The World War II Homefront: An ERIC/ChESS Sample.

Science.gov (United States)

Pinhey, Laura

2002-01-01

Provides citations with abstracts from the ERIC database focusing on the U.S. homefront during World War II. Includes background information and teaching materials on topics such as popular music from 1941-1945, propaganda directed towards women, and learning about Japanese American internment. (CMK)

Saladusi mäletavad pildid : järelvaade Eric Soovere fotograafilisele dokumentalistikale / Peeter Linnap

Index Scriptorium Estoniae

Linnap, Peeter, 1960-

2010-01-01

Eric Sooverest ja tema fotoloomingust. Eric Soovere ja Johannes Pääsukese loomingu võrdlus. Katkendeid Eric Soovere raamatust "Käru ja kaameraga : pilte ja päevikulehti põgenemisteelt 1944-1949". Pikemalt emigreerumisest Ameerikasse

Database Changes (Post-Publication). ERIC Processing Manual, Section X.

Science.gov (United States)

Brandhorst, Ted, Ed.

The purpose of this section is to specify the procedure for making changes to the ERIC database after the data involved have been announced in the abstract journals RIE or CIJE. As a matter of general ERIC policy, a document or journal article is not re-announced or re-entered into the database as a new accession for the purpose of accomplishing a…

DNA fingerprinting by ERIC-PCR for comparing Listeria spp. strains isolated from different sources in San Luis: Argentina Caracterización molecular por ERIC-PCR de cepas de Listeria spp. aisladas de diversos orígenes en San Luis: Argentina

Directory of Open Access Journals (Sweden)

A. Laciar

2006-04-01

Full Text Available In this study, a total of 24 Listeria spp. strains were analyzed. Twenty-two isolates were obtained in San Luis (Argentina from human, animal, and food samples. Two types of strains, Listeria monocytogenes CLIP 22762 and Listeria innocua CLIP 74915, were included as reference strains. All isolates were biochemically identified and characterized by serotyping, phage typing, and amplification of the flaA gene by polymerase chain reaction (PCR. Repetitive intergenic consensus (ERIC sequence-based PCR was used to generate DNA fingerprints. On the basis of ERIC-PCR fingerprints, Listeria spp. strains were divided into three major clusters matching origin of isolation. ERIC-PCR fingerprints of human and animal isolates were different from those of food isolates. In addition, groups I and II included ten L. monocytogenes strains, and only one Listeria seeligeri strain. Group III included nine L. innocua strains and four L. monocytogenes strains. Computer evaluation of ERIC-PCR fingerprints allowed discrimination between the tested serotypes 1/2b, 4b, 6a, and 6b within each major cluster. The index of discrimination calculated was 0.94. This study suggests that the ERIC-PCR technique provides an alternative method for the identification of Listeria species and the discrimination of strains within one species.En este estudio se analizaron 24 cepas de Listeria spp. De ellas, 22 fueron obtenidas en San Luis (Argentina, a partir de muestras humanas, de animales y alimentos. Se incluyeron 2 cepas de referencia Listeria monocytogenes CLIP 22762 y Listeria innocua CLIP 74915. Todos los aislamientos fueron identificados bioquímicamente y caracterizados por serotipificación, fagotipificación y detección del gen flaA por reacción en cadena de la polimerasa (PCR. Se generaron perfiles de bandas de ADN mediante la amplificación de secuencias repetitivas de consenso intergénico de enterobacterias (ERIC-PCR. De acuerdo a los resultados obtenidos por ERIC

Encore: A Selction of Articles from ERIC/ECE Newsletters (Jan. 1971-Dec. 1972).

Science.gov (United States)

ERIC Clearinghouse on Early Childhood Education, Champaign, IL.

This compilation of articles from newsletters issued by the ERIC Clearinghouse on Early Childhood Education, (January 1971 - December 1972) includes a wide variety of topics such as: teachers' developmental stages, family day care in Pasadena, television violence, children's altruistic lying, and the Home Start program. Also included is a complete…

Fractal dimensions the digital art of Eric Hammel

CERN Document Server

Hammel, Eric

2014-01-01

The concept behind fractal geometry is extremely difficult to explain . . . but easy to see and enjoy. Eric Hammel, a professional author of military history books, is unable to explain fractals in a way that will be clear to anyone else, but most mathematicians can't explain fractals in language most people can understand. The simplest explanation is that fractals are graphic representations of high-order mathematical formulas that repeat patterns to infinity.Don't get hung up on the math. It's really all in the seeing. Like Volume 1 of Eric Hammel's Fractal Dimensions, Volume 2 is filled wit

Fractal dimensions the digital art of Eric Hammel

CERN Document Server

Hammel, Eric

2014-01-01

The concept behind fractal geometry is extremely difficult to explain . . . but easy to see and enjoy. Eric Hammel, a professional author of military history books, is unable to explain fractals in a way that will be clear to anyone else, but most mathematicians can't explain fractals in language most people can understand. The simplest explanation is that fractals are graphic representations of high-order mathematical formulas that repeat patterns to infinity.Don't get hung up on the math. It's really all in the seeing. Like Volumes 1, 2, and 3 of Eric Hammel's Fractal Dimensions, Volume 4 is

Fractal dimensions the digital art of Eric Hammel

CERN Document Server

Hammel, Eric

2014-01-01

The concept behind fractal geometry is extremely difficult to explain . . . but easy to see and enjoy. Eric Hammel, a professional author of military history books, is unable to explain fractals in a way that will be clear to anyone else, but most mathematicians can't explain fractals in language most people can understand. The simplest explanation is that fractals are graphic representations of high-order mathematical formulas that repeat patterns to infinity.Don't get hung up on the math. It's really all in the seeing. Like Volumes 1 and 2 of Eric Hammel's Fractal Dimensions, Volume 3 is fil

A Canonical Approach to the Argument/Adjunct Distinction

Directory of Open Access Journals (Sweden)

Diana Forker

2014-01-01

Full Text Available This paper provides an account of the argument/adjunct distinction implementing the 'canonical approach'. I identify five criteria (obligatoriness, latency, co-occurrence restrictions, grammatical relations, and iterability and seven diagnostic tendencies that can be used to distinguish canonical arguments from canonical adjuncts. I then apply the criteria and tendencies to data from the Nakh-Daghestanian language Hinuq. Hinuq makes extensive use of spatial cases for marking adjunct-like and argument-like NPs. By means of the criteria and tendencies it is possible to distinguish spatial NPs that come close to canonical arguments from those that are canonical adjuncts, and to place the remaining NPs bearing spatial cases within the argument-adjunct continuum.

Teaching about Presidential Elections. ERIC Digest.

Science.gov (United States)

Vontz, Thomas S.; Nixon, William A.

Although elections are an annual theme in many social studies classrooms, presidential election years prompt increased interest among students in the electoral process and offer an opportunity to teach about a national election as it happens. This ERIC Digest describes the legal requirements and traditions of U.S. presidential elections, processes…

Adjunction, Labeling, and Bare Phrase Structure

Directory of Open Access Journals (Sweden)

Norbert Hornstein

2008-03-01

Full Text Available The primary aim in this paper is to propose a phrase structure for adjunction that is compatible with the precepts of Bare Phrase Structure (BPS. Current accounts are at odds with the central vision of BPS and current practice leans more to descriptive eclecticism than to theoretical insight. A diagnosis for this conceptual disarray is suggested here: It stems from a deeply held though seldom formulated intuition; the tacit view that adjuncts are the abnormal case while arguments describe the grammatical norm. In actuality, it is argued, adjuncts are so well behaved that they require virtually no grammatical support to function properly. Arguments, in contrast, are refractory and require grammatical aid to allow them to make any propositional contribution. This last remark should come as no surprise to those with neo-Davidsonian semantic sympathies. Connoisseurs of this art form are well versed in the important role that grammatical (aka, thematic roles play in turning arguments into modifiers of events. Such fulcra are not required for meaningfully integrating adjuncts. into sentences. In what follows, we take this difference to be of the greatest significance and we ask ourselves what this might imply for the phrase structure of adjunction.

"Innovation and Intellectual Property Policies in European Research Infrastructure Consortia - PART I: The Case of the European Spallation Source ERIC"

DEFF Research Database (Denmark)

Yu, Helen; Wested, Jakob; Minssen, Timo

2017-01-01

, the European Spallation Source ERIC is required to adopt various policy documents relating to the operation and management of the facility. These cover a wide variety of issues such as user access, public procurement, intellectual property rights (IPR), data management, and dissemination. One of the main goals...... of the problems society is facing today. To facilitate the creation and operation of such RIs, the EU adopted legal frameworks for European Research Infrastructure Consortia (ERIC). On August 31, 2015, the European Spallation Source (ESS) was established as an ERIC. Under the ERIC Regulations and ESS Statutes...... international research collaborations? The complex relationship between scientific excellence, innovation, and IPRs must be carefully considered. Taking the European Spallation Source ERIC as an example, this article investigates ERIC Regulations and EU policies and discusses what issues and perspectives ERICs...

Adolescents: Your Children and Mine. ERIC Report.

Science.gov (United States)

Demo, Mary Penasack

1981-01-01

Reviews 10 items from the ERIC collection covering various aspects of adolescence: the impact of pop music, attitudes about drinking, television viewing, the effect of the new morality, the adolescent learning process, popular books, attitudes toward school, and others. (JMF)

Athletic Trainers' Knowledge Regarding Airway Adjuncts

Science.gov (United States)

Edler, Jessica R.; Eberman, Lindsey E.; Kahanov, Leamor; Roman, Christopher; Mata, Heather Lynne

2015-01-01

Context: Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective: To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the…

Eric Monkkonen (1942-2005)

OpenAIRE

Roth, Randolph

2009-01-01

Eric Monkkonen, who passed away on May 30, 2005 at the age of 62, was one of the greatest historians ever to write on the history of crime. An urban and social science historian by training, he dedicated his life to understanding the social problems that, like many historians of his generation, he believed most pressing: poverty, prejudice, and violence. He was an iconoclast in his approach to those problems, on good terms with ideologues of all stripes but unwilling to settle for ideological...

Online Training and Practice Manual for ERIC Data Base Searchers. 2nd Edition.

Science.gov (United States)

Markey, Karen; Cochrane, Pauline A.

Revised to reflect changes in both DIALOG and ERIC, this second edition of a self-improvement manual for online searchers who wish to refine their skills presents three basic approaches to searching and provides illustrations from DIALOG's ERIC ONTAP database. The manual is divided into two parts: an 8-step model of the total search process which…

Freedom of Expression: A Troublesome Imperative. ERIC Report.

Science.gov (United States)

Del Polito, Carolyn M.

1980-01-01

Presents an annotated bibliography of 19 items from ERIC identifying troublesome paradoxes regarding the media and freedom of expression. Items are categorized by issues identified as relevant to radio and television, commercial advertising, and the press. (JMF)

Television Violence and Children. ERIC/EECE Report.

Science.gov (United States)

Cesarone, Bernard

1998-01-01

Summarizes 12 recent documents and journal articles from the ERIC database that discuss topics related to television violence and children. Articles cited address the effects of television violence on child behavior and attitudes at school and home, and methods of reducing the impact of television on children. (JPB)

Ultrasound as an Adjunct to Mammography for Breast Cancer Screening: A Health Technology Assessment

Science.gov (United States)

Nikitovic-Jokic, Milica; Tu, Hong Anh; Palimaka, Stefan; Higgins, Caroline; Holubowich, Corinne

2016-01-01

Background Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Ultrasound has been suggested as a safe adjunct screening tool that can detect breast cancers missed on mammography. We investigated the benefits, harms, cost-effectiveness, and cost burden of ultrasound as an adjunct to mammography compared with mammography alone for screening women at average risk and at high risk for breast cancer. Methods We searched Ovid MEDLINE, Ovid Embase, EBM Reviews, and the NHS Economic Evaluation Database, from January 1998 to June 2015, for evidence of effectiveness, harms, diagnostic accuracy, and cost-effectiveness. Only studies evaluating the use of ultrasound as an adjunct to mammography in the specified populations were included. We also conducted a cost analysis to estimate the costs in Ontario over the next 5 years to fund ultrasound as an adjunct to mammography in breast cancer screening for high-risk women who are contraindicated for MRI, the current standard of care to supplement mammography. Results No studies in average-risk women met the inclusion criteria of the clinical review. We included 5 prospective, paired cohort studies in high-risk women, 4 of which were relevant to the Ontario context. Adjunct ultrasound identified between 2.3 and 5.9 additional breast cancers per 1,000 screens. The average pooled sensitivity of mammography and ultrasound was 53%, a statistically significant increase relative to mammography alone (absolute increase 13%; P screening alone. The GRADE for this body of evidence was low. Additional annual costs of using breast ultrasound as an adjunct to mammography for high-risk women in Ontario contraindicated for MRI would range from $15,500 to $30,250 in the next 5 years. Conclusions We found no evidence that evaluated the comparative effectiveness or diagnostic accuracy of screening breast ultrasound as an adjunct to

RAPD- and ERIC-Based Typing of Clinical and Environmental Pseudomonas aeruginosa Isolates.

Science.gov (United States)

Auda, Ibtesam Ghadban; Al-Kadmy, Israa M S; Kareem, Sawsan Mohammed; Lafta, Aliaa Khyuon; A'Affus, Mustafa Hussein Obeid; Khit, Ibrahim Abd Aloahd; Al Kheraif, Abdulaziz Abdullah; Divakar, Darshan Devang; Ramakrishnaiah, Ravikumar

2017-03-01

Pseudomonas aeruginosa is a major cause of nosocomial infection in children and adults, resulting in significant morbidity and mortality due to its ability to acquire drug resistance. The ability of P. aeruginosa in the environment to cause infection in individuals has been reported previously; henceforth, surveillance of the emergence and transmission of P. aeruginosa strains among patients is important for infection control in a clinical setup. Various gene-typing methods have been used for epidemiological typing of P. aeruginosa isolates for the purpose of surveillance. In this work, the suitability and comparability of two typing methods, enterobacterial repetitive intergenic consensus (ERIC)-PCR and random amplification of polymorphic DNA (RAPD)-PCR fingerprinting, were studied to characterize P. aeruginosa strains isolated from clinical and environmental sources. Forty-four clinical and environmental bacterial isolates of P. aeruginosa were collected between October 2015 and January 2016. DNA extraction, ERIC-PCR and RAPD-PCR, agarose gel electrophoresis, and phylogenetic analyses were carried using the unweighted pair-group method with mean. RAPD typing revealed less clonality among clinical isolates, whereas the ERIC method showed greater similarity in comparison with RAPD. Environmental isolates, however, showed greater similarity using RAPD compared with ERIC typing. With only a few exceptions, most clinical isolates were distinct from environmental isolates, irrespective of the typing method. In conclusion, both the RAPD and ERIC typing methods proved to be good tools in understanding clonal diversity. The results also suggest that there is no relationship between clinical and environmental isolates. The absence of clonality among the clinical isolates may indicate that most P. aeruginosa infection cases could be endemic and not epidemic and that endemic infections may be due to nonclonal strains of P. aeruginosa.

Adjuncts and the Processing of Lexical Rules

NARCIS (Netherlands)

Noord, G. van; Bouma, G.

2001-01-01

Abstract: The standard HPSG analysis of Germanic verb clusters can not explain the observed narrow-scope readings of adjuncts in such verb clusters. We present an extension of the HPSG analysis that accounts for the systematic ambiguity of the scope of adjuncts in verb cluster constructions, by

Adjuncts in Social Work Programs: Good Practice or Unethical?

Science.gov (United States)

Pearlman, Catherine A.

2013-01-01

Social work education programs rely heavily on adjunct instructors, as do most academic institutions. This article adds to existing literature on adjuncts by focusing on the unique issues in social work education, using social work values and ethics as a focus. The benefits and detriments for adjuncts, programs, and students in schools of social…

La Disciplina Positiva (Positive Discipline). ERIC Digest.

Science.gov (United States)

ERIC Clearinghouse on Elementary and Early Childhood Education, Urbana, IL.

This ERIC Digest suggests methods and language that can be used in handling difficult, but common, situations involving young children. The digest explains 12 methods of disciplining children that promote children's self-worth. These methods are: (1) showing children that the reasons for their actions are understood; (2) stating reasons; (3)…

Online Public Access Catalogs. ERIC Fact Sheet.

Science.gov (United States)

Cochrane, Pauline A.

A listing is presented of 17 documents in the ERIC database concerning the Online Catalog (sometimes referred to as OPAC or Online Public Access Catalog), a computer-based and supported library catalog designed for patron use. The database usually represents recent acquisitions and often contains information about books on order and items in…

Eric Hobsbawm y su lectura marxista de la historia

Directory of Open Access Journals (Sweden)

Pilatowsky, Mauricio

2014-06-01

Full Text Available This paper presents a brief survey of the contributions made by the historian Eric Hobsbawm to the field of History and his Marxist stance, both in his academic work and political practice. According to the author, the circumstances in which the researchers live are determinant to their study; hence this analysis includes a review of his biography. This perspective discusses his interpretation of Marx and Marxism, his understanding of History, his militancy in the Communist Party, his Jewish identity, and how he addresses nationalism in relation to the study of capitalism.En este ensayo se presenta un breve estudio de las aportaciones del historiador Eric Hobsbawm en el campo de la historia y de sus posturas marxistas; tanto en su trabajo académico como en su práctica política. El análisis incluye una revisión de su biografía ya que según el autor los investigadores y su manera de investigar responden a las circunstancias que les toca vivir. Desde esta perspectiva se aborda su interpretación de Marx y del marxismo, su forma de entender la historia, su militancia en el Partido Comunista, su identidad judía y el tratamiento del nacionalismo en su relación con el estudio del capitalismo.

[Comparison of Bacteria ERIC-PCR Fingerprints of Index Fingers and Contactants].

Science.gov (United States)

Liu, Y T; Sun, D M; Shi, S P; Yang, X

2018-02-01

To explore the bacteria relevance between index fingers and contactant' surfaces （mobile phone touch screen and desktop of personal office table）. Bacteria were collected from the index fingers, mobile phone touch screen and desktop of personal office table of 10 volunteers. Enterobacterial repetitive intergenic consensus （ERIC）-PCR fingerprint was established by PCR amplification technique of metagenome. There were 7 volunteers' ERIC-PCR fingerprints of index fingers matched that took from the mobile phone touch screens, and different from each other. There were 3 volunteers' ERIC-PCR fingerprints of index fingers matched that took from desk top of personal office table, and other 7 volunteers' ERIC-PCR fingerprints did not match perfectly with that took from desk top of personal office table, but had at least one similar band for both. The bacteria on index finger shows individual specificity, which on mobile phone touching screen and personal desktop may be a new biological sample of forensic identification. Copyright© by the Editorial Department of Journal of Forensic Medicine.

Adjunct Faculty Job Satisfaction in California Community Colleges: A Narrative Inquiry

Science.gov (United States)

Nagle, Tonya

2016-01-01

The problem addressed in the qualitative narrative inquiry is the perceived level of adjunct faculty job satisfaction. The general problem is the inconclusive and contradictory information on job satisfaction for adjuncts nationwide. The specific problem is poor job satisfaction for adjunct faculty in California where adjuncts are 48% of the…

32 CFR 728.93 - Chart of adjuncts.

Science.gov (United States)

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Chart of adjuncts. 728.93 Section 728.93 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.93 Chart of...

Eric Kandel's Reductionism in Art and Brain Science - Bridging the Two Cultures.

Science.gov (United States)

Bilsky, Ed

2017-01-01

Reductive art is a term to describe an artistic style or an aesthetic, rather than an art movement. It is stripping down as a new way of seeing. Movements and other terms that are sometimes associated with reductive art include abstract art, minimalism, ABC art, anti-illusionism, cool art, and rejective art. Eric Kandel's fifth book focuses on reductionism as the principle guiding an ongoing dialogue between the worlds of science and art .

Understanding Mathematics and Culture in Rural Contexts. ERIC Digest.

Science.gov (United States)

Bush, William S.

This ERIC Digest provides an overview of concepts, writers, and tenets associated with the study of mathematics and culture and offers researchers a framework for the field, particularly with regard to rural contexts. (Author)

Conferencias de padres-educadores: Sugerencias para los padres (Parent-Teacher Conferences: Suggestions for Parents). ERIC Digest.

Science.gov (United States)

Clark, Ann-Marie

Parent-teacher conferences sometimes become a cause for concern for everyone involved. This Spanish-language ERIC Digest outlines ways to improve communication during parent-teacher conferences. Suggestions are offered to help parents participate more effectively in conferences, including identifying what is being done to help a child overcome a…

"Innovation and Intellectual Property Policies in European Research Infrastructure Consortia - PART I: The Case of the European Spallation Source ERIC"

DEFF Research Database (Denmark)

Yu, Helen; Wested, Jakob; Minssen, Timo

2017-01-01

of the problems society is facing today. To facilitate the creation and operation of such RIs, the EU adopted legal frameworks for European Research Infrastructure Consortia (ERIC). On August 31, 2015, the European Spallation Source (ESS) was established as an ERIC. Under the ERIC Regulations and ESS Statutes......, the European Spallation Source ERIC is required to adopt various policy documents relating to the operation and management of the facility. These cover a wide variety of issues such as user access, public procurement, intellectual property rights (IPR), data management, and dissemination. One of the main goals...

The future seen from Erice

International Nuclear Information System (INIS)

Anon.

1986-01-01

A few specialists have been finding time to think beyond the LEP electron- positron Collider now being built at CERN and the SSC Superconducting Super Collider proposed for the US to the physics needs and accelerator possibilities of the future. Despite the modest effort, a lot of progress has been made in sorting the wheat from the chaff amongst proposed accelerator schemes and in defining crucial features of future machines. Some of this thinking came together at a seminar on 'New Techniques for Future Accelerators' held in Erice, Sicily, from 12-17 May

Saladusi mäletavad pildid : järelvaade Eric Soovere fotograafilisele dokumentalistikale / Peeter Linnap

Index Scriptorium Estoniae

Linnap, Peeter, 1960-

2009-01-01

Ameerikas elanud eesti fotograafi Eric Soovere (sünd. Erich Soeson, 1916-2008) eluloolisi andmeid. Tema loomingust, mis jaguneb kolme perioodi: etnograafiline fotokooslus Lõuna-Eesti külaelanikest (1930ndate lõpp), Sooverede perekonna põgenemisteekond Eestist USA-sse (ca 1944-1949), perekonna elu Cincinnatis USA-s (1950ndad). Fotod eestlaste põgenemisteekonnast on avaldatud raamatus Eric Soovere. Käru ja kaameraga : pilte ja päevikulehti põgenemisteelt 1944-1949. Tallinn : Olion, 1999

Metformin as an adjunct therapy for the treatment of moderate to severe acne vulgaris.

Science.gov (United States)

Lee, John K; Smith, Andrew D

2017-11-15

The purpose of this literature review is to evaluate the use of metformin as an adjunct therapy in the treatment of moderate-to-severe acne in those not diagnosed with polycystic ovary syndrome (PCOS) or androgen excess. The authors conducted independent literature searches. Results were limited to clinical trials and randomized controlled trials. Studies with participants diagnosed with moderateto-severe acne vulgaris taking metformin versus placebo or other active treatment were included;studies with participants diagnosed with PCOS or androgen excess were excluded. The authors found three studies consistent with the search guidelines that evaluated the effects of metformin as adjunct therapy in moderate to severe acne vulgaris. In eachstudy, metformin was an effective adjunct therapy in the treatment of moderate-to-severe acne vulgaris.

Educating the Educator: Teaching Airway Adjunct Techniques in Athletic Training

Science.gov (United States)

Berry, David C.; Seitz, S. Robert

2011-01-01

The 5th edition of the "Athletic Training Education Competencies" ("Competencies") now requires athletic training educators (ATEs) to introduce into the curriculum various types of airway adjuncts including: (1) oropharyngeal airways (OPA), (2) nasopharyngeal airways (NPA), (3) supraglottic airways (SGA), and (4) suction. The addition of these…

Professor Eric Can't See: A Project-Based Learning Case for Neurobiology Students.

Science.gov (United States)

Ogilvie, Judith Mosinger; Ribbens, Eric

2016-01-01

"Professor Eric Can't See" is a semi-biographical case study written for an upper level undergraduate Neurobiology of Disease course. The case is integrated into a unit using a project-based learning approach to investigate the retinal degenerative disorder Retinitis pigmentosa and the visual system. Some case study scenes provide specific questions for student discussion and problem-based learning, while others provide background for student inquiry and related active learning exercises. The case was adapted from "'Chemical Eric' Can't See," and could be adapted for courses in general neuroscience or sensory neuroscience.

Effects of incidental pictorial and verbal adjuncts on text learning.

Science.gov (United States)

Terry, W S; Howe, D C

1988-01-01

In this study, college students read and studied texts on historical figures in psychology, which were supplemented by drawings and/or brief biographies of these persons. In Experiment 1, a 2 x 2 between-groups design was conducted in which students received one adjunct with each text, both adjuncts, or neither. In Experiment 2, a single group of students received a within-subjects manipulation of the same adjunct conditions. In the between-groups comparison, students receiving biographies learned less of the target text passages, with the group receiving illustrations and biographies performing least accurately. In the within-subject conditions, texts accompanied by an illustration were better learned, with these students doing best on the text with both picture and biography. The results suggest that adjuncts may emphasize some texts, at the expense of learning from the other texts, but that too much adjunct material interferes with the learning of the target passages.

Propranolol as an adjunct therapy for hyperthyroid tremor.

Science.gov (United States)

Henderson, J M; Portmann, L; Van Melle, G; Haller, E; Ghika, J A

1997-01-01

We evaluated the use of propranolol as an adjunct to carbimazole in the treatment of hyperthyroid tremor and tachycardia in a double-blind, cross-over and placebo-controlled study. Seven patients were given carbimazole plus either placebo or propranolol (40 mg) for 1 month and then switched to the alternative adjunct treatment for a further month. All patients showed significant improvements (p tremor amplitude after 1 or 2 months from baseline. One month after the baseline, the mean improvements of heart rate were 23% for the carbimazole + placebo group and 38% for carbimazole + propranolol group. Tremor also improved during the 1st month of the study by 31% in the carbimazole + placebo group versus 59% in the carbimazole + propranolol group. Whereas further improvements were observed in both variables in those receiving propranolol as the second adjunct treatment, this was not the case in those who received placebo during the same period. These findings confirm that the beta-blocker propranolol is a useful adjunct in the early treatment of both the tremor and tachycardia of hyperthyroidism.

Kunst elada piiri peal / Eric Kluitenberg ; interv. Heie Treier

Index Scriptorium Estoniae

Kluitenberg, Eric

1999-01-01

Võrguteoreetik Eric Kluitenberg Amsterdamist valgustab 'Interstanding 3' 'Ülalpool piire' tagamaad ja seost Eestiga. Üritus toob Eestisse rahvusvahelisi tippteoreetikuid, kes analüüsivad elu piiri peal, ja kunstnikke, kes seda seisundit oma loomingus kajastavad. Osalema kutsutuid. Piiripealsuset seoses poliitika, interneti, meediaga, äärealadest.

Host modulation therapeutics in periodontics: role as an adjunctive periodontal therapy.

Science.gov (United States)

Shinwari, Muhammad Saad; Tanwir, Farzeen; Hyder, Pakiza Raza; Bin Saeed, Muhammad Humza

2014-09-01

Host Modulation Therapy (HMT) is a treatment concept that reduces tissue destruction and stabilizes or even regenerates inflammatory tissue by modifying host response factors. It has been used for treating osteoporosis and arthritis for several decades. However, its use in dentistry has only been recently reported. The objective of this article is to present a review of the various literatures available on HMT and also its role as adjunct therapy in periodontics. For identifying studies for this review, a PUBMED search was carried out in 2013 for all articles published till December 2012. The search was restricted to English language publications only. Longitudinal prospective and retrospective studies were included in the search. The key words used were: Host Modulation Therapy; Sub antimicrobial dose doxycycline and Non-Surgical Periodontal Therapy. The main outcomes sought were host modulation therapeutics in periodontics. Exclusion criteria included cross sectional studies, short case series as well as studies with short follow-up periods. There is a paucity of literature on HMT in periodontics although the only drug approved by United States Food and Drug Administration (FDA) is a subantimicrobial dose of doxycycline (SDD) with highly predictable results as a host modulating agent in periodontal diseases and also an effective adjunctive therapy in various diseases of periodontium. However, more randomized controlled trials are needed to obtain clinical guidelines on the usage of other host modulating agents as adjunct as well as definite therapy for periodontal diseases. SDD is an effective adjunct therapy when used in dosage of 20mg twice daily for minimum 3 months duration in various periodontal diseases with predictable clinical outcomes. It is also recommended that future clinical research on anti cytokine drugs, chemically modified tetracycline and other HMT agents should be conducted so that new drugs are available with highly predictable results.

A Worthy Asset: The Adjunct Faculty and the Influences on Their Job Satisfaction

Science.gov (United States)

Rich, Telvis

2015-01-01

The author explored the intrinsic factors that foster job satisfaction of adjunct faculty members working in the southeastern United States. The literature concerning adjunct work experiences is limited, although adjuncts comprise the great majority of the faculty pool in many community and technical colleges. Twenty-seven adjuncts' work…

DSM-5 and ADHD - an interview with Eric Taylor.

Science.gov (United States)

Taylor, Eric

2013-09-12

In this podcast we talk to Prof Eric Taylor about the changes to the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in DSM-5 and how these changes will affect clinical practice. The podcast for this interview is available at: http://www.biomedcentral.com/sites/2999/download/Taylor.mp3.

Insight into the genomic diversity and relationship of Astragalus glycyphyllos symbionts by RAPD, ERIC-PCR, and AFLP fingerprinting.

Science.gov (United States)

Gnat, Sebastian; Małek, Wanda; Oleńska, Ewa; Trościańczyk, Aleksandra; Wdowiak-Wróbel, Sylwia; Kalita, Michał; Wójcik, Magdalena

2015-11-01

We assessed the genomic diversity and genomic relationship of 28 Astragalus glycyphyllos symbionts by three methodologies based on PCR reaction, i.e., RAPD, ERIC-PCR, and AFLP. The AFLP method with one PstI restriction enzyme and selective PstI-GC primer pair had a comparable discriminatory power as ERIC-PCR one and these fingerprinting techniques distinguished among the studied 28 A. glycyphyllos symbionts 18 and 17 genomotypes, respectively. RAPD method was less discriminatory in the genomotyping of rhizobia analyzed and it efficiently resolved nine genomotypes. The cluster analysis of RAPD, ERIC-PCR, and AFLP profiles resulted in a generally similar grouping of the test strains on generated dendrograms supporting a great potential of these DNA fingerprinting techniques for study of genomic polymorphism and evolutionary relationship of A. glycyphyllos nodulators. The RAPD, ERIC-PCR, and AFLP pattern similarity coefficients between A. glycyphyllos symbionts studied was in the ranges 8-100, 18-100, and 23-100%, respectively.

Setting the stage for the EPOS ERIC: Integration of the legal, governance and financial framework

Science.gov (United States)

Atakan, Kuvvet; Bazin, Pierre-Louis; Bozzoli, Sabrina; Freda, Carmela; Giardini, Domenico; Hoffmann, Thomas; Kohler, Elisabeth; Kontkanen, Pirjo; Lauterjung, Jörn; Pedersen, Helle; Saleh, Kauzar; Sangianantoni, Agata

2017-04-01

, software and services (DDSS) accessible through EPOS. From a financial standpoint, EPOS elaborated common guidelines for all institutions providing services, and selected a costing model and funding approach which foresees a mixed support of the services via national contributions and ERIC membership fees. In the EPOS multi-disciplinary environment, harmonization and integration are required at different levels and with a variety of different stakeholders; to this purpose, a Service Coordination Board (SCB) and technical Harmonization Groups (HGs) were established to develop the EPOS metadata standards with the EPOS Integrated Central Services, and to harmonize data and product standards with other projects at European and international level, including e.g. ENVRI+, EUDAT and EarthCube (US).

Eric Stahlberg Named to FCW’s Federal 100 | FNLCR Staging

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Eric Stahlberg, Ph.D., director of high-performance computing at the Frederick National Lab, has been named one of FCW‘s Federal 100 for his work in predictive oncology and his role in the collaboration between the National Cancer Institute and the

The Impact of Denominational Affiliation on Organizational Sense of Belonging and Commitment of Adjunct Faculty at Bible Colleges and Universities

Science.gov (United States)

Pilieci, Kimberly M.

2016-01-01

The majority of faculty in higher education, including secular and biblical institutions, are adjunct faculty. The literature suggests that adjunct faculty are less effective and satisfied, and have weaker organizational sense of belonging (OSB) and affective organizational commitment (AOC). Denominational affiliation (DA) and religious commitment…

Can surprising nonreward and adjunctive behavior influence each other?

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Patricia Rick

2018-02-01

Full Text Available Adjunctive or schedule-induced behavior can be defined as an increase in the frequency of a behavior under conditions of intermittent reinforcement. Adjunctive behavior has been explained as developing from reinforcement contingencies and emotional responses of frustration due to periods of reward omission, among other accounts. Two experiments with rats were designed to test the hypothesis that frustration mediates adjunctive behavior. According to this hypothesis, extensive training under conditions involving both reward and reward omission (e.g., partial reinforcement and intermittent reinforcement promote frustration counterconditioning, a mechanism activated when reward omissions are followed by reward. Frustration counterconditioning reduces avoidance and enhances approach, inducing behavioral persistence that transfers across situations inducing frustration—a mechanism yielding transsituational transfer. In Experiment 1, Phase 1 involved runway training under continuous vs. partial food reinforcement, whereas Phase 2 involved exposure to a fixed-time 60-s schedule of intermittent food reinforcement with free access to a wheel. Counterconditioning of goal approach in Phase 1 led only to a modest increase in wheel running in Phase 2. In Experiment 2, Phase 1 involved groups exposed to either intermittent reinforcement or massed-food control, both with access to a wheel, followed in Phase 2 by runway training under continuous reinforcement and extinction. No support was found for a transfer effect. The results are discussed in relation to accounts of adjunctive behavior based on Amsel’s frustration theory and Killeen-Pellón’s reinforcement theory of adjunctive behavior.

Recovering traditional raw-milk Tetilla cheese flavour and sensory attributes by using Kocuria varians and Yarrowia lipolytica adjunct cultures.

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Centeno, J A; Garabal, J I; Docampo, F; Lorenzo, J M; Carballo, J

2017-06-19

The rationale of the present study was to evaluate the potential of microbial adjunct cultures including Kocuria varians and/or Yarrowia lipolytica strains in the recovery of the typical sensory profile of traditional (raw-milk) Tetilla cheese. Four batches of Tetilla cheese, a short ripened cows' milk cheese produced in Galicia (NW Spain), were made in duplicate from pasteurized milk inoculated with different microbial cultures. A control batch was manufactured by adding a mesophilic commercial D-starter only. The other three batches were made with the same starter after a cheese-milk pre-ripening step carried out with (i) an adjunct culture of K. varians, (ii) an adjunct culture of Y. lipolytica, or (iii) a combination of both adjunct cultures. The highest pH and water activity values, associated with softer textures were determined in the cheeses manufactured with the Y. lipolytica adjunct after 21days of ripening. The contents of the volatile compounds 3-methylbutanol, dimethyl disulfide and dimethyl trisulfide were higher in the cheeses made with only the K. varians adjunct than in the cheeses made with the only yeast adjunct and in the control cheeses. The contents of hexanoic and octanoic acids were highest in the cheeses made with the Y. lipolytica adjunct, and levels of ethyl hexanoate, ethyl octanoate and ethyl decanoate were higher in the cheeses made with only the yeast adjunct than in the other batches of cheese. The cheeses manufactured with both adjunct cultures were awarded the highest scores for flavour and overall sensory parameters (considering the standards of the traditional product) and were considered very similar to 'good quality' artisanal raw-milk cheeses. We conclude that use of selected Micrococcaceae and Y. lipolytica strains as adjunct cultures would differentiate the sensory properties and contribute to the quality and typicality of the short-ripened rennet-curd Galician Tetilla and Arzúa-Ulloa cheeses. Copyright © 2017 Elsevier B

Q & A with Ed Tech Leaders: Interview with Eric Chiang

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Viner, Mark; Shaughnessy, Michael F.

2016-01-01

The authors present this interview with Eric Chiang, Associate Professor of Economics, Director of Instructional Technology, and Technology Director for the Online MBA Program at Florida Atlantic University. He has authored 26 peer-reviewed research publications and is the author of "CoreEconomics," an economic principles textbook now in…

Project To Design a Marketing Plan for Promoting Educators' Awareness of and Access to ERIC Products. Proposed Marketing Plan.

Science.gov (United States)

Contemporary Associates, Inc., Washington, DC.

The proposed strategy, which is designed to maximize the effectiveness and minimize the costs of marketing the Information Analysis Products (IAPs) produced by the 16 ERIC Clearinghouses, is based on a study of the concept of centralized versus decentralized ordering of selected ERIC products. The experiment measured four variables--postage,…

Adjunct methods for caries detection

DEFF Research Database (Denmark)

Twetman, Svante; Axelsson, Susanna Bihari; Dahlén, Gunnar

2012-01-01

Abstract Objective. To assess the diagnostic accuracy of adjunct methods used to detect and quantify dental caries. Study design. A systematic literature search for relevant papers was conducted with pre-determined inclusion and exclusion criteria. Abstracts and full text articles were assessed...

Efficacy, acceptability, and safety of adjunctive aripiprazole in treatment-resistant depression: a meta-analysis of randomized controlled trials

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Luan SX

2018-02-01

Full Text Available Shuxin Luan,1,2 Hongquan Wan,2 Lei Zhang,3 Hua Zhao1,4 1Department of Physiology, College of Basic Medical Sciences, Jilin University, Changchun, China; 2Department of Mental Health, The First Hospital of Jilin University, Changchun, China; 3Department of Radiology, The First Hospital of Jilin University, Changchun, China; 4Neuroscience Research Center, The First Hospital of Jilin University, Changchun, China Background: Treatment-resistant depression (TRD is common and potentially life-threatening in adults, and the benefits and risks of adjunctive aripiprazole in these patients remain controversial. Therefore, we conducted a meta-analysis of randomized controlled trials (RCTs to assess the efficacy, acceptability, safety, and quality of life of adjunctive aripiprazole in patients with TRD.Methods: RCTs published in PubMed, Web of Science, and Embase were systematically reviewed to evaluate the efficacy and safety profiles of TRD patients who were treated with adjunctive aripiprazole. The main outcome measures included response rate, remission rate, changes from baseline in Montgomery–Asberg Depression Rating Scale (MADRS, Clinical Global Impression-severity (CGI-S, Clinical Global Impression-improvement (CGI-I, 17-Item Hamilton Rating Scale for Depression (HAM-D17, Sheehan Disability scale (SDS, and Inventory of Depressive Symptomatology Self-Report Scale (IDS-SR, discontinuation due to adverse events, and adverse events. Risk ratio (RR or weight mean difference with 95% confidence intervals (CIs were pooled using a fixed-effects or random-effects model according to the heterogeneity among studies.Results: A total of 8 RCTs involving 2,260 patients were included in this meta-analysis. Adjunctive aripiprazole was associated with a significantly higher remission rate (RR =1.64, 95% CI: 1.42 to 1.89; P<0.001 and response rate (RR =1.45, 95% CI: 1.13 to 1.87; P=0.004 than other treatments. Moreover, adjunctive aripiprazole had greater changes in

An Annotated Bibliography of Research on Reading and Adults Learning English as a Second Language.

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Burt, Miriam, Comp.; Florez, MaryAnn, Comp.; Terrill, Lynda, Comp.; Van Duzer, Carol, Comp.

This annotated bibliography contains 27 references regarding research on reading and adults learning English as a Second Language (ESL). None of the resources are more than 10 years old. (Adjunct ERIC Clearinghouse for ESL Literacy Education) (KFT)

On the structural position of non-peripheral adjunct clauses

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Maria Lobo

2002-06-01

Full Text Available This paper is concerned with the structural position occupied by a subset of adjunct clauses, namely those which can occur in final position without a special intonational break. After a definition of the structures to be considered, it will be shown that the classical assumption according to which they are generated as adjuncts is empirically superior to the adjunct-as-complement analysis (cf. Larson 1988; 1990, and to more recent analyses, which follow an antisymmetric framework (cf. Kayne 1994. It will also be shown that a base generation account of preverbal adverbial clauses is to be preferred over a movement analysis on the basis of empirical data, and in conformity with theoretical economy assumptions (Merge over Move.

Expectations, Motivations, and Barriers to Professional Development: Perspectives from Adjunct Instructors Teaching Online

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Dailey-Hebert, Amber; Mandernach, B. Jean; Donnelli-Sallee, Emily; Norris, Virgil Rusty

2014-01-01

Adjunct instructors are the fastest growing population of faculty in the academy; and, given the current economic condition and its impact on institutions of higher learning, the proportion of adjunct faculty is likely to increase (Gappa, Austin & Trice, 2007; NCES, 2011). Yet the adjunct population continues to remain disconnected from the…

Adjunctive triamcinolone acetonide for Ahmed glaucoma valve implantation: a randomized clinical trial.

Science.gov (United States)

Yazdani, Shahin; Doozandeh, Azadeh; Pakravan, Mohammad; Ownagh, Vahid; Yaseri, Mehdi

2017-06-26

To evaluate the effect of intraoperative sub-Tenon injection of triamcinolone acetonide (TA) as an adjunct to Ahmed glaucoma valve (AGV) implantation. In this triple-blind randomized clinical trial, 104 eyes with refractory glaucoma were randomly assigned to conventional AGV (non-TA group) or AGV with adjunctive triamcinolone (TA group). In the TA group, 10 mg TA was injected in the sub-Tenon space around the AGV plate intraoperatively. Patients were followed for 1 year. The main outcome measure was intraocular pressure (IOP). Other outcome measures included best-corrected visual acuity (BCVA), occurrence of hypertensive phase (HP), peak IOP, number of antiglaucoma medications, and complications. A total of 90 patients were included in the final analysis. Mean IOP was lower in the TA group at most follow-up visits; however, the difference was statistically significant only at the first month (p = 0.004). Linear mixed model showed that mean IOP was 1.5 mm Hg lower in the TA group throughout the study period (p = 0.006). Peak postoperative IOP was significantly lower in the TA group (19.3 ± 4.8 mm Hg versus 29 ± 9.2 mm Hg, p = 0.032). Rates of success (defined as 6 2 lines was more common in the non-TA group (p = 0.032). Adjunctive intraoperative TA injection during AGV implantation can blunt peak IOP levels and reduce mean IOP up to 1 year. Visual outcomes also seem to be superior to standard surgery.

Systems Theory and the Earth Systems Approach in Science Education. ERIC Digest.

Science.gov (United States)

Lee, Hyongyong

The systems approach provides a framework for integrating different scientific disciplines. This approach is used often in Earth Systems Education. This ERIC Digest describes the systems theory and its influence on science education. (Contains 16 references.) (YDS)

Book Review: The X-Ways Forensics Practitioner's Guide

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Linda Lau

2014-09-01

Full Text Available Shavers, B., and Zimmerman, E. (2013. The X-Ways Forensics Practitioner's Guide. Waltham, MA: Syngress, 242 pages. ISBN: 978-0-12-411605-4. Print: US $50.90. Includes exercises, case studies, references, and index. Reviewed by Linda K. Lau, Longwood UniversityBrett Shavers is a former law enforcement officer, a digital forensics examiner, an adjunct instructor, and a frequent speaker at many conferences. After writing his first book, titled Placing the Suspect Behind the Keyboard: Using Digital Forensics and Investigative Techniques to Identify Cybercrime Suspects, he co-wrote his 2nd book with Eric Zimmerman and Jimmy Weg, who is a knowledgeable technical editor. Both Brett and Eric are experts in cyber forensics, with many years of law enforcement experience at both the state and federal levels.

Eric Davidson and deep time.

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Erwin, Douglas H

2017-10-13

Eric Davidson had a deep and abiding interest in the role developmental mechanisms played in generating evolutionary patterns documented in deep time, from the origin of the euechinoids to the processes responsible for the morphological architectures of major animal clades. Although not an evolutionary biologist, Davidson's interests long preceded the current excitement over comparative evolutionary developmental biology. Here I discuss three aspects at the intersection between his research and evolutionary patterns in deep time: First, understanding the mechanisms of body plan formation, particularly those associated with the early diversification of major metazoan clades. Second, a critique of early claims about ancestral metazoans based on the discoveries of highly conserved genes across bilaterian animals. Third, Davidson's own involvement in paleontology through a collaborative study of the fossil embryos from the Ediacaran Doushantuo Formation in south China.

Gabapentin adjunctive to risperidone or olanzapine in partially responsive schizophrenia: an open-label pilot study

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Adel Gabriel

2010-10-01

Full Text Available Adel GabrielDepartments of Psychiatry and Community Health Sciences, University of Calgary, Alberta, CanadaBackground: There is a great need in the treatment of schizophrenia for a drug, or drug ­combinations, to improve clinical response with fewer serious side effects. The objective of this study was to explore the therapeutic effects and tolerability of the anticonvulsant gabapentin as an adjunctive in the treatment of patients with partially responsive schizophrenia.Methods: Ten consenting patients with a confirmed Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision diagnosis of schizophrenia were identified. All patients failed at least one 12-week treatment trial with risperidone or olanzapine. Gabapentin was added to ongoing antipsychotic treatment with olanzapine or risperidone for eight weeks. The primary outcome measure was the Positive and Negative Syndrome Scale (PANSS. Other scales included the Calgary Depression Scale (CDSS and the Abnormal Involuntary Movement Scale (AIMS. Repeated-measures multivariate analysis of variance was utilized to examine changes in outcome measures over time with adjunctive treatment with gabapentin.Results: There was a significant drop in the PANSS and CDSS scores at endpoint (week 8. There were no significant differences between the two treatment groups with regard to changes in all outcome measures or in AIMS score. The adjunctive treatments were well tolerated and side effects were transient.Conclusion: Gabapentin could be used successfully as an adjunct to novel antipsychotics in partially responsive schizophrenia. However, large controlled studies are needed to examine the effectiveness of gabapentin in psychotic disorders.Keywords: schizophrenia, refractory, adjunctive treatment, gabapentin, risperidone, olanzapine

Physics and medicine: at Erice the new perspectives of an ancient cooperation

CERN Multimedia

2004-01-01

From April the 15th to the 17th, at Ettore Majorana Foundation in Erice, in the context of the International School on Physics and Industry, there will be a congress entitled "Particle accelerators and detectors: from physics to medicine".

Interference in the processing of adjunct control

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Dan eParker

2015-09-01

Full Text Available Recent research on the memory operations used in language comprehension has revealed a selective profile of interference effects during memory retrieval. Dependencies such as subject-verb agreement show strong facilitatory interference effects from structurally inappropriate but feature-matching distractors, leading to illusions of grammaticality (Dillon, Mishler, Sloggett, & Phillips, 2013; Pearlmutter, Garnsey, & Bock, 1999; Wagers, Lau, & Phillips, 2009. In contrast, dependencies involving reflexive anaphors are generally immune to interference effects (Dillon et al., 2013; Sturt, 2003; Xiang, Dillon, & Phillips, 2009. This contrast has led to the proposal that all anaphors that are subject to structural constraints are immune to facilitatory interference. Here we use an animacy manipulation to examine whether adjunct control dependencies, which involve an interpreted anaphoric relation between a null subject and its licensor, are also immune to facilitatory interference effects. Our results show reliable facilitatory interference in the processing of adjunct control dependencies, which challenges the generalization that anaphoric dependencies as a class are immune to such effects. To account for the contrast between adjunct control and reflexive dependencies, we suggest that variability within anaphora could reflect either an inherent primacy of animacy cues in retrieval processes, or differential degrees of match between potential licensors and the retrieval probe.

Freedom of Speech: A Clear and Present Need to Teach. ERIC Report.

Science.gov (United States)

Boileau, Don M.

1983-01-01

Presents annotations of 21 documents in the ERIC system on the following subjects: (1) theory of freedom of speech; (2) theorists; (3) research on freedom of speech; (4) broadcasting and freedom of speech; and (5) international questions of freedom of speech. (PD)

Understanding Burnout and Promoting Engagement among Adjunct Faculty in Community Colleges

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Bates, Michael Alan

2012-01-01

This mixed methods study explored the phenomenon of job burnout among adjunct faculty at two suburban Illinois community colleges. The Maslach Burnout Inventory-Educators' Survey (MBI-ES) was administered to adjuncts at both colleges to determine overall levels of burnout for the three dimensions of burnout--emotional exhaustion,…

Comparison of Alcohol Withdrawal Outcomes in Patients Treated with Benzodiazepines Alone versus Adjunctive Phenobarbital: a Retrospective Cohort Study

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Lauren Z. Gashlin

2015-03-01

Full Text Available Background: For treatment of severe alcohol withdrawal syndrome, high dose benzodiazepines (BZDs may cause delirium and over-sedation. Phenobarbital (PBT is a long-acting barbiturate effective for the treatment of alcohol withdrawal. Given the potential benefits of PBT, we sought to investigate the effectiveness of PBT as adjunctive treatment for alcohol withdrawal. Methods: This was a retrospective cohort study on patients with a diagnosis of alcohol withdrawal who had a CIWA-Ar score > 10 treated with either BZDs alone (BZD alone group or BZDs with adjunctive PBT (PBT-adjunct group. The patients received at least one dose of PBT in addition to BZDs (variable doses in the PBT-adjunct group, and three doses of 20 mg diazepam equivalents within 6 hours in the BZD alone group. The primary endpoint was the proportion of patients with a CIWA-Ar score < 10 at 24 hours after initial treatment. Duration of withdrawal and cumulative dose of BZDs were also assessed. Results: Seven subjects in the adjunctive phenobarbital and 21 in the benzodiazepine group were included in the final analysis. Two patients (28.6% in the PBT-adjunct group and 5 patients (23.8% in the BZD only group achieved the primary endpoint, though the difference between the two groups was not statistically significant (P = 0.588. The median (IQR duration of withdrawal symptoms was 44 (12-62 hours in the PBT-adjunct group compared to 53 (37-87 hours in the BZD only group, with no significant difference between the groups (P = 0.249. The median (IQR cumulative BZD dose requirement (diazepam equivalent in the PBT-adjunct group was significantly lower than BZD alone group (25 (20-226 vs. 326 (160-550 mg, P = 0.02. Conclusion: PBT appears to be a safe and effective alternative to BZDs for the treatment of alcohol withdrawal in non-critically ill patients and may be BZD sparing.

Contrastive Analysis of Place of Adjuncts in English and Persian Sentences

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Mirzahoseini, Zeynab; Gowhary, Habib; Azizifar, Akbar; Mirzahoseini, Ehsan

2015-01-01

This study investigates the position of adjuncts in sentences in English and Persian languages. The numbers of 136 sentences are collected from English story books and their Persian translations. The frequencies of each position (initial, middle, final) of adjuncts are determined by SPSS software and frequencies in English sentences are matched…

Little evidence for the use of diode lasers as an adjunct to non-surgical periodontal therapy.

Science.gov (United States)

Dederich, Douglas N

2015-03-01

Medline, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase databases. Randomised controlled trials (RCTs) using thermal diode lasers as an adjunct to non-surgical conventional periodontal initial therapy conducted in patients ≥18 years old written in English or Dutch were considered. Study assessment data extraction and quality assessment was carried out independently by two reviewers. The main outcome variables were probing pocket depth (PPD) and clinical attachment loss (CAL), but plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were also considered. Meta-analysis was carried out using a random effects model. Nine studies involving 247 patients were included. Seven studies were of split mouth design and two were parallel group studies. The study designs showed considerable heterogeneity and follow up ranged from six weeks to six months. Meta-analysis found no significant effect on PPD, CAL and PS. There was however a significant effect for GI and BS favouring adjunctive use of the diode laser. The collective evidence regarding adjunctive use of the diode laser with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. With respect to BS the results showed a small but significant effect favouring the diode laser, however, the clinical relevance of this difference remains uncertainStandard . This systematic review questions the adjunctive use of diode laser with traditional mechanical modalities of periodontal therapy in patients with periodontitis. The strength of the recommendation for the adjunctive use of the diode laser is considered to be 'moderate' for changes in PPD and CAL.

Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial.

Science.gov (United States)

Dean, Olivia M; Kanchanatawan, Buranee; Ashton, Melanie; Mohebbi, Mohammadreza; Ng, Chee Hong; Maes, Michael; Berk, Lesley; Sughondhabirom, Atapol; Tangwongchai, Sookjaroen; Singh, Ajeet B; McKenzie, Helen; Smith, Deidre J; Malhi, Gin S; Dowling, Nathan; Berk, Michael

2017-08-01

Conventional antidepressant treatments result in symptom remission in 30% of those treated for major depressive disorder, raising the need for effective adjunctive therapies. Inflammation has an established role in the pathophysiology of major depressive disorder, and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth. This double-blind, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder. A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) were randomised to this 12-week trial. Outcome measures included the Montgomery-Asberg Depression Rating Scale (primary outcome), Clinical Global Impression-Improvement and Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au , #ACTRN12612000283875. Based on mixed-methods repeated measures analysis of variance at week 12, there was no significant difference in Montgomery-Asberg Depression Rating Scale scores between groups. However, there were significant differences, favouring the minocycline group at week 12 for Clinical Global Impression-Improvement score - effect size (95% confidence interval) = -0.62 [-1.8, -0.3], p = 0.02; Quality of Life Enjoyment and Satisfaction Questionnaire score - effect size (confidence interval) = -0.12 [0.0, 0.2], p minocycline may be a useful adjunct to improve global experience, functioning and quality of life in people with

Eric's Journey: A Restructured School's Inclusion Program and a Student with Disabilities.

Science.gov (United States)

Richardson, Don H.

1998-01-01

Profiles a Milford, Connecticut, middle school's efforts to help Eric Kowalchick, a developmentally disabled adolescent, develop life skills and friendships, prepare for work, pursue school and community club memberships, and attend high school classes. The school's mainstreaming program is a success, thanks to an institutional mission understood…

Eric Bach : ilustrador de Luis de Góngora

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María Dolores Antigüedad del Castillo Olivares

1991-01-01

Full Text Available El pintor holandés Eric Bach [Eríurt (Alemania 1911] ha mostrado durante el año 1991 sus obras como ilustrador en sendas exposiciones celebradas en Córdoba y Madrid. El artista que reside indistintamente en Munich y Barcelona, expuso las ilustraciones que ha realizado para la edición en alemán de Los veinticuatro sonetos amorosos, heroicos y fúnebres de don Luis de Góngora, edición hecha por encargo del Sr. Rüdiger Kampmann de Munich.

Locative-Related Roles and the Argument-Adjunct Distinction in Balinese

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I Wayan Arka

2014-01-01

Full Text Available This paper uses the realisation of locative-related roles in Balinese to show that there is no clear-cut distinction between arguments and adjuncts, supporting the gradient nature of grammatical functions (cf. Croft 2001; Langacker 1987; Aarts 2007. It argues that argumenthood is not wholly a property of a lexical head predicate and that a purely lexically based projectionist approach to syntactic argument structures cannot be maintained. It also explores the effect that the interplay between relevant properties of locatives has on their recruitability as arguments, and a novel argument-index analysis is proposed as a means to distinguish adjuncts from arguments. The analysis makes use of both general and language-specific morphosyntactic and morphosemantic tests. Investigation of locative-related roles reveals that certain properties determine their status in the argument-adjunct continuum: thematic, individuated and animate locatives are more argument-like than non-thematic, inanimate and general deictic locatives (in line with Kittila 2007, 2008; Peterson 2007. Interplay between these properties is shown to affect argument recruitment in Balinese, based on the value of the argument index for a given locative-related role. More generally, there also is evidence that languages vary in whether they allow true adjuncts to be recruited as arguments at all.

During Her Pregnancy, Kathy Prepares for Breastfeeding. Mother-to-Mother Support = Durante Su Embarazo, Josefa Se Prepara para la Lactancia. Apoyo Madre a Madre.

Science.gov (United States)

Magalhaes, Rebecca; Stone-Jimerez, Maryanne; Allen de Smith, Paulina; Smith, Natalia

These magazine-sized booklets, one in English, one in Spanish, are in a cartoon format and designed to be used by people with limited literacy in English or Spanish. They explain the importance of both prenatal care and breastfeeding. (Adjunct ERIC Clearinghouse for ESL Literacy Education) (KFT)

Eric Davidson, his philosophy, and the history of science.

Science.gov (United States)

Deichmann, Ute

2017-10-16

Eric Davidson, a passionate molecular developmental biologist and intellectual, believed that conceptual advances in the sciences should be based on knowledge of conceptual history. Convinced of the superiority of a causal-analytical approach over other methods, he succeeded in successfully applying this approach to the complex feature of organismal development by introducing the far-reaching concept of developmental Gene Regulatory Networks. This essay reviews Davidson's philosophy, his support for the history of science, and some aspects of his scientific personality.

Fans of Columbine shooters Eric Harris and Dylan Klebold

OpenAIRE

Andrew Ryan Rico

2015-01-01

On April 20, 1999, Eric Harris and Dylan Klebold murdered 12 students and one teacher at Columbine High School in Littleton, Colorado, in what was then the deadliest school shooting in American history. Despite causing a national panic and serving as a flash point for larger narratives on bullying, gun control, and media violence, both boys have gained active online fans. These fandoms dedicated to the Columbine shooters are widely referred to as dark examples of Internet communities, while t...

Patient Susceptibility to Candidiasis—A Potential for Adjunctive Immunotherapy

Science.gov (United States)

Davidson, Linda; Netea, Mihai G.; Kullberg, Bart Jan

2018-01-01

Candida spp. are colonizing fungi of human skin and mucosae of the gastrointestinal and genitourinary tract, present in 30–50% of healthy individuals in a population at any given moment. The host defense mechanisms prevent this commensal fungus from invading and causing disease. Loss of skin or mucosal barrier function, microbiome imbalances, or defects of immune defense mechanisms can lead to an increased susceptibility to severe mucocutaneous or invasive candidiasis. A comprehensive understanding of the immune defense against Candida is essential for developing adjunctive immunotherapy. The important role of underlying genetic susceptibility to Candida infections has become apparent over the years. In most patients, the cause of increased susceptibility to fungal infections is complex, based on a combination of immune regulation gene polymorphisms together with other non-genetic predisposing factors. Identification of patients with an underlying genetic predisposition could help determine which patients could benefit from prophylactic antifungal treatment or adjunctive immunotherapy. This review will provide an overview of patient susceptibility to mucocutaneous and invasive candidiasis and the potential for adjunctive immunotherapy. PMID:29371502

Patient Susceptibility to Candidiasis—A Potential for Adjunctive Immunotherapy

Directory of Open Access Journals (Sweden)

Linda Davidson

2018-01-01

Full Text Available Candida spp. are colonizing fungi of human skin and mucosae of the gastrointestinal and genitourinary tract, present in 30–50% of healthy individuals in a population at any given moment. The host defense mechanisms prevent this commensal fungus from invading and causing disease. Loss of skin or mucosal barrier function, microbiome imbalances, or defects of immune defense mechanisms can lead to an increased susceptibility to severe mucocutaneous or invasive candidiasis. A comprehensive understanding of the immune defense against Candida is essential for developing adjunctive immunotherapy. The important role of underlying genetic susceptibility to Candida infections has become apparent over the years. In most patients, the cause of increased susceptibility to fungal infections is complex, based on a combination of immune regulation gene polymorphisms together with other non-genetic predisposing factors. Identification of patients with an underlying genetic predisposition could help determine which patients could benefit from prophylactic antifungal treatment or adjunctive immunotherapy. This review will provide an overview of patient susceptibility to mucocutaneous and invasive candidiasis and the potential for adjunctive immunotherapy.

An update on adjunctive treatment options for bipolar disorder.

Science.gov (United States)

Dean, Olivia M; Gliddon, Emma; Van Rheenen, Tamsyn E; Giorlando, Francesco; Davidson, Sandra K; Kaur, Manreena; Ngo, Trung T; Williams, Lana J

2018-03-01

Bipolar disorder is a complex illness often requiring combinations of therapies to successfully treat symptoms. In recent years, there have been significant advancements in a number of therapies for bipolar disorder. It is therefore timely to provide an overview of current adjunctive therapeutic options to help treating clinicians to inform their patients and work towards optimal outcomes. Publications were identified from PubMed searches on bipolar disorder and pharmacotherapy, nutraceuticals, hormone therapy, psychoeducation, interpersonal and social rhythm therapy, cognitive remediation, mindfulness, e-Health and brain stimulation techniques. Relevant articles in these areas were selected for further review. This paper provides a narrative review of adjunctive treatment options and is not a systematic review of the literature. A number of pharmacotherapeutic, psychological and neuromodulation treatment options are available. These have varying efficacy but all have shown benefit to people with bipolar disorder. Due to the complex nature of treating the disorder, combination treatments are often required. Adjunctive treatments to traditional pharmacological and psychological therapies are proving useful in closing the gap between initial symptom remission and full functional recovery. Given that response to monotherapy is often inadequate, combination regimens for bipolar disorder are typical. Correspondingly, psychiatric research is working towards a better understanding of the disorder's underlying biology. Therefore, treatment options are changing and adjunctive therapies are being increasingly recognized as providing significant tools to improve patient outcomes. Towards this end, this paper provides an overview of novel treatments that may improve clinical outcomes for people with bipolar disorder. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Eric Hobsbawm, sociólogo do milenarismo campesino Eric Hobsbawm, sociologist of peasant millenarianism

Directory of Open Access Journals (Sweden)

Michael Löwy

2010-01-01

Full Text Available Graças à problemática do milenarismo, a historiografia de Eric Hobsbawm integra toda a riqueza da subjetividade sociocultural, a profundidade das crenças, sentimentos e emoções em sua análise dos acontecimentos históricos, que não são mais, nessa perspectiva, percebidos simplesmente como produtos do jogo "objetivo" das forças econômicas ou políticas. Ainda distinguindo cuidadosamente os milenarismos primitivos dos revolucionários modernos, não deixa de mostrar sua afinidade eletiva. Isso não quer dizer que todos os movimentos revolucionários sejam milenaristas em sentido estrito ou, pior todavia, que respondam a um quiliasmo de tipo primitivo. Isso não impede afirmar que a afinidade entre os dois seja um fato fundamental na história das revoltas camponesas contra a modernização capitalista. Trata-se de uma das hipóteses de investigação mais interessantes esquematizadas em seus trabalhos desta época. Hobs-bawm ilustra seus propósitos com dois estudos de caso apaixonantes: o anarquismo rural na Andaluzia e as ligas camponesas da Sicília, os dois surgidos em fins do século XIX com prolongamentos no XX.Thanks to the problematic of millenarianism, Eric Hobsbawm's historiography incorporates all the richness of socio-cultural subjectivity - the depth of beliefs, feelings and emotions - into his analysis of historical events, which, from this viewpoint, are no longer perceived simply as products of the "objective" interplay of economic or political forces. Although he makes a careful distinction between primitive millenarianisms and modern revolutionary movements, Hobsbawm nevertheless shows their elective affinity between them. This does not mean that all revolutionary movements are millenarian in the strict sense or - which is even worse - that they are connected to a primitive type of chiliasm. All the same, the affinity between them is a basic fact in the history of peasant revolts against capitalist modernization. This

Cumulative Index of ERIC Resources in Counseling and Personnel Services. 1967-1976.

Science.gov (United States)

Walz, Garry R.; And Others

This cumulative index contains over 5500 titles from the ERIC collection, and represents all the document input from the Clearinghouse on Counseling and Personnel Services between 1967-1976. Topics cover theoretical and practical information in all areas of counseling and guidance as well as in drug abuse, aging, sexuality and death. Directions…

Adjunct Faculty: Perception of Leadership Styles, Leadership Outcomes, and Organizational Commitment in Online and Faith-Based Education Settings

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Pope Zinsser, Kam Lara

2017-01-01

Research indicates that adjunct faculty continues to grow in the higher education setting. Overall, universities continue to hire adjunct faculty to facilitate online courses and as a cost saving measure. While institutions continue to rely on adjunct faculty, a disconnection exists between the adjunct and the higher education administrators. This…

American Academic: A National Survey of Part-time/Adjunct Faculty. Volume 2

Science.gov (United States)

American Federation of Teachers (NJ), 2010

2010-01-01

Plainly, part-time/adjunct faculty members now play a vital role in educating the nation's college students. Even so, the data and research on part-time/adjunct faculty members have tended to be pretty spotty. This survey, conducted by Hart Research Associates on behalf of the American Federation of Teachers, is one of the first nationwide…

Automated Text Messaging as an Adjunct to Cognitive Behavioral Therapy for Depression: A Clinical Trial.

Science.gov (United States)

Aguilera, Adrian; Bruehlman-Senecal, Emma; Demasi, Orianna; Avila, Patricia

2017-05-08

Cognitive Behavioral Therapy (CBT) for depression is efficacious, but effectiveness is limited when implemented in low-income settings due to engagement difficulties including nonadherence with skill-building homework and early discontinuation of treatment. Automated messaging can be used in clinical settings to increase dosage of depression treatment and encourage sustained engagement with psychotherapy. The aim of this study was to test whether a text messaging adjunct (mood monitoring text messages, treatment-related text messages, and a clinician dashboard to display patient data) increases engagement and improves clinical outcomes in a group CBT treatment for depression. Specifically, we aim to assess whether the text messaging adjunct led to an increase in group therapy sessions attended, an increase in duration of therapy attended, and reductions in Patient Health Questionnaire-9 item (PHQ-9) symptoms compared with the control condition of standard group CBT in a sample of low-income Spanish speaking Latino patients. Patients in an outpatient behavioral health clinic were assigned to standard group CBT for depression (control condition; n=40) or the same treatment with the addition of a text messaging adjunct (n=45). The adjunct consisted of a daily mood monitoring message, a daily message reiterating the theme of that week's content, and medication and appointment reminders. Mood data and qualitative responses were sent to a Web-based platform (HealthySMS) for review by the therapist and displayed in session as a tool for teaching CBT skills. Intent-to-treat analyses on therapy attendance during 16 sessions of weekly therapy found that patients assigned to the text messaging adjunct stayed in therapy significantly longer (median of 13.5 weeks before dropping out) than patients assigned to the control condition (median of 3 weeks before dropping out; Wilcoxon-Mann-Whitney z=-2.21, P=.03). Patients assigned to the text messaging adjunct also generally

The ERICE-score: the new native cardiovascular score for the low-risk and aged Mediterranean population of Spain.

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Gabriel, Rafael; Brotons, Carlos; Tormo, M José; Segura, Antonio; Rigo, Fernando; Elosua, Roberto; Carbayo, Julio A; Gavrila, Diana; Moral, Irene; Tuomilehto, Jaakko; Muñiz, Javier

2015-03-01

In Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population. Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11800 people (6387 women) representing 107915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk. Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic=0.789 in men and C=0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women. The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

REEP Grammar Favorites.

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Arlington County Public Schools, VA. REEP, Arlington Education and Employment Program.

This document provides the Arlington Education and Employment Program's (REEP) favorite techniques for teaching English-as-a-Second-Language (ESL) grammar. The focus, levels, and materials needed are presented for each of the techniques as well as the steps to follow. (Adjunct ERIC Clearinghouse for ESL Literacy Education) (Author/VWL)

Online Literacies at Work.

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Searle, Jean

1999-01-01

Uses examples drawn from research across several sites in tourism and hospitality in which employees are required to interact with technology, in order to highlight issues relating to new online literacies that are now required for efficient work practices and to discuss implications for practice. (Adjunct ERIC Clearinghouse for ESL Literacy…

How To Use the SilverPlatter Software To Search the ERIC CD ROM.

Science.gov (United States)

Merrill, Paul F.

This manual provides detailed instructions for using SilverPlatter software to search the ERIC CD ROM (Compact Disk Read Only Memory), a large bibliographic database relating to education which contains reference information on numerous journal articles from over 750 journals cited in the "Current Index to Journals in Education" (CIJE),…

Adjunctive aids for the detection of oral premalignancy

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D Charanya

2016-01-01

Full Text Available Early detection of cancer greatly decreases the morbidity and mortality rates and thereby increases the 5-year survival rates. In developing countries like India where the disease is highly prevalent focus is mainly on decreasing the mortality rates which can be easily achieved by detection at an asymptomatic stage. Visual examination has been the standard screening method for screening oral cancer through several decades, and it is well known that conventional visual examination is limited to subjective interpretation and cannot be easily achieved in certain anatomical sites. As a solution to all these adjunctive techniques have emerged, and it has been widely used. An effort is made through this paper to review the most commonly used adjunctive aids for the detection of premalignancy and cancer.

Eric Clapton et Pete Postlethwaite sur la liste des honneurs de fin d'annee

CERN Multimedia

2003-01-01

"Le guitariste Eric Clapton, l'acteur Pete Postlethwaite et l'un des peres de l'internet Tim Berners-Lee figurent, aux cotes du XV d'Angleterre, sur la liste de fin d'annee des principales personnalites distinguees par la reine Elizabeth II" (1/2 page).

