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Macronutrients Intake in Iranian Multiple Sclerosis Patients  

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The objective of this study was to assess intake of macronutrients in MS patients. 108 MS patients were randomly selected from Iranian MS society in Tehran in 2005. Two questionnaires regarding personal and medical information were filled for each patient. Food intake was assessed by three 24 h recalls and a semi-quantitative food frequency questionnaire. The recorded data were converted to values in grams using Manual for Household Measures and then to nutrient ingredients by nutritionist 3 ...

Mohammad Shirazi, M.; Taleban, F. A.; Ghafarpoor, M.

2007-01-01

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Macronutrients Intake in Iranian Multiple Sclerosis Patients  

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Full Text Available The objective of this study was to assess intake of macronutrients in MS patients. 108 MS patients were randomly selected from Iranian MS society in Tehran in 2005. Two questionnaires regarding personal and medical information were filled for each patient. Food intake was assessed by three 24 h recalls and a semi-quantitative food frequency questionnaire. The recorded data were converted to values in grams using Manual for Household Measures and then to nutrient ingredients by nutritionist 3 application. Data was analyzed by SPSS; mean and standard deviation of each macronutrient was calculated; student`s t-test was applied to compare the results with reference values. Protein and carbohydrate intake in Iranian MS patients were less than recommended, while their daily intake of total and saturated fat were higher than reference values. Their intake of polyunsaturated fat and dietary fiber was shown to be less than recommended. Body mass index in 14.8% of patients was lower than normal and in 38% of them showed to be higher than normal. It seems nutritional assessment, counseling and education to improve diet is necessary in Iranian MS patients.

M. Mohammad Shirazi

2007-01-01

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Comparison of anamnestic history, alcohol intake and smoking, nutritional status, and liver dysfunction between thorotrast patients who developed primary liver cancer and those who did not  

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In order to clarify the differences in past history, nutritional condition and, consumption of alcohol and tobacco, and liver dysfunction between the thorotrast patients who developed primary liver cancer and those who did not, 103 persons who had no primary liver cancer in January 1980 were studied. All subjects were military men who had undergone angiography with thorotrast between 1943 and 1946. Twenty persons developed hepatocellular carcinoma and 16 developed intrahepatic bile duct carcinoma by April 1987, whereas 67 are still alive without any cancer. There was no difference in age or period after thorotrast infusion between those two groups of patients in January 1980. A difference in history of hepatitis and/or jaundice and presence of hepatic dysfunction was found between the subjects who developed primary liver cancers and those who did not. These findings suggest that an anamnestic history of hepatitis and liver dysfunction are risks for development of thorotrast-induced liver cancer. On the basis of the above findings, early detection of liver dysfunction offers a possibility of early diagnosis of primary liver cancer

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Assessment of Daily Food and Nutrient Intake in Japanese Type 2 Diabetes Mellitus Patients Using Dietary Reference Intakes  

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Full Text Available Medical nutrition therapy for the management of diabetes plays an important role in preventing diabetes complications and managing metabolic control. However, little is known about actual eating habits of individuals with type 2 diabetic mellitus (T2DM, especially in Japan. Therefore, we sought to (1 assess the dietary intake of individuals with T2DM, and (2 characterize their intake relative to national recommendations. This cross-sectional study involved 149 patients (77 males and 72 females aged 40–79 years with T2DM recruited at a Kyoto hospital. Dietary intake was assessed using a validated self-administered diet history questionnaire. Under-consumption, adequacy, and over-consumption, of nutrients were compared to the age- and sex-based standards of the Japanese Dietary Reference Intakes. Among the results, most notable are (1 the inadequacy of diets in men with respect to intake of vitamins and minerals, likely owing to low intake of vegetables and fruits; (2 excess contributions of fat intake to total energy in both sexes; and (3 excess consumption of sweets and beverages relative to the national average. The prevalence of diabetes complications may be increasing because of a major gap between the typical dietary intake of individuals with T2DM and dietary recommendation.

Naoto Nakamura

2013-06-01

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Reorganization of a hospital catering system increases food intake in patients with inadequate intake  

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Background: Low food intake is a frequent problem in undernourished hospital patients. Objective: To study whether a reorganization of a hospital catering system enabling patients to choose their evening meal individually, in combination with an increase in the energy density of the food, increases the energy and protein intake of the patients. Design: Observational study comparing the food intake before and twice after the implementation of the new system, the first time by specially trained staff and the second time by ordinary staff members, following training. The amount of food served, eaten and wasted was measured, and energy and protein intake calculated. Results: The quartile of patients with the lowest energy intake consumed on average 128 kJ per patient [(95% confidence interval (CI) 79-178 kJ] with the old system; with the new system they consumed 560 kJ per patient (95% CI 489-631 kJ) on the first occasion, and 1021 kJ per patient (95% CI 939-1104 kJ)on the second occasion. With the old system, the wastage was on average 276 g per patient (48% of the total amount produced) compared with 118 g per patient (30%) and 78 g (21%) on the two test occasions with the new system. Conclusions: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially. Keywords: hospital food; nutritional risk; undernutrition

Freil, M.; Nielsen, M. A.

2006-01-01

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Evaluation of Food Intake in Ulcerative Colitis Patients  

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Full Text Available Introduction: Ulcerative colitis (UC is a chronic inflammatory disorder of the colon of unknown cause that is associated with important nutrition deficiencies such as protein-energy malnutrition, vitamin and mineral deficiencies. Because no study has been carried out to date in Iran, the aim of this pilot study was the assessment of dietary intake of these patients. Methods: In this pilot study, 41 UC patients whose disease severity was mild or moderate were selected. Data about diet restrictions were collected via a questionnaire and dietary intake was assessed 3 times during a 2 month period with 30 days interval and 3-day food-recall (9days in general. Results: Subjects were 26 men and 15 women and 65.9% patients avoided completely or limited milk intake. Dietary limitation about fruits and vegetables was 24.4 and 43.9 percent, respectively and legumes intake was 58.5%. Mean calorie intake in 41 patients was 2125.14±60.83 calories/day and in two groups, calcium and fiber intake was significantly less than the standard dietary recommendation. Conclusion: Dietary intake examination showed some deficiencies such as calcium and iron deficiency and fiber intake was low because the intake of fruits, vegetables and legumes was limited.

Z Faghfoori

2010-04-01

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Nutritional intake of gut failure patients on home parenteral nutrition  

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Nutrient intake patterns were analyzed in 23 patients with gut failure who were receiving home parenteral nutrition (HPN). All patients had stable weights without changes in intravenous calories or protein for 3 consecutive months. Our objectives were to assess oral intake of calories, carbohydrates, fat, and protein, to examine relationships between oral nutrient intakes and disease categories, and to compare oral and intravenous intakes to calculated resting energy expenditure (REE). Two patterns of oral nutrient intake were identified among the patients. Patients with short bowel syndrome, regardless of the underlying disease, consumed calories by mouth that clearly exceeded calculated resting energy expenditure (short bowel, non-Crohn's, 170% of REE; short bowel, Crohn's, 200 of REE); however, calories approximating the REE had to be given via HPN, suggesting that efficiency of absorption was at a very low level. Patients with diffuse gut diseases (radiation enteritis or pseudo-obstruction syndromes) had very low intakes of oral nutrients. The distribution of oral calories among carbohydrate, protein, and fat did not differ among the disease categories

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Evaluation of Food Intake in Ulcerative Colitis Patients  

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Introduction: Ulcerative colitis (UC) is a chronic inflammatory disorder of the colon of unknown cause that is associated with important nutrition deficiencies such as protein-energy malnutrition, vitamin and mineral deficiencies. Because no study has been carried out to date in Iran, the aim of this pilot study was the assessment of dietary intake of these patients. Methods: In this pilot study, 41 UC patients whose disease severity was mild or moderate were selected. Data about diet restric...

Faghfoori, Z.; Shaker Hosseini, R.; Navai, L.; Nikniaz, Z.; Somi, M.

2010-01-01

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Dietary fat and antioxidant vitamin intake in patients of neurodegenerative disease in a rural region of Jalisco, Mexico  

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Objective To evaluate and compare the intake of lipids and (A, E, and C) vitamins in patients with and without possible neurodegenerative diseases. Methods Twenty adults with possible Alzheimer's disease or Parkinson's disease and 41 control subjects (50–89 years old) from a rural region were studied. Dietary intake was evaluated with the analysis of macronutrients and micronutrients conducted by a food frequency questionnaire and 24 hours dietary record. Analyses were adjusted for age, sex, body mass index, and energy intake. Through interrogation and use of medical record form of health secretary we obtained information about the sociodemographic characteristics. Multivariate analysis of variance to allow for covariated adjustment was used. Results Patients had a lower energy intake, vitamin C (P = 0.016), fruits (P < 0.001), vegetables (P = 0.037), and oils and fat (P = 0.002), than the controls. Interestingly, the C vitamin intake in patients was still higher than the recommended. Patients had a higher consumption of cereals (P = 0.017), high-animal fat diet (P = 0.024), and whole milk (P < 0.001); 2.4% of the controls smoke and 5% are alcohol consumers. Eighty-five percent of patients and 78% of the controls do not have physical activity. Family history of subjects in this study indicated chronic diseases. Conclusion The subjects included in this study had a high intake of C vitamin, this is due to the consumption of fruits and vegetables. However, patients with possible Alzheimer's or Parkinson's disease had a lower intake of fruits and vegetables, which could be due to type of food to which they have access. PMID:24257159

Navarro-Meza, Mónica; Gabriel-Ortiz, Genaro; Pacheco-Moisés, Fermín P.; Cruz-Ramos, José A.; López-Espinoza, Antonio

2014-01-01

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Caffeine intake is independently associated with neuropsychological performance in patients with obstructive sleep apnea  

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In healthy individuals, caffeine intake may improve performance on cognitive tests. Obstructive sleep apnea (OSA) is a disorder that has been associated with impaired cognitive function. In this study, we investigated whether increased caffeine intake in untreated patients with OSA is linked to better cognitive performance. Forty-five untreated OSA patients underwent baseline polysomnography after completing a survey of 24-h caffeine intake. Participants completed a battery of neuropsychologi...

Norman, Daniel; Bardwell, Wayne A.; Loredo, Jose S.; Ancoli-israel, Sonia; Heaton, Robert K.; Dimsdale, Joel E.

2008-01-01

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Dietary intake in head and neck irradiated patients with permanent dry mouth symptoms  

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Radiotherapy of the head and neck region, which includes the major and minor salivary glands in the radiation field, usually leads to temporary or permanent xerostomia. This may affect eating and increase the risk of inadequate intake of energy and nutrients. The aim of the present study was to investigate the effects of radiotherapy-induced xerostomia on energy and nutrient intake in individuals treated for malignancies in the head and neck region. The dietary intake of 24 patients with a low chewing stimulated whole saliva flow rate (1.0 ml/min) was recorded for 7 days. The average daily energy intake was nearly 300 kcal lower in the irradiated patients with dry mouth symptoms than in the control group. The mean intake in the former group was 1925 kcal per day whereas the control group had an intake of 2219 kcal per day. Irradiated patients with dry mouth symptoms had significantly lower mean intakes of vitamin A, ?-carotene, vitamin E, vitamin B6, folacine, iron and zinc than those in the control group. There was also a lower intake of vitamin C, but this was not statistically significant. The intake of vitamins A and C exceeded or reached the levels recommended in the Swedish Nutritional recommendations, but the average intakes of fibre, iron, ?-carotene, vitamin E, zinc, selenium, and iron did not reach recommended levels, in neither the experimental nor the control group. (Autexperimental nor the control group. (Author)

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Food caregivers influence on nutritional intake among admitted haematological cancer patients - a prospective study  

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Haematological cancer patients have an increased risk of undernourishment due to their malignancy, treatment toxicity and severe infections. This study examines whether kitchen assistants working as food caregivers increase nutritional intake and knowledge among haematological cancer patients.

Lindman, Astrid; Rasmussen, Helle Brygger

2013-01-01

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Factors Associated with Low Intake of Dietary Fiber in Inflammatory Bowel Disease Patients  

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Full Text Available Inflammatory bowel disease patients reduce their intake of foods rich in dietary fibers in an attempt to prevent recurrence of the disease, predisposing these patients to nutritional losses. The aim of this study was to evaluate the intake of dietary fiber and associated factors in a group of patients with inflammatory bowel disease. This was a cross-sectional study with 61 inflammatory bowel disease patients, and all participants were outpatients in Salvador, Bahia. Patients completed a semi-structured questionnaire that included questions about demographics, socioeconomic status and anthropometric and clinical information and a food frequency questionnaire to assess the intake of dietary fiber. The mean intake of dietary fiber was 28.2 ± 14.8 g/day for inflammatory bowel disease patients, 27.9 ± 10.1 g/day for ulcerative colitis (UC patients and 28.9 ± 21.1 g/days for those with Crohn’s disease (CD (p > 0.05. Most inflammatory bowel disease patients (52.5% had intake below that recommended for dietary fiber. Inadequate consumption was present in 56.3% of CD patients and 43.8% of those with UC (p = 0.28. Men had lower fiber intake than women (p = 0.04. No significant associations between fiber intake and disease activity, location, presence of complications, gastrointestinal complaints, and nutrition counseling were found (p > 0.05. The low intake of dietary fiber was present in most patients, and the greatest inadequacy was found in males. Insufficient intake of dietary fiber appears to be linked to demographic features and not necessarily clinical characteristics relevant to inflammatory bowel disease.

Vanessa Rosa Brito Oliveira

2014-05-01

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Adequacy of oral intake in critically ill patients 1 week after extubation.  

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Hospital malnutrition is associated with increased morbidity and mortality, particularly among patients admitted to intensive care units (ICUs). The purpose of this observational study (August to November 2007) was to examine the adequacy of oral intake and to identify predictors of oral intake after ICU patients were removed from invasive mechanical ventilation. Patients aged > or = 18 years who required mechanical ventilation for at least 24 hours, advanced to an oral diet postextubation, and did not require supplemental enteral or parenteral nutrition were included. The first 7 days of oral intake after extubation were assessed via modified multiple-pass 24-hour recall and the numbers of days on therapeutic diets and reasons for decreased intake were collected. Oral intake Assessment determined 44% were malnourished upon admission to the ICU. The average daily energy and protein intake failed to exceed 50% of daily requirements on all 7 days for the entire population. The majority of patients who consumed oral diets and suggest that alternative medical nutrition therapies are needed to optimize nutrient intake in this unique patient population. PMID:20184993

Peterson, Sarah J; Tsai, Annalisa A; Scala, Celina M; Sowa, Diane C; Sheean, Patricia M; Braunschweig, Carol L

2010-03-01

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High sodium intake is associated with important risk factors in a large cohort of chronic kidney disease patients.  

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Background/objectives:An increased risk of mortality and cardiovascular disease (CVD) is observed in people with chronic kidney disease (CKD) even in early stages. Dietary sodium intake has been associated with important CVD and CKD progression risk factors such as hypertension and proteinuria in this population. We aimed to investigate the relationship between sodium intake and CVD or CKD progression risk factors in a large cohort of patients with CKD stage 3 recruited from primary care.Subjects/methods:A total of 1733 patients with previous estimated glomerular filtration rate (eGFR) of 30-59?ml/min/1.73m(2), with a mean age 72.9±9.0 years, were recruited from 32 general practices in primary care in England. Medical history was obtained and participants underwent clinical assessment, urine and serum biochemistry testing. Sodium intake was estimated from three early-morning urine specimens using an equation validated for this study population.Results:Sixty percent of participants who had estimated sodium intake above recommendation (>100?mmol/day or 6?g salt/day) also had higher diastolic blood pressure, mean arterial pressure (MAP), urinary albumin-to-creatinine ratio, high-sensitive C-reactive protein and uric acid and used a greater number of anti-hypertensive drugs. In multivariable regression analysis, excessive sodium intake was an independent predictor of MAP (B=1.57, 95% confidence interval (CI) 0.41-2.72; P=0.008) and albuminuria (B=1.35, 95% CI 1.02-1.79; P=0.03).Conclusions:High sodium intake was associated with CVD and CKD progression risk factors in patients with predominantly early stages of CKD followed up in primary care. This suggests that dietary sodium intake could afffect CVD risk even in early or mild CKD. Intervention studies are warranted to investigate the potential benefit of dietary advice to reduce sodium intake in this population.European Journal of Clinical Nutrition advance online publication, 8 October 2014; doi:10.1038/ejcn.2014.215. PMID:25293433

Nerbass, F B; Pecoits-Filho, R; McIntyre, N J; McIntyre, C W; Taal, M W

2014-10-01

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Urea synthesis in patients with chronic pancreatitis : relation to glucagon secretion and dietary protein intake  

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Up-regulation of urea synthesis by amino acids and dietary protein intake may be impaired in patients with chronic pancreatitis (CP) due to the reduced glucagon secretion. Conversely, urea synthesis may be increased as a result of the chronic inflammation. The aims of the study were to determine urea synthesis kinetics in CP patients in relation to glucagon secretion (study I) and during an increase in protein intake (study II).

Hamberg, Ole; Andersen, Vibeke

2001-01-01

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Dietary Calcium Intake and Calcium Supplementation in Hungarian Patients with Osteoporosis  

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Purpose. Adequate calcium intake is the basis of osteoporosis therapy—when this proves insufficient, even specific antiosteoporotic agents cannot exert their actions properly. Methods. Our representative survey analyzed the dietary intake and supplementation of calcium in 8033 Hungarian female and male (mean age: 68 years) (68.01 (CI95: 67.81–68.21)) patients with osteoporosis. Results. Mean intake from dietary sources was 665 ± 7.9?mg (68.01 (CI95: 67.81–68.21)) daily. A significant...

