Although previous research suggests that preamputation pain is a riskfactor for pain after amputation, little is known about the association between acute postsurgical pain and chronic amputation-related pain. The current prospective study examined the associations of preamputation pain and acute postamputation pain with chronic amputation-related pain. The sample consisted of patients with lower limb amputation (N = 57) who provided both preamputation and postamputation data during a 2-year study period. Preamputation pain intensity and duration were assessed before amputation; acute phantom limb pain (PLP) and residual limb pain (RLP) intensity were assessed on postsurgical days 4 and 5. Acute PLP intensity was the only significant ...
Little is known about how sociodemographic factors relate to children’s chronic pain. This paper describes the pain, health, and sociodemographic characteristics of a cohort of children...Full Text Available
Chronic pain patients who show aberrant drug-related behavior often are discontinued from treatment when they are noncompliant with their use of opioids for pain. The purpose of this study was...Full Text Available
ObjectiveThe purpose of this study is to identify the factors affecting the failure of trials (<50% pain reduction in pain for trial period) to improve success rate of spinal...Full Text Available
The treatment of chronic pain conditions continue to present a challenge to the medical field. Physical therapy treatment needs to approach the management of chronic pain differently than the approach used to resolve acute pain. Patients with chronic pain often have many factors that have perpetuated the pain condition. These factors, as well as pain itself, influence their ability to reactivate and perform functional daily activities. Physical therapists can begin to address some of the factors, including fear and deconditioning, by building confidence and body awareness in a self-care model including a slow graduated reactivation program. There is evidence that patients with chronic pain conditions have altered motor control that may be influencing reoccurrences and possible ...
Back pain from osteoporosis is commonly related to compression fractures. The patient with vertebral compression fractures additionally suffers from an ongoing risk of recurrent fractures and postural abnormalities that can result in impaired respiratory function, leading to increased risk of morbidity. Weakened back muscles, especially the back extensor group, are felt to contribute significantly to this risk. The combination of pharmacologic and nonpharmacologic interventions, through physical activity, exercise, and modalities, are potential interventions that could be used to help reduce the pain of osteoporotic compression fractures as well as potentially reducing recurrent fracture rates.
In response to an earlier published paper by Fordyce, some assumptions underlying the behavior management paradigm of chronic pain are critically discussed. While operant treatment has proved successful, the conclusion that operant factors play an important role in the development and maintenance of chronic benign pain is debated. Some empirical studies, regularly used to demonstrate this role, are re-evaluated. An alternative theory is proposed for chronic pain behavior, in which the role of a lower tolerance to proprioceptive stimuli, which may include more than just pain stimuli, is emphasized. PMID:3313200
BackgroundAnterior knee pain (AKP) is a common musculoskeletal complaint. It has been suggested that one factor that may contribute to the presence of AKP is a delay in the recruitment...Full Text Available
Shoulder pain is a common orthopedic condition seen by physical therapists, with many potential contributing factors and proposed treatments. Although manual physical therapy interventions for the cervicothoracic...Full Text Available
The development of central neuropathic pain varies among patients with spinal cord injury (SCI). The factors contributing to the development and perpetuation of segmental pain (at-level allodynia)...Full Text Available
The utilization of health care services in children and adolescents with chronic benign pain was studied in a Dutch population sample of 254 chronic pain sufferers aged 0-18 years. Children and adolescents who had reported chronic pain (continuous or recurrent pain >3 months) in our previous prevalence study were asked to keep a 3-week diary on their pain and to fill out questionnaires on background factors, health care use and the impact of pain. Parent ratings were used for children aged 0-11 years, self-report was used in adolescents (12-18 years). In a 3-month period, in 53.4% of the cases medication was used for pain, and general practitioners and specialists were consulted for pain in 31.1% and 13.9% of subjects, respectively. Physiotherapists, psychologists and alternative health providers ...
Chronic benign pain is commonly associated with chronic fatigue and depression. Depression and chronic fatigue syndrome are also associated with each other and often include pain. Psychologic factors are prominent in these conditions, and they may share neurobiologic factors as well. Management requires separately addressing each component of patients' distress and usually includes physical rehabilitation, education, administration of nonhabituating medications and often counseling. Depression may be a favorable prognostic sign, as it suggests a treatable condition and provides incentive for recovery. PMID:1876618
A new method of administration of an opioid was recently registered: fentanyl transdermal (brand name: Durogesic), intended particularly for the indication range 'pain in cancer'. Fentanyl is lipid-soluble so that deposition in the skin takes place and the biological half-life is approximately 20 hours after removal of the plaster. It is safe to start on a basis of an equianalgesic conversion of 100:1 in relation to oral morphine, although this may entail some risk of fentanyl under dosage. The dose adjustment time is 12-24 hours before a constant fentanyl level is reached; therefore, after attaching the first sticking plaster, the original morphine dose should be continued for another 12 hours. In addition, the patient may, if necessary, be given supplementary morphine preferably as a short-acting drug. There seems to be no clear indication for transdermal fentanyl either in neuropathic pain or in chronic benign ...
Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period of 6-months. Results: Eight patients were treated in this study ...
The subjective experience of one's environment is constructed by interactions among sensory, cognitive, and affective processes. For centuries, meditation has been thought to influence such processes by enabling a nonevaluative representation of sensory events. To better understand how meditation influences the sensory experience, we used arterial spin labeling functional magnetic resonance imaging to assess the neural mechanisms by which mindfulness meditation influences pain in healthy human participants. After 4 d of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest. A two-factor repeated-measures ANOVA was used to identify interactions between meditation and pain-related brain activation. Meditation reduced pain-related ...
For the risk estimate of fatal malignancies, an effective dose was proposed on the basis of the assumption that the risk should be equal whether the whole body irradiated uniformly or whether there is non-uniform irradiation. The effective dose was defined by the product of organ or tissue doses and a weighting factor representing the proportion of riskfactor for a fatal malignancy resulting from organ or tissue irradiation to the total malignant factor. The risk of malignancies can be derived by multiplying the malignant significant factor by the product of the riskfactor and the effective dose. For the genetic risk, a significant factor was a relative child expectancy and organ or tissue doses were gonad doses. And, for the ...
Organizational risk indicators are proposed as a tool for risk control during operation of offshore installations, as a complement to QRA-based indicators. An organizational factor framework is developed based on a review of existing organizational factor frameworks, research on safety performance indicators, and previous work on QRA-based indicators. The results comprise a qualitative organizational model, proposed organizational risk indicators, and a quantification methodology for assessing the impact of the organization on risk. The risk indicators, when validated, will aid in a frequent control of the risk in the periods between the updating of the quantitative risk assessments.
The two main aspects of the concept proposed by the ICRP in recommendation 26 for the radiation risk, the differentiation of stochastic and non stochastic damages and the qualification of the stochastic risk, are discussed in its consequences for radiation protection in X-ray diagnostics. Quantitative results from the literature serve to demonstrate the riskfactors for the various organs and their sum concerning the position of the layer. As special points of somatic risk appeared the mamma and the pelvic region. The particular risk of CT examination is determined by number and position of the layers and the scan parameters of the system. For typical CT examination the resulting riskfactors are estimated in comparison with conventional X-ray diagnostics. The somatic risk of CT examination is ...
The two main aspects of the concept proposed by the ICRP in recommendation 26 for the radiation risk, the differentiation of stochastic and non stochastic damages and the qualification of the stochastic risk, are discussed in its consequences for radiation protection in X-ray diagnostics. Quantitative results from the literature serve to demonstrate the riskfactors for the various organs and their sum concerning the position of the layer. As special points of somatic risk appeared the mamma and the pelvic region. The particular risk of CT examination is determined by number and position of the layers and the scan parameters of the system. For typical CT examination the resulting riskfactors are estimated in comparison with conventional X-ray diagnostics. The somatic risk of CT examination is ...
The two main aspects of the concept proposed by the ICRP in recommendation 26 for the radiation risk, the differentiation of stochastic and non stochastic damages and the qualification of the stochastic risk, are discussed in its consequences for radiation protection in X-ray diagnostics. Quantitative results from the literature serve to demonstrate the riskfactors for the various organs and their sum concerning the position of the layer. As special points of somatic risk appeared the mamma and the pelvic region. The particular risk of CT examination is determined by number and position of the layers and the scan parameters of the system. For typical CT examination the resulting riskfactors are estimated in comparison with conventional X-ray diagnostics. The somatic risk of CT examination is ...
BackgroundHearing loss is a common sensory disorder, yet prospective data on potentially modifiable riskfactors are limited. Regularly used analgesics, the most...Full Text Available
ObjectiveTo determine whether erectile dysfunction (ED) predicts cardiovascular disease (CVD) beyond traditional riskfactors.BackgroundFull Text Available
Antimicrobial resistance is an emerging problem with Pseudomonas aeruginosa. This study determined riskfactors for the recovery of piperacillin-tazobactam-resistant P. aeruginosa...Full Text Available
BackgroundHealthcare professionals can play a crucial role in optimizing the health status of patients with cardiovascular riskfactors (abdominal obesity, high blood pressure, low...Full Text Available
This study investigated potential riskfactors for the presence of Salmonella on 89 Alberta swine-finishing farms with the use of a questionnaire. Salmonella status...Full Text Available
Antimicrobial resistance is an emerging problem among nosocomial bacteria. Riskfactors for the recovery of ceftriaxone-resistant (CRCF) or -susceptible (CSCF) Citrobacter freundii...Full Text Available
BackgroundHepatitis B and C is common in Pakistan and various riskfactors are attributable to its spread.One thousand and fifty consecutive male cases suffering from chronic...Full Text Available
The purpose of this article is to critically review the available evidence pertaining to occupational, environmental, and individual factors that can affect the development of occupational asthma (OA)....Full Text Available
Abstract The success of software projects is quite subjective in nature and is fettered by many risks, the perception of which varies from individual to individual and largely depends on the demographic characteristics of the executives and even the characteristics of the project. This study aims to identify and gauge the software risk dimensions and analyze the differences of perception among executives toward software risks. The contributions of this study untangle the issues underlying risks in the software industry and associates these issues with the perception of the -human- factor present in the industry.
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurobehavioral disorder affecting 5% to 10% of children. Although considered to be a highly familial disorder, ADHD heritability estimates of 60% to 80% highlight the considerable role that environmental factors may still play in disorder susceptibility. Proposed ADHD environmental riskfactors include prenatal substance exposures, heavy metal and chemical exposures, nutritional factors, and lifestyle/psychosocial factors. This paper reviews the literature published in 2010 investigating the association between environmental riskfactors and ADHD or related symptomatology. Sources of riskfactor exposure and the proposed mechanism by which each exposure is linked to ADHD-related neurobehavioral changes are also reported. Metho...
The E and P industry has high levels of uncertainty and risk, which oil companies attempt to quantify before embarking on each individual E and P project. However, the actual return on investment often falls well short of the hurdle rate. This discrepancy has been attributed to systemic limitations in decision analysis processes and workflow, which result in repeated underestimation of risk and overestimation of the predicted production of the project. Well designed decision analysis processes in association with clearly defined, multi-scenario analyses of significant technical uncertainties are required. However, simulation of these uncertainties is not realistic given the performance and infrastructure limitations of conventional technology (Begg et al., 2001; Floris and Peersmann, 2000). During the past five years, more than 20 companies have attempted to map the requirements of new technology that is needed to improve uncertainty assessment ...
Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients. Experiment II compared cancer pain patients matched with benign pain patients on intensity of pain report on the affective dimension of the MPQ. Cancer pain patients reported a reliably higher affective loading to their pain. These data suggest that cancer pain patients employ different criteria than benign pain patients in selecting affective ...
Radium is known to be taken up by aquatic animals, and tends to accumulate in bone, shell and exoskeleton. The most common approach to estimating the uptake of a radionuclide by aquatic animals for use in health and environmental risk assessments is the concentration factor method. The concentration factor method relates the concentration of a contaminant in an organism to the concentration in the surrounding water. Site specific data are not usually available, and generic, default values are often used in risk assessment studies. This paper describes the concentration factor method, summarizes some of the variables which may influence the concentration factor for radium, reviews reported concentration factors measured in marine environments and presents concentration factors derived from data collected in a study in ...
Radium is known to be taken up by aquatic animals, and tends to accumulate in bone, shell and exoskeleton. The most common approach to estimating the uptake of a radionuclide by aquatic animals for use in health and environmental risk assessments is the concentration factor method. The concentration factor method relates the concentration of a contaminant in an organism to the concentration in the surrounding water. Site specific data are not usually available, and generic, default values are often used in risk assessment studies. This paper describes the concentration factor method, summarizes some of the variables which may influence the concentration factor for radium, reviews reported concentration factors measured in marine environments and presents concentration factors derived from data collected in a study in ...
Background:Tobacco smoking is the most important riskfactor for chronic obstructive pulmonary disease (COPD) development. Inhaled cigarette smoke can induce tumor necrosis factor-α...Full Text Available
Background and objectives: Higher urinary calcium is a riskfactor for nephrolithiasis. This study delineated associations between demographic, dietary, and urinary factors and 24-h urinary calcium.Design,...Full Text Available
Childhood anxiety is impairing and associated with later emotional disorders. Studying riskfactors for child anxiety may allow earlier identification of at-risk children for prevention efforts. This study applied an ecological risk model to address how early childhood anxiety symptoms, child temperament, maternal anxiety and depression symptoms, violence exposure, and sociodemographic riskfactors predict school-aged anxiety symptoms. This longitudinal, prospective study was conducted in a representative birth cohort (n = 1109). Structural equation modeling was used to examine hypothesized associations between riskfactors measured in toddlerhood/preschool (age = 3.0 years) and anxiety symptoms measured in kindergarten (age = 6.0 years) and second grade (age = 8.0 years). Early child risk ...
Visceral hypersensitivity is currently considered a key pathophysiological mechanism involved in pain perception in large subgroups of patients with functional gastrointestinal disorders, including irritable bowel syndrome (IBS). In IBS, visceral hypersensitivity has been described in 20%?90% of patients. The contribution of the central nervous system and psychological factors to visceral hypersensitivity in patients with IBS may be significant, although still debated. Peripheral factors have gained increasing attention following the recognition that infectious enteritis may trigger the development of persistent IBS symptoms, and the identification of mucosal immune, neural, endocrine, microbiological, and intestinal permeability abnormalities. Growing evidence suggests that these factors ...
Construction is one of the important industries employing a large number of people on its workforce. A wide range of activities are involved in it. Due to the advent of industrialization and recent developments, this industry is taking a pivotal role for construction of buildings, roads, bridges, and so forth. The workers engaged in this industry are victims of different occupational disorders and psychosocial stresses. In India, they belong to the organized and unorganized sectors. However, data in respect to occupational health and psychosocial stress are scanty in our country. It is true that a sizable number of the workforce is from the unorganized sectors - the working hours are more than the stipulated hours of work - the work place is not proper - the working conditions are non-congenial in most of the cases and involve riskfactors. Their wages are also not adequate, making it difficult for them to run their families. The hazards ...
Studies on the determinants of pain-related support are needed to enhance couples-based treatments for pain. The purpose of this study was to determine the extent to which pain catastrophizing...Full Text Available
Nerve growth factor (NGF), a survival factor for neurons enforces pain by sensitizing nociceptors. Also in the pancreas, NGF was associated with pain and it can stimulate the proliferation of pancreatic cancer cells. Hepatic stellate cells (HSC) respond to NGF with apoptosis. Transforming growth factor (TGF)-b, one of the strongest pro-fibrogenic activators of pancreatic stellate cells (PSC) induced NGF and its two receptors in an immortalized human cell line (ihPSC) and primary rat PSC (prPSC) as determined by RT-PCR, western blot, and immunofluorescence. In contrast to HSC, PSC expressed both NGF receptors, although p75NTR expression was weak in prPSC. In contrast to ihPSC TGF-b activated both Smad signaling cascades in prPSC. NGF secretion was diminished by the activin-like kinase (ALK)...
BackgroundThere has been substantial research on psychosocial and health care determinants of health disparities in the United States (US) but less on the role of modifiable risk...Full Text Available
Carotid artery stenosis is a major riskfactor for stroke, and treatments for this condition to decrease the risk of stroke include medical therapy, carotid endarterectomy (CEA), and, more recently,...Full Text Available
Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...
[music] Narrator: New treatments can limit the disability caused by a stroke, but you need to know the signs and act in time. Here are the signs to ...
INTRODUCTION:Postprandial lipemia is characterized by an increased concentration of circulating lipids after fat intake and is an independent riskfactor for cardiovascular disease....Full Text Available
Spatial epidemiology is the description and analysis of geographic variations in disease with respect to demographic, environmental, behavioral, socioeconomic, genetic, and infectious riskfactors....Full Text Available
BackgroundBrucellosis is a zoonosis of veterinary, public health and economic significance in most developing countries. Human brucellosis is a severely debilitating disease that...Full Text Available
Conclusions. There are gender differences when it comes to the riskfactors for sleep apnea. Large tonsils, a high tongue and a wide uvula are riskfactors for sleep apnea in men, while large tonsils and a retrognathic mandible are riskfactors in women. Upper airway abnormalities including mandibular retrognathia are, however, unable to predict sleep apnea among snorers being investigated for suspected sleep apnea. Objectives. To identify gender-specific riskfactors for obstructive sleep apnea and the diagnostic performance from physical upper airway examinations among snoring men and women investigated because of suspected sleep apnea. Patients and methods. The dimensions of the uvula, tonsils, velopharynx and tongue, and nasal septal deviation, mandibular position, neck circumference, ...
Tobacco use has been recognized to be a significant riskfactor for the development and progression of periodontal disease. Its use is associated with increased pocket depths, loss of periodontal attachment,...Full Text Available
Aging is the most significant riskfactor for a range of degenerative disease such as cardiovascular, neurodegenerative and metabolic disorders. While the cause of aging and its associated diseases...Full Text Available
PURPOSE: To determine the riskfactors and clinical signs of Curvularia keratitis and to evaluate the management and outcome of this corneal phaeohyphomycosis. METHODS: We reviewed clinical and laboratory...Full Text Available
The criterion the study is based on in evaluating environmental risks is the possibility of harmful changes in air, water and soils rather than the harmful environmental impacts these changes are caused by. The two significant criteria, i.e. the evaluated environmental hazards potentials or 'value parameters', and the evaluated damage-to-the-environment probabilities or 'safety parameters', reveal the respective environmental risks or 'riskfactors'. These riskfactors are classified by 23 environmental risk parameters for differentiation between low-risk and high-aid for pollution abatement measures provided that one fixes acceptance limits for the environmental parameters. As a rule the environmental risks of technical facilities which handle ...
IntroductionShoulder pain covers a wide range of problems and affects up to 20% of the population. It is not a specific diagnosis. Shoulder pain can be caused by problems with the...Full Text Available
BACKGROUND:In adults, it is well known that high levels of pain catastrophizing are related to increased pain and disability as well as to heightened anxiety and depression. However,...Full Text Available
BACKGROUND:Despite increasing attention to the epidemiology of pain, relatively little is known about the association between pain and health in children. In particular, no studies...Full Text Available
Stabbing paroxysmal pain due to neurological disease can often be controlled by anticonvulsants, whereas steady burning pain is often responsive to tricyclic antidepressants, and to neuroleptics. Overuse...Full Text Available
Despite the existence of effective analgesic drugs, many cancer patients live and die with ineffective pain control. The control of cancer pain is largely achievable with the appropriate use of available...Full Text Available
BackgroundAdequate pain assessment is critical for evaluating the efficacy of analgesic treatment in clinical practice and during the development of new therapies. Yet the currently...Full Text Available
BackgroundThe main objective of this study was to determine the prevalence and factors associated with mental illness in Oyo State at community level using the general health questionnaire...Full Text Available
Background:Parity has been linked to gallbladder cancer and gallstones, but the effects of other reproductive factors are less clear.Methods:We examined...Full Text Available
BackgroundPolymorphisms in Epidermal Growth Factor Receptor (EGFR) gene may influence EGFR production and/or activity, thereby modulating susceptibility to lung...Full Text Available
BackgroundThe aim of the present article was to evaluate whether angiogenic parameters as assessed by transvaginal color Doppler ultrasound (TVCD) may predict those prognostic factors...Full Text Available
The Screening Risk Evaluation (SRE) guidance document is a set of guidelines provided for the uniform implementation of SREs performed on decontamination and decommissioning (D&D) facilities. Although this method has been developed for D&D facilities, it can be used for transition (EM-60) facilities as well. The SRE guidance produces screening risk scores reflecting levels of risk through the use of risk ranking indices. Five types of possible risk are calculated from the SRE: current releases, worker exposures, future releases, physical hazards, and criticality. The Current Release Index (CRI) calculates the current risk to human health and the environment, exterior to the building, from ongoing or probable releases within a one-year time period. The Worker Exposure Index (WEI) calculates the current risk to workers, occupants and ...
The risks from radiation exposure during radiological diagnosis has usually been estimated in relation to genetic changes. Relevant information has been expressed as the genetically significant dose. In this paper we attempt to produce an analogous measure for evaluating the somatic risk in the form of a somatically significant dose index for radiological and CT examinations. It is shown that, for both types of examination, the two riskfactors may be entirely different.
The risks from radiation exposure during radiological diagnosis has usually been estimated in relation to genetic changes. Relevant information has been expressed as the genetically significant dose. In this paper we attempt to produce an analogous measure for evaluating the somatic risk in the form of a somatically significant dose index for radiological and CT examinations. It is shown that, for both types of examination, the two riskfactors may be entirely different. (orig.).
The risks of genetic, leukemia and malignant diseases from medical X-ray diagnostic examinations were estimated using the frequency of radiographic and fluoroscopic exposures per diagnostic examination, child expectancy, leukemia and malignancy significant factors, and using a weighting factor determined on the basis of data concerning the cancer mortality among atomic bomb survivors in Nagasaki and of a recommendation of International Commission of Radiological Protection. The organ or tissue doses with respect to the stochastic risks were determined with ionization chambers and thermoluminescent dosimeters placed at the positions of the organs or tissues in a RANDO woman phantom which was exposed to diagnostic X-rays according to technical factors of typical radiographic and fluoroscopic examinations obtained from a nationwide survey. The resultant risks by ...
The aims of this study were to identify riskfactors and evaluate the association with clinical outcomes of postoperative cardiac surgery-associated acute kidney injury (CSA-AKI). Data from 2488 consecutive adult patients were analyzed. Patients were classified as having CSA-AKI based on the risk, injury, failure, loss of kidney function, and end-stage kidney disease (RIFLE) criteria using peak postoperative creatinine in the postoperative intensive care unit (ICU). Multiple stepwise logistic regression analysis was used to identify independent riskfactors for CSA-AKI. CSA-AKI occurred in 584 patients (23.5%). CSA-AKI patients had significantly longer aortic cross-clamp and cardiopulmonary bypass times. Furthermore, CSA-AKI patients had higher hospital mortality (5.5% vs 1.5%, PCopyright2...