Learning about the Human Genome. Part 2: Resources for Science Educators. ERIC Digest.

Science.gov (United States)

Haury, David L.

This ERIC Digest identifies how the human genome project fits into the "National Science Education Standards" and lists Human Genome Project Web sites found on the World Wide Web. It is a resource companion to "Learning about the Human Genome. Part 1: Challenge to Science Educators" (Haury 2001). The Web resources and…

An Examination of Adjunct Faculty Job Satisfaction and Loyalty in Christian Higher Education

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Couch, Jeremy J.

2014-01-01

In order to address the deficiency of research regarding the job attitudes of adjunct faculty members in Christian higher education, a quantitative causal-comparative study was conducted for the purpose of examining the influence of six extrinsic and three intrinsic variables on the job satisfaction and loyalty of 388 adjuncts teaching at seven…

Exploratory RCT of art therapy as an adjunctive treatment in schizophrenia

OpenAIRE

Richardson, Phil; Jones, Kevin; Evans, Chris; Stevens, Peter; Rowe, Anna; HASH(0x7f4d76f6c120)

2007-01-01

Background\\ud There is no high quality controlled trial evidence for the effectiveness of art therapy in the adjunctive treatment of schizophrenia.\\ud \\ud Aims\\ud To conduct the first exploratory RCT of group interactive art therapy (AT) as an adjunctive treatment in chronic schizophrenia.\\ud \\ud Method\\ud The outcomes of 43 patients randomised to 12 sessions of AT were compared with those of 47 who received standard psychiatric care. Patients were assessed on a range of measures of symptoms,...

La investigación en Educación Musical en la base de datos ERIC

Directory of Open Access Journals (Sweden)

Galera, María

2008-12-01

Full Text Available This article describes a bibliometrical analysis of articles on research in Music Education published from 1995 to 2007 and included in ERIC database. These articles represent 54% of all music education articles included in this database. The results show a list with 10 journals which has more than 20 of these articles. The sum of the articles contained in the first four journals is equivalent to 60% of music education articles published from 1995 to 2007. None of these journals are at JCR Social Sciences. Almost all authors of the revised articles usually work alone and occasionally. It seems that there are not research groups or strong consolidated research directions. The most common subjects are: students (attitudes, motivation and effectiveness; teachers; musical composition (activities and music techniques.

Topical corticosteroids as adjunctive therapy for bacterial keratitis

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Herretes, Samantha; Wang, Xue; Reyes, Johann MG

2014-01-01

Background Bacterial keratitis is a serious ocular infectious disease that can lead to severe visual disability. Risk factors for bacterial corneal infection include contact lens wear, ocular surface disease, corneal trauma, and previous ocular or eyelid surgery. Topical antibiotics constitute the mainstay of treatment in cases of bacterial keratitis, whereas the use of topical corticosteroids as an adjunctive therapy to antibiotics remains controversial. Topical corticosteroids are usually used to control inflammation using the smallest amount of the drug. Their use requires optimal timing, concomitant antibiotics, and careful follow-up. Objectives The objective of the review was to assess the effectiveness and safety of corticosteroids as adjunctive therapy for bacterial keratitis. Secondary objectives included evaluation of health economic outcomes and quality of life outcomes. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 6), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to July 2014), EMBASE (January 1980 to July 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to July 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 July 2014. We also searched the Science Citation Index to identify additional studies that had cited the only trial included in the original version of this review, reference lists of included trials, earlier reviews, and the American Academy of Ophthalmology guidelines. We also contacted experts to identify any unpublished and

Effects of adjunctive exercise on physiological and psychological parameters in depression: a randomized pilot trial.

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Kerling, Arno; Tegtbur, Uwe; Gützlaff, Elke; Kück, Momme; Borchert, Luise; Ates, Zeynep; von Bohlen, Anne; Frieling, Helge; Hüper, Katja; Hartung, Dagmar; Schweiger, Ulrich; Kahl, Kai G

2015-05-15

Major depressive disorder (MDD) is associated with decreased physical activity and increased rates of the metabolic syndrome (MetS), a risk factor for the development of type 2 diabetes and cardiovascular disorders. Exercise training has been shown to improve cardiorespiratory fitness and metabolic syndrome factors. Therefore, our study aimed at examining whether patients receiving an exercise program as an adjunct to inpatient treatment will benefit in terms of physiological and psychological factors. Fourty-two inpatients with moderate to severe depression were included. Twenty-two patients were randomized to additional 3x weekly exercise training (EXERCISE) and compared to treatment as usual (TAU). Exercise capacity was assessed as peak oxygen uptake (VO2peak), ventilatory anaerobic threshold (VAT) and workload expressed as Watts (W). Metabolic syndrome was defined according to NCEP ATPIII panel criteria. After 6 weeks of treatment, cardiorespiratory fitness (VO2peak, VAT, Watt), waist circumference and HDL cholesterol were significantly improved in EXERCISE participants. Treatment response expressed as ≥50% MADRS reduction was more frequent in the EXERCISE group. Adjunctive exercise training in depressed inpatients improves physical fitness, MetS factors, and psychological outcome. Given the association of depression with cardiometablic disorders, exercise training is recommended as an adjunct to standard antidepressant treatment. Copyright © 2015 Elsevier B.V. All rights reserved.

Molecular typing of uropathogenic E. coli strains by the ERIC-PCR method.

Science.gov (United States)

Ardakani, Maryam Afkhami; Ranjbar, Reza

2016-04-01

Escherichia coli (E. coli) is the most common cause of urinary infections in hospitals. The aim of this study was to evaluate the ERIC-PCR method for molecular typing of uropathogenic E. coli strains isolated from hospitalized patients. In a cross sectional study, 98 E. coli samples were collected from urine samples taken from patients admitted to Baqiyatallah Hospital from June 2014 to January 2015. The disk agar diffusion method was used to determine antibiotic sensitivity. DNA proliferation based on repetitive intergenic consensus was used to classify the E. coli strains. The products of proliferation were electrophoresed on 1.5% agarose gel, and their dendrograms were drawn. The data were analyzed by online Insillico software. The method used in this research proliferated numerous bands (4-17 bands), ranging from 100 to 3000 base pairs. The detected strains were classified into six clusters (E1-E6) with 70% similarity between them. In this study, uropathogenic E. coli strains belonged to different genotypic clusters. It was found that ERIC-PCR had good differentiation power for molecular typing of uropathogenic E. coli strains isolated from the patients in the study.

Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts: Interim Report of a Prospective Comparative Trial.

Science.gov (United States)

Tagliafico, Alberto S; Calabrese, Massimo; Mariscotti, Giovanna; Durando, Manuela; Tosto, Simona; Monetti, Francesco; Airaldi, Sonia; Bignotti, Bianca; Nori, Jacopo; Bagni, Antonella; Signori, Alessio; Sormani, Maria Pia; Houssami, Nehmat

2016-03-09

Debate on adjunct screening in women with dense breasts has followed legislation requiring that women be informed about their mammographic density and related adjunct imaging. Ultrasound or tomosynthesis can detect breast cancer (BC) in mammography-negative dense breasts, but these modalities have not been directly compared in prospective trials. We conducted a trial of adjunct screening to compare, within the same participants, incremental BC detection by tomosynthesis and ultrasound in mammography-negative dense breasts. Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts is a prospective multicenter study recruiting asymptomatic women with mammography-negative screens and dense breasts. Eligible women had tomosynthesis and physician-performed ultrasound with independent interpretation of adjunct imaging. Outcome measures included cancer detection rate (CDR), number of false-positive (FP) recalls, and incremental CDR for each modality; these were compared using McNemar's test for paired binary data in a preplanned interim analysis. Among 3,231 mammography-negative screening participants (median age, 51 years; interquartile range, 44 to 78 years) with dense breasts, 24 additional BCs were detected (23 invasive): 13 tomosynthesis-detected BCs (incremental CDR, 4.0 per 1,000 screens; 95% CI, 1.8 to 6.2) versus 23 ultrasound-detected BCs (incremental CDR, 7.1 per 1,000 screens; 95% CI, 4.2 to 10.0), P = .006. Incremental FP recall occurred in 107 participants (3.33%; 95% CI, 2.72% to 3.96%). FP recall (any testing) did not differ between tomosynthesis (FP = 53) and ultrasound (FP = 65), P = .26; FP recall (biopsy) also did not differ between tomosynthesis (FP = 22) and ultrasound (FP = 24), P = .86. The Adjunct Screening With Tomosynthesis or Ultrasound in Women With Mammography-Negative Dense Breasts' interim analysis shows that ultrasound has better incremental BC detection than tomosynthesis in mammography

Systematic review of the adjunctive use of diode and Nd:YAG lasers for nonsurgical periodontal instrumentation.

Science.gov (United States)

Roncati, Marisa; Gariffo, Annalisa

2014-04-01

The aims of this study were (1) to conduct a literature search and systematically evaluate the additional therapeutic effects of pulsed Nd:YAG or diode laser use in patients with periodontitis, (2) to assess evidence supporting the additional benefit of laser-mediated periodontal treatment in conjunction with scaling and root planning (SRP) (not as monotherapy), and (3) to interpret the evidence presented in retrieved publications. Opinions about the additional use of diode lasers in the nonsurgical treatment of plaque-induced periodontal lesions are conflicting. The April 2011 American Academy of Periodontology's "Statement on the Efficacy of Lasers in the Non-Surgical Treatment of Inflammatory Periodontal Disease" asserted that the use of a laser as monotherapy or in addition to nonsurgical periodontal instrumentation conveyed no advantage. After initial screening, 23/77 potentially relevant articles and abstracts identified through electronic and manual searches of the MEDLINE(®)/PubMed database and the Cochrane Central Register of Controlled Trials (1990-2012) were included in this review. A meta-analysis could be performed. The results indicate that Nd:YAG or diode laser, used in an adjunctive capacity to SRP, may provide some additional benefit, in 6 month studies, compared with mechanical debridement. The results show the adjunctive benefits that diode laser treatment can provide when it is used as an adjunct to nonsurgical periodontal treatment in adults with chronic periodontitis. Further long-term, well-designed, parallel randomized clinical trials are needed to assess the effectiveness of the adjunctive use of the diode laser, as well as the appropriate dosimetry and laser settings.

Eric Woods - A lone radiographer at the Normandy landings

Energy Technology Data Exchange (ETDEWEB)

Barrett, Jean [British Society for the History of Radiology (United Kingdom); Ferris, Christine [International Development Facilitator, Robert Winston Building, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S10 2BP (United Kingdom)], E-mail: c.m.ferris@shu.ac.uk

2009-12-15

Although much of the activity around D-day is recorded many of the support services such as radiography do not feature. This account of a radiographer at the Normandy landings gives an insight into the everyday work of a lone radiographer in the Armed Forces in the 1940s. This work is the product of an oral history taken by Jean Barrett in accordance with the acknowledged ethical requirements of oral history. Eric Wood has given his permission for the publication of his stories. The work was presented at the conference for the British Society for the History of Radiology 2008 (Sheffield)

Eric Woods - A lone radiographer at the Normandy landings

International Nuclear Information System (INIS)

Barrett, Jean; Ferris, Christine

2009-01-01

Although much of the activity around D-day is recorded many of the support services such as radiography do not feature. This account of a radiographer at the Normandy landings gives an insight into the everyday work of a lone radiographer in the Armed Forces in the 1940s. This work is the product of an oral history taken by Jean Barrett in accordance with the acknowledged ethical requirements of oral history. Eric Wood has given his permission for the publication of his stories. The work was presented at the conference for the British Society for the History of Radiology 2008 (Sheffield).

Das US-Fachinformationssystem ERIC und die Entwicklung eines Fachinformationssystems Bildung in der Bundesrepublik Deutschland (The American Subject Information System ERIC and the Development of an Information System on Education in the German Federal Republic).

Science.gov (United States)

Nachrichten fur Dokumentation, 1982

1982-01-01

In order to further develop West German information services for education, it is suggested that the ERIC structural model--a coordinating central office and a network of clearinghouses--be developed as a continuation of the existing "Dokumentationsring Padagogik" (DOPAED) documentation service. (16 references) (EJS)

A Field Study of Adjunct Faculty: The Impact of Career Stage on Reactions to Non-Tenure-Track Jobs.

Science.gov (United States)

Feldman, Daniel C.; Turnley, William H.

2001-01-01

A survey of 105 nontenure-track instructors and research associates identified advantages of adjunct status (flexibility, autonomy, challenge) and disadvantages (lack of advancement, remuneration, and respect). Late-career adjuncts had more positive attitudes and work behaviors. Midcareer adjuncts had the most difficulty balancing work and family.…

Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses.

Science.gov (United States)

Sarris, Jerome; Murphy, Jenifer; Mischoulon, David; Papakostas, George I; Fava, Maurizio; Berk, Michael; Ng, Chee H

2016-06-01

There is burgeoning interest in augmentation strategies for improving inadequate response to antidepressants. The adjunctive use of standardized pharmaceutical-grade nutrients, known as nutraceuticals, has the potential to modulate several neurochemical pathways implicated in depression. While many studies have been conducted in this area, to date no specialized systematic review (or meta-analysis) has been conducted. A systematic search of PubMed, CINAHL, Cochrane Library, and Web of Science was conducted up to December 2015 for clinical trials using adjunctive nutrients for depression. Where sufficient data were available, a random-effects model analyzed the standard mean difference between treatment and placebo in the change from baseline to endpoint, combining the effect size data. Funnel plot and heterogeneity analyses were also performed. Primarily positive results were found for replicated studies testing S-adenosylmethionine (SAMe), methylfolate, omega-3 (primarily EPA or ethyl-EPA), and vitamin D, with positive isolated studies for creatine, folinic acid, and an amino acid combination. Mixed results were found for zinc, folic acid, vitamin C, and tryptophan, with nonsignificant results for inositol. No major adverse effects were noted in the studies (aside from minor digestive disturbance). A meta-analysis of adjunctive omega-3 versus placebo revealed a significant and moderate to strong effect in favor of omega-3. Conversely, a meta-analysis of folic acid revealed a nonsignificant difference from placebo. Marked study heterogeneity was found in a Higgins test for both omega-3 and folic acid studies; funnel plots also revealed asymmetry (reflecting potential study bias). Current evidence supports adjunctive use of SAMe, methylfolate, omega-3, and vitamin D with antidepressants to reduce depressive symptoms.

Polypodium leucotomos as an Adjunct Treatment of Pigmentary Disorders.

Science.gov (United States)

Nestor, Mark; Bucay, Vivian; Callender, Valerie; Cohen, Joel L; Sadick, Neil; Waldorf, Heidi

2014-03-01

Extracts of the tropical fern Polypodium leucotomos appear to possess beneficial properties for the skin attributed to the presence of numerous compounds within the extract that have antioxidant and photoprotective properties. Orally administered Polypodium leucotomos may provide protection against the detrimental photoaging effects of sunlight and can also help reduce the frequency and severity of polymorphous light eruption. Polypodium leucotomos has also been shown to be beneficial for the prevention and potential treatment of several aesthetically relevant conditions. The purpose of this review is to investigate the beneficial role of Polypodium leucotomos as an adjunct treatment for vitiligo, melasma, and postinflammatory hyperpigmentation. Based on a review of relevant literature including the results of a randomized, placebo-controlled study, the oral administration of Polypodium leucotomos significantly improved the severity of melasma in women after 12 weeks. Three randomized, double-blind, placebo-controlled studies have demonstrated significant improvements in vitiligo when oral Polypodium leucotomos therapy was combined with psoralens plus ultraviolet A and narrowband ultraviolet B. No controlled studies have assessed the efficacy of Polypodium leucotomos for the treatment of postinflammatory hyperpigmentation; however, its known antioxidant and anti-inflammatory properties and demonstrated effectiveness for melasma support its use for treating this condition. No adverse events have been associated with the use of Polypodium leucotomos. In addition to preventing many harmful effects associated with sunlight exposure, orally administered Polypodium leucotomos also appears to provide adjunctive benefits in treating vitiligo, melasma, and may have the potential to help with postinflammatory hyperpigmentation.

Adjunctive raloxifene treatment improves attention and memory in men and women with schizophrenia.

Science.gov (United States)

Weickert, T W; Weinberg, D; Lenroot, R; Catts, S V; Wells, R; Vercammen, A; O'Donnell, M; Galletly, C; Liu, D; Balzan, R; Short, B; Pellen, D; Curtis, J; Carr, V J; Kulkarni, J; Schofield, P R; Weickert, C S

2015-06-01

There is increasing clinical and molecular evidence for the role of hormones and specifically estrogen and its receptor in schizophrenia. A selective estrogen receptor modulator, raloxifene, stimulates estrogen-like activity in brain and can improve cognition in older adults. The present study tested the extent to which adjunctive raloxifene treatment improved cognition and reduced symptoms in young to middle-age men and women with schizophrenia. Ninety-eight patients with a diagnosis of schizophrenia or schizoaffective disorder were recruited into a dual-site, thirteen-week, randomized, double-blind, placebo-controlled, crossover trial of adjunctive raloxifene treatment in addition to their usual antipsychotic medications. Symptom severity and cognition in the domains of working memory, attention/processing speed, language and verbal memory were assessed at baseline, 6 and 13 weeks. Analyses of the initial 6-week phase of the study using a parallel groups design (with 39 patients receiving placebo and 40 receiving raloxifene) revealed that participants receiving adjunctive raloxifene treatment showed significant improvement relative to placebo in memory and attention/processing speed. There was no reduction in symptom severity with treatment compared with placebo. There were significant carryover effects, suggesting some cognitive benefits are sustained even after raloxifene withdrawal. Analysis of the 13-week crossover data revealed significant improvement with raloxifene only in attention/processing speed. This is the first study to show that daily, oral adjunctive raloxifene treatment at 120 mg per day has beneficial effects on attention/processing speed and memory for both men and women with schizophrenia. Thus, raloxifene may be useful as an adjunctive treatment for cognitive deficits associated with schizophrenia.

Retention and recruitment of general dentists in an adjunct teaching model-A pilot study.

Directory of Open Access Journals (Sweden)

Brian J Howe

Full Text Available Retention and recruitment of part time clinical adjunct faculty members in dental education is becoming increasingly difficult as dental schools come to rely on this workforce for their increased involvement in clinical education. Contributing factors include full time faculty shortage, aging workforce, practice and student debt, practice and family commitments, and financial compensation. This study attempts to ascertain barriers to teaching so appropriate strategies can be formulated to address this issue.In the spring of 2016 an email survey was sent to current and former adjunct faculty members to ascertain demographics and retention and recruitment strategies. Descriptive analyses were completed for all variables in the sample.Twenty nine of forty six subjects responded to the survey with a response rate of 63%. Subjects over the age of sixty comprised 55% with only 17% being under the age of forty five. Overall family and practice commitments along with compensation were the primary barriers to teaching part time. For new dentists, student loan debt was the primary barrier to teaching. Travel to teach was also a barrier as 70% of respondents drove 200 miles or less to the dental school.The study demonstrated that the aging part time work force is a great concern and new part time clinical adjunct faculty members must be recruited. Barriers to recruitment and retention of faculty must be considered and addressed to sustain this teaching model.

A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia.

Science.gov (United States)

Bhatia, Triptish; Mazumdar, Sati; Wood, Joel; He, Fanyin; Gur, Raquel E; Gur, Ruben C; Nimgaonkar, Vishwajit L; Deshpande, Smita N

2017-04-01

Yoga and physical exercise have been used as adjunctive intervention for cognitive dysfunction in schizophrenia (SZ), but controlled comparisons are lacking. Aims A single-blind randomised controlled trial was designed to evaluate whether yoga training or physical exercise training enhance cognitive functions in SZ, based on a prior pilot study. Consenting, clinically stable, adult outpatients with SZ (n=286) completed baseline assessments and were randomised to treatment as usual (TAU), supervised yoga training with TAU (YT) or supervised physical exercise training with TAU (PE). Based on the pilot study, the primary outcome measure was speed index for the cognitive domain of 'attention' in the Penn computerised neurocognitive battery. Using mixed models and contrasts, cognitive functions at baseline, 21 days (end of training), 3 and 6 months post-training were evaluated with intention-to-treat paradigm. Speed index of attention domain in the YT group showed greater improvement than PE at 6 months follow-up (pattention domain showed greater improvement than TAU alone at 6-month follow-up (pattention and additional cognitive domains well past the training period, supporting our prior reported beneficial effect of YT on speed index of attention domain. As adjuncts, YT or PE can benefit individuals with SZ.

Comparison of Intraocular Pressure Reduction of Initial and Adjunct ...

African Journals Online (AJOL)

Conclusion: Initial SLT showed a sustained reduction in IOP, compared to adjunct with marginally lower ... of reducing exposure to benzalkonium chloride is by substituting some of the ... in which the trabecular meshwork is targeted using.

Predicting the Satisfaction and Loyalty of Adjunct Faculty

Science.gov (United States)

Hoyt, Jeff E.

2012-01-01

Satisfaction with the quality of students, autonomy, faculty support, honorarium, and preference for teaching were significant predictors of adjunct faculty loyalty. With the exception of autonomy, these factors along with a heavy teaching load, collaborative research with full-time faculty, and satisfaction with teaching schedule were predictive…

Screening and selection of Lactobacillus strains for use as adjunct cultures in production of semi-hard cheese.

Science.gov (United States)

Antonsson, Martin; Ardö, Ylva; Nilsson, Bengt Frans; Molin, Göran

2002-08-01

Thirty-three Lactobacillus strains were tested as adjuncts in a cheese model system. Eighteen strains originated from cheese (nine Lactobacillus spp. and nine Lb. paracasei/casei) and 15 from human intestinal mucosa (11 Lb. rhamnosus; three Lb. paracasei; one Lb. plantarum). Model cheeses weighing 120 g were made of cheese grains from full-scale production of washed curd semi-hard cheese (Herrgård). The model system was reproducible and similar to full-scale production with respect to moisture, salt content, pH and microbial flora. The model cheeses were sampled for aerobic and anaerobic plate count and viable counts of Lactobacillus and Lactococcus. The presence of adjuncts in the model cheeses was confirmed by typing isolates with Randomly Amplified Polymorphic DNA (RAPD). The sensory properties of model cheeses were described. In a first trial 23 of the 33 adjuncts were re-isolated from the corresponding model cheeses after 9 or 13 weeks. Adjuncts of Lb. paracasei were re-isolated more frequently than adjuncts of Lb. rhamnosus. Nine strains were selected, on the basis of their ability to grow and be a dominating part of the microflora of model cheese with interesting sensory properties. These strains were further studied together with two commercial cultures. The sensory influences on model cheeses of six of the adjuncts were confirmed, and flavour scores were in the range of 2.9-7.1 for model cheeses with different adjuncts while the control had a flavour score of 5.6 (0-10 scale). Survival and growth of seven out of the nine strains correlated with the results of the first trial. Growth and influence on flavour of four adjunct cultures were confirmed in experimental cheese manufactured in a 400-1 open vat.

Utility of adjunctive modalities in Coronary chronic total occlusion intervention

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Hemal Bhatt

2017-05-01

Full Text Available Coronary chronic total occlusion (CTO intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i.e., using fractional flow reserve. In this review we present the current literature describing the utility and efficacy of these adjunctive modalities in CTO intervention.

Efficacy of Adjunctive Treatments Added to Olanzapine or Clozapine for Weight Control in Patients with Schizophrenia: A Systematic Review and Meta-Analysis

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Yun-Jung Choi

2015-01-01

Full Text Available Objectives. This study was conducted to review systematically adjunctive treatments for weight reduction in patients with schizophrenia and compare efficacies of clinical trials through meta-analysis, so as to provide effective clinical guideline regarding weight control for patients taking atypical antipsychotics. Methods. Candidate clinical trials were identified through searching the Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO. Fourteen randomized clinical trials were included for systematic review and meta-analysis from 132 potential trials. The Comprehensive Meta-Analysis version 2 was used for meta-analysis. Results. Difference in means and significances from meta-analyses regarding weight control by adjunctive treatments showed that topiramate, aripiprazole, or sibutramine was more effective than metformin or reboxetine. Psychiatric evaluations did not show statistically significant changes between treatment groups and placebo groups except topiramate adjunctive treatments. Adverse effects regarding adjunctive therapies were tolerable and showed statistically no significances compared to control groups. Conclusion. Though having several reports related to exacerbation of psychiatric symptoms, topiramate and aripiprazole are more efficacious than other medications in regard to weight reduction and less burden of critical adverse effects as well as being beneficial for clinical improvement.

Adamson-Eric 100 : XX sajandi kunsti- ja kultuurilugu ühe inimsaatuse kaudu / Ülle Kruus

Index Scriptorium Estoniae

Kruus, Ülle

2002-01-01

Näitus "Adamson-Eric 100" Eesti Kunstimuuseumi Rüütelkonna hoones ja Adamson-Ericu muuseumis. Koostajad Ülle Kruus, Kersti Koll, Hanno Soans, kujundajad Leonhard Lapin (EKM), Jaak Soans (Adamson-Ericu muuseum). Adamson-Ericu teosed väljaspool Eestit ja Eestisse tagasi jõudnud tööd

Adjunctive therapy in Parkinson's disease: the role of rasagiline

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Gaines KD

2012-07-01

Full Text Available Kathryn D Gaines,1 Vanessa K Hinson21Department of Neurology, Aurora Advanced Healthcare, Milwaukee, WI, 2Department of Neurosciences, Movement Disorders Program, Medical University of South Carolina, Charleston, SC, USAAbstract: Parkinson's disease is the second most common neurodegenerative disorder, currently affecting 1.5 million people in the US. In this review, we describe the diagnostic and pathological features of Parkinson's disease, as well as its clinical course. We then review pharmacologic treatments for the disease, with a particular focus on therapies adjunctive to levodopa and specifically the role of rasagiline. We review the four pivotal rasagiline trials, and discuss rasagiline and its use as adjunctive therapy for Parkinson's disease. Finally, we discuss potential side effects, drug interactions, and other practical aspects concerning the use of rasagiline in Parkinson's disease.Keywords: Parkinson's disease, treatment, rasagiline, clinical trials

Esthetic rhinoplasty as an adjunctive technique in nasal oncoplastic ...

African Journals Online (AJOL)

Adham Farouk

2016-01-15

Jan 15, 2016 ... Esthetic rhinoplasty;. Oncoplastic surgery nose;. Basal cell carcinoma;. Squamous cell carcinoma;. Nonmelanoma skin cancer;. Nasal reconstruction ... Conclusions: Esthetic rhinoplasty is a useful adjunctive technique in nasal oncoplastic surgery. .... All procedures performed in the study involving human.

Arginine Adjunctive Therapy in Active Tuberculosis

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Aliasghar Farazi

2015-01-01

Full Text Available Background. Dietary supplementation has been used as a mechanism to augment the immune system. Adjunctive therapy with L-arginine has the potential to improve outcomes in active tuberculosis. Methods. In a randomized clinical trial 63 participants with smear-positive pulmonary tuberculosis in Markazi Province of Iran were given arginine or placebo for 4 weeks in addition to conventional chemotherapy. The final treatment success, sputum conversion, weight gain, and clinical symptoms after one and two months were considered as primary outcomes and secondary outcomes were ESR, CRP, and Hg. Data were collected and analyzed with SPSS software (ver. 18. Results. Arginine supplementation reduced constitutional symptoms (P=0.032 in patients with smear-positive TB at the end of the first month of treatment. Arginine treated patients had significantly increased BMI at the end of the first and second months of treatment (P=0.032 and P=0.04 and a reduced CRP at the end of the first month of treatment (P=0.03 versus placebo group. Conclusion. Arginine is useful as an adjunctive therapy in patients with active tuberculosis, in which the effects are more likely mediated by the increased production of nitric oxide and improved constitutional symptoms and weight gain. This trial is registered with Clinical Trials Registry of Iran: IRCT201211179855N2.

Herzberg's Theory of Motivation as Applied to Community College Full-Time and Adjunct Online Faculty

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Gullickson, Larry

2011-01-01

This study was designed to identify the factors that influence full-time and adjunct faculty perceptions regarding job satisfaction and dissatisfaction. It was also designed to determine if those factors relate differently to full-time and adjunct faculty. It is anticipated that this information will aid administrators in improving morale and…

CAS Accelerator Physics held in Erice, Italy

CERN Multimedia

CERN Accelerator School

2013-01-01

The CERN Accelerator School (CAS) recently organised a specialised course on Superconductivity for Accelerators, held at the Ettore Majorana Foundation and Centre for Scientific Culture in Erice, Italy from 24 April-4 May, 2013.   Photo courtesy of Alessandro Noto, Ettore Majorana Foundation and Centre for Scientific Culture. Following a handful of summary lectures on accelerator physics and the fundamental processes of superconductivity, the course covered a wide range of topics related to superconductivity and highlighted the latest developments in the field. Realistic case studies and topical seminars completed the programme. The school was very successful with 94 participants representing 23 nationalities, coming from countries as far away as Belorussia, Canada, China, India, Japan and the United States (for the first time a young Ethiopian lady, studying in Germany, attended this course). The programme comprised 35 lectures, 3 seminars and 7 hours of case study. The case studies were p...

Online Adjunct Faculty: A Quantitative Examination of the Predictive Relationship between Leadership and Job Satisfaction

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Barnett, Donald E.

2018-01-01

Advances in technology and the rapid expansion and affordability of the internet have helped facilitate the use of online education, or e-learning. To accommodate increased online enrollments, universities are hiring adjunct faculty to teach online courses. Despite the importance of adjunct faculty, there is a lack of research on the experiences…

Adjunctive use of the diode laser in non-surgical periodontal therapy: exploring the controversy.

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Porteous, Mary Sornborger; Rowe, Dorothy J

2014-04-01

Despite the controversy regarding clinical efficacy, dental hygienists use the diode laser as an adjunct to non-surgical periodontal therapy. The technique to maximize successful laser therapy outcome is controversial as well. The purpose of this review is to explore the scientific foundation of the controversy surrounding the use of the diode laser as an adjunct to non-surgical periodontal therapy. Further, this paper addresses the weaknesses in study design, the heterogeneity of methodology in the published clinical studies, especially the laser parameters, and how these issues impact the collective clinical and microbial data, and thus conclusions regarding clinical efficacy. Evaluation of the literature identifies possible mechanisms that could contribute to the varied, often conflicting results among laser studies that are the foundation of the controversy surrounding clinical efficacy. These mechanisms include current paradigms of periodontal biofilm behavior, tissue response to laser therapy being dependent on tissue type and health, and that the successful therapeutic treatment window is specific to the target tissue, biofilm composition, laser wavelength, and laser energy delivered. Lastly, this paper discusses laser parameters used in the various clinical studies, and how their diversity contributes to the controversy. Although this review does not establish clinical efficacy, it does reveal the scientific foundation of the controversy and the need for standardized, well designed randomized controlled clinical trials to develop specific guidelines for using the laser as an adjunct to non-surgical periodontal therapy. Using evidence-based laser guidelines would allow dental hygienists to provide more effective non-surgical periodontal care.

Efficacy, safety and tolerability of rasagiline as adjunctive therapy in elderly patients with Parkinson's disease.

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Tolosa, E; Stern, M B

2012-02-01

Rasagiline, an MAO-B inhibitor, is indicated for the treatment of Parkinson's disease (PD). In this post hoc analysis, the efficacy, safety and tolerability of rasagiline as an adjunct to levodopa were compared with placebo in elderly (≥70 years) and younger (Rasagiline: Efficacy and Safety on the Treatment of 'OFF' and Lasting effect in Adjunct therapy with Rasagiline Given Once daily randomized, double-blind, placebo-controlled trials with the primary efficacy end-point being the reduction from baseline in daily OFF time. Secondary efficacy end-points included scores for Clinical Global Improvement (CGI)-Examiner during ON time, Unified Parkinson's Disease Rating Scale (UPDRS)-ADL during OFF time, UPDRS-Motor during ON time and total daily ON time with and without troublesome dyskinesia. Tolerability was evaluated from adverse events (AEs) in the two age groups. Rasagiline decreased daily OFF time versus placebo (Prasagiline but were not significant. Between-group comparisons (≥70 vs. efficacy was unaffected by age for all end-points (P>0.1), and rasagiline was well tolerated amongst both groups of patients with a comparable incidence of total and dopaminergic AEs (P>0.1). Adjunct rasagiline is efficacious and well tolerated in elderly non-demented patients (≥70 years) with moderate to advanced PD. Confirmation of the efficacy and safety of rasagiline in the elderly patient subgroup is especially relevant because of the increasing number of elderly patients with PD. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

The Efficacy of Danshen Injection as Adjunctive Therapy in Treating Angina Pectoris: A Systematic Review and Meta-Analysis.

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Shao, Huikai; Li, Mengsi; Chen, Fuchao; Chen, Lianghua; Jiang, Zhengjin; Zhao, Lingguo

2018-04-01

During the last 40 years, Danshen injection has been widely used as an adjunctive therapy for angina pectoris in China, but its efficacy is not yet well defined. The objective of this study was to verify the efficacy of Danshen injection as adjunctive therapy in treating angina pectoris. The major databases including PubMed, Cochrane Library, Sino-Med, Medline, Embase, Google Scholar, China National Knowledge Infrastructure, Wanfang Databases, Chinese Scientific Journal Database, Chinese Biomedical Literature Database and the Chinese Science Citation Database were systematically searched for the published randomised controlled trials (RCTs) on Danshen injection until April 2016. Meta-analysis was conducted on the primary outcomes (i.e., the improvements in symptoms and electrocardiography (ECG)). The quality of the included RCTs was evaluated with the M scoring system (the refined Jadad scale). Based on the quality, year of publication and sample size of RCTs, sensitivity analysis and subgroup analysis were performed in this study. Ten RCTs, including 944 anginal patients, were identified in this meta-analysis. Compared with using antianginal agents (β-blockers, calcium antagonists, nitrates, etc.) alone, Danshen injection combined with antianginal agents had a better therapeutic effect in symptom improvement (odds ratio [OR], 3.66; 95% confidence interval [CI]: 2.50-5.36) and in ECG improvement (OR, 3.25; 95% CI: 1.74-6.08). This study showed that Danshen injection as adjunctive therapy seemed to be more effective than antianginal agents alone in treating angina pectoris. However, more evidence is needed to accurately evaluate the efficacy of Danshen injection because of the low methodological quality of the included RCTs. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Covert radar and signals interception the secret career of Eric Ackermann

CERN Document Server

Hayson, David

2014-01-01

Of German stock dating back to 1530 in Saxony, Eric George Ackermann GM was born on the Isle of Wight in 1919 and became a leading figure in the world of signals and electronic intelligence. As a Junior Scientific Officer at the Telecommunication Research Establishment, Boscombe Down, with an honorary commission in the Royal Air Force, he made numerous flights over occupied territory searching for, monitoring and destroying Germany's Wuerzburg, Knickebein and X Band radar systems. Much of his research was passed to the highest levels of wartime government, and was highly prized, ensuring that

Adjuncts to local anesthesia: separating fact from fiction.

Science.gov (United States)

Wong, J K

2001-01-01

Adjunctive local anesthetic techniques and their armamentaria, such as intraosseous injection, computer-controlled delivery systems, periodontal ligament injection and needleless jet injection, have been proposed to hold particular advantages over conventional means of achieving local anesthesia. This article describes the use of each technique and proprietary armamentarium and reviews the literature appraising their use.

Exercise as adjunctive treatment for alcohol use disorder

DEFF Research Database (Denmark)

Roessler, Kirsten K.; Bilberg, Randi; Søgaard Nielsen, Anette

2017-01-01

AIMS: To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation. METHODS: The study is a randomized controlled stu...... was protective against excessive drinking following treatment. A dose-response effect of exercise on drinking outcome supports the need for implementing physically active lifestyles for patients in treatment for alcohol use disorder.......AIMS: To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months' duration, and at 12 months after treatment initiation. METHODS: The study is a randomized controlled study...... regression model was used to evaluate the odds of excessive drinking among the three groups, based on intention-to-treat. Changes in level of physical activity in all three groups were tested by using a generalized linear mixed model. A multiple linear model was used to test if there was an association...

Use of the Spanish Language in the United States: Trends, Challenges, and Opportunities. ERIC Digest.

Science.gov (United States)

Santiestevan, Stina

This ERIC digest examines the Spanish-speaking group in the United States, its growth through net immigration and natural increase, and its eventual decline as speakers shift to English. The Hispanic population is growing rapidly, but data suggest that U.S. Hispanics do learn and speak English. Research predicts that by the year 2001 the…

A High School Student's Bill of Rights. Teaching Resources in the ERIC Database (TRIED) Series.

Science.gov (United States)

Gottlieb, Stephen S.

Designed to tap the rich collection of instructional techniques in the ERIC database, this compilation of lesson plans focuses on teaching high school students their Constitutional rights and responsibilities. The 40 lesson plans in the book cover the courts and basic rights, the rights of criminal suspects, the rights of minors and education law,…

Soaps and Germicides as Adjunct Topical Antimycotic Agents on ...

African Journals Online (AJOL)

Objective: The study aims at evaluating the potentials of soaps and germicides / disinfectants as adjunct topical anti-vulvovaginal candidasis agents. Methods: In vitro inhibitory activities of the test agents, prepared according to the manufacturer's specification for toilet and midwifery purposes were determined using modified ...

The influence of starter and adjunct lactobacilli culture on the ripening of washed curd cheeses

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E. Hynes

2002-12-01

Full Text Available Ten strains of lactobacillus from the CNRZ collection were tested as adjunct culture in miniature washed curd cheeses manufactured under controlled bacteriological conditions with two different starters, Lactococcus lactis subsp. lactis IL 416 and Lactococcus lactis subsp. cremoris AM2. Lactobacilli growth seemed to be dependent on the Lactobacillus strain but was not influenced by the starter strain or counts. Lactococci counts were higher in the miniature cheeses with AM2 starter and added lactobacilli than in the control cheeses without lactobacilli. Gross composition and hydrolysis of s1 casein were similar for miniature cheeses with and without lactobacilli. In the miniature cheeses manufactured with IL416 starter, the lactobacilli adjunct slightly increased the soluble nitrogen content, but that was not verified in the AM2 miniature cheeses. Phosphotungstic acid nitrogen content increased in miniature cheeses manufactured with IL416 when Lactobacillus plantarum 1572 and 1310 adjunct cultures were added. That was also verified for several Lactobacillus strains, specially Lactobacillus casei 1227, for miniature cheeses manufactured with AM2 starter. Free fatty acid content increased in miniature cheeses made with lactobacilli adjuncts 1310, 1308 and 1219 with IL416 starter, and with strains 1218, 1244 and 1308 for miniature cheeses with AM2 starter. These results indicate that production of soluble nitrogen compounds as well as free fatty acid content could be influenced by the lactobacilli adjunct, depending on the starter strain.

Evaluation of Adjunct Faculty in Higher Education Institutions

Science.gov (United States)

Langen, Jill M.

2011-01-01

The role that part-time faculty play in higher education is changing. No longer are part-time faculty used on an occasional basis at a few institutions. These individuals now play a critical part in the delivery of higher education to students. This study was developed to answer questions regarding how the performance of adjunct faculty is…

Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial.

OpenAIRE

Rascol, O.; Brooks, D.J.; Melamed, E.; Oertel, W.; Poewe, W.; Stocchi, F.; Tolosa, E.; LARGO study group

2005-01-01

Lancet. 2005 Mar 12-18;365(9463):947-54. Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial. Rascol O, Brooks DJ, Melamed E, Oertel W, Poewe W, Stocchi F, Tolosa E; LARGO study group. Clinical Investigation Centre, Department of Clinical Pharmacology, University Hospital, Toulouse, France. ...

Nobel Prize Recipient Eric Betzig Presents Lecture on Efforts to Improve High-Resolution Microscopy | Poster

Science.gov (United States)

Eric Betzig, Ph.D., a 2014 recipient of the Nobel Prize in Chemistry and a scientist at Janelia Research Campus (JRC), Howard Hughes Medical Institute, in Ashburn, Va., visited NCI at Frederick on Sept. 10 to present a Distinguished Scientist lecture and discuss the latest high-resolution microscopy techniques. Betzig co-invented photoactivation localization microscopy (PALM)

The Attraction of Adjunct Faculty to Rural Community Colleges

Science.gov (United States)

Charlier, Hara Dracon

2010-01-01

As rural community colleges face mounting fiscal pressure, the ability to attract adjunct faculty members to support the institutional mission becomes increasingly important. Although the professional literature documents differences between rural, suburban, and urban community colleges, the effect of this institutional diversity on the role and…

Arbitration of family separation issues – a useful adjunct to ...

African Journals Online (AJOL)

Arbitration of family separation issues – a useful adjunct to mediation and the ... Lastly, it is concluded that although family arbitration will not have universal appeal or ... arbitrator qualifications; arbitral awards; court review of arbitral awards.

Microbiological effects and recolonization patterns after adjunctive subgingival debridement with Er:YAG laser.

Science.gov (United States)

Sanz-Sánchez, Ignacio; Ortiz-Vigón, Alberto; Herrera, David; Sanz, Mariano

2016-07-01

The objective of this study was to assess the microbiological effects and recolonization patterns after non-surgical periodontal treatment protocol based on the adjunctive use of erbium-doped yttrium aluminium garnet (Er:YAG) laser. Patients diagnosed with chronic periodontitis were randomly assigned to two different treatment protocols: test, full-mouth subgingival ultrasonic instrumentation followed by Er-YAG laser application 1 week later to sites with initial probing pocket depth ≥4.5 mm; and control, full-mouth ultrasonic subgingival instrumentation within 1 week. Clinical (at sampled sites) and microbiological (culture-based) parameters were recorded at baseline and 3 and 12 months. Microbiological variables included total counts, frequency of detection, proportions and counts of target species. Results from 19 test and 21 control patients were compared. Minor changes were observed for total colony-forming units, with no differences between groups. For the frequency of detection, a limited and similar impact in both groups was observed for the most prevalent (over 80 %) periodontal pathogens (Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum). For proportions, reductions in P. gingivalis occurred at 3 months, both in the test and control groups (from 16.3 to 10 % and 16 to 14.8 %, respectively), although these differences were not statistically significant. At 12 months, the test group showed a statistically significant greater reduction in probing depth for the sampled sites. The adjunctive use of Er:YAG laser when compared with conventional ultrasonic debridement did not provide a microbiological added benefit. Even though some clinical benefits with the adjunctive laser application were identified when comparing both treatment protocols, there were no differences in microbiological outcomes or in the bacterial recolonization patterns.

Similarity-Based Interference and the Acquisition of Adjunct Control

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Juliana Gerard

2017-10-01

Full Text Available Previous research on the acquisition of adjunct control has observed non-adultlike behavior for sentences like “John bumped Mary after tripping on the sidewalk.” While adults only allow a subject control interpretation for these sentences (that John tripped on the sidewalk, preschool-aged children have been reported to allow a much wider range of interpretations. A number of different tasks have been used with the aim of identifying a grammatical source of children’s errors. In this paper, we consider the role of extragrammatical factors. In two comprehension experiments, we demonstrate that error rates go up when the similarity increases between an antecedent and a linearly intervening noun phrase, first with similarity in gender, and next with similarity in number marking. This suggests that difficulties with adjunct control are to be explained (at least in part by the sentence processing mechanisms that underlie similarity-based interference in adults.

Selection, application and monitoring of Lactobacillus paracasei strains as adjunct cultures in the production of Gouda-type cheeses.

Science.gov (United States)

Van Hoorde, Koenraad; Van Leuven, Isabelle; Dirinck, Patrick; Heyndrickx, Marc; Coudijzer, Kathleen; Vandamme, Peter; Huys, Geert

2010-12-15

Raw milk cheeses have more intense flavours than cheeses made from pasteurized milk and harbour strains with potential adjunct properties. Two Lactobacillus paracasei strains, R-40926 and R-40937, were selected as potential adjunct cultures from a total of 734 isolates from good quality artisan raw milk Gouda-type cheeses on the basis of their prevalence in different cheese types and/or over several production batches, safety and technological parameters. Conventional culturing, isolation and identification and a combined PCR-DGGE approach using total cheese DNA extracts and DNA extracts obtained from culturable fractions were employed to monitor viability of the introduced adjuncts and their effect on the cheese microbiota. The control cheese made without adjuncts was dominated by members of the starter, i.e. Lactococcus lactis and Leuconostoc pseudomesenteroides. In the cheeses containing either R-40926 or R-40937, the respective adjuncts increased in number as ripening progressed indicating that both strains are well adapted to the cheese environment and can survive in a competitive environment in the presence of a commercial starter culture. Principal component analysis of cheese volatiles determined by steam distillation-extraction and gas chromatography-mass spectrometry could differentiate cheeses made with different concentrations of adjunct R-40926 from the control cheese, and these differences could be correlated to the proteolytic and lipolytic properties of this strain. Collectively, results from microbiological and metabolic analyses indicate that the screening procedure followed throughout this study was successful in delivering potential adjunct candidates to enrich or extend the flavour palette of artisan Gouda-type cheeses under more controlled conditions. Copyright © 2010 Elsevier B.V. All rights reserved.

Balancing Biography and Institutional History: Eric Worrell’s Australian Reptile Park

Directory of Open Access Journals (Sweden)

Nancy Cushing

2009-11-01

Full Text Available When a young naturalist opened his new wildlife park at Wyoming on the NSW Central Coast in the late 1950s, he gave it his own name: Eric Worrell’s Australian Reptile Park. Through the park, Worrell made a significant contribution to environmental education, the development of knowledge of captive animal care and display and the provision of antivenoms for the bites of a range of dangerous creatures. More than this, it was the geographic and emotional centre of Worrell’s world: the fulfilment of a childhood dream, a home for his family and a site for forming new personal and professional relationships. In preparation for the jubilee of the park, its history is being written by two academics from the University of Newcastle. An attractive means of creating the necessary narrative structure and human interest to ensure the wide appeal of this history is to follow Worrell’s lead and place his life at the centre of this institutional history. This is the direction suggested by the written sources on the park and it is accentuated by many of our oral informants who organise their memories of the park around Worrell. To what extent can an institutional history be a biography of the person at the heart of that institution? Is it possible to disentangle the life from the institution? This article offers some preliminary answers to these questions through a case study of the writing of a history of Eric Worrell’s Australian Reptile Park.

Effect of adjuncts on sensory properties and consumer liking of Scamorza cheese.

Science.gov (United States)

Braghieri, A; Piazzolla, N; Romaniello, A; Paladino, F; Ricciardi, A; Napolitano, F

2015-03-01

The present study aimed to evaluate the effect of a peptidolytic adjunct (Lactococcus lactis, Lactobacillus helveticus, and Lactobacillus paracasei), as a tool to accelerate ripening, on sensory properties and acceptability of Scamorza cheese obtained using 2 types of milk (Friesian and Friesian+Jersey) and Streptococcus thermophilus as primary starter. A 10-member panel was trained using a specific frame of references and used a specific vocabulary to assess cheese sensory properties through quantitative descriptive analysis (QDA), whereas 87 consumers were used to evaluate product acceptability. Analysis of variance showed that milk type did not markedly alter cheese sensory properties. Conversely, panelists perceived higher intensities of butter, saltiness, and sweetness flavors in cheese without adjunct culture (ST), whereas the addition of the adjunct culture (ST+A) induced higher and sourness flavors, oiliness and grainy textures, and lower adhesiveness, moisture, springiness, and tenderness. Principal component analysis showed positive relationships between pH and tenderness, sweetness and saltiness and a negative correlation between pH and grainy, oiliness, color and structure uniformity, sourness, and milk. Most of the differences observed in QDA and most of the relationships observed in the principal component analysis were linked to the higher microbial activity induced by the adjunct culture. Independently of milk and starter types, consumers perceived Scamorza cheese as characterized by a good eating quality (mean liking scores were all above the neutral point of the hedonic scale). Although ST cheeses showed higher values for overall liking, 2 homogeneous groups of consumers were identified using partial least squares regression analysis. One group preferred ST cheeses with higher levels of tenderness, adhesiveness, springiness, and moisture in terms of texture, butter in terms of flavor, and sweetness in terms of taste, whereas a second group

Rare case of malignant craniopharyngioma reactive to adjunctive stereotactic radiotherapy and chemotherapy; Case report and review.

Science.gov (United States)

Nomura, Shunsunke; Aihara, Yasuo; Amano, Kosaku; Eguchi, Seiichiro; Chiba, Kentaro; Komori, Takashi; Kawamata, Takakazu

2018-06-19

Malignant craniopharyngioma or anaplastic craniopharyngioma was first reported in 1987 by Akachi. It has a malignant clinical and histological feature; remarkably rapid progression, atypical pathology like squamous cell carcinoma and poor prognosis. To date seventeen cases of malignant craniopharyngioma have been reported and of these cases, most were of secondary malignant tumor in nature. With respect to traditional benign craniopharyngioma, adjunctive treatment after gross total removal is not necessary, but in the case of malignant types of the tumor, adjunctive treatment is important. This paper presents the first case of malignant craniopharyngioma reactive to adjunctive Gamma knife stereotactic radiosurgery and chemotherapy. Malignant craniopharyngioma is very rare, and we report Gamma knife stereotactic radiosurgery and chemotherapy (Carboplatine and etoposide chemotherapy), as well as Temozolomide chemotherapy were effective and could control progression of the tumor temporarily. Since adjunctive Gamma knife stereotactic radiosurgery and chemotherapy of malignant craniopharyngioma cases affects follow-up strategies, we propose supporting the need to a revision to the WHO classification regarding malignancy evaluation of craniopharyngioma. Copyright © 2018 Elsevier Inc. All rights reserved.

Las ericáceas de la vertiente pacífica de Nariño, Colombia

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Nelson R. Salinas

2005-01-01

La mayor riqueza de especies y endemismos se presentó entre 1.000 y 1.600 m de altitud, con 45 especies. Los resultados obtenidos muestran que la vertiente pacífica del departamento de Nariño, Colombia, es la región de América con mayor número de especies de ericáceas por unidad de área.

Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts.

Science.gov (United States)

Smiley, Christopher J; Tracy, Sharon L; Abt, Elliot; Michalowicz, Bryan S; John, Mike T; Gunsolley, John; Cobb, Charles M; Rossmann, Jeffrey; Harrel, Stephen K; Forrest, Jane L; Hujoel, Philippe P; Noraian, Kirk W; Greenwell, Henry; Frantsve-Hawley, Julie; Estrich, Cameron; Hanson, Nicholas

2015-07-01

Conduct a systematic review and meta-analysis on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. A panel of experts convened by the American Dental Association Council on Scientific Affairs conducted a search of PubMed (MEDLINE) and Embase for randomized controlled trials of SRP with or without the use of adjuncts with clinical attachment level (CAL) outcomes in trials at least 6 months in duration and published in English through July 2014. The authors assessed individual study bias by using the Cochrane Risk of Bias Tool and conducted meta-analyses to obtain the summary effect estimates and their precision and to assess heterogeneity. The authors used funnel plots and Egger tests to assess publication bias when there were more than 10 studies. The authors used a modified version of the US Preventive Services Task Force methods to assess the overall level of certainty in the evidence. The panel included 72 articles on the effectiveness of SRP with or without the following: systemic antimicrobials, a systemic host modulator (subantimicrobial-dose doxycycline), locally delivered antimicrobials (chlorhexidine chips, doxycycline hyclate gel, and minocycline microspheres), and a variety of nonsurgical lasers (photodynamic therapy with a diode laser, a diode laser, neodymium:yttrium-aluminum-garnet lasers, and erbium lasers). With a moderate level of certainty, the panel found approximately a 0.5-millimeter average improvement in CAL with SRP. Combinations of SRP with assorted adjuncts resulted in a range of average CAL improvements between 0.2 and 0.6 mm over SRP alone. The panel judged the following 4 adjunctive therapies as beneficial with a moderate level of certainty: systemic subantimicrobial-dose doxycycline, systemic antimicrobials, chlorhexidine chips, and photodynamic therapy with a diode laser. There was a low level of certainty in the benefits of the other included adjunctive

Single‑shot lamina technique of paravertebral block as an adjunct to ...

African Journals Online (AJOL)

2014-08-28

Aug 28, 2014 ... adjunct to GA for modified radical mastectomy with axillary dissection for breast cancer. The total ... treatment modality in many parts of the world, especially ... postoperative pain, reduced opioid consumption and.

Social networking sites: an adjunctive treatment modality for psychological problems.

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Menon, Indu S; Sharma, Manoj Kumar; Chandra, Prabha S; Thennarasu, K

2014-07-01

Social networking is seen as a way to enhance social support and feeling of well-being. The present work explores the potentials of social networking sites as an adjunctive treatment modality for initiating treatment contact as well as for managing psychological problems. Interview schedule, Facebook intensity questionnaire were administered on 28 subjects with a combination of 18 males and 10 females. They were taken from the in-patient and out-patient psychiatry setting of the hospital. Facebook was the most popular sites and used to seek emotional support on the basis of the frequent updates of emotional content that users put in their profile; reconciliations, escape from the problems or to manage the loneliness; getting information about illness and its treatment and interaction with experts and also manifested as problematic use. It has implications for developing social networking based adjunctive treatment modality for psychological problems.

ERic Acute StrokE Recanalization: A study using predictive analytics to assess a new device for mechanical thrombectomy.

Science.gov (United States)

Siemonsen, Susanne; Forkert, Nils D; Bernhardt, Martina; Thomalla, Götz; Bendszus, Martin; Fiehler, Jens

2017-08-01

Aim and hypothesis Using a new study design, we investigate whether next-generation mechanical thrombectomy devices improve clinical outcomes in ischemic stroke patients. We hypothesize that this new methodology is superior to intravenous tissue plasminogen activator therapy alone. Methods and design ERic Acute StrokE Recanalization is an investigator-initiated prospective single-arm, multicenter, controlled, open label study to compare the safety and effectiveness of a new recanalization device and distal access catheter in acute ischemic stroke patients with symptoms attributable to acute ischemic stroke and vessel occlusion of the internal cerebral artery or middle cerebral artery. Study outcome The primary effectiveness endpoint is the volume of saved tissue. Volume of saved tissue is defined as difference of the actual infarct volume and the brain volume that is predicted to develop infarction by using an optimized high-level machine learning model that is trained on data from a historical cohort treated with IV tissue plasminogen activator. Sample size estimates Based on own preliminary data, 45 patients fulfilling all inclusion criteria need to complete the study to show an efficacy >38% with a power of 80% and a one-sided alpha error risk of 0.05 (based on a one sample t-test). Discussion ERic Acute StrokE Recanalization is the first prospective study in interventional stroke therapy to use predictive analytics as primary and secondary endpoint. Such trial design cannot replace randomized controlled trials with clinical endpoints. However, ERic Acute StrokE Recanalization could serve as an exemplary trial design for evaluating nonpivotal neurovascular interventions.

Value of combined exercise and ultrasound as an adjunct to compression therapy in chronic venous leg ulcers

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Rehab A.E Sallam

2017-01-01

Conclusion Combined prescription of exercises and ultrasound as an adjunct to compression therapy would be a more effective means of promoting chronic venous ulcer healing, when standard compression therapy have failed. It is safe, easy and well tolerated and should be considered as adjunctive therapy in patients with venous leg ulcers.

Treatment of hyperthyroidism with radioiodine: adjunctive therapy with antithyroid drugs reconsidered

International Nuclear Information System (INIS)

Velkeniers, B.; Vanhaelst, L.; Cytryn, R.; Jonckheer, M.H.

1988-01-01

To assess the value of antithyroid drugs as an adjunct to radioactive iodine for the treatment of hyperthyroidism the incidence of relapse or hypothyroidism after a mean follow-up of 51/2 years (range 2-7 years) was reviewed retrospectively for 206 patients, some treated with and others without antithyroid drugs after radioiodine therapy. Allocation to treatment group had been random, and both groups were similar in all respects except for the adjunctive treatment with antithyroid drugs. All doses of 131 I had been calculated by one physician. Compared with those who received 131 I alone, those starting on antithyroid drugs within 8 days after 131 I had a lower incidence of hypothyroidism but a higher incidence of early post-treatment recurrence or persistence of hyperthyroidism, and considerably lower incidence of remission. (author)

Embracing complexity: the post-secular pilgrimage of Eric-Emmanuel Schmitt

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Ruth Illman

2010-01-01

Full Text Available This article deals with the phenomenon of pilgrimage as a personal transformative process; an exploration of spiritual space rather than a journey undertaken to a physical place. The analysis focuses on the life story and authorship of the novelist and playwright Eric-Emmanuel Schmitt (b. 1960. Schmitt began his career as an academic philosopher specialised in enlightenment rationality. A mystical experience in the deserts of Sahara, however, opened his eyes to the spiritual dimensions of reality and encouraged him to redirect his professional strivings from academic writing to fiction. Today, Schmitt has reached a world-wide audience with his plays and novels on interreligious dialogue, especially the series of five short novellas called Le cycle d’Invisible. These narratives all deal with inter-religious encounters in a complex and compassionate way as Schmitt is particularly concerned with preserving the mystery of the situations he describes. The atheist conviction of his previous life has thus given way to an agnostic and mystically inspired world view focusing on diversity, divinity and inexplicability: “I am obsessed with complexity”, as he puts it himself. The presentation is based on ethnographic material, and key themes to be addressed include pilgrimage as a spiritual journey, interreligious encounters and mystical experiences.

Meditation as an Adjunct to the Management of Multiple Sclerosis

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Adam B. Levin

2014-01-01

Full Text Available Background. Multiple sclerosis (MS disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS. Methods. Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, and mindfulness. Results. 12 pieces of primary literature fitting the selection criteria were selected: two were randomised controlled studies, four were cohort studies, and six were surveys. The current literature varies in quality; however common positive effects of meditation include improved quality of life (QOL and improved coping skills. Conclusion. All studies suggest possible benefit to the use of meditation as an adjunct to the management of multiple sclerosis. Additional rigorous clinical trials are required to validate the existing findings and determine if meditation has an impact on disease course over time.

SGLT2 inhibitors as adjunct therapy to insulin in type 1 diabetes: Meta analysis

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Jiao CHEN

2017-02-01

Full Text Available Objective　To evaluate the efficacy and safety of sodium glucose co-transporter-2 (SGLT-2 inhibitors as adjunct therapy to insulin in type 1 diabetes (T1DM. Methods　The PubMed, The Cochrane Library, EMbase, CENTRRAI, CBM, CNKI, VIP and WangFang database were searched from inception to April 5, 2016 for systematic reviews, references screen was performed manually. The trials of SGLT2 inhibitors versus placebo add to insulin carried out in patients with T1DM were collected, and their bias risk was assessed and meta-analysis was conducted by using RevMan 5.3 software. Results　Four randomized control trials (RCTs were yielded for meta-analysis, including 529 patients. Compared with control group, SGLT2 inhibitors as adjunct therapy to insulin significantly reduced fasting plasma glucose (FPG [weighted mean difference (WMD=–0.65mmol/L, 95% confidence interval (CI=–1.30 to –0.08, P<0.05], glycated hemoglobin A1C (HbA1c (WMD=–0.37%, 95%CI=–0.54 to –0.20, P<0.00001, body weight (WMD=–2.54kg, 95%CI=–3.48 to –1.60, P<0.0001 and total daily insulin dose (WMD=–6.23IU, 95% CI=–8.05 to –4.40, P<0.0001, but the total adverse events (AEs, hypoglycemia, genital and urinary infections showed no significant difference. Conclusions　Based on current studies, SGLT-2 inhibitors are effective as adjunct therapy to insulin in T1DM, may improve glycemic control, reduce body weight and total daily insulin dose without increase of total AEs, hypoglycemia, and genital and urinary infections. DOI: 10.11855/j.issn.0577-7402.2016.12.15

Clinical effectiveness of diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized clinical study.

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Dukić, Walter; Bago, Ivona; Aurer, Andrej; Roguljić, Marija

2013-08-01

The aim of this randomized clinical study is to evaluate the effect of a 980-nm diode laser as an adjunct to scaling and root planing (SRP) treatment. Thirty-five patients with chronic periodontitis were selected for the split-mouth clinical study. SRP was performed using a sonic device and hand instruments. Quadrants were equally divided between the right and left sides. Teeth were treated with SRP in two control quadrants (control groups [CG]), and the diode laser was used adjunctively with SRP in contralateral quadrants (laser groups [LG]). Diode laser therapy was applied to periodontal pockets on days 1, 3, and 7 after SRP. Baseline data, including approximal plaque index (API), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), were recorded before the treatment and 6 and 18 weeks after treatment. Changes in PD and CAL were analyzed separately for initially moderate (4 to 6 mm) and deep (7 to 10 mm) pockets. The results were similar for both groups in terms of API, BOP, PD in deep pockets, and CAL. The laser group showed only significant PD gain in moderate pockets during the baseline to 18-week (P 0.05). The present study indicates that, compared to SRP alone, multiple adjunctive applications of a 980-nm diode laser with SRP showed PD improvements only in moderate periodontal pockets (4 to 6 mm).

Illustrations as Adjuncts to Prose: A Text-Appropriate Processing Approach.

Science.gov (United States)

Waddill, Paula J.; And Others

1988-01-01

The effects of pictorial illustrations on memory for text were studied in 144 college students. Two experiments indicated that illustrations serve a supplementary function; adjunct pictures alone, without special processing instructions, do not help learners encode information that is not normally encoded in the first place. (SLD)

Budget impact analysis of adjunctive therapy with lacosamide for partial-onset epileptic seizures in Belgium.

Science.gov (United States)

Simoens, Steven

2011-01-01

This study aims to compute the budget impact of lacosamide, a new adjunctive therapy for partial-onset seizures in epilepsy patients from 16 years of age who are uncontrolled and having previously used at least three anti-epileptic drugs from a Belgian healthcare payer perspective. The budget impact analysis compared the 'world with lacosamide' to the 'world without lacosamide' and calculated how a change in the mix of anti-epileptic drugs used to treat uncontrolled epilepsy would impact drug spending from 2008 to 2013. Data on the number of patients and on the market shares of anti-epileptic drugs were taken from Belgian sources and from the literature. Unit costs of anti-epileptic drugs originated from Belgian sources. The budget impact was calculated from two scenarios about the market uptake of lacosamide. The Belgian target population is expected to increase from 5333 patients in 2008 to 5522 patients in 2013. Assuming that the market share of lacosamide increases linearly over time and is taken evenly from all other anti-epileptic drugs (AEDs), the budget impact of adopting adjunctive therapy with lacosamide increases from €5249 (0.1% of reference drug budget) in 2008 to €242,700 (4.7% of reference drug budget) in 2013. Assuming that 10% of patients use standard AED therapy plus lacosamide, the budget impact of adopting adjunctive therapy with lacosamide is around €800,000-900,000 per year (or 16.7% of the reference drug budget). Adjunctive therapy with lacosamide would raise drug spending for this patient population by as much as 16.7% per year. However, this budget impact analysis did not consider the fact that lacosamide reduces costs of seizure management and withdrawal. The literature suggests that, if savings in other healthcare costs are taken into account, adjunctive therapy with lacosamide may be cost saving.

Effects of Time-Compressed Narration and Representational Adjunct Images on Cued-Recall, Content Recognition, and Learner Satisfaction

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Ritzhaupt, Albert Dieter; Barron, Ann

2008-01-01

The purpose of this study was to investigate the effect of time-compressed narration and representational adjunct images on a learner's ability to recall and recognize information. The experiment was a 4 Audio Speeds (1.0 = normal vs. 1.5 = moderate vs. 2.0 = fast vs. 2.5 = fastest rate) x Adjunct Image (Image Present vs. Image Absent) factorial…

Interdisciplinary Treatment of an Adult Patient Using an Adjunctive Orthodontic Approach. Case Report

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Rugina Roxana

2017-03-01

Full Text Available The aim of this case presentation is to outline some of the advantages that an adjunct orthodontic treatment can offer in a comprehensive oral rehabilitation of an adult patient. Adjunctive orthodontic treatment is usually limited to a dental arch or to a group of teeth within an arch. The purpose of dental movements in this case will be to position the teeth in a way that makes the restoration or replacement of damaged or missing teeth as easy as possible and with minimal dental tissue sacrifice. In addition, the improved position of the teeth will create a healthier periodontal environment that is easier to maintain over time.

Two-year clinical outcomes following non-surgical mechanical therapy of peri-implantitis with adjunctive diode laser application.

Science.gov (United States)

Mettraux, Gérald R; Sculean, Anton; Bürgin, Walter B; Salvi, Giovanni E

2016-07-01

Non-surgical mechanical therapy of peri-implantitis (PI) with/without adjunctive measures yields limited clinical improvements. To evaluate the clinical outcomes following non-surgical mechanical therapy of PI with adjunctive application of a diode laser after an observation period ≥2 years. At baseline (BL), 15 patients with 23 implants with a sandblasted and acid-etched (SLA) surface diagnosed with PI were enrolled and treated. PI was defined as presence of probing pocket depths (PPD) ≥5 mm with bleeding on probing (BoP) and/or suppuration and ≥2 threads with bone loss after delivery of the restoration. Implant sites were treated with carbon fiber and metal curettes followed by repeated application of a diode laser 3x for 30 s (settings: 810 nm, 2.5 W, 50 Hz, 10 ms). This procedure was performed at Day 0 (i.e., baseline), 7 and 14. Adjunctive antiseptics or adjunctive systemic antibiotics were not prescribed. All implants were in function after 2 years. The deepest PPD decreased from 7.5 ± 2.6 mm to 3.6 ± 0.7 mm at buccal (P surgical mechanical therapy of PI with adjunctive repeated application of a diode laser yielded significant clinical improvements after an observation period of at least 2 years. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Effectiveness of Adjunct Class on The Mastery of Vocabulary And Course Content of Students of Accounting Department

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Patrisius Istiarto Djiwandono

2014-05-01

Full Text Available The paper reports a classroom action research that aimed to determine the impact of a Content and Language Integrated Learning on the mastery of vocabulary and of course contents of a group of students in the Accounting Department of Universitas Ma Chung. It also intended to identify their opinions about the effectiveness of such approach. To achieve these objectives, a Time Series Design was used in a Classroom Action Research framework to introduce an adjunct class to the accounting class. The baseline data in the form of their vocabulary mastery and knowledge of the course contents were gained before the adjunct session was given. Then, the adjunct sessions were given for a period of two months. A few tests were administered to measure their progress in the mastery of vocabulary and course contents. A comparison was then drawn between the scores of the baseline data and the subsequent measures. In general, although they gained better mastery of new words, they failed to utilize them to increase their mastery of the course contents. Further exploration into the interview data reveals that most of them did not feel any significant assistance in mastering the course contents, although many of them admitted the benefit of mastering new vocabulary. There are some possible causes of the results. First, the limited duration of the adjunct sessions was felt to hinder the effectiveness. Second, the explanation in the adjunct sessions were not matched quite well with the focus during the main content course. On the basis of the results, the recommended points are the matching between the emphasis of both classes, and the lengthening of the duration of the adjunct sessions.