Amp Xe Bor Speer, G.; Szamosujv Amp Xe Ri, P. Amp Xe L.; Amp Xe Ter Dombai, P.; Amp Xe, Katalin Cs Amp Xf R.; Kinga Mikófalvi; Amp Xed Mea Steindl, T.; Ildikó Streicher; Amp Xfa Lia Tarsoly, J.; Gergely Zajzon; Amp Xe Ter Somogyi, P.; Szamos Amp Xfa Jv Amp Xe Ri, P. Amp Xe L.; Amp Xe Ter Lakatos, P.

2013-01-01

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Relationship between dietary macronutrient intake and the risk of age-related cataract in middle-aged and elderly patients in northeast China  

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Full Text Available AIM: To examine the association between dietary macronutrient intake and the risk of age-related cataract (ARC in middle-aged and elderly men.METHODS:A hospital-based case-control study was conducted from December 2009 to November 2011. Cases (n=360 were patients with cataract aged 45-85 years old, and controls (n=360 were patients who had been admitted to the same hospital for diseases not related with cataract. All subjects were interviewed using a structured interviewer-administrated questionnaire that included information on socio-demographic characteristics, lifestyle habits and detailed medical history, simultaneously, the dietary intakes of nutrients were collected via a valid semi-quantitative food frequency questionnaire (FFQ. The odds ratios (OR and corresponding 95% confidence intervals (CI of three types of ARC were estimated using multiple logistic regression models.RESULTS: After adjusting for multiple potential confounders, total dietary intake of carbohydrate was positively associated with cortical cataract, compared to controls in the lowest quartile, and the OR for cases in the highest quartile of intake was 2.471 (95%CI:1.348-6.043, P=0.027. Higher dietary intakes of protein were protective for posterior subcapsular cataract (PSC (OR=0.528, 95%CI:0.148-0.869, P=0.023. Dietary fat intake was not associated with any type of cataract, however, participants in the highest quartile of polyunsaturated fatty acids intake had 2.7 times the risk of nuclear cataract as did those in the lowest quartile (OR=2.742, 95%CI:1.790-4.200, P=0.033.CONCLUSION: A high intake of carbohydrate and polyunsaturated fatty acid may increase the odds of cortical and nuclear cataract, respectively, whereas high intake of protein, especially animal protein, may protect against PSC cataract. It is possible that dietary changes of target population may reduce the risk of ARC.

Zhi-Quan Lu

2013-12-01

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Gastrointestinal Side Effects and Adequacy of Enteral Intake in Hematopoietic Stem Cell Transplant Patients.  

Science.gov (United States)

Background: Patients undergoing hematopoietic stem cell transplant (HSCT) can experience gastrointestinal (GI) side effects as a complication of the treatment. Limited research exists describing how the duration and severity of GI side effects influence the consumption of adequate calorie intake in this population. The purpose of this study was to assess differences in GI side effects between patients who consumed adequate calories compared with those who did not. Methods: The MD Anderson Symptom Inventory-Gastrointestinal (MDASI-GI) tool was used to record daily GI side effects of 72 HSCT patients. Daily calorie intake was determined via calorie counts. Data were collected from day of transplant until engraftment. Results: Median percentage of caloric needs consumed for all patients was 49.2% (interquartile range, 35.1-66.6). Calorie intake decreased from baseline to transplant day 8 as severity of GI symptoms increased. An inverse relationship between percentage of caloric needs met and MDASI-GI component score, MDASI-GI symptom score, and lack of appetite score was observed. The only significant difference in MDASI-GI symptom scores between those who consumed adequate calories and those who consumed inadequate calories was for diarrhea; subjects who consumed >60% of caloric needs had significantly lower median diarrhea scores. Conclusion: Most patients consumed intake and to describe the implications of prolonged inadequate intake in HSCT patients. PMID:25227122

Walrath, Maegan; Bacon, Cheryl; Foley, Sharon; Fung, Henry C

2014-09-16

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AN ANALYSIS OF NURISHEMENT STATE, ENERGY INTAKE AND INTAKE OF MACRONUTRIENTS IN HOSPITALIZED PATIENTS  

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Introduction: Patients’ nutrition during their stay in a hospital is one of more important factors in the process of healing and rehabilitation. Inadequate and insufficient nutritional input while being ill, when our needs are substantially on the increase, results in a worse outcome of the illness. With hospitalized patients, malnutrition is related to a slower woundhealing, greater possibility of complex infections, greater risk for a repeated hospitalization and increased ...

Volk, Irena

2011-01-01

 
 
 
 
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Cardiovascular Risk Factors and Nutritional Intake are not Associated with Ultrasound-defined Increased Carotid Intima Media Thickness in Individuals Without a History of Cardiovascular Events  

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Background: Carotid ultrasound appears to be useful in the assessment of cardiovascular risk. In this study, we have assessed the carotid intima-media thickness (CIMT) in a group of individuals without a history of cardiovascular events. Methods: A sample of 431subjects (189 [43.9%] males and 242 [56.1%] females) was obtained from an urban population using a stratified-cluster method in Mashhad stroke and heart atherosclerosis disorder study. None of the subjects had a history of the cardiovascular event. Carotid artery duplex ultrasound was used to determine the CIMT in all subjects, and to identify those with an abnormal value (CIMT [+]; i.e., CIMT ? 0.8 mm). Dietary intake of participants was assessed using a questionnaire for 24-h dietary recall. The relationship between anthropometric, biochemical and dietary data and CIMT were assessed. Results: The mean age of subjects was 48.7 ± 8.0 years. Of the 431 patients, 118 (27.4%) were found to be CIMT (+). Of the cardiovascular parameters assessed, only age (odds ratio [OR] [95% confidence interval (CI)], 1.11 [0.56-4.34]; P < 0.01) and male gender (OR [95% CI], 1.14 [0.63-2.23]; P < 0.05) were significant independent predictors of ultrasound defined CIMT. Crude and total energy adjusted intake were not associated with the presence of CIMT (+). Conclusions: It appears that within a relatively young Iranian population of individuals without a history of cardiovascular event, the presence of CIMT (+) defined by duplex ultrasound cut-off value of ?0.8 mm, did not associate with several modifiable cardiovascular risk factors or measures of dietary intake.

Azarpazhooh, Mahmoud Reza; Kazemi-Bajestani, Seyyed Mohammad Reza; Esmaeili, Habib; Vedadian, Payam; Ebrahimi, Mahmoud; Parizadeh, Seyyed Mohammad Reza; Heidari-Bakavoli, Ali Reza; Moohebati, Mohsen; Safarian, Mohammad; Mokhber, Naghmeh; Nematy, Mohsen; Mazidi, Mohsen; Ferns, Gorden A; Ghayour-Mehrabani, Majid

2014-01-01

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[Food intake during the month of Ramadan in Moroccan patients with type 2 diabetes].  

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This cross-sectional study aimed to assess the daily dietary intake of type 2 diabetes patients attending Mohamed VI hospital in Marrakech during Ramadan 2010. Sociodemographic and clinical data were collected by interview, and qualitative and quantitative food intake, based on French nutritional tables, was assessed by a dietician. Of the 71 patients recruited, 55% were fasting. The average age of participants was 56.3 (SD 11,2) years. There were no statistically significant clinical differences between the fasting and nonfasting groups except for overweight/obesity and insulin dependence, which were more prevalent in the nonfasting group. The mean total daily caloric intake was significantly lower in the fasting than nonfasting group [1447.5 (SD 756.3) versus 1919.0 (SD 823.4) Kcal/d], as was the carbohydrate, lipid and protein intake. Carbohydrate intake was 57% and 56% of total calories. Overall during Ramadan the diet of the fasting group was calorie deficient and inadequate while for non-fasters it was excessive, which put them at risk of complications. Nutritional education may be needed for diabetic patients for Ramadan. PMID:23879080

Sebbani, M; El Ansari, N; El Mghari, G; Amine, M

2013-03-01

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Assessment of habitual energy and macronutrient intake in adults: comparison of a seven day food record with a dietary history interview  

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Objective: To examine the quantitative agreement between a 7 day food record and a diet history interview when these are conducted under the same conditions and to evaluate whether the two methods assess habitual diet intake differently among subgroups of age and body mass index (BMI). Design: Cross-sectional study. Setting: Population study, Denmark. Subjects: A total of 175 men and 173 women aged 30-60 y, selected randomly from a larger population sample of Danish adults. Interventions: All subjects had habitual diet intake assessed by a diet history interview and completed a 7 day food record within 3 weeks following the interview. The diet history interview and coding of records were performed by the same trained dietician. Main outcome measure: Median between-method difference in assessment of total energy intake, absolute intake of macronutrients, and nutrient energy percentages. Difference between reported energy intake from both methods and estimated energy expenditure in different subgroups. Results: Energy and macronutrient intake was assessed slightly higher by the 7 day food record than by the diet history interview, but in absolute terms the differences were negligible. The between-method difference in assessment of total energy intake appeared to be stable over the range of age and BMI in both sexes. As compared to estimated total energy expenditure, both diet assessment methods underestimated energy intake by approximately 20%. For both methods the under-reporting increased by BMI in both sexes and by age in men. Conclusions: Energy and macronutrient intake data collected under even conditions by either a 7 day food record or a diet history interview may be collapsed and analysed independent of the underlying diet method. Both diet methods, however, appear to underestimate energy intake dependent on age and BMI.

HØidrup, S.; Andreasen, A. H.

2002-01-01

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Energy and Protein Intake and Its Relationship with Pulmonary Function in Chronic Obstructive Pulmonary Disease (COPD) Patients  

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"nChronic Obstructive Pulmonary Disease (COPD) is a public health problem worldwide. Increased energy and protein needs, decreased energy and protein intake are common in COPD patients. Adequate intake is essential to improve pulmonary function and immune system, prevention of weight loss and maintaining muscle mass and strength. Assessment of energy and protein intake and its relationship with pulmonary function in COPD patients was performed in this study. The study group included 63 C...

Leila Yazdanpanah; Farzad Shidfar; Ali Javad Moosavi; Hassan Heidarnazhad; Hamid Haghani

2010-01-01

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Functional oral intake and time to reach unrestricted dieting for patients with traumatic brain injury  

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OBJECTIVES: To investigate the status of functional oral intake for patients with severe traumatic brain injury (TBI) and time to return to unrestricted dieting; and to investigate whether severity of brain injury is a predictor for unrestricted dieting. DESIGN: Observational retrospective cohort study. SETTING: Subacute rehabilitation department, university hospital. PARTICIPANTS: Patients age 16 to 65 years (N=173) with severe TBI (posttraumatic amnesia from 7d to >6 mo) admitted over a 5-year period. Patients are transferred to the brain injury unit as soon as they ventilate spontaneously. INTERVENTION: Facial oral tract therapy. MAIN OUTCOME MEASURE: Unrestricted dieting assessed by the Functional Oral Intake Scale (FOIS). RESULTS: We found that 93% of all patients had problems with functional oral intake at admission. Within 126 days of rehabilitation, 64% recovered to unrestricted dieting before discharge. The chance of returning to total oral diet depends on the severity of the brain injury and can be predicted by Glasgow Coma Scale (GCS; measured the day after cessation of sedation; Wald chi(2)=42.78, P<.01), Rancho Los Amigos Scale (RLAS) level (Wald chi(2)=11.84, P=.01), FIM instrument (Wald chi(2)=44.40, P<.01), and FOIS score at admission (Wald chi(2)=82.93, P<.01). CONCLUSIONS: Impairment in functional oral intake was found to be very common for patients with severe TBI admitted to a subacute rehabilitation department. For those who recovered during hospital rehabilitation, return to unrestricted dieting happened within 126 days of rehabilitation. The chance of returning to unrestricted dieting depends on the severity of the brain injury and can be predicted by GCS score, RLAS level, FIM score, and functional oral intake at admission. These results are important when planning rehabilitation, giving information to patients and relatives, and designing efficacy studies of facial oral tract therapy, which are highly recommended.

Hansen, Trine S; Engberg, Aase W

2008-01-01

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Variations in Dietary Intake Between Newly Diagnosed Gallstone Patients and Controls  

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Full Text Available To compare dietary intake of newly diagnosed gallstone patients and controls, 56 gallstone patients and 101 randomly selected control subjects without gallstones were enrolled in the study. The presence of gallstones were determined by ultrasonography. Both patients and control subjects completed a questionnaire exploring their dietary intake. Aanthropometric measurements were collected. Blood samples were analyzed for glucose triglycerides, total cholesterol, low density lipoprotein cholesterol (LDL-C, high density lipoprotein cholesterol (HDL-C, Apolipoprotein A-I (Apo A-I and Apolipoprotein B (Apo B. Oral contraceptive usage was significantly higher in gallstone patients than controls. Patients were significantly older than controls and had higher body mass index (BMI, however HDL-cholesterol levels were found significantly higher in controls. Dietary intake including energy, proteins, carbohydrates, refined sugar, sodium, calcium, and iron were significantly higher in patients. Dietary fiber and antioxidant vitamin (vitamin C levels were significantly lower in patients. Dietary interventions that emphasize the prevention effect of some nutrients and the contributory effect of others might provide a method of avoiding the formation of gallstones.

Mohammed A. Alsaif

2005-01-01

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Natural history of elderly patients with asymptomatic meningiomas  

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OBJECTIVE—For the treatment of elderly patients with asymptomatic meningiomas, it is important to determine their natural history. Based on results of follow up examinations, the natural history of such patients was clarified and prognostic factors concerning the potential of tumour growth in the aged were identified.?METHODS—The clinical records and imaging studies of 40 elderly (over 70 years) patients with asymptomatic meningiomas were analysed. The patients were...

Niiro, M.; Yatsushiro, K.; Nakamura, K.; Kawahara, Y.; Kuratsu, J.

2000-01-01

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Ingestão alimentar em pacientes com doença inflamatória intestinal Food intake in patients with inflammatory bowel disease  

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Full Text Available RACIONAL: Pacientes com doença inflamatória intestinal podem apresentar deficiências nutricionais. OBJETIVO: Verificar a adequação da ingestão alimentar de pacientes com doença de Crohn e retocolite ulcerativa inespecífica. MÉTODOS: Para avaliação da ingestão alimentar de 55 pacientes, 28 com doença de Crohn e 27 com retocolite ulcerativa atendidos em ambulatório de gastroenterologia, utilizou-se o Recordatório Alimentar de 24 Horas e o Questionário de Frequência Alimentar. A atividade inflamatória da doença foi avaliada pelos níveis séricos de proteína C reativa e o Índice de Harvey e Bradshaw. Para comparação de médias foi usado o teste t não pareado e, para as médias não paramétricas, o teste de Mann-Whitney, considerando nível de significância valor de pBACKGROUND: Patients with inflammatory bowel disease may have nutritional deficiencies. AIM: To verify the adequacy of dietary intake of patients with Crohn's disease and ulcerative colitis. METHODS: To assess food intake of 55 patients, 28 with Crohn's disease and 27 with ulcerative colitis treated in the gastroenterology clinic, was used the 24-Hour Food Recall and Food Frequency Questionnaire. The inflammatory activity of the disease was evaluated by serum C-reactive protein and Harvey and Bradshaw Index. For comparison of means t test was used, and the average on non-parametric, the Mann-Whitney test, with level of significance p <0.05. RESULTS: The patients were aged between 19 and 63 years and time since diagnosis was 7.9 years (1 to 22. According to the food intake was identified deficiency in energy intake, fiber, iron, potassium, sodium, magnesium, calcium, menadione, riboflavin, niacin, folate, pantothenic acid, tocopherol and cholecalciferol in Crohn's disease and ulcerative colitis, active or in remission. The intake of vegetables, fruits, dairy products and beans were low, and intake of fats and sweets was higher than the recommendations. CONCLUSION: There was a deficiency in food intake both in Crohn's disease and in ulcerative colitis, in activity and in remission. These deficiencies can adversely affect the disease course, and justify the need for nutritional intervention with these patients.

Alice Freitas da Silva

2011-09-01

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Salt intake and renal outcome in patients with progressive renal disease.  

Science.gov (United States)

Experimental studies suggest that salt intake plays a critical role in the progressive glomerular filtration rate (GFR) loss of established renal disease; however, this issue has never been addressed in humans. To this aim, we have retrospectively analyzed the clinical data of patients with chronic renal failure (CRF), in whom a low-protein diet was prescribed, over a period of about 3 years. On the basis of the daily urinary sodium output, the patients were divided into two groups: a group of patients constantly ingesting > 200 mEq NaCl/day (high sodium intake, HSD, n = 30) and a group in which salt intake was < 100 mEq/day (low sodium intake, LSD, n = 27). Patients taking diuretics or ACE inhibitors were excluded. At baseline, the LSD group, as compared to the HSD group, was characterized by significantly lower creatinine clearance (24 +/- 2 vs. 28 +/- 2 ml/min) and higher proteinuria (2.9 +/- 0.3 vs. 1.5 +/- 0.2 g/day). Despite the presence of these risk factors for progression, and a similar control of blood pressure (the average of the mean arterial pressure during follow-up was 111 +/- 2 mm Hg in LSD and 107 +/- 2 mm Hg in HSD), the LSD patients showed a better renal outcome: in this group, as compared to HSD, the GFR decline was lower (0.25 +/- 0.07 vs. 0.51 +/- 0.09 ml/min/month, p < 0.05), and proteinuria did not change while it markedly increased in HSD. During follow-up, LSD patients also ingested a significantly lower amount of protein. This study therefore suggests that efficacious salt restriction in CRF patients improves the outcome of renal disease independent from its antihypertensive effects. PMID:9554571

Cianciaruso, B; Bellizzi, V; Minutolo, R; Tavera, A; Capuano, A; Conte, G; De Nicola, L

1998-01-01

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Influence of food intake and postural changes on gastroesophageal sphincter pressure in patients with reflux esophagitis and in controls  

DEFF Research Database (Denmark)

The gastroesophageal sphincter pressure (GESP) was studied before, during, and after food intake in 9 reflux esophagitis patients and 11 healthy controls. A significant decrease in GESP was observed 5, 10, and 30 min after the beginning of the meal in reflux esophagitis patients, contrasting with an increase during food intake in the control group. In the supine position GESP was significantly lower than in the sitting position in esophagitis patients, contrasting with a significantly higher GESP in the supine position in the control group. These results may explain why patients with gastroesophageal reflux often develop their symptoms during food intake and in the supine position.

