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Sample records for active patients younger

  1. Head and neck malignancies in younger patients

    We treated 23 (1.4% of all our primary cases) younger patients who are from 15 years old to 29 years old with head and neck malignancies at the Department of Head and Neck Surgery of the Miyagi Cancer Center Hospital for the past 12 years. There were 12 male and 11 female, and the sex ratio was approximately 1:1. There were 12 oral cancer patients, 6 epipharyngeal cancer patients and so on. There were 14 squamous cell carcinomas, 3 nasopharyngeal carcinomas and so on. 60% of all cases were squamous cell carcinomas. Clinically, advanced stage (stage III and IV) was diagnosed in 70% of patients at presentation. Although 19 patients had no past history, 2 patients had bronchial asthma, one had schizophrenia, and one had psychological disorder. Radical treatment was performed in 20 of 23 examples. The estimated Kaplan-Meier 5-year cause-specific survival rates for all patients were 76% and the 10-year cause-specific survival rates were 63%, respectively. It was thought that survival consequence was excellent in the whole. The problems of head and neck tumor treatment in a younger patient were thought about with late effect by radioactive rays and genital disorder by cancer chemotherapy. (author)

  2. Differences between younger and older patients with childhood hodgkin lymphoma.

    Pourtsidis, Apostolos; Doganis, Dimitrios; Baka, Margarita; Bouhoutsou, Despina; Varvoutsi, Maria; Synodinou, Maria; Strantzia, Katerina; Kosmidis, Helen

    2013-09-01

    From 1979 to 2006, 74 children with Hodgkin's lymphoma were treated at our center. Among them, 15 (14 boys and 1 girl) and 59 (33 boys and 26 girls) patients were younger and older than 8 years, respectively. Six (40%) children among younger patients and 26 (44%) among older patients had advanced stage disease. We detected 3 (20%) relapses among younger patients and 5 (8.5%) among the older patients. All of younger patients are alive whereas three of the older patients have died. Second malignancy developed in one and three children among younger and older patients, respectively. The only difference that was detected concerning the age was a male predominance among the younger patients. PMID:23941743

  3. Younger dialytic patients are really at risk to be not transplanted. The Tuscany experience.

    Bertoni, E; Rosati, A; Zanazzi, M; Di Maria, L; Becherelli, P; Gallo, M; Salvadori, M

    2004-01-01

    The huge increase in organ donation (27.2 pmp in 2002), that characterized our regional transplant program was mainly due to the increase of marginal (older) donors. As allocating organs coupling donor and recipient age is mandatory, aim of this study was to verify the consequences of such retrieval policy over the renal transplant activity. According our longitudinal data younger uremic patients in Tuscany waiting list for transplantation, have the lowest chance to receive kidney transplantation, mainly with respect to older patients that are easily removed from the waiting list. This unfair condition need to be corrected either by promoting living donation, either increasing cadaveric donation from younger donors. PMID:15478911

  4. Routine Activities Preceding Adolescent Sexual Abuse of Younger Children.

    Leclerc, Benoit; Felson, Marcus

    2016-03-01

    Adolescent abuse of younger children has long been recognized, but empirical research on the circumstances of this phenomenon is rare. This article examines how adolescent offenders find and gain access to victims, work out time alone with them, and set up or exploit settings for sexual contact. Prior researchers learned that adult sex offenders use certain routine activities to perform these tasks. The current research inquires whether adolescent offenders are similar. We administered Kaufman's Modus Operandi Questionnaire to a sample of 116 Canadian adolescent males undergoing treatment for a sexual offense against a child. Adolescent offenders follow routines similar to adults but are better able to use games and activities as a prelude to sexual abuse. We discuss how routine legal activities set the stage for activities and should be considered when devising situational prevention strategies. PMID:25060598

  5. Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients

    Oude Voshaar, R. C.; van der Veen, D. C.; Kapur, N.; Hunt, I.; Williams, A.; Pachana, N. A.

    2015-01-01

    Background: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. Method: A 15-y

  6. Early outcomes of colon laparoscopic resection in the elderly patients compared with the younger

    Bottino, Vincenzo; Esposito, Maria Grazia; Mottola, Arianna; Marte, Giampaolo; Di Maio, Vittorio; Sciascia, Valerio; Nunziante, Marco; Fregola, Giovanni; Cuzzovaglia, Salvatore; Galante, Francesco; Andreoli, Federica; Breglia, Alfredo; Giuliano, Maria Elena; Papaleo, Domenico; Della Rocca, Paola

    2012-01-01

    Background The aim of this study was to define any benefits in terms of early outcome for laparoscopic colectomy in patients over 75 years old (OP) compared with the outcomes of a younger populations (YP). Methods Forty elderly patients undergoing laparoscopic colectomy for colorectal cancer between 2007-2011 were studied, the patients are divided for gender, age, year of surgery, site of cancer, and comorbidity on admission and compared with 40 younger patients. Results and discussion Mean (...

  7. Oral administration and younger age decrease plasma concentrations of voriconazole in pediatric patients.

    Kato, Karin; Nagao, Miki; Yamamoto, Masaki; Matsumura, Yasufumi; Takakura, Shunji; Fukuda, Kazuhiko; Ichiyama, Satoshi

    2016-01-01

    Voriconazole is used for treating or preventing invasive aspergillosis and other invasive fungal infections. To minimize adverse reactions and to maximize treatment effects, therapeutic drug monitoring should be performed. However, it is challenging to optimize daily voriconazole dosing because limited data have been published so far on pediatric patients. We retrospectively analyzed voriconazole concentrations in patients aged 0-18 years. In addition, a literature review was conducted. In our study cohort, younger age and oral administration were significantly associated with lower plasma voriconazole concentrations (P voriconazole (P = 0.01). Reports of voriconazole administration in pediatric patients show that higher doses are required in younger children and in patients receiving oral administration. Hence, the current data suggest that we should escalate both initial and maintenance doses of voriconazole in pediatric patients, particularly in patients of younger age receiving an oral administration of voriconazole. PMID:26538245

  8. Breast cancer in 30-year-old or younger patients: clinicopathologic characteristics and prognosis

    Yao, Yongqiang; Cao, Mingqian; Fang, Hong; Xie, JiPing

    2015-01-01

    Background The number of 30-year-old or younger patients with breast cancer is increasing. The aim was to describe the clinicopathological features and prognosis of 30-year-old or younger patients with breast cancer. Methods We reviewed the records of 1,406 consecutive patients aged ≤50 years with first diagnosis of invasive breast cancer referred to surgery from March 2001 to March 2009. A total of 105 patients were aged ≤30 years (group I) and 1,301 were aged 31–50 years (group II). Results...

  9. Prospective comparison of outcomes of percutaneous nephrolithotomy in elderly patients versus younger patients

    Okeke, Zeph; Smith, Arthur D; Labate, Gaston; D'Addessi, Alessandro; Venkatesh, Ramakrishna; Assimos, Dean; Strijbos, Willem E M; de la Rosette On Behalf Of The Croes Pcnl Study Group, Jean J M C H; Osther, Palle Jørn Sloth

    2012-01-01

    Abstract Purpose: The purpose of the study was to prospectively compare operative and postoperative characteristics and outcomes in elderly patients undergoing percutaneous nephrolithotomy (PCNL) compared with younger patients. Patients and Methods: Prospectively collected data from the Clinical...... for assessing stone-free status. Patient characteristics, operative data, and postoperative outcomes were compared. Results: The median age of the elderly group vs the young group was 74 years (range 70-93 years) vs 49 years. In the unmatched analysis, staghorn stones were seen at higher rates in the...... elderly group (27.8% vs 21.8%, P=0.014); however, the mean stone size was not significantly different (465.0 vs 422.8, P=0.063). The length of hospitalization was significantly longer in the elderly group compared with the young group in the unmatched analysis (5 days vs 4.1 days, P...

  10. Comparison between surgical outcomes of colorectal cancer in younger and elderly patients

    Longxue Jin; Katsutoshi Kaneko; Norio Inoue; Naoki Sato; Susumu Matsumoto; Hitoshi Kanno; Yuko Hashimoto; Kazuhiro Tasaki; Kinya Sato; Shun Sato

    2011-01-01

    AIM: To compare the outcome of surgical treatment of colorectal adenocarcinoma in elderly and younger patients. METHODS: The outcomes of 122 patients with colorectal adenocarcinoma who underwent surgical treatment between January 2004 and June 2009 were analyzed. The clinicopathological and blood biochemistry data of the younger group (< 75 years) and the elderly group (≥ 75 years) were compared. RESULTS: There were no significant differences between the two groups in operation time, intraoperative blood loss, hospital stay, time to resumption of oral intake, or morbidity. The elderly group had a significantly higher rate of hypertension and cardiovascular disease. levels were significantly lower in the elderly than in the younger group. The serum carcinoembryonic antigen level was lower in the elderly than in the younger group, and there was a significant decreasing trend after the operation in the elderly group. CONCLUSION: The short-term outcomes of surgical treatment in elderly patients with colorectal adenocarcinoma were acceptable. Surgical treatment in elderly patients was considered a selectively effective approach.

  11. Mortality of Geriatric and Younger Patients with Schizophrenia in the Community

    Ran, Mao-Sheng; Chan, Cecilia Lai-Wan; Chen, Eric Yu-Hai; Tang, Cui-Ping; Lin, Fu-Rong; Li, Li; Li, Si-Gan; Mao, Wen-Jun; Hu, Shi-Hui; Schwab, Gerhard; Conwell, Yeates

    2008-01-01

    Little is known about the differences in mortality among non-institutionalized geriatric and younger patients with schizophrenia. In this study long-term mortality and suicidal behavior of all the geriatric (age greater than or equal to 65 years), middle-age (age 41-64 years), and young (age 15-40 years) subjects with schizophrenia living in a…

  12. Younger and older chronic somatoform pain patients in psycho-diagnostics, physician-patient relationship and treatment outcome

    Bergander Bernd; Erdur Laurence; Kallenbach-Dermutz Bettina; Deter Hans-Christian

    2013-01-01

    Abstract Introduction Patients with chronic pain are found with highly variable clinical presentation and differing physical complaints. They are seen as a heterogenic group. Based on clinical observations, elderly patients seem to differ from younger patients with chronic pain. We examined whether there were systematic differences between young and old pain patients. Methods As part of a routine evaluation of university hospital care, a newly developed psychosomatic treatment model for chron...

  13. Acute diverticulitis in younger patients: Any rationale for a different approach?

    Gil R Faria; Ana B Almeida; Herculano Moreira; Jo(a)o Pinto-de-Sousa; Pedro Correia-da-Silva; Amadeu P Pimenta

    2011-01-01

    AIM: To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently.METHODS: This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1, 2004 and December 31, 2007. Diverticulitis was stratified according to the Hinchey classification.Patients were divided into 2 populations: group A ≤50 years (n = 31); group B > 50 years (n = 126). Mean patient follow-up was 15 mo.RESULTS: The median age was 60 years. A significantly higher proportion of patients in group B presented with complicated diverticulitis (36.5% vs 12.9%,P = 0.01). Recurrence was more frequent in group A (25.8% vs 11.1%, P = 0.03) and the mean time-torecurrence was shorter (12 mo vs 28 mo, P = 0.26).The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stage Ⅰ and none of the patients required emergency surgery. In multivariate analysis, only age (P = 0.024) was identified as an independent prognostic factor for recurrence.CONCLUSION: Based on the results of this study, we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.

  14. Lower extremity venous thrombosis in patients younger than 50 years of age

    Kreidy R

    2012-03-01

    Full Text Available Raghid Kreidy1, Pascale Salameh2, Mirna Waked31Department of Vascular Surgery, Saint George Hospital, University Medical Center, University of Balamand, 2Laboratory of Clinical and Epidemiological Research, Faculty of Pharmacy, Lebanese University, 3Department of Pulmonary Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Lower extremity deep venous thrombosis in the young adult is uncommon and has not been well studied in the literature. The aim of this study is to define risk factors for deep venous thrombosis among patients younger than 50 years of age, to compare them with a control group, and to suggest recommendations for the management and treatment of venous thrombosis in this particular group of patients.Methods: From January 2003 to January 2011, 66 consecutive Lebanese patients (29 males and 37 females younger than 50 years, diagnosed in an academic tertiary-care center with lower extremity deep venous thrombosis by color flow duplex scan, were retrospectively reviewed. Their age varied between 21 and 50 years (mean 38.7 years. The control group included 217 patients (86 males and 131 females older than 50 years (range: 50–96 years; mean 72.9 years.Results: The most commonly reported risk factors in the younger age group were inherited thrombophilia (46.9% compared with 13.8% in the control group; P < 0.001, pregnancy (18.2% compared with 0.5%; P < 0.001, treatment with estrogen drugs (13.6% compared with 2.3%; P = 0.001, and family history of venous thromboembolism (9.1% compared with 3.8%; P = 0.084.Conclusion: Inherited thrombophilia is the most commonly observed risk factor among patients younger than 50 years, with a prevalence of three times more than the control group. Young adults should be screened for thrombophilia even in the presence of transient acquired risk factors. Pregnancy and treatment with estrogen drugs essentially when associated with inherited thrombophilia

  15. Leptomeningeal carcinomatosis in a younger patient with signet-ring cell carcinoma

    Kılıçkap, Saadettin; Ateş, Öztürk; Ateş, İrem Kor; Önder, Sevgen

    2011-01-01

    AbstractLeptomeningeal metastasis (LMM) occurs in about 3-8% of patients with systemic cancer. It is very rare in patients with signet-ring cell carcinoma. But, the prognosis is also very poor. We report a case of a younger woman with signet-ring cell carcinoma of primary origin unknown who presented with meningeal carcinomatosis.Keywords: Leptomeningeal metastasis; signet-ring cell carcinoma; prognosis. ÖzetLeptomenengeal metastazlar, sistemik kanserli hastaların yaklaşık %3-8’inde oluşur. B...

  16. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

    Klit, Jakob

    2013-01-01

    in younger PAO, TKA, and THA patients our aims were, to explore patient satisfaction, fulfillment of expectations, symptoms of depression, the effect on socioeconomic status, and abilities in sex-life in younger PAO, TKA, and THA patients using PROMs. These alternative endpoints were collected in...... addition to traditional measures of function and HRQoL. Our aims were: 1. To investigate the consequences of TKA, and THA treatment in younger patients in regard to patient satisfaction, expectations, symptoms of depression, socioeconomic effects, and abilities in sex-life. To generate important new...... information, important to both patients and surgeons during the decision making process prior to TKA and THA surgery. 2. To create a database that can follow this well-defined high-demanding younger patient group over years, and reveal complications and revision rates due to a higher wear in this group. To...

  17. [Intraparenchymatous hemorrhagic pathology in patients aged over seventy: a comparative study with younger subjects].

    Moltó, J M; Moreno, A; Martínez-García, F; Morales, A; Fernández-Barreiro, A

    1996-02-01

    The aim of our study was to compare a group of over 70 year-old patients suffering from spontaneous intracerebral haemorrhage with a similarly affected group under 70 years of age. With this in mind we carried out a prospective study of all patients admitted to the Neurology Service at the Virgen de la Arrixaca Hospital between March and December 1993. They totalled some 67 patients, 33 being over 70 years of age and 34 being younger than 70. Although our data clearly show that age is a factor indicative of bad prognosis, we found no other differences between these two groups which might justify these data with the exception of a greater prevalence of consciousness abnormalities at the moment of onset in those patients aged over 70. This fact, ascertained using the Canadian scale, may, we feel, be useful in dealing with patients presenting clinical pictures compatible with brain haemorrhage who attend hospitals not having computerized tomography. PMID:8714480

  18. Genetic and Prognostic Differences of Non-small Cell Lung Cancer between Elderly Patients and Younger Counterparts.

    Suda, Kenichi; Tomizawa, Kenji; Mizuuchi, Hiroshi; Ito, Simon; Kitahara, Hirokazu; Shimamatsu, Shinichiro; Kohno, Mikihiro; Yoshida, Tsukihisa; Okamoto, Tatsuro; Maehara, Yoshihiko; Yatabe, Yasushi; Mitsudomi, Tetsuya

    2012-12-01

    Many elderly patients suffer from lung cancers, but it is not clear if their lung cancers differ from those of younger patients. In this study, we compared genetic and prognostic characteristics of lung cancers of patients aged ≥75 years with those of patients aged ≤ 64 years. In the genetic analysis, we explored 292 surgically treated non-squamous cell lung cancers with known mutational status of epidermal growth factor (EGFR) and anaplastic lymphoma kinase (ALK). In the prognostic analysis, we retrospectively analyzed 405 surgically treated non-small cell lung cancers (NSCLCs) before the era of routine clinical application of post-surgical adjuvant chemotherapy. Postsurgical recurrence-free survival (RFS) was compared between elderly patients and younger counterparts. The genetic analysis showed elderly non-squamous cell lung cancer patients to have higher prevalence of EGFR mutations (53.1 % vs 42.0%, P = 0.15) and lower prevalence of the ALK translocation (0 % vs 4.5%, P = 0.23) than their younger counterparts. The prognostic analysis showed postsurgical RFS was similar between the elderly NSCLC patients and the younger patients. However in multivariate analysis, adjusting for gender, smoking status, pathological stage, and histology, elderly patients had significantly worse prognoses (HR 1.57, 95% CI, 1.08-2.29; P = 0.02) compared with younger patients. These results suggest differences in genetic and prognostic aspects between elderly lung cancer patients and younger lung cancer patients. PMID:23251849

  19. The issues of the intellectual and cognitive activity stimulation of younger pupils

    Repko I.P.

    2012-02-01

    Full Text Available Some means of stimulating the intellectual and cognitive activity of younger pupils are considered: the creation of favourable educational environment (organization of the pedagogically rational dialogue with the children; using the ways of intellectual and emotional stimulating of the pupils, the use of active teaching methods and form (methods of empathy and figurative vision, didactical games, discussions, conducting of the non standard lessons est., personality-oriented evaluation of the study-cognitive activity of pupils.

  20. Differences in dual-task performance and prefrontal cortex activation between younger and older adults

    Ohsugi Hironori; Ohgi Shohei; Shigemori Kenta; Schneider Eric B

    2013-01-01

    Abstract Background The purpose of this study was to examine task-related changes in prefrontal cortex (PFC) activity during a dual-task in both healthy young and older adults and compare patterns of activation between the age groups. We also sought to determine whether brain activation during a dual-task relates to executive/attentional function and how measured factors associated with both of these functions vary between older and younger adults. Results Thirty-five healthy volunteers (20 y...

  1. A high BMI is a risk factor in younger patients with de novo acute myelogenous leukemia.

    Crysandt, Martina; Kramer, Michael; Ehninger, Gerhard; Bornhäuser, Martin; Berdel, Wolfgang E; Serve, Hubert; Röllig, Christoph; Kaifie, Andrea; Jost, Edgar; Brummendorf, Tim H; Wilop, Stefan

    2016-07-01

    Overweight and obese patients have an increased risk to develop several malignancies and, additionally, body mass index (BMI) impacts on outcome in several solid tumors. However, little is known for AML. We analyzed a cohort of 3526 patients with AML treated in three prospective multicenter trials within the German Study Alliance Leukemia. In multivariate analyses, we identified BMI as an independent risk factor for both DFS (HR 1.014, P = 0.0217) and OS (HR 1.015, P AML younger than 65 yr with intermediate risk and adverse cytogenetics. Overweight with a BMI ≥25 kg/m² best discriminated the worse outcome and led to an absolute reduction in long-term survival of 5-7% in the group of all younger patients (3-yr OS 39.9% vs. 47.3%; 10-yr OS 28.7% vs. 33.8%, P = 0.0002). Additionally, response to induction therapy was significantly reduced in these patients (76.9% vs. 82.8%, P AML, overweight and obesity are risk factors for impaired response to induction therapy, DFS and OS. This effect is, in part but not fully, explained by dose reduction such as dose-capping at a body surface area of 2 m². PMID:26277604

  2. Differences in dual-task performance and prefrontal cortex activation between younger and older adults

    Ohsugi Hironori

    2013-01-01

    Full Text Available Abstract Background The purpose of this study was to examine task-related changes in prefrontal cortex (PFC activity during a dual-task in both healthy young and older adults and compare patterns of activation between the age groups. We also sought to determine whether brain activation during a dual-task relates to executive/attentional function and how measured factors associated with both of these functions vary between older and younger adults. Results Thirty-five healthy volunteers (20 young and 15 elderly participated in this study. Near-infrared spectroscopy (NIRS was employed to measure PFC activation during a single-task (performing calculations or stepping and dual-task (performing both single-tasks at once. Cognitive function was assessed in the older patients with the Trail-making test part B (TMT-B. Major outcomes were task performance, brain activation during task (oxygenated haemoglobin: Oxy-Hb measured by NIRS, and TMT-B score. Mixed ANOVAs were used to compare task factors and age groups in task performance. Mixed ANOVAs also compared task factors, age group and time factors in task-induced changes in measured Oxy-Hb. Among the older participants, correlations between the TMT-B score and Oxy-Hb values measured in each single-task and in the dual-task were examined using a Pearson correlation coefficient. Oxy-Hb values were significantly increased in both the calculation task and the dual-task within patients in both age groups. However, the Oxy-Hb values associated with there were higher in the older group during the post-task period for the dual-task. Also, there were significant negative correlations between both task-performance accuracy and Oxy-Hb values during the dual-task and participant TMT-B scores. Conclusions Older adults demonstrated age-specific PFC activation in response to dual-task challenge. There was also a significant negative correlation between PFC activation during dual-task and executive

  3. Increase in head and neck cancer in younger patients due to human papillomavirus (HPV).

    Young, David; Xiao, Christopher C; Murphy, Benjamin; Moore, Michael; Fakhry, Carole; Day, Terry A

    2015-08-01

    The face of head and neck cancer has changed dramatically over the past 30 years. There has been a steady decline in the number of tobacco and alcohol related squamous cell carcinomas over the past 30 years, but and increasing incidence of human papillomavirus (HPV) related cancers. Some estimates suggest that 70-90% of new oropharyngeal cancers have evidence of HPV. These patients have different demographic patterns, in that they are more likely to be younger, white adults in their 40s and 50s who are never smokers or have reduced tobacco exposure. Studies have shown that a higher number of lifetime oral sex partners (>5) and a higher number of lifetime vaginal sex partners (>25) have been associated with increased risk of HPV positive head and neck cancer. People can also reduce their risk of HPV linked head and neck cancer by receiving the HPV vaccine series prior to becoming sexually active. Recent evidence suggests HPV related head and neck cancers present with different symptoms than those caused by tobacco. The most popular test for HPV status is the p16 immunohistochemical stain because it is cheap, simple, and studies have shown it to have comparable sensitivity and specificity to the previous standards. It is widely recommended that all cancers of the oropharynx be tested for the presence of HPV, and some recommend it for all head and neck cancers. Overall 2-year and 5-year survival for HPV positive head and neck cancer is significantly greater than for HPV negative cancers, likely due to HPV positive cancers being more responsive to treatment. PMID:26066977

  4. Of learning motivation of younger schoolboys to technical activities by means of educational robotics

    Vera Sinebruhova; Aliya Mamedova

    2015-01-01

    This article deals with the problem of formation of educational motivation of younger students to the tech-nical activities of educational robotics means. The article covers the main provisions of learning motivation in children of primary school age, especially of the subject "Technology" for primary school results marked the initial diagnosis of the level of development in primary school children learning motivation to technical activities, as well as the potential of educational robotics i...

  5. Coaching Younger Practitioners and Students Using Components of the Co-Active Coaching Model

    Tofade, Toyin

    2010-01-01

    Coaching is used to improve performance, achieve preset goals and obtain desired results. Several coaching models have been used in health professions for leadership and professional development. This article describes some components of Co-Active Coaching® that can be applied while coaching pharmacy students and younger practitioners. Co-Active Coaching requires the coach to use a broad range of communication skills, including listening, asking powerful questions, making insightful comments,...

  6. Hormone therapy affects plasma measures of factor VII-activating protease in younger postmenopausal women

    Mathiasen, Jørn Sidelmann; Skouby, S.O.; Vitzthum, F.; Schwarz, H.; Jespersen, J.

    2010-01-01

    for the determination of FSAP antigen and FSAP activity. Results The FSAP measures were comparable at baseline. No significant changes were observed in the control group after 12 months. HT in general induced a significant increase in FSAP antigen (7.7 mu g/ml at baseline and 8.0 mu g/ml after 12...... induced by HT in younger postmenopausal women...

  7. Total Knee Arthroplasty in Younger Patients Evaluated by Alternative Outcome Measures

    Klit, Jakob; Jacobsen, Steffen; Rosenlund, Signe; Sonne-Holm, Stig; Troelsen, Anders

    2014-01-01

    sexual life. Questionnaires including Oxford Knee Score (OKS) and SF-36 were evaluated preoperatively and three, six, and twelve months postoperatively. OKS and SF-36 showed significant improvements. However, patient satisfaction and fulfillment of personal expectations did not reflect these scores......In this prospective multicenter study we included subjects younger than 60 years of age and scheduled for primary total knee arthroplasty (TKA). The study assessed patients’ overall satisfaction, fulfillment of pre-operative expectations, the effect on socioeconomic parameters, and quality of....... Overall, TKA did not affect the patients’ socioeconomic status, and overall, patients did not experience impairment of sexual life, but decreased frequency and negative affection of sexual practice should be anticipated. Alternative outcome measurements of TKA surgery not focusing on implants and surgical...

  8. Coaching younger practitioners and students using components of the co-active coaching model.

    Tofade, Toyin

    2010-04-12

    Coaching is used to improve performance, achieve preset goals and obtain desired results. Several coaching models have been used in health professions for leadership and professional development. This article describes some components of Co-Active Coaching(R) that can be applied while coaching pharmacy students and younger practitioners. Co-Active Coaching requires the coach to use a broad range of communication skills, including listening, asking powerful questions, making insightful comments, offering encouragement, and giving sincere praise. The characteristics of the ideal candidate for coaching and the value of coaching are also discussed. PMID:20498744

  9. Assessing Compliance With Mercaptopurine Treatment in Younger Patients With Acute Lymphoblastic Leukemia in First Remission | Division of Cancer Prevention

    This randomized phase III trial studies compliance to a mercaptopurine treatment intervention compared to standard of care in younger patients with acute lymphoblastic leukemia in remission. Assessing ways to help patients who have acute lymphoblastic leukemia to take their medications as prescribed may help them in taking their medications more consistently and may improve treatment outcomes. |

  10. Genetic and Prognostic Differences of Non-small Cell Lung Cancer between Elderly Patients and Younger Counterparts

    Suda, Kenichi; Tomizawa, Kenji; Mizuuchi, Hiroshi; Ito, Simon; Kitahara, Hirokazu; Shimamatsu, Shinichiro; Kohno, Mikihiro; Yoshida, Tsukihisa; Okamoto, Tatsuro; Maehara, Yoshihiko; Yatabe, Yasushi; Mitsudomi, Tetsuya

    2012-01-01

    Many elderly patients suffer from lung cancers, but it is not clear if their lung cancers differ from those of younger patients. In this study, we compared genetic and prognostic characteristics of lung cancers of patients aged ≥75 years with those of patients aged ≤ 64 years. In the genetic analysis, we explored 292 surgically treated non-squamous cell lung cancers with known mutational status of epidermal growth factor (EGFR) and anaplastic lymphoma kinase (ALK). In the prognostic analysis,...

  11. Survival and tolerability of liver radioembolization: a comparison of elderly and younger patients with metastatic colorectal cancer

    Tohme, Samer; Sukato, Daniel; Nace, Gary W; Zajko, Albert; Amesur, Nikhil; Orons, Philip; Chalhoub, Didier; Marsh, James W; Geller, David A; Tsung, Allan

    2014-01-01

    Aim To evaluate the outcomes among elderly (≥70 years) and younger patients (<70 years) with liver-dominant metastatic colorectal cancer (mCRC) who received radioembolization (RE) as salvage therapy. Methods A retrospective review of 107 consecutive patients with unresectable mCRC treated with RE after failing first- and second-line chemotherapy. Results From 2002 to 2012, 44 elderly and 63 younger (<70 years) patients received RE. Patients had similar previous extensive chemotherapy and liver-directed interventions. Using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria, either a stable or a partial radiographical response was seen in 65.8% of the younger compared with 76.5% of the elderly patients. RE was equally well tolerated in both groups and common procedure-related adverse events were predominantly grade 1–2 and of short duration. No significant difference was found with regard to overall median survival between younger [8.4 months; 95% confidence interval (CI) = 6.2–10.6] or elderly patients (8.2 months; 95% CI = 5.9–10.5, P = 0.667). The presence of extrahepatic disease at the time of RE was associated with a significantly worse median survival in both groups. Conclusion Radioembolization appears to be as well tolerated and effective for the elderly as it is for younger patients with mCRC. Age alone should not be a discriminating factor for the use of radioembolization in the management of mCRC patients. PMID:25123597

  12. Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

    Marius Dettmer

    2015-01-01

    Full Text Available Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS from a young group of patients (n=52, age 48.9 ± 6.1 years who had received hip resurfacing (HR with a cohort of patients (n=73, age 48.2 ± 6.6 years who had received neck-preserving, short-stem implant total hip arthroplasty (THA. Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year in both groups (p<0.0001, η2=0.69; there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8 than MiniHip surgery (62.5 min ± 14.8, U=85.0, p<0.0001, η2=0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs.

  13. A comparison of activity classification in younger and older cohorts using a smartphone

    Automatic recognition of human activity is useful as a means of estimating energy expenditure and has potential for use in fall detection and prediction. The emergence of the smartphone as a ubiquitous device presents an opportunity to utilize its embedded sensors, computational power and data connectivity as a platform for continuous health monitoring. In the study described herein, 37 older people (83.9  ±  3.4 years) performed a series of activities of daily living (ADLs) while a smartphone (containing a triaxial accelerometer, triaxial gyroscope and barometric pressure sensor) was placed in the front pocket of their trousers. These results are compared to a similar trial conducted previously in which 20 young people (21.9  ±  1.65 years) were asked to perform the same ADLs using the same smartphone (again in the front pocket of their trousers). In each trial, the participants were asked to perform several activities (standing, sitting, lying, walking on level ground, up and down staircases, and riding an elevator up and down) in a free-living environment. During each acquisition session, the internal sensor signals were recorded and subsequently used to develop activity classifiers based on a decision tree algorithm that classified ADL in epochs of ∼1.25 s. When training and testing with the younger cohort, using a leave-one-out cross validation procedure, a total classification sensitivity of 80.9% ± 9.57% (κ = 0.75  ±  0.12) was obtained. Retraining and testing on the older cohort, again using cross validation, gives a comparable total class sensitivity of 82.0% ± 8.88% (κ =0.74  ±  0.12). When trained with the younger group and tested on the older group, a total class sensitivity of 69.2% ± 24.8% (95% confidence interval [69.6%, 70.6%]) and κ = 0.60  ±  0.27 (95% confidence interval [0.58, 0.59]) was obtained. When trained on the older group and tested on the younger group, a total class sensitivity of

  14. Being 40 or younger is an independent risk factor for relapse in operable breast cancer patients: The Saudi Arabia experience

    Breast cancer in young Saudi women is a crucial problem. According to the 2002 annual report of Saudi National Cancer Registry, breast cancers that developed before the age of 40 comprise 26.4% of all female breast cancers comparing to 6.5% in the USA. Breast cancer in young patients is often associated with a poorer prognosis, but there has been a scarcity of published data in the Middle East population. Total of 867 breast cancer patients seen at King Faisal Specialist Hospital & Research Centre (KFSH&RC) between 1986 and 2002 were reviewed. Patients were divided in two age groups: ≤ 40 years and above 40 years. The clinicopathological characteristics and treatment outcomes were compared between younger and older age groups. Median age at presentation was 45 years. A total of 288 (33.2%) patients were aged ≤ 40 years. Hormone receptors were positive in 69% of patients 40 and 78.2% of patients above 40 (p = 0.009). There was a significantly higher incidence of grade III tumor in younger patients compared to older patients (p = 0.0006). Stage, tumor size, lymphatic/vascular invasion, number of nodes and axillary lymph node status, did not differ significantly between the two age groups. Younger patients had a greater probability of recurrence at all time periods (p = 0.035). Young age had a negative impact on survival of patients with positive axillary lymph nodes (p = 0.030) but not on survival of patients with negative lymph nodes (p = 0.695). Stage, tumor size, nodal status and hormonal receptors had negative impact on survival. Adjuvant chemotherapy was administered to 87.9% of younger and 65.6% of older patients (p < 0.0001). In terms of hormone therapy, the proportion of tamoxifen treated patients was significantly lower in young age group (p < 0.0001). No significant difference in radiation therapy between the two groups. Young age (≤ 40) is an independent risk factor for relapse in operable Saudi breast cancer patients. The fundamental biology of

  15. Pain, distress, and anticipated recovery for older versus younger emergency department patients after motor vehicle collision

    Pereira, Gregory F; McLean, Samuel A.; Tkacik, Thomas J; Swor, Robert A; Jones, Jeffrey S.; Lee, David C; Peak, David A.; Domeier, Robert M.; Rathlev, Niels K.; Hendry, Phyllis L.; Platts-Mills, Timothy F.

