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During the past decade idiopathic venous thromboembolism has become a separate entity, a chronic illness which has required prolonged anticoagulation and other prevention strategies to avoid recurrences....Full Text Available

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Spondylarthritides (SpA) and inflammatory bowel disease (IBD) are idiopathic, chronic inflammatory disorders. Although they are very distinct and well-defined entities, there is clinical and genetic evidence supporting some degree of overlap between the pathogenesis of the two. Subclinical gut inflammation is present in up to two thirds of all SpA patients and can evolve into IBD. This subclinical gut inflammation has been shown to be strongly associated with joint inflammation, providing a clue for a common pathophysiologic background. Despite extensive research progress in the field over the past few years, many questions remain unanswered. In this paper, we focus on the clinical, genetic, and pathophysiologic overlap of SpA and IBD. Furthermore, we discuss some of the targets that may i...

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Congenital isolated pleural effusion is a rare cause of respiratory distress in neonates. It is usually chylous. Herein, we report a rare case of nonchylous congenital idiopathic pleural effusion.

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We investigated the extended-spectrum beta lactamases among 62 Salmonella enterica Typhimurium isolates recovered from children with diarrhea in a Chinese pediatric hospital. A large...Full Text Available

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BackgroundThe presence of enthesitis (insertional inflammation) in patients with juvenile idiopathic arthritis (JIA) is difficult to establish clinically and may influence classification...Full Text Available

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IntroductionPrevious observations suggest that active systemic juvenile idiopathic arthritis (sJIA) is associated with a prominent erythropoiesis gene-expression signature. The aim...Full Text Available

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The abnormal megakaryocytopoiesis associated with idiopathic myelofibrosis (IM) plays a role in its pathogenesis. Because mice with defective expression of transcription factor GATA-1 (GATA-1^low...Full Text Available

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Oleoresin Capsicum (OC) is an extract of the pepper plant used for centuries as a culinary spice (hot peppers). This material has been identified as a safe and effective Less-Than- Lethal weapon for use by Law enforcement and security professionals against assault. The National Institute of Justice (NIJ) is currently also evaluating its use in conjunction with other Less-Than-Lethal agents such as aqueous foam for use in corrections applications. Therefore, a comprehensive toxicological review of the literature was performed for the National Institute of Justice Less-Than-Lethal Force program to review and update the information available on the toxicity and adverse health effects associated with OC exposure. The results of this evaluation indicate that exposure to OC can result in dermatitis, as well as adverse nasal, pulmonary, and gastrointestinal effects in humans. The primary effects of OC exposure include pain and irritation of the mucous membranes of the eyes, nose, and lining ...

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Objectives: To report six month outcome in patients undergoing their first pulmonary vein ablation procedure for idiopathic atrial fibrillation (AF) at a “non-pioneering”...Full Text Available

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PMID:2255360

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Clostridium difficile (C. difficile) is a common causative agent of pseudomembranous colitis (PMC). C. difficile-associated diarrhea (CDAD) ranges...Full Text Available

UK PubMed Central (United Kingdom)

Exposure of a group of horses to tetracycline-contaminated feed resulted in acute colitis and subsequent death in one horse and milder diarrhea in 3 others. The most severely affected animal demonstrated...Full Text Available

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We describe here seven cases (from five kindreds) of Anderson's disease, which is characterized by diarrhea, steatorrhea, hypobetalipoproteinemia with low levels of cholesterol, triglycerides, and phospholipids,...Full Text Available

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Enterotoxigenic Escherichia coli (ETEC) is a leading cause of diarrhea in travelers to countries where the disease is endemic and causes a major disease burden in the indigenous population,...Full Text Available

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Paratuberculosis (Johne's disease), an endemic mycobacteriosis of cattle that is caused by Mycobacterium paratuberculosis, is characterized by incoercible diarrhea and fecal shedding of bacteria. The...Full Text Available

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The objective of this work is to verify whether the home-made teas form Brazilian plants, used for control of childish diarrhea have been efficient reaching the composition recommended by World Health Organizations (WHO). This work has been carried out using the neutron activation analysis and the TRIGA MARK I reactor, the IPR-R1, in the Centro de Desenvolvimento da Tecnologia Nuclear - CDTN. (author). 4 refs., 2 tabs.

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Idiopathic frozen shoulder is a common medical diagnosis for patients seeking physical therapy. Radiographic and surgical evidence exists that describes the coracohumeral ligament (CHL) as a major contributor...Full Text Available

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Idiopathic or functional abdominal pain (FAP) is common in school-age children and typically reflects a functional gastrointestinal disorder (FGID). FGIDs in adults have been distinguished by...Full Text Available

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Cholera vaccine candidate Peru-15 was derived from a Vibrio cholerae O1 El Tor Inaba strain by deleting the cholera toxin genetic element, introducing the gene encoding cholera toxin B subunit into recA, and screening for nonmotility. In a controlled study, Peru-15 (2 x 10(8) cfu) was administered to 11 volunteers. No vaccinee developed diarrhea, and 10 of 11 had > 4-fold rises in vibriocidal antibody titers. One month later, 5 vaccinees and 5 control volunteers were challenged with wild type V. cholerae O1. Four of 5 controls developed diarrhea (mean, 1.9 L). Two Peru-15 vaccinees developed diarrhea, 1 with < 0.3 L and 1 with approximately 1.0 L; this latter volunteer had not developed a significant vibriocidal immune response to vaccination. Peru-15 shows promise as a single-dose, oral cholera vaccine that is safe, immunogenic, and protective. PMID:7561195

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PMID:339527

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PMID:21990156

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PMID:1354044

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Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains an enigmatic medical condition. Creation of the (NIH) Chronic Prostatitis Collaborative Research Network (CPCRN) funded by...Full Text Available

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Idiopathic pulmonary fibrosis is the most lethal form of diffuse lung fibrosis, killing approximately half of those affected within 2-3 years of diagnosis. Until recently, no therapies had been shown to have an impact on disease progression. The Clinical Studies Assessing Pirfenidone (Esbriet) in IPF: Research of Efficacy and Safety Outcomes (CAPACITY) program comprised two almost identical double-blind placebo-controlled studies assessing the effects of pirfenidone on change in forced vital capacity, the primary end point, over a 72-week period. One of these studies was positive, matching in magnitude the benefit seen in two previous positive Japanese studies. The other study did not meet its primary end point but positive trends were consistent in this and a number of secondary end point...

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The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample...Full Text Available

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BackgroundNo consensus evidence-based guidelines for the routine laboratory monitoring of children with JIA receiving non-steroidal anti-inflammatory drugs (NSAIDs) exist. The purpose...Full Text Available

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In a prospective study, patients with the diagnosis of chronic ethmoid sinusitis were evaluated microbiologically by using biopsy specimens of the ethmoid sinus mucosa. Microbiology cultures were performed...Full Text Available

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In contrast to the increasing availability of information pertaining to the care of children with chronic kidney disease (CKD) from large-scale observational and interventional studies, epidemiological...Full Text Available

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CHRONIC HEALTH EFFECTS

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PMID:1461290

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PMID:21998366

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The diagnosis of idiopathic pulmonary hemosiderosis (IPH) may be elusive. A 6-year-old boy had microcytic hypochromic anemia and a hemolytic component. Hemosiderin-laden macrophages were not found in the gastric aspirate. He had no pulmonary signs or symptoms. Extensive hematologic and roentgenologic investigations failed to reveal the cause of the anemia. Quantitative serial scintigraphic scanning showed significant (35%) pulmonary sequestration of autologous erythrocytes labeled with sodium chromate Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy spece Cr51. The half-life of the RBCs was moderately decreased (half-life, 15 days; normal, 25 to 35 days). An open-lung biopsy specimen confirmed the diagnosis of IPH. A diagnosis of IPH should be considered when children have iron deficiency anemia and pulmonary signs or symptoms. Organ sequestration studies may be helpful in equivocal cases.