Entrevista com Eric McLuhan

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McLuhan, Eric

2011-01-01

Full Text Available Marshall McLuhan faria 100 anos em 2011. Para marcar esta data, que já provocou uma recente revisitação à obra do teórico, o XI Seminário Internacional da Comunicação, promovido pela PUCRS, destacou temas como as relações do homem com as tecnologias e os efeitos psicológicos das mídias para nortear às discussões dos três dias de evento. Mas se engana que acredita que entender a obra mcluhiana é tarefa fácil. Mesmo tendo se dedicado com afinco a explicar metáforas como ‘o meio é a mensagem’ e ‘aldeia global’, McLuhan nunca chegou a ser completamente entendido. Ou as pessoas não sedavam ao trabalho de entendê-lo, ou, simplesmente, não conseguiam enxergar as mudanças que estavam acontecendo com a mesma clareza que o pesquisador. Numa tentativa não só de entender a obra do ‘profeta da globalização’, mas de ampliar os entendimentos sobre as tecnologias e as extensões do homem, Eric McLuhan, filho do teórico, participou como palestrante do Seminário para falar, entre outros assuntos, da percepção acadêmica quanto a obra de seu pai, além de introduzir novas ideias sobre televisão, globalização e ecologia

Reflections on Sven-Eric Liedman’s Marx-Biography “A World to Win: The Life and Works of Karl Marx”

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Christian Fuchs

2018-05-01

Full Text Available The English translation of Sven-Eric Liedman’s Marx-biography A World to Win: The Life and Works of Karl Marx was published two weeks before Marx’s bicentenary. This article presents reflections on Liedman’s book and asks how one should best write biographically about Marx. The paper compares Liedman’s biography to the Marx-biographies written by Jonathan Sperber (Karl Marx: A Nineteenth-Century Life and Gareth Stedman-Jones (Karl Marx: Greatness and Illusion. A biography is a way of repeating a person’s life, works and age in a process of reconstruction and retelling. The question that arises is how to write a biography as a dialectical text. Sven-Eric Liedman: A World to Win: The Life and Works of Karl Marx. London: Verso, London, 2018. 768 pages., £35.00 hbk. ISBN 9781786635044

Fairness & Equity: Standards of Good Practice in the Employment of Part-Time/Adjunct Faculty. Item Number 36-0698

Science.gov (United States)

American Federation of Teachers, 2002

2002-01-01

Citing a decreased proportion of full-time tenured faculty at American colleges and steady increase of part-time adjunct and other nontenure-track faculty, this American Federation of Teachers' (AFT) document advocates professionalism of the manner in which part-time/adjunct faculty are employed, compensated, supported and treated in higher…

Genotipificación de aislamientos de Bartonella bacilliformis por amplificación de elementos repetitivos mediante el uso de REP-PCR y ERIC-PCR

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Carlos Padilla R

2003-07-01

Full Text Available Objetivos: Genotipificar los aislamientos de Bartonella bacilliformis a través de la amplificación de elementos repetitivos mediante el uso de ERIC-PCR y REP-PCR, y determinar si existe variabilidad genética entre aislamientos de varias zonas endémicas. Materiales y Métodos: Se evaluaron mediante el uso del ERIC-PCR y REP-PCR 17 aislamientos de B. bacilliformis de Lima, Cusco y Ancash. Los aislamientos fueron realizados durante los años 1998 y 1999. Para el análisis de los patrones de bandas se usó el software GelCompar 4,0. Resultados: Fueron identificados en los 17 aislamientos 10 genotipos. Los genotipos D, E y H fueron detectados en Cusco; mientras que los genotipos B, C, G, J e I en Lima; y el genotipo F en Ancash. Conclusiones: Nuestros resultados sugieren que REP-PCR y ERIC-PCR son métodos útiles para genotipificar aislamientos de B. bacilliformis. La variabilidad genética debe ser tomada en cuenta en estudios epidemiológicos y clínicos de Bartonelosis; así como el desarrollo de nuevas técnicas diagnósticas y de vacunas.

Management of extra-articular segmental defects in long bone using a titanium mesh cage as an adjunct to other methods of fixation.

Science.gov (United States)

Attias, N; Thabet, A M; Prabhakar, G; Dollahite, J A; Gehlert, R J; DeCoster, T A

2018-05-01

Aims This study reviews the use of a titanium mesh cage (TMC) as an adjunct to intramedullary nail or plate reconstruction of an extra-articular segmental long bone defect. Patients and Methods A total of 17 patients (aged 17 to 61 years) treated for a segmental long bone defect by nail or plate fixation and an adjunctive TMC were included. The bone defects treated were in the tibia (nine), femur (six), radius (one), and humerus (one). The mean length of the segmental bone defect was 8.4 cm (2.2 to 13); the mean length of the titanium mesh cage was 8.3 cm (2.6 to 13). The clinical and radiological records of the patients were analyzed retrospectively. Results The mean time to follow-up was 55 months (12 to 126). Overall, 16 (94%) of the patients achieved radiological filling of their bony defect and united to the native bone ends proximally and distally, resulting in a functioning limb. Complications included device failure in two patients (12%), infection in two (12%), and wound dehiscence in one (6%). Four patients (24%) required secondary surgery, four (24%) had a residual limb-length discrepancy, and one (6%) had a residual angular limb deformity. Conclusion A titanium mesh cage is a useful adjunct in the treatment of an extra-articular segmental defect in a long bone. Cite this article: Bone Joint J 2018;100-B:646-51.

Chinese Herbal Medicines as an Adjunctive Therapy for Unresectable Pancreatic Cancer: A Systematic Review and Meta-Analysis

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Bin Li

2015-01-01

Full Text Available Pancreatic cancer is a common malignancy with a high mortality. Most patients present clinically with advanced pancreatic cancer. Moreover, the effect of radiotherapy or chemotherapy is limited. Complementary and alternative medicines represent exciting adjunctive therapies. In this study, we ascertained the beneficial and adverse effects of Chinese herbal medicine (CHM in combination with conventional therapy for inoperable pancreatic cancer by using meta-analysis methods for controlled clinical trials. We extracted data for studies searched from six electronic databases that were searched and also assessed the methodological quality of the included studies. We evaluated the following outcome measures: 6-month and 1-year survival rate, objective response rate, disease control rate, quality of life, and adverse effects. The final analysis showed CHM is a promising strategy as an adjunctive therapy to treat advanced or inoperable pancreatic cancer and that CHM in combination with conventional therapy is a promising strategy for resistant disease. However, convincing evidence must be obtained and confirmed by high-quality trials in future studies.

Molecular characterization of Salmonella enterica serotype Enteritidis isolates from food and human samples by serotyping, antimicrobial resistance, plasmid profiling, (GTG5-PCR and ERIC-PCR

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F. Fardsanei

2016-11-01

Full Text Available In recent years, Salmonella enterica serovar Enteritidis has been a primary cause of human salmonellosis in many countries. The major objective of this study was to investigate genetic diversity among Salmonella Enteritidis strains from different origins (food and human by Enterobacterial Repetitive Intergenic Consensus (ERIC -PCR, as well as to assess their plasmid profiling and antimicrobial resistance. A total of 30 Salmonella Enteritidis isolates, 15 from food samples (chicken, lamb, beef and duck meats and 15 from clinical samples were collected in Tehran. Identification of isolates as Salmonella was confirmed by using conventional standard biochemical and serological tests. Multiplex-PCR was used for serotyping of isolates to identify Salmonella Enteritidis. Antimicrobial susceptibility testing to 16 agents founds drug resistance patterns among Salmonella Enteritidis isolates. No resistance was observed to cephalexin, ceftriaxone, ceftazidime and cefotaxime, ciprofloxacin, imipenem or meropenem, chloramphenicol and gentamicin. The highest resistance (96.7% was observed to nitrofurantoin. Seven plasmid profiles (P1–P7 were detected, and a 68-kb plasmid was found in all isolates. Two different primers; ERIC and (GTG5 were used for genotyping, which each produced four profiles. The majority of clinical and food isolates fell into two separate common types (CTs with a similar percentage of 95% by ERIC-PCR. Using primer (GTG5, 29 isolates incorporated in three CTs with 70% of isolates showing a single banding pattern. Limited genetic diversity among human and food isolates of Salmonella Enteritidis may indicate that contaminated foods were possibly the source of human salmonellosis. These results confirmed that ERIC-PCR genotyping has limited discriminatory power for Salmonella Enteritidis of different origin.

ERIC-PCR fingerprinting-based community DNA hybridization to pinpoint genome-specific fragments as molecular markers to identify and track populations common to healthy human guts.

Science.gov (United States)

Wei, Guifang; Pan, Li; Du, Huimin; Chen, Junyi; Zhao, Liping

2004-10-01

Bacterial populations common to healthy human guts may play important roles in human health. A new strategy for discovering genomic sequences as markers for these bacteria was developed using Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR fingerprinting. Structural features within microbial communities are compared with ERIC-PCR followed by DNA hybridization to identify genomic fragments shared by samples from healthy human individuals. ERIC-PCR profiles of fecal samples from 12 diseased or healthy human and piglet subjects demonstrated stable, unique banding patterns for each individual tested. Sequence homology of DNA fragments in bands of identical size was examined between samples by hybridization under high stringency conditions with DIG-labeled ERIC-PCR products derived from the fecal sample of one healthy child. Comparative analysis of the hybridization profiles with the original agarose fingerprints identified three predominant bands as signatures for populations associated with healthy human guts with sizes of 500, 800 and 1000 bp. Clone library profiling of the three bands produced 17 genome fragments, three of which showed high similarity only with regions of the Bacteroides thetaiotaomicron genome, while the remainder were orphan sequences. Association of these sequences with healthy guts was validated by sequence-selective PCR experiments, which showed that a single fragment was present in all 32 healthy humans and 13 healthy piglets tested. Two fragments were present in the healthy human group and in 18 children with non-infectious diarrhea but not in eight children with infectious diarrhea. Genome fragments identified with this novel strategy may be used as genome-specific markers for dynamic monitoring and sequence-guided isolation of functionally important bacterial populations in complex communities such as human gut microflora.

Effects of Addition of Systemic Tramadol or Adjunct Tramadol to Lidocaine Used for Intravenous Regional Anesthesia in Patients Undergoing Hand Surgery

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Abdulkadir Yektaş

2016-01-01

Full Text Available Intravenous regional anesthesia (IVRA is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages. The present study aimed to investigate the effects of addition of systemic tramadol or adjunct tramadol to lidocaine for IVRA in patients undergoing hand surgery. American Society of Anesthesiologists (ASA I-II patients (n=60 who underwent hand surgery were included. For this purpose, only lidocaine (LDC, lidocaine+adjunct tramadol (LDC+TRA group, or lidocaine+systemic tramadol (LDC+SysTRA group was administered to the patients for IVRA and the groups were compared in terms of onset and recovery time of sensory and motor blocks, quality of anesthesia, and the degree of intraoperative and postoperative pain. The onset time of sensorial block was significantly shorter in the LDC+TRA group than that in the LDC+SysTRA group. The motor block recovery time was significantly shorter in the LDC+SysTRA group than that in the LDC+TRA and LDC groups. Administration of tramadol as an adjunct showed some clinical benefits by providing a shorter onset time of sensory and motor block, decreasing pain and analgesic requirement, and improving intraoperative conditions during IVRA. It was determined that systemic tramadol administration had no superiority.

Project LINC: Supporting Lecturers and Adjunct Instructors in Foreign Language Classrooms

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Scott, Sally S.; Edwards, Wade

2012-01-01

Foreign language learning can pose a barrier to some students with disabilities. This practice brief describes a collaborative process used on one campus to provide professional development for foreign language instructors. Training opportunities were intentionally focused on the needs of adjunct and temporary lecturers in providing inclusive…

The utilization of the seven principles for good practices of full-time and adjunct faculty in teaching health & science in community colleges

Science.gov (United States)

Musaitif, Linda M.

Purpose. The purpose of this study was to determine the degree to which undergraduate full-time and adjunct faculty members in the health and science programs at community colleges in Southern California utilize the seven principles of good practice as measured by the Faculty Inventory of the Seven Principles for Good Practice in Undergraduate Education. A second purpose was to compare degree of utilization for gender and class size. Methodology. This is a quantitative study wherein there exists a systematic and mathematical assessment of data gathered through the use of a Likert scale survey to process and determine the mathematical model of the use of the principles by the target population of both full-time and adjunct faculty of health/science programs of community colleges in Southern California. Findings. Examination of the data revealed that both full-time and adjunct faculty members of Southern California community colleges perceive themselves a high degree of utilization of the seven principles of good practice. There was no statistically significant data to suggest a discrepancy between full-time and adjunct professors' perceptions among the utilization of the seven principles. Overall, male faculty members perceived themselves as utilizing the principles to a greater degree than female faculty. Data suggest that faculty with class size 60 or larger showed to utilize the seven principles more frequently than the professors with smaller class sizes. Conclusions. Full-time and adjunct professors of the health and sciences in Southern California community colleges perceive themselves as utilizing the seven principles of good practice to a high degree. Recommendations. This study suggests many recommendations for future research, including the degree to which negative economic factors such as budget cuts and demands affect the utilization of the seven principles. Also recommended is a study comparing students' perceptions of faculty's utilization of the seven

Meta-analysis of adjunctive levetiracetam in refractory partial sei

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ZHANG Ying

2012-10-01

Full Text Available Objective To evaluate the effects and tolerability of adjunctive levetiracetam (LEV in refractory partial seizures. Methods Relevant research articles about randomized controlled trials of adjunctive LEV in refractory partial seizures from January 1998 to December 2010 were retrieved from Cochrane Library, MEDLINE, EMbase, Social Sciences Citation Index (SSCI, VIP, Chinese National Knowledge Infrastructure (CNKI database, China Biology Medicine (CBM. Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted by using RevMan 5.0 software. Results According to the enrollment criteria, eleven prospective, randomized controlled clinical trials with a total of 1192 in LEV group and 789 in placebo group were finally selected. The reduction in three endpoints (a 50% or greater reduction of partial seizure frequency per week, a 75% or greater reduction of partial seizure frequency per week and seizure free was significant in LEV group than placebo group. There was no significance between LEV group and placebo group in the withdrawl rate (1000 mg/d: OR = 1.180, 95%CI: 0.690-2.010, P = 0.540; 2000 mg/d: OR = 1.530, 95%CI: 0.770-3.030, P = 0.230; 3000 mg/d: OR = 1.000, 95% CI: 0.620-1.600, P = 1.000. The following adverse events were associated with LEV: somnolence (OR = 1.720, 95%CI: 1.280-2.310, P = 0.000, dizziness (OR = 1.490, 95%CI: 1.000-2.220, P = 0.050, asthenia (OR = 1.670, 95%CI: 1.140-2.240, P = 0.008, nasopharyngitis (OR = 1.120, 95% CI: 0.710-1.760, P = 0.630, psychiatric and behavioral abnormalities (OR = 2.120, 95% CI: 1.370-3.280, P = 0.000. Conclusion LEV is effective and well tolerated when added to existing therapy in patients with refractory partial seizures compared with control drugs. Further studies are needed to identify the effects of monotherapy of LEV in partial seizures.

Cross-Linguistic Variation in the Treatment of Beneficiaries and the Argument vs. Adjunct Distinction

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Denis Creissels

2014-01-01

Full Text Available This paper compares the expression of beneficiaries with that of typical arguments and typical adjuncts in a sample of languages illustrating the variation in the extent to which NPs encoding beneficiaries show a syntactic behavior more or less similar to that of typical arguments or typical adjuncts. The observations support the position according to which semantic argumenthood as a comparative concept must be distinguished from its possible syntactic correlates, and must be defined as a scalar rather than categorical concept reflecting the interaction between the various factors that may contribute to defining the degree of involvement of participants in an event.

Is adjunctive photodynamic therapy more effective than scaling and root planing alone in the treatment of periodontal disease in hyperglycemic patients? A systematic review.

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Javed, Fawad; Salehpoor, Danial; Al-Dhafeeri, Talal; Yousuf, Muhammad; Malmstrom, Hans; Khan, Junad; Akram, Zohaib

2018-02-19

To assess the impact of scaling and root planing (SRP) with and without adjunct photodynamic therapy (PDT) in the treatment of periodontal disease (PD) in hyperglycemic patients. Databases (MEDLINE, EMBASE; and CENTRAL) were searched up to December 2017. The addressed PICO question was: "What is the effectiveness of adjunctive PDT to non-surgical periodontal treatment by means of clinical periodontal and glycemic parameters in hyperglycemic patients?" Four clinical trials and 1 experimental study were included. Energy fluence, power output, power density and duration of irradiation were 2.79 joules per square centimeters (J cm -2 ), 150 milliwatts (mW), 428 milliwatts per square centimeters (mW cm -2 ) and 133 seconds (s) respectively. All studies reporting clinical periodontal and metabolic parameters, showed that aPDT was effective in the treatment of periodontal inflammation in hyperglycemic patients at follow-up. When compared with SRP alone, none of the studies showed additional benefits of PDT as compared to SRP alone at follow up. Three studies showed no influence of SRP with or without aPDT on HbA1c levels. One study showed a significant reduction of HbA1c levels in adjunctive aPDT as compared to SRP alone at follow-up. It remains debatable whether adjunctive PDT as compared to SRP is effective in the treatment of periodontal inflammation and reduction of HbA1c levels in hyperglycemic patients. Copyright © 2018 Elsevier B.V. All rights reserved.

Measuring Adjunct Instructor Job Satisfaction by Using Herzberg's Motivation-Hygiene Theory

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Dickens, Durrell

2011-01-01

This study was designed to use Herzberg's motivation-hygiene theory to investigate the different levels of job satisfaction among adjunct college instructors at eight institutions of higher education located in southeast Texas. Differences in job satisfaction were measured by instructor gender, ethnicity, age, teaching experience, type of course…

Effect of vitamin A adjunct therapy for cerebral malaria in children ...

African Journals Online (AJOL)

Objective: To determine the effect of vitamin A supplementation on treatment outcome of cerebral malaria Methods: In this randomised double-blind placebo controlled clinical trial we ... Conclusions: Vitamin A as adjunct therapy did not significantly reduce coma duration but there were fewer deaths in the vitamin A arm.

Magnetic Resonance Imaging as an Adjunct to Mammography for Breast Cancer Screening in Women at Less Than High Risk for Breast Cancer: A Health Technology Assessment

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Nikitovic-Jokic, Milica; Holubowich, Corinne

2016-01-01

Background Screening with mammography can detect breast cancer early, before clinical symptoms appear. Some cancers, however, are not captured with mammography screening alone. Among women at high risk for breast cancer, magnetic resonance imaging (MRI) has been suggested as a safe adjunct (supplemental) screening tool that can detect breast cancers missed on screening mammography, potentially reducing the number of deaths associated with the disease. However, the use of adjunct screening tests may also increase the number of false-positive test results, which may lead to unnecessary follow-up testing, as well as patient stress and anxiety. We investigated the benefits and harms of MRI as an adjunct to mammography compared with mammography alone for screening women at less than high risk (average or higher than average risk) for breast cancer. Methods We searched Ovid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Centre for Reviews and Dissemination (CRD) Health Technology Assessment Database, and National Health Service (NHS) Economic Evaluation Database, from January 2002 to January 2016, for evidence of effectiveness, harms, and diagnostic accuracy. Only studies evaluating the use of screening breast MRI as an adjunct to mammography in the specified populations were included. Results No studies in women at less than high risk for breast cancer met our inclusion criteria. Conclusions It remains uncertain if the use of adjunct screening breast MRI in women at less than high risk (average or higher than average risk) for breast cancer will reduce breast cancer–related mortality without significant increases in unnecessary follow-up testing and treatment. PMID:27990198

Futebol, Cultura e Utopia: uma leitura de À procura de Eric, de Ken Loach

OpenAIRE

André Luís Reis Fernandes

2016-01-01

O presente trabalho tem como objetivo analisar o filme À procura de Eric(2009), do cineasta inglês Ken Loach. A análise procura fundamentar de que forma a narrativa do filme apresenta aspectos formais e conceituais que permitam aproximar os elementos constitutivos do jogo de futebol com possibilidades de explicações do mundo da pós-modernidade pautadas pelo materialismo histórico. Para tal, será necessário compreender a noção de Mapeamento Cognitivo, de Fredric Jameson, visando delimitar de q...

Adjunctive Treatment of Acute Mania with Risperidone versus Typical Antipsychotics: A Retrospective Study

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Jui-Hsiu Tsai

2005-12-01

Full Text Available Few studies have directly compared atypical antipsychotics (e.g. risperidone with typical antipsychotics as adjunctive therapy in patients hospitalized for acute mania, especially during a lengthy hospital stay. Our retrospective, case-controlled study is a chart review of 64 patients with Diagnostic and Statistical Manual of Mental Disorders, 4th edition, defined bipolar I disorder (current episode, mania. Patients were divided into two groups according to the adjunctive medications used: the risperidone group (mood stabilizers plus risperidone and the control group (mood stabilizers plus typical antipsychotics. Outcome at discharge, medications, adverse drug effects, and length of hospital stay were compared between groups, controlling for gender, age, number of prior admissions, and duration of illness. Results indicated no statistically significant differences between groups in the controlled factors, Global Assessment of Functioning and Clinical Global Impression-Improvement scores, and adverse drug events. Patients in the risperidone group used significantly lower doses of trihexyphenidyl than those in the control group (p < 0.05. Patients treated with risperidone had a shorter hospital stay than those treated with typical antipsychotics (p < 0.01. In conclusion, antipsychotics are effective as adjunctive agents in the treatment of acute mania. The use of risperidone, in particular, decreases the need for anticholinergics and may lead to a shorter hospital stay compared with typical antipsychotics.

Single‑shot lamina technique of paravertebral block as an adjunct to ...

African Journals Online (AJOL)

Thoracic paravertebral block can be employed as an alternative or an adjunct to general anesthesia (GA) for breast cancer surgery. There is no report of this new lamina technique for catheter placement in our environment. In low‑resource settings, potent opioids are lacking and the extended postoperative analgesia it ...

Factors Influencing the Integration of Technology by Community College Adjunct Faculty

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Paver, Jonathan David

2012-01-01

This research examined the factors that predict intention to integrate technology into instruction by community college adjunct faculty. For this study the integration of technology was defined as beyond simple occasional use, within the next academic year. The decomposed theory of planned behavior was tested for its predictive ability with this…

In Praise of Mr. S. Platter and His Marvelous, Magnificent CD ROM Laser Disc Index for ERIC and PSYCHLIT.

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Huffman, Robert F.

These instructions are designed to help patrons of the University of Missouri-Columbia library perform searches on PSYCHLIT, a CD-ROM (compact disc, read only memory) version of the Psych Abstracts database, and a CD-ROM version of the ERIC database, both produced by SilverPlatter Information Services. Basic information is provided about the disk…

The role of adjunctive dexamethasone in the treatment of bacterial meningitis: an updated systematic meta-analysis

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Shao M

2016-07-01

Full Text Available Mei Shao,1 Peng Xu,2 Jun Liu,3 Wenyun Liu,1 Xiujie Wu1 1Department of Neurosurgery, Linyi People’s Hospital, 2Department of Neurosurgery, Linyi Yishui Central Hospital, Linyi, 3Department of Neurosurgery, Binzhou Medical College, Yantai, Shandong, People’s Republic of China Background: Bacterial meningitis is a serious infection in children and adults worldwide, with considerable morbidity, mortality, and severe neurological sequelae. Dexamethasone is often used before antibiotics in cases of this disease, and improves outcomes.Objective: Although several studies have identified the role of adjunctive dexamethasone therapy in the treatment of bacterial meningitis, the results are still inconclusive. The aim of this study was to systematically evaluate the therapeutic and adverse effect of adjunctive dexa­methasone in patients with bacterial meningitis.Materials and methods: Relevant randomized, double-blind, placebo-controlled trials of dexamethasone in bacterial meningitis published between 2000 and 2016 were retrieved from the common electronic databases. The odds ratio (OR and risk ratio (RR with their 95% confidence interval (CI were employed to calculate the effect.Results: A total of ten articles including 2,459 bacterial meningitis patients (1,245 in the dexamethasone group and 1,214 in the placebo group were included in this meta-analysis. Our result found that dexamethasone was not associated with a significant reduction in follow-up mortality (292 of 1,245 on dexamethasone versus 314 of 1,214 on placebo; OR =0.91, 95% CI =0.80–1.03, P=0.14 and severe neurological sequelae (22.4% versus 24.1%, OR =0.84, 95% CI =0.54–1.29, P=0.42. However, dexamethasone seemed to reduce hearing loss among survivors (21.2% versus 26.1%; OR =0.76, 95% CI =0.59–0.98, P=0.03. No significant difference was found between these two groups in adverse events.Conclusion: Our results suggested that adjunctive dexamethasone might not be beneficial in the

PACS: Do clinical users benefit from it as a training adjunct?

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J van Heerden

2011-05-01

as a training adjunct included the frustrations associated with PACS downtime (especially during the period in 2009 when many electrical power cuts were experienced nationwide, resulting in network interruptions and slow image retrieval during peak work-flow times. The advantages of PACS as a positive training adjunct were highlighted in the areas of multi-site viewing and consultation, the possibility of image manipulation and measurement tools, and better overall image quality. Clinicians felt that their training experience was also enhanced because of better patient follow-up made possible by access to all previous radiological imaging of a particular patient. Of the clinicians who completed the questionnaires, 63.5% felt that the PACS at Steve Biko Academic Hospital contributed positively to their training by creating more overall learning opportunities than other training environments without a PACS.

Sensorimotor rhythm neurofeedback as adjunct therapy for Parkinson's disease.

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Philippens, Ingrid H C H M; Wubben, Jacqueline A; Vanwersch, Raymond A P; Estevao, Dave L; Tass, Peter A

2017-08-01

Neurofeedback may enhance compensatory brain mechanisms. EEG-based sensorimotor rhythm neurofeedback training was suggested to be beneficial in Parkinson's disease. In a placebo-controlled study in parkinsonian nonhuman primates we here show that sensorimotor rhythm neurofeedback training reduces MPTP-induced parkinsonian symptoms and both ON and OFF scores during classical L-DOPA treatment. Our findings encourage further development of sensorimotor rhythm neurofeedback training as adjunct therapy for Parkinson's disease which might help reduce L-DOPA-induced side effects.

Survival of probiotic adjunct cultures in cheese and challenges in their enumeration using selective media.

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Oberg, C J; Moyes, L V; Domek, M J; Brothersen, C; McMahon, D J

2011-05-01

Various selective media for enumerating probiotic and cheese cultures were screened, with 6 media then used to study survival of probiotic bacteria in full-fat and low-fat Cheddar cheese. Commercial strains of Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus paracasei, or Bifidobacterium lactis were added as probiotic adjuncts. The selective media, designed to promote growth of certain lactic acid bacteria (LAB) over others or to differentiate between LAB, were used to detect individual LAB types during cheese storage. Commercial strains of Lactococcus, Lactobacillus, and Bifidobacterium spp. were initially screened on the 6 selective media along with nonstarter LAB (NSLAB) isolates. The microbial flora of the cheeses was analyzed during 9 mo of storage at 6°C. Many NSLAB were able to grow on media presumed selective for Lactococcus, Bifidobacterium spp., or Lb. acidophilus, which became apparent after 90 d of cheese storage, Between 90 and 120 d of storage, bacterial counts changed on media selective for Bifidobacterium spp., suggesting growth of NSLAB. Appearance of NSLAB on Lb. casei selective media [de man, Rogosa, and Sharpe (MRS)+vancomycin] occurred sooner (30 d) in low-fat cheese than in full-fat control cheeses. Differentiation between NSLAB and Lactococcus was achieved by counting after 18 to 24h when the NSLAB colonies were only pinpoint in size. Growth of NSLAB on the various selective media during aging means that probiotic adjunct cultures added during cheesemaking can only be enumerated with confidence on selective media for up to 3 or 4 mo. After this time, growth of NSLAB obfuscates enumeration of probiotic adjuncts. When adjunct Lb. casei or Lb. paracasei cultures are added during cheesemaking, they appear to remain at high numbers for a long time (9 mo) when counted on MRS+vancomycin medium, but a reasonable probability exists that they have been overtaken by NSLAB, which also grow readily on this medium. Enumeration using multiple

Posterior subtenon triamcinolone acetonide in gas-filled eyes as an adjunctive treatment for complicated proliferative diabetic retinopathy.

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Lee, Yongeun; Kang, Seungbum; Park, Young-Hoon

2013-02-01

To evaluate the effect of adjunctive subtenon injection of triamcinolone acetonide (TA) in gas-filled eyes after vitrectomy for complicated proliferative diabetic retinopathy (PDR). This nonrandomized comparative study included 27 patients (27 eyes) who underwent pars plana vitrectomy and gas tamponade for treatment of PDR with tractional or combined tractional-rhegmatogenous retinal detachment and who received subtenon injection of TA (40 mg) at the end of surgery. The study group was compared with the control group (29 eyes), which was matched with the study group for preoperative and intraoperative parameters, but underwent pars plana vitrectomy and gas tamponade without a subtenon injection of TA. Retinal reattachments without reoperation were achieved in 25 eyes (92.6%) and 26 eyes (89.7%) at 6 months (p = 1.000) in the study and control groups, respectively. The study group and the control group did not differ significantly in the frequency of postoperative proliferative vitreoretinopathy, retinal redetachment rate, reoperation rate, macular pucker formation, postoperative vitreous hemorrhage, gain in visual acuity, intraocular pressure, and intraocular inflammation (p > 0.05). The clinical results of pars plana vitrectomy for complicated PDR are not improved significantly by an adjunctive subtenon TA injection in gas-filled eyes.

BBMRI-ERIC as a resource for pharmaceutical and life science industries: the development of biobank-based Expert Centres.

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van Ommen, Gert-Jan B; Törnwall, Outi; Bréchot, Christian; Dagher, Georges; Galli, Joakim; Hveem, Kristian; Landegren, Ulf; Luchinat, Claudio; Metspalu, Andres; Nilsson, Cecilia; Solesvik, Ove V; Perola, Markus; Litton, Jan-Eric; Zatloukal, Kurt

2015-07-01

Biological resources (cells, tissues, bodily fluids or biomolecules) are considered essential raw material for the advancement of health-related biotechnology, for research and development in life sciences, and for ultimately improving human health. Stored in local biobanks, access to the human biological samples and related medical data for transnational research is often limited, in particular for the international life science industry. The recently established pan-European Biobanking and BioMolecular resources Research Infrastructure-European Research Infrastructure Consortium (BBMRI-ERIC) aims to improve accessibility and interoperability between academic and industrial parties to benefit personalized medicine, disease prevention to promote development of new diagnostics, devices and medicines. BBMRI-ERIC is developing the concept of Expert Centre as public-private partnerships in the precompetitive, not-for-profit field to provide a new structure to perform research projects that would face difficulties under currently established models of academic-industry collaboration. By definition, Expert Centres are key intermediaries between public and private sectors performing the analysis of biological samples under internationally standardized conditions. This paper presents the rationale behind the Expert Centres and illustrates the novel concept with model examples.

Genetic diversity of Mycosphaerella fijiensis in Brazil analyzed using an ERIC-PCR marker.

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Silva, G F; Paixão, R D V; Queiroz, C B; Santana, M F; Souza, A; Sousa, N R; Hanada, R E; Gasparotto, L

2014-09-26

The Enterobacterial repetitive intergenic consensus (ERIC) marker was used to analyze the genetic variability of Mycosphaerella fijiensis, the causative agent of Black Sigatoka disease in banana plants. A total of 123 isolates were used, which were divided into populations based on their original hosts and collection sites in Brazil. A total of 9 loci were amplified, 77.8% of which were found to be polymorphic. The genetic diversity found in the population was 0.20. Analysis of molecular variance (AMOVA) demonstrated that the highest level of genetic variation is within populations. Cluster analysis revealed three main groups in Brazil, with no correlation between geographic and genetic distance.

Adjunctive Mitomycin C or Amniotic Membrane Transplantation for Ahmed Glaucoma Valve Implantation: A Randomized Clinical Trial.

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Yazdani, Shahin; Mahboobipour, Hassan; Pakravan, Mohammad; Doozandeh, Azadeh; Ghahari, Elham

2016-05-01

To determine whether adjunctive mitomycin C (MMC) or amniotic membrane transplantation (AMT) improve the outcomes of Ahmed glaucoma valve (AGV) implantation. This double-blind, stratified, 3-armed randomized clinical trial includes 75 eyes of 75 patients aged 7 to 75 years with refractory glaucoma. Eligible subjects underwent stratified block randomization; eyes were first stratified to surgery in the superior or inferior quadrants based on feasibility; in each subgroup, eyes were randomly assigned to the study arms using random blocks: conventional AGV implantation (group A, 25 eyes), AGV with MMC (group B, 25 eyes), and AGV with AMT (group C, 25 eyes). The 3 study groups were comparable regarding baseline characteristics and mean follow-up (P=0.288). A total of 68 patients including 23 eyes in group A, 25 eyes in group B, and 20 eyes group C completed the follow-up period and were analyzed. Intraocular pressure was lower in the MMC group only 3 weeks postoperatively (P=0.04) but comparable at other time intervals. Overall success rate was comparable in the 3 groups at 12 months (P=0.217). The number of eyes requiring medications (P=0.30), time to initiation of medications (P=0.13), and number of medications (P=0.22) were comparable. Hypertensive phase was slightly but insignificantly more common with standard surgery (82%) as compared with MMC-augmented (60%) and AMT-augmented (70%) procedures (P=0.23). Complications were comparable over 1 year (P=0.28). Although adjunctive MMC and AMT were safe during AGV implantation, they did not influence success rates or intraocular pressure outcomes. Complications, including hypertensive phase, were also comparable.

Finding a Seat at the Table Meeting the Pedagogical Needs of Adjunct Faculty in the Community College the Development and Implementation of a Staff Training Plan

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Spigelmyer, Frances Erickson

2011-01-01

This qualitative study via an action research design explored adjunct faculty pedagogical perceptions at Butler County Community College (BC3) in Butler, Pennsylvania. Based on a preliminary study by the researcher, adjunct survey data was analyzed to determine if there was a need for pedagogy training and, if so, what adjuncts believed that…

Diagnosis of breast cancer: contribution of US as an adjunct to mammography

NARCIS (Netherlands)

Zonderland, H. M.; Coerkamp, E. G.; Hermans, J.; van de Vijver, M. J.; van Voorthuisen, A. E.

1999-01-01

PURPOSE: To determine the value of ultrasonography (US) as an adjunct to mammography for the diagnosis of breast cancer. MATERIALS AND METHODS: In a 2-year prospective study, 4,811 mammograms were classified according to level of suspicion of malignancy. Targeted US was performed to analyze (a)

Adjunctive rifampicin to reduce early mortality from Staphylococcus aureus bacteraemia (ARREST: study protocol for a randomised controlled trial

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Thwaites Guy

2012-12-01

Full Text Available Abstract Background Staphylococcus aureus bacteraemia is a common and serious infection, with an associated mortality of ~25%. Once in the blood, S. aureus can disseminate to infect almost any organ, but bones, joints and heart valves are most frequently affected. Despite the infection’s severity, the evidence guiding optimal antibiotic therapy is weak: fewer than 1,500 patients have been included in 16 randomised controlled trials investigating S. aureus bacteraemia treatment. It is uncertain which antibiotics are most effective, their route of administration and duration, and whether antibiotic combinations are better than single agents. We hypothesise that adjunctive rifampicin, given in combination with a standard first-line antibiotic, will enhance killing of S. aureus early in the treatment course, sterilise infected foci and blood faster, and thereby reduce the risk of dissemination, metastatic infection and death. Our aim is to determine whether adjunctive rifampicin reduces all-cause mortality within 14 days and bacteriological failure or death within 12 weeks from randomisation. Methods We will perform a parallel group, randomised (1:1, blinded, placebo-controlled trial in NHS hospitals across the UK. Adults (≥18 years with S. aureus (meticillin-susceptible or resistant grown from at least one blood culture who have received ≤96 h of active antibiotic therapy for the current infection and do not have contraindications to the use of rifampicin will be eligible for inclusion. Participants will be randomised to adjunctive rifampicin (600-900mg/day; orally or intravenously or placebo for the first 14 days of therapy in combination with standard single-agent antibiotic therapy. The co-primary outcome measures will be all-cause mortality up to 14 days from randomisation and bacteriological failure/death (all-cause up to 12 weeks from randomisation. 940 patients will be recruited, providing >80% power to detect 45% and 30% reductions in

Adjunctive rifampicin to reduce early mortality from Staphylococcus aureus bacteraemia (ARREST): study protocol for a randomised controlled trial.

Science.gov (United States)

Thwaites, Guy; Auckland, Cressida; Barlow, Gavin; Cunningham, Richard; Davies, Gerry; Edgeworth, Jonathan; Greig, Julia; Hopkins, Susan; Jeyaratnam, Dakshika; Jenkins, Neil; Llewelyn, Martin; Meisner, Sarah; Nsutebu, Emmanuel; Planche, Tim; Read, Robert C; Scarborough, Matthew; Soares, Marta; Tilley, Robert; Török, M Estée; Williams, John; Wilson, Peter; Wyllie, Sarah; Walker, A Sarah

2012-12-18

Staphylococcus aureus bacteraemia is a common and serious infection, with an associated mortality of ~25%. Once in the blood, S. aureus can disseminate to infect almost any organ, but bones, joints and heart valves are most frequently affected. Despite the infection's severity, the evidence guiding optimal antibiotic therapy is weak: fewer than 1,500 patients have been included in 16 randomised controlled trials investigating S. aureus bacteraemia treatment. It is uncertain which antibiotics are most effective, their route of administration and duration, and whether antibiotic combinations are better than single agents. We hypothesise that adjunctive rifampicin, given in combination with a standard first-line antibiotic, will enhance killing of S. aureus early in the treatment course, sterilise infected foci and blood faster, and thereby reduce the risk of dissemination, metastatic infection and death. Our aim is to determine whether adjunctive rifampicin reduces all-cause mortality within 14 days and bacteriological failure or death within 12 weeks from randomisation. We will perform a parallel group, randomised (1:1), blinded, placebo-controlled trial in NHS hospitals across the UK. Adults (≥ 18 years) with S. aureus (meticillin-susceptible or resistant) grown from at least one blood culture who have received ≤ 96 h of active antibiotic therapy for the current infection and do not have contraindications to the use of rifampicin will be eligible for inclusion. Participants will be randomised to adjunctive rifampicin (600-900 mg/day; orally or intravenously) or placebo for the first 14 days of therapy in combination with standard single-agent antibiotic therapy. The co-primary outcome measures will be all-cause mortality up to 14 days from randomisation and bacteriological failure/death (all-cause) up to 12 weeks from randomisation. 940 patients will be recruited, providing >80% power to detect 45% and 30% reductions in the two co-primary endpoints of death by

Practice guidelines for acupuncturists using acupuncture as an adjunctive treatment for anorexia nervosa.

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Fogarty, Sarah; Ramjan, Lucie Michelle

2015-02-01

Anorexia nervosa is a potentially life-threatening eating disorder where people intentionally refuse to eat sufficient amounts to maintain a healthy body-weight for fear of becoming fat. The intense preoccupation with restriction of food and control of body weight makes this one of the most complex and confusing conditions for practitioners to treat. While no single treatment has been found to be superior to another in the treatment of anorexia nervosa, general practice guidelines are available to guide mainstream treatment, however there are no guidelines for practitioners of complementary therapies. Complementary therapies such as acupuncture show promise as an adjunctive therapy in improving co-morbidities such as depression and anxiety levels among people with anorexia nervosa, by strengthening mind, body and overall well-being. The aim of this guideline is to assist and support acupuncture practitioners to deliver effective and safe adjunctive acupuncture treatments to people with anorexia nervosa, by providing a practice guideline that is underpinned by an ethical and evidence-based framework. The use of complementary therapies and specifically acupuncture in the treatment of anorexia nervosa may provide important adjunctive care to allow a comprehensive treatment approach that potentially improves quality of life, reduces anxiety and instils hope for recovery. It is hoped that acupuncture practitioners treating patients with anorexia nervosa will refer to these guidelines and apply the guidance (as deemed appropriate). Copyright © 2015 Elsevier Ltd. All rights reserved.

Stress Management as an Adjunct to Physical Therapy for Chronic Neck Pain

Science.gov (United States)

Bruflat, Angela K.; Balter, Jaclyn E.; McGuire, Denise; Fethke, Nathan B.

2012-01-01

Background and Purpose Chronic neck pain is prevalent in the workplace. Research suggests that psychosocial stress may contribute to the development of neck pain by causing excessive or prolonged muscle activity in some individuals. The purpose of this case report is to describe the rationale, development, and implementation of stress management as an adjunct to standard physical therapist management of chronic neck pain in a female office worker who responded to psychosocial stress with elevated muscle activity prior to treatment. Case Description A 44-year-old female office employee with an 8-year history of chronic neck pain participated in this case report. The patient was selected from a group of research participants who demonstrated elevated electromyographic (EMG) activity of the trapezius muscle in response to simulated occupational stressors. The multidisciplinary intervention consisted of 8 physical therapy sessions, supplemented by 8 stress management sessions that included EMG biofeedback and psychotherapy to facilitate muscle relaxation. Outcomes Neck disability decreased by 50%, trait anxiety decreased by 21%, and the duration of trapezius muscle rest in the workplace increased by 56% immediately after the 8-week intervention. These improvements were maintained 6 months after treatment, and the patient reported a complete absence of neck disability at the 2-year follow-up assessment. Discussion A sustained reduction in neck disability was observed for a patient with chronic neck pain after participating in a multidisciplinary intervention that combined physical therapy and stress management approaches to facilitate muscle relaxation in the workplace. Future clinical trials are needed to assess whether stress management is a useful adjunct therapy for patients with chronic neck pain who show elevated muscle activity in response to psychosocial stress. PMID:22700538

Pharmacogenetics in electroconvulsive therapy and adjunctive medications.

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Mirzakhani, Hooman; van Noorden, Martijn S; Swen, Jesse; Nozari, Ala; Guchelaar, Henk-Jan

2015-01-01

Electroconvulsive therapy (ECT) has shown apparent efficacy in treatment of patients with depression and other mental illnesses who do not respond to psychotropic medications or need urgent control of their symptoms. Pharmacogenetics contributes to an individual's sensitivity and response to a variety of drugs. Clinical insights into pharmacogenetics of ECT and adjunctive medications not only improves its safety and efficacy in the indicated patients, but can also lead to the identification of novel treatments in psychiatric disorders through understanding of potential molecular and biological mechanisms involved. In this review, we explore the indications of pharmacogenetics role in safety and efficacy of ECT and present the evidence for its role in patients with psychiatric disorders undergoing ECT.

Efficacy of diltiazem as an adjunct to lignocaine in intravenous regional anesthesia

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Puneet Khanna

2013-01-01

Full Text Available Background: Various adjuncts have been used with lignocaine to decrease tourniquet pain and prolong post-operative analgesia during intravenous regional anesthesia (IVRA. Calcium-channel blockers potentiate the analgesic effect of local anesthetics. This study was designed to evaluate the efficacy of diltiazem as an adjunct to lignocaine in IVRA with respect to tourniquet tolerance, perioperative analgesia, and quality of anesthesia. Methods: In this prospective, randomized, and double-blind study, 40 patients (American Society for Anesthesiologists grade I/II undergoing elective hand surgery under IVRA were assigned into two groups of 20 each and administered IVRA either with lignocaine 3 mg/kg (group Lignocaine (L or lignocaine 3 mg/kg plus diltiazem 0.2 mg/kg (group Lignocaine-Diltiazem (LD with normal saline (total volume-40 ml. Hemodynamic parameters, onset of the complete sensory blockade, motor blockade, and intraoperative (tourniquet pain and post-operative Visual Analogue Scale scores, total intraoperative and consumption of post-operative fentanyl intraoperative were recorded. Results: Sensory block was established in 2.5±0.688 min in group LD verses 5.60±0.851 min in group L. Motor blockade was established in 8.65±0.933 min in group LD and 13.46±0.604 min in group L. The mean VAS scores >3 were attained early at 30 min (3.1±0.912 in group L. Patients in group L requested early rescue analgesic at 30±8.633 min compared with 49.64±7.958 min in group LD. Conclusions: Diltiazem as an adjunct to lignocaine provided enhanced intraoperative and post-operative analgesia without any significant side effects.

[Efficiency of brimonidine 0.2% and dorzolamide 2% as adjunctive therapy to beta-blockers].

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Carrasco Font, C; Arias Puente, A; García Sáenz, M C; Villarejo Díaz-Maroto, I

2004-04-01

To evaluate the clinical efficiency and tolerability of brimonidine and dorzolamide twice daily as an adjunctive therapy for glaucoma patients with an inadequate response to beta-blockers therapy. This multicenter prospective analysis included 92 patients (180 eyes) with primary open-angle glaucoma or ocular hypertension on therapy beta-blockers and with intraocular pressure (IOP) greater than or equal to 18mmHg. The patients were randomly treated either with brimonidine 0.2% or dorzolamide 2% added for three months. Efficiency was determined by the reduction in 15% IOP from baseline at the first and the third month. Mean pre-treatment IOP was 22.37 DE 2.8 mmHg in the brimonidine group and 22.38 DE 2.6 mmHg in the dorzolamide group; mean post-treatment IOP decrease was 4.39 mmHg in the brimonidine group and 3.29 mmHg in the dorzolamide group. Clinical control at the first month was achieved in 78.3% and 71% of cases respectively (p=0.05). No statistical differences existed between groups for systemic adverse events. Four patients on brimonidine discontinued treatment due to local side effects. In the dorzolamide group, two patients left the treatment referring itching and three others left due to ocular allergy. This study found similar efficiency and safety when treating with brimonidine or dorzolamide as an adjunctive therapy for patients with hypertension or primary open-angle glaucoma.

Ketamine hydrochloride - an adjunct for analgesia in dogs with burn wounds : clinical communication

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K. Joubert

1998-07-01

Full Text Available The management of pain in patients with burn wounds is complex and problematic. Burn-wound pain is severe, inconsistent and underestimated. Patients experience severe pain, especially during procedures, until wound healing has occurred. A multi-modality approach is needed for effective management of pain, which requires an understanding of the mechanisms of pain. Altered pharmacokinetics and pharmacodynamics in burn-wound patients makes drug actions unpredictable. Opioids alone are seldom sufficient for pain control. The multi-modality approach includes the use of opioids and non-steroidal antiinflammatory, anxiolytic and alternative drugs. Ketamine has been found to be a useful agent for analgesia in burn-wound patients; a dose of 10 mg/kg qid per os was found to be an effective adjunct to pain therapy.

Surgery as an Adjunctive Treatment for Multidrug-Resistant Tuberculosis: An Individual Patient Data Metaanalysis.

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Fox, Gregory J; Mitnick, Carole D; Benedetti, Andrea; Chan, Edward D; Becerra, Mercedes; Chiang, Chen-Yuan; Keshavjee, Salmaan; Koh, Won-Jung; Shiraishi, Yuji; Viiklepp, Piret; Yim, Jae-Joon; Pasvol, Geoffrey; Robert, Jerome; Shim, Tae Sun; Shin, Sonya S; Menzies, Dick; Ahuja, S; Ashkin, D; Avendaño, M; Banerjee, R; Bauer, M; Burgos, M; Centis, R; Cobelens, F; Cox, H; D'Ambrosio, L; de Lange, W C M; DeRiemer, K; Enarson, D; Falzon, D; Flanagan, K; Flood, J; Gandhi, N; Garcia-Garcia, L; Granich, R M; Hollm-Delgado, M G; Holtz, T H; Hopewell, P; Iseman, M; Jarlsberg, L G; Kim, H R; Lancaster, J; Lange, C; Leimane, V; Leung, C C; Li, J; Menzies, D; Migliori, G B; Narita, M; Nathanson, E; Odendaal, R; O'Riordan, P; Pai, M; Palmero, D; Park, S K; Pena, J; Pérez-Guzmán, C; Ponce-de-Leon, A; Quelapio, M I D; Quy, H T; Riekstina, V; Royce, S; Salim, M; Schaaf, H S; Seung, K J; Shah, L; Shean, K; Sifuentes-Osornio, J; Sotgiu, G; Strand, M J; Sung, S W; Tabarsi, P; Tupasi, T E; Vargas, M H; van Altena, R; van der Walt, M; van der Werf, T S; Westenhouse, J; Yew, W W

2016-04-01

Medical treatment for multidrug-resistant (MDR)-tuberculosis is complex, toxic, and associated with poor outcomes. Surgical lung resection may be used as an adjunct to medical therapy, with the intent of reducing bacterial burden and improving cure rates. We conducted an individual patient data metaanalysis to evaluate the effectiveness of surgery as adjunctive therapy for MDR-tuberculosis. Individual patient data, was obtained from the authors of 26 cohort studies, identified from 3 systematic reviews of MDR-tuberculosis treatment. Data included the clinical characteristics and medical and surgical therapy of each patient. Primary analyses compared treatment success (cure and completion) to a combined outcome of failure, relapse, or death. The effects of all forms of resection surgery, pneumonectomy, and partial lung resection were evaluated. A total of 4238 patients from 18 surgical studies and 2193 patients from 8 nonsurgical studies were included. Pulmonary resection surgery was performed on 478 patients. Partial lung resection surgery was associated with improved treatment success (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.5-5.9; I(2)R, 11.8%), but pneumonectomy was not (aOR, 1.1; 95% CI, .6-2.3; I(2)R, 13.2%). Treatment success was more likely when surgery was performed after culture conversion than before conversion (aOR, 2.6; 95% CI, 0.9-7.1; I(2)R, 0.2%). Partial lung resection, but not pneumonectomy, was associated with improved treatment success among patients with MDR-tuberculosis. Although improved outcomes may reflect patient selection, partial lung resection surgery after culture conversion may improve treatment outcomes in patients who receive optimal medical therapy. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

WPAs and Adjuncts: What We Can Learn from Social Identity & Expertise Theories

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Sidey, Mark Edward

2012-01-01

This dissertation examines the social identity of adjunct faculty and the implications for writing program administrators (WPAs). With the ever increasing reliance on Master's degree teachers to teach first-year composition and other writing classes, WPAs are faced with the task of attempting to bring some level of disciplinary coherence to…

PACS: Do clinical users benefit from it as a training adjunct? | van ...

African Journals Online (AJOL)

Although a PACS relates specifically to the archiving and retrieval of radiological images and reports, it became clear from the feedback received from medical clinicians (who ... The advantages of PACS as a positive training adjunct were highlighted in the areas of multi-site viewing and consultation, the possibility of image ...

Utility of adjunctive macrolide therapy in treatment of children with asthma: a systematic review and meta-analysis

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Mikailov A

2013-01-01

Full Text Available Anar Mikailov,1 Ilona Kane,2 Stephen C Aronoff,3 Raemma Luck,3,† Michael T DelVecchio31Beth Israel Deaconess Medical Center, Boston, MA, 2St Christopher's Hospital for Children, Philadelphia, PA, 3Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA†Raemma Luck is now deceasedBackground: The purpose of this study was to investigate macrolides as an adjunct to an asthma controller regimen in children with asthma.Methods: Prospective clinical trials of macrolide therapy in children with asthma using outcome measures of change in forced expiratory volume in one second (FEV1 and/or oral corticosteroid requirement were searched for in PubMed up to December 2009. The reference lists of studies were also included in the analysis, as well as those listed in published meta-analyses.Results: The literature search yielded 116 studies, six of which were included in this meta-analysis. The change in FEV1 from baseline with adjunctive use of macrolide therapy in all children was not significant (0.25% predicted; 95% confidence interval [CI] −0.37, 0.86 predicted, P = 0.43; however, the change in FEV1 among children receiving daily oral corticosteroids was significant (3.89% predicted; 95% CI −0.01, 7.79, P = 0.05. Addition of macrolide therapy to the treatment of children with oral corticosteroid-dependent asthma resulted in a statistically significant decrease in daily corticosteroid dosage (−3.45 mg/day; 95% CI −5.79, −1.09 mg/day, P = 0.004. This reduction in daily corticosteroid dosage was directly proportional to the duration of macrolide therapy (−0.17 mg methylprednisolone per week of macrolide therapy; 95% CI −0.33, −0.021, P = 0.025.Conclusion: Addition of macrolides to the treatment regimen of children with oral corticosteroid-dependent asthma improves FEV1 and decreases the daily dosage of corticosteroids required for control in these children. The degree of dose reduction is directly related to

Discriminação de sorovares de Salmonella spp. isolados de carcaças de frango por REP e ERIC-PCR e fagotipagem do sorovar Enteriditis Discrimination of Salmonella serovars isolated from chicken meat by REP and ERIC-PCR and phagotyping of Enteriditis sorovar

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Iliana Alcocer

2006-06-01

Full Text Available Salmonelose é a infecção bacteriana de origem alimentar mais freqüente no Paraná, Brasil, e os surtos estão associados, principalmente, ao consumo de ovos, carne de aves e derivados. Os objetivos deste trabalho foram identificar os sorovares de Salmonella isolados de carcaças de frango e caracterizá-los molecularmente por REP e ERIC-PCR, assim como identificar os fagotipos de Salmonella Enteriditis. Dos 25 isolados de Salmonella spp. analisados, 18 foram identificados como Enteriditis, 4 como Braenderup, 2 como Worthington e 1 como infantis. Dos 18 isolados de Enteriditis, 14 foram PT4, 2 PT4a, 1 PT7 e 1 RDNC, por se tratar de colônia rugosa. REP-PCR forneceu padrão eletroforético distinto de 10 a 13 bandas distribuídas entre 120 e 2072 pb para cada sorovar diferente testado. A ERIC-PCR mostrou um padrão de 4 a 5 bandas entre 180 e 1000 pb e foi menos discriminativa quando comparada à REP-PCR. Os resultados encontrados confirmaram que a fagotipagem é uma ferramenta útil e discriminativa para o sorovar Enteriditis. Apesar do pequeno número de sorovares testados, os resultados sugerem que a REP-PCR parece ser um método atrativo a ser utilizado no futuro para a discriminação preliminar de sorovares de Salmonella.Salmonellosis is the most prevalent bacterial food-borne disease in the State of Paraná, Brazil, and the outbreaks are often associated with consumption of poultry products. The aim of this study was to serotype Salmonella strains isolated from chicken carcasses and characterize them molecularly using REP and ERIC-PCR. The phage types of Salmonella Enteriditis were also identified. Of the 25 Salmonella strains analysed, 18 were identified as Enteriditis, 4 as Braenderup, 2 as Worthington and 1 as infantis. Of the 18 Enteriditis isolates, 14 were PT4, 2 PT4a, 1 PT7 and 1 "reacted, but did not conform" - RDNC. Distinct REP-PCR profiles with 10 to 13 fragments distributed between 120 and 2072 pb were easily obtained for

The role and effectiveness of adjunctive hyperbaric oxygen therapy in the management of musculoskeletal disorders.

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Wang J

2002-07-01

Full Text Available The management of musculoskeletal disorders is an increasing challenge to clinicians. Successful treatment relies on a wide range of multidisciplinary interventions. Adjunctive hyperbaric oxygen (HBO therapy has been used as an orthopaedic treatment for several decades. Positive outcomes have been reported by many authors for orthopaedic infections, wound healing, delayed union and non-union of fractures, acute traumatic ischemia of the extremities, compromised grafts, and burn injuries. Severe side effects have also been reported with this therapy. To aid in the use of HBO therapy in orthopaedics, we reviewed 43 papers published in the past four decades and summarised the mechanisms, effectiveness, indications and contraindications, side effects, and cost impact of adjunctive hyperbaric oxygen therapy in the management of difficult musculoskeletal disorders. Adjunctive HBO therapy is an effective treatment modality for the management of some severe and refractory musculoskeletal problems. If appropriate candidates are carefully identified, hyperbaric oxygen is a limb- and sometimes life-saving therapy. HBO therapy significantly reduces the length of the patient′s hospital stay, amputation rate, and wound care expenses. Thus, it is a cost-effective modality. A clinician must understand the side effects and risks of HBO treatment. Close monitoring throughout the treatment is warranted to minimise the risk to the patients.

The Role of Adjunctive Therapies in Septic Shock by Gram Negative MDR/XDR Infections.

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Busani, Stefano; Roat, Erika; Serafini, Giulia; Mantovani, Elena; Biagioni, Emanuela; Girardis, Massimo

2017-01-01

Patients with septic shock by multidrug resistant microorganisms (MDR) are a specific sepsis population with a high mortality risk. The exposure to an initial inappropriate empiric antibiotic therapy has been considered responsible for the increased mortality, although other factors such as immune-paralysis seem to play a pivotal role. Therefore, beyond conventional early antibiotic therapy and fluid resuscitation, this population may benefit from the use of alternative strategies aimed at supporting the immune system. In this review we present an overview of the relationship between MDR infections and immune response and focus on the rationale and the clinical data available on the possible adjunctive immunotherapies, including blood purification techniques and different pharmacological approaches.

The Role of Adjunctive Therapies in Septic Shock by Gram Negative MDR/XDR Infections

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Stefano Busani

2017-01-01

Full Text Available Patients with septic shock by multidrug resistant microorganisms (MDR are a specific sepsis population with a high mortality risk. The exposure to an initial inappropriate empiric antibiotic therapy has been considered responsible for the increased mortality, although other factors such as immune-paralysis seem to play a pivotal role. Therefore, beyond conventional early antibiotic therapy and fluid resuscitation, this population may benefit from the use of alternative strategies aimed at supporting the immune system. In this review we present an overview of the relationship between MDR infections and immune response and focus on the rationale and the clinical data available on the possible adjunctive immunotherapies, including blood purification techniques and different pharmacological approaches.

Lithium as an adjunct to radioiodine therapy in Graves' disease for prolonging the intrathyroidal effective half-life of radioiodine. Useful or not?

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Dunkelmann, S.; Kuenstner, H.; Nabavi, E.; Eberlein, U.; Groth, P.; Schuemichen, C. [Rostock Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin, Zentrum fuer Radiologie

2006-07-01

Aim: Evaluation of intrathyroidal kinetics of radioiodine with and without lithium as adjunct with respect to the increase in radiation dose delivered to the thyroid. Patients, methods: 267 patients in three groups were included in the study. Group I with 227 patients served as control group, Group II with 21 patients and Group III with 19 patients were distinguished by an intrathyroidal half-life of radioiodine below 3.5 days in the diagnostic test. Patients in Group III received 885 mg lithium carbonate a day for 2 weeks as adjunct to radioiodine therapy. Both diagnostic and therapeutic radioiodine kinetics were followed up by at least 10 uptake measurements within a minimum of 48 h. Kinetics of radioiodine were defined mathematically as balance of the thyroidal iodine intake and excretion by a two-compartment model. Results: Under therapy the maximum uptake of radioiodine was reduced by nearly 10% in all groups, in Group I, the effective half-life as well as the product of maximum uptake x effective half-life as an equivalent of radiation dose independent of thyroid volume was lowered in the same magnitude. In Group II, the energy-dose equivalent remained constant under therapy. With adjunct lithium in Group III, the effective half-life was prolonged significantly by factor 1.61{+-}0.49 and the volume-independent energy-dose equivalent by factor 1.39{+-}0.37. No severe side effects of lithium were observed. Conclusion: Using lithium as adjunct to radio-iodine therapy increases the radiation dose delivered to the thyroid by 39% on average and nearly 30% of radioiodine activity can be saved in these patients. Lithium is recommended in patients with very short effective half-life in the diagnostic test in order to reduce the activity required and whole-body radiation dose. (orig.)

A mindful eating group as an adjunct to individual treatment for eating disorders: a pilot study.

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Hepworth, Natasha S

2011-01-01

The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.

Pelvic floor muscle training and adjunctive therapies for the treatment of stress urinary incontinence in women: a systematic review

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Neumann Patricia B

2006-06-01

Full Text Available Abstract Background Stress urinary incontinence (SUI is a prevalent and costly condition which may be treated surgically or by physical therapy. The aim of this review was to systematically assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training (PFMT performed alone and together with adjunctive therapies (eg biofeedback, electrical stimulation, vaginal cones for the treatment of female SUI. Methods All major electronic sources of relevant information were systematically searched to identify peer-reviewed English language abstracts or papers published between 1995 and 2005. Randomised controlled trials (RCTs and other study designs eg non-randomised trials, cohort studies, case series, were considered for this review in order to source all the available evidence relevant to clinical practice. Studies of adult women with a urodynamic or clinical diagnosis of SUI were eligible for inclusion. Excluded were studies of women who were pregnant, immediately post-partum or with a diagnosis of mixed or urge incontinence. Studies with a PFMT protocol alone and in combination with adjunctive physical therapies were considered. Two independent reviewers assessed the eligibility of each study, its level of evidence and the methodological quality. Due to the heterogeneity of study designs, the results are presented in narrative format. Results Twenty four studies, including 17 RCTs and seven non-RCTs, met the inclusion criteria. The methodological quality of the studies varied but lower quality scores did not necessarily indicate studies from lower levels of evidence. This review found consistent evidence from a number of high quality RCTs that PFMT alone and in combination with adjunctive therapies is effective treatment for women with SUI with rates of 'cure' and 'cure/improvement' up to 73% and 97% respectively. The contribution of adjunctive therapies is unclear and there is limited

REAL TIME PCR IDENTIFICATION FOR TARGET ADJUNCTIVE ANTIBIOTIC THERAPY OF SEVERE CHRONIC PERIODONTITIS. PART II - MICROBIOLOGICAL EFFECTIVENESS.

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Kamen Kotsilkov

2014-10-01

Full Text Available INTRODUCTION: Antibiotic use in chronic periodontitis may result in improvement in periodontal status, although many questions regarding the indications for this therapy remain unanswered. The polymicrobial etiology of the periodontal infection hinders the choice of the proper antibiotic agent. Furthermore the indiscriminate use of antibiotics could lead to high levels of resistance and to various adverse reactions. In the recent years a various molecular diagnostics protocols were proposed in order to facilitate the decision for adjunctive antibiotic administration. OBJECTIVE: The aim of this study is to compare the microbiological effectiveness of adjunctive antibiotic administration with the mechanical periodontal therapy. METHODS: 30 patients with severe chronic periodontitis were enrolled in this study and were divided in 3 groups: Control group – with mechanical debridement only. Test group 1 – with combined adjunctive antibiotic administration using Amoxicillin+ Metronidazole. Test group 2 – with target antibiotic administration according to the resuts from the Real Time PCR identification. RESULTS: The prevalence of all the isolated microorganisms (exept. E.nodatum and C.gingivalis in Test Group 2 demonstrates statistically significant reduction compared with the other treatment approaches. Almost complete elimination was registered for the consensus pathogens from the red and orange complexes (above 99% and 100% for P.intemedia. CONCLUSION: The adjunct antibiotic treatment targeted with Real-Time PCR identification demonstrates almost complete elimination of the putative periodontal pathogens in the deep periodontal pockets in patients with severe chronic periodontitis. This result suggests slower recolonisation of these habitats thus limiting the risk for progression of the periodontal destruction.

Lithium as an adjunct to radioactive iodine for the treatment of hyperthyroidism: a systematic review and meta-analysis.

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Kessler, Lynn; Palla, Jyothsna; Baru, Joshua S; Onyenwenyi, Chioma; George, Amrutha M; Lucas, Brian P

2014-07-01

Radioactive iodine (RAI) is commonly used in the treatment of hyperthyroidism but is not uniformly successful. Lithium increases thyroidal iodine retention without reducing iodide uptake, increasing the radiation dose to the thyroid when administered with RAI. Although these actions suggest that adjuvant lithium may increase the efficacy of RAI, its role as an adjunct to RAI remains contentious. To evaluate the safety and efficacy of adding lithium to RAI to treat hyperthyroidism. Relevant studies were identified by a search of Medline and the Cochrane Central Register of Controlled Trials. To be included, a study had to be a controlled trial comparing the effect of RAI alone to RAI with lithium in the treatment of hyperthyroidism. Relevant data were extracted and meta-analyses were performed. Of the 75 identified studies, 6 met the inclusion criteria; 4 of these studies were interventional and 2 were observational trials. Meta-analysis of the observational trials (N = 851), both of which were retrospective cohort studies, showed significant improvement in the primary outcome (i.e., cure rate) with adjunctive lithium (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.24 to 2.96). The combined interventional trials (N = 485) also showed an improvement in cure rate, but the difference did not reach statistical significance (OR, 1.28; 95% CI, 0.85 to 1.91). Adjunctive lithium reduced time to cure and blunted thyroid hormone excursions after RAI. Lithium-related side effects were infrequent and usually mild. The observational trials demonstrated significant improvement in the cure rate of hyperthyroidism when lithium is added to RAI. The improvements shown in the interventional trials did not reach statistical significance due to the effect of a single, large negative trial.

Nonsurgical therapy of chronic periodontitis with adjunctive systemic azithromycin or amoxicillin/metronidazole.

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Jentsch, Holger F R; Buchmann, Andreas; Friedrich, Abel; Eick, Sigrun

2016-09-01

The objective of the present study is to compare the effect of systemic adjunctive use of azithromycin with amoxicillin/metronidazole to scaling and root planing (SRP) in a clinical study. Data from 60 individuals with chronic periodontitis were evaluated after full-mouth SRP. Antibiotics were given from the first day of SRP, in the test group (n = 29), azithromycin for 3 days and, in the control group (n = 31), amoxicillin/metronidazole for7 days. Probing depth (PD), attachment level (AL), and bleeding on probing (BOP) were recorded at baseline and after 3 and 12 months. Gingival crevicular fluid was analyzed for matrix metalloprotease (MMP)-8 and interleukin (IL)-1beta levels. Subgingival plaque was taken for assessment of the major bacteria associated with periodontitis. In both groups, PD, AL, and BOP were significantly reduced (p chronic periodontitis; however, a randomized placebo-controlled multicenter study is needed. Application of azithromycin as a single antibiotic for 3 days might be considered as an additional adjunctive antibiotic to SRP in selected patients.

The Relationship of Perceived Organizational Support, Job Satisfaction, and Years of Online Teaching Experience to Work Engagement among Online Undergraduate Adjunct Faculty Members

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Zone, Emma J.

2013-01-01

The rapid growth of online higher education has necessitated increased employment of adjunct faculty. Correlational analyses were implemented to determine whether a relationship exists between adjunct undergraduate faculty's perceptions of organizational support, overall job satisfaction, and online teaching experience, and their work engagement.…

Double-blind, placebo-controlled pilot study of adjunctive quetiapine SR in the treatment of PMS/PMDD.

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Jackson, Christine; Pearson, Brenda; Girdler, Susan; Johnson, Jacqueline; Hamer, Robert M; Killenberg, Susan; Meltzer-Brody, Samantha

2015-11-01

Premenstrual dysphoric disorder (PMDD), a more severe form of premenstrual syndrome (PMS), afflicts 5-8% of reproductive age women and results in significant functional impairment. We conducted a double-blind, placebo-controlled trial of adjunctive quetiapine in patients with PMS/PMDD who had inadequate response to selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor therapy for their symptoms. A PMS/PMDD diagnosis was confirmed by 2-month prospective diagnostic assessment of PMS/PMDD using the Prospective Record of the Impact and Severity of Premenstrual Symptoms (PRISM) calendar. Women were randomized equally to receive quetiapine sustained-release (SR) or placebo (25-mg starting dose) during the luteal phase for 3 months. Outcome variables included the Hamilton Depression and Anxiety Scales, Clinical Global Impression Scale, and PRISM. Twenty women were enrolled in the treatment phase. Although the study was underpowered, greater reductions in luteal phase mood ratings were observed in the quetiapine group on the 17-item Hamilton Depression Rating Scale, Clinical Global Impression improvement rating, and PRISM daily score. The quetiapine group showed most improvement in symptoms of mood lability, anxiety, and irritability. This small double-blind study suggests that adjunctive treatment with quetiapine SR may be a useful addition to selective serotonin reuptake inhibitor therapy in women with PMS/PMDD by reducing symptoms and improving quality of life. Copyright © 2015 John Wiley & Sons, Ltd.

Hypnosis as an Adjunct Treatment for Distress Associated with Pediatric Cancer Procedures.

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White, Jerre Lee

This paper reviews research literature pertaining to the pain and anxiety associated with pediatric cancer and the use of hypnosis as an adjunct treatment. It is noted that pain and anxiety are most often associated with the procedural treatment of cancer, and that the literature suggests that both pain and anxiety are multi-faceted constructs.…

No Effect of Acupuncture as Adjunctive Therapy for Patients with Total Knee Replacement

DEFF Research Database (Denmark)

Petersen, Tom; Hautopp, Holger; Duus, Benn

2018-01-01

Objective: Acupuncture is a low risk option in pain management following total knee replacement as an alternative to opioid analgesics. Therefore, the benefit of acupuncture as adjunct to an exercise program was investigated. Furthermore, the modifying effect of previous benefit from acupuncture...... was explored. Design: Three weeks postoperatively, eligible patients were randomized to acupuncture and exercises or exercises alone. Setting: An outpatient rehabilitation centre in the municipality of Copenhagen, Denmark. Subjects: A total of 172 patients were included. Methods: Main outcome was proportion...... of the course of treatment were assessed. Results: No additional benefit of acupuncture was found on any of the main outcomes. Between-group differences were non-significant in proportions of patients with a clinically important reduction of night pain (Relative Risk: 0.98; 95% Confidence Interval (CI): 0...

Adjunctive Non-Surgical Therapy of Inflamed Periodontal Pockets During Maintenance Therapy Using Diode Laser: A Randomized Clinical Trial.

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Nguyen, Naomi-Trang; Byarlay, Matthew R; Reinhardt, Richard A; Marx, David B; Meinberg, Trudy A; Kaldahl, Wayne B

2015-10-01

Numerous studies have documented the clinical outcomes of laser therapy for untreated periodontitis, but very few have reported on lasers treating inflamed pockets during maintenance therapy. The aim of this study is to compare the effectiveness of scaling and root planing (SRP) plus the adjunctive use of diode laser therapy to SRP alone on changes in the clinical parameters of disease and on the gingival crevicular fluid (GCF) inflammatory mediator interleukin-1β (IL-1β) in patients receiving regular periodontal maintenance therapy. This single-masked and randomized, controlled, prospective study includes 22 patients receiving regular periodontal maintenance therapy who had one or more periodontal sites with a probing depth (PD) ≥ 5 mm with bleeding on probing (BOP). Fifty-six sites were treated with SRP and adjunctive laser therapy (SRP + L). Fifty-eight sites were treated with SRP alone. Clinical parameters, including PD, clinical attachment level (CAL), and BOP, and GCF IL-1β levels were measured immediately before treatment (baseline) and 3 months after treatment. Sites treated with SRP + L and SRP alone resulted in statistically significant reductions in PD and BOP and gains in CAL. These changes were not significantly different between the two therapies. Similarly, differences in GCF IL-1β levels between SRP + L and SRP alone were not statistically significant. In periodontal maintenance patients, SRP + L did not enhance clinical outcomes compared to SRP alone in the treatment of inflamed sites with ≥ 5 mm PD.

