WorldWideScience

Sample records for additional patients sensitive

  1. Sensitization to Food Additives in Patients with Allergy: A Study Based on Skin Test and Open Oral Challenge.

    Moghtaderi, Mozhgan; Hejrati, Zinatosadat; Dehghani, Zahra; Dehghani, Faranak; Kolahi, Niloofar

    2016-06-01

    There has been a great increase in the consumption of various food additives in recent years. The purpose of this study was to identify the incidence of sensitization to food additives by using skin prick test in patients with allergy and to determine the concordance rate between positive skin tests and oral challenge in hypersensitivity to additives. This cross-sectional study included 125 (female 71, male 54) patients aged 2-76 years with allergy and 100 healthy individuals. Skin tests were performed in both patient and control groups with 25 fresh food additives. Among patients with allergy, 22.4% showed positive skin test at least to one of the applied materials. Skin test was negative to all tested food additives in control group. Oral food challenge was done in 28 patients with positive skin test, in whom 9 patients showed reaction to culprit (Concordance rate=32.1%). The present study suggested that about one-third of allergic patients with positive reaction to food additives showed positive oral challenge; it may be considered the potential utility of skin test to identify the role of food additives in patients with allergy. PMID:27424134

  2. Patch testing with a new fragrance mix detects additional patients sensitive to perfumes and missed by the current fragrance mix

    Frosch, Peter J; Pirker, Claudia; Rastogi, Suresh C;

    2005-01-01

    The currently used 8% fragrance mix (FM I) does not identify all patients with a positive history of adverse reactions to fragrances. A new FM II with 6 frequently used chemicals was evaluated in 1701 consecutive patients patch tested in 6 dermatological centres in Europe. FM II was tested in 3...... regarding a history of adverse reactions to fragrances: certain, probable, questionable, none. Positive reactions to FM I occurred in 6.5% of the patients. Positive reactions to FM II were dose-dependent and increased from 1.3% (2.8% FM II), through 2.9% (14% FM II) to 4.1% (28% FM II). Reactions classified...... as doubtful or irritant varied considerably between the 6 centres, with a mean value of 7.2% for FM I and means ranging from 1.8% to 10.6% for FM II. 8.7% of the tested patients had a certain fragrance history. Of these, 25.2% were positive to FM I; reactivity to FM II was again dose-dependent and...

  3. Further important sensitizers in patients sensitive to fragrances

    Frosch, P J; Johansen, J D; Menné, T;

    2002-01-01

    In order to find sensitizers additional to the current fragrance mix (FM) a series of fragrance materials (series II) was evaluated in 6 dermatological centres in Europe. 11 of the test materials were essential oils, the remaining 7 being either mixtures of isomers or simple chemicals of frequent...... a history of adverse reactions to fragrances which was classified as certain. This group reacted to FM only in 22.9%, to series II and FM in 15.6% and to series II only in 5.2%. 63.5% of the patients reacting to both FM and 1 of the materials of series II had some type of positive fragrance history......, which was higher in comparison to those with isolated reactions to FM (46.2% of 121) or to series II, respectively, (45.8% of 48). However, this difference was not statistically significant. In conclusion, the materials of series II identified a further subset of patients with a fragrance problem, which...

  4. Nitrogen Addition Enhances Drought Sensitivity of Young Deciduous Tree Species.

    Dziedek, Christoph; Härdtle, Werner; von Oheimb, Goddert; Fichtner, Andreas

    2016-01-01

    Understanding how trees respond to global change drivers is central to predict changes in forest structure and functions. Although there is evidence on the mode of nitrogen (N) and drought (D) effects on tree growth, our understanding of the interplay of these factors is still limited. Simultaneously, as mixtures are expected to be less sensitive to global change as compared to monocultures, we aimed to investigate the combined effects of N addition and D on the productivity of three tree species (Fagus sylvatica, Quercus petraea, Pseudotsuga menziesii) in relation to functional diverse species mixtures using data from a 4-year field experiment in Northwest Germany. Here we show that species mixing can mitigate the negative effects of combined N fertilization and D events, but the community response is mainly driven by the combination of certain traits rather than the tree species richness of a community. For beech, we found that negative effects of D on growth rates were amplified by N fertilization (i.e., combined treatment effects were non-additive), while for oak and fir, the simultaneous effects of N and D were additive. Beech and oak were identified as most sensitive to combined N+D effects with a strong size-dependency observed for beech, suggesting that the negative impact of N+D becomes stronger with time as beech grows larger. As a consequence, the net biodiversity effect declined at the community level, which can be mainly assigned to a distinct loss of complementarity in beech-oak mixtures. This pattern, however, was not evident in the other species-mixtures, indicating that neighborhood composition (i.e., trait combination), but not tree species richness mediated the relationship between tree diversity and treatment effects on tree growth. Our findings point to the importance of the qualitative role ('trait portfolio') that biodiversity play in determining resistance of diverse tree communities to environmental changes. As such, they provide further

  5. Highly sensitive troponin T in patients with acute ischemic stroke

    Jensen, J K; Ueland, T; Aukrust, P; Antonsen, Lisbeth; Kristensen, Søren Risom; Januzzi, J L; Ravkilde, J

    2012-01-01

    sensitive troponin T (hsTnT) was measured daily during the first 4 days in 193 consecutive patients with acute ischemic stroke without overt ACS or atrial fibrillation. The patients were previously tested normal with a fourth-generation TnT assay. The patients were followed for 47 months, with all-cause and...... in patients with acute ischemic stroke previously tested normal with a fourth-generation TnT assay. hsTnT did not provide additional prognostic information in these subjects....

  6. Electronic transfer of sensitive patient data.

    Detterbeck, A M W; Kaiser, J; Hirschfelder, U

    2015-01-01

    The purpose of this study was to develop decision-making aids and recommendations for dental practitioners regarding the utilization and sharing of sensitive digital patient data. In the current environment of growing digitization, healthcare professionals need detailed knowledge of secure data management to maximize confidentiality and minimize the risks involved in both archiving patient data and sharing it through electronic channels. Despite well-defined legal requirements, an all-inclusive technological solution does not currently exist. The need for a preliminary review and critical appraisal of common practices of data transfer prompted a search of the literature and the Web to identify viable methods of secure data exchange and to develop a flowchart. A strong focus was placed on the transmission of datasets both smaller than and larger than 10 MB, and on secure communication by smartphone. Although encryption of patient-related data should be routine, it is often difficult to implement. Pretty Good Privacy (PGP) and Secure/Multipurpose Internet Mail Extensions (S/MIME) are viable standards for secure e-mail encryption. Sharing of high-volume data should be accomplished with the help of file encryption. Careful handling of sensitive patient data is mandatory, and it is the end-user's responsibility to meet any requirements for encryption, preferably by using free, open-source (and hence transparent) software. PMID:25911828

  7. The effects of freeze drying and freeze drying additives on the prothrombin time and the international sensitivity index.

    Poller, L; Keown, M; Shepherd, S A; Shiach, C R; Tabeart, S

    1999-01-01

    AIM: To determine whether freezing, freeze drying protective additives, or freeze drying of plasma samples from patients on coumarin treatment and from normal individuals affects prothrombin times or the international sensitivity index (ISI) calibration. METHODS: The effect of the addition of the protective additives singly and combined on the prothrombin time of coumarin samples and normal samples before and after freeze drying was observed using high and low ISI reference thromboplastins. I...

  8. Unique proteomic signature for radiation sensitive patients; a comparative study between normo-sensitive and radiation sensitive breast cancer patients

    Skiöld, Sara [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden); Azimzadeh, Omid [Institute of Radiation Biology, German Research Center for Environmental Health, Helmholtz Zentrum München (Germany); Merl-Pham, Juliane [Research Unit Protein Science, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg (Germany); Naslund, Ingemar; Wersall, Peter; Lidbrink, Elisabet [Division of Radiotherapy, Radiumhemmet, Karolinska University Hospital, Stockholm (Sweden); Tapio, Soile [Institute of Radiation Biology, German Research Center for Environmental Health, Helmholtz Zentrum München (Germany); Harms-Ringdahl, Mats [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden); Haghdoost, Siamak, E-mail: Siamak.Haghdoost@su.se [Center for Radiation Protection Research, Department of Molecular Biosciences, The Wernner-Gren Institute, Stockholm University, Stockholm (Sweden)

    2015-06-15

    Highlights: • The unique protein expression profiles were found that separate radiosensitive from normal sensitive breast cancer patients. • The oxidative stress response, coagulation properties and acute phase response suggested to be the hallmarks of radiation sensitivity. - Abstract: Radiation therapy is a cornerstone of modern cancer treatment. Understanding the mechanisms behind normal tissue sensitivity is essential in order to minimize adverse side effects and yet to prevent local cancer reoccurrence. The aim of this study was to identify biomarkers of radiation sensitivity to enable personalized cancer treatment. To investigate the mechanisms behind radiation sensitivity a pilot study was made where eight radiation-sensitive and nine normo-sensitive patients were selected from a cohort of 2914 breast cancer patients, based on acute tissue reactions after radiation therapy. Whole blood was sampled and irradiated in vitro with 0, 1, or 150 mGy followed by 3 h incubation at 37 °C. The leukocytes of the two groups were isolated, pooled and protein expression profiles were investigated using isotope-coded protein labeling method (ICPL). First, leukocytes from the in vitro irradiated whole blood from normo-sensitive and extremely sensitive patients were compared to the non-irradiated controls. To validate this first study a second ICPL analysis comparing only the non-irradiated samples was conducted. Both approaches showed unique proteomic signatures separating the two groups at the basal level and after doses of 1 and 150 mGy. Pathway analyses of both proteomic approaches suggest that oxidative stress response, coagulation properties and acute phase response are hallmarks of radiation sensitivity supporting our previous study on oxidative stress response. This investigation provides unique characteristics of radiation sensitivity essential for individualized radiation therapy.

  9. Unique proteomic signature for radiation sensitive patients; a comparative study between normo-sensitive and radiation sensitive breast cancer patients

    Highlights: • The unique protein expression profiles were found that separate radiosensitive from normal sensitive breast cancer patients. • The oxidative stress response, coagulation properties and acute phase response suggested to be the hallmarks of radiation sensitivity. - Abstract: Radiation therapy is a cornerstone of modern cancer treatment. Understanding the mechanisms behind normal tissue sensitivity is essential in order to minimize adverse side effects and yet to prevent local cancer reoccurrence. The aim of this study was to identify biomarkers of radiation sensitivity to enable personalized cancer treatment. To investigate the mechanisms behind radiation sensitivity a pilot study was made where eight radiation-sensitive and nine normo-sensitive patients were selected from a cohort of 2914 breast cancer patients, based on acute tissue reactions after radiation therapy. Whole blood was sampled and irradiated in vitro with 0, 1, or 150 mGy followed by 3 h incubation at 37 °C. The leukocytes of the two groups were isolated, pooled and protein expression profiles were investigated using isotope-coded protein labeling method (ICPL). First, leukocytes from the in vitro irradiated whole blood from normo-sensitive and extremely sensitive patients were compared to the non-irradiated controls. To validate this first study a second ICPL analysis comparing only the non-irradiated samples was conducted. Both approaches showed unique proteomic signatures separating the two groups at the basal level and after doses of 1 and 150 mGy. Pathway analyses of both proteomic approaches suggest that oxidative stress response, coagulation properties and acute phase response are hallmarks of radiation sensitivity supporting our previous study on oxidative stress response. This investigation provides unique characteristics of radiation sensitivity essential for individualized radiation therapy

  10. Efficiency enhancement of dye-sensitized solar cells with addition of additives (single/binary) to ionic liquid electrolyte

    H-S Lee; S-H Bae; C-H Han; S S Sekhon

    2012-11-01

    The effect of addition of single and binary additives on the performance of dye-sensitized TiO2 solar cells based on electrolytes containing an ionic liquid (IL), 1,2-dimethyl-3-propylimidazolium iodide (DMPII) has been studied. Among the seven additives used, the addition of 2-(dimethylamino)-pyridine (DMAP) to IL resulted in best cell efficiency, which showed further enhancement with the addition of 5-chloro-1-ethyl-2-methylimidazole (CEMI) as second additive. The efficiency of the dye-sensitized solar cell (DSC) based on an electrolyte containing binary additives (DMAP and CEMI in equal molar ratios) has been found to increase by 62.5% from 4.35 to 7.07%. The dependence of different photovoltaic performance parameters (\\oc, sc, , ) of DSC upon temperature has been studied over a 30–120°C range and only a small decrease in conversion efficiency has been observed. The electrolyte containing binary additives (DMAP and CEMI) shows best cell performance up to 120°C.

  11. Analysis of the individual radio sensitivity of breast cancer patients

    Individual radiosensitivity has a crucial impact on radiotherapy related side effects. A prediction of individual radiosensitivity could avoid these side effects. Our aim was to study a breast cancer collective for its variation of individual radiosensitivity. Peripheral blood samples were obtained from 129 individuals. 67 breast cancer patients and 62 healthy and age matched individuals were looked at and their individual radiosensitivity was estimated by a 3-color Fluorescence in situ hybridization approach. Blood samples were obtained (i) before starting adjuvant radiotherapy and were in vitro irradiated by 2 Gy; (ii) after 5 single doses of 1.8 Gy and after 72 h had elapsed. DNA of lymphocytes was probed with whole chromosome painting for chromosomes 1, 2 and 4. The rate of breaks per metaphase was analyzed and used as a predictor of individual radiosensitivity. Breast cancer patients were distinctly more radio-sensitive compared to healthy controls. Additionally the distribution of the cancer patients' radiosensitivity was broader. A subgroup of 9 rather radio-sensitive and 9 rather radio-resistant patients was identified. A subgroup of patients aged between 40 and 50 was distinctly more radio-sensitive than younger or older patients. The in vivo irradiation approach was not applicable to detect individual radiosensitivity. In the breast cancer collective a distinctly resistant and sensitive subgroup is identified, which could be subject for treatment adjustment. Especially in the range of age 40 to 50 patients have an increased radiosensitivity. An in vivo irradiation in a breast cancer collective is not suitable to estimate individual radiosensitivity due to a low deposed dose.

  12. 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...

  13. Lyral is an important sensitizer in patients sensitive to fragrances

    Frosch, P J; Johansen, Jeanne Duus; Menné, T;

    1999-01-01

    Contact allergy to fragrances is a common problem world-wide. The currently used fragrance mix (FM) for patch testing has only eight constituents and does not identify all fragrance-allergic patients. As perfumes may contain 100 or more substances, the search for markers for allergy continues. The...... synthetic fragrance 4-(4-hydroxy-4-methylpentyl)-3-cyclohexene carboxaldehyde (Lyral) was tested together with the FM and 11 other fragrance substances on consecutive patients in six European departments of dermatology. All patients were carefully questioned regarding a history of reactions to scented.......1%) reacted positively only to Lyral. Of 124 patients with a 'certain' history, 53.2% reacted to the FM and a further 7.2% to Lyral only. If any kind of history of fragrance intolerance was given, 80% (40 of 50) of Lyral positive patients had a 'positive' history while only 58.6% (123 of 210) of FM positive...

  14. Further important sensitizers in patients sensitive to fragrances

    Frosch, P J; Johansen, Jeanne Duus; Menné, T;

    2002-01-01

    The aim of this study was to determine the frequency of responses to selected fragrance materials in consecutive patients patch tested in 6 dermatological centres in Europe. 1855 patients were evaluated with the 8% fragrance mix (FM) and 14 other frequently used well-defined fragrance chemicals...... (series I). Each patient was classified regarding a history of adverse reactions to fragrances: certain, probable, questionable, none. Reactions to FM occurred in 11.3% of the subjects. The 6 substances with the highest reactivity following FM were Lyral (2.7%), citral (1.1%), farnesol P (0.......5%), citronellol (0.4%), hexyl cinnamic aldehyde (0.3%), and coumarin (0.3%). 41 (2.2%) of the patients reacted only to materials of series I and not to FM. 6.6% of 1855 patients gave a history of adverse reactions to fragrances which was classified as certain. This group reacted to FM only in 41.1%, to series I...

  15. Additional Sensitivity Penalty of Burst Mode Receivers in Ethernet PON due to Extinction Ratio

    Sub; Han; Ja-Won; Seo; Tae-Whan; Yoo; Man-Seop; Lee

    2003-01-01

    An additional sensitivity penalty of burst mode receivers due to the extinction ratio is analyzed considering the specific transmitter control in Ethernet PON. For an extinction ratio of 6dB, a penalty of 8dB occurs additionally.

  16. Galantamine: additional benefits to patients with Alzheimer's disease.

    Lilienfeld, S; Parys, W

    2000-09-01

    Galantamine, a novel treatment for Alzheimer's disease (AD), has a dual mechanism of action, combining allosteric modulation of nicotinic acetylcholine receptors with reversible, competitive inhibition of acetylcholinesterase. In the Phase III clinical trial programme, over 3,000 patients with mild-to-moderate AD were enrolled in one of five randomized, controlled, double-blind studies. Using the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) to assess memory and other cognitive functions, galantamine was found to be significantly superior to placebo in all five studies at doses of 16, 24 and 32 mg/day. In all studies, galantamine-treated patients maintained their cognitive function, whereas the placebo-treated patients experienced a significant deterioration in ADAS-cog scores. The 32-mg/day dose was not associated with any additional cognitive benefit. Pooled data from two 6-month studies (n = 1,269), which were of identical design, show that the therapeutic benefits of galantamine are sustained for the duration of treatment. The treatment effect (galantamine-placebo difference on ADAS-cog) for the pooled data was approximately 4 points. Clinical benefit was seen in all levels of disease severity, with a 7-point advantage over placebo on ADAS-cog for patients with moderately severe disease. Galantamine was well tolerated, with most patients completing the 6-month studies. The long-term effects of galantamine have been evaluated in a 12-month study. Patients who completed one of the pivotal 6-month studies (n = 353) were entered into a 6-month open-label extension. Cognitive and daily function were maintained throughout the 12 months in patients who received galantamine 24 mg/day. This sustained level of benefit may reflect galantamine's dual effect on the cholinergic system. Data from a 5-month, placebo-controlled study have also shown that galantamine produces significant benefits on behavioural symptoms. The persistence and range of

  17. Effect of basic additives on sensitivity and diffusion of acid in chemical amplification resists

    Asakawa, Koji; Ushirogouchi, Tohru; Nakase, Makoto

    1995-06-01

    The effect of amine additives in chemical amplification resists is discussed. Phenolic amines such as 4-aminophenol and 2-(4-aminophenyl)-2-(4-hydroxyphenyl) propane were investigated as model compounds from the viewpoint of sensitivity, diffusion and resolution. Equal molar amounts of acid and amine deactivated at the very beginning of post-exposure bake, and could not participate in decomposing the inhibitor as a catalyst. Only the acid which survived from the deactivation diffuses in the resist, decomposing the inhibitors from the middle to late stage of PEB. The basic additives reduce the diffusion range of the acid, especially for long-range diffusion, resulting in higher contrast at the interfaces between the exposed and unexposed areas. In addition, the amine concentration required is found to be less than the concentration which causes the resist sensitivity to start decreasing.

  18. Influence of sensitizing additives on deformation-strength properties of radiation vulcanized rubber

    Full text: Expanding the practical use of products of radiation-vulcanized elastopolymers (RVEP) makes it necessary to increase their operational properties. Applied to the exploitation of polymers in the field of the ionizing radiation does not always meet shown requirements to them. In the present report the influence of sensitizer of disulpho chloride aromatic compounds on deformation-strength and their ageing under the influence of radiation exposure is being examined. The serial produced aromatic compounds of disulpho chloride bezene (DSCB) were used as sensitizers. It is established that, during the sensitization of radiation chemical vulcanization the mixture of butadiene-nitrile rubber with PVC with other ingredients affect the density of the spatial grid which determines the mechanical properties of vulcanized rubber. Two processes simultaneously run in the presence of sensitizing additives: inhibition of radiation oxidation which causes cross-linking and formation of the spatial grid in BNC. The role of sensitizer in the process of radiation vulcanization is defined first of all by reducing the doze of irradiation in the vulcanization process; simultaneously accelerate the cross-linking of the polymer chains. On the base of physical mechanical and structure of DSCB, can be judged that the influence of ionizing radiation leads the polar groups to ionization besides, their excited potential during ionization is very high which provides material with radiation resistance. Considering the resistance of DSCB to radiation, its practical value is high and can conduct vulcanization at low doses (150-300 kGy). (authors)

  19. Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain Sensitivity in Knee Osteoarthritis

    Soriano-Maldonado, Alberto; Klokker, Louise; Bartholdy, Cecilie;

    2016-01-01

    OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100 particip......OBJECTIVE: To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN: Randomized, masked, parallel, placebo-controlled trial involving 100...... the injections all participants undertook a 12-week supervised exercise program. Main outcomes were changes from baseline in pressure-pain sensitivity (pressure-pain threshold [PPT] and temporal summation [TS]) assessed using cuff pressure algometry on the calf. These were exploratory outcomes from a...... analyzed. The mean group difference in changes from baseline at week 14 was 0.6 kPa (95% CI: -1.7 to 2.8; P = 0.626) for PPT and 384 mm×sec (95% CI: -2980 to 3750; P = 0.821) for TS. CONCLUSIONS: These results suggest that adding intra-articular corticosteroid injection 2 weeks prior to an exercise program...

  20. Influence of electrolyte co-additives on the performance of dye-sensitized solar cells

    Stergiopoulos, Thomas; Rozi, Evangelia; Karagianni, Chaido-Stefania; Falaras, Polycarpos

    2011-12-01

    The presence of specific chemical additives in the redox electrolyte results in an efficient increase of the photovoltaic performance of dye-sensitized solar cells (DSCs). The most effective additives are 4- tert-butylpyridine (TBP), N-methylbenzimidazole (NMBI) and guanidinium thiocyanate (GuNCS) that are adsorbed onto the photoelectrode/electrolyte interface, thus shifting the semiconductor's conduction band edge and preventing recombination with triiodides. In a comparative work, we investigated in detail the action of TBP and NMBI additives in ionic liquid-based redox electrolytes with varying iodine concentrations, in order to extract the optimum additive/I2 ratio for each system. Different optimum additive/I2 ratios were determined for TBP and NMBI, despite the fact that both generally work in a similar way. Further addition of GuNCS in the optimized electrolytic media causes significant synergistic effects, the action of GuNCS being strongly influenced by the nature of the corresponding co-additive. Under the best operation conditions, power conversion efficiencies as high as 8% were obtained.

  1. Allergic sensitization to ornamental plants in patients with allergic rhinitis and asthma.

    Aydin, Ömür; Erkekol, Ferda Öner; Misirloigil, Zeynep; Demirel, Yavuz Selim; Mungan, Dilşad

    2014-01-01

    Ornamental plants (OPs) can lead to immediate-type sensitization and even asthma and rhinitis symptoms in some cases. This study aimed to evaluate sensitization to OPs in patients with asthma and/or allergic rhinitis and to determine the factors affecting the rate of sensitization to OPs. A total of 150 patients with asthma and/or allergic rhinitis and 20 healthy controls were enrolled in the study. Demographics and disease characteristics were recorded. Skin-prick tests were performed with a standardized inhalant allergen panel. Skin tests by "prick-to-prick" method with the leaves of 15 Ops, which are known to lead to allergenic sensitization, were performed. Skin tests with OPs were positive in 80 patients (47.1%). There was no significant difference between OP sensitized and nonsensitized patients in terms of gender, age, number of exposed OPs, and duration of exposure. Skin test positivity rate for OPs was significantly high in atopic subjects, patients with allergic rhinitis, food sensitivity, and indoor OP exposure, but not in patients with pollen and latex allergy. Most sensitizing OPs were Yucca elephantipes (52.5%), Dieffenbachia picta (50.8%), and Euphorbia pulcherrima (47.5%). There was significant correlation between having Saintpaulia ionantha, Croton, Pelargonium, Y. elephantipes, and positive skin test to these plants. Sensitivity to OPs was significantly higher in atopic subjects and patients with allergic rhinitis, food allergy, and indoor OP exposure. Furthermore, atopy and food sensitivity were found as risk factors for developing sensitization to indoor plants. Additional trials on the relationship between sensitization to OPs and allergic symptoms are needed. PMID:24717779

  2. Effect of boron addition on hydrogen embrittlement sensitivity in Fe-Ni based alloys

    In Fe-Ni based alloys, hydrogen embrittlement sensitivity is thought to correlate well with microstructure. The effect of boron addition on microstructure of Fe-Ni austenitic alloys has been investigated. It is found that 0.002 wt.% boron addition can significantly retard the formation of η phase, and only a few continuous carbides precipitate at the grain boundaries. As the boron content increases to 0.006 wt.%, carbides at grain boundaries become discontinuous, and are finer in size than that in the alloy with 0.002 wt.% boron. Significant decrease of the percent loss of reduction of area (RA) are seen in the alloys with boron contents lower than 0.006 wt.%. However, when further increasing the boron concentration to 0.01 wt.%, an increase in the percent loss of RA is found, due to the re-appearance of η phase and boride precipitation. Appropriate addition of boron can be an effective way of lowering hydrogen embrittlement sensitivity in Fe-Ni based alloys.

  3. Tactile sensitivity on the hands skin in rheumatic patients

    Kaluga, Elżbieta; Kostiukow, Anna; Samborski, Włodzimierz; Rostkowska, Elżbieta

    2014-01-01

    Introduction Clinical symptoms of rheumatic diseases can cause changes in the level of skin tactile sensitivity. Aim To determine the tactile threshold of the hands in female patients with rheumatic diseases. It also attempted to determine correlations between rheumatic patients’ tactile sensitivity and the degree of articular movement limitations, the Barthel Index (BI) and Edinburgh Handedness Inventory (EHI) results, the level of disability of the right hand and the left hand as well as ag...

  4. A highly efficient electric additive for enhancing photovoltaic performance of dye-sensitized solar cells

    2010-01-01

    N-cetylpyridinium iodide (N-CPI) as a new electric additive for enhancing photovoltaic performance of the dye-sensitized solar cell (DSSC) was studied.It showed high efficiency for enhancing both the open-circuit voltage and the short-circuit current density of DSSC when the suitable amount of N-CPI as 0.02 M was added in liquid electrolyte.The energy conversion effi- ciency of DSSC increased from 4.429% to 6.535%,with 47.55% enhancement.Therefore,it is a highly efficient electric addi- tive for DSSC.The intrinsic reason is owing to the special molecular structure of N-CPI,which contains two different polarity groups.As a surfactant,N-CPI could form ordered arrangement in liquid electrolyte,which affects the diffusing ability and the redox reaction of I-/I3-,and further affects the photovoltaic performance of DSSC.

  5. Rectal Sensitivity in Diabetes Patients with Symptoms of Gastroparesis

    Eirik Søfteland

    2014-01-01

    Full Text Available In a clinical setting, diabetic autonomic complications (cardiac, gastrointestinal, urogenital, etc. are often handled as separate entities. We investigated rectal sensitivity to heat, mechanical distension, and electrical stimulations in 20 patients with diabetes and symptoms of gastroparesis, to evaluate the extent of visceral neuronal damage. Furthermore, to evaluate the relation between the nervous structures we examined gastric emptying and cardiac autonomic function with the hypothesis being an association between these. We found that 60% of patients had delayed gastric empting. Rectal hyposensitivity was a general finding as they tolerated 67% higher thermal, 42% more mechanical, and 33% higher electrical current intensity compared to healthy controls. In patients, most heart rate variability parameters were reduced; they reported significantly more gastrointestinal symptoms and a reduced quality of life in all SF-36 domains. Shortened RR interval correlated with reduced rectal temperature sensitivity, and gastric retention rate was negatively associated with symptoms of nausea and vomiting. To conclude, in these patients with signs and symptoms of diabetic gastroparesis, rectal sensitivity was reduced, and heart rate variability was impaired. Thus, we suggest regarding diabetic autonomic neuropathy as a diffuse disorder. Symptoms of widespread autonomic dysfunction and sensory disorders should be expected and treated in these patients.

  6. Carbon flux from plants to soil microbes is highly sensitive to nitrogen addition and biochar amendment

    Kaiser, C.; Solaiman, Z. M.; Kilburn, M. R.; Clode, P. L.; Fuchslueger, L.; Koranda, M.; Murphy, D. V.

    2012-04-01

    The release of carbon through plant roots to the soil has been recognized as a governing factor for soil microbial community composition and decomposition processes, constituting an important control for ecosystem biogeochemical cycles. Moreover, there is increasing awareness that the flux of recently assimilated carbon from plants to the soil may regulate ecosystem response to environmental change, as the rate of the plant-soil carbon transfer will likely be affected by increased plant C assimilation caused by increasing atmospheric CO2 levels. What has received less attention so far is how sensitive the plant-soil C transfer would be to possible regulations coming from belowground, such as soil N addition or microbial community changes resulting from anthropogenic inputs such as biochar amendments. In this study we investigated the size, rate and sensitivity of the transfer of recently assimilated plant C through the root-soil-mycorrhiza-microbial continuum. Wheat plants associated with arbuscular mycorrhizal fungi were grown in split-boxes which were filled either with soil or a soil-biochar mixture. Each split-box consisted of two compartments separated by a membrane which was penetrable for mycorrhizal hyphae but not for roots. Wheat plants were only grown in one compartment while the other compartment served as an extended soil volume which was only accessible by mycorrhizal hyphae associated with the plant roots. After plants were grown for four weeks we used a double-labeling approach with 13C and 15N in order to investigate interactions between C and N flows in the plant-soil-microorganism system. Plants were subjected to an enriched 13CO2 atmosphere for 8 hours during which 15NH4 was added to a subset of split-boxes to either the root-containing or the root-free compartment. Both, 13C and 15N fluxes through the plant-soil continuum were monitored over 24 hours by stable isotope methods (13C phospho-lipid fatty acids by GC-IRMS, 15N/13C in bulk plant

  7. Sensitivity, specificity and predictive accuracy of radionuclide cineangiography during exercise in patients with coronary artery disease

    Noninvasive radionuclide cineangiography permits the assessment of global and regional left ventricular function during intense exercise. To assess the sensitivity of the technique in detecting coronary artery disease, we studied 63 consecutive patients with greater than or equal to 50% stenosis of at least one coronary artery. Fifty-nine (94%) had regional dysfunction with exercise; 56 (89%) developed lower-than-normal ejection fractions during exercise. When both regional dysfunction and subnormal ejection fractions are considered together, the sensitivity was 95%. Each patient also underwent exercise electrocardiography to either angina or 85% of predicted maximal heart rate. Of the 42 patients who developed angina during exercise electrocardiography, 26 (62%) developed greater than or equal to 1 mm ST-segment depression; four additional patients (10%) had Q waves diagnostic of previous myocardial infarction. In contrast, 39 (93%, p < 0.001) developed regional dysfunction during radionuclide study, and one additional patient developed a subnormal ejection fraction without regional dysfunction. To assess specificity, we studied 21 consecutive patients with chest pain who had normal coronary arteries. None developed regional dysfunction; ejection fraction increased in all to levels within the range previously defined as normal. The Predictive accuracy in this symptomatic population was 100%. We conclude that radionuclide cineangiography is highly sensitive (more so than exercise electrocardiography), predictive and specific in detecting patients with coronary artery disease

  8. Analysis of photo-pattern sensitivity in patients with Pokemon-related symptoms.

    Funatsuka, Makoto; Fujita, Michinari; Shirakawa, Seigo; Oguni, Hirokazu; Osawa, Makiko

    2003-01-01

    This study was designed to analyze photo-pattern sensitivity in patients who developed acute neurologic symptoms associated with watching an animated television program, "Pokemon." The 18 patients (13 females and five males) underwent electroencephalograms and photo-pattern stimulation testing, including special stimulation test batteries (strobe-pattern test and cathode ray tube-pattern test). Photo-pattern sensitivity was confirmed in 16 patients with and without seizure episodes. The strobe-pattern test including a white flickering light test (with eyes open, closed, and open or closed), and the cathode ray tube-pattern test each induced a photo-paroxysmal response in more than 80% of patients. However, with the eyes closed only, as is common in Japan, the photo-paroxysmal response induction rate with a white flickering light stimulus was significantly lower (43%). In the cathode ray tube-pattern test, higher spatial frequencies produced higher rates of photo-paroxysmal response induction. It was demonstrated that underlying photo-pattern sensitivity is more accurately investigated by our method than by standard intermittent photic stimulation alone. By characterizing underlying photo-pattern sensitivity and identifying predisposing factors more precisely, we can develop better guidelines for prevention of a second "Pokemon" incident. According to the results of the present cathode ray tube-pattern test, pattern sensitivity (especially spatial resolution) appears to also be involved in Pokemon-related symptoms, in addition to chromatic sensitivity. PMID:12657417

  9. Impaired hapten sensitization in patients with autoimmune disease

    Bangsgaard, N; Engkilde, K; Menné, T;

    2011-01-01

    sensitized 68 adult individuals (23 patients with psoriasis, 22 patients with diabetes and 23 healthy controls) with diphenylcyclopropenone (DPCP) and assessed challenge responses with visual scoring and ultrasound. Skin biopsies from challenged skin were investigated for differences in down...... reactions, with no difference among the groups. No specific mRNA expression was found in the challenged skin of negative elicitation reactions, also indicating no sign of active down-regulation. The study contibutes strongly to the evidence of a decreased susceptibility to develop contact allergy in...

  10. Effec of green Tea Toward Sensitivity of Diabetic Melitus Patients

    Hamrun, Nurlindah

    2007-01-01

    Advantages of green tea as a medicine ascribed from plant had been known and used by community. In dental medicine, several researchers had reported that the advantages of green tea for dental health. The research aims to examine effect of green tea toward sensitivity tooth of diabetic mellitus patients. / Khasiat teh hijau sebagai obat yg berasal dari tumbuhan telah diketahui dan digunakan oleh masyarakat. Dalam bidang kedokteran gigi, beberapa peneliti telah melaporkan khasiat teh hijau

  11. Increased incidence of stings in venom-sensitive patients.

    Stone, B D; Hutcheson, P S; Evans, R G; Slavin, R G

    1992-11-01

    We compared the histories of 29 venom-sensitive and 28 control subjects who were selected from our venom referral and general allergy clinics respectively. The variables in the study included insect avoidance knowledge, the number of stings during the previous 2 years, insects involved, and time spent out of doors per week. There was no significant difference between the two groups with respect to age. All venom-sensitive patients were well versed in avoidance techniques while only 3 of 28 controls (11%) claimed such knowledge. Venom-sensitive subjects were stung almost ten times more frequently than control subjects. Wasp stings were the most common, followed by yellow jacket, honey bee, and hornet. The venom-sensitive patients also reported spending a greater amount of time outdoors (x 17.4 hours versus x 11.8, P < .05). An analysis of covariance showed that this difference in outdoor exposure was insufficient to account for the disparity in the number of stings. We conclude that other factors such as intrinsic attractants must be responsible for this phenomenon. PMID:1456488

  12. Strain rate sensitivity of Al-based composites reinforced with MnO{sub 2} additions

    Blaz, L.; Lobry, P.; Zygmunt-Kiper, M.; Koziel, J.; Wloch, G. [AGH-University of Science and Technology, Faculty of Non-Ferrous Metals, Cracow (Poland); Dymek, S. [AGH-University of Science and Technology, Faculty of Metals Engineering and Industrial Informatics, Cracow (Poland)

    2015-01-15

    Highlights: • Fine-grained Al–MnO{sub 2} and Al–MnO{sub 2}–Mg composites were processed and studied. • Powder metallurgy (PM) and mechanical alloying (MA) methods were used. • Increase of strain rate sensitivity (SRS) vs. temperature was observed at 300–600 K. • Efficiency of the SRS increase was reduced above ∼600 K for PM composites. • Decrease of SRS above ∼600 K was observed for MA Al–MnO{sub 2} composite. - Abstract: Fine-grained Al-based composites reinforced with MnO{sub 2} particles were manufactured by means of powder metallurgy (PM) and mechanical alloying (MA) methods. It was found that the applied powder consolidation methods, including KOBO extrusion, did not induce any chemical reaction between thermodynamically unstable components. However, it was shown that addition of magnesium to the Al-matrix initiated a reaction in the vicinity of MnO{sub 2} particles that resulted in the nucleation and growth of nano-sized aluminum–magnesium oxides. This led to a local refining of structural components. The most intense refining of structural components was observed for the MA Al–MnO{sub 2} composite. Strain rate sensitivity (SRS) of as-extruded materials was tested in compression in the range 293–773 K. SRS was determined by making a rapid change in the basic true strain rate from ε-dot=1.2·10{sup -3} to ε-dot=1.2·10{sup -2}. It is found that SRS did not practically depend on strain. The highest value of SRS was observed for the PM Al–MnO{sub 2}–Mg composite. SRS of PM materials evidently increases with deformation temperature; however, it becomes smaller above a temperature of ∼600 K. For the MA Al–MnO{sub 2} composite, tested at high temperatures, primary mechanical alloying resulted in relatively low increase of SRS with temperature that also becomes smaller above ∼600 K. Suppression of the increase in SRS at high temperatures can be attributed to the specific features of grain boundaries created by the adhesive

  13. Strain rate sensitivity of Al-based composites reinforced with MnO2 additions

    Highlights: • Fine-grained Al–MnO2 and Al–MnO2–Mg composites were processed and studied. • Powder metallurgy (PM) and mechanical alloying (MA) methods were used. • Increase of strain rate sensitivity (SRS) vs. temperature was observed at 300–600 K. • Efficiency of the SRS increase was reduced above ∼600 K for PM composites. • Decrease of SRS above ∼600 K was observed for MA Al–MnO2 composite. - Abstract: Fine-grained Al-based composites reinforced with MnO2 particles were manufactured by means of powder metallurgy (PM) and mechanical alloying (MA) methods. It was found that the applied powder consolidation methods, including KOBO extrusion, did not induce any chemical reaction between thermodynamically unstable components. However, it was shown that addition of magnesium to the Al-matrix initiated a reaction in the vicinity of MnO2 particles that resulted in the nucleation and growth of nano-sized aluminum–magnesium oxides. This led to a local refining of structural components. The most intense refining of structural components was observed for the MA Al–MnO2 composite. Strain rate sensitivity (SRS) of as-extruded materials was tested in compression in the range 293–773 K. SRS was determined by making a rapid change in the basic true strain rate from ε-dot=1.2·10-3 to ε-dot=1.2·10-2. It is found that SRS did not practically depend on strain. The highest value of SRS was observed for the PM Al–MnO2–Mg composite. SRS of PM materials evidently increases with deformation temperature; however, it becomes smaller above a temperature of ∼600 K. For the MA Al–MnO2 composite, tested at high temperatures, primary mechanical alloying resulted in relatively low increase of SRS with temperature that also becomes smaller above ∼600 K. Suppression of the increase in SRS at high temperatures can be attributed to the specific features of grain boundaries created by the adhesive bonding between powder particles. This could hinder grain

  14. Sensitivity of Raman spectroscopy to normal patient variability

    Vargis, Elizabeth; Byrd, Teresa; Logan, Quinisha; Khabele, Dineo; Mahadevan-Jansen, Anita

    2011-11-01

    Many groups have used Raman spectroscopy for diagnosing cervical dysplasia; however, there have been few studies looking at the effect of normal physiological variations on Raman spectra. We assess four patient variables that may affect normal Raman spectra: Race/ethnicity, body mass index (BMI), parity, and socioeconomic status. Raman spectra were acquired from a diverse population of 75 patients undergoing routine screening for cervical dysplasia. Classification of Raman spectra from patients with a normal cervix is performed using sparse multinomial logistic regression (SMLR) to determine if any of these variables has a significant effect. Results suggest that BMI and parity have the greatest impact, whereas race/ethnicity and socioeconomic status have a limited effect. Incorporating BMI and obstetric history into classification algorithms may increase sensitivity and specificity rates of disease classification using Raman spectroscopy. Studies are underway to assess the effect of these variables on disease.

  15. Sensitivity alteration of fiber Bragg grating sensors with additive micro-scale bi-material coatings

    Zhang, Xixi; Alemohammad, Hamidreza; Toyserkani, Ehsan

    2013-02-01

    This paper describes a combined fabrication method for creating a bi-material micro-scale coating on fiber Bragg grating (FBG) optical sensors using laser-assisted maskless microdeposition (LAMM) and electroless nickel plating. This bi-material coating alters the sensitivity of the sensor where it also acts as a protective layer. LAMM is used to coat bare FBGs with a 1-2 µm thick conductive silver layer followed by the electroless nickel plating process to increase layer thickness to a desired level ranging from 1 to 80 µm. To identify an optimum coating thickness and predict its effect on the sensor's sensitivity to force and temperature, an optomechanical model is developed in this study. According to the model if the thickness of the Ni layer is 30-50 µm, maximum temperature sensitivity is achieved. Our analytical and experimental results suggest that the temperature sensitivity of the coated FBG with 1 µm Ag and 33 µm Ni is almost doubled compared to a bare FBG with sensitivity of 0.011 ± 0.001 nm °C-1. In contrast, the force sensitivity is decreased; however, this sensitivity reduction is less than the values reported in the literature.

  16. Sensitivity alteration of fiber Bragg grating sensors with additive micro-scale bi-material coatings

    This paper describes a combined fabrication method for creating a bi-material micro-scale coating on fiber Bragg grating (FBG) optical sensors using laser-assisted maskless microdeposition (LAMM) and electroless nickel plating. This bi-material coating alters the sensitivity of the sensor where it also acts as a protective layer. LAMM is used to coat bare FBGs with a 1–2 µm thick conductive silver layer followed by the electroless nickel plating process to increase layer thickness to a desired level ranging from 1 to 80 µm. To identify an optimum coating thickness and predict its effect on the sensor's sensitivity to force and temperature, an optomechanical model is developed in this study. According to the model if the thickness of the Ni layer is 30–50 µm, maximum temperature sensitivity is achieved. Our analytical and experimental results suggest that the temperature sensitivity of the coated FBG with 1 µm Ag and 33 µm Ni is almost doubled compared to a bare FBG with sensitivity of 0.011 ± 0.001 nm °C−1. In contrast, the force sensitivity is decreased; however, this sensitivity reduction is less than the values reported in the literature. (paper)

  17. Controlling the Electrostatic Discharge Ignition Sensitivity of Composite Energetic Materials Using Carbon Nanotube Additives

    Kade H. Poper; Eric S. Collins; Michelle L. Pantoya; Michael Daniels

    2014-10-01

    Powder energetic materials are highly sensitive to electrostatic discharge (ESD) ignition. This study shows that small concentrations of carbon nanotubes (CNT) added to the highly reactive mixture of aluminum and copper oxide (Al + CuO) significantly reduces ESD ignition sensitivity. CNT act as a conduit for electric energy, bypassing energy buildup and desensitizing the mixture to ESD ignition. The lowest CNT concentration needed to desensitize ignition is 3.8 vol.% corresponding to percolation corresponding to an electrical conductivity of 0.04 S/cm. Conversely, added CNT increased Al + CuO thermal ignition sensitivity to a hot wire igniter.

  18. PARK2 patient neuroprogenitors show increased mitochondrial sensitivity to copper.

    Aboud, Asad A; Tidball, Andrew M; Kumar, Kevin K; Neely, M Diana; Han, Bingying; Ess, Kevin C; Hong, Charles C; Erikson, Keith M; Hedera, Peter; Bowman, Aaron B

    2015-01-01

    Poorly-defined interactions between environmental and genetic risk factors underlie Parkinson's disease (PD) etiology. Here we tested the hypothesis that human stem cell derived forebrain neuroprogenitors from patients with known familial risk for early onset PD will exhibit enhanced sensitivity to PD environmental risk factors compared to healthy control subjects without a family history of PD. Two male siblings (SM and PM) with biallelic loss-of-function mutations in PARK2 were identified. Human induced pluripotent stem cells (hiPSCs) from SM, PM, and four control subjects with no known family histories of PD or related neurodegenerative diseases were utilized. We tested the hypothesis that hiPSC-derived neuroprogenitors from patients with PARK2 mutations would show heightened cell death, mitochondrial dysfunction, and reactive oxygen species generation compared to control cells as a result of exposure to heavy metals (PD environmental risk factors). We report that PARK2 mutant neuroprogenitors showed increased cytotoxicity with copper (Cu) and cadmium (Cd) exposure but not manganese (Mn) or methyl mercury (MeHg) relative to control neuroprogenitors. PARK2 mutant neuroprogenitors also showed a substantial increase in mitochondrial fragmentation, initial ROS generation, and loss of mitochondrial membrane potential following Cu exposure. Our data substantiate Cu exposure as an environmental risk factor for PD. Furthermore, we report a shift in the lowest observable effect level (LOEL) for greater sensitivity to Cu-dependent mitochondrial dysfunction in patients SM and PM relative to controls, correlating with their increased genetic risk for PD. PMID:25315681

  19. Corneal Sensitivity and Dry Eye Symptoms in Patients with Keratoconus

    Dienes, Lóránt; Kiss, Huba J.; Perényi, Kristóf; Nagy, Zoltán Z.; Acosta, M. Carmen; Gallar, Juana; Kovács, Illés

    2015-01-01

    Purpose To investigate corneal sensitivity to selective mechanical, chemical, and thermal stimulation and to evaluate their relation to dry eye symptoms in patients with keratoconus. Methods Corneal sensitivity to mechanical, chemical, and thermal thresholds were determined using a gas esthesiometer in 19 patients with keratoconus (KC group) and in 20 age-matched healthy subjects (control group). Tear film dynamics was assessed by Schirmer I test and by the non-invasive tear film breakup time (NI-BUT). All eyes were examined with a rotating Scheimpflug camera to assess keratoconus severity. Results KC patients had significatly decreased tear secretion and significantly higher ocular surface disease index (OSDI) scores compared to controls (5.3±2.2 vs. 13.2±2.0 mm and 26.8±15.8 vs. 8.1±2.3; p0.05). The mean threshold for selective mechanical (KC: 139.2±25.8 vs. control: 109.1±24.0 ml/min), chemical (KC: 39.4±3.9 vs. control: 35.2±1.9%CO2), heat (KC: 0.91±0.32 vs. control: 0.54±0.26 Δ°C) and cold (KC: 1.28±0.27 vs. control: 0.98±0.25 Δ°C) stimulation in the KC patients were significantly higher than in the control subjects (p0.05), whereas in the control subjects both mechanical (r = 0.52, p = 0.02), chemical (r = 0.47, p = 0.04), heat (r = 0.26, p = 0.04) and cold threshold (r = 0.40, p = 0.03) increased with age. In the KC group, neither corneal thickness nor tear flow, NI-BUT or OSDI correlated significantly with mechanical, chemical, heat or cold thresholds (p>0.05 for all variables). Conclusions Corneal sensitivity to different types of stimuli is decreased in patients with keratoconus independently of age and disease severity. The reduction of the sensory input from corneal nerves may contribute to the onset of unpleasant sensations in these patients and might lead to the impaired tear film dynamics. PMID:26495846

  20. Highly sensitive detection of Staphylococcus aureus directly from patient blood.

    Padmapriya P Banada

    Full Text Available BACKGROUND: Rapid detection of bloodstream infections (BSIs can be lifesaving. We investigated the sample processing and assay parameters necessary for highly-sensitive detection of bloodstream bacteria, using Staphylococcus aureus as a model pathogen and an automated fluidic sample processing-polymerase chain reaction (PCR platform as a model diagnostic system. METHODOLOGY/PRINCIPAL FINDINGS: We compared a short 128 bp amplicon hemi-nested PCR and a relatively shorter 79 bp amplicon nested PCR targeting the S. aureus nuc and sodA genes, respectively. The sodA nested assay showed an enhanced limit of detection (LOD of 5 genomic copies per reaction or 10 colony forming units (CFU per ml blood over 50 copies per reaction or 50 CFU/ml for the nuc assay. To establish optimal extraction protocols, we investigated the relative abundance of the bacteria in different components of the blood (white blood cells (WBCs, plasma or whole blood, using the above assays. The blood samples were obtained from the patients who were culture positive for S. aureus. Whole blood resulted in maximum PCR positives with sodA assay (90% positive as opposed to cell-associated bacteria (in WBCs (71% samples positive or free bacterial DNA in plasma (62.5% samples positive. Both the assays were further tested for direct detection of S. aureus in patient whole blood samples that were contemporaneous culture positive. S. aureus was detected in 40/45 of culture-positive patients (sensitivity 89%, 95% CI 0.75-0.96 and 0/59 negative controls with the sodA assay (specificity 100%, 95% CI 0.92-1. CONCLUSIONS: We have demonstrated a highly sensitive two-hour assay for detection of sepsis causing bacteria like S. aureus directly in 1 ml of whole blood, without the need for blood culture.

  1. Clinical Outcome of Magnetic Resonance Imaging-Detected Additional Lesions in Breast Cancer Patients

    Ha, Gi-Won; Yi, Mi Suk; Lee, Byoung Kil; Youn, Hyun Jo; Jung, Sung Hoo

    2011-01-01

    Purpose The aim of this study was to investigate the clinical outcome of additional breast lesions identified with breast magnetic resonance imaging (MRI) in breast cancer patients. Methods A total of 153 patients who underwent breast MRI between July 2006 and March 2008 were retrospectively reviewed. Thirty-three patients (21.6&) were recommended for second-look ultrasound (US) for further characterization of additional lesions detected on breast MRI and these patients constituted our study ...

  2. Aeroallergen sensitivity among patients suffering from bronchial asthma in Bangalore

    Giriyanna Gowda

    2013-01-01

    Full Text Available Background: Asthma is a serious public health problem throughout the world and its prevalence has increased in last 2-3 decades. Allergens are one of the many factors which trigger an attack of asthma. Skin prick test is useful in identifying the offending allergen in bronchial asthma. Aim: To identify the possible offending allergens in patients of bronchial asthma. Materials and Methods: The study was a descriptive study conducted at allergy center, Kempegowda Institute of Medical Sciences Hospital and Research Center, Bangalore from January to December 2011. Skin prick test was done in 139 patients suffering from bronchial asthma using 49 allergens extracts. Statistical Analysis: Frequency, proportions, Chi-square test, odds ratio, and 95% confidence interval was used. Results: Out of 139 patients who underwent the skin prick tests, 40% (56 were males and 60% (83 were females. Majority, that is, 60% were in the age group of 21-40 years. Forty-three percent (60 had family history of asthma/atopy, 80% (111 had allergic rhinitis, 24% (34 had chronic urticaria, and 24% (33 had allergic conjunctivitis. Out of 139 patients, 100 (71.94% were sensitive for one or more allergens. The common offending allergens found in the study were dust mites (Dermatophagoides farinae and D. pteronyssinus (DF and DP - 49.28%, dusts - 7.2%, pollens - 6.77%, insects - 6.62%, fungi - 4.53%, and epithelia - 1.92%. Conclusion: The most common allergens in bronchial asthma were dust mites followed by dusts and pollens. Identifying possible allergens in asthma patients help in allergen avoidance and immunotherapy in these patients.

  3. Clinical Evaluation and Management of Patients with Suspected Fungus Sensitivity.

    Larenas-Linnemann, Desiree; Baxi, Sachin; Phipatanakul, Wanda; Portnoy, Jay M

    2016-01-01

    Fungus-sensitized patients usually present with symptoms that are similar to symptoms presented by those who are sensitized to other aeroallergens. Therefore, diagnosis and management should follow the same pathways used for patients with allergic conditions in general. The physician should consider that a relationship between fungal exposure and symptoms is not necessarily caused by an IgE-mediated mechanism, even when specific fungal IgE is detected. Until recently, IgE-mediated allergy has been documented only for a limited number of fungi. We propose a series of questions to be used to identify symptoms that occur in situations with high fungal exposure and a limited skin-prick-test panel (Alternaria, Cladosporium, Penicillium, Aspergillus, Candida) that can be amplified only in cases of high suspicion of other fungal exposure (eg, postfloods). We also review in vitro testing for fungi-specific IgE. Treatment includes environmental control, medical management, and, when appropriate, specific immunotherapy. Low-quality evidence exists supporting the use of subcutaneous immunotherapy for Alternaria to treat allergic rhinitis and asthma, and very low quality evidence supports the use of subcutaneous immunotherapy for Cladosporium and sublingual immunotherapy for Alternaria. As is the case for many allergens, evidence for immunotherapy with other fungal extracts is lacking. The so-called toxic mold syndrome is also briefly discussed. PMID:26755100

  4. Analysis of the individual radio sensitivity of breast cancer patients; Untersuchungen zur individuellen Strahlenempfindlichkeit von Brustkrebspatientinnen

    Auer, Judith

    2013-04-04

    Individual radiosensitivity has a crucial impact on radiotherapy related side effects. A prediction of individual radiosensitivity could avoid these side effects. Our aim was to study a breast cancer collective for its variation of individual radiosensitivity. Peripheral blood samples were obtained from 129 individuals. 67 breast cancer patients and 62 healthy and age matched individuals were looked at and their individual radiosensitivity was estimated by a 3-color Fluorescence in situ hybridization approach. Blood samples were obtained (i) before starting adjuvant radiotherapy and were in vitro irradiated by 2 Gy; (ii) after 5 single doses of 1.8 Gy and after 72 h had elapsed. DNA of lymphocytes was probed with whole chromosome painting for chromosomes 1, 2 and 4. The rate of breaks per metaphase was analyzed and used as a predictor of individual radiosensitivity. Breast cancer patients were distinctly more radio-sensitive compared to healthy controls. Additionally the distribution of the cancer patients' radiosensitivity was broader. A subgroup of 9 rather radio-sensitive and 9 rather radio-resistant patients was identified. A subgroup of patients aged between 40 and 50 was distinctly more radio-sensitive than younger or older patients. The in vivo irradiation approach was not applicable to detect individual radiosensitivity. In the breast cancer collective a distinctly resistant and sensitive subgroup is identified, which could be subject for treatment adjustment. Especially in the range of age 40 to 50 patients have an increased radiosensitivity. An in vivo irradiation in a breast cancer collective is not suitable to estimate individual radiosensitivity due to a low deposed dose.

  5. Systematic comparative and sensitivity analyses of additive and outranking techniques for supporting impact significance assessments

    Assessing the significance of environmental impacts is one of the most important and all together difficult processes of Environmental Impact Assessment. This is largely due to the multicriteria nature of the problem. To date, decision techniques used in the process suffer from two drawbacks, namely the problem of compensation and the problem of identification of the 'exact boundary' between sub-ranges. This article discusses these issues and proposes a methodology for determining the significance of environmental impacts based on comparative and sensitivity analyses using the Electre TRI technique. An application of the methodology for the environmental assessment of a Power Plant project within the Valencian Region (Spain) is presented, and its performance evaluated. It is concluded that contrary to other techniques, Electre TRI automatically identifies those cases where allocation of significance categories is most difficult and, when combined with sensitivity analysis, offers greatest robustness in the face of variation in weights of the significance attributes. Likewise, this research demonstrates the efficacy of systematic comparison between Electre TRI and sum-based techniques, in the solution of assignment problems. The proposed methodology can therefore be regarded as a successful aid to the decision-maker, who will ultimately take the final decision

  6. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    van Heugten, C.M.; Dekker, J; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    2000-01-01

    PURPOSE: The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. METHOD: A group of 33 patients with apraxia were treated according to the guidelines of a therapy programme based on teaching patients strategies to compensate for the presence of apraxia. Patients were treated at occupational therapy departments in general hospitals, rehabilitation centres and nur...

  7. The impact of additional malignancies in patients diagnosed with gastrointestinal stromal tumors.

    Smith, Myles J; Smith, Henry G; Mahar, Alyson L; Law, Calvin; Ko, Yoo-Joung

    2016-10-15

    A higher incidence of additional malignancies has been described in patients diagnosed with gastrointestinal stromal tumors (GIST). This study aimed to identify risk factors for developing additional malignancies in patients diagnosed with GIST and evaluate the impact on survival. Individuals diagnosed with GIST from 2001 to2009 were identified from the SEER database. Logistic regression was used to identify predictors of additional malignancies and Cox-proportional hazards regression used to identify predictors of survival. In the study period, 1705 cases of GIST were identified, with 181 (10.6%) patients developing additional malignancies. Colorectal cancer was the most common cancer developing within 6 months of GIST diagnosis (30%). The median time to diagnosis of a malignancy after 6 months of GIST diagnosis was 21.9 months. Older age (p factors associated with additional malignancies. The overall 5-year survival was 65%, with the presence of additional malignancies within 6 months of GIST diagnosis associated with poor overall survival (54%, HR 1.55 1.05-2.3 95% CI, p = 0.04). Predictive factors of additional malignancies in patients diagnosed with GIST are increasing age and the primary disease site. Developing additional malignancies within 6 months of GIST diagnosis is associated with poorer overall survival. Targeted surveillance may be warranted in patients diagnosed with GIST that are at high risk of developing additional malignancies. PMID:27299364

  8. Modifying structure-sensitive reactions by addition of Zn to Pd

    Childers, David J.; Schweitzer, Neil M.; Kamali Shahari, Seyed Mehdi; Rioux, Robert M.; Miller, Jeffrey T.; Meyer, Randall J.

    2014-10-01

    Silica-supported Pd and PdZn nanoparticles of a similar size were evaluated for neopentane hydrogenolysis/isomerization and propane hydrogenolysis/dehydrogenation. Monometallic Pd showed high neopentane hydrogenolysis selectivity. Addition of small amounts of Zn to Pd lead Pd–Zn scatters in the EXAFS spectrum and an increase in the linear bonded CO by IR. In addition, the neopentane turnover rate decreased by nearly 10 times with little change in the selectivity. Increasing amounts of Zn lead to greater Pd–Zn interactions, higher linear-to-bridging CO ratios by IR and complete loss of neopentane conversion. Pd NPs also had high selectivity for propane hydrogenolysis and thus were poorly selective for propylene. The PdZn bimetallic catalysts, however, were able to preferentially catalyze dehydrogenation, were not active for propane hydrogenolysis, and thus were highly selective for propylene formation. The decrease in hydrogenolysis selectivity was attributed to the isolation of active Pd atoms by inactive metallic Zn,demonstrating that hydrogenolysis requires a particular reactive ensemble whereas propane dehydrogenation does not.

  9. Improvement of the LET sensitivity in ESR dosimetry for {gamma}-photons and thermal neutrons through gadolinium addition

    Marrale, M. [Dipartimento di Fisica e Tecnologie Relative, Universita di Palermo, Viale delle Scienze, Edificio 18, 90128 Palermo (Italy); Unita CNISM, Palermo and Gruppo V Sezione INFN, Catania (Italy)], E-mail: marrale@difter.unipa.it; Brai, M. [Dipartimento di Fisica e Tecnologie Relative, Universita di Palermo, Viale delle Scienze, Edificio 18, 90128 Palermo (Italy); Unita CNISM, Palermo and Gruppo V Sezione INFN, Catania (Italy); Gennaro, G.; Triolo, A. [Dipartimento di Fisica e Tecnologie Relative, Universita di Palermo, Viale delle Scienze, Edificio 18, 90128 Palermo (Italy); Bartolotta, A. [Dipartimento Farmacochimico Tossicologico e Biologico, Universita di Palermo, Via Archirafi 32, 90123 Palermo (Italy); Unita CNISM, Palermo and Gruppo V Sezione INFN, Catania (Italy)

    2007-07-15

    We investigated the ESR response of new materials, alanine and ammonium tartrate to which gadolinium was added. The addition of gadolinium enhances sensitivity for {sup 60}Co{gamma}-photons because of its high atomic number (Z=64) and an enhancement of sensitivity for thermal neutrons because of its high thermal neutron cross section and high linear energy transfer (LET) secondary particles produced after the reaction with neutrons. In particular, in this paper we analyzed the microwave power saturation properties of dosimeters of alanine and ammonium tartrate with or without gadolinium exposed to different LET beams. The power saturation trends of dosimeters exposed to photons and to thermal neutrons are different. For ammonium tartrate dosimeters the gadolinium addition intensifies significantly these differences and therefore, it improves the ammonium tartrate's ability to discriminate the radiation LET.

  10. Additional Gastrectomy after Endoscopic Submucosal Dissection for Early Gastric Cancer Patients with Comorbidities

    Naohiko Koide

    2012-01-01

    Full Text Available Purpose. We investigated the clinicopathologic features of early gastric cancer (EGC patients who have undergone additional gastrectomy after endoscopic submucosal dissection (ESD because of their comorbidities. Methods. Eighteen (7.1% of 252 GC patients were gastrectomized after prior ESD. Reasons for further surgery, preoperative and postoperative problems, and the clinical outcome were determined. Results. The 18 patients had submucosal EGC and several co-morbidities. Other primary cancers were observed in 8 (44.4%. Histories of major abdominal operations were observed in 6 (33.3%. Fourteen patients (77.8% hoped for endoscopic treatment. Due to additional gastrectomy, residual cancer was suspected in 10, and node metastasis was suspected in 11. A cancer remnant was histologically observed in one. Node metastasis was detected in 3 (16.7%. Small EGC was newly detected in 4. Consequently, additional gastrectomy was necessary for the one third. No patient showed GC recurrence. However, 9 (50% had new diseases, and 4 (22.2% died of other diseases. The overall survival after surgery in these patients with additional gastrectomy was poorer than those with routine gastrectomy for submucosal EGC (=0.0087. Conclusions. Additional gastrectomy was safely performed in EGC patients with co-morbidities. However, some issues, including presence of node metastasis and other death after surgery, remain.

  11. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    2000-01-01

    PURPOSE: The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. METHOD: A group of 33 patients with apraxia were treated according to the guidelines of a therapy prog

  12. Rehabilitation of stroke patients with apraxia : the role of additional cognitive and motor impairments

    van Heugten, CM; Dekker, J; Deelman, BG; Stehmann-Saris, JC; Kinebanian, A

    2000-01-01

    Purpose : The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. Method: A group of 33 patients with apraxia were treated according to the guidelines of a therapy pro

  13. Additive value of three-phase of Tc-99m HMPAO WBC scintigraphy in patients with suspected knee prosthesis infection

    We investigated if three-phase Tc-99m HMPAO WBC scintigraphy (TP-WBC) to detect infection in patients with knee protheses has more additive values than conventional Tc-99m HMPAO WBC scintigraphy (C-WBC). Thirty patients (M: F=8: 22, Age; 69.26.2 yrs) with suspected knee prothesis infection were enrolled in our study. We performed Tc-99m HMPAO WBC scintigraphies at 4 different time points after the injection of the labeled leukocytes; Immediately after the bolus injection (perfusion phase image), 1 min (blood-pool phase image), and 1 and 3 hours (delayed static images, C-WBC). The final diagnosis of infection was based on surgical, histologic, and bacteriologic data and other follow-up studies. We compared with diagnostic performance between TP-WBC and C-WBC. Twenty patients (66.7%) finally had infected prothesis, the other ten (33.3%) didn't have it. C-WBC showed 85.0% of sensitivity, 30.0% of specificity, 70.8% of PPV, 50.0% of PNV, and 66.7% of accuracy. TP-WBC also showed 95.0% of sensitivity, 30.0% of specificity, 73.1 % of PPV, 75.0% of PNV, and 73.3% of accuracy. TP-WBC demonstrated higher sensitivity and accuracy than C-WBC. Three-phase images of Tc-99m HMPAO WBC scintigraphy may have more additive value to detect infection in patients with suspected knee prosthesis infection

  14. Increased mitochondrial substrate sensitivity in skeletal muscle of patients with type 2 diabetes

    Larsen, S; Stride, N; Hey-Mogensen, Martin;

    2011-01-01

    AIMS/HYPOTHESIS: Mitochondrial respiration has been linked to insulin resistance. We studied mitochondrial respiratory capacity and substrate sensitivity in patients with type 2 diabetes (patients), and obese and lean control participants. METHODS: Mitochondrial respiration was measured in.......4). Substrate sensitivity for octanoyl-carnitine did not differ between groups. CONCLUSIONS/INTERPRETATION: Increased mitochondrial substrate sensitivity is seen in skeletal muscle from type 2 diabetic patients and is confined to non-lipid substrates. Respiratory capacity per mitochondrion is not decreased with...

  15. Variable Temperature Stress in the Nematode Caenorhabditis elegans (Maupas) and Its Implications for Sensitivity to an Additional Chemical Stressor.

    Cedergreen, Nina; Nørhave, Nils Jakob; Svendsen, Claus; Spurgeon, David J

    2016-01-01

    A wealth of studies has investigated how chemical sensitivity is affected by temperature, however, almost always under different constant rather than more realistic fluctuating regimes. Here we compared how the nematode Caenorhabditis elegans responds to copper at constant temperatures (8-24°C) and under fluctuation conditions of low (±4°C) and high (±8°C) amplitude (averages of 12, 16, 20°C and 16°C respectively). The DEBkiss model was used to interpret effects on energy budgets. Increasing constant temperature from 12-24°C reduced time to first egg, life-span and population growth rates consistent with temperature driven metabolic rate change. Responses at 8°C did not, however, accord with this pattern (including a deviation from the Temperature Size Rule), identifying a cold stress effect. High amplitude variation and low amplitude variation around a mean temperature of 12°C impacted reproduction and body size compared to nematodes kept at the matching average constant temperatures. Copper exposure affected reproduction, body size and life-span and consequently population growth. Sensitivity to copper (EC50 values), was similar at intermediate temperatures (12, 16, 20°C) and higher at 24°C and especially the innately stressful 8°C condition. Temperature variation did not increase copper sensitivity. Indeed under variable conditions including time at the stressful 8°C condition, sensitivity was reduced. DEBkiss identified increased maintenance costs and increased assimilation as possible mechanisms for cold and higher copper concentration effects. Model analysis of combined variable temperature effects, however, demonstrated no additional joint stressor response. Hence, concerns that exposure to temperature fluctuations may sensitise species to co-stressor effects seem unfounded in this case. PMID:26784453

  16. Extreme Thermal Sensitivity and Pain-Induced Sensitization in a Fibromyalgia Patient

    Fong Wong

    2010-01-01

    Full Text Available During the course of a psychophysical study of fibromyalgia syndrome (FMS, one of the subjects with a long history of headache and facial pain displayed an extraordinarily severe thermal allodynia. Her stimulus-response function for ratings of cutaneous heat pain revealed a sensitivity clearly beyond that of normal controls and most FMS subjects. Specially designed psychophysical methods showed that heat sensitivity sometimes increased dramatically within a series of stimuli. Prior exposure to moderate heat pain served as a trigger for allodynic ratings of series of normally neutral thermal stimulation. These observations document a case of breakthrough pain sensitivity with implications for mechanisms of FMS pain.

  17. Re-analysis of survival data of cancer patients utilizing additive homeopathy.

    Gleiss, Andreas; Frass, Michael; Gaertner, Katharina

    2016-08-01

    In this short communication we present a re-analysis of homeopathic patient data in comparison to control patient data from the same Outpatient´s Unit "Homeopathy in malignant diseases" of the Medical University of Vienna. In this analysis we took account of a probable immortal time bias. For patients suffering from advanced stages of cancer and surviving the first 6 or 12 months after diagnosis, respectively, the results show that utilizing homeopathy gives a statistically significant (pcontrol patients regarding survival time. In conclusion, bearing in mind all limitations, the results of this retrospective study suggest that patients with advanced stages of cancer might benefit from additional homeopathic treatment until a survival time of up to 12 months after diagnosis. PMID:27515878

  18. Parental age effects on odor sensitivity in healthy subjects and schizophrenia patients.

    Malaspina, Dolores; Walsh-Messinger, Julie; Antonius, Daniel; Dracxler, Roberta; Rothman, Karen; Puthota, Jennifer; Gilman, Caitlin; Feuerstein, Jessica L; Keefe, David; Goetz, Deborah; Goetz, Raymond R; Buckley, Peter; Lehrer, Douglas S; Pato, Michele; Pato, Carlos

    2016-06-01

    A schizophrenia phenotype for paternal and maternal age effects on illness risk could benefit etiological research. As odor sensitivity is associated with variability in symptoms and cognition in schizophrenia, we examined if it was related to parental ages in patients and healthy controls. We tested Leukocyte Telomere Length (LTL) as an explanatory factor, as LTL is associated with paternal age and schizophrenia risk. Seventy-five DSM-IV patients and 46 controls were assessed for detection of PEA, WAIS-III for cognition, and LTL, assessed by qPCR. In healthy controls, but not schizophrenia patients, decreasing sensitivity was monotonically related to advancing parental ages, particularly in sons. The relationships between parental aging and odor sensitivity differed significantly for patients and controls (Fisher's R to Z: χ(2)  = 6.95, P = 0.009). The groups also differed in the association of odor sensitivity with cognition; lesser sensitivity robustly predicted cognitive impairments in patients (schizophrenia patients. In patients, decreased odor sensitivity strongly predicted cognitive deficits, whereas more sensitive acuity was associated with older parents. These data support separate risk pathways for schizophrenia. A parental age-related pathway may produce psychosis without impairing cognition and odor sensitivity. Diminished odor sensitivity may furthermore be useful as a biomarker for research and treatment studies in schizophrenia. © 2015 Wiley Periodicals, Inc. PMID:26224136

  19. The Additive Effects of Core Muscle Strengthening and Trunk NMES on Trunk Balance in Stroke Patients

    Ko, Eun Jae; Kim, Dae Yul; Yi, Jin Hwa; Kim, Won; Hong, Jayoung

    2016-01-01

    Objective To investigate an additive effect of core muscle strengthening (CMS) and trunk neuromuscular electrical stimulation (tNEMS) on trunk balance in stroke patients. Methods Thirty patients with acute or subacute stroke who were unable to maintain static sitting balance for >5 minutes were enrolled and randomly assigned to 3 groups, i.e., patients in the CMS (n=10) group received additional CMS program; the tNMES group (n=10) received additional tNMES over the posterior back muscles; and the combination (CMS and tNMES) group (n=10) received both treatments. Each additional treatment was performed 3 times per week for 20 minutes per day over 3 weeks. Korean version of Berg Balance Scale (K-BBS), total score of postural assessment scale for stroke patients (PASS), Trunk Impairment Scale (TIS), and Korean version of Modified Barthel Index (K-MBI) were evaluated before and after 3 weeks of therapeutic intervention. Results All 3 groups showed improvements in K-BBS, PASS, TIS, and K-MBI after therapeutic interventions, with some differences. The combination group showed more improvements in K-BBS and the dynamic sitting balance of TIS, as compared to the CMS group; and more improvement in K-BBS, as compared to the tNMES group. Conclusion The results indicated an additive effect of CMS and tNMES on the recovery of trunk balance in patients with acute or subacute stroke who have poor sitting balance. Simultaneous application of CMS and tNMES should be considered when designing a rehabilitation program to improve trunk balance in stroke patients. PMID:26949681

  20. Specificity and sensitivity of chest radiographs in the diagnosis of paediatric pulmonary tuberculosis and the value of additional high-kilovolt radiographs

    Tuberculosis (TB) remains the most common notifiable infectious disease in South Africa. The diagnosis of pulmonary TB in children is often very difficult because of the non-specific radiological signs and inter-observer variation in the interpretation of radiographs. The frontal high-kilovolt (kV) radiograph has been used to assess the effect of TB adenopathy on the tracheobronchial tree and to detect endobronchial lesions. The aims of the present study were to assess the specificity and sensitivity of chest radiographs in the diagnosis of pulmonary TB and to assess whether the addition of the high-kV radiograph affects these parameters. The study group consisted of paediatric patients suspected of having pulmonary TB over a 6-year period. These patients had clinical, bacteriological and radiographic examinations. Radiographs were examined by one experienced radiologist in two sittings separated by a 6-week interval. On the first sitting, only standard radiographs were examined and, on the second sitting, these were supplemented with high-kV radiographs. Differences in the detection of each recognized radiological feature of pulmonary TB before and after the addition of the high-kV film were analysed for statistical significance. The frequency of radiographic findings in our study compared favourably with other reports. No statistically significant differences for the detection of radiographic features consistent with pulmonary TB, or for the diagnosis of pulmonary TB, were demonstrated between the two sittings. Specificity increased from 74.4% to 86.6% with the addition of the high-kV view and sensitivity remained constant at 38.8%. The present study does not support the routine use of the frontal high-kV radiograph for the diagnosis of pulmonary TB. This paper also confirms the findings of others, that standard chest radiographs are a poor indicator of pulmonary TB in children Copyright (2004) Blackwell Publishing Asia Pty Ltd

  1. Safety and efficacy of the addition of simvastatin to panitumumab in previously treated KRAS mutant metastatic colorectal cancer patients.

    Baas, Jara M; Krens, Lisanne L; Bos, Monique M; Portielje, Johanneke E A; Batman, Erdogan; van Wezel, Tom; Morreau, Hans; Guchelaar, Henk-Jan; Gelderblom, Hans

    2015-09-01

    Panitumumab has proven efficacy in patients with metastatic or locally advanced colorectal cancer patients, provided that they have no activating KRAS mutation in their tumour. Simvastatin blocks the mevalonate pathway and thereby interferes with the post-translational modification of KRAS. We hypothesize that the activity of the RAS-induced pathway in patients with a KRAS mutation might be inhibited by simvastatin. This would theoretically result in increased sensitivity to panitumumab, potentially comparable with tumours with wild-type KRAS. A Simon two-stage design single-arm, phase II study was designed to test the safety and efficacy of the addition of simvastatin to panitumumab in colorectal cancer patients with a KRAS mutation after failing fluoropyrimidine-based, oxaliplatin-based and irinotecan-based therapy. The primary endpoint of this study was the proportion of patients alive and free from progression 11 weeks after the first administration of panitumumab, aiming for at least 40%, which is comparable with, although slightly lower than, that in KRAS wild-type patients in this setting. If this 40% was reached, then the study would continue into the second step up to 46 patients. Explorative correlative analysis for mutations in the KRAS and related pathways was carried out. One of 14 patients was free from progression at the primary endpoint time. The median progression-free survival was 8.4 weeks and the median overall survival status was 19.6 weeks. We conclude that the concept of mutant KRAS phenotype expression modulation with simvastatin was not applicable in the clinic. PMID:26053280

  2. Influences of water in bis-benzimidazole-derivative electrolyte additives to the degradation of the dye-sensitized solar cells

    Lu, Hung-Lin; Yang, Thomas C.-K. [Department of Chemical Engineering, National Taipei University of Technology, No. 1, Section 3, Chung-hsiao East Road, Taipei 106 (China); Lee, Yu-Hui; Huang, Sheng-Tung [Institute of Biotechnology, National Taipei University of Technology, Taipei 106 (China); Su, Chaochin [Institute of Organic and Polymeric Materials, National Taipei University of Technology, Taipei 106 (China)

    2011-01-15

    The chemical stability of dye-sensitized solar cells (DSSC) determines both the cell performance and the cell life-time. The presence of water in the solar cell from surrounding leakage through the imperfection packaging sealants causes the decrease in life-time of photogenerated electrons on the working electrodes, which induces the occurrence of the dark current to the electrolytes and thus leakage current significantly deteriorated the life-time of the DSSC. Reliable electrolyte additives diminishing the influences of water to the DSSCs degradation process becomes a critical issue in maintaining an acceptable cell life-time. In this work, the effects of four benzimidazole derivatives a-d as the electrolyte additives in the presence of water were comprehensively examined by time-dependent photovoltaic performance of the cells. As a result, open-circuit voltage (V{sub oc}), short-circuit current (J{sub sc}), efficiency ({eta}), and fill factor (FF) collected from I-V curves were studied. In addition, electrochemical impedance spectroscopy (EIS) technique was implemented to evaluate the effects of the charge-transfer resistance (R{sub ct}) at the interfaces between TiO{sub 2}/dye/electrolyte. Results showed that the bis-benzimidazole derivative c gives significant improvement in the long-term stability due to the effective protection of the ligands between dye and working electrodes from the attack by environmental water molecules. (author)

  3. Urea as a long-term stable alternative to guanidium thiocyanate additive in dye-sensitized solar cell

    Kim, Mi-Jeong; Park, Nam-Gyu

    2012-09-01

    Photovoltaic performance of 0.05 M urea-contained redox electrolyte is compared to that of 0.05 M guanidinium thiocyanate (GSCN)-contained one in dye-sensitized solar cell. No significant difference in the initial photovoltaic performance is observed, which means that the role of urea additive is similar to that of GSCN. Initial solar-to-electrical conversion efficiency of the device containing GSCN shows 7% that is diminished to 5.8% after 40 days, whereas the device containing urea exhibits stable photovoltaic performance showing that initial efficiency of 7.2% is almost remained unchanged after 40 days (7.1%). The lowered efficiency of the GSCN-contained device is mainly due to the decreased photocurrent density, which is ascribed to the formation of needle-shaped crystals on TiO2 layer. Infrared spectroscopic study confirms that the crystals are dye analogue, which is indicative of dye desorption in the presence of GSCN. On the other hand, no crystals are formed in the urea-contained electrolyte, which implies that dye desorption is negligible. Urea additive is thus found to be less reactive in dye desorption than GSCN, leading to long-term stability.