UK PubMed Central (United Kingdom)

BackgroundThe use of complementary and alternative medicine (CAM) is on the increase globally with a high prevalence in children and adults with chronic illnesses. Many studies have...Full Text Available

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Recommended treatment of chronic hepatitis B with interferon-α and/or nucleos(t)ide analogues does not lead to a satisfactory result. Induction of HBV-specific T cells by therapeutic...Full Text Available

UK PubMed Central (United Kingdom)

Introduction:Chronic obstructive pulmonary disease (COPD) is a major public health problem. It imparts a substantial economic burden on individuals and society. Acute exacerbations...Full Text Available

UK PubMed Central (United Kingdom)

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundAlthough symptoms of sleepiness and fatigue are common among adults with Chronic Kidney Disease (CKD), little is known about the prevalence of these symptoms...Full Text Available

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Objective To determine whether a centralised telephone intervention reduces the incidence of death or admission for worsening heart failure in outpatients with chronic heart failure.Design...Full Text Available

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We investigated the role of early portal hypotensive pharmacotherapy in preventing the development of portal-systemic shunting in a portal hypertensive model of chronic murine schistosomiasis induced...Full Text Available

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Background and objectives: Chronic kidney disease (CKD) is associated with impaired physical activity. However, it is unclear whether the associations of physical activity with mortality are modified...Full Text Available

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Opioids have been regarded for millennia as among the most effective drugs for the treatment of pain. Their use in the management of acute severe pain and chronic pain related to advanced medical...Full Text Available

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A Legionella-like organism, strain 1677-MI-H, was isolated from the bronchoscopy washings of a patient with pneumonia who had a 2-year history of progressive, chronic lymphocytic leukemia. The growth...Full Text Available

UK PubMed Central (United Kingdom)

Chronic colonization of the human stomach by Helicobacter pylori, a Gram-negative bacterium, is the major cause of chronic gastritis, peptic ulcers and gastric cancer. Recent...Full Text Available

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Inclusion of family members in the assessment of patients with chronic pain can improve outcomes. Family functioning can be assessed in four basic areas: boundaries, power, communication, and intimacy....Full Text Available

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BackgroundHepatitis B and C is common in Pakistan and various risk factors are attributable to its spread.One thousand and fifty consecutive male cases suffering from chronic...Full Text Available

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BackgroundUntil now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation...Full Text Available

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The effect of potential risk factors for chronic lymphatic leukaemia was evaluated in a case-referent study encompassing 111 cases and 431 randomised referents, all alive. Information on exposure was...Full Text Available

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Chronic wasting disease (CWD) is a contagious, fatal prion disease of deer and elk that continues to emerge in new locations. To explore the means by which prions are transmitted with high efficiency...Full Text Available

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BACKGROUND:The value of other health care professionals is increasingly being recognized to compensate for the shortage of physicians in Canada. Chronic cough is one of the most...Full Text Available

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Background. Erythropoietin deficiency and anemia occur in Chronic Kidney Disease (CKD) and may be treated with Erythropoietin Stimulating Agents (ESAs). The optimal hemoglobin,...Full Text Available

UK PubMed Central (United Kingdom)

MRI plays an increasingly important role for assessment of patients with chronic liver disease. MRI has numerous advantages, including lack of ionizing radiation and the possibility of performing...Full Text Available

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OBJECTIVES: Although the tricyclic antidepressant amitriptyline is extensively used in the prophylactic treatment of chronic tension-type headache, only few studies have investigated the efficacy of...Full Text Available

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Bacterial attachment-effacement (att-eff) is emerging as an important virulence characteristic common to both enteropathogenic Escherichia coli (EPEC) and enterohemorrhagic E. coli (EHEC). The contribution of the plasmid-encoded EPEC adherence factor to the production of mucosal lesions and diarrhea was investigated in gnotobiotic piglets. Bacterial att-aff in the intestinal mucosa of piglets infected with plasmid-cured EPEC strain E2348/69 (O127) was indistinguishable from that in piglets infected with the parent strain, but the distribution of lesions was different; it occurred in the small intestines of 6 of 7 piglets infected with the parent strain compared with only 2 of 11 (P = 0.006) infected with the plasmid-cured strain. Plasmid-encoded factors in EPEC and EHEC strains did not appear to contribute to bacterial competition with normal gut microflora. Of 13 strains belonging to five EPEC serogroups, O55, O142, O26, O119, and O111, 3 fulfilled the criteria ...

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has the potential to cause severe acute and chronic health effects with over exposure.Use safe work

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The xenotropic murine leukaemia virus-related virus (XMRV), a gammaretrovirus, was discovered in prostate cancer tumours by Virochip technology in 2006. It was subsequently detected in chronic fatigue patients in 2009. The association between XMRV and chronic fatigue has proved to be controversial. No study has confirmed these findings and many have refuted them. Here, we present the evidence for our contention that XMRV is not a human pathogen. PMID:21978843

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The treatment of chronic pain conditions continue to present a challenge to the medical field. Physical therapy treatment needs to approach the management of chronic pain differently than the approach used to resolve acute pain. Patients with chronic pain often have many factors that have perpetuated the pain condition. These factors, as well as pain itself, influence their ability to reactivate and perform functional daily activities. Physical therapists can begin to address some of the factors, including fear and deconditioning, by building confidence and body awareness in a self-care model including a slow graduated reactivation program. There is evidence that patients with chronic pain conditions have altered motor control that may be influencing reoccurrences and possible flares of pa...

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ALLEYNE G., HANCOCK C. & HUGHES P. (2011) Chronic and non-communicable diseases: a critical challenge for nurses globally. International Nursing Review58, 328-331 Background:- Chronic and non-communicable diseases (NCDs) are a growing and enormous challenge that faces countries across the world. Low- and middle-income countries are disproportionately affected. Contributory factors:- Three risk factors - tobacco use, poor diet (including excessive alcohol intake) and lack of physical activity - contribute to four major chronic diseases - cardiovascular, chronic obstructive pulmonary disease, diabetes and some cancers, which are responsible for over 50% of deaths worldwide. Potential solutions:- International governmental and non-governmental agencies are becoming increasingly concerned and ...

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An asymptomatic pink discoloration of a maxillary right fourth premolar tooth was discovered during a routine oral examination on a 9 year-old Belgian Malinois dog. A radiolucent lesion was seen in the pulpal chamber on radiographic examination. The lesion had perforated the mesiobuccal root of the tooth. The primary differential diagnosis was idiopathic internal resorption. The tooth was treated by partial resection (removal of the mesiobuccal root and associated crown). A vital pulpotomy and amalgam restoration was performed on the remaining tooth structure. A follow-up 1 year later demonstrated a successful treatment outcome. The animal was asymptomatic and able to perform military duties. Clinical and radiographic signs of healing were evident and the tooth was functional. PMID:10518874

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Precocious puberty is a significant child health problem, especially in girls, because 95% of cases are idiopathic. Our earlier studies demonstrated that low-dose levels of manganese (Mn) caused precocious puberty via stimulating the secretion of luteinizing hormone-releasing hormone (LHRH). Because glial-neuronal communications are important for the activation of LHRH secretion at puberty, we investigated the effects of prepubertal Mn exposure on specific glial-derived puberty-related genes known to affect neuronal LHRH release. Animals were supplemented with MnCl2 (10 mg/kg) or saline by gastric gavage from day 12 until day 22 or day 29, then decapitated, and brains removed. The site of LHRH release is the medial basal hypothalamus (MBH), and tissues from this area were analyzed by real-...

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Individuals with male factor infertility resulting from idiopathic oligo-, astheno- or teratozoospermia are frequently offered IVF in an attempt to increase their chances of having a child. A concern remains whether these infertile males have an elevated risk of transmitting chromosomal abnormalities to their offspring. Sperm chromosomal complements from these men were assayed using the human sperm/hamster oocyte fusion system and fluorescence in situ hybridization (FISH) on sperm nuclei. For each of 5 infertile patients, 100 sperm karyotypes were analyzed and multicolour FISH analysis was performed on a minimum of 10,000 sperm nuclei for each chromosome-specific DNA probe for chromosomes 1 (pUC1.77), 12 (D12Z3), X (XC) and Y (DYZ3). As a group, the infertile patients showed increased frequencies of both numerical ({chi}{sup 2}=17.26, {proportional_to} <0.001) and total abnormalities ({chi}{sup 2}=7.78, {proportional_to} <0.01) relative to control donors when ...

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In response to an earlier published paper by Fordyce, some assumptions underlying the behavior management paradigm of chronic pain are critically discussed. While operant treatment has proved successful, the conclusion that operant factors play an important role in the development and maintenance of chronic benign pain is debated. Some empirical studies, regularly used to demonstrate this role, are re-evaluated. An alternative theory is proposed for chronic pain behavior, in which the role of a lower tolerance to proprioceptive stimuli, which may include more than just pain stimuli, is emphasized. PMID:3313200

UK PubMed Central (United Kingdom)

A case of xanthogranulomatous salpingitis (XGS) associated with a large uterine leiomyoma in a 50-year-old woman is presented. Xanthogranulomatous inflammation is an uncommon form of chronic inflammation...Full Text Available

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The pathological effects of lead on the renal, nervous, reproductive, endocrine, and immune systems have been reviewed. Emphasis is placed on reported subclinical effects due to chronic, low-level lead...Full Text Available

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Unlike in normal rabbits, pulmonary rapidly adapting receptors (RARs) in rabbits with chronic mitral regurgitation (MR) do not respond to small changes in extravascular...Full Text Available

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Although previous research suggests that preamputation pain is a risk factor for pain after amputation, little is known about the association between acute postsurgical pain and chronic amputation-related pain. The current prospective study examined the associations of preamputation pain and acute postamputation pain with chronic amputation-related pain. The sample consisted of patients with lower limb amputation (N = 57) who provided both preamputation and postamputation data during a 2-year study period. Preamputation pain intensity and duration were assessed before amputation; acute phantom limb pain (PLP) and residual limb pain (RLP) intensity were assessed on postsurgical days 4 and 5. Acute PLP intensity was the only significant independent predictor of chronic PLP intensity at 6 and...