    2014-01-01

    Background Motor vehicle collisions (MVCs) are the second most common injury mechanism resulting in emergency department (ED) visits by older adults. MVCs result in substantial pain and psychological distress among younger individuals, but little is known about the occurrence of these symptoms in older individuals. We describe the frequency of and characteristics associated with pain, distress, and anticipated time for physical and emotional recovery for older adults presenting to the ED afte...

  16. A pilot study assessing social support among cancer patients enrolled on clinical trials: a comparison of younger versus older adults

    Paul J Novotny

    2010-05-01

    Full Text Available Paul J Novotny1, Denise J Smith1, Lorna Guse2, Teresa A Rummans3, Lynn Hartmann4, Steven Alberts4, Richard Goldberg5, David Gregory6, Mary Johnson7, Jeff A Sloan11Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 2Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada; 3Psychiatry, Mayo Clinic, Rochester, MN, USA; 4Medical Oncology, Mayo Clinic, Rochester, MN, USA; 5Oncology Services, University of North Carolina, Chapel Hill, NC, USA; 6Faculty of Health Sciences Nursing, University of Lethbridge, Lethbridge, Alberta, Canada; 7Chaplain Services, Mayo Clinic, Rochester, MN, USAPurpose: This study tested the logistical feasibility of obtaining data on social support systems from cancer patients enrolled on clinical trials and compared the social support of older adults (age ≥65 and younger adults (<50 years of age with cancer.Methods: Patients had to be eligible for a phase II or phase III oncology clinical trial and enter the study prior to treatment. Patients filled out the Lubben Social Network Scale (LSNS at baseline. The Symptom Distress Scale (SDS and single-item overall quality of life (QOL Uniscale were assessed at baseline and weekly for 4 weeks.Results: There was no significant difference in overall mean Lubben social support levels by age. Older patients had more relatives they felt close to (85% versus 53% with 5 or more relatives, P = 0.02, heard from more friends monthly (84% versus 53% with 3 or more friends, P = 0.02, less overall symptom distress (P = 0.03, less insomnia (P = 0.003, better concentration (P = 0.005, better outlook (P = 0.01, and less depression (P = 0.005 than younger patients.Conclusions: Younger subjects reported worse symptoms, a smaller social support network, and fewer close friends and relatives than older subjects. Having someone to discuss decisions and seeing friends or relatives often was associated with longer survival. Keywords: social support, Lubben scale, QOL, elderly

  17. Reduced solar activity as a trigger for the start of the Younger Dryas?

    Renssen, H; van Geel, B; van der Plicht, J; Magny, M

    2000-01-01

    It is generally assumed that changes in ocean circulation forced the abrupt climate changes during the Late Pleistocene, including the Younger Dryas event. Recently, however, it was proposed that variations in solar irradiance could have played a much more prominent role in forcing Pleistocene clima

  18. Computed tomography-guided percutaneous radiofrequency thermocoagulation for primary trigeminal neuralgia in older and younger patients

    Guanghui Lai; Jiaxiang Ni; Baishan Wu; Mingwei He; Liqiang Yang; Jianning Yue; Yuna Guo

    2011-01-01

    We evaluated the immediate and long-term clinical efficacy of computed tomography (CT)-guided radiofrequency thermocoagulation for primary trigeminal neuralgia (RTPTN) in 852 patients includ-ing 502 patients aged ≥ 60 years and 350 patients aged < 60 years. After discharge, the incidence of complications was 1.0% and 0.9% in patients aged ≥ 60 years and patients aged < 60 years, respectively. Over 3-year follow-up after CT-guided RTPTN, 96.8% of the patients aged ≥ 60 years and 98.6% of the patients aged < 60 years were completely pain-free, and there was no significant difference between these two age brackets. In addition, there were no significant differences in quality of life scores and numbness scores between these two age brackets. These findings suggest that CT-guided RTPTN is a safe and effective method and is recommended for older and poor-risk patients.

  19. Mainly the younger hypothyroid patients are referred to hospital - Evidence for referral bias

    Carle, Allan; Laurberg, Peter; Pedersen, Inge Bülow;

    2009-01-01

    Objective: Studies of hypothyroidism are often based on patients referred to hospital. It is unknown, to what extent such studies are referral biased. Thus, the aim of the present study was to evaluate the magnitude of selection bias in a study of patients newly diagnosed with hypothyroidism. Study....... Among patient characteristics recorded at the time of diagnosis-age, gender, nosological subgroup of hypothyroidism, thyroid stimulating hormone (TSH), total thyroxine (T4), total triiodothyronine (T3), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and calendar year-we searched for......, referral bias should always be considered in hospital-based studies of hypothyroid patients....

  20. Use of Rate- and Rhythm-Control Drugs in Patients Younger than 65 Years with Atrial Fibrillation

    Nancy M. Allen LaPointe; Yuliya Lokhnygina; Jacqueline Rimmler; Gillian D. Sanders; Eric D. Peterson; Sana M. Al-Khatib

    2014-06-01

    Full Text Available Little is known about the use of pharmacologic rhythm or rate control in younger atrial fibrillation (AF patients in clinical practice. Using commercial health data from 2006 through 2010, patients aged <65 years with an initial AF encounter were categorized as receiving pharmacologic rhythm- or rate-control treatment. Factors associated with each treatment were determined. Cox models with inverse propensity-weighted estimators were used to compare times to AF, heart failure, cardiovascular, non-cardiovascular, and any-cause hospitalizations. Of 79,232 patients meeting the study criteria, 12,408 (16% received a rhythm-control drug and 66,824 (84% received only rate-controlling drugs. Only 2% and 0.1%, respectively, received electrical cardioversion and AF ablation during the initial AF encounter. Patients who were men (OR 1.10, 95% CI 1.06–1.15, had index encounters in later years (2010 versus 2006: OR 1.34, 95% CI 1.23–1.45, were in the southern United States, and had other cardiac comorbidities were more likely to receive a rhythm-control drug. There was a greater risk of AF (HR 1.40, 95% CI 1.31–1.50, cardiovascular (HR 1.26, 95% CI 1.20–1.33, and all-cause (HR 1.11, 95% CI 1.07–1.16 hospitalizations in the rhythm-control group, but there was no difference between groups in heart failure (HR 1.01, 95% CI 0.88–1.17 or non-cardiovascular (HR 1.04, 95% CI 0.99–1.09 hospitalizations. Among younger AF patients receiving initial pharmacologic treatment, antiarrhythmic drugs were used less frequently than only rate-controlling drugs, and were associated with a higher risk of subsequent hospitalization.

  1. Nonapnea Sleep Disorders in Patients Younger than 65 Years Are Significantly Associated with CKD: A Nationwide Population-Based Study.

    Hugo You-Hsien Lin

    Full Text Available Nonapnea sleep disorders (NASD and sleep-related problems are associated with poor health outcomes. However, the association between NASD and the development and prognosis of chronic kidney disease (CKD has not been investigated thoroughly. We explored the association between CKD and NASD in Taiwan.We conducted a population-based study using the Taiwan National Health Insurance database with1,000,000 representative data for the period from January 1, 2000 to December 31, 2009. We investigated the incidence and risk of CKD in 7,006 newly diagnosed NASD cases compared with 21,018 people without NASD matched according to age, sex, index year, urbanization, region, and monthly income at a 1:3 ratio.The subsequent risk of CKD was 1.48-foldhigher in the NASD cohort than in the control cohort (95% confidence interval [CI] = 1.26-1.73, p< 0.001. Men, older age, type 2 diabetes mellitus, and gout were significant factors associated with the increased risk of CKD (p< 0.001. Among different types of NASDs, patients with insomnia had a 52% increased risk of developing CKD (95%CI = 1.23-1.84; P<0.01, whereas patients with sleep disturbance had a 49%increased risk of subsequent CKD (95% CI = 1.19-1.87; P<0.001. Younger women (aged < 65 years were at a high risk of CKD with NASD (adjusted hazard ratio, [HR] = 1.81; 95% CI = 1.35-2.40, p< 0.001.In this nationwide population-based cohort study, patients with NASD, particularly men of all ages and women aged younger than 65 years, were at high risk of CKD.

  2. A cohort study on the evolution of psychosocial problems in older patients with breast or colorectal cancer: comparison with younger cancer patients and older primary care patients without cancer

    Deckx, Laura; van Abbema, Doris L.; van den Akker, Marjan; Van Den Broeke, Carine; van Driel, Mieke; Bulens, Paul; Tjan-Heijnen, Vivianne C. G.; Kenis, Cindy; de Jonge, Eric T.; Houben, Bert; Buntinx, Frank

    2015-01-01

    Background Although older cancer survivors commonly report psychosocial problems, the impact of both cancer and ageing on the occurrence of these problems remains largely unknown. The evolution of depression, cognitive functioning, and fatigue was evaluated in a group of older cancer patients in comparison with a group of younger cancer patients and older persons without cancer. Methods Older (≥70 years) and younger cancer patients (50 – 69 years) with breast or colorectal cancer stage I - II...

  3. Comparison of Outcome of Femoral Shaft Fracture Fixation with Intramedullary Nail in Elderly Patient and Patients Younger than 60 Years Old

    Asgar Elmi

    2014-06-01

    Full Text Available Background:   Although intramedullary nailing (IMN is an established and accepted operative treatment for femoral shaft fracture in patients younger than 60, there is a lack of data on the results of this treatment on those over 60. The purpose of this study was to determine if the outcome of IMN for femoral shaft fracture in elderly patients is also acceptable. Particular challenges in this group of patients included osteopenia and other associated multiple medical problems frequently observed. Methods: The outcome of 84 patients who had IMN for femoral shaft fracture was reviewed and the results were compared between two groups of patients (younger than 60 and over 60 year old patients. Complications and mortality was analyzed for each group, and then compared between the two groups by testing the null hypothesis that the outcome of treatment in the two groups are similar (P>0.05. Results: The mean duration of follow up was 57.3 months (range: 10-94 months. Incidence of malunion, nonunion, infection, DVT, and dependence on walker/crutch in the groups were similar and differences were not significant (P>0.05. However, incidence of mortality (P

  4. Molecular characteristics of erythromycin-resistant Streptococcus pneumoniae from pediatric patients younger than five years in Beijing, 2010

    Zhou Lin

    2012-10-01

    Full Text Available Abstract Background Streptococcus pneumoniae is the main pathogen that causes respiratory infections in children younger than five years. The increasing incidence of macrolide- and tetracycline-resistant pneumococci among children has been a serious problem in China for many years. The molecular characteristics of erythromycin-resistant pneumococcal isolates that were collected from pediatric patients younger than five years in Beijing in 2010 were analyzed in this study. Results A total of 140 pneumococcal isolates were collected. The resistance rates of all isolates to erythromycin and tetracycline were 96.4% and 79.3%, respectively. Of the 135 erythromycin-resistant pneumococci, 91.1% were non-susceptible to tetracycline. In addition, 30.4% of the erythromycin-resistant isolates expressed both the ermB and mef genes, whereas 69.6% expressed the ermB gene but not the mef gene. Up to 98.5% of the resistant isolates exhibited the cMLSB phenotype, and Tn6002 was the most common transposon present in approximately 56.3% of the resistant isolates, followed by Tn2010, with a proportion of 28.9%. The dominant sequence types (STs in all erythromycin-resistant S. pneumoniae were ST271 (11.9%, ST81 (8.9%, ST876 (8.9%, and ST320 (6.7%, whereas the prevailing serotypes were 19F (19.3%, 23F (9.6%, 14 (9.6%, 15 (8.9%, and 6A (7.4%. The 7-valent pneumococcal conjugate vaccine (PCV7 and 13-valent pneumococcal conjugate vaccine (PCV13 coverage of the erythromycin-resistant pneumococci among the children younger than five years were 45.2% and 62.2%, respectively. ST320 and serotype 19A pneumococci were common in children aged 0 to 2 years. CC271 was the most frequent clonal complex (CC, which accounts for 24.4% of all erythromycin-resistant isolates. Conclusions The non-invasive S. pneumoniae in children younger than five years in Beijing presented high and significant resistance rates to erythromycin and tetracycline. The expressions of ermB and tetM genes

  5. Pancreatic-specific autoantibodies to glycoprotein 2 mirror disease location and behaviour in younger patients with Crohn’s disease

    Bogdanos Dimitrios P

    2012-08-01

    Full Text Available Abstract Background Glycoprotein 2 (GP2 was discovered as the major autoantigen of Crohn’s disease (CD-specific pancreatic autoantibodies (PAB. We investigated anti-GP2 IgA and IgG antibodies as novel serological parameters in CD and assessed their association with distinct disease phenotypes. Methods Anti-GP2 and anti-Saccharomyces cerevisiae (ASCA IgA and IgG were detected by ELISA employing recombinant human GP2 and phosphopeptidomannan, respectively and PAB by indirect immunofluorescence (IIF in 271 sera, 169 with CD and 102 with ulcerative colitis (UC. As healthy controls 160 adult blood donors and 65 children were included. Results Anti-GP2 IgG and/or IgA were more prevalent in CD (51/169, 30.2% than in UC (9/102, 8.9% patients and in controls (9/225, 4% (p  Conclusions Anti-GP2 IgG and IgA, constituting novel CD specific autoantibodies, appear to be associated with distinct disease phenotypes identifying patients at a younger age, with ileocolonic location, and stricturing behaviour with perianal disease.

  6. Radio(chemo)therapy in Elderly Patients with Esophageal Cancer: A Feasible Treatment with an Outcome Consistent with Younger Patients

    PhilippeRochigneux

    2014-01-01

    Background: Although the prevalence of esophageal cancer increases in elderly patients, its clinical history and outcome after treatment remain poorly described. Methods: Between January 2001 and December 2011, 58 patients (pts) older than 75 years received 3D-conformal radiotherapy (mean dose 51 Gy) in two French cancer centers. 47/58 (82%) patients received concomitant chemotherapy (with CDDP and/or FU regimens) and 8 patients underwent surgery after primary radiochemotherapy (RCT). R...

  7. Outcome and survival of patients aged 75 years and older compared to younger patients after ruptured abdominal aortic aneurysm repair: do the results justify the effort?

    Shahidi, S; Schroeder, T Veith; Carstensen, M.;

    2009-01-01

    were also performed with the variables that were found to be significant in the univariate analysis. Health economy and cost analysis for the two groups were estimated. Out of 72 open repairs of RAAA, 44 patients (61%) were under 75 years of age and 28 (39%) were 75 years or older. The average age of...... elderly because of the increased incidence of surgical risk factors and hospital mortality in this subset of patients (cut-off age). Demographic, clinical, and operative factors were analyzed together with 30-day mortality. Univariate analysis was performed with the chi-squared test. Multivariate analyses......%-33%) of 44 younger patients (p < 0.001). An age of 75 years or older and a serum creatinine >or=0.150 mmol/L in elderly patients with RAAA (p < 0.01) were identified to be significant risk factors for operative mortality. We did not encounter significant differences in the distribution of other risk...

  8. Age-Related Differences in the Effect of Psychological Distress on Mortality: Type D Personality in Younger versus Older Patients with Cardiac Arrhythmias

    Johan Denollet

    2013-01-01

    Full Text Available Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14 was used to assess general psychological distress in 455 younger (≤70 y,. Cardiac resynchronization therapy (CRT, but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34 and 2.26 (95% CI 1.16–4.41 for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.

  9. Links between Older and Younger Adolescent Siblings' Adjustment: The Moderating Role of Shared Activities

    Tucker, Corinna Jenkins; McHale, Susan M.; Crouter, Ann C.

    2008-01-01

    Siblings' constructive and unstructured shared activities were examined as moderators of the links between first- and second-born siblings' adjustment across a two-year period in adolescence. Siblings (N = 189 dyads) reported on their depression, peer competency, self worth during home interviews, and their time together in constructive (e.g.,…

  10. Short-term Outcomes and Mid-term Follow-up After Coronary Angioplasty in Patients Younger Than 40 Years of Age

    Hamidreza Poorhosseini; Saeed Sadeghian; Ebrahim Nematipour; Alimohammad Haji Zeinali; Mojtaba Salarifar; Mohammad Alidoosti; Seyed Ebrahim Kassaian; Leila Pirzadeh; Hamidreza Goodarzynejad; Ahmad Sharafi

    2007-01-01

    Background: Stenting is currently the standard of care in percutaneous coronary intervention (PCI). Whether young patients remain at increased risk after PCI in the present stent era has not been investigated widely. We evaluated angiographic characteristics and short- and mid-term outcomes in patients younger than 40 years of age who underwent PCI. Methods: From April 2003 to March 2005, prospective data were collected in 118 consecutive patients, who were less than 40 years of age and under...

  11. Fourth-generation ceramic-on-ceramic total hip arthroplasty in patients of 55 years or younger: short-term results and complications analysis

    Wang Weiguo; Guo Wanshou; Yue Debo; Shi Zhencai; Zhang Nianfei; Liu Zhaohui; Sun Wei

    2014-01-01

    Background The incidence of total hip replacement in the younger and more active patients is ever increasing.The ceramic-on-ceramic (COC) bearing was developed to reduce wear debris-induced osteolysis and loosening and to improve the longevity of hip arthroplasties.Few studies have reported the clinical results and complications of the new zirconia-toughened ceramic total hip arthroplasty (THA).Methods A consecutive series of 132 young patients (177 hips) that underwent primary cementless THAs between January 2010 and December 2012 were included in this study.These arthroplasties all had fourth-generation COC bearings performed through a posterolateral approach.The average age was (41.8±8.3) years (ranging from 22 to 55 years),and the mean follow-up period was (24.5±9.4) months (ranging from 12 to 47 months).The results were evaluated both clinically and radiographically.Harris hip score (HHS) was determined before surgery and at the time of each follow-up.Presence of postoperative groin or thigh pain and squeaking were recorded.Other complications such as dislocations,periprosthetic fractures,and ceramic components fractures were diagnosed and treated in emergency.Results The average HHSs improved from preoperative 60.3±10.7 (ranging from 29 to 76) to 91.0±5.1 (ranging from 74 to 100) at the final follow-up (t=-45.064,P <0.05),and 97.7% of cases were scored as excellent and good results.At the last follow-up,incidental inguinal pain was found in three hips (1.7%) and thigh pain in 11 hips (6.2%).Radiographs showed a high rate of new bone formation around the acetabular and stem components.No obvious osteolysis or prosthesis loosening was detected.Complications occurred in six hips (3.4%):posterior dislocation in two hips (1.1%),periprosthetic femoral fracture in one hip (0.6%),asymptomatic squeaking in two hips (1.1%),and ceramic liner fracture in one hip (0.6%).Conclusions The fourth-generation COC THA showed excellent clinical results in

  12. Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association

    Pedersen, A B; Mehnert, F; Havelin, L I;

    2014-01-01

    Objectives: To evaluate implant survival following primary total hip replacement (THR) in younger patients. To describe the diversity in use of cup-stem implant combinations. Design: 29,558 primary THRs osteoarthritis (OA) patients younger than 55 years of age performed from 1995 through 2011 were...... identified using the Nordic Arthroplasty Registry Association database. We estimated adjusted relative risk (aRR) of revision with 95% confidence interval (CI) using Cox regression. Results: In general, no difference was observed between uncemented and cemented implants in terms of risk of any revision...... uncemented and hybrid implants led to elevated risk of revision due to other causes, as well as elevated risk of revision due to any reason within 2 years. 183 different uncemented cup-stem implant combinations were registered in Denmark, of these, 172 were used in less than 100 operations which is similar...

  13. Factors impacting the growth and nutritional status of cystic fibrosis patients younger than 10 years of age who did not undergo neonatal screening

    Taís Daiene Russo Hortencio; Roberto José Negrão Nogueira; Fernando Augusto de Lima Marson; Gabriel Hessel; José Dirceu Ribeiro; Antônio Fernando Ribeiro

    2015-01-01

    OBJECTIVE: The aim of this study was to evaluate by clinical and laboratory parameters how cystic fibrosis (CF) affects growth and nutritional status of children who were undergoing CF treatment but did not receive newborn screening. METHODS: A historical cohort study of 52 CF patients younger than 10 years of age were followed in a reference center in Campinas, Southeast Brazil. Anthropometric measurements were abstracted from medical records until March/2010, when neonatal screening program...

  14. Association Between History of Severe Hypoglycemia and Risk of Falls in Younger and Older Patients With Diabetes

    Lu, Chin-Li; Hsu, Pei-Chun; Shen, Hsiu-Nien; Chang, Ya-Hui; Chen, Hua-Fen; Li, Chung-Yi

    2015-01-01

    Abstract To compare the incidence and relative risk of falls between adults with and without diabetes, and to prospectively assess the role of history of severe hypoglycemia in the putative relationship between diabetes and falls in younger and older people, respectively. The National Health Insurance Research Database in Taiwan was used in this cohort study. Diabetic cases (with and without history of severe hypoglycemia) and nondiabetic people were followed from 2000 to 2009. There were 31,...

  15. FORMATION OF COMMUNICATIVE ABILITIES OF YOUNGER SCHOOL STUDENTS IN TEACHING AND EDUCATIONAL ACTIVITY IN THE CONDITIONS OF CONTINUITY OF FGOS OF HOO AND FGOS TO

    Ksenia Pavlovna Zaytseva

    2015-12-01

    Full Text Available In this work we will consider features of formation of communicative abilities of younger school students as a basis of their social adaptation. For this purpose we will reveal features of the teaching and educational activity of younger school students creating conditions for formation of their communicative abilities and we will show as the communicative abilities formed in teaching and educational activity can be directed on training of younger school students for social adaptation.Purpose. In the Federal state educational standard of the general education (FGOS of the second generation transition from minimizatsionny approach in education is designated. Communicative abilities are a basis not only productive inclusion of pupils in interpersonal relationship with contemporaries and adults in educational activity, socially important for them, but also basis for an exit in system of broader social relationship with people and the world in general.Methodology. The basis of research is formed by the empirical – studying and the analysis of literature, normative documents and textbooks for elementary school; supervision, poll (oral and written.Results. Results of work consists preparation of methodical ensuring process of formation of communicative abilities of younger school students in teaching and educational activity as bases of their social adaptation: Socialization programs.Practical implications. Results of research can be used by elementary school teachers in teaching and educational activity, and also students when writing theses and carrying out experiment.

  16. The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty

    Vukomanović Aleksandra

    2008-01-01

    third day after the operation the study group was significantly more independent than the control one while performing any basic activities (changing position in bed from supine to side lying, from supine to sitting on the edge of the bed, from sitting to standing, from standing to lying in the bad, standing, walking, using toilet and chair. At discharge the patients from the control group still needed the therapist help for walking up and down stairs (3±1.26, while the patients from the study group performed there activities independently (4.85±0.37 (p ≤ 0.000. Endurance while walking was significantly better in the study group than in the control one. The length of hospital stay after the operation was similar for both groups, but the patients from the study group needed significantly less classes with the therapist (5.2±2.35 vs 6.85±1.14, p ≤ 0.02 during hospital stay. Conclusion. The short-term preoperative program of education with the elements of physical therapy accelerated early functional recovery of patients (younger than 70 immediately after THA and we recommend it for routine use.

  17. Early reconstruction should be considered in younger patients with symptomatic mucoid degeneration of the anterior cruciate ligament

    Masashi Kusano; Shuji Horibe; Yoshinari Tanaka; Yasukazu Yonetani; Takashi Kanamoto; Yoshiki Shiozaki; Akira Tsujii

    2015-01-01

    Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is mostly observed in middle-aged patients with knee pain and limited range of motion. Although arthroscopic resection of the degenerated ACL is the treatment of choice following the failure of conservative management, the extent of the excision and subsequent ACL reconstruction for postoperative knee instability remains controversial. Case reports: We present four cases of mucoid degeneration of the ACL in patients aged

  18. Congenital scoliosis treated with posterior vertebral column resection in patients younger than 18 years: longer than 10-year follow-up.

    Chang, Dong-Gune; Yang, Jae Hyuk; Lee, Jung-Hee; Kim, Jin-Hyok; Suh, Seung-Woo; Ha, Kee-Yong; Suk, Se-Il

    2016-08-01

    OBJECTIVE There have been no reports on the long-term radiographic outcomes of posterior vertebral column resection (PVCR) in patients with congenital scoliosis. The purpose of this study was to evaluate the surgical outcomes and complications after PVCR and its long-term effects on correcting this deformity in children with congenital scoliosis. METHODS The authors retrospectively analyzed the medical records of 45 patients with congenital scoliosis who were younger than 18 years at the time of surgery and who underwent PVCR and fusion with pedicle screw fixation (PSF). The mean age of the patients at the time of surgery was 11.3 years (range 2.4-18.0 years), and the mean length of follow-up was 12.8 years (range 10.1-18.2 years). RESULTS The mean Cobb angle of the main curve was 46.5° before PVCR, 13.7° immediately after PVCR, and 17.6° at the last follow-up. For the compensatory cranial curve, PVCR corrected the preoperative Cobb angle of 21.2° to 9.1° postoperatively and maintained it at 10.9° at the last follow-up. For the compensatory caudal curve, the preoperative Cobb angle of 23.8° improved to 7.7° postoperatively and was 9.8° at the last follow-up. The authors noted 22 complications, and the overall incidence of complications was 48.9%. CONCLUSIONS Posterior vertebral column resection is an effective procedure for managing congenital scoliosis in patients younger than 18 years. Use of PVCR and fusion with PSF for congenital scoliosis achieved rigid fixation and satisfactory deformity correction that was maintained over the long term. However, the authors note that PVCR is a technically demanding procedure and entails risks for major complications and excessive blood loss. PMID:26967991

  19. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

    Klit, Jakob

    2014-01-01

    population. All patients received a questionnaire concerning aspects of functional ability, patient satisfaction, expectations, and quality of life following PAO. Both Study II and Study III are prospective multicenter cohort studies. Consecutive patients less than 60 years of age scheduled for (study II...... unilateral THA, six simultaneous bilateral THA, and 44 HR. The study groups received a paper-format questionnaire within one month before surgery and at three, six, and 12 months postoperatively. RESULTS: Study I showed a high willingness to undergo PAO again with the experience and knowledge they have today...... and improvements were seen in all quality of life parameters except for ability in sex-life for males. Study II showed significantly improvements in joint function and HRQoL. Satisfaction and fulfillment of expectations do, however, not fully mirror the observed significant improvements in knee...

  20. Detection of Melanoma Nodal Metastases; Differences in Detection Between Elderly and Younger Patients Do Not Affect Survival

    Kruijff, S.; Bastiaannet, E.; Suurmeijer, A. J. H.; Hoekstra, H. J.

    2010-01-01

    Background. Melanoma lymph nodes metastases may be detected by patients or by physicians. Understanding the outcomes of self-detection or physician detection is essential for the design of follow-up studies. We evaluated the role of the method of detection in nodal disease in the prognosis of melano

  1. The angiotensin-converting enzyme (ACE) gene insertion/ deletion dimorphism tracks with higher serum ace activities in both younger and older subjects

    The absence of a 287 base pair alu sequence in the ACE gene (D allele) is associated with higher ACE levels than its presence (I allele) in adults. We carried out a case control study of thr ACE*I/D dimorphism in relation to circulating ACE activities to evaluate associations between the two variables in adults, compared to younger (18 years or less) individuals. Genotypes of the ACE*I/D dimorphism were determined on DNA samples from a population of 164 random (unrelated) Emirtaes nationals, composed of groups: 112 subjects above 18 years of age (range=20-77), and 52 subjects of 18 years or less (range=1-18) and analyzed for putative associations with serum ACE activities. ACE*I/D genotypes of the 164 individualds were determined by assays based on polymerase chain reaction. ACE activities were determined on serum samples of these subjects bu colorimetric assays. The D allele was associared with increasd ACE values in both adult and younger individuals. Mean ACE activity levels associated with II, ID and DD genotypes, however, were 42%-61% higher in the 18 years and under group of subjects. The ACE*I/D marker accounted for 28% of the variance of the phenomenon determining ACE levels in adults, and for 30% among youngsters. The ACE*I/D dimorphism is correlated strongly with circulating ACE activities in both and young Emirati, subjects and the corresponding mean ACE activities were significantly higher among the youngsters. (author)

  2. A phase 3 study of gemtuzumab ozogamicin during induction and postconsolidation therapy in younger patients with acute myeloid leukemia.