  4. Time limited psychodynamic group therapy: Predictors of patients seeking additional treatment

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2010-01-01

    were the Symptom Check List 90 Revised (SCL-90-R), Millon Clinical Multiaxial Inventory II (MCMI-II), non-symptomatic Psychodynamic Focus, retrospective outcome evaluations, and socio-demographic and psychiatric variables. At follow-up, 57.6% of the patients had been seeking additional treatment for...... with seeking additional treatment. Even though we identified only a small number of predictors for participation in further treatment, our study nevertheless points to the importance of employing reliable and validated methods in the evaluation of treatment outcome and further treatment planning....

  5. Usefulness of additional SPECT/CT identifying lymphatico-renal shunt in a patient with chyluria

    Lymphoscintigraphy is known to be a useful and non-invasive modality for the evaluation of lymphatic abnormality. However, lymphoscintigraphy has limitations in evaluating chyluria because of its lack of anatomical information. Additional single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was considered to be potentially helpful in detecting the abnormal lymphatico-renal communication. A 20-year-old male patient was referred to our hospital for evaluation of recurrent chyluria. During the third recurrence of chyluria, additional SPECT/CT along with lymphoscintigraphy was performed for evaluation. From the combined SPECT/CT images, lymphatic drainage of radiotracers to the kidney was well visualized, helping diagnosis of a patient with chyluria

  6. Usefulness of additional SPECT/CT identifying lymphatico-renal shunt in a patient with chyluria

    Suh, Min Seok; Cheon, Gi Jeong; Seo, Hyo Jung; KIm, Hyeon Hoe; Lee, Dong Soo [Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-03-15

    Lymphoscintigraphy is known to be a useful and non-invasive modality for the evaluation of lymphatic abnormality. However, lymphoscintigraphy has limitations in evaluating chyluria because of its lack of anatomical information. Additional single-photon emission computed tomography (SPECT) combined with computed tomography (CT) was considered to be potentially helpful in detecting the abnormal lymphatico-renal communication. A 20-year-old male patient was referred to our hospital for evaluation of recurrent chyluria. During the third recurrence of chyluria, additional SPECT/CT along with lymphoscintigraphy was performed for evaluation. From the combined SPECT/CT images, lymphatic drainage of radiotracers to the kidney was well visualized, helping diagnosis of a patient with chyluria.

  7. Immunosuppression prior to marrow transplantation for sensitized aplastic anemia patients: comparison of TLI with TBI

    From May 1980 through July 1986, 26 patients with severe aplastic anemia, sensitized with multiple transfusions of blood products, were treated on either of two immunosuppressive regimens in preparation for bone marrow transplantation from a matched donor. There were 10 patients treated with total body irradiation (TBI), 200 cGy/fraction X 4 daily fractions (800 cGy total dose), followed by cyclophosphamide, 60 mg/kg/d X 2 d. An additional 16 patients were treated with total lymphoid irradiation (TLI) [or, if they were infants, a modified TLI or thoracoabdominal irradiation (TAI)], 100 cGy/fraction, 3 fractions/d X 2 d (600 cGy total dose), followed by cyclophosphamide, 40 mg/kg/d X 4 d. The extent of immunosuppression was similar in both groups as measured by peripheral blood lymphocyte depression at the completion of the course of irradiation (5% of initial concentration for TBI and 24% for TLI), neutrophil engraftment (10/10 for TBI and 15/16 for TLI), and time to neutrophil engraftment (median of 22 d for TBI and 17 d for TLI). Marrow and peripheral blood cytogenetic analysis for assessment of percent donor cells was also compared in those patients in whom it was available. 2/2 patients studied with TBI had 100% donor cells, whereas 6/11 with TLI had 100% donor cells. Of the five who did not, three were stable mixed chimeras with greater than or equal to 70% donor cells, one became a mixed chimera with about 50% donor cells, but became aplastic again after Cyclosporine A cessation 5 mo post-transplant, and the fifth reverted to all host cells by d. 18 post-transplant. Overall actuarial survival at 2 years was 56% in the TLI group compared with 30% in the TBI group although this was not statistically significant. No survival decrement has been seen after 2 years in either group

  8. Nano-morphology induced additional surface plasmon resonance enhancement of SERS sensitivity in Ag/GaN nanowall network

    Sharvani, S.; Upadhayaya, Kishor; Kumari, Gayatri; Narayana, Chandrabhas; Shivaprasad, S. M.

    2015-11-01

    The GaN nanowall network, formed by opening the screw dislocations by kinetically controlled MBE growth, possesses a large surface and high conductivity. Sharp apexed nanowalls show higher surface electron concentration in the band-tail states, in comparison to blunt apexed nanowalls. Uncapped silver nanoparticles are vapor deposited on the blunt and sharp GaN nanowall networks to study the morphological dependence of band-edge plasmon-coupling. Surface enhanced Raman spectroscopy studies performed with a rhodamine 6G analyte on these two configurations clearly show that the sharp nanowall morphology with smaller Ag nanoparticles shows higher enhancement of the Raman signal. A very large enhancement factor of 2.8 × 107 and a very low limit of detection of 10-10 M is observed, which is attributed to the surface plasmon resonance owing to the high surface electron concentration on the GaN nanowall in addition to that of the Ag nanoparticles. The significantly higher sensitivity with same-sized Ag nanoparticles confirms the unconventional role of morphology-dependent surface charge carrier concentration of GaN nanowalls in the enhancement of Raman signals.

  9. Nano-morphology induced additional surface plasmon resonance enhancement of SERS sensitivity in Ag/GaN nanowall network.

    Sharvani, S; Upadhayaya, Kishor; Kumari, Gayatri; Narayana, Chandrabhas; Shivaprasad, S M

    2015-11-20

    The GaN nanowall network, formed by opening the screw dislocations by kinetically controlled MBE growth, possesses a large surface and high conductivity. Sharp apexed nanowalls show higher surface electron concentration in the band-tail states, in comparison to blunt apexed nanowalls. Uncapped silver nanoparticles are vapor deposited on the blunt and sharp GaN nanowall networks to study the morphological dependence of band-edge plasmon-coupling. Surface enhanced Raman spectroscopy studies performed with a rhodamine 6G analyte on these two configurations clearly show that the sharp nanowall morphology with smaller Ag nanoparticles shows higher enhancement of the Raman signal. A very large enhancement factor of 2.8 × 10(7) and a very low limit of detection of 10(-10) M is observed, which is attributed to the surface plasmon resonance owing to the high surface electron concentration on the GaN nanowall in addition to that of the Ag nanoparticles. The significantly higher sensitivity with same-sized Ag nanoparticles confirms the unconventional role of morphology-dependent surface charge carrier concentration of GaN nanowalls in the enhancement of Raman signals. PMID:26502004

  10. [Morphological characteristics of temporal area skin in patients with an additional pathology on age aspect

    Tverdokhlib I.V.

    2015-09-01

    Full Text Available Background. Improvement of the technical aspects of surgery in aesthetic surgery led to an increase in the number of transactions and significant increase contingent of women who are turning to specialized clinics. But it also significantly increased the proportion of patients with a variety of concomitant diseases requiring new approaches to operational technologies and special attention in the postoperative period. In this group of patients is high risk of intraoperative and postoperative complications significantly limits the range of indications. So to prevent these complications is an important question when planning operations in aesthetic surgery of the face. Objective. Determine structural and functional changes of temporal area skin in women of different age groups with an additional internal pathology. Methods. Intraoperative biopsy material of skin of 104 women at the age from 19 to 73 years, that was taken during standard surgery instrumentations for different defects of face skin correction, was investigated. Results and conclusion. It was determined, that involutive dynamic of microvessel condition in papillary layer of derma coincides with grade reduction of relative volume of microvessels bed. Microcirculation age changes include structural disorders of intrapapillary capillary loops, disorganization of arterioles in papillary and reticular layers of derma, disorders of venules because of the changes in microenvironmental fibrillar network. It is typical at the patients with nicotinic dependence, ischemic heart disease, hypertonic disease, a diabetes, and also adiposity of a different degree essential infringement of microvessels bed structure criteria of skin condition that gives the basis for allocation of the given contingent of patients as group of high intraoperative and postoperative risk at carrying out of frontlift. Citation: Tverdokhlib IV, Makarchuk OI. [Morphological characteristics of temporal area skin in patients

  11. Assessment of pulmonary melanoma metastases with 18F-FDG PET/CT: which PET-negative patients require additional tests for definitive staging?

    To determine, in patients with melanoma, the dependence of PET sensitivity on pulmonary metastasis size, and to determine patients who require further evaluation for definite staging. Of 183 melanoma patients who underwent 18F-fluorodeoxyglucose PET/computed tomography (CT) for staging or follow-up between January 2008 and June 2011, 38 patients (18 women and 20 men; mean age 62.0 ± 14.7 years) with one or more pulmonary metastases visible on CT were included in the retrospective study. Each pulmonary metastasis was rated as positive or negative on PET, and lesion size (maximum transverse diameter) was assessed on CT. PET sensitivity was calculated according to the lesions' size, in 2-mm steps. A total of 181 pulmonary metastases were analysed. PET sensitivity was 7.9 % for lesions of 4-5 mm; 33.3 % for lesions of 6-7 mm; 56.8 % for lesions of 8-9 mm; 63.6 % for lesions of 10-11 mm; 100 % for lesions of 12-14 mm; and 100 % for lesions of at least 15 mm. The differences in sensitivity between the size groups were significant (P < 0.001) With current state-of-the-art PET/CT technology, additional tests are necessary for definitive staging of melanoma patients who have one or more PET-negative lung nodules less than 12 mm in diameter on expiratory CT. (orig.)

  12. Increased capsaicin-induced secondary hyperalgesia in patients with multiple chemical sensitivity

    Holst, Helle; Arendt-Nielsen, Lars; Mosbech, Holger;

    2011-01-01

    the underlying cause of pathophysiological mechanisms triggering multiple chemical sensitivity (MCS) remains disputed.Recently, alterations in the central nervous system, for example,central sensitization, similar to various chronic pain disorders, have been suggested. Capsaicin is used in...... experimental pain models to provoke peripheral and central sensitization. In patients with symptoms elicited by odorous chemicals capsaicin-induced secondary hyperalgesia and temporal summation were assessed as markers for abnormal central nociceptive processing together with neurogenic inflammation (flare)....

  13. Balance between pattern and flicker sensitivities in the visual fields of ophthalmological patients.

    Regan, D.; Neima, D

    1984-01-01

    We measured the balance between visual sensitivities to pattern and to flicker rather than measuring absolute sensitivities to pattern or flicker. The test target was a 2-cycle deg-1 sinewave grating that was counterphase modulated at 8 Hz. Seventeen points in the visual field were tested out to eccentricities of 24 degrees. We examined 10 control subjects, 6 patients with glaucoma 10 with ocular hypertension, and 10 with multiple sclerosis. For controls pattern sensitivity was lower than fli...

  14. A low-fat diet improves peripheral insulin sensitivity in patients with Type 1 diabetes

    Rosenfalck, A M; Almdal, T; Viggers, L;

    2006-01-01

    To compare the effects on insulin sensitivity, body composition and glycaemic control of the recommended standard weight-maintaining diabetes diet and an isocaloric low-fat diabetes diet during two, 3-month periods in patients with Type 1 diabetes.......To compare the effects on insulin sensitivity, body composition and glycaemic control of the recommended standard weight-maintaining diabetes diet and an isocaloric low-fat diabetes diet during two, 3-month periods in patients with Type 1 diabetes....

  15. 367 Evaluation of Allergen Sensitivity in Patients with Contact Dermatitis in Antalya

    Yalcin, Arzu Didem; Hilmi, Cekin Ayhan; Gumuslu, Saadet; Polat, Hasan Hüseyin; Kose, Sukran; Cetinkay, Ramazan

    2012-01-01

    Background Allergic contact dermatitis (ACD) is a delayed type of induced sensitivity (allergy) resulting from cutaneous contact with a specific allergen to which the patient has developed a specific sensitivity. This allergic reaction causes inflammation of the skin manifested by varying degrees of erythema, edema, and vesiculation. In this study, the socio-demographic characteristics, patch test were evaluated in treated patients diagnosed with Allergic contact dermatitis Methods The study ...

  16. Correlation between carotid atherosclerosis and serum high-sensitivity C-reactive protein in patients with cerebral infarction

    Yan Du; Yan Ren; Bo Chen; Chun Li

    2007-01-01

    artery atherosclerostic plaques. If artery atherosclerostic plaques were formed, their properties and amounts were determined based on the characteristics of light-echo signals. Evaluating criteria: Intima media thickness of artery was the vertical dimension from crossed face between lumen and tunica intima to crossed face between tunica media and tunica adventitia. Intima media thickness ≤ 0.9 mm was regarded as normal; 0.9 mm < intima media thickness ≤ 1.2 mm was regarded as thickening; when local eminence thickening was processed towards to lumen, the intima media thickness was more than 1.2 mm and plaque of tunica intima was formed at the same time. Properties of plaque were classified into 4 types: steady low-echo lipid malacoplakia, equal-echo fiber plaque, strong-echo or sound imaging calcification hard plaque and unsteady-echo ulcer mixed plaque. Fiber plaque and calcification hard plaque were steady but malacoplakia and mixed plaque were unsteady.MAIN OUTCOME MEASURES: Thickness of tunica media, characteristics of plaque and level of serum high-sensitivity C-reactive protein in carotid artery in two groups.RESULTS: All 102 patients with cerebral infarction and 96 healthy subjects were involved in the final analysis. ① Comparisons of level of high-sensitivity C-reactive protein: Level of high-sensitivity C-reactive protein in normal tunica media was higher in the cerebral infarction group [(4.66±1.55) mg/L]than the control group [(3.49±1.24) mg/L, t =2.541, P <0.05]. In addition, level of high-sensitivity C-reactive protein in patients with thickening tunica media and plaque was not significantly different between the cerebral infarction group and the control group (P > 0.05). ② Correlation between various degrees of vascular lesion and level of high-sensitivity C-reactive protein in the cerebral infarction group:Level of high-sensitivity C-reactive protein was statistically significantly higher in patients with thickening tunica media [(8.16±2

  17. Non-trauma-associated additional findings in whole-body CT examinations in patients with multiple trauma; Nicht traumaassozierte Nebenbefunde bei Ganzkoerpercomputertomografien im Rahmen der Polytraumadiagnostik

    Hoffstetter, P.; Herold, T.; Daneschnejad, M.; Zorger, N.; Jung, E.M.; Feuerbach, S.; Schreyer, A.G. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Regensburg (Germany)

    2008-02-15

    Purpose: whole-body CT scans for patients with multiple trauma represent an increasingly accepted first diagnostic tool. The multidetector approach in particular provides appropriate diagnostic algorithms for detecting nearly all relevant traumatic findings in a short time with a high grade of sensitivity and specificity. Non-trauma-associated additional findings are commonly depicted based on these CT examinations. The aim of this study is to evaluate the number and quality of these additional findings in consecutive patients with multiple trauma. Materials and methods: between 3/04 and 8/06 we scanned 304 patients according to our dedicated multiple trauma protocol. The examination protocol includes a head scan without intravenous contrast followed by a whole-body scan including the neck, thorax and abdomen acquired by a 16-row CT Scanner (Siemens, Sensation 16). The CT scans were retrospectively analyzed by two radiologists with respect to non-trauma-associated findings. Lesions were assessed according to their clinical relevance (highly relevant, moderately relevant, not relevant). For patients with highly relevant findings, additional follow-up research was performed. Results: The average age was 43 years (range 3 - 92). 236 of the patients were male (77.6%), 68 female (22.4%). 153 patients (50.3%) had additional non-trauma-associated findings. In 20 cases (6.6%) lesions with high clinical relevance were detected (e.g. carcinoma of the kidney or the ovary). In 71 patients (23.4%) findings with moderate relevance were described. In 63 patients (20.7%) additional findings without major relevance were diagnosed. Conclusion: Whole-body CT scans of patients randomized by a trauma show a considerable number of non-trauma-associated additional findings. In about 30% of cases, these findings are clinically relevant because further diagnostic workup or treatment in the short or medium-term is needed. The results of these analyses emphasize the diagnostic value of CT

  18. On the addition of conducting ceramic nanoparticles in solvent-free ionic liquid electrolyte for dye-sensitized solar cells

    Lee, Chuan-Pei

    2009-08-01

    Titanium carbide (TiC) is an extremely hard conducting ceramic material often used as a coating for titanium alloys as well as steel and aluminum components to improve their surface properties. In this study, conducting ceramic nanoparticles (CCNPs) have been used, for the first time, in dye-sensitized solar cells (DSSCs), and the incorporation of TiC nanoparticles in a binary ionic liquid electrolyte on the cell performance has been investigated. Cell conversion efficiency with 0.6 wt% TiC reached 1.68%, which was higher than that without adding TiC (1.18%); however, cell efficiency decreased when the TiC content reached 1.0 wt%. The electrochemical impedance spectroscopy (EIS) technique was employed to analyze the interfacial resistance in DSSCs, and it was found that the resistance of the charge-transfer process at the Pt counter electrode (Rct1) decreased when up to 1.0 wt% TiC was added. Presumably, this was due to the formation of the extended electron transfer surface (EETS) which facilitates electron transfer to the bulk electrolyte, resulting in a decrease of the dark current, whereby the open-circuit potential (VOC) could be improved. Furthermore, a significant increase in the fill factor (FF) for all TiC additions was related to the decrease in the series resistance (RS) of the DSSCs. However, at 1.0 wt% TiC, the largest charge-transfer resistance at the TiO2/dye/electrolyte interface was observed and resulted from the poor penetration of the electrolyte into the porous TiO2. The long-term stability of DSSCs with a binary ionic liquid electrolyte, which is superior to that of an organic solvent-based electrolyte, was also studied. © 2009 Elsevier B.V. All rights reserved.

  19. Tracheal and laryngeal tumors in the dog and cat: literature review and 13 additional patients

    Primary tumors of the larynx or trachea are uncommon in the dog and cat. In a review of the English language literature, description of 65 such patients were found. In a search of the Veterinary Teaching Hospitals of the University of Pennsylvania and North Carolina State University, an additional 13 previously unreported patients were identified, bringing the total to at least 78. Of these 78, there have been 16 canine tracheal, 7 feline tracheal, 34 canine laryngeal and 21 feline laryngeal tumors. In the canine and feline trachea, osteochondroma and epithelial malignancies, respectively, appear to be the most common. Epithelial malignancies appear to be the most common tumor of the canine larynx whereas lymphosarcoma appears to be the most common feline laryngeal tumor. In patients described herein, tumors produced clinical signs consistent with airway obstruction. Voice alteration was common in patients with laryngeal tumors. Patients were middle-aged to older, except for dogs with osteochondroma. This compares favorably to historical data. All tumors in this study were readily seen radiographically, with most laryngeal and tracheal tumors appearing as masses within the lumen of the airway. Mineralization was uncommon except for canine osteochondromas. Feline laryngeal tumors in this study appeared as generalized laryngeal thickening rather than as a distinct mass. Response of canine and feline tracheal and laryngeal thickening rather than as a distinct mass. Response of canine and feline tracheal and laryngeal tumors to treatment can not be adequately assessed from available data. Benign tumors of the larynx or trachea may be amenable to complete excision. Neoplastic lesions must be differentiated from polyps or abscesses within the upper airway as these may appear radiographically identical to primary tumors. This can be achieved by endoscopic evaluation and biopsy of airway masses before formulating a prognosis

  20. Changes in the prostacyctin sensitivity of thrombocytes after intravaginal radium irradiation of patients with corpus carcinoma

    The goal of this work was to investigate, to what extent the platelet sensitivity in comparison to prostacyclin (PGI2) should be seen as a responsible factor in the increase of the thrombosis rate. For this blood was examined from 22 patients with corpus carcinoma who had received an intravaginal Radium implant with a radiation dose of 960 mgeh to over 24 h. These patients were compared to a control group of 21 clinically healthy women. Even before the radiation therapy there was an increased aggregation rate of the thrombocytes in the carcinoma patients as well as a reduced sensitivity to PGI2. Under irradiation there was an even greater decrease in the sensitivity of the thrombocytes to PGI2. The aggregation speed increase statistically significantly and the number of thrombocytes decreased during the Radium irradiation. After the giving of heparin the sensitivity of the thrombocytes to PGI2 sank strongly. (orig./MG)

  1. Sensitization patterns in Compositae-allergic patients with current or past atopic dermatitis

    Paulsen, Evy; Andersen, Klaus Ejner

    2013-01-01

    Background. An association between Compositae sensitization and atopic dermatitis has been suggested on the basis of case reports and clinical studies. Objectives. To describe the characteristics of sensitization in Compositae-allergic patients with current and/or past atopic dermatitis. Patients....../materials/methods. Consecutive Compositae-sensitive patients were selected for analysis if they had a history of (i) present and/or past atopic dermatitis or (ii) childhood flexural eczema or (iii) childhood eczema of any kind and a positive prick test result. Results. Fifty-one persons (35 females and 16 males) were included...... of non-atopics, except that dandelion was an important allergen in children. Cobalt allergy was the most frequent other contact allergy, occurring in 37%. Conclusions. Persons with current or past atopic dermatitis may become sensitized to Compositae at any age, both occupationally and non...

  2. Sensitizing Medical Students to Impression Formation Processes in the Patient Interview

    Breytspraak, Linda M.; And Others

    1977-01-01

    Medical students in a course that included instruction in patient interviewing participated in an experiment devised to alert them to sources of bias that might influence their judgments and management of patients. Suggestions are made for incorporating such sensitization experiments in the medical curriculum. (Author/LBH)

  3. A sensitive scale to assess nociceptive pain in patients with disorders of consciousness.

    Chatelle, Camille; Majerus, Steve; Whyte, John; Laureys, Steven; Schnakers, Caroline

    2012-01-01

    OBJECTIVE: To determine the sensitivity of the Nociception Coma Scale (NCS), the first scale developed to assess nociceptive pain in vegetative state and minimally conscious state patients, in comparing behavioural changes in response to noxious versus non-noxious stimulation. METHODS: The NCS was administered to assess patients' responses in three conditions: (1) baseline (observation of spontaneous behaviours), (2) non-noxious/tactile stimulation (taps on the patient's shoulder), and (3) no...

  4. Sensitivity of Emergency Bedside Ultrasound to Detect Hydronephrosis in Patients with Computed Tomography-proven Stones

    Jeff Riddell

    2014-02-01

    Full Text Available Introduction: Non-contrast computed tomography (CT is widely regarded as the gold standard for diagnosis of urolithiasis in emergency department (ED patients. However, it is costly, time-consuming and exposes patients to significant doses of ionizing radiation. Hydronephrosis on bedside ultrasound is a sign of a ureteral stone, and has a reported sensitivity of 72-83% for identification of unilateral hydronephrosis when compared to CT. The purpose of this study was to evaluate trends in sensitivity related to stone size and number. Methods: This was a structured, explicit, retrospective chart review. Two blinded investigators used reviewed charts of all adult patients over a 6-month period with a final diagnosis of renal colic. Of these charts, those with CT evidence of renal calculus by attending radiologist read were examined for results of bedside ultrasound performed by an emergency physician. We included only those patient encounters with both CT-proven renal calculi and documented bedside ultrasound results. Results: 125 patients met inclusion criteria. The overall sensitivity of ultrasound for detection of hydronephrosis was 78.4% [95% confidence interval (CI=70.2-85.3%]. The overall sensitivity of a positive ultrasound finding of either hydronephrosis or visualized stones was 82.4% [95%CI: 75.6%, 89.2%]. Based on a prior assumption that ultrasound would detect hydronephrosis more often in patients with larger stones, we found a statistically significant (p = 0.016 difference in detecting hydronephrosis in patients with a stone ≥6mm (sensitivity=90% [95% CI=82-98%] compared to a stone <6mm (sensitivity=75% [95% CI=65-86%]. For those with 3 or more stones, sensitivity was 100% [95% CI=63-100%]. There were no patients with stones ≥6mm that had both a negative ultrasound and lack of hematuria.Conclusion: In a population with CT-proven urolithiasis, ED bedside ultrasonography had similar overall sensitivity to previous reports but showed

  5. [Subcutaneous stimulation as additional therapy to spinal cord stimulation in a post-laminectomy syndrome patient].

    Akbaş, Mert; Yeğin, Mehmet Arif; Özdemir, İrem; Göksu, Ethem; Akyüz, Mahmut

    2016-01-01

    Spinal cord stimulation as treatment of chronic low back pain via neuromodulation has been frequently performed in recent years. The dorsal column is stimulated by an electrode placed at the epidural region. In the case presently described, subcutaneous lead was implanted in a patient with failed back syndrome after spinal cord stimulation was inadequate to treat back and gluteal pain. A 65-year-old male had undergone surgery to treat lumbar disc herniation, after which he received physical therapy and multiple steroid injections due to unrelieved pain. He was admitted to the pain clinic with pain radiating to right gluteal muscle and leg. Spinal cord stimulation was performed and, as pain was not relieved, subcutaneous lead was applied to the right cluneal nerve distribution. Following treatment, the patient scored 1-2 on visual analog scale. Pain had been reduced by over 80%. Octad electrode was placed between T8 and T10 vertebrae after Tuohy needle was introduced to intervertebral area between L1 and L2. Paresthesia occurred in the right extremity. Boundaries were determined by area of right gluteal region in which paresthesia did not occur. Octad electrode was placed subcutaneously after vertical line was drawn from center point. Paresthesia occurred throughout the region. Pulse wave was 390-450 msec; frequency was 10-30 Hz. Subcutaneous electrode replacement is effective additional therapy when pain is not relieved by spinal cord stimulation. PMID:27225614

  6. Effect of TENS on pain in relation to central sensitization in patients with osteoarthritis of the knee: study protocol of a randomized controlled trial

    Beckwée David

    2012-02-01

    Full Text Available Abstract Background Central sensitization has recently been documented in patients with knee osteoarthritis (OAk. So far, the presence of central sensitization has not been considered as a confounding factor in studies assessing the pain inhibitory effect of tens on osteoarthritis of the knee. The purpose of this study is to explore the pain inhibitory effect of burst tens in OAk patients and to explore the prognostic value of central sensitization on the pain inhibitory effect of tens in OAk patients. Methods Patients with knee pain due to OAk will be recruited through advertisements in local media. Temporal summation, before and after a heterotopic noxious conditioning stimulation, will be measured. In addition, pain on a numeric rating score, WOMAC subscores for pain and function and global perceived effect will be assessed. Patients will be randomly allocated to one of two treatment groups (tens, sham tens. Follow-up measurements will be scheduled after a period of 6 and 12 weeks. Discussion Tens influences pain through the electrical stimulation of low-threshold A-beta cutaneous fibers. The responsiveness of central pain-signaling neurons of centrally sensitized OAk patients may be augmented to the input of these electrical stimuli. This would encompass an adverse therapy effect of tens. To increase treatment effectiveness it might be interesting to identify a subgroup of symptomatic OAk patients, i.e., non-sensitized patients, who are likely to benefit from burst tens. Trial Registration ClinicalTrials.gov: NCT01390285

  7. Sensitization to Common Ragweed in Southern Bavaria: Clinical and Geographical Risk Factors in Atopic Patients

    Rueff, Franziska; Przybilla, Bernhard; Walker, Annett; Gmeiner, Jennifer; Kramer, Matthias; Sabanés-Bové, Daniel; Küchenhoff, Helmut; Herzinger, Thomas

    2012-01-01

    Background: Sensitization to common ragweed (Ambrosia artemisiifolia) is associated with a variety of risk factors, which are incompletely defined. Our aim was to evaluate the association of a variety of clinical, geographical and demographical variables with ragweed sensitization and also to determine its frequency in southern Bavaria. Methods: In this cross-sectional multicentre study, we enrolled 977 patients with a documented or suspected atopic disease or food allergy. Data were collecte...

  8. Thyroglobulin measurement using highly sensitive assays in patients with differentiated thyroid cancer:

    Giovanella, Luca; Clark, Penelope M; Chiovato, Luca; Duntas, Leonidas; Elisei, Rossella; Feldt-Rasmussen, Ulla; Leenhardt, Laurence; Luster, Markus; Schalin-Jäntti, Camilla; Schott, Matthias; Seregni, Ettore; Rimmele, Herald; Smit, Jan; Verburg, Frederik A

    2014-01-01

    low concentrations now allows detection of very low Tg concentrations reflecting minimal amounts of thyroid tissue without the need for TSH stimulation. Use of these highly sensitive Tg assays has not yet been incorporated into clinical guidelines but they will, we believe, be used by physicians...... caring for patients with DTC. The aim of this clinical position paper is, therefore, to offer advice on the various aspects and implications of using these highly sensitive Tg assays in the clinical care of patients with DTC....

  9. Cough sensitivity and extrathoracic airway responsiveness to inhaled capsaicin in chronic cough patients.

    Cho, You Sook; Lee, Chang-Keun; Yoo, Bin; Moon, Hee-Bom

    2002-01-01

    Enhanced cough response has been frequently observed in chronic cough. Recently, extrathoracic airway constriction to inhaled histamine was demonstrated in some chronic cough patients. However, relation between extrathoracic airway hyperresponsiveness (EAHR) and cough sensitivity determined by capsaicin inhalation is unclear in each etiological entity of chronic cough. Seventy-seven patients, with dry cough persisting for 3 or more weeks, normal spirometry and chest radiography, and 15 contro...

  10. Pioglitazone in addition to metformin improves erythrocyte deformability in patients with Type 2 diabetes mellitus.

    Forst, Thomas; Weber, Matthias M; Löbig, Mirjam; Lehmann, Ute; Müller, Jürgen; Hohberg, Cloth; Friedrich, Christiane; Fuchs, Winfried; Pfützner, Andreas

    2010-10-01

    The aim of the present study was to compare the effect of PIO (pioglitazone) or GLIM (glimepiride) on erythrocyte deformability in T2DM (Type 2 diabetes mellitus). The study covered 23 metformin-treated T2DM patients with an HbA1c (glycated haemoglobin) >6.5%. Patients were randomized to receive either PIO (15 mg, twice a day) or GLIM (1 mg, twice a day) in combination with metformin (850 mg, twice a day) for 6 months. Blood samples were taken for the measurement of fasting glucose, HbA1c, fasting insulin, intact proinsulin, adiponectin and Hct (haematocrit). In addition, the erythrocyte EI (elongation index) was measured using laser diffractoscopy. Both treatments significantly improved HbA1c levels (PIO, -0.9+/-1.1%; GLIM, -0.6+/-0.4%; both PHct (-1.3+/-2.3%; P=0.09), whereas adiponectin levels increased (8.2+/-4.9 microg/ml; P<0.05). No significant change in these parameters was observed during GLIM treatment. PIO improved the EI, resulting in a significant increase in EI at all physiological shear stress ranges (0.6-6.0 Pa; P<0.05). The improvement in EI correlated with the increase in adiponectin levels (r=0.74; P<0.001), and inversely with intact proinsulin levels (r=-0.47; P<0.05). This is the first study showing an improvement in EI during treatment with PIO, which was associated with an increase in adiponectin and a decrease in intact proinsulin levels, but independent of glycaemic control. PMID:20509857

  11. Effects of Taiwan Roselle anthocyanin treatment and single-walled carbon nanotube addition on the performance of dye-sensitized solar cells

    Chou, C. S.; Tsai, P. J.; Wu, P.; Shu, G. G.; Huang, Y. H.; Chen, Y. S.

    2014-04-01

    This study investigates the relationship between the performance of a dye-sensitized solar cell (DSSC) sensitized by a natural sensitizer of Taiwan Roselle anthocyanin (TRA) and fabrication process conditions of the DSSC. A set of systematic experiments has been carried out at various soaking temperatures, soaking periods, sensitizer concentrations, pH values, and additions of single-walled carbon nanotube (SWCNT). An absorption peak (520 nm) is found for TRA, and it is close to that of the N719 dye (518 nm). At a fixed concentration of TRA and a fixed soaking period, a lower pH of the extract or a lower soaking temperature is found favorable to the formation of pigment cations, which leads to an enhanced power conversion efficiency (η) of DSSC. For instance, by applying 17.53 mg/100ml TRA at 30 for 10 h, as the pH of the extract decreases to 2.00 from 2.33 (the original pH of TRA), the η of DSSC with TiO2+SWCNT electrode increases to 0.67% from 0.11% of a traditional DSSC with TiO2 electrode. This performance improvement can be explained by the combined effect of the pH of sensitizer and the additions of SWCNT, a first investigation in DSSC using the natural sensitizer with SWCNT.

  12. Effects of Taiwan Roselle anthocyanin treatment and single-walled carbon nanotube addition on the performance of dye-sensitized solar cells

    This study investigates the relationship between the performance of a dye-sensitized solar cell (DSSC) sensitized by a natural sensitizer of Taiwan Roselle anthocyanin (TRA) and fabrication process conditions of the DSSC. A set of systematic experiments has been carried out at various soaking temperatures, soaking periods, sensitizer concentrations, pH values, and additions of single-walled carbon nanotube (SWCNT). An absorption peak (520 nm) is found for TRA, and it is close to that of the N719 dye (518 nm). At a fixed concentration of TRA and a fixed soaking period, a lower pH of the extract or a lower soaking temperature is found favorable to the formation of pigment cations, which leads to an enhanced power conversion efficiency (η) of DSSC. For instance, by applying 17.53 mg/100ml TRA at 30 for 10 h, as the pH of the extract decreases to 2.00 from 2.33 (the original pH of TRA), the η of DSSC with TiO2+SWCNT electrode increases to 0.67% from 0.11% of a traditional DSSC with TiO2 electrode. This performance improvement can be explained by the combined effect of the pH of sensitizer and the additions of SWCNT, a first investigation in DSSC using the natural sensitizer with SWCNT.

  13. Predictors of additional intraocular pressure reduction in patients changed to latanoprost/timolol fixed combination

    Nordmann Jean-Philippe

    2010-03-01

    Full Text Available Abstract Background Given the growing number of ocular hypotensive medications available, it is important to be able to predict a positive response to therapy. The purpose of the present study was to identify predictors of an additional 10% intraocular pressure (IOP reduction after 12 weeks of treatment with latanoprost/timolol fixed combination (FC in patients requiring a change in their previous ocular hypotensive medication. Methods This multicenter, open-label, prospective, phase IIIb study included subjects ≥18 years of age with open-angle glaucoma (OAG or ocular hypertension (OHT. Eligible subjects had baseline IOP ≥21 mmHg and insufficient response to current beta-blocker monotherapy. The primary efficacy analysis (logistic regression identified predictors of a positive response after 12 weeks of latanoprost/timolol FC. Results The intent-to-treat (ITT population included 383 subjects treated with ≥1 drop of FC and having ≥1 follow-up IOP assessment. Mean IOP was 22.19 ± 2.16 mmHg at baseline and was reduced by 5.42 ± 2.71 mmHg at study end. In all, 325 (84.9% subjects had a positive response to latanoprost/timolol FC; the response rate was similar across groups: OAG (n = 208; 82.7%; OHT (n = 161; 87.6%; OAG+OHT (n = 14; 85.7%. Higher baseline IOP (odds ratio: 1.284; 95% confidence interval [CI]: 1.101, 1.497; p = 0.0014 and absence of adverse events (odds ratio: 0.318; 95% CI: 0.161, 0.629; p = 0.0010 were significant predictors of positive response. Age, gender, ethnic origin, diagnosis, family history of OAG/OHT, corneal thickness, and concomitant systemic beta-blocker were not significant predictors of a positive response in the ITT analysis. The FC was well tolerated. The most common adverse events were related to the eye and were consistent with known adverse events associated with latanoprost and timolol. Conclusions These results support the use of latanoprost/timolol FC in patients whose IOP is insufficiently controlled

  14. Altered sensitization patterns to sweet food stimuli in patients recovered from anorexia and bulimia nervosa.

    Wagner, Angela; Simmons, Alan N; Oberndorfer, Tyson A; Frank, Guido K W; McCurdy-McKinnon, Danyale; Fudge, Julie L; Yang, Tony T; Paulus, Martin P; Kaye, Walter H

    2015-12-30

    Recent studies show that higher-order appetitive neural circuitry may contribute to restricted eating in anorexia nervosa (AN) and overeating in bulimia nervosa (BN). The purpose of this study was to determine whether sensitization effects might underlie pathologic eating behavior when a taste stimulus is administered repeatedly. Recovered AN (RAN, n=14) and BN (RBN, n=15) subjects were studied in order to avoid the confounding effects of altered nutritional state. Functional magnetic resonance imaging (fMRI) measured higher-order brain response to repeated tastes of sucrose (caloric) and sucralose (non-caloric). To test sensitization, the neuronal response to the first and second administration was compared. RAN patients demonstrated a decreased sensitization to sucrose in contrast to RBN patients who displayed the opposite pattern, increased sensitization to sucrose. However, the latter was not as pronounced as in healthy control women (n=13). While both eating disorder subgroups showed increased sensitization to sucralose, the healthy controls revealed decreased sensitization. These findings could reflect on a neuronal level the high caloric intake of RBN during binges and the low energy intake for RAN. RAN seem to distinguish between high energy and low energy sweet stimuli while RBN do not. PMID:26596520

  15. Effect of Continuous Positive Airway Pressure Therapy on Glycemic Excursions and Insulin Sensitivity in Patients with Obstructive Sleep Apnea-hypopnea Syndrome and Type 2 Diabetes

    Li-Xin Guo

    2015-01-01

    Conclusions: CPAP therapy may have a beneficial effect on improving not only blood glucose but also upon insulin sensitivity in T2DM patients with OSAHS. This suggests that CPAP may be an effective treatment for T2DM in addition to intensive diabetes management.

  16. Additional Detection of Multiple Osteomas in a Patient with Gardner's Syndrome by Bone SPECT/CT

    Kim, Woo Hyoung; Kim, Daeweung; Kim, Chang Guhn; Kim, Myoung Hyoun [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of)

    2013-12-15

    Familial adenomatous polyposis (FAP) is an autosomal dominant disorder which generally develops numerous polyps in the colon and rectum during the second decade of life. Gardner's syndrome is a variant of FAP which has multiple osteomas, dental abnormalities, and fibromas, with incidence ranging between 1 in 4,000 and 1 in 40,000, depending on the region. We present the case of a 35-year-old man referred to our department for bone scintigraphy who was shown to have multiple colon polyps and nuchal type fibroma. In this patient, planar image showed intensely increased uptakes of bone agent in the maxilla and mandible, which are typical findings of Gardner's syndrome. Single photon emission computed tomography/computed tomography (SPECT/CT) was acquired to accurately identify and locate abnormal uptakes detected on planar images. SPECT/CT showed numerous osteomas in the maxilla and mandible where intense uptakes of bone agent were seen. Mildly asymmetrical, focally increased uptake in the superomedial aspect of the left orbit on anterior planar image was shown to be a fontal sinus osteoma on SPECT/CT. Enhanced sensitivity of detecting lesions of SPECT/CT superior to planar scintigraphy has been reported in previous studies. In this report, additional osteomas of sphenoidal and ethmoidal sinuses, which were not seen on planar scintigraphy, were detected by SPECT/CT. This case emphasizes that nuclear physicians should be aware of the typical findings of bone scintigraphy for Gardner's syndrome and also that SPECT/CT could be helpful to diagnose additional lesions not seen on planar images.

  17. Variable Temperature Stress in the Nematode Caenorhabditis elegans (Maupas) and Its Implications for Sensitivity to an Additional Chemical Stressor

    Cedergreen, Nina; Nørhave, Nils Jakob; Svendsen, Claus; Spurgeon, David J

    2016-01-01

    A wealth of studies has investigated how chemical sensitivity is affected by temperature, however, almost always under different constant rather than more realistic fluctuating regimes. Here we compared how the nematode Caenorhabditis elegans responds to copper at constant temperatures (8–24°C) and under fluctuation conditions of low (±4°C) and high (±8°C) amplitude (averages of 12, 16, 20°C and 16°C respectively). The DEBkiss model was used to interpret effects on energy budgets. Increasing ...

  18. Influence of carbon monoxide additions on the sensitivity of the dry hydrogen-air mixtures to detonation

    Under severe accident conditions of water cooled nuclear reactors the hydrogen-air detonation represents one of the most hazardous events which can result in the reactor containment damage. An important factor related with the measure of gas mixture detonability is the detonation cell size which correlates with the critical tube diameter and detonation initiation energy. A numerical kinetic study is presented of the influence of carbon monoxide admixtures (from 0 vol.% to 40 vol.%) upon the sensitivity (detonation cell size) of the dry hydrogen-air gas mixtures to detonation in post-accident containment atmosphere. (author). 3 refs., 3 figs

  19. A prospective audit of the impact of additional staff on the care of diabetic patients in a community podiatry service

    Claire M. Buckley; Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda

    2015-01-01

    Objective: The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service.Methods: An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK go...

  20. Macular sensitivity and fixation patterns in patients with autosomal dominant optic atrophy

    Rönnbäck, Cecilia; Larsen, Michael

    2014-01-01

    INTRODUCTION: The objective of this study was to test macular sensitivity, fixation stability and fixation location using microperimetry in patients with autosomal dominant optic atrophy (ADOA) and mutation-free relatives. MATERIAL AND METHODS: This was a cross-sectional study of 43 patients with...... exon 28 (2826 delT) mutation in OPA1 (age 11.7-71.5 years, best-corrected visual acuity (BCVA) 20/24-20/13). The patients and 49 mutation-free first-degree relatives (BCVA 20/25-20/10) underwent ophthalmic examination including macular microperimetry out to 12° eccentricity with registration of...

  1. Chromosome sensitivity to bleomycin in G2 lymphocytes from Down syndrome patients

    Bartholomei-Santos Marlise Ladvocat

    1997-01-01

    Full Text Available Several studies have demonstrated that lymphocytes from patients with Down syndrome (DS exhibit an increased frequency of chromosome aberrations when they are exposed to ionizing radiation or to chemicals at the G0 or G1 phases of the cell cycle, but not at G2, when compared to normal subjects. To determine the susceptibility of DS lymphocytes at G2 phase, bleomycin, a radiomimetic agent, was used to induce DNA breaks in blood cultures from 24 Down syndrome patients. All the patients with DS showed free trisomy 21 (47,XX + 21 or 47,XY + 21. Individuals that showed an average number of chromatid breaks per cell higher than 0.8 were considered sensitive to the drug. No control child showed susceptibility to bleomycin, and among the 24 patients with DS, only one was sensitive to the drug. No significant difference was observed between the two groups, regarding chromatid break frequencies in treated G2 lymphocytes. The distribution of bleomycin-induced breaks in each group of chromosomes was similar for DS and controls. No significant difference was found in the response to bleomycin between male and female subjects. Probably, the main factor involved in chromosome sensitivity of lymphocytes from patients with DS is the phase of the cell cycle in which the cell is treated.

  2. Platinum Sensitivity as an Independent Prognostic Factor in Patients with Brain Metastases from Ovarian Carcinoma

    John Windara Green

    2011-10-01

    Full Text Available Background: The brain is a rare site of metastases from ovarian cancer. Limited data are available on prognostic factors, standard treatment, and survival. Knowledge of clinical prognostic factors would help the management of patients with brain metastases. The aim of this study is to evaluate the impact of clinical factors and treatment modalities on survival in patients with brain metastases from ovarian cancer. Methods: We performed a retrospective analysis of an electronic database of patients with brain metastases from ovarian primary treated at Clatterbridge Centre for Oncology. Results: A total of 20 patients with brain metastases from an ovarian primary were treated from April 2001-February 2011. Median age at occurrence of brain metastases was 55 years. The median time from primary diagnosis to occurrence of brain metastases was 23 months. Median overall survival from diagnosis of brain metastases was 9 months. Poor ECOG performance status, platinum resistance, andadvanced FIGO staging were the most significant adverse variables identified. Median survival was 13 months for platinum sensitive patients and 6 months for platinum resistant patients. Conclusion: Platinum sensitivity is an important prognostic factor in patients with brain metastases from an ovarian primary tumor. Multimodal therapy that consists of surgery, radiotherapy, and chemotherapy should be considered where feasible.

  3. A low-fat Diet improves insulin sensitivity in patients with type 1 diabetes

    Rosenfalck, AM; Almdal, Thomas Peter; Viggers, Lone;

    2006-01-01

    AIMS: To compare the effects on insulin sensitivity, body composition and glycaemic control of the recommended standard weight-maintaining diabetes diet and an isocaloric low-fat diabetes diet during two, 3-month periods in patients with Type 1 diabetes. METHODS: Thirteen Type 1 patients were...... included, of whom 10 completed the cross-over study. Ten non-diabetic, matched control subjects were also examined. Body composition was estimated by dual-energy X-ray absorptiometry (DXA) whole-body scanning, diet intake was monitored by 7-day dietary record and insulin sensitivity was measured by the...... insulin clamp technique at baseline and after each of the diet intervention periods. RESULTS: On an isocaloric low-fat diet, Type 1 diabetic patients significantly reduced the proportion of fat in the total daily energy intake by 12.1% (or -3.6% of total energy) as compared with a conventional diabetes...

  4. Older South Asian patient and carer perceptions of culturally sensitive care in a community hospital setting.

    Clegg, Angie

    2003-03-01

    This study describes the application of grounded theory to establish older, south Asian patient and carer views of service delivery in the UK. The purpose of the study was to inform the development of culturally sensitive services by defining the concept of cultural sensitivity from a user/carer perspective. The study took place in two community hospitals providing nurse-led intermediate care to a culturally diverse inner city population. Fifty-five per cent of the inner city population is of south Asian origin. Admissions to intermediate care, however, do not reflect the demography. Recent reports commissioned by the Department of Health highlight the failure of the National Health Service in England to provide culturally sensitive services to black and Asian patients. The Department of Health is trying to redress this inequality providing policy guidance for improving access and cultural sensitivity in the British health care system. There is little existing empirical evidence, however, to clarify the concept of culturally sensitive care. Patients and carers in this study described culturally appropriate care as that which respects individuality, creates mutual understanding, caters for spiritual need and maintains dignity. Older south Asian patients and their carers identified respect, understanding, spirituality and dignity as central to their conceptualization of cultural sensitivity. Their focus was on the nature of human relationships and their ability to interact in a positive way with staff. The findings of this small piece of empirical research are limited by the sample size (four patients and three carers), but illustrate that cultural sensitivity, although complex, can be defined. This then provides a basis for developing appropriate care strategies. One universal principle explicit in this research was that to be sensitive to culture staff must challenge their own assumptions and develop an understanding of the many layers of culture and subculture

  5. Pupil cycle time and contrast sensitivity in type II diabetes mellitus patients: A pilot study

    Hoyoung Lee

    2011-01-01

    Full Text Available Context: Pupil cycle time (PCT has been widely used for examination of ocular diabetic autonomic neuropathy (DAN. Aims: The primary aim of this study was to evaluate the difference of contrast sensitivity according to PCT results, and the secondary aim was to determine the factors associated with PCT difference for type II diabetes patients. Settings and Design: A clinical pilot study that included a total of 60 eyes of 60 type II diabetes patients. Materials and Methods: We divided all patients into three groups according to PCT results. Group A and Group C were composed of patients who had upper one third PCT and lower one third PCT, respectively. We analyzed difference of age, diabetes duration, hypertension duration, mean best corrected visual acuity (BCVA, mean spherical equivalent (SE, HbA1C, glomerular filtration rate (GFR, stage of diabetic retinopathy, and Cardiac Autonomic Function Score (CAFS. Contrast sensitivity and decrease of visual acuity by glare were also estimated and analyzed for 28 eyes of 28 non-proliferative diabetic retinopathy (NPDR patients. Group [NPDR] A and Group [NPDR] C were defined as those who had lower one third PCT and upper one third PCT, respectively. Statistical Analysis: Statistical analysis was done using SPSS 17.0 software. Results and Conclusions: Each group contained 20 eyes. Significant differences between Group A and Group C were observed in duration of diabetes and CAFS (P ≤ 0.001 and P < 0.001, respectively. Contrast sensitivity in Group [NPDR] A was significantly more than in Group [NPDR] C at all cpds (all P ≤ 0.001. We found that PCT can influence contrast sensitivity or glare in diabetes patients and also confirmed a significant correlation of PCT with CAFS and duration of diabetes.

  6. General practitioners' experiences with provision of healthcare to patients with self-reported multiple chemical sensitivity

    Skovbjerg, Sine; Johansen, Jeanne Duus; Rasmussen, Alice; Thorsen, Hanne; Elberling, Jesper

    2009-01-01

    OBJECTIVE: To describe general practitioners' (GPs') evaluation of and management strategies in relation to patients who seek medical advice because of multiple chemical sensitivity (MCS). DESIGN: A nationwide cross-sectional postal questionnaire survey. The survey included a sample of 1000 Danish...... GPs randomly drawn from the membership list of GPs in the Danish Medical Association. SETTING: Denmark. RESULTS: Completed questionnaires were obtained from 691 GPs (69%). Within the last 12 months 62.4% (n = 431) of the GPs had been consulted by at least one patient with MCS. Of these, 55.2% of the...... GPs evaluated the patients' complaints as chronic and 46.2% stated that they were rarely able to meet the patients' expectations for healthcare. The majority, 73.5%, had referred patients to other medical specialties. The cause of MCS was perceived as multi-factorial by 64.3% of the GPs, as somatic...

  7. A study on the effects of aging treatment and W addition on the mechanical properties and sensitization behaviors of Fe-Cr-Mn stainless steels

    The characteristics of the mechanical properties and sensitization behaviors in Fe-Cr-Mn stainless steels by W addition and aging treatment were studied. Yield strength, tensile strength, elongation and impact energy were decreased, and hardness was slightly increased by aging treatment. W-containing alloys showed especially a larger degree of brittle characteristics due to the hard chi(χ) phase formed from the decomposition of ferrite. Carbides precipitated in grain boundary had a bad effect on impact energy rather than strength and hardness. Ni addition suppressed the formation of ferrite and resulted in the some improvement of mechanical properties. Anodic polarization tests showed that the corrosion resistance of aged alloys was decreased by the formation of carbides and secondary austenites. It was observed that W addition made no improvement of the pitting potential and passive current density of aged alloys in the HCl solution. But Ni and W decreased critical current density in the sulfuric acid and made easier formation of passive film, contributing to corrosion resistance. From the results of EPR (Electrochemical Potentiokinetic Reactivation), DOS (Degree of Sensitization) was increased with aging time and carbides and ferrite was preferentially attacked. It was observed that Ni delayed the sensitization. It can be concluded from the previous results that the selective dissolution of ferrite is due to the ferrite decomposition to chi (χ) phase and secondary austenites. In the secondary austenite Cr and W which are known to improve the corrosion resistance were depleted. Therefore, it seems that ferrite phase became sensitive to corrosion

  8. The efficacy of additive use of etizolam in patients with essential hypertension and unspecified complaints.

    Matsuo, H; Watanabe, S; Ishiguro, M; Arai, M; Sugiyama, A; Matsuno, Y; Hirano, T; Arakawa, M

    1992-02-01

    The relationship between hypertension and emotional depression or anxiety has been long-argued. We assessed the efficacy of etizolam (an antianxiety drug) in 18 patients with essential hypertension accompanied with unspecified complaints. In the assessment of overall improvement, 4 patients (22.2%) were rated as markedly improved, 4 patients (22.2%) as moderately improved, 7 patients (38.9%) as slightly improved, 3 patients (16.7%) as unchanged, and none as worsened. Systolic and diastolic pressure decreased significantly in 13 patients (72.2%) and 10 patients (55.5%), respectively. Many subjective symptoms such as anxiety, fatigue and depression improved. No significant adverse reaction from drug was observed. These results allow us to conclude that etizolam is effective and safe for the treatment of essential hypertension accompanied with unspecified complaints. PMID:1551746

  9. Observation of Pain-Sensitive Points along the Meridians in Patients with Gastric Ulcer or Gastritis

    Hui Ben

    2012-01-01

    Full Text Available This study aims to investigate the sensitization of human skin points along certain meridians related to visceral disease by using the pressure-pain threshold (PPT as an indicator. We detected and compared the PPTs of people with and without gastric ulcer or gastritis on the related acupoints, abdomen area, and back area with von Frey detector and observed the similarities and differences under their respective physiological and pathological states. The results showed that (1 the PPTs of patients with gastric ulcer on related acupoints decreased significantly compared with the control group; (2 there was no significant difference in PPT between the chosen points of the measured meridian and the adjacent nonacupoints; (3 there was an apparent distribution of tender points on the relevant abdomen and back regions of patients with gastric ulcer or gastritis, but none was found on the control group; (4 the pain-sensitive points of gastric ulcer and gastritis patients were BURONG (ST19, LIANGMEN (ST21, and HUAROUMEN (ST24 of the stomach meridian on the abdominal region and PISHU (BL20, WEISHU (BL21, and WEICANG (BL50 on the back, among others The results suggest that the practical significance of acupoints may lie in its role as a relatively sensitive functional area. In a pathological state, the reflex points on the skin which are related to certain visceral organs become sensitive and functionally intensify.

  10. Venous thromboembolism: Additional diagnostic value and radiation dose of pelvic CT venography in patients with suspected pulmonary embolism

    Reichert, Miriam, E-mail: Miriam.Reichert@umm.de [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Henzler, Thomas; Krissak, Radko; Apfaltrer, Paul [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Huck, Kurt [1st Department of Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim (Germany); Buesing, Karen [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany); Sueselbeck, Tim [1st Department of Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim (Germany); Schoenberg, Stefan O.; Fink, Christian [Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim (Germany)

    2011-10-15

    Purpose: To assess the additional diagnostic value of indirect CT venography (CTV) of the pelvis and upper thighs performed after pulmonary CT angiography (CTA) for the diagnosis of venous thromboembolism (VTE). Materials and methods: In a retrospective analysis, the radiology information system entries between January 2003 and December 2007 were searched for patients who received pulmonary CTA and additional CTV of the pelvis and upper thighs. Of those patients, the radiology reports were reviewed for the diagnosis of pulmonary embolism (PE) and deep venous thrombosis (DVT) in the pelvic veins and veins of the upper thighs. In cases with an isolated pelvic thrombosis at CTV (i.e. which only had a thrombosis in the pelvic veins but not in the veins of the upper thigh) ultrasound reports were reviewed for the presence of DVT of the legs. The estimated radiation dose was calculated for pulmonary CTA and for CTV of the pelvis. Results: In the defined period 3670 patients were referred to our institution for exclusion of PE. Of those, 642 patients (353 men, 289 women; mean age, 65 {+-} 15 years, age range 18-98 years) underwent combined pulmonary CTA and CTV. Among them, PE was found in 227 patients (35.4%). In patients without PE CTV was negative in all cases. In patients with PE, CTV demonstrated pelvic thrombosis in 24 patients (3.7%) and thrombosis of the upper thighs in 43 patients (6.6%). Of those patients 14 (2.1%) had DVT in the pelvis and upper thighs. In 10 patients (1.5%) CTV showed an isolated pelvic thrombosis. Of those patients ultrasound reports were available in 7 patients, which revealed DVT of the leg veins in 5 cases (1%). Thus, the estimated prevalence of isolated pelvic thrombosis detected only by pelvic CTV ranges between 1-5/642 patients (0.1-0.7%). Radiation dose ranges between 4.8 and 9.7 mSv for additional CTV of the pelvis. Conclusion: CTV of the pelvis performed after pulmonary CTA is of neglectable additional diagnostic value for the

  11. How low can you go: Spatial frequency sensitivity in a patient with pure alexia

    Starrfelt, Randi; Nielsen, Simon; Habekost, Thomas;

    2013-01-01

    Pure alexia is a selective deficit in reading, following lesions to the posterior left hemisphere. Writing and other language functions remain intact in these patients. Whether pure alexia is caused by a primary problem in visual perception is highly debated. A recent hypothesis suggests that a low...... detection and a classification task, LK’s contrast sensitivity is comparable to normal controls for all spatial frequencies. Thus, reduced spatial frequency sensitivity does not constitute a general explanation for pure alexia, suggesting that the core deficit in this disorder is at a higher level in the...

  12. Role of the addition of cabergoline to the management of acromegalic patients resistant to longterm treatment with octreotide LAR.

    Vilar, Lucio; Azevedo, Monalisa F; Naves, Luciana Ansaneli; Casulari, Luiz Augusto; Albuquerque, José Luciano; Montenegro, Renan M; Montenegro, Renan M; Figueiredo, Patricia; Nascimento, Gilvan C; Faria, Manuel S

    2011-06-01

    The aim of this prospective open trial was to evaluate the efficacy in normalizing IGF-I levels of the addition of cabergoline to the treatment of acromegalic patients partially responsive to Octreotide-LAR (OCT-LAR), a long acting somatotastin analog (SSA). Fifty-two patients who did not achieve hormonal control after longterm therapy (at least, 12 months) with OCT-LAR (30 mg every 28 days intramuscularly) were given cabergoline in addition to the SSA treatment. Normalization of IGF-I levels was achieved in 40.4% of patients by 6 months after the addition of cabergoline (1.0-3.0 mg/week; mean, 2.19 ± 0.64), and these patients were considered responsive. Compared to non-responsive subjects, responsive patients had significantly lower mean %ULNR-IGF-I and GH levels. However, the rate of hyperprolactinemia and positive immunohistochemical staining for PRL was similar in both groups, before the addition of cabergoline. Responsive patients were followed for at least 12 months on combination treatment and persisted with normal IGF-I levels. Patients with baseline %ULNR IGF-I up to 220% and/or GH up to 5 ng/ml were those who benefited the most from combination treatment. No patients with %ULNR-IGF-I>250% reached normalization of IGF-I levels. Our findings demonstrated that the addition of cabergoline, even at relatively low doses, is effective in both short- and long-term control of IGF-I levels in acromegalic patients partially responsive to octreotide LAR, particularly in those with mild/moderately elevated GH/IGF-levels, irrespective of prolactin status. PMID:21104199

  13. Indeterminate pulmonary nodules on CT images in breast cancer patient: the additional value of 18F-FDG PET/CT

    To assess the potential role of 18F-Fluorodeoxiglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) in characterizing indeterminate lung nodules detected at CT scan in patients previously treated for a breast cancer (BC). wenty-nine consecutive BC patients (28 females, mean age 65 ± 12 years) with evidence of indeterminate lung nodules at contrast-enhanced CT (CECT) scan (lesions with axial diameter ≥8 mm) were retrospectively analysed: all patients underwent 18F-FDG PET/CT within a mean 2 ± 1 months from CECT imaging. PET/CT was considered positive in the presence of abnormal FDG uptake in the pulmonary nodules and/or in other organs. The nature of lung nodules was defined at histopathology and/or imaging follow-up. Fourteen (48%) patients showed negative and 15 (52%) positive PET/CT scan in the lungs: of these 15 patients, 7 (47%) had pathologic FDG-uptake in lungs only, whereas 8 (53%) showed abnormal FDG-uptake also in sites different from lungs. At histology and/or imaging follow-up, five (17%) patients were considered positive for BC lung metastases while in seven (24%) a second cancer was diagnosed. In this subset of patients, the sensitivity and specificity for FDG PET/CT in revealing lung lesions were 17% and 100%, respectively, for nodules <8 mm in diameter, and 77% and 85%, respectively, for nodules with diameter ≥8 mm. The therapeutic planning was changed to surgery in seven patients, chemotherapy in one patient and continued hormonal therapy in five. The inclusion of PET/CT in the diagnostic algorithm of the evaluated patients helped avoid unnecessary over-treatment in 12 of 29 patients. FDG PET/CT appears useful in characterizing indeterminate lung nodules found at CECT scan in BC patients, with a sensitivity that is proportional to nodule size. In addition, PET/CT helped in avoiding over-treatment in a significant proportion of patients.

  14. Allergen Microarray Indicates Pooideae Sensitization in Brazilian Grass Pollen Allergic Patients.

    Priscila Ferreira de Sousa Moreira

    Full Text Available Grass pollen, in particular from Lolium multiflorum is a major allergen source in temperate climate zones of Southern Brazil. The IgE sensitization profile of Brazilian grass pollen allergic patients to individual allergen molecules has not been analyzed yet.To analyze the IgE sensitization profile of a Brazilian grass pollen allergic population using individual allergen molecules.We analyzed sera from 78 grass pollen allergic patients for the presence of IgE antibodies specific for 103 purified micro-arrayed natural and recombinant allergens by chip technology. IgE-ELISA inhibition experiments with Lolium multiflorum, Phleum pratense extracts and a recombinant fusion protein consisting of Phl p 1, Phl p 2, Phl p 5 and Phl p 6 were performed to investigate cross-reactivities.Within the Brazilian grass pollen allergic patients, the most frequently recognized allergens were Phl p 1 (95%, Phl p 5 (82%, Phl p 2 (76% followed by Phl p 4 (64%, Phl p 6 (45%, Phl p 11 (18% and Phl p 12 (18%. Most patients were sensitized only to grass pollen allergens but not to allergens from other sources. A high degree of IgE cross-reactivity between Phleum pratense, Lolium multiflorum and the recombinant timothy grass fusion protein was found.Component-resolved analysis of sera from Brazilian grass pollen allergic patients reveals an IgE recognition profile compatible with a typical Pooideae sensitization. The high degree of cross-reactivity between Phleum pratense and Lolium multiflorum allergens suggests that diagnosis and immunotherapy can be achieved with timothy grass pollen allergens in the studied population.

  15. Radiation sensitivity of fibroblast strains from patients with Usher's syndrome, Duchenne muscular dystrophy, and Huntington's disease

    The colony-forming ability of 10 normal human fibroblast cell strains and of 10 strains representing 3 degenerative diseases of either nerve or muscle cells was determined after exposure of the cells to X-rays or β-particles from tritiated water. Both methods of irradiation yielded similar comparative results. The fibroblast strains from the 5 Usher's syndrome patients and from 1 of the 2 Huntington's disease patients were hypersensitive to radiation, while those from the 3 Duchenne muscular dystrophy patients and the second Huntington's disease patient had normal sensitivity to radiation. These results indicate both disease-specific and strain-specific differences in the survival of fibroblasts after exposure to ionizing radiation. 38 refs.; 2 figs.; 3 tabs

  16. Beta-carotene suppression of benzophenone-sensitized lipid peroxidation in hexane through additional chain-breaking activities

    The aim of this work is to estimate the antioxidant activity of β-carotene in the presence of two different mixtures of phospholipids in hexane solution, under continuous UV-irradiation from three different ranges (UV-A, UV-B, and UV-C). β-Carotene is employed to control lipid peroxidation process generated by UV-irradiation, in the presence and in the absence of selected photosensitizer, benzophenone, by scavenging the involved, created free radicals. The results show that β-carotene undergoes to a substantial, probably structural dependent destruction (bleaching), highly dependent on UV-photons energy input, more expressed in the presence than in the absence of benzophenone. The additional bleaching is synchronized with the further increase in β-carotene antioxidant activity in the presence of benzophenone, implying the same cause: increase in (phospholipids peroxidation) chain-breaking activities.

  17. Beta-carotene suppression of benzophenone-sensitized lipid peroxidation in hexane through additional chain-breaking activities

    Cvetkovic, Dragan [Faculty of Technology, 16000 Leskovac (Serbia); Markovic, Dejan, E-mail: dejan_markovic57@yahoo.co [Faculty of Technology, 16000 Leskovac (Serbia)

    2011-01-15

    The aim of this work is to estimate the antioxidant activity of {beta}-carotene in the presence of two different mixtures of phospholipids in hexane solution, under continuous UV-irradiation from three different ranges (UV-A, UV-B, and UV-C). {beta}-Carotene is employed to control lipid peroxidation process generated by UV-irradiation, in the presence and in the absence of selected photosensitizer, benzophenone, by scavenging the involved, created free radicals. The results show that {beta}-carotene undergoes to a substantial, probably structural dependent destruction (bleaching), highly dependent on UV-photons energy input, more expressed in the presence than in the absence of benzophenone. The additional bleaching is synchronized with the further increase in {beta}-carotene antioxidant activity in the presence of benzophenone, implying the same cause: increase in (phospholipids peroxidation) chain-breaking activities.

  18. Macular sensitivity and fixation patterns in patients with autosomal dominant optic atrophy

    Rönnbäck, Cecilia; Larsen, Michael

    2014-01-01

    in the nasal macula (13.6 (± 5.7) dB versus 19.7 (± 0.7) dB) and in the central macula (14.2 (± 5.1) dB versus 19.9 (± 0.3) dB). The average sensitivity decreased with decreasing BCVA in ADOA (p < 0.0001). Stable fixation was found in 58% of ADOA patients versus 86% of controls, and relatively...... unstable fixation was observed in 35% of ADOA patients versus 14% of controls. Unstable fixation was found only in ADOA, where its prevalence was 7%. CONCLUSION: ADOA was associated with unstable fixation and subnormal microperimetric sensitivity, especially in the central and nasal macula where the...

  19. Assessing decision quality in patient-centred care requires a preference-sensitive measure

    Kjer Kaltoft, Mette; Cunich, Michelle; Salkeld, Glenn;

    2014-01-01

    decision making by calculating, for each criterion, the Incremental Value of Perfect Rating, that is, the increase in their decision quality score that would result if their performance rating on the criterion had been 100%, weightings unchanged. MyDecisionQuality, which is a web-based generic and...... aspects of decision making. Current instruments using the term 'decision quality' have adopted a decision- and thus condition-specific approach. We argue that patient-centred care requires decision quality to be regarded as both preference-sensitive across multiple relevant criteria and generic across all...... preference-sensitive instrument, can constitute a key patient-reported measure of the quality of the decision-making process. It can provide the basis for future decision improvement, especially when the clinician (or other stakeholders) completes the equivalent instrument and the extent and nature of...

  20. Possible cross-sensitivity between sertraline and paroxetine in a panic disorder patient

    Khairkar Praveen

    2010-01-01

    Full Text Available Cross-sensitivity due to paroxetine and sertraline, the SSRIs, is rarely reported in the literature. We report an adverse drug reaction to paroxetine and sertraline in a patient of panic disorder, who initially developed a maculopapular, erythematous, pruritic rash in the third week with sertraline 50 mg/day. The rash resolved within 2 days of its discontinuation and oral supplementation of diphenhydramine and betamethasone. 10 days following discontinuation of sertraline, the patient was shifted on sustain release paroxetine 12.5 mg/day when another skin reaction with the same appearance and distribution appeared on day 4 of it, suggesting a possibility of cross-sensitivity, a drug class effect. This case report intends to improve the awareness among clinicians to use caution when choosing an alternative SSRIs.

  1. Sensitization to Aeroallergens in Patients with Respiratory Allergies Based on Skin-Prick Test Results

    G Bejtullahu

    2012-10-01

    Full Text Available Background: The aim of this study was to identify the most common aeroallergens in patients with asthma and rhinitis.Methods: The study enrolled 102 participants including 64 patients with respiratory allergies (among them 15 were clinically diagnosed as asthma patients, 41 with rhinitis, 8 were both and 38 healthy controls. All of participants were subject of skin prick tests (SPT with series of common allergenic extracts. Sera from all participants were tested for total IgE and eosinophil count. To measure airflow limitation and reversibility in asthma patients the pulmonary function testing were carried out.Results: M/F ratio was 1:1.6 in patients and 1:0.7 in control group with mean age 28.88 year (SD 13.16; range 6 – 55year and 20.47 respectively (SD 1.16; range 19-23 year. The most common risk factors in these patients were total IgE more than 100 IU/ml, eosinophils above 4% and positive family history of atopy. Skin prick testing results showed prevalence rates for allergen groups in this manner: house dust mites 81.3 %, pollens 57.8 %, animal dandruff12.5% and moulds 4.9%. Polysensitization was common in 51.6% of all sensitized patients being positive to more than one group of allergens.Conclusion: House dust mites are the main sensitizing allergens among our allergic patients as well as healthy controls. Next in importance, in all participants, are grasses. This pattern of prevalence was expected based on herbal geography, climate and specially lifestyle. It was also compatible with the results from studies carried out in places with the same habitat.

  2. Additional value of procalcitonin for diagnosis of infection in patients with fever at the emergency department

    M.D. de Kruif; M. Limper; H. Gerritsen; C.A. Spek; D.P.M. Brandjes; H. ten Cate; P.M. Bossuyt; P.H. Reitsma; E.C.M. van Gorp

    2010-01-01

    Objective: First, to determine whether procalcitonin (PCT) significanty adds diagnostic value in terms of sensitivity and specificity to a common set of markers of infection, including C-reactive protein (CRP), at the Emergency Department. Second, to create a simple scoring rule implementing PCT val

  3. Evaluation of Serum Homocysteine, High-Sensitivity CRP, and RBC Folate in Patients with Alopecia Areata

    Yousefi, Maryam; Namazi, Mohammad Reza; Rahimi, Hoda; Younespour, Shima; Ehsani, Amir Houshang; Shakoei, Safoura

    2014-01-01

    Introduction: Alopecia areata (AA) is a common type of hair loss with an autoimmune basis. As the role of homocysteine (Hcys), folate, and CRP has been considered in some autoimmune diseases. Objectives: To evaluate homocysteine, folate and CRP level in AA. Methods: This study was performed on 29 patients who had AA for at least 6 months affecting more than 20% of scalp, and 32 healthy controls. Levels of serum Hcys, blood high-sensitivity CRP, and RBC folate were measured in all subjects. Results: The mean level of RBC folate was significantly lower in the patient group than that in controls (P < 0.001). Also, the level of RBC folate was significantly lower in patients with extensive forms of disease (alopecia totalis/alopecia universalis) in comparison with more localized form (patchy hair loss) (P < 0.05). Patients with higher “Severity of Alopecia Total” (SALT) score had lower RBC folate, as well. Serum Hcys and blood high-sensitivity CRP levels did not show a significant difference in two groups. Conclusion: Patients with alopecia areata have lower level of RBC folate which is in negative correlation with both severity and extension of AA. PMID:25484412

  4. Evaluation of serum homocysteine, high-sensitivity CRP, and RBC folate in patients with alopecia areata

    Maryam Yousefi

    2014-01-01

    Full Text Available Introduction: Alopecia areata (AA is a common type of hair loss with an autoimmune basis. As the role of homocysteine (Hcys, folate, and CRP has been considered in some autoimmune diseases. Objectives: To evaluate homocysteine, folate and CRP level in AA. Methods: This study was performed on 29 patients who had AA for at least 6 months affecting more than 20% of scalp, and 32 healthy controls. Levels of serum Hcys, blood high-sensitivity CRP, and RBC folate were measured in all subjects. Results: The mean level of RBC folate was significantly lower in the patient group than that in controls (P < 0.001. Also, the level of RBC folate was significantly lower in patients with extensive forms of disease (alopecia totalis/alopecia universalis in comparison with more localized form (patchy hair loss (P < 0.05. Patients with higher "Severity of Alopecia Total" (SALT score had lower RBC folate, as well. Serum Hcys and blood high-sensitivity CRP levels did not show a significant difference in two groups. Conclusion: Patients with alopecia areata have lower level of RBC folate which is in negative correlation with both severity and extension of AA.

  5. High prevalence of lipid transfer protein sensitization in apple allergic patients with systemic symptoms.

    Francisca Gomez

    Full Text Available Apple allergy manifests as two main groups of clinical entities reflecting different patterns of allergen sensitization: oral allergy syndrome (OAS and generalized symptoms (GS.We analysed the sensitization profile to a wide panel of different components of food allergens (rMal d 1, Mal d 2, rMal d 3, rMal d 4, rPru p 3, rBet v 1 and Pho d 2 for a population of Mediterranean patients with OAS and GS to apple.Patients (N = 81 with a history of apple allergy that could be confirmed by positive prick-prick test and/or double-blind-placebo-controlled food challenge (DBPCFC, were included. Skin prick test (SPT and ELISA were performed using a panel of inhalant, fruit and nut allergens. ELISA and ELISA inhibition studies were performed in order to analyse the sensitization patterns.Thirty-five cases (43.2% had OAS and 46 (56.8% GS. SPT showed a significantly higher number of positive results with peach, cherry and hazelnut in those with GS. ELISA showed a significantly high percentage of positive cases to rMal d 3, rMal d 4, rPru p 3 and Pho d 2 in patients with OAS and GS compared to controls, and to rBet v 1 in patients with OAS vs controls and between OAS and GS patients. Three different patterns of recognition were detected: positive to LTP (rMal d 3 or rPru p 3, positive to profilin (rMal d 4 and Pho d 2, or positive to both. There were also patients with rMal d 1 recognition who showed cross-reactivity to rBet v 1.In an apple allergy population with a high incidence of pollinosis different patterns of sensitization may occur. LTP is most often involved in those with GS. Profilin, though more prevalent in patients with OAS, has been shown to sensitise patients with both types of symptoms.

  6. Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

    Mehrdad Bakhshayeshkaram

    2016-01-01

    Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

  7. Additional Drug Resistance of Multidrug-Resistant Tuberculosis in Patients in 9 Countries

    Kurbatova, Ekaterina V.; Dalton, Tracy; Ershova, Julia; Tupasi, Thelma; Caoili, Janice Campos; van der Walt, Martie; Kvasnovsky, Charlotte; Yagui, Martin; Bayona, Jaime; Contreras, Carmen; Leimane, Vaira; Via, Laura E.; Kim, HeeJin; Akksilp, Somsak; Kazennyy, Boris Y.

    2015-01-01

    Data from a large multicenter observational study of patients with multidrug-resistant tuberculosis (MDR TB) were analyzed to simulate the possible use of 2 new approaches to treatment of MDR TB: a short (9-month) regimen and a bedaquiline-containing regimen. Of 1,254 patients, 952 (75.9%) had no resistance to fluoroquinolones and second-line injectable drugs and thus would qualify as candidates for the 9-month regimen; 302 (24.1%) patients with resistance to a fluoroquinolone or second-line ...

  8. The radiation sensitizing effect of PSK in the treatment for the cervical cancer patients

    PSK is the protein-bound polysaccharide isolated from Coriolus versicolor (strain CM-101) belonging to Basidiomycetes. It has been widely used as antitumor agent by oral route in Japan for cancer of digestive organs, lung cancer, breast cancer and so on. In this paper, clinical data for the radiation sensitizing effect of PSK in the treatment for the cervical cancer patients is reported. The action mechanism of PSK is still unclear. (Auth.)

  9. Impairment of skeletal muscle adenosine triphosphate–sensitive K+ channels in patients with hypokalemic periodic paralysis

    Tricarico, Domenico; Servidei, Serenella; Tonali, Pietro; Jurkat-Rott, Karin; Camerino, Diana Conte

    1999-01-01

    The adenosine triphosphate (ATP)–sensitive K+ (KATP) channel is the most abundant K+ channel active in the skeletal muscle fibers of humans and animals. In the present work, we demonstrate the involvement of the muscular KATP channel in a skeletal muscle disorder known as hypokalemic periodic paralysis (HOPP), which is caused by mutations of the dihydropyridine receptor of the Ca2+ channel. Muscle biopsies excised from three patients with HOPP carrying the R528H mutation of the dihydropyridin...