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Paratuberculosis (Johne's disease) is a chronic, wasting, widespread mycobacteriosis of ruminants. It involves extensive mycobacterial shedding, which accounts for the high contagiousness, and ends...Full Text Available

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Kidney Failure, Chronic

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Numerous reports of chronic renal disease in patients who habitually use phenacetin-containing compounds to excess have aroused considerable controversy over the possible relationship between phenacetin,...Full Text Available

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... VIDEO: FASDs Cause More Severe Behavioral Problems Than ADHD, Baking Soda May Slow Chronic Kidney Disease, Higher ...

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The family physician dealing with gynecologic pelvic pain (acute or chronic) enters at the beginning of the problem as diagnostician, refers the patient to a specialist in the interim, and resumes...Full Text Available

International Nuclear Information System (INIS)

Lupinus albus L. plants were grown from seeds and irradiated at various stages of development with acute or chronic gamma rays. All plants were greenhouse grown (pre- and post-irradiation) and allowed to proceed through their normal growth cycle. The purpose of these experiments was to establish a Plactochron Index for Lupinus albus L. and to determine the effects of acute and chronic irradiation on development at the macro and microscopic levels. A Plastochron Index was calculated and used as an indirect time scale to evaluate the effects of gamma rays from a common base line. Acute radiation treatment lasted for a period of a few days, whereas chronic treatment was initiated at the seedling stage and lasted for the entire growth season. Vegetative plants were used to study the effects of acute radiation exposure on apical meristem morphology, Plastochron Index, phyllatoxis and gross morphology.

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Systemic lupus erythematosus (SLE) persists as a chronic inflammatory autoimmune disease and is characterized by the production of autoantibodies and immune complexes that affects multiple organs....Full Text Available

UK PubMed Central (United Kingdom)

In general, the etiologic factors of chronic paranasal sinusitis are systemic conditions such as nutrition, predisposition, allergy, and local factors such as nasal anatomic conditions. Among these...Full Text Available

UK PubMed Central (United Kingdom)

ObjectiveTo describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb,...Full Text Available

UK PubMed Central (United Kingdom)

OBJECTIVES:To investigate the effect of opioid receptor blockade on the myocardial protection conferred by chronic exercise and to compare exercise training with different strategies...Full Text Available

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The liver has enormous regenerative capacity. Following acute liver injury, hepatocyte division regenerates the parenchyma but, if this capacity is overwhelmed during massive or chronic liver...Full Text Available

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BackgroundMycobacterium avium subspecies paratuberculosis causes systemic infection and chronic intestinal inflammation in many species including...Full Text Available

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Chronic workplace exposure to formaldehyde and solvents at low doses reduced pulmonary function in 280 non-smoker white women working as histology technicians. They were studied during national workshops...Full Text Available

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Ocular and urogenital tract infections with Chlamydia trachomatis can progress to chronic inflammatory diseases that produce blindness and tubal infertility. The pathophysiology of these chronic disease...Full Text Available

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Mutations in full-length HBV isolates obtained from a chronic HBV-infected patient were evaluated at three time points: 1 day, 6 months, and 31 months. While 5 nucleotides variation, and an 18 bp...Full Text Available

DEFF Research Database (Denmark)

Citrate is an important naturally occurring inhibitor of calcium stone formation in urine. Urinary citrate excretion was examined in 43 consecutive patients with recurrent idiopathic calcium nephrolithiasis and in 50 normal controls by a specific enzymatic technique. Hypocitraturia (<1.6 mmol/24h) was found in 14 (33%) stone formers compared to 6 (12%) normal controls (p = 0.03). Citrate excretion expressed as citrate-creatinine ratio in 24 hour urine samples was significantly lower in the stone formers than in the healthy controls (p = 0.03), and significantly lower in healthy men, compared to healthy females (p = 0.006). There was a great variability in urinary citrate levels in both groups, and a considerable overlap in the urinary citrate excretion between normal subjects and stone formers. Factors other than urinary citrate excretion must therefore be of importance in the pathophysiology of calcium stone formation. Citrate-calcium ratio in urine proved to ...

Science.gov (United States)

Clinical and hormonal indices of androgenic activity were compared in 118 males chronically intoxicated with alcohol. The population was divided into two groups with respect to their clinical and hormonal androgenic indices: 76 patients with (Group 1), and 46 patients without (Group 2) androgenic insufficiency. Distinct signs and syndromes of alcohol addiction were shown to correlate with the extent of cross-regulation impairment within hypothalamo-hypophyseo-gonadal system. This was particularly derived from comparison of clinical picture of chronic alcohol intoxication and hormone activity in the groups. Conventional therapy failed to restore the neuroendocrine indices that was apparently due to inhibition of cross-regulation links in the hypothalamo-hypophyseo-gonadal system at several stages of alcohol addiction. PMID:3223149

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Abstract While substantial attention has been paid to the issue of sexual dysfunction in men on chronic dialysis, less is known about this problem in women with end-stage renal disease. We sought to assess sexual dysfunction in women on chronic dialysis and determine whether patients discuss this problem with their providers and receive treatment. We prospectively enrolled women receiving chronic hemodialysis or peritoneal dialysis in Pittsburgh, PA. We asked patients to complete the 19-item Female Sexual Function Index (FSFI) to assess sexual function and a 5-item survey that assessed whether patients had discussed sexual dysfunction with their providers and/or received treatment for this problem in the past. We enrolled 66 patients; 59 (89%) on hemodialysis and 7 (11%) on peritoneal dial...

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Acute {gamma}-irradiation of rats at doses of 100 and 270 Gy stimulates lipid synthesis and changes the lipid composition of liver cell organelles. The content of cholesterol and cholesterol esters in microsomes increased at 100 Gy and decreased at 270 Gy, with total phospholipid content remaining unchanged. The lipid content in mitochondria decreased considerably 1 h after irradiation at 270 Gy. This change was significantly less pronounced 47 h later. Under chronic {gamma}-irradiation (0.129 Gy/day), cholesterol and cardiolipin in mitochondria increased. The changes in lipid content caused by acute irradiation are presumed to be related to activated synthesis of lipids in the liver. The modification of the lipid content of mitochondria observed in chronically irradiated rats may indicate that energy-metabolizing liver cell systems are involved in the adaptation to irradiation.

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Twenty-two out of 31 patients with chronic renal failure and secondary hyperparathyroidism who underwent parathyroidectomy before operation underwent non-invasive image diagnosis of parathyroid glands by computed tomography (CT), scintigraphy with /sup 201/TlCl and /sup 99m/TcO/sup 4 +/, and/or ultrasonography. CT visualized 39 of 45 parathyroid glands (86.7%), weighing more than 500 mg. Scintigraphy with a subtraction method using a computer performed the diagnosis in 19 of 27 glands (70.4%). Ultrasonography detected 21 of 27 glands (77.8%). Image diagnosis was also useful in the postoperative follow-up study. The non-invasive image diagnosis of parathyroid glands in patients with chronic renal failure is thus valuable for 1) definite diagnosis of secondary hyperparathyroidism, 2) localization, and 3) diagnosis for effectiveness of conservative treatment.

British Library Electronic Table of Contents (United Kingdom)

Maternal stress during pregnancy, particularly that combined with low socioeconomic status (SES), has been linked to an increased risk for impaired behavioural and emotional development and affective disorders in children. In animal models, acute periods of prenatal stress have profound effects on hypothalamo-pituitary-adrenal (HPA) function and behaviour. However, few studies have determined the impact of chronic exposure to stress in animal models. The objective of this study was to determine the effects of chronic maternal stress (CMS) during the 2nd half of pregnancy and nursing on growth, locomotor behaviour and HPA axis function in juvenile guinea pig offspring. Pregnant guinea pigs were exposed to a random combination of variable stressors every other day over the 2nd half of gestat...

UK PubMed Central (United Kingdom)

Objective:The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether...Full Text Available

UK PubMed Central (United Kingdom)

Background:Tobacco smoking is the most important risk factor for chronic obstructive pulmonary disease (COPD) development. Inhaled cigarette smoke can induce tumor necrosis factor-α...Full Text Available

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Background and objectives: The severity of anemia at which to initiate erythropoiesis-stimulating agent (ESA) treatment in nondialysis chronic kidney disease (CKD) patients is unclear. Risk of mortality,...Full Text Available

UK PubMed Central (United Kingdom)

Cryoanalgesia (the use of cold to provide anesthesia or analgesia) is the oldest anesthetic and analgesic still in current clinical use. Its intraoperative use in providing postoperative analgesia for...Full Text Available

UK PubMed Central (United Kingdom)

Chronically elevated interleukin-6 (IL-6) affects lipid and lipoprotein metabolism. Individuals genetically predisposed to higher IL-6 secretion may be at risk of dyslipidemia, especially during the...Full Text Available

UK PubMed Central (United Kingdom)

Fetal growth restriction (FGR) is an adverse pregnancy outcome associated with significant perinatal and paediatric morbidity and mortality, and an increased risk of chronic disease later in adult life....Full Text Available

UK PubMed Central (United Kingdom)

Background and objectives: While many patients with end-stage renal disease (ESRD) have impaired physical and psychologic well-being, less is known about these health domains in patients with advanced...Full Text Available