    Petersdorf, Stephen H; Kopecky, Kenneth J; Slovak, Marilyn; Willman, Cheryl; Nevill, Thomas; Brandwein, Joseph; Larson, Richard A; Erba, Harry P; Stiff, Patrick J; Stuart, Robert K; Walter, Roland B; Tallman, Martin S; Stenke, Leif; Appelbaum, Frederick R

    2013-06-13

    This randomized phase 3 clinical trial evaluated the potential benefit of the addition of gemtuzumab ozogamicin (GO) to standard induction and postconsolidation therapy in patients with acute myeloid leukemia. Patients were randomly assigned to receive daunorubicin (45 mg/m(2) per day on days 1, 2, and 3), cytarabine (100 mg/m(2) per day by continuous infusion on days 1-7), and GO (6 mg/m(2) on day 4; DA+GO) vs standard induction therapy with daunorubicin (60 mg/m(2) per day on days 1, 2, and 3) and cytarabine alone (DA). Patients who achieved complete remission (CR) received 3 courses of high-dose cytarabine. Those remaining in CR after consolidation were randomly assigned to receive either no additional therapy or 3 doses of GO (5 mg/m(2) every 28 days). From August 2004 until August 2009, 637 patients were registered for induction. The CR rate was 69% for DA+GO and 70% for DA (P = .59). Among those who achieved a CR, the 5-year relapse-free survival rate was 43% in the DA+GO group and 42% in the DA group (P = .40). The 5-year overall survival rate was 46% in the DA+GO group and 50% in the DA group (P = .85). One hundred seventy-four patients in CR after consolidation underwent the postconsolidation randomization. Disease-free survival was not improved with postconsolidation GO (HR, 1.48; P = .97). In this study, the addition of GO to induction or postconsolidation therapy failed to show improvement in CR rate, disease-free survival, or overall survival. PMID:23591789

  3. A STUDY ON EARLY ONSET CORONARY ARTERY DISEASE IN RELATION TO HYPER HOMOCYSTEINEMIA IN PATIENTS YOUNGER THAN 40 YEARS OF AGE

    Sugunakar

    2013-12-01

    Full Text Available ABSTRACT: There has been a rising incidence of myocardial infarction as a whole in recent times much because of changing pattern of life style , urbanization , changing food habits , and increase in cigarette smoking , psycho social stress and increase in the incidence of diabete s mellitus. Adding to this there is drastic increase in the incidence of MI in young people much to the influence of novel risk factors which are of current debate especially homocysteine , lipoprotein little (a , fibrinogen , anticardiolipin antibody , prote in C , protein S and antithrombin deficiency. The first ever positive prospective study on plasma homocystein and CAD was reported in 1992 by Selhubetal who showed an association of plasma homocysteine with extracranial carotid stenosis in the elderly. We r eport our study to analyze the special risk factors of MI in patients younger than 40years of age in special reference to serum homocysteine levels.

  4. Short-term Outcomes and Mid-term Follow-up After Coronary Angioplasty in Patients Younger Than 40 Years of Age

    Hamidreza Poorhosseini

    2007-07-01

    Full Text Available Background: Stenting is currently the standard of care in percutaneous coronary intervention (PCI. Whether young patients remain at increased risk after PCI in the present stent era has not been investigated widely. We evaluated angiographic characteristics and short- and mid-term outcomes in patients younger than 40 years of age who underwent PCI. Methods: From April 2003 to March 2005, prospective data were collected in 118 consecutive patients, who were less than 40 years of age and underwent PCI at our referral center. The PCI outcomes in these patients were compared to those in 354 patients, randomly selected from 2493 patients older than 40 years of age in our database. Follow-up was scheduled at 1 month, 5 months, and 9 months through clinic visits, telephone interviews, and reviewing hospital records. Results: Patients<40 years of age were more often male (91.5% vs. 71.8%, P<0.001, current smokers (33.9% vs. 15.2 %, P<0.001, and had more family history of coronary artery disease (38.1% vs. 21.8%, P<0.001 and myocardial infarction (44.1 vs. 31.1, p=0.01, while diabetes mellitus (6.8% vs. 22.1%, P<0.001, hypertension (13.6% vs. 35.3%, P<0.001, and hyperlipidemia (34.7% vs. 44.8%, P=0.055 were less common in these patients. There were no significant differences between the two groups regarding vessel involvement, reference vessel diameter, stenosis rate (before and after procedure, and lesion characteristics, with an exception that angulated lesions were more common in the patients≤ 40 years of age (P<0.05. The young patients, who underwent PCI, presented more frequently with single-vessel disease (61% vs. 46%, P=0.01.The vessel and lesion sites of PCI and clinical success rates were similar in these age groups. Usage of stent was high and similar, and drug- eluting stent use was not significantly different between the two groups. With a high procedural success (94.9% vs. 91.8%, intra-hospital and late complications were very low and

  5. Younger patients with primary Sjögren's syndrome are more likely to have salivary IgG anti-muscarinic acetylcholine receptor type 3 antibodies.

    Jayakanthan, K; Ramya, J; Mandal, Santosh Kumar; Sandhya, P; Gowri, M; Danda, Debashish

    2016-03-01

    Acetylcholine type 3 receptor (M3R) is recognized as an autoantigen in primary Sjögren's syndrome (pSS). Assay of anti-M3R antibody levels in serum is fraught with low sensitivity for diagnosis of pSS. Salivary assay is more likely to improve the diagnostic accuracy. Patients with pSS classified either by the American European Consensus Group (AECG) or American college of Rheumatology (ACR) criteria, attending rheumatology clinic between October 2014 and July 2015 were included. Hospital staff and lupus patients constituted healthy and disease controls, respectively. Evaluation of pSS included clinical evaluation, laboratory tests, ESSDAI and ESSPRI scoring. Unstimulated saliva was collected by the spitting method. Salivary IgG antibody against M3R (anti-M3R) was quantified by indirect ELISA. In this study, 43 patients with pSS, 34 with lupus and 42 healthy controls were recruited. The frequency of anti-M3R antibody levels was 55.81, 17.64 and 7 % for pSS, lupus and healthy controls, respectively. Area under the Receiver Operator Characteristic was 0.7791 (95 % CI,, 0.67-0.87). Sensitivity and specificity of the assay for diagnosis of pSS were 44.19 and 88.16 %, respectively. Salivary anti-M3R IgG antibody positivity was associated with lower age, shorter disease duration and higher globulin levels in our cohort. Salivary anti-M3R IgG antibody assay has high specificity in pSS; younger patients and those with hyperglobulinemia more frequently tested positive for this antibody. PMID:26809799

  6. Stress May Take Greatest Toll on Younger Women's Hearts

    ... 160597.html Stress May Take Greatest Toll on Younger Women's Hearts: Study Female heart disease patients under ... may be especially hard on the hearts of younger women who have heart disease, new research suggests. ...

  7. Reasons given by general practitioners for non-treatment decisions in younger and older patients with newly diagnosed type 2 diabetes mellitus in the United Kingdom: a survey study

    Davies Michael J

    2011-10-01

    Full Text Available Abstract Background Older patients with newly diagnosed type 2 diabetes mellitus are less likely to receive antihyperglycaemic therapy compared to their younger counterparts. The purpose of this study was to assess the reasons of general practitioners (GPs for not treating younger and older patients with newly diagnosed type 2 diabetes mellitus with antihyperglycaemic agents. Methods In a survey conducted between November 2009 and January 2010, 358 GPs from the United Kingdom selected reasons for not initiating antihyperglycaemic therapy in younger (Mild hyperglycaemia, Factors related to antihyperglycaemic agents, Comorbidities and polypharmacy, and Patient-related reasons. Reasons for non-treatment were compared between younger (n = 1, 023 and older (n = 1, 005 patients. Results Non-treatment reasons related to Mild hyperglycaemia were selected more often by GPs for both younger (88% and older (86% patients than those in other categories. For older patients, Factors related to antihyperglycaemic agents (46% vs. 38% and Comorbidities and polypharmacy (33% vs. 19%, both including safety-related issues, were selected significantly (p Patient-related reasons category. The GP-reported HbA1c threshold for initiating antihyperglycaemic therapy was significantly (p Conclusions GPs selected reasons related to Mild hyperglycaemia for non-treatment of their untreated patients with newly diagnosed type 2 diabetes mellitus, despite nearly one-third of these patients having their most recent HbA1c value ≥7%. The findings further suggest that safety-related issues may influence the non-treatment of older patients with type 2 diabetes mellitus.

  8. Attitudes of Oncologists, Oncology Nurses, and Patients from a Women's Clinic Regarding Medical Decision Making for Older and Younger Breast Cancer Patients.

    Beisecker, Analee E.; And Others

    1994-01-01

    Administered Beisecker Locus of Authority in Decision Making: Breast Cancer survey to 67 oncologists, 94 oncology nurses, and 288 patients from women's clinic. All groups believed that physicians should have dominant role in decision making. Nurses felt that patients should have more input than patients or physicians felt they should. Physicians…

  9. A nationwide, retrospective analysis of symptoms, comorbidities, medical care and autopsy findings in cases of fatal pulmonary embolism in younger patients

    Haunsø, S; Theilade, J; Winkel, B G; Holst, A G; Tfelt-Hansen, J; Svendsen, J H; Haunsø, Stig

    2010-01-01

    Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings.......Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings....

  10. Even a Little Exercise May Help Younger Women's Hearts

    ... 160054.html Even a Little Exercise May Help Younger Women's Hearts Those active about 2.5 hours ... 25, 2016 MONDAY, July 25, 2016 (HealthDay News) -- Younger women who exercise just 2.5 hours a ...

  11. Predictors of non-invasive therapy and 28-day-case fatality in elderly compared to younger patients with acute myocardial infarction: an observational study from the MONICA/KORA Myocardial Infarction Registry

    Amann, Ute; Kirchberger, Inge; Heier, Margit; Thilo, Christian; Kuch, Bernhard; Peters, Annette; Meisinger, Christa

    2016-01-01

    Background A substantial proportion of patients with acute myocardial infarction (AMI) did not receive invasive therapy, defined as percutaneous coronary intervention and/or coronary artery bypass grafting. Aims of this study were to evaluate predictors of non-invasive therapy in elderly compared to younger AMI patients and to assess the association between invasive therapy and 28-day-case fatality. Methods From the German population-based registry, 3475 persons, consecutively hospitalized wi...

  12. Chronic mucus hypersecretion: prevalence and risk factors in younger individuals

    Harmsen, Lotte; Thomsen, S F; Ingebrigtsen, Truls;

    2010-01-01

    Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals.......Chronic mucus hypersecretion (CMH) is a common condition in patients with chronic respiratory diseases. Little is known about the incidence, prevalence and determinants of CMH in younger individuals....

  13. Cytokine production and mRNA expression in pulmonary tuberculosis patients and their household contacts of younger age group (15-25years).

    Joshi, Lavanya; Ponnana, Meenakshi; Sivangala, Ramya; Chelluri, Lakshmi Kiran; Nallari, Pratibha; Valluri, Vijaya Lakshmi; Gaddam, Sumanlatha

    2016-05-01

    Household contacts of tuberculosis patients are at high risk of infection and development of active disease. In this study we evaluated the cytokine production and mRNA expression of IFN-γ, TNF-α, IL-10&IL-6 stimulated with r32kDa M. bovis BCGAg in active pulmonary tuberculosis patients (APTB), household contacts (HHC) and healthy controls (HC). The results showed the stimulated levels of IFN-γ and TNF-α were low while IL-10 levels were high in APTB and HHC compared to HC. IL-6 has not shown any significant difference. The mRNA expression of TNF- α was 8 fold high in HCs compared to APTB and HHC. The IL-6 expression was 2.2 fold &1 fold less in APTB and HHC compared to HCs. Multinomial logistic regression analysis indicated that the stimulated levels of IFN-γ & IL-6 and sex significantly predicted the HHC group from HCs at p<0.05.In conclusion further follow up studies with r32kd antigen might help to identify the high risk individuals. PMID:26876300

  14. Cartilage Grown in Lab Might One Day Help Younger Arthritis Sufferers

    ... Cartilage Grown in Lab Might One Day Help Younger Arthritis Sufferers Made of patients' stem cells and ... eliminate the need for hip replacement surgery in younger arthritis patients. The cartilage hasn't been tested ...

  15. Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

    Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Bloem, Rolf M. [Leiden University Medical Center, Department of Orthopaedic Surgery, Leiden (Netherlands); Napoleon, L.J.; Coene, M.N. [HAGA Hospital, Department of Orthopaedic Surgery, The Hague (Netherlands); Luijt, Peter A. van [Leiden University Medical Center, Department of Traumatology, Leiden (Netherlands); Lange, Sam de [Medical Center Haaglanden, Department of Orthopaedic Surgery, The Hague (Netherlands); Department of Orthopaedic Surgery, Delft (Netherlands)

    2007-12-15

    The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

  16. Subchondral insufficiency fracture of the femoral head in younger adults

    We report two cases of subchondral insufficiency fracture of the femoral head observed in younger adults without any history of overexertion. In both cases, MRI revealed an irregular, discontinuous low-intensity band on the T1-weighted images. Both patients were treated operatively, and histological examination confirmed the diagnosis of subchondral fracture. A diagnosis of subchondral insufficiency fracture needs to be put in as one of the diagnoses in younger patients with a hip pain. (orig.)

  17. Subchondral insufficiency fracture of the femoral head in younger adults

    Yamamoto, Takuaki; Nakashima, Yasuharu; Shuto, Toshihide; Jingushi, Seiya; Iwamoto, Yukihide [Graduate School of Medical Sciences, Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan)

    2007-06-15

    We report two cases of subchondral insufficiency fracture of the femoral head observed in younger adults without any history of overexertion. In both cases, MRI revealed an irregular, discontinuous low-intensity band on the T1-weighted images. Both patients were treated operatively, and histological examination confirmed the diagnosis of subchondral fracture. A diagnosis of subchondral insufficiency fracture needs to be put in as one of the diagnoses in younger patients with a hip pain. (orig.)

  18. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P; Riis, Anders; Lucht, Ulf; Overgaard, Søren

    2007-01-01

    BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthropla......BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip...

  19. Good performance of a titanium femoral component in cementless hip arthroplasty in younger patients: 97 arthroplasties followed for 5-11 years

    Jacobsen, Steffen; Jensen, Frank Krieger; Poulsen, Klaus;

    2003-01-01

    We performed 97 uncemented primary total hip arthroplasties in 80 patients having an average age of 50 years. The femoral implant was a titanium stem with a proximal circumferential plasma spray-coating. Three different acetabular components were used: a threaded and partly porous-coated design i...

  20. Comparison of Angiography Findings in Iranian Patients Younger and Older Than 50 Years Underwent Coronary Angiography in Boo-Ali Hospital: A Cross-sectional Study

    Moshar

    2016-01-01

    Full Text Available Background Coronary artery disease (CAD or ischemic heart disease (IHD is the most common cause of death globally. CAD is a multifactorial disease with many variable risk factors. It is estimated that its prevalence is increasing in various populations. CAD in young adults is also increasing in Iran due to the life style changes. Identifying risk factors and timely correction can reduce the burden of disease and related health problems. Objectives To evaluate the prevalence of CAD and the traditional risk factors according to angiographic findings of patient’s ≤ 50 and > 50 years old. Patients and Methods This is a cross sectional descriptive study on 112 patients who were admitted to Boo-Ali hospital from November 2013 to December 2014 for evaluation of CAD. Self-administered questionnaire consisted of demographic data and risk factors were filled. Angiographic film was reviewed in respect to coronary arteries involvement and echocardiography was performed. For evaluation of left ventricular (LV function, patients divided into two groups of ages ≤ 50 (group A and > 50 (group B years old. Risk factors, coronary angiography and ejection fraction (EF were compared. Results Of the 112 patients, 51 (45.5% were in group A and 61 (54.5% were in group B with mean age of 37.6 ± 4.4 and 63 ± 8.5, respectively. No significant statistical differences were found between the body mass index (BMI, smoking, family history (FH, hyperlipidemia (HLP and diabetes mellitus type 2 (DM2 between two groups (P > 0.05. Hypertension (HTN was significantly higher in group B vs. group A respect to 65.6% and 31.4% (P 0.05. There were a significant higher number of patients with a decline in EF in group B (P = 0.01. Conclusions The pattern and number of vessels involved were similar in both groups. Based on common prevalence of traditional risk factors among two groups, planning for lifestyle changes is recommended.

  1. Análise comparativa das características do trauma entre pacientes idosos e não idosos Comparative analysis of trauma characteristics between elderly and younger trauma patients

    José Gustavo Parreira

    2010-01-01

    Full Text Available OBJETIVO: Definir as características do trauma em idosos pela comparação de variáveis entre este grupo e o de traumatizados não idosos. MÉTODOS: Realizamos uma análise dos protocolos coletados no período de 10 de junho de 2008 a 9 de março de 2009, incluindo todos os traumatizados atendidos com idade superior a 13 anos. Foram coletados dados de identificação, mecanismo de trauma, informações do pré-hospitalar, dados vitais à admissão, índices de trauma, exames complementares, doenças associadas, lesões diagnosticadas e tratamento. Os traumatizados com idade superior a 60 anos foram considerados idosos. Para a identificação das características do trauma em idosos, comparamos as variáveis entre este grupo (Grupo I e os traumatizados não idosos (Grupo II. Foram empregados os testes T de Student, Qui quadrado e Fisher para a comparação entre os grupos, considerando o valor de p 3 no segmento cefálico (11,4% vs. 7% (p=0,023 e menor frequência de lesões graves no abdome (1,4% vs. 4,3 % (p=0,025. Algumas lesões foram significativamente mais frequentes nos idosos, como os hematomas subdurais (2,8% vs. 0,8% (p=0,008, as hemorragias subaracnóideas (3,8% vs. 1,3% (p=0,005 e as contusões cerebrais (5,2% vs. 2,3% (p=0,015 quando comparados aos demais traumatizados. CONCLUSÃO: Em comparação aos traumatizados não idosos, os idosos apresentaram as seguintes características: maior frequência de quedas da própria altura, de doenças associadas e de lesões graves intracranianas, incluindo os hematomas subdurais, as contusões cerebrais e as hemorragias em espaço subaracnoide.OBJECTIVE: Assess the characteristics of trauma in the elderly by comparison to a group of younger trauma patients. METHODS: Trauma protocols from June 10, 2008 to March 9, 2009 were evaluated including all trauma patients above 13 years of age admitted in the emergency room. Data on trauma mechanism, concomitant diseases, vital signs upon admission

  2. Leukocyte Activation in Obese Patients

    Minervino, Daniele; Gumiero, Daniela; Nicolazzi, Maria Anna; Carnicelli, Annamaria; Fuorlo, Mariella; Guidone, Caterina; Di Gennaro, Leonardo; Fattorossi, Andrea; Mingrone, Geltrude; Landolfi, Raffaele

    2015-01-01

    Abstract The rising prevalence of obesity is a major global health problem. In severe obesity, bariatric surgery (BS) allows to obtain a significant weight loss and comorbidities improvement, among them one of the factors is the thrombotic risk. In this observational study, we measured indices of leukocyte activation in severely obese patients as markers of increased thrombotic risk in relation with serum markers of inflammation before and after BS. Frequency of polymorphonuclear neutrophil-platelet (PLT) and monocyte (MONO)-PLT aggregates as well as of tissue factor (TF) expressing MONOs was measured in the peripheral blood of 58 consecutive obese patients and 30 healthy controls. In 31 of the 58 obese patients, data obtained at the enrollment were compared with those obtained at 3, 6, and 12 months after BS. Compared with healthy controls, obese patients showed a higher frequency of polymorphonuclear leukocyte (PMNL)-PLT aggregates (7.47 ± 2.45 [6.82–8.11]% vs 5.85 ± 1.89 [5.14–6.55]%, P = 0.001), MONO-PLT aggregates (12.31 ± 7.33 [10.38–14.24]% vs 8.14 ± 2.22 [7.31–8.97]%, P < 0.001), and TF expressing MONOs (4.01 ± 2.11 [3.45–4.56]% vs 2.64 ± 1.65 [2.02–3.25]%, P = 0.002). PMNL-PLT and MONO-PLT aggregate frequency was positively correlated with TF expressing MONOs (R2 = 0.260, P = 0.049 and R2 = 0.318, P = 0.015, respectively). BS was performed in 31 patients and induced a significant reduction of the body mass index, and waist and hip circumferences. These effects were associated with a significant decrease of PMNL-PLT aggregates at 12 months (7.58 ± 2.27 [6.75–8.42]% vs 4.47 ± 1.11 [3.93–5.01]%, P < 0.001), and a reduction of TF expressing MONOs at 6 (3.82 ± 2.04 [3.07–4.57]% vs 1.60 ± 1.69 [0.30–2.90]%, P = 0.008) and 12 months (3.82 ± 2.04 [3.07–4.57]% vs 1.71 ± 0.54 [1.45–1.97]%, P = 0.001) after BS. These data suggest that leukocyte

  3. Study of Kidney Tumors in Younger Patients

    2016-05-17

    Clear Cell Sarcoma of the Kidney; Congenital Mesoblastic Nephroma; Diffuse Hyperplastic Perilobar Nephroblastomatosis; Rhabdoid Tumor of the Kidney; Stage I Renal Cell Cancer; Stage I Wilms Tumor; Stage II Renal Cell Cancer; Stage II Wilms Tumor; Stage III Renal Cell Cancer; Stage III Wilms Tumor; Stage IV Renal Cell Cancer; Stage IV Wilms Tumor; Stage V Wilms Tumor

  4. Atomoxetine Treatment for ADHD: Younger Adults Compared with Older Adults

    Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory

    2010-01-01

    Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…

  5. Heart transplantation in the elderly: why cardiac transplantation does not need to be limited to younger patients but can be safely performed in patients above 65 years of age.

    Daneshvar, Daniel A; Czer, Lawrence S C; Phan, Anita; Trento, Alfredo; Schwarz, Ernst R

    2010-01-01

    Within the last forty years, heart transplantation as the ultimate option for the treatment of end-stage heart disease has undergone dramatic changes and advances in operative techniques, postoperative care, immunosuppression, and rejection management which resulted in reduced morbidity and mortality. As the heart failure epidemic worsens and the population grows older, cardiac transplantation criteria have expanded for end-stage heart disease refractory to medical management. Although outcomes after cardiac transplantation have improved, the critical organ shortage is a limitation to its efficacy. The demand-supply disparity for heart transplantations has led to clinical and ethical issues examining adequate candidacy for organ transplantation. Cardiac transplantation in the elderly recipient was considered a contraindication due to poor survival rates compared to younger recipients. Given the increase in life expectancy over the last decades, single-center studies have assessed the outcome of transplantation among elderly recipients and comparable survival and quality of life have been described among older heart transplantation recipients. Alternatives to cardiac transplantation which have become more common, such as mechanical circulatory support, and further investigation of the viability of transplantation in the elderly may help determine the proper allocation of the limited organ supply. PMID:21183885

  6. Older Siblings Influence Younger Siblings' Motor Development

    Berger, Sarah E.; Nuzzo, Katie

    2008-01-01

    Evidence exists for two competing theories about the effects of having an older sibling on development. Previous research has found that having an older sibling has both advantages and disadvantages for younger siblings' development. This study examined whether and how older siblings influenced the onset of their own younger siblings' motor…

  7. Preferences for active and aggressive intervention among patients with advanced cancer

    Ennis Marguerite

    2010-10-01

    Full Text Available Abstract Background Intrinsic to "Patient-Centered Care" is being respectful and responsive to individual patient preferences, expressed needs, and personal values. Establishing a patient's preferences for active and aggressive intervention is imperative and foundational to the development of advance care planning. With the increasing awareness and acceptance of palliative philosophies of care, patients with advanced cancer are increasingly transitioning from active and aggressive medical management (AAMM to conservative palliative management (CPM. Methods A cross-sectional study based on a prospective and sequential case series of patients referred to a regional palliative medicine consultative program was assembled between May 1, 2005 and June 30, 2006. Patients and/or their substitute decision makers (SDM completed a questionnaire, at baseline, that assessed their preferences for AAMM en route to their eventual deaths. Seven common interventions constituting AAMM were surveyed: cardiopulmonary resuscitation (CPR & mechanical ventilation (MV, chemotherapy, antibiotics, anticoagulants, blood transfusions, feeding tubes, and artificial hydration. Multivariable analyses were conducted on the seven interventions individually as well as on the composite score that summed preferences for the seven interventions. Results 380 patients with advanced cancer agreed to participate in the study. A trend to desire a mostly conservative palliative approach was noted as 42% of patients desired one or fewer interventions. At baseline, most patients and their SDM's were relatively secure about decisions pertaining to the seven interventions as the rates of being "undecided" ranged from a high of 23.4% for chemotherapy to a low of 3.9% for feeding tubes. Multivariable modeling showed that more AAMM was preferred by younger patients (P Conclusions Although the majority of patients with advanced cancer in this study expressed preferences for CPM, younger age

  8. Why do younger women have higher breast cancer recurrence rates after breast-conserving surgery?

    Preventing breast cancer recurrence after breast-conserving surgery is an important issue. The main factors contributing to such recurrence are positive margins, absence of radiotherapy and young age. To investigate the clinical significance of age in breast-conserving surgery, we examined the relationship between clinicopathological findings or outcome and age, especially young age. The cases were divided into three groups by age; 35 years old or less, 36-50y.o. and 51y.o. or higher. Between April 1989 and March 2003, 743 patients were treated with breast-conserving surgery. There were 49 patients aged 35 years old or less (6.6%). Younger age significantly correlated with positive surgical margin, lymph node metastases, higher proliferative activity, negative estrogen receptor (ER) or progesterone receptor (PgR), larger tumor size, and shorter nipple-tumor distances. Although younger patients had a higher recurrence rate irrespective of radiotherapy, margin status had an impact on recurrence rate. Thus, the reason young age was a significant factor for breast recurrence after breast-conserving surgery was that young patients frequently had numerous risk factors such as positive margin, higher proliferative activity, positive nodes, negative ER/PgR and larger tumor. However, negative surgical margins could reduce recurrence rates even in young women. These results suggest that more suitable criteria and strategies may be needed for young patients with breast cancer. (author)

  9. Nutrition and Physical Activity in CKD patients

    Adamasco Cupisti

    2014-07-01

    Full Text Available Chronic kidney disease (CKD patients are at risk for protein-energy wasting, abnormal body composition and impaired physical capacity. These complications lead to increased risk of hospitalization, morbidity and mortality.In CKD patient as well as in healthy people, there is a close association between nutrition and physical activity. Namely, inadequate nutrient (energy intake impairs physical performance thus favoring a sedentary lifestyle: this further contributes to loss of muscle strength and mass, which limit the quality of life and rehabilitation of CKD patients. In CKD as well as in end-stage-renal-disease patients, regular physical activity coupled with adequate energy and protein intake counteracts protein-energy wasting and related comorbidity and mortality. In summary, exercise training can positively influence nutritional status and the perception of well-being of CKD patients and may facilitate the anabolic effects of nutritional interventions.

  10. [Pseudocholinesterase activity in type 1 bipolar patients].

    Ezzaher, Asma; Haj Mouhamed, Dhouha; Mechri, Anwar; Neffati, Fadoua; Douki, Wahiba; Gaha, Lotfi; Najjar, Mohamed Fadhel

    2012-01-01

    This study aims to investigate the variation of pseudocholinesterase activity (BuChE) in bipolar patients and to explore its relation to the clinical and therapeutic characteristics of this disease. Our study included 105 patients with bipolar disorder and 100 control subjects aged 38.7 ± 12.2 and 36.4 ± 15.7 y, respectively. BuChE was determined by kinetic methods on Cobas Integra 400 plus™. Compared with controls, patients had a significantly higher pseudocholinesterase activity. Moreover, this increase was significantly associated (p = 0.001) with bipolar disorder with sensibility of 58% and specificity of 62% at threshold of 7392 IU/L. There was no significant change in pseudocholinesterase activity in relation to illness episodes and treatment, whereas the lowest values of this activity were seen in euthymic patients and those taking psychotics. Therefore, this activity is a real interest in the biological monitoring of patients as a risk factor for neurodegenerative diseases associated with bipolar disorder. But it would be most useful to evaluate their interest as a predictor of bipolar disorder in patients at risk. PMID:22294139

  11. A Survey on the Willingness to Use Physical Activity Smartphone Applications (Apps) in Patients with Chronic Diseases.

    Sun, Liu; Jiao, Chen; Wang, Yanling; Xiao, Qian; Zhang, Yiling; Wu, Ying

    2016-01-01

    This study aimed to explore the willingness of using physical activity smartphone apps among patients with chronic diseases. 218 outpatients from a tertiary hospital in Beijing were involved using a questionnaire. Over half of the patients (53.7%) were willing to use smartphone apps to promote physical activities. The individuals more likely to use physical activity apps tended to be younger (≤44 years), be more educated, perceiving their disease need exercise instruction or professional support, current smartphone user, having previous experience of using physical activity apps, and accepting paid apps (P<0.05). The results could help health educator suggest chronic disease patients to use apps to do more exercises. Further research could be focus on evaluate the effects of using physical activity apps in chronic disease patients. PMID:27332468

  12. GASTROINTESTINAL MALIGNANCIES: GETTING A DECADE YOUNGER?

    Sushmitha

    2014-06-01

    Full Text Available INTRODUCTION: Gastrointestinal malignancies are one of the most common malignancies encountered frequently, with rising incidence in young age due to the changing lifestyle and food habits in India. Oesophagus, stomach and colonic cancers are the commonly affected regions of the GI tract. These malignancies is known to occur in older age of fifth decade onwards. This is a study intended to highlight the rising incidence of such malignancies in the younger age in second to third decade as observed in and around Mangalore. Upper gastrointestinal malignancies are common in oesophagus and stomach, whereas lower gastrointestinal malignancies occur more commonly seen in colon. Colorectal cancer (CRC is one of the most common of all familial malignancies with peak incidence in 60 to 70 years of age, 90% of cases occur in people aged 50 or older.Risk factors include a genetic predisposition, diet and lifestyle changes in the current era. Inheritance plays a role in the pathogenesis of upto a third of CRC cases. AIMS AND OBJECTIVE: To study the prevalence of gastrointestinal malignancies in patients less than fifty years and the association of positive family history and polyps with colorectal carcinomas. MATERIAL AND METHODS: This is a retrospective study of 128 cases of gastrointestinal malignancies from June 2010 to May 2012 received in and around Mangalore. The study includes endoscopic biopsies, colonoscopic biopsies partial and total colectomy specimens with growth seen anywhere from oesophagus to rectum. Representative sections are taken, processed routinely and stained with H & E. The pathological findings are then correlated with clinical data like age and sex distribution, site, family history and presence of other malignancies. RESULTS: In this study gastrointestinal malignancies were studied as upper and lower gastrointestinal lesions. Upper gastrointestinal (GI lesions were those in oesophagus, stomach, and duodenum. A total of 128 cases

  13. Physical activity in patients with anorexia nervosa.

    Achamrah, Najate; Coëffier, Moïse; Déchelotte, Pierre

    2016-05-01

    Anorexia nervosa (AN) is often associated with physical hyperactivity. Recent studies have established links between anorexia and hyperactivity, suggesting the existence of commonalities in neural pathways. How physical activity should be managed during the clinical care of patients with anorexia remains controversial. This review first focuses on the implication of hyperactivity in the pathophysiology of AN. Hyperactivity during refeeding of patients with AN has been associated with increased energy needs to achieve weight gain, poorer clinical outcome, longer hospitalization, and increased psychiatric comorbidity. This typically leads to the prescription of bed rest. However, current knowledge suggests that preserving some kind of physical activity during refeeding of patients with AN should be safe and beneficial for the restoration of body composition, the preservation of bone mineral density, and the management of mood and anxiety. In the absence of standardized guidelines, it is suggested here that physical activity during refeeding of patients with AN should be personalized according to the physical and mental status of each patient. More research is needed to assess whether programmed physical activity may be a beneficial part of the treatment of AN. PMID:27052638

  14. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  15. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  16. Hippocampal sclerosis in children younger than 2 years

    Kadom, Nadja [Children' s National Medical Center, Department of Diagnostic Imaging and Radiology, Washington, DC (United States); Tsuchida, Tammy; Gaillard, William D. [Children' s National Medical Center, Department of Neurology, Washington, DC (United States)

    2011-10-15

    Hippocampal sclerosis (HS) is rarely considered as a diagnosis in children younger than 2 years. To describe imaging features in conjunction with clinical information in patients with hippocampal sclerosis who are younger than 2 years. We retrospectively reviewed MR brain imaging and clinical information in five children in whom the diagnosis of HS was made both clinically and by MRI prior to 2 years of age. Imaging features establishing the diagnosis of hippocampal sclerosis were bright T2 signal and volume loss, while the internal architecture of the hippocampal formation was preserved in almost all children. Clinically, all children had an infectious trigger. It is necessary for radiologists to consider HS in children with certain clinical features to plan an MRI protocol that is appropriate for detection of hippocampal pathology. (orig.)