BackgroundComplaints of arm, neck and/or shoulders (CANS) affects millions of computer office workers. However its prevalence and associated riskfactors in developing countries...Full Text Available
BackgroundUnderstanding immunity, incidence and riskfactors of the 2009 influenza A(H1N1) pandemic (2009 H1N1) through a national seroprevalence study is necessary for informing...Full Text Available
IntroductionThe major riskfactor for osteoarthritis (OA) is aging, but the mechanisms underlying this risk are only partly understood. Age-related accumulation of advanced glycation...Full Text Available
Foreign travel has been suggested to be a riskfactor for the acquisition of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. To our knowledge, this has not previously...Full Text Available
IntroductionMeniscal injury is a riskfactor for the development and progression of knee osteoarthritis, yet little is known about riskfactors for meniscal pathology. Joint loading...Full Text Available
Pain and pain-related interference with physical function have not been thoroughly studied in individuals who have undergone knee-disarticulation amputations. The principal aim of this study...Full Text Available
Opioids have been regarded for millennia as among the most effective drugs for the treatment of pain. Their use in the management of acute severe pain and chronic pain related to advanced medical...Full Text Available
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample...Full Text Available
Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Riskfactors were derived from epidemiologic studies of patients treated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may ...
Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Riskfactors were derived from epidemiologic studies of patients treated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may ...
BACKGROUND: Glyphosate resistance has been confirmed in 58 populations of Lolium rigidum (Gaud.), a major weed of crops in southern Australia. Extensive use of glyphosate in conjunction with minimal soil disturbance has been identified as high risk for resistance to that herbicide. Land managers need a simple method for rapid assessment of the risk of resistance occurring as a result of past and proposed future management practices. Modelled on risk assessment nomographs, a simple calculator for indicating the risk of evolved glyphosate resistance in L. rigidum is described.RESULTS: The calculator uses the generations since first use and the frequency of use of glyphosate in combination with historical cultivation levels as critical factors for determining the risk of glyphosate resistance...
To many, recent developments in electric markets are perplexing. Competition has appeared, often in the form of new players who do not own and operate generation or transmission facilities. Yet, these players happily enter into contracts obliging them to make or take delivery of power at set prices for months or even years into the future. They seem unconcerned about predicted capacity shortages, fuel price uncertainty or unpredictable plant outages. For the most part, these new players understand these risks quite well. They simply believe in the efficacy of markets. Until recently, price ensured recovery of cost. They foresee a true market where price makes supply equal demand and cost is not a factor in the short term at least. The appearance of such players is an augury of the new industry structure, one in which specialists in taking and managing distinct business risks evolve from within or enter from outside. They ...
Alzheimer's disease (AD) is the most common form of neurodegenerative disease. The vast majority cases of AD are sporadic, without clear cause, and a combination of environmental and genetic factors has been implicated. The hypothesis that homocysteine (Hcy) is a riskfactor for AD was initially prompted by the observation that patients with histologically confirmed AD had higher plasma levels of Hcy, termed hyperhomocysteinemia (HHcy), than age-matched controls. Most evidence accumulated so far implicates HHcy as a riskfactor for AD onset, but there are also conflicting results. In this review we summarize reports on the relationship between HHcy and AD from epidemiological investigations, including observational studies and randomized controlled clinical trials. We also examine recent i...
The genetically significant dose (GSD), per Caput mean bone marrow dose (CMD), leukemia significant dose (LSD) and malignancy significant dose (MSD) from medical diagnostic X-ray examinations in Japan were estimated based on a 1979 nationwide survey of randomly sampled hospitals and clinics. The population risk estimates were carried out using the resultant values of GSD, LSD and MSD. In the risk estimates, the significant factors, namely, the relative child expectancy, the leukemia significant factor and the malignancy significant factor, for patients were assumed to be same as those of general population. The riskfactors used were 185 x 10"-"6 rad"-"1 for genetic risk of all generations, 20 x 10"-"6 rad"-"1 for fatal leukemia and 165 x 10"-"6 rad"-"1 for fatal malignant diseases, respectively. The resultant annual ...
This paper is a result of a research with the primary purpose of extending Probabilistic Risk Assessment (PRA) modeling frameworks to include the effects of organizational factors as the deeper, more fundamental causes of accidents and incidents. There have been significant improvements in the sophistication of quantitative methods of safety and risk assessment, but the progress on techniques most suitable for organizational safety risk frameworks has been limited. The focus of this paper is on the choice of 'representational schemes' and 'techniques.' A methodology for selecting appropriate candidate techniques and their integration in the form of a 'hybrid' approach is proposed. Then an example is given through an integration of System Dynamics (SD), Bayesian Belief Network (BBN), Event Sequence Diagram (ESD), and Fault Tree (FT) in order to ...
RIFLE criteria have been used to determine the incidence of acute kidney dysfunction (AKD) after orthotopic liver transplantation (OLT). However, no studies have focused on the incidence of AKD after OLT in patients with normal pre-OLT kidney functions. Using the RIFLE criteria, we determined the incidence and riskfactors for AKD after OLT in patients with normal pre-OLT kidney function. We retrospectively analyzed the records of 112 patients who underwent OLT from January 2000 to February 2009 with normal prior kidney function. We investigated three levels of renal dysfunction outlined in the RIFLE criteria: risk (R); injury (I); and failure (F). Preoperative, intraoperative, and postoperative variables were collected. AKD occurred in 64 (57%) OLTs with risk, injury, and failure frequenc...
As is well documented, subprime mortgage markets carried significant default risk. This paper investigates the relationship between default risk premium, stock market conditions and macroeconomic variables during the financial crisis. Using iTraxx Japan Credit Default Swap (CDS) index spreads covering the period from March 2006 to November 2009, we employ a time-varying dynamic factor model with Markov regime switching to generate regime probabilities for default risk. We analyze the sensitivity of default risk premium changes to stock market conditions and macroeconomic variables by using two-state Markov switching models: a crisis regime sparked by rising loan defaults in the sub-prime mortgage market, and a non-crisis regime. We found strong evidence that the relationship between defaul...
In quantifying health risks arising from radiation exposure and synergistic effects promoted by radiation the dose-effect relationship must be used as a basis. Special problems arise in the extrapolation of experimental results or in the treatment of data in the region of low doses administered over long periods of time. For radiation protection purposes, especially manifestations of cancer and genetic effects are significant. The International Commission on Radiation Protection has published binding guiding values on the basis of which to assess the risk of cancer. The cancer risk and genetic risks are estimated for relevant dose ranges and compared with other factors of civilization. For the most important chemical pollutants emitted into the environment the possibilities of impacts arising from synergistic effects are discussed on the basis of the rules and regulations specified ...
This paper presents an application of the state of the art and new trends for risk management of safety-related control and monitoring systems, currently applied in the industry. These techniques not only enable to manage safety and reliability issues but they also help in the control of quality and economic factors affected by the availability and maintenance of the system. The method includes an unambiguous definition of the system in terms of functions and a systematic analysis of hazardous situations, undesired events and possible malfunctions. It also includes the identification and quantification of the risk associated to the system. The required risk reduction is specified in terms of safety integrity levels. The safety integrity level results in requirements, preventive measures, possible improvements and recommendations to assure the satisfactory management of the risk.
During sporting events, injured athletes often return to competition after icing because of the reduction in pain. Although some controversy exists, several studies suggest that cryotherapy causes a decrease in muscle activity, which may lead to a higher risk of injury upon return to play. The purpose of this study was to investigate the effect of a 20-min knee joint cryotherapy application on the electromyographic activity of leg muscles during a single-leg drop jump in twenty healthy subjects, randomly assigned to an experimental and a control group. After the pre-tests, a crushed-ice bag was applied to the knee joint of the experimental group subjects for 20min, while the control group subjects rested for 20min. All subjects were retested immediately after this period and retested again...
Abstract Recently, a study of patients with rheumatoid arthritis who developed herpes zoster while taking a tumor necrosis factor (TNF)- inhibitor reported a decreased incidence of postherpetic neuralgia. The objective of this study was to investigate whether patients on TNF- inhibitors who developed herpes zoster have a lower incidence of subsequent development of postherpetic neuralgia. A retrospective review of herpes zoster patients on TNF- inhibitors (infliximab, etanercept, or adalimumab) was conducted in 12 dermatology clinics. Medical records of such patients were reviewed thoroughly to confirm herpes zoster and TNF- inhibitors and any subsequent development of postherpetic neuralgia (pain score -3 out of 10 after 90 days of shingles onset) was noted. A total of 206 cases were revi...
Collection, analysis and quantification of human factor data are important compositions of human reliability analysis (HRA) and probabilistic risk assessment (PRA). Various human factor databases have been set up, but there are comparatively little human factor data management systems which can be uses for collection, classification, analysis, calculation and predication of the human factor data. Therefore, the human factor data management system for Daya Bay NPP is developed, with the following three modules and four databases: original data module, computing module, introduced data module, and basic database, other data source of the plant, external database and introduced database. The foundational problems about human factor data and the systemic structure and function are described. The data structure in the database is also discussed, ...
Skip to Content Cancer Control and Population Sciences Home Applied Research Home RiskFactor Monitoring and Methods Home Diet Usual Dietary Intakes: Background The NCI Method Details of the NCI Method Food Intakes, US Population, 2001-04 Selected Intakes
Skip to Content Cancer Control and Population Sciences Home Applied Research Home RiskFactor Monitoring and Methods Home Diet Usual Dietary Intakes: Background The NCI Method Details of the NCI Method Food Intakes, US Population, 2001-04 Selected Intakes
ObjectivesTo assess the distribution and riskfactors of depleted uranium uptake in military personnel who had taken part in the invasion of Iraq in 2003.MethodsSector...Full Text Available
Thoracic aortic aneurysms (TAAs) are potentially devastating, and due to their asymptomatic behavior, pose a serious health risk characterized by the lack of medical treatment options and high...Full Text Available
AbstractBackgroundGender concordance between patients and their physicians is related to prevention screening and other quality indicators. Research suggests female...Full Text Available
BackgroundEpidemiological studies have shown a J- or U-shaped relation between alcohol and type 2 diabetes and coronary heart disease (CHD). The underlying mechanisms are not clear....Full Text Available
Aging is a riskfactor for heart failure, which is a leading cause of death world-wide. Elderly patients are more likely than young patients to experience a myocardial infarction (MI) and are...Full Text Available
Irish dairy herd fertility has been declining since the 1980s. The extent, nature and causes of this decline in fertility and the current status of Irish dairy herd fertility were described....Full Text Available
Syndrome X is a combination or co-occurrence of several known cardiovascular riskfactors (including central obesity, dyslipidemias, fatty liver disease, hyperinsulinemia, insulin resistance,...Full Text Available
IntroductionSevere obstructive sleep apnea has been associated with sexual dysfunction; however, it is unclear whether milder forms of sleep disturbances might also...Full Text Available
Significant asymptomatic bacteriuria is a riskfactor for symptomatic urinary infection and septicemia among predisposed individuals such as diabetics. We investigated the pattern of asymptomatic bacteriuria...Full Text Available
Between 1946 and 1976 over 9,000 women with breast cancer were seen within one year of diagnosis at the A. Maxwell Evans Clinic (AMEC) in Vancouver, British Columbia. By 1978, 275 had a subsequent diagnosis...Full Text Available
Zoonotic visceral leishmaniasis (ZVL) is a serious public health problem in several Brazilian cities. Although the proximity of chicken houses is often cited as a riskfactor in studies of urban ZVL,...Full Text Available
The cumulative rate of childhood eczema during the first three years was studied in a birth cohort of 1265 New Zealand infants. A parental history of eczema was the strongest predictor of rates of childhood...Full Text Available
Lupus anticoagulant, concentrations of anticardiolipin antibodies, antithrombin III, plasminogen, (free) protein S, protein C, prothrombin, platelet counts, and bleeding times were determined in 74...Full Text Available
Preterm and low birthweight (PTLBW) continues to be a major cause of mortality and morbidity across the world. In recent years, maternal periodontal disease has been implicated as a riskfactor for...Full Text Available
Study objectives:To verify the existence of a symptomatic form of restless legs syndrome (RLS) secondary to multiple sclerosis (MS) and to identify possible associated riskfactors.Design:Prospective,...Full Text Available
The purpose of this prospective cohort study was to identify factors that place a dairy cow with uncomplicated milk fever (MF) at significant risk of becoming an alert downer cow (ADC) and to verify...Full Text Available
BackgroundThe aim of this study was to investigate the mental health status, and the riskfactors associated with mild psychiatric disorders, of female foreign spouses (from Vietnam,...Full Text Available
Heart disease, cancer, and cerebrovascular disease together cause more than two out of three deaths in the United States annually. These three diseases are largely a result of widespread riskfactors...Full Text Available
BackgroundA deficiency of specific glycosylphosphatidyl inositol-anchored proteins in paroxysmal nocturnal hemoglobinuria may be responsible for most of the clinical features of...Full Text Available
BackgroundIs living alone a riskfactor for depression among older adults? Previous research is mixed and inconclusive, and it is unclear whether living alone influences psychological...Full Text Available
BackgroundApolipoprotein E (ApoE), a cholesterol carrier associated with atherosclerosis, is a major riskfactor for Alzheimer's disease (AD). The low-density lipoprotein receptor...Full Text Available
Study objectiveThe study aim was to improve our understanding of the relationships between contextual socioeconomic characteristics and coronary heart disease (CHD)...Full Text Available
Peptic ulcer bleeding is a common disease and recurrent bleeding is an independent riskfactor of mortality. Infusion with proton pump inhibitors (PPIs) prevents recurrent bleeding after successful...Full Text Available
BackgroundMuch of our current understanding of the epidemiology of Ascaris lumbricoides infections in humans has been acquired by analyzing worm count data. These...Full Text Available
ObjectivesIn 2003, the Omani Ministry of Health Child Health Care Program initiated a national Birth Defects (BD) Register. This paper reviews the magnitude and riskfactors of birth...Full Text Available
Hyperproliferation of the colonic epithelium, leading to expansion of colonic crypt progenitors, is a recognized riskfactor for colorectal cancer. Overexpression of progastrin, a nonamidated and incompletely...Full Text Available
IntroductionIn lung cancer surgery, large tidal volume and elevated inspiratory pressure are known riskfactors of acute lung (ALI). Mechanical ventilation with low tidal volume...Full Text Available
Illthrift was observed in 20/60 lambs aged 40–45 days in a dairy sheep flock in Greece. Cryptosporidiosis had been diagnosed and successfully treated with halofuginone lactate a month earlier....Full Text Available
BackgroundHepatitis B virus (HBV) infection is a serious health problem in the developing countries including Pakistan. Various riskfactors are responsible for the spread of this...Full Text Available
BackgroundPoverty, lack of female empowerment, and lack of education are major riskfactors for childhood illness worldwide. Microcredit programs, by offering small loans to poor...Full Text Available
Patients treated with bleomycin are at risk of developing the acute adult respiratory distress syndrome post-operatively. In a prospective study of 12 patients who had received bleomycin preoperatively...Full Text Available
BackgroundExcessive television (TV) viewing might play an important role in the development of cardiovascular disease (CVD). The aim of this study was to examine the independent...Full Text Available
BackgroundAlzheimer's Disease (AD) is the most common neurodegenerative disease and the leading cause of dementia among senile subjects. It has been proposed that AD can be caused...Full Text Available
Obesity is a riskfactor for stroke and neurodegenerative disease. Excess body fat has been linked to impaired glucose metabolism, insulin resistance, and impulsivity and may be a precursor to decline...Full Text Available
The earliest clinical evidence of diabetic nephropathy is microalbuminuria. Progression from microalbuminuria to overt nephropathy occurs in 20-40% within a 10-year period with approximately 20% of...Full Text Available
We investigate the default time of a firm when a stochastic discount factor is used so that both diffusion and regime switching risks are priced. We establish the relationship between the probability distribution of the default time and the solution of a system of coupled partial differential equations.
ObjectiveTo evaluate the riskfactors that may be responsible for the development of contralateral reherniations from ipsilateral ones after open lumbar microdiscectomy (OLM), and...Full Text Available
Conjugated linoleic acid (CLA) has been the subject of extensive investigation regarding its possible benefits on a variety of human diseases. In some animal studies, CLA has been shown to have a beneficial...Full Text Available
Endometrial carcinoma is the most commonly diagnosed gynaecological cancer in developed countries. Although the molecular genetics of this disease has been in the focus of many research laboratories...Full Text Available
A cross sectional population based epidemiological survey of 899 adults aged between 15 and 59 was undertaken in two urban areas of demographic surveillance sites in Dar es Salaam, Tanzania, using the...Full Text Available
IntroductionColonoscopic perforation is a rare but serious complication of colonoscopy. Factors known to increase the risk of perforation include colonic strictures, extensive diverticulosis,...Full Text Available
The effect of potential riskfactors for chronic lymphatic leukaemia was evaluated in a case-referent study encompassing 111 cases and 431 randomised referents, all alive. Information on exposure was...Full Text Available
One of the modifiable riskfactors associated with coronary heart disease (CHD) is hypercholesterolemia. This paper reviews the major plasma lipids and how they relate to coronary heart disease. Among...Full Text Available
Objective: Determine and compare the prevalence of known riskfactors for cardiovascular disease among unselected individuals presenting with their first ever episode of...Full Text Available
Objective:This study examined the role of cognitive factors—such as expectancies regarding the consequences of not drinking and perceptions of peer drinking—in...Full Text Available
To diagnose asymptomatic bacterial vaginosis (BV), self-sampled vaginal smears were collected during a study of riskfactors for preterm birth in African American women. More than 90% of those...Full Text Available
BackgroundParents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary...Full Text Available
BACKGROUND: The aetiologies of glioma and meningioma tumors are largely unknown. Although reproductive hormones are thought to influence the risk of these tumors, epidemiologic data are not supportive of this hypothesis; however, few cohort studies have published on this topic. We examined the relation between reproductive factors and risk of glioma and meningioma among women in the European Prospective Investigation into Cancer and Nutrition (EPIC).METHODS: After a mean of 8.4 years of follow-up, 193 glioma and 194 meningioma were identified among 276,212 women. Information on reproductive factors and hormone use was collected at baseline. Cox proportional hazard regression was used to determine hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: No associations were observed between glioma or meningioma risk and reproductive factors, including age ...
From the frequency of diagnostic radiologic examinations and their radiation dose delivered to the population the risk of cancer induction and genetic damage is calculated on the basis of the riskfactors given by the ICRP. Thus 0.38 % and 3 % of the total mortality for cancer and leukemia, resp., can be attributed to X-ray diagnostics. Chest examinations alone result in 0.07-0.7 damages per 100,000 persons depending on the imaging technique applied. (author).
Menopause is characterized by the progressive reduction of estrogens resulting to cessation of menses. It is associated with an increase of cardiovascular riskfactors such as hyperglycemia, hypertension, dyslipidemia and of abdominal and/or selective visceral fat mass deposition. Obesity, a modern day epidemic, is promoted by an obesogenic environment that interacts with the genetic background. The result is a positive energy balance materialized by the accumulation of the adipose tissue. This process is marked by great individual variation. Obesity is also associated with the presence of cardiovascular riskfactors. In this review, the main pathophysiologic processes for the increase of obesity in menopause and the possible effects of pre-menopausal obesity regarding the cessation of ova...
A risk-based sensor placement methodology is proposed to solve the problem of optimal location of sensors or detectors to protect population against the exposure to and effects of known and/or postulated chemical, biological, and/or radiological threats. Risk is calculated as a quantitative value representing population at risk from exposure against standard exposure levels. Historical meteorological data are used to characterize weather conditions as the frequency of wind speed and direction pairs. The meteorological data drive atmospheric transport and dispersion modeling of the threats, the results of which are used to calculate risk values. Sensor locations are determined via an iterative dynamic programming algorithm whereby threats captured or detected by sensors placed in prior stages are removed from consideration in subsequent stages. In addition to the risk-based placement ...
Pain is necessary for survival but chronic pain is disabling and causes significant health and economic problems. This study provides an understanding of the future for spinal cord stimulation. Stimulation by means of chronically implanted electrodes, was carried out in 200 patients with pain of varied benign organic etiology. In 177 of them, pain was confined to the failed back syndrome. Most patients were referred by a Pain Management Service. 226 epidural implants were used: 80 unipolar, 59 Resume, 12 bipolar, and 75 quadripolar. Patients were followed for periods of 6 months to 12 years, with a mean follow-up of 44 months. 84 patients (42%) were able to control their pain by stimulation alone, 22 patients (11%) needed occasional analgesic supplements along with their stimulation program. Pain secondary to failed back syndrome, multiple ...
The University of North Carolina Comprehensive Pain Center, which has been in existence since 1972, is a pain evaluation, treatment and research program based upon individual diagnosis, comprehensive...Full Text Available
While research has shown that patients’ beliefs about their pain are related to pain adjustment and treatment outcomes, little is known about the beliefs of their significant others....Full Text Available
Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain...Full Text Available
Sex differences in pain are frequently reported in the literature. However, less is known about possible sex differences in the experience of pain secondary to a disability. The current study...Full Text Available
In all mammals, tissue inflammation leads to pain and behavioral sensitization to thermal and mechanical stimuli called hyperalgesia. We studied pain mechanisms in the African naked mole-rat, an unusual...Full Text Available
BACKGROUND:Canadian chronic pain prevalence estimates range from 11% to 66%, are affected by sampling and measurement bias, and largely represent urban settings.OBJECTIVES:To...Full Text Available
Chronic neurogenous pain is often an extremely difficult condition to manage. In the orofacial region, trauma from injury or dental procedures may lead to the development of severe neuralgic pains and...Full Text Available
BACKGROUND:Reports indicate that characteristics of older adults with chronic pain may be different than those of younger persons.OBJECTIVE:To study...Full Text Available
ObjectiveTo examine the longitudinal relationship between depressive symptoms at study entry (T1) on pain intensity (PI) and functional disability over a 1-year period...Full Text Available
Even clinicians who keep up with the research literature on pain mechanisms may find themselves uncertain when trying to bring these new theories down to practical application for a patient with pain....Full Text Available
Idiopathic or functional abdominal pain (FAP) is common in school-age children and typically reflects a functional gastrointestinal disorder (FGID). FGIDs in adults have been distinguished by...Full Text Available
Objective:To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP).Materials...Full Text Available
Psychological illness influences the experience and expression of pain and disability. We tested three null hypotheses: (1) patients with nonspecific pain (medically unexplained and idiopathic) and...Full Text Available
Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this...Full Text Available
Five methods of personality assessment are evaluated to provide guidance for the psychological treatment of patients with chronic back pain. Patient pain drawings, pentothal pain studies, stress score...Full Text Available
The U.S. Department of Energy's (DOE) Savannah River Site (SRS) is decommissioning many of its excess facilities through removal of the facility structures leaving only the concrete-slab foundations in place. Site-specific, risk-based derived concentration guideline levels (DCGLs) for radionuclides have been determined for a future industrial worker potentially exposed to residual contamination on these concrete slabs as described in Jannik. These risk-based DCGLs were estimated for an exposure area of 100 m2. During deactivation and decommissioning (D and D) operations at SRS, the need for area factors for larger and smaller contaminated areas arose. This paper compares the area factors determined for an industrial worker exposed to a concrete slab end-state for several radionuclides of concern at SRS with 1) the illustrative area factors provided in MARSSIM, 2) the area correction ...