UK PubMed Central (United Kingdom)

While research has shown that patients’ beliefs about their pain are related to pain adjustment and treatment outcomes, little is known about the beliefs of their significant others....Full Text Available

UK PubMed Central (United Kingdom)

The development of central neuropathic pain varies among patients with spinal cord injury (SCI). The factors contributing to the development and perpetuation of segmental pain (at-level allodynia)...Full Text Available

UK PubMed Central (United Kingdom)

ObjectivesThe updated Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs) include new FGID categories and changes to the Rome II criteria...Full Text Available

UK PubMed Central (United Kingdom)

Lifetime exposure to physical activity is an important construct for evaluating associations between physical activity and disease outcomes, given the long induction periods in many chronic diseases....Full Text Available

UK PubMed Central (United Kingdom)

Chronic neurogenous pain is often an extremely difficult condition to manage. In the orofacial region, trauma from injury or dental procedures may lead to the development of severe neuralgic pains and...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe long latent stage seen in syphilis, followed by chronic central nervous system infection and inflammation, can be explained by the persistence of atypical cystic and...Full Text Available

UK PubMed Central (United Kingdom)

Paediatric palliative care is a holistic approach aimed at addressing the complex issues related to the care of children and families facing chronic life limiting illnesses. The needs of children are...Full Text Available

UK PubMed Central (United Kingdom)

Acute inflammation is important for tissue repair; however, chronic inflammation contributes to neurodegeneration in Alzheimer’s disease (AD) and occurs when glial cells undergo prolonged...Full Text Available

UK PubMed Central (United Kingdom)

Background and objectives: Blacks are over-represented among dialysis patients, but they have better survival rates than whites. It is unclear if the over-representation of blacks on dialysis is due...Full Text Available

UK PubMed Central (United Kingdom)

Nearly every drug may cause changes to ocular tissues through a variety of mechanisms. Medication overdoses, drug–drug interactions but also chronic administration of medications at...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundAlthough considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients...Full Text Available

UK PubMed Central (United Kingdom)

Background: Squamous differentiation/squamous metaplasia is often associated with endometrial adenocarcinoma and benign lesions, such as endometrial hyperplasia and chronic endometritis....Full Text Available

UK PubMed Central (United Kingdom)

Although management of warfarin is challenging for patients with chronic kidney disease (CKD), no prospective studies have compared response to warfarin among patients with minimal, moderate, and severe...Full Text Available

UK PubMed Central (United Kingdom)

Serial studies of iron transport in patients on maintenance dialysis showed normal or raised values in almost all subjects and a transient increase soon after the start of dialysis in three. These...Full Text Available

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Background The scale-up of treatment for HIV and multidrug-resistant tuberculosis (MDR-TB) in developing countries requires a long-term relationship with the...Full Text Available

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Of 868 patients admitted with pancreatitis between 1971 and 1976, coexisting hyperbilirubinemia was noted in 125 (14%). The patient population was primarily composed of alcoholics (84%) with chronic...Full Text Available

UK PubMed Central (United Kingdom)

In order to maintain stable functionality in the face of continually changing input, neurones in the CNS must dynamically modulate their electrical characteristics. It has been hypothesized that in...Full Text Available

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For many years, epidemiological studies have demonstrated a strong link between chronic hepatitis B virus (HBV) infection and the development of primary hepatocellular carcinoma (PHC). Other hepatocarcinogens...Full Text Available

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BackgroundEpidemiological studies showed that physical exercise, specifically moderate lifelong training, is protective against cardiovascular morbidity and mortality. Most experimental...Full Text Available

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The article describes the caregiving responsibility to provide food for chronically ill family members and the meanings attached to food and eating when ill created stress for family caregivers. The...Full Text Available

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BackgroundAt least some forms of breast cancer are increasingly being viewed as a chronic illness, where an emphasis is placed on meeting the various ongoing needs of people living...Full Text Available

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Ulcerative colitis (UC) is a chronic inflammatory disease of the colon with a high incidence of colon cancer. Dysplasia is a precursor to carcinoma and a predictor of malignant potential; epithelia...Full Text Available

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The effects of Escherichia coli endotoxin on lung mechanics, hemodynamics, gas exchange, and lung fluid and solute exchange were studied in 12 chronically instrumented unanesthetized sheep. A possible...Full Text Available

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Total health care expenditure in 2006 was $2.1 trillion. This figure is estimated to double within the next few years as the cost of treating diabetes and other chronic conditions continues to rise....Full Text Available

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BackgroundChronic wasting disease (CWD) of cervids is a prion disease distinguished by high levels of transmissibility, wherein bodily fluids and excretions are thought to play an...Full Text Available

UK PubMed Central (United Kingdom)

Lymphocytes from patients with insulin-dependent diabetes mellitus (IDDM), a chronic autoimmune disease, have recently been shown to have decreased surface expression of MHC class I antigens. Since...Full Text Available

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Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this...Full Text Available

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Diabetic pregnancies are characterized by chronic metabolic insults, including iron deficiency, that place the developing brain at risk and for memory impairment later in life. A behavioral...Full Text Available

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The mitogen-activated protein kinase/extracellular regulated kinase (MAPK/ERK) pathway plays a key role in mediating estrogen actions in the brain and neuronal sensitization during inflammation....Full Text Available

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Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about 1 in every 5 deaths. The morbidity, mortality, and socioeconomic importance...Full Text Available

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The effects of sennosides on colonic motility were investigated in eight conscious dogs chronically fitted with two strain gauge transducers in the proximal colon, an intracolonic silicone catheter...Full Text Available

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Studies on alcoholic liver injury mechanisms show a significant inhibition of the proteasome activity. To investigate this phenomenon, we isolated proteasome complexes from the liver of rats...Full Text Available

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Tick-borne encephalitis (TBE) virus causes severe encephalitis with serious sequelae in humans. The disease is characterized by fever and debilitating encephalitis that can progress to chronic illness...Full Text Available

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Autoimmune pancreatitis (AIP) is a rare cause of recurrent acute pancreatitis or chronic pancreatitis in middle-aged patients, and is characterised by a marked infiltration of lymphocytes and plasma...Full Text Available

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The objective of this retrospective field study was to associate the type and smell of discharge, the size of the uterus, the ovarian and treatment status, and the time to diagnosis of animals with...Full Text Available

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beta-Endorphin-like immunoreactivity in human ventricular cerebrospinal fluid was measured with a specific radioimmunoassay. The subjects were undergoing a surgical procedure for relief of chronic intractable...Full Text Available

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ObjectiveThe purpose of this study is to identify the factors affecting the failure of trials (<50% pain reduction in pain for trial period) to improve success rate of spinal...Full Text Available

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BackgroundChronic kidney disease and end-stage renal disease are major causes of morbidity and mortality that are seen far more commonly in the aged population. Interestingly, kidney...Full Text Available

UK PubMed Central (United Kingdom)

Hypersensitivity pneumonitis (HP) is an inflammatory lung disease caused by repeated inhalation of aerosolized antigens. With chronic exposure to an inhaled antigen, patients are at risk of...Full Text Available

Science.gov (United States)

Over the years, nurses, doctors and scientists have sought ways of assessing the impact of pain on patients. While many of the instruments devised have been extremely useful in identifying the nature and intensity of pain, defining the effect it has on people's lives and perceptions has proved much more problematic. Based on the work she carried out with patients suffering from chronic benign pain, Karen Rose explores one aspect of these effects--the feeling of isolation. By using a four-step anthropological approach to identify the impact of pain, she argues, nurses can arrive at a realistic and accurate assessment of how patients are coping. PMID:7947167

International Nuclear Information System (INIS)

A 37-year-old military mechanic presented to our institution with a chronic history of a slowly enlarging left elbow antecubital fossa mass. There was no history of other chronic illness or trauma. Magnetic resonance imaging (MRI) and excisional biopsy revealed fatty villi and synovial inflammation within the left bicipitoradial bursa, consistent with lipoma arborescens. Four years later the patient presented with a 6-month history of swelling at the antecubital fossa of the opposite elbow. Diagnostic computed tomography and MRI examinations were performed. The surgical and pathologic findings confirmed the imaging diagnosis of lipoma arborescens at the right bicipitoradial bursa. (orig.)

International Nuclear Information System (INIS)

The mechanism of action of Clostridium difficile enterotoxin A (CA), of Escherichia coli enterotoxin (STa) and of cholera toxin (CT), which are known to cause severe diarrhea, were studied in a preparation of ligated jejunal loops of anesthetized rats in vivo. The toxins were administered intraluminally. Pharmacological agents, which were tested for their potency to influence toxin-related effects, were administered subcutaneously. Net fluid transport was determined gravimetrically, prostaglandin (PG) E_2-output into the lumen, cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) contents in the mucosa were measured by radioimmunoassay, serotonin-(5-HT)-output into the lumen was determined by high performance liquid chromatography. The histopathological effects of CA and CT were examined by light- and scanning electron microscopy. All three toxins caused net fluid secretion (FS). 5-HT_2-(ketanserin) and 5-HT_3-receptor antagonists ...