  17. Gamma-N activation of cancer patients

    High energy gamma radiation (8 to 30 MeV) is gaining acceptance for radiation therapy of patients with deep cancers. This radiation is of sufficient energy to induce photonuclear activation of the elements in the human body. Our results of measurements of nitrogen and phosphorus in an anthropomorphic phantom, a cadaver, and a cancer patient with bremsstrahlung radiation from 15 MeV electrons demonstrate the feasibility of a method to monitor these two elements in the human body in vivo by measuring the radioactivity induced in these targets by photonuclear reactions. 14 refs., 3 figs., 2 tabs

  18. Coping strategies, stress, physical activity and sleep in patients with unexplained chest pain

    Kjellgren Karin I

    2006-10-01

    Full Text Available Abstract Background The number of patients suffering from unexplained chest pain (UCP is increasing. Intervention programmes are needed to reduce the chest pain and suffering experienced by these patients and effective preventive strategies are also required to reduce the incidence of these symptoms. The aim of this study was to describe general coping strategies in patients with UCP and examine the relationships between coping strategies, negative life events, sleep problems, physical activity, stress and chest pain intensity. Method The sample consisted of 179 patients younger than 70 years of age, who were evaluated for chest pain at the emergency department daytime Monday through Friday and judged by a physician to have no organic cause for their chest pain. The study had a cross-sectional design. Results Emotive coping was related to chest pain intensity (r = 0.17, p = 0.02. Women used emotive coping to a greater extent than did men (p = 0.05. In the multivariate analysis was shown that physical activity decreased emotive coping (OR 0.13, p Conclusion Our results indicated that patients with more intense UCP more often apply emotive coping in dealing with their pain. Given that emotive coping was also found to be related to disturbed sleep, negative life events, mental strain at work and physical activity, it may be of value to help these patients to both verbalise their emotions and to become cognizant of the influence of such factors on their pain experience.

  19. Activities, procedures and doses in pediatric patients due to radiopharmaceuticals

    Silvia Maria Velasques de Oliveira

    2008-12-01

    Full Text Available An investigation performed between 2003 and 2005 in sixteen selected public and private institutions in Northeast, Southeast and South geographical regions of Brazil evaluated average organ doses and effective doses in 2,411 pediatric patients due to diagnostic procedures with radiopharmaceuticals. For 1 year, effective doses were greater than literature. For 5 years, differences were noticed between present work and literature for bone scintigraphy, thyroid scintigraphy and 67Ga citrate scintigraphy. These differences may be attributed to the uncertainties in internal dose calculations. High absorved doses in bone surfaces of children due to 67Ga citrate and bone scintigraphy should be evaluated accordingly. Current protocols used recommend standardized mean activities per mean weight for all ages. However, it was observed that the activities were not standardized and were higher for children with younger ages. Future studies are needed for optimising activities of radiopharmaceuticals to these patients in the country.Foi realizado no Brasil, no período 2003-2005, um estudo sobre doses absorvidas em órgãos e doses efetivas devido ao uso de radiofármacos em pacientes pediátricos. Foram estudadas 2.411 crianças e adolescentes menores de 18 anos. Foi observado que as atividades usadas não foram padronizadas, sendo maiores para crianças de menor idade, podendo ser otimizadas conforme apropriado. Para 1 ano, as doses efetivas foram maiores do que as publicadas na literatura e para 5 anos, foram observadas diferenças para cintilografias ósseas, cintilografias da tireóide, e pesquisas de corpo inteiro com citrato de 67G. Deve ser avaliado se doses absorvidas em órgãos, especialmente para superfície óssea devido a cintilografias ósseas com 99mTc MDP e pesquisa de corpo inteiro com citrato de 67Ga podem acarretar risco radiológico adicional aos pacientes, considerando-se as peculiaridades de seu estado clínico.

  20. Prognostic impact of day 15 blast clearance in risk-adapted remission induction chemotherapy for younger patients with acute myeloid leukemia: long-term results of the multicenter prospective LAM-2001 trial by the GOELAMS study group

    Bertoli, Sarah; Bories, Pierre; Béné, Marie C.; Daliphard, Sylvie; Lioure, Bruno; Pigneux, Arnaud; Vey, Norbert; Delaunay, Jacques; Leymarie, Vincent; Luquet, Isabelle; Blanchet, Odile; Cornillet-Lefebvre, Pascale; Hunault, Mathilde; Bouscary, Didier; Fegueux, Nathalie

    2014-01-01

    Early response to chemotherapy has a major prognostic impact in acute myeloid leukemia patients treated with a double induction strategy. Less is known about patients treated with standard-dose cytarabine and anthracycline. We designed a risk-adapted remission induction regimen in which a second course of intermediate-dose cytarabine was delivered after standard “7+3” only if patients had 5% or more bone marrow blasts 15 days after chemotherapy initiation (d15-blasts). Of 823 included patient...

  1. Sexuality and body image in younger women with breast cancer.

    Schover, L R

    1994-01-01

    Breast cancer has the potential to be most devastating to the sexual function and self-esteem of premenopausal women. Nevertheless, not one study has systematically compared the impact of breast cancer treatment on sexual issues across age groups. Research shows that younger women with breast cancer have more severe emotional distress than older cohorts. In a group of patients seeking sexual rehabilitation in a cancer center, younger couples were more distressed, but also had the best prognosis with treatment. In theory, loss of a breast or poor breast appearance would be more distressing to women whose youth gives them high expectations for physical beauty. Seeking new dating relationships after breast cancer treatment is a special stressor for single women. Potential infertility also may impact on a woman's self-concept as a sexual person. Systemic treatment disrupts sexual function by causing premature menopause, with estrogen loss leading to vaginal atrophy and androgen loss perhaps decreasing sexual desire and arousability. Research on mastectomy versus breast conservation across all ages of women has demonstrated that general psychological distress, marital satisfaction, and overall sexual frequency and function do not differ between the two treatment groups. Women with breast conservation do rate their body image more highly and are more comfortable with nudity and breast caressing. There is some evidence that breast conservation offers more psychological "protection" for younger women. Research on the impact of breast reconstruction is sparse, but reveals similar patterns. Future studies should use rigorous methodology and focus on the impact of premature menopause and the effectiveness of sexual rehabilitation for younger women. PMID:7999462

  2. Appendicitis in Children: Evaluation of the Pediatric Appendicitis Score in Younger and Older Children

    Martin Salö

    2014-01-01

    Full Text Available Background. This study aimed to evaluate Pediatric Appendicitis Score (PAS, diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis. Method. 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years (n=102 and <4 years (n=20. Results. The mean PAS was lower among the younger compared with the older patients (5.3 and 6.6, resp.; P=0.005, despite the fact that younger children had more severe appendicitis (75.0% and 33.3%, resp.; P=0.001. PAS had low sensitivity in both groups, with a significantly lower sensitivity among the younger patients. Parent and doctor delay were confirmed in children <4 years of age with appendicitis. PAS did not aid in patients with doctor delay. Parameters in patient history, symptoms, and abdominal examination were more diffuse in younger children. Conclusion. PAS should be used with caution when examining children younger than 4 years of age. Diffuse symptoms in younger children with acute appendicitis lead to delay and to later diagnosis and more complicated appendicitis.

  3. 饮食习惯与青年人膀胱移行细胞癌关系的病例对照研究%A case-control study of the relation of eating habit and transitional cell carcinoma of the bladder in patients 40 years old or younger

    任维果; 边家盛; 夏宝山; 宋海峰; 吴石; 许真俊; 章建胜

    2011-01-01

    Objective:To investigate the relation of eating habit and patients with carcinoma of the bladder with 40 years old or younger. Methods: A case - control study was deployed. From January 1995 to August 2006,82 patients with age less than 40 with transitional cell carcinoma of the bladder treated at Shandong Provincial Hospital, Shandong Tumor Hospital and The Central Hospital of Feicheng Mining Group Company were selected as the case group( EG ), and another 82 young adult without bladder cancer as control group( CG ). X test was used for monovariate factor analysis while non - conditional logistic regression for multivariate analysis. Results: Non - conditional logistic regression for multivariate analysis displayed that the bladder cancer in patients younger than 40 was associated with the following factors: Irregular food and drink ( OR = 6. 117,95%CI:1. 079 -34.685 )milchigs intake( OR =0. 031,95% CI: 0. 002 - 0. 544 ). While monovariate analysis displayed that the bladder cancer in patients younger than 40 was associated with the following factors: regular food and drink, milk product intake, vegetable consumption, dietary soy. Conclusion: The bladder cancer in patients younger than 40 was associated with eating habit, regular food and drink, ordinarily intake milk products and vegetable, much water intake and less dietary soy may be the possible protective factors for patients younger than 40 of bladder cancer.%目的:探讨饮食习惯与青年人膀胱移行细胞癌的关系.方法:采用以人群为基础的1∶1病例对照研究,病例组为1995年1月1日至2006年8月31日山东省省立医院、山东省肿瘤医院、山东肥城矿业中心医院三家医院收治的40岁以下膀胱移行细胞癌患者,对照组为无膀胱癌的40岁以下青年人.病例组与对照组各82例.单因素分析采用χ2检验,多因素分析采用非条件Logistic回归分析.结果:多因素非条件Logistic 回归分析显示40岁以下膀胱癌患者与下列

  4. Educational and cognitive competence of the younger schoolboy: the concept, the specific stages of development and

    Mariya Afanaseva

    2013-01-01

    competence of the younger schoolboy ", the stages of its formation in the process of learning activities. The author cites the "generalized portrait" of different levels of cognitive competence of primary school children, based on research, years of experience, observation.

  5. Adalimumab in Patients with Active Noninfectious Uveitis.

    Jaffe, Glenn J; Dick, Andrew D; Brézin, Antoine P; Nguyen, Quan Dong; Thorne, Jennifer E; Kestelyn, Philippe; Barisani-Asenbauer, Talin; Franco, Pablo; Heiligenhaus, Arnd; Scales, David; Chu, David S; Camez, Anne; Kwatra, Nisha V; Song, Alexandra P; Kron, Martina; Tari, Samir; Suhler, Eric B

    2016-09-01

    Background Patients with noninfectious uveitis are at risk for long-term complications of uncontrolled inflammation, as well as for the adverse effects of long-term glucocorticoid therapy. We conducted a trial to assess the efficacy and safety of adalimumab as a glucocorticoid-sparing agent for the treatment of noninfectious uveitis. Methods This multinational phase 3 trial involved adults who had active noninfectious intermediate uveitis, posterior uveitis, or panuveitis despite having received prednisone treatment for 2 or more weeks. Investigators and patients were unaware of the study-group assignments. Patients were randomly assigned in a 1:1 ratio to receive adalimumab (a loading dose of 80 mg followed by a dose of 40 mg every 2 weeks) or matched placebo. All patients received a mandatory prednisone burst followed by tapering of prednisone over the course of 15 weeks. The primary efficacy end point was the time to treatment failure occurring at or after week 6. Treatment failure was a multicomponent outcome that was based on assessment of new inflammatory lesions, best corrected visual acuity, anterior chamber cell grade, and vitreous haze grade. Nine ranked secondary efficacy end points were assessed, and adverse events were reported. Results The median time to treatment failure was 24 weeks in the adalimumab group and 13 weeks in the placebo group. Among the 217 patients in the intention-to-treat population, those receiving adalimumab were less likely than those in the placebo group to have treatment failure (hazard ratio, 0.50; 95% confidence interval, 0.36 to 0.70; Pplacebo group. Adverse events and serious adverse events were reported more frequently among patients who received adalimumab (1052.4 vs. 971.7 adverse events and 28.8 vs. 13.6 serious adverse events per 100 person-years). Conclusions In our trial, adalimumab was found to be associated with a lower risk of uveitic flare or visual impairment and with more adverse events and serious adverse

  6. High feasibility and antileukemic efficacy of fludarabine, cytarabine, and idarubicin (FLAI) induction followed by risk-oriented consolidation: A critical review of a 10-year, single-center experience in younger, non M3 AML patients.

    Guolo, Fabio; Minetto, Paola; Clavio, Marino; Miglino, Maurizio; Di Grazia, Carmen; Ballerini, Filippo; Pastori, Giordana; Guardo, Daniela; Colombo, Nicoletta; Kunkl, Annalisa; Fugazza, Giuseppina; Rebesco, Barbara; Sessarego, Mario; Lemoli, Roberto Massimo; Bacigalupo, Andrea; Gobbi, Marco

    2016-08-01

    About 105 consecutive acute myeloid leukemia (AML) patients treated with the same induction-consolidation program between 2004 and 2013 were retrospectively analyzed. Median age was 47 years. The first induction course included fludarabine (Flu) and high-dose cytarabine (Ara-C) plus idarubicin (Ida), with or without gemtuzumab-ozogamicin (GO) 3 mg/m(2) (FLAI-5). Patients achieving complete remission (CR) received a second course without fludarabine but with higher dose of idarubicin. Patients not achieving CR received an intensified second course. Patients not scheduled for early allogeneic bone marrow transplantation (HSCT) where planned to receive at least two courses of consolidation therapy with Ara-C. Our double induction strategy significantly differs from described fludarabine-containing regimens, as patients achieving CR receive a second course without fludarabine, to avoid excess toxicity, and Ara-C consolidation is administrated at the reduced cumulative dose of 8 g/m(2) per cycle. Toxicity is a major concern in fludarabine containing induction, including the recent Medical Research Council AML15 fludarabine, cytarabine, idaraubicin and G-CSF (FLAG-Ida) arm, and, despite higher anti-leukemic efficacy, only a minority of patients is able to complete the full planned program. In this article, we show that our therapeutic program is generally well tolerated, as most patients were able to receive subsequent therapy at full dose and in a timely manner, with a 30-day mortality of 4.8%. The omission of fludarabine in the second course did not reduce efficacy, as a CR rate of 83% was achieved and 3-year disease-free survival and overall survival (OS) were 49.6% and 50.9%, respectively. Our experience shows that FLAI-5/Ara-C + Ida double induction followed by risk-oriented consolidation therapy can result in good overall outcome with acceptable toxicity. Am. J. Hematol. 91:755-762, 2016. © 2016 Wiley Periodicals, Inc. PMID:27084986

  7. The impact on outcome of the addition of all-trans retinoic acid to intensive chemotherapy in younger patients with nonacute promyelocytic acute myeloid leukemia: overall results and results in genotypic subgroups defined by mutations in NPM1, FLT3, and CEBPA.

    Burnett, Alan K; Hills, Robert K; Green, Claire; Jenkinson, Sarah; Koo, Kenneth; Patel, Yashma; Guy, Carol; Gilkes, Amanda; Milligan, Donald W; Goldstone, Anthony H; Prentice, Archibald G; Wheatley, Keith; Linch, David C; Gale, Rosemary E

    2010-02-01

    We investigated the benefit of adding all-trans retinoic acid (ATRA) to chemotherapy for younger patients with nonacute promyelocytic acute myeloid leukemia and high-risk myelodysplastic syndrome, and considered interactions between treatment and molecular markers. Overall, 1075 patients less than 60 years of age were randomized to receive or not receive ATRA in addition to daunorubicin/Ara-C/thioguanine chemotherapy with Ara-C at standard or double standard dose. There were data on FLT3 internal tandem duplications and NPM1 mutations (n = 592), CEBPA mutations (n = 423), and MN1 expression (n = 195). The complete remission rate was 68% with complete remission with incomplete count recovery in an additional 16%; 8-year overall survival was 32%. There was no significant treatment effect for any outcome, with no significant interactions between treatment and demographics, or cytarabine randomization. Importantly, there were no interactions by FLT3/internal tandem duplications, NPM1, or CEBPA mutation. There was a suggestion that ATRA reduced relapse in patients with lower MN1 levels, but no significant effect on overall survival. Results were consistent when restricted to patients with normal karyotype. ATRA has no overall effect on treatment outcomes in this group of patients. The study did not identify any subgroup of patients likely to derive a significant survival benefit from the addition of ATRA to chemotherapy. PMID:19965647

  8. [Tissue grafts: an activity concerning many patients].

    Loty, B

    1997-11-15

    Tissue allografts mainly include corneas, bone (and cartilage, tendon, ligament, aponevrosis), skin, vessels and cardiac valves. All these grafts have been widely used for many years and were the subject of a large number of experimental and clinical studies. The different steps allowing the obtention of different tissue allografts have in fact a common organization through tissue procurement and banking activities. Tissue banks have a central situation ensuring security, safety, traceability and distribution of tissues. Appropriate organization of the banks, and respect of high level standards are thus mandatory. Tissue transplantation activity in France has been studied through national surveys: they concern more than 600 hospitals and clinics, and grafts procured in France (excluding imported allografts) are around 15,000 a year. Precise regulation implied by the bioethical law published in 1994 and homogeneous organization of the activity allow the use of stringent and regularly updated standards, allowing the distribution to the patients of safe grafts procured in ethical conditions. The actual shortage of tissue allografts in France implies increasing procurement through a better organization of retrieval in hospitals and clinics and donation promotion. PMID:9501596

  9. Daily Physical Activity in Stable Heart Failure Patients

    Dontje, Manon L.; van der Wal, Martje H.L; Stolk, Ronald P; Brügemann, Johan; Jaarsma, Tiny; Wijtvliet, Petra E P J; van der Schans, Cees P; Greef, Mathieu H.G.

    2014-01-01

    BACKGROUND:: Physical activity is the only nonpharmacological therapy that is proven to be effective in heart failure (HF) patients in reducing morbidity. To date, little is known about the levels of daily physical activity in HF patients and about related factors. OBJECTIVE:: The objectives of this study were to (a) describe performance-based daily physical activity in HF patients, (b) compare it with physical activity guidelines, and (c) identify related factors of daily physical activity. ...

  10. Sex Suffers for Younger Adults After Heart Attack

    ... gov/news/fullstory_160722.html Sex Suffers for Younger Adults After Heart Attack Lack of interest a ... 2016 (HealthDay News) -- After a heart attack, many younger adults experience sexual difficulties -- and women more so ...

  11. CDC Vital Signs: Preventing Pregnancies in Younger Teens

    ... Read the MMWR Science Clips Preventing Pregnancies in Younger Teens Language: English Español (Spanish) Recommend on Facebook ... sexually transmitted diseases, including HIV/AIDS. Problem Many younger teens give birth at ages 15 to 17. ...

  12. Survey Says: Hair Transplants Make Men Look Younger

    ... html Survey Says: Hair Transplants Make Men Look Younger Study supports notion that balding men appear older, ... a hair transplant, observers thought of them as younger and more attractive, the study found. The transplant ...

  13. Radiation-associated chronic myelogenous leukaemia in younger people

    Chronic myelogenous leukaemia (CML) is known to be induced by exposure to ionizing radiation, as is acute leukaemia. However, CML has been recorded only rarely as a complication of radiation exposure early in life. During the period from 1973 to 1976, 75 patients with CML were admitted to Roswell Park Memorial Institute (RPMI). In addition, 64 patients admitted to RPMI previously were also available for study in 1973. Among 79 patients who were born after 1925, information regarding radiation exposure was obtained in 89%; 49 were interviewed and 21 responded to a mailed questionnaire. Consultation with parents was achieved in 52 of the 70 responding cases (74%). Replies were obtained from 15 of the 18 patients below the age of 25, and were confirmed by parents or siblings in all instances. Replies to the mailed questionnaire were obtained from 45 age- and sex-matched controls. In addition to two patients already known to have radiation exposure for treatment of malignant neoplasms, these inquiries yielded a total of nine patients with histories of radiation exposure for benign conditions. Three had therapeutic irradiation, two for thymic enlargement and one for eczema. Three had exposure in utero by pelvimetry. Two had diagnostic exposure during the perinatal period and one had occupational exposure as a nurse. Four of these patients were below the age of 25. All nine patients had the Ph' chromosome. The course of CML in these patients was not different from that of other patients with Ph' chromosome-positive CML without a history of radiation exposure. A history of radiation exposure was elicited in one-fourth of the younger patients (<25) in this study, compared with one of 45 age- and sex-matched controls without leukaemia (p<0.02)

  14. On Younger Stakeholders and Decommissioning of Nuclear Facilities

    In modern democratic countries, information sharing and effective and open communication concerning dismantling and decommissioning of of nuclear facilities as well as the management of nuclear waste are essential for the task to build the confidence required for any further development of nuclear energy. At the same time, it is often perceived that all decision making processes about nuclear energy policies are probably increasingly influenced by public opinion. Nuclear and radiation safety Authorities have a clear role in this regard to provide unbiased information on any health and safety related issues. In order to meet this need, it is necessary for Authorities and others to understand the values and opinions of the citizens, and especially the younger ones. They hold the key to the future at the same time as their perspective on these issues is the least understood. The need of greater public participation in decision making is becoming increasingly recognised the scientific as well as the political community. Many activities are carried out in order to stimulate to higher levels of public involvement in decision making in this active research area. Younger citizens is a stakeholder group that is often excluded in decision- making processes. The existence of large gaps between the involvement of older and younger stakeholders in decision making processes needs to be addressed, since such imbalances might otherwise lead to unequal opportunities between generations and limit the future consumption level of the coming generations. Another demanding task for the present generation is to assure that appropriate financial resources are injected into the Swedish Nuclear Waste Fund. It will thereby be possible for coming generations to undertake efficient measures in the decommissioning and dismantling of older nuclear facilities. To undertake such measures in line with the environmental and health codex is essential. An appropriate balance in this regard must be

  15. On Younger Stakeholders and Decommissioning of Nuclear Facilities

    Tyszkiewicz, Bogumila; Labor, Bea

    2009-08-15

    In modern democratic countries, information sharing and effective and open communication concerning dismantling and decommissioning of of nuclear facilities as well as the management of nuclear waste are essential for the task to build the confidence required for any further development of nuclear energy. At the same time, it is often perceived that all decision making processes about nuclear energy policies are probably increasingly influenced by public opinion. Nuclear and radiation safety Authorities have a clear role in this regard to provide unbiased information on any health and safety related issues. In order to meet this need, it is necessary for Authorities and others to understand the values and opinions of the citizens, and especially the younger ones. They hold the key to the future at the same time as their perspective on these issues is the least understood. The need of greater public participation in decision making is becoming increasingly recognised the scientific as well as the political community. Many activities are carried out in order to stimulate to higher levels of public involvement in decision making in this active research area. Younger citizens is a stakeholder group that is often excluded in decision- making processes. The existence of large gaps between the involvement of older and younger stakeholders in decision making processes needs to be addressed, since such imbalances might otherwise lead to unequal opportunities between generations and limit the future consumption level of the coming generations. Another demanding task for the present generation is to assure that appropriate financial resources are injected into the Swedish Nuclear Waste Fund. It will thereby be possible for coming generations to undertake efficient measures in the decommissioning and dismantling of older nuclear facilities. To undertake such measures in line with the environmental and health codex is essential. An appropriate balance in this regard must be

  16. Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

    Hartman, Jorine E.; Boezen, H. Marike; Zuidema, Menno J.; de Greef, Mathieu H. G.; ten Hacken, Nick H. T.; Boezen, Hendrika

    2014-01-01

    Background: Physical activity recommendations are hardly studied in patients with chronic obstructive pulmonary disease (COPD), and specifically recommendations that are individualized to a patient's aerobic fitness level are not studied. Objectives: To compare individualized (relative) and nonindiv

  17. Analysis of the Younger Dryas Impact Layer

    Firestone, Richard B.; West, Allen; Revay, Zsolt; Hagstrum, Jonathon T,; Belgya, Thomas; Hee, Shane S. Que; Smith, Alan R.

    2010-02-27

    We have uncovered a thin layer of magnetic grains and microspherules, carbon spherules, and glass-like carbon at nine sites across North America, a site in Belgium, and throughout the rims of 16 Carolina Bays. It is consistent with the ejecta layer from an impact event and has been dated to 12.9 ka BP coinciding with the onset of Younger Dryas (YD) cooling and widespread megafaunal extinctions in North America. At many locations the impact layer is directly below a black mat marking the sudden disappearance of the megafauna and Clovis people. The distribution pattern of the Younger Dryas boundary (YDB) ejecta layer is consistent with an impact near the Great Lakes that deposited terrestrial-like ejecta near the impact site and unusual, titanium-rich projectile-like ejecta further away. High water content associated with the ejecta, up to 28 at. percent hydrogen (H), suggests the impact occurred over the Laurentide Ice Sheet. YDB microspherules and magnetic grains are highly enriched in TiO{sub 2}. Magnetic grains from several sites are enriched in iridium (Ir), up to 117 ppb. The TiO{sub 2}/FeO, K/Th, TiO{sub 2}/Zr, Al{sub 2}O{sub 3}/FeO+MgO, CaO/Al{sub 2}O{sub 3}, REE/ chondrite, FeO/MnO ratios and SiO{sub 2}, Na{sub 2}O, K{sub 2}O, Cr{sub 2}O{sub 3}, Ni, Co, U, Th and other trace element abundances are inconsistent with all terrestrial and extraterrestrial (ET) sources except for KREEP, a lunar igneous rock rich in potassium (K), rare-earth elements (REE), phosphorus (P), and other incompatible elements including U and Th. Normal Fe, Ti, and {sup 238}U/{sup 235}U isotopic abundances were found in the magnetic grains, but {sup 234}U was enriched over equilibrium values by 50 percent in Murray Springs and by 130 percent in Belgium. 40K abundance is enriched by up to 100 percent in YDB sediments and Clovis chert artifacts. Highly vesicular carbon spherules containing nanodiamonds, glass-like carbon, charcoal and soot found in large quantities in the YDB layer are

  18. Lower paraoxonase 1 activity in Tunisian bipolar I patients

    Araoud Manel; Mechri Anwar; Mouhamed Dhouha; Ezzaher Asma; Neffati Fadoua; Douki Wahiba; Gaha Lotfi; Najjar Mohamed

    2010-01-01

    Abstract Background The purpose of this study was to investigate the variations of paraoxonase activity and lipid profile in bipolar I patients, and the association of this activity with the sociodemographic, clinical and therapeutic characteristics of this population. Patients and methods Our study included 66 patients with bipolar I disorder and 64 controls aged 37.9 ± 12.6 and 36.3 ± 18.2 years, respectively. Paraoxonase activity was determined by kinetic methods; high-density lipoprotein ...

  19. Do characteristics of seriously injured older adults differ from those of their younger counterparts in the emergency department?

    Aköz, Ayhan; IŞIK, Memet; ŞAHİN, Hüseyin; EMET, Mücahit

    2013-01-01

    To analyze the injury characteristics of younger and older adult trauma victims. Materials and methods: This was a prospective, cross-sectional, observational, and single-center study including both younger adult and geriatric trauma patients. The relationships between the age groups and the number of consultations in the emergency department (ED) were compared with analysis of covariance after adjusting for Injury Severity Score (ISS). Results: The data consisted of 779 patients, 131 (16.8...

  20. The assessment of anticoagulant activity to predict bleeding outcome in atrial fibrillation patients receiving dabigatran etexilate.

    Chang, Yao-Ting; Hu, Yu-Feng; Liao, Jo-Nan; Chern, Chang-Ming; Lin, Yenn-Jiang; Chang, Shih-Lin; Wu, Cheng-Hsueh; Sung, Shih-Hsien; Wang, Kang-Ling; Lu, Tse-Min; Chao, Tze-Fan; Lo, Li-Wei; Hsu, Li-Chi; Chung, Chih-Ping; Chang, Peter M-H; Hsu, Wei-Hsuan; Chiou, Chuen-Wang; Chen, Shih-Ann

    2016-06-01

    Special circumstances may require the measurement of the anticoagulant effect of dabigatran etexilate. No data currently link any given coagulation test to bleeding outcomes in patients receiving dabigatran etexilate for atrial fibrillation. Nonvalvular atrial fibrillation patients receiving dabigatran etexilate of 110 mg (DE110) or 150 mg (DE150) were consecutively enrolled. The hemoclot thrombin inhibitor (HTI) assay, prothrombin time, and activated partial thromboplastin time (APTT) measurements were correlated with bleeding events during a prospective follow-up. There were 17 bleeding events (8.2%) in 208 patients (74.7 ± 10.3 years old, 67.9% male, median follow-up: 364 days), whereas 15 patients with bleeding events used DE110. Compared with DE110, the patients receiving DE150 were younger and more often male and had lower HAS-BLED and CHA2DS2VASc scores and better renal function. Patients' HTI levels were very variable (DE110, 10-90th percentile: 20.5-223.9 ng/ml). A receiver-operator characteristic curve gave a median cutoff HTI level of 117.7 ng/ml to predict bleeding events (C-statistics: 0.65; P = 0.036), but no cutoff could be determined for prothrombin time or APTT. Based on the Kaplan-Meier analysis, a dabigatran etexilate level greater than 117.7 ng/ml was associated with a higher bleeding rate (15.4% vs. 4.9%, P = 0.01). After multivariate Cox regression analysis, HTI levels, history of stroke, and male sex were independent risk factors for bleeding events. Dabigatran etexilate-HTI levels were independently associated with bleeding in patients receiving routine clinical care. Blood sampling at multiple time points might be needed to increase reliability because of high variation of dabigatran etexilate-HTI levels. PMID:26991859

  1. Long-term Results of a First-Generation Annealed Highly Cross-Linked Polyethylene in Young, Active Patients.

    Ranawat, Chitranjan S; Ranawat, Amar S; Ramteke, Alankar A; Nawabi, Danyal; Meftah, Morteza

    2016-03-01

    The survivorship of total hip arthroplasty in younger patients is dependent on the wear characteristics of the bearing surfaces. Long-term results with conventional polyethylene in young patients show a high failure rate. This study assessed the long-term results of a first-generation annealed highly cross-linked polyethylene (HCLPE) in uncemented total hip arthroplasty in young, active patients. Between 1999 and 2003, 112 total hip arthroplasty procedures performed in 91 patients with an average University of California Los Angeles activity score of 8 and mean age of 53 years (range, 24-65 years) were included from a prospective database. In all patients, a 28-mm metal femoral head on annealed HCLPE (Crossfire; Stryker, Mahwah, New Jersey) was used. At minimum 10-year follow-up (11.5±0.94 years), Kaplan-Meier survivorship was 97% for all failures (1 periprosthetic infection and 1 late dislocation) and 100% for mechanical failure (no revisions for osteolysis or loosening). This study showed low revision rates for wear-related failure and superior survivorship in young, active patients. Oxidation causing failure of the locking mechanism has not been a problem with Crossfire for up to 10 years. [Orthopedics. 2016; 39(2):e225-e229.]. PMID:26811959

  2. Melanoma inhibitory activity in Brazilian patients with cutaneous melanoma*

    Odashiro, Macanori; Hans Filho, Gunter; Pereira, Patricia Rusa; Castro, Ana Rita Coimbra Motta; Stief, Alcione Cavalheiro; Pontes, Elenir Rose Jardim Cury; Odashiro, Alexandre Nakao

    2015-01-01

    BACKGROUND: Melanoma inhibitory activity is a protein secreted by melanoma cells and has been used as a tumor marker. Increased Melanoma inhibitory activity serum levels are related to metastatic disease or tumor recurrence. Currently there are no studies on Melanoma inhibitory activity and cutaneous melanoma involving Brazilian patients. OBJECTIVE: To evaluate the performance and feasibility of measuring Melanoma inhibitory activity levels in Brazilian patients with cutaneous melanoma. METHO...