Funch-Jensen, Peter; Oster, M J

1982-01-01

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Energy and Protein Intake and Its Relationship with Pulmonary Function in Chronic Obstructive Pulmonary Disease (COPD Patients  

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Full Text Available "nChronic Obstructive Pulmonary Disease (COPD is a public health problem worldwide. Increased energy and protein needs, decreased energy and protein intake are common in COPD patients. Adequate intake is essential to improve pulmonary function and immune system, prevention of weight loss and maintaining muscle mass and strength. Assessment of energy and protein intake and its relationship with pulmonary function in COPD patients was performed in this study. The study group included 63 COPD patients. For all subjects, evaluation of energy and protein intake by Food Frequency Questionnaire (FFQ and 24-hour recall, spirometry for measuring pulmonary function and determining disease severity were performed. The subjects were divided into three groups based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD stages. Relationship between energy and protein intake with pulmonary function was assessed. Energy and protein intake were lower than the calculated energy and protein demand for all groups. Significant relationship was found between the amount of protein intake extrapolated from food frequency questionnaire with Forced Vital Capacity (FVC (r=0.2, P=0.02 and Vital Capacity (VC (r=0.3, P=0.008. The results of the study suggest that accurate evaluation of protein and energy intake and requirements should be included in the goals of medical treatment of COPD patients.

Leila Yazdanpanah

2010-11-01

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Energy and protein intake and its relationship with pulmonary function in chronic obstructive pulmonary disease (COPD) patients.  

Science.gov (United States)

Chronic Obstructive Pulmonary Disease (COPD) is a public health problem worldwide. Increased energy and protein needs, decreased energy and protein intake are common in COPD patients. Adequate intake is essential to improve pulmonary function and immune system, prevention of weight loss and maintaining muscle mass and strength. Assessment of energy and protein intake and its relationship with pulmonary function in COPD patients was performed in this study. The study group included 63 COPD patients. For all subjects, evaluation of energy and protein intake by Food Frequency Questionnaire (FFQ) and 24-hour recall, spirometry for measuring pulmonary function and determining disease severity were performed. The subjects were divided into three groups based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages. Relationship between energy and protein intake with pulmonary function was assessed. Energy and protein intake were lower than the calculated energy and protein demand for all groups. Significant relationship was found between the amount of protein intake extrapolated from food frequency questionnaire with Forced Vital Capacity (FVC) (r=0.2, P=0.02) and Vital Capacity (VC) (r=0.3, P=0.008). The results of the study suggest that accurate evaluation of protein and energy intake and requirements should be included in the goals of medical treatment of COPD patients. PMID:21287476

Yazdanpanah, Leila; Shidfar, Farzad; Moosavi, Ali Javad; Heidarnazhad, Hassan; Haghani, Hamid

2010-01-01

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Effects of oral intake of water in patients with oropharyngeal dysphagia  

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Abstract Background Dysphagia is associated with numerous medical conditions and the major intervention to avoid aspiration in people with dysphagia involves modifying the diet to thickened fluids. This is associated with issues related to patient quality of life and in many cases non-compliance leading to dehydration. Given these concerns and in the absence of conclusive scientific evidence, we designed a study, to further investigate the effects of oral intake of water in p...

Chivers Leonie; Jp, Karagiannis Martha; Karagiannis Tom C

2011-01-01

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Effects of oral intake of water in patients with oropharyngeal dysphagia  

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Full Text Available Abstract Background Dysphagia is associated with numerous medical conditions and the major intervention to avoid aspiration in people with dysphagia involves modifying the diet to thickened fluids. This is associated with issues related to patient quality of life and in many cases non-compliance leading to dehydration. Given these concerns and in the absence of conclusive scientific evidence, we designed a study, to further investigate the effects of oral intake of water in people with dysphagia. Methods We monitored lung related complications, hydration levels and assessed quality of life in two groups of people with dysphagia. The control group was allowed only thickened fluids and patients in the intervention group were allowed access to water for a period of five days. Results Our findings indicate a significantly increased risk in the development lung complications in patients given access to water (6/42; 14.3% compared to the control group (0/34; no cases. We have further defined patients at highest risk, namely those with degenerative neurologic dysfunction who are immobile or have low mobility. Our results indicate increased total fluid intake in the patients allowed access to water, and the quality of life surveys, albeit from a limited number of patients (24% of patients, suggest the dissatisfaction of patients to diets composed of only thickened fluids. Conclusions On the basis of these findings we recommend that acute patients, patients with severe neurological dysfunction and immobility should be strongly encouraged to adhere to a thickened fluid or modified solid consistency diet. We recommend that subacute patients with relatively good mobility should have choice after being well-informed of the relative risk. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12608000107325

Chivers Leonie

2011-03-01

35

Prescription History of Emergency Department Patients Prescribed Opioids  

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Introduction: To use Colorado’s prescription drug monitoring program (PDMP) to describe the recent opioid prescription history of patients discharged from our emergency department (ED) with a prescription for opioid pain medications.Methods: Retrospective cohort study of 300 adult ED patients who received an opioid prescription. We abstracted prescription histories for the six months prior to the ED visit from the PDMP, and abstracted clinical and demographic variables from the chart.Result...

Hoppe, Jason A.; John Houghland; Michael Yaron; Kennon Heard

2013-01-01

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Nutrient intake and the risk of pressure sore development in older patients.  

Science.gov (United States)

This study explored the possibility of a link between diet prior to admission to hospital and the development of pressure sores in older patients. The intention was to use this information to develop a nutrient prediction score and nutrient risk indicator. Thirty patients over the age of 75, admitted with either a fractured neck of femur or for hip replacement surgery, formed the study population. A Waterlow assessment was completed on admission and each patient answered a specially developed food frequency questionnaire. Patients in both diagnostic groups had Waterlow scores which put them into the high-risk category. A total of 20 pressure sores developed in the two groups of patients during their stay in hospital. Patients admitted for hip replacement had higher nutrient intake values than patients with fractured neck of femur and they also had a higher occurrence of pressure sores. Overall diet for all patients appeared to be adequate; however, the diet of patients with fractured neck of femur was significantly lower in both iron and vitamin C than that of patients having hip replacement surgery. The nutritional assessment tool was not as sensitive as expected and further development and validation are needed. While no firm conclusions can be drawn from this small study, the results do emphasise the importance of adequate diet in elderly patients prior to admission, especially for planned admissions for hip replacement. PMID:9510748

Lewis, B K

1998-01-01

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The association of functional oral intake and pneumonia in patients with severe traumatic brain injury  

DEFF Research Database (Denmark)

OBJECTIVES: To investigate the incidence and onset time of pneumonia for patients with severe traumatic brain injury (TBI) in the early phase of rehabilitation and to identify parameters associated with the risk of pneumonia. DESIGN: Observational retrospective cohort study. SETTING: Subacute rehabilitation department in a university hospital in Denmark. PARTICIPANTS: Patients (N=173) aged 16 to 65 years with severe TBI who were admitted during a 5-year period. Patients are transferred to the brain injury unit as soon as they ventilate spontaneously. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Pneumonia. RESULTS: Twenty-seven percent of the patients admitted to the brain injury unit were in treatment for pneumonia; pneumonia developed in 12% of the patients during rehabilitation; the condition occurred within 19 days of admission in all but 1 patient. Of these patients, 81% received nothing by mouth. Three factors identified patients at highest risk of pneumonia: Glasgow Coma Scale score less than 9 (1 day after cessation of sedation); Rancho Los Amigos Scale score less than 3 (on admission); and no oral intake on admission. Having a tracheotomy tube and/or feeding tube was also associated with a higher occurrence of pneumonia. CONCLUSIONS: Among patients with severe TBI, 27% had pneumonia at transfer from the intensive care unit. Pneumonia developed in only 12% of the participants during rehabilitation. Patients with a low level of consciousness and patients with a tracheotomy tube or feeding tube had a higher likelihood of pneumonia.

Hansen, Trine Schow; Larsen, Klaus

2008-01-01

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Food intake in patients on hemodialysis / Ingestão alimentar de pacientes em hemodiálise  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Objetivo: Avaliar o consumo de energia e nutrientes de indivíduos em hemodiálise, segundo recomendações específicas para essa população, e de acordo com o Guia Alimentar para a População Brasileira. Métodos: Tr [...] ata-se de estudo transversal, com 118 pacientes adultos considerados estáveis, tratados em 10 centros de diálise em Goiânia, Estado de Goiás. A ingestão alimentar foi estimada por meio de seis recordatórios de 24 horas, sendo classificada em adequada ou inadequada, conforme recomendações específicas para indivíduos em hemodiálise, é recomendado para uma alimentação saudável. Foi realizada análise descritiva dos dados. Resultados: Observou-se ingestão alimentar média de 2022,40 ± 283,70 kcal/dia; 31,18 kcal/kg/dia; 55,03 ± 4,20% de carboidrato; 30,23 ± 3,71% de lipídeo; e 1,18 ± 0,23 g de proteína/kg/dia. Importantes prevalências de inadequação foram observadas para a ingestão de calorias (39,0%), proteínas (39,0%) e outros nutrientes, como retinol (94,9%), gordura saturada (87,3%), colesterol (61,9%), ferro (61,0%), potássio (60,2%) e zinco (45,0%). Os pacientes apresentaram baixa ingestão de alimentos do grupo das frutas (1,22 ± 0,89 porções), legumes e verduras (1,76 ± 1,01 porções), leite e derivados (0,57 ± 0,43 porções), bem como ingestão elevada de alimentos do grupo dos óleos e gorduras (3,45 ± 0,95 porções) e açúcares e doces (1,55 ± 0,77 porções). Conclusão: Foi observado um consumo alimentar em desequilíbrio, caracterizado pelo excesso de óleos e gorduras, sobretudo gordura saturada e colesterol, açúcares e doces, paralelamente à baixa ingestão de frutas, legumes e verduras, leite e derivados. Um percentual considerável de pacientes deixou de ingerir a recomendação mínima de calorias, proteína, retinol, ferro, zinco e potássio. Abstract in english Objective: To evaluate the intake of energy and nutrients by individuals on hemodialysis, following especific recommendations for this population and according to Food Guide for the Brazilian Population. Methods: [...] A cross-sectional study, 118 adult patients, considered stable from, ten dialysis centers in Goiânia, Goiás. Dietary intake was estimated by six 24-hour recalls, and classified as adequate or inadequate, according to specific recommendations for individuals undergoing dialysis and that recommended for a healthy diet. A descriptive analysis was performed. Results: Average dietary intake of 2022.40 ± 283.70 kcal/day; 31.18 kcal/kg/day; 55.03 ± 4.20% carbohydrate; 30.23 ± 3.71% lipid, 1.18 ± 0.23 g protein/kg/day. Important prevalences of inadequacy were observed for the intake of calories (39.0%), protein (39.0%) and other nutrients such as retinol (94.9%), saturated fat (87.3%), cholesterol (61,9%), iron (61.0%), potassium (60.2%) and zinc (45.0%). Patients had a low intake of fruit food group (1.22 ± 0.89 servings) and vegetables (1.76 ± 1.01 servings), dairy products (0.57 ± 0.43 servings) and high intake of food group of oils and fats (3.45 ± 0.95 servings), sugars and sweets (1.55 ± 0.77 servings). Conclusion: Observed food consumption imbalance, characterized by excess of oils and fats, especially saturated oils and cholesterol, sugars and sweets, parallel to low intake of fruits and vegetables and dairy products. A considerable percentage of patients did not intake the minimum recommended of calories, protein, retinol, iron, zinc and potassium.

Inaiana Marques Filizola, Vaz; Ana Tereza Vaz de Souza, Freitas; Maria do Rosário Gondim, Peixoto; Sanzia Francisca, Ferraz; Marta Izabel Valente Augusto Morais, Campos.

2014-12-01

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The effect of dietary intake changes on nutritional status in acute leukaemia patients after first induction chemotherapy.  

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This study aimed to evaluate how changes in dietary intake among acute lymphoblastic and acute myeloid leukaemia (ALL and AML) patients affect nutritional status after the first induction chemotherapy. Dietary intake was assessed using 24-h recall and a 136-item food frequency questionnaire. Nutritional status was assessed by Patients Subjective Global Assessment questionnaire before starting induction therapy and again after 1 month. All newly diagnosed acute leukaemia patients aged 15 years old and older who attended three referral hospitals for initiation of their induction chemotherapy were included in the sample selection provided that they gave informed consent. A total of 30 AML and 33 ALL patients participated in the study. Dietary intake and nutritional status worsened after the chemotherapy treatment. Dietary intake in terms of macronutrients, micronutrients, food variety and diet diversity score changed significantly after the induction chemotherapy. No significant relationship was found between the changes in dietary indices and nutritional status. Chemotherapy-related side effects as an additional factor to cancer itself could affect dietary intake of leukaemia patients. The effectiveness of an early assessment of nutritional status and dietary intake should be further investigated in order to deter further deterioration. PMID:25355468

Malihi, Z; Kandiah, M; Chan, Y M; Esfandbod, M; Vakili, M; Hosseinzadeh, M; Zarif Yeganeh, M

2014-10-30

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First Quantification of Calcium Intake from Calcium-Dense Dairy Products in Dutch Fracture Patients (The Delft Cohort Study  

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Full Text Available Recommendations for daily calcium intake from dairy products are variable and based on local consensus. To investigate whether patients with a recent fracture complied with these recommendations, we quantified the daily dairy calcium intake including milk, milk drinks, pudding, yoghurt, and cheese in a Dutch cohort of fracture patients and compared outcomes with recent data of a healthy U.S. cohort (80% Caucasians. An observational study analyzed dairy calcium intakes of 1526 female and 372 male Dutch fracture patients older than 50. On average, participants reported three dairy servings per day, independently of age, gender or population density. Median calcium intake from dairy was 790 mg/day in females and males. Based on dairy products alone, 11.3% of women and 14.2% of men complied with Dutch recommendations for calcium intake (adults ? 70 years: 1100 mg/day and >70 years: 1200 mg/day. After including 450 mg calcium from basic nutrition, compliance raised to 60.5% and 59.1%, respectively, compared to 53.2% in the U.S. cohort. Daily dairy calcium intake is not associated with femoral neck bone mineral density (BMD T-scores or WHO Fracture Assessment Tool (FRAX risk scores for major fracture or hip fracture. However, when sub analyzing the male cohort, these associations were weakly negative. The prevalence of maternal hip fracture was a factor for current fracture risks, both in women and men. While daily dairy calcium intake of Dutch fracture patients was well below the recommended dietary intake, it was comparable to intakes in a healthy U.S. cohort. This questions recommendations for adding more additional dairy products to preserve adult skeletal health, particularly when sufficient additional calcium is derived from adequate non-dairy nutrition.

Peter van den Berg

2014-06-01

 
 
 
 
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Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study  

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Full Text Available Abstract Background Information regarding dietary nutrient intake during tuberculosis disease is lacking. We established the relationship between disease severity or wasting during pulmonary tuberculosis and nutrient intake. Methods In a cross-sectional study of 131 adults with or without pulmonary tuberculosis were screened for human immune-deficiency virus (HIV, wasting, disease severity using 13 item validated clinical TBscore, and 24-hour dietary intake recall. Results Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following nutrients: energy, protein, total fat, carbohydrate, calcium, vitamin A, and folate were low among patients with severe tuberculosis disease. Patients with moderate-to-severe clinical TBscore had lower average energy intake than patients with mild TBscores (6.11 vs. 9.27 MJ, respectively (p Conclusions Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake. Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.

Mupere Ezekiel

2012-12-01

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Antidepressants may lead to a decrease in niacin and NAD in patients with poor dietary intake.  

