University of Louisville

About: University of Louisville is a education organization based out in Louisville, Kentucky, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 24600 authors who have published 49248 publications receiving 1573346 citations. The organization is also known as: UofL.

Interventional Techniques: Evidence-based Practice Guidelines in the Management of Chronic Spinal Pain

Abstract: Background: The evidence-based practice guidelines for the management of chronic spinal pain with interventional techniques were developed to provide recommendations to clinicians in the United States. Objective: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain, utilizing all types of evidence and to apply an evidence-based approach, with broad representation by specialists from academic and clinical practices. Design: Study design consisted of formulation of essentials of guidelines and a series of potential evidence linkages representing conclusions and statements about relationships between clinical interventions and outcomes. Methods: The elements of the guideline preparation process included literature searches, literature synthesis, systematic review, consensus evaluation, open forum presentation, and blinded peer review. Methodologic quality evaluation criteria utilized included the Agency for Healthcare Research and Quality (AHRQ) criteria, Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria, and Cochrane review criteria. The designation of levels of evidence was from Level I (conclusive), Level II (strong), Level III (moderate), Level IV (limited), to Level V (indeterminate). Results: Among the diagnostic interventions, the accuracy of facet joint nerve blocks is strong in the diagnosis of lumbar and cervical facet joint pain, whereas, it is moderate in the diagnosis of thoracic facet joint pain. The evidence is strong for lumbar discography, whereas, the evidence is limited for cervical and thoracic discography. The evidence for transforaminal epidural injections or selective nerve root blocks in the preoperative evaluation of patients with negative or inconclusive imaging studies is moderate. The evidence for diagnostic sacroiliac joint injections is moderate. The evidence for therapeutic lumbar intraarticular facet injections is moderate for short-term and long-term improvement, whereas, it is limited for cervical facet joint injections. The evidence for lumbar and cervical medial branch blocks is moderate. The evidence for medial branch neurotomy is moderate. The evidence for caudal epidural steroid injections is strong for short-term relief and moderate for long-term relief in managing chronic low back and radicular pain, and limited in managing pain of postlumbar laminectomy syndrome. The evidence for interlaminar epidural steroid injections is strong for short-term relief and limited for long-term relief in managing lumbar radiculopathy, whereas, for cervical radiculopathy the evidence is moderate. The evidence for transforaminal epidural steroid injections is strong for short-term and moderate for long-term improvement in managing lumbar nerve root pain, whereas, it is moderate for cervical nerve root pain and limited in managing pain secondary to lumbar post laminectomy syndrome and spinal stenosis.

Complications and treatment of mild hypothermia

Abstract: THE combination of anesthetic-induced impairment of thermoregulatory control and exposure to a cool operating room environment makes most surgical patients hypothermic. Several prospective, randomized trials have demonstrated various hypothermia-induced complications. There is no widely accepted definition for the term mild hypothermia. Furthermore, the term is not even used consistently in the literature. For the purpose of this review, mild hypothermia refers to core temperatures between 34 and 36°C.

Alignment of the IS functions with the enterprise: toward a model of antecedents

Abstract: Identifying the best way to organize the IS functions within an enterprise has been a critical IS management issue since the mid-1980s. Yet to date, MIS researchers have offered little empirical evidence on which to base guidelines for the practitioner. This study seeks to explain a firm's IS organization design decision for a decentralized, centralized, or "hybrid" locus of responsibility from an expanded set of environmental, overall organizational, and IS-specific antecedants as well as a larger concept of organizational alignment. Potential antecedents are selected from prior contingency research and the IS literature; other variables emerge from the data collection. Data collected via on-site interviews from IS and general managers in six multi-divisional firms, paired by industry, confirm that centralized, decentralized, and hybrid IS structures exist -- but often not in ''pure'' form -- and that industry type is not a strong predictor. Data was also collected via survey form on the importance of potential antecedents for a recent IS design change in each firm. Based on both qualitative and quantitative data, four configurations are discussed; patterns of antecedents that are associated with (1) highly centralized or (2) highly decentralized IS structures; and patterns of antecdents that explain a firm's choice to (3) decentralize of (4) recentralize systems development and application planning functions in particular. A model based on these configurations is then proposed. The article concludes with implications for researchers and practioners .

Receptor and ligand domains for invasion of erythrocytes by Plasmodium falciparum

Abstract: A 175-kilodalton erythrocyte binding protein, EBA-175, of the parasite Plasmodium falciparum mediates the invasion of erythrocytes. The erythrocyte receptor for EBA-175 is dependent on sialic acid. The domain of EBA-175 that binds erythrocytes was identified as region II with the use of truncated portions of EBA-175 expressed on COS cells. Region II, which contains a cysteine-rich motif, and native EBA-175 bind specifically to glycophorin A, but not to glycophorin B, on the erythrocyte membrane. Erythrocyte recognition of EBA-175 requires both sialic acid and the peptide backbone of glycophorin A. The identification of both the receptor and ligand domains may suggest rational designs for receptor blockade and vaccines.