  3. Pediatric patients: criteria for radiopharmaceuticals activities in diagnostic procedures

    Recent studies recommend new criteria to determine radiopharmaceuticals activities per diagnostic procedures for children and teenagers. In USA, the criteria are: minimum and maximum activity and activity per body weight. The minimum activity is necessary for assuring the quality image due to the minimum requested statistical counting. The reduction of maximum activities minimizes the probability of detriment of radiation. In the European Union (EU), the Pediatric Dosage Card (PDC) proposes combined parameters: category of radiopharmaceutical, patient body weight and minimum activity per procedure. The PDC classifies the radiopharmaceuticals according to their biodistribution in the most sensitive organs. In Brazil, an investigation evaluated radiopharmaceuticals activities administered to 2,411 pediatric patients in sixteen institutions. The Brazilian mean activities per body weight, minimum and maximum activities used per institutions were compared with similar parameters surveyed in thirteen American hospitals. It was also used the PDC model to calculate the minimum activities per radiopharmaceuticals using recorded Brazilian patients corporal masses. The wider differences between Brazilian and USA installations were noticed for minimum activities by as much as a factor of 2 and 8. For 67Ga Citrate, the ranges of activities per patient corporal mass were by as much as a factor of 2 and 9 than activities used in USA. The range of maximum activities presented fewer differences, varying between 0.5 and 2 times for the radiopharmaceuticals studied. The present work needs the collaboration of the professional staff for discussion of the results, to promote regional surveys and to optimize pediatric patient protocols (author)

  4. Employment Status and Perceived Health Status in Younger and Older People with Multiple Sclerosis

    Krokavcova, Martina; Nagyova, Iveta; Rosenberger, Jaroslav; Gavelova, Miriam; Middel, Berrie; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2012-01-01

    This study explores how employment is associated with perceived physical and mental health status in people with multiple sclerosis (MS) adjusted for sociodemographic and clinical variables stratified by age. The sample consisted of 184 MS patients divided into a younger (less than 45 years) and an older (greater than or equal to 45 years) age…

  5. Active surveillance strategy for patients with localised prostate cancer

    Thomsen, Frederik Birkebæk

    2014-01-01

    BACKGROUND: Active surveillance - an initial observational strategy - offers a tailored management of patients with localised prostate cancer. The aim of the strategy is to appoint patients with potentially lethal prostate cancer to curatively intended treatment, while patients with slowly evolving...... criteria in the management of prostate cancer patients on active surveillance is emphasised....... measurements, repeated biopsies, and regular digital rectal examinations. The programme recommended change of management from active surveillance to curatively intended treatment based on PSA doubling time, deteriorating histopathology in repeated prostatic biopsies, and increased clinical tumour category...

  6. Physical activity maintenance in patients with rheumatoid arthritis

    Loeppenthin, K; Esbensen, Bente Appel; Østergaard, Mikkel;

    2014-01-01

    OBJECTIVE: To describe the experience of physical activity maintenance in patients with rheumatoid arthritis. DESIGN: A qualitative salutogenic-oriented interview study. SETTING: A rheumatology outpatient clinic. SUBJECTS: A purposive sample of 16 physically active patients (mean age 50, range 37...

  7. Performance of activities of daily living among hospitalized cancer patients

    Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen;

    2015-01-01

    BACKGROUND: Many cancer patients report unmet rehabilitation needs. Rehabilitation may include activities of daily living (ADL) tasks, but little is known about how cancer patients perform these tasks and how they prioritize their daily activities. Hence, this study aims to identify and character...

  8. Poor survival of ABG I hip prosthesis in younger patients

    Gallo, J.; Langová, K.; Havránek, Vítězslav; Čechová, I.

    2008-01-01

    Roč. 152, č. 1 (2008), s. 152-163. ISSN 1213-8118 Institutional research plan: CEZ:AV0Z10100522 Keywords : total hip arthroplasty * ABG I * survival analysis * hydroxyapatie coating * osteolysis Subject RIV: BH - Optics, Masers, Lasers

  9. Distribution of Active and Resting Periods in the Motor Activity of Patients with Depression and Schizophrenia

    Fasmer, Ole Bernt; Hauge, Erik; Berle, Jan Øystein; Dilsaver, Steven; Oedegaard, Ketil J.

    2015-01-01

    Objective Alterations of activity are prominent features of the major functional psychiatric disorders. Motor activity patterns are characterized by bursts of activity separated by periods with inactivity. The purpose of the present study has been to analyze such active and inactive periods in patients with depression and schizophrenia. Methods Actigraph registrations for 12 days from 24 patients with schizophrenia, 23 with depression and 29 healthy controls. Results Patients with schizophren...

  10. Patient Activation and Mental Health Care Experiences Among Women Veterans

    Kimerling, Rachel; Pavao, Joanne; Wong, Ava

    2016-01-01

    We utilized a nationally representative survey of women veteran primary care users to examine associations between patient activation and mental health care experiences. A dose–response relationship was observed, with odds of high quality ratings significantly greater at each successive level of patient activation. Higher activation levels were also significantly associated with preference concordant care for gender-related preferences (use of female providers, women-only settings, and women-...

  11. Habitual fat intake predicts memory function in younger women

    Edward Leigh eGibson

    2013-12-01

    Full Text Available High intakes of fat have been linked to greater cognitive decline in old age, but such associations may already occur in younger adults. We tested memory and learning in 38 women (25-45 years old, recruited for a larger observational study in women with polycystic ovary syndrome. These women varied in health status, though not significantly between cases (n=23 and controls (n=15. Performance on tests sensitive to medial temporal lobe function (CANTABeclipse, Cambridge Cognition Ltd., i.e. verbal memory, visuo-spatial learning and delayed pattern matching, were compared with intakes of macronutrients from 7-day diet diaries and physiological indices of metabolic syndrome. Partial correlations were adjusted for age, activity and verbal IQ (National Adult Reading Test. Greater intakes of saturated and trans fats, and higher saturated to unsaturated fat ratio (Sat:UFA, were associated with more errors on the visuo-spatial task and with poorer word recall and recognition. Unexpectedly, higher UFA intake predicted poorer performance on the word recall and recognition measures. Fasting insulin was positively correlated with poorer word recognition only, whereas higher blood total cholesterol was associated only with visuo-spatial learning errors. None of these variables predicted performance on a delayed pattern matching test. The significant nutrient-cognition relationships were tested for mediation by total energy intake: saturated and trans fat intakes, and Sat:UFA, remained significant predictors specifically of visuo-spatial learning errors, whereas total fat and UFA intakes now predicted only poorer word recall. Examination of associations separately for mono- (MUFA and polyunsaturated fats suggested that only MUFA intake was predictive of poorer word recall. Saturated and trans fats, and fasting insulin, may already be associated with cognitive deficits in younger women. The findings need extending but may have important implications for public

  12. First Younger Dryas moraines in Greenland

    Funder, Svend; Larsen, Nicolaj K.; Linge, Henriette; Möller, Per; Schomacker, Anders; Fabel, Derek; Kjær, Kurt H.; Xu, Sheng

    2016-04-01

    Over the Greenland ice sheet the Younger Dryas (YD) cold climate oscillation (12.9-11.7 kaBP) began with up to 10°C drop in temperatures and ended with up to 12°C abrupt warming. In the light of the present warming and melting of the ice sheet, and its importance for future climate change, the ice sheet's response to these dramatic changes in the past is of great interest. However, even though much effort has gone into charting YD ice margin behaviour around Greenland in recent years, no clear-cut signal of response to the oscillation has been uncovered. Here we show evidence to suggest that three major outlets from a local ice cap at Greenland's north coast advanced and retreated synchronously during YD. The evidence comprises OSL (optically stimulated luminescence) dates from a marine transgression of the coastal valleys that preceded the advance, and exposure ages from boulders on the moraines, formed by glaciers that overrode the marine sediment. The OSL ages suggest a maximum age of 12.4 ±0.6 kaBP for the marine incursion, and 10 exposure ages on boulders from the three moraines provide an average minimum age of 12.5 ±0.7 kaBP for the moraines, implying that the moraines were formed within the interval 11.8-13.0 kaBP. Elsewhere in Greenland evidence for readvance has been recorded in two areas. Most notably, in the East Greenland fjord zone outlet glaciers over a stretch of 800 km coast advanced through the fjords. In Scoresby Sund, where the moraines form a wide belt, an extensive 14C and exposure dating programme has shown that the readvance here probably culminated before YD, while cessation of moraine formation and rapid retreat from the moraine belt did not commence until c. 11.5 kaBP, but no moraines have so far been dated to YD. Readvance is also seen in Disko Bugt, the largest ice sheet outlet in West Greenland. However, here the advance and retreat of the ice stream took place in mid YD times, and lasted only a few hundred years, while YD in

  13. Pacemaker patients' perception of unsafe activities: a survey

    Shafquat Azam

    2008-11-01

    Full Text Available Abstract Background Cardiac pacing is a recognized and widely used treatment for patients presenting with bradycardia. Physicians expect patients to return to normal activities almost immediately post implantation. However, patients themselves may perceive interference to pacemaker function by various routine activities and devices, and hence continue to lead restricted, disabled lives. The aim of this study is to determine if routine activities are perceived by pacemaker patients to interfere with their device function. Methods A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded. Results The final sample included 93 adult patients (45% males. 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%, passing through metal detectors (31%, bending over (37%, and sleeping on the side of the pacemaker (30%. Also considered unsafe were operation of household appliances- TV/VCR (television/video cassette recorders (53%, irons (55% and electrical wall switches (56%. For nearly all variables neither literacy nor history of counselling improved incorrect perceptions. Conclusion This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these

  14. Parkin gene mutations in younger onset Parkinson's disease

    Piu Chan; Hua Bai; Rong Chen; J Willian Langston

    2000-01-01

    Objective': To screen for exonic and point mutations in the Parkin gene in both Chinese and American Caucasian younger onset Parkinson's disease (YOPD) patients.Background: Recently, the Autosomal recessive juvenile parkinsonism (ARJP) gene was first mapped to chromosome 6q25.2-27 and was late cloned and designated as Parkin. A wide variety of mutations, including homozygous exonic deletions and point mutations,have been found in at least more than 50 ARJP families of Japanese, European and Jewish origins. However, the distribution of Parkin gene mutations is not known in the Chinese and American Caucasians, It is also not clear how frequent the Parkin gene mutations occur in YOPD patients. Method and Material: Twenty-one Chinese subjects were selected from 121 Chinese PD inpatients who were admitted to the Xuanwu Hospital in Beijing between August of 1998 and April of 1999 and had an onset before age 51. Thirty-eight American subjects were PD patients with an onset before age 41 from the Tissue Bank of the Parkinson′s Institute at California. Homozygous exonic deletion and point mutations in all 12 exons of the Parkin gene were screened using PCR, SSCP and direct sequencing methods. Mutations identified by sequencing were further confirmed by restriction enzyme digestion. Results: Five different types of homozygous deletion mutations (exons 1, 4, 6, 7 and 12) were found in 7 out of 21 Chinese cases but none of the 37 American Caucasian patients in all 12 exons of Parkin gene. One novel and four polymorphic mutationswere found in the American Caucasian YOPD cases.Conclusion: our results suggest that homozygous exonic deletions in the Parkin gene may account for a significant amount of YOPD in the Chinese but not in the American Caucasian YOPD.

  15. Obesity and sexual dysfunction in younger Danish men

    Andersen, Ingelise; Heitman, B. L.; Wagner, Gorm

    2008-01-01

    examine a possible association between sexual disorders (erectile dysfunction, ejaculatory disorders, and sexual desire disorders) and obesity among younger men born and living in Denmark. METHODS: A community-based cross-sectional study of sexual health among Danish younger men. Questionnaires were...... to height, weight, smoking status, and alcohol consumption. Erectile dysfunction (ED) was more prevalent among these younger and older men with higher BMI, but only significant among men 20-45 years old, with an odds ratio of 2.74 (95% confidence interval 1.1-6.8). The prevalence of ED was higher...... among the younger obese nonsmokers than obese smokers. Premature ejaculation, retarded ejaculation, and sexual desire disorders were all unrelated to overweight or obesity. CONCLUSION: Obesity (BMI > or = 30 kg/m(2)) seems associated with ED among younger men aged 20-45 years. Health programs directed...

  16. Lower paraoxonase 1 activity in Tunisian bipolar I patients

    Araoud Manel

    2010-10-01

    Full Text Available Abstract Background The purpose of this study was to investigate the variations of paraoxonase activity and lipid profile in bipolar I patients, and the association of this activity with the sociodemographic, clinical and therapeutic characteristics of this population. Patients and methods Our study included 66 patients with bipolar I disorder and 64 controls aged 37.9 ± 12.6 and 36.3 ± 18.2 years, respectively. Paraoxonase activity was determined by kinetic methods; high-density lipoprotein cholesterol (c-HDL, low-density lipoprotein cholesterol (c-LDL, triglycerides and total cholesterol were determined by enzymatic methods; apolipoprotein (ApoA1, ApoB and lipoprotein (a (Lp(a were determined by immunoturbidimetry using Konelab 30 equipment (Thermo Scientific. Results Compared with controls, patients had a significantly lower paraoxonase activity and ApoA1 level, and significantly higher total cholesterol, c-LDL and Lp(a level and ApoB/ApoA1 ratio. Furthermore, paraoxonase activity was significantly correlated with c-HDL values (r = 0.5612; P Conclusions Bipolar patients had a significant decrease in paraoxonase activity and perturbations in their lipid profile that contribute to increased risk of cardiovascular diseases. Decrease in this activity was significantly associated with treatment with lithium but not with sociodemographic and clinical characteristics. Therefore, such patients require specific care, particularly with regard to their lipid profile.

  17. Educational and cognitive competence younger pupils: the concept, the specificity and stages of

    Afanasjeva, Marija

    2013-01-01

    The article reveals the concept of "learning and cognitive competence younger pupils' stages of its formation in the process of learning activity. The author cites the "generalized portrait 'different levels of cognitive competence of primary school children, based on research, experience, and observation.

  18. Educational and cognitive competence of the younger schoolboy: the concept, the specific stages of development and

    Mariya Afanaseva

    2013-04-01

    Full Text Available competence of the younger schoolboy ", the stages of its formation in the process of learning activities. The author cites the "generalized portrait" of different levels of cognitive competence of primary school children, based on research, years of experience, observation.

  19. Treatment with active orthodontic appliance in adult patient

    Radeska, Ana; Radeski, Josif; Zlatanovska, Katerina; Papakoca, Kiro; Zarkova, Julija

    2012-01-01

    Aim: Showing the efficiency of orthodontic mobile appliance in treatment of adult patient Case summary: The patient A.K. Age 25 years whit forced progenia, bilateral hypodontia of the maxillary incisors and cross bite of 2 mm in front. The patient was treated with active orthodontic appliance whit bitten ridge and down labial arch. The treatment lasted 18 months after which periods is reached normal occlusion with normal overlap in front and closed diastema mediana. The hypodontia of the m...

  20. Serum paraoxonase activity and protein thiols in patients with hyperlipidemia

    Mungli Prakash; Jeevan K Shetty; Sudeshna Tripathy; Pannuri Vikram; Manish Verma

    2009-01-01

    Objective: In the present study we evaluated the paraoxonase activity and protein thiols level in south Indian population with newly diagnosed hyperlipidemia. Methods: The study was conducted on 55 newly diagnosed hyperlipidemic pa-tients and 57 healthy controls. Serum paraoxonase activity and protein thiols were estimated by spectrophotometeric method and lipid profile by enzymatic kinetic assay method. Results: Serum paraoxonase activity, protein thiols and high density lipoprotein levels were low and total cholesterol, triglycerides and low density lipoprutein levels were high in patients with hyperlipidemia compared to healthy controls ( P < 0.01 ). Serum paranxonase activity correlated positively with protein thiols and high density lipoprotein (P<0.01). Conclusion: Decreased paraoxonase activity and protein thiols were found in patients with hyperlipi-demia. This may indicate the susceptibility of this population to accelerated atherogenesis and protein oxidation.

  1. DETECTION OF TELOMERASE ACTIVITY IN PATIENTS WITH MYCOSIS FUNGOIDES

    应作霖; 孙建方; 刘珊

    2003-01-01

    Objectives. To detect telomerase activity in patients with mycosis fungoides (MF) and to study therole of telomerase in the tumorigenesis of MF.Methods. The technique of PCR-ELISA was employed to detect telomerase activity in 35 patientswith various stages of MF.Results. 92.3% tumor stage of MF, 78.6% plaque stage of MF and 75.0% patch stage of MF hadpositive telomerase activity. The control samples had no telomerase activity. Telomerase activity in tumorstage of MF was significantly higher than that in plaque stage, while the latter was higher than that inpatch stage. Telomerase activity was correlated with the stage of MF.Conclusion. High level of telomerase activity frequently occurred in patients with MF, suggestingthat telomerase might play an important role in the tumorigenesis of MF and is a useful marker for thediagnosis of MF possibly.

  2. Interaction between functional health literacy, patient activation, and glycemic control

    Woodard LD

    2014-07-01

    Full Text Available LeChauncy D Woodard, Cassie R Landrum, Amber B Amspoker, David Ramsey, Aanand D Naik Veterans Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Background: Functional health literacy (FHL and patient activation can impact diabetes control through enhanced diabetes self-management. Less is known about the combined effect of these characteristics on diabetes outcomes. Using brief, validated measures, we examined the interaction between FHL and patient activation in predicting glycosylated hemoglobin (HbA1c control among a cohort of multimorbid diabetic patients.Methods: We administered a survey via mail to 387 diabetic patients with coexisting ­hypertension and ischemic heart disease who received outpatient care at one regional VA medical center between November 2010 and December 2010. We identified patients with the study conditions using the International Classification of Diseases-Ninth Revision-Clinical ­Modification (ICD-9-CM diagnoses codes and Current Procedure Terminology (CPT ­procedures codes. Surveys were returned by 195 (50.4% patients. We determined patient activation levels based on participant responses to the 13-item Patient Activation Measure and FHL levels using the single-item screening question, “How confident are you filling out medical forms by yourself?” We reviewed patient medical records to assess glycemic control. We used multiple logistic regression to examine whether activation and FHL were individually or jointly related to HbA1c control.Results: Neither patient activation nor FHL was independently related to glycemic control in the unadjusted main effects model; however, the interaction between the two was significantly associated with glycemic control (odds ratio 1.05 [95% confidence

  3. Cortical activity in tinnitus patients and its modification by phonostimulation

    Katarzyna Pawlak-Osińska

    2013-04-01

    Full Text Available OBJECTIVE: The goal of this study was to observe spontaneous cortical activity and cortical activity modulated by tinnitus-matched sound in tinnitus patients and healthy subjects with no otoneurologic symptoms. METHOD: Data were prospectively collected from 50 tinnitus patients and 25 healthy subjects. Cortical activity was recorded in all subjects with eyes closed and open and during photostimulation, hyperventilation and acoustic stimulation using 19-channel quantitative electroencephalography. The sound applied in the tinnitus patients was individually matched with the ability to mask or equal the tinnitus. The maximal and mean amplitude of the delta, theta, alpha and beta waves and the type and amount of the pathologic EEG patterns were noted during each recording. Differences in cortical localization and the influence of sound stimuli on spontaneous cortical activity were evaluated between the groups. RESULTS: The tinnitus group exhibited decreased delta activity and increased alpha and beta activity. Hyperventilation increased the intensity of the differences. The tinnitus patients had more sharp-slow waves and increased slow wave amplitude. Sound stimuli modified the EEG recordings; the delta and beta wave amplitudes were increased, whereas the alpha-1 wave amplitude was decreased. Acoustic stimulation only slightly affected the temporal region. CONCLUSION: Cortical activity in the tinnitus patients clearly differed from that in healthy subjects, i.e., tinnitus is not a “phantom” sign. The changes in cortical activity included decreased delta wave amplitudes, increased alpha-1, beta-1 and beta-h wave amplitudes and pathologic patterns. Cortical activity modifications occurred predominantly in the temporal region. Acoustic stimulation affected spontaneous cortical activity only in tinnitus patients, and although the applied sound was individually matched, the pathologic changes were only slightly improved.

  4. Synchronization of EEG activity in patients with bipolar disorder

    Panischev, O. Yu; Demin, S. A.; Muhametshin, I. G.; Demina, N. Yu

    2015-12-01

    In paper we apply the method based on the Flicker-Noise Spectroscopy (FNS) to determine the differences in frequency-phase synchronization of the cortical electroencephalographic (EEG) activities in patients with bipolar disorder (BD). We found that for healthy subjects the frequency-phase synchronization of EEGs from long-range electrodes was significantly better for BD patients. In BD patients a high synchronization of EEGs was observed only for short-range electrodes. Thus, the FNS is a simple graphical method for qualitative analysis can be applied to identify the synchronization effects in EEG activity and, probably, may be used for the diagnosis of this syndrome.

  5. Measuring patient activation in the Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13)

    Rademakers Jany; Nijman Jessica; van der Hoek Lucas; Heijmans Monique; Rijken Mieke

    2012-01-01

    Abstract Background The American short form Patient Activation Measure (PAM) is a 13-item instrument which assesses patient (or consumer) self-reported knowledge, skills and confidence for self-management of one’s health or chronic condition. In this study the PAM was translated into a Dutch version; psychometric properties of the Dutch version were established and the instrument was validated in a panel of chronically ill patients. Methods The translation was done according to WHO guidelines...

  6. Compensatory muscle activation in patients with glenohumeral cuff tears

    Steenbrink, Franciscus

    2010-01-01

    Patients suffering tendon tears in the glenohumeral cuff muscles show activation of muscles which pull the arm downwards during arm elevation tasks. This so-called co-activation deviates from healthy controls and is triggered by pain. Goal of this thesis was to demonstrate that deviating muscle acti

  7. Drive for activity in patients with anorexia nervosa

    Sternheim, Lot; Danner, Unna; Adan, Roger; van Elburg, Annemarie

    2014-01-01

    OBJECTIVE: Hyperactivity and elevated physical activity are both considered symptom characteristics of anorexia nervosa (AN). It has been suggested that a drive for activity (DFA) may underlie these expressions, yet research into DFA in AN remains scant. This study investigated DFA levels in patient

  8. Somatomedin activity in synovial fluid from patients with joint diseases

    The somatomedin activity in synovial fluids from 50 patients with a variety of joint diseases has been studied and compared with the activity in each of the Patient's own serum and a standard reference serum (SRS). The porcine costal cartilage bioassay of Van den Brande and Du Caju (Acta Endocrinologica, 75, 233, 1974), has been used with the isotopes 3H-thymidine and 35S-sulphate. Synovial fluids from most patients with post-traumatic and post-operative effusions, osteoarthritis and arthritis associated with psoriasis, Reiter's disease, and ankylosing spondylitis stimulated the synthesis of DNA and proteoglycans in cartilage. Synovial fluids from patients with rheumatoid arthritis either had impaired capacity to stimulate DNA synthesis, or they inhibited it; a similar, but less evident pattern was observed for proteoglycan synthesis. Some synovial fluids from patients with miscellaneous synovitides stimulated, while other inhibited cartilage metabolism. It is concluded that the synovial fluid from patients with rheumatoid arthritis and from patients with miscellaneous synovitides contained an inhibitor(s) to DNA and possible proteoglycan synthesis. The sera from nearly all the patients stimulated both DNA and proteoglycan synthesis, but the somatomedin potency ratios for serum in terms of SRS were generally less than 1.0. There was a significant inverse correlation between the serum somatomedin potency ratio and the age of the patient. (author)

  9. Neural basis for recognition confidence in younger and older adults

    Chua, Elizabeth F.; Schacter, Daniel L.; Sperling, Reisa A.

    2009-01-01

    Although several studies have examined the neural basis for age-related changes in objective memory performance, less is known about how the process of memory monitoring changes with aging. We used fMRI to examine retrospective confidence in memory performance in aging. During low confidence, both younger and older adults showed behavioral evidence that they were guessing during recognition, and that they were aware they were guessing when making confidence judgments. Similarly, both younger ...

  10. Managing hypercholesterolemia and preventing cardiovascular events in elderly and younger Chinese adults: focus on rosuvastatin

    Wang Z

    2013-12-01

    Full Text Available Zhen Wang, Junbo GeDepartment of Cardiology, Zhongshan Hospital, Shanghai, People's Republic of ChinaAbstract: Coronary heart disease (CHD is the leading cause of death worldwide. The efficacy and safety of statins in primary and secondary prevention of CHD is confirmed in several large studies, and rosuvastatin is the latest statin on market. We review the published literature on rosuvastatin in Chinese people. The pharmacokinetics of rosuvastatin in Chinese is somewhat different from that in Caucasians, but this does not influence the linear relationship between dosage and efficacy and with no drug accumulation. Rosuvastatin 5–20 mg/day is effective and safe in decreasing low-density lipoprotein cholesterol in both younger and elderly patients with hypercholesterolemia, even in very elderly patients. Rosuvastatin also shows anti-inflammatory and antiatherosclerosis features, such as reducing carotid intima-media thickness and plaque area. Rosuvastatin can also improve the prognosis of Chinese CHD patients, such as in the case of acute myocardial infarction. Its adverse-event rate is low and comparable to other statins. In conclusion, rosuvastatin is effective and safe for younger or elderly Chinese patients.Keywords: rosuvastatin, Chinese, younger, elderly

  11. Development of the Patient Activation Measure for mental health.

    Green, Carla A; Perrin, Nancy A; Polen, Michael R; Leo, Michael C; Hibbard, Judith H; Tusler, Martin

    2010-07-01

    Our objective was to adapt the physical health Patient Activation Measure (PAM) for use among people with mental health conditions (PAM-MH). Data came from three studies among people with chronic mental health conditions and were combined in Rasch analyses. The PAM-MH's psychometric properties equal those of the original 13-item PAM. Test-retest reliability and concurrent validity were good, and the PAM-MH showed sensitivity to change. The PAM-MH appears to be a reliable and valid measure of patient activation among individuals with mental health problems. It appears to have potential for use in assessing change in activation. PMID:19728074

  12. Risk of Cardiomyopathy in Younger Persons With a Family History of Death from Cardiomyopathy

    Ranthe, Mattis F; Carstensen, Lisbeth; Øyen, Nina;

    2015-01-01

    at the population level is unclear. In a nationwide cohort, we examined the risk of cardiomyopathy by family history of premature death (data, we constructed a cohort of 3.9 million persons born from 1950 to 2008. We......BACKGROUND: Recommendations for presymptomatic screening of relatives of cardiomyopathy patients are based on findings from tertiary centers. Cardiomyopathy inheritance patterns are fairly well understood, but how cardiomyopathy in younger persons (... ascertained family history of premature (

  13. VASCULAR DEMENTIA TYPE BINSWANGER'S DISEASE IN PATIENTS WITH ACTIVE NEUROCYSTICERCOSIS.

    Foyaca Sibat H, MD.

    2003-01-01

    Full Text Available We report seven patients who presented with clinical manifestations of ischemic cerebrovascular disease (CVD, dementia, and on CT Scan radiological signs of active neurocysticercosis and Binswanger’s Disease (BD were found. Two patients died due to bilateral pulmonary thromboembolism secondary to deep venous thrombosis on lower limbs and the others remain alive. In almost all of them after one day of treatment with praziquantel(PZQ some aggravation of the clinical manifestations of BD were observed. We have hypothesized about the Taenia solium-microglial activation-coagulation disorder and glial disorders-Blood-Brain-Barrier disturbances-Binswanger’s disease. We considered that anti-parasitic therapy for active NCC in patients with an associated BD should be prescribed for some isolated cases when it’s extremely necessary.

  14. Demoralization, Patient Activation, and the Outcome of Spine Surgery.

    Block, Andrew R

    2016-01-01

    It is now well established that psychosocial factors can adversely impact the outcome of spine surgery. This article discusses in detail one such recently-identified "risk" factor: demoralization. Several studies conducted by the author indicate that demoralization, an emotional construct distinct from depression, is associated with poorer pain reduction, less functional improvement and decreased satisfaction among spine surgery patients. However, there are indications that the adverse impact of risk factors such as demoralization can be mitigated by psychosocial "maximizing" factors-characteristics that propel the patient towards positive surgical results. One of these maximizing factors, patient activation, is discussed in depth. The patient activation measure (PAM), an inventory assessing the extent to which patients are active and engaged in their health care, is associated not only with improved spine surgery results, but with better outcomes across a broad range of medical conditions. Other maximizing factors are discussed in this article. The author concludes that the past research focus on psychosocial risk factors has limited the value of presurgical psychological screening, and that future research, as well as clinical assessment, should recognize that the importance of evaluating patients' strengths as well as their vulnerabilities. PMID:27417599

  15. Indications of CT scan after minor head trauma in children. Can age younger than 2 years be a risk factor?

    The indications of CT scan after minor head trauma in children are often discussed, including risks of radiation-induced malignancy. Our aim is to identify whether children younger than 2 years have greater risk of traumatic brain injury compared to older children. We enrolled and analysed 1,830 patients younger than 7 years who underwent CT scans after head trauma in our institute. Patients without any symptoms (n=916) were defined as Group A (age<2: n=391, age 2-6: n=525). Patients with extracranial traumatic findings such as scalp hematoma or laceration, and without any neurological symptoms (n=600) were defined as Group B (age<2: n=163, age 2-6: n=437). In order to analyze whether children younger than 2 years have risks of abnormal CT findings due to head trauma, we used the chi-square test in both Group A and Group B. A P-value of less than 0.05 was considered statistically significant. In Group A, there was no significant difference in the frequency of abnormal CT findings between the younger and older groups (p=0.526). In Group B, however, there was a significant difference between those groups (p=0.0186). We suggest that, based on our findings, children younger than 2 years without any symptoms don't have a greater risk of brain injury compared to older children after minor head trauma. This study might contribute to save those children from receiving unnecessary radiation. (author)

  16. The experience of demanding work environments in younger workers

    Winding, Trine Nøhr; Labriola, Merete; Nohr, Ellen Aagaard;

    2015-01-01

    : To describe the work environment of Danish 20- to 21-year olds and to investigate the influence of family socioeconomic background and individual characteristics at age 14-15 on later experience of physical and psychosocial work environments. METHODS: We obtained information on subjects' school performance......BACKGROUND: Investigating whether certain individual or background characteristics are associated with an increased risk of experiencing an excessively demanding work environment in younger workers may help to reduce future inequality in health and maximize their labour market participation. AIMS...... younger workers aged 20-21. The psychosocial work environment was in general good but younger workers experienced more demanding physical work than the general working population. Overall, individual as well as family factors had a limited impact on their assessment of the work environment. Low self...

  17. Younger Dryas glaciers in the High Atlas, Morocco

    Hughes, Philip; Fink, David

    2016-04-01

    Twelve cirque glaciers formed during the Younger Dryas on the mountains of Aksoual (3912 m a.s.l.) and Adrar el Hajj (3129 m a.s.l.) in the Marrakesh High Atlas. Moraines in two separate cirques on these mountains have been dated using 10Be and 36Cl exposure dating. In both cirques the age scatter is relatively small (13.8-10.1 ka) and all ages overlap within error with the Younger Dryas (12.9-11.7 ka). The glaciers were small and covered depression of > 1000 m from the modern theoretical regional ELA. Under precipitation values similar to today this would require a mean annual temperature depression of 9°C. Moreover, the glacier-climate modelling indicates that it is very unlikely that climate was drier than today during the Younger Dryas in the Marrakesh High Atlas.