  10. Primary care patient willingness for genetic testing for salt-sensitive hypertension: a cross sectional study

    Okayama, Masanobu; Takeshima, Taro; Ae, Ryusuke; Harada, Masanori; Kajii, Eiji

    2013-01-01

    Background The current research into single nucleotide polymorphisms has extended the role of genetic testing to the identification of increased risk for common medical conditions. Advances in genetic research may soon necessitate preparation for the role of genetic testing in primary care medicine. This study attempts to determine what proportion of patients would be willing to undergo genetic testing for salt-sensitive hypertension in a primary care setting, and what factors are related to ...

  11. Frequency and antimicrobial sensitivity of Ureaplasma urealyticum and Mycoplasma hominis in patients with vaginal discharge

    Leonor Díaz

    2013-10-01

    Full Text Available Determination of antimicrobial sensitivity helps establish adequate treatment and avoids future genital tract diseases in women of fertile age. In Cuba, prevalence of mycoplasma in patients with vaginal discharge is unknown. The objective of this research was to determine frequency and antimicrobial sensitivity of Ureaplasma urealyticum and Mycoplasma hominis in women with vaginal discharge through analysis of laboratory data from vaginal smears from 255 patients referred to the Municipal Hygiene and Epidemiology Center in Güines, Mayabeque Province, Cuba. Mycoplasma System Plus (Italy was used for detection, identification, count and sensitivity testing. The finding of mycoplasmas in almost two thirds of specimens examined suggests that the sexually active female population should be screened for these bacteria and that barrier contraception methods should be promoted to decrease their spread and prevent longterm sequelae. Such updating of local patterns of antimicrobial resistance supports decision making for best treatment options in patients with these infections. Our results should help clinicians in our area choose an antibiotic, and also confirm the utility of Mycoplasma System Plus for mycoplasma research in resource-scarce settings, to benefit individual and population health.

  12. Medicare hospital spending per patient (Medicare Spending per Beneficiary) – Additional Decimal Places

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  13. Agenda-setting revisited: When and how do primary-care physicians solicit patients' additional concerns?

    Robinson, JD; Tate, A.; Heritage, J

    2016-01-01

    © 2015 Elsevier Ireland Ltd. Objective: Soliciting patients' complete agendas of concerns (aka. 'agenda setting') can improve patients' health outcomes and satisfaction, and physicians' time management. We assess the distribution, content, and effectiveness of physicians' post-chief-complaint, agenda-setting questions. Methods: We coded videotapes/transcripts of 407 primary-, acute-care visits between adults and 85 general-practice physicians operating in 46 community-based clinics in two sta...

  14. Optimising the treatment of the partially platinum-sensitive relapsed ovarian cancer patient

    Nicoletta Colombo

    2014-12-01

    Full Text Available The choice of second-line chemotherapy in patients with recurrent ovarian cancer (ROC is complex, with several factors to be considered, the most important of which is the length of the platinum-free treatment interval (PFI. Recently ROC patients have been further stratified into platinum sensitive (PS, partially platinum sensitive (PPS and platinum resistant (PR subgroups depending on the length of the PFI. Response to second-line therapy, progression-free survival (PFS and overall survival (OS are linked to the PFI, all of them improving as the PFI increases. Consequently, there is increasing interest in PFI extension strategies with platinum-free therapeutic options. Such strategies are currently being studied in patients with partially platinum-sensitive disease (PFI 6-12 months, as the treatment of these patients remains clinically challenging. A non-platinum option, trabectedin + pegylated liposomal doxorubicin (PLD combination, has been evaluated in ROC patients in the pivotal phase III OVA-301 study. The OVA-301 study differed from previous trials in the same setting as it included only patients who were not expected to benefit from or who were ineligible for or who were unwilling to receive re-treatment with platinum-based chemotherapy, including those with PPS and PR disease. Subset analysis of patients with PPS disease in OVA-301 showed that the trabectedin + PLD combination significantly improved PFS compared with PLD alone; median PFS 7.4 versus 5.5 months, p=0.0152. Final survival data from the same subset of patients, showed that trabectedin + PLD also achieved a significant 36% decrease in the risk of death compared with PLD alone (HR=0.64; 95% CI, 0.47–0.88; p=0.0027. Median overall survival (OS was 22.4 months in the trabectedin + PLD arm versus 16.4 months in the PLD arm. This represents a statistically significant 6-month improvement in median OS in patients treated with trabectedin + PLD compared to those treated with PLD

  15. Sensitivity of T lymphocytes to gamma rays in patients with cervix tumor

    In this work we studied the effect of radiotherapy on normal cells in patients with cervix tumors treated only by gamma rays. In our laboratory, after lymphocytes separation, we tested the proliferation system of these cells against the phytohemagglutinin and the concanavalin a antigens; at the same time we tested their sensitivity to lys the erythroid tumor cells line K 562. According to the clinical stage of disease the 25 patients studied were divided in two groups; group I composed of 14 patients at stage I and II proximal, received 50 Gy from a cesium 137 source, in intrauterine and in continuous treatment during 4 days. The second group composed of 11 patients at stage II distal and III, received 50 Gy from a cobalt-60 source in extra uterine, the treatment is fractioned in 3 to 5 times per week, at each time the patient received 1,5 - 3 Gy. To compare with their immunological status before treatment, until 1 month after total dose received, all of our patients lost transitory their capacity to prolifere in vitro. Although the capacity to lys the tumor cells is diminished in cancer patients, the drop of this activity is principally. The selective recuperation of T lymphocytes stimulated by concanavalin A is also observed. 3 figs., 2 tabs

  16. First application of diethyl oxalate as efficient additive in high performance dye-sensitized solar cells based on iodide/triiodide electrolyte

    In this study, diethyl oxalate (DEOX) is applied as an effective inexpensive additive based iodide/triiodide electrolyte in the dye-sensitized solar cells (DSSCs). Addition the suitable amount of DEOX as 1 M into the electrolyte shows dramatically improvement in the short circuit current (Jsc) and consequently, in the total conversion efficiency (η). The fabricated devices based on N719 and 2-cyano-3-(4-(diphenylamino) phenyl) acrylic acid (TPA) sensitizers with modified electrolyte show the efficiency of 7.33% and 2.63% at an irradiation of AM1.5, and an 37% and 22% energy conversion efficiency increments, respectively. The boost in the photocurrent density mainly is due to the molecular complex formation between DEOX and redox species in the electrolyte solution that promotes the electrochemical properties of electrolyte. Also, electrochemical impedance measurements indicate adsorbing of DEOX on the semiconductor surface leads to an incensement in the lifetime (τ) and the electron density (ns) in the conduction band (CB) of TiO2 that shifts the Fermi level (EF) which leads to small enhancement in the Voc. Adsorbing of DEOX on the titania surface retards the interfacial charge recombination that has a beneficial effect on the Voc and Jsc. Furthermore, we compares the effect mechanisms of DEOX and 4-tert-butylpyridine (TBP) additives on the cell performance by applying different electrolytes containing the additives. These results show that TBP increases Voc while DEOX additive has effect on the Jsc and using of combination of additives leads to a remarkable improvement in η. As a result, DEOX is a new promising co-additive which can be used for high efficient and low cost DSSCs

  17. Spectrum and antibiotic sensitivity of bacteria contaminating the upper gut in patients with malabsorption syndrome from the tropics

    Naik Subhash R; Ranjan Piyush; Ghoshal Uday C; Ghoshal Ujjala; Ayyagari Archana

    2003-01-01

    Abstract Background Various causes of malabsorption syndrome (MAS) are associated with intestinal stasis that may cause small intestinal bacterial overgrowth (SIBO). Frequency, nature and antibiotic sensitivity of SIBO in patients with MAS are not well understood. Methods Jejunal aspirates of 50 consecutive patients with MAS were cultured for bacteria and colony counts and antibiotic sensitivity were performed. Twelve patients with irritable bowel syndrome were studied as controls. Results Cu...

  18. Effect of gene polymorphism of COMT and OPRM1 on the preoperative pain sensitivity in patients with cancer

    Yao, Peng; DING Yuan-yuan; Wang, Zhi-Bin; Ma, Jia-Ming; Hong, Tao; Pan, Shi-Nong

    2015-01-01

    Objectives: To evaluate the effect of COMT and OPRM1 gene polymorphisms on the preoperative pain sensitivity in tumor patients. Methods: 300 cases of cancer patients undergoing elective surgery were included, and the Val158 Met loci of COMT gene and OPRM1 loci of A118 G gene were genotyped by PCR-RFLP. Pain threshold and pain tolerance threshold were measured using electrical stimulation to investigate the preoperative pain sensitivity in patients with different genotypes. Results: For the CO...

  19. Influence of multivessel disease with or without additional revascularization on mortality in patients with ST-segment elevation myocardial infarction

    Jensen, Lisette Okkels; Terkelsen, Christian Juhl; Horváth-Puhó, Erzsébet;

    2015-01-01

    patients presenting with STEMI and treated with primary PCI were identified from the Western Denmark Heart Registry, which covers a population of 3.0 million. The hazard ratio (HR) for death was estimated using a Cox regression model, controlling for potential confounding. RESULTS: The study cohort......BACKGROUND: In patients with ST-segment elevation myocardial infarction (STEMI), timely reperfusion with primary percutaneous coronary intervention (PCI) is the preferred treatment. In primary PCI patients with multivessel disease, it is unclear whether culprit vessel PCI only is the preferred...... treatment. We compared mortality among (1) STEMI patients with single-vessel disease and those with multivessel disease and (2) multivessel disease patients with and without additional revascularization of nonculprit lesions within 2 months after the index PCI. METHODS: From January 2002 to June 2009, all...

  20. Value of additional cervicothoracic sagittal T2- weighted images in elderly patients with symptoms suggestive of lumbar spinal stenosis

    Park, Sung Hee; Ahn, Joong Mo; Lee, Joon Woo; Lee, Guen Young; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-07-15

    The purpose of this study was to analyze the incidence and predictive factors of tandem cervical spinal stenosis (CSS) in patients with lumbar spinal stenosis (LSS) based on MR. From January to May of 2011, 140 consecutive patients (36 men, 94 women; mean age, 68.9 years; age range, 60-87 years) were included for the analysis. All patients were at least 60 years old, had undergone lumbar spine MRI including additional cervicothoracic sagittal T2-weighted images, and were clinically suspected of LSS. Two spine radiologists evaluated the risk factors for CSS, considering the possible risk factors such as age, sex, alignment disorder of the lumbar spine, number of levels of LSS, and severity of LSS, based on MR. Of the 140 patients, 42 (30%) patients had tandem spinal stenosis. CSS was more common among patients with LSS (42 of 61, 69%) than among patients without LSS (27 of 79, 34%) (p = 0.000). Grade 2 or 3 CSS was more commonly observed among patients with grade 2 or 3 LSS (15 of 53, 28%), than among patients with grade 0 or 1 LSS (8 of 87, 9%) (p = 0.003). Only the severity of LSS showed a significant association with the severity of CSS (p = 0.045). Tandem CSS is common in LSS, and the severity of LSS is a risk factor of CSS.

  1. Value of additional cervicothoracic sagittal T2- weighted images in elderly patients with symptoms suggestive of lumbar spinal stenosis

    The purpose of this study was to analyze the incidence and predictive factors of tandem cervical spinal stenosis (CSS) in patients with lumbar spinal stenosis (LSS) based on MR. From January to May of 2011, 140 consecutive patients (36 men, 94 women; mean age, 68.9 years; age range, 60-87 years) were included for the analysis. All patients were at least 60 years old, had undergone lumbar spine MRI including additional cervicothoracic sagittal T2-weighted images, and were clinically suspected of LSS. Two spine radiologists evaluated the risk factors for CSS, considering the possible risk factors such as age, sex, alignment disorder of the lumbar spine, number of levels of LSS, and severity of LSS, based on MR. Of the 140 patients, 42 (30%) patients had tandem spinal stenosis. CSS was more common among patients with LSS (42 of 61, 69%) than among patients without LSS (27 of 79, 34%) (p = 0.000). Grade 2 or 3 CSS was more commonly observed among patients with grade 2 or 3 LSS (15 of 53, 28%), than among patients with grade 0 or 1 LSS (8 of 87, 9%) (p = 0.003). Only the severity of LSS showed a significant association with the severity of CSS (p = 0.045). Tandem CSS is common in LSS, and the severity of LSS is a risk factor of CSS

  2. Hypnosis as sole anaesthesia for skin tumour removal in a patient with multiple chemical sensitivity.

    Facco, E; Pasquali, S; Zanette, G; Casiglia, E

    2013-09-01

    A female patient with multiple chemical sensitivity and previous anaphylactoid reactions to local anaesthetics was admitted for removal of a thigh skin tumour under hypnosis as sole anaesthesia. The hypnotic protocol included hypnotic focused analgesia and a pre-operative pain threshold test. After inducing hypnosis, a wide excision was performed, preserving the deep fascia, and the tumour was removed; the patient's heart rate and blood pressure did not increase during the procedure. When the patient was de-hypnotised, she reported no pain and was discharged immediately. Our case confirms the efficacy of hypnosis and demonstrates that it may be valuable as a sole anaesthetic method in selected cases. Hypnosis can prevent pain perception and surgical stress as a whole, comparing well with anaesthetic drugs. PMID:23845031

  3. Capsaicin cough sensitivity is related to the older female predominant feature in chronic cough patients

    Song, Woo-Jung; Kim, Ju-Young; Jo, Eun-Jung; Lee, Seung-Eun; Kim, Min-Hye; Yang, Min-Suk; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Min, Kyung-Up

    2014-01-01

    Purpose The present study aimed to examine the age and gender distributions among chronic cough patients referred to a tertiary cough clinic in Korea, and to investigate clinical factors related to the demographic findings. Methods Study participants were unselectively recruited from adult chronic cough patients who attended the cough clinic for the first time during one year. To validate their representativeness, their age and gender distributions were compared to the entire chronic cough population, or with those presenting with other chronic disease. Data from the baseline investigations were analyzed to identify clinical factors related to the demographic findings. Results A total of 272 chronic cough patients were included. They had a middle-aged female predominant feature (mean age: 52.8±15.7 years and female 69.1%). Their age and gender distributions were almost identical to the entire chronic cough population, but were distinct from patients with hypertension. Among clinical factors, the older female predominance was associated with enhanced capsaicin cough sensitivity, and also with the presence of 'cough by cold air' symptom. Allotussia and laryngeal paresthesia were highly common in chronic cough patients, affecting 94.8% and 86.8% of them, respectively. Conclusions The present study demonstrated older female predominance among adult chronic cough patients attending a referral cough clinic in Korea. The demographic features were significantly associated with the capsaicin cough responses and also potentially with allotussia (particularly cold air as the trigger). These findings suggest a role of cough reflex sensitization in the pathophysiology of chronic cough in adults. PMID:25228996

  4. High-sensitivity C-reactive protein predicts mortality and technique failure in peritoneal dialysis patients.

    Shou-Hsuan Liu

    Full Text Available INTRODUCTION: An elevated level of serum C-reactive protein (CRP is widely considered an indicator of an underlying inflammatory disease and a long-term prognostic predictor for dialysis patients. This cross-sectional cohort study was designed to assess the correlation between the level of high-sensitivity CRP (HS-CRP and the outcome of peritoneal dialysis (PD patients. METHODS: A total of 402 patients were stratified into 3 tertiles (lower, middle, upper according to serum HS-CRP level and and followed up from October 2009 to September 2011. During follow-up, cardiovascular events, infection episodes, technique failure, and mortality rate were recorded. RESULTS: During the 24-month follow-up, 119 of 402 patients (29.6% dropped out from PD, including 28 patients (7.0% who died, 81 patients (20.1% who switched to hemodialysis, and 10 patients (2.5% who underwent kidney transplantation. The results of Kaplan-Meier analysis and log-rank test demonstrated a significant difference in the cumulative patient survival rate across the 3 tertiles (the lowest rate in upper tertile. On multivariate Cox regression analysis, only higher HS-CRP level, older age, the presence of diabetes mellitus (DM, lower serum albumin level, and the occurrence of cardiovascular events during follow-up were identified as independent predictors of mortality. Every 1 mg/L increase in HS-CRP level was independently predictive of a 1.4% increase in mortality. Multivariate Cox regression analysis also showed that higher HS-CRP level, the presence of DM, lower hemoglobin level, lower serum albumin level, higher dialysate/plasma creatinine ratio, and the occurrence of infective episodes and cardiovascular events during follow-up were independent predictors of technique failure. CONCLUSIONS: The present study shows the importance of HS-CRP in the prediction of 2-year mortality and technique survival in PD patients independent of age, diabetes, hypoalbuminemia, and the occurrence of

  5. Sensitization Profile to Allergens in Patients Using Multi-Test II

    Maniglia, Sergio Fabricio; Tsuru, Fernanda Miyoko; Santos, Victor Carvalho dos; Ueda, Denis Massatsugu

    2014-01-01

    Introduction Medical intervention in allergies has broadened its perspective, also focusing in the quality of life of patients. Patients are instructed, before using pharmacotherapy agents, to avoid the causal agent. Objective This study aims to analyze the sensitization profile of patients with allergic complaints and identify possible characteristics specific to each age group and gender. Methods A descriptive cross-sectional study included data collected from medical records (from Multi-Test II database, Lincoln Diagnostics Inc. Decatur, Illinois) of 1,912 patients who underwent skin prick test from March to October 2013. Patients were organized and analyzed according to gender, age, and results of the allergens subtypes tested. Results The study was composed of 1,912 patients (60% male and 40% female) of ages between 3 and 87 years. Positive tests were more prevalent in quantity and intensity with the mites Dermatophagoides pteronyssinus and Dermatophagoides farinae, each with 60% of the total analyzed. In second place were pollens, especially Dactylis glomerata and Festuca pratensis. Conclusion The female and male sexes were equally atopic. Fungi and epithelia of dog and cat were not considered potential aeroallergens that could cause symptoms. However, mites are common in Paraná, Brazil. Further studies regarding the pollens are needed, as this study result diverged from the literature. PMID:25992129

  6. Quantum enhancement of N-photon phase sensitivity by interferometric addition of down-converted photon pairs to weak coherent light

    It is shown that the addition of down-converted photon pairs to coherent laser light enhances the N-photon phase sensitivity due to the quantum interference between components of the same total photon number. Since most of the photons originate from the coherent laser light, this method of obtaining non-classical N-photon states is much more efficient than methods based entirely on parametrically down-converted photons. Specifically, it is possible to achieve an optimal phase sensitivity of about δφ2 = 1/N3/2, equal to the geometric mean of the standard quantum limit and the Heisenberg limit, when the average number of down-converted photons contributing to the N-photon state approaches √N/2

  7. Oral anticoagulation and the risk of stroke or death in patients with atrial fibrillation and one additional stroke risk factor

    Fauchier, Laurent; Lecoq, Coralie; Clementy, Nicolas; Bernard, Anne; Angoulvant, Denis; Ivanes, Fabrice; Babuty, Dominique; Lip, Gregory Y H

    2016-01-01

    Background: It remains uncertain whether patients with atrial fibrillation (AF) and a single additional stroke risk factor (CHA2DS2-VASc score = 1 in males, 2 in females) should be treated with oral anticoagulation (OAC). We investigated the risk of ischemic stroke, systemic embolism and death in...

  8. The prevalence of diabetic retinopathy in patients with screen-detected type 2 diabetes in Denmark: the ADDITION study

    Bek, Toke; Lund-Andersen, Henrik; Hansen, Anja Bech;

    2009-01-01

    BACKGROUND: The prevalence of type 2 diabetes is increasing, but the exact prevalence of the disease and its accompanying late complications are unknown. In the Anglo-Danish-Dutch study of Intensive Treatment in People with Screen-detected Diabetes in Primary Care (ADDITION study), patients with...

  9. Modified ultrafiltration for paediatric cardiac surgical patients:additional benefits and concerns

    Shahzad G.Raja

    2004-01-01

    @@ To the Editor: Ⅰ read with great interest the article by Huang et al1 and have a few comments which I am sure will not only substantiate the findings of the authors but will also give the readers additional information on use of modified ultrafiltration after paediatric cardiac surgery.

  10. Survey of patients' impressions of radiotherapy and their need for additional medical information. Japanese domestic survey of 1,529 patients in 2002

    We clarified the images, impressions, and information about radiotherapy in standard Japanese patients and, at the same time, investigated their need for information about radiotherapy, in order to identify what we, as radiation oncologists, should do to decrease patient anxiety and create good physician-patient relationships. We handed out 10 questionnaires to 1529 patients from April 2002 through July 2002 in 22 Japanese institutions that were equipped with radiotherapy machines. Questionnaires contained 10 items asking about patients' background, their impression of radiotherapy, frequency of exposure to information about radiotherapy, need to obtain information about radiotherapy, and ideal additional medical informational resources or their content. About 60% of patients had had the opportunity to obtain information about radiotherapy ''sometimes'' or ''often,'' but 80% of them were not satisfied with the availability of information and answered that it was inadequate. Ten percent responded that they had no idea about radiotherapy. Thirty percent felt unspecified anxiety concerning radiotherapy, and those who had less chance to be exposed to information about radiotherapy felt more anxiety than the others (33.2% vs. 25.2%, p=0.0008). The need for ''explanation and information about adverse effects'' was the top priority, followed by ''explanation of outcome''. Although they generally obtained information from their physician (radiation oncologist), they also wanted additional information via written media (662 patients, 43%). However, patients who were over 60 years old most wanted to obtain additional medical information directly from their own radiation oncologist (37.7%). Information about radiotherapy given to patients and the general public is still insufficient in Japan. To fully utilize radiotherapy, which is a very effective treatment option against cancer, and to reduce anxiety about radiotherapy among cancer patients, more information is necessary

  11. Additional drug resistance of multidrug-resistant tuberculosis in patients in 9 countries.

    Kurbatova, Ekaterina V; Dalton, Tracy; Ershova, Julia; Tupasi, Thelma; Caoili, Janice Campos; Van Der Walt, Martie; Kvasnovsky, Charlotte; Yagui, Martin; Bayona, Jaime; Contreras, Carmen; Leimane, Vaira; Via, Laura E; Kim, HeeJin; Akksilp, Somsak; Kazennyy, Boris Y; Volchenkov, Grigory V; Jou, Ruwen; Kliiman, Kai; Demikhova, Olga V; Cegielski, J Peter

    2015-06-01

    Data from a large multicenter observational study of patients with multidrug-resistant tuberculosis (MDR TB) were analyzed to simulate the possible use of 2 new approaches to treatment of MDR TB: a short (9-month) regimen and a bedaquiline-containing regimen. Of 1,254 patients, 952 (75.9%) had no resistance to fluoroquinolones and second-line injectable drugs and thus would qualify as candidates for the 9-month regimen; 302 (24.1%) patients with resistance to a fluoroquinolone or second-line injectable drug would qualify as candidates for a bedaquiline-containing regimen in accordance with published guidelines. Among candidates for the 9-month regimen, standardized drug-susceptibility tests demonstrated susceptibility to a median of 5 (interquartile range 5-6) drugs. Among candidates for bedaquiline, drug-susceptibility tests demonstrated susceptibility to a median of 3 (interquartile range 2-4) drugs; 26% retained susceptibility to <2 drugs. These data may assist national TB programs in planning to implement new drugs and drug regimens. PMID:25988299

  12. Is the addition of cisplatin to S-1 better than S-1 alone for patients with advanced gastroesophageal cancer?

    Ajani, Jaffer A

    2008-09-01

    The investigators of the recent phase III SPIRITS trial found that the addition of cisplatin to S-1 (a fourth generation oral fluoropyrimidine) provided a significant overall survival advantage (P = 0.04) over treatment with S-1 alone among previously untreated patients with advanced gastric cancer. In addition, the combination had an acceptable safety profile. This trial establishes a new first-line standard treatment for patients with advanced gastric cancer in Japan. Level 1 evidence for prolonged survival of patients with advanced gastroesophageal cancer has been established for docetaxel (V-325 trial) and cisplatin (SPIRITS trial) but not for S-1. Fluoropyrimidines (S-1 included) have been considered part of standard front-line therapy without the establishment of level 1 evidence for prolonging survival. The future lies in the rapid incorporation of biologic agents in combination with cytotoxics, with a continued focus on safety and convenience, and efforts to individualize therapy for each patient. Individualized therapy may be defined as the selection of optimum treatment for a specific patient on the basis of knowledge of the cancer's genetic and epigenetic alterations and the patient's genotype. PMID:18628737

  13. Improved foot sensitivity and pain reduction in patients with peripheral neuropathy after treatment with monochromatic infrared photo energy--MIRE.

    Harkless, Lawrence B; DeLellis, Salvatore; Carnegie, Dale H; Burke, Thomas J

    2006-01-01

    The medical records of 2239 patients (mean age=73 years) with established peripheral neuropathy (PN) were examined to determine whether treatment with MIRE was, in fact, associated with increased foot sensitivity to the Semmes Weinstein monofilament (SWM) 5.07 and a reduction in neuropathic pain. The PN in 1395 of these patients (62%) was due to diabetes. Prior to treatment with MIRE, of the 10 tested sites (5 on each foot), 7.1+/-2.9 were insensitive to the SWM 5.07, and 2078 patients (93%) exhibited loss of protective sensation defined by Medicare as a loss of sensation at two or more sites on either foot. After treatment, the number of insensate sites on both feet decreased to 2.4+/-2.6, an improvement of 66%. Of the 2078 (93%) patients initially presenting with loss of protective sensation, 1106 (53%) no longer had loss of protective sensation after treatment (P<.0001); 1563 patients (70%) also exhibited neuropathic pain in addition to sensory impairment. Prior to treatment with MIRE, pain measured on the 11-point visual analogue scale (VAS) was 7.2+/-2.2 points, despite the use of a variety of pain-relieving therapeutic agents. After treatment with MIRE, pain was reduced by 4.8+/-2.4 points, a 67% reduction. Therefore, MIRE appears to be associated with significant clinical improvement in foot sensation and, simultaneously, a reduction in neuropathic pain in a large cohort of primarily Medicare aged, community-dwelling patients, initially diagnosed with PN. The quality of life associated with these two outcomes cannot be underappreciated. PMID:16504836

  14. Does progressive resistance strength training as additional training have any measured effect on functional outcomes in older hospitalized patients?

    Tibaek, Sigrid; Andersen, Christina W.; Pedersen, Sigrid F;

    2014-01-01

    OBJECTIVE: To evaluate the effect of progressive resistance strength training as additional training measured on functional outcomes in older hospitalized patients. DESIGN: A single-blinded randomized controlled trial. SETTING: Department of Geriatric Rehabilitation in university hospital...... treatment group were treated in groups with progressive resistance strength training in addition to standard care. Progressive resistance strength training of the lower extremities was performed in three sets of 12-15 repetitions, intensity 60-70% of one repetition maximum, in four 50-minute sessions per...... = 0.05). Analysis by the mixed-effects model showed that the treatment group improved more than the control group in all outcome variables. CONCLUSION: The results indicate that for older hospitalized patients progressive resistance strength training as additional training may have an effect compared...

  15. Association of exercise therapy and reduction of pain sensitivity in patients with knee osteoarthritis

    Henriksen, Marius; Klokker, Louise; Graven-Nielsen, Thomas;

    2014-01-01

    , participants were assigned to 12 weeks of supervised exercise therapy (ET; 36 sessions) or a no attention control group (CG). Pressure-pain sensitivity was assessed by cuff pressure algometry on the calf of the most symptomatic leg. The coprimary outcomes were pressure-pain thresholds (PPTs) and cumulated......OBJECTIVE: Exercise has beneficial effects on pain in knee osteoarthritis (OA), yet the underlying mechanisms are unclear. The purpose of this study was to investigate the effects of exercise on pressure-pain sensitivity in patients with knee OA. METHODS: In a randomized controlled trial...... visual analog scale pain scores during constant pressure for 6 minutes at 125% of the PPT as a measure of temporal summation (TS) of pressure-pain. Secondary outcomes included self-reported pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Analyses were based on the "per...

  16. Does addition of `mud-pack and hot pool treatment' to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study

    Bağdatlı, Ali Osman; Donmez, Arif; Eröksüz, Rıza; Bahadır, Güler; Turan, Mustafa; Erdoğan, Nergis

    2015-12-01

    The aim of this randomized controlled single-blind study is to explore whether addition of mud-pack and hot pool treatments to patient education make a significant difference in short and mild term outcomes of the patients with fibromyalgia. Seventy women with fibromyalgia syndrome were randomly assigned to either balneotherapy with mud-pack and hot pool treatments (35) or control (35) groups. After randomization, five patients from balneotherapy group and five patients from control group were dropped out from the study with different excuses. All patients had 6-h patient education programme about fibromyalgia syndrome and were given a home exercise programme. The patients in balneotherapy group had heated pool treatment at 38 °C for 20 min a day, and mud-pack treatment afterwards on back region at 45 °C. Balneotherapy was applied on weekdays for 2 weeks. All patients continued to take their medical treatment. An investigator who was blinded to the intervention assessed all the patients before and after the treatment, at the first and the third months of follow-up. Outcome measures were FIQ, BDI and both patient's and physician's global assessments. Balneotherapy group was significantly better than control group at after the treatment and at the end of the first month follow-up assessments in terms of patient's and physician's global assessment, total FIQ score, and pain intensity, fatigue, non-refreshed awaking, stiffness, anxiety and depression subscales of FIQ. No significant difference was found between the groups in terms of BDI scores. It is concluded that patient education combined with 2 weeks balneotherapy application has more beneficial effects in patients with fibromyalgia syndrome as compared to patient education alone.

  17. Challenges to culturally sensitive care for elderly chinese patients: a first-generation Chinese-American perspective.

    Chan, Karen C

    2013-01-01

    Physicians and medical institutions in the United States are placing increasing emphasis on providing culturally sensitive care for patients, such as implementing a Confucian family-based model of medical decision making when caring for elderly Chinese patients. In this article, I articulate various reasons why deferring to the family is not a guarantee of culturally sensitive care, particularly when family members are first-generation Chinese-Americans. Nonetheless, I offer several suggestions to help physicians, medical institutions, and family members to provide more culturally sensitive care for elderly Chinese patients. PMID:24597422

  18. Low whole-body insulin sensitivity in patients with ischaemic heart disease is associated with impaired myocardial glucose uptake predictive of poor outcome after revascularisation

    We tested the hypothesis that low whole-body insulin sensitivity in patients with ischaemic heart disease and impaired left ventricular (LV) function is associated with abnormalities of insulin-mediated myocardial glucose uptake affecting outcome after coronary bypass surgery (CABG). We studied 29 patients with ischaemic heart disease and impaired LV ejection fraction (EF) and age-matched healthy volunteers (n=30). As assessed by euglycaemic glucose-insulin clamp, 15 patients had a low and 14 a normal whole-body insulin sensitivity. Using positron emission tomography, patterns of fluorine-18 fluorodeoxyglucose and nitrogen-13 ammonia uptake in addition to quantified glucose uptake, blood flow and hyperaemic blood flow were assessed before CABG in 16 myocardial segments of the left ventricle. Major adverse cardiac events and LVEF were evaluated 7 months after CABG. Glucose uptake in normokinetic PET-normal myocardium was found to be higher in patients with normal whole-body insulin sensitivity (P<0.001), whereas in patients with low whole-body insulin sensitivity more segments displayed a pattern of reduced glucose uptake in normoperfused myocardium (PET-reverse mismatch) (P<0.05). Hyperaemic blood flow was impaired in both patient groups. A major cardiac event after CABG could partly be predicted by the LV extent of normoperfused segments with PET-reverse mismatch. We conclude that low whole-body insulin sensitivity in patients with ischaemic heart disease and impaired LV function is associated with impaired insulin-mediated myocardial glucose uptake, which is partially predictive of a worse outcome after CABG. (orig.)

  19. Is this a reflux patient or is it a patient with functional dyspepsia with additional reflux symptoms?

    Funch-Jensen, P

    1995-01-01

    complications. The therapeutic goals in GORD are symptom relief, healing of lesions, prevention of complications, and omittance of adverse effects at the lowest possible costs. Patients with functional dyspepsia usually have symptoms of less severe intensity and as, per definition, no organic substrate is...... functional dyspepsia is less documented and in most studies the symptomatic pattern could not predict the pharmacologic principle of clinical benefit. This may be because a separation between presence of symptoms and presence of symptoms as a major problem has not been taken into account. Cisapride is the...

  20. The sensitivity of patient specific IMRT QC to systematic MLC leaf bank offset errors

    Purpose: Patient specific IMRT QC is performed routinely in many clinics as a safeguard against errors and inaccuracies which may be introduced during the complex planning, data transfer, and delivery phases of this type of treatment. The purpose of this work is to evaluate the feasibility of detecting systematic errors in MLC leaf bank position with patient specific checks. Methods: 9 head and neck (H and N) and 14 prostate IMRT beams were delivered using MLC files containing systematic offsets (±1 mm in two banks, ±0.5 mm in two banks, and 1 mm in one bank of leaves). The beams were measured using both MAPCHECK (Sun Nuclear Corp., Melbourne, FL) and the aS1000 electronic portal imaging device (Varian Medical Systems, Palo Alto, CA). Comparisons with calculated fields, without offsets, were made using commonly adopted criteria including absolute dose (AD) difference, relative dose difference, distance to agreement (DTA), and the gamma index. Results: The criteria most sensitive to systematic leaf bank offsets were the 3% AD, 3 mm DTA for MAPCHECK and the gamma index with 2% AD and 2 mm DTA for the EPID. The criterion based on the relative dose measurements was the least sensitive to MLC offsets. More highly modulated fields, i.e., H and N, showed greater changes in the percentage of passing points due to systematic MLC inaccuracy than prostate fields. Conclusions: None of the techniques or criteria tested is sufficiently sensitive, with the population of IMRT fields, to detect a systematic MLC offset at a clinically significant level on an individual field. Patient specific QC cannot, therefore, substitute for routine QC of the MLC itself.

  1. Kidney bean: a major sensitizer among legumes in asthma and rhinitis patients from India.

    Ramkrashan Kasera

    Full Text Available BACKGROUND: The prevalence of IgE mediated food allergies has increased over the last two decades. Food allergy has been reported to be fatal in highly sensitive individuals. Legumes are important food allergens but their prevalence may vary among different populations. The present study identifies sensitization to common legumes among Indian population, characterizes allergens of kidney bean and establishes its cross reactivity with other legumes. METHODOLOGY: Patients (n = 355 with history of legume allergy were skin prick tested (SPT with 10 legumes. Specific IgE (sIgE and total IgE were estimated in sera by enzyme-linked immunosorbent assay. Characterization of kidney bean allergens and their cross reactivity was investigated by immunobiochemical methods. Identification of major allergens of kidney bean was carried out by mass spectrometry. PRINCIPAL FINDINGS: Kidney bean exhibited sensitization in 78 (22.0% patients followed by chickpea 65 (18.0% and peanut 53 (15%. SPT positive patients depicted significantly elevated sIgE levels against different legumes (r = 0.85, p<0.0001. Sera from 30 kidney bean sensitive individuals exhibited basophil histamine release (16-54% which significantly correlated with their SPT (r = 0.83, p<0.0001 and sIgE (r = 0.99, p<0.0001. Kidney bean showed eight major allergens of 58, 50, 45, 42, 40, 37, 34 and 18 kDa on immunoblot and required 67.3±2.51 ng of homologous protein for 50% IgE inhibition. Inhibition assays revealed extensive cross reactivity among kidney bean, peanut, black gram and pigeon pea. nLC-MS/MS analysis identified four allergens of kidney bean showing significant matches with known proteins namely lectin (phytohemagglutinin, phaseolin, alpha-amylase inhibitor precursor and group 3 late embryogenesis abundant protein. CONCLUSION/SIGNIFICANCE: Among legumes, kidney bean followed by chick pea and peanut are the major allergic triggers in asthma and rhinitis patients in India

  2. Pain sensitivity and tactile spatial acuity are altered in healthy musicians as in chronic pain patients.

    Anna M. eZamorano

    2015-01-01

    Full Text Available Extensive training of repetitive and highly skilled movements, as it occurs in professional classical musicians, may lead to changes in tactile sensitivity and corresponding cortical reorganization of somatosensory cortices. It is also known that professional musicians frequently experience musculoskeletal pain and pain-related symptoms during their careers. The present study aimed at understanding the complex interaction between chronic pain and music training with respect to somatosensory processing. For this purpose, tactile thresholds (mechanical detection, grating orientation, two-point discrimination and subjective ratings to thermal and pressure pain stimuli were assessed in 17 professional musicians with chronic pain, 30 pain-free musicians, 20 non-musicians with chronic pain, and 18 pain-free non-musicians. We found that pain-free musicians displayed greater touch sensitivity (i.e. lower mechanical detection thresholds, lower tactile spatial acuity (i.e., higher grating orientation thresholds and increased pain sensitivity to pressure and heat compared to pain-free non-musicians. Moreover, we also found that musicians and non-musicians with chronic pain presented lower tactile spatial acuity and increased pain sensitivity to pressure and heat compared to pain-free non-musicians. The significant increment of pain sensitivity together with decreased spatial discrimination in pain-free musicians and the similarity of results found in chronic pain patients, suggests that the extensive training of repetitive and highly skilled movements in classical musicians could be considered as a risk factor for developing chronic pain, probably due to use-dependent plastic changes elicited in somatosensory pathways.

  3. Influence of zinc additions on the intergranular stress corrosion crack initiation and growth of sensitized stainless steel in high temperature water

    Previous studies have shown the beneficial influence of Zn in lowering the radiation buildup in boiling water reactor (BWR) primary systems. Here the effect of fumed zinc oxide additions on the stress corrosion crack initiation and growth of sensitized type 304 stainless steel (SS) were studied in 550 F water containing various amounts of dissolved oxygen. The addition of zinc at levels varying from 3 ppb to 100 ppb showed some benefit in mitigating both crack initiation and growth. Depending on the type of test used, the degree of benefit appear to vary in the broad range from 25 to 55%. The data show that a considerable benefit can be derived by reducing the electrochemical corrosion potential (ECP) of type 304 SS to < -0.110 V (SHE)

  4. Mild obstructive sleep apnea does not modulate baroreflex sensitivity in adult patients

    Blomster, Henry; Laitinen, Tomi P; Hartikainen, Juha EK; Laitinen, Tiina M; Vanninen, Esko; Gylling, Helena; Sahlman, Johanna; Kokkarinen, Jouko; Randell, Jukka; Seppä, Juha; Tuomilehto, Henri

    2015-01-01

    Background Obstructive sleep apnea (OSA) is a chronic and progressive disease. OSA is associated with increased cardiovascular morbidity and mortality, the risk being more frequently encountered with severe degrees of OSA. Increased sympathetic activation and impaired cardiac autonomic control as reflected by depressed baroreceptor reflex sensitivity (BRS) are possible mechanisms involved in the cardiovascular complications of OSA. However, it is not known at what stage of OSA that changes in BRS appear. The aim of this study was to evaluate BRS in patients with mild OSA. Methods The study population consisted of 81 overweight patients with mild OSA and 46 body weight-matched non-OSA subjects. BRS, apnea-hypopnea index, body mass index, and metabolic parameters were assessed. The phenylephrine test was used to measure BRS. Results Patients in the OSA group were slightly but significantly older than the non-OSA population (50.3±9.3 years vs 45.7±11.1 years, P=0.02). Body mass index, percentage body fat, blood pressure, fasting glucose, insulin, and lipid levels did not differ between the OSA patients and non-OSA subjects. Absolute BRS values in patients with mild OSA and non-OSA subjects (9.97±6.70 ms/mmHg vs 10.51±7.16 ms/mmHg, P=0.67) and BRS values proportional to age-related and sex-related reference values (91.4%±22.7% vs 92.2%±21.8%, P=0.84) did not differ from each other. BRS <50% of the sex-specific reference value was found in 6% of patients with mild OSA and in 2% of non-OSA subjects (P=0.29). Conclusion Patients with mild OSA did not show evidence of disturbed BRS in comparison with weight-matched non-OSA controls. PMID:26203292

  5. Whole-Body Magnetic Resonance Angiography with Additional Steady-State Acquisition of the Infragenicular Arteries in Patients with Peripheral Arterial Disease

    The purpose of this investigation was to determine if addition of infragenicular steady-state (SS) magnetic resonance angiography (MRA) to first-pass imaging improves diagnostic performance compared with first-pass imaging alone in patients with peripheral arterial disease (PAD) undergoing whole-body (WB) MRA. Twenty consecutive patients with PAD referred to digital-subtraction angiography (DSA) underwent WB-MRA. Using a bolus-chase technique, first-pass WB-MRA was performed from the supra-aortic vessels to the ankles. The blood-pool contrast agent gadofosveset trisodium was used at a dose of 0.03 mmol/kg body weight. Ten minutes after injection of the contrast agent, high-resolution (0.7-mm isotropic voxels) SS-MRA of the infragenicular arteries was performed. Using DSA as the 'gold standard,' sensitivities and specificities for detecting significant arterial stenoses (≥50% luminal narrowing) with first-pass WB-MRA, SS-MRA, and combined first-pass and SS-MRA were calculated. Kappa statistics were used to determine intermodality agreement between MRA and DSA. Overall sensitivity and specificity for detecting significant arterial stenoses with first-pass WB-MRA was 0.70 (95% confidence interval 0.61 to 0.78) and 0.97 (0.94 to 0.99), respectively. In first-pass WB-MRA, the lowest sensitivity was in the infragenicular region, with a value of 0.42 (0.23 to 0.63). Combined analysis of first-pass WB-MRA and SS-MRA increased sensitivity to 0.81 (0.60 to 0.93) in the infragenicular region, with specificity of 0.94 (0.88 to 0.97). Sensitivity and specificity for detecting significant arterial stenoses with isolated infragenicular SS-MRA was 0.47 (0.27 to 0.69) and 0.86 (0.78 to 0.91), respectively. Intermodality agreement between MRA and DSA in the infragenicular region was moderate for first-pass WB-MRA (κ = 0.49), fair for SS-MRA (κ = 0.31), and good for combined first-pass/SS-MRA (κ = 0.71). Addition of infragenicular SS-MRA to first-pass WB MRA improves diagnostic

  6. Cognitive-emotional sensitization contributes to wind-up-like pain in phantom limb pain patients

    Vase, Lene; Nikolajsen, Lone; Christensen, Bente;

    2011-01-01

    Peripheral mechanisms are known to play a role in phantom pain following limb amputation, and more recently it has been suggested that central mechanisms may also be of importance. Some patients seem to have a psychological sensitivity that predisposes them to react with pain catastrophizing after...... amputation of a limb, and this coping style may contribute to increased facilitation, impaired modulation of nociceptive signals, or both. To investigate how pain catastrophizing, independently of anxiety and depression, may contribute to phantom limb pain and to alterations in pain processing twenty......-four upper-limb amputees with various levels of phantom limb pain were included in the study. Patients' level of pain catastrophizing, anxiety and depression was assessed and they went through quantitative sensory testing (QST) of thresholds (mechanical and thermal) and wind-up-like pain (brush and pinprick...

  7. Mild obstructive sleep apnea does not modulate baroreflex sensitivity in adult patients

    Blomster H

    2015-06-01

    Full Text Available Henry Blomster,1 Tomi P Laitinen,2 Juha EK Hartikainen,3,6 Tiina M Laitinen,2 Esko Vanninen,2 Helena Gylling,4,8 Johanna Sahlman,1 Jouko Kokkarinen,5 Jukka Randell,5 Juha Seppä,1 Henri Tuomilehto4,7 1Department of Otorhinolaryngology, Institute of Clinical Medicine, 2Department of Clinical Physiology and Nuclear Medicine, 3Department of Internal Medicine, 4Department of Clinical Nutrition, School of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 5Department of Respiratory Medicine, 6Heart Center, Kuopio University Hospital, 7Oivauni Sleep Clinic, Kuopio, 8Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland Background: Obstructive sleep apnea (OSA is a chronic and progressive disease. OSA is associated with increased cardiovascular morbidity and mortality, the risk being more frequently encountered with severe degrees of OSA. Increased sympathetic activation and impaired cardiac autonomic control as reflected by depressed baroreceptor reflex sensitivity (BRS are possible mechanisms involved in the cardiovascular complications of OSA. However, it is not known at what stage of OSA that changes in BRS appear. The aim of this study was to evaluate BRS in patients with mild OSA. Methods: The study population consisted of 81 overweight patients with mild OSA and 46 body weight-matched non-OSA subjects. BRS, apnea-hypopnea index, body mass index, and metabolic parameters were assessed. The phenylephrine test was used to measure BRS. Results: Patients in the OSA group were slightly but significantly older than the non-OSA population (50.3±9.3 years vs 45.7±11.1 years, P=0.02. Body mass index, percentage body fat, blood pressure, fasting glucose, insulin, and lipid levels did not differ between the OSA patients and non-OSA subjects. Absolute BRS values in patients with mild OSA and non-OSA subjects (9.97±6.70 ms/mmHg vs 10.51±7.16 ms/mmHg, P=0.67 and BRS values proportional

  8. Evaluation of possible factors affecting contrast sensitivity function in patients with primary Sjögren’s syndrome

    Sedat Arikan

    2015-06-01

    Full Text Available ABSTRACT Purpose: The contrast sensitivity (CS function in patients with primary Sjögren’s syndrome (pSS may be impaired either frequently as a result of dry eye diseases or rarely as a result of optic neuropathy. In this study, we aimed to evaluate the CS function in pSS patients as well as to assess corneal aberrations and thickness of the peripapillary retinal nerve fiber layer (pRNFL. Methods: Fourteen eyes of 14 pSS patients (pSS group and 14 eyes of 14 healthy participants (control group were subjected to assessment of CS at the spatial frequencies of 1.5, 3.0, 6.0, 12, and 18 cycles/degree (cpd using a functional visual acuity contrast test (FACT; measurement of corneal high-order aberrations (HOAs in terms of coma-like, spherical-like, and total HOAs using Scheimpflug corneal topography; and measurement of the thickness of both the macular ganglion cell-inner plexiform layer (mGCIPL and pRNFL in all quadrants using optical coherence tomography. None of the participants were under treatment with artificial tears. Results: The results of the CS test did not differ between the 2 groups at all spatial frequencies (p>0.05. In addition, there were no statistically significant differences between the 2 groups in terms of corneal HOAs (p>0.05 and thickness of mGCIPL (p>0.05. However, among all quadrants, only the inferior quadrant of pRNFL in pSS patients was statistically significantly thinner than that in the healthy participants (p=0.04. Conclusions: The CS function in pSS patients can be maintained with normal thickness of both pRNFL and mGCIPL and with lack of increased corneal HOAs, which may be present even in the absence of artificial tear usage.

  9. Additional genetic abnormalities significantly worsen poor prognosis associated with 1q21 amplification in multiple myeloma patients.

    Grzasko, Norbert; Hus, Marek; Pluta, Andrzej; Jurczyszyn, Artur; Walter-Croneck, Adam; Morawska, Marta; Chocholska, Sylwia; Hajek, Roman; Dmoszynska, Anna

    2013-03-01

    We investigated the prognostic value of amp(1q21) alone and in combination with other abnormalities in newly diagnosed myeloma patients. The study group consisted of 104 patients treated with various induction regimens, mostly thalidomide based (87 patients). Amp(1q21) was detected in 49 (47.1%) of patients; in 26 (25.0%) cases, it was combined with del(13q14), in 7 (6.7%) with del(17p13) and in 15 (14.4%) with t(4;14)(p16;q32). The response rate was significantly better in amp(1q21)-negative than in amp(1q21)-positive patients (74.5% vs 55.1%, p = 0.025; complete response 18.2% vs 4.1%, p = 0.024). The median progression-free survival (PFS) was 33.9 months in patients without amp(1q21) and 10.3 months with this aberration (p = 0.002). The presence of additional abnormalities resulted in significantly shortened PFS when compared with patients with isolated amp(1q21): coexisting del(13q14) resulted in 7.8 vs 29.0 months of PFS (p = 0.024) and del(17p13) resulted in 4.0 vs 24.9 months of PFS (p = 0.034). The presence of amp(1q21) significantly influenced overall survival (OS) as well as PFS resulting in the median OS of 26.6 vs 62.4 months (p = 0.018) in patients without amp(1q21). The presence of additional genetic abnormalities significantly affected OS when compared with patients carrying isolated amp(1q21): for del(13q14) 18.9 vs 58.4 months (p = 0.004) and for del(17p13) 12.0 vs 46.5 months (p = 0.036). On multivariate analysis amp(1q21), del(13q14) and del(17p13) were found to be an independent adverse predictors of shorter PFS and OS. Our results showed that the presence of amp(1q21) was associated with poor prognosis. Moreover additional genetic abnormalities made PFS and OS further shortened. PMID:22674819

  10. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions

    Hopkinson Linda C

    2005-02-01

    Full Text Available Abstract Background Multiple studies have linked fungal exposure to asthma, but the link to severe asthma is controversial. We studied the relationship between asthma severity and immediate type hypersensitivity to mold (fungal and non-mold allergens in 181 asthmatic subjects. Methods We recruited asthma patients aged 16 to 60 years at a University hospital and a nearby General Practice. Patients were categorized according to the lifetime number of hospital admissions for asthma (82 never admitted, 53 one admission, 46 multiple admissions. All subjects had allergy skin prick tests performed for 5 mold allergens (Aspergillus, Alternaria, Cladosporium, Penicillium and Candida and 4 other common inhalant allergens (D. pteronyssinus, Grass Pollen, Cat and Dog. Results Skin reactivity to all allergens was commonest in the group with multiple admissions. This trend was strongest for mold allergens and dog allergen and weakest for D. pteronyssinus. 76% of patients with multiple admissions had at least one positive mold skin test compared with 16%-19% of other asthma patients; (Chi squared p Conclusion These findings support previous suggestions that mold sensitization may be associated with severe asthma attacks requiring hospital admission.

  11. Sensitive Patient Data Hiding using a ROI Reversible Steganography Scheme for DICOM Images.

    Mantos, Petros L K; Maglogiannis, Ilias

    2016-06-01

    The exchange of medical images over the Internet has evoked significant interest over the past few years due to the introduction of web and cloud based medical information systems. The protection of sensitive data has always been a key indicator in the performance of such systems. In this context, this work presents an algorithm developed for Digital Imaging and Communications in Medicine (DICOM) medical images, which applies secret-sharing steganography methods for ensuring the integrity of sensitive patient data as well as the important parts of the image. In the proposed algorithm, images are divided into two parts: the region of interest (ROI) and the region of non interest (RONI). Patient data and integrity hashes are positioned inside the ROI while the information (map) needed to recover the ROI before insertion is positioned in the RONI. Security of the extraction process is assured through the use of cryptography. The experimental results prove that the original (cover) images and the stego images provide an excellent visual equality result in terms of PSNR. Furthermore, they prove that the proposed scheme can be efficiently used as a steganography scheme in DICOM images with limited smooth areas. PMID:27167526

  12. Comparison of Mean Contrast Sensitivity Results of LASIK and LASEK in Patients with Myopia and Myopic Astigmatism

    Okan Taşkın; Zeynep Özbek

    2014-01-01

    Objectives: To compare LASIK and LASEK for the correction of myopia and myopic astigmatism in terms of contrast sensitivity. Materials and Methods: Sixty eyes of 30 patients who underwent LASIK and 60 eyes of 30 patients who underwent LASEK for myopia and myopic astigmatism at the Excimer Laser Center of Dokuz Eylül University, Faculty of Medicine, were included in this study. Mean best-corrected contrast sensitivity values were noted before surgery. Mean uncorrected contrast sensiti...

  13. Influence of NH{sub 3}.H{sub 2}O additive on the photovoltaic performance of dye-sensitized solar cells with chemical sintered scattering layers

    Lan Zhang, E-mail: lanzhang@hqu.edu.cn [Engineering Research Center of Environment-Friendly Functional Materials, Ministry of Education, Huaqiao University, Quanzhou 362021 (China); Key Laboratory of Functional Materials for Fujian Higher Education, Huaqiao University, Quanzhou 362021 (China); Institute of Materials Physical Chemistry, Huaqiao University, Quanzhou 362021 (China); Wu Jihuai, E-mail: jhwu@hqu.edu.cn [Engineering Research Center of Environment-Friendly Functional Materials, Ministry of Education, Huaqiao University, Quanzhou 362021 (China); Key Laboratory of Functional Materials for Fujian Higher Education, Huaqiao University, Quanzhou 362021 (China); Institute of Materials Physical Chemistry, Huaqiao University, Quanzhou 362021 (China); Lin Jianming; Huang, Miaoliang [Engineering Research Center of Environment-Friendly Functional Materials, Ministry of Education, Huaqiao University, Quanzhou 362021 (China); Key Laboratory of Functional Materials for Fujian Higher Education, Huaqiao University, Quanzhou 362021 (China); Institute of Materials Physical Chemistry, Huaqiao University, Quanzhou 362021 (China)

    2011-11-30

    Graphical abstract: Chemical sintered bi-functional nanocrystalline TiO{sub 2} layers for highly efficient photoelectrodes. Display Omitted Highlights: > A chemical sintered bi-functional nanocrystalline TiO{sub 2} layer was prepared. > The nanocrystalline TiO{sub 2} layer can offer both light-scattering and electron generating properties. > The DSSC with this nanocrystalline TiO{sub 2} layer in the photoelectrode shows obviously enhanced photovoltaic performance. > The influence of additional amount of NH{sub 3}.H{sub 2}O chemical sintering agent on the photovoltaic performance of DSSCs was studied. - Abstract: A bi-functional nanocrystalline TiO{sub 2} (nc-TiO{sub 2}) layer able to offer both light-scattering and electron generating properties was prepared with a simple method through adding the basic NH{sub 3}.H{sub 2}O agent into an acid nc-TiO{sub 2} paste to form some big rod-like nc-TiO{sub 2} aggregates by the chemical sintering process. The influence of additional amount of NH{sub 3}.H{sub 2}O on the photovoltaic performance of the dye-sensitized solar cell with this bi-functional nc-TiO{sub 2} layer in the photoelectrode was studied. It was found that through controlling the additional amount of NH{sub 3}.H{sub 2}O and the thickness of the bi-functional nc-TiO{sub 2} layer, the highest energy conversion efficiency about 8.11% could be obtained, which was much higher than that of the dye-sensitized solar cell containing a single nc-TiO{sub 2} layer prepared with the original acid nc-TiO{sub 2} paste (4.34%).

  14. Influence of NH3.H2O additive on the photovoltaic performance of dye-sensitized solar cells with chemical sintered scattering layers

    Graphical abstract: Chemical sintered bi-functional nanocrystalline TiO2 layers for highly efficient photoelectrodes. Display Omitted Highlights: → A chemical sintered bi-functional nanocrystalline TiO2 layer was prepared. → The nanocrystalline TiO2 layer can offer both light-scattering and electron generating properties. → The DSSC with this nanocrystalline TiO2 layer in the photoelectrode shows obviously enhanced photovoltaic performance. → The influence of additional amount of NH3.H2O chemical sintering agent on the photovoltaic performance of DSSCs was studied. - Abstract: A bi-functional nanocrystalline TiO2 (nc-TiO2) layer able to offer both light-scattering and electron generating properties was prepared with a simple method through adding the basic NH3.H2O agent into an acid nc-TiO2 paste to form some big rod-like nc-TiO2 aggregates by the chemical sintering process. The influence of additional amount of NH3.H2O on the photovoltaic performance of the dye-sensitized solar cell with this bi-functional nc-TiO2 layer in the photoelectrode was studied. It was found that through controlling the additional amount of NH3.H2O and the thickness of the bi-functional nc-TiO2 layer, the highest energy conversion efficiency about 8.11% could be obtained, which was much higher than that of the dye-sensitized solar cell containing a single nc-TiO2 layer prepared with the original acid nc-TiO2 paste (4.34%).

  15. Do patients with a limited number of brain metastases need whole-brain radiotherapy in addition to radiosurgery?

    Background: About 40% of patients with brain metastases have a very limited number of lesions and may be candidates for radiosurgery. Radiosurgery alone is superior to whole-brain radiotherapy (WBRT) alone for control of treated and new brain metastases. In patients with a good performance status, radiosurgery also resulted in better survival. However, the question is whether the results of radiosurgery alone can be further improved with additional WBRT. Methods: Information for this review was compiled by searching the PubMed and MEDLINE databases. Very important published meeting abstracts were also considered. Results: Based on both retrospective and prospective studies, the addition of WBRT to radiosurgery improved control of treated and new brain metastases but not survival. However, because a recurrence within the brain has a negative impact on neurocognitive function, it is important to achieve long-term control of brain metastases. Conclusion: The addition of WBRT provides significant benefits. Further randomized studies including adequate assessment of neurocognitive function and a follow-up period of at least 2 years are needed to help customize the treatment for individual patients. (orig.)

  16. Deficient Expression of Aldehyde Dehydrogenase 1A1 Is Consistent with Increased Sensitivity of Gorlin Syndrome Patients to Radiation Carcinogenesis

    Wright, Aaron T.; Magnaldo, Thierry; Sontag, Ryan L.; Anderson, Lindsey N.; Sadler, Natalie C.; Piehowski, Paul D.; Gache, Yannick; Weber, Thomas J.

    2015-06-01

    Human phenotypes that are highly susceptible to radiation carcinogenesis have been identified. Sensitive phenotypes often display robust regulation of molecular features that modify biological response, which can facilitate identification of relevant pathways/networks. Here we interrogate primary dermal fibroblasts isolated from Gorlin syndrome patients (GDFs), who display a pronounced tumorigenic response to radiation, in comparison to normal human dermal fibroblasts (NHDFs). Our approach exploits newly developed thiol-reactive probes with a flexible click chemistry functional group to define changes in protein thiol profiles in live cell studies, which minimizes artifacts associated with cell lysis. We observe qualitative differences in protein thiol profiles by SDS-PAGE analysis when detection by iodoacetamide vs maleimide probe chemistries are compared, and pretreatment of cells with hydrogen peroxide eliminates detection of the majority of SDS-PAGE bands. Redox probes revealed deficient expression of an apparent 55 kDa protein thiol in GDFs from independent donors, compared with NHDFs. Proteomics tentatively identified this protein as aldehyde dehydrogenase 1A1 (ALDH1A1), a key enzyme regulating retinoic acid synthesis, and this deficiency was confirmed by Western blot. Redox probes revealed additional protein thiol differences between GDFs and NHDFs, including radiation responsive annexin family members. Our results indicate a multifactorial basis for the unusual sensitivity of Gorlin syndrome to radiation carcinogenesis, and the pathways identified have plausible implications for radiation health effects.

  17. Malignant focal hepatic lesions complicating underlying liver disease: dual-phase contrast-enhanced spiral CT sensitivity and specificity in orthotopic liver transplant patients

    The aim of this study was to determine the accuracy of contrast-enhanced biphasic spiral CT as a screening tool in the preoperative evaluation of orthotopic liver transplant (OLT) patients. Spiral-CT examinations were performed before liver transplantation in 53 patients. Scans were retrospectively reviewed and compared with pathologic findings in fresh-sectioned livers. When findings between spiral CT and pathology were discordant, formalized livers were reexamined with lesion-by lesion evaluation. Fresh pathologic evaluation revealed 23 liver lesions (16 HCC, 7 macro-regenerative nodules). Malignancy was identified in 13 of 53 patients (24.5%). Pre-transplantation spiral CT depicted 27 liver lesions (23 HCC, 4 macro-regenerative nodules). Malignancy was suspected in 14 patients (26.4%). In 10 of 53 (18.9%), spiral CT and pathologic evaluation were discordant. Subsequent retrospective pathologic evaluation showed malignancy in 4 additional patients. Spiral CT compared with the retrospective pathologic findings revealed 36 real-negative, 14 real-positive, 0 false-positive, and 3 false-negative patients with malignancy. Sensitivity and specificity of spiral CT in detection of malignancy was 82 and 100%, respectively. Contrast-enhanced biphasic spiral CT is an accurate technique in the evaluation of patients preceding OLT. Routine fresh-sectioned liver pathologic findings are not as sensitive as previously estimated. (orig.)

  18. Malignant focal hepatic lesions complicating underlying liver disease: dual-phase contrast-enhanced spiral CT sensitivity and specificity in orthotopic liver transplant patients

    Mortele, K.J. [Dept. of Radiology, University Hospital Gent (Belgium); Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 (United States); De Keukeleire, K. [Dept. of Radiology, University Hospital Gent (Belgium); Praet, M. [Dept. of Pathology, University Hospital Gent, Gent (Belgium); Van Vlierberghe, H. [Dept. of Gastroenterology, University Hospital Gent, Gent (Belgium); Hemptinne, B. de [Dept. of Surgery, University Hospital Gent, Gent (Belgium); Ros, P.R. [Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 (United States)

    2001-09-01

    The aim of this study was to determine the accuracy of contrast-enhanced biphasic spiral CT as a screening tool in the preoperative evaluation of orthotopic liver transplant (OLT) patients. Spiral-CT examinations were performed before liver transplantation in 53 patients. Scans were retrospectively reviewed and compared with pathologic findings in fresh-sectioned livers. When findings between spiral CT and pathology were discordant, formalized livers were reexamined with lesion-by lesion evaluation. Fresh pathologic evaluation revealed 23 liver lesions (16 HCC, 7 macro-regenerative nodules). Malignancy was identified in 13 of 53 patients (24.5%). Pre-transplantation spiral CT depicted 27 liver lesions (23 HCC, 4 macro-regenerative nodules). Malignancy was suspected in 14 patients (26.4%). In 10 of 53 (18.9%), spiral CT and pathologic evaluation were discordant. Subsequent retrospective pathologic evaluation showed malignancy in 4 additional patients. Spiral CT compared with the retrospective pathologic findings revealed 36 real-negative, 14 real-positive, 0 false-positive, and 3 false-negative patients with malignancy. Sensitivity and specificity of spiral CT in detection of malignancy was 82 and 100%, respectively. Contrast-enhanced biphasic spiral CT is an accurate technique in the evaluation of patients preceding OLT. Routine fresh-sectioned liver pathologic findings are not as sensitive as previously estimated. (orig.)

  19. Outcome Measure of Pain in Patients with Lumbar Disc Herniation: Validation Study of the Iranian version of Pain Sensitivity Questionnaire

    Azhari, Shirzad; Shahzadi, Sohrab; Nayeb Aghaei, Hossain; Mohammadi, Hassan Reza; Montazeri, Ali

    2016-01-01

    Study Design Cross-sectional. Purpose To translate and culturally adapt an Iranian version of the Pain Sensitivity Questionnaire (PSQ) in Iran. Overview of Literature Instruments measuring patient reported outcomes should satisfy certain psychometric properties. Methods The PSQ was translated following cross-cultural adaptation guidelines. A total of 101 patients with lumbar disc herniation (LDH), and 39 healthy cases were included in the study. All participants completed the PSQ and the Pain Catastrophizing Scale (PCS). The internal consistency, test-retest reliability, known group comparison, criterion validity and item-scale correlations were assessed. Results The mean age of participants was 51.7 years. Reliability, validity and correlation of PSQ and PCS showed satisfactory results. Cronbach's alpha coefficients were 0.81 for PSQ-total, 0.82 for PSQ-minor, and 0.82 for PSQ-moderate. The intraclass correlation coefficients value was 0.84 (0.616–0.932) indicating an excellent test-retest reliability. The instrument discriminated well between sub-groups of patients who differed in a standard predictive measure of LDH surgery (the Finneson–Cooper score). Total PSQ were also significantly correlated with the total scores of the PCS, lending support to its good convergent validity. Additionally, the correlation of each item with its hypothesized domain on the PSQ indicated acceptable results, suggesting that the items had a substantial relationship with their own domains. Conclusions The adapted Iranian PSQ is a valid and reliable questionnaire for the assessment of pain in patients with LDH. PMID:27340527

  20. Sensitivity of whole-body CT and MRI versus projection radiography in the detection of osteolyses in patients with monoclonal plasma cell disease

    Wolf, Maya B., E-mail: m.mueller-wolf@dkfz.de [Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg Germany (Germany); Department of Radiology, German Cancer Research Center (Dkfz), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Murray, Fritz, E-mail: fritz.murray@hotmail.de [Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg Germany (Germany); Kilk, Kerstin, E-mail: k_fechtner@hotmail.com [Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg Germany (Germany); Hillengass, Jens, E-mail: jens.hillengass@med.uni-heidelberg.de [Department of Haematology, Oncology, Rheumatology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Delorme, Stefan, E-mail: s.delorme@dkfz-heidelberg.de [Department of Radiology, German Cancer Research Center (Dkfz), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Heiss, Christiane, E-mail: c.heiss@dkfz-heidelberg.de [Department of Biostatistics, German Cancer Research Center (Dkfz), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Neben, Kai, E-mail: k.neben@klinikum-mittelbaden.de [Department of Haematology, Oncology, Rheumatology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Goldschmidt, Hartmut, E-mail: hartmut.goldschmidt@med.uni-heidelberg.de [Department of Haematology, Oncology, Rheumatology, University Hospital Heidelberg and National Center for Tumour Diseases, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Kauczor, Hans-Ulrich, E-mail: hu.kauczor@med.uni-heidelberg.de [Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg Germany (Germany); and others

    2014-07-15

    Purpose: To compare sensitivity of whole-body Computed Tomography (wb-CT) and whole-body Magnetic Resonance Imaging (wb-MRI) with Projection Radiography (PR) regarding each method's ability to detect osteolyses in patients with monoclonal plasma cell disease. Patients and methods: The bone status of 171 patients was evaluated. All patients presented with multiple myeloma (MM) of all stages, monoclonal gammopathy of unknown significance (MGUS) or solitary plasmacytoma. Two groups were formed. Group A consisted of 52 patients (26 females, 26 males) with an average age of 62 years (range, 45–89 years) who received, both, PR and wb-CT as part of their diagnostic work-up. Group B comprised 119 patients (58 females, 61 males) averaging 57 years of age (range, 20–80 years) who received, both, PR and wb-MRI. Two experienced radiologists were blinded regarding the disease status and assessed the number and location of osteolyses in consensus. A distinction was made between axial and extra-axial lesions. Results: In group A, wb-CT revealed osteolyses in 12 patients (23%) that were not detected in PR. CT was superior in detecting lesions in patients with osteopenia and osteoporosis. Compared with PR, wb-CT was significantly more sensitive in detecting osteolyses than PR (p < 0.001). This was particularly true for axial lesions. Additionally, CT revealed clinically relevant incidental findings in 33 patients (63%). In group B, wb-MRI revealed lesions in 19 patients (16%) that were not detected in PR. All lesions detected by PR were also detected by wb-MRI and wb-CT. Wb-MRI and wb-CT are each superior to PR in detecting axial lesions. Conclusion: Wb-CT can detect 23% more focal lesions than PR, especially in the axial skeleton. Therefore, this imaging method should be preferred over PR in the diagnostic work-up and staging of patients with monoclonal plasma cell disease.

  1. Sensitivity of whole-body CT and MRI versus projection radiography in the detection of osteolyses in patients with monoclonal plasma cell disease

    Purpose: To compare sensitivity of whole-body Computed Tomography (wb-CT) and whole-body Magnetic Resonance Imaging (wb-MRI) with Projection Radiography (PR) regarding each method's ability to detect osteolyses in patients with monoclonal plasma cell disease. Patients and methods: The bone status of 171 patients was evaluated. All patients presented with multiple myeloma (MM) of all stages, monoclonal gammopathy of unknown significance (MGUS) or solitary plasmacytoma. Two groups were formed. Group A consisted of 52 patients (26 females, 26 males) with an average age of 62 years (range, 45–89 years) who received, both, PR and wb-CT as part of their diagnostic work-up. Group B comprised 119 patients (58 females, 61 males) averaging 57 years of age (range, 20–80 years) who received, both, PR and wb-MRI. Two experienced radiologists were blinded regarding the disease status and assessed the number and location of osteolyses in consensus. A distinction was made between axial and extra-axial lesions. Results: In group A, wb-CT revealed osteolyses in 12 patients (23%) that were not detected in PR. CT was superior in detecting lesions in patients with osteopenia and osteoporosis. Compared with PR, wb-CT was significantly more sensitive in detecting osteolyses than PR (p < 0.001). This was particularly true for axial lesions. Additionally, CT revealed clinically relevant incidental findings in 33 patients (63%). In group B, wb-MRI revealed lesions in 19 patients (16%) that were not detected in PR. All lesions detected by PR were also detected by wb-MRI and wb-CT. Wb-MRI and wb-CT are each superior to PR in detecting axial lesions. Conclusion: Wb-CT can detect 23% more focal lesions than PR, especially in the axial skeleton. Therefore, this imaging method should be preferred over PR in the diagnostic work-up and staging of patients with monoclonal plasma cell disease

  2. Variation in High-Sensitivity C-Reactive Protein Levels over 24 Hours in Patients with Stable Coronary Artery Disease

    Koc, Mevlut; KARAARSLAN, OSMAN; Abali, Gulcan; Batur, Mustafa Kemal

    2010-01-01

    Limited, controversial data exist regarding changes in high-sensitivity C-reactive protein (hs-CRP) levels over short times and the importance of detecting these changes in patients who have coronary artery disease (CAD). We investigated the variation of hs-CRP levels and their association with the severity of CAD in patients with stable CAD.

  3. [Assessment of efficiency of dietotherapy with addition of a vitamin-mineral complex in patients with diabetes mellitus type 2].

    Lapik, I A; Sokol'nikov, A A; Sharafetdinov, Kh Kh; Sentsova, T B; Plotnikova, O A

    2014-01-01

    The influence of diet inclusion of vitamin and mineral complex (VMC), potassium and magnesium in the form of asparaginate on micronutrient status, body composition and biochemical parameters in patients with diabetes mellitus type 2 (DM2) has been investigated. 120 female patients with DM2 and obesity of I-III degree (mean age - 58 +/- 6 years) have been included in the study. The patients were divided into two groups: main group (n = 60) and control group (n = 60). For 3 weeks patients of both groups received a low-calorie diet (1600 kcal/day). Patients of the main group received VMC, providing an additional intake of vitamins C and E (100-120% RDA), beta-carotene (40% RDA), nicotinamide (38% RDA), pantothenic acid and biotin (60% RDA), vitamins B12, B2 and folic acid (75-83% RDA), vitamins B1 and B6 (160-300% RDA), zinc (100% RDA) and chromium (400% RDA), and also received magnesium (17.7% RDA) and potassium (9.4% RDA) in the form of asparaginate. Body composition, biochemical parameters and micronutrient status (blood serum level of vitamins C, D, B6, B12, folate, potassium, calcium, magnesium, zinc, phosphorus) were evaluated in all patients before and after the 3-week course of diet therapy. After the low-calorie diet therapy average body weight reduction was 4.2 +/- 0.2 kg in the main group, and 4.4 +/- 0.1 kg in the control group, without statistically significant differences between groups. Statistically significant decrease of total cholesterol, triglycerides, and glucose concentration in blood serum was registered in both groups. It should be noted that in the control group glycemia decreased on 1.2 +/- 0.1 mmol/l, while the main group showed a decrease on 1.8 +/- 0.1 (p optimal supplied with vitamins and minerals. After the dietotherapy significant increase of vitamin C, 25-hydroxyvitamin D, vitamin B6, folate, vitamin B12, potassium, magnesium, calcium, zinc and phosphorus concentration in blood serum was observed in patients receiving VMC. While in the

  4. Can Homeopathy Bring Additional Benefits to Thalassemic Patients on Hydroxyurea Therapy? Encouraging Results of a Preliminary Study

    Antara Banerjee

    2010-01-01

    Full Text Available Several homeopathic remedies, namely, Pulsatilla Nigricans (30th potency, Ceanothus Americanus (both mother tincture and 6th potency and Ferrum Metallicum (30th potency selected as per similia principles were administered to 38 thalassemic patients receiving Hydroxyurea (HU therapy for a varying period of time. Levels of serum ferritin (SF, fetal hemoglobin (HbF, hemoglobin (Hb, platelet count (PC, mean corpuscular volume (MCV, mean corpuscular hemoglobin concentration (MCHC, mean corpuscular hemoglobin (MCH, white blood cell (WBC count, bilirubin content, alanine amino transferase (ALT, aspartate amino transferase (AST and serum total protein content of patients were determined before and 3 months after administration of the homeopathic remedies in combination with HU to evaluate additional benefits, if any, derived by the homeopathic remedies, by comparing the data with those of 38 subjects receiving only HU therapy. Preliminary results indicated that there was a significant decrease in the SF and increase in HbF levels in the combined, treated subjects. Although the changes in other parameters were not so significant, there was a significant decrease in size of spleen in most patients with spleenomegaly and improvement in general health conditions along with an increased gap between transfusions in most patients receiving the combined homeopathic treatment. The homeopathic remedies being inexpensive and without any known side-effects seem to have great potentials in bringing additional benefits to thalassemic patients; particularly in the developing world where blood transfusions suffer from inadequate screening and fall short of the stringent safety standards followed in the developed countries. Further independent studies are encouraged.

  5. Highly sensitive C reactive protein in patients with metabolic syndrome and cardiovascular disease

    Mukta N Chowta

    2012-01-01

    Full Text Available Context: Although there are several studies reported in the western literature regarding the association of C reactive protein (CRP level with components of metabolic syndrome, data in the Indian population were lacking. As there will be a considerable difference in the profile of risk factors for cardiovascular diseases (CVDs, studies regarding the correlation of CRP level with cardiovascular risk factors and metabolic syndrome in the Indian population are required. Objective: To correlate the highly sensitive CRP (hsCRP level to individual components of metabolic syndrome and coronary vascular disease. Materials and Methods : Forty patients who were diagnosed clinically with metabolic syndrome were included in the study. Detailed history with regard to diabetes mellitus, hypertension and other CVD was collected from each patient. All the patients underwent complete physical examination, including ECG. Height, weight, fasting blood glucose and lipid levels were measured in all the patients. CVD was assessed with the following: new-onset angina, fatal and non-fatal myocardial infarction or stroke, transient ischemic attack, heart failure or intermittent claudication. Results: The mean hsCRP level was higher in patients with CVD compared with those without CVD. The CRP level correlation with CVD showed a statistically significant correlation. hsCRP level was very high in eight hypertensive patients, whereas it was very high in five normotensives. But, statistical analysis has not shown any significant correlation between hypertension and hsCRP level. Similarly, although a higher hsCRP level was seen in diabeteics, statistical analysis failed to show a significant correlation between diabetes and the hsCRP level. Analyses of hsCRP correlation with body mass index, fasting glucose, cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein did not show a significant correlation with the hsCRP level. Conclusions: Increased hs

  6. Sensitivity of cultured skin fibroblasts from patients with neurofibromatosis to DNA-damaging agents

    Neurofibromatosis (NF) is an autosomal dominant disorder associated with various constitutional abnormalities as well as a striking predisposition for malignant and nonmalignant neoplasms, both in cells originating in and not originating in the neural crest. We have examined the sensitivity of cultured skin fibroblasts from patients with neurofibromatosis to several types of DNA damage. Fibroblasts in Dulbecco's modified Eagle's medium were plated at 10(2) to 2 X 10(4) cells per 75 cm2 tissue culture plates, and exposed to various doses of gamma radiation (leads to DNA scission), actinomycin D, or mitomycin C. Cells were reincubated for 15 to 40 days until surviving colonies exhibited greater than 30-50 cells. Plates were then stained with 1% methylene blue and the colonies counted, with surviving fraction determined relative to plating efficiency. Nine skin fibroblast cell strains from normal individuals were studied as controls. One neurofibromatosis (NF) cell strain, SB23, exhibited normal sensitivity to all three DNA-damaging agents studied in early (7-8) and middle (12-13) in vitro passage. Strain GM0622, on the other hand, exhibited normal sensitivity to the three DNA-damaging agents studied at early passage, but showed a significant decrease in survival after exposure to both gamma radiation (D0 = 106 rad) and actinomycin D (D0 = 0.024 mcg/ml) with increasing passage. Strain GM1639 exhibited decreased survival after actinomycin D exposure at early passage (D0 = 0.017 mcg/ml), with normal survival after exposure to gamma radiation and mitomycin C at the same passage

  7. Dye stability and performances of dye-sensitized solar cells with different nitrogen additives at elevated temperatures - Can sterically hindered pyridines prevent dye degradation?