Science.gov (United States)

The term niacin is the generic name for the two compounds nicotinic acid and nicotinamide, the major dietary precursors for two important coenzymes, nicotinamide adenine dinucleotide (NAD) and its phosphorylated form, NADP. Niacin is important for the maintenance of cellular integrity and energy production and is involved in more than 500 intracellular reactions. Deficiencies of niacin may contribute to neuropsychiatric and neurodegenerative disorders. Patients who develop nutritional deficiencies as a result of poor dietary intake, especially inadequate intake of proteins and vitamins, could potentially suffer from niacin deficiency and NAD depletion. However, de novo synthesis of niacin and NAD in the kynurenine pathway of tryptophan metabolism may compensate for impaired dietary intake. The rate of synthesis of NAD and niacin from tryptophan oxidation depends on the induction of the enzyme indoleamine 2,3-dioxygenase (IDO) by pro-inflammatory cytokines such as interferon-gamma. Niacin synthesis is not limited by a decrease in tryptophan and excessive IDO activity may therefore lead to a decline in tryptophan levels. Antidepressants have an anti-inflammatory effect, including reduction of interferon-gamma and therefore inhibition of IDO, the rate-limiting enzyme of the kynurenine pathway. In theory, this could account for increased serotonin as more tryptophan becomes available for serotonin synthesis. However, the downside may be that less NAD and niacin are synthesised downstream, which could exacerbate common psychiatric problems. It is our hypothesis that patients with poor dietary intake, who are treated with antidepressants, are at risk of developing niacin/NAD deficiency with possible development of associated neuropsychiatric symptoms. We therefore propose that niacin supplementation be considered in patients with inadequate diets who are treated with antidepressants. We believe that if this does not happen, a subclinical niacin deficiency may result, which would be difficult to detect as it would cause the same symptoms of the original illness (e.g. depression). Niacin deficiency should be considered and ruled out in all patients with treatment-resistant depression, who have a poor response to antidepressants. This is potentially a cost-effective and easy intervention, which could be examined in a randomized controlled trial. PMID:25596911

Viljoen, Margaretha; Swanepoel, Annie; Bipath, Priyesh

2015-03-01

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Ingestão alimentar em pacientes com doença inflamatória intestinal / Food intake in patients with inflammatory bowel disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese RACIONAL: Pacientes com doença inflamatória intestinal podem apresentar deficiências nutricionais. OBJETIVO: Verificar a adequação da ingestão alimentar de pacientes com doença de Crohn e retocolite ulcerativa inespecífica. MÉTODOS: Para avaliação da ingestão alimentar de 55 pacientes, 28 com doença [...] de Crohn e 27 com retocolite ulcerativa atendidos em ambulatório de gastroenterologia, utilizou-se o Recordatório Alimentar de 24 Horas e o Questionário de Frequência Alimentar. A atividade inflamatória da doença foi avaliada pelos níveis séricos de proteína C reativa e o Índice de Harvey e Bradshaw. Para comparação de médias foi usado o teste t não pareado e, para as médias não paramétricas, o teste de Mann-Whitney, considerando nível de significância valor de p Abstract in english BACKGROUND: Patients with inflammatory bowel disease may have nutritional deficiencies. AIM: To verify the adequacy of dietary intake of patients with Crohn's disease and ulcerative colitis. METHODS: To assess food intake of 55 patients, 28 with Crohn's disease and 27 with ulcerative colitis treated [...] in the gastroenterology clinic, was used the 24-Hour Food Recall and Food Frequency Questionnaire. The inflammatory activity of the disease was evaluated by serum C-reactive protein and Harvey and Bradshaw Index. For comparison of means t test was used, and the average on non-parametric, the Mann-Whitney test, with level of significance p

Alice Freitas da, Silva; Maria Eliana Madalozzo, Schieferdecker; Heda Maria Barska dos Santos, Amarante.

2011-09-01

44

Nutritional status and food intake of patients with systemic psoriasis and psoriatic arthritis associated  

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Full Text Available Objective: To identify the nutritional status and food intake ofindividuals with systemic psoriasis and psoriatic arthritis associated. Methods: This is an exploratory and cross-sectional study with 34 men aged between 19 and 60 years seen at a Psoriasis Center.Participants were divided into systemic psoriasis group and arthriticsystemic psoriasis associated group. For nutritional assessment we used anthropometry, bioelectrical impedance analysis and wholebody plethysmography. Clinical and nutritional information were assessed using the clinical and nutritional history-taking, and the 24-hour dietary recall. For statistics the general linear model test (p 25% and a high risk formetabolic complications according to the waist circumference andthe obesity index, however, there were no statistically significantdifferences between groups. The mean food intake, total fat, caloriesand protein were above recommended levels, being 58.8% for lipids(319.17 ± 241.02 mg of cholesterol and 17.42 ± 11.4 g saturated fattyacids; 29.4% for calories and 67.6% for proteins. Thus, regardless ofthe psoriasis type, an excessive consumption of calories, lipids, fatty acids, cholesterol and a higher incidence of overweight were found. Conclusion: The sample showed an abnormal nutritional condition, an increased risk for chronic diseases related to obesity, worsening of the psoriatic lesions, and poor quality of life.

Marina Yazigi Solis

2012-03-01

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The influence of high versus low sodium intake on blood pressure and haemodynamics in patients with morbid obesity  

DEFF Research Database (Denmark)

BACKGROUND: Many patients with morbid obesity (BMI?>?40?kg/m) have hypertension. The complex pathophysiological abnormalities linking hypertension to obesity have not been fully clarified, but abnormal sodium handling could be an important mechanism. METHOD: Therefore, we examined changes in body fluid compartments and haemodynamic responses (at rest and during exercise) after 5 days of a low-sodium diet (90?mmol/day) and 5 days of a high-sodium diet (250?mmol/day) in 12 morbidly obese, hypertensive patients; 12 morbidly obese, normotensive patients and 12 nonobese controls. RESULTS: High sodium intake as compared to low sodium intake was associated with an increase in plasma volume (obese, hypertensive patients: 5?±?4%; obese, normotensive patients: 10?±?11%; nonobese controls: 7?±?6%), cardiac output (CO) (obese, hypertensive patients: 17?±?12%; obese, normotensive patients: 20?±?16%; nonobese controls: 13?±?14%) and stroke volume (SV) (obese, hypertensive patients: 27?±?26%; obese, normotensive patients:27?±?24%; nonobese controls: 18?±?27%) in all three groups with no differences between the groups. Despite an increase in CO during high salt intake, 24-h blood pressure (BP) was unchanged in patients and controls as a result of a reduction in total peripheral resistance (obese, hypertensive patients: -11?±?11%; obese, normotensive patients: -10?±?12%; nonobese controls: -5?±?14%). Similar changes were observed during an incremental bicycle exercise test wherein CO and SV were higher, whereas mean arterial BP was unchanged at each exercise level during high sodium intake. CONCLUSION: Despite substantial increases in CO and SV, we did not observe any significant change in BP during high sodium intake, neither in morbid obese patients nor in lean individuals.

Bonfils, Peter K; Taskiran, Mustafa

2013-01-01

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Prevalence of low dietary calcium intake in patients with epilepsy: A study from South India  

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Full Text Available Background: The effects of antiepileptic drugs (AED on bone health are well documented. Inadequate dietary intake of calcium and vitamin D plays a vital role and further compromises the bone health. Objective: To assess the dietary pattern with special reference to calcium and related minerals in people with epilepsy (PWE on AED. Materials and Methods: The dietary assessment in PWE was documented by dietary recall method. Patients were categorized according to age: group I: < 14 years; group II: between 15-20 years; group III: between 21-45 years; group IV:> 46 years. From the raw weights, total energy, dietary calcium, dietary phosphorous intake and phytate calcium ratio was calculated using a food composition table by Indian Council of Medical Research (ICMR and analyzed statistically. Results: A total of 362 patients with mean age of 29 + 15 years were studied. There were 190 women. The mean duration of AED treatment was 4 + 3 yrs, 64% on monotherapy 64% and 36% on polytherapy. The mean dietary intake of the total chohort was 2,007 + 211 Kcal/day, carbohydrate 335 + 33 gm/day; protein 31 + 7 gm/day; fat 18+2 gm/day; calcium 294 + 40 mg/day; phosphorus 557 + 102; phytates 179 + 30 mg/day; and phytate/calcium ratio 0.56+0.2. Milk and milk products were consumed by 42% of the total cohort. The daily dietary calcium (301 + 40 mg/day intake of men was significantly higher than women (287 + 39 mg/day (P < 0.001. This was more evident in group II (P < 0.01 and group III (P < 0.03. There was a positive correlation between dietary calcium and dietary phytates (P < 0.001, dietary proteins (P < 0.001, dietary fat (P < 0.001, and total energy (P < 0.001. Conclusions: The dietary consumption of calcium of all the patients was far below the recommended daily dietary allowance (RDA by Indian Council of Medical Research (ICMR. Low dietary calcium could have a confounding effect on PWE on AED in all age groups. There is a need to formulate consensus guidelines to supplement dietary calcium to PWE.

Menon Bindu

2010-01-01

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Increased calcium intake does not suppress circulating 1,25-dihydroxyvitamin D in normocalcemic patients with sarcoidosis.  

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Ca absorption is regulated by 1,25(OH)2D, and serum values vary inversely with Ca intake. In sarcoidosis, 1,25(OH)2D is produced by alveolar macrophages in response to gamma-interferon, and patients may develop hypercalcemia after prolonged exposure to sunlight and increased dermal production of vitamin D3. To determine if increased Ca intake suppresses serum 1,25(OH)2D in normocalcemic patients and to identify those at risk, 17 normal subjects and 11 patients were studied on a metabolic ward...

Basile, J. N.; Liel, Y.; Shary, J.; Bell, N. H.

1993-01-01

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Nutritional knowledge, nutrients intake and nutritional status of hypertensive patients in Ondo State, Nigeria.  

Science.gov (United States)

This study aimed at assessing the anthropometry, dietary intake and micronutrient status of hypertensive patients attending specialist hospitals in Ondo State, Nigeria. A descriptive case control study was conducted among subjects attending two specialist hospitals located in Akure and Ondo towns. A total of 452 subjects (44.9% males and 55.1% females), was purposely selected from the study centres. A structured questionnaire was designed to collect information on demographic characteristics, socio-economic parameters, nutrition knowledge and dietary intakes of the subjects. The quantities of subjects' dietary intakes were measured using household measurements. Weight, height, systolic (SBP) and diastolic (DBP) blood pressures were measured using electronic bathroom scale, standiometer and sphygmomanometer, respectively. The subject's urine was collected; and vitamin C, sodium, potassium, calcium, zinc and magnesium were determined using standard procedures. The results showed the following means: age 52.4 +/- 2.38 years, weight 66.4 +/- 1.63kg, height 1.64 +/- 0.01m, body mass index (BMI) 24.13 +/- 0.69kg/m2, SBP 124.86 +/- 2.3mmHg and DBP 76.22 +/- 1.86 mmHg. Blood pressure (BP) of the subjects showed that 46.9% had optimal BP, 14.2% normal BP, 11.5% high normal BP, 12.8% mild hypertension, 9.7% moderate hypertension and 4.9% severe hypertension. For BMI, 8.8% were underweight, 47.1% normal, 30.3% overweight, 6.0% obesity class I, 6.0% obesity class II and 1.8% obesity class III. The proportion of hypertensive subjects that were obese was significantly (P = 0.0001) higher than control subjects. Three-fifth of the control subjects had good nutrition knowledge compared to one-fifth of hypertensive subjects. The estimated mean energy intake was 8.46 MJ, protein 93.1g, carbohydrate 314.5g, fat 42.9g, fibres 5.6g and appreciable amount of vitamin C, calcium, zinc, magnesium, sodium and potassium. The subjects' urinary vitamin C concentration was 32.49 +/- 2.53mg; calcium 0.41 +/- 0.06mg, zinc 0.04 +/- 0.01mg; magnesium 4.57 +/- 0.37mg, sodium 8.33 +/- 0.37mg) and potassium 7.45 +/- 0.21mg. Statistically, there were significant differences (P < 0.05) between urinary vitamin C, sodium and potassium concentration (except zinc) of hypertensive patients and the control subjects. Weak correlations were observed between the subjects' systolic (P < 0.05) and diastolic (P < 0.01) BP and age, BMI and magnesium; with inverse correlations between vitamin C, sodium and potassium. The study concluded that hypertension was significantly influenced by BMI of the subjects, which may be an indication of high intake of calories. Therefore, calorie intake should be controlled among the hypertensives. PMID:18846781

Ijarotimi, O S; Keshinro, O O

2008-04-01

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Prescription History of Emergency Department Patients Prescribed Opioids  

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Full Text Available Introduction: To use Colorado’s prescription drug monitoring program (PDMP to describe the recent opioid prescription history of patients discharged from our emergency department (ED with a prescription for opioid pain medications.Methods: Retrospective cohort study of 300 adult ED patients who received an opioid prescription. We abstracted prescription histories for the six months prior to the ED visit from the PDMP, and abstracted clinical and demographic variables from the chart.Results: There were 5,379 ED visits during the study month, 3,732 of which were discharged. Providers wrote 1,165 prescriptions for opioid analgesics to 1,124/3,732 (30% of the patients. Median age was 36 years. Thirty-nine percent were male. Patients were 46% Caucasian, 26% African American, 22% Hispanic, 2% Asian and 4% other. These were similar to our overall ED population. There was substantial variability in the number of prescriptions, prescribers and total number of pills. A majority (205/296 of patients had zero or one prescription. The 90th percentile for number of prescriptions was seven, while the 10th percentile was zero. Patients in the highest decile tended to be older, with a higher proportion of Caucasians and females. Patients in the lowest decile resembled the general ED population. The most common diagnoses associated with opioid prescriptions were abdominal pain (11.5%, cold/flu symptoms (9.5%, back pain (5.4%, flank pain (5.0% and motor vehicle crash (4.7%.Conclusion: Substantial variability exists in the opioid prescription histories of ED patients, but a majority received zero or one prescription in the preceding six months. The top decile of patients averaged more than two prescriptions per month over the six months prior to ED visit, written by more than 6 different prescribers. There was a trend toward these patients being older, Caucasian and female. [West J Emerg Med. 2013;14(3:247–252.

Jason A Hoppe

2013-05-01

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Insufficient voluntary intake of nutrients and energy in hospitalized patients / Ingestión voluntariamente insuficiente de nutrientes y energía en pacientes hospitalizados  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Objetivo: El propósito de nuestro estudio fue evaluar la inadecuación de la ingestión voluntaria de energía y nutrientes durante el primer día de ingreso hospitalario. Pacientes y métodos: Se realizó un estudio transversal en dos centros hospitalarios de atención terciaria con una muestra probabilís [...] tica del 50% de pacientes ingresados. Se evaluó la ingestión alimenticia mediante un diario de 24 horas, y se hizo un cribado de desnutrición mediante la herramienta Nutritional Risk Screening 2002. Se estimó la falta de adecuación del consumo de energía y nutrientes mediante el Dietary Reference Intakes. Resultados: El consumo de energía y nutrientes en 258 pacientes mostró niveles muy bajos tanto en hombre como en mujeres. No se hallaron diferencias significativas en el consumo de energía y nutrientes entre los distintos grupos de edad ( Abstract in english Aim: The aim of our study was to evaluate the inadequacy of voluntary energy and nutrient intake on the first day of hospital admission. Patients and methods: A cross-sectional study was carried out in two terciary care hospitals, with a probabilistic sample of 50% of in-patients. Dietary intake was [...] evaluated by a 24-hour dietary recall, and undernutrition was screened through the Nutritional Risk Screening 2002 tool. The overall frequency of inadequate energy and nutrient intake was estimated using Dietary Reference Intakes. Results: Energy and nutrient intakes from 258 patients showed very low values for both men and women. No significant differences were found for energy and nutrient intakes across age groups (

M. M., Tavares; L., Matos; T. F., Amaral.

2007-10-01

51

Multi-modal intervention improved oral intake in hospitalized patients : A one year follow-up study  

DEFF Research Database (Denmark)

BACKGROUND: Good nutritional practice (GNP) includes screening, nutrition plan and monitoring, and is mandatory for targeted treatment of malnourished patients in hospital. AIMS: To optimize energy- and protein-intake in patients at nutritional risk and to improve GNP in a hospital setting. METHODS: A 12-months observational multi-modal intervention study was done, using the top-down and bottom-up principle. All hospitalized patients (>3 days) were included. Setting: A university hospital with 758 beds and all specialities. Measurements: Record audit of GNP, energy- and protein-intake by 24-h recall, patient interviews and staff questionnaire before and after the intervention. Interventions: Based on pre-measurements, nutrition support teams in each department made targeted action plans, supervised by an expert team. Education, diagnose-specific nutrition plans, improved menus and eating environment, and awareness were initiated. Statistics: Mann-Whitney and Kruskal-Wallis test was used for ordinal data, and Pearson Chi square test for nominative data. RESULTS: Overall 545 patients participated (287 before/258 after) from 26/22 departments. There were no significant differences regarding sex, age, BMI or previous weight loss before and after the intervention. Result-indicators: Energy intake improved from 52% to 68% (p 75% of requirements). Intake of less than 50% of requirements decreased with 50%. Process-indicators: Screening improved from 56% to 77% (p < 0.001), nutrition plans from 21% to 56% (p < 0.0001), and monitoring food intake from 29% to 58% (p < 0.0001). CONCLUSIONS: Intake of energy and protein as well as GNP improved using a multi-modal top-down and bottom-up approach.

Holst, M; Beermann, T

2014-01-01

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Fat intake in patients newly diagnosed with type 2 diabetes: a 4-year follow-up study in general practice.  

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BACKGROUND: Although treatment targets for the consumption of dietary fat in patients with type 2 diabetes mellitus are well accepted, little is known about the actual fat consumption by newly diagnosed patients or the dietary adjustments that they make in the following years. AIMS: To measure fat intake in patients with type 2 diabetes in general practice at diagnosis, shortly after dietary consultation, and after 4 years. DESIGN OF STUDY: A prospective cohort study. SETTING: Thirty-three ge...

Laar, F. A.; Lisdonk, E. H.; Lucassen, P. L.; Tigchelaar, J. M.; Meyboom, S.; Mulder, Jan; Hoogen, H. J. Den; Rutten, G. E. H. M.; Weel, C.

2004-01-01

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Preoperative evaluation of patients with history of allergy  

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Full Text Available The prevalence of allergic reactions in general population shows a constant rise. It has been estimated that up to 40% of surgical patients have a positive history of some kind of allergy. These patients represent a challenge during perioperative evaluation, since they can be exposed to a large variety of drugs and substances during surgery and anesthesia. A lot of adverse drug reactions show similar clinical presentation with allergic reactions. The latter are usually poorly explored since preoperative allergology testing is performed in a limited number of patients. Management of patients with history of allergy is impeded by the fact that most of allergens cross-react in a manner that is not always easy to predict. Allergies can manifest themselves with a broad spectrum of clinical symptoms, ranging from mild skin symptoms such as itch and urticaria, to a life-threatening anaphylactic reactions followed by hypotension, bronchospasm and cardiovascular collapse. Prevention of allergic reactions during perioperative period requires detailed history taking in order to identify patients at risk, optimization of anesthesia strategy, pharmacological premedication and further allergology diagnostic work-up in selected cases.