Science.gov (United States)

A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily living, and pain report. The median number of ...

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The effect of chronic administration of phenobarbital on the binding of phorbol-12,13-dibutyrate (({sup 3}H)PDBu), an activator of protein kinase C (PKC), was examined in rat liver microsomes. A significant increase in the number of binding sites was observed in microsomes of Fisher 344 rats. However, no change appeared in liver cytosol binding of PDBu. Consequently, a translocation process of PKC is unlikely. The increase in ({sup 3}H)PDBu binding in liver microsomes is significant 24 h. after one injection of phenobarbital and reaches its maximum in 2 days. In other strains of rats (ACI and lean Zucker), significant differences were found in the increase of ({sup 3}H)PDBu binding in microsomes. Fisher 344 were the most sensitive, lean Zucker rats, the least sensitive. Those results parallel the pentoxy-resorufin O demethylase activity in the microsomes of the same animals. EC{sub 50} values for inhibition of ({sup 3}H)PDBu binding by pentobarbital were determined ...

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The gene expression of beta(1)-adrenergic receptor (beta(1)AR) and stimulatory G-protein Gsalpha in ventricle after chronic treatment with doxorubicin (DOX) in rat was investigated. The rats were treated with DOX in a dose of 2.5 mg/kg once a week for 5 weeks, the cumulative dose being 12.5 mg/kg. Two weeks after the last injection, the positive inotropic effect of isoproterenol was noticeably decreased in left atrial muscle preparations isolated from DOX-treated rats. Northern blot hybridization showed that the mRNA transcripts of beta(1)AR and Gsalpha, important signal transduction elements for regulating heart rate and contractility, were significantly decreased in the ventricle of DOX-treated rats. Thus, chronic treatment with DOX decreases the gene expression levels of myocardial beta(1)AR and Gsalpha. PMID:15353854

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Full text: Disorders of brain development and phakomatosis are resulting from disturbed embryonic-foetal development One third of all major embryological anomalies involve CNS, and over 2000 different anomalies have been described. Anomalies of the brain often cause foetal and neonatal death, and mental and physical retardation in pediatric group. The majority of disorders of brain development and phakomatosis are idiopathic, and most of them are not hereditary or familial. Ultrasonography plays the important role in screening foetal and neonatal brain, but after closure of fontanels it is difficult to find the acoustic window. CT has limited contrast resolution, and disadvantage exposing infant to ionizing radiation. It is helpful to demonstrate the presence of calcifications. MR imaging has proved to be a diagnostic tool of major importance in children with disorders of brain development and phakomatosis. The excellent grey/white matter differentiation and ...

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The function of the hypothalamo-pituitary-gonadal system has been studied in 118 males with different stages of alcoholism. Comparison with the control group has shown decreased levels of interstitial cell stimulating hormone (ICSH), follicle-stimulating hormone (FSH), and testosterone, and elevated concentrations of prolactin (Prl). Differences in the parameters of hormonal activity expressed in a varying degree of a decrease in FSH, ICSH, and testosterone, and a Prl elevation are related to change in mutual regulatory influences between the gonads and hypothalamo-pituitary complex. The most informative parameters were concentrations of Prl and testosterone (considering elevation in the former and reduction in the latter hormone) and the ratio of their concentrations. Difference of these parameters in each group (corresponding to the stages of alcoholism) may be used as an additional diagnostic criterion of chronic alcohol intoxication. PMID:3434080

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The effects of repeated low-level nerve agent exposure on animal performance and lethality are a major concern of USAF Medical Research. This concern has generated interest in the role that pretreatment drugs such as pyridostigmine may play during simultaneous exposure to soman. This role was investigated by recording lethality, weights, symptoms, and cholinesterase (ChE) inhibition in rats chronically exposed to 4 levels of soman (32, 39, 48 or 59 micrograms/kg/day) while simultaneously receiving 10.0 milligrams/kg/day pyridostigmine, 1.0 milligrams/kg/day pyridostigmine, or vehicle via an osmotic pump. No effect (either protective or detractive) was found in the soman-poisoned animals due to the presence or absence of pyridostigmine. However, rat blood biochemistry is different from that of the primate, warranting further study in the primate before extrapolation to man.

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Summary This third paper, in a three-part CE series on the preventions of infection in patients with chronic kidney disease, focuses on surveillance and auditing of healthcare-associated infections within the renal care environment. The last decade has seen an increased awareness of the threat to patient safety from healthcare-associated infection (HCAI) and the emergence of multi-drug resistance organisms. Effective HCAI prevention strategies include adequate governance structures, access to expert advice, adherence to standard and transmission-based precautions, minimising the use of invasive medical devices, and surveillance. Surveillance data can be collected using outcome (e.g. infection) and/or process (e.g. hand hygiene compliance audit) measures. Establishing a surveillance program...

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Hepatocellular carcinoma (HCC) is considered to be one of the most common malignancies worldwide, and the most common one in Africa and Asia. Over the last decade, a rising incidence of up to 10-15/100,000 per population has been seen in the Western world, with an estimate of 250,000 deaths and more than a million worldwide per year. By the year 2010, the World Health Organization expects that HCC will be the leading cause of cancer mortality surpassing lung cancer. This increasing incidence is most likely related to an increasing prevalence of chronic hepatitis C (HC) and B (HB) virus infections and other diseases inducing chronic inflammation (Befeler and Di Bisceglie 2002; Llovet et al. 2003).

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XMRV or xenotropic murine leukemia virus-related retrovirus, a recently discovered retrovirus, has been linked to both prostate cancer and chronic fatigue syndrome (CFS). Recently, the teams of Drs. Shyh-Ching Lo and Harvey Alter discovered the presence of sequences closely related to XMRV in the blood of 86.5% of patients with CFS [1]. These findings are important because since the initial discovery of XMRV in CFS, several studies have failed to find XMRV in specimens collected from CFS patients. While the current study also did not find XMRV in CFS, Lo et al. did detect sequences that belong to polytropic mouse endogenous retroviruses (PMV), which share considerable similarity with XMRV. Criteria for future studies that will help bring greater clarity to the issue of retroviral sequences in CFS are proposed below. PMID:21994623

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It is uncertain if downregulation of ?-adrenoceptor signaling pathway is promoted by an enhanced adrenergic tone at an early stage of cardiac disease, or it develops secondary to detrimental local myocardial changes in advanced heart failure. We examined the integrity of ?-adrenoceptor signaling pathway upon chronic infusion of isoproterenol, a ?-adrenoceptor agonist, at a dose producing no structural left ventricular (LV) remodeling and systolic dysfunction. Subcutaneous isoproterenol infusion (400??g?kg?1?h?1 over 16?days) to guinea pigs using osmotic minipumps produced no change in cardiac weights, LV internal dimensions, myocyte cross-sectional area, extent of interstitial fibrosis, and basal contractile function. Isolated, perfused heart preparations from isoproterenol-treated guinea ...

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Background. The `RISchio CArdiovascolare nei pazienti afferenti all' Area Vasta In Dialisi (RISCAVID) study is an observational and prospective trial including the whole chronic haemodialysis (HD) population in the northwest part of Tuscany (1.235 million people). The aim of the study was to elucidate the relevance of traditional and non-traditional risk factors of mortality and morbidity in HD patients as well as the impact of different HD modalities.Methods. A total of 757 HD patients (mean age 66 +- 14 years, mean dialytic age 70 +- 76 months, diabetes 19%) were prospectively followed up for 30 months and all-cause mortality, cardiovascular (CV) mortality and non-fatal CV events (acute myocardial infarction and stroke) were registered. At the time of the enrolment, demographic, clinical...

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Hormone levels were examined in the venous blood in 54 men suffering from stage 2 alcoholism and in 30 normal subjects, using a radioimmunochemical assay. The alcoholics were found to have a statistically significant increase in prolactin and a decrease in testosterone. A definite ratio in the secretion of these hormones differing from that in the control group was elucidated. This ratio (prolactin-testosterone index) is proposed as a diagnostic test of alcoholism. PMID:6441404

UK PubMed Central (United Kingdom)

Chronic HTLV-I (human T cell lymphotropic virus type I) infection may cause adult T cell leukemia/lymphoma (ATL), a disease with dismal long-term prognosis. The HTLV-I transactivator, Tax, initiates...Full Text Available

International Nuclear Information System (INIS)

The effect of in vitro and in vivo administration of ethanol on the binding of "3"5S-t-butyl-bicyclophosphorothionate ("3"5S-TBPS) to cortical brain membranes of C57B1 mice was investigated using KCl (100 mM) containing assay media. The in vitro addition of ethanol produced a dose-dependent inhibition of basal "3"5S-TBPS binding. In the presence of chloride ions, GABA and pentobarbital had a biphasic action (stimulation followed by inhibition) on "3"5S-TBPS binding, whereas diazepam only stimulated the binding. Ethanol reduced the stimulatory effects of GABA and pentobarbital in a dose-dependent manner, but had no effect on the enhancement of "3"5S-TBPS binding produced by diazepam. "3"5S-TBPS binding to cortical brain membranes was inhibited by the putative Cl"- channel blocking agent DIDS. This inhibitory action of DIDS was significantly, and dose-dependently reduced by ethanol (#<=# 100 mM ethanol). Chronic ethanol ingestion in vivo, which produced tolerance ...