    Tuyet Nguyen, Phuong; Lund, Torben [Department of Science, Systems and Models, Roskilde University, 4000 Roskilde (Denmark); Rand Andersen, Anders [University of Southern Denmark, Institute of Sensors, Signals and Electrotechnics (SENSE), Niels Bohrs Alle 1, 5230 Odense M (Denmark); Danish Technological Institute, Plastics Technology, Gregersensvej 2630 Taastrup (Denmark); Morten Skou, Eivind [University of Southern Denmark, Department of Chemical Engineering, Biotechnology and Enviromental Technology, Niels Bohrs Alle 1, 5230 Odense M (Denmark)

    2010-10-15

    The homogeneous kinetics of the nucleophilic substitution reactions between the ruthenium dye N719 and eight pyridines and 1-methylbenzimidazole have been investigated in 3-methoxypropionitrile at 100 C. The half lives of N719 with the additives 4-tert-butylpyridine (0.5 M) and 1-methylbenzimidazole (0.5 M) were 57 and 160 h, respectively. Sterically hindered pyridines like 2,6-lutidine did not react with N719. The efficiencies of dye-sensitized solar cells (DSC, area=8.0 cm{sup 2}) prepared with 1-methylbenzimidazole (MBI), 4-tert-butylpyridine (4-TBP), 2,6-lutidine and without any additive were 7.1%, 6.2%, 6.0% and 4.8%, respectively. The cells were stored in dark at 85 C and their I-V curves and impedance spectra were measured at regular time intervals. The N719 dye degradation in the cells were monitored by a new dye extraction protocol combined with analysis of the dye extract by HPLC coupled to mass spectrometry. After 300 h storage in dark at 85 C 40% of the initial amount of N719 dye was degraded in DSC cells prepared with MBI and the efficiency was decreased to 40% of its initial value. DSC cells prepared with 2,6-lutidine or no additives showed smaller thermal dye and efficiency stability at elevated temperatures than DSC cells prepared with the none sterically hindered additives MBI and 4-TBP. In the cells prepared with 2,6-lutidine or no additive higher contents of the iodo products [RuL{sub 2}(NCS)(iodide)]{sup +} and [RuL{sub 2}(3-MPN)(iodide)]{sup +} were found than in cells prepared with 4-TBP and MBI. It is suggested that sterically hindered pyridines have smaller complexation constants with I{sub 3}{sup -} than unsterically hindered additives. This may explain the observed faster nucleophilic substitution rates of uncomplexed I{sub 3}{sup -} with N719 in DSC cells prepared with sterically hindered pyridines. The EIS analysis showed that the lifetime of the injected electrons in the TiO{sub 2}{tau}{sub eff} is reduced by a thermally induced change

  8. Eculizumab, bortezomib and kidney paired donation facilitate transplantation of a highly sensitized patient without vascular access.

    Lonze, B E; Dagher, N N; Simpkins, C E; Locke, J E; Singer, A L; Segev, D L; Zachary, A A; Montgomery, R A

    2010-09-01

    A 43-year-old patient with end-stage renal disease, a hypercoagulable condition and 100% panel reactive antibody was transferred to our institution with loss of hemodialysis access and thrombosis of the superior and inferior vena cava, bilateral iliac and femoral veins. A transhepatic catheter was placed but became infected. Access through a stented subclavian into a dilated azygos vein was established. Desensitization with two cycles of bortezomib was undertaken after anti-CD20 and IVIg were given. A flow-positive, cytotoxic-negative cross-match live-donor kidney at the end of an eight-way multi-institution domino chain became available, with a favorable genotype for this patient with impending total loss of a dialysis option. The patient received three pretransplant plasmapheresis treatments. Intraoperatively, the superior mesenteric vein was the only identifiable patent target for venous drainage. Eculizumab was administered postoperatively in the setting of antibody-mediated rejection and an inability to perform additional plasmapheresis. Creatinine remains normal at 6 months posttransplant and flow cross-match is negative. In this report, we describe the combined use of new agents (bortezomib and eculizumab) and modalities (nontraditional vascular access, splanchnic drainage of graft and domino paired donation) in a patient who would have died without transplantation. PMID:20636451

  9. Identification of coumarin as the sensitizer in a patient sensitive to her own perfume but negative to the fragrance mix

    Mutterer, V; Giménez Arnau, E; Lepoittevin, J P;

    1999-01-01

    obtained was afterwards tested on the patient using a ROAT and/or a patch test. Only 1 fraction gave a positive ROAT result. This fraction was analyzed and found to contain coumarin and ethyl vanillin. Coumarin, one of the most widely used fragrance compounds that is not present in the fragrance mix, was...

  10. High sensitive C-reactive protein assessment in patients with typical chest pain and normal coronary arteriography

    Objective: To determine the changes of high-sensitive serum C-reactive protein (hs-CRP) in patients with typical chest pain and normal coronary arteriography. Methods: One hundred and twenty three patients were included. CRP was determined using a standard technique, and all patients underwent ECG exercise testing. Results: Plasma level of hs-CRP was significantly increased in patients with typical chest pain, coronary arteriography negative and exercise test positive. Conclusion: Inflammation may play a role in the mechanism of chest pain for patients with normal coronary angiography. (authors)

  11. Carboplatin and pegylated liposomal doxorubicin versus carboplatin and paclitaxel in very platinum-sensitive ovarian cancer patients

    Mahner, Sven; Meier, Werner; du Bois, Andreas;

    2015-01-01

    - and paclitaxel-based therapies. Patients were randomised to CD [carboplatin-pegylated liposomal doxorubicin (PLD)] or CP (carboplatin-paclitaxel) and stratified by treatment-free interval (TFI). In this analysis, patients with a TFI>24 months were analysed separately for progression free survival (PFS...... patients versus 0 in CP arm; P=0.089). CONCLUSION: CP and CD were equally effective treatment regimens for patients with very platinum-sensitive ROC. The favourable risk-benefit profile suggests carboplatin-PLD as treatment of choice for these patients....

  12. Cisapride a green analytical reagent for rapid and sensitive determination of bromate in drinking water, bread and flour additives by oxidative coupling spectrophotometric methods

    Al Okab, Riyad Ahmed

    2013-02-01

    Green analytical methods using Cisapride (CPE) as green analytical reagent was investigated in this work. Rapid, simple, and sensitive spectrophotometric methods for the determination of bromate in water sample, bread and flour additives were developed. The proposed methods based on the oxidative coupling between phenoxazine and Cisapride in the presence of bromate to form red colored product with max at 520 nm. Phenoxazine and Cisapride and its reaction products were found to be environmentally friendly under the optimum experimental condition. The method obeys beers law in concentration range 0.11-4.00 g ml-1 and molar absorptivity 1.41 × 104 L mol-1 cm-1. All variables have been optimized and the presented reaction sequences were applied to the analysis of bromate in water, bread and flour additive samples. The performance of these method was evaluated in terms of Student's t-test and variance ratio F-test to find out the significance of proposed methods over the reference method. The combination of pharmaceutical drugs reagents with low concentration create some unique green chemical analyses.

  13. Increased treatment-related mortality with additional cisplatin-based chemotherapy in patients with nasopharyngeal carcinoma treated with standard radiotherapy

    Background and purposes: We performed a meta-analysis of randomized controlled trials (RCTs) to determine the overall risk of treatment-related death associated with additional cisplatin-based chemotherapy in patients with nasopharyngeal carcinoma treated with standard radiotherapy. Material and methods: Eligible studies included RCTs in which cisplatin-based chemotherapy in combination with radiotherapy was compared with radiotherapy alone. Statistical analyses were conducted to calculate the summary incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) using fixed- or random-effects models based on the heterogeneity of included studies. Results: A total of 2829 patients from 13 RCTs were included in this study. The overall incidence for treatment-related death in chemoradiotherapy and radiotherapy treated patients was 1.7% and 0.8%. Compared to radiotherapy alone, radiotherapy plus cisplatin-based chemotherapy significantly increased the risk of treatment-related mortality. On subgroup analyses, no difference was found in treatment-related mortality between different timings of chemotherapy and chemotherapeutic agents. Adding cisplatin-based chemotherapy was associated with higher incidences of severe acute toxicity. Conclusions: Cisplatin-based chemotherapy plus radiotherapy increased the risk of treatment-related death and severe acute toxicity, compared with radiotherapy alone. Better management of treatment toxicity might improve the therapeutic gain in patients with nasopharyngeal carcinoma.

  14. Addition of local anesthetics to contrast media. Pt. 1. Effects on patient discomfort and hemodynamics in aortofemoral angiography

    Nilsson, P.; Almen, T.; Golman, K.; Jonsson, K.; Nyman, U.

    Effects of equiosmolar solutions (osmolality 1.35 mol/kg) of the ratio 1.5 contrast medium metrizoate (250 mg I/ml) containing either the local anesthetic mepivacaine or saline were evaluated on subjective discomfort, aortic blood pressure and heart rate in 17 patients referred for aortofemoral angiography due to intermittent claudication. Each patient was injected with 30 ml (15 ml/s) of each solution in random double-blind order. Each patient was then injected with 45 ml (12 ml/s) of the raio 3 medium ioxaglate (320 mg I/ml, osmolality 0.58 ml/kg). Ioxaglate caused significantly less total discomfort, pain, heat, vocal reaction, involuntary movements and hemodynamic effects than mitrizoate-mepivacaine and metrizoate-saline. The effects of the two metrizoate solutions did not differ significantly. Previous contradictory reports on the effects of anesthetics in contrast media were reviewed with regard to experimental design, different osmolality of the test and control solutions, premedication, and pH dependence of local anesthetics. Ratio 3 media are recommended because they produce a more reliable relief of patient discomfort and fewer hemodynamic changes than the addition of local anesthetics to ratio 1.5 media.

  15. Evaluating patients' preferences for type of bowel preparation prior to screening CT colonography: Convenience and comfort versus sensitivity and specificity

    Aims: To explore the relative value patients place on comfort and convenience versus test sensitivity and specificity in the context of computed tomographic colonography (CTC) screening. Materials and methods: Twenty semi-structured interviews were carried out with patients attending hospital for radiological tests unrelated to CTC. Preferences for CTC with different types of bowel preparation for CTC screening were examined and interviews were analysed thematically. The discussion guide included separate sections on CTC, bowel preparation methods (non-, reduced- and full-laxative), and sensitivity and specificity. Patients were given information on each topic in turn and asked about their views and preferences during each section. Results: Following information about the test, patients' attitudes towards CTC were positive. Following information on bowel preparation, full-laxative purgation was anticipated to cause more adverse physical and lifestyle effects than using reduced- or non-laxative preparation. However, stated preferences were approximately equally divided, largely due to patients anticipating that non-laxative preparations would reduce test accuracy (because the bowel was not thoroughly cleansed). Following information on sensitivity and specificity (which supported patients' expectations), the predominant stated preference was for full-laxative preparation. Conclusions: Patients are likely to value test sensitivity and specificity over a more comfortable and convenient preparation. Future research should test this hypothesis on a larger sample

  16. Adding Papillomacular Bundle Measurements to Standard Optical Coherence Tomography Does Not Increase Sensitivity to Detect Prior Optic Neuritis in Patients with Multiple Sclerosis

    Laible, Mona; Jarius, Sven; Schmidt-Bacher, Annette; Platten, Michael; Haas, Jürgen

    2016-01-01

    Purpose To improve the detection of retinal nerve fiber layer (RNFL) thinning in multiple sclerosis (MS), a special peripapillary ring scanning algorithm (N-site RNFL, N-RNFL) was developed for spectral domain optical coherence tomography (SD-OCT). In contrast to the standard protocol (ST-RNFL) scanning starts nasally, not temporally, and provides an additional sector of analysis, the papillomacular bundle (PMB). We aimed to ascertain whether the temporal RNFL differs between the two techniques, whether N-RNFL is more sensitive than ST-RNFL to detect previous optic neuritis (ON), and whether analyzing the PMB adds additional sensitivity. Furthermore, we investigated whether RNFL is associated with disease severity and/or disease duration. Methods We conducted a cross-sectional case-control study of 38 patients with MS, of whom 24 had a history of ON, and 40 healthy controls (HC). Subjects with ON within the previous 6 months were excluded. Records included clinical characteristics, visual evoked potentials (VEP), and SD-OCT in both techniques. Results In a total of 73 evaluable MS eyes, temporal N-RNFL was abnormal in 17.8%, temporal ST-RNFL in 19.2%, and the PMB-RNFL in 21.9%. In ON eyes, the sensitivity of temporal N-RNFL and ST-RNFL did not differ significantly (37.0%/33.3%, p = 0.556). The sensitivity of VEP was 85.2%. RNFL thickness was associated with disease severity in all eyes, with and without a history of ON, and with disease duration. Conclusion The two OCT techniques detected previous ON with similar sensitivity, but the sensitivity of VEPs was superior to that of both N-RNFL and ST-RNFL. Our results indicate that the widely used ST-RNFL technique is appropriate for peripapillary RNFL measurements in MS patients. PMID:27171375

  17. Antimicrobial sensitivity and frequency of DRUG resistance among bacterial strains isolated from cancer patients

    Blood stream infections (bacteremia) is potentially life threatening. Concomitant with a change in the incidence and epidemiology of infecting organisms, there has been an increase in resistance to many antibiotic compounds. The widespread emergence of resistance among bacterial pathogens has an impact on our ability to treat patients effectively. The changing spectrum of microbial pathogens and widespread emergence of microbial resistance to antibiotic drugs has emphasized the need to monitor the prevalence of resistance in these strains. In the present study frequency of isolation of clinically significant bacteria and their susceptibility and resistance pattern against a wide range of antimicrobial drugs from positive blood cultures collected during 2001-2003 was studied. A total of 102 consecutive isolates were found with 63% gram positive and 44% gram negative strains. The dominating pathogens were Staphylococcus aureus (51%), Streptococci (31%), Pseudomonas (40%), Proteus (13%), Klebsiella (13%). The isolated strains were tested against a wide range of antibiotics belonging to cephalosporins, aminoglycosides and quinolone derivative group by disk diffusion method. It has been observed that isolated strains among gram positive and negative strains showed different level of resistance against aminoglycosides and cephalosporin group of antibiotics with gram positives showing highest number and frequency of resistance against aminoglycosides (40-50%) and cephalosporins.(35-45%) whereas cephalosporins were found to be more effective against gram negatives with low frequency of resistant strains. Cabapenem and quinolone derivative drugs were found to be most effective among other groups in both gram positive and negative strains with 23-41% strains found sensitive to these two drugs. The frequency of sensitive strains against aminoglycoside and cephalosporin in gram negative and gram positive strains were found to be decreasing yearwise with a trend towards an

  18. Title: The Comparison of Anxiety Sensitivity and Happiness in Irritable Bowel Syndrome Patients with Normal Matched Group in Shiraz

    2012-09-01

    Full Text Available Background & Objective: The purpose of this study was the comparison of anxiety sensitivity and happiness between patients with Irritable Bowel Syndrome (IBS and normal matched group. Materials & Methods: The Subjects were 35 (21 females and 14 male IBS patients diagnosed by gastroenterologist and 35 (25 female and 10 males normal matched group all in 14– 63 old age. Anxiety Sensitivity Index (ASI-R, Oxford Happiness Questionnaire (OHQ, and a checklist applied as measures of anxiety sensitivity, happiness and demographic information. Results: Data analysis indicates that IBS patients significantly are higher than matched group in fear of publicly observable symptoms (P= 0.032, fear of cardiovascular symptoms (P= 0.01, fear of gastrointestinal symptoms (P= 0.001, fear of dissociative and neurological symptoms (P= 0.018, & general anxiety sensitivity (P= 0.003, and lower in joy (P= 0.005, control (P= 0.008, self- esteem (P= 0.001 calm (P= 0.006 and general happiness (P= 0.001. Although no significant differences were found in life satisfaction (P= 0.083 & efficacy (P= 0.09, fear of respiratory symptoms (P= 0.067, and fear of cognitive control deficiency (p= 0.097. Conclusion: As a psychological variable anxiety sensitivity can predict treatment seeking of IBS patient, and happiness negatively influenced by both anxiety sensitivity and IBS.

  19. The impact of pegvisomant treatment on substrate metabolism and insulin sensitivity in patients with acromegaly

    Lindberg-Larsen, Rune; Møller, Niels; Schmitz, Ole;

    2007-01-01

    CONTEXT: Pegvisomant is a specific GH receptor antagonist that is able to normalize serum IGF-I concentrations in most patients with acromegaly. The impact of pegvisomant on insulin sensitivity and substrate metabolism is less well described. PATIENTS AND METHODS: We assessed basal and insulin.......3 microg/liter, P = 0.02). Basal serum insulin and plasma glucose levels decreased after treatment (insulin, 54 +/- 5.9 vs. 42 +/- 5.3 pmol/liter, P = 0.001; glucose, 5.7 +/- 0.1 vs. 5.3 +/- 0.0 mmol/liter, not significant), whereas palmitate kinetics were unaltered. During the clamp, the glucose infusion...... rate increased after pegvisomant (3.1 +/- 0.5 vs. 4.4 +/- 0.6 mg/kg.min, P = 0.02), whereas the suppression of endogenous glucose production tended to increase (0.7 +/- 0.0 vs. 0.5 +/- 0.1 mg/kg.min, not significant). Total resting energy expenditure decreased after pegvisomant treatment (1703 +/- 109...

  20. Optimal Cutoff Levels of More Sensitive Cardiac Troponin Assays for the Early Diagnosis of Myocardial Infarction in Patients With Renal Dysfunction

    Twerenbold, Raphael; Wildi, Karin; Jaeger, Cedric; Gimenez, Maria Rubini; Reiter, Miriam; Reichlin, Tobias; Walukiewicz, Astrid; Gugala, Mathias; Krivoshei, Lian; Marti, Nadine; Moreno Weidmann, Zoraida; Hillinger, Petra; Puelacher, Christian; Rentsch, Katharina; Honegger, Ursina

    2015-01-01

    Background— It is unknown whether more sensitive cardiac troponin (cTn) assays maintain their clinical utility in patients with renal dysfunction. Moreover, their optimal cutoff levels in this vulnerable patient population have not previously been defined. Methods and Results— In this multicenter study, we examined the clinical utility of 7 more sensitive cTn assays (3 sensitive and 4 high-sensitivity cTn assays) in patients presenting with symptoms suggestive of acute myocardial infarction. ...

  1. The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial.

    Moustafa, Ibrahim M; Diab, Aliaa A

    2015-07-01

    The aim of this study was to investigate the immediate and long-term effects of a one-year multimodal program, with the addition of upper cervical manipulative therapy, on fibromyalgia management outcomes in addition to three-dimensional (3D) postural measures. This randomized clinical trial with one-year follow-up was completed at the research laboratory of our university. A total of 120 (52 female) patients with fibromyalgia syndrome (FMS) and definite C1-2 joint dysfunction were randomly assigned to the control or an experimental group. Both groups received a multimodal program; additionally, the experimental group received upper cervical manipulative therapy. Primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), whereas secondary outcomes included Pain Catastrophizing Scale (PCS), algometric score, Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and 3D postural measures. Measures were assessed at three time intervals: baseline, 12 weeks, and 1 year after the 12-week follow-up. The general linear model with repeated measures indicated a significant group × time effect in favor of the experimental group on the measures of 3D postural parameters (P < .0005), FIQ (P < .0005), PCS (P < .0005), algometric score (F = P < .0005), PSQI (P < .0005), BAI (P < .0005), and BDI (P < .0005). The addition of the upper cervical manipulative therapy to a multimodal program is beneficial in treating patients with FMS. PMID:25782585

  2. Comparison of Mean Contrast Sensitivity Results of LASIK and LASEK in Patients with Myopia and Myopic Astigmatism

    Okan Taşkın

    2014-12-01

    Full Text Available Objectives: To compare LASIK and LASEK for the correction of myopia and myopic astigmatism in terms of contrast sensitivity. Materials and Methods: Sixty eyes of 30 patients who underwent LASIK and 60 eyes of 30 patients who underwent LASEK for myopia and myopic astigmatism at the Excimer Laser Center of Dokuz Eylül University, Faculty of Medicine, were included in this study. Mean best-corrected contrast sensitivity values were noted before surgery. Mean uncorrected contrast sensitivity values were evaluated 1 month and 6 months after surgery as well as at the last exam. Complications were noted. The results of LASIK and LASEK groups were compared. Results: The two groups were similar in terms of age and gender. No significant difference was noted between the mean preoperative best-corrected contrast sensitivity values of the two groups. Mean uncorrected contrast sensitivity values were not significantly different at the first and sixth months. Mean last exam time was 13.4 (9-36 months. Also at the last exam, mean uncorrected contrast sensitivity values were not significantly different. Mean uncorrected contrast sensitivity values at the last exam were higher than the preoperative mean best-corrected contrast sensitivity values in both LASIK and LASEK groups. Conclusion: Both LASIK and LASEK for the correction of myopia and myopic astigmatism seem to be safe procedures in terms of contrast sensitivity when performed to appropriate patients. Neither technique demonstrated significantly different contrast sensitivity results in this study. (Turk J Ophthalmol 2014; 44: 436-9

  3. A sensitive immunoblotting method for screening of microalbuminuria in diabetic patient's urine

    Urinary albumin excretion is a useful marker in the prognosis of diabetic nephropathy and microvascular diseases. Methods such as enzyme linked immunosorbent assay (ELISA), radio immunoassay(RIA), radial immunodiffusion, albu screen, micro bumin and micral test are usually used for detection and screening of microalbuminuria in these patients. With consideration to the cost of an assay, methods such as ELISA and RIA are not suitable methods for screening purpose. Therefore, the aim of this work is to set a dot immunoblotting method for the measurement and screening of microalbumin in urine samples. The study was conducted during the period August 2001 to June 2003 at the National Research Center for Genetic Engineering and Biotechnology (NRCGEB) and Pars Hospital Laboratory of Tehran, Iran on 96 diabetic patients urine samples. First, anti human albumin antibodies (Abs) were produced in rabbit and immunoglobulin G (IgG) fraction was purified by protein-A affinity chromatography. Titer of Abs and optimum incubation conditions were tested by direct ELISA. Then different concentration of human albumin (0-300 mg/l) was loaded to nitrocellulose membranes and was assayed by dot immunoblotting method. The specificity and cross reactivity of Abs was tested by SDS-PAGE electrophoresis and western immunoblotting. The sensitivity of the method was calculated from human albumin calibration curve and compared with commercial immunoturbidimetric assays. Our results indicates that in using IgG with the concentrations 0.5-1 ug/ml (2 x 10-5 to 10-4 dilutions) the intensity of color directly increased with the increase of human albumin standards in blots. Western immunoblotting of urine samples did not show any cross reactivity with other urine proteins. Comparison of results of this method by commercial immunoturbidimetric methods indicates the correlation regression of approximately 0.979. The sensitivity of the method was approximately 5 mg/L of human albumin. This simple

  4. A plan for directional dark matter sensitivity in high-pressure xenon detectors through the addition of wavelength shifting gaseous molecules

    Gehman, V. M.; Goldschmidt, A.; Nygren, D.; Oliveira, C. A. B.; Renner, J.

    2013-10-01

    Xenon is an especially attractive candidate for both direct WIMP and 0νββ decay searches. Although the current trend has exploited the liquid phase, the gas phase xenon offers remarkable performance advantages for: energy resolution, topology visualization, and discrimination between electron and nuclear recoils. The NEXT-100 experiment, now under construction in the Canfranc Underground Laboratory, Spain, will operate at ~ 15 bars with 100 kg of 136Xe for the 0νββ decay search. We will describe recent results with small prototypes, indicating that NEXT-100 can provide about 0.5% FWHM energy resolution at the decay's Q value (2457.83 keV), as well as rejection of γ-rays with topological cuts. However, sensitivity goals for WIMP dark matter and 0νββ decay searches indicate the probable need for ton-scale active masses. NEXT-100 provides the springboard to reach this scale with xenon gas. We describe a scenario for performing both searches in a single, high-pressure, ton-scale xenon gas detector, without significant compromise to either. In addition, even in a single ton-scale, high-pressure xenon gas TPC, an intrinsic sensitivity to the nuclear recoil direction may exist. This plausibly offers an advance of more than two orders of magnitude relative to current low-pressure TPC concepts. We argue that, in an era of deepening fiscal austerity, such a dual-purpose detector may be possible at acceptable cost, within the time frame of interest, and deserves our collective attention.

  5. Culture and sensitivity pattern in patients with external ventricular drain infection

    Background: External ventricular (EVD) is a life saving procedure and involves insertion of a catheter in ventricular space to drain cerebrospinal fluid (CSF). Our objective of this study was to determine the culture and sensitivity (C/S) pattern in patients with EVD infection. Methods: This cross sectional study was conducted in Department of Neurosurgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad from December 1, 2008 to January 31, 2010. All admitted patients who had acute hydrocephalus, underwent EVD insertion after excluding meningitis and ventriculitis by physical examination and per operative CSF sampling. The EVD was done at right Kocher's point. Prophylactic third generation antibiotic (Ceftriaxone) was started and continued till EVD was in place. C/S was sent to PIMS laboratory on first documented fever and or change of CSF color or when plan was to replace EVD with Ventriculo-peritoneal shunt (VP). Once infection was there CSF was sent for C/S initially and routine examination (R/E) daily. Antibiotics were changed according to C/S report and continued till they were needed. Infection rate was also estimated. Results: Among 76 patients 41 (53.9%) were male and 35 (46.1%) were females. Most were adults and were between 31 to 40 years of age. Mean duration of EVD was 11.41 days. Overall infection rate was 11.8%. Among causative organisms Staphylococcus Aureus (44.4%) was most common followed by Acenitobacter and Enterobacter and commonly used prophylactic antibiotic (Ceftriaxone) had considerable resistance. Conclusion: EVD is a simple and life saving procedure. Most common organisms causing infection are Staphylococcus Aureus followed by Acenitobacter. Conventional used antibiotic Ceftriaxone has considerable resistance. (author)

  6. Are additional trace elements necessary in total parenteral nutrition for patients with esophageal cancer receiving cisplatin-based chemotherapy?

    Akutsu, Yasunori; Kono, Tsuguaki; Uesato, Masaya; Hoshino, Isamu; Murakami, Kentaro; Fujishiro, Takeshi; Imanishi, Shunsuke; Endo, Satoshi; Toyozumi, Takeshi; Matsubara, Hisahiro

    2012-12-01

    It is known that cisplatin induces the excretion of zinc from the urine and thereby reduces its serum concentration. However, the fluctuation of these trace elements during or after cisplatin-based chemotherapy has not been evaluated. To answer this question, we performed a clinical study in esophageal cancer patients undergoing cisplatin-based chemotherapy. Eighteen patients with esophageal cancer who were not able to swallow food or water orally due to complete stenosis of the esophagus were evaluated. The patients were divided into a control group [total parenteral nutrition (TPN) alone for 28 days, ten cases] and an intervention group (TPN with additional trace elements for 28 days, eight cases). The serum concentrations of zinc, iron, copper, manganese, triiodothyronin (T3), and thyroxin (T4), as alternative indicators of iodine, were measured on days 0, 14, and 28 of treatment, and statistically analyzed on day 28. In the control group, the serum concentration of copper was significantly decreased from 135.4 (day 0) to 122.1 μg/ml (day 14), and finally to 110.6 μg/ml (day 28, p = 0.015). The concentration of manganese was also significantly decreased from 1.34 (day 0) to 1.17 μg/ml (day 14) and finally to 1.20 (day 28, p = 0.049). The levels of zinc, iron, T3, and T4 were not significantly changed. In the intervention group, the supplementation with trace elements successfully prevented these decreases in their concentrations. TPN with supplementary trace elements is preferable and recommended for patients who are undergoing chemotherapy in order to maintain the patients' nutrient homeostasis. PMID:23054866

  7. Gene expression profiling of human dermal fibroblasts exposed to bleomycin sulphate does not differentiate between radiation sensitive and control patients

    Gene expression profiling of the transcriptional response of human dermal fibroblasts to in vitro radiation has shown promise as a predictive test of radiosensitivity. This study tested if treatment with the radiomimetic drug bleomycin sulphate could be used to differentiate radiation sensitive patients and controls in patients who had previously received radiotherapy for early breast cancer. Eight patients who developed marked late radiation change assessed by photographic breast appearance and 8 matched patients without any change were selected from women entered in a prospective randomised trial of breast radiotherapy fractionation. Gene expression profiling of primary skin fibroblasts exposed in vitro to bleomycin sulphate and mock treated fibroblast controls was performed. 973 genes were up-regulated and 923 down-reguated in bleomycin sulphate treated compared to mock treated control fibroblasts. Gene ontology analysis revealed enriched groups were cellular localisation, apoptosis, cell cycle and DNA damage response for the deregulated genes. No transcriptional differences were identified between fibroblasts from radiation sensitive cases and control patients; subgroup analysis using cases exhibiting severe radiation sensitivity or with high risk alleles present in TGF β1 also showed no difference. The transcriptional response of human dermal fibroblasts to bleomycin sulphate has been characterised. No differences between clinically radiation sensitive and control patients were detected using this approach

  8. Comparison of the effects of barnidipine+losartan compared with telmisartan+hydrochlorothiazide on several parameters of insulin sensitivity in patients with hypertension and type 2 diabetes mellitus.

    Derosa, Giuseppe; Querci, Fabrizio; Franzetti, Ivano; Dario Ragonesi, Pietro; D'Angelo, Angela; Maffioli, Pamela

    2015-10-01

    The aim of this study was to evaluate the effects of barnidipine+losartan compared with telmisartan+hydrochlorothiazide on several parameters of insulin sensitivity in patients with hypertension and type 2 diabetes mellitus. We enrolled 148 normocholesterolemic patients with mild-to-moderate hypertension and type 2 diabetes mellitus. Patients were treated with barnidipine, 20 mg day(-1), in combination with losartan, 100 mg day(-1), or with telmisartan+hydrochlorothiazide, 80/12.5 mg day(-1), for 6 months. We assessed blood pressure (BP) on a monthly basis; additionally, blood samples were collected to assess, at baseline and after 6 months, the following parameters: fasting plasma glucose; glycated hemoglobin; fasting plasma insulin; HOMA index; and some adipocytokines, such as adiponectin (ADN), resistin, leptin, visfatin and vaspin. Patients were also subjected to an euglycemic hyperinsulinemic clamp to assess the M value and glucose infusion rate to ascertain their insulin sensitivity. One hundred and forty-one patients completed the study. The BP was reduced in both groups, although the reduction was greater with barnidipine+losartan (PADN was increased (P<0.05), and resistin and leptin were reduced from baseline with barnidipine+losartan (P<0.05 vs. baseline), but they were not reduced with telmisartan+hydrochlorothiazide. Visfatin and vaspin were reduced by barnidipine+losartan compared with baseline (P<0.05). The adipocytokine levels obtained with barnidipine+losartan were significantly better than those obtained with telmisartan+hydrochlorothiazide (P<0.05 for all parameters). In addition to providing a greater BP reduction, barnidipine+losartan improved the insulin sensitivity, as assessed by an euglycemic hyperinsulinemic clamp, and improved some of the adipocytokines related to insulin resistance. PMID:25994603

  9. Leucine-sensitive hyperinsulinaemic hypoglycaemia in patients with loss of function mutations in 3-Hydroxyacyl-CoA Dehydrogenase

    Heslegrave Amanda J

    2012-05-01

    Full Text Available Abstract Background Loss of function mutations in 3-Hydroxyacyl-CoA Dehydrogenase (HADH cause protein sensitive hyperinsulinaemic hypoglycaemia (HH. HADH encodes short chain 3-hydroxacyl-CoA dehydrogenase, an enzyme that catalyses the penultimate reaction in mitochondrial β-oxidation of fatty acids. Mutations in GLUD1 encoding glutamate dehydrogenase, also cause protein sensitive HH (due to leucine sensitivity. Reports suggest a protein-protein interaction between HADH and GDH. This study was undertaken in order to understand the mechanism of protein sensitivity in patients with HADH mutations. Methods An oral leucine tolerance test was conducted in controls and nine patients with HADH mutations. Basal GDH activity and the effect of GTP were determined in lymphoblast homogenates from 4 patients and 3 controls. Immunoprecipitation was conducted in patient and control lymphoblasts to investigate protein interactions. Results Patients demonstrated severe HH (glucose range 1.7–3.2 mmol/l; insulin range 4.8-63.8 mU/l in response to the oral leucine load, this HH was not observed in control patients subjected to the same leucine load. Basal GDH activity and half maximal inhibitory concentration of GTP was similar in patients and controls. HADH protein could be co-immunoprecipitated with GDH protein in control samples but not in patient samples. Conclusions We conclude that GDH and HADH have a direct protein-protein interaction, which is lost in patients with HADH mutations causing leucine induced HH. This is not associated with loss of inhibitory effect of GTP on GDH (as in patients with GLUD1 mutations.

  10. Health information, behavior change, and decision support for patients with type 2 diabetes: development of a tailored, preference-sensitive health communication application

    Weymann N

    2013-10-01

    Full Text Available Nina Weymann,1 Martin Härter,1 Frank Petrak,2 Jörg Dirmaier11Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, 2Clinic of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, GermanyPurpose: Patient involvement in diabetes treatment such as shared decision-making and patient self-management has significant effects on clinical parameters. As a prerequisite for active involvement, patients need to be informed in an adequate and preference-sensitive way. Interactive Health Communication Applications (IHCAs that combine web-based health information for patients with additional support offer the opportunity to reach great numbers of patients at low cost and provide them with high-quality information and support at the time, place, and learning speed they prefer. Still, web-based interventions often suffer from high attrition. Tailoring the intervention to patients’ needs and preferences might reduce attrition and should thereby increase effectiveness. The purpose of this study was to develop a tailored IHCA offering evidence-based, preference-sensitive content and treatment decision support to patients with type 2 diabetes. The content was developed based on a needs assessment and two evidence-based treatment guidelines. The delivery format is a dialogue-based, tunneled design tailoring the content and tone of the dialogue to relevant patient characteristics (health literacy, attitudes toward self-care, and psychological barriers to insulin treatment. Both content and tailoring were revised by an interdisciplinary advisory committee.Conclusion: The World Wide Web holds great potential for patient information and self-management interventions. With the development and evaluation of a tailored IHCA, we complement face-to-face consultations of patients with their health care practitioners and make them more efficient and satisfying for both sides. Effects of the

  11. Distinct cerebral metabolic patterns related to high pain sensitivity in episodic or chronic migraine patients and healthy volunteers

    D'Ostilio, Kevin; Lisicki Martinez, Marco; Schoenen, Jean; Magis, Delphine

    2016-01-01

    Introduction Allodynia, i.e. pain evoked by a non-painful stimulus, is prevalent in chronic pain and in migraine where it augments with disease severity and chronicity [1]. Central sensitization is thought to be the culprit [2]. It is not known, however, which central areas are involved. The aim of the present study was to evaluate whether brain metabolism in subjects that are more sensitive to pain is different between migraine patients and healthy controls. Subjects and methods Qu...

  12. Improved insulin sensitivity and body fat distribution in HIV-infected patients treated with rosiglitazone: a pilot study.

    Gelato, Marie C; Mynarcik, Dennis C; Quick, Joyce L; Steigbigel, Roy T; Fuhrer, Jack; Brathwaite, Collin E M; Brebbia, John S; Wax, Mark R; McNurlan, Margaret A

    2002-10-01

    The insulin-sensitizing drugs thiazolidinediones (TZDs), such as rosiglitazone, improve insulin sensitivity and also promote adipocyte differentiation in vitro. The authors hypothesized that TZDs might be beneficial to patients with HIV disease to improve insulin sensitivity and the distribution of body fat by increasing peripheral fat. The ability of rosiglitazone (8 mg/d) to improve insulin sensitivity (from hyperinsulinemic-euglycemic clamp) and to improve body fat distribution (determined from computed tomography measurements of visceral adipose tissue [VAT] and subcutaneous adipose tissue [SAT]) was determined in 8 HIV-positive patients. Before treatment, the insulin sensitivity of the patients was reduced to approximately 34% of that in control subjects. The rate of glucose disposal during a hyperinsulinemic-euglycemic clamp (Rd) was 3.8 +/-.4 (SEM) mg glucose/kg lean body mass/min compared with 11.08 +/- 1.1 (p<.001) in healthy age- and body mass index (BMI)-matched control subjects. After rosiglitazone treatment of 6 to 12 weeks, Rd increased to 5.99 +/-.9 (p=.02), an improvement of 59 +/- 22%. SAT increased by 23 +/- 10% (p=.05), and, surprisingly, VAT was decreased by 21 +/- 8% (p=.04) with a trend for increased SAT/VAT that failed to reach statistical significance. There were no significant changes in blood counts, viral loads, or CD4 counts with rosiglitazone treatment. The study demonstrates that rosiglitazone therapy improves insulin resistance and body fat distribution in some patients with HIV disease. PMID:12394794

  13. SENSITIVITY TO ANTIBIOTICS, ANTISEPTICAL NOSOCOMIAL PSEUDOMONAS AERUGINOSA, ISOLATED IN UROLOGICAL PATIENTS

    Rymsha E.V.

    2015-05-01

    Full Text Available Introduction. Given the active introduction into clinical practice of new groups of antibiotics and antiseptics, the problem of treatment of purulent-inflammatory complications after prostatectomy and today is relevant. Of particular concern belated cases of diagnosis and treatment of postoperative complications in urological practice patients receiving antibiotic therapy The use of traditional antibiotics is not prevents the development of infection, because the problem of resistance of microorganisms to antibiotics and antiseptics remains relevant. The solution to the problem of development of infectious complications and prevent the formation of resistant clinical strains largely depends on the isolated pathogen, susceptibility to antimicrobial agents based on its bioavailability , ability to spread and penetrate into cells and tissues, selection of dose, interval, and route of administration to maintain minimum bactericidal concentration Material and methods. The study involved 145 patients who were treated in the urology Department of the Vinnytsia regional clinical hospital named of M. I. Pirogov. Patients underwent the surgical treatment of benign hypertrophic prostate. Material for bacteriological studies of purulent-inflammatory diseases were urine, pieces of the prostate, remote operationally, urinary catheters, through which conducted irrigation of the bladder. Specimen collection, transportation was carried out in accordance with modern requirements. Identification was done by morphological, cultural and biochemical properties. The definition of antibiotic resistance were performed according to "guidelines for the definition of sensitivity of microorganisms to antibiotics by the method of diffusion in agar using discs" (No. 2675-83, Kiev, 2007 12 .]. Evaluation of the results of determining the sensitivity of microorganisms to antibiotics was carried out on the basis of the determination of the zone of growth (mm of the studied

  14. Utilization of intravenous dihydroxypropyl theophylline (dyphylline) in an aminophylline-sensitive patient, and its pharmacokinetic comparison with theophylline.

    Lawyer, C H; Bardana, E J; Rodgers, R; Gerber, N

    1980-05-01

    The pharmacokinetics and urinary excretion of intravenously administered 7-(2,3-dihydroxypropyl) theophylline (dyphylline), were studied in a 37-yr-old asthmatic woman with ethylene diamine sensitivity who manifested intolerance to intravenous aminophylline on three separate occasions. In this subject, intravenously administered dyphylline was tolerated very well and was effective in the subsequent management of acute bronchospastic episodes. Dyphylline was significantly concentrated in the urine. This, coupled with its rapid clearance, suggests potential clinical application in patients with hepatic dysfunction. Though aminophylline sensitivity is rare, ethylene diamine sensitivity should be considered in untoward reactions to this drug. PMID:7372953

  15. Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety.

    Ulrey, K L; Amason, P

    2001-01-01

    Cultural diversity is becoming increasingly more important in the workplace. This is particularly true in health care organizations facing demographic shifts in the patients served and their families. This study serves to aid the development of intercultural communication training programs for health care providers by examining how cultural sensitivity and effective intercultural communication, besides helping patients, personally benefit health care providers by reducing their stress. Effective intercultural communication and cultural sensitivity were found to be related. Health care providers' levels of intercultural anxiety also were found to correlate with effective intercultural communication. PMID:11771806

  16. 42 CFR 22.1 - Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay.

    2010-10-01

    ... care of Hansen's disease patients; additional pay. 22.1 Section 22.1 Public Health PUBLIC HEALTH... Hansen's Disease Duty by Personnel Other Than Commissioned Officers § 22.1 Duty at a station of the Service devoted to the care of Hansen's disease patients; additional pay. (a) Non-commissioned...

  17. Association between polymorphisms of BAG-1 and XPD and chemotherapy sensitivity in advanced non-small-cell lung cancer patients treated with vinorelbine combined cisplatin regimen.

    Li, Ping; Wang, Ya-Di; Cheng, Jian; Chen, Jun-Chen; Ha, Min-Wen

    2015-12-01

    BCL-2 Associated athanogene 1 (BAG-1) and Xeroderma pigmentosum group D (XPD) are involved in the nucleotide excision repair pathway and DNA repair. We aimed to investigate whether polymorphisms in BAG-1 and XPD have effects on chemotherapy sensitivity and survival in patients with advanced non-small-cell lung cancer (NSCLC) treated with vinorelbine combined cisplatin (NP) regimen. A total of 142 patients with diagnosed advanced NSCLC were recruited in the current study. NP regimen was applied for all eligible patients. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for BAG-1 (codon 324) and XPD (codons 312 and 751) genotyping. The treatment response was evaluated according to the RECIST guidelines. Progression-free survival (PFS) and overall survival (OS) were record as median and end point, respectively. As for BAG-1 codon 324, the chemotherapy sensitivity in NSCLC patients with CT genotype was 0.383 times of those with CC genotype (P < 0.05). With respect to XPD codon 751, the chemotherapy sensitivity in NSCLC patients with Lys/Gln genotype was 0.400 times of those with Lys/Lys genotype (P < 0.05). In addition, NSCLC patients carrying combined C/C genotype at codon 324 in BAG-1, Asp/Asp of XPD codon 312, and Lys/Lys of XPD codon 751 produced a higher efficacy of NP chemotherapy compared to those carrying mutation genotypes (all P < 0.05). Further, there were significant differences in PFS between patients with combined C/C genotype of BAG-1 codon 324, Lys/Lys genotype of XPD codon 751, and Asp/Asp genotype of XPD codon 312 and patients carrying BAG-1 codon 324 C/T genotype, XPD codon751 Lys/Gln genotype, and XPD codon312 Asp/Asn genotype (P < 0.05). Multivariate Cox regression analysis indicated that the combined wild-type of codon 324 XPD, codon 751 XPD, and codon 312 BAG-1 is the protective factor for OS and PFS, and clinical stages is the risk factor for OS and PFS. In conclusion, our research

  18. Radioresistant DNA synthesis in cells of patients showing increased chromosomal sensitivity to ionizing radiation

    The rate of DNA synthesis after γ-irradiation was studied either by analysis of the steady-state distribution of daughter [3H]DNA in alkaline sucrose gradients or by direct assay of the amount of [3H]thymidine incorporated into DNA of fibroblasts derived from a normal donor (LCH882) and from Down's syndrome (LCH944), Werner's syndrome (WS1LE) and xeroderma pigmentosum (XP2LE) patients with chromosomal sensitivity to ionizing radiation. Doses of γ-irradiation that markedly inhibited the rate of DNA synthesis in normal human cells caused almost no inhibition of DNA synthesis in the cells from the affected individuals. The radioresistant DNA synthesis in Down's syndrome cells was mainly due to a much lower inhibition of replicon initiation than that in normal cells; these cells were also more resistant to damage that inhibited replicon elongation. Our data suggest that radioresistant DNA synthesis may be an intrinsic feature of all genetic disorders showing increased radiosensitivity in terms of chromosome aberrations. (orig.)

  19. Calcium dobesilate reduces endothelin-1 and high-sensitivity C-reactive protein serum levels in patients with diabetic retinopathy

    Javadzadeh, Alireza; Ghorbanihaghjo, Amir; Adl, Farzad Hami; Andalib, Dima; Khojasteh-Jafari, Hassan; Ghabili, Kamyar

    2013-01-01

    Purpose To determine the benefits of calcium dobesilate (CaD) administration on endothelial function and inflammatory status in patients with diabetic retinopathy through measurement of serum levels of endothelin-1 and high-sensitivity C-reactive protein (hsCRP). Methods In a double-blind, randomized clinical trial, 90 patients with either severe nonproliferative or proliferative diabetic retinopathy and with blood glucose level of 120–200 mg/dl were randomly allocated to treatment with eithe...

  20. Malignancy and mortality in a population-based cohort of patients with coeliac disease or 'gluten sensitivity'

    2007-01-01

    AIM: To determine the risk of malignancy and mortality in patients with a positive endomysial or anti-gliadin antibody test in Northern Ireland.METHODS: A population-based retrospective cohort study design was used. Laboratory test results used in the diagnosis of coeliac disease were obtained from the Regional Immunology Laboratory, cancer statistics from the Northern Ireland Cancer Registry and mortality statistics from the General Registrar Office, Northern Ireland. Age standardized incidence ratios of malignant neoplasms and standardized mortality ratios of all-cause and cause-specific mortality were calculated.RESULTS: A total of 13 338 people had an endomysial antibody and/or an anti-gliadin antibody test in Northern Ireland between 1993 and 1996. There were 490 patients who tested positive for endomysial antibodies and they were assumed to have coeliac disease. There were 1133 patients who tested positive for anti-gliadin antibodies and they were defined as gluten sensitive. Malignant neoplasms were not significantly associated with coeliac disease; however, all-cause mortality was significantly increased following diagnosis. The standardized incidence and mortality ratios for non-Hodgkin's lymphoma were increased in coeliac disease patients but did not reach statistical significance. Lung and breast cancer incidence were significantly lower and all-cause mortality, mortality from malignant neoplasms, non-Hodgkin's lymphoma and digestive system disorders were significantly higher in gluten sensitive patients compared to the Northern Ireland population.CONCLUSION: Patients with coeliac disease or gluten sensitivity had higher mortality rates than the Northern Ireland population. This association persists more than one year after diagnosis in patients testing positive for anti-gliadin antibodies. Breast cancer is significantly reduced in the cohort of patients with gluten sensitivity.

  1. Comparison of C-reactive protein and high-sensitivity C-reactive protein levels in patients on hemodialysis

    Imed Helal; Lilia Zerelli; Madiha Krid; Fethi ElYounsi; Hedi Ben Maiz; Bechir Zouari; Jaouida Adelmoula; Adel Kheder

    2012-01-01

    Chronic inflammation is highly prevalent in patients on hemodialysis (HD), as evidenced by increased levels of C-reactive protein (CRP). We compared CRP to high-sensitivity C-reactive protein (hs-CRP) to determine whether it has any clinical implications and prognostic significance in terms of mortality. CRP was measured using a standard immunoturbidometric assay on the COBAS; INTEGRA system and hs-CRP was measured using the Dade Behring on the Konelab Nephelometer in 50 patients on HD. CRP (...

  2. A sensitive high throughput ELISA for human eosinophil peroxidase: a specific assay to quantify eosinophil degranulation from patient-derived sources.

    Ochkur, Sergei I; Kim, John Dongil; Protheroe, Cheryl A; Colbert, Dana; Condjella, Rachel M; Bersoux, Sophie; Helmers, Richard A; Moqbel, Redwan; Lacy, Paige; Kelly, Elizabeth A; Jarjour, Nizar N; Kern, Robert; Peters, Anju; Schleimer, Robert P; Furuta, Glenn T; Nair, Parameswaran; Lee, James J; Lee, Nancy A

    2012-10-31

    Quantitative high throughput assays of eosinophil-mediated activities in fluid samples from patients in a clinical setting have been limited to ELISA assessments for the presence of the prominent granule ribonucleases, ECP and EDN. However, the demonstration that these ribonucleases are expressed by leukocytes other than eosinophils, as well as cells of non-hematopoietic origin, limits the usefulness of these assays. Two novel monoclonal antibodies recognizing eosinophil peroxidase (EPX) were used to develop an eosinophil-specific and sensitive sandwich ELISA. The sensitivity of this EPX-based ELISA was shown to be similar to that of the commercially available ELISA kits for ECP and EDN. More importantly, evidence is also presented confirming that among these granule protein detection options, EPX-based ELISA is the only eosinophil-specific assay. The utility of this high throughput assay to detect released EPX was shown in ex vivo degranulation studies with isolated human eosinophils. In addition, EPX-based ELISA was used to detect and quantify eosinophil degranulation in several in vivo patient settings, including bronchoalveolar lavage fluid obtained following segmental allergen challenge of subjects with allergic asthma, induced sputum derived from respiratory subjects following hypotonic saline inhalation, and nasal lavage of chronic rhinosinusitis patients. This unique EPX-based ELISA thus provides an eosinophil-specific assay that is sensitive, reproducible, and quantitative. In addition, this assay is adaptable to high throughput formats (e.g., automated assays utilizing microtiter plates) using the diverse patient fluid samples typically available in research and clinical settings. PMID:22750539

  3. An Experience with Managing Cancer Patients Reportedly Previously Informed of the Absence of Additional Available Antineoplastic Therapeutic Options

    George River

    2014-09-01

    Full Text Available Over the past 5 years, a small group of cancer patients who stated their physicians had determined there were no additional available antineoplastic therapeutic options (including potential investigational strategies were seen for a ‘second opinion' in a cancer hospital-based oncology program and subsequently experienced what can reasonably be characterized as having achieved meaningful ‘clinical benefit' (functioning at a fairly high level for a minimum 1 year in the work, home, and/or family environments following the further delivery of a variety of treatment approaches. While recognized to be limited (or even simply ‘anecdotal', this experience emphasizes several clinically relevant conclusions, including the overall utility of a ‘second-opinion' strategy and the potential that the reported statement of an individual practitioner or cancer program that all rational options have been attempted may be inaccurate.

  4. Measures of 'exposure needed for one additional patient to be harmed' in population-based case-control studies

    Hallas, J.; Christensen, R. D.; Sturmer, T.;

    2014-01-01

    Purpose The magnitude of risk for adverse drug reactions may be communicated by a measure of 'exposure needed for one additional patient to be harmed' (ENH). We present four ENH measures, based on four different counterfactual contrasts, as illustrated by the known effects of NSAID use on peptic...... ulcer bleeding. Methods The four measures were basic ENH (estimating the excess risk when treating the entire source population versus treating no one), age-restricted ENH (the entire source population above, e. g. 50 years old treated versus no one above 50 years old treated), standardised ENH (a...... 1995-2006. We incorporated prescription and census data to account for the source population's drug use. Results Estimates of basic, age-restricted, standardised and naturalistic ENH were 619 person-years (py) (95% confidence interval (CI): 558-684), 223 py (CI: 201-246), 131 py (CI: 118-144) and 162...

  5. Do patients with very few brain metastases from breast cancer benefit from whole-brain radiotherapy in addition to radiosurgery?

    An important issue in palliative radiation oncology is the whether whole-brain radiotherapy should be added to radiosurgery when treating a limited number of brain metastases. To optimize personalized treatment of cancer patients with brain metastases, the value of whole-brain radiotherapy should be described separately for each tumor entity. This study investigated the role of whole-brain radiotherapy added to radiosurgery in breast cancer patients. Fifty-eight patients with 1–3 brain metastases from breast cancer were included in this retrospective study. Of these patients, 30 were treated with radiosurgery alone and 28 with radiosurgery plus whole-brain radiotherapy. Both groups were compared for local control of the irradiated metastases, freedom from new brain metastases and survival. Furthermore, eight additional factors were analyzed including dose of radiosurgery, age at radiotherapy, Eastern Cooperative Oncology Group (ECOG) performance score, number of brain metastases, maximum diameter of all brain metastases, site of brain metastases, extra-cranial metastases and the time from breast cancer diagnosis to radiotherapy. The treatment regimen had no significant impact on local control in the univariate analysis (p = 0.59). Age ≤59 years showed a trend towards improved local control on univariate (p = 0.066) and multivariate analysis (p = 0.07). On univariate analysis, radiosurgery plus whole-brain radiotherapy (p = 0.040) and ECOG 0–1 (p = 0.012) showed positive associations with freedom from new brain metastases. Both treatment regimen (p = 0.039) and performance status (p = 0.028) maintained significance on multivariate analysis. ECOG 0–1 was positively correlated with survival on univariate analysis (p < 0.001); age ≤59 years showed a strong trend (p = 0.054). On multivariate analysis, performance status (p < 0.001) and age (p = 0.041) were significant. In breast cancer patients with few brain metastases, radiosurgery plus whole

  6. Spectrum and antibiotic sensitivity of bacteria contaminating the upper gut in patients with malabsorption syndrome from the tropics

    Naik Subhash R

    2003-05-01

    Full Text Available Abstract Background Various causes of malabsorption syndrome (MAS are associated with intestinal stasis that may cause small intestinal bacterial overgrowth (SIBO. Frequency, nature and antibiotic sensitivity of SIBO in patients with MAS are not well understood. Methods Jejunal aspirates of 50 consecutive patients with MAS were cultured for bacteria and colony counts and antibiotic sensitivity were performed. Twelve patients with irritable bowel syndrome were studied as controls. Results Culture revealed growth of bacteria in 34/50 (68% patients with MAS and 3/12 controls (p 2 to 1015 (median 105 in MAS and 100 to 1000 (median 700 CFU/ml in controls (p 0.003. 21/50 (42% patients had counts ≥105 CFU/ml in MAS and none of controls (p Escherichia coli respectively. The isolated bacteria were more often sensitive to quinolones than to tetracycline (ciprofloxacin: 39/47 and norfloxacin: 34/47 vs. tetracycline 19/47, Conclusions SIBO is common in patients with MAS due to various causes and quinolones may be the preferred treatment. This needs to be proved further by a randomized controlled trial.

  7. Additional Therapy with a Mistletoe Product during Adjuvant Chemotherapy of Breast Cancer Patients Improves Quality of Life: An Open Randomized Clinical Pilot Trial

    Wilfried Tröger; Zdravko Ždrale; Nevena Tišma; Miodrag Matijašević

    2014-01-01

    Background. Breast cancer patients receiving adjuvant chemotherapy often experience a loss of quality of life. Moreover chemotherapy may induce neutropenia. Patients report a better quality of life when additionally treated with mistletoe products during chemotherapy. Methods. In this prospective randomized open-label pilot study 95 patients were randomized into three groups. All patients were treated with an adjuvant chemotherapy. The primary objective of the study was quality of life, the s...

  8. Hypokalemic myopathy in a patient with gluten-sensitive enteropathy and dermatitis herpetiformis Duhring: A case report

    Zsolt Barta; Zsofia Miltenyi; Laszlo Toth; Arpad Illes

    2005-01-01

    The case of a 22-year-old patient with symptomatic hypokalemia caused by rhabdomyolysis is presented as a rarely reported complication of gluten-sensitive enteropathy (GSE) and dermatitis herpetiformis Duhring. The patient's myopathy ceased on potassium supplementation and her other complaints resolved while on gluten-free diet.Recovery was otherwise uneventful with a rapid decline in serum CPK level. At the time of her last follow-up a few months later, she was free of symptoms and CPK remained stable. Patients with GSE may present with hypokalemia in association with diarrhea and emesis, and if potassium loss is rapid, rhabdomyolysis may occur.

  9. Prognostic nomogram to predict progression-free survival in patients with platinum-sensitive recurrent ovarian cancer

    Lee, C.K.; Simes, R. J.; Brown, C.; Lord, S.; Wagner, U; Plante, M; Vergote, I; Pisano, C.; Parma, G.; Burges, A.; Bourgeois, H; Hogberg, T; Bentley, J; Angleitner-Boubenizek, L; Ferrero, A.

    2011-01-01

    BACKGROUND: Patients with platinum-sensitive recurrent ovarian cancer are a heterogeneous group, and it is not possible to accurately predict the progression-free survival (PFS) in these patients. We developed and validated a nomogram to help improve prediction of PFS in patients treated with platinum-based chemotherapy. METHODS: The nomogram was developed in a training cohort (n = 955) from the CALYPSO trial and validated in the AGO-OVAR 2.5 Study (n = 340). The proportional-hazards model (n...

  10. Endurance training improves insulin sensitivity and body composition in prostate cancer patients treated with androgen deprivation therapy

    Hvid, Thine; Winding, Kamilla; Rinnov, Anders; Dejgaard, Thomas Engel; Thomsen, Carsten; Iversen, Peter; Brasso, Klaus; Mikines, Kari J; van Hall, Gerrit; Lindegaard, Birgitte; Solomon, Thomas; Pedersen, Bente K

    2013-01-01

    Insulin resistance and changes in body composition are side effects of androgen deprivation therapy (ADT) given to prostate cancer patients. The present study investigated whether endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients. Nine men...... undergoing ADT for prostate cancer and ten healthy men with normal testosterone levels underwent 12 weeks of endurance training. Primary endpoints were insulin sensitivity (euglycemic-hyperinsulinemic clamps with concomitant glucose-tracer infusion) and body composition (dual-energy X-ray absorptiometry and...... magnetic resonance imaging). The secondary endpoint was systemic inflammation. Statistical analysis was carried out using two-way ANOVA. Endurance training increased VO2max (ml(O2)/min per kg) by 11 and 13% in the patients and controls respectively (P...

  11. Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)

    Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, ≤Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis. (author)

  12. Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)

    Kosuda, Shigeru; Watanabe, Masumi; Kobayashi, Hideo; Kusano, Shoichi [National Defence Medical College, Tokorozawa, Saitama (Japan); Ichihara, Kiyoshi

    1998-07-01

    Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, {<=}Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis. (author)

  13. Addition of anticholinergic solution prolongs bronchodilator effect of beta 2 agonists in patients with chronic obstructive pulmonary disease.

    Levin, D C; Little, K S; Laughlin, K R; Galbraith, J M; Gustman, P M; Murphy, D; Kram, J A; Hardie, G; Reuter, C; Ostransky, D; McFarland, K; Petty, T L; Silvers, W; Rennard, S I; Mueller, M; Repsher, L H; Zuwallack, R L; Vale, R

    1996-01-29

    A randomized, double-blind placebo-controlled clinical trial was designed to assess the safety, efficacy, and duration of the bronchodilation resulting from the addition of 500 micrograms of ipratropium bromide (Atrovent; Boehringer Ingelheim, CT) inhalation solution to standard small volume nebulizer treatments with 2.5 mg albuterol inhalation solution. A total of 195 patients (63% men, average age 64 years) with > 10 pack-year smoking histories and stable, moderate-to- severe chronic obstructive pulmonary disease (COPD; forced expiratory volume in 1 second [FEV1] 1.02 liter, 38.8% predicted) from eight university-affiliated chest clinics in seven U.S. cities were enrolled into the study. Asthma, rhinitis, and eosinophilia were exclusions, as was daily use of > 10 mg of prednisone (or 20 mg on alternate days). There was a 2-week stabilization period during which the patients were instructed in the use of the small volume nebulizers, which they used three times daily with albuterol alone. They were asked to keep daily logs of peak flow rates, pulmonary symptoms, and additional medication usage. On their test day 1 the subjects came to the pulmonary function laboratory having been off theophylline for 24 hours and beta 2-agonists for 12 hours and performed a baseline spirometry. They then received their morning small volume nebulizer treatment of albuterol to which was added either 500 micrograms if ipratropium bromide or a saline placebo. Spirometry was repeated at 15, 30, and 60 minutes, and then hourly for 8 hours. Subjects then took home a 2-week supply of albuterol and test drug for thrice daily use in their small volume nebulizer. They were evaluated for pulmonary symptoms and adverse effects every 14 days. The 8-hour spirometry was repeated on test day 43 and finally on test day 85. Primary data evaluated were the peak increase in FEV1 and the area between the FEV1 baseline value and the 8-hour FEV1 curve. Similar calculations were made for forced vital

  14. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

    Di Pierro F

    2012-07-01

    Full Text Available Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which could delay the introduction of injectable insulin or reduce the insulin dose needed. Commonly available as a nutraceutical, berberine is a potential candidate.Methods and results: Because its low oral bioavailability can be overcome by P-glycoprotein inhibitors like herbal polyphenols, we have tested the nutraceutical combination of Berberis aristata extract and Silybum marianum extract (Berberol® in type 2 diabetes in terms of its additive effect when combined with a conventional oral regimen for patients with suboptimal glycemic control. After 90 days of treatment, the nutraceutical association had a positive effect on glycemic and lipid parameters, significantly reducing glycosylated hemoglobin, basal insulin, homeostatic model assessment of insulin resistance, total and low-density lipoprotein cholesterol, and triglycerides. A relevant effect was also observed in terms of liver function by measuring aspartate transaminase and alanine transaminase. The product had a good safety profile, with distinctive gastrointestinal side effects likely due to its acarbose-like action.Conclusion: Although further studies should be carried out to confirm our data, Berberol could be considered a good candidate as an adjunctive treatment option in diabetes, especially in patients with suboptimal glycemic control.Keywords: berberine, silymarin, glycosylated hemoglobin, diabetes

  15. Highly sensitive proximity mediated immunoassay reveals HER2 status conversion in the circulating tumor cells of metastatic breast cancer patients

    Kim Phillip

    2011-12-01

    Full Text Available Abstract Background The clinical benefits associated with targeted oncology agents are generally limited to subsets of patients. Even with favorable biomarker profiles, many patients do not respond or acquire resistance. Existing technologies are ineffective for treatment monitoring as they provide only static and limited information and require substantial amounts of tissue. Therefore, there is an urgent need to develop methods that can profile potential therapeutic targets with limited clinical specimens during the course of treatment. Methods We have developed a novel proteomics-based assay, Collaborative Enzyme Enhanced Reactive-immunoassay (CEER that can be used for analyzing clinical samples. CEER utilizes the formation of unique immuno-complex between capture-antibodies and two additional detector-Abs on a microarray surface. One of the detector-Abs is conjugated to glucose oxidase (GO, and the other is conjugated to Horse Radish Peroxidase (HRP. Target detection requires the presence of both detector-Abs because the enzyme channeling event between GO and HRP will not occur unless both Abs are in close proximity. Results CEER was able to detect single-cell level expression and phosphorylation of human epidermal growth factor receptor 2 (HER2 and human epidermal growth factor receptor 1 (HER1 in breast cancer (BCa systems. The shift in phosphorylation profiles of receptor tyrosine kinases (RTKs and other signal transduction proteins upon differential ligand stimulation further demonstrated extreme assay specificity in a multiplexed array format. HER2 analysis by CEER in 227 BCa tissues showed superior accuracy when compared to the outcome from immunohistochemistry (IHC (83% vs. 96%. A significant incidence of HER2 status alteration with recurrent disease was observed via circulating tumor cell (CTC analysis, suggesting an evolving and dynamic disease progression. HER2-positive CTCs were found in 41% (7/17 while CTCs with significant HER2

  16. Monitoring of epidermal growth factor receptor tyrosine kinase inhibitor-sensitizing and resistance mutations in the plasma DNA of patients with advanced non-small cell lung cancer during treatment with erlotinib

    Sorensen, Boe S; Wu, Lin; Wei, Wen; Tsai, Julie; Weber, Britta; Nexo, Ebba; Meldgaard, Peter

    2014-01-01

    was tested in plasma DNA from patients with advanced NSCLC with allele-specific polymerase chain reaction assays. Blood samples from 23 patients with adenocarcinoma of NSCLC that carried tyrosine kinase inhibitor-sensitizing EGFR mutations were taken immediately before treatment with erlotinib......BACKGROUND: The feasibility of monitoring epidermal growth factor receptor (EGFR) mutations in plasma DNA from patients with advanced non-small cell lung cancer (NSCLC) during treatment with erlotinib and its relation to disease progression was investigated. METHODS: The amount of EGFR-mutant DNA....... Additional blood samples were taken at timed intervals until erlotinib treatment was withdrawn. RESULTS: The amount of plasma DNA with sensitizing EGFR mutations was found to be reduced after the first cycle of erlotinib treatment in 22 of 23 patients (96%). No patients presented with the resistant T790M...

  17. High-sensitivity C-reactive protein predicts target organ damage in Chinese patients with metabolic syndrome

    Zhao, Zhigang; Nie, Hai; He, Hongbo;

    2007-01-01

    with metabolic syndrome. A total of 1082 consecutive patients of Chinese origin were screened for the presence of metabolic syndrome according to the National Cholesterol Education Program's Adult Treatment Panel III. High-sensitivity C-reactive protein and target organ damage, including cardiac...... hypertrophy, carotid intima-media thickness, and renal impairment, were investigated. The median (25th and 75th percentiles) of high-sensitivity C-reactive protein in 619 patients with metabolic syndrome was 2.42 mg/L (0.75 and 3.66 mg/L) compared with 1.13 mg/L (0.51 and 2.46 mg/L) among 463 control subjects...... (P <.01). There was a progressive increase in high-sensitivity C-reactive protein level with the number of components of the metabolic syndrome. Stratification of patients with metabolic syndrome into 3 groups according to their high-sensitivity C-reactive protein concentrations (3.0 mg/L) showed...

  18. Assessment of the radiation sensitivity of patients after conditioning irradiation as preparation for bone marrow or stem cell transplantation

    The knowledge on the radiation sensitivity of individual patients would allow a better planning of conditioning irradiation including the possibility of dose increase that might enhance the chance of a successful bone marrow or stem cell transplantation. The study was focused on the search of reliable and fast laboratory test procedures to predict the individual radiation sensitivity. Several blood tests were evaluated with respect to their appropriateness: mostly flow-cytometric test on lymphocytes: micronuclei, cell proliferation, apoptosis activation of cytokines and the total number of leucocytes, blood stem cells CD4+ and CD8+ lymphocytes, and a spectro-photometric test of blood plasma for the determination of the antioxidative capacity

  19. Ranking hospitals for outcomes in total hip replacement - administrative data with or without additional patient surveys? - Part 1: Administrative data

    Dörning, Hans

    2007-03-01

    Full Text Available Background: Many hospital rankings rely on the frequency of adverse outcomes and are based on administrative data. In the study presented here, we tried to find out, to what extent available administrative data of German Sickness Funds allow for an adequate hospital ranking and compared this with rankings based on additional information derived from a patient survey. Total hip replacement was chosen as an example procedure. In part I of the publication, we present the results of the approach based on administrative data. Methods: We used administrative data from the AOK-Lower Saxony of the years 2000, 2001 and 2002. The study population comprised all beneficiaries, who received total hip replacement in the years 2000 or 2001. Performance indicators used where “critical incident (Mortality or revision” and “number of revisions” within the first year. Hospitals were ranked if they performed at least 20 procedures on AOK-beneficiaries in each of the two years. Multivariate modelling (logistic and poisson regression was used to estimate the performance indicators by case-mix variables (age, sex, co-diagnoses and hospital characteristics (hospital size, surgical volume. The actual ranking was based on these multivariate models, excluding hospital variables and adding dummy-variables for each hospital. Hospitals were ranked by their case-mix adjusted odds ratio or SMR respectively with respect to a pre-selected reference hospital. The resulting rankings were compared with each other, with regard to temporal stability, and the impact of case-mix variables.Results: About 4500 beneficiaries received total hip replacement in each year (n2000: 4482; n2001: 4579. The ranking included 65 hospitals. Comparing the years 2000 and 2001, the temporal stability of the rankings based on a single performance indicator was low (Spearman rang correlation coefficients 0.158 and 0.191. The agreement of rankings based on different performance indicators in the

  20. Effects of supplementation with omega-3 on insulin sensitivity and non-esterified free fatty acid (NEFA in type 2 diabetic patients

    Payam Farahbakhsh Farsi

    2014-06-01

    Full Text Available Objective: The aim of this study was to determine the role of omega-3 supplementation on NEFA concentration, insulin sensitivity and resistance, and glucose and lipid metabolism in type 2 diabetic patients. Subjects and methods: Forty-four type 2 diabetic patients were randomly recruited into two groups. Group A received 4 g/day omega-3 soft gels, and group B received a placebo for 10 wks. Blood samples were collected after 12-h fast. Physical activity records, three-day food records, and anthropometric measurements were obtained from all participants at the beginning and end of the study. Results: Omega-3 supplementation caused a significant reduction in NEFA in the intervention group compared with the placebo group (P = 0.009. Additionally, the administration of omega-3 resulted in significantly greater changes (Diff for the intervention group in various parameters, such as insulin and Quicki indices compared with the placebo group (P < 0.05. Conclusions: Omega-3 fatty acid supplementation in type 2 diabetic patients improved insulin sensitivity, probably due to the decrease in NEFA concentrations. Arq Bras Endocrinol Metab. 2014;58(4:335-40

  1. Low Rates of Additional Cancer Detection by Magnetic Resonance Imaging in Newly Diagnosed Breast Cancer Patients Who Undergo Preoperative Mammography and Ultrasonography

    Kim, Jisun; Han, Wonshik; Moon, Hyeong-Gon; Ahn, Soo Kyung; Shin, Hee-Chul; You, Jee-Man; Chang, Jung Min; Cho, Nariya; Moon, Woo Kyung; Park, In-Ae; Noh, Dong-Young

    2014-01-01

    Purpose We evaluated the efficacy of breast magnetic resonance imaging (MRI) for detecting additional malignancies in breast cancer patients newly diagnosed by breast ultrasonography and mammography. Methods We retrospectively reviewed the records of 1,038 breast cancer patients who underwent preoperative mammography, bilateral breast ultrasonography, and subsequent breast MRI between August 2007 and December 2010 at single institution in Korea. MRI-detected additional lesions were defined as...

  2. Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletoe Extract to Chemotherapy Alone

    Tröger, Wilfried; Jezdić, Svetlana; Ždrale, Zdravko; Tišma, Nevena; Hamre, Harald J; Matijašević, Miodrag

    2009-01-01

    Background: Chemotherapy for breast cancer often deteriorates quality of life, augments fatigue, and induces neutropenia. Mistletoe preparations are frequently used by cancer patients in Central Europe. Physicians have reported better quality of life in breast cancer patients additionally treated with mistletoe preparations during chemotherapy. Mistletoe preparations also have immunostimulant properties and might therefore have protective effects against chemotherapy-induced neutropenia. Pati...

  3. Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletoe Extract to Chemotherapy Alone

    Wilfried Tröger; Svetlana Jezdić; Zdravko Ždrale; Nevena Tišma; Hamre, Harald J; Miodrag Matijašević

    2009-01-01

    Background: Chemotherapy for breast cancer often deteriorates quality of life, augments fatigue, and induces neutropenia. Mistletoe preparations are frequently used by cancer patients in Central Europe. Physicians have reported better quality of life in breast cancer patients additionally treated with mistletoe preparations during chemotherapy. Mistletoe preparations also have immunostimulant properties and might therefore have protective effects against chemotherapy-induced neutropenia.Patie...

  4. National rates and regional differences in sensitization to allergens of the standard series. Population-adjusted frequencies of sensitization (PAFS) in 40,000 patients from a multicenter study (IVDK).

    Schnuch, A; Geier, J; Uter, W; Frosch, P J; Lehmacher, W; Aberer, W; Agathos, M; Arnold, R; Fuchs, T; Laubstein, B; Lischka, G; Pietrzyk, P M; Rakoski, J; Richter, G; Ruëff, F

    1997-11-01

    Sensitization rates to contact allergens vary between centers and are influenced by sex and age. Eliminating the latter 2 factors by standardization of data by age and sex, the present analysis addresses possible differences between centers remaining after elimination of these confounders, and analyzes other factors which might influence rates, e.g., the MOAHL index. Overall standardized rates were well within the range reported in previous studies and may be regarded as representing the rates of the "patch test population" in Central Europe (e.g., nickel sulfate 12.9%, fragrance mix 10.5%, balsam of Peru 7.3%, thimerosal 5.6%). For this analysis, data of those departments which contributed more than 2000 patients, or of those with extreme proportions concerning sex, age and occupational cases were selected. Patients from these 10 departments differed considerably with regard to the items of the MOAHL index and with regard to standardized rates. The items of the MOAHL index proved to be suitable for describing different patch test populations and for explaining some differences between centers. Only 'atopic dermatitis' seems to have little influence on (standardized) rates. Face dermatitis is not yet represented in the MOAHL index, but should be included, together with age > 40 years, in an extended index (acronym: MOAHLFA). Regional allergen exposure (with striking differences between East Germany, West Germany and, to a lesser extent, Austria) seems to have a great influence on the sensitization pattern observed in a department. In addition, sociological factors may influence sensitization rates, which is exemplified by high rates of nickel allergy in a socially defined subgroup. Future studies should focus on these factors, as well as on factors concerning patch test practices and quality control. PMID:9412746

  5. BPI-ANCA Provides Additional Clinical Information to Anti-Pseudomonas Serology: Results from a Cohort of 117 Swedish Cystic Fibrosis Patients

    Ulrika Lindberg; Malin Carlsson; Thomas Hellmark; Mårten Segelmark

    2015-01-01

    Patients with cystic fibrosis (CF) colonized with Pseudomonas aeruginosa (P. aeruginosa) have worse prognosis compared with patients who are not. BPI-ANCA is an anti-neutrophil cytoplasmic antibody against BPI (bactericidal/permeability increasing protein) correlating with P. aeruginosa colonization and adverse long time prognosis. Whether it provides additional information as compared to standard anti-P. aeruginosa serology tests is not known. 117 nontransplanted CF patients at the CF centre...

  6. Clinical features of panic patients sensitive to hyperventilation or breath-holding methods for inducing panic attacks

    A.E. Nardi; A.M. Valença; F.L. Lopes; Nascimento, I.; M.A. Mezzasalma; W.A. Zin

    2004-01-01

    Our aim was to compare the clinical features of panic disorder (PD) patients sensitive to hyperventilation or breath-holding methods of inducing panic attacks. Eighty-five PD patients were submitted to both a hyperventilation challenge test and a breath-holding test. They were asked to hyperventilate (30 breaths/min) for 4 min and a week later to hold their breath for as long as possible, four times with a 2-min interval. Anxiety scales were applied before and after the tests. We selected the...

  7. Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization

    Costantini, Raffaele; Affaitati, Giannapia; Massimini, Francesca; Tana, Claudio; Innocenti, Paolo; Giamberardino, Maria Adele

    2016-01-01

    Fibromyalgia, a chronic syndrome of diffuse musculoskeletal pain and somatic hyperalgesia from central sensitization, is very often comorbid with visceral pain conditions. In fibromyalgia patients with gallbladder calculosis, this study assessed the short and long-term impact of laparoscopic cholecystectomy on fibromyalgia pain symptoms. Fibromyalgia pain (VAS scale) and pain thresholds in tender points and control areas (skin, subcutis and muscle) were evaluated 1week before (basis) and 1wee...

  8. Characterization of a New Sensitive PCR Assay for Quantification of Viral DNA Isolated from Patients with Hepatitis B Virus Infections▿

    Thibault, Vincent; Pichoud, Christian; Mullen, Carolyn; Rhoads, James; Smith, Jane B.; Bitbol, Alain; Thamm, Sven; Zoulim, Fabien

    2007-01-01

    Sensitive and accurate quantification of hepatitis B virus (HBV) DNA is necessary for monitoring patients with chronic hepatitis receiving antiviral therapy in order to determine treatment response and to adapt therapy in case of inadequate virologic control. The development of quantitative PCR assays has been crucial in meeting these needs. The objective of this study was to compare the performance of a new real-time PCR assay (Abbott RealTime) for HBV DNA with that of three other commercial...