Efficacy of Adjunctive Tofacitinib Therapy in Mouse Models of Tuberculosis

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Mamoudou Maiga

2015-08-01

Full Text Available The global tuberculosis (TB epidemic and the spread of multi- and extensively-drug resistant strains of Mycobacterium tuberculosis (M.tb have been fueled by low adherence to following lengthy treatment protocols, and the rapid spread of HIV (Human Immunodeficiency Virus. Persistence of the infection in immunocompetent individuals follows from the ability of M.tb to subvert host immune responses in favor of survival within macrophages. Alternative host-directed strategies are therefore being currently sought to improve treatment efficacy and duration. In this study, we evaluated tofacitinib, a new oral Janus kinase (JAK blocker with anti-inflammatory properties, in shortening tuberculosis treatment. BALB/c mice, which are immunocompetent, showed acceleration of M.tb clearance achieving apparent sterilization after 16 weeks of adjunctive tofacitinib therapy at average exposures higher than recommended in humans, while mice receiving standard treatment alone did not achieve clearance until 24 weeks. True sterilization with tofacitinib was not achieved until five months. C3HeB/FeJ mice, which show reduced pro-inflammatory cytokines during M.tb infection, did not show improved clearance with adjunctive tofacitinib therapy, indicating that the nature of granulomatous lesions and host immunity may influence responsiveness to tofacitinib. Our findings suggest that the JAK pathway could be explored further for host-directed therapy in immunocompetent individuals.

Efficacy of Adjunctive Tofacitinib Therapy in Mouse Models of Tuberculosis

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Maiga, Mamoudou; Ahidjo, Bintou Ahmadou; Maiga, Mariama C.; Cheung, Laurene; Pelly, Shaaretha; Lun, Shichun; Bougoudogo, Flabou; Bishai, William R.

2015-01-01

The global tuberculosis (TB) epidemic and the spread of multi- and extensively-drug resistant strains of Mycobacterium tuberculosis (M.tb) have been fueled by low adherence to following lengthy treatment protocols, and the rapid spread of HIV (Human Immunodeficiency Virus). Persistence of the infection in immunocompetent individuals follows from the ability of M.tb to subvert host immune responses in favor of survival within macrophages. Alternative host-directed strategies are therefore being currently sought to improve treatment efficacy and duration. In this study, we evaluated tofacitinib, a new oral Janus kinase (JAK) blocker with anti-inflammatory properties, in shortening tuberculosis treatment. BALB/c mice, which are immunocompetent, showed acceleration of M.tb clearance achieving apparent sterilization after 16 weeks of adjunctive tofacitinib therapy at average exposures higher than recommended in humans, while mice receiving standard treatment alone did not achieve clearance until 24 weeks. True sterilization with tofacitinib was not achieved until five months. C3HeB/FeJ mice, which show reduced pro-inflammatory cytokines during M.tb infection, did not show improved clearance with adjunctive tofacitinib therapy, indicating that the nature of granulomatous lesions and host immunity may influence responsiveness to tofacitinib. Our findings suggest that the JAK pathway could be explored further for host-directed therapy in immunocompetent individuals. PMID:26425693

Adjunct Ketamine Use in the Management of Severe Ethanol Withdrawal.

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Pizon, Anthony F; Lynch, Michael J; Benedict, Neal J; Yanta, Joseph H; Frisch, Adam; Menke, Nathan B; Swartzentruber, Greg S; King, Andrew M; Abesamis, Michael G; Kane-Gill, Sandra L

2018-05-08

Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal. Retrospective observational cohort study. Academic tertiary care hospital. Patients admitted to the ICU and diagnosed with delirium tremens by Diagnostic and Statistical Manual of Mental Disorders V criteria. Pre and post guideline, all patients were treated in a symptom-triggered fashion with benzodiazepines and/or phenobarbital. Postguideline, standard symptom-triggered dosing continued as preguideline, plus, the patient was initiated on an IV ketamine infusion at 0.15-0.3 mg/kg/hr continuously until delirium resolved. Based upon withdrawal severity and degree of agitation, a ketamine bolus (0.3 mg/kg) was provided prior to continuous infusion in some patients. A total of 63 patients were included (29 preguideline; 34 postguideline). Patients treated with ketamine were less likely to be intubated (odds ratio, 0.14; p trend toward a shorter hospitalization.

Adjunctive Systemic Antimicrobial Therapy vs Asepsis in Conjunction with Guided Tissue Regeneration: A Randomized, Controlled Clinical Trial.

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Abu-Ta'a, Mahmoud

2016-01-01

This randomized clinical trial compares the usefulness of adjunctive antibiotics, while strict asepsis was followed during periodontal surgery involving guided tissue regeneration. Two groups of 20 consecutive patients each with advanced periodontal disease were randomly assigned to treatment. They displayed one angular defect each with an intrabony component ≥3 mm, probing pocket depth and probing attachment level (PAL) ≥7 mm. Test group included 13 males, mean age 60 years, treated with enamel matrix derivative (EMD) and demineralized freeze-dried bone allograft with modified papilla preservation technique, received oral amoxicillin 1 gm, 1 hour preoperatively and 2 gm for 2 days postoperatively. Control group included 10 males, mean age 57 years, treated with EMD and demineralized freeze-dried bone allograft with modified papilla preservation technique, received no antibiotics. Outcome measures were clinical attachment level (CAL) gain, residual periodontal pocket depth (res. PD), gingival recession (GR), bleeding on probing (BOP), adverse events and postoperative complications. Patients were followed up to 12 months after periodontal surgery involving guided tissue regeneration. There were no significant differences between both groups for CAL gain, res. PD, GR, BOP nor other clinical parameters, though patients' subjective perception of postoperative discomfort was significantly smaller in the group receiving antibiotics. Antibiotics do not provide significant advantages concerning clinical periodontal parameters nor concerning postoperative infections in case of proper asepsis. It does, on the contrary, reduce postoperative discomfort. Regarding the results of this study, adjunc-tive systemic antibiotics in combination with guided tissue regeneration may be useful in reducing postoperative discomfort but may not be helpful for improving periodontal regeneration outcomes.

Digital health intervention as an adjunct to a workplace health program in hypertension.

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Senecal, Conor; Widmer, R Jay; Johnson, Matthew P; Lerman, Lilach O; Lerman, Amir

2018-05-30

Hypertension is a common and difficult-to-treat condition; digital health tools may serve as adjuncts to traditional pharmaceutical and lifestyle-based interventions. Using a retrospective observational study we sought to evaluate the effect of a desktop and mobile digital health intervention (DHI) as an adjunct to a workplace health program in those previously diagnosed with hypertension. As part of a workplace health program, 3330 patients were identified as previously diagnosed with hypertension. A DHI was made available to participants providing motivational and educational materials assisting in the management of hypertension. We evaluated changes in blood pressure, weight, and body mass index (BMI) between users and nonusers based on login frequency to the DHI using multivariate regression through the five visits over the course of 1 year. One thousand six hundred twenty-two (49%) participants logged into the application at least once. DHI users had significant greater improvements in systolic blood pressure (SBP; -2.79 mm Hg), diastolic blood pressure (-2.12 mm Hg), and BMI (-0.23 kg/m 2 ) at 1 year. Increased login frequency was significantly correlated with reductions in SBP, diastolic blood pressure, weight, and BMI (P ≤ .014). This large, observational study provides evidence that a DHI as an adjunct to a workplace health program is associated with greater improvement in blood pressure and BMI at 1 year. This study adds to the growing body of evidence that DHIs may be useful in augmenting the treatment of hypertension in addition to traditional management with pharmaceuticals and lifestyle changes. Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.

Inhaled nitric oxide for the adjunctive therapy of severe malaria: Protocol for a randomized controlled trial

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Lavery James V

2011-07-01

Full Text Available Abstract Background Severe malaria remains a major cause of global morbidity and mortality. Despite the use of potent anti-parasitic agents, the mortality rate in severe malaria remains high. Adjunctive therapies that target the underlying pathophysiology of severe malaria may further reduce morbidity and mortality. Endothelial activation plays a central role in the pathogenesis of severe malaria, of which angiopoietin-2 (Ang-2 has recently been shown to function as a key regulator. Nitric oxide (NO is a major inhibitor of Ang-2 release from endothelium and has been shown to decrease endothelial inflammation and reduce the adhesion of parasitized erythrocytes. Low-flow inhaled nitric oxide (iNO gas is a US FDA-approved treatment for hypoxic respiratory failure in neonates. Methods/Design This prospective, parallel arm, randomized, placebo-controlled, blinded clinical trial compares adjunctive continuous inhaled nitric oxide at 80 ppm to placebo (both arms receiving standard anti-malarial therapy, among Ugandan children aged 1-10 years of age with severe malaria. The primary endpoint is the longitudinal change in Ang-2, an objective and quantitative biomarker of malaria severity, which will be analysed using a mixed-effects linear model. Secondary endpoints include mortality, recovery time, parasite clearance and neurocognitive sequelae. Discussion Noteworthy aspects of this trial design include its efficient sample size supported by a computer simulation study to evaluate statistical power, meticulous attention to complex ethical issues in a cross-cultural setting, and innovative strategies for safety monitoring and blinding to treatment allocation in a resource-constrained setting in sub-Saharan Africa. Trial Registration ClinicalTrials.gov Identifier: NCT01255215

A rapid evidence assessment of immersive virtual reality as an adjunct therapy in acute pain management in clinical practice.

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Garrett, Bernie; Taverner, Tarnia; Masinde, Wendy; Gromala, Diane; Shaw, Chris; Negraeff, Michael

2014-12-01

Immersive virtual reality (IVR) therapy has been explored as an adjunct therapy for the management of acute pain among children and adults for several conditions. Therapeutic approaches have traditionally involved medication and physiotherapy but such approaches are limited over time by their cost and side effects. This review seeks to critically evaluate the evidence for and against IVR as an adjunctive therapy for acute clinical pain applications. A rapid evidence assessment (REA) strategy was used. CINAHL, Medline, Web of Science, IEEE Xplore Digital Library, and the Cochrane Library databases were screened in from December 2012 to March 2013 to identify studies exploring IVR therapies as an intervention to assist in the management of pain. Main outcome measures were for acute pain and functional impairment. Seventeen research studies were included in total including 5 RCTs, 6 randomized crossover studies, 2 case series studies, and 4 single-patient case studies. This included a total of 337 patients. Of these studies only 4 had a low risk of bias. There was strong overall evidence for immediate and short-term pain reduction, whereas moderate evidence was found for short-term effects on physical function. Little evidence exists for longer-term benefits. IVR was not associated with any serious adverse events. This review found moderate evidence for the reduction of pain and functional impairment after IVR in patients with acute pain. Further high-quality studies are required for the conclusive judgment of its effectiveness in acute pain, to establish potential benefits for chronic pain, and for safety.

[Αnti-Inflammatory medication as adjunctive antidepressive treatment].

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Boufidou, F; Nikolaou, C

2016-01-01

Mounting data of evidence that have emerged during the last twenty years, point towards the existence of an inflammatory mechanism underlying the pathophysiology of depressive disorder. These data have inspired a number of clinical studies characterized by the administration of inflammatory response altering medication in addition to conventional medication in depressive disorder patients. The drugs were either Non Steroid Anti-inflammatory Drugs (NSAIDs) or Tumor Necrosis Factor-alpha (TNFa) inhibitors and were selected among those that are already in use for various diseases related to the immune system. The choice of these specific immunomodulatory agents for the co-administration with conventional antidepressive medication was based on a number of laboratory data and clinical evidence. A total of seven relevant clinical trials have been conducted, all of them with promising results that have been published between 2006 and 2013. However, only four out of them were eligibly designed regarding the homogeneity of the study groups, randomization, double-blinding and placebo controlling. These three studies showed clinical advantages of the adjunctive medication as estimated by significant drops in Hamilton scores. Of interest are the findings of the most recent and largest clinical trial of the TNF-a antagonist infliximab which show that treatment with anti-inflammatory agents may be beneficial only in depressive patients with raised levels of baseline inflammatory markers. A limitation of the studies was that, since no guidelines currently exist for anti-inflammatory agents and depression, adjunctive medication could have been under or overdosed. Other limitations were the follow-up period that was rather small and the number of the participants that was also small. Recently, a lot of progress has been made in identifying therapeutic targets along metabolic pathways in the brain relevant to depression, which could be manipulated by immune mediators. In fact

Surgery as an Adjunctive Treatment for Multidrug-Resistant Tuberculosis : An Individual Patient Data Metaanalysis

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Fox, Gregory J.; Mitnick, Carole D.; Benedetti, Andrea; Chan, Edward D.; Becerra, Mercedes; Chiang, Chen-Yuan; Keshavjee, Salmaan; Koh, Won-Jung; Shiraishi, Yuji; Viiklepp, Piret; Yim, Jae-Joon; Pasvol, Geoffrey; Robert, Jerome; Shim, Tae Sun; Shin, Sonya S.; Menzies, Dick; van der Werf, Tjip S.

2016-01-01

Background. Medical treatment for multidrug-resistant (MDR)-tuberculosis is complex, toxic, and associated with poor outcomes. Surgical lung resection may be used as an adjunct to medical therapy, with the intent of reducing bacterial burden and improving cure rates. We conducted an individual

Evaluation of the efficacy and safety of topiramate as adjunctive drug in the treatment of refractory partial seizures with Meta-analysis

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Dai LI

2014-12-01

Full Text Available Background Epilepsy is a chronic neurological condition characterized by paroxysm of seizures due to abnormal electrical discharge from central nervous system neurons. Several new antiepileptic drugs (AEDs were listed over the past two decades, and they were believed to be equally effective and have better tolerability and side effect profiles. This paper aims to evaluate the efficacy and safety of adjunctive topiramate in refractory partial seizures.  Methods Relevant research articles about randomized controlled trials of adjunctive topiramate in refractory partial seizures, with topiramate, Topamax, add-on treatment, adjunctive treatment, add-on therapy, adjunctive therapy, refractory partial seizure, refractory partial epilepsy both in Chinese and English as retrieval words, were retrieved from PubMed (1995-2014, Cochrane Central Register of Controlled Trials (CENTRAL, 1995-2014, The Cochrane Database of Systematic Reviews (CDSR, 1995-2014, China National Knowledge Infrastructure (CNKI, 1995-2014 and Wanfang Data (1999-2014. Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted using RevMan 5.0 software.  Results According to the enrollment criteria, 13 prospective, randomized controlled clinical trials with a total of 1622 patients were finally selected. The proportions of patients with reduction in seizure frequency ≥ 50% (OR = 3.710, 95% CI: 2.870-4.810; P = 0.000, ≥ 75% (OR = 7.220, 95% CI: 3.310-15.750; P = 0.000 and seizure free (OR = 3.380, 95%CI: 1.720-6.640; P = 0.000 in topiramate group were significantly higher than that in control group. The treatment withdrawal ratio was significantly higher compared to placebo in 600 mg/d and 800 mg/d subgroups, but not in 200 mg/d subgroup (200 mg/d: OR = 2.170, 95%CI: 0.470-9.950, P = 0.320; 600 mg/d: OR = 2.090, 95%CI: 1.020-4.270, P = 0.040; 800 mg/d: OR = 8.000, 95%CI: 1.390-46.140, P = 0.020. The common

Adjunctive antipsychotic in the treatment of body dysmorphic disorder - A retrospective naturalistic case note study.

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Rashid, Haroon; Khan, Akif A; Fineberg, Naomi A

2015-06-01

A retrospective naturalistic case note study to determine the frequency, co-morbidity and treatment-response of body dysmorphic disorder (BDD). Records from 280 patients attending a highly specialised obsessive-compulsive disorder (OCD)/BDD service were analysed. The clinical outcome was measured either through scoring of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for OCD/BDD, or textual analysis of case notes for evidence of symptomatic improvement, treatment tolerability, and premature disengagement. A total of 32 patients (11.43%) were diagnosed with BDD. Of these, 28 (87.5%) had at least one co-morbidity. All patients were offered cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI). Adjunctive low-dose antipsychotic was prescribed for 21 (66%) patients. Overall, 18/32 (56%) responded, and 7/32 (22%) disengaged prematurely. Patients offered antipsychotic, SSRI and CBT (n = 21) were compared with those offered SSRI and CBT only (n = 11). The treatment was well-tolerated. Whereas there was no significant inter-group difference in the clinical response rate, premature disengagement occurred less frequently in the antipsychotic-treated patients (9.5% versus 45%; Fisher's Exact Test P = 0.0318). BDD frequently presents with co-morbidity, treatment-resistance and premature disengagement. Adjunctive antipsychotic was associated with significantly better treatment adherence, but responder rates did not differ significantly, possibly related to the small sample-size. A well-powered randomised controlled study is warranted, to determine clinical outcomes with adjunctive antipsychotic in BDD.

Are anti-inflammatory agents effective in treating gingivitis as solo or adjunct therapies? A systematic review.

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Polak, David; Martin, Conchita; Sanz-Sánchez, Ignacio; Beyth, Nurit; Shapira, Lior

2015-04-01

Systematically review the scientific evidence for efficiency of anti-inflammatory agents against gingivitis, either as solo treatments or adjunctive therapies. A protocol was developed aimed to answer the following focused question: "Are anti-inflammatory agents effective in treating gingivitis as solo or adjunct therapies?" RCTs and cohort studies on anti-inflammatory agents against gingivitis studies were searched electronically. Screening, data extraction and quality assessment were conducted. The primary outcome measures were indices of gingival inflammation. A sub-analysis was performed dividing the active agents into anti-inflammatory and other drugs. The search identified 3188 studies, of which 14 RCTs met the inclusion criteria. The use of anti-inflammatory or other agents, in general showed a higher reduction in the test than in the control in terms of gingival indexes and bleeding scores. Only two RCTs on inflammatory drugs could be meta-analysed, showing a statistically significant reduction in the GI in the experimental group [WMD = -0.090; 95% CI (-0.105; -0.074); p = 0.000]. However, the contribution of both studies to the global result was unbalanced (% weight: 99.88 and 0.12 respectively). Most of the tested material showed beneficial effect as anti-inflammatory agents against gingivitis, either as a single treatment modality or as an adjunctive therapy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Plant foods in the management of diabetes mellitus: spices as beneficial antidiabetic food adjuncts.

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Srinivasan, K

2005-09-01

Diet has been recognized as a corner stone in the management of diabetes mellitus. Spices are the common dietary adjuncts that contribute to the taste and flavour of foods. Besides, spices are also known to exert several beneficial physiological effects including the antidiabetic influence. This review considers all the available information from animal experimentation as well as clinical trials where spices, their extracts or their active principles were examined for treatment of diabetes. Among the spices, fenugreek seeds (Trigonella foenumgraecum), garlic (Allium sativum), onion (Allium cepa), and turmeric (Curcuma longa) have been experimentally documented to possess antidiabetic potential. In a limited number of studies, cumin seeds (Cuminum cyminum), ginger (Zingiber officinale), mustard (Brassica nigra), curry leaves (Murraya koenigii) and coriander (Coriandrum sativum) have been reported to be hypoglycaemic.

Nonstarter Lactobacillus strains as adjunct cultures for cheese making: in vitro characterization and performance in two model cheeses.

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Briggiler-Marcó, M; Capra, M L; Quiberoni, A; Vinderola, G; Reinheimer, J A; Hynes, E

2007-10-01

Nonstarter lactic acid bacteria are the main uncontrolled factor in today's industrial cheese making and may be the cause of quality inconsistencies and defects in cheeses. In this context, adjunct cultures of selected lactobacilli from nonstarter lactic acid bacteria origin appear as the best alternative to indirectly control cheese biota. The objective of the present work was to study the technological properties of Lactobacillus strains isolated from cheese by in vitro and in situ assays. Milk acidification kinetics and proteolytic and acidifying activities were assessed, and peptide mapping of trichloroacetic acid 8% soluble fraction of milk cultures was performed by liquid chromatography. In addition, the tolerance to salts (NaCl and KCl) and the phage-resistance were investigated. Four strains were selected for testing as adjunct cultures in cheese making experiments at pilot plant scale. In in vitro assays, most strains acidified milk slowly and showed weak to moderate proteolytic activity. Fast strains decreased milk pH to 4.5 in 8 h, and continued acidification to 3.5 in 12 h or more. This group consisted mostly of Lactobacillus plantarum and Lactobacillus rhamnosus strains. Approximately one-third of the slow strains, which comprised mainly Lactobacillus casei, Lactobacillus fermentum, and Lactobacillus curvatus, were capable to grow when milk was supplemented with glucose and casein hydrolysate. Peptide maps were similar to those of lactic acid bacteria considered to have a moderate proteolytic activity. Most strains showed salt tolerance and resistance to specific phages. The Lactobacillus strains selected as adjunct cultures for cheese making experiments reached 10(8) cfu/g in soft cheeses at 7 d of ripening, whereas they reached 10(9) cfu/g in semihard cheeses after 15 d of ripening. In both cheese varieties, the adjunct culture population remained at high counts during all ripening, in some cases overcoming or equaling primary starter. Overall

Adjunctive agomelatine therapy in the treatment of acute bipolar II depression: a preliminary open label study

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Fornaro M

2013-02-01

Full Text Available Michele Fornaro,1 Michael J McCarthy,2,3 Domenico De Berardis,4 Concetta De Pasquale,1 Massimo Tabaton,5 Matteo Martino,6 Salvatore Colicchio,7 Carlo Ignazio Cattaneo,8 Emanuela D'Angelo,9 Pantaleo Fornaro61Department of Formative Sciences, University of Catania, Catania, Italy; 2Department of Psychiatry, Veteran's Affairs San Diego Healthcare System, 3University of California San Diego, La Jolla, CA, USA; 4Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "ASL 4", Teramo, Italy; 5Department of Internal Medicine and Medical Specialties, University of Genova, Genoa, Italy; 6Department of Neurosciences, Section of Psychiatry, University of Genova, Genoa, Italy; 7Unit of Sleep Medicine, Department of Neuroscience, Catholic University, Rome, Italy; 8National Health System, "ASL 13", Novara, Italy; 9National Health System, "ASL 3", Genoa, ItalyPurpose: The circadian rhythm hypothesis of bipolar disorder (BD suggests a role for melatonin in regulating mood, thus extending the interest toward the melatonergic antidepressant agomelatine as well as type I (acute or II cases of bipolar depression.Patients and methods: Twenty-eight depressed BD-II patients received open label agomelatine (25 mg/bedtime for 6 consecutive weeks as an adjunct to treatment with lithium or valproate, followed by an optional treatment extension of 30 weeks. Measures included the Hamilton depression scale, Pittsburgh Sleep Quality Index, the Clinical Global Impression Scale–Bipolar Version, Young Mania Rating Scale, and body mass index.Results: Intent to treat analysis results demonstrated that 18 of the 28 subjects (64% showed medication response after 6 weeks (primary study endpoint, while 24 of the 28 subjects (86% responded by 36 weeks. When examining primary mood stabilizer treatment, 12 of the 17 (70.6% valproate and six of the 11 (54.5% lithium patients responded by the first endpoint. At 36 weeks, 14 valproate treated (82.4% and 10 lithium

Adjunctive social media for more effective contraceptive counseling: a randomized controlled trial.

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Kofinas, Jason D; Varrey, Aneesha; Sapra, Katherine J; Kanj, Rula V; Chervenak, Frank A; Asfaw, Tirsit

2014-04-01

To determine whether social media, specifically Facebook, is an effective tool for improving contraceptive knowledge. English-speaking women aged 18-45 years receiving care at an urban academic center obstetrics and gynecology clinic were included and randomized to a trial of standard contraceptive education and pamphlet (n=74) compared with standard contraceptive education and Facebook (n=69) information for contraception counseling. Contraceptive knowledge was evaluated preintervention and postintervention by the Contraceptive Knowledge Inventory. We evaluated the effect of the intervention by raw score and percent increase in Contraceptive Knowledge Inventory score, participant satisfaction with counseling method, and contraceptive preference postintervention. All analyses were stratified by age group. The median raw postintervention Contraceptive Knowledge Inventory score was significantly higher in the Facebook compared with the pamphlet group (15 compared with 12, PSocial media as an adjunct to traditional in-office counseling improves patient contraceptive knowledge and increases patient preference for LARCs. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01994005.

Zinc as an adjunct therapy in the management of severe pneumonia among Gambian children: randomized controlled trial.

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Howie, Stephen; Bottomley, Christian; Chimah, Osaretin; Ideh, Readon; Ebruke, Bernard; Okomo, Uduak; Onyeama, Charles; Donkor, Simon; Rodrigues, Onike; Tapgun, Mary; Janneh, Marie; Oluwalana, Claire; Kuti, Bankole; Enwere, Godwin; Esangbedo, Pamela; Doherty, Conor; Mackenzie, Grant; Greenwood, Brian; Corrah, Tumani; Prentice, Andrew; Adegbola, Richard; Zaman, Syed

2018-06-01

The benefit of zinc as an adjunct therapy for severe pneumonia is not established. We assessed the benefit of adjunct zinc therapy for severe pneumonia in children and determined whether the study children were zinc deficient. This was a randomized, parallel group, double-blind, placebo-controlled trial with an allocation ratio of 1:1 conducted in children with severe pneumonia to evaluate the efficacy of daily zinc as an adjunct treatment in preventing 'treatment failure' (presence of any sign of severe pneumonia) on day-5 and day-10 and in reducing the time to resolution of signs of severe pneumonia. Six hundred and four children 2-59 months of age presenting with severe pneumonia at six urban and rural health care facilities in The Gambia were individually randomised to receive placebo (n = 301) or zinc (n = 303) for seven days. To determine if the study children were zinc deficient, supplementation was continued in a randomly selected subgroup of 121 children from each arm for six months post-enrolment, and height-gain, nutritional status, plasma zinc concentrations, and immune competence were compared. Percentage of treatment failure were similar in placebo and zinc arms both on day 5 (14.0% vs 14.1%) and day 10 (5.2% vs 5.9%). The time to recovery from lower chest wall indrawing and sternal retraction was longer in the placebo compared to zinc arm (24.4 vs 23.0 hours; P  = 0.011 and 18.7 vs 11.0 hours; P  = 0.006 respectively). The time to resolution for all respiratory symptoms of severity was not significantly different between placebo and zinc arms (42.3 vs 30.9 hours respectively; P  = 0.242). In the six months follow-up sub-group, there was no significant difference in height gain, height-for-age and weight-for-height Z-scores, mid upper arm circumference, plasma zinc concentrations, and anergy at six months post-enrolment. In this population, zinc given as an adjunct treatment for severe pneumonia showed no benefit in treatment

Design of price incentives for adjunct policy goals in formula funding for hospitals and health services

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Duckett Stephen J

2008-04-01

Full Text Available Abstract Background Hospital policy involves multiple objectives: efficiency of service delivery, pursuit of high quality care, promoting access. Funding policy based on hospital casemix has traditionally been considered to be only about promoting efficiency. Discussion Formula-based funding policy can be (and has been used to pursue a range of policy objectives, not only efficiency. These are termed 'adjunct' goals. Strategies to incorporate adjunct goals into funding design must, implicitly or explicitly, address key decision choices outlined in this paper. Summary Policy must be clear and explicit about the behaviour to be rewarded; incentives must be designed so that all facilities with an opportunity to improve have an opportunity to benefit; the reward structure is stable and meaningful; and the funder monitors performance and gaming.

A Bricolage Exploration in "Genkan" Space: "Tengu" and Adjunct TEFL in the Japanese University Context

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Whitsed, Craig; Wright, Peter

2016-01-01

This paper reports on research focusing on a group of adjunct teachers of English employed in Japanese universities. Grounded in interpretive epistemology foregrounding constructionist traditions, this research employed bricolage as way of inquiring into, then representing, these teacher's experiences utilising multi-perspectival,…

Successful Use of Orbital Atherectomy as an Adjunct in Treating Extensively Calcified Mesenteric Artery Lesions.

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Richard, Michele; Krol, Emilia; Dietzek, Alan

2016-10-01

To describe the use of orbital technique of atherectomy as an adjunct to successful angioplasty and stent placement of the superior mesenteric artery (SMA). The technique is demonstrated in a 68-year-old man with critical SMA stenosis. The SMA was cannulated with 0.014-in wire, but the lesion was highly stenotic and densely calcified and prevented the passage of even the smallest 1.5-mm balloon. Orbital atherectomy was thus performed with a 1.25-mm CSI crown. Balloon angioplasty was then possible with a 4 mm × 2 cm balloon followed by placement of a 7 mm × 22 mm balloon-mounted stent. The use of atherectomy as an adjunct to angioplasty and stenting in extensive, calcified SMA lesions supports the value of this technique to avoid a much larger and morbid open procedure. Published by Elsevier Inc.

Adjunctive selective estrogen receptor modulator increases neural activity in the hippocampus and inferior frontal gyrus during emotional face recognition in schizophrenia.

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Ji, E; Weickert, C S; Lenroot, R; Kindler, J; Skilleter, A J; Vercammen, A; White, C; Gur, R E; Weickert, T W

2016-05-03

Estrogen has been implicated in the development and course of schizophrenia with most evidence suggesting a neuroprotective effect. Treatment with raloxifene, a selective estrogen receptor modulator, can reduce symptom severity, improve cognition and normalize brain activity during learning in schizophrenia. People with schizophrenia are especially impaired in the identification of negative facial emotions. The present study was designed to determine the extent to which adjunctive raloxifene treatment would alter abnormal neural activity during angry facial emotion recognition in schizophrenia. Twenty people with schizophrenia (12 men, 8 women) participated in a 13-week, randomized, double-blind, placebo-controlled, crossover trial of adjunctive raloxifene treatment (120 mg per day orally) and performed a facial emotion recognition task during functional magnetic resonance imaging after each treatment phase. Two-sample t-tests in regions of interest selected a priori were performed to assess activation differences between raloxifene and placebo conditions during the recognition of angry faces. Adjunctive raloxifene significantly increased activation in the right hippocampus and left inferior frontal gyrus compared with the placebo condition (family-wise error, Precognition in schizophrenia. These findings support the hypothesis that estrogen plays a modifying role in schizophrenia and shows that adjunctive raloxifene treatment may reverse abnormal neural activity during facial emotion recognition, which is relevant to impaired social functioning in men and women with schizophrenia.

Effect of rasagiline as adjunct therapy to levodopa on severity of OFF in Parkinson's disease.

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Stocchi, F; Rabey, J M

2011-12-01

The LARGO study demonstrated that rasagiline 1 mg/day as adjunct to levodopa significantly reduces OFF time to the same magnitude as adjunct entacapone. This substudy of LARGO aimed to assess the effect of rasagiline and entacapone on the motor symptoms of PD during the practically defined OFF state. LARGO was a randomized, double-blind, multicenter trial that assessed the efficacy and safety of rasagiline (1 mg/day), entacapone (200 mg with each levodopa dose), and placebo in 687 levodopa-treated PD patients with motor fluctuations. A substudy of LARGO measured UPDRS motor scores in the practically defined OFF state in 32 rasagiline, 36 entacapone, and 37 placebo patients. Treatment with rasagiline produced a significant improvement over placebo of 5.64 units in UPDRS motor OFF score (P = 0.013 vs. placebo). By contrast, the effect of adjunct entacapone was not significant (P = 0.14 vs. placebo). Whereas rasagiline also showed a trend in reducing the UPDRS-ADL OFF score (P = 0.058 vs. placebo), no such trend was noted for entacapone (P = 0.26 vs. placebo). Retrospective analysis, using the Bonferroni correction, of UPDRS motor subdomains further revealed that rasagiline, but not entacapone, significantly improved bradykinesia (P rasagiline 1 mg/day is effective in reducing the severity of motor symptoms in the OFF state. This suggests a continuous effect of rasagiline 1 mg/day throughout the day and night and is consistent with its extended duration of therapeutic action. © 2011 The Author(s). European Journal of Neurology © 2011 EFNS.

Colleges Are Slashing Adjuncts' Hours to Skirt New Rules on Health-Insurance Eligibility

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Dunn, Sydni

2013-01-01

Allison G. Armentrout, an adjunct instructor at Stark State College, does not get paid by the hour. She earns $4,600 to teach two English composition courses. But now she carefully tracks how many hours she works on an electronic time sheet. During a recent week, she spent three hours preparing for her lectures, close to six hours in the…

Effects of local alendronate sodium gel as an adjunct to scaling and root planing on smokers with chronic periodontitis: a pilot study

OpenAIRE

Farin Kiany; Hashem Montaseri; Sadaf Adibi; Masoud Golshah; Saba Golshah

2017-01-01

Background: Chemical treatments for the modulation of host response are applied along with mechanical modalities as adjunctive to periodontal treatment. The objective of this pilot study was to investigate the effects of locally-delivered alendronate sodium gel in adjunction to scaling and root planning on periodontal indices and bone formation within vertical defects of smokers with chronic periodontitis. Methods and Materials: In this study vertical defects (n=8) with depth>5 mm have be...

Adjunctive therapy for glucose control in patients with type 1 diabetes

Directory of Open Access Journals (Sweden)

Harris K

2018-04-01

Full Text Available Kira Harris,1,2 Cassie Boland,1,3 Lisa Meade,1,4 Dawn Battise1,5 1Pharmacy Practice Faculty, Wingate University School of Pharmacy, Wingate, NC, USA; 2Clinical Pharmacy Specialist – Novant Health Family Medicine Residency Program, Cornelius, NC, USA; 3Clinical Pharmacy Specialist – Novant Health Cotswold Family Medicine – Arboretum, Charlotte, NC, USA; 4Clinical Pharmacy Specialist – Piedmont HealthCare Endocrinology, Statesville, NC, USA; 5Clinical Pharmacy Specialist – Cabarrus Family Medicine – Harrisburg, Harrisburg, NC, USA Abstract: Type 1 diabetes mellitus (T1DM is characterized by relative or absolute insulin deficiency. Despite treatment with insulin therapy, glycemic goals are not always met, and insulin therapy is sometimes limited by adverse effects, including hypoglycemia and weight gain. Several adjunctive therapies have been evaluated in combination with insulin in patients with T1DM to improve glycemic control while minimizing adverse effects. Pramlintide, an amylin analog, can improve glycemic control, primarily through lowering postprandial blood glucose levels. Patients may experience weight loss and an increased risk of hypoglycemia and require additional mealtime injections. Metformin provides an inexpensive, oral treatment option and may reduce blood glucose, especially in overweight or obese patients with minimal risk of hypoglycemia. Metformin may be more effective in patients with impaired insulin sensitivity. Glucagon-like peptide-1 receptor agonists reduce primarily postprandial blood glucose and insulin dose and promote weight loss. They are expensive, cause transient nausea, may increase risk of hypoglycemia and require additional injections. Sodium–glucose transport-2 inhibitors improve glycemic control, promote weight loss and have low risk of hypoglycemia with appropriate insulin adjustment; however, these agents may increase the risk of diabetic ketoacidosis in patients with T1DM. Patient

Debating Modernity as Secular Religion: Hans Kelsen’s futile exchange with Eric Voegelin

DEFF Research Database (Denmark)

Thomassen, Bjørn

2014-01-01

This article reviews the mysterious and recently published last book by Hans Kelsen, “Secular Religion. A Polemic Against the Misinterpretation of Modern Social Philosophy, Science and Politics as ‘New Religions’”, contextualizing it with reference to the little known dialogue between Hans Kelsen...... and Eric Voegelin. The confrontation between Kelsen and Voegelin, two of the most illustrious émigré scholars who found in America their new home, is important to revisit because it touches upon several axes of debate of crucial importance to postwar intellectual history: the religion/secularity debate......, the positivist/anti-positivist debates, and the controversy that also led to the famous Voegelin/Arendt debate: how to read the horrors of totalitarianism into a historical trajectory of modernity. Although the Kelsen/Voegelin exchange ended in failure and bitterness its substance matter goes to the heart...

Research on hypnosis as an adjunct to cognitive-behavioral psychotherapy.

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Schoenberger, N E

2000-04-01

There is a growing body of research evaluating the use of hypnosis with cognitive-behavioral techniques in the treatment of psychological disorders. The central question for research is whether the addition of hypnosis enhances the efficacy of cognitive-behavioral treatments. Overall, studies demonstrate a substantial benefit from the addition of hypnosis; however, the number of published studies is relatively small, and many of them have methodological limitations. For cognitive-behavioral hypnotherapies to be recognized as empirically supported treatments, a number of well-designed, randomized clinical trials are necessary. Currently, the efficacy of hypnosis as an adjunctive treatment remains unresolved.

Glioblastoma chemotherapy adjunct via potent serotonin receptor-7 inhibition using currently marketed high-affinity antipsychotic medicines

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Kast, RE

2010-01-01

Glioblastoma treatment as now constituted offers increased survival measured in months over untreated patients. Because glioblastomas are active in synthesizing a bewildering variety of growth factors, a systematic approach to inhibiting these is being undertaken as treatment adjunct. The serotonin 7 receptor is commonly overexpressed in glioblastoma. Research documentation showing agonists at serotonin receptor 7 cause increased extracellular regulated kinase 1/2 activation, increased interleukin-6 synthesis, increased signal transducer and activator of transcription-3 activation, increased resistance to apoptosis and other growth enhancing changes in glioblastoma is reviewed in this paper. Because three drugs in wide use to treat thought disorders – paliperidone, pimozide and risperidone – are also potent and well-tolerated inhibitors at serotonin receptor 7, these drugs should be studied for growth factor deprivation in an adjunctive role in glioblastoma treatment. PMID:20880389

Selective Attentional Effects of Adjunct Study Questions on Achievement in Nigerian Secondary School Science

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Okoye, Nnamdi S.

2008-01-01

The study investigated the selective attentional effects of adjunct study questions inserted before or after the presentation of science flow diagrams. The basic design for the study was a post-test only control group design involving a total of 252 students randomly selected from six secondary schools in Ile-Ife, Oshun State Nigeria. These were…

Eric Hermelin and mystical hermeneutics: interpretation beyond itself

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Tina Hamrin

1999-01-01

Full Text Available Eric Hermelin (1860-1944 translated more than 10.000 pages Persian Sufi poetry, German texts by Jakob Böhme and Latin texts by Emmanuel Swedenborg. In the translation process Hermelin shaped his strategies and perceptions in ways which served their patterns of desire, and what they constructed reflected and served their own unique identity. Added up, the devices which constitute strategies of reading set in motion by the selfs defense of its identity are: Defenses, Expectations, Fantasies, and Transformations. Hermelin's mystical hermeneutics produced not only understanding of texts, but often no less produced an increased awareness, with appropriate hermeneutical sensitivity, of self-perception and self-identity. A self-awareness and a strengthening of an individual and corporate identity as one who has a stake in the texts and that to which they bear witness constitutes an important reader-effect in this case of Sufi poetry. But without any principle of suspicion, in Gadamer's terminology a premature fusion of horizons will take place before Hermelin has listened in openness with respect for the tension between the horizons of the text and the horizon of Hermelin. The textual horizon has col-lapsed into that of Hermelin's narrative biography, and is unable to do more than to speak back his own valnes and desires. Something socio-pragmatical was after all woven into the controversial bon vivant, when he used literary works to replicate himself. At the same time, the texts spoke from beyond the self.

Nintendo Wii Fit as an adjunct to physiotherapy following lower limb fractures: preliminary feasibility, safety and sample size considerations.

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McPhail, S M; O'Hara, M; Gane, E; Tonks, P; Bullock-Saxton, J; Kuys, S S

2016-06-01

The Nintendo Wii Fit integrates virtual gaming with body movement, and may be suitable as an adjunct to conventional physiotherapy following lower limb fractures. This study examined the feasibility and safety of using the Wii Fit as an adjunct to outpatient physiotherapy following lower limb fractures, and reports sample size considerations for an appropriately powered randomised trial. Ambulatory patients receiving physiotherapy following a lower limb fracture participated in this study (n=18). All participants received usual care (individual physiotherapy). The first nine participants also used the Wii Fit under the supervision of their treating clinician as an adjunct to usual care. Adverse events, fracture malunion or exacerbation of symptoms were recorded. Pain, balance and patient-reported function were assessed at baseline and discharge from physiotherapy. No adverse events were attributed to either the usual care physiotherapy or Wii Fit intervention for any patient. Overall, 15 (83%) participants completed both assessments and interventions as scheduled. For 80% power in a clinical trial, the number of complete datasets required in each group to detect a small, medium or large effect of the Wii Fit at a post-intervention assessment was calculated at 175, 63 and 25, respectively. The Nintendo Wii Fit was safe and feasible as an adjunct to ambulatory physiotherapy in this sample. When considering a likely small effect size and the 17% dropout rate observed in this study, 211 participants would be required in each clinical trial group. A larger effect size or multiple repeated measures design would require fewer participants. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Adjunctive low-dose docosahexaenoic acid (DHA) for major depression: An open-label pilot trial.

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Smith, Deidre J; Sarris, Jerome; Dowling, Nathan; O'Connor, Manjula; Ng, Chee H

2018-04-01

Whilst the majority of evidence supports the adjunctive use of eicosapentaenoic acid (EPA) in improving mood, to date no study exists using low-dose docosahexaenoic acid (DHA) alone as an adjunctive treatment in patients with mild to moderate major depressive disorder (MDD). A naturalistic 8-week open-label pilot trial of low-dose DHA, (260 mg or 520 mg/day) in 28 patients with MDD who were non-responsive to medication or psychotherapy, with a Hamilton Depression Rating Scale (HAM-D) score of greater than 17, was conducted. Primary outcomes of depression, clinical severity, and daytime sleepiness were measured. After 8 weeks, 54% of patients had a ≥50% reduction on the HAM-D, and 45% were in remission (HAM-D ≤ 7). The eta-squared statistic (0.59) indicated a large effect size for the reduction of depression (equivalent to Cohen's d of 2.4). However confidence in this effect size is tempered due to the lack of a placebo. The mean score for the Clinical Global Impression Severity Scale was significantly improved by 1.28 points (P depression.

Resolution of orbitocerebral aspergillosis during combination treatment with voriconazole and amphotericin plus adjunctive cytokine therapy.

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Bethell, Delia; Hall, Georgina; Goodman, T Robin; Klein, Nigel; Pollard, Andrew J

2004-05-01

Orbitocerebral aspergillosis has a very high fatality rate and cure is unusual. We describe the successful management of a child with cereberal aspergillosis who had a dramatic response to therapy with a combination of liposomal amphotericin and voriconazole with adjunctive cytokine therapy during immunosuppresive chemotherapy for acute lymphoblastic leukaemia.

Is Antimicrobial Photodynamic Therapy Effective as an Adjunct to Scaling and Root Planing in Patients with Chronic Periodontitis? A Systematic Review

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Betsy Joseph

2017-11-01

Full Text Available The aim of this systematic review was to investigate whether antimicrobial photodynamic therapy (aPDT as either a primary mode of treatment or an adjunct to non-surgical treatment was more effective than scaling and root planing (SRP alone in treating chronic periodontitis in terms of clinical attachment level (CAL gain and probing depth (PD reduction. The focused question was developed using the Patient, Intervention, Comparison, and Outcome (PICO format, and two authors independently searched the Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies from January 2008 to December 2016. Twenty studies included in this systematic review were randomized clinical trials (RCTs or quasi-RCTs of aPDT compared to placebo, no intervention, or non-surgical treatment in an adult population. Basic study characteristics, photosensitizing agents and wavelengths used in aPDT, frequency of aPDT application, effect of aPDT on clinical parameters, antimicrobial effect of aPDT in chronic periodontitis, effect of immunological parameters following aPDT and patient-based outcome measures were collected from the studies. Although there was a wide range of heterogeneity in the included studied, they all indicated that aPDT has the potential to be an effective adjunct in the treatment of chronic periodontitis. Long-term, multicenter studies with larger sample sizes are needed before aPDT can be recommended as an effective treatment modality.

Extracorporeal shock-wave lithotripsy as an adjunct to biliary interventional procedures

International Nuclear Information System (INIS)

Zeman, R.K.; Garra, B.S.; Matsumoto, A.H.; Teitelbaum, G.P.; Barth, K.H.; Cattau, E.L.; Davros, W.J.; McClennan, B.L.; Picus, D.; Paushter, D.M.

1989-01-01

This paper reviews the records of nine patients undergoing extracorporeal shock wave lithotripsy (ESWL) of bile duct stones as an adjunct to other biliary intervention. Lithotripsy was successful in producing fragmentation in seven of nine patients. Keeping the duct mildly distended with contrast medium, distributing the shock waves over the stone(s) by taking advantage of respiratory excursion, and pinning stone fragments with balloon catheters facilitated fragmentation. Six patients underwent duct manipulation (stricture dilation, fragment extraction) within 24 hours of ESWL, suggesting that immediate instrumentation is safe in conjunction with lithotripsy

Role of adenosine as adjunctive therapy in acute myocardial infarction.

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Forman, Mervyn B; Stone, Gregg W; Jackson, Edwin K

2006-01-01

Although early reperfusion and maintained patency is the mainstay therapy for ST elevation myocardial infarction, experimental studies demonstrate that reperfusion per se induces deleterious effects on viable ischemic cells. Thus "myocardial reperfusion injury" may compromise the full potential of reperfusion therapy and may account for unfavorable outcomes in high-risk patients. Although the mechanisms of reperfusion injury are complex and multifactorial, neutrophil-mediated microvascular injury resulting in a progressive decrease in blood flow ("no-reflow" phenomenon) likely plays an important role. Adenosine is an endogenous nucleoside found in large quantities in myocardial and endothelial cells. It activates four well-characterized receptors producing various physiological effects that attenuate many of the proposed mechanisms of reperfusion injury. The cardio-protective effects of adenosine are supported by its role as a mediator of pre- and post-conditioning. In experimental models, administration of adenosine in the peri-reperfusion period results in a marked reduction in infarct size and improvement in ventricular function. The cardioprotective effects in the canine model have a narrow time window with the drug losing its effect following three hours of ischemia. Several small clinical studies have demonstrated that administration of adenosine with reperfusion therapy reduces infarct size and improves ventricular function. In the larger AMISTAD and AMISTAD II trials a 3-h infusion of adenosine as an adjunct to reperfusion resulted in a striking reduction in infarct size (55-65%). Post hoc analysis of AMISTAD II showed that this was associated with significantly improved early and late mortality in patients treated within 3.17 h of symptoms. An intravenous infusion of adenosine for 3 h should be considered as adjunctive therapy in high risk-patients undergoing reperfusion therapy.

N-Acetylcysteine as adjunctive treatment in severe malaria: A randomized double blinded placebo controlled clinical trial

Science.gov (United States)

Charunwatthana, Prakaykaew; Faiz, M. Abul; Ruangveerayut, Ronnatrai; Maude, Richard; Rahman, M. Ridwanur; Roberts, L. Jackson; Moore, Kevin; Yunus, Emran Bin; Hoque, M. Gofranul; Hasan, Mahatab Uddin; Lee, Sue J.; Pukrittayakamee, Sasithon; Newton, Paul N.; White, Nicholas J.; Day, Nicholas P.J.; Dondorp, Arjen M.

2009-01-01

Objective Markers of oxidative stress are reported to be increased in severe malaria. It has been suggested that the antioxidant N-acetylcysteine (NAC) may be beneficial in treatment. We studied the efficacy and safety of parenteral N-acetylcysteine as an adjunct to artesunate treatment of severe falciparum malaria. Design A randomized double-blind placebo controlled trial on the use of high dose intravenous NAC as adjunctive treatment to artesunate. Setting A provincial hospital in Western Thailand and a tertiary referral hospital in Chittagong, Bangladesh. Patients One hundred and eight adult patients with severe falciparum malaria. Interventions Patients were randomized to receive N-acetylcysteine or placebo as adjunctive treatment to intravenous artesunate. Measurements and main results A total of 56 patients were treated with NAC and 52 received placebo. NAC had no significant effect on mortality, lactate clearance times (p=0.74) or coma recovery times (p=0.46). Parasite clearance time was increased from 30h (range 6h to 144h) to 36h (range 6h to 120h) (p=0.03), but this could be explained by differences in admission parasitemia. Urinary F2-isoprostane metabolites, measured as a marker of oxidative stress, were increased in severe malaria compared to patients with uncomplicated malaria and healthy volunteers. Admission red cell rigidity correlated with mortality, but did not improve with NAC. Conclusion Systemic oxidative stress is increased in severe malaria. Treatment with N-acetylcysteine had no effect on outcome in patients with severe falciparum malaria in this setting. PMID:19114891

Intraosseous injection as an adjunct to conventional local anesthetic techniques: A clinical study

OpenAIRE

Mohamed Idris; Nasil Sakkir; Kishore Gopalakrishna Naik; Nandakishore Kunijal Jayaram

2014-01-01

Background: The achievement of successful local anesthesia is a continual challenge in dentistry. Adjunctive local anesthetic techniques and their armamentaria, such as intraosseous injection (the Stabident system and the X-tip system) have been proposed to be advantageous in cases where the conventional local anesthetic techniques have failed. Aim: A clinical study was undertaken using intraosseous injection system by name X-tip to evaluate its effectiveness in cases where inferior alve...

Reflections on Sven-Eric Liedman’s Marx-Biography “A World to Win: The Life and Works of Karl Marx”

OpenAIRE

Christian Fuchs

2018-01-01

The English translation of Sven-Eric Liedman’s Marx-biography A World to Win: The Life and Works of Karl Marx was published two weeks before Marx’s bicentenary. This article presents reflections on Liedman’s book and asks how one should best write biographically about Marx. The paper compares Liedman’s biography to the Marx-biographies written by Jonathan Sperber (Karl Marx: A Nineteenth-Century Life) and Gareth Stedman-Jones (Karl Marx: Greatness and Illusion). A biography is a way of repeat...

Usefulness of breast-specific gamma imaging as an adjunct modality in breast cancer patients with dense breast. A comparative study with MRI

International Nuclear Information System (INIS)

Kim, Bom Sahn

2012-01-01

The aim of this study was to evaluate the adjunctive benefits of breast-specific gamma imaging (BSGI) versus magnetic resonance imaging (MRI) in breast cancer patients with dense breasts. This study included a total of 66 patients (44.1±8.2 years) with dense breasts (breast density >50%) and already biopsy-confirmed breast cancer. All of the patients underwent BSGI and MRI as part of an adjunct modality before the initial therapy. Of 66 patients, the 97 undetermined breast lesions were newly detected and correlated with the biopsy results. Twenty-six of the 97 breast lesions proved to be malignant tumors (invasive ductal cancer, n=16; ductal carcinoma in situ, n=6; mixed or other malignancies, n=4); the remaining 71 lesions were diagnosed as benign tumors. The sensitivity and specificity of BSGI were 88.8% (confidence interval (CI), 69.8-97.6%) and 90.1% (CI, 80.7-95.9%), respectively, while the sensitivity and specificity of MRI were 92.3% (CI, 74.9-99.1%) and 39.4% (CI, 28.0-51.7%), respectively (p<0.0001). MRI detected 43 false-positive breast lesions, 37 (86.0%) of which were correctly diagnosed as benign lesions using BSGI. In 12 malignant lesions <1 cm, the sensitivities of BSGI and MR imaging were 83.3% (CI, 51.6-97.9%) and 91.7% (CI, 61.5-99.8%), respectively. BSGI showed an equivocal sensitivity and a high specificity compared to MRI in the diagnosis of breast lesions. In addition, BSGI had a good sensitivity in discriminating breast cancers ≤1 cm. The results of this study suggest that BSGI could play a crucial role as an adjunctive imaging modality which can be used to evaluate breast cancer patients with dense breasts. (author)

Stent underexpansion in angiographic guided percutaneous coronary intervention, despite adjunctive balloon post-dilatation, in drug eluting stent era

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Mehrdad Taherioun

2014-01-01

Full Text Available BACKGROUND: Stent underexpansion is the most powerful predictor of long-term stent patency and clinical outcome. The purpose of this study was to evaluate the incidence and predictors of stent underexpansion despite adjunctive post-dilatation with non-compliant balloon. METHODS: After elective coronary stent implantation and adjunctive post-dilatation with non-compliant balloon and optimal angiographic result confirmed by the operator, intravascular ultrasound (IVUS was performed for all the treated lesions. If the treated lesions fulfilled the IVUS criteria, they are considered as the optimal stent group; if not, they are considered as the suboptimal group. RESULTS: From 50 patients enrolled in this study 39 (78% had optimal stent deployment and 11 (22% had suboptimal stent deployment. In the suboptimal group 7 (14% had underexpansion, 2 (4% malposition, and 2 (4% had asymmetry. There were no stent edge dissections detected by IVUS. We did not find any correlation between lesion calcification, ostial lesions, stent length, and stent underexpansion. Stent diameter ≤ 2.75 mm had a strong correlation with stent underexpansion. CONCLUSION: Despite adjunctive post-dilatation with noncompliant balloon, using a relatively small stent diameter was a strong predictor for underexpansion. IVUS guided percutaneous coronary intervention (PCI may be considered for drug eluting stent (DES implantation in relatively small vessels.   Keywords: Stent, Percutaneous Coronary Intervention, Ultrasound, Post-dilatation 

Feasibility of adjunct therapeutic hypothermia treatment for hyperammonemia and encephalopathy due to urea cycle disorders and organic acidemias.

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Lichter-Konecki, Uta; Nadkarni, Vinay; Moudgil, Asha; Cook, Noah; Poeschl, Johannes; Meyer, Michael T; Dimmock, David; Baumgart, Stephen

2013-08-01

feasible and could be conducted safely in pediatric and neonatal intensive care units experienced in the application of therapeutic hypothermia in critically ill neonates. However, including adjunct therapeutic hypothermia in the already involved treatment regimen of critically ill patients with hyperammonemia and encephalopathy adds to the complexity of care and should not be done unless it is proven efficacious in a randomized clinical trial. Copyright © 2013 Elsevier Inc. All rights reserved.

Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial

Science.gov (United States)

Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Karagülle, Müfit Zeki

2018-02-01

This study aims to investigate whether 2-week spa therapy, as an adjunct to usual pharmacological therapy, has any beneficial effect in patients with rheumatoid arthritis (RA). In this single-blind crossover study, 50 patients were randomly assigned in a 1:1 manner to receive usual pharmacological therapy plus 2-week spa therapy or usual pharmacological therapy alone (period 1.6 months); after a 9-month washout, patients were crossed over to the opposite assignment (period 2.6 months). Spa therapy program included a daily saline balneotherapy session at 36-37 °C for 20 min except Sundays. The clinical outcomes were evaluated at baseline, after spa therapy (2 weeks) and 3 and 6 months after the spa therapy in both period and were pain (Visual Analogue Scale (VAS)), patient and physician global assessments (VAS), Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28). Spa therapy was superior to control therapy in improving all the assessed clinical outcomes at the end of the spa therapy. This superiority persisted significantly in physician global assessment ( p = 0.010) and with a trend in favor of spa group in patient global assessment ( p = 0.058), function ( p = 0.092), and disease activity ( p = 0.098) at 3 months. Statistically significant improvements were found in spa therapy compared to control in disease activity ( p = 0.006) and patient ( p = 0.020) and physician global ( p = 0.011) assessments, and a trend toward improvements in pain ( p = 0.069) and swollen joints ( p = 0.070) at 6 months. A 2-week spa therapy adjunct to usual pharmacological therapy provided beneficial clinical effects compared to usual pharmacological therapy alone, in RA patients treated with traditional disease-modifying antirheumatic drugs. These beneficial effects may last for 6 months.

Risperidone, quetiapine, and olanzapine adjunctive treatments in major depression with psychotic features: a comparative study

Directory of Open Access Journals (Sweden)

Gabriel A

2013-04-01

Full Text Available A Gabriel Departments of Psychiatry and Community Health Sciences, University of Calgary, Calgary, AB, Canada Objectives: The purpose of this study was to compare the effectiveness of novel antipsychotics in the treatment of psychotic depression. Method: Consecutive patients who were admitted (n = 51 with a confirmed diagnosis of major depression with psychotic features (delusions or hallucinations or both participated in this open-label, naturalistic study. All patients were treated with selective serotonin reuptake inhibitors (SSRIs and serotonin–norepinephrine reuptake inhibitors (SNRIs (citalopram or venlafaxine extended release [XR], and atypical antipsychotic agents were added, as tolerated, during the first week of initiating the citalopram or venlafaxine. There were patients (n = 16 who received risperidone, who received quetiapine (n = 20, and who received olanzapine (n = 15, as an adjunctive treatment to either citalopram or venlafaxine for at least 8 weeks. Outcome measures included the Clinical Global Impression-Severity subscale (CGI-S, as the primary outcome measure, as well as the Hamilton Rating Scale for Depression-21 item (HAM-D21 and the Brief Psychiatric Rating Scale (BPRS. Tolerance to treatments and weight changes were monitored over the period of the trial. Results: All patients completed the trial with no drop outs. At 8 weeks, there was a statistically significant (P 0.01 in the olanzapine group. Conclusion: Quetiapine, risperidone, and olanzapine, given as adjunctive treatment with SSRIS or SNRIs can significantly and equally improve depressive and psychotic symptoms, in the short-term treatment of major depression with psychotic features. The author recommends that large controlled trials be conducted to examine the differences in long-term efficacy and tolerance between the atypical antipsychotic agents, in the treatment of major depression with or without psychotic features. Keywords: depression, novels

Adjunctive hyperbaric oxygen therapy in severe burns: Experience in Taiwan Formosa Water Park dust explosion disaster.

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Chiang, I-Han; Chen, Shyi-Gen; Huang, Kun-Lun; Chou, Yu-Ching; Dai, Niann-Tzyy; Peng, Chung-Kan

2017-06-01

Despite major advances in therapeutic strategies for the management of patients with severe burns, significant morbidity and mortality is observed. Hyperbaric oxygen therapy (HBOT) increases the supply of oxygen to burn areas. The aim of this study was to determine whether HBOT is effective in the treatment of major thermal burns. On June 27, 2015 in New Taipei, Taiwan, a mass casualty disaster occurred as fire erupted over a large crowd, injuring 499 people. Fifty-three victims (20 women and 33 men) were admitted to Tri-Service General Hospital. Thirty-eight patients underwent adjunctive HBOT (HBOT group), and 15 patients received routine burn therapy (control group). Serum procalcitonin (PCT) level, a sepsis biomarker, was measured until it reached normal levels (burn care combined with adjunctive HBOT improves sepsis control compared with standard treatment without HBOT. Prospective studies are required to define the role of HBOT in extensive burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Distal anastomotic vein adjunct usage in infrainguinal prosthetic bypasses.

Science.gov (United States)

McPhee, James T; Goodney, Philip P; Schanzer, Andres; Shaykevich, Shimon; Belkin, Michael; Menard, Matthew T

2013-04-01

Single-segment saphenous vein remains the optimal conduit for infrainguinal revascularization. In its absence, prosthetic conduit may be used. Existing data regarding the significance of anastomotic distal vein adjunct (DVA) usage with prosthetic grafts are based on small series. This is a retrospective cohort analysis derived from the regional Vascular Study Group of New England as well as the Brigham and Women's hospital database. A total of 1018 infrainguinal prosthetic bypass grafts were captured in the dataset from 73 surgeons at 15 participating institutions. Propensity scoring and 3:1 matching was performed to create similar exposure groups for analysis. Outcome measures of interest included: primary patency, freedom from major adverse limb events (MALEs), and amputation free survival at 1 year as a function of vein patch utilization. Time to event data were compared with the log-rank test; multivariable Cox proportional hazard models were used to evaluate the adjusted association between vein cuff usage and the primary end points. DVA was defined as a vein patch, cuff, or boot in any configuration. Of the 1018 bypass operations, 94 (9.2%) had a DVA whereas 924 (90.8%) did not (no DVA). After propensity score matching, 88 DVAs (25%) and 264 no DVAs (75%) were analyzed. On univariate analysis of the matched cohort, the DVA and no DVA groups were similar in terms of mean age (70.0 vs 69.0; P = .55), male sex (58.0% vs 58.3%; P > .99), and preoperative characteristics such as living at home (93.2% vs 94.3%; P = .79) and independent ambulatory status (72.7% vs 75.7%; P = .64). The DVA and no DVA groups had similar rates of major comorbidities such as hypertension chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, and dialysis dependence (P > .05 for all). Likewise, they had similar rates of distal origin grafts (13.6% vs 12.5%; P = .85), critical limb ischemia indications (P = .53), and prior arterial bypass (58% vs 47%; P = .08

Adjunctive Treatment in Juvenile Nasopharyngeal Angiofibroma: How Should We Approach Recurrence?

Science.gov (United States)

Scholfield, Daniel W; Brundler, Marie-Anne; McDermott, Ann-Louise; Mussai, Francis; Kearns, Pamela

2016-04-01

A recent case of advanced, recurrent juvenile nasopharyngeal angiofibroma (JNA) at our institution has highlighted the limited evidence regarding adjunctive treatment. We present the case of a 10-year-old boy who is the first to undergo multiple-staged surgical resections alongside vincristine treatment. We performed a review of the literature analyzing the roles of radiation therapy, cytotoxic drugs, and novel targeted agents in JNA relapse. Small cohort studies suggest radiotherapy and flutamide are the most rational treatment options for residual and recurrent JNA. Our review highlights the need for further research into the management of primary and recurrent JNA.

WhatsApp Messenger as an Adjunctive Tool for Telemedicine: An Overview.

Science.gov (United States)

Giordano, Vincenzo; Koch, Hilton; Godoy-Santos, Alexandre; Dias Belangero, William; Esteves Santos Pires, Robinson; Labronici, Pedro

2017-07-21

The advent of telemedicine has allowed physicians to deliver medical treatment to patients from a distance. Mobile apps such as WhatsApp Messenger, an instant messaging service, came as a novel concept in all fields of social life, including medicine. The use of instant messaging services has been shown to improve communication within medical teams by providing means for quick teleconsultation, information sharing, and starting treatment as soon as possible. The aim of this study was to perform a comprehensive systematic review of present literature on the use of the WhatsApp Messenger app as an adjunctive health care tool for medical doctors. Searches were performed in PubMed, EMBASE, and the Cochrane Library using the term "whatsapp*" in articles published before January 2016. A bibliography of all relevant original articles that used the WhatsApp Messenger app was created. The level of evidence of each study was determined according to the Oxford Levels of Evidence ranking system produced by the Oxford Centre for Evidence-Based Medicine. The impact and the indications of WhatsApp Messenger are discussed in order to understand the extent to which this app currently functions as an adjunctive tool for telemedicine. The database search identified a total of 30 studies in which the term "whatsapp*" was used. Each article's list of references was evaluated item-by-item. After literature reviews, letters to the editor, and low-quality studies were excluded, a total of 10 studies were found to be eligible for inclusion. Of these studies, 9 had been published in the English language and 1 had been published in Spanish. Five were published by medical doctors. The pooled data presents compelling evidence that the WhatsApp Messenger app is a promising system, whether used as a communication tool between health care professionals, as a means of communication between health care professionals and the general public, or as a learning tool for providing health care information

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children

DEFF Research Database (Denmark)

Agouropoulos, A; Twetman, S; Pandis, N

2014-01-01

by the varnish treatments. CONCLUSIONS: Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000ppm fluoride toothpaste. CLINICAL SIGNIFICANCE......OBJECTIVES: To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000ppm fluoride toothpaste. METHODS: 424 preschool children, 2-5 year of age, from 10 different pre schools.......9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity. RESULTS: The groups were balanced at baseline and no significant differences...

Tissue-engineering as an adjunct to pelvic reconstructive surgery

DEFF Research Database (Denmark)

Jangö, Hanna

of pelvic organ prolapse (POP) are warranted. Traditional native tissue repair may be associated with poor long-term outcome and augmentation with permanent polypropylene meshes is associated with frequent and severe adverse effects. Tissue-engineering is a regenerative strategy that aims at creating...... functional tissue using stem cells, scaffolds and trophic factors. The aim of this thesis was to investigate the potential adjunctive use of a tissue-engineering technique for pelvic reconstructive surgery using two synthetic biodegradable materials; methoxypolyethyleneglycol-poly(lactic-co-glycolic acid......) (MPEG-PLGA) and electrospun polycaprolactone (PCL) - with or without seeded muscle stem cells in the form of autologous fresh muscle fiber fragments (MFFs).To simulate different POP repair scenarios different animal models were used. In Study 1 and 2, MPEG-PLGA was evaluated in a native tissue repair...

Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures

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Mumoli L

2015-10-01

central nervous system and include fatigue, dizziness, and somnolence; these apparently disappear during treatment. In this review, we analyzed BRV, focusing on the current evidences from experimental animal models to clinical studies with particular interest on potential use in clinical practice. Finally, pharmacological properties of BRV are summarized with a description of its pharmacokinetics, safety, and potential/known drug–drug interactions. Keywords: brivaracetam, epilepsy, partial seizure, adjunctive therapy, antiepileptic drugs

Adjunctive Taurine in First-Episode Psychosis: A Phase 2, Double-Blind, Randomized, Placebo-Controlled Study.

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O'Donnell, Colin P; Allott, Kelly A; Murphy, Brendan P; Yuen, Hok Pan; Proffitt, Tina-Marie; Papas, Alicia; Moral, Jennifer; Pham, Tee; O'Regan, Michaela K; Phassouliotis, Christina; Simpson, Raelene; McGorry, Patrick D

2016-12-01

Taurine is an inhibitory neuromodulatory amino acid in the central nervous system that activates the GABA- and glycine-insensitive chloride channel and inhibits the N-methyl-D-aspartate receptor. It also functions as a neuroprotective agent and has a role in neural development and neurogenesis. The aim of this study was to determine the efficacy of adjunctive taurine in improving symptomatology and cognition among patients with a DSM-IV first-episode psychotic disorder. 121 patients with first-episode psychosis, aged 18-25 years, attending early intervention services consented to participate in this randomized, double-blind, placebo-controlled trial conducted from January 2007 to May 2009. Patients taking low-dose antipsychotic medication were randomly assigned to receive once-daily taurine 4 g or placebo for 12 weeks. The coprimary outcomes were change in symptomatology (measured by the Brief Psychiatric Rating Scale [BPRS] total score) and change in cognition (measured by the Measurement and Treatment Research to Improve Cognition in Schizophrenia [MATRICS] Consensus Cognitive Battery composite score) at 12 weeks. Secondary outcomes included tolerability and safety and additional clinical and functioning measures. 86 participants (n = 47 taurine; n = 39 placebo) were included in the final analysis. Taurine significantly improved symptomatology measured by the BPRS total score (95% CI, 1.8-8.5; P = .004) and psychotic subscale (95% CI, 0.1-1.5; P = .026) compared to placebo. Additionally, improvements were observed in the Calgary Depression Scale for Schizophrenia (95% CI, 0.1-3.0; P = .047) and Global Assessment of Functioning (95% CI, 0.3-8.8; P = .04) scores. There was no group difference in composite cognitive score (95% CI, -1.7 to 1.0; P = .582). A significant group difference was found on one safety and tolerability item (psychic item 2, asthenia/lassitude/increased fatigability) of the Udvalg for Kliniske Undersogelser, with the taurine group showing a

A randomized, double-blind study comparing the efficacy of selenium sulfide shampoo 1% and ciclopirox shampoo 1% as adjunctive treatments for tinea capitis in children.

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Chen, Catherine; Koch, Laine H; Dice, James E; Dempsey, Kimberly K; Moskowitz, Alan B; Barnes-Eley, Myra L; Hubbard, Thomas W; Williams, Judith V

2010-01-01

Our objective was to compare the efficacy of selenium sulfide shampoo 1% and ciclopirox shampoo 1% as adjunctive treatments for tinea capitis in children. Forty children aged 1-11 years with clinically diagnosed tinea capitis were randomized to receive selenium sulfide shampoo 1% or ciclopirox shampoo 1% twice a week as adjuncts to an 8-week course of ultramicronized griseofulvin dosed at 10-12 mg/kg/day. At weeks 2, 4, and 8, subjects returned to the clinic for evaluation and scalp cultures. Subjects then returned for follow-up visits 4 weeks after completing treatment. Overall, by 8 weeks, 30 of 33 (90.9%) treated children demonstrated mycological cure. Selenium sulfide shampoo 1% and ciclopirox shampoo 1% were equally effective as adjunctive treatments for tinea capitis in children in our study. © 2010 Wiley Periodicals, Inc.

