerra & De Francisci, 1973, Amphidelus coluber Andrássy, 1973, Aporcelaimellus alius Andrássy, 2002 and Apor ce laimellus amylovorus (Thorne & Swanger, 1936) Heyns, 1965. Of them, A. lagrecai is new to the fauna of Hungary.
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