  9. Investigation of High-Sensitivity C-reactive Protein and Erythrocyte Sedimentation Rate in Low Back Pain Patients

    Park, Chan Hong; Lee, Sang Ho

    2010-01-01

    Background Chronic low back pain can be a manifestation of lumbar degenerative disease, herniation of intervertebral discs, arthritis, or lumbar stenosis. When nerve roots are compromised, low back pain, with or without lower extremity involvement, may occur. Local inflammatory processes play an important role in patients with acute lumbosciatic pain. The purpose of this study was to assess the value of erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) measu...

  10. Prediction of sensitivity to anticancer agents for patients with advanced or recurrent breast cancer by Tc-99m sestamibi

    Tc-99m Sestamibi (99mTc-MIBI) is known to be a substrate of P-glycoprotein (P-gp) that effluxes the drugs out of cancer cells. The overexpression of P-gp involved in multidrug resistance phenomenon in patients with advanced or recurrent breast cancers was shown in the plasma membrane of breast cancer cells. In this study, we examined the usefulness of 99mTc-MIBI scintigraphy for the prediction of sensitivity to anticancer agents in 8 cases with advanced or recurrent breast cancer. The retrospective analysis showed that the sensitivity to the chemotherapy could be evaluated in 3 cases by 99mTc-MIBI scintigraphy, but in the other 5 cases 99mTc-MIBI scintigraphy was not eligible for the prediction of sensitivity. Two out of 3 cases showed over 50% in reduction rate of target tumors (PR) with higher accumulation of 99mTc-MIBI, while another case with PD showed lower. These results suggest that the accumulation of 99mTc-MIBI could be associated with the sensitivity to P-gp-related anticancer agents, and that the functional analysis of P-gp by 99mTc-MIBI might be useful for the prediction of responsiveness of chemotherapy in patients with breast cancer. (author)

  11. Analysis of Culture and Drug Sensitivity Tests of Mycoplasmas for 387 Patients with Nongonococcal Urethritis (Cervicitis) in Chongqing

    翟志芳; 郝飞; 钟白玉; 黄秀英; 唐书谦; 刁庆春

    2004-01-01

    Objective: To investigate the prevalence of mycoplasma infections and the sensitivity to antibiotics among patients with nongonococcal urethritis or cervicitis (NGU) in Chongqing. Methods: 387 NGU cases with mycoplasma-positive results upon culture were analysed retrospectively. RESULTS: The majority of patients with mycoplasma infections were in the 20-40 year old age group. No significant difference was found between males and females. Ureaplasma urealyticum is the main pathogen of these NGU cases and no clear relationship between its concentration and pathogenic ability was noted. Drug sensitivity was tested against nine antibiotics; the sensitivity rates to josamycin, minocycline and doxycycline were 94.06%, 88.89% and 86.82% respectively, while the resistance rates to lincomycin, ofloxacin, azithromycin and roxthromycin were 74.94%, 42.12%, 41.60% and 40.31% in turn. Conclusions: Josamycin, minocycline and doxycycline could be used as the first choice to treat NGU with mycoplasma infections in Chongqing. It is important to select antibiotics for NGU treatment with mycoplasma infections based on the results of drug sensitivity tests.

  12. Comparison of the sensitivity of culture, PCR and quantitative real-time PCR for the detection of Pseudomonas aeruginosa in sputum of cystic fibrosis patients

    De Vos Daniel

    2009-11-01

    Full Text Available Abstract Background Pseudomonas aeruginosa is the major pathogen involved in the decline of lung function in cystic fibrosis (CF patients. Early aggressive antibiotic therapy has been shown to be effective in preventing chronic colonization. Therefore, early detection is important and sensitive detection methods are warranted. In this study, we used a dilution series of P. aeruginosa positive sputa, diluted in a pool of P. aeruginosa negative sputa, all from CF patients - to mimick as closely as possible the sputa sent to routine laboratories - to compare the sensitivity of three culture techniques versus that of two conventional PCR formats and four real-time PCR formats, each targeting the P. aeruginosa oprL gene. In addition, we compared five DNA-extraction protocols. Results In our hands, all three culture methods and the bioMérieux easyMAG Nuclisens protocol Generic 2.0.1, preceded by proteinase K pretreatment and followed by any of the 3 real-time PCR formats with probes were most sensitive and able to detect P. aeruginosa up to 50 cfu/ml, i.e. the theoretical minimum of one cell per PCR mixture, when taking into account the volumes used in this study of sample for DNA-extraction, of DNA-elution and of DNA-extract in the PCR mixture. Conclusion In this study, no difference in sensitivity could be found for the detection of P. aeruginosa from sputum between microbiological culture and optimized DNA-extraction and real-time PCR. The results also indicate the importance of the optimization of the DNA-extraction protocol and the PCR format.

  13. Elastography, a sensitive tool for the evaluation of neoadjuvant chemotherapy in patients with high-grade serous ovarian carcinoma

    Xie, Meng; ZHANG, XUYIN; JIA, ZHAN; Ren, Yunyun; Wang, Wenping

    2014-01-01

    The aim of the present study was to evaluate tumor stiffness by ultrasound elastography, which has the potential to provide additional information that is useful in predicting the response to neoadjuvant chemotherapy (NACT) in high-grade serous ovarian carcinoma (HGSC) patients. In total, 32 patients with International Federation of Gynecology and Obstetrics stage III and IV epithelial ovarian cancer treated with NACT underwent transvaginal and transabdominal sonography, followed by elastogra...

  14. Sensitization to Aeroallergens in Patients with Respiratory Allergies Based on Skin-Prick Test Results

    G Bejtullahu; Karahoda, N; H Pupovci; Lokaj-Berisha, V; Berisha, N; Lumezi, B; Ahmetaj, L

    2012-01-01

    Background: The aim of this study was to identify the most common aeroallergens in patients with asthma and rhinitis. Methods: The study enrolled 102 participants including 64 patients with respiratory allergies (among them 15 were clinically diagnosed as asthma patients, 41 with rhinitis, 8 were both) and 38 healthy controls. All of participants were subject of skin prick tests (SPT) with series of common allergenic extracts. Sera from all participants were tested for total IgE and eosinophi...

  15. The analysis of high sensitive C-reactive protein and diabetic nephropathy in patients with type 2 diabetes mellitus

    Objective: To investigate the changes of serum high sensitive C-reactive protein (hs-CRP) in different stages of diabetic nephropathy and their clinical significance. Methods: Serum hs-CRP was measured by enzyme-linked immunosorbent assay (ELISA), U-Alb was measured by radioimmunoassay(RIA). According to their urinary albumin excretion rate(UAER), 102 patients with type 2 diabetes mellitus were divided into three groups: 40 patients with normal UAER, 32 patients with microalbuminuria and 30 patients with clinical proteinuria, and 32 healthy subjects were taken as the controls control. Results: hs-CRP concentrations were significantly higher in patients with type 2 diabetes mellitus than those in healthy controls and increased with increment of UAER and serum creatinine. Conclusions: The level of hs-CRP is correlated with the extend of diabetic nephropathy in patients with type 2 diabetic patients.The concentration of hs-CRP can in some degree serve as a predictor for diabetic rephropathy and its progression. (authors)

  16. Relationship of High Sensitivity C-Reactive Protein with Cardiac Biomarkers in Patients Presenting with Acute Coronary Syndrome

    Objective: To determine high sensitivity C-reactive protein (hsCRP) levels in patients with acute myocardial infarction (AMI) and its correlation with classical enzyme markers of myocardial damage. Study Design: Observational study. Place and Duration of Study: Department of Emergency Medicine at King Khalid University Hospital, King Saud University, Riyadh and Department of Physiology, from August 2010 to December 2011. Methodology: Consecutive eligible patients with either ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI) who were admitted to the Emergency Department of King Khalid University Hospital were recruited. A total of 71 subjects were finally selected for the study. The hsCRP, Troponin I (Trop I), creatine kinase myocardial bound (CK-MB), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) concentrations of all patients with an acute myocardial infarction (AMI) were measured. Results: Among all patients 34 (47.9%) patients had diabetes mellitus, 21 (29.6%) were hypertensive, and 16 (22.5%) had no associated illness. Patients with STEMI had significantly higher levels of CKMB (p=0.0348), LDH (p=0.0471) and hsCRP (p=0.0231) compared to NSTEMI patients. While the differences were non-significant for Trop I (p=0.7022), AST (p=0.9729) and Lp(a) (p=0.5985). Spearman's correlations revealed that CRP correlated significantly with Trop I, CK-MB and LDH. There was a significant predictive relationship of hsCRP with Trop I, LDH and CK-MB while with AST it was nonsignificant. Conclusion: High sensitivity CRP levels is a significant predictor of standard markers for myocardial damage and it may be a useful prognostic marker in acute coronary syndromes. (author)

  17. Addition of atropine to submaximal exercise stress testing in patients evaluated for suspected ischaemia with SPECT imaging: a randomized, placebo-controlled trial

    To evaluate the effects of the addition of atropine to exercise testing in patients who failed to achieve their target heart rate (HR) during stress myocardial perfusion imaging with single-photon emission computed tomography (SPECT). The study was a prospective, randomized, placebo-controlled design. Patients with suspected or known coronary artery disease who failed to achieve a target HR (≥85% of maximal predicted HR) during exercise SPECT imaging were randomized to receive intravenous atropine (n = 100) or placebo (n = 101). The two groups of patients did not differ with respect to demographic or clinical characteristics. A higher proportion of patients in the atropine group achieved the target HR compared to the placebo group (60% versus 3%, p < 0.0001). SPECT imaging was abnormal in a higher proportion of patients in the atropine group as compared to the placebo group (57% versus 42%, p < 0.05). Stress-induced myocardial ischaemia was present in more patients in the atropine group as compared to placebo (47% versus 29%, p < 0.01). In both groups of patients, no major side effects occurred. The addition of atropine at the end of exercise testing is more effective than placebo in raising HR to adequate levels, without additional risks of complications. The use of atropine in patients who initially failed to achieve their maximal predicted HR is associated with a higher probability of achieving a diagnostic myocardial perfusion study. (orig.)

  18. Addition of atropine to submaximal exercise stress testing in patients evaluated for suspected ischaemia with SPECT imaging: a randomized, placebo-controlled trial

    Manganelli, Fiore; Sauro, Rosario; Di Lorenzo, Emilio; Rosato, Giuseppe [San Giuseppe Moscati Hospital, Department of Cardiology and Heart Surgery, Avellino (Italy); Spadafora, Marco; Varrella, Paola; Peluso, Giuseppina [San Giuseppe Moscati Hospital, Nuclear Medicine Unit, Avellino (Italy); Daniele, Stefania [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); Cuocolo, Alberto [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); University Federico II, Department of Biomorphological and Functional Sciences, Naples (Italy); National Council of Research, Institute of Biostructures and Bioimages, Naples (Italy)

    2011-02-15

    To evaluate the effects of the addition of atropine to exercise testing in patients who failed to achieve their target heart rate (HR) during stress myocardial perfusion imaging with single-photon emission computed tomography (SPECT). The study was a prospective, randomized, placebo-controlled design. Patients with suspected or known coronary artery disease who failed to achieve a target HR ({>=}85% of maximal predicted HR) during exercise SPECT imaging were randomized to receive intravenous atropine (n = 100) or placebo (n = 101). The two groups of patients did not differ with respect to demographic or clinical characteristics. A higher proportion of patients in the atropine group achieved the target HR compared to the placebo group (60% versus 3%, p < 0.0001). SPECT imaging was abnormal in a higher proportion of patients in the atropine group as compared to the placebo group (57% versus 42%, p < 0.05). Stress-induced myocardial ischaemia was present in more patients in the atropine group as compared to placebo (47% versus 29%, p < 0.01). In both groups of patients, no major side effects occurred. The addition of atropine at the end of exercise testing is more effective than placebo in raising HR to adequate levels, without additional risks of complications. The use of atropine in patients who initially failed to achieve their maximal predicted HR is associated with a higher probability of achieving a diagnostic myocardial perfusion study. (orig.)

  19. Fractionated Helical Tomotherapy as an alternative to radiosurgery in patients unwilling to undergo additional radiosurgery for recurrent brain metastases

    Sanghera, P; Lightstone, A W; Hyde, D.E.; Davey, P.

    2010-01-01

    Our clinic routinely treats brain metastases with stereotactic radiosurgery using a 6 megavoltage (MV) linear accelerator, cones, and a surgically attached head frame. Four patients declined repeat radiosurgery for new lesions due to their previous discomfort and a fifth patient could not complete radiosurgery because of uncontrolled nausea. Instead patients were treated with Helical Tomotherapy (HT). This report discusses the spatial dose distribution of HT as measured in a head phantom and ...

  20. Estimation of the sensitivity and specificity of ASAS criteria for peripheral spondyloarthritis in patients with early psoriatic arthritis

    E. Yu. Loginova

    2015-01-01

    Full Text Available Objective: to estimate the sensitivity and specificity of ASAS (Assessment of Spondyloarthritis International Society criteria for peripheral spondyloarthritis (SpA in patients with early psoriatic arthritis (ePsA.Subjects and methods. Examinations was made in 45 patients (17 men and 28 women with ePsA meeting the CASPAR (ClASsification criteria for Psoriatic ARthritis criteria (mean age, 37 years; disease duration, 1 year and in 20 patients (9 men and 11 women with signs of peripheral SpA meeting the ESSG (European Spondyloarthropathy Study Group criteria (mean age, 23 years; disease duration, 2.25 years; control group. The investigators estimated 78/76 tender/swollen joints and enthuses using MASES (Maastricht Ankylosing Spondylitis Enthesitis Score and assessed the presence of inflammatory spinal pain according to the ASAS criteria, psoriasis, uveitis, inflammatory bowel diseases, genitourinary and/or enteric infections, and a family history of SpA. They also performed X-ray studies of the hand and distal portions of the foot and pelvis and graded sacroilitis using the Kellgren scores. HLA-B27, C-reactive protein, and erythrocyte sedimentation rate were determined. The sensitivity/specificity, likelihood ratios, and clinical value of criteria were calculated.Results. 41/4 and 31/14 patents with ePsA met/unmet Criteria Sets I and II. The sensitivity/specificity of Sets I and II was 91.1/10% and 68.8/95%, respectively. One patient with ePsA and two patients in the control group did not meet one of the sing sets. The total sensitivity/specificity was 97.8/10%. In the control group, the sensitivity/specificity of Sets I and II was 91.1/100% and 68.8/100%, respectively. For ePsA, the positive likelihood ratio proved to be high for Set II (13.78% and low for Set I (1.01.Conclusion. ASAS Criteria Set I for peripheral SpA is of low value in identifying ePsA and Sign Set II shows a high value in diagnosing ePsA as it includes the major clinical

  1. Assessment of pain sensitivity in patients with deep bite and sex- and age-matched controls

    Sonnesen, Ane Liselotte; Svensson, Peter

    2011-01-01

    , and the significant differences were then tested for the effect of the presence of temporomandibular disorder (TMD) by linear regression. RESULTS: Glutamate-evoked pain intensity was significantly different between groups with no gender differences. Quality of pain did not vary between groups, but significant gender......-related differences were observed. Significant differences in thermal sensitivity between groups and gender were found, whereas mechanical sensitivity did not vary between groups but between genders. None of the significant differences were due to the effect of TMD. CONCLUSION: These data provide further evidence...

  2. Increased sensitivity to supra-threshold painful stimuli in patients with multiple functional somatic symptoms (MFS)

    Kuzminskyte, Ruta; Kupers, Ronny Clement Florent; Videbech, Poul; Gjedde, Albert; Fink, Per

    threshold and pain tolerance levels in patients with MFS. Twenty-two patients with MFS and 27 age- and sex-matched healthy control subjects volunteered for this study. The subjects received innocuous and noxious thermal stimuli to the volar forearm by means of a Peltier contact heat probe. We assessed pain...

  3. Spectrally resolved and phase-sensitive far-field measurement for the coherent addition of laser pulses in a tiled grating compressor.

    Hornung, Marco; Bödefeld, Ragnar; Kessler, Alexander; Hein, Joachim; Kaluza, Malte C

    2010-06-15

    We describe a method that can be used for the coherent addition of laser pulses. As different laser pulses are initially generated in a laser-pulse compressor equipped with a tiled grating, such a coherent addition is indispensable in order to maximize the intensity in the laser far field. We present measurements in this context where, up to now, an unavoidable difference in the grating constants between the phased gratings reduced the maximum achievable intensity. The method significantly facilitates the high-precision alignment of a tiled grating compressor and could also be used for a coherent addition of laser pulses. PMID:20548390

  4. Addition of sunitinib to cetuximab and irinotecan in patients with heavily pre-treated advanced colorectal cancer

    Qvortrup, Camilla; Jensen, Benny Vittrup; Jørgensen, Trine Lembrecht;

    2010-01-01

    Results of continuous sunitinib, in combination with cetuximab and irinotecan every other week (SIC) for compassionate use in heavily pre-treated patients with mCRC are presented.......Results of continuous sunitinib, in combination with cetuximab and irinotecan every other week (SIC) for compassionate use in heavily pre-treated patients with mCRC are presented....

  5. The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures

    Lenzen, Mattie J; Scholte op Reimer, Wilma J M; Pedersen, Susanne S.; Boersma, Eric; Maier, Willibald; Widimsky, Petr; Simoons, Maarten L; Mercado, Nestor F; Wijns, William

    2007-01-01

    Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary arter...

  6. Plasma semicarbazide-sensitive amine oxidase is elevated in patients with congestive heart failure

    Boomsma, F; vanVeldhuisen, DJ; deKam, PJ; ManintVeld, AJ; Mosterd, A; Lie, KI; Schalekamp, MADH

    1997-01-01

    Objective: Semicarbazide-sensitive amine oxidase (SSAO) is present in various mammalian tissues, especially in vascular smooth muscle cells, but also in plasma. The enzyme has been suggested to play a role in vascular endothelial damage through conversion of amines into cytotoxic aldehydes, ammonia

  7. Cut-Off Value for Pain Sensitivity Questionnaire in Predicting Surgical Success in Patients with Lumbar Disc Herniation

    Azimi, Parisa; Benzel, Edward C.

    2016-01-01

    Various factors related to predict surgical success were studied; however, a standard cut-off point for the Pain Sensitivity Questionnaire (PSQ) measure has not yet been established for a favorable surgical outcome for lumbar disc herniation (LDH). This study was to find the optimal cut-off point on the PSQ to distinguish surgical success in patients with LDH. A total of 154 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between February 2011 and January 2014. All participants completed the PSQ. Patients completed the Oswestry Disability Index (ODI) score before surgery, and at 2 years after surgery. Surgical success was defined as a 13-point improvement from the baseline ODI scores. The cut-off value for PSQ was determined by the receiver-operating characteristic curve (ROC). The mean age of patients was 49.3±9.6 years, and there were 80 women. The mean time for follow-up assessment was 31±5 months (range 24–35). Post-surgical success was 79.9% (n = 123) at 2 years follow up. The mean score for the total PSQ, PSQ-minor, and PSQ-moderate were 6.0 (SD = 1.6), 5.4 (SD = 1.9) and 6.5 (SD = 1.7), respectively. Total PSQ score was also significantly correlated with the total scores of the ODI. The optimal total PSQ cut-off point was determined as > 5.2 to predict surgical success in LDH patients, with 80.0% sensitivity and 75.6% specificity (AUC-0.814, 95% CI 0.703–0.926). This study showed that the PSQ could be considered a parameter for predicting surgical success in patients with LDH, and can be useful in clinical practice. PMID:27494617

  8. Contrast visual acuity in patients with retinitis pigmentosa assessed by a contrast sensitivity tester

    Maho Oishi

    2012-01-01

    Full Text Available Purpose: To assess contrast visual acuity (CVA in patients with retinitis pigmentosa (RP and compare the result with standard visual acuity (VA, retinal thickness, status of inner segment/outer segment junction, and central visual field. Materials and Methods: Thirty-nine eyes of 39 patients with RP and 39 eyes of 39 healthy individuals were studied. To see the difference in CVA between RP patients and normal controls, only subjects with standard VA of 1.0 (20/20 or better were included. This was a cross-sectional study. CVA in various light conditions was measured with CAT-2000 and was compared between patients and controls. CVA of patients was further analyzed for association with other parameters including foveal retinal thickness, outer nuclear layer thickness, the status of inner segment/outer segment junction measured with optical coherence tomography (OCT, and visual field mean deviation (MD measured with Humphrey field analyzer 10-2 program. Results: CVA impairment was evident in RP patients compared to controls (P < 0.01, in all measurement conditions. Multivariate analysis showed association of logarithm of the minimum angle of resolution (logMAR with CVAs in several conditions. None of the OCT measurements was associated with CVA. When patients were divided into three groups based on MD, the most advanced group (MD worse than or equal to –20 dB showed impairment of mesopic CVA (P < 0.05, under mesopic condition of 100% without glare, with glare, and 25% without glare. Conclusion: CVA impairment was confirmed in RP patients, especially in advanced cases. CVA measured with CAT-2000 may be a useful tool for assessing foveal function in RP patients.

  9. A longitudinal examination of the association between nurse staffing levels, the practice environment and nurse-sensitive patient outcomes in hospitals

    Chau, Janita P. C.; Lo, Suzanne H. S.; Choi, K. C.; Chan, Eric L. S.; McHugh, Matthew D.; Tong, Danny W. K.; Kwok, Angela M. L.; Ip, W.Y.; Lee, Iris F. K.; Lee, Diana T. F.

    2015-01-01

    Background The level of patient safety and outcomes accomplished depends on the quality of care provided. Previous studies found that nurse-to-patient ratio, practice environment, and nursing education were significant predictors of patient outcomes. However, the outcomes measured in previous studies were mainly inpatient mortality and failure-to-rescue rates. Few nurse-sensitive patient outcomes have been measured that quantify nurses’ contribution to patient care. Selecting appropriate outc...

  10. Correlation between neuromelanin-sensitive MR imaging and {sup 123}I-FP-CIT SPECT in patients with parkinsonism

    Kuya, Keita; Shinohara, Yuki; Miyoshi, Fuminori; Fujii, Shinya; Tanabe, Yoshio; Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Yonago (Japan)

    2016-04-15

    Neuromelanin-sensitive MR imaging (MRI) can visualize neuromelanin-containing neurons in the substantia nigra pars compacta (SNc), and its utility has been reported in the evaluation of parkinsonism. Conversely, dopamine transporter imaging by {sup 123}I-N-v-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl)nortropane (FP-CIT) SPECT (DaTSCAN) is now an established method for evaluating parkinsonism, detecting presynaptic dopamine neuronal dysfunction. Both methods can assist differentiating neurodegenerative and other forms of parkinsonism. However, to our knowledge, there have been no studies concerning a correlation between the two methods. The aim of this study was to assess the utility of neuromelanin-sensitive MRI for diagnosing parkinsonism by examining a correlation with DaTSCAN. Twenty-three patients with parkinsonism who underwent both neuromelanin-sensitive MRI and DaTSCAN were included. We measured the neuromelanin-positive SNc region volume by manually contouring the high signal intensity region of the SNc on neuromelanin-sensitive MRI and measured the specific binding ratio (SBR) on DaTSCAN. The asymmetry index of neuromelanin-positive SNc volume and the asymmetry index of SBR were also calculated. The volume of the neuromelanin-positive SNc region showed significant correlation with specific binding ratio (SBR) (right P <.001, ρ = 0.78, left P <.001, ρ = 0.86). The asymmetry index of neuromelanin-positive SNc volume also showed significant correlations with the asymmetry index of SBR (P <.001, ρ = 0.73). Decrease of the high signal intensity region of the SNc on neuromelanin-sensitive MRI would indicate damage to the nigrostriatal dopaminergic function as well as loss of dopaminergic neurons. We conclude that neuromelanin-sensitive MRI is a useful diagnostic biomarker for parkinsonism. (orig.)

  11. Sensitivity to ionising radiation of lymphocytes from Huntington's chorea patients compared to controls

    Blood samples were collected from 22 patients with Huntington's chorea and from 22 matched controls. Lymphocytes were separated from aliquots of each sample and cultures set up both from these and from further aliquots of whole blood. After 24 hours, half of each culture was subjected to X irradiation. Seventy-two hours later the percentages of live lymphocytes were estimated for each half of every culture and the viability ratio calculated for each sample. The lymphocytes derived from the patients with Huntington's chorea were found to be more susceptible to X irradiation than were the lymphocytes derived from controls. This was true both for whole blood and separated lymphocyte cultures. This susceptibility was found not to be the result of the main types of medication received by the patients. The small differences between viability ratios from patients and controls and the degree of overlap makes this test unsuitable for the prediction of asymptomatic carriers of the Huntington's chorea gene. (author)

  12. Mold sensitization is common amongst patients with severe asthma requiring multiple hospital admissions

    Hopkinson Linda C; O'Driscoll B Ronan; Denning David W

    2005-01-01

    Abstract Background Multiple studies have linked fungal exposure to asthma, but the link to severe asthma is controversial. We studied the relationship between asthma severity and immediate type hypersensitivity to mold (fungal) and non-mold allergens in 181 asthmatic subjects. Methods We recruited asthma patients aged 16 to 60 years at a University hospital and a nearby General Practice. Patients were categorized according to the lifetime number of hospital admissions for asthma (82 never ad...

  13. Cardiac β 2-adrenoceptor sensitization by chronic β1-selective antagonist treatment in patients with essential hypertension

    Peng Yingxin; Qi Xiaoyong; Xue Hao; Zhang Jianqing; Ma Shuping

    2002-01-01

    Objective:It has been hypothesized that with drawal of treatment with β 1-selective antagonist leads to increased sensitivity of β - adrenoceptor stimulation with isoproterenol.Several studies in vitro have shown that cardiac β 2- adrenoceptor was sensitized by β 1-selective antagonist treatment in patients with coronary heart disease.Therefore,the object of the present study was to explore in vivo to demonstrate that the cardiac β 2- adrenoceptor is sensitized in patients with essential hypertension by the chronic β 1-selective antagonis. Methods: β - adrenoceptor in peripheral lymphocytes was assessed by 3H-dihydyoalprenolol(3H-DHA) radio ligand binding. β - adrenaleptor responsiveness was measured by sulbtamol( β 2-selective agonist) in male patients with essential hypertension after β 1-selective antagonist treatment for at least 4 months (twenty cases)and.with drugs other than β 1-antagonist for at least 4 months(twenty cases).Results:In patients with β 1-selective antagonist treatment and those with non- β -antagonist treatment the maximal number of binding sites( β max)in peripheral lymphocytes was not significantly different(528+104fmol/107cell v s.571±98fmol/107cell ,P>0.05) In β 1-selective antagonist treatment group the chronotropic dose of sulbtamol(in) required to increase heart rate by 30beats/min.(CD30) was significantly lower than that in non - β -antagonist treatment group(1.8±0.3 μ g/kg v s.2.7±0.2 μ g/kg,P<0.001).The maximal fall of diastolic pressure(0.96±0.50kPa v s.0.91±0.42kPa) were not significatn changed(P>0.05) after sulbtamol injection. Conclusion:The treatment with β 1-selective antagonist led to sensitization of β 2-adrenoceptor function,while no change in β 2- adrenoceptors density in peripheral lymphocytes in vivo in patients with essential hypertension,the dissociation between function and density of cardiac β 2- adrenoceptors may partially explain the mechanism of β -antagonist withdrawal syndrome.

  14. Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)

    Dubin, Ruth F.; Li, Yongmei; He, Jiang; Jaar, Bernard G.; Kallem, Radhakrishna; Lash, James P.; Makos, Gail; Rosas, Sylvia E.; Soliman, Elsayed Z.; Townsend, Ray R; Yang, Wei; Go, Alan S.; Keane, Martin; deFilippi, Christopher; Mishra, Rakesh

    2013-01-01

    Abstract Background Cardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD). Methods We...

  15. Sensitivity and specificity of the amer dizziness diagnostic scale (adds) for patients with vestibular disorders

    Al Saif, Amer; Alsenany, Samira

    2015-01-01

    [Purpose] To investigate the sensitivity and specificity of a newly developed diagnostic tool, the Amer Dizziness Diagnostic Scale (ADDS), to evaluate and differentially diagnose vestibular disorder and to identify the strengths and weaknesses of the scale and its usefulness in clinical practice. [Subjects and Methods] Two hundred subjects of both genders (72 males, 128 females) aged between 18 to 60 (49.5±7.8) who had a history of vertigo and/or dizziness symptoms for this previous two weeks...

  16. Clinical criteria replenish high-sensitive troponin and inflammatory markers in the stratification of patients with suspected acute coronary syndrome.

    Barbara Elisabeth Stähli

    Full Text Available OBJECTIVES: In patients with suspected acute coronary syndrome (ACS, rapid triage is essential. The aim of this study was to establish a tool for risk prediction of 30-day cardiac events (CE on admission. 30-day cardiac events (CE were defined as early coronary revascularization, subsequent myocardial infarction, or cardiovascular death within 30 days. METHODS AND RESULTS: This single-centre, prospective cohort study included 377 consecutive patients presenting to the emergency department with suspected ACS and for whom troponin T measurements were requested on clinical grounds. Fifteen biomarkers were analyzed in the admission sample, and clinical parameters were assessed by the TIMI risk score for unstable angina/Non-ST myocardial infarction and the GRACE risk score. Sixty-nine (18% patients presented with and 308 (82% without ST-elevations, respectively. Coronary angiography was performed in 165 (44% patients with subsequent percutaneous coronary intervention--accounting for the majority of CE--in 123 (33% patients, respectively. Eleven out of 15 biomarkers were elevated in patients with CE compared to those without. High-sensitive troponin T (hs-cTnT was the best univariate biomarker to predict CE in Non-ST-elevation patients (AUC 0.80, but did not yield incremental information above clinical TIMI risk score (AUC 0.80 vs 0.82, p = 0.69. Equivalence testing of AUCs of risk models and non-inferiority testing demonstrated that the clinical TIMI risk score alone was non-inferior to its combination with hs-cTnT in predicting CE. CONCLUSIONS: In patients presenting without ST-elevations, identification of those prone to CE is best based on clinical assessment based on TIMI risk score criteria and hs-cTnT.

  17. Addition of 25-hydroxyvitamin D levels to the Deyo-Charlson Comorbidity Index improves 90-day mortality prediction in critically ill patients

    Mahato, Bisundev; Otero, Tiffany M. N.; Holland, Carrie A.; Giguere, Patrick T.; Bajwa, Ednan K; Camargo, Carlos A.; Quraishi, Sadeq A

    2016-01-01

    Background The Deyo-Charlson Comorbidity Index (DCCI) has low predictive value in the intensive care unit (ICU). Our goal was to determine whether addition of 25-hydroxyvitamin D (25OHD) levels to the DCCI improved 90-day mortality prediction in critically ill patients. Methods Plasma 25OHD levels, DCCI, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were assessed within 24 h of admission in 310 ICU patients. Receiver operating characteristic curves of the prediction...

  18. Added value of SPECT/CT in addition to whole-body scintigraphy augmented with prone lateral views in patients with well-differentiated thyroid carcinoma

    ATASAYAR N.

    2014-01-01

    Purpose: We aimed to determine the impact of SPECT/CT performed in addition to whole-­‐body scintigraphy augmented with prone lateral views in patients with well-­‐differentiated thyroid carcinoma. Methods and Materials: This retrospective study included 141 patients (87 female, 54 male, mean age 47 years) with well-­‐differentiated thyroid carcinoma (105 papillary, 31 follicular, 1 Hürthle cell and 4 poorly differentiated) treated with radioiodine therapy (1000-7400 MBq). P...

  19. Additive efficacy of short-acting bronchodilators on dynamic hyperinflation and exercise tolerance in stable COPD patients treated with long-acting bronchodilators

    Kitaguchi, Yoshiaki; Fujimoto, Keisaku; Komatsu, Yoshimichi; Hanaoka, Masayuki; Honda, Takayuki; Kubo, Keishi

    2013-01-01

    The purpose of this study was to clarify the additive efficacy of short-acting beta(2)-agonists (SABA) or muscarinic antagonists (SAMA) on dynamic hyperinflation and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) who had been treated with long-acting bronchodilators. Thirty-two patients with stable COPD who had been treated with long-acting bronchodilators, including long-acting muscarinic antagonists (LAMA), were examined by pulmonary function tests, dynamic...

  20. Dual-energy-CT of hypervascular liver lesions in patients with HCC: investigation of image quality and sensitivity

    To investigate dual-energy CT of hypervascular liver lesions in patients with HCC. Forty patients with hepatocellular carcinomas were investigated with abdominal dual-energy CT. In each patient unenhanced and contrast-enhanced imaging with arterial und portovenous delay were performed. Hypervascular lesions were documented on arterial phase 80-kVp images, 140-kVp images, and the averaged arterial images by two radiologists. Subjective image quality (5-point scale, from 5 [excellent] to 1 [not interpretable]) was rated on all images. The mean number of hypervascular HCC lesions detected was 3.37 ± 1.28 on 80-kVp images (p < 0.05), 1.43 ± 1.13 on 140-kVp images (p < 0.05), and 2.57 ± 1.2 on averaged images. The image quality was 0.3 ± 0.5 for 80-kVp (p < 0.05), 1.6 ± 0.5 for 140-kVp (p < 0.05) and 3.2 ± 0.4 for the averaged images. Low-kVp images of dual-energy datasets are more sensitive in detecting hypervascular liver lesions. However, this increase in sensitivity goes along with a decrease in the subjective image quality of low-kVp images. (orig.)

  1. c-MYC expression sensitizes medulloblastoma cells to radio- and chemotherapy and has no impact on response in medulloblastoma patients

    To study whether and how c-MYC expression determines response to radio- and chemotherapy in childhood medulloblastoma (MB). We used DAOY and UW228 human MB cells engineered to stably express different levels of c-MYC, and tested whether c-MYC expression has an effect on radio- and chemosensitivity using the colorimetric 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl) -2H-tetrazolium inner salt (MTS) assay, clonogenic survival, apoptosis assays, cell cycle analysis, and western blot assessment. In an effort to validate our results, we analyzed c-MYC mRNA expression in formalin-fixed paraffin-embedded tumor samples from well-documented patients with postoperative residual tumor and compared c-MYC mRNA expression with response to radio- and chemotherapy as examined by neuroradiological imaging. In DAOY - and to a lesser extent in UW228 - cells expressing high levels of c-MYC, the cytotoxicity of cisplatin, and etoposide was significantly higher when compared with DAOY/UW228 cells expressing low levels of c-MYC. Irradiation- and chemotherapy-induced apoptotic cell death was enhanced in DAOY cells expressing high levels of c-MYC. The response of 62 of 66 residual tumors was evaluable and response to postoperative radio- (14 responders (CR, PR) vs. 5 non-responders (SD, PD)) or chemotherapy (23 CR/PR vs. 20 SD/PD) was assessed. c-MYC mRNA expression was similar in primary MB samples of responders and non-responders (Mann-Whitney U test, p = 0.50, ratio 0.49, 95% CI 0.008-30.0 and p = 0.67, ratio 1.8, 95% CI 0.14-23.5, respectively). c-MYC sensitizes MB cells to some anti-cancer treatments in vitro. As we failed to show evidence for such an effect on postoperative residual tumors when analyzed by imaging, additional investigations in xenografts and larger MB cohorts may help to define the exact function of c-MYC in modulating response to treatment

  2. Patient dose reduction using a high-sensitivity imaging plate with frequency processing

    Nishihara, Sadamitsu; Ohmura, Keiko; Ohtsuka, Akiyoshi; Yoshida, Ken-ichi; Yamauchi, Syuichi; Ueda, Katsuhiko; Nakanishi, Takashi [Yamaguchi Univ., Ube (Japan). School of Medicine; Fujikawa, Tsuyoshi

    1995-11-01

    There are two types of imaging plate (HR and ST) in Fuji Computed Radiography System. We studied the reduction in patient dose using ST with equivalent image qualities through the use of image processing (ST{sub Pro}) for HR. As a result, when the image quality of HR and ST{sub Pro} were almost the same, the incident dose of HR and ST{sub Pro} were about 0.13 {mu}C/kg and 0.09 {mu}C/kg respectively. Therefore, the patient dose using ST{sub Pro}, is expected about 30% reduction to HR. (author).

  3. Patient dose reduction using a high-sensitivity imaging plate with frequency processing

    There are two types of imaging plate (HR and ST) in Fuji Computed Radiography System. We studied the reduction in patient dose using ST with equivalent image qualities through the use of image processing (STPro) for HR. As a result, when the image quality of HR and STPro were almost the same, the incident dose of HR and STPro were about 0.13 μC/kg and 0.09 μC/kg respectively. Therefore, the patient dose using STPro, is expected about 30% reduction to HR. (author)

  4. The scars of childhood adversity: minor stress sensitivity and depressive symptoms in remitted recurrently depressed adult patients.

    Gemma Kok

    Full Text Available Childhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily stress is associated with depressive relapse. Therefore, we examine the impact of childhood adversity on daily stress and its predictive value on prospectively assessed depressive symptoms in recurrently depressed patients.Daily stress was assessed in recurrently depressed adult patients, enrolled into two randomized trials while remitted. The reported intensity and frequency of dependent and independent daily stress was assessed at baseline. Independent stress is externally generated, for example an accident happening to a friend, while dependent stress is internally generated, for example getting into a fight with a neighbor. Hierarchical regression analyses were performed with childhood adversity, independent and dependent daily stress as predictor variables of prospectively measured depressive symptoms after three months of follow-up (n = 138.We found that childhood adversity was not significantly associated with a higher frequency and intensity of daily stress. The intensity of both independent and dependent daily stress was predictive of depressive symptom levels at follow-up (unadjusted models respectively: B = 0.47, t = 2.05, p = 0.041, 95% CI = 0.02-0.92; B = 0.29, t = 2.20, p = 0.028, 95% CI = 0.03-0.55. No associations were found between childhood adversity and depressive symptoms at follow-up.No evidence was found supporting stress sensitization due to the experience of childhood adversity in this recurrently depressed but remitted patient group. Nevertheless, our research indicates that daily stress might be a target for preventive treatment.Trial A: Nederlands Trial Register NTR1907 Trial B: Nederlands Trial Register NTR2503.

  5. Cardiac MRI in addition to MR angiography: a longitudinal study in vascular risk patients; Kardiale MRT als Ergaenzung zur MR-Angiografie: Eine longitudinale Studie bei vaskulaeren Risikopatienten

    Seeger, A.; Grimm, F.; Fenchel, M.; Kramer, U.; Doering, J.S.; Klumpp, B.; Claussen, C.D.; Miller, S. [Abt. fuer Radiologische Diagnostik, Eberhard-Karls-Univ. Tuebingen (Germany); Scheule, A. [Abt. fuer Herz-, Thorax- und Gefaesschirurgie, Eberhard-Karls-Univ. Tuebingen (Germany); May, A.E. [Abt. fuer Kardiologie, Eberhard-Karls-Univ. Tuebingen (Germany)

    2008-05-15

    Purpose: the aim of the study was to assess the feasibility and additional diagnostic information of cardiac MRI as a supplement to state-of-the-art MR angiography (MRA) in the case of vascular risk patients. Therefore, the prevalence of delayed myocardial enhancement (DE) was determined in patients suffering from peripheral artery disease (PAD) and a clinical follow-up was evaluated after 2 years. Materials and method: 87 consecutive patients (ages 66 {+-} 10 years, 67 males) with symptomatic peripheral arterial occlusive disease (n = 68) or abdominal aortic aneurysm (n = 19) were examined using delayed cardiac enhancement (DE) within the clinical indication of MRA at a 1.5T system. A follow-up examination was carried out two years later (24 months {+-} 4 months) with regards to cardiac events (cardiac death, myocardial infarction or acute coronary syndrome, heart insufficiency, coronary revascularization). Results: in total, 40/87 patients had myocardial infarctions shown in MRI (46%). In 25 patients (29%), the myocardial infarction was already known, while in 15 patients (17%) an occult progressing infarction was diagnosed (38% of the myocardial infarcts). Follow-up data was able to be obtained after 2 years for 82 patients. 15 patients had a major cardiac event during the follow-up period, and 10 (67%) of them already showed DE in the MRI. In the group with occult progressing infarctions, cardiac events occurred in 40% (6/15 patients, cardiac death n = 1, ischemia n = 4, heart insufficiency n = 1, bypass n = 1), in patients with known infarction in 17% (4/23 patients, cardiac death n = 1, ischemia n = 3, bypass n = 2) and in 11% of patients without myocardial scars (5/44 patients, cardiac death n = 1, ischemia n = 2, heart insufficiency n = 2). (orig.)

  6. Increase of plasma brain-derived neurotrophic factor levels in two psychotic depressed patients responding to lithium addition to paroxetine treatment

    Yoshimura, Reiji; Tsuji, Koshiro; Ueda, Nobuhisa; Nakamura, Jun

    2007-01-01

    We report two patients with psychotic depression who were successfully treated with a lithium addition to ongoing paroxetine treatment. In both cases, plasma brain-derived neurotrophic factor (BDNF) levels increased about 2-fold after lithium augmentation to paroxetine, compared with paroxetine treatment alone. Plasma paroxetine levels did not change after lithium addition. These results suggest that the increases in plasma BDNF levels reflect recovery from depressive symptoms in psychotic de...

  7. 300 The Method of Antigen Specific Damage of Leucocytes by Food Additives in Patients with Bronchial Asthma

    Titova, Nadya

    2012-01-01

    Background Diagnosis of adverse reactions to food additives is difficult due to a variety of mechanisms involved and the lack of sufficiently reliable methods for their determination. The diagnosis of intolerance to food additives is still based only on placebo-controlled oral provocation. Methods The aim of this study was to determine the incidence of intolerance to ponceau 4R (E124), indigo carmine (E132), azorubine (E122), tartrazine (E102), sunset yellow (E110) and sodium benzoate (E211) ...

  8. Additional telerehabilitation contributes to a sustained improvement in physical fitness in coronary artery disease patients, who have completed phase 2 of cardiac rehabilitation

    Frederix, Ines; Van Driessche, Niels; Laenen, Valerie; Loverix, Liselore; Hansen, Dominique; DENDALE, PAUL

    2013-01-01

    Purpose: The purpose of the study was to evaluate whether the addition of a motion sensor with automated feed-back by email or SMS to cardiac rehabilitation (CR) could result in improved health conditions of coronary artery disease (CAD) patients. Methods: 80 CAD patients in phase II of the CR program were included in this RCT after admission for PCI or CABG. Patients with a defibrillator, important arrhythmias or severe heart failure (NYHA class III and IV) were excluded from the trial. T...

  9. Post-traumatic Stress Disorder Symptoms in a Female Patient Following Repeated Teasing: Treatment with Gabapentin and Lamotrigine and the Possible Role of Sensitization.

    Kishimoto, Akira; Goto, Yurie; Hashimoto, Kenji

    2014-12-01

    Post-traumatic stress disorder (PTSD) is a pathological response to trauma characterized by frequent recollections, recurrent nightmares, and flashbacks of the traumatic event(s). To date, the precise mechanisms underlying the development of PTSD remain unknown. Several studies have suggested that antiepileptic drugs, such as gabapentin and lamotrigine, may be effective in the treatment of PTSD symptoms. We report on a 15-year-old Japanese female junior high school student who developed PTSD symptoms following repeated teasing from male classmates. Additionally, we underscore the beneficial effects of treatment with gabapentin and lamotrigine on flashbacks and nightmares. This patient developed PTSD symptoms after repeated teasing from male classmates at school. Her flashbacks and nightmares were treated with a combination of gabapentin and lamotrigine. After recovery, treatment with lamotrigine alone controlled her symptoms. Our observations suggest that a process of sensitization may be involved in the development of PTSD symptoms. Additionally, gabapentin and/or lamotrigine were effective in the treatment of flashbacks and nightmares in this patient. Thus, doctors should consider using these anti-epileptic drugs as an alternative approach to treating PTSD symptoms. PMID:25598830

  10. Correlation of high-sensitivity C-reactive protein and carotid plaques with coronary artery disease in elderly patients

    LIANG, YANHONG; HOU, YUANPING; NIU, HONGYU; Lu, Mei; Xue, Lei; Sun, Qianmei

    2015-01-01

    The aim of this study was to explore the correlation of high-sensitivity C-reactive protein (hs-CRP) and carotid plaques with the severity of coronary artery disease (CAD). A total of 140 patients with angina who underwent coronary angiography were selected and divided into a single-vessel disease group (n=11), double-vessel disease group (n=18), multi-vessel disease group (n=71) and control group (n=40). Color Doppler ultrasound was applied to measure the intima-media thickness (IMT) of the ...

  11. How patients understand physicians’ solicitations of additional concerns: implications for up-front agenda setting in primary care

    Robinson, JD; Heritage, J

    2016-01-01

    © 2015, Routledge. All rights reserved. In the more than 1 billion primary-care visits each year in the United States, the majority of patients bring more than one distinct concern, yet many leave with “unmet” concerns (i.e., ones not addressed during visits). Unmet concerns have potentially negative consequences for patients’ health, and may pose utilization-based financial burdens to health care systems if patients return to deal with such concerns. One solution to the problem of unmet conc...

  12. Additional Therapy with a Mistletoe Product during Adjuvant Chemotherapy of Breast Cancer Patients Improves Quality of Life: An Open Randomized Clinical Pilot Trial

    Wilfried Tröger

    2014-01-01

    Full Text Available Background. Breast cancer patients receiving adjuvant chemotherapy often experience a loss of quality of life. Moreover chemotherapy may induce neutropenia. Patients report a better quality of life when additionally treated with mistletoe products during chemotherapy. Methods. In this prospective randomized open-label pilot study 95 patients were randomized into three groups. All patients were treated with an adjuvant chemotherapy. The primary objective of the study was quality of life, the secondary objective was neutropenia. Here we report the comparison of HxA (n = 34 versus untreated control (n = 31. Results. In the explorative analysis ten of 15 scores of the EORTC QLQ-C30 showed a better quality of life in the HxA group compared to the control group (P<0.001 to P=0.038 in Dunnett-T3 test. The difference was clinically relevant (difference of at least 5 points, range 5.4–12.2 in eight of the ten scores. Neutropenia occurred in 7/34 HxA patients and in 8/31 control patients (P = 0.628. Conclusions. This pilot study showed an improvement of quality of life by treating breast cancer patients with HxA additionally to CAF. Although the open design may be a limitation, the findings show the feasibility of a confirmatory study using the methods described here.

  13. Sensitivity to mitomycin-C and radiation of cells derived from patients with familial colon polyposis: an autosomal dominant hereditary disease

    This study was undertaken to investigate the sensitivity to mitomycin-C (MMC) of skin fibroblasts derived from patients with adenomatosis coli (AC), especially familial colon polyposis. The sensitivity to X rays and ultraviolet rays of AC cells cultured at RERF was similar to that of normal human diploid cells. However, there were large individual differences in sensitivity to MMC. DNA elongation in cells sensitive to MMC was found to be inhibited after MMC treatment. Sites highly sensitive to MMC were considered to be involved in the initial stages of DNA synthesis. (author)

  14. Clinical features of panic patients sensitive to hyperventilation or breath-holding methods for inducing panic attacks

    A.E. Nardi

    2004-02-01

    Full Text Available Our aim was to compare the clinical features of panic disorder (PD patients sensitive to hyperventilation or breath-holding methods of inducing panic attacks. Eighty-five PD patients were submitted to both a hyperventilation challenge test and a breath-holding test. They were asked to hyperventilate (30 breaths/min for 4 min and a week later to hold their breath for as long as possible, four times with a 2-min interval. Anxiety scales were applied before and after the tests. We selected the patients who responded with a panic attack to just one of the tests, i.e., those who had a panic attack after hyperventilating (HPA, N = 24, 16 females, 8 males, mean age ± SD = 38.5 ± 12.7 years and those who had a panic attack after breath holding (BHPA, N = 20, 11 females, 9 males, mean age ± SD = 42.1 ± 10.6 years. Both groups had similar (chi² = 1.28, d.f. = 1, P = 0.672 respiratory symptoms (fear of dying, chest/pain disconfort, shortness of breath, paresthesias, and feelings of choking during a panic attack. The criteria of Briggs et al. [British Journal of Psychiatry, 1993; 163: 201-209] for respiratory PD subtype were fulfilled by 18 (75.0% HPA patients and by 14 (70.0% BHPA patients. The HPA group had a later onset of the disease compared to BHPA patients (37.9 ± 11.0 vs 21.3 ± 12.9 years old, Mann-Whitney, P < 0.001, and had a higher family prevalence of PD (70.8 vs 25.0%, chi² = 19.65, d.f. = 1, P = 0.041. Our data suggest that these two groups - HPA and BHPA patients - may be specific subtypes of PD.

  15. Working with Jewish ultra-orthodox patients: guidelines for a culturally sensitive therapy.

    Bilu, Y; Witztum, E

    1993-06-01

    The epistemological gap between the medical reality of mental health practitioners and the sacred reality of their Jewish ultra-orthodox patients poses a major challenge for therapy. Based on our work with psychiatric patients from the ultra-orthodox community of northern Jerusalem, we propose a set of guidelines to cope with this challenge. Basically, we seek to incorporate religiously congruent elements, composed of metaphoric images, narratives and actions, into the wide range of our "secular" treatment modalities in order to respond to the patient's suffering, often expressed through distinctively religious idioms of distress. This endeavor calls for "a temporary suspension of disbelief" on both sides. The guidelines presented include three sets of factors which appear pertinent to working with ultra-orthodox patients. The first set is contextual in nature, dealing with the image of the clinic and its physical setting; the second discusses the necessary role requisites of the therapists; and the third one, accorded a central importance, deals on various levels with the therapeutic interventions administered in terms of form and content. Several case vignettes are presented to illustrate three classes of religiously informed interventions: healing rituals, dream interpretation, and the use of culturally congruent metaphors and stories. In the concluding part we discuss ethical and instrumental issues that the proposed therapeutic guidelines may raise. PMID:8222706

  16. Sensitization and cross-reaction patterns in Danish Compositae-allergic patients

    Paulsen, E; Andersen, Klaus Ejner; Hausen, B M

    2001-01-01

    Results of aimed patch testing with constituents of sesquiterpene lactone (SL) mix, Compositae mix (CM) and other Compositae extracts and allergens in 190 Compositae-allergic patients detected in an 8-year period are presented. Feverfew of CM elicited positive reactions most frequently, followed ...

  17. Cobalt release from implants and consumer items and characteristics of cobalt sensitized patients with dermatitis

    Thyssen, Jacob Pontoppidan; Menne, Torkil; Liden, Carola;

    2012-01-01

    Background. Cobalt allergy is prevalent in dermatitis patients. Very little documentation exists about current sources of cobalt exposure.Objectives. To investigate and discuss putative sources of cobalt exposure and to present selected epidemiological data on cobalt allergy from patch-tested der...

  18. Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletoe Extract to Chemotherapy Alone

    Wilfried Tröger

    2009-01-01

    Full Text Available Background: Chemotherapy for breast cancer often deteriorates quality of life, augments fatigue, and induces neutropenia. Mistletoe preparations are frequently used by cancer patients in Central Europe. Physicians have reported better quality of life in breast cancer patients additionally treated with mistletoe preparations during chemotherapy. Mistletoe preparations also have immunostimulant properties and might therefore have protective effects against chemotherapy-induced neutropenia.Patients and Methods: We conducted a prospective randomized open label pilot study with 95 patients randomized into three groups. Two groups received Iscador® M special (IMS or a different mistletoe preparation, respectively, additionally to chemotherapy with six cycles of cyclophosphamide, adriamycin, and 5-fluoro-uracil (CAF. A control group received CAF with no additional therapy. Here we report the comparison IMS (n = 30 vs. control (n = 31. Quality of life including fatigue was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30. Neutropenia was defined as neutrophil counts <1,000/µl and assessed at baseline and one day before each CAF cycle.Results: In the descriptive analysis all 15 scores of the EORTC-QLQ-C30 showed better quality of life in the IMS group compared to the control group. In 12 scores the differences were significant (p < 0.02 and nine scores showed a clinically relevant and significant difference of at least 5 points. Neutropenia occurred in 3/30 IMS patients and in 8/31 control patients (p = 0.182.Conclusions: This pilot study showed an improvement of quality of life by treating breast cancer patients with IMS additionally to CAF. CAF-induced neutropenia showed a trend to lower frequency in the IMS group.

  19. Transmission scans using Gd-153 line sources in cardiac SPECT studies: What is the additional patient radiation dose burden?

    Aim: To determine the contribution of transmission scan acquisition obtained for attenuation/scatter correction to total patient effective dose from cardiac SPECT studies. Materials and Methods: A dual-headed L-shaped gamma camera equipped with a transmission scan acquisition system based on two 153Gd line sources was used. Transmission scan acquisition was performed on a humanoid phantom. Thermoluminescence dosimeters were used to directly monitor the dose to 550 measuring points in the phantom. Patient effective dose and associated risk from transmission scans acquisition were estimated and compared to those associated to the radiopharmaceutical injected. Results: The maximum effective dose from a typical transmission measurements acquisition was 1.3 μSv and 1.9 μSv for male and female patients, respectively. The contribution of the typical transmission scans acquisition to total patient radiation risk from a cardiac SPECT study was less than 10-3. Conclusion: Radiation exposure may not be considered as a limiting factor for the clinical application of attenuation correction methods based on transmission measurements in cardiac SPECT

  20. Cardiovascular effects of a chlorpheniramine/paracetamol combination in hypertensive patients who were sensitive to the pressor effect of pseudoephedrine.

    Chua, S S; Benrimoj, S I; Gordon, R D; Williams, G

    1991-03-01

    Twelve hypertensive patients who were classified as pseudoephedrine-sensitive in a preliminary trial were selected for further investigation with single doses of pseudoephedrine 60 mg, a combination of chlorpheniramine 4 mg with paracetamol 650 mg and placebo. A double-blind, randomised, crossover study design was followed. Treatment with pseudoephedrine produced significant effects on all the four variables measured (systolic, diastolic and mean arterial blood pressure, and heart rate). Effects of the chlorpheniramine/paracetamol combination were found to be not significantly different from placebo. It was concluded that the combination may be useful as a medication for 'colds' in hypertensive patients, since it does not induce cardiovascular effects such as those observed with pseudoephedrine. PMID:2054278

  1. Patient Controlled Epidural Analgesia during Labour: Effect of Addition of Background Infusion on Quality of Analgesia & Maternal Satisfaction

    Uma Srivastava

    2009-01-01

    Full Text Available Patient controlled epidural analgesia (PCEA is a well established technique for pain relief during labor. But the inclusion of continuous background infusion to PCEA is controversial. The aim of this study was to assess whether the use of continuous infusion along with PCEA was beneficial for laboring women with regards to quality of analgesia, maternal satisfaction and neonatal outcome in comparison to PCEA alone. Fifty five parturients received epidural bolus of 10ml solution containing 0.125% bupivacaine +2 ìg.ml-1 of fentanyl. For maintenance of analgesia the patients of Group PCEA self administered 8 ml bolus with lockout interval of 20 minutes of above solution on demand with no basal infusion. While the patients of Group PCEA + CI received continuous epidural infusion at the rate of 10 ml.hr-1 along with self administered boluses of 3 ml with lockout interval of 10 minutes of similar epidural solution. Patients of both groups were given rescue boluses by the anaesthetists for distressing pain. Verbal analogue pain scores, incidence of distressing pain, need of supplementary/rescue boluses, dose of bupivacaine consumed, maternal satisfaction and neonatal Apgar scores were recorded. No significant difference was observed between mean VAS pain scores during labor, maternal satisfaction, mode of delivery or neonatal Apgar scores. But more patients (n=8 required rescue boluses in PCEA group for distressing pain. The total volume consumed of bupivacaine and opioid was slightly more in PCEA + CI group. In both the techniques the highest sensory level, degree of motor block were comparable& prolongation of labor was not seen. It was concluded that both the techniques provided equivalent labor analgesia, maternal satisfaction and neonatal Apgar scores. PCEA along with continuous infusion at the rate of 10 ml/ hr resulted in lesser incidence of distressing pain and need for rescue analgesic. Although this group consumed higher dose of bupivacaine

  2. Sensitivity to ionising radiation of lymphocytes from Huntington's chorea patients compared to controls.

    McGovern, D.; Webb, T.

    1982-01-01

    Blood samples were collected from 22 patients with Huntington's chorea and from 22 matched controls. Lymphocytes were separated from aliquots of each sample and cultures set up both from these and from further aliquots of whole blood. After 24 hours, half of each culture was subjected to X irradiation. Seventy-two hours later the percentages of live lymphocytes were estimated for each half of every culture and the viability ratio calculated for each sample. The lymphocytes derived from the pa...

  3. Hormonal therapy and chemotherapy in patients with hormone-sensitive prostate cancer

    R. A. Gafanov

    2016-01-01

    Full Text Available Prostate cancer is the most common men`s cancer in men in developed world and the second cause of death in this population. This review focuses on management of advanced castration resistant prostate cancer (CRPC has been rapidly changing and is still evolving. In the last years, there has been an increasing knowledge of prostate cancer biology. New therapeutic agents and approaches have been evaluated demonstrating benefits in survival and quality of life in patients with metastatic prostate cancer.

  4. Hormonal therapy and chemotherapy in patients with hormone-sensitive prostate cancer

    R. A. Gafanov

    2016-01-01

    Prostate cancer is the most common men`s cancer in men in developed world and the second cause of death in this population. This review focuses on management of advanced castration resistant prostate cancer (CRPC) has been rapidly changing and is still evolving. In the last years, there has been an increasing knowledge of prostate cancer biology. New therapeutic agents and approaches have been evaluated demonstrating benefits in survival and quality of life in patients with metastatic prostat...

  5. Posttraumatic Stress Disorder Increases Sensitivity to Long Term Losses among Patients with Major Depressive Disorder

    Engelmann, Jan B.; Maciuba, Britta; Vaughan, Christopher; Paulus, Martin P.; Dunlop, Boadie W.

    2013-01-01

    Background Decisions under risk and with outcomes that are delayed in time are ubiquitous in real life and can have a significant impact on the health and wealth of the decision-maker. Despite its potential relevance for real-world choices, the degree of aberrant risky and intertemporal decision-making in patients suffering from major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) has received little attention to date. Method We used a case-control design to co...

  6. Highly sensitivity adhesion molecules detection in hereditary haemochromatosis patients reveals altered expression.

    Norris, S

    2012-02-01

    Several abnormalities in the immune status of patients with hereditary haemochromatosis (HH) have been reported, suggesting an imbalance in their immune function. This may include persistent production of, or exposure to, altered immune signalling contributing to the pathogenesis of this disorder. Adhesion molecules L-, E- and P-Selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) are some of the major regulators of the immune processes and altered levels of these proteins have been found in pathological states including cardiovascular diseases, arthritis and liver cancer. The aim of this study was to assess L-, E- and P-Selectin, ICAM-1 and VCAM-1 expression in patients with HH and correlate these results with HFE mutation status and iron indexes. A total of 139 subjects were diagnosed with HH (C282Y homozygotes = 87, C282Y\\/H63D = 26 heterozygotes, H63D homozygotes = 26), 27 healthy control subjects with no HFE mutation (N\\/N), 18 normal subjects heterozygous for the H63D mutation served as age-sex-matched controls. We observed a significant decrease in L-selectin (P = 0.0002) and increased E-selectin and ICAM-1 (P = 0.0006 and P = 0.0059) expression in HH patients compared with healthy controls. This study observes for the first time that an altered adhesion molecules profile occurs in patients with HH that is associated with specific HFE genetic component for iron overload, suggesting that differential expression of adhesion molecules may play a role in the pathogenesis of HH.

  7. 426 The Evaluation of Allergen Sensitivity in Food Allergy Patients in Antalya, Turkey

    Yalcin, Arzu Didem; Cekýn, Ayhan Hilmi; Polat, Hasan Hüseyin; Cetinkaya, Ramazan; Gorczynski, Reginald M.

    2012-01-01

    Background In this study, the socio-demographic characteristics, skin prick test were evaluated in treated patients diagnosed with Food allergies. Methods The study was conducted in Antalya between 10 November 2009 and 20 September 2010. A questionnaire made by the investigators taking the latest literature data into consideration were used during the study. The total and specific IgE levels were made by fluoroenzyme immunoassay method via use of ImmunoCAP kit. For dermal prick tests Alyostal...

  8. Identification of a radiation sensitivity gene expression profile in primary fibroblasts derived from patients who developed radiotherapy-induced fibrosis

    Background and purpose: During radiotherapy, normal tissue is unavoidably exposed to radiation which results in severe normal tissue reactions in a small fraction of patients. Because those who are sensitive cannot be determined prior to radiotherapy, the doses are limited to all patients to avoid an unacceptable number of severe adverse normal tissue responses. This limitation restricts the optimal treatment for individuals who are more tolerant to radiation. Genetic variation is a likely source for the normal tissue radiosensitivity variation observed between individuals. Therefore, understanding the radiation response at the genomic level may provide knowledge to develop individualized treatment and improve radiotherapy outcomes. Material and methods: Exon arrays were utilized to compare the basal expression profile between cell lines derived from six cancer patients with and without severe fibrosis. These data were supported by qRT-PCR and RNA-Seq techniques. Results: A set of genes (FBN2, FST, GPRC5B, NOTCH3, PLCB1, DPT, DDIT4L and SGCG) were identified as potential predictors for radiation-induced fibrosis. Many of these genes are associated with TGFβ or retinoic acid both having known links to fibrosis. Conclusion: A combinatorial gene expression approach provides a promising strategy to predict fibrosis in cancer patients prior to radiotherapy

  9. Estimation of high sensitivity C-reactive protein in patients with periodontal disease and without coronary artery disease

    V Anitha

    2015-01-01

    Full Text Available Background: HsCRP (Highly sensitive C reactive protein is a global indicator for future vascular events in adults detected in blood stream 48 hours before the cardiovascular event. Periodontal disease may increase blood levels of inflammatory markers like IL-6, CRP and HsCRP. Hence the aim of the present study is to evaluate the presence of elevated HsCRP levels in chronic periodontitis patients. Material and Methods: 100 patients who reported for cardiac master health check up were enrolled in the study. The periodontal status was assessed using periodontal probing pocket depth and clinical attachment level. The decayed, missing and filled tooth was recorded using DMFT index. The venous samples of these patients were obtained for recording HsCRP levels. Results: Pearson correlation was used to analyze the relationship between HsCRP level and probing pocket depth, clinical attachment loss and DMFT. The correlation value was 0.051, 0.025 and 0.101 respectively, the correlation is statistically significant for probing pocket depth and clinical attachment level (P>0.05. Chi- square test was performed to study the association between gender and HsCRP, Diabetes Mellitus and HsCRP and Hypertension and HsCRP; the results showed that there is no significant association between any of the above mentioned factors and HsCRP level in blood. Conclusions: We found an increased level of HsCRP in patients with chronic periodontitis which revealed the susceptibility of these patients to cardiac diseases like myocardial infarction and stroke. Hence present day focus in the line of management of cardiac patient has changed from the periodontal perspective.

  10. VANCOMYCIN SENSITIVITY OF Staphylococcus aureus ISOLATES FROM HOSPITAL PATIENTS IN KARACHI, PAKISTAN

    Javaid SG

    2007-01-01

    Full Text Available Methicillin-resistant Staphylococcus aureus (S. aureus (MRSA, resistant to all antibiotics including Vancomycin, has been reported in Japan, USA, Canada and Brazil. Hence, the main objective of this study was to evaluate the possible presence of Vancomycin resistant or intermediate S.aureus in Karachi. A total of 850 clinical isolates were collected from two civil hospitals in the city between February 2006 and January 2007. They were identified using standard bacteriological methods. Sensitivity to recommended antibiotics was determined by disc diffusion, agar dilution, and E-test quantitative minimum inhibitory concentration (MIC. Susceptibility to natural or semi-natural products was determined by the agar dilution method. Out of 850 isolates, 250 were MRSA, of which 22% were resistant to 4 mg/ml Vancomycin, 24% to 8 mg/ml, 15.2% to 16 mg/ml, 10% to 20 mg/ml, and 13.2% to 30 mg/ml; the remaining 15.6% were sensitive to all used concentrations. Although we did not detect any Vancomycin-resistant S. aureus (VRSA, we found that 13% of the strains were intermediates (VISA, i.e. resistant to 30 mg/ml of Vancomycin. Because of the continuously increasing prevalence of VISA, it is imperative to minimize the use of Vancomycin. Indeed, the drug should only be prescribed for the treatment of documented, culture-proven infections with MRSA that are not susceptible to routine or alternative agents. This should help avoid the consequences of the development of Vancomycin resistant S. aureus (VRSA in our environment.

  11. Butanolysis derivatization: improved sensitivity in LC-MS/MS quantitation of heparan sulfate in urine from mucopolysaccharidosis patients.

    Trim, Paul J; Hopwood, John J; Snel, Marten F

    2015-09-15

    Heparan sulfate (HS) is a complex oligosaccharide that is a marker of a number of diseases, most notably several of the mucopolysaccharidoses (MPS). It is a very heterogeneous compound and its quantification at physiological concentrations in patient samples is challenging. Here, we demonstrate novel derivatization chemistry for depolymerization/desulfation and alkylation of HS based on butanolysis. The resultant alkylated disaccharides are quantifiable by LC-MS/MS. This new method is at least 70-fold more sensitive than a previously published methanolysis method. Disaccharide yield over time is compared for methanolysis, ethanolysis, and butanolysis. Maximum disaccharide concentration was observed after 2 h with butanolysis and 18 h with ethanolysis whereas a maximum was not reached over the 24 h of the experiment with methanolysis. The sensitivity of the new technique is illustrated by the quantification of HS in 5 μL urine samples from MPS patients and healthy controls. HS was quantifiable in all samples including controls. Disaccharide reaction products were further characterized using exact mass MS/MS. PMID:26301744

  12. Additional Therapy with a Mistletoe Product during Adjuvant Chemotherapy of Breast Cancer Patients Improves Quality of Life: An Open Randomized Clinical Pilot Trial.

    Tröger, Wilfried; Zdrale, Zdravko; Tišma, Nevena; Matijašević, Miodrag

    2014-01-01

    Background. Breast cancer patients receiving adjuvant chemotherapy often experience a loss of quality of life. Moreover chemotherapy may induce neutropenia. Patients report a better quality of life when additionally treated with mistletoe products during chemotherapy. Methods. In this prospective randomized open-label pilot study 95 patients were randomized into three groups. All patients were treated with an adjuvant chemotherapy. The primary objective of the study was quality of life, the secondary objective was neutropenia. Here we report the comparison of HxA (n = 34) versus untreated control (n = 31). Results. In the explorative analysis ten of 15 scores of the EORTC QLQ-C30 showed a better quality of life in the HxA group compared to the control group (P control patients (P = 0.628). Conclusions. This pilot study showed an improvement of quality of life by treating breast cancer patients with HxA additionally to CAF. Although the open design may be a limitation, the findings show the feasibility of a confirmatory study using the methods described here. PMID:24701238

  13. Elevated frequencies of circulating Th22 cell in addition to Th17 cell and Th17/Th1 cell in patients with acute coronary syndrome.

    Lei Zhang

    Full Text Available BACKGROUND: Atherosclerosis is a chronic inflammatory disease mediated by immune cells. Th22 cells are CD4(+ T cells that secret IL-22 but not IL-17 or IFN-γ and are implicated in the pathogenesis of inflammatory disease. The roles of Th22 cells in the pathophysiologic procedures of acute coronary syndrome (ACS remain unclear. The purpose of this study is to investigate the profile of Th22, Th17 and Th17/Th1 cells in ACS patients, including unstable angina (UA and acute myocardial infarction (AMI patients. DESIGN AND METHODS: In this study, 26 AMI patients, 16 UA patients, 16 stable angina (SA patients and 16 healthy controls were included. The frequencies of Th22, Th17 and Th17/Th1 cells in AMI, UA, SA patients and healthy controls were examined by flow cytometry. Plasma levels of IL-22, IL-17 and IFN-γ were measured by enzyme-linked immunosorbent assay (ELISA. RESULTS: Th22, Th17 and Th17/Th1 cells were significantly increased in AMI and UA patients compared with SA patients and healthy controls. Moreover, plasma IL-22 level was significantly elevated in AMI and UA patients. In addition, Th22 cells correlated positively with IL-22 as well as Th17 cells in AMI and UA patients. CONCLUSION: Our findings showed increased frequencies of both Th22 and Th17 cells in ACS patients, which suggest that Th22 and Th17 cells may play a potential role in plaque destabilization and the development of ACS.

  14. Level of high-sensitivity C-reactive protein in saudi patients with chronic stable coronary artery disease

    Inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) is an independent predictor of future cardiovascular events and it predicts risk of incident hypertension and diabetes. The aim of this study was to determine the serum levels of the circulating acute-phase reactant high-sensitivity C-reactive protein (hsCRP) in Saudi patients with chronic stable Coronary Artery Disease (CAD). This cross sectional study was conducted in the Department of Physiology and Department of Cardiology, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh between August 2006 and December 2007. One hundred and seven individuals with chronic stable CAD and 33 healthy, age and BMI-matched individuals were studied. Overnight fasting blood samples were collected, and analyzed for total cholesterol (TC), Triglycerides (TG), Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL) and hsCRP in patients with chronic stable CAD. TC (Control 4.41+-0.57 vs CAD 4.28+-1.40, p=0.8394) and LDL levels (Control 2.70+-0.52 vs CAD 2.71+-1.20, p=0.7963) did not differ significantly between the two groups. While there were significant differences in TG (Control 1.13+-0.47 vs CAD 1.84+-1.10, p=0.0135) and HDL levels (Control 1.06+-0.30 vs CAD 0.71+-0.25, p=0.0000). hsCRP levels were significantly higher in patients with CAD (5.0+-4.4) compared to healthy individuals (2.7+-2.7, p=0.0166). Frequency of low risk levels was significantly higher in Controls than CAD patients (24.2% vs 8.4%, p=0.0332) and vice versa for high risk levels (24.2% vs 51.4%, p=0.0110). At average risk levels frequency did not differ significantly (51.5% vs 40.1%, p=0.3429) between control and CAD groups. Saudi patients with stable chronic CAD have higher hsCRP levels compared to healthy individuals. Moreover the prevalence of undesirable risk levels of hsCRP is also higher in CAD patients. (author)

  15. Posttraumatic stress disorder increases sensitivity to long term losses among patients with major depressive disorder.

    Jan B Engelmann

    Full Text Available BACKGROUND: Decisions under risk and with outcomes that are delayed in time are ubiquitous in real life and can have a significant impact on the health and wealth of the decision-maker. Despite its potential relevance for real-world choices, the degree of aberrant risky and intertemporal decision-making in patients suffering from major depressive disorder (MDD and posttraumatic stress disorder (PTSD has received little attention to date. METHOD: We used a case-control design to compare decision-making in healthy control subjects (N=16 versus untreated depressed subjects in a current major depressive episode (N=20. In order to examine how major depressive disorder (MDD may impact decision-making, subjects made decisions over (1 risky outcomes and (2 delayed outcomes in the domain of gains and losses using choice paradigms from neuroeconomics. In a pre-planned analysis, depressed subjects were subdivided into those with primary PTSD along with comorbid MDD (MDD+PTSD versus those with primary MDD without PTSD (MDD-only. Choice behavior was modeled via a standard econometric model of intertemporal choice, a quasi-hyperbolic temporal discounting function, which was estimated for each subject group separately. RESULTS: Under conditions of potential gain, depressed subjects demonstrated greater discounting for gains across all time frames compared to controls. In the realm of losses, both subgroups of depressed subjects discounted more steeply than controls for short time frames. However, for delayed losses ranging from >1-10 years, MDD+PTSD subjects showed shallower discounting rates relative to MDD-only subjects, who continued to discount future losses steeply. Risk attitudes did not contribute to differences in intertemporal choice. CONCLUSIONS: Depressed patients make choices that minimize current pain and maximize current reward, despite severe later consequences or lost opportunities. Anxiety associated with PTSD may serve as a partially

  16. Visual contrast sensitivity in patients with impairment of functional independence after stroke

    dos Santos Natanael; Andrade Suellen

    2012-01-01

    Abstract Background Stroke has been considered a serious public health problem in many countries, accounting for complex disorders involving perception, such as visual, cognitive and functional deficits. The impact of stroke on the visual perception of individuals with impairments in functional independence was investigated. Methods We measured changes in functional independence and visual function in 40 patients with stroke (M = 52.3, SD = 0.65) and 10 controls (M = 52.5, SD = 0.66). The pat...

  17. Neuroscience education in addition to trigger point dry needling for the management of patients with mechanical chronic low back pain: A preliminary clinical trial.

    Téllez-García, Mario; de-la-Llave-Rincón, Ana I; Salom-Moreno, Jaime; Palacios-Ceña, Maria; Ortega-Santiago, Ricardo; Fernández-de-Las-Peñas, César

    2015-07-01

    The objective of the current study was to determine the short-term effects of trigger point dry needling (TrP-DN) alone or combined with neuroscience education on pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical low back pain (LBP). Twelve patients with LBP were randomly assigned to receive either TrP-DN (TrP-DN) or TrP-DN plus neuroscience education (TrP-DN + EDU). Pain intensity (Numerical Pain Rating Scale, 0-10), disability (Roland-Morris Disability Questionnaire-RMQ-, Oswestry Low Back Pain Disability Index-ODI), kinesiophobia (Tampa Scale of Kinesiophobia-TSK), and pressure pain thresholds (PPT) over the C5-C6 zygapophyseal joint, transverse process of L3 vertebra, second metacarpal, and tibialis anterior muscle were collected at baseline and 1-week after the intervention. Patients treated with TrP-DN + EDU experienced a significantly greater reduction of kinesiophobia (P = 0.008) and greater increases in PPT over the transverse process of L3 (P = 0.049) than those patients treated only with TrP-DN. Both groups experienced similar decreases in pain, ODI and RMQ, and similar increases in PPT over the C5/C6 joint, second metacarpal, and tibialis anterior after the intervention (all, P > 0.05). The results suggest that TrP-DN was effective for improving pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical LBP at short-term. The inclusion of a neuroscience educational program resulted in a greater improvement in kinesiophobia. PMID:26118519

  18. The Addition of Vascular Calcification Scores to Traditional Risk Factors Improves Cardiovascular Risk Assessment in Patients with Chronic Kidney Disease

    Liabeuf, Sophie; Desjardins, Lucie; Diouf, Momar; Temmar, Mohamed; Renard, Cédric; Choukroun, Gabriel; Massy, Ziad A.

    2015-01-01

    Background Although a variety of non-invasive methods for measuring cardiovascular (CV) risk (such as carotid intima media thickness, pulse wave velocity (PWV), coronary artery and aortic calcification scores (measured either by CT scan or X-ray) and the ankle brachial index (ABI)) have been evaluated separately in chronic kidney disease (CKD) cohorts, few studies have evaluated these methods simultaneously. Here, we looked at whether the addition of non-invasive methods to traditional risk f...