Assessment of the results of laminectomy for lumbar disc lesions is unsatisfactory, but it seems that some degree of recurrent pain is virtually inevitable. The clinical features and incidence of the...Full Text Available
BackgroundLow back pain (LBP) is the most prevalent musculoskeletal condition and one the most common causes of disability in the developed nations. Anecdotally, there is a general...Full Text Available
BackgroundNonsteroidal anti-inflammatory drugs are commonly used to treat postoperative and chronic pain. Animal studies suggest these drugs act in part by blocking...Full Text Available
Interest and research into the mechanisms and treatment of neuropathic pain have increased during recent years, but current treatment is still far from satisfactory (Dworkin...Full Text Available
BackgroundStump and phantom pains are debilitating sequelae of amputations that are often resistant to treatment. The efficacy of pharmacologic therapies, including...Full Text Available
The family physician dealing with gynecologic pelvic pain (acute or chronic) enters at the beginning of the problem as diagnostician, refers the patient to a specialist in the interim, and resumes...Full Text Available
Cryoanalgesia, the local application of extreme cold to nerves to produce analgesia, has been used to treat patients with intractable perineal pain. The cryoprobe was inserted percutaneously through...Full Text Available
ObjectiveTo describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb,...Full Text Available
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was drawn from the records of ten general practices. According to their responses to a pain questionnaire, subjects were assigned to the chronic benign pain group (n = 95) if they had pain of more than three months' duration, or to the control group (n = 105) if they had pain of less than three months' duration or no pain at all. All the subjects had an average GP consultation rate of 2.6 contacts per year. No significant age and sex differences were found. Chronic benign pain in childhood and adolescence is not related to increased use of healthcare ...
The biological age (BA) of the majority of the liquidators of the consequences of the radiation accidents in the Navy and of the liquidators of the Chernobyl' APS accident exceeds the medium standard and the DBA (due BA). The index of the BA can be a characteristic of the influence of the social-hygienic factors on the health condition of the Special Risk Subunit--the liquidators of the consequences of the radiation accidents. It was established, that the radiation influence concerns to the factors dramatically increasing the BA and the rate of senescence of the liquidators of the consequences of the radiation accidents. PMID:21809627
BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated riskfactors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...
Perceptions of sensation and pain in healthy people are believed to be the net result of sensory input and descending modulation from brainstem and cortical regions depending on emotional and cognitive factors. Here, the influence of attention on neural activity in the spinal cord during thermal sensory stimulation of the hand was investigated with functional magnetic resonance imaging by systematically varying the participants' attention focus across and within repeated studies. Attention states included (1) attention to the stimulus by rating the sensation and (2) attention away from the stimulus by performing various mental tasks of watching a movie and identifying characters, detecting the direction of coherently moving dots within a randomly moving visual field and answering mentally-...
B vitamins and polymorphisms in genes coding for enzymes involved in one-carbon metabolism may affect DNA synthesis and methylation and thereby be implicated in carcinogenesis. Previous data on vitamins B2 and B6 and genetic polymorphisms other than those involving MTHFR as riskfactors for gastric cancer (GC) are sparse and inconsistent. In this case-control study nested within the European Prospective Investigation into Cancer and Nutrition cohort, cases (n = 235) and controls (n = 601) were matched for study center, age, sex, and time of blood sampling. B2 and B6 species were measured in plasma, and the sum of riboflavin and flavin mononucleotide was used as the main exposure variable for vitamin B2 status, whereas the sum of pyridoxal 5'-phosphate, pyridoxal, and 4-pyridoxic acid was used to define vitamin B6 status. In addition, we determined eight polymorphisms related to one-carbon metabolism. Relative risks for GC ...
Sex differences in pain are frequently reported in the literature. However, less is known about possible sex differences in the experience of pain secondary to a disability. The current study explored these issues in persons with limb loss (n = 335, 72% men) who were recruited as part of a postal survey. Participants provided ratings of phantom limb pain (PLP), residual limb pain (RLP), and general pain intensity. Participants also completed measures of pain-related interference, catastrophizing, coping, and beliefs. Results indicated that a greater proportion of males than females (86% vs 77%, respectively) reported the presence of PLP; however, this difference was no longer prominent when cause of limb loss was controlled. No sex differences were found in the presence of RLP, or in avera...
In the medical and occupational exposures, there is a tradition to use the genetically significant dose as an index of harm to the population although it only includes the genetical effects from ionizing radiations. A similar significant dose for somatic effects such as radiation leukemogenesis and carcinogenesis should be added to the genetically significant dose in order to approach an index of total harm to the population from medical and occupational exposures. For this purpose, leukemia and malignant significant factors were determined based on the induction of malignant diseases including leukemia for the atomic bombs in Hiroshima and Nagasaki and the life expectancy of individuals subject to medical examinations or treatments as well as radiation workers, taking account of the possibility of their deaths due to other diseases or accidents during a latent period of malignant diseases. The resultant significant factors were tabulated as a ...
The language used by chronic benign pain patients to characterize their pain complaint was analyzed to determine the best predictor of psychiatric disturbance. Using the 78 adjectives provided by the McGill Pain Questionnaire, the number of affective descriptors used was the best predictor of psychiatric disturbance. Addition of sensory descriptors either to augment the total number of descriptors used (magnitude) or as a pattern of sensory greater than affective or sensory less than affective failed to increase predictive strength. PMID:6877847
Over the years, nurses, doctors and scientists have sought ways of assessing the impact of pain on patients. While many of the instruments devised have been extremely useful in identifying the nature and intensity of pain, defining the effect it has on people's lives and perceptions has proved much more problematic. Based on the work she carried out with patients suffering from chronic benign pain, Karen Rose explores one aspect of these effects--the feeling of isolation. By using a four-step anthropological approach to identify the impact of pain, she argues, nurses can arrive at a realistic and accurate assessment of how patients are coping. PMID:7947167
The study was performed for evaluating the risk effect of digital systems on the total plant. Based on risk monitor, a fault tree model for the Korean Standard Nuclear Power Plants (KSNPP), we integrate the fault-tree models for Digital Plant Protection System (DPPS) and Digital Engineered SaFety Actuation System (DESFAS) which are the most important safety-critical I and C systems in the KSNPP. In this study, however, three important factors (the probabilities of manual actuation failure, the software failure probability, and the watchdog timer fault coverage) are treated as the variables of the sensitivity study because quantification methodologies for these factors are not developed yet. Not only the unavailability of digital safety-critical system itself, but also the risk effect of digital systems on the total plant should be assessed to prove the safety of digital systems. The ...
OBJECTIVE To identify patients with gestational diabetes mellitus (GDM) who will need antenatal insulin treatment (AIT) by using a risk-prediction tool based on maternal clinical and biochemical characteristics at diagnosis. RESEARCH DESIGN AND METHODS Data from 3,009 women attending the Royal Prince Alfred Hospital GDM Clinic, Australia, between 1995 and 2010 were studied. A risk engine was developed from significant factors identified for AIT using a logistic regression model. RESULTS A total of 51% of GDM patients required AIT. Ethnicity, gestation at diagnosis, HbA(1c), fasting and 60-min glucose oral glucose tolerance test, BMI, and diabetes family history were significant independent determinants of AIT. Notably, only 9% of the attributable risk for AIT can be explained by the clinical factors studied. A modeled risk-scoring system was therefore a poor ...
Trastuzumab increases survival amongst women with human epidermal growth factor receptor (HER)-2 receptor positive metastatic breast cancer, but maternal and fetal risks are associated with advanced disease and its treatment in pregnancy. We present a case of a primigravid with HER-2 positive metastatic breast cancer who received trastuzumab throughout pregnancy. She presented with cerebral metastases, requiring surgical decompression and resection. Reversible oligohydramnios developed during pregnancy. Fetal safety data on trastuzumab in pregnancy is limited, but case reports suggest a recurring pattern of (mostly reversible) oligohydramnios.
With regard to polybrominated diphenyl ether (PBDE), there is few scientific knowledge on the emission patterns into the environment and exposure pathways to humans, and basic information is insufficient to consider what measures effective are. For the purpose of promoting risk reduction of target substances more effectively and efficiently, it is desirable to comprehend accurately the causal chain from the target substances utilization to the risk intake, and to evaluate the measures covering the whole applications of target substances. As the existing researches on the PBDE emission inventory, there are EU risk assessment report (European Chemical Bureau 2000, 2002, 2003), Danish EPA (1999), Palm et al.(2002) and Alcock et al. (2003). In addition, emissions of DecaBDE are published in TRI (Toxic Release Inventory) of US EPA. However, the primary information of the previous inventories is often the same and estimations ...
Summary 1. In the Greater Yellowstone Ecosystem, bison Bison bison and elk Cervus canadensis nelsoni act as hosts for Brucella abortus. The presence of B. abortus within wildlife populations is an important conservation issue because of the risk of brucellosis transmission from wildlife to cattle. 2. We investigated conditions facilitating contact between bison (40-60% seroprevalence) and elk on a shared winter range in the Madison headwaters area of Yellowstone National Park. We evaluated the effects of snow pack, season, elk and bison population sizes, and wolf Canis lupus predation risk on the degree of spatial overlap between bison and elk from 1991 to 2006. 3. Sixty-eight per cent of 10 093 independent elk observations occurred within the known bison wintering range, 29% occurred with...
An assessment was undertaken of the risk of liver cancer in the USA associated with aflatoxin ingestion from peanuts. Both laboratory-animal data and epidemiological data collected from the scientific literature and several prominent mathematical extrapolation techniques were used. Risk estimates differed by a factor of greater than 1000 when the extrapolated results of three selected animal studies were analysed. Dose-response data for the male Fischer rat, the most sensitive mammalian species studied, produced an estimate of 158 cases of liver cancer per year in the USA at current levels of aflatoxin exposure. An estimate of 58 annual cases was predicted on the basis of epidemiological data of populations in Africa and Thailand.
Ozone is the most important regional-scale air pollutant causing risks for vegetation and human health in many parts of the world. Ozone impacts on yield and quality of crops and pastures depend on precursor emissions, atmospheric transport and leaf uptake and on the plant?s biochemical defence capacity, all of which are influenced by changing climatic conditions, increasing atmospheric CO2 and altered emission patterns. In this article, recent findings about ozone effects under current conditions and trends in regional ozone levels and in climatic factors affecting the plant?s sensitivity to ozone are reviewed in order to assess implications of these developments for future regional ozone risks. Based on pessimistic IPCC emission scenarios for many cropland regions elevated mean ozone lev...
Smoking during pregnancy is widely known to increase health risks to the foetus, and understanding the quitting process during pregnancy is essential in order to realise national government targets. Qualitative studies have been used in order to gain a greater understanding of the quitting process and the objective of this systematic review was to examine and evaluate qualitative studies that have investigated the psychological and social factors around women attempting to quit smoking during pregnancy. Electronic databases and journals were searched with seven articles included in this review. The findings demonstrated that women were aware of the health risks to the foetus associated with smoking; however knowledge of potential health risks was not sufficient to motivate them to quit. Se...
A population of female civil servants in Rome, Italy, was investigated to determine the prevalence of symptomatic and asymptomatic gallstone disease and to define the associated factors. Field activities started in February 1981 and concluded in April 1982. Diagnosis was assessed by real time ultrasonography. Prevalence of gallstone disease increased with age from 2.5% in the 20- to 29-year-old age group to 25.0% in the 60- to 64-year-old age group, based on both presence of gallstones and history of cholecystectomy. Only one third of the women with gallstones had complained of at least one episode of biliary pain in the last five years. Frequency of "minor" dyspeptic symptoms was not different between women with and those without gallstones. In a multiple logistic function analysis, a positive association was found between age, body mass index, parity, and prevalence of gallstone disease. No association was demonstrated between the presence of ...
Biopharmaceutical R&D complexes are major emission sources of volatile organic compounds (VOCs), which may pose potential health risks for staff on site and residents nearby. In this paper health risk assessments were performed for the VOCs in the ambient air of a typical biopharmaceutical R&D complex in China. Results showed halogenated and alkyl compounds were dominant components among 24 major VOCs from 9 selected sampling sites, inside or around the complex. The principal component analysis (PCA) indicated VOCs were generated predominantly from the biopharmaceutical research activities (factor 1 (F1), 71.6%) and traffic vehicles (factor 2 (F2), 15.4%), which were confirmed by contour maps of five selected VOCs (benzene, toluene, chlorobenzene, methylene chloride and n-hexane) simulated...
Objective Comorbidities predisposing cardiac surgical patients toward deep sternal wound infection, such as diabetes and obesity, are rising in the United States. Longitudinal analysis of riskfactors, morbidity, and mortality was performed to assessed effects of these health trends on deep sternal wound infection rates. Methods In this retrospective analysis of all median sternotomies performed at a single institution from 1991 through 2006, demographic and surgical characteristics were identified from a prospective database. The cohort was separated into periods from 1992 through 2001 and 2002 through 2006 to identify longitudinal trends in riskfactors for deep sternal wound infection. Univariate and matched multivariable analyses were performed. Results Overall, study population had in...
In organic livestock production systems, farm-management factors are thought to play an important role in the on-farm prevalence of Toxoplasma gondii. Serological results and the results of an HACCP analysis were combined to determine important riskfactors for the prevalence of this protozoan parasite. Mathematical analysis demonstrated that feeding goat whey to pigs and the presence of a high number of cats were positively correlated to T. gondii seroprevalence in pigs. Not covering roughage and the farmers' assumption that pigs can come into contact with cat feces also showed a positive relationship. In order to decrease the risk of T. gondii infecting their pigs, farmers should limit the access and number of cats on their farms and refrain from feeding goat whey to their pigs. PMID:16989566
This investigation of a brain cancer cluster in Missouri used two approaches to investigate associations with potential riskfactors. In a case-control study in a rural town, we interviewed surrogates of cases and controls about potential riskfactors. We found a statistically significant positive association of brain cancer with reported exposure to dental x-rays. Occupation was not associated with the cluster in the rural town. In a standardized proportional mortality study for the state of Missouri, we calculated the observed and expected proportion of brain cancers by occupation and industry in Missouri decedents. We found that motor vehicle manufacturers, beauty shop workers, managers and administrators, elementary school teachers, and hairdressers and cosmetologists had significantly elevated proportions of brain cancer. Brain tumors are inconsistently associated with occupation in the literature. ...
Abstract Background The increase in the incidence of atopic dermatitis (AD) in developed countries has been related to familiar and environmental factors. This survey was undertaken to investigate the family background, birthweight and the home environment of children suffering from AD in order to point out the possible factors that provoke the development of the disease. Methods The study uses data collected by means of self-administered questionnaires and discusses 461 cases of children (age 0-12) with active skin signs of AD. The control group comprised of 343 children (age 0-12) with no skin signs or positive lifetime history of AD. Associations between familiar and various home environmental factors and the risk of AD were calculated by means of odds ratios. Results There were statist...
The hydroelectric industry's recognition of the importance of avoiding unexpected failure, or forced outages, led to the development of probabilistic, or risk-based, methods in order to attempt to quantify exposures. Traditionally, such analysis has been carried out by qualitative assessments, relying on experience and sound engineering judgment to determine the optimum time to maintain, repair or replace a part or system. Depending on the nature of the problem, however, and the level of experience of those included in the decision making process, it is difficult to find a balance between acting proactively and accepting some amount of risk. The development of a practical means for establishing the probability of failure of any part or system, based on the determination of the statistical distribution of engineering properties such as acting stresses, is discussed. The capacity-demand analysis methodology, coupled with probablistic, ...
The purpose of this research is to clarify how psychological factor's impact on public acceptance of nuclear energy varies with people's degree of knowledge. For this purpose, we carried out questionnaire survey about nuclear energy at Suginami ward, Tokyo. After collecting data, we applied factor analysis to the data, and found 4 factors: Trust in the Authorities, Superiority of Nuclear Power Generation, Benefit for Nuclear Power Plants' Siting Areas, and Risk Perception about Nuclear Technology. In addition, using multiple regression analysis, we evaluated the impact of the 4 factors on 2 issues: the decision for or against nuclear policy and the reaction to nuclear power plant siting. Consequently, we found the change of impact of all 4 factors on the 2 issues. Especially, the impact of the 4 factors to the ...
The purpose of this research is to clarify how psychological factor's impact on public acceptance of nuclear energy varies with people's degree of knowledge. For this purpose, we carried out questionnaire survey about nuclear energy at Suginami ward, Tokyo. After collecting data, we applied factor analysis to the data, and found 4 factors: Trust in the Authorities, Superiority of Nuclear Power Generation, Benefit for Nuclear Power Plants' Siting Areas, and Risk Perception about Nuclear Technology. In addition, using multiple regression analysis, we evaluated the impact of the 4 factors on 2 issues: the decision for or against nuclear policy and the reaction to nuclear power plant siting. Consequently, we found the change of impact of all 4 factors on the 2 issues. Especially, the impact of the 4 factors to the reaction to nuclear power plant ...
Forty-one patients were treated with epidural neurolysis using 50 % ethyl alcohol 2 ml. Thirty eight patients were suffering from cancer pain and three patients were complaining of chronic benign pain. Alcohol block was repeated 2.3 times (mean) in the same patient. Thirty patients were followed after the treatment. Forty-seven percent of the patients reported 70 % or greater pain relief and 20 % of the patients reported about 50 % pain relief. Duration of pain relief was from 9 days to 203 days with a mean duration of 54 days. Adverse effects were reported 43 % of the patients. There is no miserable adverse effect. Adverse effect reported most was pain with epidural injection of drugs after the alcohol block had been performed. PMID:8544293
"Pillar pain" is a relatively frequent complication after surgical release of the median nerve at the wrist. Its etiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms two or even three years after surgery. The aim of this study was to investigate the efficacy of low-energy, flux density-focused extracorporeal shock wave therapy (ESWT) in the treatment of pillar pain. We treated 40 consecutive patients with ESWT who had pillar pain for at least six months after carpal tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this c...
Background and aims. The multiplicity of vaccine injections during childhood leads to iterative painful and stressful experiences which may lead in turn to anticipated pain and then possibly to a true needle phobia. We aimed at evaluating a multifactorial strategy of pain management combining pharmacological and non-pharmacological approaches during vaccination, as compared to usual care, in 4- to 12-year-old children. Methods. In all, 239 children were enroled by 25 family practitioners in an open-label study. After a pseudo-randomization, usual pain management (n = 132) was compared to a multifactorial strategy (n = 107) associating preliminary application of an anesthesic patch, preferential use of specified vaccines, child education by the parents and the doctor, parental accompaniment...
Structural reliability and risk based techniques have recently been used to demonstrate safe operation of high-pressure pipelines at design factors greater than 0.72. In particular several pipelines are now operating on the Transco National Transmission System, in the UK, at design factors of 0.78 owing to the use of the techniques. The overall structural reliability and risk based approach for justifying safe operation of pipelines at these stress levels is thus now established. However, in order to establish cost effective and viable widespread use of the technique, formal guidelines are necessary which will allow analyses to be performed with minimal requirements for regulator liaison meetings, external audits and extensive reporting. Structured and comprehensive guidelines, which have recently been constructed based on extensive analytical consideration of the underlying issues, are presented in ...
Quantitative ecological risk assessment (ERA) is a means whereby the risk posed by a toxicant in any system can be evaluated by comparing the distribution of its measured or modelled concentrations (water quality data (WQD)) with available information on the range of concentrations that are known to adversely affect biota within that, or similar, habitats (dose-response data (DRD)). Initially, the WQD are compared with regulatory criteria (e.g. ANZECC and ARMCANZ, 2000). If they fail this test, then, on the assumption that both data sets comprise subsets of the entire range of concentrations, probability density functions are derived assuming a standard distribution form a typically log-normal. In this paper, AQUARISK has been used to estimate the risk posed by copper in effluent from the Rum Jungle mine site, pre- and post-remediation, and the proportion of taxa likely to be affected in the East Branch (EB) of the Finniss ...
This book deals with organizations that operate in high hazard industries, such as the nuclear power, aviation, oil and chemical industry organisations. The society puts a great strain on these organisations to rigorously manage the risks inherent in the technology they use and the products they produce. In this book, an organisational psychology view is taken to analyse what are the typical challenges of daily work in these environments. The analysis is based on a literature review about human and organisational factors in safety critical industries, and on the interviews of Finnish safety experts and safety managers from four different companies. In addition to this, personnel interviews conducted in the Finnish nuclear power plants are utilised. The authors come up with eight themes that seem to be common organizational challenges cross the industries. These include e.g. how does the personnel understand the risks and ...
Persons with a thermolabile form of the enzyme 5,10 methylenetetrahydrofolate reductase (MTHFR) have reduced enzyme activity and increased plasma homocysteine which can be lowered by supplemental folic acid. Thermolability of the enzyme has recently been shown to be caused by a common mutation (677C{sup {r_arrow}}T) in the MTHFR gene. We studied 41 fibroblast cultures from NTD-affected fetuses and compared their genotypes with those of 109 blood specimens from individuals in the general population. 677C{sup {r_arrow}}T homozygosity was associated with a 7.2 fold increased risk for NTDs (95% confidence interval: 1.8-30.3; p value: 0.001). These preliminary data suggest that the 677C{sup {r_arrow}}T polymorphism of the MTHFR gene is a riskfactor for spina bifida and anencephaly that may provide a partial biologic explanation for why folic acid prevents these types of NTD. 13 refs., 1 fig., 1 tab.
Information is presented concerning new trends in licensing; seismic considerations and system structural behavior; TMI-2 risk assessment and thermal hydraulics; statistical assessment of potential accidents and verification of computational methods; issues with respect to improved safety; human factors in nuclear power plant operation; diagnostics and activities in support of recovery; LOCA transient analysis; unresolved safety issues and other safety considerations; and fission product transport.
Information is presented concerning new trends in licensing; seismic considerations and system structural behavior; TMI-2 risk assessment and thermal hydraulics; statistical assessment of potential accidents and verification of computational methods; issues with respect to improved safety; human factors in nuclear power plant operation; diagnostics and activities in support of recovery; LOCA transient analysis; unresolved safety issues and other safety considerations; and fission product transport.