Fans of Columbine shooters Eric Harris and Dylan Klebold

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Andrew Ryan Rico

2015-09-01

Full Text Available On April 20, 1999, Eric Harris and Dylan Klebold murdered 12 students and one teacher at Columbine High School in Littleton, Colorado, in what was then the deadliest school shooting in American history. Despite causing a national panic and serving as a flash point for larger narratives on bullying, gun control, and media violence, both boys have gained active online fans. These fandoms dedicated to the Columbine shooters are widely referred to as dark examples of Internet communities, while the fans are also frequently denigrated as unstable and violent outcasts. Such dark online fandoms are yet to permeate mainstream culture or to challenge the preexisting perception of these communities as breeding grounds for the next wave of school shooters. While studies have covered the types of fans and their myriad interests, the field remains focused on more conventional examples of fan communities. In an effort to challenge and expand the object of focus when we study fandom, this qualitative study examines Columbine fans and their activity in order to understand the dominant motives they appear to have for engaging with and around such controversial figures and then concludes by exploring how this community might help us reflect more broadly on our concept of fandom. Redeeming these fans as part of diverse and complex communities of social relevance can demonstrate how even a dark fandom such as that of these Columbine shooters provides valuable cultural insights and benefits the field of fan studies.

Natural Products as Adjunctive Treatment for Pancreatic Cancer: Recent Trends and Advancements

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Qingxi Yue

2017-01-01

Full Text Available Pancreatic cancer is a type of common malignant tumors with high occurrence in the world. Most patients presented in clinic had pancreatic cancer at advanced stages. Furthermore, chemotherapy or radiotherapy had very limited success in treating pancreatic cancer. Complementary and alternative medicines, such as natural products/herbal medicines, represent exciting adjunctive therapies. In this review, we summarize the recent advances of using natural products/herbal medicines, such as Chinese herbal medicine, in combination with conventional chemotherapeutic agents to treat pancreatic cancer in preclinical and clinical trials.

Efficacy of Mycobacterium indicus pranii immunotherapy as an adjunct to chemotherapy for tuberculosis and underlying immune responses in the lung.

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Ankan Gupta

Full Text Available BACKGROUND: The 9-month-long chemotherapy of tuberculosis often results in poor compliance and emergence of drug-resistant strains. So, improved therapeutic strategy is urgently needed. Immunotherapy could be beneficial for the effective management of the disease. Previously we showed the protective efficacy of Mycobacterium indicus pranii (MIP when given as prophylactic vaccine in animal models of tuberculosis. METHODS: We sought to investigate whether MIP can be used as an adjunct to the chemotherapy in guinea pig models of tuberculosis. Efficacy of MIP was evaluated when given subcutaneously or by aerosol. RESULTS: MIP-therapy as an adjunct to the chemotherapy was found to be effective in accelerating bacterial killing and improving organ pathology. MIP-immunotherapy resulted in higher numbers of activated antigen-presenting cells and lymphocytes in the infected lungs and also modulated the granulomatous response. Early increase in protective Th1 immune response was observed in the immunotherapy group. Following subsequent doses of MIP, decrease in the inflammatory response and increase in the immunosuppressive response was observed, which resulted in the improvement of lung pathology. CONCLUSION: MIP immunotherapy is a valuable adjunct to chemotherapy for tuberculosis. Aerosol route of immunotherapy can play a crucial role for inducing immediate local immune response in the lung.

Partial Tenon's capsule resection with adjunctive mitomycin C in Ahmed glaucoma valve implant surgery.

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Susanna, R

2003-08-01

To verify if partial intraoperative Tenon's capsule resection (PTCR) with adjunctive mitomycin C is effective in developing thin, avascular blebs in eyes undergoing Ahmed glaucoma valve insertion, and to assess the efficacy and safety of this procedure. A multicentre, prospective, alternating case assignment, investigator unmasked, parallel group, comparative interventional study was conducted in four Latin American countries (Argentina, Brazil, Colombia, and Peru). Ahmed glaucoma valve implant insertion with PTCR (group A) and without PCTR (group B) was performed in neovascular glaucomatous eyes without previous surgery. Adjunctive mitomycin C (MMC) was used in both groups. Patients were examined 1 day, 10 days, 1 month, 2 months, 3 months, 6 months, and 1 year following the surgery. Intraocular pressure (IOP) and the appearance of the bleb were evaluated at each examination. Appearance of the bleb was classified at both the 1 month mark and last examinations into one of three groups: flat and vascularised; elevated avascular; or elevated and not avascular. 92 eyes from 92 patients were included in the study. The preoperative mean IOP was 50.0 (SD 10.5) mm Hg in group A and 48.4 (11.7) in group B (p>0.05). Statistically significant IOP reductions were observed at all periods of follow up. 12 months after surgery, the mean IOP was 17.2 (5.0) mm Hg in group A and 18.3 (8.7) mm Hg in group B (p>0.05). A hypertensive phase occurred in 40.0% in group A and in 46.8% in group B (p>0.05). At the 1 month and the final follow up, the blebs in all eyes were considered elevated and not avascular. The success rate (IOP0.05). Overall, 74.2% of the patients achieved an IOP glaucoma, PCTR with MMC augmentation showed no additional benefits or complications over MMC augmentation alone; no avascular bleb was obtained with this technique. The incidence of a hypertensive phase was lower than reported in previous studies.

Computer simulation games as an adjunct for treatment in male veterans with alcohol use disorder.

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Verduin, Marcia L; LaRowe, Steven D; Myrick, Hugh; Cannon-Bowers, Jan; Bowers, Clint

2013-03-01

This study examined the impact of a computer simulation designed to provide the opportunity for individuals with alcohol use disorders (AUDs) to practice relapse prevention skills. Participants were 41 male veterans enrolled in an intensive outpatient substance abuse treatment program. Participants were randomly assigned to either view educational slides about treatment for AUD or play a simulation videogame for eight sessions within 12 weeks. Participants were assessed at a 4-week follow-up visit. Outcome measures included relapse rates as well as ratings on the Obsessive Compulsive Drinking Scale (OCDS) and a custom-designed relapse prevention self efficacy scale. While rates of relapse did not differ between groups, those who played the game showed overall reductions in ratings on the OCDS, as well as higher ratings of self-efficacy at week 8, suggesting that the videogame simulation may be a useful adjunct to AUD treatment. Published by Elsevier Inc.

Adjunctive treatment of manic agitation with lorazepam versus haloperidol: a double-blind study.

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Lenox, R H; Newhouse, P A; Creelman, W L; Whitaker, T M

1992-02-01

While lithium is effective in treating the majority of bipolar patients during a manic episode, the addition of neuroleptic during the early phase of treatment has been common clinical practice in inpatient settings. In an earlier open study, we demonstrated the utility of the short-acting benzodiazepine lorazepam as an adjunct to lithium for the clinical management of manic agitation. We now present data from a randomized, double-blind clinical study of lorazepam versus haloperidol in 20 hospitalized patients with a DSM-III-R diagnosis of bipolar disorder who were being treated concomitantly with lithium. Patients were rated using the Mania Rating Scale, Brief Psychiatric Rating Scale, Physician Global Impression Scale, and side effects scales. Data were analyzed using standard group comparisons and survival analysis. There was no evidence for a significant difference between the two treatment groups in the magnitude of or time to response (5.0 +/- .82 days for haloperidol; 6.5 +/- .93 days for lorazepam). Of the patients who were terminated from the protocol early, nonresponse was the primary reason in the lorazepam group while side effects were the reason in the haloperidol group. Lorazepam may offer an efficacious and safe alternative to haloperidol as an adjunctive treatment to lithium in the clinical management of the early phase of manic agitation in a subgroup of bipolar patients.

The Adjunctive Digital Breast Tomosynthesis in Diagnosis of Breast Cancer

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Tsung-Lung Yang

2013-01-01

Full Text Available Purpose. To compare the diagnostic performance of digital breast tomosynthesis (DBT and digital mammography (DM for breast cancers. Materials and Methods. Fifty-seven female patients with pathologically proved breast cancer were enrolled. Three readers gave a subjective assessment superiority of the index lesions (mass, focal asymmetry, architectural distortion, or calcifications and a forced BIRADS score, based on DM reading alone and with additional DBT information. The relevance between BIRADS category and index lesions of breast cancer was compared by chi-square test. Result. A total of 59 breast cancers were reviewed, including 17 (28.8% mass lesions, 12 (20.3% focal asymmetry/density, 6 (10.2% architecture distortion, 23 (39.0% calcifications, and 1 (1.7% intracystic tumor. Combo DBT was perceived to be more informative in 58.8% mass lesions, 83.3% density, 94.4% architecture distortion, and only 11.6% calcifications. As to the forced BIRADS score, 84.4% BIRADS 0 on DM was upgraded to BIRADS 4 or 5 on DBT, whereas only 27.3% BIRADS 4A on DM was upgraded on DBT, as BIRADS 4A lesions were mostly calcifications. A significant P value (<0.001 between the BIRADS category and index lesions was noted. Conclusion. Adjunctive DBT gives exquisite information for mass lesion, focal asymmetry, and/or architecture distortion to improve the diagnostic performance in mammography.

Is Photodynamic Therapy with Adjunctive Non-Surgical Periodontal Therapy Effective in the Treatment of Periodontal Disease under Immunocompromised Conditions

International Nuclear Information System (INIS)

Javed, F.; Hezaimi, K.A.; Qadri, T.; Ahmed, H.B.; Corbet, F.E.; Romanos, G.E.

2013-01-01

The aim was to assess whether or not photodynamic therapy (PDT) with adjunctive scaling-and-root-planing (SRP) is effective in the treatment of periodontitis under immunocompromised conditions. PubMed/Medline and Google-Scholar databases were searched from 1967 to May 2013 using various key words. Six studies (five experimental and one clinical) were included. In the clinical study, SRP with PDT was reported to be ineffective in treating chronic periodontitis in T2DM patients. All experimental studies reported significantly less bone loss in periodontal defects treated with SRP+PDT than those treated with SRP alone. Efficacy of PDT+SRP in the treatment of periodontal disease under immunocompromised conditions remains unclear. (author)

Is Photodynamic Therapy with Adjunctive Non-Surgical Periodontal Therapy Effective in the Treatment of Periodontal Disease under Immunocompromised Conditions

Energy Technology Data Exchange (ETDEWEB)

Javed, F.; Hezaimi, K. A. [King Saud Univ., Riyadh (Saudi Arabia). College of Applied Medical Sciences; Qadri, T. [Karolinska Inst., Huddinge (Sweden). Dept. of Dental Medicine; Ahmed, H. B. [Al-Farabi Dental College, Riyadh (Saudi Arabia). Dept. of Dentistry; Corbet, F. E. [University of Hong Kong, Hong Kong (Hong Kong). Dept. of Periodontology; Romanos, G. E. [Stony Brook University, New York (United States). School of Dental Medicine

2013-10-15

The aim was to assess whether or not photodynamic therapy (PDT) with adjunctive scaling-and-root-planing (SRP) is effective in the treatment of periodontitis under immunocompromised conditions. PubMed/Medline and Google-Scholar databases were searched from 1967 to May 2013 using various key words. Six studies (five experimental and one clinical) were included. In the clinical study, SRP with PDT was reported to be ineffective in treating chronic periodontitis in T2DM patients. All experimental studies reported significantly less bone loss in periodontal defects treated with SRP+PDT than those treated with SRP alone. Efficacy of PDT+SRP in the treatment of periodontal disease under immunocompromised conditions remains unclear. (author)

A retrospective analysis of the efficacy of Oncept vaccine for the adjunct treatment of canine oral malignant melanoma.

Science.gov (United States)

Ottnod, J M; Smedley, R C; Walshaw, R; Hauptman, J G; Kiupel, M; Obradovich, J E

2013-09-01

Oral malignant melanoma (OMM) in the dog is often locally aggressive with a high metastatic potential and there are few treatment options that have been demonstrated to improve outcome of this disease. The purpose of this study was to determine whether adjunctive treatment with the Oncept melanoma vaccine affected the outcome of dogs with OMM that had achieved loco-regional cancer control. Medical records from 45 dogs that presented to the Animal Cancer and Imaging Center were reviewed, including 30 dogs with stage II and III disease. Dogs that received the vaccine did not achieve a greater progression-free survival, disease-free interval or median survival time than dogs that did not receive the vaccine. © 2013 John Wiley & Sons Ltd.

Single dose silodosin prior to voiding cystourethrogram: a pharmacological adjunct to enhance visualization of posterior urethra.

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Nagathan, Deepak Sharanappa; Dalela, Divakar; Sankhwar, Satyanarayan; Goel, Apul; Dwivedi, Amod Kumar; Yadav, Rahul

2014-03-04

Voiding cystourethrogram (VCUG) is needed to ascertain the upper end of urethral stricture. Occasionally, a patient is unable to open the bladder neck with resultant failure of the test. Realizing the strong and prompt alpha antagonistic action of silodosin, we evaluated single 8 mg dose as a pharmacological adjunct prior to VCUG to overcome this problem.

Oily calcium hydroxide suspension (Osteoinductal) used as an adjunct to guided bone regeneration: an experimental study in rats.

NARCIS (Netherlands)

Stavropoulos, A.; Geenen, C.; Nyengaard, J.R.; Karring, T.; Sculean, A.

2007-01-01

OBJECTIVES: To evaluate whether an oily calcium hydroxide suspension (OCHS) promotes bone healing when used as an adjunct to guided bone regeneration (GBR). MATERIAL AND METHODS: Rigid, hemispherical, teflon capsules were placed with their open part facing the lateral surface of the ramus on both

Exercise as an adjunct to nicotine gum in treating tobacco dependence among women.

Science.gov (United States)

Kinnunen, Taru; Leeman, Robert F; Korhonen, Tellervo; Quiles, Zandra N; Terwal, Donna M; Garvey, Arthur J; Hartley, Howard L

2008-04-01

This was the first randomized, controlled smoking cessation trial assessing the efficacy of an exercise intervention as an adjunct to nicotine gum therapy in comparison with both equal contact control and standard care control conditions. Sedentary female smokers aged 18-55 years were provided with nicotine gum treatment along with brief behavioral counseling and were randomized into one of these three behavioral adjunct conditions. In the "intent-to-treat" sample (N = 182), at end of treatment and at 1-year follow-up, there were clear, but nonsignificant, trends in univariate analyses in which the exercise and equal contact control conditions both had higher rates of abstinence than the standard care control. However, when adjusting for other predictors of relapse in a multiple logistic regression, both exercise and equal contact control showed an advantage over standard care control in avoiding early relapse (i.e., after 1 week). In a multivariate survival model adjusting for other predictors, the equal contact condition had a significantly lower likelihood of relapse compared with the standard care condition and there was a near significant trend in which exercise offered an advantage over standard care as well. While these findings suggest a slightly improved likelihood of abstinence with exercise compared with standard care, exercise did not differ from equal contact control in its efficacy. Potential explanations for these equivalent levels of efficacy and implications for the findings are discussed.

Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts

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Flamer D

2011-11-01

Full Text Available David Flamer, Philip WH PengDepartment of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, CanadaPurpose: To provide a review of local anesthetic (LA agents and adjuncts, opioids and muscle relaxants, and their intraoperative effects and postoperative outcomes in intravenous regional anesthesia (IVRA.Source: A search for prospective, double-blind, randomized controlled trials evaluating LA agents, opioids and muscle relaxants as adjuvants for IVRA, was conducted (MEDLINE®, Embase. Intraoperative benefits (onset/recovery of sensory and motor block, intraoperative analgesia, tourniquet pain, postoperative benefits (pain score, analgesic consumption, time to first analgesia, and side effects were recorded. A conclusion for overall benefit was made based on statistical significance and clinical relevance.Findings: Thirty-one studies were evaluated, with data collected on 1523 subjects. LA agents evaluated were lidocaine, ropivacaine, and prilocaine. Adjuncts evaluated were opioids (morphine, fentanyl, meperidine, sufentanil, tramadol and muscle relaxants (pancuronium, atracurium, mivacurium, cisatacurium. There was good evidence that ropivacaine provided effective IVRA and improved postoperative analgesia. Lidocaine and prilocaine were effective LA agents, however they lacked postoperative benefits. Morphine, fentanyl, and meperidine as sole adjuncts did not demonstrate clinically significant benefits or result in an increased risk of side effects. Sufentanil data was limited, but appeared to provide faster onset of sensory block. Tramadol provided faster onset of sensory block and tourniquet tolerance, however postoperative benefits were not consistent and the risk of minor side effects increased. Muscle relaxants improved the quality of motor block, but at the expense of delayed motor recovery. The combination of fentanyl and muscle relaxants can achieve an equivalent quality of IVRA with 50

Two Phase III randomised double-blind studies of fixed-dose TC-5214 (dexmecamylamine) adjunct to ongoing antidepressant therapy in patients with major depressive disorder and an inadequate response to prior antidepressant therapy.

Science.gov (United States)

Möller, Hans-Jürgen; Demyttenaere, Koen; Olausson, Bengt; Szamosi, Johan; Wilson, Ellis; Hosford, David; Dunbar, Geoffrey; Tummala, Raj; Eriksson, Hans

2015-10-01

To evaluate the neuronal nicotinic channel modulator TC-5214 (dexmecamylamine) as adjunct therapy in patients with major depressive disorder (MDD) and inadequate response to prior antidepressant treatment. Study 004 (D4130C00004) and Study 005 (D4130C00005) comprised an 8-week open-label antidepressant (SSRI/SNRI) treatment period followed by an 8-week randomised, active treatment with twice-daily TC-5214 (0.5, 2 or 4 mg in Study 004; 0.1, 1 or 4 mg in Study 005) or placebo, adjunct to ongoing SSRI/SNRI. Primary efficacy endpoint was change in MADRS total score from randomisation (Week 8) to treatment end (Week 16). Secondary endpoints included MADRS response and remission, and changes in SDS and HAM-D-17-item scores. Safety and tolerability were monitored throughout. Studies 004 and 005 randomised 640 and 696 patients, respectively, to TC-5214 or placebo. No statistically significant improvements in MADRS total score or any secondary endpoints were seen with TC-5214 versus placebo in either study at treatment end. The most commonly reported adverse events (> 10%) with TC-5214 were constipation, dizziness and dry mouth. TC-5214 adjunct to antidepressant was generally well tolerated. However, the studies were not supportive of an antidepressant effect for TC-5214 in patients with MDD and inadequate response to prior antidepressant therapy.

Bedside Ultrasonography as an Adjunct to Routine Evaluation of Acute Appendicitis in the Emergency Department

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Lam, Samuel H.F.; Grippo, Anthony; Kerwin, Chistopher; Konicki, P. John; Goodwine, Diana; Lambert, Michael J.

2014-01-01

Introduction: Appendicitis is a common condition presenting to the emergency department (ED). Increasingly emergency physicians (EP) are using bedside ultrasound (BUS) as an adjunct diagnostic tool. Our objective is to investigate the test characteristics of BUS for the diagnosis of appendicitis and identify components of routine ED workup and BUS associated with the presence of appendicitis. Methods: Patients four years of age and older presenting to the ED with suspect...

Role of diode lasers (800-980 nm) as adjuncts to scaling and root planing in the treatment of chronic periodontitis: a systematic review.

Science.gov (United States)

Qadri, Talat; Javed, Fawad; Johannsen, Gunnar; Gustafsson, Anders

2015-11-01

The purpose of this study was to systematically review currently available evidence regarding the role of diode lasers (810-980 nm) as adjuncts to scaling and root planing (SRP) in the treatment of chronic periodontitis (CP). Mechanical instrumentation of periodontal tissues followed by diode laser application leads to complete removal of pocket epithelium compared with conventional SRP. To address the focused question "Is SRP with adjunct diode lasers (810-980 nm) therapy more effective in the treatment of CP than when CP is treated by SRP alone?" databases were searched using the following key words: chronic periodontitis, diode laser, surgical, AND scaling and root planing, periodontal diseases, periodontal therapy, AND periodontal treatment. Original studies were included. Letters to the editor, case reports, commentaries, and reviews were excluded. Ten clinical studies were included. In all studies, patients were systemically healthy, and cigarette smokers were included in two studies. In five studies, SRP plus diode laser application was more effective in the treatment of CP than SRP, and three studies showed no difference. In two studies, there was a moderate reduction in periodontal inflammation using SRP plus diode laser. The diameter of optic fiber, laser wavelengths, power, pulse repetition rate, and duration of laser exposure ranged between 300 μm and 2 mm, 810-980 nm, 0.8-2.5 W, 10-60 Hz, and 10-100 ms, respectively. In CP patients with probing depths ≤5 mm, diode lasers, SRP plus diode laser (800-980 nm) is more effective in the treatment of CP than when SRP is used alone.

Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination.

Science.gov (United States)

Steinmetz, Peter; Oleskevich, Sharon; Dyachenko, Alina; McCusker, Jane; Lewis, John

2018-03-25

This study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US). Fourth-year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total). The reference standard for identification of pleural effusion was a lung US examination by 2 expert point-of-care sonographers. The odds of correctly identifying the presence versus absence of pleural effusion was 5 times greater with lung US as an adjunct to the physical examination compared to the physical examination alone (odds ratio [OR], 5.1 from multivariate logistic regression; 95% confidence interval, 3.3-8.0). The addition of lung US to the physical examination resulted in an increase in sensitivity from 48% to 90%, in specificity from 73% to 86%, and in accuracy from 60% to 88%. The benefits of using US were greater when pleural effusion was present versus absent (OR, 10.8 versus 2.4) and when examining older versus younger patients (OR, 10.2 versus 2.8). These results demonstrate that medical students' ability to detect the presence or absence of pleural effusion is superior when using lung US as an adjunct to the physical examination than when using the physical examination alone. © 2018 by the American Institute of Ultrasound in Medicine.

Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.

Science.gov (United States)

Shiranibidabadi, Shahrzad; Mehryar, Amirhooshang

2015-09-15

Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date. In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n = 15) or standard treatment only (n = 15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4 ± 1.9 vs standard treatment only: 15.1 ± 1.7, p Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy + standard treatment: 16.9 ± 7.4 vs standard treatment only: 22.9 ± 4.6, p music therapy + standard treatment: 10.8 ± 3.8 vs standard treatment: 17.1 ± 3.7, p music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms. Copyright © 2015. Published by Elsevier B.V.

Adjunctive Platelet-Rich Plasma (PRP in Infrabony Regenerative Treatment: A Systematic Review and RCT’s Meta-Analysis

Directory of Open Access Journals (Sweden)

Mubashir Saleem

2018-01-01

Full Text Available Background and Objective. The purpose of this study was to highlight the clinical performance of platelet-rich plasma (PRP used as an adjunctive tool for regeneration in infrabony periodontal defects using different biomaterials or performing different surgical flap approaches. Comparative evaluation of main clinical outcomes as probing pocket depth reduction, clinical attachment gain, and recession reduction with and without the use of PRP has been analysed. Materials and Methods. According to the focused question, an electronic and hand searching has been performed up to December 2016. From a batch of 73 articles, the selection strategy and Jadad quality assessment led us to include 15 studies for the meta-analysis. Results. Despite the high heterogeneity found and the lack of complete data regarding the selected clinical outcomes, a comparative analysis has been possible by the categorization of used biomaterials and surgical flap approaches. This method led us to observe the best performance of grafts with the use of adjunctive PRP in CAL gain and PPD reduction. No difference has been outlined with a specific surgical flap. Conclusions. Although PRP is considered a cheap and patient’s derived growth factor, the not conclusive data reported would suggest that its use in addition to bone substitutes could be of some clinical benefit in the regenerative treatment of infrabony defects. Clinical Relevance. This systematic review was intended to sort out the huge controversial debate in the field about the possible use of PRP in regenerative surgery in infrabony defect. The clinical relevance of using blood-borne growth factors to conventional procedures is effective as these could determine a better performance and outcomes despite the surgical approach adopted and limit the use of additional biomaterials for the blood clot stabilization.

Antipsychotic adjunctive therapy to mood stabilizers and 1-year rehospitalization rates in bipolar disorder: A cohort study.

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Hochman, Eldar; Krivoy, Amir; Schaffer, Ayal; Weizman, Abraham; Valevski, Avi

2016-12-01

Antipsychotic adjunctive therapy to mood stabilizers (MSs) may improve relapse prevention; however, only a few naturalistic studies, reflecting more generalizable bipolar disorder (BD) samples, support this notion. We compared the 1-year rehospitalization rates of manic patients with bipolar I disorder (BD-I) who were discharged with MS (lithium or valproate) monotherapy or with adjunctive atypical or typical antipsychotic therapy. A total of 201 patients with BD-I who were hospitalized with manic episodes between 2005 and 2013 were retrospectively followed for 1-year rehospitalization rates according to treatment at discharge: MS monotherapy, MS with atypical antipsychotics, and MS with typical antipsychotics. Additionally, time to rehospitalization during the 1-year period after discharge was compared between treatment groups. Multivariable survival analyses adjusted for covariates known to influence rehospitalization were conducted. Rehospitalization rates within 1 year were significantly lower in the MS with atypical antipsychotics group (6.3%) compared to the MS monotherapy group (24.3%, P=.008) and to the MS with typical antipsychotics group (20.6%, P=.02). Time to rehospitalization was significantly longer for the MS with atypical antipsychotics group (345.5 days) compared to the MS monotherapy group (315.1 days, P=.006) and to the MS with typical antipsychotics group (334.1 days, P=.02). The MS with atypical antipsychotics group had a significantly reduced adjusted risk of rehospitalization (hazard ratio=0.17, 95% confidence interval: 0.05-0.61, P=.007) compared to the MS monotherapy group. Atypical antipsychotic adjunctive therapy to MSs may be more effective than MS monotherapy in preventing rehospitalization during the 1-year period after a BD manic episode. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Theoretical role of adjunctive implant positional support in stress distribution of distal-extension mandibular removable partial dentures.

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Xiao, Wei; Li, Zhiyong; Shen, Shiqian; Chen, Shaowu; Wang, Yining; Wang, Jiawei

2014-01-01

This preliminary study evaluated the adjunctive supporting role of diverse implant positions on stress distribution in a Class I removable partial denture (RPD) design. Nine three-dimensional finite element models were prepared to simulate mandibular RPD designs with three different loading conditions applied. Implant supported designs demonstrated lower stress value concentrations and mucosal displacement.

Reduction of methanol in brewed wine by the use of atmospheric and room-temperature plasma method and the combination optimization of malt with different adjuncts.

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Liang, Ming-Hua; Liang, Ying-Jie; Chai, Jiang-Yan; Zhou, Shi-Shui; Jiang, Jian-Guo

2014-11-01

Methanol, often generated in brewed wine, is highly toxic for human health. To decrease the methanol content of the brewed wine, atmospheric and room-temperature plasma (ARTP) was used as a new mutagenesis tool to generate a mutant of Saccharomyces cerevisiae with lower methanol content. Headspace gas chromatography was used to determine the identity and concentration of methanol with butyl acetate as internal standard in brewed wine. With 47.4% higher and 26.3% positive mutation rates were obtained, the ARTP jet exhibited a strong effect on mutation breeding of S. cerevisiae. The mutant S. cerevisiae S12 exhibited the lowest methanol content, which was decreased by 72.54% compared with that of the wild-type strain. Subsequently, the mutant S. cerevisiae S12 was used to ferment different combinations of malt and adjuncts for lower methanol content and higher alcoholic content. It was shown that the culture 6#, which was 60% malt, 20% wheat, and 20% corn, was the best combinations of malt and adjuncts, with the lowest methanol content (104.8 mg/L), and a relatively higher alcoholic content (15.3%, v/v). The optimal malt-adjunct culture 6#, treated with the glucoamylase dose of 0.04 U/mg of grain released the highest reducing sugars (201.6 mg/mL). It was indicated that the variation in reducing sugars among the combinations of malt and different adjuncts could be due to the dose of exogenous enzymes. © 2014 Institute of Food Technologists®

Endovascular Treatment of Left Iliofemoral Deep Vein Thrombosis Using Urokinase Thrombolysis and Adjunctive Aspiration Thrombectomy

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Suh, Sang Hyun; Lee, Do Yun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

2010-02-15

To evaluate the efficacy of adjunctive aspiration thrombectomy for the treatment of iliofemoral deep vein thrombosis (DVT). 24 patients (9 males and 15 females; mean age, 53 years), treated by aspiration thrombectomy were enrolled in this study. The day after undergoing urokinase (UK) thrombolysis, any residual thrombus over a long segment was treated by aspiration thrombectomy using a 12 Fr long sheath. Residual short-segment (< 10 cm) iliac vein thrombus and/or stenosis were treated with a stent. The evaluation of venous patency was conducted by color Doppler ultrasonography, venography and/or computed tomography. The technical and clinical success rates were 100% and 92%, respectively. Twenty-three patients were treated by UK thrombolysis and iliac stent. The overall patency rate at 1, 2 and 3 years was 85%, 82% and 81%, respectively. Over the course of the follow-up period, occlusion was observed in 4 cases (1 acute and 3 chronic cases). Periprocedural complication occurred in 4 cases (17%) in the form of a minimal hematoma or pain on the puncture site as well as a case of pulmonary embolism at one month after treatment. The adjunctive aspiration thrombectomy with conventional thrombolysis and stent placement can be an effective and safe method in the treatment of left iliofemoral DVT

Effectiveness of Physical Therapy as an Adjunctive Treatment for Trauma-induced Chronic Torticollis in Raptors.

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Nevitt, Benjamin N; Robinson, Narda; Kratz, Gail; Johnston, Matthew S

2015-03-01

Management of trauma-induced chronic torticollis in raptors has historically been challenging. Euthanasia is common in affected birds because of their inability to maintain normal cervical position, although they may be able to function normally. To assess effectiveness of physical therapy of the neck and head as an adjunct treatment for this condition, a case-control study was done in raptors admitted to the Rocky Mountain Raptor Program from 2003 to 2010. Eleven cases were identified with a diagnosis of chronic torticollis resulting from traumatic brain injury. Five cases were treated with physical therapy of the head and neck, and 6 control cases did not receive any physical therapy for the torticollis. Of the control cases, 0 of 6 had resolution of the torticollis, 0 of 6 were released, and 5 of 6 were euthanatized. Of the treated cases, 4 of 5 had complete resolution of the torticollis and 5 of 5 were released. Resolution of torticollis differed significantly between cases receiving physical therapy and controls. These results indicate that physical therapy should be used as an adjunctive therapy in cases of chronic torticollis induced by trauma in raptors because it results in better resolution of the torticollis and increased likelihood of release.

Neurochemical changes underpinning the development of adjunct therapies in recovery after stroke: A role for GABA?

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Johnstone, Ainslie; Levenstein, Jacob M; Hinson, Emily L; Stagg, Charlotte J

2017-01-01

Stroke is a leading cause of long-term disability, with around three-quarters of stroke survivors experiencing motor problems. Intensive physiotherapy is currently the most effective treatment for post-stroke motor deficits, but much recent research has been targeted at increasing the effects of the intervention by pairing it with a wide variety of adjunct therapies, all of which aim to increase cortical plasticity, and thereby hope to maximize functional outcome. Here, we review the literature describing neurochemical changes underlying plasticity induction following stroke. We discuss methods of assessing neurochemicals in humans, and how these measurements change post-stroke. Motor learning in healthy individuals has been suggested as a model for stroke plasticity, and we discuss the support for this model, and what evidence it provides for neurochemical changes. One converging hypothesis from animal, healthy and stroke studies is the importance of the regulation of the inhibitory neurotransmitter GABA for the induction of cortical plasticity. We discuss the evidence supporting this hypothesis, before finally summarizing the literature surrounding the use of adjunct therapies such as non-invasive brain stimulation and SSRIs in post-stroke motor recovery, both of which have been show to influence the GABAergic system.

Text messaging as an adjunct to a web-based intervention for college student alcohol use: A preliminary study.

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Tahaney, Kelli D; Palfai, Tibor P

2017-10-01

Brief, web-based motivational interventions have shown promising results for reducing alcohol use and associated harm among college students. However, findings regarding which alcohol use outcomes are impacted are mixed and effects tend to be small to moderate, with effect sizes decreasing over longer-term follow-up periods. As a result, these interventions may benefit from adjunctive strategies to bolster students' engagement with intervention material and to extend interventions beyond initial contacts into student's daily lives. This study tested the efficacy of text messaging as an adjunct to a web-based intervention for heavy episodic drinking college students. One-hundred and thirteen undergraduate student risky drinkers recruited from an introductory psychology class were randomly assigned to one of three conditions-assessment only (AO), web intervention (WI), and web intervention plus text messaging (WI+TXT). Heavy drinking episodes (HDEs), weekend quantity per occasion, and alcohol-related consequences were assessed at baseline and one month follow-up. Univariate analysis of covariance (ANCOVA) was used to assess the influence of condition assignment on 1-month outcomes, controlling for baseline variables. Planned contrasts showed that those in the WI+TXT condition showed significantly less weekend drinking than those in the AO and WI conditions. Although those in the WI+TXT condition showed significantly fewer HDEs compared to AO, it was not significantly different than the WI only condition. No differences were observed on alcohol-related problems. These findings provide partial support for the view that text messaging may be a useful adjunct to web-based interventions for reducing alcohol consumption among student drinkers. Copyright © 2017. Published by Elsevier Ltd.

Mindfulness and meditation as an adjunctive treatment for adolescents involved in the juvenile justice system: Is repairing the brain and nervous system possible?

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Winters, Drew E; Beerbower, Emily

2017-08-01

Adolescents involved in the juvenile justice system are prone to more traumatic events than other adolescents, leaving them in danger of developmental difficulties. Trauma exposure is predictive of poor outcomes including mental and physical health issues as well as criminal activity. Current treatment approaches either have a nominal effect on recidivism rates or increase the likelihood of future criminal offenses. This article explores adolescent brain development, the unique difficulties that juvenile justice youth face, and mindfulness meditation as an adjunctive treatment to system-based treatment. Mindfulness meditation may be a way to redress damage to the brain and facilitate healthy brain development, thus impacting prosocial behavior. Practice implications include integrating mindfulness meditation as an important part of rehabilitative efforts with juvenile justice youth.

A Review of Eslicarbazepine Acetate for the Adjunctive Treatment of Partial-Onset Epilepsy

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Rajinder P. Singh

2011-01-01

Full Text Available Eslicarbazepine acetate (ESL is a novel antiepileptic drug indicated for the treatment of partial-onset seizures. Structurally, it belongs to the dibenzazepine family and is closely related to carbamazepine and oxcarbazepine. Its main mechanism of action is by blocking the voltage-gated sodium channel. ESL is a pro-drug that is rapidly metabolized almost exclusively into S-licarbazepine, the biologically active drug. It has a favorable pharmacokinetic and drug-drug interaction profile. However, it may induce the metabolism of oral contraceptives and should be used with caution in females of child-bearing age. In the pre-marketing placebo-controlled clinical trials ESL has proven effective as adjunctive therapy in adult patients with refractory of partial-onset seizures. Best results were observed on a single daily dose between 800 and 1200 mg. In general, ESL was well tolerated, with most common dose-related side effects including dizziness, somnolence, headache, nausea and vomiting. Hyponatremia has been observed (0.6%-1.3%, but the incidence appears to be lower than with the use of oxcarbazepine. There is very limited information on the use of ESL in children or as monotherapy.

The Relative Effectiveness of Three Types of Notes Used as Adjunct Study Activities to Group Audiovisual Instruction.

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Lavin, Marvin H.

A graduate thesis investigated the value of notetaking and prepared notes as adjunctive activities in audiovisual instruction. In the first experiment, taking notes on prepared topic outlines was found to be better than taking notes on blank paper. In the second experiment, not taking on topic outlines and the use of study guides were shown to be…

Neurofeedback as an adjunct therapy for treatment of chronic posttraumatic stress disorder related to refugee trauma and torture experiences: two case studies.

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Askovic, Mirjana; Watters, Anna J; Aroche, Jorge; Harris, Anthony W F

2017-08-01

The objective of this study was to describe the use of neurofeedback for refugee-related chronic posttraumatic stress disorder (PTSD) in two case studies. We describe the assessment and application of neurofeedback integrated into the treatment of two clients with chronic PTSD. We include details of our treatment schedule, symptoms and quantitative electrophysiological data for each case. Results All clients achieved significant reduction in symptoms of PTSD and improvement in daily functioning post-neurofeedback therapy. Quantitative electroencephalogric (EEG) measures indicate a normalisation of EEG markers relating to trauma, including overarousal at rest and working memory function. Conclusions Neurofeedback as an adjunct to trauma-informed therapy may help to remediate chronic PTSD relating to refugee experiences. If replicated then improvements demonstrated in this population would be generalisable to all chronic PTSD.

Are Simulation Stethoscopes a Useful Adjunct for Emergency Residents' Training on High-fidelity Mannequins?

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Warrington, Steven J; Beeson, Michael S; Fire, Frank L

2013-05-01

Emergency medicine residents use simulation training for many reasons, such as gaining experience with critically ill patients and becoming familiar with disease processes. Residents frequently criticize simulation training using current high-fidelity mannequins due to the poor quality of physical exam findings present, such as auscultatory findings, as it may lead them down an alternate diagnostic or therapeutic pathway. Recently wireless remote programmed stethoscopes (simulation stethoscopes) have been developed that allow wireless transmission of any sound to a stethoscope receiver, which improves the fidelity of a physical examination and the simulation case. Following institutional review committee approval, 14 PGY1-3 emergency medicine residents were assessed during 2 simulation-based cases using pre-defined scoring anchors on multiple actions, such as communication skills and treatment decisions (Appendix 1). Each case involved a patient presenting with dyspnea requiring management based off physical examination findings. One case was a patient with exacerbation of heart failure, while the other was a patient with a tension pneumothorax. Each resident was randomized into a case associated with the simulation stethoscope. Following the cases residents were asked to fill out an evaluation questionnaire. Residents perceived the most realistic physical exam findings on those associated with the case using the simulation stethoscope (13/14, 93%). Residents also preferred the simulation stethoscope as an adjunct to the case (13/14, 93%), and they rated the simulation stethoscope case to have significantly more realistic auscultatory findings (4.4/5 vs. 3.0/5 difference of means 1.4, p=0.0007). Average scores of residents were significantly better in the simulation stethoscope-associated case (2.5/3 vs. 2.3/3 difference of means 0.2, p=0.04). There was no considerable difference in the total time taken per case. A simulation stethoscope may be a useful adjunct to

Effect of Adjunctive Thrombus Aspiration on In-Hospital and 3-Year Outcomes in Patients With ST-Segment Elevation Myocardial Infarction and Large Native Coronary Artery Thrombus Burden.

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Keskin, Muhammed; Kaya, Adnan; Tatlısu, Mustafa Adem; Uzman, Osman; Börklü, Edibe Betül; Çinier, Göksel; Tekkeşin, Ahmet İlker; Türkkan, Ceyhan; Hayıroğlu, Mert İlker; Kozan, Ömer

2017-11-15

Although the long-term clinical benefit of adjunctive thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) remains controversial, the impact of TA in patients with large thrombus has not been evaluated. The aim of the present study was to investigate the effect of adjunctive TA during PPCI on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and a large thrombus. We assessed the effect of adjunctive TA on in-hospital and 3-year clinical outcomes in 627 patients with STEMI and a large thrombus in the native coronary artery. The cumulative 3-year incidence of all-cause death was not significantly different between the 2 groups (91.5% vs 89.0%, log-rank test p = 0.347). After adjusting for confounders, the risk of all-cause death in the TA group was not significantly lower than that in the non-TA group (hazard ratio 1.11, 95% confidence interval 0.60 to 3.54, p = 0.674). The adjusted risks of target lesion revascularization, nonfatal acute myocardial infarction, and stent thrombosis were also not significantly different between the 2 groups. In conclusion, adjunctive TA during PPCI was not associated with better in-hospital and 3-year all-cause deaths in patients with STEMI and a large coronary artery thrombus. Copyright © 2017 Elsevier Inc. All rights reserved.

Hypnotherapy: A useful adjunctive therapeutic modality in hansen′s disease

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E N Abdul Latheef

2014-01-01

Full Text Available Hypnotherapy is a useful adjunctive psychotherapeutic procedure used in various conditions such as pain disorders, atopic dermatitis, and alopecia areata. However, it is less utilized in the field of dermatology. Only limited data exist on its role in the management of various skin diseases. There is dearth of literature on the role of hypnotherapy in Hansen′s disease (HD. We report two cases of HD, one with very resistant neuralgia and the other with recurrent erythema nodosum leprosum (ENL. Both the patients were assessed using hospital anxiety and depression scale, dermatology life quality index and the neuralgia was assessed using the visual analog scale. Three sessions of hypnotherapy were given to both the patients. There was dramatic improvement in the incidence of ENL and neuralgia and we could rapidly reduce the dose of drugs used for both conditions.

Low-Dose Ketamine Infusion for Adjunct Management during Vaso-occlusive Episodes in Adults with Sickle Cell Disease: A Case Series.

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Palm, Nicole; Floroff, Catherine; Hassig, Tanna B; Boylan, Alice; Kanter, Julie

2018-05-23

The optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD. This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs). Patients were treated with a continuous-infusion of low-dose ketamine (up to 5 µg/kg/min) after insufficient pain control with opioid analgesic therapy. Outcomes studied included impact on opioid analgesic use, a description of ketamine dosing strategy, and an analysis of adverse events due to opioid or ketamine analgesia. Descriptive statistics are provided. During ketamine infusion, patients experienced a lower reported pain score (mean numeric rating scale [NRS] score 7.2 vs. 6.4), reduced opioid-induced adverse effects, and decreased opioid dosing requirements (median reduction of 90 mg morphine equivalents per patient). The average duration of severe pain during admission prior to ketamine therapy was 8 days. Only one of five patients reported an adverse effect (vivid dreams) secondary to ketamine infusion. The Richmond Agitation Sedation Scale (RASS) was assessed throughout therapy, with only one patient experiencing light drowsiness. Low-dose ketamine infusion may be considered as an adjunct analgesic agent in patients with vaso-occlusive episodes who report continued severe pain despite high-dose opioid therapy, particularly those experiencing opioid-induced adverse effects.

Transient mitral regurgitation: An adjunctive sign of myocardial ischemia during dipyridamole-thallium imaging

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Lette, J.; Gagnon, A.; Lapointe, J.; Cerino, M.

1989-01-01

A patient developed transient exacerbation of a mitral insufficiency murmur and a reversible posterior wall perfusion defect during dipyridamole-thallium imaging. Coronary angiography showed significant stenoses of both the right and the circumflex coronary arteries that supply the posterior papillary muscle. Cardiac auscultation for transient mitral incompetence, a sign of reversible papillary muscle dysfunction, is a simple and practical adjunctive test for myocardial ischemia during dipyridamole-thallium imaging. It may confirm that an isolated reversible posterior wall myocardial perfusion defect is truly ischemic in nature as opposed to an artifact resulting from attenuation by the diaphragm

Omentalisation as adjunctive treatment of an infected femoral nonunion fracture: a case report

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McAlinden A

2009-10-01

Full Text Available Abstract A three-year-old male working border collie with an infected femoral nonunion fracture was managed in a two-stage procedure involving debridement and omentalisation, followed by stabilisation with a bone plate and an autogenous cancellous bone graft. Osseous union was documented radiographically 16 weeks after surgery. Telephone follow-up one year later revealed the dog had returned to full working function without evidence of lameness. To the authors' knowledge, this is the first clinical case described in the veterinary literature using omentalisation as an adjunct to the management of an infected, biologically inactive nonunion fracture.

Adjunct effect of music therapy on cognition in Alzheimer’s disease in Taiwan: a pilot study

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Li CH

2015-02-01

Full Text Available Chien-Hsun Li,1–3 Ching-Kuan Liu,2,3 Yuan-Han Yang,2–4 Mei-Chuan Chou,2,4 Chun-Hung Chen,2 Chiou-Lian Lai2,3 1Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; 2Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 3Department of and Master’s Program in Neurology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan Purpose: Music therapy (MT reviews have found beneficial effects on behaviors and social interaction in Alzheimer’s disease (AD but inconsistent effects on cognition. The purpose of the study was to evaluate the adjunct effect of long-term and home-based MT in AD patients under pharmacological treatment. Patients and methods: Mild AD cases (clinical dementia rating =0.5~1 were consecutively recruited and voluntarily separated into an MT group or control group (CG for 6 months. Outcome assessments included Cognitive Abilities Screening Instrument (CASI, CASI-estimated mini-mental state examination, clinical dementia rating with sum of box scores, and neuropsychiatric inventory. The MT interventions were Mozart’s Sonata (KV 448 and Pachelbel’s Canon, listening with headphones for 30 minutes daily in the morning and before sleep, respectively. Results: Forty-one cases (MT versus CG number =20 versus 21 were analyzed. Adjusted differences of CASI-estimated mini-mental state examination and CASI after 6 months in the MT group were slightly less decreased than the CG without statistical significance. In further analysis of cognitive domains of CASI, the adjusted difference of abstraction domain in the MT group was significantly better than the CG. Conclusion: Although there were no apparent additional benefits of this MT on the global cognition and daily functioning in mild AD patients, it confirms the adjunct

Effectiveness of traditional Chinese medicine as an adjunct therapy for Parkinson's disease: a systematic review and meta-analysis.

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Guoxin Zhang

Full Text Available Idiopathic Parkinson disease (PD is a common neurodegenerative disease that seriously hinders limb activities and affects patients' lives. We performed a meta-analysis aiming to systematically review and quantitatively synthesize the efficacy and safety of traditional Chinese medicine (TCM as an adjunct therapy for clinical PD patients.An electronic search was conducted in PubMed, Cochrane Controlled Trials Register, China National Knowledge Infrastructure, Chinese Scientific Journals Database and Wanfang data to identify randomized trials evaluating TCM adjuvant therapy versus conventional treatment. The change from baseline of the Unified Parkinson's Disease Rating Scale score (UPDRS was used to estimate the effectiveness of the therapies.Twenty-seven articles involving 2314 patients from 1999 to 2013 were included. Potentially marked improvements were shown in UPDRS I (SMD 0.68, 95%CI 0.38, 0.98, II (WMD 2.41, 95%CI 1.66, 2.62, III (WMD 2.45, 95%CI 2.03, 2.86, IV (WMD 0.32, 95%CI 0.15, 049 and I-IV total scores (WMD 6.18, 95%CI 5.06, 7.31 in patients with TCM plus dopamine replacement therapy (DRT compared to DRT alone. Acupuncture add-on therapy was markedly beneficial for improving the UPDRS I-IV total score of PD patients (WMD 10.96, 95%CI 5.85, 16.07. However, TCM monotherapy did not improve the score. The effectiveness seemed to be more obvious in PD patients with longer adjunct durations. TCM adjuvant therapy was generally safe and well tolerated.Although the data were limited by methodological flaws in many studies, the evidence indicates the potential superiority of TCM as an alternative therapeutic for PD treatment and justifies further high-quality studies.

Soil bacterial and fungal community successions under the stress of chlorpyrifos application and molecular characterization of chlorpyrifos-degrading isolates using ERIC-PCR*

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Chen, Lie-zhong; Li, Yan-li; Yu, Yun-long

2014-01-01

Chlorpyrifos is a widely used insecticide in recent years, and it will produce adverse effects on soil when applied on crops or mixed with soil. In this study, nested polymerase chain reaction (PCR) and denaturing gradient gel electrophoresis (DGGE) were combined to explore the bacterial and fungal community successions in soil treated with 5 and 20 mg/kg of chlorpyrifos. Furthermore, isolates capable of efficiently decomposing chlorpyrifos were molecular-typed using enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR). Under the experimental conditions, degradation of chlorpyrifos in soil was interpreted with the first-order kinetics, and the half-lives of chlorpyrifos at 5 and 20 mg/kg doses were calculated to be 8.25 and 8.29 d, respectively. DGGE fingerprint and principal component analysis (PCA) indicated that the composition of the fungal community was obviously changed with the chlorpyrifos treatment, and that samples of chlorpyrifos treatment were significantly separated from those of the control from the beginning to the end. While for the bacterial community, chlorpyrifos-treated soil samples were apparently different in the first 30 d and recovered to a similar level of the control up until 60 d, and the distance in the PCA between the chlorpyrifos-treated samples and the control was getting shorter through time and was finally clustered into one group. Together, our results demonstrated that the application of chlorpyrifos could affect the fungal community structure in a quick and lasting way, while only affecting the bacterial community in a temporary way. Finally, nine typical ERIC types of chlorpyrifos-degrading isolates were screened. PMID:24711353

Inhibitory activity of Lactobacillus plantarum LMG P-26358 against Listeria innocua when used as an adjunct starter in the manufacture of cheese

LENUS (Irish Health Repository)

2011-08-30

Abstract Lactobacillus plantarum LMG P-26358 isolated from a soft French artisanal cheese produces a potent class IIa bacteriocin with 100% homology to plantaricin 423 and bacteriocidal activity against Listeria innocua and Listeria monocytogenes. The bacteriocin was found to be highly stable at temperatures as high as 100°C and pH ranges from 1-10. While this relatively narrow spectrum bacteriocin also exhibited antimicrobial activity against species of enterococci, it did not inhibit dairy starters including lactococci and lactobacilli when tested by well diffusion assay (WDA). In order to test the suitability of Lb. plantarum LMG P-26358 as an anti-listerial adjunct with nisin-producing lactococci, laboratory-scale cheeses were manufactured. Results indicated that combining Lb. plantarum LMG P-26358 (at 108 colony forming units (cfu)\\/ml) with a nisin producer is an effective strategy to eliminate the biological indicator strain, L. innocua. Moreover, industrial-scale cheeses also demonstrated that Lb. plantarum LMG P-26358 was much more effective than the nisin producer alone for protection against the indicator. MALDI-TOF mass spectrometry confirmed the presence of plantaricin 423 and nisin in the appropriate cheeses over an 18 week ripening period. A spray-dried fermentate of Lb. plantarum LMG P-26358 also demonstrated potent anti-listerial activity in vitro using L. innocua. Overall, the results suggest that Lb. plantarum LMG P-26358 is a suitable adjunct for use with nisin-producing cultures to improve the safety and quality of dairy products.

Rehabilitation of Schizophrenia: Adjunctive Therapy of Negative Symptoms

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Saeed Shoja Shafti

2004-09-01

Full Text Available Negative symptoms in schizophrenia are among the important barriers against psychosocial rehabilitation of such patients. Adjunctive drugs can be used for reducing the severity of these symptoms. In this research we studied the efficacy of Clomipramine, Alprazolam, Citalopram, Bromocriptine, Fluoxetine, Nortriptyline, Maprotiline and Fluvoxamine, in this regard. After a primary prevalence survey regarding Negative symptoms, 170 schizophrenic patients were divided into three different groups, and then the aforesaid adjuvant drugs were examined in three double-blind clinical controlled trials. Estimation of negative symptoms by "SANS" were done at the beginning of each trial for the first time and then three weeks later, after prescription of drugs in lower dosage and finally at the end of sixth week, means three weeks after doubling the dosages. The data were analyzed by z and chi-square (X2test formula. Clomipramine, Alprazolam, Citalopram, Nortriptyline and Maprotiline could reduce the severity of negative symptoms. Their effectiveness in comparing with placebo was statistically remarkable. No important side effect or worsening of positive symptoms was seen in our samples during aforesaid trials. Conservative usage of adjuvant drugs can be an advantageous means for making rehabilitative programs more efficacious than before.

Adjunctive N-acetylcysteine in depression: exploration of interleukin-6, C-reactive protein and brain-derived neurotrophic factor.

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Hasebe, Kyoko; Gray, Laura; Bortolasci, Chiara; Panizzutti, Bruna; Mohebbi, Mohammadreza; Kidnapillai, Srisaiyini; Spolding, Briana; Walder, Ken; Berk, Michael; Malhi, Gin; Dodd, Seetal; Dean, Olivia M

2017-12-01

This study aimed to explore effects of adjunctive N-acetylcysteine (NAC) treatment on inflammatory and neurogenesis markers in unipolar depression. We embarked on a 12-week clinical trial of NAC (2000 mg/day compared with placebo) as an adjunctive treatment for unipolar depression. A follow-up visit was conducted 4 weeks following the completion of treatment. We collected serum samples at baseline and the end of the treatment phase (week 12) to determine changes in interleukin-6 (IL6), C-reactive protein (CRP) and brain-derived neurotrophic factor (BDNF) following NAC treatment. NAC treatment significantly improved depressive symptoms on the Montgomery-Asberg Depression Rating Scale (MADRS) over 16 weeks of the trial. Serum levels of IL6 were associated with reductions of MADRS scores independent of treatment response. However, we found no significant changes in IL6, CRP and BDNF levels following NAC treatment. Overall, this suggests that our results failed to support the hypothesis that IL6, CRP and BDNF are directly involved in the therapeutic mechanism of NAC in depression. IL6 may be a useful marker for future exploration of treatment response.

Influence of adjunctive classical homeopathy on global health status and subjective wellbeing in cancer patients - A pragmatic randomized controlled trial.

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Frass, Michael; Friehs, Helmut; Thallinger, Christiane; Sohal, Narinderjit Kaur; Marosi, Christine; Muchitsch, Ilse; Gaertner, Katharina; Gleiss, Andreas; Schuster, Ernst; Oberbaum, Menachem

2015-06-01

The use of complementary and alternative medicine has increased over the past decade. The aim of this study was to evaluate whether homeopathy influenced global health status and subjective wellbeing when used as an adjunct to conventional cancer therapy. In this pragmatic randomized controlled trial, 410 patients, who were treated by standard anti-neoplastic therapy, were randomized to receive or not receive classical homeopathic adjunctive therapy in addition to standard therapy. The study took place at the Medical University Vienna, Department of Medicine I, Clinical Division of Oncology. The main outcome measures were global health status and subjective wellbeing as assessed by the patients. At each of three visits (one baseline, two follow-up visits), patients filled in two different questionnaires. 373 patients yielded at least one of three measurements. The improvement of global health status between visits 1 and 3 was significantly stronger in the homeopathy group by 7.7 (95% CI 2.3-13.0, p=0.005) when compared with the control group. A significant group difference was also observed with respect to subjective wellbeing by 14.7 (95% CI 8.5-21.0, p<0.001) in favor of the homeopathic as compared with the control group. Control patients showed a significant improvement only in subjective wellbeing between their first and third visits. Results suggest that the global health status and subjective wellbeing of cancer patients improve significantly when adjunct classical homeopathic treatment is administered in addition to conventional therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

A randomized, double-blind, placebo-controlled, proof-of-concept trial of creatine monohydrate as adjunctive treatment for bipolar depression.

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Toniolo, Ricardo Alexandre; Silva, Michelle; Fernandes, Francy de Brito Ferreira; Amaral, José Antonio de Mello Siqueira; Dias, Rodrigo da Silva; Lafer, Beny

2018-02-01

Depressive episodes are a major cause of morbidity and dysfunction in individuals suffering from bipolar disorder. Currently available treatments for this condition have limited efficacy and new therapeutic options are needed. Extensive research in the pathophysiology of bipolar disorder points to the existence of mitochondrial and bioenergetic dysfunction. We hypothesized that creatine monohydrate, a nutraceutical that works as a mitochondrial modulator, would be effective as an adjunctive therapy for bipolar depression. We conducted a double-blind trial in which 35 patients with bipolar disorder type I or II in a depressive episode by DSM-IV criteria and in use of regular medication for the treatment of this phase of the disease were randomly allocated into two adjunctive treatment groups for 6 weeks: creatine monohydrate 6 g daily (N = 17) or placebo (N = 18). Primary efficacy was assessed by the change in the Montgomery-Åsberg Depression Rating Scale (MADRS). We did not find a statistically significant difference in the comparison between groups for the change in score on the MADRS after 6 weeks in an intention-to-treat (ITT) analysis (p = 0.560; Cohen's d = 0.231). However, we found significant superiority of creatine add-on vs. placebo when we considered the remission criterion of a MADRS score ≤ 12 at week 6 analyzing the outcome of the 35 randomized patients on ITT (52.9% remission in the creatine group vs. 11.1% remission in the placebo group) and of the 23 completers (66.7% remission in the creatine group vs. 18.2% remission in the placebo group) (p = 0.012; OR = 9.0 and p = 0.036; OR = 9.0, respectively). Two patients who received creatine switched to hypomania/mania early in the trial. No clinically relevant physical side-effects were reported or observed. This proof-of-concept study, aiming to restore brain bioenergetics using an adjunctive mitochondrial modulator, is not conclusive on the efficacy of creatine add-on for bipolar

Behavioral Parent Training as an Adjunct to Routine Care in Children with Attention-Deficit/Hyperactivity Disorder : Moderators of Treatment Response

NARCIS (Netherlands)

van den Hoofdakker, Barbara J.; Nauta, Maaike H.; van der Veen-Mulders, Lianne; Sytema, Sjoerd; Emmelkamp, Paul M. G.; Minderaa, Ruud B.; Hoekstra, Pieter J.

Objective To investigate predictors and moderators of outcome of behavioral parent training (BPT) as adjunct to ongoing routine clinical care (RCC), versus RCC alone. Methods We randomly assigned 94 referred children (4-12 years) with attention-deficit/hyperactivity disorder (ADHD) to BPT plus RCC

Polyethylene versus cotton cap as an adjunct to body wrap in preterm infants.

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Shafie, Hashim; Syed Zakaria, Syed Zulkifli; Adli, Ali; Shareena, Ishak; Rohana, Jaafar

2017-07-01

Occlusive body wrap using polyethylene plastic applied immediately after birth had been shown to reduce hypothermia among preterm infants. Various adjunct methods have been studied in an attempt to further reduce the incidence of hypothermia. This study was conducted to determine whether polyethylene cap is more effective than cotton cap as an adjunct to polyethylene occlusive body wrap in reducing hypothermia in preterm infants. The subjects consisted of preterm infants 24-34 weeks' gestation born at Universiti Kebangsaan Malaysia Medical Centre. Infants were randomly assigned to NeoCap or control groups. Infants in both groups were wrapped in polyethylene sheets from the neck downwards immediately after birth without prior drying. Infants in the control group had their heads dried and subsequently covered with cotton caps while infants in the NeoCap group had polyethylene caps put on without drying. Axillary temperature was measured on admission to the neonatal intensive care unit (NICU), and after having been stabilized in the incubator. Among the 80 infants recruited, admission hypothermia (axillary temperature <36.5°C) was present in 37 (92.5%) and in 40 (100%) in the NeoCap and control groups, respectively. There was no significant difference in mean temperature on NICU admission between the two groups (35.3 vs 35.1°C, P = 0.36). Mean post-stabilization temperature, however, was significantly higher in the NeoCap group (36.0 vs 35.5°C, P = 0.01). Combined use of polyethylene body wrap and polyethylene cap was associated with a significantly higher mean post-stabilization temperature compared with polyethylene body wrap and cotton cap. © 2017 Japan Pediatric Society.

Is adjunctive pharmacotherapy in attention-deficit/hyperactivity disorder cost-effective in Canada: a cost-effectiveness assessment of guanfacine extended-release as an adjunctive therapy to a long-acting stimulant for the treatment of ADHD.

Science.gov (United States)

Lachaine, Jean; Sikirica, Vanja; Mathurin, Karine

2016-01-16

Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder in children, with worldwide prevalence of ADHD varying from 5.9 to 7.1 %, depending on the reporter. In case of inadequate response to stimulants, combination therapy of stimulants and an adjunctive medication may improve the control of ADHD symptoms, reduce the dose-limiting adverse events, and help control comorbidities. To date, the only medication to be used for adjunctive therapy to psychostimulants is guanfacine extended release (GXR). The aim of this study was to assess the economic impact of GXR as an adjunct therapy with long-acting stimulants (GXR + stimulant) compared to long-acting stimulant monotherapy (stimulant alone) in the treatment of children and adolescents with ADHD in Canada. A Markov model was developed using health states defined based on the clinician-reported Clinical Global Impression-Severity (CGI-S) score (normal, mild, moderate, severe). Transition probabilities were calculated based on patient-level data from a published study. Long-acting stimulants available in Canada were considered in the base-case model: amphetamine mixed salts, methylphenidate HCl formulations, and lisdexamfetamine dimesylate. Analyses were conducted from a Canadian Ministry of Health (MoH; Ontario) and a societal perspective over a 1-year time horizon with weekly cycles. Over a 1-year time horizon, GXR + stimulant was associated with 0.655 quality-adjusted life year (QALY), compared to 0.627 QALY with stimulant alone, for a gain of 0.028 QALY. From a MoH perspective, GXR+ stimulant and stimulant alone were associated with total costs of $CA1,617 and $CA949, respectively (difference of $CA668), which resulted in an incremental cost-effectiveness ratio (ICER) of $CA23,720/QALY. From a societal perspective, GXR + stimulant and stimulant alone were associated with total costs of $CA3,915 and $CA3,582, respectively (difference of $CA334), which resulted in an ICER of $CA11

Meta-analysis of Huangqi injection for the adjunctive therapy of aplastic anemia

Science.gov (United States)

Zhu, Changtai; Gao, Yulu; Jiang, Ting; Hao, Cao; Gao, Zongshuai; Sun, Yongning

2015-01-01

Aplastic anemia therapy remains difficult, due to lack of effective treatment regimens. In recent years, Huangqi injection for the adjunctive therapy of aplastic anemia has been reported in many clinical trials. Considering that Huangqi injection may be a novel approach to aplastic anemia treatment, we conducted a meta-analysis of clinical controlled trials to assess the clinical value of Huangqi injection in the treatment of aplastic anemia. We searched the Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Full-text Database (VIP), Wanfang Database, PubMed and EMBASE database to collect the data about the trials of Huangqi injection combined with androgens for treating aplastic anemia. A total of ten studies involving 720 patients with aplastic anemia were included in this study. The meta-analysis showed significant increases in the pool effectiveness rate, white blood cells (WBC), haematoglobin (Hb), platelets (PLT), and reticulocytes (Ret) between the experimental group versus the control group. No severe side effects were found in this study. However, the lower Jadad scores and asymmetric funnel plot degrades the validity of the meta-analysis as the clinical evidence. Therefore, Huangqi injection may significantly enhance the efficacy of androgens for aplastic anemia, suggesting that the novel approach of Chinese traditional medicine combined with Western medicine is promising. The exact outcome required confirmation with rigorously well-designed multi-center trials. PMID:26379817

Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification: the COR-BMOD trial

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This 56-week, randomized, placebo-controlled trial examined the efficacy and safety of naltrexone plus bupropion as an adjunct to intensive behavior modification (BMOD). A total of 793 participants (BMI = 36.5 +/- 4.2 kg/m(2)) was randomly assigned in a 1:3 ratio to: (i) placebo + BMOD (N = 202); or...

Systemic antimicrobial therapy (minocycline as an adjunct to non-surgical approach to recurrent chronic generalized gingival hyperplasia

Directory of Open Access Journals (Sweden)

Parag M Khatri

2014-01-01

Full Text Available Systemic antibiotic treatment has emerged as a powerful adjunct to conventional mechanical debridement for therapeutic management of the periodontal diseases. The conceptual basis for treating periodontal diseases as infections is particularly attractive in part because of substantial data indicating that these diseases may be associated with specific putative pathogens. Further, discrete groups of patients respond well to systemic antibiotics and exhibit improvement of clinical parameters, including attachment level and inflammation. This bacterial-host interaction, which is ever-so-present in periodontitis, directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report presents a case of a female patient with recurrence of the chronic generalized periodontitis with gingival enlargement, which is treated thrice by referral dentist. A through clinical examination was carried out pre-operatively and treatment was planned with systemic minocycline in conjunction with the conventional non-surgical approach. There was a significant reduction of pocket depth, gain in attachment with dramatic improvement clinically.

Systemic antimicrobial therapy (minocycline) as an adjunct to non-surgical approach to recurrent chronic generalized gingival hyperplasia.

Science.gov (United States)

Khatri, Parag M; Bacha, Shraddanand

2014-03-01

Systemic antibiotic treatment has emerged as a powerful adjunct to conventional mechanical debridement for therapeutic management of the periodontal diseases. The conceptual basis for treating periodontal diseases as infections is particularly attractive in part because of substantial data indicating that these diseases may be associated with specific putative pathogens. Further, discrete groups of patients respond well to systemic antibiotics and exhibit improvement of clinical parameters, including attachment level and inflammation. This bacterial-host interaction, which is ever-so-present in periodontitis, directs us toward utilizing antimicrobial agents along with the routine mechanical debridement. This case report presents a case of a female patient with recurrence of the chronic generalized periodontitis with gingival enlargement, which is treated thrice by referral dentist. A through clinical examination was carried out pre-operatively and treatment was planned with systemic minocycline in conjunction with the conventional non-surgical approach. There was a significant reduction of pocket depth, gain in attachment with dramatic improvement clinically.

Contrasting Complement Control, Temporal Adjunct Control and Controlled Verbal Gerund Subjects in ASD: The Role of Contextual Cues in Reference Assignment.

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Janke, Vikki; Perovic, Alexandra

2017-01-01

This study examines two complex syntactic dependencies (complement control and sentence-final temporal adjunct control) and one pragmatic dependency (controlled verbal gerund subjects) in children with ASD. Sixteen high-functioning (HFA) children (aged 6-16) with a diagnosis of autism and no language impairment, matched on age, gender and non-verbal MA to one TD control group, and on age, gender and verbal MA to another TD control group, undertook three picture-selection tasks. Task 1 measured their base-line interpretations of the empty categories ( ec ). Task 2 preceded these sentence sets with a weakly established topic cueing an alternative referent and Task 3 with a strongly established topic cueing an alternative referent. In complement control (Ron persuaded Hermione ec to kick the ball) and sentence-final temporal adjunct control (Harry tapped Luna while ec feeding the owl), the reference of the ec is argued to be related obligatorily to the object and subject respectively. In controlled verbal-gerund subjects (VGS) ( ec Rowing the boat clumsily made Luna seasick), the ec 's reference is resolved pragmatically. Referent choices across the three tasks were compared. TD children chose the object uniformly in complement control across all tasks but in adjunct control, preferences shifted toward the object in Task 3. In controlled VGSs, they exhibited a strong preference for an internal-referent interpretation in Task 1, which shifted in the direction of the cues in Tasks 2 and 3. HFA children gave a mixed performance. They patterned with their TD counterparts on complement control and controlled VGSs but performed marginally differently on adjunct control: no TD groups were influenced by the weakly established topic in Task 2 but all groups were influenced by the strongly established topic in Task 3. HFA children were less influenced than the TD children, resulting in their making fewer object choices overall but revealing parallel patterns of performance. In

Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum

OpenAIRE

Russo, Emilio; Mumoli,Laura; Palleria,Caterina; Gasparini,Sara; Citraro,Rita; Labate,Angelo; Ferlazzo,Edoardo; Gambardella,Antonio; De Sarro,Giovambattista

2015-01-01

Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum] Mumoli L, Palleria C, Gasparini S, et al. Drug Des Devel Ther. 2015;9:5719–5725.   The authors advise several errors in the paper that are corrected in Corrigendum. View the original article by Mumoli et al.

Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum

Directory of Open Access Journals (Sweden)

Mumoli L

2015-12-01

Full Text Available Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures [Corrigendum] Mumoli L, Palleria C, Gasparini S, et al. Drug Des Devel Ther. 2015;9:5719–5725.   The authors advise several errors in the paper that are corrected in Corrigendum. View the original article by Mumoli et al.

The Prerogative of "Corrective Recasts" as a Sign of Hegemony in the Use of Language: Further Thoughts on Eric Hauser's (2005) "Coding 'Corrective Recasts': The Maintenance of Meaning and More Fundamental Problems"

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Rajagopalan, Kanavillil

2006-01-01

The objective of this response article is to think through some of what I see as the far-reaching implications of a recent paper by Eric Hauser (2005) entitled "Coding 'corrective recasts': the maintenance of meaning and more fundamental problems". Hauser makes a compelling, empirically-backed case for his contention that, contrary to widespread…

Brivaracetam: review of its pharmacology and potential use as adjunctive therapy in patients with partial onset seizures.

Science.gov (United States)

Mumoli, Laura; Palleria, Caterina; Gasparini, Sara; Citraro, Rita; Labate, Angelo; Ferlazzo, Edoardo; Gambardella, Antonio; De Sarro, Giovambattista; Russo, Emilio

2015-01-01

Brivaracetam (BRV), a high-affinity synaptic vesicle protein 2A ligand, reported to be 10-30-fold more potent than levetiracetam (LEV), is highly effective in a wide range of experimental models of focal and generalized seizures. BRV and LEV similarly bind to synaptic vesicle protein 2A, while differentiating for other pharmacological effects; in fact, BRV does not inhibit high voltage Ca(2+) channels and AMPA receptors as LEV. Furthermore, BRV apparently exhibits inhibitory activity on neuronal voltage-gated sodium channels playing a role as a partial antagonist. BRV is currently waiting for approval both in the United States and the European Union as adjunctive therapy for patients with partial seizures. In patients with photosensitive epilepsy, BRV showed a dose-dependent effect in suppressing or attenuating the photoparoxysmal response. In well-controlled trials conducted to date, adjunctive BRV demonstrated efficacy and good tolerability in patients with focal epilepsy. BRV has a linear pharmacokinetic profile. BRV is extensively metabolized and excreted by urine (only 8%-11% unchanged). The metabolites of BRV are inactive, and hydrolysis of the acetamide group is the mainly involved metabolic pathway; hepatic impairment probably requires dose adjustment. BRV does not seem to influence other antiepileptic drug plasma levels. Six clinical trials have so far been completed indicating that BRV is effective in controlling seizures when used at doses between 50 and 200 mg/d. The drug is generally well-tolerated with only mild-to-moderate side effects; this is confirmed by the low discontinuation rate observed in these clinical studies. The most common side effects are related to central nervous system and include fatigue, dizziness, and somnolence; these apparently disappear during treatment. In this review, we analyzed BRV, focusing on the current evidences from experimental animal models to clinical studies with particular interest on potential use in clinical

Psychiatric and cognitive adverse events: A pooled analysis of three phase III trials of adjunctive eslicarbazepine acetate for partial-onset seizures.