  18. Demoralization, Patient Activation, and the Outcome of Spine Surgery

    Andrew R Block

    2016-01-01

    Full Text Available It is now well established that psychosocial factors can adversely impact the outcome of spine surgery. This article discusses in detail one such recently-identified “risk” factor: demoralization. Several studies conducted by the author indicate that demoralization, an emotional construct distinct from depression, is associated with poorer pain reduction, less functional improvement and decreased satisfaction among spine surgery patients. However, there are indications that the adverse impact of risk factors such as demoralization can be mitigated by psychosocial “maximizing” factors—characteristics that propel the patient towards positive surgical results. One of these maximizing factors, patient activation, is discussed in depth. The patient activation measure (PAM, an inventory assessing the extent to which patients are active and engaged in their health care, is associated not only with improved spine surgery results, but with better outcomes across a broad range of medical conditions. Other maximizing factors are discussed in this article. The author concludes that the past research focus on psychosocial risk factors has limited the value of presurgical psychological screening, and that future research, as well as clinical assessment, should recognize that the importance of evaluating patients’ strengths as well as their vulnerabilities.

  19. Adrenocortical activity and hormoneprotein interactions in patients with complicated hypertension

    Patients with essential hypertension and hypertension complicated by coronary heart disease showed adrenal glucocortocoid activation along with reduced transconton binding capacity (TBC). A correlation between TBC and plasma protein level was found. The absence of adrenal functional response to an abrupt drop in TBC is interpreted as a complete failure of the adaptation systems

  20. Drive for activity in patients with anorexia nervosa

    Sternheim, Lot; Danner, Unna; Adan, Roger; Van Elburg, Annemarie

    2015-01-01

    Method Two hundred and forty female patients with AN completed measures for DFA, eating disorder (ED) pathology, anxiety, and clinical parameters. Objective Hyperactivity and elevated physical activity are both considered symptom characteristics of anorexia nervosa (AN). It has been suggested that a

  1. Coagulation activation and microparticle-associated coagulant activity in cancer patients: An exploratory prospective study

    van Doormaal, Frederiek F.; Kleinjan, Ankie; Berckmans, René J.; Mackman, Nigel; Manly, David; Kamphuisen, Pieter W.; Richel, Dick J.; Büller, Harry R.; Sturk, Auguste; Nieuwland, Rienk

    2012-01-01

    Cancer increases the risk of venous thromboembolism (VTE). Here, we investigated the contribution of microparticle (MP)-dependent procoagulant activity to the prothrombotic state in these patients. In 43 cancer patients without VTE at study entry and 22 healthy volunteers, markers of in vivo and MP-

  2. Substance Use Trends among Younger vs. Older Homeless Parolees

    Nyamathi, Adeline; Salem, Benissa; Marshall, Lori; Idemundia, Faith; Mata, Ray; Khalilifard, Farinaz; Farabee, David; Leake, Barbara

    2014-01-01

    This cross-sectional study of 540 homeless ex-offenders exiting prisons and jails assessed sociodemographic, childhood and drug-related differences. Older ex-offenders from prison were more likely to have been married, come from a two-parent family and used crack while younger ex-offenders were more likely to have used methamphetamine. Older ex-offenders from jail were more likely to be African-American, have children, and report a history of crack and injection drug use, while those younger ...

  3. Interleukin-19 impairment in active Crohn's disease patients.

    Elisabet Cantó

    Full Text Available The exact function of interleukin-19 (IL-19 on immune response is poorly understood. In mice, IL-19 up-regulates TNFα and IL-6 expression and its deficiency increases susceptibility to DSS-induced colitis. In humans, IL-19 favors a Th2 response and is elevated in several diseases. We here investigate the expression and effects of IL-19 on cells from active Crohn's disease (CD patient. Twenty-three active CD patients and 20 healthy controls (HC were included. mRNA and protein IL-19 levels were analyzed in monocytes. IL-19 effects were determined in vitro on the T cell phenotype and in the production of cytokines by immune cells. We observed that unstimulated and TLR-activated monocytes expressed significantly lower IL-19 mRNA in active CD patients than in HC (logFC = -1.97 unstimulated; -1.88 with Pam3CSK4; and -1.91 with FSL-1; p<0.001. These results were confirmed at protein level. Exogenous IL-19 had an anti-inflammatory effect on HC but not on CD patients. IL-19 decreased TNFα production in PBMC (850.7 ± 75.29 pg/ml vs 2626.0 ± 350 pg/ml; p<0.01 and increased CTLA4 expression (22.04 ± 1.55% vs 13.98 ± 2.05%; p<0.05 and IL-4 production (32.5 ± 8.9 pg/ml vs 13.5 ± 2.9 pg/ml; p<0.05 in T cells from HC. IL-10 regulated IL-19 production in both active CD patients and HC. We observed that three of the miRNAs that can modulate IL-19 mRNA expression, were up-regulated in monocytes from active CD patients. These results suggested that IL-19 had an anti-inflammatory role in this study. Defects in IL-19 expression and the lack of response to this cytokine could contribute to inflammatory mechanisms in active CD patients.

  4. A breast cancer meta-analysis of two expression measures of chromosomal instability reveals a relationship with younger age at diagnosis and high risk histopathological variables

    Endesfelder, David; McGranahan, Nicholas; Birkbak, Nicolai Juul; Szallasi, Zoltan Imre; Kschischo, Maik; A. Graham, Trevor; Swanton, Charles

    2011-01-01

    Breast cancer in younger patients often presents with adverse histopathological features, including increased frequency of estrogen receptor negative and lymph node positive disease status. Chromosomal instability (CIN) is increasingly recognised as an important prognostic variable in solid tumours...

  5. The correlation between a passion for computer games and the school performance of younger schoolchildren.

    Maliy D.V.

    2015-07-01

    Full Text Available Today computer games occupy a significant place in children’s lives and fundamentally affect the process of the formation and development of their personalities. A number of present-day researchers assert that computer games have a developmental effect on players. Others share the point of view that computer games have negative effects on the cognitive and emotional spheres of a child and claim that children with low self-esteem who neglect their schoolwork and have difficulties in communication are particularly passionate about computer games. This article reviews theoretical and experimental pedagogical and psychological studies of the nature of the correlation between a passion for computer games and the school performance of younger schoolchildren. Our analysis of foreign and Russian psychology studies regarding the problem of playing activities mediated by information and computer technologies allowed us to single out the main criteria for children’s passion for computer games and school performance. This article presents the results of a pilot study of the nature of the correlation between a passion for computer games and the school performance of younger schoolchildren. The research involved 32 pupils (12 girls and 20 boys aged 10-11 years in the 4th grade. The general hypothesis was that there are divergent correlations between the passion of younger schoolchildren for computer games and their school performance. A questionnaire survey administered to the pupils allowed us to obtain information about the amount of time they devoted to computer games, their preferences for computer-game genres, and the extent of their passion for games. To determine the level of school performance we analyzed class registers. To establish the correlation between a passion for computer games and the school performance of younger schoolchildren, as well as to determine the effect of a passion for computer games on the personal qualities of the children

  6. Exercise Holds Immediate Benefits for Affect and Cognition in Younger and Older Adults

    Hogan, Candice L.; Mata, Jutta; Carstensen, Laura L.

    2013-01-01

    Physical activity is associated with improved affective experience and enhanced cognitive processing. Potential age differences in the degree of benefit, however, are poorly understood because most studies examine either younger or older adults. The present study examined age differences in cognitive performance and affective experience immediately following a single bout of moderate exercise. Participants (144 community members aged 19 to 93) were randomly assigned to one of two experimental...

  7. GENDER ORIENTATION FORMATION FEATURES OF YOUNGER PUPILS IN THE EDUCATIONAL PROCESS

    Yulia V. KURBATOVA

    2015-01-01

    In the modern Russian society modernization of education, accompanied by a rethinking, re-evaluating and adopting new values and orientations. Significant changes have affected and General education, in which the system-activity approach is crucial. The subject of study in this paper is the development of gender orientations of younger students in the educational process. In the process of research used complex methods of research: analysis of scientific literature on the research problem, th...

  8. Human Endogenous Retrovirus W Activity in Cartilage of Osteoarthritis Patients

    Signy Bendiksen

    2014-01-01

    Full Text Available The etiology of viruses in osteoarthritis remains controversial because the prevalence of viral nucleic acid sequences in peripheral blood or synovial fluid from osteoarthritis patients and that in healthy control subjects are similar. Until now the presence of virus has not been analyzed in cartilage. We screened cartilage and chondrocytes from advanced and non-/early osteoarthritis patients for parvovirus B19, herpes simplex virus-1, Epstein Barr virus, cytomegalovirus, human herpes virus-6, hepatitis C virus, and human endogenous retroviruses transcripts. Endogenous retroviruses transcripts, but none of the other viruses, were detected in 15 out the 17 patients. Sequencing identified the virus as HERV-WE1 and E2. HERV-W activity was confirmed by high expression levels of syncytin, dsRNA, virus budding, and the presence of virus-like particles in all advanced osteoarthritis cartilages examined. Low levels of HERV-WE1, but not E2 envelope RNA, were observed in 3 out of 8 non-/early osteoarthritis patients, while only 3 out of 7 chondrocytes cultures displayed low levels of syncytin, and just one was positive for virus-like particles. This study demonstrates for the first time activation of HERV-W in cartilage of osteoarthritis patients; however, a causative role for HERV-W in development or deterioration of the disease remains to be proven.

  9. Older and Younger Workers: The Equalling Effects of Health

    Beck, Vanessa; Quinn, Martin

    2012-01-01

    Purpose: The purpose of this paper is to consider the statistical evidence on the effects that ill health has on labour market participation and opportunities for younger and older workers in the East Midlands (UK). Design/methodology/approach: A statistical analysis of Labour Force Survey data was undertaken to demonstrate that health issues…

  10. Memory Dynamics and Decision Making in Younger and Older Adults

    Lechuga, M. Teresa; Gomez-Ariza, Carlos J.; Iglesias-Parro, Sergio; Pelegrina, Santiago

    2012-01-01

    The main aim of this research was to study whether memory dynamics influence older people's choices to the same extent as younger's ones. To do so, we adapted the retrieval-practice paradigm to produce variations in memory accessibility of information on which decisions were made later. Based on previous results, we expected to observe…

  11. The Experiences of the Younger Supervisor: Implications for Organizations

    Hanson, Lea

    2012-01-01

    With four generations in today's workforce, roles are being redefined to include a growing number of younger supervisor/older subordinate relationships, referred to as the intergenerational dyad. What current and limited literature exists about the intergenerational dyad exclusively addresses the issues of generational workplace differences…

  12. Asymmetric pallidal neuronal activity in patients with cervical dystonia

    Edgar Galindo-Leon

    2014-02-01

    Full Text Available The origin of asymmetric clinical manifestation of symptoms in patients suffering from cervical dystonia (CD is hitherto poorly understood. Dysregulated neuronal activity in the basal ganglia has been suggested to have a role in the pathophysiology of CD. Here, we re-assessed the question to what extent relative changes occur in the direct versus indirect basal ganglia pathway in CD, whether these circuit changes are lateralized, and how these alterations relate to CD symptoms. To this end, we recorded ongoing single cell and local field potential (LFP activity from the external (GPe and internal pallidal segment (GPi of thirteen CD patients undergoing microelectrode-guided stereotactic surgery for deep brain stimulation in the GPi. We compared pallidal recordings from CD patients operated under local anaesthesia (LA with those obtained in CD patients operated under general anaesthesia (GA. In awake patients, mean GPe discharge rate (52 Hz was lower than that of GPi (72 Hz. Mean GPi discharge ipsilateral to the side of head turning was higher than contralateral and correlated with torticollis symptom severity. Lateralized differences were absent at the level of the GPe and in recordings from patients operated under GA. Furthermore, in the GPi of CD patients there was a subpopulation of theta-oscillatory cells with unique bursting characteristics. Power and coherence of GPe- and GPi-LFPs were dominated by a theta peak and also exhibited band-specific interhemispheric differences. Strong cross-frequency coupling of low-gamma amplitude to theta phase was a feature of pallidal LFPs recorded under LA, but not GA. These results indicate that CD is associated with an asymmetric pallidal outflow. Based on the finding of symmetric neuronal discharges in the GPe, we propose that an imbalanced interhemispheric direct pathway gain may be involved in CD pathophysiology.

  13. Neutron activation analysis of hair from breast cancer patients

    Hair samples from breast cancer patients were collected at the same time as tumour and normal tissues obtained during mastectomy, in order to determine elemental concentrations and investigate whether hair can act as an epidemiological monitor of the disease. Instrumental neutron activation analysis was used and concentrations for Na, Mg, S, Cl, Ca, Mn, Cu, Zn, Br, I, Sb, Ba, Au and Hg in the hair samples measured. No strong correlations were found between the concentrations of Cl, Cu, Zn and Br in hair and those in tumour tissues and in normal tissues. The level of Zn in the patients hair is low and that of Ca very high

  14. ACTIVE OBSERVATION TACTICS IN PATIENTS WITH KIDNEY NEOPLASMS

    B. Ya. Alekseev

    2012-01-01

    Full Text Available As of now, about 40-60% of the first detected kidney tumors are accidentally diagnosed. These are most often asymptomatic small kidney tumors (SKT without distant metastases; 15–20% of them are benign. A number of studies have revealed that kidney malignant tumors grow slowly and spread extremely rarely, as evidenced by a histological study. These and other data formed the basis for the active observation tactic that became possible and acceptable in well-selected patients, in elderly patients with SKT and severe comorbidity in particular.

  15. Basophil Activation Test with Food Additives in Chronic Urticaria Patients

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the te...

  16. Studies on Activity of NK Cells in Preeclampsia Patients

    张展; 龚非力; 贾莉婷; 常彩红; 侯磊; 杨如镜; 郑芳

    2004-01-01

    The activity of the NK cells in patients with preeclampsia was studied to investigate the pathogenesis of preeclampsia. By using MTT and 51Cr releasing technique, the proliferation and killing ability of the NK cells in maternal and umbilical blood from preeclampsia patients (n= 18)and normal third trimester pregnant women (n= 18) were detected. The NK-92 cell line was as the positive control. The results showed that the NK cell counts of umbilical blood in preeclampsia patients and normal third trimester pregnant women were significantly greater than those of maternal blood (both P<0.05). Compared with that in normal third trimester pregnant women, the proliferative ability of the NK cells in preeclampsia patients was apparently increased (P<0.05). Compared with that in maternal blood, the proliferative ability of the NK cells in umbilical blood from both preeclampsia patients and normal third trimester pregnant women was dramatically increased.The killing ability of the NK cells in preeclampsia patients was significantly higher than that in normal third trimester pregnant women (P <0.05). It was suggested that both number and function of the NK cells in preeclampsia women were increased, and that in umbilical blood was greater than that in maternal blood, speculating that the function of the NK cells may affect the maintenance of the maternal and fetal immune tolerance during pregnancy.

  17. Recognising lifestyle activities of diabetic patients with a smartphone

    Mitja Luštrek

    2015-11-01

    Full Text Available Diabetes is both heavily affected by the patients’ lifestyle, and it affects their lifestyle. Most diabetic patients can manage the disease without technological assistance, so we should not burden them with technology unnecessarily, but lifestylemonitoring technology can still be beneficial both for patients and their physicians. Because of that we developed an approach to lifestyle monitoring that uses the smartphone, which most patients already have. The approach consists of three steps. First, a number of features are extracted from the data acquired by smartphone sensors, such as the user’s location from GPS coordinates and visible wi-fi access points, and the physical activity from accelerometer data. Second, several classifiers trained by machine learning are used to recognise the user’s activity, such as work, exercise or eating. And third, these activities are refined by symbolic reasoning encoded in Event Calculus. The approach was trained and tested on five people who recorded their activities for two weeks each. Its classification accuracy was 0.88.

  18. Glacier retreat in New Zealand during the Younger Dryas stadial.

    Kaplan, Michael R; Schaefer, Joerg M; Denton, George H; Barrell, David J A; Chinn, Trevor J H; Putnam, Aaron E; Andersen, Bjørn G; Finkel, Robert C; Schwartz, Roseanne; Doughty, Alice M

    2010-09-01

    Millennial-scale cold reversals in the high latitudes of both hemispheres interrupted the last transition from full glacial to interglacial climate conditions. The presence of the Younger Dryas stadial (approximately 12.9 to approximately 11.7 kyr ago) is established throughout much of the Northern Hemisphere, but the global timing, nature and extent of the event are not well established. Evidence in mid to low latitudes of the Southern Hemisphere, in particular, has remained perplexing. The debate has in part focused on the behaviour of mountain glaciers in New Zealand, where previous research has found equivocal evidence for the precise timing of increased or reduced ice extent. The interhemispheric behaviour of the climate system during the Younger Dryas thus remains an open question, fundamentally limiting our ability to formulate realistic models of global climate dynamics for this time period. Here we show that New Zealand's glaciers retreated after approximately 13 kyr bp, at the onset of the Younger Dryas, and in general over the subsequent approximately 1.5-kyr period. Our evidence is based on detailed landform mapping, a high-precision (10)Be chronology and reconstruction of former ice extents and snow lines from well-preserved cirque moraines. Our late-glacial glacier chronology matches climatic trends in Antarctica, Southern Ocean behaviour and variations in atmospheric CO(2). The evidence points to a distinct warming of the southern mid-latitude atmosphere during the Younger Dryas and a close coupling between New Zealand's cryosphere and southern high-latitude climate. These findings support the hypothesis that extensive winter sea ice and curtailed meridional ocean overturning in the North Atlantic led to a strong interhemispheric thermal gradient during late-glacial times, in turn leading to increased upwelling and CO(2) release from the Southern Ocean, thereby triggering Southern Hemisphere warming during the northern Younger Dryas. PMID

  19. Prediction of residual metabolic activity after treatment in NSCLC patients

    Rios Velazquez, Emmanuel; Aerts, Hugo J.W.L.; Oberije, Cary; Ruysscher, Dirk De; Lambin, Philippe (Dept. of Radiation Oncology, School for Oncology and Developmental Biology, Maastricht Univ. Medical Center, Maastricht (Netherlands)), E-mail: emmanuel.rios@maastro.nl

    2010-10-15

    Purpose. Metabolic response assessment is often used as a surrogate of local failure and survival. Early identification of patients with residual metabolic activity is essential as this enables selection of patients who could potentially benefit from additional therapy. We report on the development of a pre-treatment prediction model for metabolic response using patient, tumor and treatment factors. Methods. One hundred and one patients with inoperable NSCLC (stage I-IV), treated with 3D conformal radical (chemo)-radiotherapy were retrospectively included in this study. All patients received a pre and post-radiotherapy fluorodeoxyglucose positron emission tomography-computed tomography FDG-PET-CT scan. The electronic medical record system and the medical patient charts were reviewed to obtain demographic, clinical, tumor and treatment data. Primary outcome measure was examined using a metabolic response assessment on a post-radiotherapy FDG-PET-CT scan. Radiotherapy was delivered in fractions of 1.8 Gy, twice a day, with a median prescribed dose of 60 Gy. Results. Overall survival was worse in patients with residual metabolic active areas compared with the patients with a complete metabolic response (p=0.0001). In univariate analysis, three variables were significantly associated with residual disease: larger primary gross tumor volume (GTVprimary, p=0.002), higher pre-treatment maximum standardized uptake value (SUV{sub max}, p=0.0005) in the primary tumor and shorter overall treatment time (OTT, p=0.046). A multivariate model including GTVprimary, SUV{sub max}, equivalent radiation dose at 2 Gy corrected for time (EQD2, T) and OTT yielded an area under the curve assessed by the leave-one-out cross validation of 0.71 (95% CI, 0.65-0.76). Conclusion. Our results confirmed the validity of metabolic response assessment as a surrogate of survival. We developed a multivariate model that is able to identify patients at risk of residual disease. These patients may

  20. Lifestyle, cardiovascular drugs and risk factors in younger and elder adults: The PEP family heart study

    Peter Schwandt

    2010-01-01

    Full Text Available Objectives: This study aimed to compare cardiovascular disease (CVD risk factors, lifestyle habits and pharmacological treatment in two groups of elder adults with 20 years difference in their mean age. Methods: This study comprised 590 women including two groups with mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of two groups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data on physical examination, fasting blood analyses, 7-day dietary re-cords, physical activity, smoking and actual medication use were recorded. Results: Compared with younger individuals, seniors had a more adverse risk factor profile in terms of abdominal obesity, over-weight, hyperglycemia, hypertension, dyslipoproteinemia without differences in HDL-C. But this is not reflected by lifestyle behav-ior. Less than 2% of the elderly and 17% of the younger adults were current smoker. Furthermore, the pattern of physical activ-ity was different in terms of more continuous sports in seniors contrasting with extremes between no sports and more than twice a week in the younger group. Seniors consumed significantly less carbohydrates including more monosaccharide and less polysaccharides, more alcohol and water. The intake of fat and protein was higher in elder women than in all other groups. One third of seniors took antihypertensive medications and 12% used lipid modifying drugs. Conclusions: Different levels of prevention against CVDs and their risk factors shall be considered for various age groups of population. The findings of this study emphasize on the necessity of preventive measures against smoking and physical inactivity in younger adults and dietary habits in seniors.

  1. Clinical outcome 5 to 18 years after the Fontan operation performed on children younger than 5 years.

    Robbers-Visser, D.; Kapusta, L.; Osch-Gevers, L. van; Strengers, J.L.; Boersma, E.; Rijke, Y.B. de; Boomsma, F.; Bogers, A.J.; Helbing, W.A.

    2009-01-01

    OBJECTIVE: This study assessed clinical condition at midterm follow-up after total cavopulmonary connection for a functionally univentricular heart performed on children younger than 5 years. METHODS: Thirty-four Fontan patients (median age 10.4 years, range 6.8-20.7 years, 22 boys, median follow-up

  2. Sexual Activity and Heart Patients: A Contemporary Perspective.

    Stein, Ricardo; Sardinha, Aline; Araújo, Claudio Gil S

    2016-04-01

    Sexual activity (SA) encompasses several behaviors such as kissing (Ki), touching (T), oral (O) stimulation, masturbation (M), and vaginal/anal intercourse (I). The acronym KiTOMI is proposed here to represent these behaviors. SA, particularly coitus, is a major aspect of health-related quality of life and is often considered the most pleasant and rewarding exercise performed during an entire lifetime. Although several studies have been conducted on sexuality, relatively limited information is available regarding SA in patients with heart disease. Moreover, the level of evidence of this limited information is nearly always B or C. This article provides a comprehensive and updated review of the relevant literature and offers evidence and expert-based practical messages regarding SA in patients with heart disease. Considering the rationale for exercise prescription, SA is typically well tolerated by most clinically stable patients with heart disease. Even in more debilitated and sicker individuals, KiT activities would most likely be feasible and desirable. The absolute risk of major adverse cardiovascular events during SA is typically very low. Even lower death rates have been reported for specific groups, such as women in general, aerobically fit men, and asymptomatic young adults with congenital heart disease. Finally, we emphasize the relevance of sexual counselling for patients and their partners, including the proper use of medications to treat erectile dysfunction. Counselled patients will be reassured and adequately informed regarding how to gradually resume habitual SA after a major cardiac event or procedure, starting with KiT and progressively advancing to KiTOM until all KiTOMI activities are allowed. PMID:26690295

  3. Paraoxonase Activity and Oxidative Status in Patients with Tinnitus

    Akyüz, Servet; Somuk, Battal Tahsin; Soyalic, Harun; Yılmaz, Beyhan; Taskin, Abdullah; Bilinc, Hasan; Aksoy, Nurten

    2016-01-01

    Background and Objectives The aim of this study was to investigate serum paraoxanase-1 (PON) activity, total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) in tinnitus; and to compare the results with data from healthy subjects. Subjects and Methods A total of 114 subjects-54 patients with tinnitus and 60 healthy controls were enrolled in this study. Serum PON activity, TOS, TAS, and OSI levels were measured. Results In the tinnitus group, TAS, and PON were significantly lower than in the control group (p<0.001). However, the TOS, and OSI levels were significantly higher in the tinnitus group than in the control group (p<0.001). Conclusions According to the data obtained from the present study, patients with tinnitus were exposed to potent oxidative stress. Oxidative stress may be the key contributing factor to the pathogenesis of tinnitus. PMID:27144229

  4. Limitations of Activities in Patients with Musculoskeletal Disorders

    Banerjee, A.; Jadhav, SL; Bhawalkar, JS

    2012-01-01

    Background: Musculoskeletal disorders (MSD) are the major cause of morbidity throughout the world, having a substantial influence on quality of life (QOL). We studied QOL ascertained by limitations of activities of daily living, impact on family and social relationships, and sleep disturbances among patients with MSD. Aim: Ascertain QOL in MSD. Materials and Methods: A cross-sectional study among 2633 randomly selected subjects. The study was carried out in the field practice area of D Y Pati...

  5. Asymmetric pallidal neuronal activity in patients with cervical dystonia

    Edgar Galindo-Leon; Andrew Sharott; Carsten Buhmann; Koeppen, Johannes A.; Tobias Bäumer

    2014-01-01

    The origin of asymmetric clinical manifestation of symptoms in patients suffering from cervical dystonia (CD) is hitherto poorly understood. Dysregulated neuronal activity in the basal ganglia has been suggested to have a role in the pathophysiology of CD. Here, we re-assessed the question to what extent relative changes occur in the direct versus indirect basal ganglia pathway in CD, whether these circuit changes are lateralized, and how these alterations relate to CD symptoms. To this end, ...

  6. Depressed older adults may be less cared for than depressed younger ones.

    Sanglier, Thibaut; Saragoussi, Delphine; Milea, Dominique; Tournier, Marie

    2015-10-30

    The aim of the study was to investigate depression treatment use, either psychotherapy (PT) or antidepressant drugs (ADT) in the older and younger depressed population. Cohorts of 6316 elderly (≥65 year-old) and 25,264 matched non-elderly (25-64 year-old) depressed patients were created from a large national claims database of managed care plans from 2003 to 2006. Factors associated with ADT or PT were assessed using multivariate logistic models. During the 120 days following the depression diagnosis, the elderly persons were less often treated than the younger adults either by ADT (25.6% vs. 33.8%) or by PT (13.0% vs. 34.4%). ADT dispensing occurred later in the elderly group (51 vs. 14 days). ADT was associated with comorbid chronic conditions or polypharmacy in the elderly and younger adults. The selection of treatment (ADT or PT) was associated with the history of treated depression using the same type of treatment, in both groups. Thus, depression goes commonly untreated. Comorbidity was associated with higher ADT dispensing rates. However, although depressed elderly commonly presented with comorbidity, this age group was at higher risk of untreated illness or later treatment. PMID:26233825

  7. Nonoxidized, biologically active parathyroid hormone determines mortality in hemodialysis patients

    Tepel, Martin; Armbruster, Franz Paul; Grön, Hans Jürgen; Scholze, Alexandra; Reichetzeder, Christoph; Roth, Heinz Jürgen; Hocher, Berthold

    2013-01-01

    Background: It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity. Methods: In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system. Results......: Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival......-oxPTH levels. Conclusions: The predictive power of n-oxPTH and iPTH on the mortality of hemodialysis patients differs substantially. Measurements of n-oxPTH may reflect the hormone status more precisely. The iPTH-associated mortality is most likely describing oxidative stress-related mortality....

  8. Interplay between patient global assessment, pain, and fatigue and influence of other clinical disease activity measures in patients with active rheumatoid arthritis

    Egsmose, Emilie Lund; Madsen, Ole Rintek

    2015-01-01

    analog scales (VAS) in the daily clinic by patients with active rheumatoid arthritis (RA). Associations with other measures of disease activity were also examined. Traditional disease activity data on 221 RA patients with active disease planned to initiate biological treatment were extracted from the...

  9. Spontaneous neutrophil activation in HTLV-1 infected patients

    Jaqueline B. Guerreiro

    2005-12-01

    Full Text Available Human T cell lymphotropic Virus type-1 (HTLV-1 induces lymphocyte activation and proliferation, but little is known about the innate immune response due to HTLV-1 infection. We evaluated the percentage of neutrophils that metabolize Nitroblue tetrazolium (NBT to formazan in HTLV-1 infected subjects and the association between neutrophil activation and IFN-gamma and TNF-alpha levels. Blood was collected from 35 HTLV-1 carriers, from 8 patients with HAM/TSP (HTLV-1- associated myelopathy; 22 healthy individuals were evaluated for spontaneous and lipopolysaccharide (LPS-stimulated neutrophil activity (reduction of NBT to formazan. The production of IFN-gamma and TNF-alpha by unstimulated mononuclear cells was determined by ELISA. Spontaneous NBT levels, as well as spontaneous IFN-gamma and TNF-alpha production, were significantly higher (p<0.001 in HTLV-1 infected subjects than in healthy individuals. A trend towards a positive correlation was noted, with increasing percentage of NBT positive neutrophils and levels of IFN-gamma. The high IFN-gamma producing HTLV-1 patient group had significantly greater NBT than healthy controls, 43±24% and 17±4.8% respectively (p< 0.001, while no significant difference was observed between healthy controls and the low IFN-gamma-producing HTLV-1 patient group (30±20%. Spontaneous neutrophil activation is another marker of immune perturbation resulting from HTLV-1 infection. In vivo activation of neutrophils observed in HTLV-1 infected subjects is likely to be the same process that causes spontaneous IFN-gamma production, or it may partially result from direct IFN-gamma stimulation.

  10. Measuring patient activation in the Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13

    Rademakers Jany

    2012-07-01

    Full Text Available Abstract Background The American short form Patient Activation Measure (PAM is a 13-item instrument which assesses patient (or consumer self-reported knowledge, skills and confidence for self-management of one’s health or chronic condition. In this study the PAM was translated into a Dutch version; psychometric properties of the Dutch version were established and the instrument was validated in a panel of chronically ill patients. Methods The translation was done according to WHO guidelines. The PAM 13-Dutch was sent to 4178 members of the Dutch National Panel of people with Chronic illness or Disability (NPCD in April 2010 (study A and again to a sub sample of this group (N = 973 in June 2010 (study B. Internal consistency, test-retest reliability and cross-validation with the SBSQ-D (a measure for Health literacy were computed. The Dutch results were compared to similar Danish and American data. Results The psychometric properties of the PAM 13-Dutch were generally good. The level of internal consistency is good (α = 0.88 and item-rest correlations are moderate to strong. The Dutch mean PAM score (61.3 is comparable to the American (61.9 and lower than the Danish (64.2. The test-retest reliability was moderate. The association with Health literacy was weak to moderate. Conclusions The PAM-13 Dutch is a reliable instrument to measure patient activation. More research is needed into the validity of the Patient Activation Measure, especially with respect to a more comprehensive measure of Health literacy.