Abstract Clonidine Extended Release Augmentation of Psychostimulants in ADHD ADHD a RiskFactor for Substance Abuse; Cognitive Deficits Not a Predictor Commentary on Kollins et al.; Clonidine XR Augmentation for ADHD Pharmacologic Treatment of Childhood Insomnias Effects of Guanfacine Extended Release on Alertness in ADHD Long Term ADHD Drug Treatment Bipolar Disorder Rates Similar Across Selected Countries Group CBT Alone or Group CBT Plus SSRIs in Childhood Anxiety Resolution of Quetiapine-Induced Oral Dyskinesia From the FDA
Altogether 99 029 men aged 40-59, employed on the Italian railroad system, were classified in three levels of physical activity at work and three levels of job responsibility and then followed up for...Full Text Available
Two patients receiving maintenance dialysis therapy developed osteonecrosis, the first in the humeral head and the second in the talus. Both patients lacked known riskfactors for developing osteonecrosis. A possible pathogenic role of secondary hyperparathyroidism in this disorder is suggested. Rheumatologists evaluating patients receiving maintenance dialysis with rheumatic manifestations should be aware of this potential complication. PMID:2185360
The extent to which the effect of riskfactors on cognitive ageing is dependent on APOE ε4 remains unclear. The objective of this study is to examine whether APOE ε4 allele modifies...Full Text Available
BackgroundHuman papillomavirus (HPV) infection is a major riskfactor for the development of nearly all cases of cervical cancer worldwide. The presence of HPV DNA in cases of esophageal...Full Text Available
Background: Hypertriglyceridemia is a riskfactor for cardiovascular disease. Variation in the apolipoprotein A5 (APOA5) and glucokinase regulatory protein (GCKR)...Full Text Available
Presented here is a case of a young woman, with an undiagnosed osteoid osteoma of the spine, which presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood....Full Text Available
ObjectivesUse of prescription opioids for chronic pain is increasing, as is abuse of these medications, though the nature of the link between these trends is unclear....Full Text Available
BackgroundThe objective of this study was to develop and validate a daily electronic Endometriosis Pain and Bleeding Diary (EPBD) for assessing treatment-related changes in endometriosis...Full Text Available
A retrospective study is presented of 83 athletes with tendo Achillis pain (TAP) treated conservatively over a 12-year period from 1976 to 1988. Local steroid injections did not contribute to an earlier...Full Text Available
BackgroundPatients’ general tendency to adhere to health care provider-recommended treatments is associated with a number of health outcomes, but whether it influences pain...Full Text Available
This article reports on an exploratory study of hospice social workers’ assessment and collaborative practices related to pain management; especially caregiver concerns about patient...Full Text Available
Sex-related influences on pain and analgesia have become a topic of tremendous scientific and clinical interest, especially in the last 10 to 15 years. Members of our research group published...Full Text Available
BackgroundSeverely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs,...Full Text Available
Previous studies in several different trigeminal nerve injury/inflammation models indicated that the hyperexcitability of primary afferent neurons contributes to the pain pathway underlying mechanical...Full Text Available
The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available
Racial and ethnic disparities in healthcare persist in the U.S. Although pain is one of the most prevalent and disabling symptoms of disease, only a few studies have assessed disparities in...Full Text Available
BackgroundControversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in...Full Text Available
The frozen shoulder is a common cause of shoulder pain and disability. Most patients slowly improve over 12 to 24 months. Some have prolonged loss of movement, pain, and associated disability. Treatments...Full Text Available
Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given...Full Text Available
Objectives. To assess the feasibility of treating musculoskeletal pain in the lower back and/or lower extremities in persons with Parkinson's disease (PD) with cranial electrotherapy...Full Text Available
Inclusion of family members in the assessment of patients with chronic pain can improve outcomes. Family functioning can be assessed in four basic areas: boundaries, power, communication, and intimacy....Full Text Available
BackgroundNeuropathic pain (NP) is partially mediated by neuroinflammatory mechanisms, and also modulates local neurogenic inflammation. Dietary lipids, in particular the total amount...Full Text Available
Patients with adhesive capsulitis were clinically evaluated to establish whether pain elicited by pressure on the coracoid area may be considered a pathognomonic sign of this condition. The study group...Full Text Available
... Search Help? Coping with Test Pain, Discomfort, and Anxiety Introduction | Be Prepared | Know Your Tests | Relax | Conclusion ... though they may feel some embarrassment, discomfort, or anxiety at the outset. If undergoing medical tests makes ...
BackgroundThe purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA).MethodsTwenty-three...Full Text Available
BackgroundUntil now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation...Full Text Available
ObjectivePersons with chronic or recurrent pain frequently visit the emergency department (ED), yet little research examines this experience. We conducted this national survey to...Full Text Available
Approximately 20% to 30% of patients who undergo coronary arteriography for the evaluation of chest pain are found to have normal coronary arteries. These patients have a survival rate comparable to...Full Text Available
BackgroundChronic non-specific musculoskeletal pain (CNSMSP) may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood....Full Text Available
Functional imaging has revolutionized the neurosciences. In the pain field it has dramatically altered our understanding of how the brain undergoes significant functional, anatomical and chemical changes...Full Text Available
Behavioural assessment methods have been used to signal the need for intervention and to evaluate treatment effectiveness. Direct observation and rating scales have been used to assess pain and distress...Full Text Available
The aim of this study was to investigate whether astroglia in the medullary dorsal horn (trigeminal spinal subnucleus caudalis; Vc) may be involved in orofacial neuropathic pain following trigeminal...Full Text Available
ContextWhile opioids are increasingly used for chronic non-cancer pain (CNCP), we know little about opioid dosing patterns among individuals with CNCP in usual care...Full Text Available
Awaiting new data from RERF, an attempt was made to estimate the somatic risks of low doses of radiation for members of the German public. The new estimate follows closely the approach used in deriving the values published in the NIH Radioepidemiological Tables. The lifetime riskfactors thus calculated are significantly larger than the estimates presented in ICRP Report 26 and are consistent with estimates recently made in the ongoing reactor safety study of NUREG. The increase in lifetime risks is mainly due to the introduction of a new time projection model which appears to be more consistent with the epidemiological data for many late effect end points than the constant absolute risk model previously employed. Results from a study in which epidemiological data were stochastically simulated with a computer indicate that the shapes of actual dose effect curves might be ...
Colorectal cancer is the third most common malignant tumor and the fourth-leading cause of cancer death worldwide. The crucial role of fatty acids for a number of important biological processes suggests a more in depth analysis of inter-individual differences in fatty acid metabolizing genes as contributing factor to colon carcinogenesis. We examined the association between genetic variability in 43 fatty acid metabolism-related genes and colorectal risk in 1225 CRC cases and 2032 controls participating in the European Prospective Investigation into Cancer and Nutrition study. 392 single nucleotide polymorphisms were selected using pairwise tagging with an r(2) cutoff of 0.8 and a minor allele frequency of >5%. Conditional logistic regression models were used to estimate odds ratios and corresponding 95% confidence intervals. Haplotype analysis was performed using a generalized linear model framework. On the genotype level, HPGD, PLA2G6, and ...
In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinical practice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.
Asymptomatic cholelithiasis is increasingly diagnosed today, mainly as a result of the widespread use of abdominal ultrasonography for the evaluation of patients for unrelated or vague abdominal complaints. About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Asymptomatic gallstone disease has a benign natural course; the progression of asymptomatic to symptomatic disease is relatively low, ranging from 10-25%. The majority of patients rarely develop gallstone-related complications without first having at least one episode of biliary pain ("colic"). In the prelaparoscopy era, (open) cholecystectomy was generally performed for symptomatic disease. The minimally invasive laparoscopic cholecystectomy refueled the discussion about the optimal management of asymptomatic cholelithiasis. Despite some controversy, most authors agree that the vast majority of subjects should be managed by ...
BackgroundAδ and C fibers are the major pain-conducting nerve fibers, activate only partly the same brain areas, and are differently involved in pain syndromes....Full Text Available
We discuss the foundations of factor or regression models in the light of the self-consistency condition that the market portfolio (and more generally the riskfactors) is (are) constituted of the assets whose returns it is (they are) supposed to explain. As already reported in several articles, self-consistency implies correlations between the return disturbances. As a consequence, the alpha's and beta's of the factor model are unobservable. Self-consistency leads to renormalized beta's with zero effective alpha's, which are observable with standard OLS regressions. Analytical derivations and numerical simulations show that, for arbitrary choices of the proxy which are different from the true market portfolio, a modified linear regression holds with a non-zero value $\\alpha_i$ at the origin between an asset $i$'s return and the proxy's return. Self-consistency also introduces ``orthogonality'' and ...
This paper aims to estimate the prevalence of cigarette smoking among students in Vietnam ages 13-15 and examines its relationship with compositional and contextual factors. The data used in this paper were obtained from the 2007 Global Youth Tobacco Survey conducted in nine provinces in Vietnam. A multilevel logistic regression model was applied to analyse the association between the current incidence of cigarette smoking and factors on both the individual and school level. The prevalence of cigarette smoking among students was 3.3% overall. The prevalence of smoking among male students (5.9%) was higher than that among females (1.2%). Parental smoking was a significant riskfactor for smoking among the students. Having a friend who smoked was the strongest predictor of smoking status amo...
We tested two approaches to forecast species distributions while balancing the impact of climate change against the inertia promoted by other influential factors that have been forecast as not changing. Given that mountain species are presumed to be more at risk due to climate warming, we selected an amphibian, a reptile, a bird, and a mammal species present in the Spanish mountains, to model their distributional response to climate change during this century. The climatic forecasts were made according to the general circulation models CGCM2 and ECHAM4 and to the A2 and B2 emission scenarios. We modelled the response of the species to spatial, topographic, human, and climatic variables separately. In our first approach, we compared each of these single-factor models using the Akaike Inform...
Study Design Best evidence synthesis. Objective To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population. Summary of Background Data The evidence on burden and determinants of neck has not previously been summarized. Methods The Bone and Joint Decade 2000?2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis. Results We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to...
Psychological distress and postamputation pain were investigated in a sample of 582 males with long-term limb amputations (mean time since amputation 639.3 months, standard deviation 166.1; range 240-784 months). Prevalence of significant depressive symptoms (Hospital Anxiety and Depression Scale [HADS]-D score?8) was 32.0%, and 34.0% of respondents met the screening criterion for clinical anxiety (HADS-A score?8). Nearly one quarter (24.6%) of respondents reported significant post-traumatic psychological stress symptoms (Impact of Event Scale scores?35). In total, 87.8% experienced either phantom or residual limb pain. Affective distress scores differed according to the respondents' type of pain experience. Respondents who experienced residual limb pain reported significantly hig...
As a series of estimations of population doses and of risk estimates from medical exposures in Japan, the malignancy significant dose (MSD) and the fatal malignant risk from beam therapy were estimated based on a nationwide survey of radiotherapeutic treatments, using a malignancy significant factor and a weighting factor determined from the data on the cancer mortality among the atomic bomb survivors in Nagasaki. The effective dose was defined as a sum of the product of the weighting factor and the organ or tissue doses with respect to the malignant diseases. The organ or tissue doses were determined with ionization chambers placed at the positions of their center in a MixDp-phantom simulated lung tissues by a block of cork, using a telecobalt unit, a conventional X-ray unit and a medical linear accelerator. The organ or tissue doses were categorized into three dose components; ...
There is limited information on the incidence of acute kidney injury (AKI) in patients with traumatic brain injury (TBI) although AKI may contribute to morbidity and mortality. We investigated the incidence of AKI in patients with moderate and severe TBI and the association of AKI with riskfactors and outcomes in these patients. We studied all TBI patients over 16 years of age admitted to the two designated trauma hospitals in the state of Victoria, Australia from 1 January to 31 December 2008. Patients were included if they had head trauma and presented with a Glasgow coma scale (GCS) <13. Prospectively collected data from the hospital trauma registries, ICUs, and pathology databases were analyzed retrospectively. Risk injury failure loss end (RIFLE) criteria were used to categorize rena...
In the field of Living Probabilistic Safety Assessment (LPSA) the reliability data updating is an important factor. In risk analysis equipment failure data is needed to estimate the frequencies of events contributing to risk posed by a facility. Five years data of emergency diesel generator (EDG) of Daya Bay Nuclear Power Plant (NPP) has been studied in this paper. The data updating process has been done by using two methods, i.e., the classical method and Bayesian method. The aim of using these methods is to calculate the operational failure rate (@l) and demand failure probability (p). The results show that the operational failure rate is 1.7E-3 per hour and the demand failure probability is 2.4E-2 demand per day for Daya Bay NPP. By comparing the results obtain from classical and Bayesi...
Objectives: Intra-operative cisplatin-based intra-peritoneal chemotherapy (IPC) may alter renal function in patients with advanced ovarian cancer. The aim of this study was to describe postoperative alteration of renal function after cisplatin-based IPC and to identify riskfactors for moderate to severe acute renal failure. Study design: This prospective observational study was carried out on 77 consecutive patients who underwent cisplatin-based IPC procedures, with (n=23) or without (n=54) intra-peritoneal epinephrine, for advanced ovarian cancer. Postoperative renal function was assessed using serial serum creatinine measurements and was based on serum creatinine changes from pre-operative values, according to the risk, injury, failure, loss, end-stage kidney disease (RIFLE) classificat...
Acute kidney injury (AKI) is a common complication after allogeneic stem cell transplantation (SCT). Although various riskfactors for AKI have been reported, the influence of pretransplant comorbidity on the incidence of AKI has not been well investigated. We performed a retrospective analysis of 207 consecutive patients undergoing myeloablative or nonmyeloablative SCT between 2001 and 2009, using the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) as a representative of pretransplant comorbidities. According to Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, 158 patients (76.3%) developed AKI, and 92 patients (44.4%) developed severe AKI (RIFLE class I or class F) within 100 days after SCT. The cumulative incidence of severe AKI within 1...
The optimal management of men with very favorable clinicopathological factors who develop biochemical recurrence (BCR) after radical prostatectomy (RP) has not been previously reported. Both local and systemic recurrences are unlikely in this cohort. This study examines their management and outcomes. Between October 2000 to March 2010, 1627 men underwent open RP by a single surgeon. In all, 448 (27.5%) met the following criteria for extremely low risk disease: preoperative PSA level <10?ng?ml?1, clinical stage T1c/T2a, Gleason score ?6, estimated cancer volume in the surgical specimen ?5% and no evidence for positive surgical margin. Undetectable PSA was defined as ?0.04?ng?ml?1. BCR was defined as PSA ?0.2?ng?ml...
Abstract Background: Obstructive sleep apnea (OSA), a highly prevalent condition, is independently associated with increased risks of developing type 2 diabetes mellitus (T2D) and metabolic syndrome. It is unclear, however, if the severity of OSA has any impact on glycemic control among patients with T2D. We therefore aimed to determine the independent association between OSA severity and glycosylated hemoglobin (HbA1c) in patients with T2D. Methods: This was an observational cross-sectional study of 52 consecutive patients attending the diabetes obesity clinic between January 2008 to February 2010 with riskfactors for sleep apnea and who underwent polysomnography study. Clinical, demographic, and lifestyle data were recorded using a questionnaire. Results: Prevalence of OSA in this clini...
The dramatic increase in diagnostic rates of bipolar disorder in children and adolescents in the USA has led to an intense interest in the phenomenology of the disorder. Here we present data from a newly-developed instrument to assess episodic mania-like symptoms in youth in a large population-based sample (N?=?5326) using parent- and self-report. We found that a substantial proportion of children screened positive for having episodes of ?going high? and were at an increased risk for morbidity and impairment. Using factor analysis, we identified that episodic mania-like symptoms comprised two dimensions: An under-controlled dimension that was associated with significant impairment, and a low-risk exuberant dimension. Using latent class analysis, we identified a small group of children scor...
Electric utilities have been surprised by recent opposition to the construction of very-high-voltage transmission lines, which met with little resistance in the past. Concerns over health and safety factors are associated with the increase in the number of such lines, although their presence has always been an inconvenience and a hazard for those living and working in the immediate vicinity. The new lines present additional hazards due to the continuous flow of small electric currents and the charges that build up in the area of the towers and lines. The lines are also a threat to persons wearing cardiac pacemakers. There is experimental evidence from the Soviet Union and the U.S. that electric and magnetic fields at the frequencies of such power lines can have serious biological effects on growth rates and the functioning of the central nervous system. Full disclosure that possible risks are involved and the opportunity to avoid these ...
Cognitive decline has been described in elderly patients with schizophrenia, but the underlying pathology remains unknown. Some studies report increases in plaques and neurofibrillary tangles, but there is no evidence for an increased risk for Alzheimer's disease (AD) in elderly schizophrenics. Models of a decreased cerebral reserve suggest that increases in AD-related neuropathology below the threshold for a neuropathological diagnosis could be related to dementia severity in elderly schizophrenia patients. We tested this hypothesis in 110 autopsy specimens of schizophrenia patients, without a neuropathological diagnosis of AD or other neurodegenerative disorders. Furthermore, we assessed the effects of apolipoprotein E (ApoE) status, a known genetic riskfactor for AD. Measures of densit...
Anaphylaxis is a serious allergic reaction that is rapid in onset and sometimes leads to death. Understanding mechanisms, triggers, and patient-specific riskfactors for severe or fatal anaphylaxis is critically important. Diagnosis of anaphylaxis is currently based on established clinical criteria. Epinephrine (adrenaline) is the first-line medication for anaphylaxis treatment and delay in injecting it contributes to biphasic reactions, hypoxic-ischemic encephalopathy, and fatality. Here, we focus on four important areas of translational research in anaphylaxis: studies of potential new biomarkers to support the clinical diagnosis of anaphylaxis, laboratory tests to distinguish allergen sensitization from clinical risk of anaphylaxis, the primary role of epinephrine (adrenaline) in anaphylaxis treatment, and strengthening the overall evidence base for anaphylaxis treatment. PMID:21668849
A method for assessing management systems for low-level radioactive waste is being developed for US Department of Energy. The method is based on benefit-cost-risk analysis. Waste management is broken down into its component steps, which are generation, treatment, packaging, storage, transportation, and disposal. Several different alternatives available for each waste management step are described. A particular waste management system consists of a feasible combination of alternatives for each step. Selecting an optimal waste management system would generally proceed as follows: (1) qualitative considerations are used to narrow down the choice of waste management system alternatives to a manageable number; (2) the costs and risks for each of these system alternatives are evaluated; (3) the number of alternatives is further reduced by eliminating alternatives with similar risks but higher costs, or those with similar costs ...
Over the past few years, NPCIL has performed comprehensive Level-1 Probabilistic Safety Assessment (PSA) for a 220 MWe Pressurised Heavy Water Reactor (PHWR) at Kakrapar Atomic Power Station (KAPS) and for the first 540 MWe PHWR at Tarapur Atomic Power Project (TAPP- 3 and 4). The major objective of these PSAs was to present an integrated picture of the safety of the plant to identify and understand key plant vulnerabilities. As a result of the availability of these PSAs, there is a desire to use them to operate the plants in the most efficient manner practicable. In recent years, the operation of Indian Nuclear Power Plants has been characterized by improved availability/capacity factors and reduced forced outages. Frequency of planned outages is also being reduced. In order to achieve this, the PSAs are now being used as an engineering tool for optimization of Technical Specifications with regard to Allowed Outage Time (AOT) and Surveillance Test Intervals ...
Abstract Common single nucleotide polymorphisms (SNPs) in SMAD7 (18q21) have been linked to colorectal cancer (CRC) risk in genome-wide association studies, but little is known about their effects on survival. SMAD7 regulates gastrointestinal inflammation by inhibiting transforming growth factor- (TGFB), which can act as both a tumor suppressor and a promoter of metastasis. Regular use of cyclooxygenase-2 (COX2) inhibitors, such as nonsteroidal anti-inflammatory drugs (NSAIDs), reduces the risk of developing CRC. Because COX2 overexpression reduces the growth suppressing effects of TGFB, we hypothesized that survival may depend on both SMAD7 genotype and prediagnostic NSAID use. Postmenopausal women, ages 50-74, diagnosed with incident invasive CRC from 1997 to 2002 were identified using t...
A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily living, and ...
Therapeutic hypothermia is a promising method for controlling intracranial pressure (ICP) in severely brain-injured patients. However, clinical data regarding the effect of brain hypothermia on overall outcome of these patients is limited. This may be because there are specific pitfalls associated with the clinical management of induced hypothermia in patients with severe traumatic brain injury (TBI). These pitfalls may be avoided by preventing specific riskfactors when cooling is induced and with rewarming. However, these riskfactors have not been well systematically discussed in the literature. In this paper, three categories of clinical issues regarding the management of brain hypothermia are discussed: (1) stress-induced secondary brain injury mechanisms; (2) technical aspects of intensive care unit (ICU) cooling management; and (3) rewarming rates and methods. For patients with a Glasgow Coma ...
The study was designed to determine the correlation between parenchymal lesions on MRI and depression. Thirty patients with depression satisfying the following criteria were selected: (1) 60 years or over at the time of MRI scanning, (2) no evidence of cerebrovascular disorder or dementia, and (3) no evidence of neurological findings such as extremity palsy. Seventy six patients with no history of psychiatric visits to a clinic served as controls. There was no significant difference in riskfactors for cerebrovascular disorders, such as hypertension, diabetes mellitus, and ischemic heart disease, between the depressive group and the control group. MRI manifestations were semiquantitatively scored according to the periventricular hyperintensity (PVH), white matter hyperintensity (WMH), and pons hyperintensity (PH). All of the PVH score, WMH score, and cerebral enlargement index correlated with age. Although there was no significant difference in ...
Objective. So far, few data are available to characterize the flare history of patients with gout. The objective of this study was to describe the frequency and riskfactors of gout flares with special consideration of the comorbidity. Methods. A cohort study was conducted in a UK general practice database (The Health Improvement Network) including all patients aged 20-89 years diagnosed with incident gout between the years 2000 and 2007. Results. In this study, 23 857 incident gout patients (mean age 61.9 years) were included, overall incidence rate was 2.68 (95% CI 2.65, 2.72) per 1000 person-years. The proportion of patients with at least one flare during the follow-up period (mean 3.8 years) was 36.9% (n = 8806). A history of ischaemic heart disease [hazard ratio (HR) 1.12 (95% CI 1.06...
By applying the linear-dose effect relation, the weighting factors for total risks recommended by IRCP can be transformed to weighting factors for somatic effects. Another weighting factor Msub(s) has to be used which takes into account the dependence of the latent period for occurrence of malignant disease and the variation of the incidence with time. On this basis a somatically significant dose equivalent can be defined as 'the dose equivalent which if received by every member of the population, would be expected to produce the same total somatic injury to the population as does the actual dose equivalent received by the various individuals', and an approximation has been derived for this. Tables are presented of the somatic effective dose equivalents calculated for different x-ray examinations for various organs and tissues. The S.E.D. equivalents have also been calculated for some of the most ...