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Andermann, Eva; Biton, Victor; Benbadis, Selim R; Shneker, Bassel; Shah, Aashit K; Carreño, Mar; Trinka, Eugen; Ben-Menachem, Elinor; Biraben, Arnaud; Rocha, Francisco; Gama, Helena; Cheng, Hailong; Blum, David

2018-05-01

To evaluate the nature and incidence of psychiatric and cognitive adverse events (AEs) reported with eslicarbazepine acetate (ESL) used as adjunctive treatment for refractory partial-onset seizures (POS) in adults. This was a post-hoc analysis of data pooled from three randomized double-blind, placebo-controlled trials (BIA-2093-301, -302, -304). After an 8-week baseline period, patients received placebo or adjunctive ESL 400mg (studies 301 and 302 only), 800mg, or 1200mg once daily (QD) for 14weeks (2-week titration period, 12-week maintenance period). Psychiatric and cognitive AEs were identified from individual patient data. Suicidality was also evaluated using the Columbia-Classification Algorithm of Suicide Assessment (C-CASA), or the Columbia-Suicide Severity Rating Scale (C-SSRS). P-values were obtained using the chi-square test of independence or Fisher's exact test, without correcting for multiplicity. The analysis population included 1447 patients (ESL, n=1021; placebo, n = 426). Psychiatric treatment-emergent AEs (TEAEs) occurred in 10.8% of patients receiving ESL, and in a comparable proportion (10.3%) of patients receiving placebo (p=0.802). The incidence of depression and suicidality-related TEAEs was higher for ESL (7.4%) vs. placebo (3.8%) (p=0.009). The occurrence of these TEAEs differed between treatment groups (p = 0.010), but there was no notable trend between increasing ESL dose and increasing incidence of depression and suicidality-related TEAEs. Aggression/hostility-related TEAEs occurred in ESL vs. 0.9% taking placebo. The incidence of cognitive TEAEs was higher for ESL (7.1%) vs. placebo (4.0%) (p=0.023); incidences of memory impairment, attention disturbance, apathy, and aphasia were higher for ESL 1200mg than for other treatment groups. Incidences of psychiatric and cognitive serious AEs (SAEs) were 0.6% and 0.2% with ESL, and 0.5% and 0% with placebo, respectively. Psychiatric and cognitive TEAEs leading to discontinuation occurred in 1

Clinical efficacy of photodynamic therapy adjunctive to scaling and root planing in the treatment of chronic periodontitis: A systematic review and meta-analysis.

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Xue, Dong; Tang, Lu; Bai, Yuhao; Ding, Qian; Wang, Pengcheng; Zhao, Ying

2017-06-01

To evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planing (SRP) in patients with untreated chronic periodontitis based on up-to-date evidence. MEDLINE and the Cochrane Library were systematically searched to identify eligible randomized controlled trials (RCTs), supplemented by a manual literature search. Mean differences (MD) and the corresponding 95% confidence intervals (CI) of probing depth (PD) reduction and clinical attachment level (CAL) gain were synthesized. The I 2 test and Q statistics were used to determine the inter-study heterogeneity. Subgroup analysis based on smoking status was performed. Eleven RCTs with a total of 243 subjects were included. Significant improvement in PD reduction (MD=0.13, CI:0.02-0.24, p=0.02) and marginal significant improvement in CAL gain (MD=0.18, CI:-0.005-0.363, p=0.056) were observed in favor of SRP+PDT at 3months. When evaluated at 6months after baseline, the association of PDT with SRP resulted in a significant benefit in PD reduction (MD=0.40, CI:0.05-0.74, p=0.03), but not in CAL gain (MD=0.37, CI:-0.18-0.93, p=0.18). Subgroup analysis revealed that the combined therapy produced no significant improvements in PD and CAL at neither 3months nor 6months for studies with smokers. No treatment-related adverse events or side effects had been reported by the included studies. Pooled analysis suggests a short-term benefit of PDT as an adjunct to SRP in clinical outcome variables. However, evidence regarding its long-term efficacy is still insufficient and no significant effect has been confirmed in terms of CAL gain at 6months. Future clinical trials of high methodological quality are needed to establish the optimal combination of photosensitizer and laser configuration. Copyright © 2017 Elsevier B.V. All rights reserved.

Are Simulation Stethoscopes a Useful Adjunct for Emergency Residents' Training on High-Fidelity Mannequins?

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Steven J Warrington

2013-05-01

.Conclusion: A simulation stethoscope may be a useful adjunct to current emergency medicine simulation-based training. Residents both preferred the use of the simulation stethoscope and perceived physical exam findings to be more realistic, leading to improved fidelity. Potential sources of bias include the small population, narrow scoring range, and the lack of blinding. Further research, focusing on use for resident assessment and clinical significance with a larger population and blinding of graders, is needed. [West J Emerg Med. 2013;14(3:275–277.

Teaching the skills that enable employees to manage change at Syncrude Canada Ltd. : case study March 2005

Energy Technology Data Exchange (ETDEWEB)

Kitagawa, K.

2005-03-01

Details of Syncrude's Effective Reading in Context (ERIC) workplace literacy program were presented as part of a series of case studies addressing best practices in the development of essential skills in the workplace. ERIC was designed to enhance supervisors' key essential skills, including reading comprehension, writing and the ability to deal with organizational changes and technological advances. Due to its success, Syncrude now offers ERIC to all of its employees and has made it available to a variety of businesses and institutions across Canada. ERIC was implemented due to a shortage of skilled workers, and concerns that a lack of essential skills in the workforce was affecting productivity. ERIC is delivered in 2 phases: a curriculum adaptation phase and a pilot workshop phase where the skills of all participants are assessed individually. Participants are given samples of printed materials they regularly encounter in their jobs. They are then assessed on how well they can generalize, synthesize and analyze the material. Program evaluations are reviewed to ensure that participants can transfer learned skills into new areas, including work tasks. It costs between $6000 and $12,000 to adapt ERIC for a specific workplace. Details of instructor training methods and course manuals were presented. Over the past 16 years, 6 large industry partners and 9 educational partners have been involved in the delivery of ERIC, which has been adapted to a variety of settings, including an Aboriginal pre-trades program at Keyano College. It was concluded that the implementation of ERIC in organizations has led to increased productivity and a decrease in work-related incidents. The Syncrude Essential Skills training program has now been expanded to include a math and writing component.

The effect of cetylpyridinium chloride-containing mouth rinses as adjuncts to toothbrushing on plaque and parameters of gingival inflammation: a systematic review

NARCIS (Netherlands)

Haps, S.; Slot, D.E.; Berchier, C.E.; van der Weijden, G.A.

2008-01-01

Objective: To review the literature concerning cetylpyridinium chloride (CPC) containing mouth rinses as effective adjuncts to toothbrushing in the prevention of plaque accumulation and gingival inflammation. Materials and methods: Medline and the Cochrane Central Register of Controlled Trials were

Behavioral outcome effects of serious gaming as an adjunct to treatment for children with Attention-Deficit/Hyperactivity Disorder : a randomized controlled trial

NARCIS (Netherlands)

K.C.M. Bul (Kim); P.M. Kato (Pamela M.); S. Van Der Oord (Saskia); M. Danckaerts (Marina); L.J. Vreeke (Leonie); A. Willems (Annik); H.J.J. Van Oers (Helga J.J.); R. Van Den Heuvel (Ria); D. Birnie (Derk); T.A.M.J. van Amelsvoort (Therese); I.H.A. Franken (Ingmar); A. Maras (Athanasios)

2016-01-01

markdownabstract__Background:__ The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called "Plan-It Commander") as an adjunct to treatment as usual for children with

Efficacy and safety of rasagiline as an adjunct to levodopa treatment in Chinese patients with Parkinson's disease: a randomized, double-blind, parallel-controlled, multi-centre trial.

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Zhang, Lina; Zhang, Zhiqin; Chen, Yangmei; Qin, Xinyue; Zhou, Huadong; Zhang, Chaodong; Sun, Hongbin; Tang, Ronghua; Zheng, Jinou; Yi, Lin; Deng, Liying; Li, Jinfang

2013-08-01

Rasagiline mesylate is a highly potent, selective and irreversible monoamine oxidase type B (MAOB) inhibitor and is effective as monotherapy or adjunct to levodopa for patients with Parkinson's disease (PD). However, few studies have evaluated the efficacy and safety of rasagiline in the Chinese population. This study was designed to investigate the safety and efficacy of rasagiline as adjunctive therapy to levodopa treatment in Chinese PD patients. This was a randomized, double-blind, placebo-controlled, parallel-group, multi-centre trial conducted over a 12-wk period that enrolled 244 PD patients with motor fluctuations. Participants were randomly assigned to oral rasagiline mesylate (1 mg) or placebo, once daily. Altogether, 219 patients completed the trial. Rasagiline showed significantly greater efficacy compared with placebo. During the treatment period, the primary efficacy variable--mean adjusted total daily off time--decreased from baseline by 1.7 h in patients treated with 1.0 mg/d rasagiline compared to placebo (p rasagiline treatment. Rasagiline was well tolerated. This study demonstrated that rasagiline mesylate is effective and well tolerated as an adjunct to levodopa treatment in Chinese PD patients with fluctuations.

Translating G-CSF as an Adjunct Therapy to Stem Cell Transplantation for Stroke.

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Peña, Ike dela; Borlongan, Cesar V

2015-12-01

Among recently investigated stroke therapies, stem cell treatment holds great promise by virtue of their putative ability to replace lost cells, promote endogenous neurogenesis,and produce behavioral and functional improvement through their "bystander effects." Translating stem cell in the clinic, however, presents a number of technical difficulties. A strategy suggested to enhance therapeutic utility of stem cells is combination therapy, i.e., co-transplantation of stem cells or adjunct treatment with pharmacological agents and substrates,which is assumed to produce more profound therapeutic benefits by circumventing limitations of individual treatments and facilitating complementary brain repair processes. We previously demonstrated enhanced functional effects of cotreatment with granulocyte-colony stimulating factor (GCSF)and human umbilical cord blood cell (hUCB) transplantation in animal models of traumatic brain injury (TBI). Here,we suggest that the aforementioned combination therapy may also produce synergistic effects in stroke. Accordingly, G-CSF treatment may reduce expression of pro-inflammatory cytokines and enhance neurogenesis rendering a receptive microenvironment for hUCB engraftment. Adjunct treatment of GCSF with hUCB may facilitate stemness maintenance and guide neural lineage commitment of hUCB cells. Moreover, regenerative mechanisms afforded by G-CSF-mobilized endogenous stem cells, secretion of growth factors by hUCB grafts and G-CSF-recruited endothelial progenitor cells(EPCs), as well as the potential graft–host integration that may promote synaptic circuitry re-establishment could altogether produce more pronounced functional improvement in stroked rats subjected to a combination G-CSF treatment and hUCB transplantation. Nevertheless, differences in pathology and repair processes underlying TBI and stroke deserve consideration when testing the effects of combinatorial G-CSF and hUCB cell transplantation for stroke treatment. Further

Evaluation of the efficacy of adjunctive lamotrigine in the treatment of epilepsy and depression with Meta-analysis

Directory of Open Access Journals (Sweden)

Juan CAO

2016-01-01

Full Text Available Objective To evaluate the efficacy of adjunctive lamotrigine in the treatment of patients with epilepsy and comorbid depressive symptoms. Methods Relevant clinical trials were searched via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL, China National Knowledge Infrastructure (CNKI and Wanfang Data from January 1998 to June 2014 using the following retrieval words: lamotrigine, epilepsy and depressive both in Chinese and English. The Cochrane Handbook for Systematic Reviews of Interventions (Version 5.0.2 was used to evaluate the quality of randomized controlled trials (RCTs. Two reviewers independently evaluated the quality of included articles and abstracted the data. Meta-analysis was conducted using RevMan 5.1.1 software. Results According to the inclusion criteria, 3 prospective clinical trials with a total of 668 patients were finally selected. The Meta-analysis showed the Beck Depression Inventory-Ⅱ (BDI-Ⅱ score (MD = - 8.400, 95%CI: - 10.890— - 5.920; P = 0.000, Cornell Dysthymia Rating Scale (CDRS score (MD = - 8.240, 95% CI: - 11.180— - 5.290; P = 0.000 and Profile of Mood States (POMS score (MD = - 24.210, 95%CI: - 30.740— - 17.680; P = 0.000 in lamotrigine group were significantly improved compared to those in control group. As for 6 mood states in POMS, the scores of tension-anxiety (MD = - 3.360, 95%CI: - 4.620— - 2.100; P = 0.000, depression-dejection (MD = - 5.490, 95%CI: - 7.420— - 3.560; P = 0.000, anger-hostility (MD = - 3.870, 95%CI: - 5.510— - 2.230; P = 0.000, fatigue-inertia (MD = - 4.480, 95%CI: - 5.630— - 3.320; P = 0.000, confusion-bewilderment (MD = - 2.720, 95%CI: - 3.730— - 1.720; P = 0.000 in lamotrigine group were all significantly lower than those in control group, while the score of vigor-activity (MD = 3.970, 95% CI: 2.870-5.070; P = 0.000 was significantly higher than that in control group. Conclusions The effect of adjunctive lamotrigine in the

Adjunctive cryotherapy for pigmentary keratitis in dogs: a study of 16 corneas.

Science.gov (United States)

Azoulay, Thierry

2014-07-01

To assess whether soft cryotherapy (dimethylether, isobutene, and propane) can remove pigmentation of the cornea that has accumulated under different conditions when conventional therapy has been unsuccessful. Nine dogs with unilateral or bilateral corneal pigmentation (16 eyes) were included based on progressive corneal pigmentation that was unresponsive to long-term etiological treatment. The dogs had keratoconjunctivitis sicca or chronic superficial keratitis. A cryogen of 95% dimethylether, 3% isobutane, and 2% propane was applied to the pigmented areas of each cornea under anesthesia. Initial corneal pigmentation and changes were documented over the entire study period using a grading scheme and clinical photographs. Most of the pigment deposits were gone by 5-15 days after cryosurgery. Postoperatively, the dogs showed some corneal edema and corneo-conjunctival inflammation, and three dogs had superficial corneal ulcers; these symptoms had resolved by 1 month after the procedure. Follow-up for more than 90 days was available in five dogs (nine corneas), and we observed total or partial repigmentation when the underlying disease was not controlled. A new cryotherapy procedure was successfully performed in two of these dogs. Given the sensitivity to cold of melanocytes, cryotherapy is a viable adjunctive treatment for refractory severe corneal pigmentation. Etiological treatment remains necessary to prevent pigmentation from rapidly reappearing. Only a few dogs were followed for more than 90 days; further study is necessary to evaluate the long-term safety and efficacy of soft cryotherapy. © 2013 American College of Veterinary Ophthalmologists.

Benefits of music therapy as an adjunct to chest physiotherapy in infants and toddlers with cystic fibrosis.

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Grasso, M C; Button, B M; Allison, D J; Sawyer, S M

2000-05-01

Routine chest physiotherapy (CPT) is an important component of prophylactic therapy in children with cystic fibrosis (CF) and requires a significant commitment of time and energy. It is important, therefore, to establish CPT as a positive experience. In this study, we evaluated the effect of recorded music as an adjunct to CPT. Specifically, we compared the use of newly composed music, familiar music, and the family's usual routine on children's and parents' enjoyment of CPT and the parents' perception of time taken to complete CPT. Enjoyment and perception of time were evaluated via questionnaires designed specifically for this study. Participants were caregivers of one or more children with CF who were aged between 4(1/2) months and 24 months at the commencement of the clinical trial and required CPT on a daily basis. Participants were randomly allocated into control and treatment groups. Control group participants experienced two conditions consecutively: no audiotape (NT; control) and familiar music tape (FT; placebo control). Treatment group participants were given the treatment music tape (TT), which was composed and compiled by a music therapist. After baseline assessment, evaluation occurred at two 6-weekly intervals. Children's enjoyment increased significantly after use of the TT (+1. 25 units) compared to NT (-0.5 units; P = 0.03), as did parents' enjoyment (+1.0 vs. 0.0 units, P = 0.02). Children's enjoyment did not change significantly after use of the FT (+0.75 units) compared to NT (n.s.). Likewise, parents' enjoyment did not change significantly after use of the FT (+1.0 units, n.s.). There was no change in perception of time after use of the TT (-4.5 vs. +0.2 min, n.s.) or the FT (+3.3 min, n.s.). These results indicate that children's and parents' enjoyment of CPT significantly increased after the use of specifically composed and recorded music as an adjunct. We therefore recommend that recorded music, such as that provided in this study, be given

Antimicrobial photodynamic therapy as an adjunct for treatment of deep carious lesions-A systematic review.

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Cieplik, Fabian; Buchalla, Wolfgang; Hellwig, Elmar; Al-Ahmad, Ali; Hiller, Karl-Anton; Maisch, Tim; Karygianni, Lamprini

2017-06-01

For deep carious lesions, a more conservative treatment modality ("selective caries removal") has been proposed, where only the heavily contaminated dentine is removed. In this regard, effective adjuncts for cavity disinfection such as the antimicrobial photodynamic therapy (aPDT) can be valuable clinically prior to definitive restoration. Therefore, the aim of this study was to systematically assess clinical studies on the effectiveness of aPDT as a supplementary tool in the treatment of deep caries lesions. Searches were performed in four databases (PubMed, EMBASE, ISI Web of Science, ClinicalTrials.gov) from 1st January, 2011 until 21st June, 2016 for search terms relevant to the observed parameters, pathological condition, intervention and anatomic entity. The pooled information was evaluated according to PRISMA guidelines. At first, 1651 articles were recovered, of which 1249 full-text articles were evaluated, 270 articles thereof were reviewed for eligibility and finally 6 articles met all inclusion criteria. The aPDT protocols involved Methylene Blue, Toluidine Blue and aluminium-chloride-phthalocyanine as photosensitizers and diode lasers, light-emitting diodes and halogen light-sources. The data from five reports, utilizing both culture-dependent and -independent methods, disclosed significant reduction of cariogenic bacterial load after mechanical caries removal with adjunct aPDT. As these studies exhibit some methodological limitations, e.g. lack of positive controls, this systematic review can support the application of aPDT to a limited extent only in terms of reducing the microbial load in deep carious lesions before restorative treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Behavioral outcome effects of serious gaming as an adjunct to treatment for children with attention-deficit/hyperactivity disorder: a randomized controlled trial.

NARCIS (Netherlands)

Bul, K.C.M.; Kato, P.M.; Van der Oord, S.; Danckaerts, M.; Vreeke, L.J.; Willems, A.; van Oers, H.J.J.; Van Den Heuvel, R.; Birnie, D.; Van Amelsvoort, T.A.M.J.; Franken, I.H.A.; Maras, A.

2016-01-01

Background: The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called “Plan-It Commander”) as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder (ADHD).

Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

NARCIS (Netherlands)

Bul, Kim Cm; Kato, Pamela M; Van Der Oord, Saskia; Danckaerts, Marina; Vreeke, Leonie J; Willems, Annik; Van Oers, Helga Jj; Van Den Heuvel, Ria; Birnie, Derk; Van Amelsvoort, Thérèse Amj; Franken, Ingmar Ha; Maras, Athanasios

Background: The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called “Plan-It Commander”) as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder (ADHD).

The plant-based immunomodulator curcumin as a potential candidate for the development of an adjunctive therapy for cerebral malaria

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Taramelli Donatella

2011-03-01

Full Text Available Abstract The clinical manifestations of cerebral malaria (CM are well correlated with underlying major pathophysiological events occurring during an acute malaria infection, the most important of which, is the adherence of parasitized erythrocytes to endothelial cells ultimately leading to sequestration and obstruction of brain capillaries. The consequent reduction in blood flow, leads to cerebral hypoxia, localized inflammation and release of neurotoxic molecules and inflammatory cytokines by the endothelium. The pharmacological regulation of these immunopathological processes by immunomodulatory molecules may potentially benefit the management of this severe complication. Adjunctive therapy of CM patients with an appropriate immunomodulatory compound possessing even moderate anti-malarial activity with the capacity to down regulate excess production of proinflammatory cytokines and expression of adhesion molecules, could potentially reverse cytoadherence, improve survival and prevent neurological sequelae. Current major drug discovery programmes are mainly focused on novel parasite targets and mechanisms of action. However, the discovery of compounds targeting the host remains a largely unexplored but attractive area of drug discovery research for the treatment of CM. This review discusses the properties of the plant immune-modifier curcumin and its potential as an adjunctive therapy for the management of this complication.

Do Women With Breast Cancer Who Choose Adjunctive Integrative Oncology Care Receive Different Standard Oncologic Treatment?

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Standish, Leanna J; Dowd, Fred; Sweet, Erin; Dale, Linda; Andersen, M Robyn

2018-04-01

To determine if women with breast cancer who choose adjunctive naturopathic oncology (NO) specialty care receive different standard oncologic treatment when compared with breast cancer patients who receive only standard care. Women with breast cancer stages 0 to 4, aged 18+ who spoke English and sought care from outpatient naturopathic doctor clinics were enrolled in an observational study of clinical and quality of life outcomes. Women who sought NO care 2 or more times within the first 2 years postdiagnosis were identified as NO cases. A matched comparison group of breast cancer patients were identified using the Western Washington Cancer Surveillance System(CSS). A longitudinal cohort design. In addition to self-report data, the CSS provided data on demographics, stage at the time of diagnosis, and initial treatment. Oncology medical records were abstracted in order to provide additional information on standard oncologic treatment for all participants. Cohorts were well matched with regard to demographic, histologic, and prognostic indicators at the time of diagnosis. Approximately 70% of women in both cohorts received standard oncologic care that met the National Comprehensive Cancer Network guidelines. There were no statistically significant differences between the cohorts in treatment received. Fewer women in the NO cohort with estrogen receptor-positive breast cancer appear to have received antiestrogen therapy. Women in both cohorts appear to receive guideline-concordant care. However, women who receive adjunctive NO care may be less likely to receive antiestrogen therapy.

Partial Tenon’s capsule resection with adjunctive mitomycin C in Ahmed glaucoma valve implant surgery

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Susanna, R

2003-01-01

Aim: To verify if partial intraoperative Tenon’s capsule resection (PTCR) with adjunctive mitomycin C is effective in developing thin, avascular blebs in eyes undergoing Ahmed glaucoma valve insertion, and to assess the efficacy and safety of this procedure. Methods: A multicentre, prospective, alternating case assignment, investigator unmasked, parallel group, comparative interventional study was conducted in four Latin American countries (Argentina, Brazil, Colombia, and Peru). Ahmed glaucoma valve implant insertion with PTCR (group A) and without PCTR (group B) was performed in neovascular glaucomatous eyes without previous surgery. Adjunctive mitomycin C (MMC) was used in both groups. Patients were examined 1 day, 10 days, 1 month, 2 months, 3 months, 6 months, and 1 year following the surgery. Intraocular pressure (IOP) and the appearance of the bleb were evaluated at each examination. Appearance of the bleb was classified at both the 1 month mark and last examinations into one of three groups: flat and vascularised; elevated avascular; or elevated and not avascular. Results: 92 eyes from 92 patients were included in the study. The preoperative mean IOP was 50.0 (SD 10.5) mm Hg in group A and 48.4 (11.7) in group B (p>0.05). Statistically significant IOP reductions were observed at all periods of follow up. 12 months after surgery, the mean IOP was 17.2 (5.0) mm Hg in group A and 18.3 (8.7) mm Hg in group B (p>0.05). A hypertensive phase occurred in 40.0% in group A and in 46.8% in group B (p>0.05). At the 1 month and the final follow up, the blebs in all eyes were considered elevated and not avascular. The success rate (IOP⩽21 mm Hg) at 1 year after surgery was 70.4% in group A and 77.7% in group B (p>0.05). Overall, 74.2% of the patients achieved an IOP ⩽21 mm Hg and 55.2% an IOP⩽17 mm Hg, with or without additional medication administered to lower IOP. The incidence of complications was similar in both groups. Conclusions: In eyes undergoing Ahmed

The use of multimedia as an adjunct to the informed consent process for Morton's neuroma resection surgery.

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Wang, Calvin; Ammon, Peter; Beischer, Andrew D

2014-10-01

The purpose of this study was to assess if a computer-based multimedia education module (MEM) improved patients' comprehension when used as an adjunct to the standard verbal consent process for Morton's neuroma resection surgery. Nineteen patients (15 females and 4 males) considered candidates for Morton's neuroma resection surgery were prospectively recruited. A standardized verbal discussion was had with each patient regarding risks and benefits of surgery, alternative treatments, and the usual postoperative course. Patient understanding was then assessed with a questionnaire. Each patient subsequently viewed the MEM and the questionnaire was repeated. Patients also rated ease of understanding and satisfaction with both methods of patient education. Patients answered a significantly greater proportion of correct answers after viewing the MEM module (85%), compared to verbal discussion alone (61%) (P = .002). Patients rated both the ease of understanding of the module and amount of information provided by the module as a mean of 9.3 cm on a 10 cm Visual Analog Scale (VAS). The majority of patients (76%) rated the multimedia tool as having answered their questions about surgery as well or better than the treating surgeon. An interactive multimedia educational tool was a useful adjunct to the informed consent process for patients considering Morton's neuroma resection surgery. Level II, prospective cohort study. © The Author(s) 2014.

Teachers at Heart: A Case Study Exploration of the Role Transition from Clinical Nurse to Community College Adjunct Clinical Nursing Instructor

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Wilson, Deborah S.

2017-01-01

The shortage of nursing faculty is limiting the number of students community colleges are able to enroll (National League for Nursing, 2014). The use of adjunct clinical nursing instructors may help lessen the impact of this shortage, while allowing nurses to gain valuable academic experience. An understanding of the process these nurses go…

Reaction-Based Reactive Transport Modeling of Iron Reduction and Uranium Immobilization at Area 2 of the NABIR Field Research Center, Subproject to Co-PI Eric E. Roden. Final Report

International Nuclear Information System (INIS)

Roden, Eric E.

2011-01-01

This report summarizes research conducted in conjunction with a project entitled 'Reaction-Based Reactive Transport Modeling of Iron Reduction and Uranium Immobilization at Area 2 of the NABIR Field Research Center', which was funded through the Integrative Studies Element of the former NABIR Program (now the Environmental Remediation Sciences Program) within the Office of Biological and Environmental Research. Dr. William Burgos (The Pennsylvania State University) was the overall PI/PD for the project, which included Brian Dempsey (Penn State), Gour-Tsyh (George) Yeh (Central Florida University), and Eric Roden (formerly at The University of Alabama, now at the University of Wisconsin) as separately-funded co-PIs. The project focused on development of a mechanistic understanding and quantitative models of coupled Fe(III)/U(VI) reduction in FRC Area 2 sediments. The work builds on our previous studies of microbial Fe(III) and U(VI) reduction, and was directly aligned with the Scheibe et al. ORNL FRC Field Project at Area 2.

The Adjunctive Role of Nutritional Therapy in the Management of Phlegmon in Two Children with Crohn’s Disease

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Andrew S. Day

2017-09-01

Full Text Available Crohn’s disease may be complicated by the development of penetrating (fistulizing or structuring complications. The presentation of an intra-abdominal phlegmon or abscess with or without an associated fistula has traditionally required surgical intervention. This series of two cases illustrates a beneficial role of non-surgical management, with parenteral and then enteral nutrition playing central roles. This report further elaborates the potential adjunctive role of enteral nutrition in the management of this complication of CD.

Smartphone Cognitive Behavioral Therapy as an Adjunct to Pharmacotherapy for Refractory Depression: Randomized Controlled Trial.

Science.gov (United States)

Mantani, Akio; Kato, Tadashi; Furukawa, Toshi A; Horikoshi, Masaru; Imai, Hissei; Hiroe, Takahiro; Chino, Bun; Funayama, Tadashi; Yonemoto, Naohiro; Zhou, Qi; Kawanishi, Nao

2017-11-03

In the treatment of major depression, antidepressants are effective but not curative. Cognitive behavioral therapy (CBT) is also effective, alone or in combination with pharmacotherapy, but accessibility is a problem. The aim is to evaluate the effectiveness of a smartphone CBT app as adjunctive therapy among patients with antidepressant-resistant major depression. A multisite, assessor-masked, parallel-group randomized controlled trial was conducted in 20 psychiatric clinics and hospitals in Japan. Participants were eligible if they had a primary diagnosis of major depression and were antidepressant-refractory after taking one or more antidepressants at an adequate dosage for four or more weeks. After a 1-week run-in in which participants started the medication switch and had access to the welcome session of the app, patients were randomized to medication switch alone or to medication switch plus smartphone CBT app via the centralized Web system. The smartphone app, called Kokoro-app ("kokoro" means "mind" in Japanese), included sessions on self-monitoring, behavioral activation, and cognitive restructuring presented by cartoon characters. The primary outcome was depression severity as assessed by masked telephone assessors with the Patient Health Questionnaire-9 (PHQ-9) at week 9. The secondary outcomes included the Beck Depression Inventory-II (BDI-II) and Frequency, Intensity, and Burden of Side Effects Ratings (FIBSER). In the total sample (N=164), 81 participants were allocated to the smartphone CBT in addition to medication change and 83 to medication change alone. In the former group, all but one participant (80/81, 99%) completed at least half, and 71 (88%) completed at least six of eight sessions. In the intention-to-treat analysis, patients allocated the CBT app scored 2.48 points (95% CI 1.23-3.72, Psmartphone app, still symptomatic, and adherent to medication with mild or less side effects after run-in), the intervention group (n=60) scored 1.72 points

Effects of copper supplement on growth and viability of strains used as starters and adjunct cultures for Emmental cheese manufacture.

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Rodríguez, L Mato; Alatossava, T

2008-10-01

To determine the effects of supplemented copper (Cu2+) on growth and viability of strains used as starters and adjunct cultures for Emmental cheese manufacture. Thirteen strains belonging to Lactobacillus delbrueckii, Lactobacillus helveticus, Lactobacillus rhamnosus, Streptococcus thermophilus or Propionibacterium freudenreichii species were exposed to various copper concentrations in the proper growth medium at relevant growth temperatures, and the effects of supplemented copper on bacterial growth and cell viability were determined by optical density and pH measurements, also by platings. Among the species considered, L. delbrueckii was the most copper resistant and S. thermophilus the most sensitive to copper. Anaerobic conditions increased this sensitivity significantly. There was also a considerable amount of variation in copper resistance at strain level. Copper resistance is both a species- and strain-dependent property and may reflect variability in copper-binding capacities by cell wall components among species and strains. In addition, the chemical state of copper may be involved. This study revealed that copper resistance is a highly variable property among starter and adjunct strains, and this variability should be considered when strains are selected for Emmental cheese manufacture.

Treatment of avoidance behavior as an adjunct to exposure therapy: Insights from modern learning theory.

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Treanor, Michael; Barry, Tom J

2017-09-01

Pathological avoidance of benign stimuli is a hallmark of anxiety and related disorders, and exposure-based treatments have often encouraged the removal of avoidance, or safety behaviors, due to their negative effects on extinction learning. Unfortunately, empirical evidence suggests that avoidance behaviors can persist following treatment, and the mere availability of avoidance behavior can be sufficient to renew fear following successful extinction learning. The present paper critically examines the function of avoidance behavior through the lens of modern learning theory, and speculates on novel behavioral and pharmacological strategies for targeting avoidance as an adjunct to current evidence-based treatments. Copyright © 2017. Published by Elsevier Ltd.

Computer simulation in conjunction with medical thermography as an adjunct tool for early detection of breast cancer

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Sudharsan NM

2004-04-01

Full Text Available Abstract Background Mathematical modelling and analysis is now accepted in the engineering design on par with experimental approaches. Computer simulations enable one to perform several 'what-if' analyses cost effectively. High speed computers and low cost of memory has helped in simulating large-scale models in a relatively shorter time frame. The possibility of extending numerical modelling in the area of breast cancer detection in conjunction with medical thermography is considered in this work. Methods Thermography enables one to see the temperature pattern and look for abnormality. In a thermogram there is no radiation risk as it only captures the infrared radiation from the skin and is totally painless. But, a thermogram is only a test of physiology, whereas a mammogram is a test of anatomy. It is hoped that a thermogram along with numerical modelling will serve as an adjunct tool. Presently mammogram is the 'gold-standard' in breast cancer detection. But the interpretation of a mammogram is largely dependent on the radiologist. Therefore, a thermogram that looks into the physiological changes in combination with numerical simulation performing 'what-if' analysis could act as an adjunct tool to mammography. Results The proposed framework suggested that it could reduce the occurrence of false-negative/positive cases. Conclusion A numerical bioheat model of a female breast is developed and simulated. The results are compared with experimental results. The possibility of this method as an early detection tool is discussed.

Computer simulation in conjunction with medical thermography as an adjunct tool for early detection of breast cancer

International Nuclear Information System (INIS)

Ng, Eddie Y-K; Sudharsan, NM

2004-01-01

Mathematical modelling and analysis is now accepted in the engineering design on par with experimental approaches. Computer simulations enable one to perform several 'what-if' analyses cost effectively. High speed computers and low cost of memory has helped in simulating large-scale models in a relatively shorter time frame. The possibility of extending numerical modelling in the area of breast cancer detection in conjunction with medical thermography is considered in this work. Thermography enables one to see the temperature pattern and look for abnormality. In a thermogram there is no radiation risk as it only captures the infrared radiation from the skin and is totally painless. But, a thermogram is only a test of physiology, whereas a mammogram is a test of anatomy. It is hoped that a thermogram along with numerical modelling will serve as an adjunct tool. Presently mammogram is the 'gold-standard' in breast cancer detection. But the interpretation of a mammogram is largely dependent on the radiologist. Therefore, a thermogram that looks into the physiological changes in combination with numerical simulation performing 'what-if' analysis could act as an adjunct tool to mammography. The proposed framework suggested that it could reduce the occurrence of false-negative/positive cases. A numerical bioheat model of a female breast is developed and simulated. The results are compared with experimental results. The possibility of this method as an early detection tool is discussed

Participant perceptions of use of CyWee Z as adjunct to rehabilitation of upper-limb function following stroke.

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Hale, Leigh A; Satherley, Jessica A; McMillan, Nicole J; Milosavljevic, Stephan; Hijmans, Juha M; King, Marcus J

2012-01-01

This article reports on the perceptions of 14 adults with chronic stroke who participated in a pilot study to determine the utility, acceptability, and potential efficacy of using an adapted CyWee Z handheld game controller to play a variety of computer games aimed at improving upper-limb function. Four qualitative in-depth interviews and two focus groups explored participant perceptions. Data were thematically analyzed with the general inductive approach. Participants enjoyed playing the computer games with the technology. The perceived benefits included improved upper-limb function, concentration, and balance; however, six participants reported shoulder and/or arm pain or discomfort, which presented while they were engaged in play but appeared to ease during rest. Participants suggested changes to the games and provided opinions on the use of computer games in rehabilitation. Using an adapted CyWee Z controller and computer games in upper-limb rehabilitation for people with chronic stroke is an acceptable and potentially beneficial adjunct to rehabilitation. The development of shoulder pain was a negative side effect for some participants and requires further investigation.

The role of splenic angioembolization as an adjunct to nonoperative management of blunt splenic injuries: A systematic review and meta-analysis.

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Crichton, James Charles Ian; Naidoo, Kamil; Yet, Barbaros; Brundage, Susan I; Perkins, Zane

2017-11-01

Nonoperative management (NOM) of hemodynamically normal patients with blunt splenic injury (BSI) is the standard of care. Guidelines recommend additional splenic angioembolization (SAE) in patients with American Association for the Surgery of Trauma (AAST) Grade IV and Grade V BSI, but the role of SAE in Grade III injuries is unclear and controversial. The aim of this systematic review was to compare the safety and effectiveness of SAE as an adjunct to NOM versus NOM alone in adults with BSI. A systematic literature search (Medline, Embase, and CINAHL) was performed to identify original studies that compared outcomes in adult BSI patients treated with SAE or NOM alone. Primary outcome was failure of NOM. Secondary outcomes included morbidity, mortality, hospital length of stay, and transfusion requirements. Bayesian meta-analyses were used to calculate an absolute (risk difference) and relative (risk ratio [RR]) measure of treatment effect for each outcome. Twenty-three studies (6,684 patients) were included. For Grades I to V combined, there was no difference in NOM failure rate (SAE, 8.6% vs NOM, 7.7%; RR, 1.09 [0.80-1.51]; p = 0.28), mortality (SAE, 4.8% vs NOM, 5.8%; RR, 0.82 [0.45-1.31]; p = 0.81), hospital length of stay (11.3 vs 9.5 days; p = 0.06), or blood transfusion requirements (1.8 vs 1.7 units; p = 0.47) between patients treated with SAE and those treated with NOM alone. However, morbidity was significantly higher in patients treated with SAE (SAE, 38.1% vs NOM, 18.6%; RR, 1.83 [1.20-2.66]; p splenic injury, SAE significantly reduced the failure rate of NOM in patients with Grade IV and Grade V splenic injuries but had minimal effect in those with Grade I to Grade III injuries. Splenic angioembolization should be strongly considered as an adjunct to NOM in patients with AAST Grade IV and Grade V BSI but should not be routinely recommended in patients with AAST Grade I to Grade III injuries. Systematic review and meta-analysis, level III.

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

Science.gov (United States)

Thwaites, Guy E; Scarborough, Matthew; Szubert, Alexander; Nsutebu, Emmanuel; Tilley, Robert; Greig, Julia; Wyllie, Sarah A; Wilson, Peter; Auckland, Cressida; Cairns, Janet; Ward, Denise; Lal, Pankaj; Guleri, Achyut; Jenkins, Neil; Sutton, Julian; Wiselka, Martin; Armando, Gonzalez-Ruiz; Graham, Clive; Chadwick, Paul R; Barlow, Gavin; Gordon, N Claire; Young, Bernadette; Meisner, Sarah; McWhinney, Paul; Price, David A; Harvey, David; Nayar, Deepa; Jeyaratnam, Dakshika; Planche, Tim; Minton, Jane; Hudson, Fleur; Hopkins, Susan; Williams, John; Török, M Estee; Llewelyn, Martin J; Edgeworth, Jonathan D; Walker, A Sarah

2018-02-17

Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute

Adjunctive Intracoronal Splint in Periodontal Treatment: Report of Two Cases

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Mora Octavia

2015-05-01

Full Text Available Reduction of the amount of tooth roots which are embedded in their periodontium could cause tooth mobility. Splinting a weaker tooth with a more stable one, and using the principle of the multiple-root stabilization is one way to overcome tooth mobility. Temporary splinting aims to prevent pathological migration, restore masticatory function, stabilize teeth before/after surgery, and evaluate the prognosis of periodontal treatment. The use of intracoronal splint is still controversial because there are only a few studies that have evaluated the effect of splinting on periodontal health. We report two cases to evaluate the effect of intracoronal splint on periodontal treatment. Two periodontal cases that use intracoronal splint before, during, and after periodontal regenerative therapy using bone graft. Causes of tooth mobility were removed and the splinting principles, terms and guidelines were mastered to get the maximum results of periodontal treatment. Both cases were evaluated radiographically 10 months after treatment. In these cases, intracoronal splint has supported the therapy before, during, or after surgery. Splinting is only for adjunctive therapy, and does not serve as the sole method in getting occlusal stability.DOI: 10.14693/jdi.v21i3.193

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

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John, Priya; Lazarus, Flemingson; Selvam, Arul; Prabhuji, Munivenkatappa Lakshmaiah Venkatesh

2015-01-01

Introduction PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. Aim The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). Settings and Design The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. Materials and Methods In a split–mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. Results In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. Conclusion The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis. PMID:26155567

The Utilization of the Seven Principles for Good Practices of Full-Time and Adjunct Faculty in Teaching Health & Science in Community Colleges

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Musaitif, Linda M.

2013-01-01

Purpose: The purpose of this study was to determine the degree to which undergraduate full-time and adjunct faculty members in the health and science programs at community colleges in Southern California utilize the seven principles of good practice as measured by the Faculty Inventory of the Seven Principles for Good Practice in Undergraduate…

Traditional Chinese medicine as adjunctive therapy improves the long-term survival of lung cancer patients.

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Liao, Yueh-Hsiang; Li, Chia-Ing; Lin, Cheng-Chieh; Lin, Jaung-Geng; Chiang, Jen-Huai; Li, Tsai-Chung

2017-12-01

Traditional Chinese medicine is one of the popular alternative treatments for cancer, mainly enhancing host immune response and reducing adverse effect of chemotherapy. This study first explored traditional Chinese medicine treatment effect on long-term survival of lung cancer patients. This study evaluated whether traditional Chinese medicine combined with conventional cancer treatment improved overall survival of lung cancer patients. We had conducted a retrospective cohort study on 111,564 newly diagnosed lung cancer patients in 2000-2009 from National Health Insurance Program database. A total of 23,803 (21.31%) patients used traditional Chinese medicine for lung cancer care. Eligible participants were followed up until 2011 with a mean follow-up period of 1.96 years (standard deviation 2.55) for non-TCM users and 3.04 years (2.85) for traditional Chinese medicine users. Patients with traditional Chinese medicine utilization were significantly more likely to have a 32% decreased risk of death [hazard ratio = 0.62; 95% confidence interval = 0.61-0.63], compared with patients without traditional Chinese medicine utilization after multivariate adjustment. We also observed a similar significant reduction risk across various subgroups of chronic lung diseases. Qing Zao Jiu Fei Tang was the most effective traditional Chinese medicine agent for mortality reduction both in the entire lung cancer (0.81; 0.72-0.91) and matched populations (0.86; 0.78-0.95). This study demonstrated adjunctive therapy with traditional Chinese medicine may improve overall survival of lung cancer patients. This study also suggested traditional Chinese medicine may be used as an adjunctive therapy for cancer treatment. These observational findings need being validated by future randomized controlled trials to rule out the possibility of effect due to holistic care.

Indications and Outcomes for Microfracture as an Adjunct to Hip Arthroscopy for Treatment of Chondral Defects in Patients With Femoroacetabular Impingement: A Systematic Review.

Science.gov (United States)

MacDonald, Austin E; Bedi, Asheesh; Horner, Nolan S; de Sa, Darren; Simunovic, Nicole; Philippon, Marc J; Ayeni, Olufemi R

2016-01-01

To evaluate the indications, preoperative workup outcomes, and postoperative rehabilitation of patients with femoroacetabular impingement (FAI) receiving microfracture as an adjunct to hip arthroscopy for chondral defects. The electronic databases MEDLINE, EMBASE, and PubMed were searched and screened in duplicate for studies involving patients with FAI treated arthroscopically with microfracture of the hip for chondral defects either solely or as an adjunct to hip arthroscopy. Data regarding indications, investigations, outcomes, and postoperative rehabilitation were abstracted from eligible studies. The references of included studies were additionally searched, and descriptive statistics are provided. There were 12 studies included in this review, involving 267 patients. With the exception of a single, one-patient case report, 11 of the 12 studies reported positive outcomes after hip arthroscopy with microfracture. Only 0.7% of the total patients experienced a complication, and 1.1% required further surgery on the basis of outcomes evaluated at a mean follow-up of 29.5 (range, 4 to 60) months across the studies. Eight of 12 studies discussed the preoperative workup of these patients, with X-rays and magnetic resonance imaging being the most common preoperative imaging used. There was little reported on weight-bearing status during postoperative rehabilitation. The outcomes reported in the literature after hip arthroscopy with microfracture for chondral defects are, in general, positive, with a very low percentage of patients requiring further surgery or experiencing complications. The most common indication used in the literature for microfracture is a full-thickness, focal chondral defect (Outerbridge grade IV). The vast majority of literature recommends limited weight bearing after microfracture; however, there was significant variation among the specific rehabilitation protocols used. More research is needed to explore what indications and postoperative

Ketamine as an Adjunct to Postoperative Pain Management in Opioid Tolerant Patients After Spinal Fusions: A Prospective Randomized Trial

OpenAIRE

Urban, Michael K.; Ya Deau, Jacques T.; Wukovits, Barbara; Lipnitsky, Jane Y.

2007-01-01

Management of acute postoperative pain is challenging, particularly in patients with preexisting narcotic dependency. Ketamine has been used at subanesthetic doses as a N-methyl d-aspartate (NMDA) receptor antagonist to block the processing of nociceptive input in chronic pain syndromes. This prospective randomized study was designed to assess the use of ketamine as an adjunct to acute pain management in narcotic tolerant patients after spinal fusions. Twenty-six patients for 1–2 level poster...

A 24-week, randomized, controlled trial of adjunctive sibutramine versus topiramate in the treatment of weight gain in overweight or obese patients with bipolar disorders

NARCIS (Netherlands)

McElroy, Susan L.; Frye, Mark A.; Altshuler, Lori L.; Suppes, Trisha; Hellemann, Gerhard; Black, David; Mintz, Jim; Kupka, Ralph; Nolen, Willem; Leverich, Gabriele S.; Denicoff, Kirk D.; Post, Robert M.; Keck, Paul E.

Objectives: Patients with bipolar disorder (BD) have an increased risk of obesity as well as psychotropic-associated weight gain. The objective of this study was to compare sibutramine and topiramate as adjunctive treatments for psychotropic-associated weight gain in overweight or obese outpatients

Cost-effectiveness and quality-of-life assessment of GM-CSF as an adjunct to intensive remission induction chemotherapy in elderly patients with acute myeloid leukaemia

NARCIS (Netherlands)

Uyl-de Groot, CA; Lowenberg, B; Vellenga, E; Suciu, S; Willemze, R; Rutten, FFH

We conducted a prospective, randomized, multicentre clinical trial comparing the effects and costs of GM-CSF as an adjunct to intensive chemotherapy in elderly patients with acute myeloid leukaemia (AML). The patients were randomized to either daunomycin-cytosine arabinoside (control arm: rr = 161)

A brief motivational interviewing as an adjunct to periodontal therapy-A potential tool to reduce relapse in oral hygiene behaviours. A three-year study.

Science.gov (United States)

Stenman, J; Wennström, J L; Abrahamsson, K H

2018-05-01

To evaluate (ii) whether inclusion of a single motivational interviewing (MI) session, as an adjunct to periodontal therapy, might be beneficial for preventing relapse in oral hygiene behaviours among patients treated for chronic periodontitis and (ii) whether individual and clinical characteristics can be of predictive value for retention of sufficient oral hygiene behaviours. This 3-year follow-up of a previously reported randomized controlled trial (RCT) study of 6-month duration included 26 patients. Patients in the test group had received one MI session by a clinical psychologist before initiation of the periodontal treatment. Otherwise, all patients followed the same treatment protocol for conventional educational intervention and non-surgical periodontal therapy. Efficacy variables assessed for evaluation of the standard of self-performed periodontal infection control were marginal bleeding index (MBI; primary efficacy variable) and plaque score (PI). The patterns of change in MBI and PI scores were similar for test and control groups over the observation period. At 3 years, both groups showed a desirable mean full-mouth MBI of 15%, a figure that was comparable to that at the short-term evaluation after active periodontal treatment. The post-treatment MBI was the only variable identified as a predictor of retained adequate oral hygiene behaviours. A single MI session as an adjunct to conventional periodontal therapy could not be proven to be of long-term beneficial additive effect with regard to prevention of relapse in oral hygiene behaviour. Desirable standard of self-performed infection control after active periodontal treatment predicted the retention of sufficient oral hygiene behaviour over time. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Acetyl-L-Carnitine as an Adjunctive Therapy in the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Placebo-Controlled Trial

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Abbasi, Seyed-Hesameddin; Heidari, Shahram; Mohammadi, Mohammad-Reza; Tabrizi, Mina; Ghaleiha, Ali; Akhondzadeh, Shahin

2011-01-01

The objective of this study was to test whether a previous observed Acetyl-L-carnitine (ALC) treatment effect could be repeated in an ALC adjunctive therapy treatment trial of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. This was a six-week, randomized clinical trial undertaken in an outpatient child and adolescent…

Adjunct therapy of Ayurvedic medicine with anti tubercular drugs on the therapeutic management of pulmonary tuberculosis.

Science.gov (United States)

Debnath, P K; Chattopadhyay, Jaydeb; Mitra, Achintya; Adhikari, Anjan; Alam, Mirza Samsur; Bandopadhyay, S K; Hazra, Jayram

2012-07-01

Pulmonary tuberculosis (PTB) is an age old disease described in Vedic Medicine as 'Yakshma'. Later on, in Ayurveda it earned a prefix and found way into mythology as 'Rajayakshma'. After the discovery of streptomycin, the therapeutic management of PTB received a major breakthrough. The treatment module changed remarkably with the formulation of newer anti-tubercular drugs (ATD) with appreciable success. Recent resurgence of PTB in developed countries like United States posed a threat to the medical community due to resistant strains. Consequently, WHO looked toward traditional medicine. Literature reveals that Ayurvedic treatment of PTB was in vogue in India before the introduction of ATD with limited success. Records show that 2766 patients of PTB were treated with Ayurvedic drugs in a tertiary care hospital in Kolkata in the year 1933-1947. To evaluate the toxicity reduction and early restoration by adjunct therapy of Ayurvedic drugs by increasing the bio-availability of ATDs. In the present study, treatment response of 99 patients treated with ATD as an adjunct with Aswagandha (Withania somnifera) and a multi-herbal formulation described in Chikitsa-sthana of Charaka samhita i.e. Chyawanprash were investigated. Hematological profile, sputum bacterial load count, immunoglobulin IgA and IgM, blood sugar, liver function test, serum creatinine were the assessed parameters besides blood isoniazid and pyrazinamide, repeated after 28 days of treatment. The symptoms abated, body weight showed improvement, ESR values were normal, there was appreciable change in IgA and IgM patterns and significantly increased bioavailability of isoniazid and pyrazinamide were recorded. This innovative clinical study coupled with empowered research may turn out to be promising in finding a solution for the treatment of PTB.

Cardiovascular Protective Effects of Adjunctive Alternative Medicine (Salvia miltiorrhiza and Pueraria lobata in High-Risk Hypertension

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K. S. Woo

2013-01-01

Full Text Available Introduction. Hypertension in association with diabetes (DM, renal impairment (RI, and left ventricular hypertrophy (LVH increases the risk of future cardiovascular events. We hypothesize, traditional herbal medicines Danshen and Gegen (D&G have beneficial effects on atherogenesis in these high-risk hypertensive subjects. Subjects and Methods. 90 asymptomatic hypertensive subjects associated with LVH (63.3%, DM (62.2%, or RI (30% were randomized to receive D&G herbal capsules 1 gm/day, 2 gm/day, or identical placebo capsules in double-blind and parallel fashion for 12 months. Brachial flow-mediated dilation (endothelium-dependent dilation, FMD and carotid intima-media thickness (IMT were measured by ultrasound. All data were analyzed using the Statistical Package for Social Sciences in Windows 16.0. Results. Their mean age was 55±8 years, and 74.4% were male. After 12 months of adjunctive therapies and compared with baseline, there were no significant changes in blood pressure, heart rate, hematological, glucose, and creatinine profiles in both placebo and D&G groups. FMD improved significantly during D&G (P=0.0001 and less so after placebo treatment (P=0.001. There was a mild but significant decrease in carotid IMT after D&G (P<0.001 but no significant changes after placebo. A trend of better improvement in FMD after higher versus lower D&G dosages was seen. D&G were well tolerated, with no significant adverse events or blood biochemistry changes. Conclusion. D&G adjunctive treatment was well tolerated and significantly improved atherogenesis in high-risk hypertensive patients, with potential in primary atherosclerosis prevention.

Examining Adjunct Instructor Characteristics, Perceived Fit, and Teaching Modality to Determine if They Predict Organizational Commitment and Job Satisfaction at a Midwestern Career College

Science.gov (United States)

Hill, Randy James

2014-01-01

The purpose of this quantitative, multiple regression study was to examine the relationship between 10 adjunct instructor characteristics and organizational commitment and job satisfaction. Part-time instructors who taught for the institution during the 2012-2013 academic year completed an electronic survey with questions from three valid and…

Do children with SLI use verbs to predict arguments and adjuncts: evidence from eye movements during listening.

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Llorenç eAndreu

2016-01-01

Full Text Available Different psycholinguistic theories have suggested the importance of verb semantics in rapidly anticipating upcoming information during real-time sentence comprehension. To date, no study has examined if children use verbs to predict arguments and adjuncts in sentence comprehension using children with specific language impairment (SLI.Twenty-five children with SLI (aged 5 years and 3 months to 8 years and 2 months, twenty-five age-matched controls (aged 5 years and 3 months to 8 years and 2 months, twenty-five MLU-w controls (aged 3 years and 3 months to 7 years and 1 month, and 31 adults took part in the study. The eye movements of participants were monitored while they heard twenty-four sentences, such as El hombre lee con atención un cuento en la cama (translation: The man carefully reads a storybook in bed, in the presence of four depicted objects, one of which was the target (storybook, another, the competitor (bed, and another two, distracters (wardrobe and grape. The proportion of looks revealed that, when the meaning of the verb was retrieved, the upcoming argument and adjunct referents were rapidly anticipated. However, the proportion of looks at the theme, source/goal and instrument referents were significantly higher than the looks at the locatives. This pattern was found in adults as well as children with and without language impairment. The present results suggest that, in terms of sentence comprehension, the ability to understand verb information is not severely impaired in children with SLI.

Percutaneous aspiration thrombectomy with adjunctive venoplasty for iliac vein compression syndrome with lower extremity deep venous thrombosis

International Nuclear Information System (INIS)

Wang Yiping; Zhang Xiquan; Sun Yequan

2013-01-01

Objective: To investigate the clinical effect of mechanical aspiration thrombectomy with adjunctive PTA and stenting for iliac vein compression syndrome with lower extremity deep venous thrombosis. Materials and Methods: The clinical data of 184 patients who had iliac vein compression syndrome with lower extremity DVT were analyzed retrospectively. The healthy femoral vein was accessed, then a 12-14 F sheath was introduced via a guide wire to aspirate thrombus in the iliofemoral; For the cases with femoropopliteal thrombus, the thrombus was macerated and pulled by Fogarty balloon catheter, then performing mechanical aspiration thrombectomy. After thrombus removal, PTA and stenting were performed on stenosis or occlusion of common iliac vein that displayed on venography. Results: The thrombus removal rate: Grade Ⅲ 80.89% and Grade Ⅱ 19.02%. The circumference of affected limbs at 15 cm above and below knee joints were (43.9±4.7) cm and (31.5±4.1) cm, respectively, after being discharged from hospital, the differences were statistical significance (t=6.43, t=-5.79, both P=0.000)compared to be hospitalized. The follow -up result: the treatment efficiency was 97.75%. The stent patency rate of postoperation at 6, 12, and 24 months were 97.19%, 94.94%, 92.13%, respectively, on sonography or digital subtract angiography. Conclusion: Mechanical aspiration thrombectomy with adjunctive venoplasty for iliac vein compression syndrome with lower extremity deep venous thrombosis is an effective and safe therapy having notable therapeutic effect in short l middle-term follow-up and shorter hospitalization time. (authors)

Sentinel node biopsy as an adjunct to limb salvage surgery for epithelioid sarcoma of the hand

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Hammond Alex

2005-06-01

Full Text Available Abstract Background Epithelioid sarcomas of the hand are rare, high-grade tumors with a propensity for regional lymphatic spread approaching 40%. Case presentation A 54-year-old male with an epithelioid sarcoma of the palm was treated with neoadjuvant radiation, wide excision, and two-stage reconstruction. Sentinel lymph node biopsy was used to stage the patient's axilla. Sentinel node biopsy results were negative. The patient has remained free of local, regional and distant disease for the follow-up time of 16 months. Conclusion The rarity of this tumor makes definitive conclusions difficult but SLN biopsy appears to be a useful adjunct in the treatment of these sarcomas.

Diabetes as a risk factor to cancer: Functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer

International Nuclear Information System (INIS)

Aruoma, Okezie I.; Somanah, Jhoti; Bourdon, Emmanuel; Rondeau, Philippe; Bahorun, Theeshan

2014-01-01

Highlights: • Cancer incidence and mortality is linked to hyperglycemia and some anti-diabetes drugs. • FPP is a safe nutraceutical adjunct for augmenting therapeutic regimens in diabetes and cancer management. • FPP through its hypoglycemic and antioxidant sensing may impact and mitigate the side effects of anticancer drugs. • FPP can diminish the intensity of side effects associated with acute radiation therapy. • FPP can maintain the integrity of erythrocyte during cancer chemotherapy augmenting compliance of treatment. - Abstract: Oncologists and diabetologists quote scientific data from epidemiological and in vitro studies to show that high levels of insulin and glucose, in combination with oxidative stress and chronic inflammation, can heighten the risk of developing cancer amongst patients with diabetes. Although the cancers that have been consistently associated with type 2 diabetes include pancreatic, colorectal, breast and liver cancer, the preponderance of the disease risk factors such as obesity, inflammation, hyperglycemia, hyperinsulinaemia (as a result of insulin resistance and oxidative β-cell damage) and the indirect influence of anti-diabetic medications are increasingly being defined. Fermented papaya preparation (FPP) has defined antioxidant and immune-modulating potentials. The ability of FPP influence signaling cascades associated with cell growth and survival presents a rational for chemopreventive adjunct that can be used in combination with traditional redox based therapies that target oxidative stress in the cancer micro environment. It is further suggested that the demonstrated efficacy FPP to control blood glucose, excessive inflammation and modulate free radical-induced oxidative damage which are triggers of liver, bladder, breast and prostate cancers in type 2 diabetics, may favorably mitigate the side effects of ensuing diabetes and cancer therapy. What remains paramount is early cancer detection and early determination of

Diabetes as a risk factor to cancer: Functional role of fermented papaya preparation as phytonutraceutical adjunct in the treatment of diabetes and cancer

Energy Technology Data Exchange (ETDEWEB)

Aruoma, Okezie I., E-mail: oaruoma@auhs.edu [Department of Pharmaceutical Sciences, School of Pharmacy, American University of Health Sciences, Signal Hill, CA (United States); Somanah, Jhoti [ANDI Center for Biomedical and Biomaterials Research, University of Mauritius, MSIRI Building, Réduit (Mauritius); Bourdon, Emmanuel; Rondeau, Philippe [Groupe d’Etude sur l’Inflammation Chronique et l’Obésité (GEICO), Université de La Réunion, Plateforme CYROI, Saint Denis (France); Bahorun, Theeshan, E-mail: tbahorun@uom.ac.mu [ANDI Center for Biomedical and Biomaterials Research, University of Mauritius, MSIRI Building, Réduit (Mauritius)

2014-10-15

Highlights: • Cancer incidence and mortality is linked to hyperglycemia and some anti-diabetes drugs. • FPP is a safe nutraceutical adjunct for augmenting therapeutic regimens in diabetes and cancer management. • FPP through its hypoglycemic and antioxidant sensing may impact and mitigate the side effects of anticancer drugs. • FPP can diminish the intensity of side effects associated with acute radiation therapy. • FPP can maintain the integrity of erythrocyte during cancer chemotherapy augmenting compliance of treatment. - Abstract: Oncologists and diabetologists quote scientific data from epidemiological and in vitro studies to show that high levels of insulin and glucose, in combination with oxidative stress and chronic inflammation, can heighten the risk of developing cancer amongst patients with diabetes. Although the cancers that have been consistently associated with type 2 diabetes include pancreatic, colorectal, breast and liver cancer, the preponderance of the disease risk factors such as obesity, inflammation, hyperglycemia, hyperinsulinaemia (as a result of insulin resistance and oxidative β-cell damage) and the indirect influence of anti-diabetic medications are increasingly being defined. Fermented papaya preparation (FPP) has defined antioxidant and immune-modulating potentials. The ability of FPP influence signaling cascades associated with cell growth and survival presents a rational for chemopreventive adjunct that can be used in combination with traditional redox based therapies that target oxidative stress in the cancer micro environment. It is further suggested that the demonstrated efficacy FPP to control blood glucose, excessive inflammation and modulate free radical-induced oxidative damage which are triggers of liver, bladder, breast and prostate cancers in type 2 diabetics, may favorably mitigate the side effects of ensuing diabetes and cancer therapy. What remains paramount is early cancer detection and early determination of

Adjunctive yoga v. health education for persistent major depression: a randomized controlled trial.

Science.gov (United States)

Uebelacker, L A; Tremont, G; Gillette, L T; Epstein-Lubow, G; Strong, D R; Abrantes, A M; Tyrka, A R; Tran, T; Gaudiano, B A; Miller, I W

2017-09-01

The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment. We conducted a randomized controlled trial of weekly yoga classes (n = 63) v. health education classes (Healthy Living Workshop; HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning. At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b = -0.82, s.e. = 0.88, p = 0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = -1.38, s.e. = 0.57, p = 0.02). At 6-month follow-up, 51% of yoga participants demonstrated a response (⩾50% reduction in depression symptoms) compared with 31% of HLW participants (odds ratio = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time. Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.

Preclinical assessment of adjunctive tPA and DNase for peritoneal dialysis associated peritonitis.

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Amanda L McGuire

Full Text Available A major complication of peritoneal dialysis is the development of peritonitis, which is associated with reduced technique and patient survival. The inflammatory response elicited by infection results in a fibrin and debris-rich environment within the peritoneal cavity, which may reduce the effectiveness of antimicrobial agents and predispose to recurrence or relapse of infection. Strategies to enhance responses to antimicrobial agents therefore have the potential to improve patient outcomes. This study presents pre-clinical data describing the compatibility of tPA and DNase in combination with antimicrobial agents used for the treatment of PD peritonitis. tPA and DNase were stable in standard dialysate solution and in the presence of antimicrobial agents, and were safe when given intraperitoneally in a mouse model with no evidence of local or systemic toxicity. Adjunctive tPA and DNase may have a role in the management of patients presenting with PD peritonitis.

Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth.

LENUS (Irish Health Repository)

2012-01-31

INTRODUCTION: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians\\' ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. STUDY DESIGN: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. RESULTS: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. CONCLUSION: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

Investigation of the role of computed tomography as an adjunct to autopsy in the evaluation of stillbirth

International Nuclear Information System (INIS)

O’Donoghue, Keelin; O’Regan, Kevin N.; Sheridan, Carmel P.; O’Connor, Owen J.; Benson, Jodie; McWilliams, Sebastian; Moore, Niamh; Murphy, Mary J.; Chopra, Raj; Higgins, John R.; Maher, Michael M.

2012-01-01

Introduction: The number of parents agreeing to autopsy following stillbirth is declining, which has undermined clinicians’ ability to assess causes of intrauterine death and can impact counselling regarding recurrence. Post-mortem radiological imaging is a potential alternative method of investigating perinatal loss. The aim of this study was to assess the role of multi-detector computed tomography (MDCT) in the investigation of stillbirth. Study design: Following ethical approval and written consent, parents were offered MDCT of the stillborn infant. MDCT was performed with 3D reconstruction, and images were analysed for image quality, anthropomorphic measurements and pathologic findings. Body part and organ-specific measurements were performed; including head, chest and abdominal circumferences, and muscle and liver mass was also measured. Findings were correlated with obstetric history, post-mortem skeletal survey (plain radiography), and formal autopsy. Results: Fourteen third-trimester stillborn infants were scanned. Image quality was moderate to excellent for most body structures. CT was better than plain radiography for imaging skeletal structures and large solid organs and demonstrated a range of pathologies including renal vein thrombosis, mesenteric calcification and skeletal hyperostosis that were not seen on plain radiographs. MDCT did not overlook autopsy findings and provided some additional information. Conclusion: This study confirms the feasibility of MDCT in the investigation of third trimester stillbirth. MDCT image quality is acceptable and the examination can demonstrate a range of anatomic and pathologic findings. Initially, its value may be as an important adjunct to conventional autopsy.

Adjunctive levetiracetam in children, adolescents, and adults with primary generalized seizures: Open-label, noncomparative, multicenter, long-term follow-up study.

LENUS (Irish Health Repository)

Delanty, Norman

2012-02-01

Purpose: To evaluate the long-term efficacy and tolerability of adjunctive levetiracetam (LEV) in patients with uncontrolled idiopathic generalized epilepsy (IGE). Methods: This phase III, open-label, long-term, follow-up study (N167; NCT00150748) enrolled patients (4 to <65 years) with primary generalized seizures (tonic-clonic, myoclonic, absence). Patients received adjunctive LEV at individualized doses (1,000-4,000 mg\\/day; 20-80 mg\\/kg\\/day for children\\/adolescents weighing <50 kg). Efficacy results are reported for all seizure types [intention-to-treat (ITT) population, N = 217] and subpopulations with tonic-clonic (n = 152), myoclonic (n = 121), and\\/or absence (n = 70) seizures at baseline. Key Findings: One hundred twenty-five (57.6%) of 217 patients were still receiving treatment at the end of the study. Mean (standard deviation, SD) LEV dose was 2,917.5 (562.9) mg\\/day. Median (Q1-Q3) exposure to LEV was 2.1 (1.5-2.8) years, and the maximum duration was 4.6 years. Most patients were taking one (124\\/217, 57.1%) or >\\/=2 (92\\/217, 42.4%) concomitant antiepileptic drugs (AEDs). Seizure freedom of >\\/=6 months (all seizure types; primary efficacy end point) was achieved by 122 (56.2%) of 217 patients, and 49 (22.6%) of 217 patients had complete seizure freedom. Seizure freedom of >\\/=6 months from tonic-clonic, myoclonic, and absence seizures was achieved by 95 (62.5%) of 152, 75 (62.0%) of 121, and 44 (62.9%) of 70 patients, respectively. Mean (SD) maximum seizure freedom duration was 371.7 (352.4) days. At least one treatment-emergent adverse event (TEAE) was reported by 165 (76%) of 217 patients; most TEAEs were mild\\/moderate in severity, with no indication of an increased incidence over time. Seventeen (7.8%) of 217 patients discontinued medication because of TEAEs. The most common psychiatric TEAEs were depression (16\\/217, 7.4%), insomnia (9\\/217, 4.1%), nervousness (8\\/217, 3.7%), and anxiety (7\\/217, 3.2%). Significance: Adjunctive

Clinical utility of contrast-enhanced spectral mammography as an adjunct for tomosynthesis-detected architectural distortion.

Science.gov (United States)

Patel, Bhavika K; Naylor, Michelle E; Kosiorek, Heidi E; Lopez-Alvarez, Yania M; Miller, Adrian M; Pizzitola, Victor J; Pockaj, Barbara A

Supplement tomosynthesis-detected architectural distortions (AD) with CESM to better characterize malignant vs benign lesions. Retrospective review CESM prior to biopsied AD. Pathology: benign, radial scar, or malignant. 49 lesions (45 patients). 29 invasive cancers, 1 DCIS (range, 0.4-4.7cm); 9 radial scars; 10 benign. 37 (75.5%) ADs had associated enhancement. PPV 78.4% (29/37), sensitivity 96.7% (29/30); specificity, 57.9% (11/19); NPV, 91.7% (11/12). False-positive rate 21.6% (8/37); false-negative rate, 8.3% (1/12). Accuracy 81.6% (40/49). High sensitivity and NPV of CESM in patients with AD is promising as an adjunct tool in diagnosing malignancy and avoiding unnecessary biopsy, respectively. Copyright © 2017 Elsevier Inc. All rights reserved.

Analysis of the scientific production on feedback on teaching English as a foreign language using ERIC database

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Carmem Silvia Lima Fluminhan

2017-11-01

Full Text Available Feedback is one of the most significant tools on learning, teaching, developing autonomy, self-efficacy and achievement in the educational environment. Its importance is emphasized in articles, dissertations and theses; however, a very little number of them have been published recently. This article intends to verify in what perspective feedback has been examined, in what ways it has been revealed to be effective for students and teachers to reach their goals and identify possible gaps of study that need to be fulfilled in future researches. In order to carry out this investigation, this study examined articles, papers and theses published from 2006 to 2015 about feedback in courses of English as a foreign language (EFL, using ERIC database. Our findings were organized into six categories: corrective feedback in oral interaction; effects of peer feedback; feedback expectancy; teachers’ conceptions of intelligence and their relations in offering feedback; the effect of different types of feedback strategies on written texts; the use of feedback through technology. The results indicate that feedback is a crucial tool in the educational process and it plays a central role in learning a foreign language. Further investigations concerning feedback are suggested.

Tramadol as adjunct to psoas compartment block with levobupivacaine 0.5%: a randomized double-blinded study.