  19. Addition of Molecular Adsorbent Recirculating System (MARS® Albumin Dialysis for the Preoperative Management of Jaundiced Patients with Hilar Cholangiocarcinoma

    Jean-Marc Regimbeau

    2013-09-01

    Full Text Available The preoperative management of hilar cholangiocarcinoma (HC with jaundice focuses on decreasing the total serum bilirubin level (SBL by performing preoperative biliary drainage (PBD. However, it takes about 6-8 weeks for the SBL to fall at a sufficient extent. The objective of this preliminary study was to evaluate the impact of Molecular Adsorbent Recirculating System (MARS® dialysis (in association with PBD on SBL decrease. From January 2010 to January 2011, we prospectively selected all jaundiced patients admitted to our university hospital for resectable HC and requiring PBD prior to major hepatectomy. The PBD was followed by 3 sessions of MARS dialysis over a period of 72 h. A total of 10 patients with HC were screened and two of them were included (Bismuth-Corlette stage IIIa, gender ratio 1, median age 68 years. The initial SBL in the two patients was 328 and 242 μmol/l, respectively. After three MARS dialysis sessions, the SBL had fallen by 30 and 52%, respectively. After the end of each session, there was a SBL rebound of about 10 μmol/l. The MARS decreased the serum creatinine level, the platelet count and the prothrombin index, but did not modify the serum albumin level. Pruritus disappeared after one and two sessions, respectively. MARS-related morbidity included hypotension (n = 1, tachycardia (n = 1, thrombocytopenia (n = 2 and anaemia (n = 1. When combined with PBD, MARS dialysis appears to accelerate the decrease in SBL and thus may enable earlier surgery. This hypothesis must be validated in a larger study.

  20. Signal intensity loss of the intervertebral discs in the cervical spine of young patients on fluid sensitive sequences

    Bruin, F. de; Horst, S. ter; Bloem, J.L.; Reijnierse, M. [Leiden University Medical Center, Department of Radiology, C2-S, Albinusdreef 2, PO box 9600, Leiden (Netherlands); Berg, R. van den; Hooge, M. de; Gaalen, F. van; Heijde, D. van der [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Fagerli, K.M. [Diakonhjemmet Hospital, Department of Rheumatology, Oslo (Norway); Landewe, R. [Amsterdam Medical Center, Department of Rheumatology, Amsterdam (Netherlands); Oosterhout, M. van [Groene Hartziekenhuis, Department of Rheumatology, Gouda (Netherlands)

    2016-03-15

    To evaluate the signal intensity (SI) of the intervertebral discs of the cervical spine on magnetic resonance (MR) fluid sensitive sequences, and correlate this to secondary signs of degeneration on MR and radiographs as well as to age. A total of 265 patients aged ≥16 with back pain (≥3-months, <2-year, onset <45-years) from the SPondyloArthritis Caught Early (SPACE) cohort were included. Sagittal 1.5 T MR images and lateral radiographs of the cervical spine were independently evaluated by two readers for: SI of the intervertebral discs using a grading system based of Pfirrmann (grade 1 normal/bright SI; 2 inhomogeneous/bright SI; 3 inhomogeneous/mildly decreased SI; 4 inhomogeneous/markedly decreased SI; 5 signal void), disc herniation and Modic changes (MRI) and disc space narrowing, osteophytes and sclerosis (radiograph). Readers were blinded for clinical information. Descriptive statistics were used for characteristics and prevalence of findings, and regression analysis was used for age and grades. Of 265 patients (36 % male, mean age 30), 221 (83 %) patients had 1 to 6 discs (median 4) with decreased SI. Of 1,590 discs, 737 (46 %) were grade 1; 711 (45 %) grade 2; 133 (8 %) grade 3; 8 (1 %) grade 4 and 1 (0 %) grade 5. Secondary signs of degeneration were rare and seen predominantly in C5-C7 and appear to be related to signal loss grade 3 and 4. Low signal intensity of intervertebral discs in absence of secondary degenerative signs in the cervical spine on fluid sensitive MR images might be pre-existing and part of the natural course. (orig.)

  1. Detection of BRAF mutation in Chinese tumor patients using a highly sensitive antibody immunohistochemistry assay

    Qiu, Tian; Lu, Haizhen; Guo, Lei; Huang, Wenting; Ling, Yun; Shan, Ling; Li, Wenbin; Ying, Jianming; Lv, Ning

    2015-03-01

    BRAF mutations can be found in various solid tumors. But accurate and reliable screening for BRAF mutation that is compatible for clinical application is not yet available. In this study, we used an automated immunohistochemistry (IHC) staining coupled with mouse monoclonal anti-BRAF V600E (VE1) primary antibody to screen the BRAF V600E mutation in 779 tumor cases, including 611 colorectal carcinomas (CRC), 127 papillary thyroid carcinomas (PTC) and 41 malignant melanomas. Among the 779 cases, 150 cases were positive for BRAF (V600E) staining, including 38 (of 611, 6%) CRCs, 102 (of 127, 80%) PTCs and 10 (of 41, 24%) malignant melanomas. Sanger sequencing and real-time PCR confirmed the sensitivity and specificity of IHC staining for the V600E mutation are 100% and 99%, respectively. Therefore, our study demonstrates that the fully automated IHC is a reliable tool to determine BRAF mutation status in CRC, PTC and melanoma and can be used for routine clinical screen.

  2. BPI-ANCA Provides Additional Clinical Information to Anti-Pseudomonas Serology: Results from a Cohort of 117 Swedish Cystic Fibrosis Patients.

    Lindberg, Ulrika; Carlsson, Malin; Hellmark, Thomas; Segelmark, Mårten

    2015-01-01

    Patients with cystic fibrosis (CF) colonized with Pseudomonas aeruginosa (P. aeruginosa) have worse prognosis compared with patients who are not. BPI-ANCA is an anti-neutrophil cytoplasmic antibody against BPI (bactericidal/permeability increasing protein) correlating with P. aeruginosa colonization and adverse long time prognosis. Whether it provides additional information as compared to standard anti-P. aeruginosa serology tests is not known. 117 nontransplanted CF patients at the CF centre in Lund, Sweden, were followed prospectively for ten years. Bacterial colonisation was classified according to the Leeds criteria. IgA BPI-ANCA was compared with assays for antibodies against alkaline protease (AP), Elastase (ELA), and Exotoxin A (ExoA). Lung function and patient outcome, alive, lung transplanted, or dead, were registered. BPI-ANCA showed the highest correlation with lung function impairment with an r-value of 0.44. Forty-eight of the 117 patients were chronically colonized with P. aeruginosa. Twenty of these patients experienced an adverse outcome. Receiver operator curve (ROC) analysis revealed that this could be predicted by BPI-ANCA (AUC = 0.77), (p = 0.002) to a better degree compared with serology tests. BPI-ANCA correlates better with lung function impairment and long time prognosis than anti-P. aeruginosa serology and has similar ability to identify patients with chronic P. aeruginosa. PMID:26273683

  3. BPI-ANCA Provides Additional Clinical Information to Anti-Pseudomonas Serology: Results from a Cohort of 117 Swedish Cystic Fibrosis Patients

    Ulrika Lindberg

    2015-01-01

    Full Text Available Patients with cystic fibrosis (CF colonized with Pseudomonas aeruginosa (P. aeruginosa have worse prognosis compared with patients who are not. BPI-ANCA is an anti-neutrophil cytoplasmic antibody against BPI (bactericidal/permeability increasing protein correlating with P. aeruginosa colonization and adverse long time prognosis. Whether it provides additional information as compared to standard anti-P. aeruginosa serology tests is not known. 117 nontransplanted CF patients at the CF centre in Lund, Sweden, were followed prospectively for ten years. Bacterial colonisation was classified according to the Leeds criteria. IgA BPI-ANCA was compared with assays for antibodies against alkaline protease (AP, Elastase (ELA, and Exotoxin A (ExoA. Lung function and patient outcome, alive, lung transplanted, or dead, were registered. BPI-ANCA showed the highest correlation with lung function impairment with an r-value of 0.44. Forty-eight of the 117 patients were chronically colonized with P. aeruginosa. Twenty of these patients experienced an adverse outcome. Receiver operator curve (ROC analysis revealed that this could be predicted by BPI-ANCA (AUC = 0.77, (p=0.002 to a better degree compared with serology tests. BPI-ANCA correlates better with lung function impairment and long time prognosis than anti-P. aeruginosa serology and has similar ability to identify patients with chronic P. aeruginosa.

  4. Association between serum levels of high sensitive C-reactive protein and inflammation activity in chronic gastritis patients.

    Rahmani, Asghar; Moradkhani, Atefeh; Hafezi Ahmadi, Mohammad Reza; Jafari Heirdarlo, Ali; Abangah, Ghobad; Asadollahi, Khairollah; Sayehmiri, Kourosh

    2016-05-01

    Background Gastritis is an important premalignant lesion and recent studies suggested a production of inflammatory cytokine-like C-reactive protein during gastritis. This study aimed to determine any relationship between high sensitive C-reactive protein (hs-CRP) and inflammation activity among patients with gastritis. Methods Demographic and clinical variables of participants were collected by a validated questionnaire. Using histology of the gastric mucosa, Helicobacter pylori status was investigated and serum concentrations of hs-CRP were measured among dyspeptic patients. Correlation between hs-CRP serum levels and inflammation activities was evaluated by logistic regression analysis. The relation between active inflammation and other variables was evaluated by logic link function model. Results Totally 239 patients (56.6% female) were analysed. The prevalence of mild, moderate and severe inflammation activities was 66.5%, 23.8% and 9.6% respectively. Mean ± SD of hs-CRP among men and women were 2.85 ± 2.84 mg/dl and 2.80 ± 4.80 mg/dl (p = 0.047) respectively. Mean ± SD of hs-CRP among patients with H. pylori infection, gland atrophy, metaplasia and dysplasia were 2.83 ± 3.80 mg/dl, 3.52 ± 5.1 mg/dl, 2.22 ± 2.3 mg/dl and 5.3 ± 5.04 mg/dl respectively. Relationship between hs-CRP and inflammation activities (p gastritis, elevated hs-CRP levels may be considered as a predictive marker of changes in gastric mucosa and a promising therapeutic target for patients with gastritis. PMID:26758551

  5. Comparison of C-reactive protein and high-sensitivity C-reactive protein levels in patients on hemodialysis

    Imed Helal

    2012-01-01

    Full Text Available Chronic inflammation is highly prevalent in patients on hemodialysis (HD, as evidenced by increased levels of C-reactive protein (CRP. We compared CRP to high-sensitivity C-reactive protein (hs-CRP to determine whether it has any clinical implications and prognostic significance in terms of mortality. CRP was measured using a standard immunoturbidometric assay on the COBAS; INTEGRA system and hs-CRP was measured using the Dade Behring on the Konelab Nephelometer in 50 patients on HD. CRP (≥6 mg/L and hs-CRP (≥3 mg/L levels were elevated in 30% and 54% of the patients, respectively. A significant correlation was noted between hs-CRP and CRP levels (r = 0.98, P <0.001. Deming regression analysis showed that the slope was near one (r = 0.90; 0.83-0.94 and that the intercept was small. Multivariate regression confirmed that age above 40 years (RR = 3.69, P = 0.027 and duration on HD greater than five years (RR = 3.71, P = 0.028 remained significant independent predictors of serum hs-CRP. Thirteen patients died during follow-up (26%. Multivariate Cox regression demonstrated that hs-CRP (RR = 1.062, P = 0.03 and CRP levels (RR = 1.057, P = 0.009 and age (RR = 1.078, P = 0.001 were the most powerful predictors of mortality. The CRP standard assay presents a reasonable alternative to the hs-CRP assay in patients on HD. The advantages of the CRP standard assay are its online and real-time availability as well as lower costs, particularly in developing countries.

  6. Fiber optic-SPR platform for fast and sensitive infliximab detection in serum of inflammatory bowel disease patients.

    Lu, Jiadi; Van Stappen, Thomas; Spasic, Dragana; Delport, Filip; Vermeire, Séverine; Gils, Ann; Lammertyn, Jeroen

    2016-05-15

    Infliximab (IFX) is a therapeutic monoclonal antibody used for treating patients with inflammatory bowel disease (IBD). In order to improve therapeutic outcomes it is recommended to monitor IFX trough concentrations. Although ELISA is currently widely used for this purpose, this method is not suitable for single patient testing. In this paper we describe the development of a fast bioassay for determining IFX concentration in serum using an in-house developed fiber-optic surface plasmon resonance (FO-SPR) biosensor. Studies were first conducted to optimize covalent immobilization of the IFX-specific antibody on the sensor surface as well as to select an optimal blocking buffer for restraining the non-specific binding. In order to reach clinically relevant sensitivity for detecting IFX in patients' serum, the SPR signal was amplified by employing gold nanoparticles functionalized with another set of IFX specific antibodies. Using the optimized sandwich bioassay, calibration curves were made with series of IFX concentrations spiked in buffer and 100-fold diluted serum, reaching the limit of detection of 0.3 and 2.2ng/ml, respectively. The established bioassay was finally validated using five IFX treated IBD patients samples. Results from the FO-SPR platform were compared with an in-house developed, clinically validated ELISA resulting in excellent Pearson and intraclass correlation coefficient of 0.998 and 0.983, respectively. Furthermore, the assay time of the FO-SPR platform was significantly reduced compared to ELISA, demonstrating the potential of this platform to be used as a point-of-care diagnostic tool for improving therapeutic outcomes of IBD patients. PMID:26706938

  7. Effect of IL-6 on the insulin sensitivity in patients with type 2 diabetes

    Harder-Lauridsen, N M; Krogh-Madsen, R; Holst, Jens Juul;

    2014-01-01

    Elevated interleukin-6 (IL-6) levels are associated with type 2 diabetes, but its role in glucose metabolism is controversial. We investigated the effect of IL-6 on insulin-stimulated glucose metabolism in type 2 diabetes patients and hypothesized that an acute, moderate IL-6 elevation would...... increase the insulin-mediated glucose uptake. Men with type 2 diabetes not treated with insulin [n = 9, age 54.9 ± 9.7 (mean ± SD) yr, body mass index 34.8 ± 6.1 kg/m(2), HbA1c 7.0 ± 1.0%] received continuous intravenous infusion with either recombinant human IL-6 (rhIL-6) or placebo. After 1 h with...

  8. 233 The Evaluation of Allergen Sensitivity in Allergic Rhinoconjunctivitis and Allergic Asthma Patients in Antalya, Turkey

    Yalcin, Arzu Didem; Polat, Hasan Hüseyin; Kamaci, Fulya; Bisgin, Atil; Gorczynski, Reginald M.

    2012-01-01

    Background Allergic rhinitis is a common health problem which has 2 forms; seasonal and perennial. The prevalence and etiology of allergic rhinitis varies from region to region and affect 10 to 20% of the population approximately. The prevalences of asthma, allergic rhinitis and allergic eye disease were detected as 8.2%, 10.8% and 7.5% respectively in Antalya, the south coast of Turkey. Methods The study was conducted in Antalya between 10th of November 2009 and 20th of September 2010. 866 of 2862 patients who had allergic rhinoconjunctivitis and asthma were enrolled in the study due to having high total IgE levels in blood conducted at the Allergy-Immunology Division of Antalya Research and Training Hospital. Allergen-spesific subcutaneous immunotherapy was given 626 of 866 patients. Results Of the 866 patients studied, 66.1 % were females. Most of the cases had declaired that the rhinitis symptomes were due to pollens and house dust the second most common irritant. Also the cases have said that their symptoms got worse with exposure to dust, smoke, heavy odors, perfumes, and detergents. Most of the patients have said that air pollution was the most important factor that exacerbated the symptoms of rhinitis and asthma. While there is a comparison between the age and SPT positivity, Aspergillus fumigatus and Dpteronyssinus sensitivity was statistically different in the mites and fungal mixture dermal test groups. As a result, in the study group of 866 allergic rhinitis patients, only the Plantagolanceolata, Corylusavellana, Aspergillus fumigatus, Dpteronyssinus and cockroach sensitivity was significantly varies with the age. Conclusions In allergic diseases; we all know that allergens may have regional variations. That's why; the allergen profiles of the regions must be determined and the dermal Prick tests must be prepared accordingly. Mostly grass and cereal mixtures and mites are responsible from the allergic rhinitis cases due to our observations in our clinic

  9. Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

    Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

  10. Digital breast tomosynthesis (DBT) to characterize MRI-detected additional lesions unidentified at targeted ultrasound in newly diagnosed breast cancer patients

    Mariscotti, Giovanna; Durando, Manuela; Regini, Elisa; Fornari, Alberto; Fonio, Paolo; Gandini, Giovanni [Breast Imaging Service, Radiology - University of Turin, Department of Diagnostic Imaging and Radiotherapy, A.O.U. Citta della Salute e della Scienza, Torino (Italy); Houssami, Nehmat [University of Sydney, Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, Sydney, NSW (Australia); Campanino, Pier Paolo [Ospedale Koelliker, Breast Imaging Service, Torino (Italy); Bussone, Riccardo [A.O.U. Citta della Salute e della Scienza of Turin, SSCVD Breast Surgery. Department of Surgery, Torino (Italy); Castellano, Isabella; Sapino, Anna [University of Turin, Department of Biomedical Sciences and Human Oncology, A.O.U. Citta della Salute e della Scienza, Torino (Italy)

    2015-09-15

    Preoperative breast magnetic resonance (MR) often generates additional suspicious findings needing further investigations. Targeted breast ultrasound (US) is the standard tool to characterize MR additional lesions. The purpose of this study is to evaluate the potential role of digital breast tomosynthesis (DBT) to characterize MR detected additional findings, unidentified at targeted breast US. This prospective study included women who a) had biopsy-proven, newly diagnosed breast cancers detected at conventional 2D mammography and/or US, referred to breast MR for tumour staging; and b) had DBT if additional MR findings were not detected at targeted ('second look') US. In 520 patients, MR identified 164 (in 114 women, 22 %) additional enhancing lesions. Targeted US identified 114/164 (69.5 %) of these, whereas 50/164 (30.5 %) remained unidentified. DBT identified 32/50 of these cases, increasing the overall characterization of MR detected additional findings to 89.0 % (146/164). Using DBT the identified lesions were significantly more likely to be malignant than benign MR-detected additional lesions (p = 0.04). DBT improves the characterization of additional MR findings not identified at targeted breast US in preoperative breast cancer staging. (orig.)

  11. Impact of Additional Transthoracic Electrical Cardioversion on Cardiac Function and Atrial Fibrillation Recurrence in Patients with Persistent Atrial Fibrillation Who Underwent Radiofrequency Catheter Ablation

    Wang, Deguo; Zhang, Fengxiang; Wang, Ancai

    2016-01-01

    Backgrounds and Objective. During the procession of radiofrequency catheter ablation (RFCA) in persistent atrial fibrillation (AF), transthoracic electrical cardioversion (ECV) is required to terminate AF. The purpose of this study was to determine the impact of additional ECV on cardiac function and recurrence of AF. Methods and Results. Persistent AF patients received extensive encircling pulmonary vein isolation (PVI) and additional line ablation. Patients were divided into two groups based on whether they need transthoracic electrical cardioversion to terminate AF: electrical cardioversion (ECV group) and nonelectrical cardioversion (NECV group). Among 111 subjects, 35 patients were returned to sinus rhythm after ablation by ECV (ECV group) and 76 patients had AF termination after the ablation processions (NECV group). During the 12-month follow-ups, the recurrence ratio of patients was comparable in ECV group (15/35) and NECV group (34/76) (44.14% versus 44.74%, P = 0.853). Although left atrial diameters (LAD) decreased significantly in both groups, there were no significant differences in LAD and left ventricular cardiac function between ECV group and NECV group. Conclusions. This study revealed that ECV has no significant impact on the maintenance of SR and the recovery of cardiac function. Therefore, ECV could be applied safely to recover SR during the procedure of catheter ablation of persistent atrial fibrillation. PMID:27022500

  12. Whole-body magnetic resonance angiography with additional steady-state acquisition of the infragenicular arteries in patients with peripheral arterial disease

    Nielsen, Yousef W; Eiberg, Jonas P; Løgager, Vibeke B; Just, Sven; Schroeder, Torben V; Thomsen, Henrik S; Nielsen, Yousef Jesper Wirenfeldt; Eiberg, Jonas Peter; Løgager, Vibeke Berg; Just, Sven Richardt Lundgren; Schroeder, Torben Veith; Thomsen, Henrik Segelcke

    2010-01-01

    The purpose of this investigation was to determine if addition of infragenicular steady-state (SS) magnetic resonance angiography (MRA) to first-pass imaging improves diagnostic performance compared with first-pass imaging alone in patients with peripheral arterial disease (PAD) undergoing whole......-body (WB) MRA. Twenty consecutive patients with PAD referred to digital-subtraction angiography (DSA) underwent WB-MRA. Using a bolus-chase technique, first-pass WB-MRA was performed from the supra-aortic vessels to the ankles. The blood-pool contrast agent gadofosveset trisodium was used at a dose of 0...

  13. Reliability, Validity, and Sensitivity to Change of Turkish Activities-Specific Balance Confidence Scale in Patients with Unilateral Peripheral Vestibular Disease

    Karapolat, Hale; Eyigor, Sibel; Kirazli, Yesim; Celebisoy, Nese; Bilgen, Cem; Kirazli, Tayfun

    2010-01-01

    The aim of this study is to evaluate the internal consistency, test-retest reliability, construct validity, and sensitivity to change of the Activities-specific Balance Confidence Scale (ABC) in people with peripheral vestibular disorder. Thirty-three patients with unilateral peripheral vestibular disease were included in the study. Patients were…

  14. Can the addition of regional radiotherapy counter-balance important risk factors in breast cancer patients with extracapsular invasion of axillary lymph-node metastases?

    Purpose: To evaluate if locoregional radiotherapy (RT) versus local irradiation only can alter the pattern of failure in breast cancer patients with extranodal invasion. Patients and Methods: From 08/1988 to 06/1998, 81 patients with extranodal invasion were treated with adjuvant RT (median total dose: 50.4 Gy), 46/81 only locally, 35/81 locoregionally due to presumed adverse parameters. The mean number of resected (positive) lymph nodes was 17 (seven). 78 patients received adjuvant systemic treatment(s). Results: Patients treated with locoregional RT had significantly more often lymphatic vessel invasion (LVI; 63% vs. 28%; p = 0.003), T3/T4 tumors (43% vs. 17%; p = 0.014), and four or more positive lymph nodes (91% vs. 46%; p < 0.001) than patients irradiated only locally. Disease progression occurred in 24/81 patients (locoregional RT: 26% vs. local RT: 33%). The above risk factors were highly significant of worse outcome. Despite their overrepresentation in the locoregional RT group, no difference was found between both groups in regard to disease-free survival (DFS; p = 0.83) and overall survival (OS; p = 0.56), suggesting that regional RT was able to counterbalance the increased risk. There was even a trend toward a better 3-year DFS, 61% in locoregional RT and 37% in local RT, in the subgroup of patients with four or more positive lymph nodes. In a Cox regression model, higher T-stage, four or more positive lymph nodes, and LVI remained significant. For DFS and distant metastasis-free survival (DMFS), the absence of estrogen receptors and the omission of regional RT were also significant. Conclusion: Our data suggest that the addition of regional RT might be beneficial in selected subgroups of patients with extranodal invasion and other poor prognostic factors. (orig.)

  15. THE IMPROVEMENT OF LIPID-LOWERING THERAPY EFFECTIVENESS IN PATIENTS WITH HIGH CARDIOVASCULAR RISK AND CONCOMITANT LIVER DISEASE (RESULTS OF ADDITIONAL ANALYSIS OF THE RAKURS STUDY

    N. P. Kutishenko

    2015-09-01

    Full Text Available Aim. To evaluate the differences between a group of patients treated with ursodeoxycholic acid (UDCA during the study period and a group of patients not treated with UDCA by pseudo-randomization using Propensity Score Matching.Material and methods. 262 patients aged 60.1±8.9 years, taking statins for the secondary prevention of cardiovascular complications were included into a 6-month observational cohort study. The UDCA intake was recommended to all the patients due to the presence of liver and/or bile duct diseases. One part of the patients strictly followed medical recommendations and used UDCA, while the other part of the patients wasn’t taking UDCA. This allowed comparing the effect of UDCA in these groups.Results. Propensity Score Matching method allowed forming two groups of patients of 52 people each with similar main clinical and demographic characteristics. A more significant decrease in the levels of total cholesterol (TC and low density lipoprotein cholesterol (LDL-C (up to 4.0 mmol/L and 1.92 mmol/L, respectively; p<0.001 after 6 months was found in patients treated with lipid-lowering therapy in combination with UDCA as compared with patients without UDCA (up to 4.52 mmol/L and 2.6 mmol/L, respectively; p<0.05. No ALT, AST, CPK, LDH activity deterioration and no bilirubin serum level increase was found. Due to statin treatment the target levels of LDL-C by the end of the study were achieved in 31% of the patients of UDCA-group. Target levels of LDL-C were not achieved in any of the patients of the group without UDCA (p<0.001. There was demonstrated a high adherence to UDCA therapy.Conclusion. Combined therapy with statins and UDCA is effective and safe in patients with high cardiovascular risk and concomitant liver disease. Co-administration of statins with UDCA is promising in the treatment of hyperlipidemia in patients with low tolerance to statins. However, additional controlled studies are required.

  16. [Influence of hypocaloric diet with addition of a vitamin-mineral complex on status of patients with obesity 1st and 2nd degrees].

    Sharafetdinov, Kh Kh; Plotnikova, O A; Zykina, V V; Mal'tsev, G Iu; Sokol'nikov, A A; Kaganov, B S

    2011-01-01

    Addition of a vitamin-mineral complex (VMC) to a standard hypocaloric diet leads to a positive dynamics of antropometric characteristics in patients with obesity 1st and 2nd degrees which is comparable to effectiveness of standard dietotherapy (dietary treatment) traditionally used in complex treatment of obesity. Addition of 1,8 mg of vitamin B2 as part of VMC to a hypocaloric diet is shown to be inadequate in eradication of marginal provision of riboflavin when using diets reduced in calories. PMID:22232885

  17. A Rapid and Sensitive Next-Generation Sequencing Method to Detect RB1 Mutations Improves Care for Retinoblastoma Patients and Their Families.

    Li, Wenhui L; Buckley, Jonathan; Sanchez-Lara, Pedro A; Maglinte, Dennis T; Viduetsky, Lucy; Tatarinova, Tatiana V; Aparicio, Jennifer G; Kim, Jonathan W; Au, Margaret; Ostrow, Dejerianne; Lee, Thomas C; O'Gorman, Maurice; Judkins, Alexander; Cobrinik, David; Triche, Timothy J

    2016-07-01

    Retinoblastoma is a childhood eye malignancy that can lead to the loss of vision, eye(s), and sometimes life. The tumors are initiated by inactivating mutations in both alleles of the tumor-suppressor gene, RB1, or, rarely, by MYCN amplification. Timely identification of a germline RB1 mutation in blood samples or either somatic RB1 mutation or MYCN amplification in tumors is important for effective care and management of retinoblastoma patients and their families. However, current procedures to thoroughly test RB1 mutations are complicated and lengthy. Herein, we report a next-generation sequencing-based method capable of detecting point mutations, small indels, and large deletions or duplications across the entire RB1 gene and amplification of MYCN gene on a single platform. From DNA extraction to clinical interpretation requires only 3 days, enabling early molecular diagnosis of retinoblastoma and optimal treatment outcomes. This method can also detect low-level mosaic mutations in blood samples that can be missed by routine Sanger sequencing. In addition, it can differentiate between RB1 mutation- and MYCN amplification-driven retinoblastomas. This rapid, comprehensive, and sensitive method for detecting RB1 mutations and MYCN amplification can readily identify RB1 mutation carriers and thus improve the management and genetic counseling for retinoblastoma patients and their families. PMID:27155049

  18. Assessment of Metformin as an Additional Treatment to Therapeutic Lifestyle Changes in Pediatric Patients with Metabolic Syndrome

    Rebecca M. Raub

    2012-01-01

    Full Text Available Objective. To assess the effectiveness of metformin and therapeutic lifestyle changes (TLCs in a clinical setting, compared to TLC alone in adolescents with metabolic syndrome (MS. Methodology. This study was a retrospective trial consisting of 60 patients, aged 8–18 years, who were treated for MS at an outpatient clinic. Two groups were formed: the metformin group (M group and the control group (C group. The M group had been given metformin along with TLC, and the C group had been given TLC alone. Several outcome measures were obtained; the main outcome measure was measuring the change in percentile and z-score of weight and BMI. Results. There were no significant differences between the two groups at the conclusion of the study, except for height percentile (P=0.02 and z-score (P=0.03. Both groups showed promising significant intragroup decreases in weight z-score but BMI percentile and z-score were only significantly decreased in the M group. Conclusion. Metformin at an average dose of 1033 mg, when added to TLC, did not show any clinically important efficacy compared to TLC alone in a pediatric population with MS. However, both groups made significant changes in a positive direction, which may be solely due to TLC.

  19. Palliative radiotherapy with or without additional care by a multidisciplinary palliative care team in patients with newly diagnosed cancer: a retrospective matched pairs comparison

    To analyze survival after early palliative radiotherapy (RT) in patients managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. Retrospective matched pairs analysis. Comparison of two groups of 29 patients each: MPCT versus none. Early RT started within three months after cancer diagnosis. Bone and brain metastases were common RT targets. No significant differences in baseline characteristics were observed between both groups. Twelve patients in each group had non-small cell lung cancer. Median performance status was 2 in each group. Twenty-seven patients in each group had distant metastases. Median survival was not significantly different. In multivariate analysis, MPCT care was not associated with survival, while performance status and liver metastases were. Rate of radiotherapy during the last month of life was comparable. Only one patient in each group failed to complete radiotherapy. MPCT care was not associated with survival in these two matched groups of patients. The impact of MPCT care on other relevant endpoints such as symptom control, side effects and quality of life should be investigated prospectively

  20. Aluminum sulfate significantly reduces the skin test response to common allergens in sensitized patients

    Grier Thomas J

    2006-02-01

    Full Text Available Abstract Background Avoidance of allergens is still recommended as the first and best way to prevent allergic illnesses and their comorbid diseases. Despite a variety of attempts there has been very limited success in the area of environmental control of allergic disease. Our objective was to identify a non-invasive, non-pharmacological method to reduce indoor allergen loads in atopic persons' homes and public environments. We employed a novel in vivo approach to examine the possibility of using aluminum sulfate to control environmental allergens. Methods Fifty skin test reactive patients were simultaneously skin tested with conventional test materials and the actions of the protein/glycoprotein modifier, aluminum sulfate. Common allergens, dog, cat, dust mite, Alternaria, and cockroach were used in the study. Results Skin test reactivity was significantly reduced by the modifier aluminum sulfate. Our studies demonstrate that the effects of histamine were not affected by the presence of aluminum sulfate. In fact, skin test reactivity was reduced independent of whether aluminum sulfate was present in the allergen test material or removed prior to testing, indicating that the allergens had in some way been inactivated. Conclusion Aluminum sulfate was found to reduce the in vivo allergic reaction cascade induced by skin testing with common allergens. The exact mechanism is not clear but appears to involve the alteration of IgE-binding epitopes on the allergen. Our results indicate that it may be possible to diminish the allergenicity of an environment by application of the active agent aluminum sulfate, thus producing environmental control without complete removal of the allergen.

  1. Search for Allergens from the Pollen Proteome of Sunflower (Helianthus annuus L.: A Major Sensitizer for Respiratory Allergy Patients.

    Nandini Ghosh

    Full Text Available Respiratory allergy triggered by pollen allergens is increasing at an alarming rate worldwide. Sunflower pollen is thought to be an important source of inhalant allergens. Present study aims to identify the prevalence of sunflower pollinosis among the Indian allergic population and characterizes the pollen allergens using immuno-proteomic tools.Clinico-immunological tests were performed to understand the prevalence of sensitivity towards sunflower pollen among the atopic population. Sera from selected sunflower positive patients were used as probe to detect the IgE-reactive proteins from the one and two dimensional electrophoretic separated proteome of sunflower pollen. The antigenic nature of the sugar moiety of the glycoallergens was studied by meta-periodate modification of IgE-immunoblot. Finally, these allergens were identified by mass-spectrometry.Prevalence of sunflower pollen sensitization was observed among 21% of the pollen allergic population and associated with elevated level of specific IgE and histamine in the sera of these patients. Immunoscreening of sunflower pollen proteome with patient sera detected seven IgE-reactive proteins with varying molecular weight and pI. Hierarchical clustering of 2D-immunoblot data highlighted three allergens characterized by a more frequent immuno-reactivity and increased levels of IgE antibodies in the sera of susceptible patients. These allergens were considered as the major allergens of sunflower pollen and were found to have their glycan moiety critical for inducing IgE response. Homology driven search of MS/MS data of these IgE-reactive proteins identified seven previously unreported allergens from sunflower pollen. Three major allergenic proteins were identified as two pectate lyases and a cysteine protease.Novelty of the present report is the identification of a panel of seven sunflower pollen allergens for the first time at immuno-biochemical and proteomic level, which substantiated the

  2. Efficacy of the Additional Neoadjuvant Chemotherapy to Concurrent Chemoradiotherapy for Patients with Locoregionally Advanced Nasopharyngeal Carcinoma: a Bayesian Network Meta-analysis of Randomized Controlled Trials

    Chen, Yu-Pei; Guo, Rui; Liu, Na; Liu, Xu; Mao, Yan-Ping; Tang, Ling-Long; Zhou, Guan-qun; Lin, Ai-Hua; Sun, Ying; Ma, Jun

    2015-01-01

    Background: Due to the lack of studies, it remains unclear whether the additional neoadjuvant chemotherapy (NACT) to concurrent chemoradiotherapy (CCRT) is superior to CCRT alone for locoregionally advanced nasopharyngeal carcinoma (NPC). The main objective of this Bayesian network meta-analysis was to determine the efficacy of NACT+CCRT as compared with CCRT alone. Methods: We comprehensively searched databases and extracted data from randomized controlled trials involving NPC patients who r...

  3. EFFECT OF CHRONIC ACE INHIBITION ON GLUCOSE TOLERANCE AND INSULIN SENSITIVITY IN HYPERTENSIVE TYPE 2 DIABETIC PATIENTS

    尹卫东; G.Seghieri; C.Boni,G,Sanna; R.Anichinl; G.Bartolomei; E.Ferrannini

    1994-01-01

    We studied 14 moderately overweight Type 2 diabetic patients with essential hypertension in stable metabolic control after a run-in period,and again after 3 months of antihypertensive treatment with the angiotensin-convert-ing enzyme(ACE)inhibitor captopril.Glucose tolerance was tested with a 75g oral glucose load (OGTT) and in-sulin sensitivity was measured by the insulin suppression test (IST)while dietary and drug treatment of the hyper-glycemia was maintained constant.In the whole group,mean blood pressure (MBP) fell progressively over 3 months from a baseline value of 123±3mmHg(1 mmHg=0.133kpa)to a final value of 115±2mmHg(P<0.005).After treatment,fasting plasma glucose,insulin,free fatty acid (FFA),potassium,and glycosylated hemoglobin concentrations were unchanged from baseling.There were no significant differences in glucose toler-ance and insulin sensitivity between pre-and post-trearment values.Neither endogenous (oral glucose)nor exoge-nous(IST)insulin caused any change in plasma potassium concentration. This resistance to the hypokalemic action of insulin was not affected by captopril.

  4. McMaster-Toronto Arthritis Patient Preference Disability Questionnaire Sensitivity to Change in Low Back Pain: Influence of Shifts in Priorities

    Sanchez, Katherine; Papelard, Agathe; Nguyen, Christelle; Bendeddouche, Imad; Jousse, Marylène; Rannou, François; Revel, Michel; Poiraudeau, Serge

    2011-01-01

    Objective To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR) in chronic low back pain (CLBP) and shifts in patients' priorities of disabling activities over time. Methods A prospective longitudinal survey of 100 patients (38 males) with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC), Hospital Anxiety and Depression scale (HAD...

  5. Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy

    The reversal of anorexia and weight loss especially in patients with advanced cancer suffering from radiation treatment (RT) -related complications and debilitated further during RT would be a welcome relief. The purpose of this study is to evaluate the feasibility of supportive treatment with megestrol acetate (MA) in the weight-losing cancer patients increasingly experiencing anorexia, smell, taste, and weight loss due to the additive adverse effects of RT plus or minus chemotherapy and how MA changes the additive role of the severity of RT reactions on such patients. From June 1997 to October 1998, 100 eligible patients were enrolled on a randomized, placebo-controlled clinical trial. Of the 100 patients, 46 received MA during RT and 4 after the end of the RT, and 50 received placebo for 3 months. Subjective parameters were assessed by a brief questionnaire form based on scoring from 1 to 5, according to the degree of the loss or change for each parameter of malnutrition, appetite, taste and smell developed by the researchers. At the end of the study a statistically significant weight gain was achieved in the patient group receiving MA compared to the placebo group (+ 3 to + 5 kg versus -3.7 to -5.9 kg, p=0.000). Significant improvements were seen in performance status p=0.000), appetite (p=0.000), malnutrition (p=0.000), loss of taste (p=0.000) and smell qualities (p=0.02) in the MA group compared to the placebo group. In the MA group there was no statistically significant difference related to the weight changes according to the grade of either the acute or late RT effects (p=0.65 and 0.07, respectively). Whereas, in the placebo group a statistically significant additive effect of the acute and late RT effects was detected on weight loss (p=0.008 and 0.007, respectively). It was observed no side-effects of MA in a 3-month time follow-up. The use of MA 480 mg/day during RT was effective in reversing anorexia and weight loss in spite of the acute RT effects, and

  6. Supportive treatment in weight-losing cancer patients due to the additive adverse effects of radiation treatment and/or chemotherapy

    Erkurt, E.; Tunali, C. [Cukurova University Medical Faculty, Dept. of Radiation Oncology, Balcali-Adana (Turkey); Erkisi, M. [Cukurova University Medical Faculty, Dept. of Medical Oncology (Turkey)

    2000-12-01

    The reversal of anorexia and weight loss especially in patients with advanced cancer suffering from radiation treatment (RT) -related complications and debilitated further during RT would be a welcome relief. The purpose of this study is to evaluate the feasibility of supportive treatment with megestrol acetate (MA) in the weight-losing cancer patients increasingly experiencing anorexia, smell, taste, and weight loss due to the additive adverse effects of RT plus or minus chemotherapy and how MA changes the additive role of the severity of RT reactions on such patients. >From June 1997 to October 1998, 100 eligible patients were enrolled on a randomized, placebo-controlled clinical trial. Of the 100 patients, 46 received MA during RT and 4 after the end of the RT, and 50 received placebo for 3 months. Subjective parameters were assessed by a brief questionnaire form based on scoring from 1 to 5, according to the degree of the loss or change for each parameter of malnutrition, appetite, taste and smell developed by the researchers. At the end of the study a statistically significant weight gain was achieved in the patient group receiving MA compared to the placebo group (+ 3 to + 5 kg versus -3.7 to -5.9 kg, p=0.000). Significant improvements were seen in performance status (p=0.000), appetite (p=0.000), malnutrition (p=0.000), loss of taste (p=0.000) and smell qualities (p=0.02) in the MA group compared to the placebo group. In the MA group there was no statistically significant difference related to the weight changes according to the grade of either the acute or late RT effects (p=0.65 and 0.07, respectively). Whereas, in the placebo group a statistically significant additive effect of the acute and late RT effects was detected on weight loss (p=0.008 and 0.007, respectively). It was observed no side-effects of MA in a 3-month time follow-up. The use of MA 480 mg/day during RT was effective in reversing anorexia and weight loss in spite of the acute RT effects

  7. Insulin sensitivity and lipid profile in prolactinoma patients before and after normalization of prolactin by dopamine agonist therapy.

    Berinder, Katarina; Nyström, Thomas; Höybye, Charlotte; Hall, Kerstin; Hulting, Anna-Lena

    2011-09-01

    Hyperprolactinemia has been associated with impaired metabolism, including insulin resistance. However, the metabolic effects of elevated prolactin (PRL) levels are not completely clarified. The aim of this study was to obtain more insights of metabolic consequences in hyperprolactinemia patients. Fourteen consecutive patients, eight women and six men, aged 39.7 (±13.7) years with prolactinomas (median PRL 72 [49-131] μg/L in women and 1,260 [123-9,600] μg/L in men) were included. Anthropometric data and metabolic values were studied before and after 2 and 6 months on DA agonists (Bromocriptine [5.7 (±3.9) mg/day, n = 13] or Cabergoline [0.5 mg/week, n = 1]). Euglycemic hyperinsulinemic clamps were studied in six patients before and after 6 months of treatment. PRL normalized in all patients. Anthropometric data changed only in males with a significant decrease of median body weight (95.6 [80.7-110.1] to 83.4 [77.8-99.1] kg, P = 0.046), waist circumference and fat percentage after 6 months. LDL cholesterol was positively correlated to PRL at diagnosis (r = 0.62, P = 0.025) and decreased within 2 months (3.4 [±0.9] to 2.9 [±0.6] mmol/L, P = 0.003). Insulin, IGFBP-1 and total adiponectin levels did not change. Insulin sensitivity tended to improve after 6 months; M-value from 5.7 (±1.8) to 7.8 (±2.6) mg/kg/min, P = 0.083 and per cent improvement in M-value was correlated to per cent reduction in PRL levels (r = -0.85, P = 0.034). In conclusion, beneficial metabolic changes were seen in prolactinoma patients after treatment with DA agonists, underscoring the importance of an active treatment approach and to consider the metabolic profile in the clinical management of hyperprolactinemia patients. PMID:21128120

  8. Clinically meaningful treatment responses after switching to galantamine and with addition of memantine in patients with Alzheimer’s disease receiving donepezil

    Kano O

    2013-02-01

    Full Text Available Osamu Kano,1 Hirono Ito,1 Takanori Takazawa,1 Yuji Kawase,1 Kiyoko Murata,1 Konosuke Iwamoto,1 Tetsuro Nagaoka,1 Takehisa Hirayama,1 Ken Miura,1 Riya Nagata,1 Tetsuhito Kiyozuka,2 Jo Aoyagi,2 Ryuta Sato,2 Teruo Eguchi,3 Ken Ikeda,1 Yasuo Iwasaki11Department of Neurology, Toho University Omori Medical Center, 2Department of Neurology, Federation of National Public Service Personnel Mutual Aid Associations Mishuku Hospital, 3Sakura-kai Medical Group, Tokyo, JapanAbstract: Clinical trials have shown the benefits of acetylcholinesterase inhibitors, such as donepezil and galantamine, and an N-methyl-d-aspartate receptor antagonist, memantine, in patients with Alzheimer’s disease (AD. However, little is known regarding the effects of switching from donepezil 5 mg/day to galantamine 16 or 24 mg/day, or regarding the effects of adding memantine to established therapy compared with increasing the dose of donepezil. This report discusses two studies conducted to evaluate treatment with galantamine and memantine with respect to cognitive benefits and caregiver evaluations in patients with AD receiving donepezil 5 mg/day for more than 6 months. Patients with mild or moderate AD (scores 10–22 on the Mini-Mental State Examination were enrolled in the Galantamine Switch study and switched to galantamine (maximum doses 16 mg versus 24 mg. Patients with moderate to severe AD (Mini-Mental State Examination scores 3–14 were enrolled in the Donepezil Increase versus Additional Memantine study and either had their donepezil dose increased to 10 mg/day or memantine 20 mg/day added to their existing donepezil dose. Patients received the study treatment for 28 weeks and their Disability Assessment for Dementia, Mental Function Impairment Scale, Cohen-Mansfield Agitation Inventory, and Neuropsychiatric Inventory scores were assessed with assistance from their caregivers. For the Galantamine Switch study after 8 weeks, agitation evaluated by the Cohen

  9. Addition of a fixed combination of brinzolamide 1%/timolol 0.5% to prostaglandin monotherapy in patients with glaucoma or ocular hypertension

    Lorenz K

    2011-12-01

    Full Text Available Katrin Lorenz1, Klaus Rosbach2, Andreas Matt3, Norbert Pfeiffer11University Medical Center, Johannes Gutenberg-Universität Mainz, Mainz, Germany; 2Private practice, Mainz, Germany; 3Private practice, Köln-Hohenhaus, GermanyBackground: This study was conducted to evaluate the safety and efficacy of adding a fixed combination of brinzolamide 1%/timolol 0.5% to prostaglandin analog (PGA monotherapy in patients with primary open-angle glaucoma, pigment dispersion glaucoma, or ocular hypertension who require additional intraocular pressure (IOP reduction.Methods: This was a prospective, multicenter (n = 5, open-label, single-arm, Phase IV clinical trial in which patients currently being treated with a PGA but requiring additional IOP reduction were administered brinzolamide 1%/timolol 0.5% twice daily as adjunctive therapy to their current PGA monotherapy regimen. The primary objective was to examine the IOP-lowering efficacy of brinzolamide-timolol when used as adjunctive therapy.Results: Forty-seven patients enrolled in and completed the study. After 12 weeks of adjunctive brinzolamide-timolol therapy, the mean IOP of the total patient population decreased from 22.1 mmHg at baseline to 16.7 mmHg. The mean IOP reduction of 5.4 mmHg (24.4% was both clinically and statistically significant (P < 0.001. This significant decrease in mean IOP at week 12 was maintained across all PGA groups (P < 0.05. No significant differences were observed in symptom frequency between baseline and week 12 for any of the six solicited symptoms. A total of 17 adverse events from six patients was reported, of which ten were drug-related. Most (n = 7 of the drug-related adverse events were mild or moderate in intensity. None of the adverse events required any treatment or resulted in treatment interruption or discontinuation. Of the 90 eligible eyes, 85.6% had a decrease in IOP of at least 3 mmHg from baseline and 98% of patients had a decrease in IOP of ≥1 mm

  10. Study of efficiency of Likoprofit Potential-Formula biologically active additive (BAA in the treatment of patients with erectile dysfunction against the background of arterial hypertension

    A. I. Neimark

    2016-03-01

    Full Text Available The efficiency of the action of Likoprofit Potential biologically active additive (BAA on microcirculation of penis in patients with erectile dysfunction (ED against the background of arterial hypertension has been studied. All the patients have passed the laser Doppler flowmetry, assessment of the index of male copulatory function and the international index of erectile function. The course of administration was three months. All the patients in 100% of cases had mild arterial hypertension. The patients of the main group had decreased libido (50%, lack of self-confidence (7%, weak spontaneous and adequate erections (21%, ejaculatory component (7%, orgasmic dysfunction (28%, increased period of sexual stimulation, decreased number and quality of coiti (100%. In patients with erectile dysfunction against the background of arterial hypertension, Likoprofit Potential produces the stimulating effect on CNS, spasmolytic action on penis vessels, and improves hemodynamics in cavernous bodies of penis. The number of patients’ complains have decreased, the psycho-emotional state has improved, and the satisfaction of the sex life has appeared. The patients’ microcirculation has improved as well.

  11. Sensitivity of P300 auditory event-related potentials for assessing cognitive impairment in elderly type 2 diabetic patients

    Hong Yang; Junhong She; Xianfu Lu; Rihong Peng

    2008-01-01

    significantly lower in the diabetes alone and diabetes and cerebral ischemia groups (P < 0.01) than in the normal control group. N2 and P3 latencies were significantly longer in the diabetes and cerebral ischemia group than in the diabetes alone group (P <0.01), but amplitude was not significantly different. N2 and P3 latencies were negatively correlated with MMSE score in elderly type 2 diabetic patients (r=-0.421, -0.604; both P < 0.01). P3 amplitude was positively related to the score of MMSE (r =0.517; P < 0.01). P3 latency was positively associated with age, course of disease, glycosylated hemoglobin and ischemic brain damage in elderly type 2 diabetic patients (t=2.186 to 3.490; all P < 0.05). P3 amplitude was negatively correlated with age, course of disease and glycosylated hemoglobin (t=-2.220, -2.491, and -2.024, respectively; all P < 0.05). N2latency was positively correlated with age, course of disease and ischemic brain damage (t=2.946, 2.511,and 2.331, respectively; P < 0.05).CONCLUSION: The course of disease, glycosylated hemoglobin and ischemic brain damage are key influential factors for cognitive impairment in elderly type 2 diabetic patients. The P300 event-related potential is a sensitive index for objective assessment of cognitive impairment in elderly diabetic patients.

  12. Highly sensitive C-reactive protein and male gender are independently related to the severity of coronary disease in patients with metabolic syndrome and an acute coronary event

    C.M.C. Monteiro

    2010-03-01

    Full Text Available Patients with metabolic syndrome are at high-risk for development of atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of coronary disease severity, including those coronary risk factors associated with metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive C-reactive protein (hsCRP, are related to coronary atherosclerosis, in addition to traditional coronary risk factors. Subjects of both genders aged 30 to 75 years (N = 116 were prospectively included if they had suffered a recent acute coronary syndrome (acute myocardial infarction or unstable angina pectoris requiring hospitalization and if they had metabolic syndrome diagnosed according to the National Cholesterol Education Program/Adult Treatment Panel III. Patients were submitted to a coronary angiography and the burden of atherosclerosis was estimated by the Gensini score. The severity of coronary disease was correlated (Spearman’s or Pearson’s coefficient with gender (r = 0.291, P = 0.008, age (r = 0.218, P = 0.048, hsCRP (r = 0.256, P = 0.020, ApoB/ApoA ratio (r = 0.233, P = 0.041, and carotid intima-media thickness (r = 0.236, P = 0.041. After multiple linear regression, only male gender (P = 0.046 and hsCRP (P = 0.012 remained independently associated with the Gensini score. In this high-risk population, male gender and high levels of hsCRP, two variables that can be easily obtained, were associated with more extensive coronary disease, identifying patients with the highest potential of developing new coronary events.

  13. Prevalence of sensitization to food allergens and challenge proven food allergy in patients visiting allergy centers in Rawalpindi and Islamabad, Pakistan.

    Inam, Muhammad; Shafique, Rubaba Hamid; Roohi, Nabila; Irfan, Muhammad; Abbas, Shahid; Ismail, Muhammad

    2016-01-01

    In this study, we estimated the prevalence of food allergy in the adult allergic patients of Rawalpindi and Islamabad , Pakistan, based on self-report, skin prick test (SPT) and oral food challenge test (OFC). SPT was used for the estimation of sensitization to wheat, egg, milk, beef, chicken, mutton, fish, corn, lentils, rice, soya, peanut and banana. Among 689 patients, 39.19 % showed sensitivity to one or more foods, where, sensitization to wheat (156; 22.6 %) was highest, followed by egg (148; 21.48 %) and milk (138; 20.03 %). Sensitization to various proteins ranged between 15.53-15.97 %, while lentils, corn, rice, soya and peanut sensitization was 15.4, 16, 12.5, 12 and 11.5 % respectively. Only 7.1 % patients were SPT positive for banana allergen. SPT was performed in patients with self-reported food allergy (341/689) and also with no self-reported history of food allergy (348/689). SPT results were positive in 69.8 % of the self-report group, whereas, in the patients with no self-reported food allergy 9.2 % were found sensitized to one or more tested food allergens. 101 patients were recruited for OFC, 61 % of these were confirmed of food allergy. The prevalence of food allergy in the study population was 9 %. Food specific OFC results show that wheat allergy is affecting 1.6 % (95 % CI 0.9-2.84 %) of the total allergy patients, followed by egg allergy 1.31 % (95 % CI 0.70-2.47 %). Furthermore, corn allergy, rice allergy and peanut allergy were 1.02, 0.87 and 0.73 %, respectively. In conclusion, wheat allergy is the most prevalent, followed by egg, chicken, beef and fish allergy, respectively. PMID:27563525

  14. Food additives

    ... this page: //medlineplus.gov/ency/article/002435.htm Food additives To use the sharing features on this page, please enable JavaScript. Food additives are substances that become part of a food ...

  15. An ultra-sensitive impedimetric immunosensor for detection of the serum oncomarker CA-125 in ovarian cancer patients

    Johari-Ahar, M.; Rashidi, M. R.; Barar, J.; Aghaie, M.; Mohammadnejad, D.; Ramazani, A.; Karami, P.; Coukos, G.; Omidi, Y.

    2015-02-01

    Effective treatment of ovarian cancer depends upon the early detection of the malignancy. Here, we report on the development of a new nanostructured immunosensor for early detection of cancer antigen 125 (CA-125). A gold electrode was modified with mercaptopropionic acid (MPA), and then consecutively conjugated with silica coated gold nanoparticles (AuNP@SiO2), CdSe quantum dots (QDs) and anti-CA-125 monoclonal antibody (mAb). The engineered MPA|AuNP@SiO2|QD|mAb immunosensor was characterised using transmission electron microscopy (TEM), atomic force microscopy (AFM), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Successive conjugation of AuNP@SiO2, CdSe QD and anti-CA-125 mAb onto the gold electrode resulted in sensitive detection of CA-125 with a limit of detection (LOD) of 0.0016 U mL-1 and a linear detection range (LDR) of 0-0.1 U mL-1. Based on the high sensitivity and specificity of the immunosensor, we propose this highly stable and reproducible biosensor for the early detection of CA-125.Effective treatment of ovarian cancer depends upon the early detection of the malignancy. Here, we report on the development of a new nanostructured immunosensor for early detection of cancer antigen 125 (CA-125). A gold electrode was modified with mercaptopropionic acid (MPA), and then consecutively conjugated with silica coated gold nanoparticles (AuNP@SiO2), CdSe quantum dots (QDs) and anti-CA-125 monoclonal antibody (mAb). The engineered MPA|AuNP@SiO2|QD|mAb immunosensor was characterised using transmission electron microscopy (TEM), atomic force microscopy (AFM), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Successive conjugation of AuNP@SiO2, CdSe QD and anti-CA-125 mAb onto the gold electrode resulted in sensitive detection of CA-125 with a limit of detection (LOD) of 0.0016 U mL-1 and a linear detection range (LDR) of 0-0.1 U mL-1. Based on the high sensitivity and specificity of the immunosensor, we propose

  16. Improved patient repositioning accuracy by integrating an additional jaw fixation into a high precision face mask system in stereotactic radiotherapy of the head

    Background: For high precision radiotherapy of the neurocranium a precise, reproducible positioning technique is the basic pre-requisite. The aim of this study was to assess the influence of a modification of the commercially available stereotactical BrainLab trademark -head mask system on accuracy in patient positioning during fractionated radiotherapy. Material and Methods: 29 patients were treated with stereotactic radiotherapy of the head. Immobilization was provided by a two layer thermoplastic mask system (BrainLab trademark). 18 of these patients received an additional custom made fixation either of the upper jaw (OKF) or of the mandibula (UKF). The positioning accuracy was assessed by measurements of the shifting of anatomical landmarks in relation to therigid mask system on biplanar simulator films using a digital imaging system. Before each measurement a fine adjustment of the simulator to an optical ring system was performed. The reference radiographs were done just before CT-planning. During a 2-7 weeks lasting course of radiotherapy displacement measurements in relation to the reference images for all three dimensions (z, y and x) were done once a week. In 29 patients 844 measurements were analyzed. Results: An additional jaw fixation improves the reproducibility of patient positioning significantly in all three spatial dimensions. The standard deviation in lateral direction (x) was 0.6 mm with jaw fixation vs. 0.7 mm without jaw fixation (p < 0.001); in longitudinal direction (z) (measured in 0 radiographs) 0.5 mm vs. 1.3 mm (p < 0.001); in longitudinal direction measured in 90 (orig.)

  17. Significant heat sensitivity increase detected in various types of diabetes mellitus patients by Akabane test for use of management of diabetic patients.

    Muzhikov, Valery; Vershinina, Elena; Belenky, Vadim; Muzhikov, Ruslan

    2016-01-01

    In order to assess patterns of heat sensitivity thresholds in patients with diabetes mellitus, the Akabane test was carried out on patients with insulin dependent diabetes mellitus (IDDM) (250 men and 309 women) and patients with noninsulin dependent diabetes mellitus (NIDDM) (158 men and 227 women). For comparison, a group of healthy subjects made up of 116 men and 277 women was also used. As soon as we revealed the influence of factors of pathology with a high significance level and gender and the interaction "gender*pathology", all the results are described separately for groups of men and women and for groups with IDDM and NIDDM. Simple effects of paired comparisons between healthy subjects, IDDM and NIDDM in groups of men and women, as well as comparisons between the profiles of men and women with IDDM and NIDDM showed significant differences between ACs in healthy subjects and those with each type of diabetes. The most significant differences are seen in the AC connected with the digestive system (SP pancreas channel), LR (liver channel), ST (stomach channel), GB (gall bladder channel). Thus, we revealed characteristic pattern of acupuncture channels (AC) lesions inherent to diabetes pathology, i.e. most vulnerable in diabetes ACs, being compromised in dependence from such factors, as type of diabetes, hyper or hypoglycemia, and from gender. The main value of the method lies in the fact that we observe the entire food chain from food ingestion to the utilization of carbohydrates with the opportunity to assess the activity of each organ and its regulatory contribution. On the basis of the body's response, an individual selection of medicines can be made, and by evaluating the individual biorhythms it is possible to determine the optimal time of administration. PMID:27244950

  18. TRIB3 protein denotes a good prognosis in breast cancer patients and is associated with hypoxia sensitivity

    Background: Tribbles homolog 3 (TRIB3) is a pseudokinase involved in the regulation of several signaling pathways involved in cell survival and/or cell stress. Here, we determined the correlation between breast cancer prognosis and TRIB3 protein levels and established the role of TRIB3 in cell survival after hypoxia and/or radiotherapy. Material and methods: TRIB3 mRNA and protein were quantified in a new independent breast cancer patient cohort using QPCR and a new specific avian antibody against TRIB3. In addition, we used siRNA-mediated knockdown of TRIB3 in a colony-forming assay after hypoxia and radiotherapy. Results: TRIB3 mRNA and protein levels did not correlate in breast cancer cell lines or human breast cancer material. We validated our earlier finding that high TRIB3 mRNA denotes a poor prognosis, but found that high TRIB3 protein levels were associated with a good prognosis in breast cancer patients. We also show that knockdown of TRIB3 resulted in an increased survival under hypoxic conditions. Conclusion: Whereas mRNA levels of TRIB3 are related with a poor prognosis, TRIB3 protein is associated with a good prognosis in human breast cancer patients, possibly due to the fact that TRIB3 is involved in hypoxia tolerance.

  19. Improving detection sensitivity of amino acids in thyroid tissues by using phthalic acid as a mobile phase additive in hydrophilic interaction chromatography-electrospray ionization-tandem mass spectrometry

    Highlights: • HILIC–ESI-MS/MS method was used to quantify 24 free AAs in human thyroid tissues. • Addition of 0.08 mM of phthalic acid to the eluent enhanced the sensitivity of AAs. • Narrowed peak shapes of AAs were achieved with phthalic acid in the mobile phase. • The mechanism for the signal intensity enhancement by phthalic acid was investigated. - Abstract: In this work, 0.08 mmol L−1 of phthalic acid was introduced as a mobile phase additive to quantify free amino acids (AAs) by hydrophilic interaction liquid chromatography (HILIC) coupled with electrospray ionization tandem mass spectrometry (ESI-MS/MS). The addition of phthalic acid significantly increased the signal intensity of protonated AA ions, resulting from the decrease of the relative abundance of AA sodium adducts. Meanwhile, the chromatographic peak shapes of AAs were optimized. As a consequence, there was a noticeable increase in the sensitivity of detection for AAs. The limits of detection (LOD) and quantification (LOQ) of the AAs ranged from 0.0500 to 20.0 ng mL−1 and from 0.100 to 50.0 ng mL−1, respectively, which were 4–50 times lower compared to the values measured without the addition of phthalic acid. The enhanced detection and separation of AAs were obtained by merely adding phthalic acid to the mobile phase without changing other conditions. Eventually, this simple method was validated and successfully applied to the analysis of twenty-four kinds of free AAs in human thyroid carcinoma and para-carcinoma tissues, demonstrating a significant increase of most AAs in thyroid carcinoma tissues (p < 0.05)

  20. Improving detection sensitivity of amino acids in thyroid tissues by using phthalic acid as a mobile phase additive in hydrophilic interaction chromatography-electrospray ionization-tandem mass spectrometry

    Qi, Wanshu [National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032 (China); Guan, Qing [Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032 (China); Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032 (China); Sun, Tuanqi, E-mail: tuanqisun@163.com [Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center (FUSCC), Shanghai 200032 (China); Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032 (China); Cao, Yanjing [National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032 (China); Zhang, Li, E-mail: zhangli7488@sioc.ac.cn [National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032 (China); Guo, Yinlong, E-mail: ylguo@sioc.ac.cn [National Center for Organic Mass Spectrometry in Shanghai, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032 (China)

    2015-04-22

    Highlights: • HILIC–ESI-MS/MS method was used to quantify 24 free AAs in human thyroid tissues. • Addition of 0.08 mM of phthalic acid to the eluent enhanced the sensitivity of AAs. • Narrowed peak shapes of AAs were achieved with phthalic acid in the mobile phase. • The mechanism for the signal intensity enhancement by phthalic acid was investigated. - Abstract: In this work, 0.08 mmol L{sup −1} of phthalic acid was introduced as a mobile phase additive to quantify free amino acids (AAs) by hydrophilic interaction liquid chromatography (HILIC) coupled with electrospray ionization tandem mass spectrometry (ESI-MS/MS). The addition of phthalic acid significantly increased the signal intensity of protonated AA ions, resulting from the decrease of the relative abundance of AA sodium adducts. Meanwhile, the chromatographic peak shapes of AAs were optimized. As a consequence, there was a noticeable increase in the sensitivity of detection for AAs. The limits of detection (LOD) and quantification (LOQ) of the AAs ranged from 0.0500 to 20.0 ng mL{sup −1} and from 0.100 to 50.0 ng mL{sup −1}, respectively, which were 4–50 times lower compared to the values measured without the addition of phthalic acid. The enhanced detection and separation of AAs were obtained by merely adding phthalic acid to the mobile phase without changing other conditions. Eventually, this simple method was validated and successfully applied to the analysis of twenty-four kinds of free AAs in human thyroid carcinoma and para-carcinoma tissues, demonstrating a significant increase of most AAs in thyroid carcinoma tissues (p < 0.05)

  1. The sensitivity of gamma-index method to the positioning errors of high-definition MLC in patient-specific VMAT QA for SBRT

    To investigate the sensitivity of various gamma criteria used in the gamma-index method for patient-specific volumetric modulated arc therapy (VMAT) quality assurance (QA) for stereotactic body radiation therapy (SBRT) using a flattening filter free (FFF) photon beam. Three types of intentional misalignments were introduced to original high-definition multi-leaf collimator (HD-MLC) plans. The first type, referred to Class Out, involved the opening of each bank of leaves. The second type, Class In, involved the closing of each bank of leaves. The third type, Class Shift, involved the shifting of each bank of leaves towards the ground. Patient-specific QAs for the original and the modified plans were performed with MapCHECK2 and EBT2 films. The sensitivity of the gamma-index method using criteria of 1%/1 mm, 1.5%/1.5 mm, 1%/2 mm, 2%/1 mm and 2%/2 mm was investigated with absolute passing rates according to the magnitudes of MLCs misalignments. In addition, the changes in dose-volumetric indicators due to the magnitudes of MLC misalignments were investigated. The correlations between passing rates and the changes in dose-volumetric indicators were also investigated using Spearman’s rank correlation coefficient (γ). The criterion of 2%/1 mm was able to detect Class Out and Class In MLC misalignments of 0.5 mm and Class Shift misalignments of 1 mm. The widely adopted clinical criterion of 2%/2 mm was not able to detect 0.5 mm MLC errors of the Class Out or Class In types, and also unable to detect 3 mm Class Shift errors. No correlations were observed between dose-volumetric changes and gamma passing rates (γ < 0.8). Gamma criterion of 2%/1 mm was found to be suitable as a tolerance level with passing rates of 90% and 80% for patient-specific VMAT QA for SBRT when using MapCHECK2 and EBT2 film, respectively

  2. Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome

    Dahlin Lars B; Rosén Birgitta; Carlsson Ingela K

    2010-01-01

    Abstract Background Cold sensitivity is a common and disabling complaint following hand injuries. The main purpose of this study was to describe self-reported consequences of cold sensitivity and the association with disability and health-related quality of life in patients with hand injuries or hand-arm vibration syndrome (HAVS) and in normal subjects. Methods Responses to the Cold Intolerance Symptom Severity (CISS) questionnaire, Potential Work Exposure Scale (PWES), Disability of the Arm,...

  3. The effect of a diiodothyronine mimetic on insulin sensitivity in male cardiometabolic patients: a double-blind randomized controlled trial.

    Fleur van der Valk

    Full Text Available BACKGROUND AND AIMS: Obesity and its associated cardiometabolic co-morbidities are increasing worldwide. Since thyroid hormone mimetics are capable of uncoupling the beneficial metabolic effects of thyroid hormones from their deleterious effects on heart, bone and muscle, this class of drug is considered as adjacent therapeutics to weight-lowering strategies. This study investigated the safety and efficacy of TRC150094, a thyroid hormone mimetic. MATERIALS AND METHODS: This 4-week, randomized, placebo-controlled, double-blind trial was conducted in India and The Netherlands. Forty subjects were randomized at a 1:1 ratio to receive either TRC150094 dosed at 50 mg or placebo once daily for 4 weeks. Hyperinsulinemic euglycemic clamp and (1H-Magnetic Resonance Spectroscopy (MRS were performed before and after treatment. RESULTS: At baseline, subjects were characterized by markedly impaired hepatic and peripheral insulin sensitivity. TRC150094 dosed 50 mg once daily was safe and well tolerated. Hepatic nor peripheral insulin sensitivity improved after TRC150094 treatment, expressed as the suppression of Endogenous Glucose Production from 59.5 to 62.1%; p = 0.477, and the rate of glucose disappearance from 28.8 to 26.4 µmol kg(-1min(-1, p = 0.185. TRC150094 administration did not result in differences in fasting plasma free fatty acids from 0.51 to 0.51 mmol/L, p = 0.887 or in insulin-mediated suppression of lipolysis from 57 to 54%, p = 0.102. Also, intrahepatic triglyceride content was unaltered. CONCLUSION: Collectively, these data show that, in contrast to the potent metabolic effects in experimental models, TRC150094 at a dose of 50 mg daily does not improve the metabolic homeostasis in subjects at an increased cardiometabolic risk. Further studies are needed to evaluate whether TRC150094 has beneficial effects in patients with more severe metabolic derangement, such as overt diabetes mellitus and hypertriglyceridemia. TRIAL REGISTRATION

  4. Evaluation of portable point-of-care CD4 counter with high sensitivity for detecting patients eligible for antiretroviral therapy.

    Yukari C Manabe

    Full Text Available BACKGROUND: Accurate, inexpensive point-of-care CD4+ T cell testing technologies are needed that can deliver CD4+ T cell results at lower level health centers or community outreach voluntary counseling and testing. We sought to evaluate a point-of-care CD4+ T cell counter, the Pima CD4 Test System, a portable, battery-operated bench-top instrument that is designed to use finger stick blood samples suitable for field use in conjunction with rapid HIV testing. METHODS: Duplicate measurements were performed on both capillary and venous samples using Pima CD4 analyzers, compared to the BD FACSCalibur (reference method. The mean bias was estimated by paired Student's t-test. Bland Altman plots were used to assess agreement. RESULTS: 206 participants were enrolled with a median CD4 count of 396 (range; 18-1500. The finger stick PIMA had a mean bias of -66.3 cells/µL (95%CI -83.4-49.2, P500 cells/µL with a mean bias of -120.6 (95%CI -162.8, -78.4, P<0.001. The sensitivity (95%CI of the Pima CD4 analyzer was 96.3% (79.1-99.8% for a <250 cells/ul cut-off with a negative predictive value of 99.2% (95.1-99.9%. CONCLUSIONS: The Pima CD4 finger stick test is an easy-to-use, portable, relatively fast device to test CD4+ T cell counts in the field. Issues of negatively-biased CD4 cell counts especially at higher absolute numbers will limit its utility for longitudinal immunologic response to ART. The high sensitivity and negative predictive value of the test makes it an attractive option for field use to identify patients eligible for ART, thus potentially reducing delays in linkage to care and ART initiation.

  5. Additional value of hybrid PET/CT fusion imaging vs. conventional CT scan alone in the staging and management of patients with malignant pleural mesothelioma

    Despite being a relatively rare disease, the incidence of malignant pleural mesothelioma (MPM) is expected to increase over the next two decades due to the long time interval elapsing between exposure to causative factors, mainly asbestos, and disease onset. Early disease stages have been reported to benefit from radical surgery. In more advanced disease stages, a multimodality treatment, including various combinations of chemotherapy, external radiotherapy and surgery, may provide some favourable results though the prognosis remains poor. In this regard, an accurate pre-treatment staging plays an important role in offering patients a more appropriate therapeutic planning. In some preliminary studies, 18F-FDG PET has proven to be able to provide useful information for staging purpose, especially for the detection of metastatic spread to lymph nodes and distant sites. In the present study, we investigated 15 consecutive patients with histologically proven MPM by means of conventional 2-mm thickness whole-body CT scan with and without contrast medium in comparison with whole-body 18F-FDG PET/CT fusion imaging. 18F-FDG PET/CT did not provide additional information about the primary tumour (T) compared to CT scan, but identified a higher number of metastatic mediastinal lymph nodes (N) in 6 patients (40% of cases) and unknown metastatic disease to distant sites (M) in 3 patients (20% of cases). On the basis of PET/CT findings, treatment planning was changed in 5 patients (33.3% of cases). Our data show that 18F-FDG PET/CT fusion imaging can play a relevant role in the staging and treatment planning of MPM patients. (author)

  6. Effect of the Administration of Alpha-Lipoic Acid on Contrast Sensitivity in Patients with Type 1 and Type 2 Diabetes

    2014-01-01

    The aim of this study was to estimate the effects of oral supplementation of alpha-lipoic acid (ALA) on contrast sensitivity (CS) in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). The study included 12 patients with T1DM aged 43±12 years, 48 patients with T2DM aged 59±10 years, and 20 control subjects aged 33±8 years. Patients from each studied group, including the control group, were randomly assigned to receive 300 mg of ALA orally once daily for 3 months...

  7. Additional androgen deprivation makes the difference. Biochemical recurrence-free survival in prostate cancer patients after HDR brachytherapy and external beam radiotherapy

    Schiffmann, Jonas; Tennstedt, Pierre; Beyer, Burkhard; Boehm, Katharina; Tilki, Derya; Salomon, Georg; Graefen, Markus [University Medical Center Hamburg-Eppendorf, Martini-Clinic Prostate Cancer Center, Hamburg (Germany); Lesmana, Hans; Platz, Volker; Petersen, Cordula; Kruell, Andreas; Schwarz, Rudolf [University Medical Center Hamburg-Eppendorf, Department of Radiation oncology, Hamburg (Germany)

    2015-04-01

    The role of additional androgen deprivation therapy (ADT) in prostate cancer (PCa) patients treated with combined HDR brachytherapy (HDR-BT) and external beam radiotherapy (EBRT) is still unknown. Consecutive PCa patients classified as D'Amico intermediate and high-risk who underwent HDR-BT and EBRT treatment ± ADT at our institution between January 1999 and February 2009 were assessed. Multivariable Cox regression models predicting biochemical recurrence (BCR) were performed. BCR-free survival was assessed with Kaplan-Meier analyses. Overall, 392 patients were assessable. Of these, 221 (56.4 %) underwent trimodality (HDR-BT and EBRT and ADT) and 171 (43.6 %) bimodality (HDR-BT and EBRT) treatment. Additional ADT administration reduced the risk of BCR (HR: 0.4, 95 % CI: 0.3-0.7, p < 0.001). D'Amico high-risk patients had superior BCR-free survival when additional ADT was administered (log-rank p < 0.001). No significant difference for BCR-free survival was recorded when additional ADT was administered to D'Amico intermediate-risk patients (log-rank p = 0.2). Additional ADT administration improves biochemical control in D'Amico high-risk patients when HDR-BT and EBRT are combined. Physicians should consider the oncological benefit of ADT administration for these patients during the decision-making process. (orig.) [German] Der Nutzen einer zusaetzlichen Hormonentzugstherapie (ADT, ''androgen deprivation therapy'') fuer Patienten mit Prostatakarzinom (PCa), welche mit einer Kombination aus HDR-Brachytherapie (HDR-BT) und perkutaner Bestrahlung (EBRT) behandelt werden, ist weiterhin ungeklaert. Fuer diese Studie wurden konsekutive, nach der D'Amico-Risikoklassifizierung in ''intermediate'' und ''high-risk'' eingeteilte Patienten ausgewaehlt, die zwischen Januar 1999 und Februar 2009 in unserem Institut eine kombinierte Therapie aus HDR-BT, EBRT ± ADT erhalten haben. Eine

  8. Additional mutations in SRSF2, ASXL1 and/or RUNX1 identify a high-risk group of patients with KIT D816V(+) advanced systemic mastocytosis.

    Jawhar, M; Schwaab, J; Schnittger, S; Meggendorfer, M; Pfirrmann, M; Sotlar, K; Horny, H-P; Metzgeroth, G; Kluger, S; Naumann, N; Haferlach, C; Haferlach, T; Valent, P; Hofmann, W-K; Fabarius, A; Cross, N C P; Reiter, A

    2016-01-01

    Most patients with KIT D816V(+) advanced systemic mastocytosis (SM) are characterized by somatic mutations in additional genes. We sought to clarify the prognostic impact of such mutations. Genotype and clinical characteristics of 70 multi-mutated KIT D816V(+) advanced SM patients were included in univariate and multivariate analyses. The most frequently identified mutated genes were TET2 (n=33 of 70 patients), SRSF2 (n=30), ASXL1 (n=20), RUNX1 (n=16) and JAK2 (n=11). In univariate analysis, overall survival (OS) was adversely influenced by mutations in SRSF2 (P<0.0001), ASXL1 (P=0.002) and RUNX1 (P=0.03), but was not influenced by mutations in TET2 or JAK2. In multivariate analysis, SRSF2 and ASXL1 remained the most predictive adverse indicators concerning OS. Furthermore, we found that inferior OS and adverse clinical characteristics were significantly influenced by the number of mutated genes in the SRSF2/ASXL1/RUNX1 (S/A/R) panel (P<0.0001). In conclusion, the presence and number of mutated genes within the S/A/R panel are adversely associated with advanced disease and poor survival in KIT D816V(+) SM. On the basis of these findings, inclusion of molecular markers should be considered in upcoming prognostic scoring systems for patients with SM. PMID:26464169

  9. McMaster-Toronto Arthritis Patient Preference Disability Questionnaire sensitivity to change in low back pain: influence of shifts in priorities.

    Katherine Sanchez

    Full Text Available OBJECTIVE: To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR in chronic low back pain (CLBP and shifts in patients' priorities of disabling activities over time. METHODS: A prospective longitudinal survey of 100 patients (38 males with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC, Hospital Anxiety and Depression scale (HAD, Fear-Avoidance Beliefs Questionnaire (FABQ, Coping Strategies Questionnaire (CSQ, and pain and handicap visual analogue scales (VASs. Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES and Standardized response mean (SRM and effect size (ES were used to evaluate sensitivity to change of the MACTAR. RESULTS: The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37 were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF, most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients; community, social and civic life (22.7%; and domestic life (22.4%. At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated. CONCLUSIONS: Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change.

  10. Apheresis and intravenous immunoglobulins used in addition to conventional therapy to treat high-risk pregnant antiphospholipid antibody syndrome patients. A prospective study.