  11. Resting state activity in patients with disorders of consciousness.

    Soddu, Andrea; Vanhaudenhuyse, Audrey; Demertzi, Athena; Bruno, Marie-Aurélie; Tshibanda, Luaba; Di, Haibo; Mélanie, Boly; Papa, Michele; Laureys, Steven; Noirhomme, Quentin

    2011-01-01

    Recent advances in the study of spontaneous brain activity have demonstrated activity patterns that emerge with no task performance or sensory stimulation; these discoveries hold promise for the study of higher-order associative network functionality. Additionally, such advances are argued to be relevant in pathological states, such as disorders of consciousness (DOC), i.e., coma, vegetative and minimally conscious states. Recent studies on resting state activity in DOC, measured with functional magnetic resonance imaging (fMRI) techniques, show that functional connectivity is disrupted in the task-negative or the default mode network. However, the two main approaches employed in the analysis of resting state functional connectivity data (i.e., hypothesis-driven seed-voxel and data-driven independent component analysis) present multiple methodological difficulties, especially in non-collaborative DOC patients. Improvements in motion artifact removal and spatial normalization are needed before fMRI resting state data can be used as proper biomarkers in severe brain injury. However, we anticipate that such developments will boost clinical resting state fMRI studies, allowing for easy and fast acquisitions and ultimately improve the diagnosis and prognosis in the absence of DOC patients' active collaboration in data acquisition. PMID:21693087

  12. Physical activity in patients with type 2 diabetes and hypertension – insights into motivations and barriers from the MOBILE study

    Duclos M

    2015-06-01

    Full Text Available Martine Duclos,1,2 Sylvie Dejager,3,4 Nicolas Postel-Vinay,5 Sylvie di Nicola,6 Stéphane Quéré,7 Béatrice Fiquet4,5 1Department of Sport Medicine and Functional Explorations, University-Hospital (CHU, G Montpied Hospital; INRA, UNH, CRNH Auvergne, 2Nutrition Department, University of Auvergne, Clermont-Ferrand, Auvergne, 3Department of Endocrinology and Metabolism, La Pitié-Salpétrière Hospital, Paris, 4Clinical and Scientific Affairs, Novartis Pharma SAS, Rueil-Malmaison, 5Department of Hypertension, Georges Pompidou European Hospital, Paris, 6Biostatistics, Inferential, Paris, 7Biostatistics, Novartis Pharma SAS, Rueil-Malmaison, France Background: Although physical activity (PA is key in the management of type 2 diabetes (T2DM and hypertension, it is difficult to implement in practice. Methods: Cross-sectional, observational study. Participating physicians were asked to recruit two active and four inactive patients, screened with the Ricci-Gagnon (RG self-questionnaire (active if score ≥16. Patients subsequently completed the International Physical Activity Questionnaire. The objective was to assess the achievement of individualized glycated hemoglobin and blood pressure goals (<140/90 mmHg in the active vs inactive cohort, to explore the correlates for meeting both targets by multivariate analysis, and to examine the barriers and motivations to engage in PA. Results: About 1,766 patients were analyzed. Active (n=628 vs inactive (n=1,138 patients were more often male, younger, less obese, had shorter durations of diabetes, fewer complications and other health issues, such as osteoarticular disorders (P<0.001 for all. Their diabetes and hypertension control was better and obtained despite a lower treatment burden. The biggest difference in PA between the active vs inactive patients was the percentage who declared engaging in regular leisure-type PA (97.9% vs 9.6%, also reflected in the percentage with vigorous activities in

  13. Personality traits and pathology in older and younger incarcerated women.

    Hurt, Susan; Oltmanns, Thomas F

    2002-04-01

    Personality disorders were examined in 157 incarcerated women, using the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1996) to assess 10 Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R; American Psychiatric Association, 1987) diagnostic categories and dimensions and 15 domains of trait/temperament relevant to disordered personality. Similar to both community samples and incarcerated men, older women had lower rates of personality disorders than younger women, and the difference was mostly accounted for by differences in the Cluster B disorders. In an exploratory analysis of trait and temperament scales, the older women also scored lower in Aggression, Disinhibition, Entitlement, Exhibitionism, Impulsivity, and Manipulativeness while younger women scored lower in Workaholism and Propriety. These findings suggest that remission of antisocial behavior in women may be associated with changes in lower order personality traits or temperament. PMID:11920697

  14. Attachment and Aggressive Manifestations in Younger Adulthood - "Preliminary Findings"

    Tatiana Lorincová

    2014-01-01

    The main topic of the contribution was comparison between retrospective attachment (emocional warmth and rejection) and aggressive manifestations (physical aggressivness, verbal aggressivness, anger and hostility) among younger adulthood. Bowlby's theory of attachment was that once a core attachment style develops in an infant, it will influence and shape the nature of all intimate relations for the individual moving forward throughout the infant's life cycle. Authors Mikulincer and Shaver...

  15. Acceptance of Smart Phone by Younger Consumers in Malaysia

    Yong Hoe Hong; Boon Heng Teh; Chin Hooi Soh

    2014-01-01

    The sales of smart phone are rapidly increasing in Malaysia and in the global markets. Which means that, smart phone has a great opportunity in the future growth of the mobile industry. The aim of this research is to determine the acceptance of smart phone by younger consumers in Malaysia. A total of 113 useable questionnaires was collected and analyzed through SPSS. Google doc form was utilized to create the online questionnaire. The data collection method utilized in this paper was online i...

  16. Habitual fat intake predicts memory function in younger women

    Edward Leigh Gibson; Suzanne Barr

    2013-01-01

    High intakes of fat have been linked to greater cognitive decline in old age, but such associations may already occur in younger adults. We tested memory and learning in 38 women (25 to 45 years old), recruited for a larger observational study in women with polycystic ovary syndrome. These women varied in health status, though not significantly between cases (n = 23) and controls (n = 15). Performance on tests sensitive to medial temporal lobe function (CANTABeclipse, Cambridge Cognition Ltd,...

  17. [Gallbladder motor activity in patients with virus hepatitis B].

    Mamos, Arkadiusz; Wichan, Paweł; Chojnacki, Jan; Grzegorczyk, Krzysztof

    2003-12-01

    In acute stage of virus hepatitis B patients often complain of dyspeptic discomfort. They may be a consequence of alimentary tract motor activity disorders including these of gallbladder. Routine ultrasonography in an early phase of virus hepatitis often reveals gallbladder wall thickening what may confirm the above thesis. Thus, a group of 15 patients in an acute phase of virus hepatitis B was subjected to examinations. Gallbladder motor activity was assessed by ultrasonographic method determining its total volume and ejection fraction and volume after test meal stimulus. First examination was performed in the first week since the appearance of yellowing of the walls, successive in 4 and 8 week of the disease. Obtained results were compared to the values obtained in the group of 25 healthy volunteers. It was found out that gallbladder volume was significantly decreased and ejection fraction increased in the acute phase of virus hepatitis B than in the controls. This may speak for gallbladder hyperreactivity in patients in the course of virus hepatitis B. These disorders decreased during two-month observation but even in the 8 week the investigated parameters differed from those found in the control group. PMID:15058248

  18. Serum arylesterase and paraoxonase activity in patients with chronic hepatitis

    Suleyman Sirri Kilic; Suleyman Aydin; Nermin Kilic; Fazilet Erman; Suna Aydin; (I)lhami Celik

    2005-01-01

    AIM: To investigate the relationship between serum paraoxonase (PON1), AST, ALT, GGT, and arylesterase (AE) activity alterations and the degree of liver damage in patients with chronic hepatitis.METHODS: We studied 34 chronic hepatitis patients and 32 control subjects, aged between 35 and 65 years,in the Department of Infection and Clinical Microbiology at the Firat University School of Medicine. Blood samples were collected from subjects between 8:00 and 10:00 a.m. following a 12-h fast. Baseline and salt-stimulated PON1 activities were measured by the hydrolysis of paraoxon. Phenyl acetate was used as the substrate and formed phenol was measured spectrophotometrically at 270 nm after the addition of a 10-fold diluted serum sample in AE activity measurements.RESULTS: The results of this investigation revealed that the levels of AE activity decreased from 132±52 to 94±36 (29%), baseline PON1 activity from 452±112 to 164±67 (64%), salt-stimulated PON1 activity from 746±394 to 294±220 (61%), HDL from 58.4±5.1 to 47.2±5.6(20%), triglyceride from 133±51.2 to 86±34.0 (35%),while a slight increase in the level of LDL (from 163±54.1 to 177.3±56.0; 9%) and significant increases in the levels of AST (from 29±9.3 to 98±44), ALP (from 57.2±13.1 to 91±38.1), ALT (from 27.9±3.32 to 89±19.1), GGT (from 24.3±2.10 to 94±48.2), total bilirubin (from 0.74±0.02 to 1.36±0.06; 84%) and direct bilirubin (from 0.18±0.01 to 0.42±0.04; 133%) were detected.However, the levels of albumin, total protein, cholesterol,and uric acid were almost the same in chronic hepatitis and the control subjects.CONCLUSION: Low PON1 and AE activity may contribute to the increased liver dysfunction in chronic hepatitis patients by reducing the ability of HDL to retard LDL oxidation and might be clinically useful for monitoring the disease of chronic hepatitis.

  19. Haploidentical transplantation in children with unmanipulated peripheral blood stem cell graft: The need to look beyond post-transplantation cyclophosphamide in younger children.

    Jaiswal, Sarita Rani; Chakrabarti, Aditi; Chatterjee, Sumita; Ray, Kunal; Chakrabarti, Suparno

    2016-08-01

    Haploidentical transplantation with PTCY following marrow or PBSC graft has been associated with low incidence of GVHD in adults with similar data lacking in children. We report on the outcome of 25 patients 10 yr and 40% in <10 yr, p = 0.01). Our data suggest that PTCY-based haploidentical PBSC transplantation is feasible in older children, but results in early and severe alloreactivity in younger children. These findings, despite being counterintuitive, could be explained by the variable metabolism of CY and oral mycophenolate in younger children indicating that PTCY-based approach as used in adults might not be adequate for younger children. PMID:27217372

  20. Comparison of Patient and Caregiver Reports of Patient Activity Participation and Its Relationship to Mental Health in Patients With Alzheimer's Disease

    Siedlecki, Karen L.; Tatarina, Oksana; Sanders, Linda; Albert, Marilyn; Blacker, Deborah; Dubois, Bruno; Brandt, Jason; Stern, Yaakov

    2009-01-01

    The relationship between engagement in pleasant activities as rated by the patient and as rated by the caregiver from the patient's perspective was examined using structural equation modeling in a sample of patients (N = 277) diagnosed with mild to moderate Alzheimer's disease. The two activity participation ratings were only moderately related to one another. Furthermore, depression was the only significant predictor of the patient-rated activity participation, whereas severity of depression...

  1. Repeated biopsies in prostate cancer patients on active surveillance

    Thomsen, Frederik Birkebaek; Marcussen, Niels; Berg, Kasper Drimer;

    2015-01-01

    OBJECTIVE: To investigate the clinical implications of interobserver variation in the assessment of re-biopsies obtained during active surveillance (AS). MATERIAL AND METHODS: A total of 107 low-risk prostate cancer patients with a total of 93 diagnostic biopsy sets and 109 re-biopsy sets were...... included. The ISUP 2005 Gleason scoring system was applied for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa statistics were used to compare the interobserver agreement. RESULTS: The overall...... recommendations would have changed in up to 10.1% (95% CI: 5.4%-17.7%) of the 109 re-biopsy sets. CONCLUSION: Kappa statistics demonstrated a strong agreement between the histological evaluations. Still, up to 10% of AS patients would receive different treatment recommendation depending upon which...

  2. An fMRI investigation on simple multiplication in younger and older adults

    Li SUN

    2014-03-01

    Full Text Available Objective To investigate the cortical activation patterns and their correlation with behavioristics during simple multiplication in Chinese younger and older adults. Methods Functional magnetic resonance imaging (fMRI was performed as healthy younger and older participants resolving arithmetic and control problems. Results Totally 39 right-handed healthy adults were recruited in this study, including 19 (11 females, 8 males younger and 20 (12 females, 8 males older subjects. Age (P = 0.000 was significantly different between 2 groups, and no significant difference was observed in years of education (P = 0.125 and IQ scores (P = 0.921. The accuracy for simple multiplication (P = 0.880 and control task (P = 0.142 were not significantly different between 2 groups, however differences were observed in reaction time for experimental (P = 0.005 and control (P = 0.000 tasks. In younger group, activation in right hemisphere included inferior parietal lobule with an extending to the intraparietal sulcus and superior/middle temporal gyrus, precentral gyrus, premotor cortex and prefrontal cortex. Activation of supramarginal gyrus, angular gyrus, temporal lobe was found in the left. And activation in medial cingulate gyrus, precuneus, parahippocampal gyrus, uncus, and supplementary motor area (SMA was also observed. In older group, supramarginal gyrus, inferior parietal lobule, precentral gyrus, premotor cortex and prefrontal cortex were activated in the right hemisphere. Left angular gyrus, supramarginal gyrus, precentral gyrus, premotor cortex, insula and prefrontal cortex were also activated, as well as cingulate gyrus, paracentral lobule and prefrontal cortex in the medial part. The conjunction analysis of the fMRI data revealed in a distributed network consisting of inferior parietal area, precuneus, precentral/postcentral gyrus and prefrontal lobe, as well as some subcortical areas. Conclusions The major components of the network subserving simple

  3. Dynamic hyperinflation during activities of daily living in COPD patients.

    Silva, Cláudia S; Nogueira, Fabiana R; Porto, Elias F; Gazzotti, Mariana R; Nascimento, Oliver A; Camelier, Aquiles; Jardim, José R

    2015-08-01

    The objective of this study was to investigate whether some activities of daily living (ADLs) usually related to dyspnea sensation in patients with chronic obstructive pulmonary disease (COPD) are associated with dynamic lung hyperinflation (DH) and whether the use of simple energy conservation techniques (ECTs) might reduce this possible hyperinflation. Eighteen patients (mean age: 65.8 ± 9.8 years) with moderate-to-severe COPD performed six ADLs (walking on a treadmill, storing pots, walking 56 meters carrying a 5-kilogram weight, climbing stairs, simulating taking a shower, and putting on shoes) and had their inspiratory capacity (IC) measured before and after each task. The patients were moderately obstructed with forced expiratory volume in 1 second (FEV1): 1.4 ± 0.4 L (50% ± 12.4); FEV1/forced vital capacity: 0.4 ± 8.1; residual volume/total lung capacity: 52.7 ± 10.2, and a reduction in IC was seen after all six activities (p < 0.05): (1) going upstairs, 170 mL; (2) walking 56 meters carrying 5 kilogram weight, 150 mL; (3) walking on a treadmill without and with ECT, respectively, 230 mL and 235 mL; (4) storing pots without and with ECT, respectively, 170 mL and 128 mL; (5) taking a shower without and with ECT, respectively, 172 mL and 118 mL; and (6) putting on shoes without and with ECT, respectively, 210 mL and 78 mL). Patients with moderate to severe COPD develop DH after performing common ADLs involving the upper and lower limbs. Simple ECTs may avoid DH in some of these ADLs. PMID:25896955

  4. Relationship between balance and physical activity measured by an activity monitor in elderly COPD patients

    Iwakura, Masahiro; Okura, Kazuki; Shibata, Kazuyuki; Kawagoshi, Atsuyoshi; Sugawara, Keiyu; Takahashi, Hitomi; Shioya, Takanobu

    2016-01-01

    Background Little is known regarding the relationship between balance impairments and physical activity in COPD. There has been no study investigating the relationship between balance and objectively measured physical activity. Here we investigated the association between balance and physical activity measured by an activity monitor in elderly COPD patients. Materials and methods Twenty-two outpatients with COPD (mean age, 72±7 years; forced expiratory volume in 1 second, 53%±21% predicted) and 13 age-matched healthy control subjects (mean age, 72±6 years) participated in the study. We assessed all 35 subjects’ balance (one-leg standing test [OLST] times, Short Physical Performance Battery total scores, standing balance test scores, 4 m gait speed, and five-times sit-to-stand test [5STST]) and physical activity (daily steps and time spent in moderate-to-vigorous physical activity per day [MV-PA]). Possible confounders were assessed in the COPD group. The between-group differences in balance test scores and physical activity were analyzed. A correlation analysis and multivariate regression analysis were conducted in the COPD group. Results The COPD patients exhibited significant reductions in OLST times (P=0.033), Short Physical Performance Battery scores (P=0.013), 4 m gait speed (Pphysical activity were observed in the COPD group. Deficits in balance are independently associated with physical inactivity.

  5. Musculoskeletal Load Assessment in Hospital Nurses with Patient Transfer Activity

    ROGHAYEH ABEDINI

    2015-10-01

    Full Text Available  Manual patient handling is known to be the major source of musculoskeletal load among hospital nurses. The objectives of the present study were determination of frequency of musculoskeletal disorders (MSDs and its associated factors together with assessment of musculoskeletal load due to patient transfer by PTAI method in hospital nursing staff of Shiraz University of Medical Sciences (SUMS, Iran. In this crosssectional study, 400 randomly selected nurses of SUMS hospital participated. Data were collected by anonymous demographic and Nordic Musculoskeletal Disorders Questionnaires together with PTAI index checklist. Statistical analyses were undertaken using SPSS, version 16. Age and job tenure means of participants were 30.76±6.44 and 6.92±5.75 years, respectively. 88.2% of the nursing staff reported some forms of musculoskeletal symptoms during the 12 months prior to the study. The results of PTAI index assessment demonstrated that in 4%, 8.5% and 87.5% of the subjects, musculoskeletal load were at levels 1, 2 and 3, respectively. The results revealed that PTAI index score was significantly associated with musculoskeletal disorders occurrence (p<0.001. Musculoskeletal load was high among nurses with patient transfer activity. Age, nurse to bed ratio, marital status, shift work and PTAI score were associated risk factors for MSDs in the studied nursing staff.

  6. Musculoskeletal Load Assessment in Hospital Nurses with Patient Transfer Activity

    Roghayeh Abedini

    2013-04-01

    Full Text Available Manual patient handling is known to be the major source ofmusculoskeletal load among hospital nurses. The objectives of the present study were determination of frequency ofmusculoskeletal disorders (MSDs and its associatedfactors together with assessment of musculoskeletal loaddue to patient transfer by PTAI method in hospitalnursing staff of Shiraz University of Medical Sciences (SUMS, Iran. In this cross-sectional study, 400 randomlyselected nurses of SUMS hospital participated. Data were collected by anonymousdemographic and Nordic Musculoskeletal Disorders Questionnaires together with PTAI index checklist. Statistical analyses wereundertaken using SPSS, version 16. Age and job tenure means of participantswere 30.76±6.44 and 6.92±5.75 years, respectively. 88.2% of the nursing staffreported some forms of musculoskeletal symptoms during the 12 months prior tothe study. The results of PTAI index assessment demonstrated that in 4%, 8.5% and87.5% of the subjects, musculoskeletal load were at levels 1, 2 and 3,respectively. The results revealed that PTAI index score was significantlyassociated with musculoskeletal disorders occurrence (p<0.001.Musculoskeletal load was high among nurses with patient transfer activity. Age, nurse to bed ratio, marital status, shiftwork and PTAI score were associated risk factors for MSDs in the studiednursing staff.

  7. Resting state activity in patients with disorders of consciousness

    Soddu, Andrea; Vanhaudenhuyse, Audrey; Demertzi, Athena; Bruno, Marie-Aurélie; Tshibanda, Luaba; Di, Haibo; Boly, Mélanie; Papa, Michele; Laureys, Steven; Noirhomme, Quentin

    Summary Recent advances in the study of spontaneous brain activity have demonstrated activity patterns that emerge with no task performance or sensory stimulation; these discoveries hold promise for the study of higher-order associative network functionality. Additionally, such advances are argued to be relevant in pathological states, such as disorders of consciousness (DOC), i.e., coma, vegetative and minimally conscious states. Recent studies on resting state activity in DOC, measured with functional magnetic resonance imaging (fMRI) techniques, show that functional connectivity is disrupted in the task-negative or the default mode network. However, the two main approaches employed in the analysis of resting state functional connectivity data (i.e., hypothesis-driven seed-voxel and data-driven independent component analysis) present multiple methodological difficulties, especially in non-collaborative DOC patients. Improvements in motion artifact removal and spatial normalization are needed before fMRI resting state data can be used as proper biomarkers in severe brain injury. However, we anticipate that such developments will boost clinical resting state fMRI studies, allowing for easy and fast acquisitions and ultimately improve the diagnosis and prognosis in the absence of DOC patients’ active collaboration in data acquisition. PMID:21693087

  8. Shock-synthesized hexagonal diamonds in Younger Dryas boundary sediments

    Kennett, Douglas J.; Kennett, James P.; West, Allen; West, G. James; Bunch, Ted E.; Brendan J. Culleton; Jon M. Erlandson; Que Hee, Shane S.; Johnson, John R.; Mercer, Chris; Shen, Feng; Sellers, Marilee; Stafford, Thomas W.; Stich, Adrienne; Weaver, James C.

    2009-01-01

    The long-standing controversy regarding the late Pleistocene megafaunal extinctions in North America has been invigorated by a hypothesis implicating a cosmic impact at the Ållerød-Younger Dryas boundary or YDB (≈12,900 ± 100 cal BP or 10,900 ± 100 14C years). Abrupt ecosystem disruption caused by this event may have triggered the megafaunal extinctions, along with reductions in other animal populations, including humans. The hypothesis remains controversial due to absence of shocked minerals...

  9. Clinical significance of plasminogen activator inhibitor activity in patients with exercise-induced ischemia

    To assess the fibrinolytic system in patients with exercise-induced ischemia and its relation to ischemia and severity of coronary artery disease (CAD), 47 patients with CAD confirmed by results of coronary angiography underwent symptom-limited multistage exercise thallium-201 emission computed tomography. All patients with CAD had exercise-induced ischemia as assessed from thallium-201 images. Pre- and peak exercise blood samples from each patient and preexercise blood samples from control subjects were assayed for several fibrinolytic components and were also assayed for plasma adrenaline. The extent of ischemia was defined as delta visual uptake score (total visual uptake score in delayed images minus total visual uptake score in initial images) and the severity of CAD as the number of diseased vessels. In the basal condition, plasminogen activator inhibitor (PAI) activity was significantly higher in patients with exercise-induced ischemia as compared to control subjects (p less than 0.01), although there were no significant differences in other fibrinolytic variables between the two groups. Moreover, PAI activity in the basal condition displayed a significantly positive correlation with the extent of ischemia (r = 0.47, p less than 0.01). Patients with exercise-induced ischemia were divided into two groups (24 with single-vessel disease and 23 with multivessel disease). There were no significant differences in coronary risk factors, hemodynamics, or plasma adrenaline levels during exercise between single-vessel and multivessel disease except that delta visual uptake score was significantly higher in multivessel disease (p less than 0.01)

  10. Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

    Chen, Jie; Mullins, C. Daniel; Novak, Priscilla; Thomas, Stephen B.

    2016-01-01

    Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and…

  11. Antischistosomal activity of artemisinin derivatives in vivo and in patients.

    Saeed, Mohamed E M; Krishna, Sanjeev; Greten, Henry Johannes; Kremsner, Peter G; Efferth, Thomas

    2016-08-01

    Schistosomiasis is a helminthic disease affecting more than 200 million people in the tropics as well as returning travellers. Treatment mainly relies on a single drug, praziquantel. Praziquantel cannot kill developing schistosomula resulting in frequent treatment failures and re-infections. Monotherapy also favors the selection for resistance. New drugs are therefore urgently needed. The activity of the semi-synthetic artemisinin derivatives artemether, artesunate and arteether is not restricted to malaria. We reviewed their anti-schistosomal activity in vivo and in patients by searching the PubMed database for publications since 1983 with the search terms "artemisinin" and "Schistosoma". Reports on in vivo studies in animals and clinical trials in human beings were selected. S. mansoni, S. japonicum, and S. haematobium have been tested in mice, rabbits, hamsters, and dogs. These artemisinin derivatives strongly reduced total worm rates with stronger reduction rates for female worms than for males. The drugs also reduced egg burden and egg-caused granulomata in the host liver. Artemisinin-type drugs induced oxidative and metabolic stress leading to morphological damage and decreased fertility of the parasites. Although artemether and artesunate have been investigated in numerous clinical trials, the poor quality of many has led to inconsistent results and has not provided convincing evidence on the therapeutic value against schistosomiasis. Despite these methodological concerns, clinical trials may indicate anti-schistosomal activity in patients. Convincing clinical trials providing unambiguous evidence are now needed. Furthermore, suitable treatment protocols for combination therapy to prevent/treat praziquantel-resistant Schistosoma strains should be investigated. PMID:26902577

  12. The Difference between Right and Wrong: Accuracy of Older and Younger Adults’ Story Recall

    Davis, Danielle K.; Nicole Alea; Susan Bluck

    2015-01-01

    Sharing stories is an important social activity in everyday life. This study used fine-grained content analysis to investigate the accuracy of recall of two central story elements: the gist and detail of socially-relevant stories. Younger (M age = 28.06) and older (M age = 75.03) American men and women (N = 63) recalled fictional stories that were coded for (i) accuracy of overall gist and specific gist categories and (ii) accuracy of overall detail and specific detail categories. Findings sh...

  13. Auditory change detection in schizophrenia: sources of activity, related neuropsychological function and symptoms in patients with a first episode in adolescence, and patients 14 years after an adolescent illness-onset

    Sachsse Jan

    2006-02-01

    Full Text Available Abstract Background The event-related brain response mismatch negativity (MMN registers changes in auditory stimulation with temporal lobe sources reflecting short-term echoic memory and frontal sources a deviance-induced switch in processing. Impairment, controversially present at the onset of schizophrenia, develops rapidly and can remain independent of clinical improvement. We examined the characteristics of the scalp-recorded MMN and related these to tests of short-term memory and set-shifting. We assessed whether the equivalent dipole sources are affected already at illness-onset in adolescence and how these features differ after a 14-year course following an adolescent onset. The strength, latency, orientation and location of frontal and temporal lobe sources of MMN activity early and late in the course of adolescent-onset schizophrenia are analysed and illustrated. Methods MMN, a measure of auditory change-detection, was elicited by short deviant tones in a 3-tone oddball-presentation and recorded from 32 scalp electrodes. Four dipole sources were placed following hypothesis-led calculations using brain electrical source analysis on brain atlas and MR-images. A short neuropsychological test battery was administered. We compared 28 adolescent patients with a first episode of schizophrenia and 18 patients 14 years after diagnosis in adolescence with two age-matched control groups from the community (n = 22 and 18, respectively. Results MMN peaked earlier in the younger than the older subjects. The amplitude was reduced in patients, especially the younger group, and was here associated with negative symptoms and slow set-shifting. In first-episode patients the temporal lobe sources were more ventral than in controls, while the left cingular and right inferior-mid frontal sources were more caudal. In the older patients the left temporal locus remained ventral (developmental stasis, the right temporal locus extended more antero

  14. Resolving the Younger Dryas Event Through Borehole Thermometry

    Firestone, John Francis

    One of the most striking features of the ice core records from Greenland is a sudden drop in oxygen isotope values (delta O-18) between approximately 11,500 and 10,700 years ago. This Younger Dryas event was an intense return to ice age conditions during a time of general de-glaciation. As recorded in the ice cores, temperatures in Greenland cooled by roughly seven degrees Kelvin. W. Broecker and R. Fairbanks have proposed competing explanations for the cooling and cause of this "aborted ice age." One supposes that the seven degree cooling is real and results from a shutdown in the North Atlantic ocean circulation; the other, that it is largely fictitious and records an intrusion of isotopically light glacial meltwater into the ice core records. Using optimal control methods and heat flow modelling, the author makes a valiant but ultimately futile attempt to distinguish the Younger Dryas event in the ice sheet temperatures measured at Dye 3, South Greenland. The author discusses the prospects for attempting the same in the new Summit boreholes in Central Greenland: how that will require more accurate temperature measurements, a coupled thermo-mechanical model, and a refined uncertainty analysis. He concludes by discussing how borehole temperature analysis may improve the climate histories determined from ice cores.

  15. Characteristics of treatment naive chronic hepatitis B in Bangladesh: Younger populations are more affected; HBeAg-negatives are more advanced

    Alam Shahinul

    2008-01-01

    Full Text Available Background/Aim: Bangladesh is a densely populated country with intermediate endemicity for chronic hepatitis B (CHB. The aim of the present study was to evaluate the biochemical, virological and histological character of CHB patients and to examine the relationship between these indices. Materials and Methods: One thousand and twenty-two patients of CHB fulfilled our inclusion criteria. Inclusion criteria were (1 HBsAg positive for at least 6 months, (2 HBeAg-positive or negative and (3 hepatitis B virus (HBV DNA positive. Patients with detectable antibodies to human immunodeficiency virus (HIV, hepatitis Delta virus (HDV or hepatitis C virus (HCV, with previous antiviral treatment, overt cirrhosis and hepatocellular carcinoma, were excluded. Of these, 191 patients were randomly selected for liver biopsy and were evaluated for analysis. Results: In the 191 patients, male to female ratio was 4.6:1; age distribution was 26.5 ± 8.5 (mean ± standard deviation years. One hundred and seventy-eight (93.2% patients were under 40 years. Sixty-eight (35.6% patients were HBeAg-negative, had less DNA load, and were significantly older, more fibrotic and cirrhotic ( P < 0.001. Correlation was not found between DNA level and histological activity. Histological activity was not correlated with ALT level in HBeAg-positive patients ( P < 0.001. Conclusion: CHB affects the younger population in Bangladesh. HBeAg-positive CHB was associated with more fibrosis and cirrhosis. Serum HBV DNA levels do not correlate with the severity of histological lesions in all patients. Evaluation by liver biopsy remains gold standard for taking decision of treatment.

  16. Informal work and formal plans: Articulating the active role of patients in cancer trajectories

    Dalsted, R.; Hølge-Hazelton, Bibi; Kousgaard, MB; Andersen, John Sahl

    2013-01-01

    Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories....... participation. When looking at integrated care from the perspective of patients, the development of a more holistic and personalized approach is needed....... patients' requests were not sufficiently supported in the professional organisation of work or formal planning. Patients' insertion and use of information in their trajectories challenged professional views and working processes. And the design of the formal pathway models limits the patients' active...

  17. Mountain glacier evolution in the Iberian Peninsula during the Younger Dryas

    García-Ruiz, J. M.; Palacios, D.; González-Sampériz, P.; de Andrés, N.; Moreno, A.; Valero-Garcés, B.; Gómez-Villar, A.