LENUS (Irish Health Repository)

Mannion, S

2012-02-03

BACKGROUND: Tramadol has been administered peripherally to prolong analgesia after brachial plexus and neuraxial blocks. Our aim was to evaluate the systemic and perineural effects of tramadol as an analgesic adjunct to psoas compartment block (PCB) with levobupivacaine. METHODS: In a randomized, prospective, double-blinded trial, 60 patients (ASA I-III), aged 49-88 yr, undergoing primary total hip or knee arthroplasty underwent PCB and subsequent bupivacaine spinal anaesthesia. Patients were randomized into three groups. Each patient received PCB with levobupivacaine 0.5%, 0.4 ml kg(-1). The control group (group L, n=21) received i.v. saline, the systemic tramadol group (group IT, n=19) received i.v. tramadol 1.5 mg kg(-1) and the perineural tramadol group (group T, n=20) received i.v. saline and PCB with tramadol 1.5 mg kg(-1). Postoperatively patients received regular paracetamol 6-hourly and diclofenac sodium 12-hourly. Time to first morphine analgesia, 24-hour morphine consumption, sensory block, pain and sedation scores and haemodynamic parameters were recorded. RESULTS: Time (h) to first morphine analgesia was similar in the three groups [mean (SD)]: group L, 11.2 (6.6); group T, 14.5 (8.0); group IT, 14.6 (6.8); P=0.35. Twenty-four-hour cumulative morphine (mg) consumption was also similar in the three groups [group L, 21.9 (10.1); group T, 19.8 (6.7), group IT, 16.5 (9.5)], as were durations of sensory and motor block. There were no differences in the incidence of adverse effects except that patients in group IT were more sedated at 14 h than group L (P=0.02). CONCLUSION: We conclude that our data do not support a clinically important local anaesthetic or peripheral analgesic effect of tramadol as adjunct to PCB with levobupivacaine 0.5%.

Pictorial Real, Historical Intermedial. Digital Aesthetics and the Representation of History in Eric Rohmer’s The Lady and the Duke

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Tagliani Giacomo

2016-09-01

Full Text Available In The Lady and the Duke (2001, Eric Rohmer provides an unusual and “conservative” account of the French Revolution by recurring to classical and yet “revolutionary” means. The interpolation between painting and film produces a visual surface which pursues a paradoxical effect of immediacy and verisimilitude. At the same time though, it underscores the represented nature of the images in a complex dynamic of “reality effect” and critical meta-discourse. The aim of this paper is the analysis of the main discursive strategies deployed by the film to disclose an intermedial effectiveness in the light of its original digital aesthetics. Furthermore, it focuses on the problematic relationship between image and reality, deliberately addressed by Rohmer through the dichotomy simulation/illusion. Finally, drawing on the works of Louis Marin, it deals with the representation of history and the related ideology, in order to point out the film’s paradoxical nature, caught in an undecidability between past and present.

Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial.

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Castro Dos Santos, Nídia Cristina; Andere, Naira Maria Rebelatto Bechara; Araujo, Cássia Fernandes; de Marco, Andrea Carvalho; Dos Santos, Lúcio Murilo; Jardini, Maria Aparecida Neves; Santamaria, Mauro Pedrine

2016-11-01

Diabetes has become a global epidemic. Its complications can have a significant impact on quality of life, longevity, and public health costs. The presence of diabetes might impair the prognosis of periodontal treatments due to its negative influence on wound healing. Antimicrobial photodynamic therapy (aPDT) is a local approach that can promote bacterial decontamination in periodontal pockets. The aim of this study was to investigate the local effect of adjunct aPDT to ultrasonic periodontal debridement (UPD) and compare it to UD only for the treatment of chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Two periodontal pockets with probing depth (PD) and clinical attachment level (CAL) ≥5 mm received UPD only (UPD group) or UPD plus adjunct aPDT (UPD + aPDT group). Periodontal clinical measures were collected and compared at baseline and 30, 90, and 180 days. After 180 days of follow-up, there were statistically significant reductions in PD from 5.75 ± 0.91 to 3.47 ± 0.97 mm in the UPD group and from 6.15 ± 1.27 to 3.71 ± 1.63 mm in the UPD + aPDT group. However, intergroup analysis did not reveal statistically significant differences in any of the evaluated clinical parameters (p > 0.05). The adjunct application of aPDT to UPD did not present additional benefits for the treatment of chronic periodontitis in type 2 diabetic patients. The ClinicalTrials.gov identifier of the present study is NCT02627534.

Proteomics in Hypothermia as Adjunctive Therapy in Patients with ST-Segment Elevation Myocardial Infarction

DEFF Research Database (Denmark)

Mohammad, Moman A; Noc, Marco; Lang, Irene

2017-01-01

Cardiovascular and inflammatory biomarkers in therapeutic hypothermia have been studied in cardiac arrest, but data on patients with ST-segment elevation myocardial infarction (STEMI) treated with therapeutic hypothermia are currently unavailable. A multiplex proximity extension assay allowed us...... patients with STEMI, randomized to hypothermia as adjunctive therapy to percutaneous coronary intervention (PCI) or standard care with PCI only. Blood samples were obtained at baseline (0 hour), 6, 24, and 96 hours post PCI, and stored at -80°C until they were analyzed by PROSEEK Multiplex CVD and PROSEEK...... in the hypothermia group as compared with the control group. In addition, seven markers were slightly elevated in the hypothermia group (OPG, FGF21, FS, IL12B, PRL, TIM, IL6). In a prespecified subgroup analysis of anterior infarctions, two additional markers were reduced (PTX3 and SELE). In this explorative...

Machine learning: a useful radiological adjunct in determination of a newly diagnosed glioma's grade and IDH status.

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De Looze, Céline; Beausang, Alan; Cryan, Jane; Loftus, Teresa; Buckley, Patrick G; Farrell, Michael; Looby, Seamus; Reilly, Richard; Brett, Francesca; Kearney, Hugh

2018-05-16

Machine learning methods have been introduced as a computer aided diagnostic tool, with applications to glioma characterisation on MRI. Such an algorithmic approach may provide a useful adjunct for a rapid and accurate diagnosis of a glioma. The aim of this study is to devise a machine learning algorithm that may be used by radiologists in routine practice to aid diagnosis of both: WHO grade and IDH mutation status in de novo gliomas. To evaluate the status quo, we interrogated the accuracy of neuroradiology reports in relation to WHO grade: grade II 96.49% (95% confidence intervals [CI] 0.88, 0.99); III 36.51% (95% CI 0.24, 0.50); IV 72.9% (95% CI 0.67, 0.78). We derived five MRI parameters from the same diagnostic brain scans, in under two minutes per case, and then supplied these data to a random forest algorithm. Machine learning resulted in a high level of accuracy in prediction of tumour grade: grade II/III; area under the receiver operating characteristic curve (AUC) = 98%, sensitivity = 0.82, specificity = 0.94; grade II/IV; AUC = 100%, sensitivity = 1.0, specificity = 1.0; grade III/IV; AUC = 97%, sensitivity = 0.83, specificity = 0.97. Furthermore, machine learning also facilitated the discrimination of IDH status: AUC of 88%, sensitivity = 0.81, specificity = 0.77. These data demonstrate the ability of machine learning to accurately classify diffuse gliomas by both WHO grade and IDH status from routine MRI alone-without significant image processing, which may facilitate usage as a diagnostic adjunct in clinical practice.

Stathmin 1 and p16(INK4A) are sensitive adjunct biomarkers for serous tubal intraepithelial carcinoma.

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Novak, Marián; Lester, Jenny; Karst, Alison M; Parkash, Vinita; Hirsch, Michelle S; Crum, Christopher P; Karlan, Beth Y; Drapkin, Ronny

2015-10-01

To credential Stathmin 1 (STMN1) and p16(INK4A) (p16) as adjunct markers for the diagnosis of serous tubal intraepithelial carcinoma (STIC), and to compare STMN1 and p16 expression in p53-positive and p53-negative STIC and invasive high-grade serous carcinoma (HGSC). Immunohistochemistry (IHC) was used to examine STMN1 and p16 expression in fallopian tube specimens (n=31) containing p53-positive and p53-negative STICs, invasive HGSCs, and morphologically normal FTE (fallopian tube epithelium). STMN1 and p16 expression was scored semiquantitatively by four individuals. The semiquantitative scores were dichotomized, and reported as positive or negative. Pooled siRNA was used to knockdown p53 in a panel of cell lines derived from immortalized FTE and HGSC. STMN1 and p16 were expressed in the majority of p53-positive and p53-negative STICs and concomitant invasive HGSCs, but only scattered positive cells were present in morphologically normal FTE. Both proteins were expressed consistently across multiple STICs from the same patient and in concomitant invasive HGSC. Knockdown of p53 in immortalized FTE cells and in four HGSC-derived cell lines expressing different missense p53 mutations did not affect STMN1 protein levels. This study demonstrates that STMN1 and p16 are sensitive and specific adjunct biomarkers that, when used with p53 and Ki-67, improve the diagnostic accuracy of STIC. The addition of STMN1 and p16 helps to compensate for practical limitations of p53 and Ki-67 that complicate the diagnosis in up to one third of STICs. Copyright © 2015 Elsevier Inc. All rights reserved.

Stathmin 1 and p16INK4A are sensitive adjunct biomarkers for serous tubal intraepithelial carcinoma

Science.gov (United States)

Novak, Marián; Lester, Jenny; Karst, Alison M.; Parkash, Vinita; Hirsch, Michelle S.; Crum, Christopher P.; Karlan, Beth Y.

2015-01-01

Objective To credential Stathmin 1 (STMN1) and p16INK4A (p16) as adjunct markers for the diagnosis of serous tubal intraepithelial carcinoma (STIC), and to compare STMN1 and p16 expression in p53-positive and p53-negative STIC and invasive high-grade serous carcinoma (HGSC). Methods Immunohistochemistry (IHC) was used to examine STMN1 and p16 expression in fallopian tube specimens (n=31) containing p53-positive and p53-negative STICs, invasive HGSCs, and morphologically normal FTE (fallopian tube epithelium). STMN1 and p16 expression was scored semiquantitatively by four individuals. The semiquantitative scores were dichotomized, and reported as positive or negative. Pooled siRNA was used to knockdown p53 in a panel of cell lines derived from immortalized FTE and HGSC. Results STMN1 and p16 were expressed in the majority of p53-positive and p53-negative STICs and concomitant invasive HGSCs, but only scattered positive cells were positive in morphologically normal FTE. Both proteins were expressed consistently across multiple STICs from the same patient and in concomitant invasive HGSC. Knockdown of p53 in immortalized FTE cells and in four HGSC-derived cell lines expressing different missense p53 mutations did not affect STMN1 protein levels. Conclusions This study demonstrates that STMN1 and p16 are sensitive and specific adjunct biomarkers that, when used with p53 and Ki-67, improve the diagnostic accuracy of STIC. The addition of STMN1 and p16 helps to compensate for practical limitations of p53 and Ki-67 that complicate the diagnosis in up to one third of STICs. PMID:26206555

Pentoxifylline therapy : A new adjunct in the treatment of oral submucous fibrosis

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Rajendran R

2006-01-01

Full Text Available OBJECTIVE : This study was designed to determine the effect of pentoxifylline (Trental on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. STUDY DESIGN : This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets. The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls were included in this study and 100% compliance was reported at the end ofthe test period. RESULTS : Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test. Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000, tongue protrusion (t= 3.898, p = 0.002, and relief from perioral fibrotic bands (p = 0.0001554. Subjective symptoms of intolerance to spices (p = 0.0063218, burning sensation of mouth (p = 0.0005797, tinnitus (p=0.000042, difficulty in swallowing (p=0.0000714. and difficulty in speech (p=0.0000020 were also recorded significant improvement at the end of the trial period. CONCLUSION : This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.

Effect of vitamin D supplementation as adjunctive therapy to methylphenidate on ADHD symptoms: A randomized, double blind, placebo-controlled trial.

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Mohammadpour, Nakisa; Jazayeri, Shima; Tehrani-Doost, Mehdi; Djalali, Mahmoud; Hosseini, Mostafa; Effatpanah, Mohammad; Davari-Ashtiani, Rozita; Karami, Elham

2018-04-01

Previous studies have shown that serum levels of vitamin D were lower in attention deficit hyperactivity disorder (ADHD) children compared to healthy controls. The aim of the study was to determine the effect of vitamin D supplementation as adjunctive therapy to methylphenidate on symptoms of children with ADHD. Sixty-two children aged 5-12 years with a diagnosis of ADHD based on DSM-IV criteria were randomly assigned into two groups to receive either 2000IU vitamin D or placebo in addition to methylphenidate for 8 weeks. Symptoms severity was assessed by Conner's Parent Rating Scale-Revised[S] (CPRS), ADHD rating scale-IV (ADHD-RS), and Weekly Parent Ratings of Evening and Morning Behavior (WPREMB) at weeks 0, 4, and 8. Serum levels of 25(OH)D were measured at baseline and after 8 weeks. Anthropometric variables, dietary intake, physical activity, sun exposure, and side effects were assessed. Fifty-four participants completed the trial. After 8 weeks of supplementation, serum levels of 25(OH)D significantly increased in the vitamin D group. ADHD symptoms decreased significantly in both groups (P D supplementation as adjunctive therapy to methylphenidate improved ADHD evening symptoms. Future research is needed to clarify vitamin D effects as monotherapy in ADHD and its mechanism. The trial was registered in www.irct.ir is (IRCT201404222394N10).

Assessment of proteolysis and sensory characteristics of prato cheese with adjunct cultureAvaliação da proteólise e das características sensoriais de queijo prato com cultura adjunta

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Priscila Cristina Bizam Vianna

2012-02-01

Full Text Available Influence of adjunct cultures on the chemical and sensory characteristics, and proteolysis of Prato cheese was investigated. Cheeses were manufactured using a commercial starter culture and Lactobacillus strains (Lactobacillus plantarum or Lactobacillus helveticus as adjunct cultures. Control cheeses lacked the adjunct culture. The chemical composition was analyzed at day 5 after manufacture and the proteolysis at days 5, 25, 45 and 65 of ripening. The sensory acceptance was assessed at 60 days. A split-plot design was used and the complete experiment was carried out in triplicate. The results were evaluated by ANOVA and Tukey’s test test at 5% significance level. There were no significant differences in chemical composition among the cheeses. A significant increase in proteolysis occurred during ripening period for the cheeses with adjunct culture when compared to cheeses without adjunct culture. Cheese with Lactobacillus helveticus showed higher scores for flavor, texture and purchase intent compared with the others treatments. Use of adjunct Lactobacillus suggests that the proteolysis of Prato cheese should be accelerated in order to reduce ripening period. A influência de culturas adjuntas sobre as características químicas e sensoriais, e sobre a proteólise do queijo Prato foi avaliada. Os queijos foram fabricados com cultura starter comercial e cepas de Lactobacillus (Lactobacillus plantarum ou Lactobacillus helveticus como culturas adjuntas. Os queijos controle não foram adicionados de cultura adjunta. A composição química foi analisada no dia 5 após a fabricação e a proteólise nos dias 5, 25, 45 e 65 de maturação. A aceitação sensorial foi avaliada em 60 dias. Um delineamento de parcelas subdivididas foi utilizado e o experimento completo foi realizado em triplicata. Os resultados foram avaliados pela análise de variância e teste de Tukey no nível de 5% de probabilidade. Os queijos não apresentaram diferen

Usefulness of intra-articular bupivacain and lidocain adjunction in MR or CT arthrography: A prospective study in 148 patients

International Nuclear Information System (INIS)

Mosimann, Pascal J.; Richarme, Delphine; Becce, Fabio; Knoepfli, Anne-Sophie; Mino, Vincent; Meuli, Reto; Theumann, Nicolas

2012-01-01

Purpose: To evaluate the influence of shorter- and longer-acting intra-articular anaesthetics on post-arthrographic pain. Materials and methods: 154 consecutive patients investigated by MR or CT arthrographies were randomly assigned to one of the following groups: 1 – intra-articular contrast injection only; 2 – lidocain 1% adjunction; or 3 – bupivacain 0.25% adjunction. Pain was assessed before injection, at 15 min, 4 h, 1 day and 1 week after injection by visual analogue scale (VAS). Results: At 15 min, early mean pain score increased by 0.96, 0.24 and 0 in groups 1, 2 and 3, respectively. Differences between groups 1 and 3 and 1 and 2 were statistically significant (p = 0.003 and 0.03, respectively), but not between groups 2 and 3 (p = 0.54). Delayed mean pain score increase was maximal at 4 h, reaching 1.60, 1.22 and 0.29 in groups 1, 2 and 3, respectively. Differences between groups 1 and 2 and 2 and 3 were statistically significant (p = 0.002 and 0.02, respectively), but not between groups 1 and 2 (p = 0.46). At 24 h and 1 week, the interaction of local anaesthetics with increase in pain score was no longer significant. Results were independent of age, gender and baseline VAS. Conclusion: Intra-articular anaesthesia may significantly reduce post-arthrographic pain. Bupivacain seems to be more effective than lidocain to reduce both early and delayed pain

A New Probiotic Cheddar Cheese with High ACE-Inhibitory Activity and γ-Aminobutyric Acid Content Produced with Koumiss-Derived Lactobacillus casei Zhang

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Hai Kuan Wang

2010-01-01

Full Text Available Cheddar cheese has been manufactured with Lactobacillus casei Zhang as the dairy starter adjunct. L. casei Zhang had previously been isolated from koumiss collected from Xilin Guole in Inner Mongolia and characterized in detail with regard to their probiotic potential. The addition of L. casei Zhang to Cheddar cheese had no adverse effects on sensory criteria. The cheese made with 0.1, 1 and 2 % of the probiotic strain L. casei Zhang adjuncts contained high levels of the Lactobacillus after 6 months of ripening with final counts of 9.6·10^7, 7.7·10^7 and 1.02·10^8 CFU/g, respectively. In the ripe control cheese, without the addition of probiotic strain L. casei Zhang, the number of Lactobacillus reached 5.7·107 CFU/g. Enterobacterial repetitive intergenic consensus PCR (ERIC-PCR analysis was used to distinguish the added L. casei Zhang from the natural flora of the cheese and to determine whether L. casei Zhang grew in the cheese. ACE-inhibitory activity and γ-aminobutyric acid (GABA concentrations in the cheese were measured. Compared with control cheese, experimental cheese with 0.1, 1 and 2 % of probiotic strain L. casei Zhang revealed some increase in ACE-inhibitory activity and GABA mass fraction. In the present study, the production of both ACE-inhibitory activity and GABA in the probiotic cheese with the L. casei Zhang adjunct isolated from koumiss has been found for the first time. The results suggest that cheese with the probiotic strain L. casei Zhang showed good potential for application in the management of hypertension.

E-mail support as an adjunct to cognitive-behavioral group therapy for social anxiety disorder: Impact on dropout and outcome

OpenAIRE

Delsignore, Aba; Rufer, Michael; Emmerich, Juliane; Weidt, Steffi; Brühl, Annette Beatrix; Moergeli, Hanspeter

2016-01-01

The present study evaluates the impact of semi-individualized e-mail support as an adjunct to cognitive behavioral group therapy (CBGT) for social anxiety disorder (SAD) on dropout and outcome. The effectiveness of additional semi-individualized e-mail support was evaluated for the whole sample and for a subsample of patients at risk of dropping out of therapy. A total of 91 patients with SAD were allocated either to the intervention condition (CBGT with e-mail support), or to the control con...

Technology Components as Adjuncts to Family-Based Pediatric Obesity Treatment in Low-Income Minority Youth.

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Tripicchio, Gina L; Ammerman, Alice S; Neshteruk, Cody; Faith, Myles S; Dean, Kelsey; Befort, Christie; Ward, Dianne S; Truesdale, Kimberly P; Burger, Kyle S; Davis, Ann

2017-12-01

Strategies to treat pediatric obesity are needed, especially among high-need populations. Technology is an innovative approach; however, data on technology as adjuncts to in-person treatment programs are limited. A total of 64 children [body mass index (BMI) ≥85th percentile, mean age = 9.6 ± 3.1 years, 32.8% female, 84.4% Hispanic] were recruited to participate in one of three cohorts of a family-based behavioral group (FBBG) treatment program: FBBG only, TECH1, and TECH2. Rolling, nonrandomized recruitment was used to enroll participants into three cohorts from May 2014 to February 2015. FBBG began in May 2014 and received the standard, in-person 12-week treatment only (n = 21); TECH1 began in September 2014 and received FBBG plus a digital tablet equipped with a fitness app (FITNET) (n = 20); TECH2 began in February 2015 and received FBBG and FITNET, plus five individually tailored TeleMed health-coaching sessions delivered via Skype (n = 23). Child BMI z-score (BMI-z) was assessed at baseline and postintervention. Secondary aims examined weekly FBBG attendance, feasibility/acceptability of FITNET and Skype, and the effect of technology engagement on BMI-z. FBBG and TECH1 participants did not show significant reductions in BMI-z postintervention [FBBG: β = -0.05(0.04), p = 0.25; TECH1: β = -0.006(0.06), p = 0.92], but TECH2 participants did [β = -0.09(0.02), p < 0.001] and TeleMed session participation was significantly associated with BMI-z reduction [β = -0.04(0.01), p = 0.01]. FITNET use and FBBG attendance were not associated with BMI-z in any cohort. Overall, participants rated the technology as highly acceptable. Technology adjuncts are feasible, used by hard-to-reach participants, and show promise for improving child weight status in obesity treatment programs.

Significant Effects of Oral Phenylbutyrate and Vitamin D3 Adjunctive Therapy in Pulmonary Tuberculosis: A Randomized Controlled Trial.

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Akhirunnesa Mily

Full Text Available Development of new tuberculosis (TB drugs and alternative treatment strategies are urgently required to control the global spread of TB. Previous results have shown that vitamin D3 (vitD3 and 4-phenyl butyrate (PBA are potent inducers of the host defense peptide LL-37 that possess anti-mycobacterial effects.To examine if oral adjunctive therapy with 5,000IU vitD3 or 2x500 mg PBA or PBA+vitD3 to standard chemotherapy would lead to enhanced recovery in sputum smear-positive pulmonary TB patients.Adult TB patients (n = 288 were enrolled in a randomized, double-blind, placebo-controlled trial conducted in Bangladesh. Primary endpoints included proportions of patients with a negative sputum culture at week 4 and reduction in clinical symptoms at week 8. Clinical assessments and sputum smear microscopy were performed weekly up to week 4, fortnightly up to week 12 and at week 24; TB culture was performed at week 0, 4 and 8; concentrations of LL-37 in cells, 25-hydroxyvitamin D3 (25(OHD3 in plasma and ex vivo bactericidal function of monocyte-derived macrophages (MDM were determined at week 0, 4, 8, 12 and additionally at week 24 for plasma 25(OHD3.At week 4, 71% (46/65 of the patients in the PBA+vitD3-group (p = 0.001 and 61.3% (38/62 in the vitD3-group (p = 0.032 were culture negative compared to 42.2% (27/64 in the placebo-group. The odds of sputum culture being negative at week 4 was 3.42 times higher in the PBA+vitD3-group (p = 0.001 and 2.2 times higher in vitD3-group (p = 0.032 compared to placebo. The concentration of LL-37 in MDM was significantly higher in the PBA-group compared to placebo at week 12 (p = 0.034. Decline in intracellular Mtb growth in MDM was earlier in the PBA-group compared to placebo (log rank 11.38, p = 0.01.Adjunct therapy with PBA+vitD3 or vitD3 or PBA to standard short-course therapy demonstrated beneficial effects towards clinical recovery and holds potential for host-directed-therapy in the treatment of TB

Creativity abhors prescription

Science.gov (United States)

Kurt Riitters

2011-01-01

Eric Gustafson (2011) has initiated a discussion aimed at advancing the field of landscape ecology by revising scientific publication formats including better use of information technology. I empathize with Eric - it is difficult to determine quickly if a paper is worth reading, and some papers were not worth reading after all.

Physical therapy as an adjunctive treatment for severe osteoarthritis in a Komodo dragon (Varanus komodoensis).

Science.gov (United States)

Wolfe, Tammy Culpepper; Stringer, Elizabeth; Krauss, Sue; Trout, Tim

2015-03-01

This case report describes a new physical therapy technique, specifically the Wolfe Kinetic Technique, as adjunctive therapy in the treatment of severe osteoarthritis in a 20-yr-old Komodo dragon (Varanus komodoensis). This animal was managed with oral analgesics for 3 yr with fair to minimal response over time. Due to worsening of lameness and mobility, physical therapy was initiated. Ten treatment sessions were administered at 1-wk intervals. Within 1 mo the Komodo dragon exhibited marked improvement in gait and function, increased responsiveness to his environment, and increased mobility which continued to improve over the subsequent sessions. Although outcomes could not be measured by standardized objective measures, this study provides a reference for treatment of future cases and a foundation for future research substantiating treatment practices in animal physical therapy.

Efficacy of adjunctive mitomycin C in transcanalicular diode laser dacryocystorhinostomy in different age groups.

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Kar, Taner; Yildirim, Yildiray; Topal, Tuncay; Çolakoğlu, Kadir; Ünal, Melih Hamdi

2016-01-01

To evaluate the efficacy of adjunctive mitomycin C (MMC) in transcanalicular multidiode laser dacryocystorhinostomy (TCL-DCR) in different age groups. Ninety-six eyes of 96 patients who underwent TCL-DCR for the treatment of nasolacrimal duct obstruction were included in this retrospective, comparative study. Patients were divided into 4 groups based on age and intraoperative use of MMC: group 1, TCL-DCR without MMC in the 20- to 44-year age group; group 2, TCL-DCR with MMC in the 20- to 44-year age group; group 3, TCL-DCR without MMC in the 45- to 76-year age group; group 4, TCL-DCR with MMC in the 45- to 76-year age group. The postoperative evaluation consisted of calculating and comparing the success rates between groups. Success rates at the final visit were 50% for group 1, 66.66% for group 2, 79.16% for group 3, and 84.61% for group 4. The differences between group 1 and group 4, and group 1 and group 3, were significant (p = 0.01 and p = 0.038, respectively). Logistic regression showed that age group had significant effect on success rate (p = 0.013). However, use of MMC had no significant effect on success rate (p = 0.23). The success rates of the TCL-DCR with MMC application were found to be higher than those of TCL-DCR without MMC in different age groups. However, the differences did not reach statistical significance. In addition, our study demonstrated that age may be a significant factor influencing the surgical outcome of TCL-DCR.

Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies.

Science.gov (United States)

Kerley, Conor P; Elnazir, Basil; Faul, John; Cormican, Liam

2015-06-01

Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25-dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard anti-asthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity. Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis. The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

The selective glycine uptake inhibitor org 25935 as an adjunctive treatment to atypical antipsychotics in predominant persistent negative symptoms of schizophrenia: results from the GIANT trial.

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Schoemaker, Joep H; Jansen, Wim T; Schipper, Jacques; Szegedi, Armin

2014-04-01

Using a selective glycine uptake inhibitor as adjunctive to second-generation antipsychotic (SGA) was hypothesized to ameliorate negative and/or cognitive symptoms in subjects with schizophrenia. Subjects with predominant persistent negative symptoms (previously stabilized ≥3 months on an SGA) were enrolled in a randomized, placebo-controlled trial to investigate adjunctive treatment with Org 25935, a selective inhibitor of type 1 glycine transporter, over 12 weeks in a flexible dose design. Org 25935 was tested at 4 to 8 mg twice daily and 12 to 16 mg twice daily versus placebo. Primary efficacy outcome was mean change from baseline in Scale for Assessment of Negative Symptoms composite score. Secondary efficacy end points were Positive and Negative Syndrome Scale total and subscale scores, depressive symptoms (Calgary Depression Scale for Schizophrenia), global functioning (Global Assessment of Functioning scale), and cognitive measures using a computerized battery (Central Nervous System Vital Signs). Responder rates were assessed post hoc. A total of 215 subjects were randomized, of which 187 (87%) completed the trial. Both dose groups of Org 25935 did not differ significantly from placebo on Scale for Assessment of Negative Symptoms, Positive and Negative Syndrome Scale (total or subscale scores), Global Assessment of Functioning, or the majority of tested cognitive domains. Org 25935 was generally well tolerated within the tested dose range, with no meaningful effects on extrapyramidal symptoms and some reports of reversible visual adverse effects. Org 25935 did not differ significantly from placebo in reducing negative symptoms or improving cognitive functioning when administered as adjunctive treatment to SGA. In our study population, Org 25935 appeared to be well tolerated in the tested dose ranges.

Bioimpedance and chronoamperometry as an adjunct to prostate-specific antigen screening for prostate cancer

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Abreu DS

2011-04-01

Full Text Available Darci Schiavon de AbreuDepartment of Urology, Hospital Unimed de Limeira, Sao Paulo, BrazilBackground: Bioimpedance is an electrical property of living tissue that has been shown to be a safe technique when used in a number of biomedical applications. The aim of this research was to assess the utility of bioimpedance measurement as a rapid, cost-effective, and noninvasive adjunct to digital rectal examination and PSA in differentiating tumor from normal prostatic tissue.Methods: Three hundred men were examined for signs and symptoms of prostate disorders. 147 patients with a digital rectal examination indicating a positive result underwent a prostate-specific antigen (PSA test. A biopsy was advised for 103 of the men, of whom 50 completed the study. Before undergoing biopsy, an examination with the EIS (electro interstitial scan system using bioimpedance and chronoamperometry was performed. In reference to the biopsy results (negative or positive, a statistical analysis of the EIS data and PSA was conducted using receiver operating characteristic curves to determine the specificity and sensitivity of each test.Results: The PSA test had a sensitivity of 73.9% and specificity of 51.9% using a cutoff value >4 and a sensitivity of 52.2% and specificity of 81.5% using a cutoff value ≥5.7 and P = 0.03. The delta of the electrical conductivity (DE of the left foot-right foot pathway had a sensitivity of 62.5% and specificity of 85.2%, with a cutoff value ≤-5 and P = 0.0001. Algorithms comprising the delta of electrical conductivity and PSA showed a sensitivity of 91.5% and a specificity of 59.3%, with a cutoff value ≤-10.52 and P = 0.0003.Conclusion: The EIS system had a very good specificity of 85.2%. However, the sensitivity of 62.5% would be a problem. Using a PSA reference >4.1 ng/mL, the adjunctive use of bioimpedance and chronoamperometry provided by EIS technology could raise the sensitivity from 73.9% to 91.5% and the specificity from 51

Contrasting Complement Control, Temporal Adjunct Control and Controlled Verbal Gerund Subjects in ASD: The Role of Contextual Cues in Reference Assignment

OpenAIRE

Janke, Vikki; Perovic, Alexandra

2017-01-01

This study examines two complex syntactic dependencies (complement control and sentence-final temporal adjunct control) and one pragmatic dependency (controlled verbal gerund subjects) in children with ASD. Sixteen high-functioning (HFA) children (aged 6 to 16) with a diagnosis of autism and no language impairment, matched on age, gender and non-verbal MA to one TD control group, and on age, gender and verbal MA to another TD control group, undertook three picture-selection tasks. Task 1 meas...

Design and rationale of a 16-week adjunctive randomized placebo-controlled trial of mitochondrial agents for the treatment of bipolar depression.

Science.gov (United States)

Dean, Olivia M; Turner, Alyna; Malhi, Gin S; Ng, Chee; Cotton, Sue M; Dodd, Seetal; Sarris, Jerome; Samuni, Yuval; Tanious, Michelle; Dowling, Nathan; Waterdrinker, Astrid; Smith, Deidre; Berk, Michael

2015-01-01

Bipolar disorder places a significant burden on individuals, caregivers and family, and the broader community. Current treatments are believed to be more effective against manic symptoms, leaving a shortfall in recovery during the depressive phase of the illness. The current study draws on recent evidence suggesting that, in addition to increased oxidative load, alterations in mitochondrial function occur in bipolar disorder. This 16-week study aims to explore the potential benefits of N-acetylcysteine (NAC) alone or in combination (CT) with selected nutraceuticals believed to enhance mitochondrial function. The study includes adults diagnosed with bipolar disorder currently experiencing an episode of depression. Participants are asked to take NAC, CT, or placebo in addition to any usual treatments. A post-discontinuation visit is conducted 4 weeks following the treatment phase. The primary outcome of the study will be mean change on the Montgomery-Asberg Depression Rating Scale. Secondary outcomes include functioning, substance use, mania ratings, and quality of life. Blood samples will be collected at baseline and week 16 to explore biochemical alterations following treatment. This study may provide a novel adjunctive treatment for bipolar depression. Analysis of biological samples may assist in understanding the therapeutic benefits and the underlying etiology of bipolar depression. Australian and New Zealand Clinical Trial Registry ACTRN12612000830897.

Effects of local alendronate sodium gel as an adjunct to scaling and root planing on smokers with chronic periodontitis: a pilot study

Directory of Open Access Journals (Sweden)

Farin Kiany

2017-04-01

Full Text Available Background: Chemical treatments for the modulation of host response are applied along with mechanical modalities as adjunctive to periodontal treatment. The objective of this pilot study was to investigate the effects of locally-delivered alendronate sodium gel in adjunction to scaling and root planning on periodontal indices and bone formation within vertical defects of smokers with chronic periodontitis. Methods and Materials: In this study vertical defects (n=8 with depth>5 mm have been investigated. After performing the phase I of periodontal treatment, alendronate sodium gel (1% was applied into the periodontal pockets. The whole procedure was repeated after 4 weeks. Periodontal indices (plaque and bleeding, probing depth, gingival recession, and radiographic parameter (depth of bony defect were measured at the beginning and following 6 months. Results: Compared to pre-treatment, the probing depth, radiographic depth of bony defect and bleeding and plaque indices were significantly reduced by local application of alendronate sodium gel (P=0.026; P=0.012 and P=0.007 respectively. Gingival recession showed significant increase (P=0.011. Conclusion: Local alendronate sodium gel (1% plays an important role in the improvement process of periodontal indices and bone formation within vertical bony defects of smoker patients with chronic periodontitis.

Filosofía y violencia. Del absoluto a la acción en la Lógica de la filosofía de Eric Weil

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Roberto Saldías Barrer

2013-01-01

Full Text Available Las tensiones y los vínculos posibles entre razón y violencia son un problema mayor para la filosofía. La obra de Eric Weil se consagra precisamente al análisis de las figuras históricas de dicha tensión, y su obra mayor, Logique de la Philosophie, desarrolla lo fundamental de dicho propósito. Se analiza la manera como Weil, desde la categoría de la acción –última categoría concreta de la filosofía–, en vínculo con las categorías precedentes (absoluto, obra, finito y con las categorías formales (sentido y sabiduría, enfrenta este desafío siempre nuevo para la filosofía.

Mechanical Thrombectomy with the Embolus Retriever with Interlinked Cages in Acute Ischemic Stroke

DEFF Research Database (Denmark)

Steglich-Arnholm, H; Kondziella, D; Wagner, A

2017-01-01

BACKGROUND AND PURPOSE: The Embolus Retriever with Interlinked Cages (ERIC) device is a novel stent retriever for mechanical thrombectomy. It consists of interlinked cages and could improve procedural benchmarks and clinical outcome compared with classic stent retrievers. This study compares.......00). However, in patients treated with the ERIC device, thrombectomy procedures were less time-consuming (67 versus 98 minutes,P= .009) and a rescue device was needed less often (18% versus 39%,P= .02) compared with classic stent retrievers. CONCLUSIONS: Mechanical thrombectomy with the ERIC device...... the rates of recanalization, favorable clinical outcome, procedural adverse events, and benchmarks between the ERIC device and classic stent retrievers. MATERIALS AND METHODS: From 545 patients treated with thrombectomy between 2012 and 2015, 316 patients were included. The mean age was 69 ±13 years...

Ketamine as an Adjunct to Opioids for Acute Pain in the Emergency Department: A Randomized Controlled Trial.

Science.gov (United States)

Bowers, Karen J; McAllister, Kelly B; Ray, Meredith; Heitz, Corey

2017-06-01

This study had five objectives: 1) to measure and compare total opioid use and number of opioid doses in patients treated with opioids versus ketamine in conjunction with opioids; 2) to measure pain scores up to 2 hours after presentation in the ED patient with pain, comparing standard opioid pain control to ketamine in conjunction with opioids; 3) to compare patient satisfaction with pain control using opioids alone versus ketamine in conjunction with opioids; 4) to monitor and compare side effects in patients treated with opioids versus ketamine in conjunction with opioids; and 5) to identify effect variation between different subgroups of patients, with the purpose of focusing future research. We hypothesized that low-dose ketamine, compared to placebo, as an adjunctive treatment to opioids would result in better pain control over 2 hours and greater patient satisfaction with pain control; further, this protocol will result in a lower opioid dosage over 2 hours. This was a randomized, double-blinded, placebo-controlled trial at a single academic emergency department evaluating the use of ketamine versus placebo in conjunction with opioids for moderate to severe pain. Subjects with a continued high level of pain after an initial dose of opioid analgesia were randomized to receive either 0.1 mg/kg ketamine or placebo prior to protocol-based dosing of additional opioid analgesia, if required. Over 120 minutes, subjects were assessed for pain level (0-10), satisfaction with pain control (0-4), side effects, sedation level, and need for additional pain medication. Total opioid dose, including the initial dose, was compared between groups. Sixty-three subjects were randomized to the placebo group and 53 to the ketamine group. No significant differences were found in demographics between the groups. Patients receiving ketamine reported lower pain scores over 120 minutes than patients receiving placebo (p = 0.015). Total opioid dose was lower in the ketamine group

Combined photoablative and photodynamic diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized split-mouth clinical trial.

Science.gov (United States)

Giannelli, Marco; Formigli, Lucia; Lorenzini, Luca; Bani, Daniele

2012-10-01

Comparing the efficacy of photoablative and photodynamic diode laser in adjunct to scaling -root planing (SRP) and SRP alone for the treatment of chronic periodontitis. Twenty-six patients were studied. Maxillary left or right quadrants were randomly assigned to sham-laser treatment + SRP or laser + SRP. This consisted of photoablative intra/extra-pocket de-epithelization with diode laser (λ = 810 nm), followed by single SRP and multiple photodynamic treatments (once weekly, 4-10 applications, mean ± SD: 3.7 ± 2.4) using diode laser (λ = 635 nm) and 0.3% methylene blue as photosensitizer. The patients were monitored at days 0 and 365 by clinical assessment (probing depth, PD; clinical attachment level, CAL; bleeding on probing, BOP) and at days 0, 15, 30, 45, 60, 75, 90, 365 by cytofluorescence analysis of gingival exfoliative samples taken in proximity of the teeth to be treated (polymorphonuclear leukocytes, PMN; red blood cells, RBC; damaged epithelial cells, DEC; bacteria). At day 365, compared with the control quadrants, the laser + SRP therapy yielded a significant (p Diode laser treatment (photoablation followed by multiple photodynamic cycles) adjunctive to conventional SRP improves healing in chronic periodontitis patients. © 2012 John Wiley & Sons A/S.

Focus group positioning and analysis: a commentary on adjuncts for enhancing the design of health care research.

Science.gov (United States)

Johnson, B C

1990-01-01

As health care competition increases, and as the penalties for making poor decisions become potentially more devastating, market research continues to play an increasingly important role in the decision-making process for hospitals. Concern over the appropriate use of market research and the costs related to it remains high. As such, efficiency in research design and clarity in research outcome are clearly the goals. This paper examines the focus group process and its adjunctive role in enhancing the overall design of health care market research. Specifically, the function and placement of focus groups within the research plan as well as several methods of creative focus group analysis are considered within the context of an effective research design.

Efficacy evaluation of Bauhinia variegata L. stem bark powder as adjunct therapy in chronic Staphylococcus aureus mastitis in goat

Science.gov (United States)

Dash, Jeevan Ranjan; Sar, Tapas Kumar; Samanta, Indranil; Pal, Subodh; Khan, Madhuchhanda; Patra, Nimai Charan; Sarkar, Uttam; Maji, Asit Kumar; Mandal, Tapan Kumar

2014-01-01

Objective: The objective was to study the effect of Bauhinia variegata L. stem bark powder as adjunct therapy in chronic Staphylococcus aureus mastitis in goat. Materials and Methods: Mastitis was induced by intracisternal inoculation of coagulase positive S. aureus (J638) at the concentration of 2000 colony forming units. Group I animals were treated with repeated dose of ceftriaxone at 20 mg/kg intravenously, and Group II animals were treated with once daily oral administration of B. variegata L. stem bark powder at 6 g/kg for 7 days followed by maintenance dose at 3 g/kg for next 7 days along with repeated dose of the antibiotic at 20 mg/kg intravenously at 4 days interval. Results: No significant improvement in the clinical condition of the udder was noticed in the group treated with repeated dose of ceftriaxone alone. However, in the group treated with B. variegata L. stem bark powder along with repeated dose of ceftriaxone, no S. aureus colony was seen at 96 h and onwards in milk samples with a marked decrease in somatic cell count and milk alkaline phosphatase activity and increased lactoperoxidase activity. Further, plasma and milk concentration of ceftriaxone/ceftizoxime was increased, which indicated antibacterial, bioenhancing and antiinflammatory properties of the bark powder. The Group II animals also exhibited marked reduction in polymorphonuclear cells and fibrous tissue indicating antifibrotic property of B. variegata L. Conclusion: B. variegata L. stem bark powder can be considered as an effective adjunct therapy to intravenous ceftriaxone in S. aureus chronic mastitis in goat. PMID:25298668

Prenatal Detection of Bladder Wall Involvement in Invasive Placentation with Sequential Two-dimensional and Adjunctive Three-dimensional Ultrasonography

Directory of Open Access Journals (Sweden)

Min-Min Chou

2009-03-01

Conclusion: 3D US may be a useful adjunctive tool in refining 2D ultrasonographic techniques to identify the extent and degree of placental invasion of the bladder. The advantages of 3D US are: (1 a multiplanar image display allows viewing of sections from sagittal, coronal and axial planes at the same time, thereby more accurately determining the location and extent of placental invasion; (2 the viewing planes of the spatial angioarchitecture network can be arbitrarily manipulated to better delineate the aberrant vessels protruding into the bladder; (3 3D reconstruction images can be clearly displayed by live 3D in a rotation mode for a better illustrative effect.

Evaluation of isoprinosine to be repurposed as an adjunct anti-tuberculosis chemotherapy.

Science.gov (United States)

Mishra, Alok K; Yabaji, Shivraj M; Dubey, Rikesh K

2018-06-01

Isoprinosine (Inos) or immunovir is a synthetic purine derivative with immune-modulatory and antiviral properties. The drug shows apparent in vivo enhancement of host immune responses by inducing pro-inflammatory cytokines and rapid proliferation of T-cell subsets. Strikingly, the cytokines induced by Inos also play crucial roles in providing immune resistance against Mycobacterium tuberculosis (Mtb). Inos has been licensed for several antiviral diseases; however, its efficacy against Mtb has not been tested yet. Since Mtb subverts the host immune system to survive within the host. Therefore, we hypothesized that the immune-stimulatory properties of Inos can be explored as an adjunct therapy for the management of tuberculosis. We have also outlined a systematic direction of study to evaluate if Inos could be repurposed for tuberculosis. The in vivo studies for therapeutic evaluation of Inos alone or in combination with the first line anti-TB drugs in a suitable TB disease model would provide a clearer picture of its utility as a host-directed anti-TB drug and may endow us with a new application of an existing drug to combat tuberculosis. Copyright © 2018 Elsevier Ltd. All rights reserved.

Clobazam as an adjunctive therapy in treating seizures associated with Lennox–Gastaut syndrome

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Leahy JT

2011-11-01

Full Text Available Jennifer T Leahy1, Catherine J Chu-Shore1,2, Janet L Fisher3 1Massachusetts General Hospital, Department of Neurology, Programs in Neurophysiology and Epilepsy, Boston, MA, 2Harvard Medical School, Boston, MA, 3University of South Carolina School of Medicine, Department of Pharmacology, Physiology and Neuroscience, Columbia, SC, USA Abstract: Lennox–Gastaut syndrome (LGS is a devastating childhood epilepsy syndrome characterized by the occurrence of multiple types of seizures and cognitive decline. Most children suffer from frequent seizures that are refractory to current medical management. Recent clinical trials have suggested that addition of clobazam may improve the clinical outcome for some LGS patients. Although clobazam has been available for over five decades, it has only recently been approved by the US Food and Drug Administration for this indication. As a 1,5-benzodiazepine, clobazam is structurally related to the widely used 1,4-benzodiazepines, which include diazepam. Clobazam has been shown to modulate GABAergic neurotransmission by positive allosteric modulation of GABAA receptors, and to increase expression of transporters for both GABA and glutamate. The active metabolite n-desmethylclobazam (norclobazam also modulates GABAA receptors, and the relative importance of these two compounds in the clinical effectiveness of clobazam remains an open question. Clinical trials involving clobazam as an addon therapy in a variety of pediatric epilepsy populations have found a significant improvement in seizure control. In patients with LGS, clobazam may have greatest efficacy for drop seizures. Longstanding clinical experience suggests that clobazam is a safe and well tolerated antiepileptic drug with infrequent and mild adverse effects. These results suggest that adjunctive treatment with clobazam may be a reasonable option for LGS patients, particularly those who are treatment-resistant. Keywords: benzodiazepine, epilepsy, gamma

Effect of using propionic acid bacteria as an adjunct culture in yogurt production.

Science.gov (United States)

Ekinci, F Y; Gurel, M

2008-03-01

Propionibacteria are able to produce a wide variety of food components beneficial to human health. In this study, yogurt was produced by using the adjunct starter cultures Propionibacterium jensenii B1264 and Propionibacterium thoenii (jensenii) P126. Although the total solids and protein contents of the yogurts did not show any significant differences, titratable acidity of the control sample (YC-380) remained lower than that of Propionibacterium spp.-supplemented yogurts during 15 d of storage. The yogurts produced by YC-380 + P126 cultures had the firmest structure (0.26 N). The highest acetaldehyde (29.35 mg/kg) content was obtained with yogurt made with YC-380 + P126 + B1264 on d 1. The addition of propionibacteria to yogurt did not have any negative effect on the counts of Streptococcus thermophilus and Lactobacillus delbrueckii ssp. bulgaricus in yogurt. During the first week of storage, propionibacteria counts remained high, suggesting that yogurt provided a good environment for these organisms. This new product would provide not only beneficial health effects, but also a new alternative product to plain set-type yogurt.

Treating malfunction filtering bleb with repeated needling combined with adjunctive 5-FU after glaucoma filtration surgery

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Yi Liu

2013-07-01

Full Text Available AIM: To evaluate the therapeutic efficacy of a repeated bleb needling technique combined with subconjunctival injection of 5-FU in eyes with previous glaucoma surgery that had malfunctional filtering blebs. METHODS: A retrospective review of 34 consecutive patients(34 eyesof repeated bleb needling combined with subconjunctival injection of 5-FU in eyes, which had malfunctional filtering blebs after previous glaucoma surgery in our hospital from March 2009 to February 2013 was performed. The intraocular pressures(IOP, shapes of filtering blebs and complications after surgery were analyzed. RESULTS: There was significant reduction of mean IOP from 35.51mmHg to 14.43mmHg(PCONCLUSION: Repeated needling with adjunctive 5-FU proved a highly effective, safe alternative to treat malfunctional filtering blebs after previous glaucoma surgery.

Immunohistochemical detection of hTERT in urothelial lesions: a potential adjunct to urine cytology

Directory of Open Access Journals (Sweden)

Khalbuss Walid

2006-08-01

Full Text Available Abstract Background Urine cytology has a critical role in evaluation for bladder carcinoma. Due to the low sensitivity of this technique, ancillary modalities such as the detection of markers of malignancy by immunochemistry are desirable. Promising factors in this context are components of the human telomerase enzyme complex. Telomerase repairs and extend telomeres, which when eroded beyond a critical limit trigger a senescence checkpoint. Accordingly, while absent in normal somatic cells, telomerase activity has been detected in the great majority of malignant tumor specimens tested, and so has potential value for the recognition of malignant cells in clinical specimens. Methods In this study, we investigated whether the immunohistochemical detection of the catalytic subunit of telomerase (hTERT can aid cytology in the diagnosis of bladder lesions. Findings from the retrospective evaluation of over 100 cell blocks, including urine sediments from confirmed malignant and benign conditions, were compared with routine urine cytology data. Results The presence of hTERT protein was indicative of the transformation of urothelia to a malignant phenotype. Nucleolar hTERT was expressed in 27 (93% of 29 samples obtained from patients with confirmed primary bladder cancer. Conversely, hTERT was detectable in only 3 (0.8% of 39 samples from benign conditions. The hTERT assay showed higher diagnostic sensitivity (84.8% than published urine cytology data (~65% for confirmed bladder carcinoma, however, the hTERT assay was less specific than cytology (65.2% vs. ~95% respectively. Conclusion As a highly sensitive marker, immunohistochemical hTERT detection in urine sediments represents a reliable adjunct to cytology in the accurate diagnosis of urothelial neoplasms.

Percutaneous lower-extremity arterial interventions with primary balloon angioplasty versus Silverhawk atherectomy and adjunctive balloon angioplasty: randomized trial.

Science.gov (United States)

Shammas, Nicolas W; Coiner, Denise; Shammas, Gail A; Dippel, Eric J; Christensen, Lori; Jerin, Michael

2011-09-01

Target lesion revascularization (TLR) with primary percutaneous transluminal angioplasty (PTA) versus SilverHawk atherectomy and adjunctive PTA of de novo infrainguinal disease has not been well defined. This study was conducted to compare the two approaches. In this prospective, two-center randomized trial of PTA versus atherectomy of infrainguinal vessels, the primary endpoint of TLR was evaluated at 1 year. Secondary endpoints included the rate of "bailout" stent placement for suboptimal acute angiographic results and the rate of target vessel revascularization (TVR). Fifty-eight patients were included in the study. Of these, 29 (36 vessels) were randomized to the atherectomy arm and 29 (48 vessels) to the PTA arm. Final acute angiographic success rates were 100% in the PTA arm and 97.2% in the atherectomy arm (P value not significant). There was no statistical difference in TLR (16.7% vs 11.1%) or TVR (21.4% vs 11.1%) between the PTA and atherectomy groups, respectively. Bailout stent placement was performed in 18 of 29 patients (62.1%) in the PTA arm and eight of 29 patients (27.6%) in the atherectomy arm (P = .017). Major adverse events were similar between the PTA and atherectomy arms. Finally, when embolic filter protection was used, distal macroembolization occurred in 11 of 17 patients (64.7%) treated with atherectomy versus none of 10 in the PTA group (P atherectomy and primary PTA. Atherectomy reduced the need for bailout stent placement compared with primary PTA. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management

International Nuclear Information System (INIS)

1993-11-01

This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management

Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies.

LENUS (Irish Health Repository)

Kerley, Conor P

2015-03-05

Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence\\/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25-dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard anti-asthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity. Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis. The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy.

Adjunctive Subantimicrobial Dose Doxycycline in the Treatment of Chronic Periodontitis in Type 2 Diabetic Patients: A Unique Combination Therapy

Directory of Open Access Journals (Sweden)

Gomaa Marwa Abdelhakim

2018-03-01

Full Text Available Background/Aim: To evaluate the effectiveness of combination therapy including subantimicrobial dose doxycycline (SDD and locally delivered doxycycline (LD as adjuncts to scaling and root planing (SRP in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus (T2DM. Material and Methods: Forty patients with controlled T2DM (HbA1c ≤7% and chronic periodontitis were selected. They were randomly divided into two groups, twenty patients each: Test group (TG, n=20 patients was treated with combination therapy of full mouth SRP, LD gel 10% and SDD 20 mg twice daily for 6 months. Control group (CG, n=20 patients was treated with full mouth SRP only. The periodontal parameters were recorded at baseline, 3, 6 and 9 months and included periodontal probing depth (PD, clinical attachment level (CAL, and bleeding on probing (BOP. Gingival crevicular fluid (GCF samples were collected and a quantitative measurement of matrix metalloproteinase-8 (MMP-8 was carried out by using Enzyme-Linked Immunosorbent Assay (ELIZA at baseline, 3, 6 and 9 months. Results: Statistically significant reduction in all clinical parameters (PPD, CAL, and BOP was observed at TG over CG at 3, 6, and 9 months (p<0.05. Moreover, combination therapy provided significant reductions in the amount of GCF MMP-8 for the TG compared to CG at 3, 6, and 9 months evaluation period (p<0.05. Conclusions: Combination therapy including SRP, SDD, and LD, provided significantly greater clinical benefits than SRP alone in the treatment of chronic periodontitis in patients with controlled T2DM.

Cognitive effects of creatine monohydrate adjunctive therapy in patients with bipolar depression: Results from a randomized, double-blind, placebo-controlled trial.

Science.gov (United States)

Toniolo, Ricardo Alexandre; Fernandes, Francy de Brito Ferreira; Silva, Michelle; Dias, Rodrigo da Silva; Lafer, Beny

2017-12-15

Depressive episodes and cognitive impairment are major causes of morbidity and dysfunction in individuals suffering from bipolar disorder (BD). Novel treatment approaches that target clinical and cognitive aspects of bipolar depression are needed, and research on pathophysiology suggests that mitochondrial modulators such as the nutraceutical creatine monohydrate might have a therapeutic role for this condition. Eighteen (N=18) patients with bipolar depression according to DSM-IV criteria who were enrollled in a 6-week, randomized, double-blind, placebo-controlled trial of creatine monohydrate 6g daily as adjunctive therapy were submitted to neuropsychological assessments (Wisconsin Card Sorting Test, Digit Span subtest of the Wechsler Adult Intelligence Scale-Third Edition, Stroop Color-Word Test, Rey-Osterrieth complex figure test, FAS Verbal Fluency Test) at baseline and week 6. There was a statistically significant difference between the treatment groups of the change on the total scores after 6 weeks in the verbal fluency test, with improvement in the group receiving adjunctive treatment with creatine. We did not find significant differences between the groups of the changes on other neuropsychological tests. Small sample and lack of a control group of healthy subjects. Our trial, which was the first to investigate the cognitive effects of creatine monohydrate on bipolar depression, indicates that supplementation with this nutraceutical for 6 weeks is associated with improvement in verbal fluency tests in patients with this condition. Copyright © 2016 Elsevier B.V. All rights reserved.

Patient factors associated with hemoglobin A1C change with pioglitazone as adjunctive therapy in type 2 Diabetes Mellitus

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Tran MT

2008-06-01

Full Text Available Objective: To identify patient factors associated with change in hemoglobin A1C (A1C with adjunct pioglitazone therapy in routine clinical practice. Methods: This was a retrospective analysis of adult type 2 diabetes mellitus patients in a health maintenance organization setting who were newly-initiated on pioglitazone between January 2002 and December 2005. Eligible patients were receiving at least one other oral antihyperglycemic medication prior to initiating pioglitazone and maintained a stable dose of pioglitazone for 90 days. Data on eligible patients’ characteristics, pharmacy purchases, comorbidities, and A1C measurement 90 days prior to the pioglitazone purchase date (baseline and 90 days after achieving a stable dose (follow-up were obtained from electronic records. Multivariate regression modeling was used to assess factors independently associated with: 1 absolute change in A1C, 2 achieving a ≥1 percentage point decrease in A1C, and 3 achieving an A1C8%. At follow-up, the mean A1C change was -1.2 percentage points (interquartile range= -0.4, -2.1, 59% achieved a ≥1 unit decrease in A1C, and 44% achieved an A1C<7%. Independent predictors in all models were baseline A1C and time (in days between baseline and follow-up A1C measurements (p<0.05. Conclusions: Adjunct pioglitazone therapy in routine clinical practice was associated with clinically meaningful reductions in A1C levels. Patients with higher baseline A1C achieved the greatest absolute reduction in A1C but were less likely to achieve levels <7%.

Design and rationale of a 16-week adjunctive randomized placebo-controlled trial of mitochondrial agents for the treatment of bipolar depression

Directory of Open Access Journals (Sweden)

Olivia M. Dean

2015-03-01

Full Text Available Objective: Bipolar disorder places a significant burden on individuals, caregivers and family, and the broader community. Current treatments are believed to be more effective against manic symptoms, leaving a shortfall in recovery during the depressive phase of the illness. The current study draws on recent evidence suggesting that, in addition to increased oxidative load, alterations in mitochondrial function occur in bipolar disorder. Methods: This 16-week study aims to explore the potential benefits of N-acetylcysteine (NAC alone or in combination (CT with selected nutraceuticals believed to enhance mitochondrial function. The study includes adults diagnosed with bipolar disorder currently experiencing an episode of depression. Participants are asked to take NAC, CT, or placebo in addition to any usual treatments. A post-discontinuation visit is conducted 4 weeks following the treatment phase. Results: The primary outcome of the study will be mean change on the Montgomery-Asberg Depression Rating Scale. Secondary outcomes include functioning, substance use, mania ratings, and quality of life. Blood samples will be collected at baseline and week 16 to explore biochemical alterations following treatment. Conclusion: This study may provide a novel adjunctive treatment for bipolar depression. Analysis of biological samples may assist in understanding the therapeutic benefits and the underlying etiology of bipolar depression. Trial registration: Australian and New Zealand Clinical Trial Registry ACTRN12612000830897.

The effect of adjunctive chlorhexidine mouthrinse on GCF MMP-8 and TIMP-1 levels in gingivitis: a randomized placebo-controlled study

Science.gov (United States)

2014-01-01

Background The aim of the present study was to evaluate the effect of adjunctive chlorhexidine (CHX) mouthrinse on gingival crevicular fluid (GCF) MMP-8 and TIMP-1 levels in plaque-associated gingivitis. Methods A total of 50 gingivitis patients were included in the present study. In addition to daily plaque control, CHX group rinsed with CHX, while placebo group rinsed with placebo mouthrinse for 4 weeks. GCF samples were collected, and clinical parameters including plaque index, papillary bleeding index, calculus index and pocket depth were recorded at baseline and 4 weeks. GCF MMP-8 and TIMP-1 levels were determined by immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA), respectively. Results In both groups, GCF MMP-8 levels of anterior and posterior sites at four weeks were not different from baseline (p > 0.05). There were no significant differences in GCF MMP-8 levels between the study groups at four weeks (p > 0.05). GCF TIMP-1 levels of anterior and posterior sites at four weeks were higher compared to baseline in both groups (p  0.05). Conclusions CHX usage had no significant effects on the GCF MMP-8 and TIMP-1 levels in plaque-associate gingivitis. However, daily plaque control resulted in the increase of GCF TIMP-1 levels regardless of CHX usage. PMID:24886536

Spray-dried adjunct cultures of autochthonous non-starter lactic acid bacteria.

Science.gov (United States)

Peralta, Guillermo H; Bergamini, Carina V; Audero, Gabriela; Páez, Roxana; Wolf, I Verónica; Perotti, M Cristina; Hynes, Erica R

2017-08-16

Spray-drying of lactic cultures provides direct-to-vat starters, which facilitate their commercialization and use. However, this process may alter the metabolic activity and deteriorate technological features. In this work, we assessed the influence of spray-drying on the survival and aroma production of two strains of mesophilic lactobacilli: Lactobacillus paracasei 90 and Lactobacillus plantarum 91, which have already been characterized as good adjunct cultures. The spray-drying was carried out using a laboratory scale spray and the dried cultures were monitored during the storage for the survival rate. The dried cultures were applied to two cheese models: sterile cheese extract and miniature soft cheese. The influence on the carbohydrate metabolism and the production of organic acids and volatile compounds was determined. Both strains retained high levels of viable counts in the powder after drying and during the storage at 5°C for twelve months. In addition, they also remained at high level in both cheese models during incubation or ripening. Similar profiles of carbohydrate fermentation and bioformation of volatile compounds were observed in the cheese extracts for each of the strains when tested as both fresh and dried cultures. In addition, the ability of Lb. paracasei 90 to increase the production of acetoin and diacetyl remarkably in cheese models was also confirmed for the spray-dried culture. Copyright © 2017 Elsevier B.V. All rights reserved.

Efficacy of controlled-release isosorbide-5-mononitrate as adjunctive treatment to beta-blocking agents in patients with stable angina pectoris

DEFF Research Database (Denmark)

Svendsen, Jesper Hastrup; Aldershvile, J; Abildgaard, U

1989-01-01

to a beta blocker. In bicycle ergometer exercise tests performed 4 h after study drug intake, total exercise time and time until 1-mm ST-depression increased significantly during both regimens as compared with placebo (p less than 0.05). However, only the 60-mg once-daily regimen was significantly better...... than placebo with regard to time until angina pectoris. The results indicate that ISMN-CR 60 mg once daily is effective as adjunctive to beta-blocker treatment, and nitrate tolerance appeared to develop during the twice-daily regimen. In 10 of the patients, the effect of additional sublingual...

A multicomponent yoga-based, breath intervention program as an adjunctive treatment in patients suffering from generalized anxiety disorder with or without comorbidities.

Science.gov (United States)

Katzman, Martin A; Vermani, Monica; Gerbarg, Patricia L; Brown, Richard P; Iorio, Christina; Davis, Michele; Cameron, Catherine; Tsirgielis, Dina

2012-01-01

The aim of this study is to evaluate the efficacy and tolerability of Sudarshan Kriya Yoga (SKY) course in generalized anxiety disorder (GAD) outpatients, who after eight weeks of an appropriate dose of traditional therapy had not yet achieved remission. The adult participants (18-65 years) were outpatients with a primary diagnosis of GAD with or without comorbidities on the Mini-International Neuropsychiatric Interview (MINI). Participants had a minimum of eight weeks standard treatment with an appropriate dose of a standard prescription anxiolytic, a clinician global impression-severity (CGI-S) score of 5-7, a Hamilton anxiety scale (HAM-A) total score ≥20 including a score of >2 on the anxious mood and tension items. Forty-one patients were enrolled in an open-label trial of the SKY course as an adjunct to standard treatment of GAD at the START Clinic for Mood and Anxiety Disorders, a tertiary care mood and anxiety disorder clinic in Toronto. The SKY course was administered over five days (22 h total). Subjects were encouraged to practice the yoga breathing techniques at home for 20 min per day after the course and were offered group practice sessions for 2 h once a week led by certified yoga instructors. The primary outcome measure was the mean change from pre-treatment on the HAM-A scale. Psychological measures were obtained at baseline and four weeks after completing the intervention. Thirty-one patients completed the program (mean age 42.6 ± 13.3 years). Among completers, significant reductions occurred in the pre- and post-intervention mean HAM-A total score (t=4.59; P<0.01) and psychic subscale (t=5.00; P≤0.01). The response rate was 73% and the remission rate 41% as measured on the HAM-A. The results of this small pilot trial suggest that the SKY course represents a potentially valuable adjunct to standard pharmacotherapy in patients with GAD or treatment-resistant GAD, and warrants further investigation. In particular, changes in worry and body

The effectiveness of fermented wheat germ extract as an adjunct therapy in the treatment of cancer: A systematic review.

Science.gov (United States)

Yeend, Tracey; Robinson, Kai; Lockwood, Craig; McArthur, Alexa

2012-01-01

The objective of this review is to synthesise the best available evidence on effectiveness of fermented wheatgerm extract (Avemar) as an adjunct therapy to conventional cancer treatments such as surgery, chemotherapy, radiotherapy and hormone therapies, in the treatment of haematological and non-haematological cancers. Cancer is a public health issue with an incidence rate and prevalence that has wide societal implications and impacts. Data from The World Health Organisation (WHO) indicate that cancer is a leading cause of death and accounts for about 13% of all deaths. The WHO estimate that this number will more than double within the next 18 years, with diagnosis of cancer of the lung, liver, stomach, breast and colon all expected to rise in conjunction with growth of middle class societies, increasing affluence and changes in lifestyle that are associated with rising socioeconomic status.Large amounts of money are invested annually in cancer research and new diagnostic methods and treatments are rapidly evolving. Surgery, chemotherapy and radiotherapy remain the forefront interventions and are all linked to improved prognostic outcomes. The improvement in outcomes can however, be limited by the type cancer, its stage, the location of the cancer, the treatment implemented and timing and continuity of treatment. The treatments can also have a range of ramifications and debilitating side effects. These include: hair loss, depleted immune system, nausea, vomiting and fatigue. As a result, for some patients, treatment may raise as many concerns as the diagnosis. Rarely, until faced with a diagnosis of cancer, does a person recognise the seriousness of the disease or consider the impact and experience of treatment interventions. The high level of cancer awareness across society is a reflection of the significance of the associated burden of disease associated with cancer diagnosis, cancer care and the social impact on families when a diagnosis is made.The prevalence

Non-invasive Markers of Liver Fibrosis: Adjuncts or Alternatives to Liver Biopsy?

Science.gov (United States)

Chin, Jun L.; Pavlides, Michael; Moolla, Ahmad; Ryan, John D.

2016-01-01

Liver fibrosis reflects sustained liver injury often from multiple, simultaneous factors. Whilst the presence of mild fibrosis on biopsy can be a reassuring finding, the identification of advanced fibrosis is critical to the management of patients with chronic liver disease. This necessity has lead to a reliance on liver biopsy which itself is an imperfect test and poorly accepted by patients. The development of robust tools to non-invasively assess liver fibrosis has dramatically enhanced clinical decision making in patients with chronic liver disease, allowing a rapid and informed judgment of disease stage and prognosis. Should a liver biopsy be required, the appropriateness is clearer and the diagnostic yield is greater with the use of these adjuncts. While a number of non-invasive liver fibrosis markers are now used in routine practice, a steady stream of innovative approaches exists. With improvement in the reliability, reproducibility and feasibility of these markers, their potential role in disease management is increasing. Moreover, their adoption into clinical trials as outcome measures reflects their validity and dynamic nature. This review will summarize and appraise the current and novel non-invasive markers of liver fibrosis, both blood and imaging based, and look at their prospective application in everyday clinical care. PMID:27378924

Perfluorochemical emulsions as adjuncts to radiation therapy: a review of preclinical studies

International Nuclear Information System (INIS)

Rockwell, S.

1989-01-01

Oxygen is a potent radiosensitizer. As virtually complete radiosensitization is observed at 0 2 levels similar to those in venous blood, most healthy normal tissues exhibit an aerobic radiosensitivity. In contrast, solid tumors contain avascular areas and blood vessels which are subject to transient and persistent interruptions in blood flow; as a result, tumors contain viable cells existing under acute and chronic hypoxia. These hypoxic cells are resistant to radiation and to many drugs used in cancer therapy, and can limit the curability of tumors by conventional therapeutic regimens. Many laboratory and clinical studies are examining ways to circumvent the problem of hypoxic cells in cancer therapy. Studies reviewed here examine the effects of infusion of perfluorochemical emulsions (PFC-E) combined with the administration of 0 2 at ambient or hyperbaric pressures on the radiation responses of solid tumors and of the normal tissues which limit the intensity of therapy. Appropriate regimens of treatment with a PFC-E and oxygen-enriched atmospheres increase the radiation response of solid tumors, without causing severe host toxicities and without producing equivalent increases in radiation injury to normal tissues. These studies show that PFC-E's have significant potential as adjuncts to radiotherapy and provide a basis for the design and initiation of clinical trials testing these agents [fr

A Randomized, Double-Blind, Placebo-Controlled Trial of Adjunctive Metformin Therapy in Overweight/Obese Youth with Type 1 Diabetes.

Directory of Open Access Journals (Sweden)

Benjamin Udoka Nwosu

Full Text Available Insulin resistance has been proposed as one of the causes of poor glycemic control in overweight/obese youth with type 1 diabetes (T1D. However, the role of adjunctive metformin, an insulin sensitizer, on glycemic control in these patients is unclear.To compare the effect of metformin vs. placebo on hemoglobin A1c (HbA1c, total daily dose (TDD of insulin, and other parameters in overweight/obese youth with T1D.Adjunctive metformin therapy will improve glycemic control in overweight/obese youth with T1D.A 9-mo randomized, double-blind, placebo controlled trial of metformin and placebo in 28 subjects (13m/15f of ages 10-20years (y, with HbA1c >8% (64 mmol/mol, BMI >85%, and T1D > 12 months was conducted at a university outpatient facility. The metformin group consisted of 15 subjects (8 m/ 7f, of age 15.0 ± 2.5 y; while the control group was made up of 13 subjects (5m/ 8f, of age 14.5 ± 3.1y. All participants employed a self-directed treat-to-target insulin regimen based on a titration algorithm of (-2-0-(+2 units to adjust their long-acting insulin dose every 3rd day from -3 mo through +9 mo to maintain fasting plasma glucose (FPG between 90-120 mg/dL (5.0-6.7 mmol/L. Pubertal maturation was determined by Tanner stage.Over the course of the 9 months of observation, the between-treatment differences in HbA1c of 0.4% (9.85% [8.82 to 10.88] for placebo versus 9.46% [8.47 to 10.46] for metformin was not significant (p = 0.903. There were non-significant reduction in fasting plasma glucose (189.4 mg/dL [133.2 to 245.6] for placebo versus 170.5 mg/dL [114.3 to 226.7] for metformin, (p = 0.927; total daily dose (TDD of short-acting insulin per kg body weight/day(p = 0.936; and the TDD of long-acting insulin per kg body weight per day (1.15 units/kg/day [0.89 to 1.41] for placebo versus 0.90 units/kg/day [0.64 to 1.16] for metformin (p = 0.221. There was no difference in the occurrence of hypoglycemia between the groups.This 9-month RCT of adjunctive

Memantine as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial.