    Ruffatti, Amelia; Favaro, Maria; Hoxha, Ariela; Zambon, Alessandra; Marson, Piero; Del Ross, Teresa; Calligaro, Antonia; Tonello, Marta; Nardelli, Giovanni B

    2016-06-01

    Pregnant women with triple antibody positive antiphospholipid syndrome (APS) who have had thrombosis or a history of early, severe pregnancy complications are generally considered at high risk of pregnancy loss. The objectives of this study were to investigate the efficacy and safety of a relatively new treatment protocol used in addition to conventional therapy in high-risk pregnant patients affected with primary APS. The study's two inclusion criteria were: (1) the presence of triple antiphospholipid positivity, (2) previous thrombosis and/or a history of one or more early, severe pregnancy complications. Eighteen pregnancies occurring between 2002 and 2015 in 14 APS patients, (mean age 34.8±3.6 SD) were monitored. All 14 (100%) patients had triple antiphospholipid positivity. In addition, six of them (42.8%) had a history of thrombosis, four (28.6%) had one or more previous early and severe pregnancy complications, and four (30.8%) met both clinical study criteria. The study protocol included weekly plasmapheresis or immunoadsorption and fortnightly 1g/kg intravenous immunoglobulins. Seventeen of the pregnancies (94.4%) produced live neonates, all born between the 26th and 37th weeks of gestation (mean 33.1±3.5 SD). One female (5.5%), born prematurely at 24 weeks, died of sepsis a week after birth. There were two cases (11.1%) of severe pregnancy complications. No treatment side effects were registered. Given the high live birth rate and the safety associated to it, the study protocol described here could be taken into consideration by medical teams treating high-risk APS pregnant patients. PMID:27088752

  11. Kinesio Taping Does Not Provide Additional Benefits in Patients With Chronic Low Back Pain Who Receive Exercise and Manual Therapy: A Randomized Controlled Trial.

    Added, Marco Aurélio Nemitalla; Costa, Leonardo Oliveira Pena; de Freitas, Diego Galace; Fukuda, Thiago Yukio; Monteiro, Renan Lima; Salomão, Evelyn Cassia; de Medeiros, Flávia Cordeiro; Costa, Lucíola da Cunha Menezes

    2016-07-01

    Study Design Randomized controlled trial. Background Many clinical practice guidelines endorse both manual therapy and exercise as effective treatment options for patients with low back pain. To optimize the effects of the treatments recommended by the guidelines, a new intervention known as Kinesio Taping is being widely used in these patients. Objectives To determine the effectiveness of Kinesio Taping in patients with chronic nonspecific low back pain when added to a physical therapy program consisting of exercise and manual therapy. Methods One hundred forty-eight patients with chronic nonspecific low back pain were randomly allocated to receive 10 (twice weekly) sessions of physical therapy, consisting of exercise and manual therapy, or the same treatment with the addition of Kinesio Taping applied to the lower back. The primary outcomes were pain intensity and disability (5 weeks after randomization) and the secondary outcomes were pain intensity, disability (3 months and 6 months after randomization), global perceived effect, and satisfaction with care (5 weeks after treatment). Data were collected by a blinded assessor. Results No between-group differences were observed in the primary outcomes of pain intensity (mean difference, -0.01 points; 95% confidence interval [CI]: -0.88, 0.85) or disability (mean difference, 1.14 points; 95% CI: -0.85, 3.13) at 5 weeks' follow-up. In addition, no between-group differences were observed for any of the other outcomes evaluated, except for disability 6 months after randomization (mean difference, 2.01 points; 95% CI: 0.03, 4.00) in favor of the control group. Conclusion Patients who received a physical therapy program consisting of exercise and manual therapy did not get additional benefit from the use of Kinesio Taping. Level of Evidence Therapy, level 1b. Prospectively registered May 28, 2013 at www.ClinicalTrials.gov (NCT01866332). J Orthop Sports Phys Ther 2016;46(7):506-513. Epub 6 Jun 2016. doi:10.2519/jospt.2016

  12. Modifications to the Patient Rule-Induction Method that utilize non-additive combinations of genetic and environmental effects to define partitions that predict ischemic heart disease

    Dyson, Greg; Frikke-Schmidt, Ruth; Nordestgaard, Børge G;

    2009-01-01

    This article extends the Patient Rule-Induction Method (PRIM) for modeling cumulative incidence of disease developed by Dyson et al. (Genet Epidemiol 31:515-527) to include the simultaneous consideration of non-additive combinations of predictor variables, a significance test of each combination......, an adjustment for multiple testing and a confidence interval for the estimate of the cumulative incidence of disease in each partition. We employ the partitioning algorithm component of the Combinatorial Partitioning Method to construct combinations of predictors, permutation testing to assess the...... that assesses the utility of genetic variants in predicting the presence of ischemic heart disease beyond the established risk factors....

  13. Serum high-sensitivity C-reaction protein and heart fatty acid binding protein level and cardiac accidents in patients with unstable angina pectoris

    朱红秋

    2006-01-01

    Objective To investigate the relationship between serum high-sensitivity C-reaction protein (hs-CRP) and heart fatty acid binding protein (h-FABP) on cardiac accidents in patients with unstable angina pectoris (UAP). Methods Serum levels of hs-CRP, h-FABP, cardiac troponin-Ⅰ(cTn-Ⅰ) and creatine kinase MB isoenzyme (CK-MB) were measured and cardiac accidents within 2 weeks after the test were observed in 74 patients (male

  14. Influence factors of salt-sensitive hypertension and responses of blood pressure and urinary sodium and potassium excretion to acute oral saline loading among essential hypertensive patients

    刘叶舟

    2014-01-01

    Objective To explore the influence factors of saltsensitive hypertension and to observe changes of blood pressures and urinary sodium and potassium excretion in response to acute oral saline loading among essential hypertensive patients in China.Methods Essential hypertensive patients from Beijing Jinzhan second community were included in this study.Salt-sensitivity was determined via the improved Sullivan’s acute oral saline loading

  15. Association of Plasma Circulatory Markers, Chlamydia pneumoniae, and High Sensitive C-Reactive Protein in Coronary Artery Disease Patients of India

    Jagdish Prasad; Rakesh Sarkar; Pragya Srivastava; Hem Chandra Jha; Aruna Singh Mittal

    2009-01-01

    Plasma inflammatory markers have been shown to be predictors for cardiovascular risk, however, there is no study where the levels of plasma circulatory markers have been evaluated in coronary artery disease patients (CAD pts) positive for C. pneumoniae IgA and high sensitive C-reactive protein (hsCRP) which may help in better understanding of disease pathogenesis. A total of 192 patients and 192 controls attending the Cardiology Outpatient Department of Safdarjung Hospital were enrolled. The ...

  16. The association of serum procalcitonin and high-sensitivity C-reactive protein with pneumonia in elderly multimorbid patients with respiratory symptoms: retrospective cohort study

    Nouvenne, Antonio; Ticinesi, Andrea; Folesani, Giuseppina; Cerundolo, Nicoletta; Prati, Beatrice; Morelli, Ilaria; Guida, Loredana; Lauretani, Fulvio; Maggio, Marcello; Aloe, Rosalia; Lippi, Giuseppe; Meschi, Tiziana

    2016-01-01

    Background Serum procalcitonin and high-sensitivity C-reactive protein (hs-CRP) elevations have been associated with pneumonia in adults. Our aim was to establish their diagnostic usefulness in a cohort of hospitalized multimorbid patients ≥65 years old admitted to hospital with acute respiratory symptoms. Methods With a retrospective cohort study design, all multimorbid patients ≥65 years-old with acute respiratory symptoms admitted to an internal medicine hospital ward in Italy from January...

  17. Synovial fluid sedimentation in the immobile patient: a commentary on modern septic arthritis and the addition of a new variable confounding diagnosis

    Cunningham G

    2013-01-01

    Full Text Available Gregory Cunningham,1 Brendan Ricciardo21Royal Perth Hospital, Perth, Western Australia, Australia; 2Bunbury Regional Hospital, Bunbury, Western Australia, AustraliaAbstract: Septic arthritis is a serious cause of morbidity and mortality. Despite recent advances, monoarticular and polyarticular septic arthritis (SA have a mortality rate of approximately 11% and 30%, respectively. SA has a 40% risk of permanent loss of joint function. Diagnosis of SA is difficult, given that no rapidly available individual test proves 100% sensitive or 100% specific. There are no previous reports on the phenomenon of synovial fluid sedimentation in an immobile patient, although the occurrence has been identified in vitro. This commentary also presents an extended report of a patient who had been immobile and supine for 24 hours before her right knee was aspirated and treated for septic arthritis. Due to her immobilization, the synovial fluid had settled. The color and opacity of the sequential aliquots from one arthrocentesis was noted to change from light straw-colored, to thick opaque purulent material. Laboratory reports showed increasing white cell counts (WCCs, from 2.6 × 109 to 78 × 109 between the sequential samples. This demonstrates a newly identified phenomenon of sedimentation. This might have led to a diagnostic difficulty, had the knee not been fully aspirated. Aspiration serves as a diagnostic tool, because it collects a sample, but it also serves as a treatment measure, because it removes purulent material. Complete aspiration of the joint should be performed for full therapeutic benefit and to avoid the potential diagnostic confusion of a falsely low WCC due to this newly identified phenomenon of synovial fluid sedimentation in the immobile patient.Keywords: septic arthritis, inflammatory arthritis, joint, sedimentation, orthopedic

  18. Assessing Caudal Block Concentrations of Bupivacaine With and Without the Addition of Intravenous Fentanyl on Postoperative Outcomes in Pediatric Patients: A Retrospective Review.

    Karkera, Megha M; Harrison, Dale R; Aunspaugh, Jennifer P; Martin, Timothy W

    2016-01-01

    Caudal blocks are a significant and efficacious aspect of pediatric anesthesia, especially in urologic and many general surgery cases. This type of regional anesthesia is common because it has a high success rate and provides between 6 and 8 hours of postoperative pain control. The aim of this study was to determine whether the concentration of bupivacaine or the addition of intravascular (i.v.) fentanyl affected the postanesthesia care unit (PACU) discharge time. A retrospective cohort study comparing the outcomes in pediatric patients who have received varying caudal concentrations with and without the addition of i.v. fentanyl was performed. A total of 849 consecutive patients undergoing hypospadias repairs or circumcisions were reviewed and placed in one of the following 3 groups: 0.125% bupivacaine (group 1), 0.25% bupivacaine (group 2), or one of these concentrations of bupivacaine + i.v. fentanyl intraoperatively (group 3). Total PACU time for each group was 46.1 minutes (group 1), 48.9 minutes (group 2), and 49.7 minutes (group 3). Our results revealed that there is no statistically significant difference between concentrations of bupivacaine administered in a caudal block with or without i.v. fentanyl with regard to the outcome of PACU duration (P = 0.16). Overall, based on the retrospective cohort design, there is no difference in primary and secondary outcomes based on the concentration of bupivacaine, when administered at a volume of 1 mL/kg. PMID:24832387

  19. Clinical diagnostic value of determination of serum lschemia modified albumin, homocysteine and high-sensitivity C-reactive protein levels in patients with acute coronary syndrome

    Objective: To study the clinical diagnostic value of determination of serum ischemia modified albumin (IMA), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) levels in patients with acute coronary syndrome (ACS). Methods: Serum IMA (with albumin-cobalt binding assay), Hcy (with ELISA) and hs-CRP (with RIA) levels were determined in 73 patients with ACS within 3 hours after onset of chest pain and 40 controls. Results: The sensitivity of IMA was 87.67%, the specificity was 100%. The area under curve of ROC was 0.985 (95% confidence interval 0.969 ∼ 1.001). All the figures were higher than those of Hcy and hs-CRP. Combined determination of IMA, Hcy and hs-CRP, would increass the sensitivity to 97.26%. Conclusion: IMA is one of the earliest sensitive indicators for clinical diagnosis of early myocardial ischemia in patients with ACS. Combined determination of IMA, Hcy and hs-CRP would be even more sensitive. (authors)

  20. The effects of additional treatment with terguride, a partial dopamine agonist, on hyperprolactinemia induced by antipsychotics in schizophrenia patients: a preliminary study

    Hashimoto K

    2014-08-01

    Full Text Available Kojiro Hashimoto, Norio Sugawara, Masamichi Ishioka, Kazuhiko Nakamura, Norio Yasui-Furukori Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan Abstract: Hyperprolactinemia is a frequent consequence of treatment with antipsychotics. Earlier studies have indicated that terguride, which is a partial dopamine agonist, reduces the prolactin levels that are induced by prolactinemia. Thus, we examined the dose effects of adjunctive treatment with terguride on the plasma concentrations of prolactin in patients with elevated prolactin levels resulting from antipsychotic treatment. Terguride was concomitantly administered to 20 schizophrenic patients (10 males and 10 females receiving paliperidone and risperidone. The dose of terguride was 1.0 mg/day. Sample collections for prolactin were conducted before terguride (baseline and 2–4 weeks after administration. The samples were obtained after the morning dose of terguride. The average (± standard deviation plasma prolactin concentration during terguride coadministration was significantly lower than the baseline concentration in females (82.3±37.1 ng/mL versus 56.5±28.5 ng/mL, P<0.01 but not in males (28.8±18.0 ng/mL versus 26.2±13.1 ng/mL, not significant. Additionally, a significant correlation between the ratio of prolactin reduction and the baseline prolactin concentration was identified in males (rs=−0.638, P<0.05 but not in females (rs=−0.152, not significant. Many patients complained of various adverse events following terguride administration, such as insomnia, agitation, and/or the aggravation of hallucinations. This study suggests that additional treatment with terguride decreases the prolactin concentrations in females experiencing high prolactin levels as a result of antipsychotic treatment. However, its utility for schizophrenia may be diminished because of its low tolerability. Keywords: hyperprolactinemia, terguride

  1. Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals : A systematic review of literature

    Stalpers, Dewi; de Brouwer, Brigitte J M; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2015-01-01

    Objective: To systematically review the literature on relationships between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals. Data sources: The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. Review methods: Included were qu

  2. Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: a systematic review of literature

    Stalpers, D.; Brouwer, B.J.M. de; Kaljouw, M.J.; Schuurmans, M.J.

    2015-01-01

    OBJECTIVE: To systematically review the literature on relationships between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals. DATA SOURCES: The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. REVIEW METHODS: Included were qu

  3. Prognostic assessment of elderly patients with symptoms of heart failure by combining high-sensitivity troponin T and N-terminal pro-B-type natriuretic peptide measurements

    Alehagen, Urban; Dahlström, Ulf; Rehfeld, Jens F.;

    2010-01-01

    N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful biomarker in heart failure assessment, whereas measurement of cardiac troponin is central in the diagnosis of patients with acute coronary syndromes. This report examined the prognostic use of combining high-sensitivity cardiac...

  4. Immunoglobulin-E-binding epitopes of wheat allergens in patients with food allergy to wheat and in mice experimentally sensitized to wheat proteins

    Sera were obtained from 39 patients suffering from food allergy to wheat. Balb/c mice were sensitized to gliadins or LTP1 by intraperitoneal immunizations. Continuous epitopes bound by IgE were delineated by the Pepscan technique. The response to reduced, alkylated LTP1 was compared to that of the n...

  5. Decreased sensitivity to paroxetine-induced inhibition of peripheral blood mononuclear cell growth in depressed and antidepressant treatment-resistant patients.

    Rzezniczek, S; Obuchowicz, M; Datka, W; Siwek, M; Dudek, D; Kmiotek, K; Oved, K; Shomron, N; Gurwitz, D; Pilc, A

    2016-01-01

    Major depression disorder (MDD) is the most widespread mental disorder. Selective serotonin reuptake inhibitors (SSRIs) are used as first-line MDD treatment but are effective in resistant (TR) MDD patients are needed for prioritizing them for alternative therapeutics. SSRI-induced inhibition of the growth of peripheral blood mononuclear cells (PBMCs) is mediated via their target, the serotonin transporter (SERT). Here, we examined whether antidepressant drug-induced inhibition of the growth of PBMCs differed between MDD patients and healthy controls. PBMCs from well-characterized 33 treatment-sensitive (TS) and 33 TR MDD patients, and 24 healthy volunteers were studied. Dose-dependent inhibition of PBMCs growth was observed for both the non-SSRI antidepressant mirtazapine and the SSRI antidepressant paroxetine. Significantly lower sensitivities to 20 μm paroxetine were observed in MDD compared with control PBMCs prior to treatment onset (13% and 46%, respectively; Pdepression. A significantly lower expression of integrin beta-3 (ITGB3), a co-factor of the SERT, was observed in the PBMCs of MDD patients prior to treatment onset compared with healthy controls, and may explain their lower paroxetine sensitivity. Further studies with larger cohorts are required for clarifying the potential of reduced PBMCs paroxetine sensitivity and lower ITGB3 expression as MDD biomarkers. PMID:27244236

  6. Relationship between visual field sensitivity loss and quadrantic macular thickness measured with Stratus-Optical coherence tomography in patients with chiasmal syndrome

    Frederico Castelo Moura

    2010-10-01

    Full Text Available PURPOSE: To correlate visual field sensitivity (VFS loss on standard automated perimetry (SAP and quadrantic macular thickness on optical coherence tomography (OCT in patients with permanent temporal hemianopia from chiasmal compression. METHODS: Forty eyes from 40 patients with chiasmal compression and 40 healthy eyes were submitted to standard automated perimetry and Stratus-OCT scanning. Raw data of the fast macular thickness scanning protocol were exported and macular thickness measurements were recorded and averaged for each quadrant and half of the central area. The correlation between visual field sensitivity loss and optical coherence tomography measurements was tested with Pearson's correlation coefficients and with linear regression analysis. RESULTS: A significant association was found between each macular thickness parameter and the corresponding central VF mean sensitivity. The strongest association was observed between superonasal macular thickness and the inferotemporal mean defect measured both in decibel (R=0.47; p=0.001 and in 1/Lambert (R=0.59; p<0.0001 units. CONCLUSION: Stratus-OCT-measured macular thickness was topographically related with visual field sensitivity loss in patients with temporal hemianopia from chiasmal compression. Such measurements could prove clinically useful in the diagnosis and follow-up of patients with chiasmal compression. ClinicalTrial.gov identifier number: NCT0039122.

  7. Correlation between serum high-mobility group box-1 levels and high-sensitivity C-reactive protein and troponin I in patients with coronary artery disease

    YAO, HENG-CHEN; ZHAO, AI-PING; HAN, QIAN-FENG; Wu, Lei; YAO, DAO-KUO; Wang, Le-Xin

    2013-01-01

    The aim of this study was to evaluate the correlation between levels of serum high-mobility group box-1 (HMGB1) and high-sensitivity C-reactive protein (hs-CRP) and cardiac troponin I in patients with coronary artery disease. The levels of serum HMGB1, hs-CRP and cardiac troponin I were measured in 98 patients with coronary artery disease and in 30 healthy subjects. The correlation between serum HMGB1 levels and hs-CRP and cardiac troponin I levels was analyzed. Serum HMGB1 levels in patients...

  8. Bicalutamide 150 mg in addition to standard care in patients with localized or locally advanced prostate cancer: results from the second analysis of the early prostate cancer program at median followup of 5.4 years

    Wirth, Manfred P; See, William A; McLeod, David G; Iversen, Peter; Morris, Tom; Carroll, Kevin

    We evaluated the efficacy and tolerability of 150 mg bicalutamide daily given in addition to standard care, in patients with localized or locally advanced prostate cancer.......We evaluated the efficacy and tolerability of 150 mg bicalutamide daily given in addition to standard care, in patients with localized or locally advanced prostate cancer....

  9. Additivity dominance

    Paul Rozin

    2009-10-01

    Full Text Available Judgments of naturalness of foods tend to be more influenced by the process history of a food, rather than its actual constituents. Two types of processing of a ``natural'' food are to add something or to remove something. We report in this study, based on a large random sample of individuals from six countries (France, Germany, Italy, Switzerland, UK and USA that additives are considered defining features of what makes a food not natural, whereas ``subtractives'' are almost never mentioned. In support of this, skim milk (with major subtraction of fat is rated as more natural than whole milk with a small amount of natural vitamin D added. It is also noted that ``additives'' is a common word, with a synonym reported by a native speaker in 17 of 18 languages, whereas ``subtractive'' is lexicalized in only 1 of the 18 languages. We consider reasons for additivity dominance, relating it to omission bias, feature positive bias, and notions of purity.

  10. Quantification of Cell-free HER-2 DNA in Plasma from Breast Cancer Patients: Sensitivity for Detection of Metastatic Recurrence and Gene Amplification

    Patricia Diana Sørensen; Rikke Fredslund Andersen; Niels Pallisgaard; Jonna Skov Madsen; Erik Hugger Jakobsen; Ivan Brandslund

    2015-01-01

    The purpose of this study was to quantify the free-circu‐ lating plasma HER-2 DNA (cfHER-2 DNA) and to assess the ability of analysis to discriminate between patients with primary breast cancer and healthy controls in order to detect metastatic recurrence in comparison with serum HER-2 protein and also HER-2 gene amplification. The study population consisted of 100 patients with primary breast cancer and 50 healthy female donors. An additional 22 patients with metastases were subsequently ...

  11. Pattern of cross-sensitivity between 4 Compositae plants, Parthenium hysterophorus, Xanthium strumarium, Helianthus annuus and Chrysanthemum coronarium, in Indian patients.

    Nandakishore, T; Pasricha, J S

    1994-03-01

    To assess the pattern of cross-sensitivity between 4 members of the Compositae family, namely Parthenium hysterophorus L., Xanthium strumarium L., Helanthus annuus L. and Chrysanthemum coronarium L., 63 patients clinically diagnosed to have airborne contact dermatitis, and 51 controls having well-defined patterns of contact dermatitis caused by agents other than plants, were patch tested with measured amounts of standardized aqueous extracts of these plants. Positive reactions were obtained in 62 patients and 13 controls with Parthenium hysterophorus, in 47 patients and 9 controls with Xanthium strumarium, in 7 patients and 2 controls with Helianthus annuus, and in 13 of the 57 patients and one out of 28 controls tested with Chrysanthemum coronarium. 2 patients were allergic to all 4 of the plants; 14 patients to 3 plants, namely Parthenium, Xanthium and Chrysanthemum in 9 cases and Parthenium, Xanthium and Helianthus in 5 cases; 32 patients to 2 plants, namely Parthenium and Xanthium in 30 cases, and Parthenium and Chrysanthemum, and Xanthium and Chrysanthemum in 1 case each; 15 patients were allergic to 1 plant only, that being Parthenium. All the 47 patients allergic to Xanthium, 13 patients allergic to Chrysanthemum and 7 patients allergic to Helianthus were positive with some other plant as well. There was 1 patient who was allergic to Xanthium and Chrysanthemum but not to Parthenium. The titre of contact hypersensitivity (TCH) determined in the patients allergic to Parthenium, Xanthium and Helianthus showed values that varied widely with each plant in different patients, and there was no parallelism between the TCH with various plants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8187516

  12. Endobronchial ultrasound-guided transbronchial needle aspiration is a sensitive method to evaluate patients who should not undergo pulmonary metastasectomy†

    Eckardt, Jens; Licht, Peter Bjørn

    2015-01-01

    metastasectomy in these patients. We prospectively evaluated how endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) could identify metastases to the mediastinal lymph nodes in patients referred for pulmonary metastasectomy. METHODS: All patients with extrapulmonary cancer and...... patients who will not benefit from pulmonary metastasectomy....

  13. Comparison of the Sensitivity of QuantiFERON-TB Gold In-Tube and T-SPOT.TB According to Patient Age.

    Bae, Won; Park, Kyoung Un; Song, Eun Young; Kim, Se Joong; Lee, Yeon Joo; Park, Jong Sun; Cho, Young-Jae; Yoon, Ho Il; Yim, Jae-Joon; Lee, Choon-Taek; Lee, Jae Ho

    2016-01-01

    Currently, there are two types of interferon-gamma release assays (IGRAs) in use for the detection of tuberculosis (TB) infection, the QuantiFERON-TB Gold In-Tube test (GFT-GIT) and T-SPOT.TB. Owing to contradictory reports regarding whether the results of these IGRAs are affected by the age of the patient, we aimed to determine if these two tests have age-related differences in sensitivity. We retrospectively reviewed the medical records of diagnosed TB patients who were tested using either QFT-GIT or T-SPOT.TB from February 2008 to December 2013. The positivity of the two tests was analyzed and compared with true TB infection, which was defined as active TB based on either a positive Mycobacterium culture or a positive TB polymerase chain reaction. The QFT-GIT group included 192 TB patients, and the T-SPOT.TB group included 212 TB patients. Of the patients with pulmonary TB, 76 (39.6%) were in the QFT-GIT group and 143 (67.5%) in the T-SPOT.TB group. The overall sensitivity was 80.2% for QFT-GIT and 91.0% for T.SPOT.TB. The sensitivities of QFT-GIT and T-SPOT.TB according to age group were as follows: 70 years, 68.3% and 85.7%, respectively. The trend of age-related changes in sensitivity was significant for both QFT-GIT (p = 0.004) and T.SPOT.TB (p = 0.039). However, only QFT-GIT was significantly related to age in the multivariate analysis. QFT-GIT, but not T-SPOT.TB, was significantly affected by patient age. PMID:27258377

  14. The role of additional computed tomography in the decision-making process on the secondary prevention in patients after systemic cerebral thrombolysis

    Sobolewski P

    2015-12-01

    Full Text Available Piotr Sobolewski,1 Grzegorz Kozera,2 Wiktor Szczuchniak,1 Walenty M Nyka2 1Department of Neurology and Stroke, Unit of Holy Spirit Specialist Hospital in Sandomierz, Sandomierz, Poland; 2Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland Introduction: Patients with ischemic stroke undergoing intravenous (iv-thrombolysis are routinely controlled with computed tomography on the second day to assess stroke evolution and hemorrhagic transformation (HT. However, the benefits of an additional computed tomography (aCT performed over the next days after iv-thrombolysis have not been determined.Methods: We retrospectively screened 287 Caucasian patients with ischemic stroke who were consecutively treated with iv-thrombolysis from 2008 to 2012. The results of computed tomography performed on the second (control computed tomography and seventh (aCT day after iv-thrombolysis were compared in 274 patients (95.5%; 13 subjects (4.5%, who died before the seventh day from admission were excluded from the analysis.Results: aCTs revealed a higher incidence of HT than control computed tomographies (14.2% vs 6.6%; P=0.003. Patients with HT in aCT showed higher median of National Institutes of Health Stroke Scale score on admission than those without HT (13.0 vs 10.0; P=0.01 and higher presence of ischemic changes >1/3 middle cerebral artery territory (66.7% vs 35.2%; P<0.01. Correlations between presence of HT in aCT and National Institutes of Health Stroke Scale score on admission (rpbi 0.15; P<0.01, and the ischemic changes >1/3 middle cerebral artery (phi=0.03 existed, and the presence of HT in aCT was associated with 3-month mortality (phi=0.03.Conclusion: aCT after iv-thrombolysis enables higher detection of HT, which is related to higher 3-month mortality. Thus, patients with severe middle cerebral artery infarction may benefit from aCT in the decision-making process on the secondary prophylaxis. Keywords: ischemic stroke, iv

  15. EFFECT OF ADDITION OF LOSARTAN TO METFORMIN ALONE AND IN COMBINATION WITH GLIMEPIRIDE OR REPAGLINIDE IN TYPE 2 DIABETES PATIENTS WITH PROTEINURIA

    Momin M. A.

    2015-09-01

    Full Text Available Diabetes mellitus is associated with increased oxidative stress due to hyperglycemia. This increased oxidative stress gives rise to micro and macro vascular complications. MATERIALS & METHODS : Randomized comparative prospective trial. Three groups were formed comprising of metformin + losartan, Metformin + Glimepiride + Losartan and metformin + Repaglinide + Losartan. The parameters like glycemic con trol, lipid profile, antioxidant status and progression of diabetic nephropthy before and after therapy was assessed by fasting blood sugar, glycated Hb, lipid profile, antioxidant status, renal function tests and proteinuria. From the group I & II comparisons our finding is that adding glimepiride or repaglinide to the basic regime of M + losartan has increased advantage and favorable effect. From comparison of group II & III finding is that repaglinide addition to the basic regime of M+ losartan had more favorable and increased advantage over glimepiride addition. The test for significant proteinuria and renal function tests was performed before enrollment and after completion of the study. After completion of the study no any patient was having significant proteinuria and all the patients have normal renal function tests. CONCLUSION: Losartan efficiently reduces proteinuria with adequate tolerance in presence of adequate glycaemic control. M + repaglinide + losartan combination is highly effective in controlling proteinuria. Several mechanisms may explain these ef f ects. Although no glomerular hemodynamic parameters were analyzed in the present study, we consider that the attenuation of proteinuria reflects an improvement in the glomerular function. Losartan has been shown to reduce proteinuria by improving glomerular basement membrane characteristics. Losartan by targeting renin angiotensin aldosterone system improves overall glomerular function. This study is of interest since hypertension , which increases intra glomerular pressure and cause

  16. Tc-99m-BrIDA hepatobiliary (HIDA) scan has a low sensitivity for detecting biliary complications after orthotopic liver transplantation in patients with hyperbilirubinemia

    Tc-99m-BrIDA hepatobiliary scans are noninvasive tests for detecting biliary leaks and obstructions. However, there is low sensitivity and specificity in patients with hyperbilirubinemia. Biliary complications (BC) are the Achilles heel of orthotopic liver transplantation (OLT). We questioned whether hyperbilirubinemia in liver transplant recipients rendered HIDA scanning less dependable. HIDA findings were compared to endoscopic retrograde cholangiopancreatography, laparotomy, and clinical course. Results were categorized as follows: true positive (TP), true negative (TN), false positive (FP), false negative (FN), or nondiagnostic/inconclusive. We searched for variables associated with erroneous or nondiagnostic tests which we defined as all examinations determined to be FP, FN and/or nondiagnostic/inconclusive. Thirty-four patients underwent a HIDA scan. The sensitivity and specificity were 70 and 100%. The sensitivity of HIDA improved to 100% in patients with a total bilirubin (TB) 5 mg/dl. One FN had a TB <5 mg/dl, but was determined inconclusive due to the roux-en-Y. HIDA scans performed when the total bilirubin was <5 mg/dl had a high sensitivity and specificity for detecting biliary complications after OLT. However, when the total bilirubin exceeded 5 mg/dl, the specificity was still 100% but the numbers of nondiagnostic/inconclusive and FN exams were increased. (author)

  17. Additivity dominance

    Paul Rozin; Claude Fischler; Christy Shields-Argeles

    2009-01-01

    Judgments of naturalness of foods tend to be more influenced by the process history of a food, rather than its actual constituents. Two types of processing of a ``natural'' food are to add something or to remove something. We report in this study, based on a large random sample of individuals from six countries (France, Germany, Italy, Switzerland, UK and USA) that additives are considered defining features of what makes a food not natural, whereas ``subtractives'' are almost never mentioned....

  18. The scars of childhood adversity : minor stress sensitivity and depressive symptoms in remitted recurrently depressed adult patients

    Kok, Gemma; van Rijsbergen, Gerard; Burger, Huibert; Elgersma, Hermien; Riper, Heleen; Cuijpers, Pim; Dekker, Jack; Smit, Filip; Bockting, Claudi

    2014-01-01

    BACKGROUND: Childhood adversity may lead to depressive relapse through its long-lasting influence on stress sensitivity. In line with the stress sensitization hypothesis, minor (daily) stress is associated with depressive relapse. Therefore, we examine the impact of childhood adversity on daily stre

  19. STUDY ON VIBRATION SENSITIVITY DIFFERENT BODY AREAS IN PATIENTS WITH VIBRATION-INDUCER DISEASES EXPOSED TO A LOCAL VIBRATION AND IN PATIENTS WITH AN OCCUPATIONAL NEUROSENSORIC DULLNESS OF HEARING

    Kartapoltseva, N.

    2008-01-01

    The pathological disorders in the state of the peripheral nerves based on the data of the vibration sensitivity studies were observed to be in both the patients with the vibration-induced diseases as a result of the local vibration exposure and in the patients with an occupational neurosensoric dullness of hearing. This may assume a total effect mechanism of the physical factors on the human organism. In the former case the alterations observedshowed a more pronounced character.

  20. Extra-intestinal symptoms in patients with irritable bowel syndrome: related to high total IgE levels and atopic sensitization?

    Vara, Ellen Johanne; Valeur, Jørgen; Hausken, Trygve; Lied, Gülen Arslan

    2016-08-01

    Objective We have previously found that high levels of total IgE, but not atopic sensitization, was a significant predictor for functional gastrointestinal (GI) symptoms. In this study, we aimed to assess the prevalence of extra-intestinal symptoms in IBS patients, and explore their relation to total IgE levels and atopic sensitization. Materials and methods Seventy-one patients with functional GI complaints were included. Severity of GI symptoms, fatigue and musculoskeletal pain was evaluated using the following questionnaires: IBS-Severity Scoring System (IBS-SSS), Fatigue Impact Scale (FIS), FibroFatigue Scale (FFS), and Visual Analog Scales (VAS) for musculoskeletal pain. Levels of total IgE and specific IgE-antibodies were analyzed. Results Fatigue and musculoskeletal pain were demonstrated in 78.9 and 43.7% of the patients, respectively. IBS-SSS scores were significantly correlated with fatigue scores and musculoskeletal pain. Patients with fatigue and musculoskeletal pain had significantly higher IBS-SSS scores than patients without fatigue and musculoskeletal pain. Total IgE levels were significantly higher in IBS patients compared to a healthy control group from a previous study. However, neither total IgE nor atopic sensitization was significantly associated with extra-intestinal symptoms. Conclusions IBS, fatigue, and musculoskeletal pain were significantly associated. Total IgE levels were higher in IBS patients than healthy controls, but not related to intestinal or extra-intestinal symptom severity. Atopy was not associated with any of the co-morbidities. Thus, the clinical significance of high IgE levels in IBS remains unclear and further studies are warranted to explore a common underlying mechanism for the co-morbid triad of IBS, fatigue, and musculoskeletal pain. PMID:27161383

  1. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients

    To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B. Two radiologists independently evaluated group A using CPRs and group B using standard MPRs. Two different radiologists reviewed both groups with the inverse methods setting. Results were compared to a standard of reference created by two senior radiologists. The reference standard identified 361 rib fractures in 61 patients. Reading CPRs showed a significantly higher overall sensitivity (P < 0.001) for fracture detection than reading standard MPRs, with 80.9 % (584/722) and 71.5 % (516/722), respectively. Mean reading time was significantly shorter for CPRs (31.3 s) compared to standard MPRs (60.7 s; P < 0.001). Using CPRs for the detection of rib fractures accelerates the reading of trauma patient chest CTs, while offering an increased overall sensitivity compared to conventional standard MPRs. (orig.)

  2. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients

    Ringl, Helmut; Lazar, Mathias; Toepker, Michael; Woitek, Ramona; Prosch, Helmut; Asenbaum, Ulrika; Balassy, Csilla; Toth, Daniel; Weber, Michael; Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Hajdu, Stefan [Medical University of Vienna, Department of Trauma Surgery, Vienna (Austria); Soza, Grzegorz; Wimmer, Andreas [Siemens AG, Healthcare Sector, Computed Tomography, Forchheim (Germany)

    2015-07-15

    To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B. Two radiologists independently evaluated group A using CPRs and group B using standard MPRs. Two different radiologists reviewed both groups with the inverse methods setting. Results were compared to a standard of reference created by two senior radiologists. The reference standard identified 361 rib fractures in 61 patients. Reading CPRs showed a significantly higher overall sensitivity (P < 0.001) for fracture detection than reading standard MPRs, with 80.9 % (584/722) and 71.5 % (516/722), respectively. Mean reading time was significantly shorter for CPRs (31.3 s) compared to standard MPRs (60.7 s; P < 0.001). Using CPRs for the detection of rib fractures accelerates the reading of trauma patient chest CTs, while offering an increased overall sensitivity compared to conventional standard MPRs. (orig.)

  3. Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

    Goel Nidhi

    2009-01-01

    Full Text Available Background: Lower respiratory tract infections (LRTIs are the most frequent infections among patients in Intensive care units (ICUs. Aims: To know the bacterial profile and determine the antibiotic susceptibility pattern of the lower respiratory tract isolates from patients admitted to the ICU. Settings and Design: Tertiary care hospital, retrospective study. Materials and Methods: Transtracheal or bronchial aspirates from 207 patients admitted to the ICU were cultured, identified, and antibiotic sensitivity was performed by standard methods. Statistical Analysis Used: SPSS software was used for calculation of % R of 95% confidence interval (CI. Results: Of 207 specimens, 144 (69.5% were culture positive and 63 (30.4% showed no growth. From 144 culture positives, 161 isolates were recovered, of which 154 (95.6% were Gram negative bacilli (GNB. In 17 (11.0% patients, two isolates per specimen were recovered. The most common GNB in order of frequency were Pseudomonas aeruginosa (35%, Acinetobacter baumannii (23.6%, and Klebsiella pneumoniae (13.6%. A very high rate of resistance (80-100% was observed among predominant GNB to ciprofloxacin, ceftazidime, co-trimoxazole, and amoxycillin/clavulanic acid combination. Least resistance was noted to meropenem and doxycycline. Conclusion: Nonfermenters are the most common etiological agents of LRTIs in ICU. There is an alarmingly high rate of resistance to cephalosporin and β-lactam-β-lactamase inhibitor group of drugs. Meropenem was found to be the most sensitive drug against all GNB. Acinetobacter and Klebsiella spp. showed good sensitivity to doxycycline.

  4. Incidence of radiation-induced Graves' disease in patients treated with radioiodine for thyroid autonomy before and after introduction of a high-sensitivity TSH receptor antibody assay

    Autoimmune hyperthyroidism may occur several months after radioiodine therapy (RIT) for functional thyroid autonomy. Exacerbation of pre-existing subclinical Graves' disease (GD) has been held responsible for this phenomenon. Determination of TSH receptor antibody using solubilised porcine epithelial cell membranes is insensitive and may have failed to diagnose GD in these patients before RIT. Following the introduction of a more sensitive assay, using the human TSH receptor as an antigen, it has been expected that the incidence of radiation-induced GD after RIT for functional thyroid autonomy will be reduced. In a first group of 1,428 patients treated between November 1993 and March 1997 (group I) we used the porcine TRAb assay to exclude GD, while in a second group comprising 1,408 patients treated between January 2000 and December 2001 (group II), GD was excluded using the human TRAb assay. A matched control group of 231 patients was derived from group II. In group I a total of 15 (1.05%) patients developed obvious or suspected radiation-induced GD, while in group II 17 (1.2%) did so; the interval until development of GD was 8.4 and 8.8 months, respectively, after RIT. Serum anti-thyroid peroxidase levels before RIT were elevated in 36.4% of group I patients and 47.1% of group II patients, but in only 5.6% of the control group. Other non-specific signs of mild immunopathy of the thyroid were seen retrospectively in 73.3%, 64.7% and 16.0% of the patients in these three groups, respectively. In conclusion, the introduction of a high-sensitivity TRAb assay did not reduce the incidence of autoimmune hyperthyroidism occurring late after RIT for functional thyroid autonomy, but mild immunopathy of the thyroid is seen more frequently in these patients and seems to be a predisposing factor in the development of radiation-induced GD. (orig.)

  5. The effects of acute levodopa withdrawal on motor performance and dopaminergic receptor sensitivity in patients with Parkinson's disease.

    Turjanski, N; Fernandez, W; Lees, A J

    1993-01-01

    The effects of acute levodopa withdrawal were studied in nine patients with levodopa related on-off oscillations. One patient withdrew from the study due to off period confusion and hallucinations. A marked deterioration in motor disability occurred in all patients following overnight withdrawal of levodopa and a further mild delayed deterioration was present over a mean withdrawal period of 44 hours. Patients with more severe disease were able to tolerate levodopa withdrawal for a shorter pe...

  6. Pattern of contact sensitization in patients with and without atopic dermatitis in a hospital-based clinical database

    Clemmensen, Kim Katrine Bjerring; Thomsen, Simon Francis; Jemec, Gregor Borut Ernst; Agner, Tove

    2014-01-01

    patch test reactions in patients with and without atopic dermatitis in a patch test cohort, and explored the influence of disease severity. PATIENTS/MATERIALS/METHODS: Patch test results, information on atopic dermatitis and demographic variables were taken from a database, including all patients patch...

  7. Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity

    Caio, Giacomo; Volta, Umberto; Tovoli, Francesco; De Giorgio, Roberto

    2014-01-01

    Background Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers. There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition. This study was designed to ch...

  8. [The evaluation of sensitivity and specificity of technique of detection of C-reactive protein under diagnostic of infectious complications in patients with acute lymphoblastic leucosis receiving chemotherapy].

    Vladimirova, S G; Tarasova, L N; Dokshina, I A; Cherepanova, V A

    2014-11-01

    The C-reactive protein is a generally recognized marker of inflammation and bacterial infection. However, issue of diagnostic effectiveness of this indicator is still open-ended in case of patients with oncologic hematological diseases. The level of C-reactive protein can increase under neoplastic processes. On the contrary, the inhibition of immune response observed under cytoplastic therapy can decrease synthesis of this protein. The study was organized to establish levels of C-reactive protein as markers of infection in adult patients with acute lymphoblastic leucosis under application of chemotherapy and to evaluate their diagnostic effectiveness. The sampling included 34 patients with acute lymphoblastic leucosis all patients had infectious complications at various stages of treatment. The levels of C-reactive protein in groups of patients with localized infections (mucositis, abscess, pneumonia, etc.) or fever of unknown genesis had no statistical differences but were reliably higher in patients without infectious complications. The concentrations of C-reactive protein in patients with syndrome of systemic inflammatory response and sepsis had no differences. At the same time, level of C-reactive protein under systemic infection (syndrome of systemic inflammatory response, sepsis) was reliably higher than in case of localized infection. The diagnostically reliable levels of C-reactive protein were established as follows: lower than 11 mg/l--infectious complications are lacking; higher than 11 mg/l--availability of infectious process; higher than 82 mg/l--generalization of infection. The given levels are characterized by high diagnostic sensitivity (92% and 97% correspondingly) and specificity (97% and 97%) when patients receive therapy without application of L-asparaginase. At the stages of introduction of this preparation effecting protein synthesizing function of liver sensitivity of proposed criteria are decreased (69% and 55% correspondingly). However; due

  9. Nutraceutical pill containing berberine versus ezetimibe on plasma lipid pattern in hypercholesterolemic subjects and its additive effect in patients with familial hypercholesterolemia on stable cholesterol-lowering treatment

    Pisciotta Livia

    2012-09-01

    Full Text Available Abstract Background Although statins (STs are drugs of first choice in hypercholesterolemic patients, especially in those at high cardiovascular risk, some of them are intolerant to STs or refuse treatment with these drugs. In view of this, we have evaluated the lipid-lowering effect of a nutraceutical pill containing berberine (BBR and of ezetimibe, as alternative treatments, in monotherapy or in combination, in 228 subjects with primary hypercholesterolemia (HCH, with history of STs intolerance or refusing STs treatment. In addition, since PCSK9 was found up-regulated by STs dampening their effect through an LDL receptors (LDLRs degradation, and BBR suppressed PCSK9 expression in cellular studies, we supplemented the stable lipid-lowering therapy of 30 genotype-confirmed Familial Hypercholesterolemia heterozygotes (HeFH with BBR, searching for a further plasma cholesterol reduction. Plasma lipid pattern was evaluated at baseline and during treatments. Results In HCH subjects the nutraceutical pill resulted more effective than EZE in lowering LDL cholesterol (−31.7% vs −25.4%, P > G silent polymorphism of NPC1L1 gene showed a higher response to EZE than homozygous for the common allele (GG + CG: LDL-C −29.4±5.0%, CC −23.6±6.5%, P Conclusions The alternative treatments tested in our HCH subjects were rather effective and safe. The findings in HeFH patients suggest that BBR might act in vivo increasing expression and stability of LDLRs and/or suppressing PCSK9 expression.

  10. Addition of a third field significantly increases dose to the brachial plexus for patients undergoing tangential whole-breast therapy after lumpectomy

    Our goal was to evaluate brachial plexus (BP) dose with and without the use of supraclavicular (SCL) irradiation in patients undergoing breast-conserving therapy with whole-breast radiation therapy (RT) after lumpectomy. Using the standardized Radiation Therapy Oncology Group (RTOG)–endorsed guidelines delineation, we contoured the BP for 10 postlumpectomy breast cancer patients. The radiation dose to the whole breast was 50.4 Gy using tangential fields in 1.8-Gy fractions, followed by a conedown to the operative bed using electrons (10 Gy). The prescription dose to the SCL field was 50.4 Gy, delivered to 3-cm depth. The mean BP volume was 14.5 ± 1.5 cm3. With tangential fields alone, the median mean dose to the BP was 0.57 Gy, the median maximum dose was 1.93 Gy, and the irradiated volume of the BP receiving 40, 45, and 50 Gy was 0%. When the third (SCL field) was added, the dose to the BP was significantly increased (P = .01): the median mean dose to the BP was 40.60 Gy, and the median maximum dose was 52.22 Gy. With 3-field RT, the median irradiated volume of the BP receiving 40, 45, and 50 Gy was 83.5%, 68.5%, and 24.6%, respectively. The addition of the SCL field significantly increases dose to the BP. The possibility of increasing the risk of BP morbidity should be considered in the context of clinical decision making.

  11. Addition of a third field significantly increases dose to the brachial plexus for patients undergoing tangential whole-breast therapy after lumpectomy

    Stanic, Sinisa; Mathai, Mathew; Mayadev, Jyoti S.; Do, Ly V.; Purdy, James A. [Department of Radiation Oncology, University of California, Davis, Sacramento, CA (United States); Chen, Allen M., E-mail: allen.chen@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis, Sacramento, CA (United States)

    2012-07-01

    Our goal was to evaluate brachial plexus (BP) dose with and without the use of supraclavicular (SCL) irradiation in patients undergoing breast-conserving therapy with whole-breast radiation therapy (RT) after lumpectomy. Using the standardized Radiation Therapy Oncology Group (RTOG)-endorsed guidelines delineation, we contoured the BP for 10 postlumpectomy breast cancer patients. The radiation dose to the whole breast was 50.4 Gy using tangential fields in 1.8-Gy fractions, followed by a conedown to the operative bed using electrons (10 Gy). The prescription dose to the SCL field was 50.4 Gy, delivered to 3-cm depth. The mean BP volume was 14.5 {+-} 1.5 cm{sup 3}. With tangential fields alone, the median mean dose to the BP was 0.57 Gy, the median maximum dose was 1.93 Gy, and the irradiated volume of the BP receiving 40, 45, and 50 Gy was 0%. When the third (SCL field) was added, the dose to the BP was significantly increased (P = .01): the median mean dose to the BP was 40.60 Gy, and the median maximum dose was 52.22 Gy. With 3-field RT, the median irradiated volume of the BP receiving 40, 45, and 50 Gy was 83.5%, 68.5%, and 24.6%, respectively. The addition of the SCL field significantly increases dose to the BP. The possibility of increasing the risk of BP morbidity should be considered in the context of clinical decision making.

  12. A 3-Arm, Randomized, Controlled Trial of Heat-Sensitive Moxibustion Therapy to Determine Superior Effect among Patients with Lumbar Disc Herniation

    Rixin Chen; Mingren Chen; Tongsheng Su; Meiqi Zhou; Jianhua Sun; Jun Xiong; Zhenhai Chi; Dingyi Xie; Bo Zhang

    2014-01-01

    Systematic reviews of moxibustion for LDH have identified ponderable evidence, especially for heat-sensitive moxibustion (HSM). Therefore, we designed and carried out the large sample trial to evaluate it. 456 patients were recruited from 4 centers in China and were randomly divided into three groups by the ratio of 1 : 1 : 1 to HSM (152) group, conventional moxibustion (152) group, and conventional drug plus acupuncture (152) group. Compared with usual care, there was a statistically signifi...

  13. In-situ Real-Time Monitoring of Volatile Organic Compound Exposure and Heart Rate Variability for Patients with Multiple Chemical Sensitivity

    Atsushi Mizukoshi; Kazukiyo Kumagai; Naomichi Yamamoto; Miyuki Noguchi; Kazuhiro Yoshiuchi; Hiroaki Kumano; Kou Sakabe; Yukio Yanagisawa

    2015-01-01

    In-situ real-time monitoring of volatile organic compound (VOC) exposure and heart rate variability (HRV) were conducted for eight multiple chemical sensitivity (MCS) patients using a VOC monitor, a Holter monitor, and a time-activity questionnaire for 24 h to identify the relationship between VOC exposure, biological effects, and subjective symptoms in actual life. The results revealed no significantly different parameters for averaged values such as VOC concentration, HF (high frequency), a...

  14. Highly sensitive C-reactive protein and male gender are independently related to the severity of coronary disease in patients with metabolic syndrome and an acute coronary event

    C.M.C. Monteiro; Pinheiro, L. F.; Izar, M.C.; S.W. Barros; M.B. Vasco; Fischer, S M; R.M. Povoa; S.A. Brandão; Santos, A.O.; Oliveira, L.; A.C. Carvalho; F.A.H. Fonseca

    2010-01-01

    Patients with metabolic syndrome are at high-risk for development of atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of coronary disease severity, including those coronary risk factors associated with metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive C-reactive protein (hsCRP), are related to coronary atherosclerosis, in additi...

  15. Neuraxial opioids in geriatrics: A dose reduction study of local anesthetic with addition of sufentanil in lower limb surgery for elderly patients

    Sumit Kumar

    2011-01-01

    Full Text Available Background and Objectives: Neuraxial anesthesia in the elderly is associated with exaggerated responses to conventional doses of local anesthetics, thereby increasing the incidence of hemodynamic complications. A double-blind prospective study was carried out in our institute with an aim to compare the hemodynamic stability and quality of the conventional dose of hyperbaric bupivacaine (LA with low dose of LA and sufentanil in elderly patients scheduled for lower limb surgery, randomized to receive combined spinal epidural anesthesia. Methods: A total of 50 elderly patients of ASA grade I and II, divided randomly into groups I and II, of either sex undergoing lower limb surgery under combined spinal epidural anesthesia at our institute attached to a Government Medical College were enrolled for study. Group I received 2.5 ml of intrathecal hyperbaric bupivacaine (LA, while group II received 1.5 ml of intrathecal LA+0.1 ml sufentanil (5 μg. Both initial and postoperative subarachnoid block characteristics, hemodynamic and respiratory parameters, duration of analgesia, and side effects were observed and recorded. Statistical analysis was carried out using Chi-square and paired t test. Results: Demographic profile was comparable in both groups. Group I had a greater incidence of hypotension and, consequently, higher use of vasopressors (P<0.05. Onset of sensory analgesia, time to achieve peak sensory level, and recovery from motor blockade were significantly earlier in group II (P<0.05. Postoperative consumption of LA through epidural route was significantly higher in group I (P<0.05. The side effect profile was similar, except for a significantly higher incidence of shivering in group I (P<0.05. Conclusions: The study established that the dose of a local anesthetic can be safely and significantly lowered by 40%, with addition of low-dose sufentanil, thereby avoiding the hemodynamic fluctuation and providing a stable perioperative and postoperative

  16. Comparative evaluation of the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients

    Firouzjaei, A; Li, G-C; Wang, N; Liu, W-X; Zhu, B-M

    2016-01-01

    Objective: Obesity induces insulin resistance (IR), the key etiologic defect of type 2 diabetes mellitus (T2DM). Therefore, an incidence of obesity-induced diabetes is expected to decrease if obesity is controlled. Although Metformin is currently one of the main treatment options for T2DM in obese patients, resulting in an average of 5% weight loss, adequate weight control in all patients cannot be achieved with Metformin alone. Thus, additional therapies with a weight loss effect, such as ac...

  17. Glucosylsphingosine is a highly sensitive and specific biomarker for primary diagnostic and follow-up monitoring in Gaucher disease in a non-Jewish, Caucasian cohort of Gaucher disease patients.

    Arndt Rolfs

    Full Text Available BACKGROUND: Gaucher disease (GD is the most common lysosomal storage disorder (LSD. Based on a deficient β-glucocerebrosidase it leads to an accumulation of glucosylceramide. Standard diagnostic procedures include measurement of enzyme activity, genetic testing as well as analysis of chitotriosidase and CCL18/PARC as biomarkers. Even though chitotriosidase is the most well-established biomarker in GD, it is not specific for GD. Furthermore, it may be false negative in a significant percentage of GD patients due to mutation. Additionally, chitotriosidase reflects the changes in the course of the disease belatedly. This further enhances the need for a reliable biomarker, especially for the monitoring of the disease and the impact of potential treatments. METHODOLOGY: Here, we evaluated the sensitivity and specificity of the previously reported biomarker Glucosylsphingosine with regard to different control groups (healthy control vs. GD carriers vs. other LSDs. FINDINGS: Only GD patients displayed elevated levels of Glucosylsphingosine higher than 12 ng/ml whereas the comparison controls groups revealed concentrations below the pathological cut-off, verifying the specificity of Glucosylsphingosine as a biomarker for GD. In addition, we evaluated the biomarker before and during enzyme replacement therapy (ERT in 19 patients, demonstrating a decrease in Glucosylsphingosine over time with the most pronounced reduction within the first 6 months of ERT. Furthermore, our data reveals a correlation between the medical consequence of specific mutations and Glucosylsphingosine. INTERPRETATION: In summary, Glucosylsphingosine is a very promising, reliable and specific biomarker for GD.

  18. Do Simulation-Based Skill Exercises and Post-Encounter Notes Add Additional Value to a Standardized Patient-Based Clinical Skills Examination?

    Michael D. Prislin

    2011-01-01

    Full Text Available Background. Standardized patient (SP clinical assessments have limited utility in assessing higher-level clinical competencies. This study explores the value of including simulation exercises and postencounter notes in an SP clinical skills examination. Methods. Two exercises involving cardiac auscultation and ophthalmic funduscopy simulations along with written post encounter notes were added to an SP-based performance examination. Descriptive analyses of students' performance and correlations with SP-based performance measures were obtained. Results. Students' abilities to detect abnormalities on physical exam were highly variable. There were no correlations between SP-based and simulation-derived measures of physical examination competency. Limited correlations were found between students' abilities to perform and document physical examinations and their formulation of appropriate differential diagnoses. Conclusions. Clinical simulation exercises add depth to SP-based assessments of performance. Evaluating the content of post encounter notes offers some insight into students' integrative abilities, and this appears to be improved by the addition of simulation-based post encounter skill exercises. However, further refinement of this methodology is needed.

  19. Identification of hazelnut major allergens in sensitive patients with positive double-blind, placebo-controlled food challenge results

    Pastorello, Elide A; Vieths, Stefan; Pravettoni, Valerio; Farioli, Laura; Trambaioli, Chiara; Fortunato, Donatella; Lüttkopf, Dirk; Calamari, Marianna; Ansaloni, Raffaella; Scibilia, Joseph; Ballmer-Weber, Barbara K; Poulsen, Lars K.; Wütrich, Brunello; Hansen, Kirsten Skamstrup; Robino, Anna Maria; Ortolani, Claudio; Conti, Amedeo

    2002-01-01

    The hazelnut major allergens identified to date are an 18-kd protein homologous to Bet v 1 and a 14-kd allergen homologous to Bet v 2. No studies have reported hazelnut allergens recognized in patients with positive double-blind, placebo-controlled food challenge (DBPCFC) results or in patients...

  20. Estudo do impacto da enxaqueca na severidade da dor miofascial da musculatura mastigatória Muscle pain intensity of patients with myofascial pain with different additional diagnoses

    Rafael dos Santos Silva

    2011-08-01

    in comparison to group 1 (p<0.05. Group 2 also presented higher levels of subjective pain, with statistical significance for "pain at the moment" and "highest pain" (p<0.05. Additionally, group 2 showed higher levels of mood problems, disability, jaw function impairment and sleep problems than group 1 with statistical significance for the later (p<0.05. CONCLUSIONS: Migraine comorbidity demonstrated a significant impact on pain intensity and life quality of patients with MFP. Clinicians should approach both conditions in order to achieve better treatment outcomes.

  1. Influence factors of cough reflex sensitivity in patients with chronic cough%慢性咳嗽患者咳嗽敏感性的影响因素

    陈如冲; 赖克方; 罗炜; 钟南山

    2008-01-01

    Objective To investigate the influence factors of cough reflex sensitivity in patients with chronic cough. Methods Patients with chronic cough were recruited by using a diagnostic program. Cough reflex sensitivity was examined through eapsaicin cough challenge and the LgC5 (C5, the concentration of capsaicin causing five or more coughs ) was used as the index of cough threshold. Score of the severity of cough, age,gender, course of disease, pulmonary ventilation function (FEV1/pred%, MMEF/pred% )and cell differential of induced sputum (the percent of neutrophils, macrophages, lymphocytes, eosinophils)were also recorded for analysis. Results One hundred and fifty patients with different etiology of chronic cough involved in the study. Cough threshold of the patients was correlated with cough score at daytime (r=0.175, P0.05 ). Regression analysis showed that only gender and disease course were significantly corrclated with LgC5 ( all P0.05.多元线性回归分析显示,咳嗽阈值仅与性别、咳嗽病程有关(P均<0.01).结论咳嗽敏感性与咳嗽症状积分反映咳嗽程度的不同特征,性别与咳嗽病程可能影响慢性咳嗽患者的咳嗽敏感性.

  2. Disgust sensitivity and anorexia nervosa

    Nielsen, Ruth Aharoni; Hertz, Marianne M

    2012-01-01

    Previous studies found inconsistent differences in disgust sensitivity between patients with a variety of eating disorders and normal controls.......Previous studies found inconsistent differences in disgust sensitivity between patients with a variety of eating disorders and normal controls....

  3. A randomised, phase II trial of the DNA-hypomethylating agent 5-aza-2′-deoxycytidine (decitabine) in combination with carboplatin vs carboplatin alone in patients with recurrent, partially platinum-sensitive ovarian cancer

    Glasspool, R M; Brown, R; Gore, M E; Rustin, G J S; McNeish, I A; Wilson, R H; Pledge, S; Paul, J; Mackean, M; Hall, G D; Gabra, H; Halford, S E R; Walker, J; Appleton, K; Ullah, R; Kaye, S

    2014-01-01

    Background: Our previous laboratory and clinical data suggested that one mechanism underlying the development of platinum resistance in ovarian cancer is the acquisition of DNA methylation. We therefore tested the hypothesis that the DNA hypomethylating agent 5-aza-2′-deoxycytodine (decitabine) can reverse resistance to carboplatin in women with relapsed ovarian cancer. Methods: Patients progressing 6–12 months after previous platinum therapy were randomised to decitabine on day 1 and carboplatin (AUC 6) on day 8, every 28 days or carboplatin alone. The primary objective was response rate in patients with methylated hMLH1 tumour DNA in plasma. Results: After a pre-defined interim analysis, the study closed due to lack of efficacy and poor treatment deliverability in 15 patients treated with the combination. Responses by GCIG criteria were 9 out of 14 vs 3 out of 15 and by RECIST were 6 out of 13 vs 1 out of 12 for carboplatin and carboplatin/decitabine, respectively. Grade 3/4 neutropenia was more common with the combination (60% vs 15.4%) as was G2/3 carboplatin hypersensitivity (47% vs 21%). Conclusions: With this schedule, the addition of decitabine appears to reduce rather than increase the efficacy of carboplatin in partially platinum-sensitive ovarian cancer and is difficult to deliver. Patient-selection strategies, different schedules and other demethylating agents should be considered in future combination studies. PMID:24642620

  4. SU-E-J-06: Additional Imaging Guidance Dose to Patient Organs Resulting From X-Ray Tubes Used in CyberKnife Image Guidance System

    Purpose: The use of image-guided radiation therapy (IGRT) has become increasingly common, but the additional radiation exposure resulting from repeated image guidance procedures raises concerns. Although there are many studies reporting imaging dose from different image guidance devices, imaging dose for the CyberKnife Robotic Radiosurgery System is not available. This study provides estimated organ doses resulting from image guidance procedures on the CyberKnife system. Methods: Commercially available Monte Carlo software, PCXMC, was used to calculate average organ doses resulting from x-ray tubes used in the CyberKnife system. There are seven imaging protocols with kVp ranging from 60 – 120 kV and 15 mAs for treatment sites in the Cranium, Head and Neck, Thorax, and Abdomen. The output of each image protocol was measured at treatment isocenter. For each site and protocol, Adult body sizes ranging from anorexic to extremely obese were simulated since organ dose depends on patient size. Doses for all organs within the imaging field-of-view of each site were calculated for a single image acquisition from both of the orthogonal x-ray tubes. Results: Average organ doses were <1.0 mGy for every treatment site and imaging protocol. For a given organ, dose increases as kV increases or body size decreases. Higher doses are typically reported for skeletal components, such as the skull, ribs, or clavicles, than for softtissue organs. Typical organ doses due to a single exposure are estimated as 0.23 mGy to the brain, 0.29 mGy to the heart, 0.08 mGy to the kidneys, etc., depending on the imaging protocol and site. Conclusion: The organ doses vary with treatment site, imaging protocol and patient size. Although the organ dose from a single image acquisition resulting from two orthogonal beams is generally insignificant, the sum of repeated image acquisitions (>100) could reach 10–20 cGy for a typical treatment fraction

  5. SU-E-J-06: Additional Imaging Guidance Dose to Patient Organs Resulting From X-Ray Tubes Used in CyberKnife Image Guidance System

    Sullivan, A; Ding, G [Vanderbilt University, Nashville, TN (United States)

    2015-06-15

    Purpose: The use of image-guided radiation therapy (IGRT) has become increasingly common, but the additional radiation exposure resulting from repeated image guidance procedures raises concerns. Although there are many studies reporting imaging dose from different image guidance devices, imaging dose for the CyberKnife Robotic Radiosurgery System is not available. This study provides estimated organ doses resulting from image guidance procedures on the CyberKnife system. Methods: Commercially available Monte Carlo software, PCXMC, was used to calculate average organ doses resulting from x-ray tubes used in the CyberKnife system. There are seven imaging protocols with kVp ranging from 60 – 120 kV and 15 mAs for treatment sites in the Cranium, Head and Neck, Thorax, and Abdomen. The output of each image protocol was measured at treatment isocenter. For each site and protocol, Adult body sizes ranging from anorexic to extremely obese were simulated since organ dose depends on patient size. Doses for all organs within the imaging field-of-view of each site were calculated for a single image acquisition from both of the orthogonal x-ray tubes. Results: Average organ doses were <1.0 mGy for every treatment site and imaging protocol. For a given organ, dose increases as kV increases or body size decreases. Higher doses are typically reported for skeletal components, such as the skull, ribs, or clavicles, than for softtissue organs. Typical organ doses due to a single exposure are estimated as 0.23 mGy to the brain, 0.29 mGy to the heart, 0.08 mGy to the kidneys, etc., depending on the imaging protocol and site. Conclusion: The organ doses vary with treatment site, imaging protocol and patient size. Although the organ dose from a single image acquisition resulting from two orthogonal beams is generally insignificant, the sum of repeated image acquisitions (>100) could reach 10–20 cGy for a typical treatment fraction.

  6. Teardrop bladder: additional considerations

    Nine cases of teardrop bladder (TDB) seen at excretory urography are presented. In some of these patients, the iliopsoas muscles were at the upper limit of normal in size, and additional evaluation of the perivesical structures with computed tomography (CT) was necessary. CT demonstrated only hypertrophied muscles with or without perivesical fat. The psoas muscles and pelvic width were measured in 8 patients and compared with the measurements of a control group of males without TDB. Patients with TDB had large iliopsoas muscles and narrow pelves compared with the control group. The psoas muscle width/pelvic width ratio was significantly greater (p < 0.0005) in patients with TDB than in the control group, with values of 1.04 + 0.05 and 0.82 + 0.09, respectively. It is concluded that TDB is not an uncommon normal variant in black males. Both iliopsoas muscle hypertrophy and a narrow pelvis are factors that predispose a patient to TDB

  7. Effect of extended-release niacin on hormone-sensitive lipase and lipoprotein lipase in patients with HIV-associated lipodystrophy syndrome

    Dominic C Chow

    2008-11-01

    Full Text Available Dominic C Chow, Anne Tasaki, Jill Ono, Bruce Shiramizu, Scott A SouzaHawaii AIDS Clinical Research Program, University of Hawaii, Honolulu, HI, USABackground: HIV-associated lipodystrophy syndrome is strongly associated with antiretroviral treatment in patients with human immunodeficiency virus (HIV. Niacin is thought to affect hormone-sensitive lipase (HSL and lipoprotein lipase (LPL expression in peripheral and intra-abdominal fat (IAF.Objective: This study investigated the effect of extended-release niacin (ERN on adipose HSL and LPL expression in patients with HIV-associated lipodystrophy syndrome.Methods: Changes in IAF and peripheral fat content and HSL and LPL expression were examined in 4 HIV-infected patients recruited from a prospective study treated with ERN. Patients underwent limited 8 slice computerized tomography abdominal scans, dual-energy X-ray absorptiometry scans, and skin punch biopsies of the mid-thigh at baseline and after 12 weeks of ERN. All subjects were on stable highly active antiretroviral therapy prior to and during the study. Changes in body habitus were self-reported.Results: Normalized HSL expression decreased in 3 patients and normalized LPL expression increased in all 4 patients when comparing pre- and post-ERN treated samples. All subjects showed a decrease in total cholesterol (TC and triglyceride (TG levels.Conclusions: Preliminary analysis suggests ERN may induce changes in HSL and LPL expression. This method is a feasible approach to identify changes in adipose RNA expression involved with lipolysis.Keywords: extended-release niacin, HIV, lipodystrophy syndrome, hormone-sensitive lipase (HSL, lipoprotein lipase (LPL

  8. Usefulness of High-Sensitivity Cardiac Troponin T for the Identification of Outlier Patients With Diffuse Coronary Atherosclerosis and Low-Risk Factors.

    Magnoni, Marco; Masson, Serge; Andreini, Daniele; Moccetti, Tiziano; Modena, Maria Grazia; Canestrari, Mauro; Berti, Sergio; Casolo, Giancarlo; Gabrielli, Domenico; Marraccini, Paolo; Pontone, Gianluca; Latini, Roberto; Maggioni, Aldo Pietro; Maseri, Attilio

    2016-05-01

    Novel high-sensitivity assay can detect very low levels of circulating cardiac troponin (hs-cTnT) in apparently healthy subjects. Within normal range, higher levels are associated with coronary artery disease (CAD) and cardiac abnormalities commonly associated to traditional risk factors (RFs) for CAD. Therefore, we investigated the relation between circulating hs-cTnT and CAD in patients with a spectrum of RF burden aiming to assess the added value of hs-cTnT to identify "outlier" patients with CAD despite a low RF burden. Hs-cTnT was measured in 525 stable patients without previous diagnosis of ischemic heart disease with 0 to 1 RF, excluded diabetes, (low-RF group, n = 263) or ≥2 RFs (multiple-RF group, n = 262) and without CAD (segment involvement score = 0) or diffuse CAD (segment involvement score >5) at coronary computed tomography angiography. Outlier patients with diffuse CAD despite low-RF burden had similar extent, severity, and plaque composition than patients with multiple RFs. Overall, hs-cTnT was measurable in 81% of patients with median value of 6.0 ng/L. In both groups, hs-cTnT concentration was higher in patients with CAD than in patients with normal coronary arteries (p 6 ng/L) was independently associated with CAD in low-RF group only. Despite very low circulating concentrations, hs-cTnT may identify with a good accuracy the outlier patients with diffuse CAD despite low-RF burden. PMID:26976791

  9. Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation.

    Jochen Wöhrle

    Full Text Available It is not known whether biomarkers of hemodynamic stress, myocardial necrosis, and renal function might predict adverse outcome in patients undergoing percutaneous repair of severe mitral valve insufficiency. Thus, we aimed to assess the predictive value of various established and emerging biomarkers for major adverse cardiovascular events (MACE in these patients.Thirty-four patients with symptomatic severe mitral valve insufficiency with a mean STS-Score for mortality of 12.6% and a mean logistic EuroSCORE of 19.7% undergoing MitraClip therapy were prospectively included in this study. Plasma concentrations of mid regional-proatrial natriuretic peptide (MR-proANP, Cystatin C, high-sensitive C-reactive protein (hsCRP, high-sensitive troponin T (hsTnT, N-terminal B-type natriuretic peptide (NT-proBNP, galectin-3, and soluble ST-2 (interleukin 1 receptor-like 1 were measured directly before procedure. MACE was defined as cardiovascular death and hospitalization for heart failure (HF.During a median follow-up of 211 days (interquartile range 133 to 333 days, 9 patients (26.5% experienced MACE (death: 7 patients, rehospitalization for HF: 2 patients. Thirty day MACE-rate was 5.9% (death: 2 patients, no rehospitalization for HF. Baseline concentrations of hsTnT (Median 92.6 vs 25.2 ng/L, NT-proBNP (Median 11251 vs 1974 pg/mL and MR-proANP (Median 755.6 vs 318.3 pmol/L, all p<0.001 were clearly higher in those experiencing an event vs event-free patients, while other clinical variables including STS-Score and logistic EuroSCORE did not differ significantly. In Kaplan-Meier analyses, NT-proBNP and in particular hsTnT and MR-proANP above the median discriminated between those experiencing an event vs event-free patients. This was further corroborated by C-statistics where areas under the ROC curve for prediction of MACE using the respective median values were 0.960 for MR-proANP, 0.907 for NT-proBNP, and 0.822 for hsTnT.MR-proANP and hsTnT strongly

  10. Prognostic role of serum concentrations of high-sensitivity C-reactive protein in patients with metastatic colorectal cancer: results from the ITACa trial

    Scarpi, Emanuela; Maltoni, Paolo; Dorizzi, Romolo M.; Passardi, Alessandro; Frassineti, Giovanni Luca; Cortesi, Pietro; Giannini, Maria Benedetta; Marisi, Giorgia; Amadori, Dino; Lucchesi, Alessandro

    2016-01-01

    Serum levels of C-reactive protein are (CRP) higher in patients with neoplastic conditions and numerous studies have been performed to clarify the etiologic and prognostic role of the high-sensitivity CRP (hs-CRP) in cancer. Our study was conducted on patients enrolled in the prospective randomized “Italian Trial in Advanced Colorectal Cancer (ITACa)” to assess hs-CRP levels and their impact on overall survival (OS) and progression-free survival (PFS). Serum samples from 132 ITACa patients were collected at baseline and 2 months after starting first-line chemotherapy. The supernatant was immediately transferred to cryovials and stored at −80°C. After thawing, hs-CRP was measured with the Cobas c501 analyzer. High levels of hs-CRP (≥ 13.1 mg/L) were associated with poorer median PFS (p < 0.0001) and OS (p < 0.0001) than low hs-CRP levels (< 13.1 mg/L). hs-CRP values in 107 patients were evaluated again after 2 months of therapy, revealing that patients with low hs-CRP levels in both baseline and second serum samples had the best median PFS and OS. Our study confirms the prognostic value of hs-CRP in patients with metastatic colorectal carcinoma. PMID:26848624

  11. Sensitivity and specificity of MRA in the diagnosis of neurovascular compression in patients with trigeminal neuralgia. A correlation of MRA and surgical findings

    The published rates of operatively confirmed neurovascular compression as the cause for trigeminal neuralgia range from 10 % to nearly 100 %. High-definition magnetic resonance angiography (MRA) was performed in 27 consecutive patients (in 6 cases with 3D reconstructions) to show neurovascular compression preoperatively. The MRA findings were compared with the relationship between the Vth nerve and the surrounding vessels at surgery. In 23 patients MRA showed present neurovascular compression in accordance with surgical findings (18/27 in complete accordance of type and side of vessel, site and direction of compression). One woman had no neurovascular compression either on MRA or intraoperatively. One MRA prediction of neurovascular compression was false, and two results were false negative. The sensitivity of MRA was therefore 88.5 % but the specificity only 50 %, if surgical findings are the reference. In one patient with right trigeminal neuralgia MRA revealed bilateral neurovascular compression of the Vth nerves. Therefore, the overall specificity of MRA might be below 50 %. In one patient with multiple sclerosis, the decision to operate was markedly influenced by the clear finding of neurovascular compression on MRA. The patient has been free from trigeminal pain for 149 weeks after microvascular decompression. In 6 patients, 3D reconstructions of the MRA data were performed. The images helped in 3D visualisation of the operation, but did not yield new information about the nature of the vessels revealed, or the site, direction or side of the neurovascular compression. (orig.)

  12. Sensitivity and specificity of MRA in the diagnosis of neurovascular compression in patients with trigeminal neuralgia. A correlation of MRA and surgical findings

    Boecher-Schwarz, H.G.; Bruehl, K.; Kessel, G.; Guenthner, M.; Perneczky, A.; Stoeter, P. [Neurosurgical Department, Klinikum der Johannes Gutenberg-Universitaet, Mainz (Germany)

    1998-02-01

    The published rates of operatively confirmed neurovascular compression as the cause for trigeminal neuralgia range from 10 % to nearly 100 %. High-definition magnetic resonance angiography (MRA) was performed in 27 consecutive patients (in 6 cases with 3D reconstructions) to show neurovascular compression preoperatively. The MRA findings were compared with the relationship between the Vth nerve and the surrounding vessels at surgery. In 23 patients MRA showed present neurovascular compression in accordance with surgical findings (18/27 in complete accordance of type and side of vessel, site and direction of compression). One woman had no neurovascular compression either on MRA or intraoperatively. One MRA prediction of neurovascular compression was false, and two results were false negative. The sensitivity of MRA was therefore 88.5 % but the specificity only 50 %, if surgical findings are the reference. In one patient with right trigeminal neuralgia MRA revealed bilateral neurovascular compression of the Vth nerves. Therefore, the overall specificity of MRA might be below 50 %. In one patient with multiple sclerosis, the decision to operate was markedly influenced by the clear finding of neurovascular compression on MRA. The patient has been free from trigeminal pain for 149 weeks after microvascular decompression. In 6 patients, 3D reconstructions of the MRA data were performed. The images helped in 3D visualisation of the operation, but did not yield new information about the nature of the vessels revealed, or the site, direction or side of the neurovascular compression. (orig.) With 3 figs., 4 tabs., 25 refs.

  13. Insulin sensitivity and beta-cell function in the offspring of type 2 diabetic patients: impact of line of inheritance.

    Natali, Andrea

    2010-10-01

    What defects in glucose metabolism are present in offspring of type 2 diabetic patients (FHD(+) with a positive family history of diabetes) and to what extent they depend on line of inheritance are uncertain.

  14. Clinical Criteria Replenish High-Sensitive Troponin and Inflammatory Markers in the Stratification of Patients with Suspected Acute Coronary Syndrome

    Barbara Elisabeth Stähli; Keiko Yonekawa; Lukas Andreas Altwegg; Christophe Wyss; Danielle Hof; Philipp Fischbacher; Andreas Brauchlin; Georg Schulthess; Pierre-Alexandre Krayenbühl; Arnold von Eckardstein; Martin Hersberger; Michel Neidhart; Steffen Gay; Igor Novopashenny; Regine Wolters

    2014-01-01

    OBJECTIVES: In patients with suspected acute coronary syndrome (ACS), rapid triage is essential. The aim of this study was to establish a tool for risk prediction of 30-day cardiac events (CE) on admission. 30-day cardiac events (CE) were defined as early coronary revascularization, subsequent myocardial infarction, or cardiovascular death within 30 days. METHODS AND RESULTS: This single-centre, prospective cohort study included 377 consecutive patients presenting to the emergency departme...

  15. High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome:a cohort study

    Shah, Anoop S V; Anand, Atul; Sandoval, Yader; Lee, Kuan Ken; Smith, Stephen W; Adamson, Philip D; Chapman, Andrew; Langdon, Timothy; Sandeman, Dennis; Vaswani, Amar; Strachan, Fiona; Ferry, Amy; Stirzaker, Alexandra G; Reid, Alan; Gray, Alasdair J

    2015-01-01

    BACKGROUND: Suspected acute coronary syndrome is the commonest reason for emergency admission to hospital and is a large burden on health-care resources. Strategies to identify low-risk patients suitable for immediate discharge would have major benefits.METHODS: We did a prospective cohort study of 6304 consecutively enrolled patients with suspected acute coronary syndrome presenting to four secondary and tertiary care hospitals in Scotland. We measured plasma troponin concentrations at prese...