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Effect of single and chronic irradiation on factors of hamsters natural immunity such as complement, lysozyme and antibodies in norm and in the cestode invasion has been investigated. Significant phase changes in the complement activity level, lysozyme content and specific antibodies tite have been shown to occur in hamster blood under the influence of ionizing radiation. Cestode invasion in irradiated host organism increases the negative effect of ionizing radiation on the hamster immyne system.

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Mucociliary transport so critical in nasal, paranasal sinus, and middle ear physiology is impaired in chronic sinsusitis and otitis media by factors such as increased mucus viscoelasticity, decreased ciliary area, and primary or secondary ciliary immotility. We reviewed the pathophysiology of primary ciliary dyskinesia, otitis media with effusion, chronic sinusitis, and allergic rhinitis in terms of mucociliary transport. Subjects with primary ciliary dyskinesia may experience recurrent middle ear infection, chronic airway infection, predominantly lower-lobe bronchiectasis, male sterility, or situs inversus. Primary ciliary dyskinesia is sometimes difficult to diagnose in cases without situs inversus. Nasal nitric oxide concentration in such patients decreases, although why is unclear. Mutations may involve dynein arm intermediate chain 1 (DNAI1) or dynein arm heavy chain 5 (DNAH5). Mucociliary clearance decreases more in ...

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AimsThe prevalence and importance of liver function test (LFT) abnormalities in a large contemporary cohort of heart failure patients have not been systematically evaluated.Full Text Available

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By polymerase chain reaction with arbitrary primer (AP-PCR), the possibility of transmission of genome instability to somatic cells of the offspring (F_1 generation) from male parents of mice exposed to chronic low-dose #gamma#-radiation was studied. Male mice 15 days after exposure to 10-50 cGy were mated with unirradiated females. Biopsies were taken from tale tips of two month-old mice progeny for DNA separation. Primer in the AP-PCR was 20-mer oligonucleotide flanking the micro-satellite locus Atplb2 on chromosome 11 of the mouse. Comparative analysis of individual fingerprints of AP-PCR products on DNA-templates from the offspring of irradiated and unirradiated male mice revealed an increased variability of micro-satellite-associated sequences in the genome of the offspring of males exposed to 25 and 50 cGy. DNA-fingerprints of the offspring of male mice exposed to chronic irradiation doses 10 and 25 cGy. 15 days before fertilization (at ...

UK PubMed Central (United Kingdom)

Nonthyroidal illness syndrome (NTIS) is a state of low serum 3,5,3′ triiodothyronine (T₃) that occurs in chronically ill patients; the degree of reduction in T₃ is associated...Full Text Available

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Wolsung nuclear power plant has experienced four occasions of reactor shutdown owing to heavy water leaks since its commercial operation. Among these heavy water leaks, only one case was acute and brought about reactor shutdown but the other cases listed below were chronic and repaired after manual reactor shutdown. (author). 4 tabs., 10 figs.

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Background:Timely access to publicly funded health services is a priority issue across the healthcare continuum in Canada. The purpose of this study was to examine wait list management...Full Text Available

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BackgroundHepatitis C virus (HCV) infection is the leading cause of chronic hepatitis which progresses to hepatocellular carcinoma (HCC) afflicting > 170 million people worldwide....Full Text Available

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The past three years of work for the Air Force Office of Scientific Research has resulted in the development of a congenic mouse model of JP-8 jet fuel exposure, the role of substance P in the JP-8 jet fuel-induced lung injury process, and development of ...

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1. It is not possible to give a threshold value for the dose - nor for genetic neither for somatic late effects. 2. The linear dose-effect exprapolation is not conservative in the sense of 'fying on the safe side'. 3. There has been found no relative reduction of the effects at chronic radiation exposure in man. 4 The numbers given by authorities and utilities for damage rates per rem received, that are called upper limits, are by far too low. (orig./HP).

UK PubMed Central (United Kingdom)

The three mammalian transforming growth factor (TGF)-β isoforms (TGF-β1, TGF-β2, and TGF-β3) differ in their putative roles in radiation-induced fibrosis in intestine...Full Text Available

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Ileal dysgenesis is an uncommon condition of unknown etiology occurring in the distal ileum in the region of the vitelline duct. The CT appearance of this lesion, although not previously described to our knowledge, is characteristic. We report a patient with ileal dysgenesis who had an abdominal CT scan to evaluate chronic iron deficiency anemia and protein-losing enteropathy. Recognition of this lesion by pediatric radiologists is important; so that surgical treatment, which is simple and effective, can be initiated quickly. (orig.)

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Pattern and model makers are skilled tradespersons who may be exposed to hardwoods, softwoods, phenol-formaldehyde resin-impregnated woods, epoxy and polyester/styrene resin systems, and welding and metal-casting fumes. The relationship of respiratory symptoms (wheezing, chronic bronchitis, dyspnea) and pulmonary function (FVC% predicted, FEV1% predicted, FEV1/FVC% predicted) with interview-derived cumulative exposure estimates to specific workplace agents and to all work with wood, plastic, or metal products was investigated in 751 pattern and model makers in southeast Michigan. In stratified analyses and age- and smoking-adjusted linear and logistic regression models, measures of cumulative wood exposures were associated with decrements in pulmonary function and dyspnea, but not with other symptoms. In similar analyses, measures of cumulative plastic exposures were associated with wheezing, chronic bronchitis, and dyspnea, but not with ...

International Nuclear Information System (INIS)

Astrocyte dysfunction is implicated in course of various age-related neurodegenerative diseases. Chronic injection of D-galactose can cause a progressive deterioration in learning and memory capacity and serve as an animal model of aging. To investigate the involvement of astrocytes in this model, oxidative stress biomarkers, biochemical and pathological changes of astrocytes were examined in the hippocampus of the rats with six weeks of D-galactose injection. D-galactose-injected rats displayed impaired antioxidant systems, an increase in nitric oxide levels, and a decrease in reduced glutathione levels. Consistently, western blotting and immunostaining of glial fibrillary acidic protein showed extensive activation of astrocytes. Double-immunofluorescent staining further showed activated astrocytes highly expressed inducible nitric oxide synthase. Electron microscopy demonstrated the degeneration of astrocytes, especially in the aggregated area of synapse and ...

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CT and MRI of acquired abnormalities of the inner ear and cerebello-pontine angle present themselves with very typical findings. The imaging should be adapted to the pathology looked for and either CT or MRI should be used alone or in combination.CT, especially high resolution CT (HRCT), provides an excellent bone contrast, while MRI has a much superior soft tissue contrast. Acute inflammatory changes of the inner ear are solely depicted by contrast-enhanced MRI. HRCT excellently depicts osseous changes of the inner ear and cerebellopontine angle such as chronic ossifying labyrinthitis occurring after acute labyrinthitis, otosclerotic or traumatic changes. Tumorous changes not yielding to bony changes are best delineated by MRI. Posttraumatic hemorrhage and chronic fibrotic changes within the labyrinth are depicted by MRI, only. In conclusion HRCT and MRI are excellent methods to delineate acquired abnormalities of the inner ear and ...

Science.gov (United States)

Preliminary psychometric properties of a new instrument, Angie/Andy Cartoon Trauma Scales (ACTS), are presented. Angie/Andy features a cartoon-based methodology, measuring trauma-related sequelae of prolonged, repeated abuse. A sample of 208 children comprised intrafamilial trauma, extrafamilial trauma, combined trauma, and nontrauma groups. Angie/Andy demonstrated high internal consistency, with coefficient alphas from 0.70 to 0.95. The three trauma groups scored significantly higher than the nontrauma group on all scales (p's < 0.0001). Generally, the most severely traumatized group scored significantly higher than the less severely traumatized groups. The number of types of violence exposures correlated with Angie/Andy scores from 0.55 to 0.74. The frequency and severity of trauma exposure correlated with Angie/Andy scores from 0.44 to 0.56. The Angie/Andy parent version correlated with a standardized parent scale from 0.71 to 0.81. Parent/child agreement was significant. ...

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After some observations about the tests of the research exposed in the literature, authors illustrate the tests for 142 patients divided into 5 groups: a) patients affected with acute viral hepatitis; b) patients affected with praegressa acute viral hepatitis; c) relatives of patients with acute viral hepatitis; d) volunteers; e) patients affected with chronic uraemia under dialisis periodic treatment. After the testing control, authors, conclude with an hipotesis: a possible epidemic function of faeces, urine saliva, in the passage of the acute viral hepatitis. PMID:488577

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1. Chronic exposure of male Microtus pennsylvanicus to photoperiods with 8, 10 and 12 hr of light per day results in gonadal regression, molt to winter pelage and significant reductions in body weight and food consumption relative to voles kept on photoperiods with 13 and 14 hr of light per day. 2. A precise critical daylength is observed in this species as exposure to photoperiods with 12 or fewer hours of light per day results in complete gonadal involution, seasonal molt and loss of body weight. 3. Pinealectomy abolishes all short-photoperiod induced responses in this species. PMID:2573458

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Innate immune responses are regulated by microorganisms and cell death, as well as by a third class of stress signal from the nervous and endocrine systems. The innate immune system also feeds back, through the production of cytokines, to regulate the function of the central nervous system (CNS), and this has effects on behaviour. These signals provide an extrinsic regulatory circuit that links physiological, social and environmental conditions, as perceived by the CNS, with transcriptional 'decision-making' in leukocytes. CNS-mediated regulation of innate immune responses optimizes total organism fitness and provides new opportunities for therapeutic control of chronic infectious, inflammatory and neuropsychiatric diseases.