Veli?kovi? Jelena

2011-01-01

54

Barriers to nutritional intake in patients with acute hip fracture: time to treat malnutrition as a disease and food as a medicine?  

Science.gov (United States)

Inadequate energy and protein intake leads to malnutrition; a clinical disease not without consequence post acute hip fracture. Data detailing malnutrition prevalence, incidence, and intake adequacy varies widely in this patient population. The limited success of reported interventional strategies may result from poorly defined diagnostic criteria, failure to address root causes of inadequate intake, or errors associated with selection bias. This pragmatic study used a sequential, explanatory mixed methods design to identify malnutrition aetiology, prevalence, incidence, intake adequacy, and barriers to intake in a representative sample of 44 acute hip fracture patients (73% female; mean age, 81.7 ± 10.8 years). On admission, malnutrition prevalence was 52.2%. Energy and protein requirements were only met twice in 58 weighed 24 h food records. Mean daily patient energy intake was 2957 kJ (50.9 ± 36.1 kJ·kg(-1)) and mean protein intake was 22.8 g (0.6 ± 0.46 g·kg(-1)). This contributed to a further in-patient malnutrition incidence of 11%. Barriers to intake included patient perceptions that malnutrition and (or) inadequate intake were not a problem, as well as patient and clinician perceptions that treatment for malnutrition was not a priority. Malnutrition needs to be treated as a disease not without consequence, and food should be considered as a medicine after acute hip fracture. PMID:23746263

Bell, Jack; Bauer, Judith; Capra, Sandra; Pulle, Chrys Ranjeev

2013-06-01

55

Positive effect of protein-supplemented hospital food on protein intake in patients at nutritional risk : a randomised controlled trial  

DEFF Research Database (Denmark)

BACKGROUND: New evidence indicates that increased dietary protein ingestion promotes health and recovery from illness, and also maintains functionality in older adults. The present study aimed to investigate whether a novel food service concept with protein-supplementation would increase protein and energy intake in hospitalised patients at nutritional risk. METHODS: A single-blinded randomised controlled trial was conducted. Eighty-four participants at nutritional risk, recruited from the departments of Oncology, Orthopaedics and Urology, were included. The intervention group (IG) received the protein-supplemented food service concept. The control group (CG) received the standard hospital menu. Primary outcome comprised the number of patients achieving ?75% of energy and protein requirements. Secondary outcomes comprised mean energy and protein intake, body weight, handgrip strength and length of hospital stay. RESULTS: In IG, 76% versus 70% CG patients reached ?75% of their energy requirements (P = 0.57);66% IG versus 30% CG patients reached ?75% of their protein requirements (P = 0.001). The risk ratio for achieving ?75% of protein requirements: 2.2 (95% confidence interval = 1.3-3.7); number needed to treat = 3 (95% confidence interval = 2-6). IG had a higher mean intake of energy and protein when adjusted for body weight (CG: 82 kJ kg(-1) versus IG: 103 kJ kg(-1) , P = 0.013; CG: 0.7 g protein kg(-1) versus 0.9 g protein kg(-1) , P = 0.003). Body weight, handgrip strength and length of hospital stay did not differ between groups. CONCLUSIONS: The novel food service concept had a significant positive impact on overall protein intake and on weight-adjusted energy intake in hospitalised patients at nutritional risk.

Munk, T; Beck, A M

2014-01-01

56

Dietary intake of micronutrients in first-degree healthy, diabetic and IGT relatives of type II diabetic patients  

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Introduction: To evaluate the dietary content of micronutrients in first-degree relatives of type II diabetic patients, with respect to the influence of dietary composition on the development of diabetes. Methods and Materials: 210 first-degree relatives of type II diabetic patients were divided into 2 groups (normal and IGT+ diabetic), according to the results of OGTT. 3-Day food recall questionnaire was completed by skilled nutritionists from all subjects. The participants’ intake of calo...

Hosein Khosravi-Broojeni; Badrolmolok Forghani; Maryam Zare; Sasan Haghighi; Masoud Amini; Ahmad Khosravi

2008-01-01

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Plasma total homocysteine and macrovascular complications are associated with food and nutrient intake in patients with Type II diabetes mellitus  

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The present study was conducted to document the association between plasma homocysteine levels and the presence of macrovascular angiopathy with food and nutrient intake patterns among patients with Type II diabetes mellitus in Korea. Plasma total homocysteine concentration was analyzed by HPLC-fluorescence detector method in 127 patients with non-insulin dependent diabetes mellitus. Logistic regression analyses were performed respectively to study the association of plasma homocysteine level...

Chang, Namsoo; Kim, Ji-myung; Kim, Hyesook; Cho, Yong Wook

2007-01-01

58

Prognostic factors of epilepsy in patients with neonatal seizures history  

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Full Text Available Background Seizures in neonates are often associated with neurological disorders in early life, including epilepsy. Several possible prognostic factors may influence the development of epilepsy in these patients. Objective To evaluate prognostic factors that may influence the occurrence of epilepsy in the first two years of life in patients with a history of neonatal seizures. Methods We performed a cohort retrospective study on patients with neonatal seizures in Sardjito Hospital during 2004-2009. Prognostic factors observed were gender, family history of epilepsy, neonatal hypoglycemia, assisted labor, hypoxic ischemic encephalopathy, preterm infant delivery, and epileptic state. Results Hypoxic ischemic encephalopathy and epileptic state increased the risk of epilepsy (HR 5.8; 95%CI 1.63 to 20.43 and HR 6.3; 95%CI 2.0 to 19.70, respectively. Assisted labor, preterm delivery, neonatal hypoglycemia, family history of epilepsy, and gender did not increase the risk of epilepsy in the first two years of life. Conclusion Hypoxic ischemic encephalopathy and epileptic state in neonates presenting with seizures are the prognostic factors to be epileptic children during the first two years of life. [Paediatr Indones. 2013;53:218-22.].

Banani Sidiq

2013-07-01

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Consumption of low-fat dairy products and energy and protein intake in cancer patients at risk of malnutrition.  

Science.gov (United States)

Current nutritional guidelines encourage the reduction of fat intake from animal sources like dairy products. The aim was to determine whether the consumption of low-fat dairy is related to poorer dietary intake and nutritional status in cancer patients at risk of malnutrition. This cross-sectional included patients with solid or hematological malignancies at risk of malnutrition. Nutritional status was studied using Subjective Global Assessment, anthropometry, and grip strength. Dietary intake was evaluated with a 24-h recall and dairy consumption with a structured questionnaire. Seventy-four patients were recruited; 71.6% males of 64.8 yr, most with gastrointestinal malignancies. Only 37.8% consumed whole milk, and 61.4% consumed whole yogurt. Reasons for consumption of low-fat dairies were healthy diet (58.0%), hypercholesterolemia (20.0%), and digestive intolerance (10.0%). There were similar rates of malnutrition according the type of dairy (whole 60.9% vs. low-fat 66.7%, P = 0.640). Low-fat dairies were related to a reduction in energy (whole 1980.1 kcal vs. low-fat 1480.9, P = 0.007) and protein intake (whole 86.0 g vs. low-fat 63.0 g, P = 0.030). PMID:25412019

Vidal-Casariego, Alfonso; Pintor-de la Maza, Begoña; Calleja-Fernández, Alicia; Villar-Taibo, Rocío; Cano-Rodríguez, Isidoro; Ballesteros-Pomar, María D

2015-01-01

60

Evaluation of computer-based medical histories taken by patients at home  

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The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the history and post-history assessment questionnaire and were for the most part positive in their assessment; and 23 continued on to complete their post...

Slack, Warner V.; Kowaloff, Hollis B.; Davis, Roger B.; Delbanco, Tom; Locke, Steven E.; Safran, Charles; Bleich, Howard L.

2012-01-01

 
 
 
 
61

The newly identified anorexigenic adipokine nesfatin-1 in hemodialysis patients: Are there associations with food intake, body composition and inflammation?  

Science.gov (United States)

Nesfatin-1 is a recently identified anorexigenic peptide that has been implicated in appetite regulation, weight loss and/or malnutrition. Anorexia and malnutrition are common features of chronic kidney disease (CKD) that predispose patients to worse outcomes. However, the reasons for the occurrence of anorexia in CKD patients are not fully elucidated. The aim of this study was to investigate the association between nesfatin-1 and protein intake and body composition in patients undergoing hemodialysis (HD). Twenty five HD patients from a private Clinic in Rio de Janeiro, Brazil were studied and compared with 15 healthy subjects that were matched for body mass index (BMI), % body fat mass (by anthropometrics) and age. Appetite was measured using a specific questionnaire, and food intake was evaluated based on 3-day food records. Nesfatin-1 levels were measured by ELISA and leptin, TNF-? and IL-6 levels were determined by a multiplex assay kit. Serum nesfatin-1 levels did not differ between HD patients (0.16±0.07ng/mL) and healthy subjects (0.17±0.10ng/mL). Nesfatin-1 levels showed significant negative correlations with protein intake (r=-0.42; p=0.03), but did not associate with inflammatory markers or appetite scores. Combining patients and controls, we observed positive correlations with BMI (r=0.33; p=0.03), % body fat (r=0.35; p=0.03), leptin (r=0.45; p=0.006) and the triceps skinfold thickness (r=0.36; p=0.02). In multivariate analysis % body fat was the main determinant of nesfatin-1 variance. In conclusion, nesfatin-1 levels did not differ between HD patients and healthy subjects and negatively correlated with protein intake. This pathway is likely not dysregulated in uremia. PMID:22036920

Saldanha, J F; Carrero, J J; Lobo, J C; Stockler-Pinto, M B; Leal, V O; Calixto, A; Geloneze, B; Mafra, D

2012-01-10

62

Oxytocin prolongs the gastric emptying time in patients with diabetes mellitus and gastroparesis, but does not affect satiety or volume intake in patients with functional dyspepsia  

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Full Text Available Abstract Background Oxytocin is released in response to a fatty meal. Blockage of the oxytocin receptor led to slower gastric emptying whereas stimulation resulted in less satiety in healthy volunteers. Patients with diabetes mellitus and gastroparesis lack oxytocin elevation, and dyspepsia is partly caused by reduced fundus accommodation causing early satiety and related symptoms. The aim of this study was thus to examine the effect of oxytocin on gastric emptying, satiety and volume intake in patients with gastrointestinal pathology. Results Gastric emptying scintigraphy was performed twice in 12 patients with diabetic gastroparesis, once with oxytocin and once with saline as intravenous infusions. The patients scored their sensation of satiety using a visual analogue scale (VAS. The gastric emptying in patients with gastroparesis was prolonged during oxytocin infusion (p = 0.034 without affecting satiety. A slow satiety drinking test was performed in 14 patients with functional dyspepsia. The patients scored their satiety every five minutes until maximal satiety was reached, and the total volume was determined. The VAS was also completed 30 minutes afterwards. The test was performed twice, once with oxytocin and once with saline as intravenous infusions. There was no difference in satiety scores or volume of nutrient intake between saline and oxytocin infusions, either before, during or after the meal. Conclusions Oxytocin prolongs gastric emptying in patients with diabetes mellitus and gastroparesis, but has no effect on volume of nutrient intake or satiety and other related symptoms in patients with functional dyspepsia.

Borg Julia

2012-03-01

63

Ingesta oral do paciente hospitalizado com disfagia orofaríngea neurogênica / Oral Intake of hospitalized patient with neurogenic oropharyngeal dysphagia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: verificar a evolução na ingesta oral e a ocorrência de broncopneumonias (BCP) em pacientes hospitalizados com disfagia orofaríngea neurogênica, após atuação fonoaudiológica. MÉTODOS: 50 pacientes adultos, divididos em grupos: I: 31 pacientes pós-acidente vascular encefálico; II: sete pacie [...] ntes pós-traumatismo crânio-encefálico; III: 12 pacientes com demência. Foram levantadas as informações antes e após a atuação fonoaudiológica: nível da Functional Oral Intake Scale (FOIS), ocorrência de BCP; número de atendimentos fonoaudiológicos e motivo de interrupção destes. RESULTADOS: houve aumento significativo dos níveis da escala FOIS e redução do percentual de ocorrência de BCP nos três grupos estudados. Nos grupos pós-AVE e demência a interrupção da fonoterapia ocorreu devido à alta hospitalar, enquanto que no grupo pós-TCE devido à alta fonoaudiológica. CONCLUSÃO: os pacientes deste estudo demonstraram avançar das consistências alimentares na ingesta oral, e redução da ocorrência de BCP, após a intervenção fonoaudiológica com relação à disfagia. Abstract in english PURPOSE: to investigate the development in oral intake and the incidence of bronchopneumonia (BCP) in hospitalized patients with neurogenic oropharyngeal dysphagia, after speech and language therapy intervention. METHODS: 50 adult patients, divided in three groups: I: 31 post stroke patients; II: se [...] ven brain injury patients ; III: 12 dementia patients. Data collected before and after the speech and language therapy intervention were: staff classification in Functional Oral Intake Scale (FOIS), incidence of BCP, number of therapies and reason for their interruption. RESULTS: significant increase in the levels of FOIS scale and reduction in incidence of pneumonia in the three studied groups. In the post stroke and dementia groups the reason for therapy interruption was hospital discharge, and in the group of brain injury the reason was speech and language therapy discharge. CONCLUSION: the studied patients show increase in food consistency as for oral intake and reductions of BCP after speech and language therapy intervention related to swallowing disorders.

Carolina Castelli, Silvério; Ana Maria, Hernandez; Maria Inês Rebelo, Gonçalves.

2010-12-01

64

Ingesta oral do paciente hospitalizado com disfagia orofaríngea neurogênica Oral Intake of hospitalized patient with neurogenic oropharyngeal dysphagia  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: verificar a evolução na ingesta oral e a ocorrência de broncopneumonias (BCP em pacientes hospitalizados com disfagia orofaríngea neurogênica, após atuação fonoaudiológica. MÉTODOS: 50 pacientes adultos, divididos em grupos: I: 31 pacientes pós-acidente vascular encefálico; II: sete pacientes pós-traumatismo crânio-encefálico; III: 12 pacientes com demência. Foram levantadas as informações antes e após a atuação fonoaudiológica: nível da Functional Oral Intake Scale (FOIS, ocorrência de BCP; número de atendimentos fonoaudiológicos e motivo de interrupção destes. RESULTADOS: houve aumento significativo dos níveis da escala FOIS e redução do percentual de ocorrência de BCP nos três grupos estudados. Nos grupos pós-AVE e demência a interrupção da fonoterapia ocorreu devido à alta hospitalar, enquanto que no grupo pós-TCE devido à alta fonoaudiológica. CONCLUSÃO: os pacientes deste estudo demonstraram avançar das consistências alimentares na ingesta oral, e redução da ocorrência de BCP, após a intervenção fonoaudiológica com relação à disfagia.PURPOSE: to investigate the development in oral intake and the incidence of bronchopneumonia (BCP in hospitalized patients with neurogenic oropharyngeal dysphagia, after speech and language therapy intervention. METHODS: 50 adult patients, divided in three groups: I: 31 post stroke patients; II: seven brain injury patients ; III: 12 dementia patients. Data collected before and after the speech and language therapy intervention were: staff classification in Functional Oral Intake Scale (FOIS, incidence of BCP, number of therapies and reason for their interruption. RESULTS: significant increase in the levels of FOIS scale and reduction in incidence of pneumonia in the three studied groups. In the post stroke and dementia groups the reason for therapy interruption was hospital discharge, and in the group of brain injury the reason was speech and language therapy discharge. CONCLUSION: the studied patients show increase in food consistency as for oral intake and reductions of BCP after speech and language therapy intervention related to swallowing disorders.

Carolina Castelli Silvério

2010-12-01

65

Effect of exercise on the caloric intake of breast cancer patients undergoing treatment  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake (TCI) of breast cancer patients undergoing treatment. A secondary purpose was to determine whether or not a relationship existed between changes in TCI, body fat composition (%BF), and fatigu [...] e during the study, which lasted 6 months. Twenty females recently diagnosed with breast cancer, scheduled to undergo chemotherapy or radiation, were assigned randomly to an experimental (N = 10) or control group (N = 10). Outcome measures included TCI (3-day food diary), %BF (skinfolds), and fatigue (revised Piper Fatigue Scale). Each exercise session was conducted as follows: initial cardiovascular activity (6-12 min), followed by stretching (5-10 min), resistance training (15-30 min), and a cool-down (approximately 8 min). Significant changes in TCI were observed among groups (F1,18 = 8.582; P = 0.009), at treatments 2 and 3, and at the end of the study [experimental (1973 ± 419), control (1488 ± 418); experimental (1946 ± 437), control (1436 ± 429); experimental (2315 ± 455), control (1474 ± 294), respectively]. A significant negative correlation was found (Spearman rho(18) = -0.759; P

C.L., Battaglini; J.P., Mihalik; M., Bottaro; C., Dennehy; M.A., Petschauer; L.S., Hairston; E.W., Shields.