Science.gov (United States)

Ghaleiha, Ali; Asadabadi, Mahtab; Mohammadi, Mohammad-Reza; Shahei, Maryam; Tabrizi, Mina; Hajiaghaee, Reza; Hassanzadeh, Elmira; Akhondzadeh, Shahin

2013-05-01

Autism is a neurodevelopmental disorder that causes significant impairment in socialization and communication. It is also associated with ritualistic and stereotypical behaviour. Recent studies propose both hyper-and hypoglutamatergic ideologies for autism. The objective of this study was to assess the effects of memantine plus risperidone in the treatment of children with autism. Children with autism were randomly allocated to risperidone plus memantine or placebo plus risperidone for a 10-wk, double-blind, placebo-controlled study. The dose of risperidone was titrated up to 3 mg/d and memantine was titrated to 20 mg/d. Children were assessed at baseline and after 2, 4, 6, 8 and 10 wk of starting medication protocol. The primary outcome measure was the irritability subscale of Aberrant Behavior Checklist-Community (ABC-C). Difference between the two treatment arms was significant as the group that received memantine had greater reduction in ABC-C subscale scores for irritability, stereotypic behaviour and hyperactivity. Eight side-effects were observed over the trial, out of the 25 side-effects that the checklist included. The difference between the two groups in the frequency of side-effects was not significant. The present study suggests that memantine may be a potential adjunctive treatment strategy for autism and it was generally well tolerated. This trial is registered with the Iranian Clinical Trials Registry (IRCT1138901151556N10; www.irct.ir).

Treatment of Creatine Transporter (SLC6A8) Deficiency With Oral S-Adenosyl Methionine as Adjunct to L-arginine, Glycine, and Creatine Supplements.

Science.gov (United States)

Jaggumantri, Sravan; Dunbar, Mary; Edgar, Vanessa; Mignone, Cristina; Newlove, Theresa; Elango, Rajavel; Collet, Jean Paul; Sargent, Michael; Stockler-Ipsiroglu, Sylvia; van Karnebeek, Clara D M

2015-10-01

Creatine transporter (SLC6A8) deficiency is an X-linked inborn error of metabolism characterized by cerebral creatine deficiency, behavioral problems, seizures, hypotonia, and intellectual developmental disability. A third of patients are amenable to treatment with high-dose oral creatine, glycine, and L-arginine supplementation. Given the limited treatment response, we initiated an open-label observational study to evaluate the effect of adjunct S-adenosyl methionine to further enhance intracerebral creatine synthesis. Significant and reproducible issues with sleep and behavior were noted in both male patients on a dose of 50/mg/kg. One of the two patients stopped S-adenosyl methionine and did not come for any follow-up. A safe and tolerable dose (17 mg/kg/day) was identified in the other patient. On magnetic resonance spectroscopy, this 8-year-old male did not show an increase in intracerebral creatine. However, significant improvement in speech/language skills, muscle mass were observed as well as in personal outcomes as defined by the family in activities related to communication and decision making. Further research is needed to assess the potential of S-adenosyl methionine as an adjunctive therapy for creatine transporter deficiency patients and to define the optimal dose. Our study also illustrates the importance of pathophysiology-based treatment, individualized outcome assessment, and patient/family participation in rare diseases research. Copyright © 2015 Elsevier Inc. All rights reserved.

Statistical analysis plan for the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial

DEFF Research Database (Denmark)

Billot, Laurent; Venkatesh, Balasubramanian; Myburgh, John

2017-01-01

BACKGROUND: The Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial, a 3800-patient, multicentre, randomised controlled trial, will be the largest study to date of corticosteroid therapy in patients with septic shock. OBJECTIVE: To describe a statistical...... and statisticians and approved by the ADRENAL management committee. All authors were blind to treatment allocation and to the unblinded data produced during two interim analyses conducted by the Data Safety and Monitoring Committee. The data shells were produced from a previously published protocol. Statistical...... analyses are described in broad detail. Trial outcomes were selected and categorised into primary, secondary and tertiary outcomes, and appropriate statistical comparisons between groups are planned and described in a way that is transparent, available to the public, verifiable and determined before...

A multicomponent yoga-based, breath intervention program as an adjunctive treatment in patients suffering from generalized anxiety disorder with or without comorbidities

Directory of Open Access Journals (Sweden)

Martin A Katzman

2012-01-01

Materials and Methods: Forty-one patients were enrolled in an open-label trial of the SKY course as an adjunct to standard treatment of GAD at the START Clinic for Mood and Anxiety Disorders, a tertiary care mood and anxiety disorder clinic in Toronto. The SKY course was administered over five days (22 h total. Subjects were encouraged to practice the yoga breathing techniques at home for 20 min per day after the course and were offered group practice sessions for 2 h once a week led by certified yoga instructors. The primary outcome measure was the mean change from pre-treatment on the HAM-A scale. Psychological measures were obtained at baseline and four weeks after completing the intervention. Results:Thirty-one patients completed the program (mean age 42.6 ± 13.3 years. Among completers, significant reductions occurred in the pre- and post-intervention mean HAM-A total score (t=4.59; P<0.01 and psychic subscale (t=5.00; P≤0.01. The response rate was 73% and the remission rate 41% as measured on the HAM-A. Conclusion: The results of this small pilot trial suggest that the SKY course represents a potentially valuable adjunct to standard pharmacotherapy in patients with GAD or treatment-resistant GAD, and warrants further investigation. In particular, changes in worry and body symptoms showed significant improvements that may further our understanding of the mechanism of change in the tolerance of anxiety and worry.

Adjunctive Effect of Autologus Platelet-Rich Fibrin to Barrier Membrane in the Treatment of Periodontal Intrabony Defects.

Science.gov (United States)

Panda, Saurav; Sankari, Malaiappan; Satpathy, Anurag; Jayakumar, Doraiswamy; Mozzati, Marco; Mortellaro, Carmen; Gallesio, Giorgia; Taschieri, Silvio; Del Fabbro, Massimo

2016-05-01

Autologous platelet-rich fibrin (PRF) and barrier membranes in the treatment of intrabony defects in chronic periodontitis patients have shown significant clinical benefits. This study evaluates the additive effect of autologous PRF in combination with a barrier membrane versus the use of barrier membrane alone for the treatment of intrabony defects in chronic periodontitis patients. A randomized split-mouth design was used. Sixteen patients with 32 paired intrabony defects were included. In each patient 1 defect was treated using a resorbable collagen membrane along with PRF (test group) and the other defect by guided tissue regeneration alone (control group). The following clinical parameters were measured at baseline and after 9 months: plaque index, modified sulcus bleeding index, probing pocket depth, clinical attachment level, and gingival marginal level. The radiographic defect depth was also assessed at baseline and after 9 months. Test group showed a statistically significant improvement for probing depth (P = 0.002), clinical attachment level (P = 0.001), and radiographic defect depth (P < 0.001) after 9 months as compared with the control sites. Radiographic defect depth reduction was 58.19 ± 13.24% in the test group as compared with 24.86 ± 9.94% reduction in the control group. The adjunctive use of PRF in combination with barrier membrane is more effective in the treatment of intrabony defects in chronic periodontitis as compared with barrier membrane alone.

Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

Science.gov (United States)

Hoermann, Simon; Ferreira Dos Santos, Luara; Morkisch, Nadine; Jettkowski, Katrin; Sillis, Moran; Devan, Hemakumar; Kanagasabai, Parimala S; Schmidt, Henning; Krüger, Jörg; Dohle, Christian; Regenbrecht, Holger; Hale, Leigh; Cutfield, Nicholas J

2017-07-01

New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

Topical Yunnan Baiyao administration as an adjunctive therapy for bleeding complications in adolescents with advanced cancer.

Science.gov (United States)

Ladas, E J; Karlik, J B; Rooney, D; Taromina, K; Ndao, D H; Granowetter, L; Kelly, K M

2012-12-01

Yunnan Baiyao (White Medicine from Yunnan, YNB) is a Chinese herbal medicinal powder used to stop bleeding and improve circulation in traumatic injuries. We describe the use of YNB in adolescents with cancer as an adjunct to uncontrolled bleeding in the palliative care setting. Through a retrospective chart review of all patients receiving integrative medicine consultations at the Integrative Therapies Program at Columbia University from January 1, 2007 to January 31, 2012, we describe the outcome of patients treated with YNB for management of uncontrolled bleeding. Four patients were identified who received topical YNB for uncontrolled bleeding; patients included two males and two females with diagnoses of solid tumors (n = 3) and Burkitt's lymphoma (n = 1). Mean age was 15.5 years (range 15-17). Fifty percent had life-threatening bleeding from the tumor site and 50 % experienced uncontrollable epistaxis. All patients received preceding therapy with packed red blood cells and platelet transfusions, topical thrombin, and oral aminocaproic acid. Two patients used YNB in the inpatient setting, and all four patients used YNB as outpatients. In all patients, bleeding control improved with the addition of YNB to conventional hemostatic interventions. Two patients using YNB in their home reported control of bleeding episodes. There were no adverse events reported. YNB may be an efficacious agent for uncontrolled bleeding in conjunction with conventional hemostatic agents in adolescents with advanced cancer. It is well accepted by patients. YNB may be especially valuable in the outpatient setting to prevent the recurrence of hemorrhage.

Efficacy and safety of adjunctive rasagiline in Japanese Parkinson's disease patients with wearing-off phenomena: A phase 2/3, randomized, double-blind, placebo-controlled, multicenter study.

Science.gov (United States)

Hattori, Nobutaka; Takeda, Atsushi; Takeda, Shinichi; Nishimura, Akira; Kato, Masafumi; Mochizuki, Hideki; Nagai, Masahiro; Takahashi, Ryosuke

2018-04-27

Rasagiline, a selective, irreversible monoamine oxidase-B inhibitor, is in development in Japan as adjunctive therapy to levodopa. This Phase 2/3 trial evaluated the efficacy and safety of adjunctive rasagiline in Japanese patients with Parkinson's disease (PD) and wearing-off phenomena. Patients aged 30-79 years with diagnosed PD and stable levodopa use were randomized 1:1:1 to rasagiline (0.5/1 mg/day) or placebo for 26 weeks. The primary endpoint was change from baseline in mean daily OFF-time during the treatment period. In total, 141, 134, and 129 patients were randomized to placebo, rasagiline 0.5 mg, or rasagiline 1 mg, respectively. Baseline characteristics were well balanced. Least squares (LS) mean differences vs. placebo for change from baseline in mean daily OFF-time were -0.84 h (rasagiline 1 mg/day) and -0.60 h (rasagiline 0.5 mg/day); both differences were statistically significant. LS mean differences vs. placebo for change from baseline in Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II and Part III total scores (in ON-state) and Parkinson's Disease Questionnaire-39 Summary Index Score were: -1.27, -1.74, and -2.51 (0.5 mg/day) and -1.27, -2.14, and -3.84 (1 mg/day); all statistically significant. Treatment-emergent adverse events (TEAEs) occurred in 50.4/69.9/73.6% of the placebo, 0.5 mg/day, and 1 mg/day groups, respectively (most common TEAEs were nasopharyngitis [9.2/18.0/14.7%] and dyskinesia [7.1/8.3/16.3%]). As an adjunct to levodopa, rasagiline reduced OFF-time and improved PD symptoms/signs (MDS-UPDRS scores) and quality of life in Japanese patients with PD and wearing-off phenomena. No important safety concerns were raised. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Adjunctive Steps for Disinfection of the Mandibular Molar Root Canal System: A Correlative Bacteriologic, Micro-Computed Tomography, and Cryopulverization Approach.

Science.gov (United States)

Alves, Flávio R F; Andrade-Junior, Carlos V; Marceliano-Alves, Marília F; Pérez, Alejandro R; Rôças, Isabela N; Versiani, Marco A; Sousa-Neto, Manoel D; Provenzano, José C; Siqueira, José F

2016-11-01

This study evaluated the disinfecting ability of chemomechanical preparation with rotary nickel-titanium instruments, followed by 2 distinct adjunctive procedures in the root canals of extracted mandibular molars by means of a correlative analytical approach. Twenty-two extracted mandibular molars were selected and anatomically matched between groups on the basis of micro-computed tomographic analysis. In the first phase of the experiment, root canals were contaminated with Enterococcus faecalis and subjected to chemomechanical preparation with BT RaCe instruments and 2.5% NaOCl irrigation. Then either XP-Endo Finisher instrument or passive ultrasonic irrigation was used to supplement disinfection. Micro-computed tomography was used to show whether the percentage of unprepared areas correlated to bacterial counts. In the second phase, the same teeth were contaminated once again, and the adjunctive procedures were used. Samples from the isthmus area of mesial roots and the apical 5-mm fragment of distal roots were obtained by cryopulverization. Samples taken before and after treatment steps in both phases were evaluated by quantitative polymerase chain reaction and statistically analyzed. In phase 1, preparation in both groups resulted in substantial decrease of bacterial counts (P  .05). In phase 2, both methods had significant antibacterial effects in the main canal, but none of them could predictably disinfect the isthmus/recess areas. Both XP-Endo Finisher and passive ultrasonic irrigation exhibited antibacterial effectiveness, but only the former caused a significant reduction in the bacterial counts after chemomechanical preparation. None of them were effective in predictably disinfecting the isthmus/recess areas. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Non-invasive ventilation used as an adjunct to airway clearance treatments improves lung function during an acute exacerbation of cystic fibrosis: a randomised trial

Directory of Open Access Journals (Sweden)

Tiffany J Dwyer

2015-07-01

Full Text Available Question: During an acute exacerbation of cystic fibrosis, is non-invasive ventilation beneficial as an adjunct to the airway clearance regimen? Design: Randomised controlled trial with concealed allocation and intention-to-treat analysis. Participants: Forty adults with moderate to severe cystic fibrosis lung disease and who were admitted to hospital for an acute exacerbation. Intervention: Comprehensive inpatient care (control group compared to the same care with the addition of non-invasive ventilation during airway clearance treatments from Day 2 of admission until discharge (experimental group. Outcome measures: Lung function and subjective symptom severity were measured daily. Fatigue was measured at admission and discharge on the Schwartz Fatigue Scale from 7 (no fatigue to 63 (worst fatigue points. Quality of life and exercise capacity were also measured at admission and discharge. Length of admission and time to next hospital admission were recorded. Results: Analysed as the primary outcome, the experimental group had a greater rate of improvement in forced expiratory volume in 1 second (FEV1 than the control group, but this was not statistically significant (MD 0.13% predicted per day, 95% CI –0.03 to 0.28. However, the experimental group had a significantly higher FEV1 at discharge than the control group (MD 4.2% predicted, 95% CI 0.1 to 8.3. The experimental group reported significantly lower levels of fatigue on the Schwartz fatigue scale at discharge than the control group (MD 6 points, 95% CI 1 to 11. There was no significant difference between the experimental and control groups in subjective symptom severity, quality of life, exercise capacity, length of hospital admission or time to next hospital admission. Conclusion: Among people hospitalised for an acute exacerbation of cystic fibrosis, the use of non-invasive ventilation as an adjunct to the airway clearance regimen significantly improves FEV1 and fatigue. Trial

Reflexiones y Experiencias desde las entrañas del Islamismo Militante. Análisis de la biografía de Eric Breininguer

Directory of Open Access Journals (Sweden)

Miguel Ángel Cano Paños

2011-05-01

Full Text Available El objetivo del siguiente trabajo es analizar el proceso de radicalización yihadista de un joven converso nacido y crecido en Occidente. Se trata del caso de Eric Breininger, un individuo alemán que en abril de 2010 encontró la muerte en la región de Waziristán en el transcurso de un combate contra soldados pakistaníes. La base del siguiente trabajo está constituida por las memorias del joven alemán, las cuales fueron publicadas en Internet días después del anuncio de su muerte. Dichas memorias suponen sin duda un documento de trascendental importancia que permiten acercarse al proceso de radicalización de un individuo de origen occidental. Asimismo, ofrecen una visión muy cercana de la vida cotidiana de aquellos individuos radicalizados que en la primera línea del frente libran su particular batalla –en algunos casos sacrificando incluso su propia vida– en defensa de su particular visión del Islam.

Perioceutics: Matrix metalloproteinase inhibitors as an adjunctive therapy for inflammatory periodontal disease

Directory of Open Access Journals (Sweden)

Esther Nalini Honibald

2012-01-01

Full Text Available Matrix metalloproteinases (MMPs form a group of more than 20 zinc-dependent enzymes that are crucial in the degradation of the main components in the extracellular matrix, and thereby play important roles in cell migration, wound healing, and tissue remodeling. MMPs have outgrown the field of extracellular matrix biology and have progressed toward being important regulatory molecules in inflammation, and hence are key components in the pathogenesis of periodontitis. This rise in status has led to the development of MMP inhibitors which can act as switches or delicate tuners in acute and chronic inflammation and the regenerative phase after inflammation. The new challenge in MMP research is to better understand the complex role these enzymes play in periodontal disease and to design inhibitors that are successful in the clinic. Perioceutics or the use of the pharmacological agents specifically developed to manage periodontitis is an interesting and emerging aid in the management of periodontal diseases along with mechanical debridement. The purpose of this review is to provide an introduction to MMPs and their inhibitors, the pathologic effects of a disturbance in the functions of enzyme cascades in balance with natural inhibitors, and highlight on the adjunctive use of MMP inhibitors in periodontal therapy and some of the current challenges with an overview of what has been achieved till date.

Clinical History of the Theranostic Radionuclide Approach to Neuroendocrine Tumors and Other Types of Cancer: Historical Review Based on an Interview of Eric P. Krenning by Rachel Levine.

Science.gov (United States)

Levine, Rachel; Krenning, Eric P

2017-09-01

In nuclear medicine, the term theranostics describes the combination of therapy and diagnostic imaging. In practice, this concept dates back more than 50 years; however, among the most successful examples of theranostics are peptide receptor scintigraphy and peptide receptor radionuclide therapy of neuroendocrine tumors. The development of these modalities through the radiolabeling of somatostatin analogs with various radionuclides has led to a revolution in patient management and established a foundation for expansion of the theranostic principle into other oncology indications. This article provides a review of the evolution and development of the theranostic radionuclide approach to the management of neuroendocrine tumors, as described by the inventor of this technique, Eric P. Krenning, in an interview with Rachel Levine. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Incidence of seizure exacerbation and seizures reported as adverse events during adjunctive treatment with eslicarbazepine acetate: A pooled analysis of three Phase III controlled trials.

Science.gov (United States)

Carreño, Mar; Benbadis, Selim; Rocha, Francisco; Blum, David; Cheng, Hailong

2017-12-01

To investigate whether adjunctive eslicarbazepine acetate (ESL) could lead to exacerbation of seizures in some patients. Post-hoc analysis of data pooled from three Phase III trials of adjunctive ESL (studies 301, 302, and 304) for refractory partial-onset seizures (POS). Following an 8-week baseline period, patients were randomized to receive placebo or ESL 400, 800, or 1,200 mg once daily (2-week titration, 12-week maintenance, 2-4 week tapering-off periods). Patient seizure diary data and seizure treatment-emergent adverse event (TEAE) reports were pooled for analysis. The modified intent-to-treat and safety populations comprised 1,410 patients and 1,447 patients, respectively. Titration period : Compared with placebo (32/21%), significantly smaller proportions of patients taking ESL 800 mg (20/15%) and 1,200 mg (22/12%) had a ≥25/≥50% increase in standardized seizure frequency (SSF) from baseline; there was no significant difference between placebo and ESL 400 mg. Maintenance period : Compared with placebo (20%), significantly smaller proportions of patients taking ESL (400 mg, 12%; 800 mg, 12%; 1,200 mg, 14%) had an increase in SSF ≥25%. When evaluating ≥50% increases in SSF, only ESL 800 mg (7%) was significantly different from placebo (12%). Some patients had no secondarily generalized tonic-clonic (sGTC) seizures during baseline but had ≥1 sGTC seizure during maintenance treatment (placebo, 11%; ESL 400 mg, 5%; 800 mg, 10%; 1,200 mg, 5%). Fewer patients had a ≥25% increase in sGTC seizure frequency with ESL (400 mg, 11%; 800 mg, 9%; 1,200 mg, 14%) versus placebo (19%). The incidence of seizures reported as TEAEs was low in all treatment groups; incidences were generally lower with ESL versus placebo. Tapering-off period : Similar proportions of patients taking ESL and placebo had a ≥25/≥50% increase in SSF. Seizure TEAE incidence was numerically higher with ESL versus placebo. Treatment with adjunctive ESL does not appear to

[Strategies for biobank networks. Classification of different approaches for locating samples and an outlook on the future within the BBMRI-ERIC].

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Lablans, Martin; Kadioglu, Dennis; Mate, Sebastian; Leb, Ines; Prokosch, Hans-Ulrich; Ückert, Frank

2016-03-01

Medical research projects often require more biological material than can be supplied by a single biobank. For this reason, a multitude of strategies support locating potential research partners with matching material without requiring centralization of sample storage. Classification of different strategies for biobank networks, in particular for locating suitable samples. Description of an IT infrastructure combining these strategies. Existing strategies can be classified according to three criteria: (a) granularity of sample data: coarse bank-level data (catalogue) vs. fine-granular sample-level data, (b) location of sample data: central (central search service) vs. decentral storage (federated search services), and (c) level of automation: automatic (query-based, federated search service) vs. semi-automatic (inquiry-based, decentral search). All mentioned search services require data integration. Metadata help to overcome semantic heterogeneity. The "Common Service IT" in BBMRI-ERIC (Biobanking and BioMolecular Resources Research Infrastructure) unites a catalogue, the decentral search and metadata in an integrated platform. As a result, researchers receive versatile tools to search suitable biomaterial, while biobanks retain a high degree of data sovereignty. Despite their differences, the presented strategies for biobank networks do not rule each other out but can complement and even benefit from each other.

Building resilience: A preliminary exploration of women's perceptions of the use of acupuncture as an adjunct to In Vitro Fertilisation

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Paterson Charlotte

2009-12-01

Full Text Available Abstract Background In Vitro Fertilisation (IVF is now an accepted and effective treatment for infertility, however IVF is acknowledged as contributing to, rather than lessening, the overall psychosocial effects of infertility. Psychological and counselling interventions have previously been widely recommended in parallel with infertility treatments but whilst in many jurisdictions counselling is recommended or mandatory, it may not be widely used. Acupuncture is increasingly used as an adjunct to IVF, in this preliminary study we sought to investigate the experience of infertile women who had used acupuncture to improve their fertility. Methods A sample of 20 women was drawn from a cohort of women who had attended for a minimum of four acupuncture sessions in the practices of two acupuncturists in South Australia. Eight women were interviewed using a semi-structured questionnaire. Six had sought acupuncture during IVF treatment and two had begun acupuncture to enhance their fertility and had later progressed to IVF. Descriptive content analysis was employed to analyse the data. Results Four major categories of perceptions about acupuncture in relation to reproductive health were identified: (a Awareness of, and perceived benefits of acupuncture; (b perceptions of the body and the impact of acupuncture upon it; (c perceptions of stress and the impact of acupuncture on resilience; and (d perceptions of the intersection of medical treatment and acupuncture. Conclusion This preliminary exploration, whilst confined to a small sample of women, confirms that acupuncture is indeed perceived by infertile women to have an impact to their health. All findings outlined here are reported cautiously because they are limited by the size of the sample. They suggest that further studies of acupuncture as an adjunct to IVF should systematically explore the issues of wellbeing, anxiety, personal and social resilience and women's identity in relation to sexuality

Testing the effectiveness of a motivational interviewing-based brief intervention for substance use as an adjunct to usual care in community-based AIDS service organizations: study protocol for a multisite randomized controlled trial

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Bryan R. Garner

2017-11-01

Full Text Available Abstract Background In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1 reducing the number of people who become infected with HIV, (2 increasing access to care and improving health outcomes for people living with HIV, and (3 reducing HIV-related health disparities and health inequities. In 2013, as part of its effort to help address the National HIV/AIDS Strategy, the National Institute on Drug Abuse (NIDA funded a type 2 effectiveness-implementation hybrid trial titled the Substance Abuse Treatment to HIV Care (SAT2HIV Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI for substance use as an adjunct to usual care within AIDS Service Organizations (ASOs as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF as an adjunct to the Addiction Technology Transfer Center (ATTC model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Methods As part of a multisite randomized controlled trial, individuals with comorbid HIV/AIDS and problematic substance use are randomized to receive either the ASOs’ usual care (control condition or usual care plus a MIBI for substance use (experimental condition delivered by trained ASO case-management staff. Primary outcome measures are reductions in days of primary substance use, number of substance-related problems, times engaging in risky behaviors, days of non-adherence to HIV medications, and increases in substance use treatment. As part of this paper, we describe the trial protocol in accordance with the Standard Protocol Items: Recommendations for Interventional Trials guidelines. Discussion If successfully able to implement MIBI as an effective adjunct to usual care, the current trial may

Aerobic Exercise as an Adjunct Therapy for Improving Cognitive Function in Heart Failure

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Rebecca A. Gary

2014-01-01

Full Text Available Persons with heart failure (HF are typically older and are at a much higher risk for developing cognitive impairment (CI than persons without HF. Increasingly, CI is recognized as a significant, independent predictor of worse clinical outcomes, more frequent hospital readmissions, and higher mortality rates in persons with HF. CI can have devastating effects on ability to carry out HF effective self-care behaviors. If CI occurs, however, there are currently no evidence based guidelines on how to manage or improve cognitive function in this population. Improvement in cognition has been reported following some therapies in HF and is thought to be the consequence of enhanced cerebral perfusion and oxygenation, suggesting that CI may be amenable to intervention. Because there is substantial neuronal loss with dementia and no effective restorative therapies, interventions that slow, reverse, or prevent cognitive decline are essential. Aerobic exercise is documented to increase cerebral perfusion and oxygenation by promoting neuroplasticity and neurogenesis and, in turn, cognitive functioning. Few studies have examined exercise as a potential adjunct therapy for attenuating or alleviating cognitive decline in HF. In this review, the potential benefit of aerobic exercise on cognitive functioning in HF is presented along with future research directions.

Foreword: The 12th International Conference on Vibrations at Surfaces (VAS 12) (Erice, 20 26 July 2007)

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Benedek, Giorgio; Vattuone, Luca

2008-06-01

The 12th International Conference on Vibrations at Surfaces (VAS 12) took place from 20 26 July 2007 as an event of the International School of Solid State Physics at the Ettore Majorana Foundation and Centre for Scientific Culture, Erice (Italy). The format and special environment of the conference have contributed to its transition from a traditional, medium-size conference into a more effective workshop, with a series of lectures reporting the most recent developments in the field, two poster sessions presenting recent results and even works in progress being discussed. The papers collected in this issue cover the highlights of the conference very thoroughly. Quite a few novel aspects concerning vibrations at surfaces are represented here, for example: new aspects in surface phonon spectroscopy, such as the very recent progress in inelastic x-ray scattering, the first observation of the boson peak in disordered surfaces, progress in the theory of atom scattering inelastic resonances, the action spectroscopy, the study of polycrystalline surfaces with electron energy-loss spectroscopy etc; parallel developments in experimental vibrational studies of adsorbed phases, either inorganic or organic, with those in ab initio theoretical simulations; the theory of enhanced electron--phonon interaction in low dimensions (2D and 1D); the extension from the traditional realm of surface vibrations and spectroscopy to other aspects of surface dynamics, like friction and various nonlinear effects, and to relevant dynamical phenomena occurring at interfaces. Other novelties presented at the conference, but already published in recent issues of the Journal of Physics: Condensed Matter, are also worth mentioning: the spin-echo spectroscopy with 3He allowing for slow-dynamics spectroscopy at very high, unprecedented resolutions (2007 J. Phys.: Cond. Matter 19 300301 and 305010; the first demonstration of dissociative surface trapping of molecules (2007 J. Phys.: Cond. Matter 19

Efficacy of Combined Treatment with Acupuncture and Bee Venom Acupuncture as an Adjunctive Treatment for Parkinson's Disease.

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Cho, Seung-Yeon; Lee, Young-Eun; Doo, Kyeong-Hee; Lee, Ji-Hyun; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Kim, Ho; Rhee, Hak Young; Park, Hi-Joon; Park, Seong-Uk

2018-01-01

The aim of this study was to evaluate the efficacy of acupuncture and bee venom acupuncture (BVA) for idiopathic Parkinson's disease (IPD) through a sham-controlled trial. We also investigated whether there is a sustained therapeutic effect by completing follow-up assessments after treatment completion. A single center, double-blind, three-armed randomized controlled trial. This study was performed at a university hospital in Seoul, Republic of Korea. Seventy-three (73) patients with IPD were the subjects. They were randomly assigned to the active treatment group, sham treatment group, or conventional treatment group. The active treatment group received acupuncture and BVA and the sham group received sham acupuncture and normal saline injections, twice a week for 12 weeks. The conventional treatment group maintained anti-parkinsonian drugs without additional intervention. The Unified Parkinson's Disease Rating Scale (UPDRS) part II and part III score, postural instability and gait disturbance (PIGD) score, gait speed and number, Parkinson's Disease Quality of Life Questionnaire, Beck Depression Inventory, and postural stability at baseline and at 12, 16, and 20 weeks. Sixty-three (63) patients provided a complete data of assessments, including a final follow-up. After 12 weeks of treatment, a significant difference was observed between the active treatment group and the conventional treatment group. After the end of the treatment, the treatment effects were maintained significantly in the active treatment group only. It is suggested that the combined treatment of acupuncture and BVA might be safe and useful adjunctive treatment for patients with IPD.

Adjunctive Application of Antimicrobial Photodynamic Therapy in Nonsurgical Periodontal Treatment: A Review of Literature

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Takeshi Kikuchi

2015-10-01

Full Text Available Periodontal disease is caused by dental plaque biofilms, and the removal of these biofilms from the root surface of teeth plays a central part in its treatment. The conventional treatment for periodontal disease fails to remove periodontal infection in a subset of cases, such as those with complicated root morphology. Adjunctive antimicrobial photodynamic therapy (aPDT has been proposed as an additional treatment for this infectious disease. Many periodontal pathogenic bacteria are susceptible to low-power lasers in the presence of dyes, such as methylene blue, toluidine blue O, malachite green, and indocyanine green. aPDT uses these light-activated photosensitizer that is incorporated selectively by bacteria and absorbs a low-power laser/light with an appropriate wavelength to induce singlet oxygen and free radicals, which are toxic to bacteria. While this technique has been evaluated by many clinical studies, some systematic reviews and meta-analyses have reported controversial results about the benefits of aPDT for periodontal treatment. In the light of these previous reports, the aim of this review is to provide comprehensive information about aPDT and help extend knowledge of advanced laser therapy.

Adjunctive use of essential oils following scaling and root planing -a randomized clinical trial.

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Azad, Mohammad Fallah; Schwiertz, Andreas; Jentsch, Holger F R

2016-06-07

Hitherto no study has been published on the effect of the adjunctive administration of essential oils following scaling and root planing (SRP). This study describes the effect of a mouthrinse consisting of essential oils (Cymbopogon flexuosus, Thymus zygis and Rosmarinus officinalis) following SRP by clinical and microbiological variables in patients with generalized moderate chronic periodontitis. Forty-six patients (aged 40-65 years) with moderate chronic periodontitis were randomized in a double-blind study and rinsed their oral cavity following SRP with an essential oil mouthrinse (n  =  23) or placebo (n  =  23) for 14 days. Probing depth (PD), attachment level (AL), bleeding on probing (BOP) and modified sulcus bleeding index (SBI) were recorded at baseline and after 3 and 6 months. Subgingival plaque was taken for assessment of major bacteria associated with periodontitis. AL, PD, BOP and SBI were significantly improved in both groups after three (p   essential oils following SRP has a positive effect on clinical variables and on bacterial levels in the subgingival biofilm. 332-12-24092012, DRKS 00009387, German Clinical Trials Register, Freiburg i. Br., 16.09.2015.

Use of abdominal binder as anti-shock garment; an adjunct to uterine tamponade in uterine atony

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Kallue, U.R.; Chughtai, F.; Chaudry, A.; Shamin, Z.

2017-01-01

Objective: Aim of the study was to control life threatening post partum haemorrhage (PPH) in women till blood and blood products were made available or the women transferred to a better equipped centre. Study Design: A prospective interventional consecutive case series. Place and Duration of Study: It was conducted in three hospitals; Heavy Industries Taxila (HIT) hospital Apr 2005 to Sep 2010, Pakistan Ordinance Factories (POF) hospital Wah cantt Oct 2011 to Dec 2014 and Combined Military Hospital (CMH) Tarbela Dec 2014 to Dec 2015. Material and Methods: Abdominal binder was used in 22 consecutive women, having moderate to severe primary PPH due to uterine atony, where despite uterotonics (i.v oxytocin, rectal misoprostol) and bimanual compression, uterine tamponade was performed but complete control of haemorrhage was not achieved. Protocols for the treatment of obstetric haemorrhage and hypotensive shock were observed, including administration of intravenous crystalloid fluids and blood transfusion. If required, surgery was performed in the form of uterine arteries ligation or B-Lynch sutures. Obstetric hysterectomy was performed to save the woman's life if conservative procedures failed. Results: Bleeding and hypotension were controlled successfully in 19 (86.4%) of these women. In 03 (14.6%) women, bleeding persisted and so hysterectomy had to be resorted to. There was no maternal mortality. At 06 weeks postnatal follow up, none of the patients were found to suffer from long term debility; physical or psychological. Conclusion: Abdominal binder was found to be very effective in controlling bleeding and hypotensive crisis due to significant PPH due to uterine atony, as an adjunct to uterine tamponade. (author)

Clinical effect of azithromycin as an adjunct to non-surgical treatment of chronic periodontitis: a meta-analysis of randomized controlled clinical trials.

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Zhang, Z; Zheng, Y; Bian, X

2016-06-01

The results of recent published studies focusing on the effect of azithromycin as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis are inconsistent. We conducted a meta-analysis of randomized controlled clinical trials to examine the effect of azithromycin combined with SRP on periodontal clinical parameters as compared to SRP alone. An electronic search was carried out on Pubmed, Embase and the Cochrane Central Register of Controlled Trials from their earliest records through December 28, 2014 to identify studies that met pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. Data were extracted independently by two authors. Either a fixed- or random-effects model was used to calculate the overall effect sizes of azithromycin on probing depth, attachment level (AL) and bleeding on probing (BOP). Heterogeneity was evaluated using the Q test and I(2) statistic. Publication bias was evaluated by Begg's test and Egger's test. A total of 14 trials were included in the meta-analysis. Compared with SRP alone, locally delivered azithromycin plus SRP statistically significantly reduced probing depth by 0.99 mm (95% CI 0.42-1.57) and increased AL by 1.12 mm (95% CI 0.31-1.92). In addition, systemically administered azithromycin plus SRP statistically significantly reduced probing depth by 0.21 mm (95% CI 0.12-0.29), BOP by 4.50% (95% CI 1.45-7.56) and increased AL by 0.23 mm (95% CI 0.07-0.39). Sensitivity analysis yielded similar results. No evidence of publication bias was observed. The additional benefit of systemic azithromycin was shown at the initially deep probing depth sites, but not at shallow or moderate sites. The overall effect sizes of systemic azithromycin showed a tendency to decrease with time, and meta-regression analysis suggested a negative relation between the length of follow-up and net change in probing depth (r = -0.05, p = 0.02). This meta-analysis provides further

Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy

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Ratna B Basak

2011-01-01

Full Text Available A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.

Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial.

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Garner, Bryan R; Zehner, Mark; Roosa, Mathew R; Martino, Steve; Gotham, Heather J; Ball, Elizabeth L; Stilen, Patricia; Speck, Kathryn; Vandersloot, Denna; Rieckmann, Traci R; Chaple, Michael; Martin, Erika G; Kaiser, David; Ford, James H

2017-11-17

Improving the extent to which evidence-based practices (EBPs)-treatments that have been empirically shown to be efficacious or effective-are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness-implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV) Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI) for substance use as an adjunct to usual care within AIDS service organizations (ASOs) as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF) as an adjunct to the Addiction Technology Transfer Center (ATTC) model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition) or the ATTC + ISF strategy (experimental condition). The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation). The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change). Building upon the exploration-preparation-implementation-sustainment (EPIS) framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1) time-to-proficiency (i.e., preparation phase outcome), (2) implementation effectiveness (i.e., implementation phase outcome), and (3) level of sustainment (i.e., sustainment phase outcome). Although not without limitations, the ISF

Testing the implementation and sustainment facilitation (ISF strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC strategy: study protocol for a cluster randomized trial

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Bryan R. Garner

2017-11-01

Full Text Available Abstract Background Improving the extent to which evidence-based practices (EBPs—treatments that have been empirically shown to be efficacious or effective—are integrated within routine practice is a well-documented challenge across numerous areas of health. In 2014, the National Institute on Drug Abuse funded a type 2 effectiveness–implementation hybrid trial titled the substance abuse treatment to HIV Care (SAT2HIV Project. Aim 1 of the SAT2HIV Project tests the effectiveness of a motivational interviewing-based brief intervention (MIBI for substance use as an adjunct to usual care within AIDS service organizations (ASOs as part of its MIBI Experiment. Aim 2 of the SAT2HIV Project tests the effectiveness of implementation and sustainment facilitation (ISF as an adjunct to the Addiction Technology Transfer Center (ATTC model for training staff in motivational interviewing as part of its ISF Experiment. The current paper describes the study protocol for the ISF Experiment. Methods Using a cluster randomized design, case management and leadership staff from 39 ASOs across the United States were randomized to receive either the ATTC strategy (control condition or the ATTC + ISF strategy (experimental condition. The ATTC strategy is staff-focused and includes 10 discrete strategies (e.g., provide centralized technical assistance, conduct educational meetings, provide ongoing consultation. The ISF strategy is organization-focused and includes seven discrete strategies (e.g., use an implementation advisor, organize implementation team meetings, conduct cyclical small tests of change. Building upon the exploration–preparation–implementation–sustainment (EPIS framework, the effectiveness of the ISF strategy is examined via three staff-level measures: (1 time-to-proficiency (i.e., preparation phase outcome, (2 implementation effectiveness (i.e., implementation phase outcome, and (3 level of sustainment (i.e., sustainment phase outcome

Efficacy of exercise as an adjunct treatment for clinically depressed inpatients during the initial stages of antidepressant pharmacotherapy: An open randomized controlled trial.

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Legrand, Fabien D; Neff, Elise M

2016-02-01

Physical exercise as adjunctive treatment for hospitalized patients with major depressive disorder (MDD) has been of increasing interest in the past few years. While preliminary findings are promising, these prior studies have been plagued by inclusion of participants at different stages of medication use at study entry. The present study evaluates the effects of a short (10-days) add-on endurance-training intervention in hospitalized MDD patients on antidepressant medication for less than two weeks. Thirty-five participants were randomly assigned to one of three study groups: aerobic exercise (n=14), placebo (stretching) exercise (n=11), or no intervention (control; n=10). The study outcome was the change in the Beck Depression Inventory (BDI-II) total score from baseline to the end of the study period. The intent-to-treat analysis showed significant improvements in BDI-II scores for both the aerobic and the stretching groups. However, comparing pre- to post-study depression changes in these two groups, we found a large effect size in favor of aerobic exercise (Cohen's d=-1.06). No significant change in depressive symptoms was found in the control group. The nature of the intervention (i.e., exercise) meant blinding participants to treatments was not possible. Precise information on medication dosage was not available, and the short duration of interventions and lack of follow-up assessment were all limitations. Endurance-training can be a helpful adjunct treatment for hospitalized patients with severe affective disorders in the initial stages of pharmacotherapy. Copyright © 2015 Elsevier B.V. All rights reserved.

Effects of adenosine and defibrotide adjunct to a standard crystalloid cardioplegic solution.

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Mantovani, V; Mariscalco, G; Borsani, P; Tenconi, S; Bruno, V D; Leva, C; Ferrarese, S; Sala, A

2005-06-01

Adenosine has many actions potentially useful as adjunct to a cardioplegia. Defibrotide was recently shown to have protective effects during cardiac arrest. The aim of this study was to compare these 2 substances to delineate their profile of action in the setting of cardioplegic arrest. A Langendorff model for isolated rat hearts was employed: 3 groups of 8 hearts each were used, respectively with plain St. Thomas cardioplegia as control (group C), and the same solution added with adenosine (group A) or defibrotide (group D). The hearts had a baseline perfusion for 30 minutes with Krebs-Henseleit solution at 37 degrees C, cardioplegia administration for 3 minutes, then 30 minutes of ischemia without any perfusion and finally 30 minutes of reperfusion with Krebs-Henseleit solution at 37 degrees C. The time to attain heart arrest was 20% shorter in group A, but this difference did not reach statistical significance (A: 13.6+/-1.5; D: 16.8+/-2.7; C: 17.3+/-2.2 s). The heart rate during reperfusion in group A was almost identical to baseline, while in both group C and D it was significantly lower (A: 101%, D: 93.4%, C: 82.4%, pdefibrotide have protective effects in an isolated model of cardioplegic arrest. Adenosine is significantly more active on heart rate while defibrotide is more active on contractily. Further studies are justified in order to test the combination of these 2 drugs.

Animal assisted therapy (AAT program as a useful adjunct to conventional psychosocial rehabilitation for patients with schizophrenia: results of a small-scale randomized controlled trial.

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Paula eCalvo

2016-05-01

Full Text Available Currently, one of the main objectives of human-animal interaction research is to demonstrate the benefits of animal-assisted therapy (AAT for specific profiles of patients or participants.The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6-month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre-program with post-program scores for the Positive and Negative Syndrome Scale (PANSS and the EuroQoL-5 dimensions questionnaire (EuroQol-5D, pre-session with post-session salivary cortisol and alpha-amylase for the last four AAT sessions, and adherence rates between different elements of the program.We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty-two institutionalized patients with chronic schizophrenia completed the 6-month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning, a community program (intended to facilitate community reintegration and a family program. Each member of the control group (n=8 participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT-treatment group (n=14 participated in twice-weekly 1-hour sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT-treatment showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT-treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT

Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial.

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Calvo, Paula; Fortuny, Joan R; Guzmán, Sergio; Macías, Cristina; Bowen, Jonathan; García, María L; Orejas, Olivia; Molins, Ferran; Tvarijonaviciute, Asta; Cerón, José J; Bulbena, Antoni; Fatjó, Jaume

2016-01-01

Currently, one of the main objectives of human-animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6-month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre-program with post-program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre-session with post-session salivary cortisol and alpha-amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty-two institutionalized patients with chronic schizophrenia completed the 6-month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT-treatment group (n = 14) participated in twice-weekly 1-h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT-treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT-treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT

Clinical efficacy, onset time and safety of bright light therapy in acute bipolar depression as an adjunctive therapy: A randomized controlled trial.

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Zhou, Tian-Hang; Dang, Wei-Min; Ma, Yan-Tao; Hu, Chang-Qing; Wang, Ning; Zhang, Guo-Yi; Wang, Gang; Shi, Chuan; Zhang, Hua; Guo, Bin; Zhou, Shu-Zhe; Feng, Lei; Geng, Shu-Xia; Tong, Yu-Zhen; Tang, Guan-Wen; He, Zhong-Kai; Zhen, Long; Yu, Xin

2018-02-01

Bright light therapy (BLT) is an effective treatment for seasonal affective disorder and non- seasonal depression. The efficacy of BLT in treating patients with bipolar disorder is still unknown. The aim of this study is to examine the efficacy, onset time and clinical safety of BLT in treating patients with acute bipolar depression as an adjunctive therapy (trial registration at ClinicalTrials.gov: NCT02009371). This was a multi-center, single blind, randomized clinical trial. Seventy-four participants were randomized in one of two treatment conditions: BLT and control (dim red light therapy, dRLT). Sixty-three participants completed the study (33 BLT, 30 dRLT). Light therapy lasted for two weeks, one hour every morning. All participants were required to complete several scales assessments at baseline, and at the end of weeks 1 and 2. The primary outcome measures were the clinical efficacy of BLT which was assessed by the reduction rate of HAMD-17 scores, and the onset time of BLT which was assessed by the reduction rate of QIDS-SR16 scores. The secondary outcome measures were rates of switch into hypomania or mania and adverse events. 1) Clinical efficacy: BLT showed a greater ameliorative effect on bipolar depression than the control, with response rates of 78.19% vs. 43.33% respectively (p < 0.01). 2) Onset day: Median onset day was 4.33 days in BLT group. 3) BLT-emergent hypomania: No participants experienced symptoms of hypomania. 4) Side effects: No serious adverse events were reported. BLT can be considered as an effective and safe adjunctive treatment for patients with acute bipolar depression. Copyright © 2017 Elsevier B.V. All rights reserved.

Intraosseous injection as an adjunct to conventional local anesthetic techniques: A clinical study.

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Idris, Mohamed; Sakkir, Nasil; Naik, Kishore Gopalakrishna; Jayaram, Nandakishore Kunijal

2014-09-01

The achievement of successful local anesthesia is a continual challenge in dentistry. Adjunctive local anesthetic techniques and their armamentaria, such as intraosseous injection (the Stabident system and the X-tip system) have been proposed to be advantageous in cases where the conventional local anesthetic techniques have failed. A clinical study was undertaken using intraosseous injection system by name X-tip to evaluate its effectiveness in cases where inferior alveolar nerve block has failed to provide pulpal anesthesia. Sixty adult patients selected were to undergo endodontic treatment for a mandibular molar tooth. Inferior alveolar nerve block was given using 4% articaine with 1:100,000 epinephrine. Twenty-four patients (40%) had pain even after administration of IAN block; intraosseous injection was administered using 4% articaine containing 1:100,000 epinephrine, using the X-tip system. The success of X-tip intraosseous injection was defined as none or mild pain (Heft-Parker visual analog scale ratings ≤ 54 mm) on endodontic access or initial instrumentation. Intraosseous injection technique was successful in 21 out of 24 patients (87.5%), except three patients who had pain even after supplemental X-tip injection. Within the limits of this study, we can conclude that supplemental intraosseous injection using 4% articaine with 1:100,000 epinephrine has a statistically significant influence in achieving pulpal anesthesia in patients with irreversible pulpitis.

Safety and efficacy of a xenogeneic DNA vaccine encoding for human tyrosinase as adjunctive treatment for oral malignant melanoma in dogs following surgical excision of the primary tumor.

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Grosenbaugh, Deborah A; Leard, A Timothy; Bergman, Philip J; Klein, Mary K; Meleo, Karri; Susaneck, Steven; Hess, Paul R; Jankowski, Monika K; Jones, Pamela D; Leibman, Nicole F; Johnson, Maribeth H; Kurzman, Ilene D; Wolchok, Jedd D

2011-12-01

To evaluate the safety and efficacy of a vaccine containing plasmid DNA with an insert encoding human tyrosinase (ie, huTyr vaccine) as adjunctive treatment for oral malignant melanoma (MM) in dogs. 111 dogs (58 prospectively enrolled in a multicenter clinical trial and 53 historical controls) with stage II or III oral MM (modified World Health Organization staging scale, I to IV) in which locoregional disease control was achieved. 58 dogs received an initial series of 4 injections of huTyr vaccine (102 μg of DNA/injection) administered transdermally by use of a needle-free IM vaccination device. Dogs were monitored for adverse reactions. Surviving dogs received booster injections at 6-month intervals thereafter. Survival time for vaccinates was compared with that of historical control dogs via Kaplan-Meier survival analysis for the outcome of death. Kaplan-Meier analysis of survival time until death attributable to MM was determined to be significantly improved for dogs that received the huTyr vaccine, compared with that of historical controls. However, median survival time could not be determined for vaccinates because dogs as adjunctive treatment for oral MM. Response to DNA vaccination in dogs with oral MM may be useful in development of plasmid DNA vaccination protocols for human patients with similar disease.

Non-surgical treatment of peri-implantitis with the adjunctive use of an 810-nm diode laser

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Marisa Roncati

2013-01-01

Full Text Available An 810-nm diode laser was used to non-surgically treat a 7-mm pocket around an implant that had five threads of bone loss, BoP+, and exudate, and the patient was followed up for 5 years. Non-surgical treatment, home care reinforcement, clinical indices records, and radiographic examination were completed in two consecutive 1-h appointments within 24 h. The patient was monitored frequently for the first 3 months. Subsequently, maintenance debridement visits were scheduled at 3-month intervals. The patient had a decreased probing pocket depth and a negative BoP index compared to initial clinical data, and the results were stable after 1 year. After 5 years of follow-up visits, there appeared to be rebound of the bone level radiographically. Within the limits of this case report, conventional non-surgical periodontal therapy with the adjunctive use of an 810-nm diode laser may be a feasible alternative approach for the management of peri-implantitis. The 5-year clinical and radiographic outcomes indicated maintenance of the clinical improvement.

Antitumor Effects of Palladium-α-Lipoic Acid Complex Formulation as an Adjunct in Radiotherapy.

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Veena, Ravindran Kalathil; Ajith, Thekkuttuparambil Ananthanarayanan; Janardhanan, Kainoor Krishnankutty; Antonawich, Francis

2016-01-01

Several investigations have been initiated to enhance the antitumor effect of radiation and ameliorate its adverse effects such as reducing blood cell counts and causing DNA damage in normal cells. Compounds that enhance the antitumor activity of radiation without reducing blood cell counts or damaging DNA in normal cells can be of immense use as an adjunct in radiotherapy. We evaluated the antitumor effect of a specific set of minerals, vitamins, and amino acids (Poly-MVA) (2 mL/kg, per os), with and without radiation, against Dalton's lymphoma ascites (DLA) and Ehrlich's ascites carcinoma (EAC) cell lines that were transplanted in a solid-tumor model. Whole-body γ-radiation exposure (2 Gy) was performed using 60Co. Poly-MVA enhanced the antitumor effect of radiation when administered beforehand. Furthermore, Poly-MVA administered once daily for 2 wk, immediately after 4 Gy irradiation, protected DNA damage in peripheral blood. It also rendered protection against the radiation-induced reduction of platelet count. The unique electronic and redox properties of palladium-α-lipoic acid complex in Poly-MVA appear to be responsible for the exhibited effect. The results conclude that the antitumor-enhancing and normal cell-protective effect of Poly-MVA warrants additional studies for its potential clinical application.

Orbital atherectomy as an adjunct to debulk difficult calcified lesions prior to mesenteric artery stenting.

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Manunga, Jesse M; Oderich, Gustavo S

2012-08-01

To describe a technique in which percutaneous orbital atherectomy is used to debulk heavily calcified superior mesenteric artery (SMA) occlusions as an adjunct in patients undergoing angioplasty and stenting. The technique is demonstrated in a 62-year-old woman with a replaced right hepatic artery originating from an SMA occluded by densely calcified lesions. Via a left transbrachial approach, a 7-F MPA guide catheter was used to engage the ostium of the SMA, which was crossed using a catheter and guidewire. The calcified lesion was debulked using the 2-mm Diamondback 360° orbital atherectomy system. The wire was exchanged for a 0.014-inch filter wire and 0.018-inch guidewire. Using a 2-guidewire technique, the SMA was stented with a self-expanding stent for the distal lesion that crossed side branches and a balloon-expandable stent at the ostium. A 0.014-inch guidewire was placed into the replaced hepatic artery through a cell of the self-expanding stent, followed by deployment of a small balloon-expandable stent to address the residual lesion. The use of orbital atherectomy to debulk occluded and heavily calcified SMA lesions may optimize the technical results with angioplasty and stenting.

BSN Program Admittance Criteria: Should Emotional Intelligence Be Included?

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Smith, Tanya

2017-01-01

Emotional intelligence refers to the ability to identify and monitor emotions and remain aware of how emotions affect thoughts and actions. Emotional intelligence has been discussed as a better predictor of personal and occupational success than performance on intellectual intelligence tests. Despite the importance of one's emotional intelligence, BSN (Bachelor of Science in Nursing) nursing schools routinely admit candidates based on the student's cumulative college course grade point average (GPA). Nursing is a profession that requires one's ability to empathize, care, and react in emotionally sound manners. Is the GPA enough to determine if a student will evolve into a professional nurse? This article will explore the routine admittance criteria for BSN nursing programs and propose the concept of using the emotional intelligence tool as an adjunct to the cumulative college course GPA. The emotional intelligence theory will be identified and applied to the nursing profession. © 2016 Wiley Periodicals, Inc.

Efficacy and safety of an adjunctive mGlu2 receptor positive allosteric modulator to a SSRI/SNRI in anxious depression.

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Kent, Justine M; Daly, Ella; Kezic, Iva; Lane, Rosanne; Lim, Pilar; De Smedt, Heidi; De Boer, Peter; Van Nueten, Luc; Drevets, Wayne C; Ceusters, Marc

2016-06-03

This phase 2a, randomized, multicenter, double-blind, proof-of-concept study was designed to evaluate, efficacy, safety and tolerability of JNJ-40411813/ADX71149, a novel metabotropic glutamate 2 receptor positive allosteric modulator as an adjunctive treatment for major depressive disorder (MDD) with significant anxiety symptoms. Eligible patients (18-64 years) had a DSM-IV diagnosis of MDD, Hamilton Depression Rating Scale-17 (HDRS17) score of ≥ 18, HDRS17 anxiety/somatization factor score of ≥ 7, and an insufficient response to current treatment with a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor. The doubly-randomized, 8-week double-blind treatment phase was comprised of two 4-week periods, from which a combined test statistic was generated, with pre-determined weights assigned to each of the 2 treatment periods. Period 1: patients (n=121) were randomly assigned (1:1) to JNJ-40411813 (n=62; 50mg to 150 mg b.i.d, flexibly dosed) or placebo (n=59); Period 2: placebo-treated patients (n=22) who continued to meet entry severity criteria were re-randomized (1:1) to JNJ-40411813 or placebo, while other patients underwent sham re-randomization and continued on their same treatment. Of 121 randomized patients, 100 patients (82.6%) were completers. No efficacy signal was detected on the primary endpoint, the 6-item Hamilton Anxiety Subscale (HAM-A6, p=0.51). Efficacy signals (based on prespecified 1-sided pdepression (HDRS17 total score, 6-item subscale of HDRS17 assessing core depressive symptoms [HAM-D6], and Inventory of Depressive Symptomatology [IDS-C30]) and anxiety (HDRS17 anxiety/somatization factor, IDS-C30 anxiety subscale). Although well-tolerated, the results do not suggest efficacy for JNJ-40411813 as an adjunctive treatment for patients with MDD with significant anxious symptoms in the dose range studied. Copyright © 2016 Elsevier Inc. All rights reserved.

Epidural cortical stimulation as adjunctive treatment for non-fluent aphasia: preliminary findings.

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Cherney, Leora R; Erickson, Robert K; Small, Steven L

2010-09-01

This study evaluated the safety and feasibility of targeted epidural cortical stimulation delivered concurrently with intensive speech-language therapy for treatment of chronic non-fluent aphasia. Eight stroke survivors with non-fluent aphasia received intensive behavioural therapy for 3 h daily for 6 weeks using a combination of articulation drills, oral reading and conversational practice. Four of these participants (investigational participants) also underwent functional MRI guided surgical implantation of an epidural stimulation device which was activated only during therapy sessions. Behavioural data were collected before treatment, immediately after treatment and at 6 and 12 weeks following termination of therapy. Imaging data were collected before and after treatment. Investigational participants showed a mean Aphasia Quotient change of 8.0 points immediately post-therapy and at the 6 week follow-up, and 12.3 points at 12 weeks. The control group had changes of 4.6, 5.5 and 3.6 points, respectively. Similar changes were noted on subjective caregiver ratings. Functional imaging suggested increased consolidation of activity in interventional participants. Behavioural speech-language therapy improves non-fluent aphasia, independent of cortical stimulation. However, epidural stimulation of the ipsilesional premotor cortex may augment this effect, with the largest effects after completion of therapy. The neural mechanisms underlying these effects are manifested in the brain by decreases in the volume of activity globally and in particular regions. Although the number of participants enrolled in this trial precludes definitive conclusions, targeted epidural cortical stimulation appears safe and may be a feasible adjunctive treatment for non-fluent aphasia, particularly when the aphasia is more severe.

COMPARISON OF EFFECT OF MAGNESIUM SULPHATE AND PRESERVATIVE-FREE KETAMINE AS AN ADJUNCT TO EPIDURAL BUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN ABDOMINAL HYSTERECTOMY

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Radha Korumbil Raghavan

2017-08-01

Full Text Available BACKGROUND Neuraxial blocks are the most common method of anaesthesia in abdominal hysterectomies and epidural technique has been used widely to provide both anaesthesia and postoperative analgesia. It has become a common practice to use polypharmacy approach for treatment of intra and postoperative pain, because no drug has yet been identified that specifically inhibit nociception without side effects. The aim of the study is to compare the effects of magnesium sulphate versus preservative-free ketamine as an adjunct to epidural bupivacaine for postoperative analgesia in abdominal hysterectomy. MATERIALS AND METHODS After obtaining informed consent, the patients were divided into 3 groups of 40 each to receive 20 mL 0.5% bupivacaine (group B, 19 mL 0.5% bupivacaine + 50 mg magnesium sulphate (group BM, 19 mL 0.5% bupivacaine + 50 mg preservative-free ketamine (group BK. Epidural catheter was inserted at L1-L2 space using standard technique. Correct placement was confirmed by a test dose of 2% lignocaine + adrenaline 1 in 2 lakhs. Postoperative analgesia were assessed by VAS score and 0.125% bupivacaine infusion and 1 g paracetamol IV infusion was given as rescue analgesics when VAS ≥4. Onset duration, motor block and side effects were also monitored. RESULTS Mean time of duration of onset in group B, BM, BK were 20, 14, 18 minutes, respectively. Mean time for rescue analgesia were 180, 240 and 480 minutes in group 1, 2 and 3, respectively. These differences were statistically significant. The side effects noticed in each group were not statistically significant. CONCLUSION The onset of effect is faster when magnesium sulphate were added as an adjunct to bupivacaine as compared to preservativefree ketamine. The postoperative analgesia is found to be more with preservative-free ketamine as compared to magnesium sulphate without any significant side effects.

Assessing sensor accuracy for non-adjunct use of continuous glucose monitoring.

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Kovatchev, Boris P; Patek, Stephen D; Ortiz, Edward Andrew; Breton, Marc D

2015-03-01

The level of continuous glucose monitoring (CGM) accuracy needed for insulin dosing using sensor values (i.e., the level of accuracy permitting non-adjunct CGM use) is a topic of ongoing debate. Assessment of this level in clinical experiments is virtually impossible because the magnitude of CGM errors cannot be manipulated and related prospectively to clinical outcomes. A combination of archival data (parallel CGM, insulin pump, self-monitoring of blood glucose [SMBG] records, and meals for 56 pump users with type 1 diabetes) and in silico experiments was used to "replay" real-life treatment scenarios and relate sensor error to glycemic outcomes. Nominal blood glucose (BG) traces were extracted using a mathematical model, yielding 2,082 BG segments each initiated by insulin bolus and confirmed by SMBG. These segments were replayed at seven sensor accuracy levels (mean absolute relative differences [MARDs] of 3-22%) testing six scenarios: insulin dosing using sensor values, threshold, and predictive alarms, each without or with considering CGM trend arrows. In all six scenarios, the occurrence of hypoglycemia (frequency of BG levels ≤50 mg/dL and BG levels ≤39 mg/dL) increased with sensor error, displaying an abrupt slope change at MARD =10%. Similarly, hyperglycemia (frequency of BG levels ≥250 mg/dL and BG levels ≥400 mg/dL) increased and displayed an abrupt slope change at MARD=10%. When added to insulin dosing decisions, information from CGM trend arrows, threshold, and predictive alarms resulted in improvement in average glycemia by 1.86, 8.17, and 8.88 mg/dL, respectively. Using CGM for insulin dosing decisions is feasible below a certain level of sensor error, estimated in silico at MARD=10%. In our experiments, further accuracy improvement did not contribute substantively to better glycemic outcomes.

Spot-On Skin Lipid Complex as an Adjunct Therapy in Dogs with Atopic Dermatitis: An Open Pilot Study

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Masato Fujimura

2011-01-01

Full Text Available The purpose of this paper was to evaluate the efficacy of topical skin lipid complex (SLC in canine atopic dermatitis (AD. Eight dogs with chronic AD and no improvement of main therapy in symptoms, erythema, lichenification, excoriation, and alopecia in the previous month were treated with SLC topically as adjunct therapy at lesion sites twice weekly for 12 weeks. A statistically significant reduction (26.0%, <0.05 in the third version of the Canine Atopic Dermatitis Extent and Severity Index (CADESI-03 modification from baseline was recorded 6 weeks after treatment, with marked reduction in the erythema subscore (36.2%, <0.005. A significant reduction in excoriation and alopecia subscores was observed 6 weeks after treatment (39.9%, <0.05 and 19.9%, <0.05, resp.. However, the lichenification subscore was not reduced significantly at 6 or 12 weeks. These findings suggest that topical SLC may have therapeutic and clinical benefits in dogs with AD.

Celecoxib as adjunctive treatment to risperidone in children with autistic disorder: a randomized, double-blind, placebo-controlled trial.

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Asadabadi, Mahtab; Mohammadi, Mohammad-Reza; Ghanizadeh, Ahmad; Modabbernia, Amirhossein; Ashrafi, Mandana; Hassanzadeh, Elmira; Forghani, Saeedeh; Akhondzadeh, Shahin

2013-01-01

Autism is associated with activation of the inflammatory response system. This study aims to assess the efficacy of a cyclooxygenase-2 inhibitor, celecoxib, as adjunctive therapy in the treatment of autism In a 10-week randomized double-blind placebo-controlled study, 40 outpatient children with a Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision clinical diagnosis of autism were randomly allocated to celecoxib plus risperidone or placebo plus risperidone. The dose of risperidone and celecoxib were titrated up to 3 and 300 mg/day, respectively. Patients were assessed at baseline and after 2, 4, 6, and 10 weeks of starting medication using the Aberrant Behavior Checklist-Community (ABC-C) Rating Scale. Primary outcome measure was the change in irritability subscale of ABC-C. Significant time × treatment interaction was observed for Irritability (F (1.658, 63.021) = 13.580, P autism. (Registration, www.irct.ir ; IRCT138711091556N2).

Intraosseous injection as an adjunct to conventional local anesthetic techniques: A clinical study

Science.gov (United States)

Idris, Mohamed; Sakkir, Nasil; Naik, Kishore Gopalakrishna; Jayaram, Nandakishore Kunijal

2014-01-01

Background: The achievement of successful local anesthesia is a continual challenge in dentistry. Adjunctive local anesthetic techniques and their armamentaria, such as intraosseous injection (the Stabident system and the X-tip system) have been proposed to be advantageous in cases where the conventional local anesthetic techniques have failed. Aim: A clinical study was undertaken using intraosseous injection system by name X-tip to evaluate its effectiveness in cases where inferior alveolar nerve block has failed to provide pulpal anesthesia. Materials and Methods: Sixty adult patients selected were to undergo endodontic treatment for a mandibular molar tooth. Inferior alveolar nerve block was given using 4% articaine with 1:100,000 epinephrine. Twenty-four patients (40%) had pain even after administration of IAN block; intraosseous injection was administered using 4% articaine containing 1:100,000 epinephrine, using the X-tip system. The success of X-tip intraosseous injection was defined as none or mild pain (Heft-Parker visual analog scale ratings ≤ 54 mm) on endodontic access or initial instrumentation. Results: Intraosseous injection technique was successful in 21 out of 24 patients (87.5%), except three patients who had pain even after supplemental X-tip injection. Conclusion: Within the limits of this study, we can conclude that supplemental intraosseous injection using 4% articaine with 1:100,000 epinephrine has a statistically significant influence in achieving pulpal anesthesia in patients with irreversible pulpitis. PMID:25298642

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial.

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Agouropoulos, A; Twetman, S; Pandis, N; Kavvadia, K; Papagiannoulis, L

2014-10-01

To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000ppm fluoride toothpaste. 424 preschool children, 2-5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity. The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p=0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments. Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000ppm fluoride toothpaste. In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000ppm fluoride toothpaste is used daily. Copyright © 2014 Elsevier Ltd. All rights reserved.

Antibiotic therapy as an adjunct to scaling and root planing in smokers: a systematic review and meta-analysis.

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Assem, Naida Zanini; Alves, Márcio Luiz Ferro; Lopes, Alessandra Barreto; Gualberto, Erivan Clementino; Garcia, Valdir Gouveia; Theodoro, Letícia Helena

2017-07-03

The aim of this study was to perform a systematic review and meta-analysis to examine the effect of systemic antibiotics in the periodontal treatment of smokers. The selection criteria were as follows: controlled randomized clinical trials; studies published in English; studies with smoker patients diagnosed with chronic periodontitis; patients without systemic diseases; studies that used systemic antibiotic therapy associated with periodontal treatment; studies that presented results for the test and control groups and assessments of clinical periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL). The differences in average weights were calculated with a confidence interval (CI) of 95% for PD reduction, CAL gain and BOP. The means of the periodontal clinical parameters were compared between the baseline and post-treatment periods between the test groups and the control groups. The heterogeneity was assessed using the Cochran Q test (Q (df = 3), α = 5%). A total of 67 articles were found, and after the selection process, three randomized controlled trials were included in the meta-analysis. The results indicate that SRP associated with systemic antibiotics promoted additional benefits when compared to SRP alone, with a greater reduction of PD (p = 0.0359, CI = -0.42, -0.01) and a gain of CAL (p = 0.0161, CI = -0.39, -0.04). There was a modest PD reduction (PD, DM -0.21) and a modest CAL gain (CAL, DM -0.22). The results of our meta-analysis reveal the clinical benefits of systemic antibiotics as an adjunct to the non-surgical periodontal treatment of smokers. These clinical improvements, although statistically significant, appeared to be of little clinical relevance.

Antibiotic therapy as an adjunct to scaling and root planing in smokers: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Naida Zanini ASSEM

2017-07-01

Full Text Available Abstract The aim of this study was to perform a systematic review and meta-analysis to examine the effect of systemic antibiotics in the periodontal treatment of smokers. The selection criteria were as follows: controlled randomized clinical trials; studies published in English; studies with smoker patients diagnosed with chronic periodontitis; patients without systemic diseases; studies that used systemic antibiotic therapy associated with periodontal treatment; studies that presented results for the test and control groups and assessments of clinical periodontal parameters, such as probing depth (PD, bleeding on probing (BOP, and clinical attachment level (CAL. The differences in average weights were calculated with a confidence interval (CI of 95% for PD reduction, CAL gain and BOP. The means of the periodontal clinical parameters were compared between the baseline and post-treatment periods between the test groups and the control groups. The heterogeneity was assessed using the Cochran Q test (Q (df = 3, α = 5%. A total of 67 articles were found, and after the selection process, three randomized controlled trials were included in the meta-analysis. The results indicate that SRP associated with systemic antibiotics promoted additional benefits when compared to SRP alone, with a greater reduction of PD (p = 0.0359, CI = -0.42, -0.01 and a gain of CAL (p = 0.0161, CI = -0.39, -0.04. There was a modest PD reduction (PD, DM -0.21 and a modest CAL gain (CAL, DM -0.22. The results of our meta-analysis reveal the clinical benefits of systemic antibiotics as an adjunct to the non-surgical periodontal treatment of smokers. These clinical improvements, although statistically significant, appeared to be of little clinical relevance.

The use of multimedia as an adjunct to the informed consent process for ankle ligament reconstruction surgery.

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Batuyong, Eldridge; Birks, Christopher; Beischer, Andrew D

2012-06-01

Obtaining "informed consent" is an integral aspect of surgery that can be fraught with difficulty. This study assessed the efficacy of a multimedia education tool in improving patients' understanding when used as an adjunct to the traditional verbal consent process regarding ankle lateral ligament reconstruction surgery. A total of 56 patients (28 males and 28 females) were recruited with a mean age of 36 years. A standardized verbal discussion regarding surgical treatment was provided to each patient. Understanding was then assessed using a knowledge questionnaire. Subsequently, each patient observed a multimedia educational program following which the knowledge questionnaire was repeated. Additional supplementary questions were then given regarding the ease of understanding and satisfaction with the 2 methods of education delivery. The patients answered 75% of the questions correctly before the multimedia module compared with 88% after it (P multimedia tool performed as well as the treating surgeon. Multimedia tools used in sequence after a verbal consent resulted in improved patient understanding of pertinent information regarding ankle lateral ligament reconstruction surgery. Therapeutic Level II.