Objectives: Acupuncture has served as a major complementary and alternative therapy that supplements conventional medicine and is the subject of growing public interest. This study was conducted to estimate the usage rate of acupuncture as a supplemental treatment in acute ischaemic stroke patients and to identify factors associated with the choice to use this therapy. Methods: Using the registry of stroke patients admitted to an academic medical centre in Korea, the use of acupuncture therapy was recorded and analysed, along with the patients' socio-demographic characteristics, hospital access variables, riskfactors for ischaemic stroke and clinical characteristics. The data were analysed using descriptive statistics, chi-square tests and multiple logistic regression analyses. Results: O...
Objective: We have conducted a longitudinal observational study in order to evaluate the prevalence and the incidence of depressive and anxious symptoms in women and men seeking infertility treatment and to analyze associated factors or riskfactors for these kinds of disorders. Study design: A total of 1000 consecutive couples that visited our center for the first time were asked to join this study. Depressive and anxious symptoms were assessed with self-rating Zung Depression Scale (ZDS) and Zung Anxiety Scale (ZAS) questionnaires. A second assessment was planned at the time of b HCG dosage (or at the moment of cycle suspension). A standard questionnaire was used to investigate socio-demographic information and the psychological aspects of couples undergoing in vitro fertilization (IVF) ...
In mobile animals, movement behavior can maximize fitness by optimizing access to critical resources and minimizing risk of predation. We sought to evaluate several hypotheses regarding the effects of landscape structure on American marten foraging path selection in a landscape experiencing forest perforation by patchcut logging. We hypothesized that in the uncut pre-treatment landscape marten would choose foraging paths to maximize access to cover types that support the highest density of prey. In contrast, in the post-treatment landscapes we hypothesized marten would choose paths primarily to avoid crossing openings, and that this would limit their ability to optimally select paths to maximize foraging success. Our limiting factor analysis shows that different resistant models may be sup...
This paper reports that there are four combustion technologies upon which U.S. electric utilities are expected to rely for the majority of their future power generating needs. These technologies are pulverized coal- fired combustion (PC); coal-fired fluidized bed combustion (AFBC); coal gasification, combined cycle systems (CGCC); and natural gas-fired combined cycle systems (NGCC). The engineering and economic parameters which affect the choice of a technology include capital costs, operating and maintenance costs, fuel costs, construction schedule, process risk, environmental and site impacts, fuel efficiency and flexibility, plant availability, capacity factors, timing of startup, and the importance of utility economic and financial factors.
ALLEYNE G., HANCOCK C. & HUGHES P. (2011) Chronic and non-communicable diseases: a critical challenge for nurses globally. International Nursing Review58, 328-331 Background:- Chronic and non-communicable diseases (NCDs) are a growing and enormous challenge that faces countries across the world. Low- and middle-income countries are disproportionately affected. Contributory factors:- Three riskfactors - tobacco use, poor diet (including excessive alcohol intake) and lack of physical activity - contribute to four major chronic diseases - cardiovascular, chronic obstructive pulmonary disease, diabetes and some cancers, which are responsible for over 50% of deaths worldwide. Potential solutions:- International governmental and non-governmental agencies are becoming increasingly concerned and ...
Aims The aim of this study is to examine the dose?response relationships between age, ?lifestyle factors?? (body mass index, tobacco smoking, sports), and symptomatic knee osteoarthritis in a population-based case?control study. Additionally, the study aims to investigate the mode of interaction between body mass index (BMI) and physical workload (occupational kneeling/squatting and lifting/carrying of loads) with respect to the risk of symptomatic knee osteoarthritis. Methods In five orthopedic clinics and five practices, 295 male patients aged 25?70 with radiographically confirmed knee osteoarthritis associated with chronic complaints were recruited. The control group comprised 327 male control subjects. In a structured personal interview, body weight at different ages, body height, cumu...
IntroductionFocusing on people and organizations, this paper aims to contribute to offshore safety assessment by proposing a methodology to model causal relationships.MethodThe methodology is proposed in a general sense that it will be capable of accommodating modeling of multiple riskfactors considered in offshore operations and will have the ability to deal with different types of data that may come from different resources. Reason's ?Swiss cheese?? model is used to form a generic offshore safety assessment framework, and Bayesian Network (BN) is tailored to fit into the framework to construct a causal relationship model. The proposed framework uses a five-level-structure model to address latent failures within the causal sequence of events. The five levels include Root causes level, Tr...
The paper presents information in the form of data, tables and diagrams compiled to a broad but very up-to-date survey of required radiation for the various most frequently performed X-ray examinations of patients. The required dose is discussed from the point of view of radiation protection, defining the inevitably administered dose to the skin, the frequency of examinations, and the diagnostic image quality as the main three factors to be observed, as these determine the radiation dose to the patient and to the personnel. The somatic risks of radiography examinations are a point of main interest. (DG).
Ammonia gas (NH{sub 3}) has been used as a nitrogen source for plasma source ion implantation processing of electroplated chromium. No evidence was found of increased hydrogen concentrations in the bulk material, implying that ammonia can be used without risking hydrogen embrittlement. The retained nitrogen dose of 2.1 {times} 10{sup 17} N-at/cm{sup 2} is sufficient to increase the surface hardness of electroplated Cr by 24% and decrease the wear rate by a factor of 4.
Using disaggregated data from the Brazilian stock market, we calculate default probabilities for 30 different economic sectors. Empirical results suggest that domestic macroeconomic factors can explain these default probabilities. In addition, we construct the Minimum Spanning Tree (MST) and the ultrametric hierarchical tree with the MST based on default probabilities to disclose common trends, which reveals that some sectors form clusters. The results of this paper imply that macroeconomic variables have distinct effects on default probabilities, which is important to take into account in credit risk modeling and the generation of stress test scenarios.
In a study of hitchhiking or contaminating insect pests on international cargo aircraft at Miami International Airport from 1998 to 1999, it was found that contamination rates were greatest, 23%, on cargo flights from Central America and much lower, near 5%, on flights from all other regions. We reanalyzed the study data to test for associations between contaminated flights and factors such as season, cargo type, and time of departure (night or day), and developed probabilistic models for predicting insect pest arrivals by region and pest risk levels. Significant (P
Anesthetic techniques vary widely in the endovascular repair of abdominal aortic aneurysms (EVAR). Previous studies have demonstrated the feasibility of using local anesthesia. However, the ideal anesthetic technique has not been determined. This study examines whether anesthesic technique influences the outcomes of EVAR. Data regarding demographics, riskfactors, procedural characteristics, recovery characteristics, treatment complications, acute ( 0.05, ANOVA). From these results we concluded that EVAR with local anesthesia is a safe and efficacious method that may reduce recovery times and postoperative medical morbidity compared to use of genera1 or spinal/epidural anesthesia.
Introduction: Previous studies have published the correlation between myocardial perfusion SPECT (MP) during cold pressor test (CPT) and intracoronary acetylcholine and its usefulness as independent marker of endothelial dysfunction (ED). Objective: To analyze the incidence of positivization of MP exercise studies in the follow up of asymptomatic patients with moderate cardiovascular risk (CV) and ED detected by PF. Material and Methods: Of 301 patients of the PARADIGMA Registry (normal exercise MP SPECT and clinical probability < 20% of events at 10 years [moderate risk by Framingham index]) 55 had positive PF (+) (18.3%). Prospectively and consecutively, 15 asymptomatic patients with PF (+), and a control group (CG) of 15 patients with negative PF, with paired sex, age and coronary riskfactors (CRF), that accomplished a 12 #+-# 2 months follow up, and that underwent a new exercise and resting MP ...
Postamputation pain (PAP) affects over 60% of major limb amputees. One of the main challenges in treating PAP is the difficulty involved in identifying pain mechanism(s), which pertains to both residual limb pain (RLP) and phantom limb pain (PLP). In this study, sympathetic blocks were performed on 17 major limb amputees refractory to treatment, including 2 placebo-controlled blocks done for bilateral amputations. One hour postinjection, mean RLP scores at rest declined from 5.2 (SD 2.8) to 2.8 (SD 2.6) (P = .0002), and PLP decreased from 5.3 (SD 3.1) to 2.3 (SD 2.1) (P = .0009). By 1 week, mean pain scores for RLP and PLP were 4.3 (SD 2.9) and 4.2 (SD 3.0), respectively. Overall, 8 of 16 (50%) patients experienced ?50% reduction in RLP 1-hour postinjection, with the beneficial effects ...
The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references.
Objective: The aim of this study was to obtain an overview of the methodological quality of studies on the measurement properties of neck pain and disability questionnaires and to describe how well various aspects of the design and statistical analyses of studies on measurement properties are performed. Methods: A systematic review was performed of published studies on the measurement properties of neck pain and disability questionnaires. Two reviewers independently rated the quality of the studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. This checklist was developed in an international Delphi consensus study. Results: A total of 47 articles were included on the measurement properties of 8 different questionnaires. The meth...
Dengue, a major public health problem throughout subtropical and tropical regions, is an acute infectious disease characterized by biphasic fever, headache, pain in various parts of the body, prostration,...Full Text Available
Abstract Residual limb pain (RLP) and phantom limb pain (PLP) can be debilitating and can prevent functional gains following amputation. High correlations have been reported between RLP and the stump neuromas following amputation. Many treatment methods including physical therapy, medications, and interventions, have been used with limited success. Pulsed radiofrequency ablation (PRFA) has shown promise in treating neuropathic pain because of the inhibition of evoked synaptic activity. We present 4 amputees who were treated with PRFA after failing conservative management for their RLP and PLP. All 4 patients underwent PRFA and demonstrated at least 80% relief of RLP for over 6 months. One patient reported a complete resolution of phantom sensation while another patient had significantly de...
ObjectiveNeuralgic amyotrophy (NA) is a distinct clinical syndrome that is characterized by the acute onset of shoulder and arm pain, weakness, and sensory loss. The purpose of this...Full Text Available
The physical demands of performing on musical instruments can cause pain, sensory loss, and lack of coordination. Five cases illustrate common problems. Knowledge of the interaction between the technique...Full Text Available
Cutaneous scarring can cause patients symptoms ranging from the psychological to physical pain. Although the process of normal scarring is well described the ultimate cause of pathological scarring...Full Text Available
Opinion statementCritical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced...Full Text Available
The antinociceptive effects of honokiol and magnolol, two major bioactive constituents of the bark of Magnolia officinalis, were investigated on animal paw licking responses and thermal...Full Text Available
The medical applications of radiation comprise three main fields namely: Diagnostic Radiology, Radiotherapy and Nuclear Medicine. With the new weighting factors of ICRP (IC91a) the effective dose due to medical applications can be established. I is common to separate the effective dose into the genetic part and the somatic part, SED. In dealing with gonad doses it is important to account for the age of the person at the time of exposure as this will influence the number of children still to be expected from that person. The resulting dose will then be called the genetically significant dose, GSD. In a similar fashion this age factor will be important in considering the chance of tumor induction. The age of patients differs considerably from the average age of the general population. This age difference has to be accounted for if a comparison is to be made with other sources of radiation. This justifies establishing a somatically significant ...
Many assays for oncogenic transformation have been developed ranging from those in established rodent cell lines where morphological alteration is scored, to those in human cells growing in nude mice where tumor invasiveness is scored. In general, systems that are most quantitaive are also the least relevant in terms of human carcinogenesis and human risk estimation. The development of cell culture systems has made it possible to assess at the cellular level the oncogenic potential of a variety of chemical, physical and viral agents. Cell culture systems afford the opportunity to identify factors and conditions that may prevent or enhance cellular transformation by radiation and chemicals. Permissive and protective factors in radiation-induced transformation include thyroid hormone and the tumor promoter TPA that increase the transformation incidence for a given dose of radiation, and retinoids, selenium, vitamin E, and ...
Many assays for oncogenic transformation have been developed ranging from those in established rodent cell lines where morphological alteration is scored, to those in human cells growing in nude mice where tumor invasiveness is scored. In general, systems that are most quantitaive are also the least relevant in terms of human carcinogenesis and human risk estimation. The development of cell culture systems has made it possible to assess at the cellular level the oncogenic potential of a variety of chemical, physical and viral agents. Cell culture systems afford the opportunity to identify factors and conditions that may prevent or enhance cellular transformation by radiation and chemicals. Permissive and protective factors in radiation-induced transformation include thyroid hormone and the tumor promoter TPA that increase the transformation incidence for a given dose of radiation, and retinoids, selenium, vitamin E, and ...
Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still 44% of patient will develop recurrent cancer This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen which is 500-1000 cGy higher than other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was 46%, but only 1 patient (1%) had operative treatment ...
BackgroundGeneralized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with...Full Text Available
1. Ro 15-8081 (Hoffmann-La Roche, Basle, Switzerland) is a novel mixed 5-HT/noradrenaline uptake inhibitor producing potent antinociceptive effects in animal pain models. 2. In healthy man, two models...Full Text Available
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains an enigmatic medical condition. Creation of the (NIH) Chronic Prostatitis Collaborative Research Network (CPCRN) funded by...Full Text Available
BACKGROUND: Immune suppressant medications such as thiopurines and anti-tumor necrosis factor agents are important for maintaining disease control in most patients with inflammatory bowel diseases (IBDs); however, their use has been associated with the development of malignant lymphoma. The purpose of this Dutch nationwide study was to estimate the relative risk of malignant lymphoma in IBD patients. METHODS: IBD patients who developed a lymphoma between 1997 and 2004 were identified using the Dutch National Database of PALGA. Data from confirmed cases were collected from individual hospitals, including data on Epstein-Barr virus (EBV). The age-adjusted 8-year incidence of malignant lymphoma in the Netherlands was retrieved from the Central Bureau of Statistics. RESULTS: Forty-two hospitals were visited and 285 matches evaluated in the total cohort of 17,834 IBD patients. Forty-four lymphomas were observed, resulting in a relative ...
The main objective of this paper is to identify conditions which affect public concern (either increase or decrease) and political acceptance for developing and implementing programmes for geologic disposal of long-lived radioactive waste. It also looks how citizens and relevant actors can be associated in the decision making process in such a way that their input is enriching the outcome towards a more socially robust and sustainable solution. Finally, it aims at learning from the interaction how to optimise risk management addressing needs and expectations of the public and of other relevant stakeholders. In order to meet these objectives, factors of relevance for societal acceptance conditions are identified, described and analysed. Subsequently these factors are looked for in the real world of nuclear waste management through cases in several countries. The analysis is conducted for six stages of a repository programme ...
Morphine sulfate (MS Contin), a proven analgesic in the treatment of cancer pain and chronic benign pain, seems to be a good analgesic for the treatment of burn pain. MS Contin is morphine sulfate incorporated in a wax cellulose matrix delivery system. This wax cellulose delivery system gives MS Contin its duration of action. Ten patients were enrolled in an open-labeled, nonrandomized study. The study was designed to examine the analgesic efficacy of MS Contin in the burn population. Each patient remained in the study for 6 days. The efficacy of the analgesic regimen was subjectively measured by the visual pain scale. The MS Contin group was retrospectively compared with a group of patients who were given continuous intravenous infusions of morphine. The two groups were matched according to age, burn size, surgical procedures, and hospital stay. The analgesic qualities of MS Contin were comparable to ...
Purpose. To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography. Methods. A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography. Results. The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p<0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19.8% in the iopromide group (p<0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p=NS). Overall diagnostic information was optimal for 94.1% in the ...
Studies of the effectiveness of operant, relaxation, cognitive, and multimodal behavioural approaches to the treatment of chronic benign pain other than headache were evaluated. In general, the quality of the studies was poor, and most investigations lacked appropriate and adequate control conditions, outcome measures, and/or follow-ups. While outcome reports for all four behavioural treatments have been mainly positive, few data were found which conclusively demonstrate that any of the approaches are effective or that they are the treatment of choice. The data do, however, imply that behavioural approaches may help patients lead more normal and productive lives. Specifically, the literature suggests that: (1) the operant method leads to increased activity levels and decreased pain and drug intake, (2) the relaxation approach results in decreased EMG levels and some pain reductions, (3) the cognitive techniques are ...
... Risk (Adverse) for Endangered Species: Risk to aquatic species if anticipated pesticide residue levels equal one-fifth of LD10 or one-tenth of LC50; risk to ...terrestrial species if anticipated pesticide residue levels equal one-fifth of LC10 or one-tenth of LC50. Risk Assessment: Qualitative and quantitative evaluation of the ... Risk for Non-Endangered Species: Risk to species if anticipated pesticide residue levels are equal to or greater than LC50. Risk Management: The process ...
The Pawtucket Heart Health Program is one of the community studies examining whether population-based efforts to lower cardiovascular riskfactors will reduce cardiovascular morbidity and mortality. The Pawtucket Heart Health Program intervention is based on a blend of social learning theory, community organization models, community psychology tenets, and diffusion research. This model allows for multifaceted programs that target individuals, groups, organizations, and the entire community to alter their cardiovascular risk through managing blood pressure, lowering blood cholesterol, quitting smoking, increasing fitness, and maintaining desirable weight levels. A dominant feature of the intervention is the emphasis that it places on volunteers for program delivery. The role of volunteers in providing direct services to help citizens lower their blood pressure and lose weight is highlighted to demonstrate the feasibility and ...
There is currently considerable interest in identifying and quantifying the effects of welding procedure parameters and steel composition factors on the risk of cracking in pipeline girth welds that may be experienced during winter construction. Although low ambient temperatures, that may be experienced during winter construction, are generally assumed to increase the risk of cracking there has been little work to quantify the effects and to suggest how welding procedures should be modified for winter conditions. The present work was undertaken to calculate the effects of changes in welding parameters on the thermal cycle and the diffusion of hydrogen for a typical pipeline girth weld. A simple analytical method and the finite element method (FEM) were used. Both methods gave similar results but the simple method was very sensitive to the value of heat transfer coefficient. The results showed that the relation between the ...
Intracranial atherosclerosis is a major cause of ischemic stroke, and depending on the studied population, it accounts for 8%-15% of all strokes that are due to cerebral atherosclerosis. The prognosis of patients with symptomatic intracranial stenoses seems to depend on the location and extent of intracranial atherosclerosis. Currently, the primary treatment in intracranial atherosclerosis is the control of vascular riskfactors such as hypertension, diabetes, hypercholesterolemia, and smoking. Secondary prevention with antiplatelet therapy has been shown to reduce the risk of subsequent vascular events in patients who have suffered a recent ischemic stroke or transient ischemic attack (TIA). Unfortunately, a significant number of patients with intracranial atherosclerosis continue to suffer from repeated strokes or TIA despite maximal medical treatment. Although endovascular revascularization for symptomatic intracranial ...
As part of their corporate policy on environmental protection, Chevron, has taken an approach to work collaboratively with other industry members, universities and government agencies in phytoremediation research. The petroleum industry is interested in the integration of phytoremediation with the many biotechnology treatment technologies currently being used by the industry. Phytoremediation is a complex technology that does not just transfer wastes to another site, but offers in-situ final use and disposal treatment at sites anywhere in the world. Sites for potential remediation range from abandoned large refineries, chemical plants, or small urban gas stations. Research has focused on the cleanup of metals and hydrocarbons in diverse types of soil, water and groundwater conditions. This includes research into remediation of petroleum contaminants such as total petroleum hydrocarbon (TPH), polynuclear aromatic hydrocarbons as well as benzene in soil and the mechanism that occurs in ...
During the Vietnam War, US military working dogs served with their companion dog handlers in close proximity, sharing common exposures to war-related activity, many zoonotic infectious agents, chemical pesticides, phenoxy herbicides, and extensive use of therapeutic drugs. To gain insight into the effects of the Vietnam experience, we investigated the occurrence of neoplasms in military working dogs based on standard necropsy examination by the Armed Forces Institute of Pathology. We observed that these dogs experienced significant elevated risks for testicular seminoma and, independently, testicular dysfunction. Experimental evidence shows testicular dysfunction and impaired spermatogenesis in laboratory animals exposed to phenoxy herbicides, dioxin, or tetracycline, and antibiotic used extensively in military working dogs in Vietnam. Because an unexplained significant decrease in sperm quality in Vietnam veterans has been observed by the Centers for Disease ...
The present work was carried out to illuminate the relation between high cholesterol diet and incidence of prostate caner. Also, in this study, the effect of DHEA, selenium or oxygen therapy were tested in order to show to what extent they are valid to ameliorate the deleterious effects of prostate cancer. The obtained results revealed that prostate cancer caused a significant (p<0.01) elevation of TAP, PAP, PSA, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol and prostate COX-2, whereas, testosterone, free testosterone, DHEA-S, FT_4 and FT_3 were decreased significantly as compared with the corresponding levels in control rats in both normal and high cholesterol diet. Supplementation of DHEA, selenium or oxygen therapy ameliorated all variables recorded herein but, their values did not revert to normal. Any how, the results of this investigation showed that the above mentioned antioxidants possess potential benefits in lessening number of ...
In order to develop competitive and reliable nuclear power generation systems, development of innovative structural design methods is indispensable and risk-based design approach based on the assessment of failure probability is being developed. Fatigue is commonly considered as an important contributor to failure probability in many components of reactor systems and its assessment gives a large influence on total reliability of the plants. In order to assess its effect on the reliability, propagation of cracks needs to be evaluated as well as their initiation and pre-existence probability. As a part of new design approach, efforts are being taken to develop a simplified estimation method for fatigue crack growth under cyclic application of thermal and thermo-mechanical loading. A simplified estimation method of J-integral based on reference stress method and elastic follow-up factor was developed based on many finite element analyses and ...
German translation of the publication 'The evaluation of risks from radiation' published in 1965 by the International Commission on Radiological Protection. In a survey, genetic and somatic risks from radiation are presented and explained. (HP).
ObjectiveTo develop a simple summary risk score for the prediction of Alzheimer disease in elderly persons based on their vascular risk profiles.DesignFull Text Available
Population residing in the northern part of the Chelyabinsk oblast and the south eastern part of the Sverdlovsk oblast of Russia affected to accidental exposure since 1957. The territory (East Ural Radioactive Trace - EURT) was contaminated after explosion of container with highly radioactive wastes at the Mayak Production Association. Studies of health effects of exposure in the southern, head part of EURT are conducted in the Ural Research and Practical Center of Radiation Medicine (U.R.P.R.M.). In the 1990's U.R.P.C.R.M. formed a cohort of EURT within Chelyabinsk oblast (14,500 cases and 19,400 external controls). The cohort was followed in 1957-1987 and the results of the study are discussed by Crestinina et al. First results of study on exposure late health effects among rural population in the northern part of the EURT are presented in this paper. Firstly, or the period 1958-2000 a statistically significant increase in cancer mortality associated with accidental exposure ...