  16. Standardization of a new photodiagnosis method based on LEDs for patients with solar urticaria sensitive to visible light

    Aguilera, J.; De Gálvez Aranda, María Victoria; Argila, Diego; Perez-Ferriols,Amparo; Rodríguez-Granados,Teresa; Gardeazabal, Jesus; Carrascosa,Jose Manel; Herrera Ceballos, Enrique

    2015-01-01

    Standard methods for photodiagnosis of solar urticaria are based in exposure of patient skin to different polychromatic UV and visible sources where minimal urticarial doses for different spectral bands (UVB and UVA) are established. Classical photodiagnosis devices are based in solar simulation and use of UVB and UVA enhanced fluorescent lamps. In case of visible US photodiagnosis, US patient skin is exposed for 15 min to a slight projector, provided with halogen lamp, at a distance of 15 cm...

  17. Oncology Nursing Minimum Data Set (ONMDS): can we hypothesize a set of prevalent Nursing Sensitive Outcomes (NSO) in cancer patients?

    Milani, A.; Mauri, S; Gandini, S.; Magon, G

    2013-01-01

    Background The nursing minimum data set (NMDS) was created in 1977 in the United States to collect uniform standardised data that could be comparable among different nursing areas or patients. So far, in the literature, an NMDS in an oncology setting has not yet been described. Considering an oncology nursing minimum data set (ONMDS), which data could be chosen to define this tool regarding cancer patient care? Material and methods At the European Institute of Oncology (IEO), 20 experienced o...

  18. Sensitive Enzyme Immunoassay for Measuring Plasma and Intracellular Nevirapine Levels in Human Immunodeficiency Virus-Infected Patients

    Azoulay, Stéphane; Nevers, Marie-Claire; Créminon, Christophe; Heripret, Laurence; Durant, Jacques; Dellamonica, Pierre; Grassi, Jacques; Guedj, Roger; Duval, Danièle

    2004-01-01

    We have developed an enzyme immunoassay to measure nevirapine (NVP) in plasma and peripheral blood mononuclear cells. Anti-NVP polyclonal antibodies were raised in rabbits by using a synthetic NVP derivative coupled to keyhole limpet hemocyanin as the immunogen, and the enzyme tracer was prepared by chemically coupling the NVP derivative with acetylcholinesterase. These reagents were used to develop a sensitive competitive enzyme immunoassay performed in microtitration plates with a 100-pg ml...

  19. Search for Allergens from the Pollen Proteome of Sunflower (Helianthus annuus L.): A Major Sensitizer for Respiratory Allergy Patients

    Ghosh, Nandini; Sircar, Gaurab; Saha, Bodhisattwa; Pandey, Naren; Gupta Bhattacharya, Swati

    2015-01-01

    Background Respiratory allergy triggered by pollen allergens is increasing at an alarming rate worldwide. Sunflower pollen is thought to be an important source of inhalant allergens. Present study aims to identify the prevalence of sunflower pollinosis among the Indian allergic population and characterizes the pollen allergens using immuno-proteomic tools. Methodology Clinico-immunological tests were performed to understand the prevalence of sensitivity towards sunflower pollen among the atop...

  20. Comparative analysis of biological activities of Der p I-derived peptides on Fc epsilon receptor-bearing cells from Dermatophagoides pteronyssinus-sensitive patients.

    Jeannin, P; Pestel, J; Bossus, M; Lassalle, P; Tartar, A; Tonnel, A B

    1993-04-01

    The ability of four uncoupled synthetic peptides (p52-71, p117-133, p176-187, p188-199) derived from Der p I, a major allergen from the house dust mite Dermatophagoides pteronyssinus (Dpt) to stimulate Fc epsilon R+ cells from Dpt-sensitive patients was comparatively analysed. Each free peptide may specifically stimulate basophils (Fc epsilon RI+ cells) and platelets (Fc epsilon RII+ cells) from patients with significant levels of anti-Der p I IgE antibodies; p52-71 and p117-133 appear the best cell stimulation inducers. Both concentration-dependent biological activities of Der p I-peptide on Fc epsilon R+ cells are enhanced by coupling peptide to a carrier (as human serum albumin). Interestingly each Der p I-sensitive patient tested presents an individual pattern of response to peptide. Thus, from our results it appears that different Der p I sequences could be involved in the immune response to Der p I. PMID:7682161

  1. Combined parecoxib and I.V. paracetamol provides additional analgesic effect with better postoperative satisfaction in patients undergoing anterior cruciate ligament reconstruction

    Zeinab Ahmed Elseify

    2011-01-01

    Full Text Available Background : Adequacy of postoperative analgesia is one of the most important factors that determine early hospital discharge and patients′ ability to resume their normal activities postoperatively. The optimal non-opioid analgesic technique for postoperative pain management would reduce pain and enhance patient satisfaction, and it also facilitates earlier mobilization and rehabilitation by reducing pain-related complications after surgery. The aim of this study was to evaluate the analgesic efficacy of intravenous paracetamol and parecoxib when used alone, or in combination. Methods : Sixty American Society of Anesthesiology (ASA physical status I and II adult patients who were scheduled for anterior cruciate ligament reconstruction were included in this study. Patients were allocated into three groups: group I patients received 1g intravenous paracetamol after induction and another 1 g 4 h later, group II received 40 mg parecoxib after induction, while group III received combination of both drugs (paracetamol 1 g and parecoxib 40 mg. Pain during rest and mobility was assessed in the immediate postoperative period, 2 h and 8 h successively using visual analog scale (VAS. Patient satisfaction was rated according to satisfaction score. Results : Total morphine requirements were lower in group III patients (6.9±2.7 mg in comparison to group I patients (12.6±3.6 mg or group II patients (9.8±2.8 mg. The least VAS scores were recorded during knee movement (3.8±1.1 in group III patients compared to group I (6.0±1.8 and group II patients (4.8±1.9. Eight hours postoperatively, group III patients were more satisfied regarding the postoperative pain management. Conclusion : Combination of intravenous paracetamol and parecoxib provided better analgesia and higher patient satisfaction than each drug when used separately.

  2. Intragastric acidification increases the sensitivity of 14C-urea breath test in patients taking a proton pump inhibitor

    Objective: To investigate if intragastric acidification at the ingestion of 14C-urea can decrease the likelihood of false-negative (FN) results of urea breath test (UBT) in patients taking a proton pump inhibitor (PPI). Methods: Twenty-three patients with positive 14C-UBT (UBT-1) results underwent an acid suppression treatment with omeprazole 40 mg/d for 14 d. On day 13, patients underwent second standard UBT (YBT-2). On day 14, patients underwent a modified UBT (UBT-3), which included consuming 200 mL of 0.1 mol/L citric acid solution 30 min before and at the administration of 14C-urea. Mean 14CO2 expiration and the number of FN results were compared for the three UBTs. Results: Omeprazole caused a significant decrease in mean 14CO2 excretion between UBT-1[(5.57 +- 3.90) Bq/mmol] and UBT-2[(1.98 +- 1.42) Bq/mmol, t=5.867, P=0.000]. Omeprazole caused 10(43.5%) FN UBT-2 results. Mean 14CO2 expiration in UBT-3 [(4.93 +- 3.77) Bq/mmol] was greater than that in UBT-2 (t=-4.538, P=0.000). UBT-3 caused only 2 FN results (8.7%, x2=6.66, P14C-urea increases 14Co2 expiration and decreases FN 14C-UBT results in patients taking PPI

  3. [Contrast sensitivity in glaucoma].

    Bartos, D

    1989-05-01

    Author reports on results of the contrast sensitivity examinations using the Cambridge low-contrast lattice test supplied by Clement Clarke International LTD, in patients with open-angle glaucoma and ocular hypertension. In glaucoma patients there was observed statistically significant decrease of the contrast sensitivity. In patients with ocular hypertension decrease of the contrast sensitivity was in patients affected by corresponding changes of the visual field and of the optical disc. The main advantages of the Cambridge low-contrast lattice test were simplicity, rapidity and precision of its performance. PMID:2743444

  4. CD4 criteria improves the sensitivity of a clinical algorithm developed to identify viral failure in HIV-positive patients on antiretroviral therapy

    Denise H Evans

    2014-09-01

    Full Text Available Introduction: Several studies from resource-limited settings have demonstrated that clinical and immunologic criteria are poor predictors of virologic failure, confirming the need for viral load monitoring or at least an algorithm to target viral load testing. We used data from an electronic patient management system to develop an algorithm to identify patients at risk of viral failure using a combination of accessible and inexpensive markers. Methods: We analyzed data from HIV-positive adults initiated on antiretroviral therapy (ART in Johannesburg, South Africa, between April 2004 and February 2010. Viral failure was defined as ≥2 consecutive HIV-RNA viral loads >400 copies/ml following suppression ≤400 copies/ml. We used Cox-proportional hazards models to calculate hazard ratios (HR and 95% confidence intervals (CI. Weights for each predictor associated with virologic failure were created as the sum of the natural logarithm of the adjusted HR and dichotomized with the optimal cut-off at the point with the highest sensitivity and specificity (i.e. ≤4 vs. >4. We assessed the diagnostic accuracy of predictor scores cut-offs, with and without CD4 criteria (CD4 30% drop in CD4, by calculating the proportion with the outcome and the observed sensitivity, specificity, positive and negative predictive value of the predictor score compared to the gold standard of virologic failure. Results: We matched 919 patients with virologic failure (1:3 to 2756 patients without. Our predictor score included variables at ART initiation (i.e. gender, age, CD4 count <100 cells/mm3, WHO stage III/IV and albumin and laboratory and clinical follow-up data (drop in haemoglobin, mean cell volume (MCV <100 fl, CD4 count <200 cells/mm3, new or recurrent WHO stage III/IV condition, diagnosis of new condition or symptom and regimen change. Overall, 51.4% had a score 51.4% had a score ≥4 and 48.6% had a score <4. A predictor score including CD4 criteria performed

  5. Analysis of the variation levels of APN, insulin, sensitive C-reactive protein and leptin in the serum of patients with type 2 diabetes mellitus

    To study the mechanism of pancreatic 13 cell dysfunction and tissue resistance to insulin, and to provide basis for early diagnosis and therapy of the disease, the levels of APN, insulin, sensitive C-reactive protein and leptin in the serum of patients with type 2 diabetes mellitus were determined. Altogether 184 untreatea type 2 diabetes mellitus patients, 30 normal people as the control group, and another 75 type 2 diabetes mellitus patients who have been treated for a year were enrolled in this study. The serum levels of the above indexes were determined by chemiluminescence immunoassay, enzyme immunoassay and radioimmunoassay. The results showed that there were obvious differences in the levels of insulin, leptin, C-reacting protein and insulin antibody between the normal control group and the group of the untreated type 2 diabetes mellitus patients (P<0.01), especially there was significant difference in the level of APN(P<0. 001). Among the 75 type 2 diabetes meltitus patients who have received a year's treatment, all the indexes except for APN and insulin antibody were decreased statistically, while the APN level was increased significantly (P<0.01) than that before the treatment. The determination of markers of type 2 diabetes mellitus is of great significance for its early diagnosis, therapy, prognosis and mechanism research. (authors)

  6. Should docetaxel be standard of care for patients with metastatic hormone-sensitive prostate cancer? Pro and contra.

    Fizazi, K; Jenkins, C; Tannock, I F

    2015-08-01

    Following the results of the TAX-327 study, questions have been raised as to whether administering chemotherapy to men with prostate cancer before symptomatic disease progression when receiving standard hormonal treatment can improve the duration and quality of patient survival. The GETUG-AFU-15 and CHAARTED studies both assessed the efficacy and tolerability of androgen deprivation therapy (ADT) with or without docetaxel in men with metastatic hormone-naive prostate cancer. Both studies included a mix of patients with de novo metastatic disease (∼75%) and patients who developed metastases following treatment of localized disease. A short course of ADT was allowed in both trials prior to accrual. Key differences between the two studies include the number of patients with high-volume metastases (GETUG-AFU-15: 52%; CHAARTED: 65%) and number of docetaxel cycles (GETUG-AFU-15: up to nine cycles; CHAARTED six cycles). Both studies reported an improvement in progression-free survival with docetaxel plus ADT versus ADT alone. The GETUG-AFU-15 did not find a significant difference in the primary end point of overall survival (OS) {hazard ratio (HR) 0.9 [95% confidence interval (CI) 0.7-1.2]; P = 0.44} for ADT plus docetaxel versus ADT alone. The CHAARTED study met the primary end point of OS [HR 0.61 (95% CI 0.47-0.80); P = 0.0003], and in a subset analysis reported the greatest improvement in OS for patients with high-volume disease [HR 0.60 (95% CI 0.45-0.81); P = 0.0006]. The following article debates the results from the GETUG-AFU-15 and CHAARTED studies and asks whether medical practice should be changed for patients with metastatic hormone-naive prostate cancer based on the results of one positive study. PMID:26002607

  7. A study of high-sensitivity C- reactive protein and trop-T in patients with coronary artery disease

    Anita Rathore

    2016-04-01

    Results: We have also come across very high levels of Hs-CRP in the CAD patients and found that the value of Hs-CRP was 2.51+/-0.79 mg/L as compared to 0.76+/-0.34 mg/L in control and therefore the rise in Hs-CRP is highly significant because of p value (0.0001. Conclusions: Hs-CRP is highly significant in CAD patients when compared to the control group. It is an independent and better predictor of CAD. [Int J Res Med Sci 2016; 4(4.000: 1051-1055

  8. The need for annual echocardiography to detect cabergoline-associated valvulopathy in patients with prolactinoma: a systematic review and additional clinical data.

    Caputo, Carmela; Prior, David; Inder, Warrick J

    2015-11-01

    Present recommendations by the US Food and Drug Administration advise that patients with prolactinoma treated with cabergoline should have an annual echocardiogram to screen for valvular heart disease. Here, we present new clinical data and a systematic review of the scientific literature showing that the prevalence of cabergoline-associated valvulopathy is very low. We prospectively assessed 40 patients with prolactinoma taking cabergoline. Cardiovascular examination before echocardiography detected an audible systolic murmur in 10% of cases (all were functional murmurs), and no clinically significant valvular lesion was shown on echocardiogram in the 90% of patients without a murmur. Our systematic review identified 21 studies that assessed the presence of valvular abnormalities in patients with prolactinoma treated with cabergoline. Including our new clinical data, only two (0·11%) of 1811 patients were confirmed to have cabergoline-associated valvulopathy (three [0·17%] if possible cases were included). The probability of clinically significant valvular heart disease is low in the absence of a murmur. On the basis of these findings, we challenge the present recommendations to do routine echocardiography in all patients taking cabergoline for prolactinoma every 12 months. We propose that such patients should be screened by a clinical cardiovascular examination and that echocardiogram should be reserved for those patients with an audible murmur, those treated for more than 5 years at a dose of more than 3 mg per week, or those who maintain cabergoline treatment after the age of 50 years. PMID:25466526

  9. Combined PET and low-dose, noncontrast CT scanning obviates the need for additional diagnostic contrast-enhanced CT scans in patients undergoing staging or restaging for lymphoma

    Elstrom, R. L.; Leonard, J. P.; Coleman, M.; Brown, R. K. J.

    2008-01-01

    Background: Positron emission tomography (PET) is more accurate than computed tomography (CT) in staging and restaging of lymphoma, but both are considered necessary. Increasingly, PET is carried out with a low-dose CT scan. Many patients undergo both PET/CT and standard diagnostic CT. The clinical utility of performing both studies in patients with lymphoma was evaluated.

  10. Estimated Creatinine Clearance, Homocysteine and High Sensitivity-C-Reactive Protein Levels Determination for Early Prediction of Nephropathy and Atherosclerosis Risk In Type 2 Diabetic Patients

    Deebukkhum, Suwipar; Pingmuangkaew, Patchanrin; Tangvarasittichai, Orathai; Tangvarasittichai, Surapon

    2012-01-01

    Type 2 diabetes mellitus (T2D) patients are increased risk for cardiovascular disease (CVD) and chronic kidney disease (CKD). Many studies had demonstrated that CKD is significantly associated with CVD. We aim to indicate the using estimated creatinine clearance (eCrCl), homocysteine (tHcy), and high sensitivity-C-reactive protein (hs-CRP) levels, may have an impact on the interpretation risk for nephropathy and CVD. eCrCl was using the Cockroft-Gault formula, eCrCl levels were stratified acc...

  11. Cultured mast cells from asthmatic patients and controls respond with similar sensitivity to recombinant Der P2 induced, IgE-mediated activation

    Krohn, Inge Jacoba Maria Kortekaas; Sverrild, Asger; Lund, Gitte;

    2013-01-01

    conditions. Mast cells were cultured from peripheral blood from twelve patients with an objectively confirmed asthma diagnosis and eight healthy subjects. During the last 2 weeks of culture, mast cells were incubated with IL-4 and 80 kU/l recombinant human IgE containing two clones (7% + 7%) specific for...... mite allergen Der p2. The sensitivity of IgE-mediated activation of mast cells was investigated as FcεRI-mediated upregulation of CD63. Ten subjects were atopic, defined as a positive skin prick test (>3 mm) to at least one of ten common allergens. After activation with recombinant Der p2, the maximum...

  12. Circulating and in situ lymphocyte subsets and Langerhans cells in patients with compositae oleoresin dermatitis and increased ultraviolet A sensitivity during treatment with azathioprine

    Baadsgaard, O.

    1986-04-01

    Circulating and in situ lymphocyte subsets and Langerhans cells in four patients with compositae oleoresin dermatitis and increased ultraviolet A sensitivity before and during treatment with azathioprine were estimated. It was found that the number of Leu 6+ Langerhans cells decreased during therapy. This decrease was accompanied by a reduction in the number of Leu 2a+, Leu 3a+, Leu 4+, DR+, and Leu M2+ cells in the blood and a reduction in the number of Leu 2a+, Leu 3a+, Leu 4+, and DR+ cells in the skin. Concomitantly with the changes in the number of immunocompetent cells, the eczema cleared.

  13. Circulating and in situ lymphocyte subsets and Langerhans cells in patients with compositae oleoresin dermatitis and increased ultraviolet A sensitivity during treatment with azathioprine

    Circulating and in situ lymphocyte subsets and Langerhans cells in four patients with compositae oleoresin dermatitis and increased ultraviolet A sensitivity before and during treatment with azathioprine were estimated. It was found that the number of Leu 6+ Langerhans cells decreased during therapy. This decrease was accompanied by a reduction in the number of Leu 2a+, Leu 3a+, Leu 4+, DR+, and Leu M2+ cells in the blood and a reduction in the number of Leu 2a+, Leu 3a+, Leu 4+, and DR+ cells in the skin. Concomitantly with the changes in the number of immunocompetent cells, the eczema cleared

  14. Sensitivity and Frequencies of Dystrophin Gene Mutations in Thai DMD/BMD Patients As Detected by Multiplex PCR

    Thanyachai Sura

    2008-01-01

    Full Text Available Background: Duchenne muscular dystrophy (DMD, a lethal X-linked disease affecting 1 in 3500 male births, and its more benign variant, Becker muscular dystrophy (BMD, are caused by mutations in the dystrophin gene. Because of its large size, analysing the whole gene is impractical. Methods have been developed to detect the commonest mutations i.e. the deletions of the exons. Although these tests are highly specific, their sensitivity is inherently limited by the prevalence of deletions, which differs among different populations.

  15. Gamma glutamyltransferase levels and its association with high sensitive C-reactive protein in patients with acute coronary syndromes

    Mehmet Yunus Emiroglu; Özlem Batukan Esen; Mustafa Bulut; Hekim Karapinar; Zekeriya Kaya; Mustafa Akcakoyun; Ramazan Kargin; Soe Moe Aung; Elnur Alızade; Selcuk Pala; Ali Metin Esen

    2010-01-01

    Background: Elevated Gamma-glutamyltransferase (GGT) level is independently correlated with conditions associatedwith increased atherosclerosis, such as obesity, elevated serum cholesterol, high blood pressure and myocardial infarction. It is also demonstrated that serum gamma-glutamyltransferase activity is an independent risk factor for myocardial infarction and cardiac death in patients with coronary artery disease. Although the relationship between gamma-glutamyltransferase and coronary a...

  16. SERUM HIGH SENSITIVE C-REACTIVE PROTEIN AND ANTICARDIOLIPIN ANTIBODY LEVEL IN CAD PATIENTS WITH AND WITHOUT TYPE 2 DIABETES MELLITUS.

    Sachu Philip

    2012-08-01

    Full Text Available The increased incidence of coronary artery disease (CAD in Type 2 Diabetes mellitus is not fully explained by the conventional risk factors. Our aim was to determine the association of biomarkers, high sensitive CRP and anticardiolipin antibody (acL with severity of coronary artery disease in patients with and without type 2 DM. In our study, hsCRP level was significantly high in CAD with DM and found to be positively correlated with severity (p<0.01 while anticardiolipin antibody does not show any significant change among the two groups. Our study concluded that increased risk of CAD in type 2 DM patients is not only because of dyslipidemia but inflammatory events also play a major role. hsCRP was found to be a valuable predictor for CAD in type 2 DM.

  17. FREE-RADICAL OXIDATION ACTIVITY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITHOUT Q WAVE TREATED WITH EPROSARTAN OR ENALAPRIL ADDITIONALLY TO THE BASIC THERAPY

    O. G. Zaylobidinov

    2009-01-01

    Full Text Available Aim. To compare effects of eprosartan and enalapril on free-radical oxidation in patients with acute myocardial infarction (AMI without Q wave.Material and methods. 50 patients (aged 52,8±3,3 y.o. with AMI without Q were involved into the study. Patients were randomized on 2 groups. The first group consisted of 24 patients (51,1±2,4 y.o. which received basic therapy and enalapril (10 mg daily. The second group consisted of 26 patients (53,1±3,0 y.o. which received basic therapy and eprosartan (600 mg daily. Basic therapy included anticoagulants, antiplatelets, beta-blockers, nitrates and statins. Intensity of free-radical oxidation was evaluated by change of serum malonic dialdehyde (MDD concentration. Functional activity of serum enzymes of antioxidatic system (AOS was evaluated by rate of reaction of superoxide dismutase (SOD and catalase (CT.Results. The intensity of free-radical oxidation increased in patients with AMI without Q: high level of MDD and peroxinitrite (ONOO-. Besides activity of AOS enzymes (SOD and CT decreased. Eprosartan reduced intensity of peroxide oxidation more prominently in comparison with enalapril. Both drugs preserved low activity of SOD and CT.Conclusion. Eprosartan was significantly more effective than enalapril in reduction of serum free-radical oxidation in patients with AMI without Q wave during 10 days after hospital admission.

  18. Evaluation of the sensitization rates and identification of IgE-binding components in wild and genetically modified potatoes in patients with allergic disorders

    Kim Seung-Hyun

    2006-07-01

    Full Text Available Abstract Background The potato is one of the most common types of genetically modified (GM food. However, there are no published data evaluating the impact of genetic manipulations on the allergenicity of GM potatoes. To compare the allergenicity of GM potatoes with that of wild-type potatoes using in vivo and in vitro methods in adult allergy patients sensitized to potatoes. Methods A total of 1886 patients with various allergic diseases and 38 healthy controls participated in the study. Skin-prick testing and IgE-ELISA were carried out with extracts prepared from wild-type and GM potatoes. An ELISA inhibition test was used to confirm the binding specificity. IgE-binding components in extracts from the two types of potato were identified by SDS-PAGE and IgE-immunoblotting. The effects of digestive enzymes and heat on the allergenicity of the extracts was evaluated by preincubating the potatoes with or without simulated gastric and intestinal fluids in the absence or presence of heat. Results Positive responses (ratio of the wheal size induced by the allergen to that induced by histamine (A/H ≥ 2+ to wild-type or GM potato extracts, as demonstrated by the skin-prick test, were observed in 108 patients (5.7%. Serum-specific IgE was detected in 0–88% of subjects who tested positively. ELISA inhibition tests indicated significant inhibition when extract from each type of potato was added. IgE-immunoblot analysis demonstrated the presence of 14 IgE-binding components within the wild-type potato and 9 within the GM potato. Furthermore, a common 45-kDa binding component that yielded similar IgE-binding patterns was noted in more than 80% of the reactions using sera from patients sensitized to wild-type or GM potato. Exposure to simulated gastric fluid and heat treatment similarly inhibited IgE binding by extracts from wild-type and GM potatoes, whereas minimal changes were obtained following exposure of the extracts to simulated intestinal fluid

  19. Addition of Arsenic Trioxide into Induction Regimens Could Not Accelerate Recovery of Abnormality of Coagulation and Fibrinolysis in Patients with Acute Promyelocytic Leukemia.

    Ye Zhang

    Full Text Available All-trans retinoic acid combined to anthracycline-based chemotherapy is the standard regimen of acute promyelocytic leukemia. The advent of arsenic trioxide has contributed to improve the anti-leukemic efficacy in acute promyelocytic leukemia. The objectives of the current study were to evaluate if dual induction by all-trans retinoic acid and arsenic trioxide could accelerate the recovery of abnormality of coagulation and fibrinolysis in patients with acute promyelocytic leukemia.Retrospective analysis was performed in 103 newly-diagnosed patients with acute promyelocytic leukemia. Hemostatic variables and the consumption of component blood were comparably analyzed among patients treated by different induction regimen with or without arsenic trioxide.Compared to patients with other subtypes of de novo acute myeloid leukemia, patients with acute promyelocytic leukemia had lower platelet counts and fibrinogen levels, significantly prolonged prothrombin time and elevated D-dimers (P<0.001. Acute promyelocytic leukemia patients with high or intermediate risk prognostic stratification presented lower initial fibrinogen level than that of low-risk group (P<0.05. After induction treatment, abnormal coagulation and fibrinolysis of patients with acute promyelocytic leukemia was significantly improved before day 10. The recovery of abnormal hemostatic variables (platelet, prothrombin time, fibrinogen and D-dimer was not significantly accelerated after adding arsenic trioxide in induction regimens; and the consumption of transfused component blood (platelet and plasma did not dramatically change either. Acute promyelocytic leukemia patients with high or intermediate risk prognostic stratification had higher platelet transfusion demands than that of low-risk group (P<0.05.Unexpectedly, adding arsenic trioxide could not accelerate the recovery of abnormality of coagulation and fibrinolysis in acute promyelocytic leukemia patients who received all

  20. Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection

    Ahmed, Kamran A. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Fulp, William J.; Berglund, Anders E. [Department of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Hoffe, Sarah E.; Dilling, Thomas J. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Eschrich, Steven A. [Department of Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Shridhar, Ravi [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Torres-Roca, Javier F., E-mail: javier.torresroca@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)

    2015-07-15

    Purpose: We previously developed a multigene expression model of tumor radiation sensitivity index (RSI) with clinical validation in multiple independent cohorts (breast, rectal, esophageal, and head and neck patients). The purpose of this study was to assess differences between RSI scores in primary colon cancer and metastases. Methods and Materials: Patients were identified from our institutional review board–approved prospective observational protocol. A total of 704 metastatic and 1362 primary lesions were obtained from a de-identified metadata pool. RSI was calculated using the previously published rank-based algorithm. An independent cohort of 29 lung or liver colon metastases treated with 60 Gy in 5 fractions stereotactic body radiation therapy (SBRT) was used for validation. Results: The most common sites of metastases included liver (n=374; 53%), lung (n=116; 17%), and lymph nodes (n=40; 6%). Sixty percent of metastatic tumors, compared with 54% of primaries, were in the RSI radiation-resistant peak, suggesting metastatic tumors may be slightly more radiation resistant than primaries (P=.01). In contrast, when we analyzed metastases based on anatomical site, we uncovered large differences in RSI. The median RSIs for metastases in descending order of radiation resistance were ovary (0.48), abdomen (0.47), liver (0.43), brain (0.42), lung (0.32), and lymph nodes (0.31) (P<.0001). These findings were confirmed when the analysis was restricted to lesions from the same patient (n=139). In our independent cohort of treated lung and liver metastases, lung metastases had an improved local control rate compared to that in patients with liver metastases (2-year local control rate of 100% vs 73.0%, respectively; P=.026). Conclusions: Assessment of radiation sensitivity between primary and metastatic tissues of colon cancer histology revealed significant differences based on anatomical location of metastases. These initial results warrant validation in a larger

  1. Differences Between Colon Cancer Primaries and Metastases Using a Molecular Assay for Tumor Radiation Sensitivity Suggest Implications for Potential Oligometastatic SBRT Patient Selection

    Purpose: We previously developed a multigene expression model of tumor radiation sensitivity index (RSI) with clinical validation in multiple independent cohorts (breast, rectal, esophageal, and head and neck patients). The purpose of this study was to assess differences between RSI scores in primary colon cancer and metastases. Methods and Materials: Patients were identified from our institutional review board–approved prospective observational protocol. A total of 704 metastatic and 1362 primary lesions were obtained from a de-identified metadata pool. RSI was calculated using the previously published rank-based algorithm. An independent cohort of 29 lung or liver colon metastases treated with 60 Gy in 5 fractions stereotactic body radiation therapy (SBRT) was used for validation. Results: The most common sites of metastases included liver (n=374; 53%), lung (n=116; 17%), and lymph nodes (n=40; 6%). Sixty percent of metastatic tumors, compared with 54% of primaries, were in the RSI radiation-resistant peak, suggesting metastatic tumors may be slightly more radiation resistant than primaries (P=.01). In contrast, when we analyzed metastases based on anatomical site, we uncovered large differences in RSI. The median RSIs for metastases in descending order of radiation resistance were ovary (0.48), abdomen (0.47), liver (0.43), brain (0.42), lung (0.32), and lymph nodes (0.31) (P<.0001). These findings were confirmed when the analysis was restricted to lesions from the same patient (n=139). In our independent cohort of treated lung and liver metastases, lung metastases had an improved local control rate compared to that in patients with liver metastases (2-year local control rate of 100% vs 73.0%, respectively; P=.026). Conclusions: Assessment of radiation sensitivity between primary and metastatic tissues of colon cancer histology revealed significant differences based on anatomical location of metastases. These initial results warrant validation in a larger

  2. Coronary microvascular function, insulin sensitivity and body composition in predicting exercise capacity in overweight patients with coronary artery disease

    Jürs, Anders; Pedersen, Lene Rørholm; Olsen, Rasmus Huan; Snoer, Martin; Chabanova, Elizaveta; Haugaard, Steen Bendix; Prescott, Eva

    2015-01-01

    BACKGROUND: Coronary artery disease (CAD) has a negative impact on exercise capacity. The aim of this study was to determine how coronary microvascular function, glucose metabolism and body composition contribute to exercise capacity in overweight patients with CAD and without diabetes. METHODS......: Sixty-five non-diabetic, overweight patients with stable CAD, BMI 28-40 kg/m(2) and left ventricular ejection fraction (LVEF) above 35 % were recruited. A 3-hour oral glucose tolerance test was used to evaluate glucose metabolism. Peak aerobic exercise capacity (VO2peak) was assessed by a...... cardiopulmonary exercise test. Body composition was determined by whole body dual-energy X-ray absorptiometry scan and magnetic resonance imaging. Coronary flow reserve (CFR) assessed by transthoracic Doppler echocardiography was used as a measure of microvascular function. RESULTS: Median BMI was 31.3 and 72...

  3. Low Sensitivity of Peripheral Blood Smear for Diagnosis of Subclinical Visceral Leishmaniasis in Human Immunodeficiency Virus Type 1-Infected Patients

    Delgado, J.; Pineda, J. A.; Macías, J.; Regordán, C.; Gallardo, J. A.; Leal, M.; Sanchez-Quijano, A.; Lissen, E.

    1998-01-01

    The peripheral blood smear is an easy method for the diagnosis of symptomatic visceral leishmaniasis (VL) in human immunodeficiency virus type 1 (HIV-1)-infected patients. However, its efficiency in diagnosing subclinical VL remains unknown. In this study, Leishmania amastigotes were seen in blood smears from 1 of 13 HIV-1-positive individuals with subclinical VL. This shows that this procedure is not suitable for subclinical-VL diagnosis.

  4. Pollen aero allergens and the climate in mediterranean region and allergen sensitivity in allergic rhinoconjunctivitis and allergic asthma patients

    Yalcin, Arzu Didem; Basaran, Saime; Bisgin, Atil; Polat, Hasan Huseyin; Gorczynski, Reginald M.

    2013-01-01

    Background We evaluated the profiles of allergic rhino-conjunctivitis and asthma patients annually in Antalya, a Mediterranean coastal city in Turkey. Material/Methods We evaluated patients’ allergic clinical status, and recorded the climate and pollens in the city center air, investigating any correlation between pollination, climatic conditions and allergic disorders. The meteorological conditions and the pollen count/cm2 during every month of the year and the concordance of this with the p...

  5. Different types of additional somatosensory information do not promote immediate benefits on gait in patients with Parkinson's disease and older adults

    Ellen Lirani-Silva

    2015-09-01

    Full Text Available AbstractPlantar cutaneous stimulation has been shown to improve gait in Parkinson's disease (PD, but the effects of different types of insoles have not been tested. We evaluated the immediate effect of different types of insoles on gait in PD patients and healthy older adults. Nineteen PD patients and nineteen healthy older adults performed and performed a walking task at their self-selected speed in three conditions: conventional insole, insole with a raised ridge around the foot perimeter, and insole with half-spheres. Plantar sensation was evaluated before and after the walking protocol. There were no differences between groups for plantar sensation before and after the walking task. PD patients demonstrated reduced stride length and stride velocity. There were no immediate benefits offered by the insoles on gait of either group. The increased plantar cutaneous stimulation does not promote immediate benefits on gait in PD patients and healthy older adults.

  6. Prediction of morbidity and mortality in middle and old aged surgical patients-comparison of standard scoring system and addition of echocardiography with hemodynamic indices

    Amit K. Singh

    2015-10-01

    Conclusions: In conclusion preoperative TTE before non-cardiac surgery can predict the risk of perioperative cardiac complications in known or suspected cases of cardiac disease patients. [Int J Res Med Sci 2015; 3(10.000: 2543-2548

  7. DNA double strand breaks in fibroblast cell lines from non-Hodgkin's lymphoma patients showing increased sensitivity to chronic gamma irradiation

    Cultured skin fibroblast cell lines from two non-Hodgkin's lymphoma patients (NHL) and a normal subject were studied for cell killing, chromosomal aberrations (breaks, translocations, dicentrics and rings) and DNA double strand breaks (dsbs) following chronic gamma irradiation. Compared to the cell line from the normal donor, the NHL patients' fibroblasts showed enhanced radiosensitivity for both cell survival and chromosomal aberrations. While spontaneous breaks were observed in both normal and patients' cells, spontaneous translocations and radiation-induced dicentrics and rings were found only in the latter. Radiation-induced DNA double-strand breaks (dsb) were determined by CHEF electrophoresis. After chronic irradiation with gamma rays the fraction of residual dsb was significantly increased from 1.4% in controls to 1.9% in the NHL cell lines. These data, thus suggest that the cellular and chromosomal sensitivity to chronic irradiation observed in NHL patients may be due to a deficiency in the repair of a small fraction of DNA double strand breaks. (author)

  8. Calculation of Absorbed Dose in Target Tissue and Equivalent Dose in Sensitive Tissues of Patients Treated by BNCT Using MCNP4C

    Zamani, M.; Kasesaz, Y.; Khalafi, H.; Pooya, S. M. Hosseini

    Boron Neutron Capture Therapy (BNCT) is used for treatment of many diseases, including brain tumors, in many medical centers. In this method, a target area (e.g., head of patient) is irradiated by some optimized and suitable neutron fields such as research nuclear reactors. Aiming at protection of healthy tissues which are located in the vicinity of irradiated tissue, and based on the ALARA principle, it is required to prevent unnecessary exposure of these vital organs. In this study, by using numerical simulation method (MCNP4C Code), the absorbed dose in target tissue and the equiavalent dose in different sensitive tissues of a patiant treated by BNCT, are calculated. For this purpose, we have used the parameters of MIRD Standard Phantom. Equiavelent dose in 11 sensitive organs, located in the vicinity of target, and total equivalent dose in whole body, have been calculated. The results show that the absorbed dose in tumor and normal tissue of brain equal to 30.35 Gy and 0.19 Gy, respectively. Also, total equivalent dose in 11 sensitive organs, other than tumor and normal tissue of brain, is equal to 14 mGy. The maximum equivalent doses in organs, other than brain and tumor, appear to the tissues of lungs and thyroid and are equal to 7.35 mSv and 3.00 mSv, respectively.

  9. Changes in cerebral blood flow during olfactory stimulation in patients with multiple chemical sensitivity: a multi-channel near-infrared spectroscopic study.

    Kenichi Azuma

    Full Text Available Multiple chemical sensitivity (MCS is characterized by somatic distress upon exposure to odors. Patients with MCS process odors differently from controls. This odor-processing may be associated with activation in the prefrontal area connecting to the anterior cingulate cortex, which has been suggested as an area of odorant-related activation in MCS patients. In this study, activation was defined as a significant increase in regional cerebral blood flow (rCBF because of odorant stimulation. Using the well-designed card-type olfactory test kit, changes in rCBF in the prefrontal cortex (PFC were investigated after olfactory stimulation with several different odorants. Near-infrared spectroscopic (NIRS imaging was performed in 12 MCS patients and 11 controls. The olfactory stimulation test was continuously repeated 10 times. The study also included subjective assessment of physical and psychological status and the perception of irritating and hedonic odors. Significant changes in rCBF were observed in the PFC of MCS patients on both the right and left sides, as distinct from the center of the PFC, compared with controls. MCS patients adequately distinguished the non-odorant in 10 odor repetitions during the early stage of the olfactory stimulation test, but not in the late stage. In comparison to controls, autonomic perception and negative affectivity were poorer in MCS patients. These results suggest that prefrontal information processing associated with odor-processing neuronal circuits and memory and cognition processes from past experience of chemical exposure play significant roles in the pathology of this disorder.

  10. Cytoreductive Surgery and Intraperitoneal Chemotherapy in Patients with Peritoneal Metastases from Colorectal Cancer : Aspects of loco-regional treatment outcome, patient selection, and chemo-sensitivity

    Cashin, Peter H.

    2012-01-01

    Previously, peritoneal metastases(PM) from colorectal cancer(CRC) have been considered a terminal and generalised form of cancer. A new treatment strategy combining cytoreductive surgery(CRS) and intraperitoneal chemotherapy(IPC) has recently shown promising results. The aim of this thesis was to investigate different aspects of this treatment in order to optimise the treatment and to clarify its potential as a new treatment option. Treatment outcome, patient selection, method of IPC (hyperth...

  11. A 3-Arm, Randomized, Controlled Trial of Heat-Sensitive Moxibustion Therapy to Determine Superior Effect among Patients with Lumbar Disc Herniation

    Rixin Chen

    2014-01-01

    Full Text Available Systematic reviews of moxibustion for LDH have identified ponderable evidence, especially for heat-sensitive moxibustion (HSM. Therefore, we designed and carried out the large sample trial to evaluate it. 456 patients were recruited from 4 centers in China and were randomly divided into three groups by the ratio of 1 : 1 : 1 to HSM (152 group, conventional moxibustion (152 group, and conventional drug plus acupuncture (152 group. Compared with usual care, there was a statistically significant reduction in mean M-JOA score at 2 weeks and 6 months for HSM (3.8 ± 2.6 versus 8.5 ± 2.9; 3.7 ± 2.2 versus 10.1 ± 2.9 and conventional moxibustion (7.9 ± 3.0 versus 8.5 ± 2.9; 8.9 ± 3.1 versus 10.1 ± 2.9. Compared with conventional moxibustion group, HSM group showed greater improvement in all the outcomes. The mean dose of moxibustion was 41.13 ± 5.26 (range 21–60 minutes in the HSM group. We found that HSM was more effective in treating patients with LDH, compared with conventional moxibustion and conventional drug plus acupuncture. This finding indicated that the application of moxibustion on the heat-sensitive points is a good moxibustion technique in treating disease.

  12. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik; Holmstrup, Palle; Helqvist, Steffen; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25–125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon. PMID:26695491

  13. A Patient Suffering from Hypokalemic Periodic Paralysis Is Deficient in Skeletal Muscle ATP-sensitive K+ channels

    Jovanović, Sofija; Du, Qingyou; Mukhopadhyay, Somnath; Swingler, Robert; Buckley, Richard; McEachen, Jane; Jovanović, Aleksandar

    2008-01-01

    Hypokalemic periodic paralysis (HOPP) is a rare disease associated with attacks of muscle weakness and hypokalemia. In the present study, immunoprecipitation/Western blotting has shown that a HOPP patient was deficient in sarcolemmal KATP channels. Real-time RT-PCR has revealed that HOPP has decreased mRNA levels of Kir6.2, a pore-forming KATP channel subunit, without affecting the expression of other KATP channel-forming proteins. Based on these findings, we conclude that HOPP could be assoc...

  14. Efficient bifacial dye-sensitized solar cells through disorder by design† †Electronic supplementary information (ESI) available. See DOI: 10.1039/c5ta10091g Click here for additional data file.

    Miranda-Muñoz, José M.; Carretero-Palacios, Sol; Jiménez-Solano, Alberto; Li, Yuelong; Lozano, Gabriel; Míguez, Hernán

    2016-01-01

    Herein we realize an optical design that optimizes the performance of bifacial solar cells by incorporating spherical TiO2 nanoparticles of controlled size and load integrated in the working electrodes of dye-sensitized solar cells without modifying any of the usually employed components.

  15. High sensitivity of the in vivo detection of somatostatin receptors by 111Indium (DTPA-Octreotide)-scintigraphy in meningioma patients

    The recent availability of isotope-labelled somatostatin analogues has allowed one to detect somatostatin receptors in normal tissue as well as in endocrine or non-endocrine cranial tumours. The purpose of the present study was to establish the value of somatostatin receptor scintigraphy using an 111indium-labelled somatostatin analogue, octreotide, in the diagnostic work-up of meningioma patients. Twenty-two patients (16 women, 6 men, aged from 19-70 years) with newly diagnosed, residual or recurrent cranial meningiomas were examined. 111indium-labelled DTPA-octreotide was injected i.v.. Planar and tomographic images were obtained with a gamma camera 4-6, and 24 hours after injection. In all of the meningiomas studies a high density of somatostatin receptor was detected by scintigraphy. No false negative test result was found. Due to this, a 100% predictive value of a negative test was calculated. However, when the tumours were taken in culture differing staining intensity could be seen in the light- and electron microscopic level even on individual cells of a single culture when silver intensified somatostatin-gold was used as ligand. We conclude, that in vivo somatostatin receptor scintigraphy may aid in the pre-operative differential diagnosis of skull base tumours

  16. Benefits of a new Metropolis-Hasting based algorithm, in non-linear regression for estimation of ex vivo antimalarial sensitivity in patients infected with two strains.

    Bauer, Rebecca; Mentré, France; Kaddouri, Halima; Le Bras, Jacques; Le Nagard, Hervé

    2014-12-01

    Malaria is one of the world׳s most widespread parasitic diseases. The parasitic protozoans of the genus Plasmodium have developed resistance to several antimalarial drugs. Some patients are therefore infected by two or more strains with different levels of antimalarial drug sensitivity. We previously developed a model to estimate the drug concentration (IC50) that inhibits 50% of the growth of the parasite isolated from a patient infected with one strain. We propose here a new Two-Slopes model for patients infected by two strains. This model involves four parameters: the proportion of each strain and their IC50, and the sigmoidicity parameter. To estimate the parameters of this model, we have developed a new algorithm called PGBO (Population Genetics-Based Optimizer). It is based on the Metropolis-Hasting algorithm and is implemented in the statistical software R. We performed a simulation study and defined three evaluation criteria to evaluate its properties and compare it with three other algorithms (Gauss-Newton, Levenberg-Marquardt, and a simulated annealing). We also evaluated it using in vitro data and three ex vivo datasets from the French Malaria Reference Center. Our evaluation criteria in the simulation show that PGBO gives good estimates of the parameters even if the concentration design is poor. Moreover, our algorithm is less sensitive than Gauss-Newton algorithms to initial values. Although parameter estimation is good, interpretation of the results can be difficult if the proportion of the second strain is close to 0 or 1. For these reasons, this approach cannot yet be implemented routinely. PMID:25450214

  17. Commentary: Effects of exam room EHR use on doctor-patient communication: a systematic literature review – triadic and other key terms may have identified additional literature

    Christopher Martin Pearce

    2014-01-01

    Full Text Available Kazmi’s systemic review concludes on the positive influence of the computer use on the biomedical aspect of the consultation interaction, and the adverse effect on the psychosocial dimension. It broaches concerns about the availability of high-quality studies focusing on the doctor–patient interactions. However, there are visible limitations associated with the search strategy employed, which indeed can be considered as a common challenge for reviews in this field of interaction research involving doctor, patient, and computer.

  18. Efficacy and safety assessment of the addition of bevacizumab to adjuvant therapy agents in cancer patients: A systematic review and meta-analysis of randomized controlled trials

    Ahmadizar, Fariba; Onland-Moret, N. Charlotte; De Boer, Anthonius; Liu, Geoffrey; Maitland-Van Der Zee, Anke H.

    2015-01-01

    Aim: To evaluate the efficacy and safety of bevacizumab in the adjuvant cancer therapy setting within different subset of patients. Methods & Design/Results: PubMed, EMBASE, Cochrane and Clinical trials.gov databases were searched for English language studies of randomized controlled trials comparin

  19. Addition of sitagliptin or metformin to insulin monotherapy improves blood glucose control via different effects on insulin and glucagon secretion in hyperglycemic Japanese patients with type 2 diabetes.

    Otsuka, Yuichiro; Yamaguchi, Suguru; Furukawa, Asami; Kosuda, Minami; Nakazaki, Mitsuhiro; Ishihara, Hisamitsu

    2015-01-01

    This study aimed to explore the effects of the dipeptidyl peptidase-4 inhibitor sitagliptin and the biguanide metformin on the secretion of insulin and glucagon, as well as incretin levels, in Japanese subjects with type 2 diabetes mellitus poorly controlled with insulin monotherapy. This was a single-center, randomized, open-label, parallel group study, enrolling 25 subjects. Eleven patients (hemoglobin A1c [HbA1c] 8.40 ± 0.96%) and 10 patients (8.10 ± 0.54%) on insulin monotherapy completed 12-week treatment with sitagliptin (50 mg) and metformin (750 mg), respectively. Before and after treatment, each subject underwent a meal tolerance test. The plasma glucose, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), C-peptide, and glucagon responses to a meal challenge were measured. HbA1c reductions were similar in patients treated with sitagliptin (0.76 ± 0.18%) and metformin (0.77 ± 0.17%). In the sitagliptin group, glucose excursion during a meal tolerance test was reduced and accompanied by elevations in active GLP-1 and active GIP concentrations. C-peptide levels were unaltered despite reduced glucose responses, while glucagon responses were significantly suppressed (-7.93 ± 1.95% of baseline). In the metformin group, glucose excursion and incretin responses were unaltered. C-peptide levels were slightly increased but glucagon responses were unchanged. Our data indicate that sitagliptin and metformin exert different effects on islet hormone secretion in Japanese type 2 diabetic patients on insulin monotherapy. A glucagon suppressing effect of sitagliptin could be one of the factors improving blood glucose control in patients inadequately controlled with insulin therapy. PMID:25328079

  20. Are Brain Natriuretic Peptide Levels, High-sensitivity Troponin T Assay and Certain Left Atrial Echocardiographic Parameters Useful in the Evaluation of Patients with Permanent Pacemakers?

    Janusz Sielski

    2014-09-01

    Full Text Available Background: The present study was undertaken to evaluate the practical value of BNP measurements, high-sensitivity troponinT (TnT hs assay and echocardiographic left ventricular volume index (LAVI in patients with permanent pacemakers, as there are no such reports in the literature. Methods and Results: BNP measurements were performed on venous blood samples using the Triage meters. The “sandwich” test was used to assess TnT hs assay. The Simpson method and the ellipse method were used to assess the left atrium on echocardiography. In the group II BNP levels, TnT hs levels increased. LAVI decreased. The probability of survival was higher in patients with low BNP before implantation. Conclusions: 1. Measurements of BNP, TnT hs and LAVI provide new information regarding cardiovascular changes after pacemaker implantation and contribute to improvement of post-implant checkups. 2. Measurements of BNP, TnT hs and LAVI in patients with permanent pacemakers facilitate the assessment of survival and cardiovascular hospitalisation rate.

  1. Addition of docetaxel or bisphosphonates to standard of care in men with localised or metastatic, hormone-sensitive prostate cancer: a systematic review and meta-analyses of aggregate data

    Vale, C.L.; Burdett, S; Rydzewska, L. H.; Albiges, L; Clarke, N W; Fisher, D; Fizazi, K; Gravis, G.; James, N. D.; Mason, M D; Parmar, M. K.; Sweeney, C. J.; Sydes, M. R.; Tombal, B.; Tierney, J. F.

    2016-01-01

    Summary Background Results from large randomised controlled trials combining docetaxel or bisphosphonates with standard of care in hormone-sensitive prostate cancer have emerged. In order to investigate the effects of these therapies and to respond to emerging evidence, we aimed to systematically review all relevant trials using a framework for adaptive meta-analysis. Methods For this systematic review and meta-analysis, we searched MEDLINE, Embase, LILACS, and the Cochrane Central Register o...

  2. Gluten Sensitivity.

    Catassi, Carlo

    2015-01-01

    Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food in subjects who are not affected by either celiac disease (CD) or wheat allergy (WA). The prevalence of NCGS is not clearly defined yet. Indirect evidence suggests that NCGS is slightly more common than CD, the latter affecting around 1% of the general population. NCGS has been mostly described in adults, particularly in females in the age group of 30-50 years; however, pediatric case series have also been reported. Since NCGS may be transient, gluten tolerance needs to be reassessed over time in patients with NCGS. NCGS is characterized by symptoms that usually occur soon after gluten ingestion, disappear with gluten withdrawal, and relapse following gluten challenge within hours/days. The 'classical' presentation of NCGS is a combination of irritable bowel syndrome-like symptoms, including abdominal pain, bloating, bowel habit abnormalities (either diarrhea or constipation), and systemic manifestations such as 'foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia. In recent years, several studies explored the relationship between the ingestion of gluten-containing food and the appearance of neurological and psychiatric disorders/symptoms like ataxia, peripheral neuropathy, schizophrenia, autism, depression, anxiety, and hallucinations (so-called gluten psychosis). The diagnosis of NCGS should be considered in patients with persistent intestinal and/or extraintestinal complaints showing a normal result of the CD and WA serological markers on a gluten-containing diet, usually reporting worsening of symptoms after eating gluten-rich food. NCGS should not be an exclusion diagnosis only. Unfortunately, no biomarker is sensitive and specific enough for diagnostic purposes; therefore, the diagnosis of NCGS is currently based on

  3. The value of the MDR1 reversal agent PSC-833 in addition to daunorubicin and cytarabine in the treatment of elderly patients with previously untreated acute myeloid leukemia (AML), in relation to MDR1 status at diagnosis

    van der Holt, B; Lowenberg, B; Burnett, AK; Knauf, WU; Shepherd, J; Piccaluga, PP; Ossenkoppele, GJ; Verhoef, GEG; Ferrant, A; Crump, M; Selleslag, D; Theobald, M; Fey, MF; Vellenga, E; Dugan, M; Sonneveld, P

    2005-01-01

    To determine whether MDR1 reversal by the addition of the P-glycoprotein (P-gp) inhibitor PSC-833 to standard induction chemotherapy would improve event-free survival (EFS), 419 untreated patients with acute myeloid leukemia (AML) aged 60 years and older were randomized to receive 2 induction cycles

  4. Effect of intravenous ondansetron on QT interval prolongation in patients with cardiovascular disease and additional risk factors for torsades: a prospective, observational study

    Hafermann MJ

    2011-10-01

    Full Text Available Matthew J Hafermann1, Rocsanna Namdar2, Gretchen E Seibold2,3, Robert Lee Page 2nd2,31University of Washington Medical Center, Department of Pharmacy, Seattle, WA; 2University of Colorado Anschutz Medical Campus, School of Pharmacy, Aurora, CO; 3University of Colorado Hospital, Department of Pharmacy, Aurora, CO USABackground: The 5-hydroxytryptamine type 3 antagonists, or setrons (eg, ondansetron, are commonly used for nausea and vomiting in the hospital setting. In 2001, droperidol was given a black box warning because it was found to prolong the QT interval and induce arrhythmias. The setrons share with droperidol the same potential proarrhythmic mechanisms, but limited data exist concerning their effects on the QT interval in individuals at high risk for torsades de pointes.Methods: Forty hospitalized patients admitted for heart failure or acute coronary syndromes with one or more risk factors for torsades de pointes and an order for intravenous ondansetron 4 mg were enrolled in this prospective, observational study. The QT interval corrected for heart rate (QTc was obtained via a 12-lead electrocardiogram on admission and again 120 minutes after the first dose of ondansetron in order to determine the mean change in QTc following ondansetron exposure.Results: The mean time interval between obtaining the baseline electrocardiogram and the second electrocardiogram following ondansetron administration was 3.5 ± 2.14 hours. In the total population, the QTc interval was prolonged by 19.3 ± 18 msec (P < 0.0001 120 minutes after ondansetron administration. For patients with an acute coronary syndrome and those with heart failure, QTc was prolonged by 18.3 ± 20 msec (P < 0.0001 and 20.6 ± 20 msec (P < 0.0012, respectively. Following ondansetron exposure, 31% and 46% in the heart failure and acute coronary syndromes groups, respectively, met gender-related thresholds for a prolonged QTc.Conclusion: Our study found QTc prolongation due to

  5. Analysis of drug sensitivity of candida to antifungal drugs in 152 infected patients%152例临床念珠菌感染药敏分析

    奚琳琳; 张群智; 李芳芹

    2011-01-01

    目的 了解医院念珠菌感染药敏情况,为临床合理用药提供实验依据.方法 从临床标本中分离培养念珠菌,进行鉴定和药敏试验.结果 1 538份临床标本中分离出念珠菌152株(9.88%);其中,白色念珠菌111株(73.03%),克柔氏念珠菌31例(20.39%),其他10(6.58%).白色念珠菌时常用抗真菌药物敏感性均较高(伊曲康唑除外),而克柔氏念珠菌则对常用抗真菌药物均有较高的敏感率.结论 白色念珠菌和克柔氏念珠菌对临床一线抗真菌药氟康哇存在耐药株,应重视对高危人群进行微生物学检测和药敏试验.%Aim To investigate drug sensitivity of candida to antibiotics in patients with candida infection.Methods Candida were isolated and cultured from clinical 152 and drug sensitivity of candida to antifungal was conducted and the results were analyzed.Results A total of 152 (9.88%)candida strains were isolated from 1 538 samples,including 111 (73.03%)Candida albicans and 31 (20.39%)Candida krusei.Candida albicans showed higher sensitive rates to conventional antifungal drugs except itraconazole.However,Candida krusei showed higher sensitive rates to antifungal agents.Conclusion Candida albicans and Candida krusei showed resistances to clinical first-line antffuangal drugs such as fluconazole.Thus srug sensitivity tests be carried out to guide clinical treatment of the infections

  6. Disorganized behavior on Link’s cube test is sensitive to right hemispheric frontal lobe damage in stroke patients

    Bruno Kopp

    2014-02-01

    Full Text Available One of Luria’s favorite neuropsychological tasks for challenging frontal lobe functions was Link’s cube test (LCT. The LCT is a cube construction task in which the subject must assemble twenty-seven small cubes into one large cube in such a manner that only the painted surfaces of the small cubes are visible. We computed two new LCT composite scores, the constructive plan composite score, reflecting the capability to envisage a cubical-shaped volume, and the behavioral (dis- organization composite score, reflecting the goal-directedness of cube construction. Voxel-based lesion-behavior mapping (VLBM was used to test the relationship between performance on the LCT and brain injury in a sample of stroke patients with right hemisphere damage (N = 32, concentrated in the frontal lobe. We observed a relationship between the measure of behavioral (dis- organization on the LCT and right frontal lesions. Further work in a larger sample, including left frontal lobe damage and with more power to detect effects of right posterior brain injury, is necessary to determine whether this observation is specific for right frontal lesions.

  7. Combined parecoxib and I.V. paracetamol provides additional analgesic effect with better postoperative satisfaction in patients undergoing anterior cruciate ligament reconstruction

    Zeinab Ahmed Elseify; Salwa Omar El-Khattab; Ahmed Metwally Khattab; Eman Mohammed Atta; Layal Fares Ajjoub

    2011-01-01

    Background : Adequacy of postoperative analgesia is one of the most important factors that determine early hospital discharge and patients′ ability to resume their normal activities postoperatively. The optimal non-opioid analgesic technique for postoperative pain management would reduce pain and enhance patient satisfaction, and it also facilitates earlier mobilization and rehabilitation by reducing pain-related complications after surgery. The aim of this study was to evaluate the analgesic...

  8. Additive effect of in-hospital TIMI bleeding and chronic kidney disease on 1-year cardiovascular events in patients with acute coronary syndrome

    Lin, Tsung-Hsien; Lai, Wen-Ter; Kuo, Chi-Tai; Hwang, Juey-Jen; Chiang, Fu-Tien; Chang, Shu-Chen; Chang, Chee-Jen

    2014-01-01

    In-hospital bleeding (IHB) is associated with the risk of subsequent cardiovascular events (CVE) in acute coronary syndrome (ACS). We investigated whether increased risk of CVE by IHB is influenced by chronic kidney disease (CKD) or both have detrimental effects on CVE. In a Taiwan national-wide registry, 2819 ACS patients were enrolled. CKD is defined as an estimated glomerular filtration rate of

  9. Addition of a fixed combination of brinzolamide 1%/timolol 0.5% to prostaglandin monotherapy in patients with glaucoma or ocular hypertension

    Lorenz K; Rosbach K; Matt A; Pfeiffer N

    2011-01-01

    Katrin Lorenz1, Klaus Rosbach2, Andreas Matt3, Norbert Pfeiffer11University Medical Center, Johannes Gutenberg-Universität Mainz, Mainz, Germany; 2Private practice, Mainz, Germany; 3Private practice, Köln-Hohenhaus, GermanyBackground: This study was conducted to evaluate the safety and efficacy of adding a fixed combination of brinzolamide 1%/timolol 0.5% to prostaglandin analog (PGA) monotherapy in patients with primary open-angle glaucoma, pigment dispersion glaucoma, or o...

  10. Peptide p5 binds both heparinase-sensitive glycosaminoglycans and fibrils in patient-derived AL amyloid extracts

    Highlights: •Polybasic peptide p5 binds human light chain amyloid extracts. •The binding of p5 with amyloid involves both glycosaminoglycans and fibrils. •Heparinase treatment led to a correlation between p5 binding and fibril content. •p5 binding to AL amyloid requires electrostatic interactions. -- Abstract: In previously published work, we have described heparin-binding synthetic peptides that preferentially recognize amyloid deposits in a mouse model of reactive systemic (AA) amyloidosis and can be imaged by using positron and single photon emission tomographic imaging. We wanted to extend these findings to the most common form of visceral amyloidosis, namely light chain (AL); however, there are no robust experimental animal models of AL amyloidosis. To further define the binding of the lead peptide, p5, to AL amyloid, we characterized the reactivity in vitro of p5 with in situ and patient-derived AL amyloid extracts which contain both hypersulfated heparan sulfate proteoglycans as well as amyloid fibrils. Histochemical staining demonstrated that the peptide specifically localized with tissue-associated AL amyloid deposits. Although we anticipated that p5 would undergo electrostatic interactions with the amyloid-associated glycosaminoglycans expressing heparin-like side chains, no significant correlation between peptide binding and glycosaminoglycan content within amyloid extracts was observed. In contrast, following heparinase I treatment, although overall binding was reduced, a positive correlation between peptide binding and amyloid fibril content became evident. This interaction was further confirmed using synthetic light chain fibrils that contain no carbohydrates. These data suggest that p5 can bind to both the sulfated glycosaminoglycans and protein fibril components of AL amyloid. Understanding these complex electrostatic interactions will aid in the optimization of synthetic peptides for use as amyloid imaging agents and potentially as

  11. Combined measurement of copeptin, high-sensitivity troponin T, and N-terminal proBNP improves the identification of patients at risk of cardiovascular death

    Alehagen, Urban; Dahlström, Ulf; Carstensen, John;

    2012-01-01

    Objectives: A multimarker strategy for the handling of patients with heart failure has been suggested in the literature. Therefore, the potential prognostic relevance of combined copeptin, high-sensitivity troponin T (HS-TnT), and N-terminal proBNP (NT-proBNP) measurement in plasma from elderly...... and all mortality was registered. Cardiovascular mortality was evaluated using Kaplan–Meier plots and multivariate Cox proportional hazard regression analyses. Results: Copeptin, HS-TnT, and NT-proBNP measurements provided independent prognostic information in a multivariate setting over 5 years......-up period). In the 13-year follow-up, combined copeptin and HS-TnT measurement did not provide independent prognostic information. Conclusion: Combined copeptin, HS-TnT, and NT-proBNP plasma measurements provide prognostic information on cardiovascular mortality that is superior to single biomarker use....

  12. Bacteroides forsythus: sensibilidade a antimicrobianos em amostras de pacientes portadores de periodontite Bacteroides forsythus: sensitivity to antimicrobial agents in samples from patients with periodontitis

    Roberto Fraga Moreira LOTUFO

    2001-03-01

    Full Text Available Os autores realizaram teste de sensibilidade antimicrobiana in vitro (técnica de diluição em ágar para 105 cepas de B. forsythus obtidas de pacientes portadores de periodontite. De acordo com o teste realizado, o microrganismo demonstrou ser sensível ao metronidazol (100% das cepas testadas e à amoxicilina (94% das cepas testadas, enquanto 72% e 65% das cepas foram susceptíveis à tetraciclina e ciprofloxacina, respectivamente. O metronidazol e a amoxicilina parecem ser os antimicrobianos indicados para o tratamento de infecções periodontais nas quais B. forsythus seja o patógeno predominante.An in vitro antimicrobial sensitivity test (technique of agar dilution was carried out for 105 clinical isolates of B. forsythus from patients with periodontitis. Metronidazole and amoxicillin were the most efficient drugs and, thus, are indicated for the treatment of periodontal infections in which this microorganism is the most prevalent pathogen.

  13. The effects of diet- and RYGB-induced weight loss on insulin sensitivity in obese patients with and without type 2 diabetes

    Hansen, Merethe; Lund, Michael Taulo; Jørgensen, Anne Line Kjærholm;

    2016-01-01

    AIMS: The impact of diet-induced weight loss and weight loss due to RYGB in patients with (T2DM, N = 16) and without (OB, N = 27) type 2 diabetes was studied. METHODS: At inclusion (A), after diet-induced weight loss (B), 4 months post-surgery (C) and 18 months post-surgery (D) body composition...... approximately one-third of the total improvement in GIR in T2DM was observed after the diet-induced weight loss of only ~6 kg (B). Insulin clearance, visceral fat and fasting plasma insulin also improved significantly after the diet (P < 0.05). Throughout the study, HGP, GLUT4 and glycogen content did not...... change significantly, but IMTG decreased significantly consistent with significant increases in GIR. Metabolic flexibility and hepatic insulin sensitivity improved after RYGB. CONCLUSIONS: Metabolic improvements of RYGB are present already after the diet-induced weight loss prior to surgery. GLUT4...

  14. Short term effects of rosuvastation on plasma concentration of high sensitivity c-reactive protein in patients with chronic stable angina

    Objective: To determine the short term effects of rosuvastatin on elevated base line high-sensitivity C-reactive protein (hs-CRP) in patients with chronic stable angina. Methodology: This Quasi-experimental comparative study was conducted in Cardiology department, Lady Reading Hospital Peshawar, between March 2010 and February, 2011. We selected 44 consecutive patients age 40 years or above, of any gender having hs-CRP levels = 1.2 mg/l with chronic stable angina. Base line levels of hs-CRP, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and creatine phosphokinase (CPK) were measured in fasting status. These patients were treated with rosuvastatin 20 mg once daily at night and followed up for one month. Using SPSS version 16 data was analyzed. Results: Mean age was 53 +- 7.2 and 50% were females. Following treatment with rosuvastatin 20 mg for one month the mean hs-CRP levels reduced from 4.08+-2.56 to 2.72 +- 2.40 (95 % CI, 0.41 to 2.29, p=0.006). Similarly mean total cholesterol levels decreased from 185.88 +- 37.62 to 147.45 +- 38.35, (p=0.0001). LDL cholesterol decreased from 118.34 +- 31.31 to 86.63 +-35.72 (p= 0.0001). But mean HDL cholesterol had no significant increase from baseline levels i.e. from 32.18+- 9.93 to 33.95 +-7.65 (p=0.174). TGs levels reduced from 240.11 +- 123.66 to 197.43 +- 88.24 (p=0.008). Mean CPK levels did not differ significantly from base line at follow up, from 101.43 +-58.63 to 96.22 +- 55.10 (p=0.646). Conclusion: Short term treatment with rosuvastatin significantly decreases elevated hs-CRP levels in patients with chronic stable angina. (author)

  15. The DISC (Diabetes in Social Context Study-evaluation of a culturally sensitive social network intervention for diabetic patients in lower socioeconomic groups: a study protocol

    Vissenberg Charlotte

    2012-03-01

    Full Text Available Abstract Background Compared to those in higher socioeconomic groups, diabetic patients in lower socioeconomic groups have less favourable metabolic control and experience more diabetes-related complications. They encounter specific barriers that hinder optimal diabetes self-management, including a lack of social support and other psychosocial mechanisms in their immediate social environments. Powerful Together with Diabetes is a culturally sensitive social network intervention specifically targeted to ethnic Dutch, Moroccan, Turkish, and Surinamese diabetic patients in lower socioeconomic groups. For ten months, patients will participate in peer support groups in which they will share experiences, support each other in maintaining healthy lifestyles, and learn skills to resist social pressure. At the same time, their significant others will also receive an intervention, aimed at maximizing support for and minimizing the negative social influences on diabetes self-management. This study aims to test the effectiveness of Powerful Together with Diabetes. Methods/Design We will use a quasi-experimental design with an intervention group (Group 1 and two comparison groups (Groups 2 and 3, N = 128 in each group. Group 1 will receive Powerful Together with Diabetes. Group 2 will receive Know your Sugar, a six-week group intervention that does not focus on the participants' social environments. Group 3 receives standard care only. Participants in Groups 1 and 2 will be interviewed and physically examined at baseline, 3, 10, and 16 months. We will compare their haemoglobin A1C levels with the haemoglobin A1C levels of Group 3. Main outcome measures are haemoglobin A1C, diabetes-related quality of life, diabetes self-management, health-related, and intermediate outcome measures. We will conduct a process evaluation and a qualitative study to gain more insights into the intervention fidelity, feasibility, and changes in the psychosocial mechanism in the

  16. A randomized phase II study of carboplatin plus pegylated liposomal doxorubicin versus carboplatin plus paclitaxel in platinum sensitive ovarian cancer patients: a Hellenic Cooperative Oncology Group study

    Briasoulis Evangelos

    2010-01-01

    Full Text Available Abstract Background Platinum-based combinations are the standard second-line treatment for platinum-sensitive ovarian cancer (OC. This randomized phase II study was undertaken in order to compare the combination of carboplatin and pegylated liposomal doxorubicin (LD with carboplatin and paclitaxel (CP in this setting. Methods Patients with histologically confirmed recurrent OC, at the time of or more than 6 months after platinum-based chemotherapy, were randomized to six cycles of CP (carboplatin AUC5 + paclitaxel 175 mg/m2, d1q21 or CLD (carboplatin AUC5 + pegylated LD 45 mg/m2, d1q28. Results A total of 189 eligible patients (CP 96, CLD 93, with a median age of 63 years, median Performance Status (PS 0 and a median platinum free interval (PFI of 16.5 months, entered the study. Discontinuation due to toxicity was higher in the CP patients (13.5% versus 3%, P = 0.016. The overall response rate was similar: CP 58% versus CLD 51%, P = 0.309 (Complete Response; CR 34% versus 23% and there was no statistical difference in time-to-progression (TTP or overall survival (OS; TTP 10.8 months CP versus 11.8 CLD, P = 0.904; OS 29.4 months CP versus 24.7 CLD, P = 0.454. No toxic deaths were recorded. Neutropenia was the most commonly seen severe toxicity (CP 30% versus CLD 35%. More frequent in CLD were severe thrombocytopenia (11% versus 2%, P = 0.016, skin toxicity and Palmar-plantar erythrodysesthesia (PPE grade 1-2 (38% versus 9%, PP = 0.029, 20% versus 5%, P = 0.003. PS and PFI were independent prognostic factors for TTP and OS. Conclusions The combination of pegylated LD with carboplatin is effective, showing less neurotoxicity and alopecia than paclitaxel-carboplatin. It thus warrants a further phase III evaluation as an alternative treatment option for platinum-sensitive OC patients. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12609000436279

  17. Antibacterial susceptibility patterns and cross-resistance of methicillin resistant and sensitive Staphyloccus aureus isolated from the hospitalized patients in Shiraz, Iran

    Aziz Japoni

    2010-10-01

    Full Text Available Nosocomial infections caused by methicillin-resistant staphylococci (MRSA pose a serious problem in many countries. This study aimed to determine the antibacterial susceptibility patterns of methicillin sensitive and resistant Staphylococcus aureus isolates from the hospitalized patients. Totally 356 isolates of Staphylococcus aureus (S. aureus including 200, 137 and 19 corresponding to MSSA, MRSA, and intermediate MRSA strains, respectively were isolated. Antibacterial susceptibility patterns of the isolates to 14 antibiotics were examined using Kirby-Bauer method. MICs of 15 antibiotics to 156 MRSA isolates were determined by E test method. Cross-resistances of MRSA isolates (137+19 to the other tested antibiotics were also determined. S.aureus with high frequencies were isolated from the blood, sputum and deep wound samples. All of 200 MSSA isolates were sensitive to oxacillin, vancomycin, tecoplanin, rifampin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid. A gradient of reduced susceptibility of MSSA to cephalexin, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin were evident. MRSA isolates were sensitive to vancomycin, tecoplanin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid, while reduced susceptibility of them to rifampin, co-trimoxazole, clindamycin, cephalexin, tetracycline, ciprofloxacin, erythromycin and gentamicin were observed. MRSA isolates exhibited a high range of cross-resistance to the eight tested antibiotics. Overall, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin showed low activity against MSSA and MRSA isolates which may indicate they are not suitable to be used in clinical practices. To preserve the effectiveness of antibiotics, rational prescription and concomitant application of preventive measures against the spread of MRSA are recommended.

  18. Antibacterial susceptibility patterns and cross-resistance of methicillin resistant and sensitive staphyloccus aureus isolated from the hospitalized patients in shiraz, iran.

    Japoni, Aziz; Ziyaeyan, Mazyar; Jmalidoust, Marzieh; Farshad, Shohreh; Alborzi, Abdolvahab; Rafaatpour, Noraladdin; Badiee, Parisa

    2010-07-01

    Nosocomial infections caused by methicillin-resistant staphylococci (MRSA) pose a serious problem in many countries. This study aimed to determine the antibacterial susceptibility patterns of methicillin sensitive and resistant Staphylococcus aureus isolates from the hospitalized patients. Totally 356 isolates of Staphylococcus aureus (S. aureus) including 200, 137 and 19 corresponding to MSSA, MRSA, and intermediate MRSA strains, respectively were isolated. Antibacterial susceptibility patterns of the isolates to 14 antibiotics were examined using Kirby-Bauer method. MICs of 15 antibiotics to 156 MRSA isolates were determined by E test method. Cross-resistances of MRSA isolates (137+19) to the other tested antibiotics were also determined. S.aureus with high frequencies were isolated from the blood, sputum and deep wound samples. All of 200 MSSA isolates were sensitive to oxacillin, vancomycin, tecoplanin, rifampin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid. A gradient of reduced susceptibility of MSSA to cephalexin, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin were evident. MRSA isolates were sensitive to vancomycin, tecoplanin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid, while reduced susceptibility of them to rifampin, co-trimoxazole, clindamycin, cephalexin, tetracycline, ciprofloxacin, erythromycin and gentamicin were observed. MRSA isolates exhibited a high range of cross-resistance to the eight tested antibiotics. Overall, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin showed low activity against MSSA and MRSA isolates which may indicate they are not suitable to be used in clinical practices. To preserve the effectiveness of antibiotics, rational prescription and concomitant application of preventive measures against the spread of MRSA are recommended. PMID:24031530

  19. Comparative proteomic analysis of sequential isolates of Mycobacterium tuberculosis from a patient with pulmonary tuberculosis turning from drug sensitive to multidrug resistant

    Amit Singh

    2015-01-01

    Full Text Available Background & objectives: Tuberculosis is a major health problem in India, and the emergence of multidrug resistant (MDR and extensively drug resistant (XDR strains of Mycobacterium tuberculosis (Mtb has further complicated the situation. Though several studies characterizing drug sensitive and drug resistant strains are available in literature, almost all studies are done on unrelated strains. Therefore, the objective of this study was to compare the proteomic data of four sequential isolates of Mtb from a single patient who developed MDR-TB during the course of anti-tuberculosis therapy (ATT. Methods: In this study, using two-dimensional (2D gel electrophoresis and MALDI-TOF mass spectrometry, we compared and analyzed the cell lysate proteins of Mtb sequential clinical isolates from a patient undergoing anti-TB treatment. The mRNA expression levels of selected identified proteins were determined by quantitative real-time polymerase chain reaction (qRT-PCR. Results: The genotypes of all four isolates remained homologous, indicating no re-infection. The initial isolate (before treatment was sensitive to all first-line drugs, but the consecutive isolates were found to be resistant to isoniazid (INH and rifampicin (RIF and developed mutations in the katG, inhA and rpoB. the intensities of 27 protein spots were found to be consistently overexpressed in INH and RIF resistant isolates. The most prominent and overexpressed proteins found during the development of drug resistance were GarA (Rv1827, wag31 (Rv2145c, Rv1437 and Rv2970c. Interpretation & conclusions: This preliminary proteomic study provides an insight about the proteins that are upregulated during drug resistance development. These upregulated proteins, identified here, could prove useful as immunodiagnostic and possibly drug resistant markers in future. However, more studies are required to confirm these findings.

  20. Urinary infection in patients of public health care of Campo Mourão-PR, Brazil: bacterial prevalence and sensitivity profile

    Josiane dos Santos Bitencourt

    2014-10-01

    Full Text Available Introduction: Cases of bacterial resistance in urinary tract infections (UTIs have increased significantly, mainly due to indiscriminate use of antimicrobials. Objective: Objective: To evaluate the prevalence and antimicrobial susceptibility of microorganisms isolated in urine cultures of patients of Consórcio Intermunicipal de Saúde da Comunidade dos Municípios da Região de Campo Mourão (CISCOMCAM clinical laboratory. Method: We performed a retrospective study of data from urine culture and sensitivity done between January 2012 and December 2013. Results: The most prevalent bacteria were Escherichia coli; women were the most affected gender and people 16-45 years, the most affected age group. The sensitivity profile showed that the antimicrobial combination trimethoprim/ sulfamethoxazole was not associated with the highest rate of bacterial resistance (59.7% and the combination of amoxicillin/clavulanic acid showed the lowest resistance rate (15.3%. For most antimicrobials, including ciprofloxacin and norfloxacin, the rates of bacterial resistance have increased from 2012 to 2013 with statistical significance (p < 0.05 in some cases. Discussion: The prevalence of Gram-negative bacilli in urinary infections is due to the fact that intestinal flora is rich in enterobacteria, and women are most affected by anatomical factors. The development of bacterial resistance to antimicrobials probably arises from their indiscriminate use. Conclusion: The rate of microbial resistance has risen, showing the need for a more effective control of antimicrobial use.