    2016-04-01

    We review the evolution of glaciers in the Iberian Mountains during the Younger Dryas (12.9-11.7 ka, following the chronology of Greenland Stadial 1 - GS1) and compare with available environmental and climate data to investigate glacier dynamics during cold stadial episodes. The best examples of Younger Dryas moraines are found in the Central Pyrenees, involving short ice tongues up to 4 km in length in the highest massifs (above 3000 m a.s.l.) of the southern versant. Small cirque glaciers and rock glaciers formed during the YD occurred in other Pyrenean massifs, in the Cantabrian Range and in the Gredos and Guadarrama sierras (Central Range), as indicated by several rocky, polished thresholds that were ice-free at the beginning of the Holocene. Although some former rock glaciers were re-activated during the Younger Dryas, glacial activity was limited in the southernmost part of the Iberian Peninsula (Sierra Nevada). Most Iberian records show vegetation changes during the YD characterized by a forest decline and an expansion of shrubs (mainly Juniperus) and steppe herbs, although the vegetation response was not homogeneous because of variable resilience among ecosystems. Available records also document a variable lake response in terms of hydrology and productivity, with a decrease in sedimentation rates and organic productivity in most high altitude lakes and increases in salinity and relatively lower lake levels at lower altitudes. The impact of the Younger Dryas on the coastal environment was almost negligible, but it was responsible for a brief cessation in sea level rise. High-resolution analyses of new speleothem records have documented a double structure for the YD with an earlier drier phase followed by a relatively more humid period. The review of geomorphological evidence demonstrates a strong latitudinal control of glacial activity during the YD, with more intense development in the northern than in the southern regions. The increase in humidity during

  18. Thyroid axis activity and suicidal behavior in depressed patients.

    Duval, Fabrice; Mokrani, Marie-Claude; Lopera, Felix Gonzalez; Diep, Thanh Son; Rabia, Hassen; Fattah, Saïd

    2010-08-01

    The aim of this study was to investigate the relationship between suicidal behavior and hypothalamic-pituitary thyroid (HPT) axis activity in depressed patients. The serum levels of thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were evaluated before and after 0800 and 2300 h thyrotropin-releasing hormone (TRH) challenges, on the same day, in 95 medication-free DSM-IV euthyroid major depressed inpatients and 44 healthy hospitalized controls. Compared to controls: (1) patients with a positive suicide history (PSH; n=53) showed lower basal FT4 (at 0800 h: p<0.005; at 2300 h: p<0.03), but normal FT3 levels, while patients with a negative suicide history (NSH; n=42) showed normal FT4 and FT3 levels; (2) TSH responses to TRH (DeltaTSH) were blunted in NSHs (at 0800 h: p<0.03; at 2300 h: p<0.00001), but not in PSHs; (3) both NSHs and PSHs showed lower DeltaDeltaTSH values (differences between 2300 h-DeltaTSH and 0800 h-DeltaTSH) (p<0.000001 and p<0.003, respectively). Compared to NSHs, basal FT4 levels were reduced in PSHs (at 0800 h: p<0.002; at 2300h: p<0.006). HPT parameters were not significantly different between recent suicide attempters (n=32) and past suicide attempters (n=21). However, compared to controls, recent suicide attempters showed lower 2300 h-DeltaTSH (p<0.04) and DeltaDeltaTSH (p<0.002) values, and lower basal FT4 values (at 0800 h: p<0.006; at 2300 h: p<0.02). Our results, obtained in a large sample of depressed inpatients, indicate that various degrees of HPT axis dysregulation are associated with the history of suicide. PMID:20129737

  19. Providers, Payers, The Community, And Patients Are All Obliged To Get Patient Activation And Engagement Ethically Right

    Danis, Marion; Solomon, Mildred

    2016-01-01

    Active and engaged patients seek the understanding, knowledge, and skills to promote their own health. Efforts to promote such patient activation and engagement are ethically justified because they are consonant with the well-established principle of respect for persons and, as the evidence shows, because they are likely to produce better outcomes for patients. Yet patient activation and engagement can also go ethically awry if, for example, nonadherent patients are abandoned or are unduly disadvantaged by punitive policies and practices, or if the conditions for successful activation and engagement are missing. In this article we discuss the ethical issues and responsibilities that pertain to patients, clinicians, health care organizations, delivery systems, insurers, payers, and communities. For example, physicians or payers could hold patients blameworthy for not following recommendations, but we suggest that a better approach would be for providers and payers to empower patients to effectively share responsibility for defining goals and achieving them. An ethical approach to patient activation and engagement should place obligations not only on patients but also on clinicians, health care organizations and delivery systems, insurers, and communities. PMID:23381534

  20. Estrogen Therapy Has No Long-Term Effect on Cognition in Younger Postmenopausal Women

    ... has no long-term effect on cognition in younger postmenopausal women NIH-funded study finds neither benefit ... A randomized clinical trial of estrogen therapy in younger postmenopausal women, aged 50–55, has found no ...

  1. Gene Test Might One Day Gauge Alzheimer's Risk in Younger Adults

    ... Test Might One Day Gauge Alzheimer's Risk in Younger Adults But doctors say the concept is not ... two times, the study authors said. Among the younger participants, a high risk score was linked to ...

  2. Glacier-derived climate for the Younger Dryas in Europe

    Pellitero, Ramon; Rea, Brice R.; Spagnolo, Matteo; Hughes, Philip; Braithwaite, Roger; Renssen, Hans; Ivy-Ochs, Susan; Ribolini, Adriano; Bakke, Jostein; Lukas, Sven

    2016-04-01

    We have reconstructed and calculated the glacier equilibrium line altitudes (ELA) for 120 Younger Dryas palaeoglaciers from Morocco in the south to Svalbard in the north and from Ireland in the west to Turkey in the east. The chronology of these landform were checked and, when derived from cosmogenic dates, these were recalculated based on newer production rates. Frontal moraines/limits for the palaeoglaciers were used to reconstruct palaeoglacier extent by using a GIS tool which implements a discretised solution for the assumption of perfect-plasticity ice rheology for a single flowline and extents this out to a 3D ice surface. From the resulting equilibrium profile, palaeoglaciers palaeo-ELAs were calculated using another GIS tool. Where several glaciers were reconstructed in a region, a single ELA value was generated following the methodology of Osmaston (2005). In order to utilise these ELAs for quantitative palaeo-precipitation reconstructions an independent regional temperature analysis was undertaken. A database of 121 sites was compiled where the temperature was determined from palaeoproxies other than glaciers (e.g. pollen, diatoms, choleoptera, chironimids…) in both terrestrial and offshore environments. These proxy data provides estimates of average annual, summer and winter temperatures. These data were merged and interpolated to generate maps of average temperature for the warmest and coldest months and annual average temperature. From these maps the temperature at the ELA was obtained using a lapse rate of 0.65°C/100m. Using the ELA temperature range and summer maximum in a degree-day model allows determination of the potential melt which can be taken as equivalent to precipitation given the assumption a glacier is in equilibrium with climate. Results show that during the coldest part of the Younger Dryas precipitation was high in the British Isles, the NW of the Iberian Peninsula and the Vosges. There is a general trend for declining precipitation

  3. Xanthine oxidase activity and free radical generation in patients with sepsis syndrome

    Galley, H F; Davies, Michael Jonathan; Webster, N R

    1996-01-01

    OBJECTIVE: To determine xanthine oxidase activity, free radical concentrations, and lipid peroxidation in patients with sepsis syndrome compared with noninfected critically ill patients. DESIGN: A prospective observational study. SETTING: A nine-bed intensive care unit in a university teaching...... hospital trust. PATIENTS: Fourteen consecutive patients who met the established criteria for sepsis syndrome with multiple organ dysfunction syndrome, and ten noninfected critically ill patients were studied. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Xanthine oxidase activity was increased in...

  4. Active video gaming in patients with renal transplant: a pilot study

    Wang, Dorothy Wei Yun; Sills, Laura L; MacDonald, Sara B; Maianski, Ziv; Alwayn, Ian

    2014-01-01

    Background Patients with renal transplant are at higher risk of mortality from cardiovascular disease (CVD) compared with the general population. Physical activity has been shown to reduce the risk of CVD mortality in these patients. Unfortunately, barriers such as the harsh Canadian climate prevent patients from engaging in and harvesting the health benefits of physical activity. This pilot study explored active video gaming (AVG) as a way for patients with renal transplant to obtain physica...

  5. The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes

    Koppelaar, E; Knibbe, H.J.J.; Miedema, H.S.; Burdorf, A

    2012-01-01

    OBJECTIVES: Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic devices on mechanical load during patient handling activities. METHODS: For each patient, based on national guidelines, it was recorded which specific ergonomic devices were required during distin...

  6. The relative effect of health literacy and patient activation on provider choice in the Netherlands.

    Rademakers, J.; Nijman, J.; Brabers, A.E.M.; Jong, J.D. de; Hendriks, M.

    2014-01-01

    Active provider choice by patients has become an important policy theme in western, countries over the last decades. However, not many patients and consumers exercise their rightto, choose. Both health literacy and patient activation are likely to have an impact on the choiceprocess.In,this article the relative effect of health literacy and patient activation on provider choice in the, Netherlands is studied. A questionnaire was sentto a representative sample of 2000 Dutch citizens. The quest...

  7. Cumulative genetic risk and prefrontal activity in patients with schizophrenia.

    Walton, Esther; Turner, Jessica; Gollub, Randy L; Manoach, Dara S; Yendiki, Anastasia; Ho, Beng-Choon; Sponheim, Scott R; Calhoun, Vince D; Ehrlich, Stefan

    2013-05-01

    The lack of consistency of genetic associations in highly heritable mental illnesses, such as schizophrenia, remains a challenge in molecular psychiatry. Because clinical phenotypes for psychiatric disorders are often ill defined, considerable effort has been made to relate genetic polymorphisms to underlying physiological aspects of schizophrenia (so called intermediate phenotypes), that may be more reliable. Given the polygenic etiology of schizophrenia, the aim of this work was to form a measure of cumulative genetic risk and study its effect on neural activity during working memory (WM) using functional magnetic resonance imaging. Neural activity during the Sternberg Item Recognition Paradigm was measured in 79 schizophrenia patients and 99 healthy controls. Participants were genotyped, and a genetic risk score (GRS), which combined the additive effects of 41 single-nucleotide polymorphisms (SNPs) from 34 risk genes for schizophrenia, was calculated. These risk SNPs were chosen according to the continuously updated meta-analysis of genetic studies on schizophrenia available at www.schizophreniaresearchforum.org. We found a positive relationship between GRS and left dorsolateral prefrontal cortex inefficiency during WM processing. GRS was not correlated with age, performance, intelligence, or medication effects and did not differ between acquisition sites, gender, or diagnostic groups. Our study suggests that cumulative genetic risk, combining the impact of many genes with small effects, is associated with a known brain-based intermediate phenotype for schizophrenia. The GRS approach could provide an advantage over studying single genes in studies focusing on the genetic basis of polygenic conditions such as neuropsychiatric disorders. PMID:22267534

  8. Immunization Uptake in Younger Siblings of Children with Autism Spectrum Disorder

    Kuwaik, Ghassan Abu; Roberts, Wendy; Zwaigenbaum, Lonnie; Bryson, Susan; Smith, Isabel M.; Szatmari, Peter; Modi, Bonnie M.; Tanel, Nadia; Brian, Jessica

    2014-01-01

    Background: Parental concerns persist that immunization increases the risk of autism spectrum disorder, resulting in the potential for reduced uptake by parents of younger siblings of children with autism spectrum disorder ("younger sibs"). Objective: To compare immunization uptake by parents for their younger child relative to their…

  9. Attitudes toward Younger and Older Adults: The German Aging Semantic Differential

    Gluth, Sebastian; Ebner, Natalie C.; Schmiedek, Florian

    2010-01-01

    The present study used the German Aging Semantic Differential (ASD) to assess attitudes toward younger and older adults in a heterogeneous sample of n = 151 younger and n = 143 older adults. The questionnaire was administered in two versions, one referring to the evaluation of younger adults, the other to the evaluation of older adults.…

  10. Ankle brachial pressure index of normal, healthy, younger adults.

    Niblo, Jane; Coull, Alison

    Doppler ultrasound and ankle brachial pressure index (ABPI) calculations are used in the assessment of lower limb vascularity, specifically to determine arterial deficiency. ABPI is important as it is used as an indicator when deciding management options for the treatment of leg ulceration. This study aimed to investigate the range of ABPI measurement, using Doppler ultrasound and sphygmomanometry in 36 young healthy adults aged 18-55 years. The findings show a mean ABPI in the left leg of 1.19 and a mean ABPI of 1.17 in the right leg which, while within the normal range, are consistently in the upper range and significantly higher than the acknowledged 'normal' midpoint of 1.0. It would appear that younger people will have ABPIs within the upper aspect of the normal range and well above the established norm of 1.0. PMID:24151719

  11. Use of photovoice with people with younger onset dementia.

    Evans, David; Robertson, Jacinta; Candy, Allen

    2016-07-01

    Photography is a tool that has been used in research for many years. It allows people to create a record of an event, capture a complex phenomenon or to tell a story with pictures. Because it does not rely on language, it can be used with vulnerable populations who might not normally be included in research. This paper discusses the use of photography as one component of the evaluation strategy for a project that provided an opportunity for people with younger onset dementia to return to the workplace one day per week. Participants in the workplace project used photography to create a record of their experience of returning to the workplace. Based on the nature of the participant's comments, photographs were grouped into four broad areas: impact of dementia, impact on family, the work experience and new friends. Issues related to the use of photography with people who have dementia are explored based on the experiences gained during this project. PMID:24962000

  12. Looking younger: cosmetics and clothing to look more vibrant.

    Palma, Diego Dalla

    2008-01-01

    This article considers and assesses all technical and practical advice to make women look younger. The different sections aim to deepen personal research and to supply a valid basis for improvement of one's own figure. This article, with my experience and competence, recommends the best choices for each area, from makeup to hairdos, clothes, and accessories. The sections will help the reader identify the salient points-the ones you should pay more attention to and the ones you should avoid so as not to obtain the opposite of what you wanted or a counterproductive effect. Finally, the final part highlights the best colors and fabrics to add light to the face. The entire article is filled with useful strategies and tips to add that extra touch that each reader can personalize to create a unique style. PMID:18940547

  13. Lifestyle, Cardiovascular Drugs and Risk Factors in Younger and Elder Adults: The PEP Family Heart Study

    Peter Schwandt

    2010-01-01

    Full Text Available Objectives: This study aimed to compare cardiovascular disease(CVD risk factors, lifestyle habits and pharmacological treatmentin two groups of elder adults with 20 years difference in theirmean age.Methods: This study comprised 590 women including two groupswith mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of twogroups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data onphysical examination, fasting blood analyses, 7-day dietary records,physical activity, smoking and actual medication use wererecorded.Results: Compared with younger individuals, seniors had a moreadverse risk factor profile in terms of abdominal obesity, overweight,hyperglycemia, hypertension, dyslipoproteinemia withoutdifferences in HDL-C. But this is not reflected by lifestyle behavior.Less than 2% of the elderly and 17% of the younger adultswere current smoker. Furthermore, the pattern of physical activitywas different in terms of more continuous sports in seniorscontrasting with extremes between no sports and more than twicea week in the younger group. Seniors consumed significantly lesscarbohydrates including more monosaccharide and less polysaccharides,more alcohol and water. The intake of fat and proteinwas higher in elder women than in all other groups. One third ofseniors took antihypertensive medications and 12% used lipidmodifying drugs.Conclusions: Different levels of prevention against CVDs andtheir risk factors shall be considered for various age groups ofpopulation. The findings of this study emphasize on the necessityof preventive measures against smoking and physical inactivity inyounger adults and dietary habits in seniors.

  14. Patient-centered activity monitoring in the self-management of chronic health conditions

    Chiauzzi, Emil; Rodarte, Carlos; DasMahapatra, Pronabesh

    2015-01-01

    Background As activity tracking devices become smaller, cheaper, and more consumer-accessible, they will be used more extensively across a wide variety of contexts. The expansion of activity tracking and personal data collection offers the potential for patient engagement in the management of chronic diseases. Consumer wearable devices for activity tracking have shown promise in post-surgery recovery in cardiac patients, pulmonary rehabilitation, and activity counseling in diabetic patients, ...

  15. Telemonitoring of Daily Activity and Symptom Behavior in Patients with COPD

    Monique Tabak

    2012-01-01

    Full Text Available Objectives. This study investigated the activity behavior of patients with COPD in detail compared to asymptomatic controls, and the relationship between subjective and objective activities (awareness, and readiness to change activity behavior. Methods. Thirty-nine patients with COPD (66.0 years; FEV1% predicted: 44.9% and 21 healthy controls (57.0 years participated. Objective daily activity was assessed by accelerometry and expressed as amount of activity in counts per minute (cpm. Patients' baseline subjective activity and stage of change were assessed prior to measurements. Results. Mean daily activity in COPD patients was significantly lower compared to the healthy controls ( cpm versus  cpm, . COPD patients showed a temporary decrease in objective activities in the early afternoon. Objective and subjective activities were significantly moderately related and most patients (55.3% were in the maintenance phase of the stages of change. Conclusions. COPD patients show a distinctive activity decrease in the early afternoon. COPD patients are moderately aware of their daily activity but regard themselves as physically active. Therefore, future telemedicine interventions might consider creating awareness of an active lifestyle and provide feedback that aims to increase and balance activity levels.

  16. The relative effect of health literacy and patient activation on provider choice in the Netherlands.

    Rademakers, J.; Nijman, J.; Brabers, A.E.M.; Jong, J.D. de; Hendriks, M.

    2014-01-01

    Active provider choice by patients has become an important policy theme in western, countries over the last decades. However, not many patients and consumers exercise their rightto, choose. Both health literacy and patient activation are likely to have an impact on the choiceprocess.In,this article

  17. ROLE OF ACTIVE ERP PARADIGMS IN AWARENESS DETECTION IN NON RESPONSIVE PATIENTS

    Lugo, Zulay; Lesenfants, Damien; Lehembre, Remy; Laureys, Steven; Noirhomme, Quentin

    2012-01-01

    The role of active vs. passive ERP paradigms in disorders of consciousness is assessed in this case study of a LIS patient. Results show that despite absent P3 in a passive auditory task, the patient displayed significant differences in the active task. This study shows the importance of using a large battery of tests when assessing DOC patients.

  18. Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia

    Using [11C]-deoxy-D-glucose and positron emission tomography (PET), the authors measured brain metabolism in 18 patients with chronic schizophrenia to assess which of the metabolic measures from two test conditions was more closely related to the patients' differing clinical characteristics. The two conditions were resting and activation, and an eye tracking task was used. Patients with more negative symptoms showed lower global metabolic rates and more severe hypofrontality than did the patients with fewer negative symptoms. Differences among the patients were distinguished by the task: sicker patients failed to show a metabolic activation response. These findings suggest that cerebral metabolic patterns reflect clinical characteristics of schizophrenic patients

  19. The Difference between Right and Wrong: Accuracy of Older and Younger Adults' Story Recall.

    Davis, Danielle K; Alea, Nicole; Bluck, Susan

    2015-09-01

    Sharing stories is an important social activity in everyday life. This study used fine-grained content analysis to investigate the accuracy of recall of two central story elements: the gist and detail of socially-relevant stories. Younger (M age = 28.06) and older (M age = 75.03) American men and women (N = 63) recalled fictional stories that were coded for (i) accuracy of overall gist and specific gist categories and (ii) accuracy of overall detail and specific detail categories. Findings showed no age group differences in accuracy of overall gist or detail, but differences emerged for specific categories. Older adults more accurately recalled the gist of when the event occurred whereas younger adults more accurately recalled the gist of why the event occurred. These differences were related to episodic memory ability and education. For accuracy in recalling details, there were some age differences, but gender differences were more robust. Overall, women remembered details of these social stories more accurately than men, particularly time and perceptual details. Women were also more likely to accurately remember the gist of when the event occurred. The discussion focuses on how accurate recall of socially-relevant stories is not clearly age-dependent but is related to person characteristics such as gender and episodic memory ability/education. PMID:26404344

  20. Exercise holds immediate benefits for affect and cognition in younger and older adults.

    Hogan, Candice L; Mata, Jutta; Carstensen, Laura L

    2013-06-01

    Physical activity is associated with improved affective experience and enhanced cognitive processing. Potential age differences in the degree of benefit, however, are poorly understood because most studies examine either younger or older adults. The present study examined age differences in cognitive performance and affective experience immediately following a single bout of moderate exercise. Participants (144 community members aged 19 to 93) were randomly assigned to one of two experimental conditions: (a) exercise (15 min of moderate intensity stationary cycling) or (b) control (15 min completing ratings of neutral IAPS images). Before and after the manipulation, participants completed tests of working memory and momentary affect experience was measured. Results suggest that exercise is associated with increased levels of high-arousal positive affect (HAP) and decreased levels of low-arousal positive affect (LAP) relative to control condition. Age moderated the effects of exercise on LAP, such that younger age was associated with a drop in reported LAP postexercise, whereas the effects of exercise on HAP were consistent across age. Exercise also led to faster RTs on a working memory task than the control condition across age. Self-reported negative affect was unchanged. Overall, findings suggest that exercise may hold important benefits for both affective experience and cognitive performance regardless of age. PMID:23795769

  1. The Difference between Right and Wrong: Accuracy of Older and Younger Adults’ Story Recall

    Danielle K. Davis

    2015-09-01

    Full Text Available Sharing stories is an important social activity in everyday life. This study used fine-grained content analysis to investigate the accuracy of recall of two central story elements: the gist and detail of socially-relevant stories. Younger (M age = 28.06 and older (M age = 75.03 American men and women (N = 63 recalled fictional stories that were coded for (i accuracy of overall gist and specific gist categories and (ii accuracy of overall detail and specific detail categories. Findings showed no age group differences in accuracy of overall gist or detail, but differences emerged for specific categories. Older adults more accurately recalled the gist of when the event occurred whereas younger adults more accurately recalled the gist of why the event occurred. These differences were related to episodic memory ability and education. For accuracy in recalling details, there were some age differences, but gender differences were more robust. Overall, women remembered details of these social stories more accurately than men, particularly time and perceptual details. Women were also more likely to accurately remember the gist of when the event occurred. The discussion focuses on how accurate recall of socially-relevant stories is not clearly age-dependent but is related to person characteristics such as gender and episodic memory ability/education.

  2. [Assessment of the size of the thalamus as a method for the evaluation of the activity of neurodegenerative process after the treatment with cerebrolisin in young patients with multiple sclerosis].

    Boĭko, A N; Batysheva, T T; Mel'nikova, M V; Boĭko, O V; Mugutdinova, B T; Gorina, T P; Ovcharov, V V; Bykova, O V; Popova, N F; Gusev, E I

    2013-01-01

    The aim of the study was to describe the atrophy of the thalamus in young patients with active relapsing multiple sclerosis (MS) treated with cerebrolysin. Eighteen MS patients (mean age 20.10±0.45 years) with disease onset in childhood or adolescence were studied. Neurological examination using the EDSS, neuropsychological testing and MRI were used. At baseline, MRI revealed the hypotrophy of the thalamus that was not correlated with the performance on neuropsychological tests. After treatment with cerebrolysin, there was the decrease in the level of atrophy that suggested the neuroprotective effect of this drug. This effect was more prominent in younger patients with the high frequency of previous relapses. PMID:23528602

  3. Validation of the German version of the patient activation measure 13 (PAM13-D) in an international multicentre study of primary care patients

    Brenk-Franz, K.; Hibbard, J.H.; Herrmann, W.J.; Freund, T.; Szecsenyi, J.; Djalali, S.; Steurer-Stey, C.; Sonnichsen, A.; Tiesler, F.; Storch, M.; Schneider, N.; Gensichen, J.

    2013-01-01

    The patients' active participation in their medical care is important for patients with chronic diseases. Measurements of patient activation are needed for studies and in clinical practice. This study aims to validate the Patient Activation Measure 13 (PAM13-D) in German-speaking primary care patien

  4. Geriatric Small Bowel Obstruction: An Analysis of Treatment and Outcomes Compared to a Younger Cohort

    Krause, William R.; Webb, Travis P.

    2016-01-01

    Background Small bowel obstruction (SBO) is a common condition, but little is known about its presentation, management, and outcomes in geriatric patients. Methods A retrospective review was performed comparing geriatric (≥65 years of age) and non-geriatric patients admitted with SBO. Admission characteristics, treatment, and outcomes were compared. Data analysis included Student’s t test and chi-square test or Fisher exact test. Results Among 80 geriatric and 136 non-geriatric patients no difference was observed between admission characteristics, treatment, time to or type of surgery, length of post-op stay, or overall complications. Cardiac complications (15% vs 0%, p=0.0082) and sub-acute care facility discharge (29% vs 5%, prisk profile and discharge disposition discussion should be encouraged. Summary This study analyzes geriatric patients presenting with small bowel obstruction when cared for by an Acute Care Surgery service. Compared to younger adults, the presentation, treatment response, and outcomes are similar with the exception of cardiac complications and discharge destination. PMID:25048569

  5. Hiding its age: the case for a younger bulge

    Haywood, M; Snaith, O; Calamida, A

    2016-01-01

    The determination of the age of the bulge has led to two contradictory results. On the one side, the color-magnitude diagrams in different bulge fields seem to indicate a uniformly old ($>$10 Gyr) population. On the other side, individual ages derived from dwarfs observed through microlensing events seem to indicate a large spread, from $\\sim$ 2 to $\\sim$ 13 Gyr. Because the bulge is now recognised as being mainly a boxy peanut-shaped bar, it is suggested that disk stars are one of its main constituents, and therefore also stars with ages significantly younger than 10 Gyr. Other arguments as well point to the fact that the bulge cannot be exclusively old, and in particular cannot be a burst population, as it is usually expected if the bulge was the fossil remnant of a merger phase in the early Galaxy. In the present study, we show that given the range of metallicities observed in the bulge, a uniformly old population would be reflected into a significant spread in color at the turn-off which is not observed. ...

  6. Paleoproductivity during the Younger Dryas off northeastern Luzon, Philippines

    Quevedo, J. M. D.; Siringan, F. P.; Villanoy, C.

    2014-12-01

    The influence of the Younger Dryas (YD) event on primary production off the northeast shelf of Luzon, Philippines is examined using sediment cores from two deep sea sites north of the Bicol shelf and with varying relative influence from terrestrial sediment input and the Kuroshio Current. Core A is immediately west of the Kuroshio feeder current and is off the slope while Core B is from a bathymetric high located almost west of Core A. XRF-, CHN- and LOI-derived geochemical proxies are utilized for reconstruction. A decrease in sediment input from ~12.9 to ~11.6 kyr BP corresponding to the YD event is indicated by the proxies, Ti, Al, and Al/Ti, in both cores. This is consistent with the drier climate during this period. Primary productivity indicators in the cores show opposing trends during the YD; Core A shows an increasing trend while Core B shows a decreasing trend. The decreasing trend in Core B can be due to a decrease in terrestrial nutrient input due to a decrease in precipitation. On the other hand, the increasing trend in Core A can be due to a swifter Kuroshio Current caused by a swifter and more southerly NEC bifurcation which in turn is due to a southerly shift of the ITCZ during YD. A swifter Kuroshio would have enhanced upwelling induced by steeper sea surface across the current and by more intense cyclonic gyres due to flow separation where the shelf width suddenly decreases north of the Bicol Shelf.

  7. A Younger Dryas glacierization in the Venezuelan Andes

    Stansell, N. D.; Abbott, M. B.; Polissar, P. J.; Bezada, M.

    2007-12-01

    The Younger Dryas (YD) was an abrupt climate change event that has been well recorded in marine archives, but is still uncertain in terrestrial records from the tropics. For instance, the YD is recorded in the Cariaco Basin as an event of increased upwelling intensity and decreased terrigenous input; however continental records of a coincident climate change event across the region are inconclusive. Moreover, pollen data from the Colombian Andes suggest that there was a local cold stadial that coincides with the YD, but paleoenvironmental records from the Venezuelan Andes during the same time interval are not clear. Here we present a high-resolution late- glacial sequence from the Pico Espejo region of Venezuela. Our record is based on radiocarbon dated lake sediments that were analyzed using magnetic susceptibility, scanning X-ray fluorescence and loss-on-ignition methods. The sequence contains a period of increased glacial-sedimentary flux between ca. 13,000 and 12,000 cal yr BP, which coincides with the timing of the YD. Glacio-lacustrine sediments also increased between ca. 11,000 to 10,000 cal yr BP. Combined, these data suggest the northern tropical Andes experienced cooling events during the YD, and from ca. 11,000 to 10,000 cal yr BP.

  8. Heinrich I and Younger Dryas Glaciation in the Central Andes

    Zech, J.; Zech, R.; May, J.; Kubik, P. W.; Veit, H.

    2009-12-01

    Short term climate reversals, such as Heinrich I (H-I) and the Younger Dryas (YD), are well documented in the Northern Hemisphere. However, the respective response of the climate system in the Southern Hemisphere during these events remains enigmatic. Here we present 10Be surface exposure ages from the Wara Wara Valley (17°S, 66°W), Cordillera Cochabamba, that reveal glacial advances in the Central Andes before 14.3 ka and 11.9 ka. These advances correlate with H-I and YD and coincide with the lake transgression phases Tauca (18-14 ka) and Coipasa (13-11 ka) on the Altiplano. They corroborate the precipitation sensitivity of glacier mass balances in the semi-arid Central Andes. We suggest that sufficient moisture for glacial advances can be explained by enhanced upper tropospheric easterlies as a response to an intensified tropical circulation and sustained la Niña like patterns in the eastern Pacific. This redistribution of the ocean and atmospheric circulation was caused by a southward shift of the ITCZ due to northern hemispheric cooling. At 10.8 ka glacier advanced again attributed to increased moisture supply by enhanced polar advection and SE trade winds during the Early Holocene. Final deglaciation started only at 9.2 ka induced by a change to drier conditions.

  9. A Blind Test of the Younger Dryas Impact Hypothesis

    Holliday, Vance

    2016-01-01

    The Younger Dryas Impact Hypothesis (YDIH) states that North America was devastated by some sort of extraterrestrial event ~12,800 calendar years before present. Two fundamental questions persist in the debate over the YDIH: Can the results of analyses for purported impact indicators be reproduced? And are the indicators unique to the lower YD boundary (YDB), i.e., ~12.8k cal yrs BP? A test reported here presents the results of analyses that address these questions. Two different labs analyzed identical splits of samples collected at, above, and below the ~12.8ka zone at the Lubbock Lake archaeological site (LL) in northwest Texas. Both labs reported similar variation in levels of magnetic micrograins (>300 mg/kg >12.8ka and <11.5ka, but <150 mg/kg 12.8ka to 11.5ka). Analysis for magnetic microspheres in one split, reported elsewhere, produced very low to nonexistent levels throughout the section. In the other split, reported here, the levels of magnetic microspherules and nanodiamonds are low or nonexistent at, below, and above the YDB with the notable exception of a sample <11,500 cal years old. In that sample the claimed impact proxies were recovered at abundances two to four orders of magnitude above that from the other samples. Reproducibility of at least some analyses are problematic. In particular, no standard criteria exist for identification of magnetic spheres. Moreover, the purported impact proxies are not unique to the YDB. PMID:27391147

  10. A breast cancer meta-analysis of two expression measures of chromosomal instability reveals a relationship with younger age at diagnosis and high risk histopathological variables.

    Endesfelder, David; McGranahan, Nicholas; Birkbak, Nicolai J; Szallasi, Zoltan; Kschischo, Maik; Graham, Trevor A; Swanton, Charles

    2011-07-01

    Breast cancer in younger patients often presents with adverse histopathological features, including increased frequency of estrogen receptor negative and lymph node positive disease status. Chromosomal instability (CIN) is increasingly recognised as an important prognostic variable in solid tumours. In a breast cancer meta-analysis of 2423 patients we examine the relationship between clinicopathological parameters and two distinct chromosomal instability gene expression signatures in order to address whether younger age at diagnosis is associated with increased tumour genome instability. We find that CIN, assessed by the two independently derived CIN expression signatures, is significantly associated with increased tumour size, ER negative or HER2 positive disease, higher tumour grade and younger age at diagnosis in ER negative breast cancer. These data support the hypothesis that chromosomal instability may be a defining feature of breast cancer biology and clinical outcome. PMID:21709316