Many foods have been implicated in theories about the etiology of inflammatory bowel disease. While evidence has accumulated that nutritional factors as part of overall lifestyle changes may play a role in the growing incidence, no specific dietary recommendations except the promotion of breastfeeding can currently be given to decrease the risk of developing Crohn's disease or ulcerative colitis. For the treatment of Crohn's disease in children and adolescents, however, enteral feeding with a semi-elemental diet seems to be as effective as corticosteroids in inducing and maintaining remission. In the meta-analyses, advantages of one formula over the other are evened out, and more research is warranted into the anti-inflammatory properties of different nutrients, such as polyunsaturated fat...
The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health riskfactors were poorer and medical consultation rates were higher than Australian population expectatio...
Tumour necrosis factor-alpha (TNF-?) antagonist drugs have been associated with increased risk of tuberculosis (TB). Tuberculin skin test (TST) is the most frequently used tool for identification of latent TB infection. We herein aimed to analyse the effect of TNF-? antagonists on the TST responses in a prospective study. The study group consisted of 182 patients (99 female, 83 male) who received TNF-? antagonists for various rheumatic disorders. All patients were evaluated with TST along with other parameters on the day of referral and on the 12th month visit. For those patients with a response of <5?mm induration at the initial evaluation, the TST was repeated to observe the booster effect. Out of 182 patients, 87 patients (48%) had a negative (0?4?mm) and 95 (52%) had a positive (?5?mm)...
PurposeThis study evaluates changes in recall of combat exposures over the first year after return from deployment. The research purpose is to assess whether recall of combat exposures is consistent at different time points; if not, what demographic and/or PTSD symptom riskfactors exist for any directional instability. MethodsSurveys completed by soldiers at 3, 6, and 12 months post-Operation Iraqi Freedom (OIF) deployment were linked for longitudinal analysis in a previous study in which three matched datasets were created: 3-6 months (N = 768), 6-12 months (N = 341), and 3-12 months (N = 445). Post-traumatic stress disorder (PTSD) was assessed by using the National Center for PTSD Checklist. The reliability of recall for 36 combat exposures was quantified. The effects of demographics an...
Summary Objective- Gamma-glutamyltransferase (GGT) has been reported to be useful in predicting cardiovascular disease. Arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) is not only a marker of vascular damage but a significant predictor of cardiovascular events. Gender difference has been reported in the association between GGT and baPWV. We assessed, therefore, the association between GGT and baPWV in a large population and determined whether there was gender difference. Design- This cross-sectional study was conducted at the Asan Medical Centre, Seoul, Republic of Korea. Subjects and measurements- Serum GGT, baPWV and conventional riskfactors were measured in 10 988 apparently healthy subjects (7248 men, 3740 women) who participated in a routine health screening...
Abstract Lyme disease is a perfect model of the complex relationship between host, vector, and the vector-borne bacteria. Both dogs and horses in Romania are exposed to infection. The aim of the present study was to assess the seroreactivity against Borrelia burgdorferi sensu lato in dogs and horses from different regions of Romania. 276 samples from dogs and 260 samples from horses located in different regions of Romania were analyzed by ELISA and IFA, respectively. The effect of several factors potentially affecting seroreactivity (location, age, gender, occupation, and vector exposition risk) was evaluated using Fisher's exact test (R 2.12.0). The overall prevalence of anti-Borrelia antibodies was 6.52% (18/276) in dogs, with a significantly higher positivity (46.15%, 6/13, p=0.0005) re...
A few studies have found poor semen quality in sons whose mothers have received fertility treatment, but it is unknown whether the poor semen quality is related to the infertility treatment or to infertility per se, for example, whether it is caused by hereditable factors. Using data from a population-based, Danish follow-up study conducted in 2005-2006, the authors of the present study examined whether sons of subfertile couples who had not received fertility treatment had poorer semen quality than sons of fertile couples. Among the 311 participants, an inverse association between parental waiting time to pregnancy and both semen volume and total sperm count was observed (p trend = 0.04 and p trend = 0.046, respectively). Semen volume in sons of subfertile parents (pregnant after ?1 ye...
Hypertension is one of the most important modifiable riskfactors for cardiovascular and cerebrovascular diseases. We investigated the potential antihypertensive effect of the purple passion fruit peel (PFP) extract, a mixture of bioflavonoids, phenolic acids, and anthocyanins, in spontaneously hypertensive rats and human. A high-performance liquid chromatography analysis was performed to identify the active ingredients of the PFP extract. In a rat liver toxicity assay, no hepatotoxicity was observed after 9 hours incubation in the presence of PFP extract (20 ?g/mL). The PFP extract also revealed hepatoprotection against chloroform (1 mmol/L)-induced liver injury. In the experimental model, 24 spontaneously hypertensive rats were divided into 3 treatment groups for a period of 8weeks: cont...
The distribution of Lipiodol in the liver and lungs following arterial or portal injection was studied in normal (n=55) and cirrhotic rats (n=20). Using magnified xeroradiography and radioisotope labeled tracers, it was found that Lipiodol was deposited mainly in the liver and lung after either arterial or portal administration. In control rats after arterial injection, deposits in the lung peaked after 2 hours and gradually declined over 48 hours; whereas after portal injection, the deposit steadily increased for 48 hours. Twenty-five percent of cirrhotic rats demonstrated a Lipiodol-induced miliary pattern in the lung. An increased number of portosystemic shunts in cirrhotic rats was also noted. These results suggest that cirrhosis of the liver may be a potential riskfactor for developing pulmonary complications after Lipiodol administration. (orig.).
Objective:- To review the rate of inadvertent cystotomy during laparoscopic hysterectomy performed by the Sydney West Advanced Pelvic Surgery Unit (SWAPS). To compare this rate with other published data. To identify the riskfactors for bladder injury at laparoscopic hysterectomy and to review the management and outcome following such injury. Method:- This was a retrospective observational study. All hysterectomies where the SWAPS clinical fellow was involved were included. The study period was from January 2001 to June 2009. Simple statistical formulae were used to analyse data in this study. Results:- There were 1223 hysterectomies performed during this period. Eighty-one percent of these were performed laparoscopically. There were 14 (1.1%) bladder injuries reported during this period. ...
The aim of this article is to report our experience in the diagnosis of two cases of iliac artery endofibrosis or arteriopathy, a rare entity occurring in high-performance athletes, presenting with intermittent claudication (right-sided in both) after maximal exercise. External iliac artery endofibrosis or arteriopathy is a likely diagnosis in competitive athletes free of cardiovascular riskfactors who present with leg claudication. Arteriography and a papaverine-assisted mean pressure gradient across the iliac arteries of more than 10 mmHg is a useful diagnostic approach. Moreover, balloon angioplasty of the iliac artery in that patient, in whom a pressure gradient was detected, resulted in symptomatic relief for 2 months followed by mild symptom recurrence. Thus, although balloon angioplasty is feasible and safe, it might not be adequate to treat this entity and, thus, its value remains undefined.
Ecosystems worldwide are experiencing unprecedented nitrogen enrichment through fertilization and pollution. While longterm ecological consequences are difficult to predict, it seems that plants and animals adapted to nitrogen-limited environments are at particular risk from these changes. This report summarizes the limited body of literature which addresses this important topic. From a herbivoreAes perspective, fertilization increases the nutritional quality of host plant tissues. In some cases fertilization has lead to decreased production of defensive compounds. How this affects populations of insects is unclear because fertilization affects not only herbivores but their natural enemies. This report outlines how fertilization affects tree processes such as growth, photosynthesis, and production of defensive compounds. The many factors that affect insect repsonse to fertilization and the difficulties in assessing how fertilization affects ...
Exposure to urban air pollution is an independent riskfactor for increased cardiovascular diseases. Heat shock protein 70 (HSP70) has been implicated in the pathogenesis of vascular dysfunction and cardiovascular diseases. This study has been designed to determine whether inhalation of urban air induces HSP70 expression in the lung and blood as well as the association of HSP70 and air pollution-induced vascular dysfunction. Apolipoprotein E (Apo-E) deficient mice were exposed to diesel exhaust (DE) either acutely (3 days, 200 or 400 g/m3 for 6 h/day) or chronically (7 weeks, 200 or 400 g/m3 for 6 h/day). HSP70 was measured in the lung using immunohistochemistry, and in the plasma by ELISA. Abdominal aorta rings were used to determine vascular functional responses. Chronic DE-exposure incr...
Purpose: The DBA/2J mice have been used as an animal model for human pigmentary glaucoma. However, these mice develop various degrees of disease symptoms at different ages, making it difficult to detect pathological changes of retinal degeneration at glaucoma onset. The purpose of this study is to develop a non-invasive assay to identify individual mice that develop visual deficits. Materials and Methods: We apply two behavioral tests, a swimming test of visual discrimination and a test of optomotor response, to identify glaucomatous DBA/2J mice. We then examine whether the elevation of intraocular pressure (IOP), the common riskfactor for glaucoma, affects visual performances of the DBA/2J mice. We further compare the retinal ganglion cell death, one of the signature glaucoma symptoms, i...
Colorectal cancer (CRC) is the most common cause of cancer death among Canadian non-smokers. Each year about 21,500 Canadians are diagnosed with CRC. Ninety percent of cases occur in people aged 50 years or older. An estimated 4,800 Canadian men and 4,100 Canadian women die each year from the disease. About 75% of all new CRC cases arise in people with no known riskfactors. Computed tomography colonography (CTC), a cross-sectional imaging examination that permits complete structural examination of the colon, shows promise as a tool for CRC screening. This article reviews the rationale for CRC screening, currently recommended Canadian and American screening guidelines and screening tools, and current evidence supporting CTC as a CRC screening tool and its advantages over conventional screening methods. (author)
Colorectal cancer (CRC) is the most common cause of cancer death among Canadian non-smokers. Each year about 21,500 Canadians are diagnosed with CRC. Ninety percent of cases occur in people aged 50 years or older. An estimated 4,800 Canadian men and 4,100 Canadian women die each year from the disease. About 75% of all new CRC cases arise in people with no known riskfactors. Computed tomography colonography (CTC), a cross-sectional imaging examination that permits complete structural examination of the colon, shows promise as a tool for CRC screening. This article reviews the rationale for CRC screening, currently recommended Canadian and American screening guidelines and screening tools, and current evidence supporting CTC as a CRC screening tool and its advantages over conventional screening methods. (author)
Abstract Purpose: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. Patients and Methods: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. Results: Patient demograp...
Background. The `RISchio CArdiovascolare nei pazienti afferenti all' Area Vasta In Dialisi (RISCAVID) study is an observational and prospective trial including the whole chronic haemodialysis (HD) population in the northwest part of Tuscany (1.235 million people). The aim of the study was to elucidate the relevance of traditional and non-traditional riskfactors of mortality and morbidity in HD patients as well as the impact of different HD modalities.Methods. A total of 757 HD patients (mean age 66 +- 14 years, mean dialytic age 70 +- 76 months, diabetes 19%) were prospectively followed up for 30 months and all-cause mortality, cardiovascular (CV) mortality and non-fatal CV events (acute myocardial infarction and stroke) were registered. At the time of the enrolment, demographic, clinical...
All patients with von Willebrand?s disease (vWD) who showed an arterial or venous thrombosis and were reported in the literature have been evaluated. 11 patients had arterial thrombosis while 19 had venous thrombosis for a total of 30 cases. 9 out the 11 cases with arterial thrombosis had myocardial infarction. Two had cerebral thrombosis. Associated riskfactors for arterial thrombosis were available only for three patients who showed, respectively, smoking and dyslipidemia (2 cases) and smoking and intravenous desmopressin infusion (1 case). The majority of patients with venous thrombosis showed DVT with or without PE. Four patients presented with apparently isolated PE. In two instances thrombosis occurred in unusual sites (central retinal vein and portal vein, respectively). Several as...
There is increasing evidence that adolescence, like early life, is a sensitive period in which ongoing brain development can be influenced by environmental factors. This review describes our use of social instability as a model of mild adolescent social stress, its effects on social interactions and on hypothalamic?pituitary?adrenal function over the course of the procedure and in response to new stressors. The effects of social instability are sex-specific, with qualitative differences between the sexes on HPA function over the course of the stressor procedure, and with greater effects in males on behaviour observed during the social instability and greater effects in females on behavioural responses to drugs of abuse into adulthood, long after the stress exposure. The results from invest...
Hepatocellular carcinoma (HCC) represents a major health problem as it afflicts an increasing number of patients worldwide. Albeit most of the riskfactors for HCC are known, this is a deadly syndrome with a life expectancy at the time of diagnosis of less than 1?year. Definition of the molecular principles governing the neoplastic transformation of the liver is an urgent need to facilitate the clinical management of patients, based on innovative methods to detect the disease in its early stages and on more efficient therapies. In the present study, we have combined the analysis of a murine model and human samples of HCC to identify genes differentially expressed early in the process of hepatocarcinogenesis, using a microarray-based approach. Expression of 190 genes was impaired in murine ...
The achievements made in the field of radiation protection over the past 20 years are outlined. Risk analysis as applied to medicine is considered and genetic significant doses, genetic risks, somatic effective doses and somatic risks are discussed. (C.F.).
A computer program, RISK-XLR, which calculates genetic risk for carrier status of a Mendelian X-linked recessive condition has been written for the Macintosh series of microcomputers. The program,...Full Text Available
BackgroundAtrial fibrillation (AF) substantially increases the risk of ischemic stroke but this risk varies among individual patients with AF. Existing risk stratification...Full Text Available
The main objective of this paper is to demonstrate that it makes good business sense to identify risks and hazards of an operation and take appropriate steps to manage them effectively. Developing and implementing an effective risk and hazard management plan also contibutes to other industry requirements and standards. Development of a risk management system, key elements of a risk management plan, and hazards and risk analysis methods are outlined. Comparing potential risk to the cost of prevention is also discussed. It is estimated that the cost of developing and preparing the first risk management plan varies between $50,000 to $200,000. 3 refs., 2 figs., 1 tab.
Knee osteoarthritis (OA) is a common degenerative joint disorder and a major cause of pain and disability. The hypothesis tested in this study was that the passion fruit peel extract (PFP), a flavonoid-rich dietary supplement, would reduce symptoms due to knee OA. Thirty-three OA patients were enrolled in a randomized, double-blind, placebo-controlled trial with parallel-group design. Patients received either placebo or PFP pills (150 mg, daily) in a double-blinded fashion for 2 months. The OA clinical symptoms were evaluated monthly with Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. In the PFP group, there was a significant improvement in total WOMAC score and WOMAC subscale score of physical function after 30 days and pain after 60 days. At 60 days, reductions o...
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-#alpha# antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-#alpha# antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
The genetically significant dose (GSD) is an index variable which exclusively allows to describe the genetic risk in the progeny of a population due to the application of ionizing radiation and radioactive substances in one part of this population. It may result in wrong interpretation of population exposure at increasing incidence of examinations in a population involving ionizing radiation and radioactive drugs at simultaneously increasing application of alternative methods in children and adolescents owing to the fact that it indicates a downward trend although somatic exposure of this population has increased. Therefore, it is recommended to state both the GSD and the level of somatic radiation exposure of the population taken from the individual sources for the comparison and assessment of radiation exposure from various sources in future. Although the somatically significant dose constitutes the suitable variable complementary to GSD in thus context, it is ...
Radiation necrosis of normal CNS tissue represents one of the main riskfactors of brain irradiation, occurring more frequently and earlier at higher total doses and higher doses per fraction. At present, it is believed that the necrosis results due to increasing capillary permeability caused by cytokine release leading to extracellular edema. This process is sustained by endothelial dysfunction, tissue hypoxia, and subsequent necrosis. Consequently, blocking the vascular endothelial growth factor (VEGF) at an early stage could be an option to reduce the development of radiation necrosis by decreasing the vascular permeability. This might help to reverse the pathological mechanisms, improve the symptoms and prevent further progression. A patient with radiation-induced necrosis was treated with an anti-VEGF antibody (bevacizumab), in whom neurologic signs and symptoms improved in accordance with a decrease in T1-weighted ...
Osteoporotic vertebral fractures often lead to pain and disability. They can be successfully treated, and possibly prevented, by injecting cement into the vertebral body, a procedure known as vertebroplasty....Full Text Available
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular...Full Text Available
Frozen shoulder (adhesive capsulitis) is a common, painful and disabling condition which is typically slow to resolve. Patients with this condition will be seen in every musculoskeletal practitioner’s...Full Text Available
In recent years RNA interference (RNAi) has rapidly become the most widely used tool for gene knockdown due to its high specificity and potency. RNAi is an evolutionarily conserved mechanism...Full Text Available
According to the International Headache Society, idiopathic stabbing headache (ISH), an indomethacin-responsive headache syndrome, is a paroxysmal disorder of short duration manifested as head pain...Full Text Available
Cryoanalgesia (the use of cold to provide anesthesia or analgesia) is the oldest anesthetic and analgesic still in current clinical use. Its intraoperative use in providing postoperative analgesia for...Full Text Available
We describe a case of sacral perineural cyst presenting with complaints of low back pain with neurological claudication. The patient was treated by laminectomy and excision of the cyst. Tarlov cysts...Full Text Available
When attempting to feed on their hosts, ticks face the problem of host hemostasis (the vertebrate mechanisms that prevent blood loss), inflammation (that can produce itching or pain and thus...Full Text Available
BackgroundAdhesive capsulitis is a common, painful, and disabling condition that has been managed with corticosteroid injections for over 50 years. There is debate over the use of...Full Text Available
BackgroundDistraction osteogenesis is the standard treatment for the management of lower limb length discrepancy of more than 3 cm and bone loss secondary to congenital anomalies,...Full Text Available
ObjectivesThe updated Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs) include new FGID categories and changes to the Rome II criteria...Full Text Available
This paper discusses the clinical application and main objective of testicular imaging. The authors present cases that represent a spectrum of the abnormalities which might be detected by testicular imaging, with special attention given to testicular torsion and the acute diseases which may mimic it clinically. Accuracy of the test is noted.
... Previous Topic Pain Next Topic Scars and wounds Prostheses Prostheses (pross-THEE-sees) are man-made substitutes ... covered by medical insurance (this includes wigs). Breast prostheses: Contact your local chapter of the American Cancer ...
Indomethacin, a potent nonsteroidal anti-inflammatory drug, has been used in the treatment of various kinds of pains, inflammation and arthritis. However, oral administration of indomethacin produces...Full Text Available
Osteoid osteoma of the spine is a relatively rare bone-forming tumor. Pain that is worse at night and relieved by aspirin and muscle contracture are the most characteristic symptoms of spinal osteoid...Full Text Available
Antagonists for kainate receptors (KARs), a family of glutamate-gated ion channels, are efficacious in a number of animal models of neuropathologies, including epilepsy, migraine pain, and anxiety....Full Text Available
The inflammatory process has direct effects on normal and abnormal wound healing. Hypertrophic scar formation is an aberrant form of wound healing and is an indication of an exaggerated function of...Full Text Available
A 63-year-old man was admitted to our hospital with a complaint of right lateroabdominal pain. He was diagnosed with metastatic colon cancer, and then developed multiple brain embolic infarctions 7...Full Text Available
Posterior spinal ligament pathology is becoming increasingly recognized as a significant cause of low back pain. Despite the growing clinical importance of interspinous ligament degeneration in low...Full Text Available
Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging...Full Text Available
BackgroundThe analgesic effect of perioperative low doses intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether...Full Text Available
The somatic sensory system responds to stimuli of distinct modalities, including touch, pain, itch, and temperature sensitivity. In the past century, great progress has been made in understanding the...Full Text Available
BackgroundWe have recently reported successful treatment of patients with chronic pain syndromes using human pooled intravenous immunoglobulin (IVIG) in a prospective, open-label...Full Text Available
Local anesthetics are able to induce pain relief by binding to the sodium channels of excitable membranes, blocking the influx of sodium ions and the propagation of the nervous impulse. Ropivacaine...Full Text Available
The indications, contra-indications and technique of caudal epidural injections in the treatment of low back pain and sciatica are described. Of 201 patients treated by epidural injection, about 56%...Full Text Available
The first case of human sparganosis in Canada is reported in a 23-year-old woman who emigrated from Greece in 1969. Examination of a ribbon-like worm removed from a painful swelling in the neighbourhood...Full Text Available
The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) were followed for up to 2.5 years for the development of PFPS. Physicians and certified athletic trainers documented the cases of PFPS. PFPS was defined as retropatellar pain during at least two of the following activities: ascending/descending stairs, hopping/jogging, prolonged sitting, kneeling, and squatting, negative findings on examination of knee ligament, menisci, bursa, and synovial plica, and pain on palpation of either the patellar facets or femoral condyles. Poisson and logistic regressions were performed to determine the association between gender and the incidence and prevalence of PFPS, respectively. The incidence rate for PFPS was 22/1000 person-years. Females ...
Background & objectives:Acanthamoeba keratitis (AK) is a painful and vision-threatening ocular infection. The differentiation of Acanthamoeba...Full Text Available
BackgroundLeukotrienes (LTs) belong to the large family of lipid mediators implicated in various inflammatory conditions such as asthma and rheumatoid arthritis. Four distinct types...Full Text Available
This case describes a 10-year-old girl who developed a Ewing's sarcoma in her proximal fibula. The radiologic features mimicked those of a unicameral bone cyst. The presence of pain and the atypical location led to a prompt biopsy and the correct diagnosis. The mechanism of this unusual radiographic presentation is discussed. (orig.)
Examination of a painful hip is fairly concise and reliable at detecting the presence of a hip joint problem. Hip joint disorders often go undetected, leading to the development of secondary disorders....Full Text Available
Low back pain is common during pregnancy. However, the prevalence of symtomatic lumbar disc herniation is rare, and cauda equina syndrome due to disc herniation during pregnancy is even rarer. We report...Full Text Available
BackgroundChronic rotator cuff pathology (CRCP) is a common shoulder condition causing pain and disability. Physiotherapy is often the first line of management for CRCP yet there...Full Text Available
Multiple disease-specific systematic reviews on the effectiveness of physical therapy intervention for shoulder dysfunction have been inconclusive. To date, there have been two systematic reviews that...Full Text Available
IntroductionChest pain with ST-segment elevation is a rare clinical problem during dobutamine stress testing. Although beta-agonists treatment prior to dobutamine stress testing...Full Text Available
Biliary obstructions are rarely caused by a foreign body and have received sparse attention. We present an unusual case with pruritis and abdominal pain caused by impacted full length surgical gauze...Full Text Available
A 23-year-old woman presented to our hospital with nonspecific pain in the abdomen. She underwent radiological investigations, which revealed a solid and cystic mass in the tail end of the pancreas....Full Text Available
BackgroundBlood sampling through heel lancing is the most common invasive painful procedure performed on newborn infants.Case PresentationWe report...Full Text Available
BackgroundAcute low back pain is a very common symptom and reason for many medical consultations. In some unusual circumstances it could be linked to a rare aetiology.Case...Full Text Available
Seventy seven patients with soft tissue shoulder lesions including adhesive capsulitis and disorders of the rotator cuff and acromioclavicular joint were admitted to a trial comparing two different...Full Text Available
The overarching goal of medical training is to nurture the growth of knowledgeable, caring and insightful clinicians guided by the ideals of medical professionalism. Recent definitions of professional...Full Text Available
Snapping or grating scapula is a condition of the shoulder girdle in which the patient complains of pain and an audible snapping sound which may be associated with pain. We evaluated the diagnostic value of the computed tomography (CT) scans using the clinical diagnosis of a grating scapula as the gold standard. This retrospective study reports the sensitivity, specificity, likelihood ratio and receiver operator characteristic curve for the CT scans and the k value as a measure of the interobserver agreement. None of the parameters validated the examination. We therefore concluded that CT scans are inappropriate for differentiation between a grating scapula and a normally functioning shoulder except in cases where bony abnormalities are present. (orig.)
Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given the increased number of epidural nerve blocks being performed, some have reported unexplained complications of a transient or permanent nature and with varying degrees of severity. However, no case has been reported of a broken epidural needle tip retained in the lumbar facet joint area. This represents the first reported case presentation of foraminal stenosis developing in a patient after a retained epidural needle tip. PMID:21286465
According to the California Earthquake Authority, only about 12% of current California residences are covered by any form of earthquake insurance, down from about 30% in 1996 following the 1994, M6.7 Northridge earthquake. Part of the reason for this decreasing rate of insurance uptake is the high deductible, either 10% or 15% of the value of the structure, and the relatively high cost of the premiums, as much as thousands of dollars per year. The earthquake insurance industry is composed of the CEA, a public-private partnership; modeling companies that produce damage and loss models similar to the FEMA HAZUS model; and financial companies such as the insurance, reinsurance, and investment banking companies in New York, London, the Cayman Islands, Zurich, Dubai, Singapore, and elsewhere. In setting earthquake insurance rates, financial companies rely on models like HAZUS, that calculate on risk and exposure. In California, the process begins with an official ...
Operations at the Savannah River Site (SRS) result in releases of small amounts of radioactive materials to the atmosphere and to the Savannah River. For regulatory compliance purposes, potential offsite radiological doses are estimated annually using computer models that follow U.S. Nuclear Regulatory Commission (NRC) Regulatory Guides. Within the regulatory guides, default values are provided for many of the dose model parameters but the use of site-specific values by the applicant is encouraged. A detailed survey of land and water use parameters was conducted in 1991 and is being updated here. These parameters include local characteristics of meat, milk and vegetable production; river recreational activities; and meat, milk and vegetable consumption rates as well as other human usage parameters required in the SRS dosimetry models. In addition, the preferred elemental bioaccumulation factors and transfer factors to be used in human health ...
The Risk Evaluation System (RES) is an integrated approach to determining safeguards and security effectiveness and risk. RES combines the planning and technical analysis into a format that promotes an orderly development of protection strategies, planning assumptions, facility targets, vulnerability and risk determination, enhancement planning, and implementation. In addition, the RES computer database program enhances the capability of the analyst to perform a risk evaluation of the facility. The computer database is menu driven using data input screens and contains an algorithm for determining the probability of adversary defeat and risk. Also, base case and adjusted risk data records can be maintained and accessed easily.
Rectus sheath hematomas are a frequent but sometimes misdiagnosed disease in patients under anticoagulative drugs, hemodialysis, or simply in the elderly. The most frequent localization is in the lower part of the abdomen: the explanation lies in the anatomy of the abdominal wall, especially in the arcuate line of the rectus sheath. Aim of this work is to explain the reason of the almost constant location correlating the anatomy with the CT features. The rectus abdominis muscle lies between the aponeuroses of the transverse and oblique muscles which form the so called rectus sheath. This arrangement is found from the costal arch to a level approximately between the umbilicus and the pubic symphisis, where the rear layer of the rectus sheath ends with a curved edge, called the arcuate or semicircular line of Douglas. Beneath this line the aponeuroses of the three muscles pass in front of the rectus which is separated from the peritoneum only by the fascia trasversalis, a thin connective ...
The condition of spent nuclear fuel (SNF) in wet storage at ten Soviet-designed research reactors has been assessed in the light of international experience in order to identify any associated safety issues. These reactors use Al-clad UO2-Al or U-Al alloy dispersion fuels of ?20% enrichment that were fabricated in Russia; the reactors have been in operation since 1955-70. Although originally sent for reprocessing, much of the SNF generated over the last 25-30 years has been stored in fuel storage pools (FSPs) of variable water quality. The external condition of wet-stored SNF assemblies from the reactors surveyed varied from significant failure due to galvanic corrosion that was driven by poor water quality, through gradual pitting caused by slightly impure water, to a stable condition of no observable change in the oxidized Al alloy surface of the irradiated fuel. SNF stability in wet storage seems to depend on three factors: Al being the sole metal in the FSP (to ...
The relative risk model (RRM) was applied in regional ecological risk assessments successfully. In this study, the RRM was developed through increasing the data of risk source and introducing the source?stressor?habitat exposure filter (SSH), the endpoint?habitat exposure filter (EH) and the stressor?endpoint effect filter (SE) to reflect the meaning of exposure and effect more explicit. Water environment which include water quality, water quantity and aquatic ecosystems was selected as the ecological risk assessment endpoints. The Luanhe River Basin located in the North China was selected as model case. The results showed that there were three low risk regions, one medium risk region and two high risk regions in the Luanhe River Basin. The results also indicated habitat destruction was th...
This report documents the evaluation of risks associated with environmental restoration activities at Brookhaven National Laboratory using two tools supplied by DOE to provide a consistent set of risk estimates across the DOE complex: Risk Data Sheets (RDS) and Relative Risk Ranking. The tools are described, the process taken characterized, results provided and discussed. The two approaches are compared and recommendations provided for continuing improvement of the process.
Based on a literature study an actual summary of the risk-utility problems in X-ray diagnosis is outlined due to the Recommendations of the International Commission for Radiation Protection (ICRP publication 26/1977). Papers demonstrating quantitative assessment of the somatic and genetical risk in X-ray examination are preferably cited and evaluated. It is concluded that the somatic and genetical risk is low in diagnostic ratiology. However, it must not be neglected and has always to be compared to the utility of an examination as well as to other risks of the examination. (author).
Recent studies have shown Y chromosome microdeletions associated with male infertility. The factors responsible for Y chromosome microdeletions in spermatozoa remain unresolved. However, the environmental pollutants are known to damage DNA in differentiating and maturing germ cells in the male reproductive tract. Therefore, the aim of this study was to investigate the effects of seminal hexachlorocyclohexane (HCH) and its isomers, an environmental pollutant, in 50 fertile and 50 infertile males in relation to semen quality and the incidence of Y chromosome microdeletion in azoospermic factor (AZF) region. As compared to control, an increased HCH level and significantly decreased semen quality were observed in the infertile males. A positive significant association was found between sperm count with alpha-HCH and beta-HCH in the infertile males. A negative significant association was observed between sperm counts with gamma-HCH in asthenospermia ...
Gastrointestinal lymphomas are almost exclusively of a non Hodgkin's type. The Western form is characterized by a higher incidence of stomach location (50 %), a MALT type (mucosa associated lymphoid tissue) (40 %), a B-cell type (90 %), and a high grade (55 %). Chronic infection with Helicobacter pylori is an important riskfactor. Mediterranean lymphomas form a particular clinical and pathological entity with diffuse involvement of the small bowel and are frequently being associated with a chronic malabsorption disorder. Eradication of Helicobacter pylori in early lymphomas, and the use of tetracyclines in early Mediterranean lymphomas, have been shown to induce durable remissions. For more advanced gastric lymphomas, treatment usually consists of anthracycline-based chemotherapy followed by involved field radiotherapy. Surgery is usually reserved for complications such as perforation or bleeding, or in some selected cases for salvage after ...
The basic structure of the LANL Environmental Restoration (ER) Site Ranking System and its use are described in this document. A related document, Instructions for Generating Inputs for the LANL ER Site Ranking System, contains detailed descriptions of the methods by which necessary inputs for the system will be generated. LANL has long recognized the need to provide a consistent basis for comparing the risks and other adverse consequences associated with the various waste problems at the Lab. The LANL ER Site Ranking System is being developed to help address this need. The specific purpose of the system is to help improve, defend, and explain prioritization decisions at the Potential Release Site (PRS) and Operable Unit (OU) level. The precise relationship of the Site Ranking System to the planning and overall budget processes is yet to be determined, as the system is still evolving. Generally speaking, the Site Ranking System will be used as a decision aid. That ...
This publication identifies conditions which affect (either increase or decrease) public concern for and political acceptance of the development and implementation of programmes for geological disposal of long lived radioactive waste. It also looks at how interested citizens can be associated in the decision making process in such a way that their input enriches the outcome of a more socially robust and sustainable solution. The publication also considers how to optimize risk management, addressing the needs and expectations of the public and of other relevant stakeholders. Factors of relevance for societal acceptance conditions are identified for the different stages of a repository programme and implementation process, from policy development to the realization of the repository itself. Further, they are described and analysed through case studies from several countries, illustrating the added value of broadening the technical dimension with ...
Metal waste generated from domestic nuclear operation for defense and commercial application has led to a growing stockpile of radioactively contaminated scrap metal, much of which is stainless steel. A significant fraction of this material cannot be efficiently surface decontaminated. The burial of this material would be wasteful and expensive, since long term monitoring would be necessary in order to minimize environmental risk. Much of this waste consists of bulky equipment. In many case, this equipment contains valuable material that may be recycled. The piece of equipment considered frequently also has complex geometries, making extremely difficult, time-consuming and expensive to determine the exact location and level of radioactivity on the internal surfaces. After melting, however, the radioactivity may be precisely determined from samples of each ingot. Moreover, an ingot may be released for restricted or unrestricted reuse, or stored for decay to ...
Childhood cancer survivors often experience complications related to cancer and its treatment that may adversely affect quality of life and increase the risk of premature death. The purpose of this...Full Text Available
Global hypomethylation has been shown to increase genome instability potentially leading to increased cancer risk. We determined whether global methylation in blood leukocyte DNA was associated...Full Text Available
From the beginning, one of the most useful applications of Probabilistic Safety Assessment (PSA) is its use in evaluating the risk importance of changes to plant design, operations, or other plant conditions. Risk importance measures the impact of a change on the risk. Risk is defined as a combination of the likelihood of failure and consequence of the failure. The consequence can be safety system unavailability, core melt frequency, early release, or various other consequence measures. The goal in this PSA application is to evaluate the risk importance of an ISI process, as applied to plant piping systems. Two approaches can be taken in this evaluation: Current PSA Approach or the Blended Approach. Both are discussed here.
The evaluation of biological markers is recognized as necessary to the future of toxicology, epidemiology, and quantitative risk assessment. For biological markers to become widely accepted, their validity...Full Text Available
Bone mineral density is considered to be the standard measure for the diagnosis of osteoporosis and the assessment of fracture risk. The majority of fragility fractures occur in patients with bone mineral...Full Text Available
NASA cost-risk assessment is composed of cost estimating relationship (CER) and technical risk assessment plus cost element correlation assessment; ...
We investigate the intertemporal risk-return trade-off of foreign exchange (FX) rates for ten currencies quoted against the USD. For each currency, we use three risk measures simultaneously that pertain to that currency; its realized volatility, its realized skewness, and its value-at-risk. We apply monthly FX excess returns and risk measures calculated from daily observations. We find that there is a significant contemporaneous risk-return trade-off for the currencies under investigation. There is no evidence of noncontemporaneous risk-return trade-off. We pay special attention to the risk-return trade-off during the recent financial crisis.
Production agriculture is associated with a variety of occupational illnesses and injuries. Agricultural workers are at higher risk of death or disabling injury than most other workers. Traumatic injury...Full Text Available
OBJECTIVEAdolescent offspring of women with a history of gestational diabetes (GD) were evaluated for their cardiometabolic risks at a mean age of 15 years.RESEARCH...Full Text Available
The management of risks of explosives are described. Administrative and procedural controls are considered. The safety management plan involves hazard identification, risk analysis, assessment and control. The current position of explosives safety is considered. 4 tabs.
BackgroundThere is no data documenting the existence of a risk of infection transmission in ambulatory healthcare settings but concern remains. Our objective was to determine the...Full Text Available
Excessive dietary phosphorus may increase cardiovascular risk in healthy individuals as well as in patients with chronic kidney disease, but the mechanisms underlying this risk are not completely understood....Full Text Available
ObjectiveTo determine whether accounting for the time dynamics of diabetes exposure will change the risk estimates for colorectal cancer.Full Text Available
The existence of thresholds for toxicants is a matter of debate in chemical risk assessment and regulation. Current risk assessment methods are based on the assumption that, in the absence of sufficient...Full Text Available
Purpose: To assess the prevalence, significance and practical value of two recently described CT signs of instable aneurysm: the crescent sign and the periluminal halo (a low-attenuating internal layer of the thrombus around the patent lumen). Material and methods: Among the CT examination performed in the last 5 years, they retrospectively selected the nonruptured aneurysms with a diameter exceeding 4 cm (no. = 93 average diameter 5.1 cm, unenhanced images in 28 cases and enhanced in 84) and the ruptured aneurysms (no. = 16, average diameter 6.7 cm, unenhanced images in 9 cases and enhanced in 9). They studied the prevalence of the crescent and halo sing, their relationship with the aneurysm diameter, and the effect of contrast enhancement. Results: The crescent sign was identified with a statistically significant prevalence in ruptured ( 37.5 % or cases) over asymptomatic aneurysms (5.5 %); the halo had the same frequency in the 2 groups (12.5 % and 9.5 %). Both signs were more ...
The relationship between single nucleotide polymorphism (SNP) of interleukin-17 (IL-17A), transforming growth factor @b (TGF-@b), as well as its receptor (TGFR-@b2) and susceptibility to intracerebral hemorrhage in patients with brain arteriovenous malformation (BAVM) was investigated in the present study. A total of 53 patients with BAVM and 120 healthy controls were recruited, all of whom were Han Chinese from South China. There were no statistically significant differences in the IL-17A-197 guanine/adenine (G/A) or TGF-@b1-509 cytosine/thymine (C/T) genotypes or gene frequencies between BAVM patients and controls (p>0.05), but the gene frequency of the TGFR-@b2-875 A/G genotype in patients with BAVM was significantly higher (p<0.05). Furthermore, the frequencies of the G allele of IL-17...
We examined whether or not BMD or bone markers were useful for assessing the risk of vertebral fractures in 248 Japanese men with type 2 diabetes. We analyzed the relationships between bone markers (osteocalcin [OC], bone-specific alkaline phosphatase [BAP], urinary N-terminal cross-linked telopeptide of type-I collagen) or BMD and HbA1c, urinary C-peptide, insulin-like growth factor-I (IGF-I), parathyroid hormone, 1,25(OH)2 vitamin D, and the presence of prevalent vertebral fractures. Multiple regression analysis adjusted for age, body height, weight, duration of diabetes, and serum creatinine showed that serum OC and OC/BAP ratio were correlated negatively with HbA1c (P?P?P?0.05). This association was still significant after additional adjustment for lumbar or femoral neck BMD. Our res...
Canisters with spent nuclear fuel can obviously not be located within deformation zones as this might jeopardise their long term mechanical stability and thereby constitute a potential hazard to the biosphere. Less apparent, but equally important, is the fact that earthquakes trigger reactivation, slip, of structures some distance from their hypocentres due to, among many other factors, stress redistribution. Fault slip across a deposition hole might damage the isolation capacity of the canister and thereby jeopardise the overall integrity of the barrier system. Therefore, the following question might be posed: What is the distance from a deformation zone beyond which a canister can be safely emplaced? This respect distance cannot be readily computed because, unknown future events aside, there are some complicated aspects that need to be addressed e.g. degree of conservatism, scale, our ability to model ice sheets and earthquakes, etc. In this report we discuss ...
The Oak Ridge National Laboratory (ORNL) is developing a treatment process for remote-handled (RH) liquid transuranic mixed waste governed by the concept of minimizing the volume of waste requiring disposal. This task is to be accomplished by decontaminating the bulk components so the process effluent can be disposed with less risk and expense. Practical processes have been demonstrated on the laboratory scale for removing cesium 137 and strontium 90 isotopes from the waste, generating a concentrated waste volume, and rendering the bulk of the waste nearly radiation free for downstream processing. The process is projected to give decontamination factors of 10{sup 4} for cesium and 10{sup 3} for strontium. Because of the extent of decontamination, downstream processing will be contact handled. The transuranic, radioactive fraction of the mixed waste stream will be solidified using a thin-film evaporator and/or microwave solidification system. ...
The reliability of the surface condenser is a key factor in plant performance level and maintenance cost optimization. This is especially the case for thermal nuclear plants where condenser raw wa-ter ingress can introduce contamination into the chemically-controlled, steam/water loop potentially causing damage to sensitive equipment. Two important parameters must be taken into account when attempting to optimize the quality and the reliability of condenser tubing. They include selecting the appropriate material according to the cooling water corrosion level present. A second and equally important parameter is the manufac-turing of the tubing product itself. This paper will identify methods to optimize manufacturing processes and improve tubing quality, according to VALTIMET's 30 years of condenser welded tubing production experience. Those methods complete the core manufacturing process (forming and welding), through improvement of the metallurgical ...
Central Nervous System (CNS) involvement, whether primary by the Human Immunodeficiency Virus - HIV - itself, or secondary (toxoplasmosis or lymphoma) is remarkably frequent in AIDS, in 40 to 70% of cases, depending upon the author. In order to study the natural history of this illness, a cohort of 25 asymptomatic seropositive patients have been established. Every 6 months these patients undergo biological and clinical examinations, as well as Magnetic Resonance brain scans. After two examinations at a 6 month's interval, the first results are reported. Out of these 25 cases, 9 present anomalies: One patient with diffuse cerebral atrophy and 8 others with high signal intensity areas on T2 weighted sequences, like those of the Multiple Sclerosis. No relationship could be demonstrated between the existence of these lesions and various criteria such as age, sex, riskfactors and T4 cells count. The nature of these lesions is not lear. They ...
This study was performed to assess the possibility that patient age may independently affect improvements in health-related quality of life following percutaneous coronary intervention. One hundred five patients undergoing elective percutaneous coronary intervention at a single tertiary referral center between January 10, 2001 and January 6, 2002 were enrolled and prospectively evaluated. Health-related quality of life was assessed before and 1 year following percutaneous coronary intervention using Short Form-12 and the Seattle Angina Questionnaire. For the purpose of analysis, patients were divided according to age (younger than 60, 60-70, and older than 70 years). One hundred patients (95%) completed both questionnaires. Baseline characteristics among the age groups were similar in terms of gender, cardiac riskfactors, and procedural details. All health-related quality-of-life indices demonstrated improvements with at least four variables ...
The current situation in the development of nuclear power in the world and in Czechoslovakia is briefly outlined and the possibilities are discussed of alternative energy resources. The environmental impact is described of conventional power plants firing coal; sulphur and nitrogen oxides are mentioned and their environmental impacts shown. Their quantities and the quantities of other gaseous, liquid and soid wastes produced by coal power plants are given. Annual estimates are presented of radioactive material emissions; trace amount emissions of toxic metals and their ecological risks are shown. Concern over the increasing concentration of CO_2 in the atmosphere is voiced. For nuclear power plants, the amount of radionuclides in stack emission and of those released into water flows is tabulated. Their effect on the aqueous ecosystem is characterized as is thermal pollution of water flows and the environmental impact of cooling towers. Other ...
While there have been many experimental and calculational investigations on absorbed dose distribution in the patient resulting from conventional X-ray procedures, such data for computerized tomography (CT) are still sparse. As this diagnostic procedure has shown a rapid increase in application during recent years, we have determined absorbed dose to body organs in a human phantom resulting from CT examinations. The exposure model consists of the heterogeneous MIRD-5 phantom and a suitable Monte-Carlo method to calculate absorbed dose to organs of interest. The exposure conditions are specified according to the exposure specifications of a CT-scanner currently in use. The calculations cover the range of body tissues of interest in terms of organ absorbed doses as well as a risk weighted absorbed dose. A detailed example showing the calculation of red bone marrow dose is given and a somatic effective dose equivalent Hsub(ES) is calculated for different conventional ...
Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders in children. Symptoms of ADHD include hyperactivity, low frustration tolerance, impulsivity, and inattention. While the biological pathways leading to ADHD are not clearly delineated, a number of genetic and environmental riskfactors for the disorder are recognized. In the early 1970s, research conducted by Dr. Benjamin Feingold found that when hyperactive children were given a diet free of artificial food additives and dyes, symptoms of hyperactivity were reduced. While some clinical studies supported these findings, more rigorous empirical studies conducted over the next 20 years were less positive. As a result, research on the role of food additives in contributing to ADHD waned. In recent years, however, interest in this area has revived. In response to more recent research and public petitions, in December 2009 the British government requested ...
Safety studies related to the disposal of low- and intermediate waste indicate that the long term risk is determined by the presence of long-lived nuclides such as "1"4C, "5"9Ni, "6"3Ni, "9"9Tc, "1"2"9I and the transuranium elements. As most of these nuclides are difficult to measure, the correlation between these critical nuclides and some other easily measurable key nuclides such as "6"0Co and "1"3"7Cs has been investigated for typical waste streams of Paks Nuclear Power Plant (Hungary) and scaling factors have been proposed. An automated gamma-scanning monitor has been purchased and calibrated to determine the gamma-emitting radionuclides. Radiochemical methods have been developed to determine significant difficult-to-measure radionuclides. The radionuclides of interest have been "3H, "1"4C, "9"0Sr, "5"5Fe, "5"9Ni, "9"9Tc, "1"2"9I and TRUs. The measurements taken so far have revealed brand new information and data on radiological composition ...
The E6 oncoproteins of high-risk human papillomaviruses provide important functions not only for malignant transformation but also in the productive viral life cycle. E6 proteins have been shown to bind to a number of cellular factors, but only a limited number of analyses have investigated the effects of these interactions on the viral life cycle. In this study, we investigated the consequences of HPV 31 E6 binding to E6TP1, a putative Rap1 GAP protein. HPV 16 E6 has been shown to bind as well as induce the rapid turnover of E6TP1, and similar effects were observed with HPV 31 E6. Mutation of amino acid 128 in HPV 31 E6 was found to abrogate the ability to bind and degrade E6TP1 but did not alter binding to another ?-helical domain protein, E6AP. When HPV 31 genomes containing mutations a...