2008-08-01

66

Insufficient voluntary intake of nutrients and energy in hospitalized patients Ingestión voluntariamente insuficiente de nutrientes y energía en pacientes hospitalizados  

Directory of Open Access Journals (Sweden)

Full Text Available Aim: The aim of our study was to evaluate the inadequacy of voluntary energy and nutrient intake on the first day of hospital admission. Patients and methods: A cross-sectional study was carried out in two terciary care hospitals, with a probabilistic sample of 50% of in-patients. Dietary intake was evaluated by a 24-hour dietary recall, and undernutrition was screened through the Nutritional Risk Screening 2002 tool. The overall frequency of inadequate energy and nutrient intake was estimated using Dietary Reference Intakes. Results: Energy and nutrient intakes from 258 patients showed very low values for both men and women. No significant differences were found for energy and nutrient intakes across age groups (Objetivo: El propósito de nuestro estudio fue evaluar la inadecuación de la ingestión voluntaria de energía y nutrientes durante el primer día de ingreso hospitalario. Pacientes y métodos: Se realizó un estudio transversal en dos centros hospitalarios de atención terciaria con una muestra probabilística del 50% de pacientes ingresados. Se evaluó la ingestión alimenticia mediante un diario de 24 horas, y se hizo un cribado de desnutrición mediante la herramienta Nutritional Risk Screening 2002. Se estimó la falta de adecuación del consumo de energía y nutrientes mediante el Dietary Reference Intakes. Resultados: El consumo de energía y nutrientes en 258 pacientes mostró niveles muy bajos tanto en hombre como en mujeres. No se hallaron diferencias significativas en el consumo de energía y nutrientes entre los distintos grupos de edad (< 65 años y ? 65 años. Cuando se analizó la proporción de sujetos del estudio con consumo inadecuado de nutrientes, se halló una alta proporción de inadecuación. El grado de inadecuación fue mayor para la fibra, niacina, folato, vitamina B12, magnesio y zinc. No se hallaron diferencias significativas en la energía y los nutrientes estudiados y los consumos inferiores a 1/3 de las recomendaciones dietéticas entre los pacientes con riesgo nutricional (n = 89 y aquellos bien nutridos (n = 169. Conclusión: La ingestión voluntaria de nutrientes y energía durante las primeras 24 horas del ingreso hospitalario es muy inadecuada. No se hallaron diferencias entre los pacientes bien y mal nutridos, ni entre los mayores o menores de 65 años.

M. M. Tavares

2007-10-01

67

Intake of antioxidants in patients with rheumatoid arthritis / Consumo de antioxidantes em portadores de artrite reumatoide  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Objectivo: investigar o consumo alimentar de antioxidantes em pacientes portadores de artrite reumatoide. Métodos: estudo transversal do tipo série de casos com 53 mulheres acompanhadas no [...] Ambulatório de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), de janeiro a outubro de 2012. Por meio de formulário, foram coletados parâmetros sociodemográficos e antropométricos (peso, estatura, índice de massa corpórea [IMC], alteração ponderal). A avaliação do consumo alimentar foi realizada por questionário de frequência alimentar semiquantitativo, analisado por tabela de composição de alimentos. A construção do banco de dados e a análise estatística foram realizadas por Excel e SPSS versão 18.0, com aplicação de testes Qui-quadrado, Anova e t-Student, com nível de confiança de 5%. Resultados: demonstrou-se que os pacientes apresentaram baixo consumo de vitaminas A, C e zinco. Portanto, ressalta-se a importância de maior consumo de alimentos fontes em antioxidantes, a fim de contribuir para a prevenção da lesão articular e a perda da função reumática, melhorando a qualidade de vida do paciente. Conclusão: demonstrou-se que os pacientes apresentaram baixo consumo de vitaminas A, C e zinco. Portanto, ressalta-se a importância de maior consumo de alimentos fontes em antioxidantes, a fim de contribuir para a prevenção da lesão articular e a perda da função reumática, melhorando a qualidade de vida do paciente. Abstract in english Objective: to investigate dietary intake of antioxidants in patients with rheumatoid arthritis. Methods: this is a cross-sectional case series study with 53 women accompanied at the [...] Rheumatology Outpatient Clinic, Hospital das Clínicas/UFPE, from January to October 2012. Demographic and anthropometric parameters (weight, height, body mass index, weight change) were collected by means of a form. The assessment of food consumption was conducted using a semi-quantitative food frequency survey, analyzed according to a food composition table. Database construction and statistical analysis were performed using Excel and SPSS version 18.0, using chi-squared test, Anova, and Student’s t-test, at a confidence level of 5%. Results: the sample was composed of 53 women with a mean age of 54.51 ± 4.24 years and BMI of 25.97 ± 5.94 kg/m². In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant. Conclusion: the sample was composed of 53 women with a mean age of 54.51 ± 4.24 years and BMI of 25.97 ± 5.94 kg/m². In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant.

Bruna Nolasco Siqueira, Silva; Ísis Lucília Santos Borges de, Araújo; Pedrita Mirella Albuquerque, Queiroz; Angela Luzia Branco Pinto, Duarte; Maria Goretti Pessoa de Araújo, Burgos.

2014-12-01

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Dose assessment of medical staff taking care of patients treated with 131I due to the intake of 131I  

International Nuclear Information System (INIS)

Aim: Legislation requires that patient receiving 131I in activities greater than 550MBq have to be hospitalized in special closed department. Medical staff taking care of these patients can be exposed to external irradiation and internal contamination with 131I. The aim of this study was to assess the annual effective dose of medical staff taking care of patients treated with 131I due to the occupational intake of 131I. Material - Medical Staff: 6 nurses took care of 6 patients (placed into two rooms) treated with 131I in activities between 550 and 1100 MBq. 131I was normally delivered to patients once per week. After patients received 131I nurses were in contact with patients in average 4 hours per day, 4 days per week. Methods: Direct Method - whole body counting (WBC) of staff was performed daily after they finished their work and indirect method - determination of air 131I concentration in patient's rooms (AC) were used to assess the intake of 131I by staff. Measurements were done in winter period.Results and Dose Assessment: Results of measurements of medical staff and determination of 131I air concentration are presented. Average daily 131I intake of staff assessed from WBC results was 315 Bq; average daily 131I air concentration for first four days was 35 Bq/m3. Assessment of annual effective dose due to the internal conual effective dose due to the internal contamination (realistic approach): - Direct method: 315 Bq/day x 208 days/year x 7,6 Sv/Bq x 10-9 = 0,498 mSv/year. - Indirect method: 35 Bq/m3 x 1,5 m3/hour x 832 hours/year x 7,6 Sv/Bq x 10-9 = 0,332 mSv/year. Conclusion: Medical staff taking care of patients treated with 131I received effective dose less than 0,5 mSv/year due to the intake of 131I. In the some time period they received 1,65 to 2,24 mSv due to the exposure to the external radiation coming from patients treated with 131I

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Five-year updates to patient family histories may lead to improved cancer screening:  

Science.gov (United States)

In order to maintain accurate family histories from their patients, physicians should get a comprehensive family history by age 30, and then update it every five to 10 years because histories change significantly between ages 30 and 50 years. According to a new study, getting updated histories every five years would maximize the likelihood of detecting cancer at an early, more treatable state.

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Consequences of radiotherapy on nutritional status, dietary intake, serum zinc and copper levels in patients with gastrointestinal tract and head and neck cancer.  

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Because of the negative effect of radiotherapy on oral feeding, nutritional assessment and intervention should be an integral part of treatment. Also, it would be worthwhile studying the effect of zinc supplementation on dietary intake and nutritional status of patients.

Reza Mahdavi

2007-03-01

71

Dietary intake of micronutrients in first-degree healthy, diabetic and IGT relatives of type II diabetic patients  

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Full Text Available Introduction: To evaluate the dietary content of micronutrients in first-degree relatives of type II diabetic patients, with respect to the influence of dietary composition on the development of diabetes. Methods and Materials: 210 first-degree relatives of type II diabetic patients were divided into 2 groups (normal and IGT+ diabetic, according to the results of OGTT. 3-Day food recall questionnaire was completed by skilled nutritionists from all subjects. The participants’ intake of calorie, magnesium, zinc, calcium, phosphorus, chromium and vitamins B1, B6, C and E was calculated and the results were compared between 2 groups. Results: The mean of age and BMI were 48.9 ? 5.2, 43.6 ? 6.7 years (P=0.373 and 29.3 ? 0.7, 28.7 ? 0.8 kg/m2 in impaired and normal groups, respectively. No significant difference was observed in energy, magnesium, zinc, calcium, phosphorus, chromium and vitamins B1, B6, C and E intake between 2 groups. Conclusion: Although the micronutrient intake between studied groups didn’t differ significantly, the dietary content of chromium, magnesium, zinc and vitamin E was less than recommended daily allowance values. This finding can be taken into consideration with respect to the influence of some micronutrients, including magnesium and chromium, on glucose tolerance and insulin resistance.

Hosein Khosravi-Broojeni

2008-01-01

72

Association between Nutrient Intake and Obesity in Type 2 Diabetic Patients from the Korean National Diabetes Program: A Cross-Sectional Study  

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The aim of the study was to assess the association between usual dietary nutrient intake and obesity in Korean type 2 diabetic patients. We examined 2,832 type 2 diabetic patients from the Korean National Diabetes Program cohort who completed dietary assessment and clinical evaluation in this cross-sectional study. In men, higher dietary fiber intake was associated with a lower odds of being obese (Ptrend = 0.003) and in women, higher protein intake was associated with a lower odds of being o...

Kim, So Hun; Hong, Seong Bin; Suh, Young Ju; Choi, Yun Jin; Nam, Moonsuk; Lee, Hyoung Woo; Park, Ie Byung; Chon, Suk; Woo, Jeong-taek; Baik, Sei Hyun; Park, Yongsoo; Kim, Dae Jung; Lee, Kwan Woo; Kim, Young Seol

2012-01-01

73

Nutritional status and food intake of Brazilian patients at various stages of Alzheimer’s disease: A crosssectional study  

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Full Text Available Alzheimer’s disease (AD is characterized by disorders that can impair the nutrition of the patient and lead to weight loss and nutritional deficits during the course of the disease. The aim of this study was to assess the nutritional status and food intake of Brazilian patients with Alzheimer’s disease at 3 different stages of the disease. The sample consisted of 30 subjects of both genders, mean age 77 years, with probable AD. Subjects were assessed by collecting anthropometric data, the Mini Nutritional Assessment (MNA, serum albumin content, Mini Mental State Examination and 24-hour records of food and drink. Although a steady decrease in average weight was observed as the disease progressed (CDR1: 70.8±15.9 kg; CDR2: 61.4±15.7 kg; CDR3: 56.1± 8.4 kg, the differences were not significant. MNA and serum albumin both fell during the progression of the disease (p = 0.042; p = 0.047, respectively and, at the severe stage, half the patients were found to be undernourished and the other half at risk of undernutrition. According to their body mass index, 23.3% of patients were overweight. The nutritional value of the food consumed was similar across the stages of AD. In conclusion, the majority of Brazilian patients with AD in this study exhibited cognitive decline and malnutrition. However, food intake was similar among the stages of the disease, thus having no direct association with the progression of AD.

Vanessa Fernanda Goes

2014-04-01

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Use of a patient-entered family health history tool with decision support in primary care: impact of identification of increased risk patients on genetic counseling attendance.  

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Several barriers inhibit collection and use of detailed family health history (FHH) in primary care. MeTree, a computer-based FHH intake and risk assessment tool with clinical decision support, was developed to overcome these barriers. Here, we describe the impact of MeTree on genetic counseling (GC) referrals and attendance. Non-adopted, English speaking adults scheduled for a well-visit in two community-based primary-care clinics were invited to participate in an Implementation-Effectiveness study of MeTree. Participants' demographic characteristics and beliefs were assessed at baseline. Immediately after an appointment with a patient for whom GC was recommended, clinicians indicated whether they referred the patient and, if not, why. The study genetic counselor kept a database of patients with a GC recommendation and contacted those with a referral. Of 542 patients completing MeTree, 156 (29 %) received a GC recommendation. Of these, 46 % (n?=?72) were referred and 21 % (n?=?33) underwent counseling. Patient preferences, additional clinical information unavailable to MeTree, and an incomplete clinician evaluation of the FHH accounted for the 85 patients clinicians chose not to refer. Although MeTree identified a significant proportion of patients for whom GC was recommended, persistent barriers indicate the need for improved referral processes and patient and physician education about the benefits of GC. PMID:25120038

Buchanan, Adam H; Christianson, Carol A; Himmel, Tiffany; Powell, Karen P; Agbaje, Astrid; Ginsburg, Geoffrey S; Henrich, Vincent C; Orlando, Lori A

2015-02-01

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The short-term effect of alcoholic beverage-intake on blood glucose levels in type 2 diabetic patients.  

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We examined changes in blood glucose levels within 2h after the respective intake of three kinds of alcoholic beverages in six type 2 diabetic men treated by diet alone. Blood glucose level following beer consumption was 195.0+/-15.8 mg/dl after 60 min and those following sake consumption was 151.2+/-9.0mg/dl after 60 min. There was no significant increase in blood glucose levels after drinking shochu. It should be considered that in diabetic patients, the elevation of blood glucose was induced by the sugar contained in the alcoholic beverages, and the limited intake of alcoholic drinks is required to keep well blood glucose levels. PMID:17897751

Hosaka, Shigetoshi; Miyashita, Manabi; Inoue, Junichi; Maruyama, Kazutoshi

2008-02-01

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A young patient with a family history of hypertension.  

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The evaluation of causes of hypertension in young adults with a family history of hypertension needs to be methodical to identify potentially treatable causes. Renal- and renovascular imaging and measurement of plasma aldosterone and plasma renin activity are at the core of this evaluation in most patients. Pertinent aspects of hypertension in autosomal dominant polycystic kidney disease are discussed with a focus on the role of the endothelium in mediating early hypertension and a review of treatment strategies. Finally, the possibility that autosomal dominant polycystic kidney disease and primary aldosteronism are connected beyond coincidence is explored; evidence to support it is scant, although there is a likely role for aldosterone excess and the resultant hypokalemia in promoting cyst growth. PMID:25092599

Peixoto, Aldo J

2014-12-01

77

Ingesta dietética en un grupo de pacientes fumadores de marihuana Dietary intakes in a group of marihuana smoking patients  

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Full Text Available Fundamentos: El uso de marihuana (cannabis sativa tiene efectos sobre el apetito, siendo los estudios en la literatura escasos. El objetivo de nuestro estudio fue evaluar la ingesta de un grupo de sujetos fumadores de marihuana. Pacientes y métodos: Se incluyeron un total de 32 varones. La edad media fue de 37,25 ± 8,8 años. A todos los pacientes se les determinó el peso corporal, la talla y el índice de masa corporal y se realizó una encuesta nutricional. Resultados: La ingesta calórica total fue de 3.350,1 ± 979 kcal/día. La distribución de calorías fue de un 44,3% en forma de hidratos de carbono, un 14% en proteínas y un 41,7% en grasas (50,6% grasas monoinsaturadas, 36,3% grasas saturadas y el 13,1% grasas polinsaturadas. La ingesta absoluta de proteínas fue evelada (109,6 ± 38,5 g/día así como la ingesta corregida por peso (1,62 ± 0,73. Con referencia a los minerales y vitaminas, existió una baja ingesta de vitamina D, E, ácido fólico, magnesio y yodo. Las ingestas de vitaminas A, C, K, tiamina, riboflavina, B6, niacina, B12, calcio, hierro y zinc fueron superiores a las recomendaciones internacionales. No existieron diferencias estadísticamente significativas en la ingesta dietética ni en el peso entre los dos grupos de consumidores de marihuana en funcion de la mediana de tiempo de consumo (19 años. Conclusiones: Los pacientes fumadores de marihuana realizan una dieta hipercalorica e hiperproteica, rica en grasas y con un aporte por encima de lo recomendado de micronutrientes. Todo ello sin relacionarse con el peso del paciente.Background: Marihuana use has effects on appetite; studies in the literature on this topic area are limited. The aim of our work was to evaluate the dietary intake of marihuana smoking patietns. Patients and methods: A total of 32 male subjects were enrolled (average age 37.25 ± 8.8 years. In all patients were determined weight, height and body mass index and a three days nutritional questionnaire. Results: Total calories intakes were higher (3,350.1 ± 979 kcal/day. Distribution of calories was 44.3% of carbohydrates, 14% of proteins and 41.7% of lipids (50.6% mono-unsaturate fats, 36.3% saturate fats and 13.1% poluunsaturated fats. Total protein intake was 109.6 ± 38.5 g/day and corrected by weight was 1.62 ± 0.73 g/kg. Low intake of vitamin D, E, folic, magnesium and iodine were detected. High intake of vitamin A, C, K, thiamine, riboflavine, B6, niacin, B12, calcium, iron and zinc were observed. No statistical differences in dietary ntake or weight were detected between groups of marihuana users by median of consumtion time of this drug. Conclusions: Marihuana smoking patients realized a hipercloric and hiperproteic diet, with high amounts of fats and with an intake of micronutrients above international recommendations. This dietary intake has not related with weight.

D. A. De Luis

2010-08-01

78

Dietary intake of cancer patients on radiotherapy / La ingesta dietética de los pacientes con cáncer en radioterapia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish La ingesta dietética de los pacientes con cáncer pueden afectar su estado nutricional. Objetivos: Evaluar la ingesta alimentaria y el estado nutricional de los pacientes con cáncer de la cabeza y cuello de la radioterapia. Métodos: Recuerdo de ingesta de 24 horas y valoración del status nutricional [...] por antropometría fueron tomadas durante la primera semana y la tercera de la radioterapia. Resultados: De los 62 pacientes, las reducciones significativas en el área muscular del brazo (p = 0,001) y la circunferencia muscular del brazo (p Abstract in english The dietary intake of cancer patients can affect their nutritional status. Objectives: To assess the dietary intake and nutritional status of head and neck cancer patients on radiotherapy. Methods: 24-hour recalls and anthropometric measures were taken during the first and third weeks of radiotherap [...] y. Results: Of the 62 patients, significant reductions were found in arm muscle area (p = 0.001) and arm muscle circumference (p

L. F., Pistóia; C. H., de Abreu Nunes; B., Andreatta Gottschall; E. I., Rabito.

1936-19-01

79

The significant other history: an interpersonal-emotional history procedure used with the early-onset chronically depressed patient.  