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An overview of current concepts on neuroinflammation and on the dialogue between neurons and non-neuronal cells in three important infections of the central nervous systems (rabies, cerebral malaria, and human African trypanosomiasis or sleeping sickness) is here presented. Large numbers of cases affected by these diseases are currently reported. In the context of an issue dedicated to Camillo Golgi, historical notes on seminal discoveries on these diseases are also presented. Neuroinflammation is currently closely associated with pathogenetic mechanisms of chronic neurodegenerative diseases. Neuroinflammatory signaling in brain infections is instead relatively neglected in the neuroscience community, despite the fact that the above infections provide paradigmatic examples of alterations o...

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Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given the increased number of epidural nerve blocks being performed, some have reported unexplained complications of a transient or permanent nature and with varying degrees of severity. However, no case has been reported of a broken epidural needle tip retained in the lumbar facet joint area. This represents the first reported case presentation of foraminal stenosis developing in a patient after a retained epidural needle tip. PMID:21286465

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Taconite tailings and their component asbestiform minerals in Lake Superior water had no demonstrable effect on the chronic toxicity of cadmium to the flagfish, Jordanella floridae. Maximum acceptable toxicant concentrations determined in life cycle tests, where effects on survival, growth, reproduction, and bioconcentration were used as endpoints, were between 3.3 to 7.4, 3.0 to 6.5, and 3.4 to 7.3 micrograms cadmium/liter at 0.004, 0.08, and 0.95 mg/liter taconite tailings concentrations, respectively.

British Library Electronic Table of Contents (United Kingdom)

Regular physical activity (PA) decreases the risk of several chronic diseases including some cancers, type II diabetes, obesity, and cardiovascular disease; however, the majority of US adults are not meeting the recommended levels to experience these benefits. To address this public health concern, the underlying mechanisms for behavior change need to be understood, translated and disseminated into appropriately tailored interventions. The Transtheoretical Model (TTM) provides a framework for both the conceptualization and the measurement of behavior change, as well as facilitating promotion strategies that are individualized and easily adapted. The purpose of this manuscript is to present the constructs of the TTM as they relate to PA behavior change. We begin with a brief synopsis of rec...

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The authors hypothesized that acute respiratory responsiveness to ozone predicts chronic lung injury from repeated exposure to ozone-containing air pollution. They tested this hypothesis in 164 middle-aged nonsmoking residents of an ozone-polluted community who underwent lung-function measurements during 1986 and 1987 (i.e., time 3). The time-3 study was a follow up of more comprehensive studies conducted in 1977--1978 (time 1) and in 1982--1983 (time 2). In contrast to the apparent rapid (i.e., {approx} 60 ml/y) decline in lung-function measurements between times 1 and 2, their subjects showed little change in forced vital capacity (FVC) or forced expired volume in 1 s (FEV{sub 1.0}) between times 2 and 3, and they experienced a normal decline between times 1 and 3. A subgroup (n = 45) underwent 2-h laboratory ozone exposures to 0.4 ppm ozone, accompanied by intermittent exercise, and they experienced mild acute reductions in FEV{sub 1.0} and FVC, but there was ...

International Nuclear Information System (INIS)

The purpose of the paper is to investigate whether high-resolution CT (HRCT) can detect the subjects with massive emphysematous destruction in a group of patients with severe chronic obstructive pulmonary disease (COPD) and therefor be of help in selecting the candidates to surgical lung volume reduction. Have been examined 40 former smokers with severe COPD (FEV_1#<=#40% of the predicted value, with no major improvement after inhalation of bronchodilators). The emphysema extent score was significantly correlated with the hematocrit value and Tiffeneau index (p<2) in all the 40 patients. The severity of bronchial obstruction was the same in bronchitis and dyspnoeic patients. The subject with chronic bronchitis had milder emphysema (mean extent 35% versus 47% in the dyspnoeic subjects) and a higher frequency of bronchial involvement. A decrease in FEV_1 was significantly correlated with emphysema extent (p<1) in dyspnoeic, but not in ...

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A new method of administration of an opioid was recently registered: fentanyl transdermal (brand name: Durogesic), intended particularly for the indication range 'pain in cancer'. Fentanyl is lipid-soluble so that deposition in the skin takes place and the biological half-life is approximately 20 hours after removal of the plaster. It is safe to start on a basis of an equianalgesic conversion of 100:1 in relation to oral morphine, although this may entail some risk of fentanyl under dosage. The dose adjustment time is 12-24 hours before a constant fentanyl level is reached; therefore, after attaching the first sticking plaster, the original morphine dose should be continued for another 12 hours. In addition, the patient may, if necessary, be given supplementary morphine preferably as a short-acting drug. There seems to be no clear indication for transdermal fentanyl either in neuropathic pain or in chronic benign pain. PMID:9221362

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B-cell Chronic Lymphocytic Leukemia; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Waldenstrom Macroglobulinemia

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Summary Background Pemphigus vulgaris and pemphigus foliaceus are rare, potentially life-threatening, autoimmune disorders characterized by antibodies to epidermal adhesion molecules. Clinical characteristics are painful chronic erosions of mucous membranes and of the skin. There are only few published studies on the impact of the disease on the health status (HS) of patients with these conditions. Objectives To assess the impact of disease on the HS of patients with pemphigus. Methods Fifty-eight patients enrolled at the Bullous Skin Diseases Unit of IDI-IRCCS in the period January-June 2006 were assessed for their HS using the Medical Outcomes Study 36-item short form health survey (SF-36) questionnaire and for anxiety and depression using the Institute for Personality and Ability Testin...

International Nuclear Information System (INIS)

In spite of the improved imaging techniques currently available, mortality for pancreatic cancer is still high, and pancreatics is often diagnosed only in its advanced stages. The authors investigated the value of different imaging techniques - i.e., US, CT, and ERCP - for an early diagnosis, when a more effective (curative?) treatment can be suggested. Fifty-six cases of pancreatic cancer and 36 cases of chronic pancreatitis were evaluated. The results indicate that ERCP, with the help of statistical methods, is superior to US and CT not only in evaluating early neoplastic or inflammatory lesions, but also for their differential diagnosis. In the letter case, ERCP can sometimes be used as a valid alternative to fine-needle aspiration biopsy.

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In Kanazawa, Japan, air pollution from a Mn treatment factory was found to affect local junior high school students, who showed reduced respiratory function relative to their exposure to Mn. The use of Mn as an antiknock ingredient in automobile fuels has recently been introduced, placing the general population at risk of chronic low-level exposure. There are few animal studies on the effects of compounds other than manganese chloride (MnCl{sub 2}). In the case of environmental pollution by Mn, the differing physiological effects of the various chemical forms of Mn must be considered. The present study therefore examined the differences in the effects of several Mn compounds on the physiology and behavior of mice by short-term oral administration.

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Human exposure to environmental chemicals is most correctly characterized as exposure to mixtures of these agents. The metals/metalloids, lead (Pb), cadmium (Cd), and arsenic (As), are among the leading toxic agents detected in the environment. Exposure to these elements, particularly at chronic low dose levels, is still a major public health concern. Concurrent exposure to Pb, Cd, or As may produce additive or synergistic interactions or even new effects that are not seen in single component exposures. Evaluating these interactions on a mechanistic basis is essential for risk assessment and management of metal/metalloid mixtures. This paper will review a number of individual studies that addressed interactions of these metals/metalloids in both experimental and human exposure studies with...

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Radon measurements were carried out in Kozlu, Karadon and Uzulmez underground coal mines of Zonguldak bituminous coal basin in Turkey. Passive-time integrating method, which is the most widely used technique for the measurement of radon concentration in air, was applied by using nuclear etched track detectors (CR-39) in the study area. The radon concentration measurements were performed on a total of 42 points in those three mines. The annual exposure, the annual effective dose and lifetime fatality risk, which are the important parameters for the health of workers, were estimated based on chronic occupational exposure to the radon gas, which is calculated using UNCEAR-2000 and ICRP-65 models. The radon concentrations at several coal production faces are higher than the action level of 1000 Bq m{sup -3}. It is suggested that the ventilation rates should be rearranged to reduce the radon concentration.