The Federal Aviation Administration (FAA) identified 17 accidents that may have resulted from fuel tank explosions on commercial aircraft from 1959 to 2001. Seven events involved JP 4 or JP 4/Jet A mixtures that are no longer used for commercial aircraft fuel. The remaining 10 events involved Jet A or Jet A1 fuels that are in current use by the commercial aircraft industry. Four fuel tank explosions occurred in center wing tanks (CWTs) where on-board appliances can potentially transfer heat to the tank. These tanks are designated as ''Heated Center Wing Tanks'' (HCWT). Since 1996, the FAA has significantly increased the rate at which it has mandated airworthiness directives (ADs) directed at elimination of ignition sources. This effort includes the adoption, in 2001, of Special Federal Aviation Regulation 88 of 14 CFR part 21 (SFAR 88 ''Fuel Tank System Fault Tolerance Evaluation Requirements''). This paper ...
Most prior climate change assessments for U.S. agriculture have focused on major world food crops such as wheat and maize. While useful from a national and global perspective, these results are not particularly relevant to the Northeastern U.S. agriculture economy, which is dominated by dairy milk production, and high-value horticultural crops such as apples (Malus domestica), grapes (vitis vinifera), sweet corn (Zea mays var. rugosa), cabbage (Brassica oleracea var. capitata), and maple syrup (sugar maple, Acer saccharum). We used statistically downscaled climate projections generated by the HadCM3 atmosphere-ocean general circulation model, run with Intergovernmental Panel on Climate Change future emissions scenarios Alfi (higher) and B1 (lower), to evaluate several climate thresholds of direct relevance to agriculture in the region. A longer (frostfree) growing season could create new opportunities for farmers with enough capital to take risks on new crops ...
Purpose: This study presents a dosimetric optimization effort aiming to compare intensity-modulated (IM) X-rays and IM protons in 4 different orbital and paraorbital tumors. These are most challenging targets for standard radiotherapy due to their close relationship with the eyes and related structures. Methods and Materials: A primary orbital lymphoma, an optic nerve meningioma, a sphenoidal ridge meningioma protruding into the orbit, and a pediatric parameningeal paraorbital rhabdomyosarcoma were selected for the purpose of this study. Planning target volumes (PTVs) and organs at risk (OAR) were defined in each patient CT data set for each tumor site. IM X-ray and IM proton three-dimensional treatment plans were implemented. The following total tumor doses were prescribed: 30 Gy for the orbital lymphoma, 54 Gy for both meningiomas, and 50.4 Gy for the rhabdomyosarcoma case. Dose-volume histograms (DVHs) were obtained for all targets and OAR with both treatment ...
ObjectiveHIV and type 2 diabetes are known riskfactors for albuminuria, but no previous reports have characterized albuminuria in HIV-infected patients with diabetes.Research Design and MethodsWe performed a cross-sectional study including 73 HIV-infected adults with type 2 diabetes, 82 HIV-infected non-diabetics, and 61 diabetic control subjects without HIV. Serum creatinine >1.5 mg/dL was exclusionary. Albuminuria was defined as urinary albumin/creatinine ratio >30 mg/g.ResultsThe prevalence of albuminuria was significantly increased among HIV-infected diabetics (34% vs. 13% of HIV non-diabetic vs. 16% diabetic control, p?=?0.005). HIV status and diabetes remained significant predictors of albuminuria after adjusting for age, race, BMI, and blood pressure. Albumin/creatinine ratio correlated significantly with HIV viral load (r?=?0.28, p?=?0.0005) and HIV-infected subjects with albuminuria had significantly greater cumulative exposure ...
The undeniable success in controlling some preventable communicable respiratory diseases in Europe has created an impression that respiratory infections are no longer as dangerous as they once were, and efforts of public health services should be concentrated on other problems. However, epidemiological data do not exactly confirm this optimistic view, as acute respiratory diseases are among the leading causes of death in Europe. When morbidity statistics - which are usually less reliable - are considered, acute respiratory infections in Europe take the lead among all communicable diseases. For example, each year 15% of the population in Spain and 30% of the population in the United Kingdom have a recorded acute respiratory disease. Several environmental riskfactors of acute respiratory diseases have been recorded, the main ones being indoor and outdoor air pollution, overcrowding in dwellings and public transport, and poor indoor climate. ...
The most important factor in assessing radiologic risk is ensuring scientific means for evaluation of the radioactive release impact upon humans and organisms. To evaluate quantitatively this impact not only knowledge of radioactivity distribution in these dynamical systems is necessary but also understanding the transfer mechanisms between ecosystem components is needed. Thus a complete radioecologic study appear to be very complex and needs defining the source term, dynamic description of radionuclides behavior in the ecosystem, estimation of radiation doses in the major components of the ecosystem and finally the effects of radiation doses upon different parts of the systems. A diagram of the steps implied in evaluation of the effects due to radioactive effluent release in the environment is presented and discussed. The following steps are described: - identification of radioactive sources, as well as their input rate. Presence of noxious ...
Human Reliability Analysis (HRA) is a very important part of Probabilistic Risk Analysis (PRA), and constant work is dedicated to improving methods, guidance and data in order to approach realism in the results as well as looking for ways to use these to reduce accident frequency at plants. Further, in order to advance in these areas, several HRA studies are being performed globally. Mexico has participated in the International HRA Empirical study with the objective of -benchmarking- HRA methods by comparing HRA predictions to actual crew performance in a simulator, as well as in the empirical study on a US nuclear power plant currently in progress. The focus of the first study was the development of an understanding of how methods are applied by various analysts, and characterize the methods for their capability to guide the analysts to identify potential human failures, and associated causes and performance shaping factors. The HRA ...
There is an increasing interest in using novel methods to generate electrical energy using wind and solar energy sources. Unfortunately, such energy sources are intermittent, and, therefore, conventional sources must still be available to meet demand during critical periods. In addition, renewable energy technologies are still expensive in general, although extensive research programs are being conducted to overcome this disadvantage. Hence, reliability, economic assessment and environmental impacts are three objectives to be satisfied simultaneously when designing either an autonomous or a grid-connected hybrid power generation system. The installation of any of these two systems should, undoubtedly, be preceded by an assessment of the available resources at the candidate site. In addition, many other factors are to be studied, including economics of transmission lines, site constraints, distances etc. In this thesis, the subjective judgments of various experts, ...
Using histopathologic diagnoses made on necropsy material from 3,024 military working dogs (MWDs) who died from 1968 to 1973, we analyzed the effect of military service in the Republic of Vietnam on testicular pathology. Among 1,048 MWDs that died in Vietnam and had no reported developmental riskfactors for testicular disease, significant excesses of testicular hemorrhage, epididymitis/orchitis, sperm granuloma, testicular degeneration, and seminoma were evident. Among 126 MWDs with prior Vietnam service who died at other duty stations outside Vietnam from 1968 to 1973, significant excesses of testicular degeneration and seminoma were likewise evident. Among 136 MWDs with prior Vietnam service that later died from 1974 to 1980, seminoma continued to be diagnosed in significant excess. In each instance, the odds ratio for the association between Vietnam service and seminoma was 2.0 or greater. Analysis of ever service by Corps Tactical Zones ...
There are several methods for the risk assessment and risk management applied to pipelines, among them the Muhlbauer's Method. W. Kent Muhlbauer is an internationally recognized authority on pipeline risk management. He made a detailed identification about 300 distinct conditions that influence the risk assessment in pipelines and he proposed a score system that is known as method of Muhlbauer. The purpose of this model is to evaluate the public exposure to the risk and identify ways for management that risk in fact. The assessment is made by the attribution of quantitative values to the several items that influences in the pipeline risk. This paper approaches the Muhlbauer's basic model for risk assessment and management in pipelines. In the beginning, the basic model for risk ...
Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of pain.(author)
We aimed to investigate the effects of local anesthetics soaked in Merocel nasal packs on hemorrhage and pain after septoplasty. The methodology includes a prospective double-blind study that was conducted in patients undergoing septoplasty because of nasal septal deviation. The study included 143 patients. The patients were divided into four groups. Each group received 1% lidocaine?+?0.000625% adrenalin, 0.375% ropivacaine, 0.25% bupivacaine as study groups or 0.9% sodium chloride as a control group in their Merocel packs postoperatively. The local anesthetics or sodium chloride were reapplied at the eighth postoperative hour. Each patient was given a questionnaire where verbal analog score and amount of postoperative hemorrhage was noted. The statistical analysis was performed using two ...
Background: Ecchymosis, oedema, haematoma and pain after SMAS-based facelift surgery are all the direct result of the physical trauma of surgery and subsequent inflammatory response. Hilotherapy is a novel form of cryotherapy that purports to minimise these events through single-use face masks circulating cooled, sterile water. This study was performed to assess the validity of Hilotherapy in this population of patients. Methods: Over 14 weeks fifty consecutive patients were randomised to post-operative facial cooling with Hilotherapy or management with standard dressings alone, while fifteen subsequent, consecutive patients were randomised to cooling of one side of the face but not the other. Assessment of ecchymosis, oedema, haematoma and pain was performed independently by clinical staf...
Abstract Introduction: Transduodenal ampullectomy (TDA) can be performed for benign and premalignant tumors of the ampulla of Vater (AOV) as an alternative to pancreaticoduodenectomy. However, the laparoscopic approach has rarely been attempted. In this report 2 cases of benign ampullary tumor that were treated by totally laparoscopic TDA. Patients and Methods: Case 1 was of a 75-year-old female who was admitted with left knee pain and underwent arthroscopic debridement. On postoperative day 6, she showed elevated levels of alkaline phosphatase, aspirate aminotransferase, alanine transaminase, and gamma-glutamyl transpeptidase, without any other laboratory test abnormality. She had no complaint of abdominal pain, and physical examinations were unremarkable. Computed tomography (CT), magnet...
Background: This study was conducted to examine the effects of prophylactic misoprostol prior to intrauterine device (IUD) placement in nulliparous women. Study Design: Nulliparous, reproductive-aged women desiring an IUD for contraception were randomized to receive 400 mcg of buccal misoprostol or placebo 90 min prior to IUD insertion. Subjects completed a series of 100-mm visual analogue scales (VAS, anchors: 0=none, 100 mm=worst imaginable) to measure their perceived pain at several times points (anticipated pain, leg positioning, speculum placement, tenaculum placement, IUD insertion, equipment removal and 5 min postinsertion). Secondary outcomes included provider ''ease of placement'' (100-mm VAS, anchors: 0=easy, 100 mm=extremely difficult), side effects and retention of the IUD afte...
SummaryBackground Persistent Lyme Disease Symptoms (PLDS) have included fatigue, headaches, poor concentration and memory, lightheadedness, joint pain, and mood disturbances. Evidence-based guidelines committees disagree over the severity of PLDS. The 2004 International Lyme and Associated Diseases Society (ILADS) concluded that PLDS are severe. The 2006 Infectious Disease Society of America (IDSA) guidelines committee concluded that PLDS are nothing more than the "aches and pains of daily living" and an ad hoc International Lyme group concluded that PLDS are "symptoms common in persons who have never had Lyme disease." Hypothesis Clinical trials validate the severity of persistent Lyme disease symptoms. Evaluation of the Hypothesis There are 22 standardized instruments used to measure the...
The interscalenic block technique is widely used for ambulatory shoulder surgery despite a substantial number of failures and adverse effects. We prospectively evaluated satisfaction in 40 consecutive patients who underwent open Bankart repair under a single general anesthesic performed in an ambulatory care unit. The mean age of the patients was 23 years. There were 29 men and 11 women. Patients were evaluated postoperatively with a visual analog scale of pain (in the recovery room, at the time of discharge, and the day after and 1 week after surgery) via a home assessment questionnaire that included the following: effectiveness of oral pain medication, ability to perform activities of daily life, and overall satisfaction. One patient failed to be discharged because of a feeling of faintn...
Pyogenic sacroiliitis is a rare entity in children. Diagnosis is often delayed because of its variable clinical presentation, low suspicion by the examining physician, and rare findings on radiographs. Delayed diagnosis, however, results in complications such as iliopsoas abscess. We report the case of a 12-year-old girl hospitalized with a 21-day history of fever, pain in the left iliac fossa, and flexion contracture of the hip. On examination, she had fever (38.9 ^oC), psoitis, localized tenderness at the left sacroiliac joint, and pain elicited by lateral compression of the pelvis. The abdominal examination was normal. The erythrocyte sedimentation rate was 130mm in the first hour, C-reactive protein was 186mg/l, and the white blood cell count was 18,400/mm^3, with 79% neutrophils. Urin...
On the 3. and 4. November 1982 the sixth conference of the Corporation for Reactor Safety (GRS) was held in Cologne's Guerzenich. The theme of this year's meeting was the 'Status of Risk Investigations at Nuclear Power Plants'. A principal topic was a report on findings made by the GRS during the 'Risk Oriented Analysis SNR-300'. The second topic comprised the newest developments within Phase B of the Risk Study of Water Pressure Reactors, the discussion of the dose/effect relationship and considerations on threshold risk values. (orig.).
In this study, for the institutionalization of risk informed and performance based regulation in Korea, the latest technical movements of overseas countries are examined and reviewed. And the issues that was found when license change petition using risk information was submitted in Korean regulatory body are reviewed. Based on these review, the applicable areas to domestic situation will be found and proposed. This study can contribute to setting up the proper direction for the institutionalization of risk informed and performance based regulation
In this study, for the institutionalization of risk informed and performance based regulation in Korea, the latest technical movements of overseas countries are examined and reviewed. And the issues that was found when license change petition using risk information was submitted in Korean regulatory body are reviewed. Based on these review, the applicable areas to domestic situation will be found and proposed. This study can contribute to setting up the proper direction for the institutionalization of risk informed and performance based regulation.
As competition dramatically reshapes power markets, electric utilities strive to increase flexibility in their commitments and limit exposure to market risks. This paper provides an overview of a promising tool called option valuation which is useful for analyzing and managing risks. The paper demonstrates an application of these techniques for developing new pricing products tailored to meet customers` risk preference.
Analyzing the risk of a safeguards system, in particular the security of a computer network based on the notion of fuzzy sets and linguistic variables, addresses concerns such as complexity and inherent imprecision in estimating the possibility of loss or compromise. Automated risk analysis allows the risk to be determined for an entire system based on estimates for lowest level components and the component weight. In addition, for each component (asset) we select the most effective combination of protection mechanisms against a given set of threats.
Surveillance of a population, such as a weapon stockpile, is needed to discover manufacturing defects as well as deterioration as the population ages. This article considers the risks of sampling rates for surveillance from three perspectives: detection probability of defects in a proportion of a population with pass/fail data, detection of a trend in a defective proportion of the population with pass/fail data, and detection of a trend with quantitative degradation measurements. Understanding of these risks will help the decision maker choose a sampling rate to protect against such problems of a specified size at a tolerable risk.
The Seismic Risk Explorer, an extension for ArcGIS Desktop developed by cedim AG, is a tool for computing the seismic risk, i.e. damage on residential buildings and thereby caused monetary losses for earthquake scenarios. It is based on the research results of the CEDIM (Center for Disaster Management and Risk Reduction Technology) research center, located at the Karlsruhe Institute of Technology (KIT) and the GeoForschungsZentrum (GFZ) in Potsdam. With this software tool seismic scenarios can be simulated for a given magnitude, depths and location. The seismic intensity, the resulting mean damage ratio for residential buildings and the seismic risk, expressed as the monetary loss caused by an earthquake can be computed downscaled to communities, postcode areas or even single buildings. Interested end-users are especially insurance companies, but also public authorities which may use the tool for ...
Drawing upon the cultural risk perspective and writings on risk taking, this paper seeks to develop ideas relating to the effective use of school cyberspace. It is argued that some individuals respond to exaggerated, yet seductive, discourses of online risks by over-blocking, unreasonably restricting students' Internet activity. At the same time, there are sensible, even compelling, motivations for teachers as well as students to use the school Internet to engage in low-level risk taking, fostering excitement, identity construction and networked media literacy. Connecting these seductive pushes and pulls of risk it is ultimately maintained that the fostering of trust through open communication is key in overcoming over-blocking whilst allowing for greater educational gains, realised in part through certain types of low-level risk taking in school cyberspace.
The risk of cyber attacks on process control networks (PCN) is receiving significant attention due to the potentially catastrophic extent to which PCN failures can damage the infrastructures and commodity flows that they support. Risk management addresses the coupled problems of (1) reducing the likelihood that cyber attacks would succeed in disrupting PCN operation and (2) reducing the severity of consequences in the event of PCN failure or manipulation. The Network Security Risk Model (NSRM) developed in this article provides a means of evaluating the efficacy of candidate risk management policies by modeling the baseline risk and assessing expectations of risk after the implementation of candidate measures. Where existing risk models fall short of providing adequate insight into the efficacy of candidate risk ...
Executive summary 1. Few studies have to date explained consumer attitudes and purchase decisions with regard to genetically engineered food products. However, the increased marketing of genetically engineered food products and the considerable concern that consumers seem to express with regard to the technology call for the development of a theoretical basis for research into these issues. 2. The aim of the paper is to present three models which we have developed to explain consumer attitudes, buying behaviour and attitude change with regard to genetically engineered food products. All three models build on established consumer behaviour theory and on existing and comparable research in the field. 3. Consumer attitudes toward genetic engineering in food products are explained in an attitude model that builds on Fishbein's multiattribute attitude model. The model deviates from Fishbein's model in a number of ways: there is an explicit distinction between perceived benefits and ...
There is a continuing need to understand dose-response relationships for ionizing radiation in order to protect the health of the public and nuclear workers from undue exposures. However, relatively few human populations have been exposed to doses of radiation high enough to cause observable, long-term health effects from which to derive dose-response relationships. This is particularly true for internally deposited radionuclides, although much effort has been devoted to epidemiological studies of the few types of exposures available, including lung cancers in uranium miners form the inhalation of the radioactive decay products of Ra, liver cancers in patients injected with Thorotrast X-ray contrast medium containing Th, bone cancers in radium dial painters who ingested Ra, and bone cancers in patients who received therapeutic doses of Ra. These four types of exposures to internally deposited radionuclides provide a basis for understanding the health effects of many other radionuclides ...
The authors give a survey of the somatic radiation risk in X-ray diagnostics. A somatic dose index is calculated for different examination methods containing the organ doses to the red bone marrow, the lung, the female breast, and the thyroid gland and evaluating their somatic significance. If this somatic dose index by which the individual radiation risk is described, is multiplied by the examination frequencies per year in the German Federal Republic, one gets the somatically significant dose index, which is a measure of the collective somatic radiation risk. In this sense, mammography has the highest, and dental radiography the lowest collective radiation risk.
This paper describes a Qualitative/Screening Methodology included in the draft ANS Low Power and Shutdown (LPSD) PRA (Probabilistic Risk Assessment) Standard. The screening methodology can be used to eliminate certain specified shutdown POSs (Plant Operating States) from requiring further quantitative risk assessment in the context of a specified application based on demonstrating that their risk is lower than some predetermined limiting value. The paper also describes a methodology for qualitative risk assessment (QRA) tools that are used to support the screening process. The paper outlines the bases of both methodologies. (authors)
Purpose - The purpose of this paper is to test the relationships among perceived risk, consumer satisfaction and repurchase loyalty, and to explore the moderating role of knowledge on the relationship between these constructs. Design/methodology/approach - The results are based on a cross-section sample of 846 households in Vietnam using self-administrating questionnaires, with fish as a main research object, and analyzed using structural equation modelling. Findings - The relationship between perceived risk and satisfaction is negative and satisfaction has a significantly positive effect on repurchase loyalty. This study suggests that perceived risk has an indirect effect on repurchase loyalty through satisfaction. Besides direct effects on perceived risk and satisfaction, knowledge prove...
The objective of Configuration Risk Management Program(CRMP) is to maintain the safety level by assuring the defense-in-depth of nuclear power plant while the configurations are changed during plant operations, especially for the LP/SD. Such a safety purpose can be achieved by establishing the risk monitoring programs with both quantitative and qualitative features. Generally, the quantitative risk evaluation models, i.e., PRA models are used for the risk evaluation during full power operation, and the qualitative risk evaluation models such as safety function assessment trees are used. Through this study, safety function assessment trees were developed.
This paper gives a summary of a risk study assuming unprotected loss of flow (ULOF) in the SNR 300. This study was initiated in 1979/80 by the Karlsruhe Nuclear Research Center and performed in close cooperation with Science Applications Inc., Palo Alto, USA, and Interatom Company. Part of the results also was integrated in the 'Risk Related Analysis for the SNR 300' carried out by the Gesellschaft fuer Reactorsicherheit. The character of the study described here is similar to other risk studies like the Reactor Safety Study and the German Risk Study for Nuclear Power Plants. The objectives and the methodology of the analyses are described and its results are discussed. (orig./RW).
Purpose: To assess the prognostic value of biologic (p53, Ki-67) and clinical factors in squamous cell carcinoma of the oropharynx after radical surgery and postoperative radiotherapy (RT). Methods and Materials: Between 1985 and 1995, a total of 102 patients with 104 tumor sites were entered onto the study. Fifty-five primary tumors (53%) involved the tonsils, 26 (25%) the soft palate, and 23 (22%) the base of the tongue. Median age was 53 years (range 36-80 years). The clinical T- and N-categories (UICC 1997) were: T1 (30), T2 (47), T3 (22), T4 (5), N0 (33), N1 (28), N2 (42), and N3 (1). Histologically-clear margins were achieved in all patients by initial surgery. Postoperative RT to the primary and regional lymphatics was given, to a total of 60 Gy in 6 weeks, and single daily fractions of 2 Gy. The expression of the nuclear p53- and Ki-67-labeling index (LI) was investigated by immunostaining using the monoclonal antibodies DO-7 and MIB 1. The nuclear ...
Dust detection and control in real time, represent one of the most challenging problem in all those environments where fine and ultrafine airborne particulate solids products are present. The presence of such products can be linked to several factors, often directly related and influenced by the working-production actions performed. Independently from the causes generating dust, airborne contaminants are an occupational problem of increasing interest as they are related to a wide number of diseases. In particular, airborne dusts are well known to be associated with several classical occupational lung diseases, such as the pneumoconiosis, especially at high levels of exposure. Nowadays there is also an increasing interest in other dust related diseases, from the most serious as cancer and asthma, to those related with allergies or irritation and other illnesses, also occurring at lower levels of exposure. Among the different critical factors ...
AbstractIn a previous study using male rats, a correlation was found between the development of “at-level” allodynia in T6-7 dermatomes following severe T8 spinal contusion...Full Text Available
During their life, intervertebral discs undergo degenerative changes which need not necessarily become lesions. Conventional X-rays do not provide information on the condition of the intervertebral discs, so MRT or CT are recommended as primary techniques as they are non-invasive. Invasive methods like myelography and especially discography should not be used unless a case is highly problematic. In infants with pains in the back, MRT should be carried out as early as possible as there is nearly always an organic cause. (orig.)
BackgroundPostherpetic neuralgia (PHN) is a painful and difficult to treat complication of acute herpes zoster. Current treatment options provide only partial relief and are often...Full Text Available