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An interpersonal-emotional history procedure, the Significant Other History, is administered to the early-onset chronically depressed patient during the second therapy session in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Patients are asked to name up to six significant others and answer two questions: (1) What was it like growing up with or being around this person? (2) What is the emotional "stamp" you take from this relationship that informs who you are today? An interpersonal-emotional theme reflecting the early learning history of the patient is derived from these "stamps" or causal theory conclusions. One transference hypothesis (TH) is derived from the Significant Other History (SOH) and is formulated in one sentence, such as "If I do this, then the therapist will likely do that" (e.g., "If I make a mistake around Dr. E, then Dr. E will label me 'stupid' or 'incompetent"). The transference hypothesis highlights the interpersonal content that most likely informs the patient's expectancy of the therapist's reactions toward him or her. Throughout the therapy process, the therapist will proactively employ the transference hypothesis in a technique known as the Interpersonal Discrimination Exercise to help patients cognitively and emotionally discriminate the practitioner from hurtful significant others. The goal here is to increase the patient's felt safety within the therapeutic dyad and eventually to generalize the felt safety to the patient's other relationships. PMID:22032046

McCullough, James P; Lord, Benjamin D; Martin, Aaron M; Conley, Kathryn A; Schramm, Elisabeth; Klein, Daniel N

2011-01-01

80

Nutritional status and food intake of patients with systemic psoriasis and psoriatic arthritis associated  

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Objective: To identify the nutritional status and food intake ofindividuals with systemic psoriasis and psoriatic arthritis associated. Methods: This is an exploratory and cross-sectional study with 34 men aged between 19 and 60 years seen at a Psoriasis Center.Participants were divided into systemic psoriasis group and arthriticsystemic psoriasis associated group. For nutritional assessment we used anthropometry, bioelectrical impedance analysis and wholebody plethysmography. Clinical and nu...

Marina Yazigi Solis; Nathalia Stefani de Melo; Maria Elisa Moschetti Macedo; Fabiana Prata Carneiro; Cid Yazigi Sabbag; Antonio Hebert Lancha Junior; Vera Silvia Frangella

2012-01-01

 
 
 
 
81

Fat intake and composition of fatty acids in serum phospholipids in a randomized, controlled, Mediterranean dietary intervention study on patients with rheumatoid arthritis  

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Abstract Background We have previously reported that rheumatoid arthritis patients, who adopted a modified Cretan Mediterranean diet, obtained a reduction in disease activity and an improvement in physical function and vitality. This shift in diet is likely to result in an altered intake of fatty acids. Therefore, the objective of the present study was to examine the dietary intake of fatty acids, as well as the fatty acid profile in serum phospholipids, during the dietary in...

Sköldstam Lars; Nilsson Ingela; Hagfors Linda; Johansson Gunnar

2005-01-01

82

Ingesta dietética en un grupo de pacientes fumadores de marihuana / Dietary intakes in a group of marihuana smoking patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Fundamentos: El uso de marihuana (cannabis sativa) tiene efectos sobre el apetito, siendo los estudios en la literatura escasos. El objetivo de nuestro estudio fue evaluar la ingesta de un grupo de sujetos fumadores de marihuana. Pacientes y métodos: Se incluyeron un total de 32 varones. La edad med [...] ia fue de 37,25 ± 8,8 años. A todos los pacientes se les determinó el peso corporal, la talla y el índice de masa corporal y se realizó una encuesta nutricional. Resultados: La ingesta calórica total fue de 3.350,1 ± 979 kcal/día. La distribución de calorías fue de un 44,3% en forma de hidratos de carbono, un 14% en proteínas y un 41,7% en grasas (50,6% grasas monoinsaturadas, 36,3% grasas saturadas y el 13,1% grasas polinsaturadas). La ingesta absoluta de proteínas fue evelada (109,6 ± 38,5 g/día) así como la ingesta corregida por peso (1,62 ± 0,73). Con referencia a los minerales y vitaminas, existió una baja ingesta de vitamina D, E, ácido fólico, magnesio y yodo. Las ingestas de vitaminas A, C, K, tiamina, riboflavina, B6, niacina, B12, calcio, hierro y zinc fueron superiores a las recomendaciones internacionales. No existieron diferencias estadísticamente significativas en la ingesta dietética ni en el peso entre los dos grupos de consumidores de marihuana en funcion de la mediana de tiempo de consumo (19 años). Conclusiones: Los pacientes fumadores de marihuana realizan una dieta hipercalorica e hiperproteica, rica en grasas y con un aporte por encima de lo recomendado de micronutrientes. Todo ello sin relacionarse con el peso del paciente. Abstract in english Background: Marihuana use has effects on appetite; studies in the literature on this topic area are limited. The aim of our work was to evaluate the dietary intake of marihuana smoking patietns. Patients and methods: A total of 32 male subjects were enrolled (average age 37.25 ± 8.8 years). In all p [...] atients were determined weight, height and body mass index and a three days nutritional questionnaire. Results: Total calories intakes were higher (3,350.1 ± 979 kcal/day). Distribution of calories was 44.3% of carbohydrates, 14% of proteins and 41.7% of lipids (50.6% mono-unsaturate fats, 36.3% saturate fats and 13.1% poluunsaturated fats). Total protein intake was 109.6 ± 38.5 g/day and corrected by weight was 1.62 ± 0.73 g/kg. Low intake of vitamin D, E, folic, magnesium and iodine were detected. High intake of vitamin A, C, K, thiamine, riboflavine, B6, niacin, B12, calcium, iron and zinc were observed. No statistical differences in dietary ntake or weight were detected between groups of marihuana users by median of consumtion time of this drug. Conclusions: Marihuana smoking patients realized a hipercloric and hiperproteic diet, with high amounts of fats and with an intake of micronutrients above international recommendations. This dietary intake has not related with weight.

D. A. De, Luis; A., Armentia; P. L., Muñoz; A., Dueñas-Laita; B., Martín; B. De la, Fuente; O., Izaola.

2010-08-01

83

Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke  

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Background According to the literature, the occurrence of dysphagia is high in cases of stroke, and its severity can be enhanced by loss of teeth and the use of poorly fitting prostheses. Objective To verify that the status of oral health influences the level of oral intake and the degree of swallowing dysfunction in elderly patients with stroke in chronic phase. Methods Thirty elderly individuals affected by stroke in chronic phase participated. All subjects underwent assessment of their oral condition, with classification from the Functional Oral Intake Scale (FOIS) and nasoendoscopic swallowing assessment to classify the degree of dysphagia. The statistical analysis examined a heterogeneous group (HG, n=30) and two groups designated by the affected body part, right (RHG, n=8) and left (LHG, n=11), excluding totally dentate or edentulous individuals without rehabilitation with more than one episode of stroke. Results There was a negative correlation between the need for replacement prostheses and the FOIS scale for the HG (P=0.02) and RHG (P=0.01). Differences in FOIS between types of prostheses of the upper dental arch in the LHG (P=0.01) and lower dental arch in the RHG (P=0.04). A negative correlation was found between the number of teeth present and the degree of dysfunction in swallowing liquid in the LHG (P=0.05). There were differences in the performance in swallowing solids between individuals without prosthesis and those with partial prosthesis in the inferior dental arch (P=0.04) for the HG. Conclusion The need for replacement prostheses, type of prostheses, and the number of teeth of elderly patients poststroke in chronic phase showed an association with the level of oral intake and the degree of oropharyngeal dysphagia. PMID:25565784

Mituuti, Cláudia T; Bianco, Vinicius C; Bentim, Cláudia G; de Andrade, Eduardo C; Rubo, José H; Berretin-Felix, Giédre

2015-01-01

84

Predictability of oral and laryngopharyngeal function for aspiration and limitation of oral intake in patients after surgery for head and neck cancer.  

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Swallowing disorders are common in patients after surgery for head and neck cancer. The clinical assessment of oral and laryngopharyngeal abilities is widely used as a dysphagia assessment tool in this patient group, despite a lack of research. The goal of this study was to assess the predictability of clinical parameters for aspiration and limitation of oral intake. A swallowing disorder with the need for further intervention was identified by fiberoptic endoscopic evaluation of swallowing (FEES) in 65%, with aspiration in 49%, silently in 21%, and limited oral intake with tube dependency in 56% of studied patients. Four clinical parameters (dysglossia, wet voice, tongue motility, and tongue strength) correlated significantly with aspiration and limitation of oral intake. However, none of these clinical parameters was able to predict one of our two reference criteria, due to low positive likelihood ratios, mostly less than two. Clinical assessment is therefore inappropriate for early detection of swallowing disorders in such patients. PMID:23898102

Hey, Christiane; Lange, Benjamin P; Aere, Christina; Eberle, Silvia; Zaretsky, Yevgen; Sader, Robert; Stöver, Timo; Wagenblast, Jens

2013-08-01

85

IMPACT OF NUTRITIONAL COUNSELLING ON BODY MASS INDEX (BMI AND NUTRIENT INTAKE OF THE NON - COMMUNICABLE DISEASE PATIENTS (NCD.  

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Full Text Available Good health is an important discussion of the quality of life. Health problem is a major concern in all over the world but especially in developing countries. Non-communicable diseases ( NCDs contribute the ill health. Diabetes, coronary heart disease, various forms of cancer, gastro intestinal disorder and various diseases of bones and joints are diet related NCDs. Nutritional counselling is one of the effective tools of changing the food habits of people. The data for this study is taken from the out patients services of Department of Endocrinology & Metabolism and Cardiology of Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi-5. Total 250 samples were included in the study. Age group 40 – 60 years were considered as study samples who attended the Endocrinology and Cardiology departments. Purposive sampling method was used in the study. Questionnaire cum interview method was adopted in the study. Anthropametric measurements were taken by using standard techniques. 24 hours diet recall method was also used in this study. Evaluation of councelling was done on basis of changes in BMI and nutrient intake. Result shows the positive impact of nutritional counselling in BMI and nutrient intake of NCD patients.

Manisha Singh

2011-12-01

86

Energy and protein intake and nutritional status in non-surgically treated patients with small cell anaplastic carcinoma of the lung  

International Nuclear Information System (INIS)

The spontaneous food intake and nutritional status was assessed in 23 patients with small cell anaplastic carcinoma of the lung before and two times during a treatment period of 6 weeks. Radiation therapy was given for 2 weeks followed by a course of chemotherapy and another 2 weeks of radiation therapy. The energy intake decreased during the treatment from 146 to 130 per cent of basal metabolic rate (p>0.10). The protein intake remained unchanged (mean 0.9 g/kg body weight).There were insignificant and small losses of weight, body fat, free body mass and arm muscle circumference, and no changes were seen in serum albumin and serum transferrin. However, 6 patients suffered a weight loss of 5 per cent or more. No correlation existed between the nutritional parameters measured before treatment and the changes during treatment. Patients who suffered a loss of body weight could therefore not be singled out before the treatment. (orig.)

87

Dietary intake of cancer patients on radiotherapy La ingesta dietética de los pacientes con cáncer en radioterapia  

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Full Text Available The dietary intake of cancer patients can affect their nutritional status. Objectives: To assess the dietary intake and nutritional status of head and neck cancer patients on radiotherapy. Methods: 24-hour recalls and anthropometric measures were taken during the first and third weeks of radiotherapy. Results: Of the 62 patients, significant reductions were found in arm muscle area (p = 0.001 and arm muscle circumference (p La ingesta dietética de los pacientes con cáncer pueden afectar su estado nutricional. Objetivos: Evaluar la ingesta alimentaria y el estado nutricional de los pacientes con cáncer de la cabeza y cuello de la radioterapia. Métodos: Recuerdo de ingesta de 24 horas y valoración del status nutricional por antropometría fueron tomadas durante la primera semana y la tercera de la radioterapia. Resultados: De los 62 pacientes, las reducciones significativas en el área muscular del brazo (p = 0,001 y la circunferencia muscular del brazo (p < 0,001, y el 69% de los pacientes tenían una pérdida de peso promedio de 5,7% en tres semanas. Con respecto a su ingesta, las reducciones fueron encontrados en la energía (26,5 kcal/ kg/día-21,3 kcal/kg/día, p < 0,001, carbohidratos (196,9 g/día-180,5 g/día, p = 0,020, la proteína (1,19 g/kg/día-0,93 g/kg/día, p = 0,009 y grasas (44,4 g/día-33,1 g/día, p < 0,001 la ingesta durante el período de estudio. Discusión: Los cambios resultan en reducción de la ingesta alimentaria y las medidas del cuerpo afectado negativamente a la sua composición.

L. F. Pistóia

2012-12-01

88

Association of Aspirin Intake and Myocardial Infarction Size  

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Full Text Available Myocardial infarction (MI is one of the most important health burdens worldwide. Aspirin as an non- Steroid Anti—inflammatory drug, has been proven to be a protective factor to decrease the incidence, however its effect of MI size is still unknown. We designed this study to compare the biomarkers after MI in patients with and without aspirin intake. 378 patients were enrolled and the results showed lower cardiac troponin T and Creatine Kinases in patients with protective dose of aspirin intake. In addition, Creatine Kinases were significantly higher in patients with no history of MI. We conclude that aspirin can reduce the size of the infraction. Also, higher enzymes can be due to higher muscle content in patient without MI history.

Seyyed Hashem Sezavar

2012-09-01

89

Consequences of radiotherapy on nutritional status, dietary intake, serum zinc and copper levels in patients with gastrointestinal tract and head and neck cancer  

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Malnutrition occurs frequently in cancer patients and is multifactorial and can lead to negative outcomes. So we studied the effect of radiotherapy on nutritional status, weight changes, dietary intake, serum zinc and copper levels. During the period of October to March 2005, 45 cancer patients who referred to the Radiotherapy Center, Imam Khomeini Hospital, Iran were recruited. We assessed the nutritional status of patients using Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire. Patients on the basis of location of radiotherapy classified to mediastinum, head and neck pelvic groups. Changes in dietary intake (using 24 hour recall method) and body weight were evaluated prior to and during radiotherapy. At the onset and the end of radiotherapy, serum levels of Zinc, copper and albumin were determined. After treatment malnutrition increased significantly in all patients (p=0.01) and in head and neck (p=0.007) and pelvic groups (p=0.04). The decreased bodyweight of patients was significant in head and neck (p=0.02) and pelvic groups (p=0.05). The mean daily energy and protein intake of head and neck and pelvic groups decreased during radiotherapy while energy intake increased significantly in mediastinum group (p=0.01). After treatment, significant decreases also observed in mean serum zinc, copper and albumin levels (p<0.05). Because of negative effect of radiotherapy on oral feeding, nutritional assessment and intervention should be an integral parand intervention should be an integral part of treatment. Also, it would be worthwhile studying the effect of zinc supplementation on dietary intake and nutritional status of patients. (author)

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[The role of chronic gastritis in past medical history with NSAID administration in patients with osteoarthrosis].  

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122 patients with osteoarthrosis, who have in the past medical history verified chronic gastritis (50 males and 72 females) at the age from 42 to 64 have been examined. Control group was comprised of 40 patients with osteoarthrosis without gastroduodenal zone pathology in the past medical history. For arthralgia relief patients were prescribed meloxicam (average dose--12.5 - 1.39 mg daily) or nimesulide (average dose--150 ± 14.91 mg daily). As a result of this research it was determined that administration of selective NSAID (meloxicam and nimesulide) in patients with chronic gastritis in the past medical history raised the risk of NSAID gastropathy/dyspepsia 2.9 times (P 0.05) of erosive gastropathy. Patients with chronic gastritis in the past medical history when taking NSAID with the purpose of gastropathy prevention are recommended to undergo gastroprotective therapy. PMID:25528842

2014-11-01

91

The prognostic value of family history among patients with urinary bladder cancer.  