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Penile rehabilitation therapy following radical prostatectomy is a much debated topic. Erectile dysfunction is still a significant contributor to postoperative morbidity following radical prostatectomy, despite meticulous nerve-sparing technique. Secondary smooth muscle changes in the penis have been identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and fibrosis. Initial observations that intracavernous injection therapies used on a regular basis postoperatively resulted in improvements in the return of spontaneous erectile function led to the development of penile rehabilitation protocols. Chronic dosing of PDE-V inhibitors is now commonly used by urologists after radical prostatectomy. Despite the current enthusiasm of penile rehabilitation therapy, current scientific evidence with clinical trials is still limited. PMID:19255627

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Asthma, affecting as many as 400 million individuals worldwide, is one of the most prevalent chronic health condition in the United States. With an increasing number of patients with asthma and the frequent inability of conventional lifestyle modification and therapy to effectively control the problem, nutritional and dietary therapies are being sought. This study was undertaken to investigate the efficacy of the purple passion fruit peel (PFP) extract, a novel mixture of bioflavonoids, on asthma symptoms. Patients with asthma were studied in a 4-week randomized, placebo-controlled, double-blind trial with oral administration of PFP extract (150 mg/d) or placebo pills. The effects of PFP extract were evaluated by assessing the clinical symptoms of asthma and spirometry tests. Most clinical...

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Abstract Despite reduced sympathetic activity below the level of a spinal cord injury (SCI), venoconstriction during autonomic dysreflexia increases venous return to the heart. Here, contractions of isometrically mounted tail veins from rats with spinal transection at T4 performed 8???10 weeks earlier are compared with those from sham-operated rats. After SCI, lumen diameter was reduced by ?30% and the contractions evoked by electrical stimulation of the perivascular axons were larger than control. This augmentation of neurovascular transmission was not associated with enhanced sensitivity to ?-adrenoceptor agonists or to adenosine-5?-triphosphate (ATP) although contractions to depolarization with K+ were larger after SCI. The percentage reduction in nerve-evoked contraction after SCI prod...

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A noninvasive method is described for estimating local cerebral blood flow (LCBF) and local partition coefficients by means of computed tomographic scanning during inhalation of 30% stable xenon gas in oxygen. Time-dependent xenon concentrations in arterial blood and brain tissue during the wash-in and washout phases are used to calculate partition coefficients and LCBF values by means of a least-squares curve-fitting analysis. Control values for partition coefficient and LCBF obtained from control subjects with minor head trauma in the chronic stage were compatible with those in several past reports, and reproducibility was satisfactory. The theoretic grounds underlying this new method of curve-fitting analysis are discussed.

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The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-#alpha# antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-#alpha# antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI is useful for ...

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Summaries are included of research contracts which expired prior to Dec. 31, 1960. The contracts were concerned with investigations of: electrophysiological responses of biological systems in nerve cells to irradiation with small doses of ionizing radiations; the mode of the protective action of certain sulfhydryl compounds against radiation effects on the synthesis of deoxyribonucleic acid, using tritium-labeled thymidine; development of a bubble chamber method of monitoring and dosimetry for Low fast neutron fluxes; effects of incorporated radioisotopes on the stability of genetic materials; interrelation of root and leaf absorption of radioisotopes in herbaceous plants; uptake of radioactive wastes by lowland rice from soils contaminated by irrigation water, and decontamination of the rice; and comparison between mutation rates induced by acute and chronic gamma irradiations. (B.O.G.)

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Gonadal hormones modulate neurogenesis in the dentate gyrus differentially in male and female adult rodents. Neurogenesis is comprised of at least two components: cell proliferation (the production of new cells) and cell survival (the number of new neurons that survive to maturity). Previous studies have found sex differences in the level of cell proliferation in the dentate gyrus only when comparing females in a high estrogen state to males. This review focuses on the effects of acute and chronic levels of estrogens or androgens on hippocampal neurogenesis in the adult male and female rodent. Evidence is also reviewed for the co-localization of androgen receptors and estrogen receptors (ER) with markers for cell proliferation or immature new cell survival. Briefly, evidence suggests that ...

Science.gov (United States)

Therapeutic decisions are quite clear-cut for asymptomatic gallstone disease and acute cholecystitis. However, the appropriate therapeutic course for older patients with chronic cholecystitis may be less obvious. Watchful waiting may be reasonable for patients with mild and infrequent symptoms. For healthy patients, cholecystectomy is recommended if symptoms are becoming more frequent and severe. Laparoscopy may reduce the complication rate and be safely performed even in those with underlying medical illness. Oral dissolution therapy can be attempted for qualifying symptomatic patients who are at poor surgical risk or who refuse surgery. Shock wave lithotripsy and contact dissolution therapy show some promise but are currently experimental. PMID:8339941

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Summary There is a current popular recognition that cigarette smoking is deleterious to health. Although this is very clearly the case for physical health, the situation regarding mental health is, however, rather more complicated. This piece concentrates on the role of smoking in schizophrenia: it is important to consider why schizophrenia, exceptionally amongst the severe and enduring mental illnesses, is associated with increased cigarette consumption. People who suffer from schizophrenia consequently have a greater risk of the complications to physical health caused by this addiction and clearly, it is important to understand why this occurs. Numerous investigators have found that both neuroleptic-naive, first-onset schizophrenics, together with chronic sufferers of the illness, consum...

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A historical perspective is given of the current paradigm that does not explicitly protect the environment from radiation, but instead, relies on the concept that if dose limits are set to protect humans then the environment is automatically protected as well. We summarize recent international questioning of this paradigm and briefly present three different frameworks for protecting biota that are being considered by the U.S. DOE, the Canadian government and the International Commission on Radiological Protection. We emphasize that an enhanced collaboration is required between what has traditionally been separated disciplines of radiation biology and radiation ecology if we are going to properly address the current environmental radiation problems. We then summarize results generated from an EMSP grant that allowed us to develop a Low Dose Irradiation Facility that specifically addresses effects of low-level, chronic irradiation on multiple levels of biological ...

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The article examines the limits and challenges small powers face when they adjust to systemic changes. Specifically, this article discusses the Philippines' conduct of a diplomatic strategy of equi balancing between the USA and China. In this strategy, the Philippines enhances and deepens its security relations with its strategic ally, the USA and at the same time, obtains economic assistance and politico diplomatic concessions from East Asia's emergent power, China. The Philippines' diplomatic gambit, however, is restrained by its formal alliance with the USA and its chronic territorial dispute with China over the Spratly Islands. At present, several developments are undermining Manila's efforts in playing this balancing game with Washington and Beijing. These are: the Philippines' passiv...

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Abstract Introduction.- There are no studies on the sexual function of male patients with Behet's disease (BD), but it is probable that male sexual dysfunction may be seen in this chronic condition. Aim.- The aim of this study was to assess the effect of BD on male sexual function and psychiatric status, and to examine the relationship between sexual function and depression in this population. Methods.- Patients with a diagnosis of BD for at least one year were included in the study. The patients' age, educational level, and duration of disease were recorded. A healthy control group was selected with highly similar characteristics to the patient group. The sexual functions of the patient and the control groups were assessed using the International Index of Erectile Functions (IIEF), and th...

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A destructive spondyloarthropathy is reported in four patients undergoing maintenance hemodialysis for chronic renal disease. In a separate investigation a controlled, prospective radiographic study of the cervical spine revealed this spondyloarthropathy in 4 (15%) of 26 long-term dialysis patients. A single disk level was involved in three patients, and two disc levels were involved in one patient. This spondyloarthropathy correlated with the duration of dialysis but not with the radiographic evidence of renal osteodystrophy or severity of laboratory abnormalities associated with hyperparathyroidism. Three of these four patients also had discovertebral erosions or destruction involving the lumbar spine. Cervical spine flexion views revealed evidence of ligamentous laxity or instability in three (12%) dialysis patients, all with vertebral resorption and disc space narrowing. It is postulated that this instability may contribute to the development of cervical ...

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Aims The aim of this study is to examine the dose?response relationships between age, ?lifestyle factors?? (body mass index, tobacco smoking, sports), and symptomatic knee osteoarthritis in a population-based case?control study. Additionally, the study aims to investigate the mode of interaction between body mass index (BMI) and physical workload (occupational kneeling/squatting and lifting/carrying of loads) with respect to the risk of symptomatic knee osteoarthritis. Methods In five orthopedic clinics and five practices, 295 male patients aged 25?70 with radiographically confirmed knee osteoarthritis associated with chronic complaints were recruited. The control group comprised 327 male control subjects. In a structured personal interview, body weight at different ages, body height, cumu...

International Nuclear Information System (INIS)

Since the publication by the International Commission on Radiological Protection of revised recommendations which set out some general principles for intervention, some ideas have emerged which address interventions in the case of chronic exposure from contaminated lands. In the past there have been interventions proposed or carried out to rehabilitate land contaminated during the era of atmospheric nuclear weapon testing. Some of these interventions are reviewed in the context of these ideas and it is concluded that, by and large, reasonable outcomes have been achieved. The concept of a 'generic action level' (an effective dose of the order of 10 mSv#centre dot#a"-"1 to representative individuals in the critical group) may be useful in future to aid decision makers in determining whether intervention is appropriate. (author)