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A history of urinary bladder cancer (UBC) in first-degree relatives increases UBC risk by twofold. The influence of positive family history on UBC prognosis is unknown. Here, we investigated association of first-degree UBC family history with clinicopathological characteristics and prognosis of UBC patients. Detailed clinical data of 1,465 non-muscle-invasive bladder cancer (NMIBC) and 250 muscle-invasive or metastatic bladder cancer (MIBC) patients, diagnosed from 1995 to 2010, were collected through medical file review. Competing risk analyses were used to compare recurrence-free survival (RFS) and progression-free survival (PFS) of NMIBC patients according to self-reported UBC family history. Overall survival in MIBC patients was estimated using Kaplan-Meier analysis. The added value of family history in prediction of NMIBC prognosis was quantified with Harrell's concordance-index. Hundred (6.8%) NMIBC and 14 (5.6%) MIBC patients reported UBC in first-degree relatives. Positive family history was statistically significantly associated with smaller tumor size and non-significantly with more favorable distribution of other tumor characteristics. In univariable analyses, positive family history correlated with longer RFS (p = 0.11) and PFS (p = 0.04). Hazard ratios for positive vs. negative family history after adjustment for clinicopathological characteristics were 0.75 (95% CI = 0.53-1.07) and 0.45 (95% CI = 0.18-1.12) for RFS and PFS, respectively. Five familial and 48 sporadic MIBC patients (Kaplan-Meier 10-year risk: 41% and 25%) died within 10 years. Family history did not improve the c-index of prediction models. This study shows that a first-degree family history of UBC is not clearly associated with NMIBC prognosis. Family history does not aid in prediction of NMIBC recurrence or progression. PMID:24978702

Egbers, Lieke; Grotenhuis, Anne J; Aben, Katja K; Alfred Witjes, J; Kiemeney, Lambertus A; Vermeulen, Sita H

2015-03-01

92

Influence of oral health condition on swallowing and oral intake level for patients affected by chronic stroke  

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Full Text Available Cláudia T Mituuti,1 Vinicius C Bianco,2 Cláudia G Bentim,3 Eduardo C de Andrade,1 José H Rubo,2 Giédre Berretin-Felix1 1Speech Language and Hearing Department, 2Department of Prosthodontics, Bauru School of Dentistry/University of São Paulo, Bauru, Brazil; 3SORRI-BAURU, Bauru, Brazil Background: According to the literature, the occurrence of dysphagia is high in cases of stroke, and its severity can be enhanced by loss of teeth and the use of poorly fitting prostheses.Objective: To verify that the status of oral health influences the level of oral intake and the degree of swallowing dysfunction in elderly patients with stroke in chronic phase.Methods: Thirty elderly individuals affected by stroke in chronic phase participated. All subjects underwent assessment of their oral condition, with classification from the Functional Oral Intake Scale (FOIS and nasoendoscopic swallowing assessment to classify the degree of dysphagia. The statistical analysis examined a heterogeneous group (HG, n=30 and two groups designated by the affected body part, right (RHG, n=8 and left (LHG, n=11, excluding totally dentate or edentulous individuals without rehabilitation with more than one episode of stroke.Results: There was a negative correlation between the need for replacement prostheses and the FOIS scale for the HG (P=0.02 and RHG (P=0.01. Differences in FOIS between types of prostheses of the upper dental arch in the LHG (P=0.01 and lower dental arch in the RHG (P=0.04. A negative correlation was found between the number of teeth present and the degree of dysfunction in swallowing liquid in the LHG (P=0.05. There were differences in the performance in swallowing solids between individuals without prosthesis and those with partial prosthesis in the inferior dental arch (P=0.04 for the HG.Conclusion: The need for replacement prostheses, type of prostheses, and the number of teeth of elderly patients poststroke in chronic phase showed an association with the level of oral intake and the degree of oropharyngeal dysphagia. Keywords: deglutition, mouth rehabilitation, aged, prosthodontics, dysphagia, cerebrovascular disorders

Mituuti CT

2014-12-01

93

Effect of alcohol intake on the radiographic quality in patients with midfacial trauma  

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The initial reports on radiologic examinations in 618 consecutive patients with midfacial injuries were compared with the final clinical diagnoses. Alcohol had to some degree been imbibed by 31% of the patients. Influence of alcohol was 3 times more common outside than within office hours. Radiographic analysis included estimation of blurring, errors in straightness, angulation, beam centering and limitation. Image quality was scored as visibility of 'the imaginary lines of bony continuity'. There was no statistically significant correlation between the degree of inebriety and image quality or diagnostic performance with the radiographic technique used, with the patient supine. There is no need to postpone midfacial radiography in inebriate patients.

Kinnunen, J.; Goethlin, J.H.

94

Effect of alcohol intake on the radiographic quality in patients with midfacial trauma  

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The initial reports on radiologic examinations in 618 consecutive patients with midfacial injuries were compared with the final clinical diagnoses. Alcohol had to some degree been imbibed by 31% of the patients. Influence of alcohol was 3 times more common outside than within office hours. Radiographic analysis included estimation of blurring, errors in straightness, angulation, beam centering and limitation. Image quality was scored as visibility of 'the imaginary lines of bony continuity'. There was no statistically significant correlation between the degree of inebriety and image quality or diagnostic performance with the radiographic technique used, with the patient supine. There is no need to postpone midfacial radiography in inebriate patients. (orig.)

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Reduction of intake of balsams in patients sensitive to balsam of Peru.  

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64 patients participated in this study. 24 were patients who had positive patch tests to balsam of Peru. The dermatitis of 9 of the patients had flared after open oral challenge with balsam of Peru, and the dermatitis of 31 patients had flared after double-blind oral challenge. All 64 patients were asked to avoid food items suspected of containing balsams for 1 to 2 months. At the end of that time, an evaluation of the diet trial was made; the dermatitis of 37 had cleared or improved markedly. If an improvement had taken place, the patient was asked to continue to diet moderately. 6 months to 3 years after the diet was initiated, a questionnaire was mailed to those patients whose dermatitis had improved after the first trial. The patients were asked to evaluate the long-term benefit of following the diet. 30 felt there was a long-term effect, and 27 still followed the diet instructions to some degree. PMID:4028703

Veien, N K; Hattel, T; Justesen, O; Nørholm, A

1985-05-01

96

Fatores associados à ingestão de sal em pacientes em tratamento crônico de hemodiálise / Factors associated to salt intake in chronic hemodialysis patients  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: A ingestão de sal tem sido diretamente relacionada ao aumento da ingestão hídrica e, consequentemente, ao incremento dos níveis da pressão arterial (PA) e do ganho de peso interdialítico (GPID), fatores de risco de morbimortalidade em pacientes em hemodiálise (HD). OBJETIVO: Avaliar a in [...] gestão de sal e suas fontes alimentares, bem como sua associação com parâmetros demográficos, clínicos e nutricionais. MÉTODOS: Estudo transversal no qual participaram 109 pacientes (66% mulheres; idade = 49,0 ± 12,6 anos) de cinco centros de diálise. Para obtenção da ingestão de sal total, foi utilizado um questionário de frequência alimentar (QFA) validado somado à estimativa da ingestão de sal de adição. Os dados obtidos foram relacionados a diversos parâmetros. RESULTADOS: A ingestão de sal média foi elevada (8,6 ± 5,4 g/dia), sendo 72% proveniente do sal de adição. Apenas a escolaridade se correlacionou tanto com a ingestão de sal total (r = -0,29; p Abstract in english INTRODUCTION: Salt intake increases fluid intake and, consequently, blood pressure (BP) and interdialytic weight gain (IDWG), known as morbi-mortality risk factors for hemodialysis (HD) patients. OBJECTIVE: Evaluate salt intake and food sources, as well as its relationship with demographics, clinica [...] l and nutritional parameters. METHODS: Cross-sectional study with 109 patients (66% women, age = 49.0 ± 12.6 years) from five dialysis centers. For total salt intake, a validated food frequency questionnaire (FFQ) and the use of discretionary salt were estimated. The relationship of salt intake with many factors was studied. RESULTS: Salt intake was high (8.6 ± 5.4 g/day) and 72% came from discretionary salt. Only literacy was significantly correlated total salt intake (r = -0.29, p

Fabiana Baggio, Nerbass; Jyana Gomes, Morais; Rafaela Gonzaga dos, Santos; Tatiana Stela, Kruger; Andrea Carolina, Sczip; Hercilio Alexandre da, Luz Filho.

2013-06-01

97

History of spine surgery in older obese patients  

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Full Text Available Goal: To study the interaction of obesity and age in patients with multiple spine surgeries. Methods: Data on the body mass index (BMI of 956 patients were collected and classified into four groups: non-obese (BMI <30 kg/m2, obese-class I (BMI ?30 kg/m2, obese-class II (BMI ?35 kg/m2 and obese-class III (BMI ?40 kg/m2. Patients' age was categorized into the following age groups: ?40, 41–65 and ?66. T-test and Chi-square test were applied using SPSS v16. Results: In lumbar patients aged ?66 years with previous spine surgery, the average number of previous spine surgeries significantly increased with increasing obesity from 1.4 in nonobese patients to 1.7, 2.5 and 3.5 in obese class I, II and III patients.In lumbar decompression and fusion patients aged ?66 years with previous spine surgery, the average number of previous spine surgeries signifi-cantly increased with increasing obesity from 1.7 in nonobese patients to 1.6, 2.0 and 3.5 in obese class I, II and III patients. A similar trend was noted in lumbar microdiskectomy patients aged ?66 years but it was statistically nonsignificant due probably to small numbers. Conclusion: Obesity is associated with an increased number of previous spine surgeries in patients over 65 years of age undergoing lumbar surgery.

Zaytseva, Nadezhda

2011-01-01

98

The accuracy of self-reported drug ingestion histories in emergency department patients.  

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Inaccuracies in self-reports may lead to duplication of therapy, failure to appreciate non-compliance leading to exacerbation of chronic medical conditions, or inaccurate research conclusions. Our objective is to determine the accuracy of self-reported drug ingestion histories in patients presenting to an urban academic emergency department (ED). We conducted a prospective cohort study in ED patients presenting for pain or nausea. We obtained a structured drug ingestion history including all prescription drugs, over-the-counter medication (OTC) drugs, and illicit drugs for the 48?hours prior to ED presentation. We obtained urine comprehensive drug screens (CDS) and determined self-report/CDS concordance. Fifty-five patients were enrolled. Self-reported drug ingestion histories were poor in these patients; only 17 (30.9%) of histories were concordant with the CDS. For the individual drug classes, prescription drug-CDS was concordant in 32 (58.2%), OTC-CDS was concordant in 33 (60%), and illicit drug-CDS was concordant in 45 (81.8%) of subjects. No demographic factors predicted an accurate self-reported drug history. Sixteen patients had drugs detected by CDS that were unreported by history. Nine of these 16 included an unreported opioid. In conclusion, self-reported drug ingestion histories are often inaccurate and resources are needed to confirm compliance and ensure unreported drugs are not overlooked. PMID:25052325

Monte, Andrew A; Heard, Kennon J; Hoppe, Jason A; Vasiliou, Vasilis; Gonzalez, Frank J

2015-01-01

99

Testicular and Scrotal Masses: Diagnosis through patient history and examination  

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The authors discuss the anatomy and embryology of the scrotum and testis. The importance of an appropriate physical examination and a thorough history is emphasized. Both painless and painful masses are reviewed with their causes and treatment. The authors recommend several investigative methods to determine the nature and extent of testicualr and scrotal masses.

Heritz, Dianne M.; Jewett, Michael A. S.

1992-01-01

100

Long-term survival of patients with a history of venous thromboembolism  

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Abstract Limited data are available regarding long-term survival following venous thromboembolism (VTE). The objectives of this study are to evaluate long-term survival by retrospective survival analysis in patients with a history of VTE and to compare their survival with that of the general population. Patients with a history of VTE (min. 3 months after VTE) without cancer, who were referred to our department between 1994 and 2007, were included in the analysis. Information conce...

2011-01-01

 
 
 
 
101

Ingesta excesiva de alcohol, malnutrición y cáncer de cabeza y cuello Heavy alcohol intake, malnutrition and head and neck cancer patients  

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Full Text Available Los pacientes con cáncer de cabeza y cuello presentan generalmente una excesiva ingesta de alcohol en su dicta diaria. El objetivo de este trabajo será establecer la relación entre consumo excesivo de alcohol en cáncer de cabeza y cuello y malnutrición junto al posible valor pronóstico del abuso de alcohol en su evolución oncológica. Pacientes y métodos: Se estudian de forma prospectiva 50 pacientes con cáncer de cavidad oral o faringolaringe en estadío T2-4. Se investigará sobre el estado nutricional y la aparición de recidivas en función de la ingesta de alcohol, así como la posibilidad de abandono del consumo de alcohol al finalizar el tratamiento oncológico. Resultados: El 51% de nuestros enfermos ingería diariamente una cantidad excesiva de alcohol en su dieta. El 70% de los grandes consumidores de alcohol presentaban mal estado nutricional, frente a una incidencia de desnutrición del 30% en los enfermos que no tomaban alcohol (p Head and neck cancer patients are frecuently heavy alcohol drinkers. The aim of this study is to determine the impact of alcohol intake on nutritional status and the impact in prognoses. Patients and methods: Fifty patients with oral and pharyngolaryngeal carcinomas were prospective studied in a control-case study. We studied nutritional status and tumoral recurrence in alcoholic and non-alcoholic patients. We also studied alcohol intake after oncologic treatment in these patients. Results: 51% of these patients had excesive alcohol intake before oncologic, treatment. The impact of malnutrition was 70% in alcoholic patients vs 30% in non-alcoholic (p < 0.01. Tumoral recurrence was 30% in alcoholic patients vs 13% in non-alcoholic patients (p < 0.05 . Only 48% of alcoholic patient stopped alcohol in-take after treatment. Conclusions: Excesive alcohol intake in head and neck cancer patients is a predictive malnutrition factor and it is related to poor prognoses. Alcoholic patients with head and neck cancer and malnutrition need an agresive nutritional, medical and psycosocial suppor after oncologic treatment, in order to reach a better and longer survival.

C. Martín Villares

2004-11-01

102

La influencia de la historia familiar de consumo de alcohol en hombres y mujeres The influence of family history on alcohol intake in males and females  

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Full Text Available OBJETIVO: Evaluar el riesgo para el uso excesivo de etanol en personas con historia familiar positiva de consumo de alcohol (HF+. MATERIAL Y MÉTODOS: Los datos corresponden a una muestra de población general (n= 8 890 y fueron recopilados a partir de una encuesta nacional de adicciones en población urbana de México, realizada en 1988. Se determinaron medidas epidemiológicas de frecuencia y asociación considerando los antecedentes de HF+ como factor de exposición. RESULTADOS: La prevalencia actual del consumo consuetudinario de alcohol fue de 13.7% para los hombres y 0.6% para las mujeres, las cifras para el síndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces más probabilidad de desarrollar el síndrome de dependencia que aquellos con HF-. La razón de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisión de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del síndrome de dependencia de los hijos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlOBJETIVE: To assess the risk for alcohol abuse among individuals with a positive family history of alcohol abuse (FH+. MATERIAL AND METHODS: The study population was a sample (n=8 890 drawn from a 1988 national survey on addictions in Mexico City's urban population. Data analysis consisted of frequency and association measures, using family history of alcohol abuse as the exposure factor. RESULTS: Prevalence of heavy drinking was 13.7% for males and 0.6% for females. Alcohol dependence syndrome was found in 9.9% of males and 0.6% of females. Men with HF+ were twice more likely to develop dependence syndrome than HF- males. The odds ratio for women was 1.27. CONCLUSIONS: Differential patterns by gender were found for familial transmission of alcohol abuse; parental alcohol intake is a main risk factor for developing alcohol dependence syndrome. The English version of this paper is available at: http://www.insp.mx/salud/index.html

Guillermina Natera-Rey

2001-02-01

103

La influencia de la historia familiar de consumo de alcohol en hombres y mujeres / The influence of family history on alcohol intake in males and females  

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Full Text Available SciELO Public Health | Language: Spanish Abstract in spanish OBJETIVO: Evaluar el riesgo para el uso excesivo de etanol en personas con historia familiar positiva de consumo de alcohol (HF+). MATERIAL Y MÉTODOS: Los datos corresponden a una muestra de población general (n= 8 890) y fueron recopilados a partir de una encuesta nacional de adicciones en població [...] n urbana de México, realizada en 1988. Se determinaron medidas epidemiológicas de frecuencia y asociación considerando los antecedentes de HF+ como factor de exposición. RESULTADOS: La prevalencia actual del consumo consuetudinario de alcohol fue de 13.7% para los hombres y 0.6% para las mujeres, las cifras para el síndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces más probabilidad de desarrollar el síndrome de dependencia que aquellos con HF-. La razón de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisión de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del síndrome de dependencia de los hijos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html Abstract in english OBJETIVE: To assess the risk for alcohol abuse among individuals with a positive family history of alcohol abuse (FH+). MATERIAL AND METHODS: The study population was a sample (n=8 890) drawn from a 1988 national survey on addictions in Mexico City's urban population. Data analysis consisted of freq [...] uency and association measures, using family history of alcohol abuse as the exposure factor. RESULTS: Prevalence of heavy drinking was 13.7% for males and 0.6% for females. Alcohol dependence syndrome was found in 9.9% of males and 0.6% of females. Men with HF+ were twice more likely to develop dependence syndrome than HF- males. The odds ratio for women was 1.27. CONCLUSIONS: Differential patterns by gender were found for familial transmission of alcohol abuse; parental alcohol intake is a main risk factor for developing alcohol dependence syndrome. The English version of this paper is available at: http://www.insp.mx/salud/index.html

Guillermina, Natera-Rey; Guilherme, Borges; Ma. Elena, Medina-Mora Icaza; Luis, Solís-Rojas; Marcela, Tiburcio-Sainz.

2001-02-01

104

La influencia de la historia familiar de consumo de alcohol en hombres y mujeres / The influence of family history on alcohol intake in males and females  

Scientific Electronic Library Online (English)

Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish OBJETIVO: Evaluar el riesgo para el uso excesivo de etanol en personas con historia familiar positiva de consumo de alcohol (HF+). MATERIAL Y MÉTODOS: Los datos corresponden a una muestra de población general (n= 8 890) y fueron recopilados a partir de una encuesta nacional de adicciones en població [...] n urbana de México, realizada en 1988. Se determinaron medidas epidemiológicas de frecuencia y asociación considerando los antecedentes de HF+ como factor de exposición. RESULTADOS: La prevalencia actual del consumo consuetudinario de alcohol fue de 13.7% para los hombres y 0.6% para las mujeres, las cifras para el síndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces más probabilidad de desarrollar el síndrome de dependencia que aquellos con HF-. La razón de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisión de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del síndrome de dependencia de los hijos. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.html Abstract in english OBJETIVE: To assess the risk for alcohol abuse among individuals with a positive family history of alcohol abuse (FH+). MATERIAL AND METHODS: The study population was a sample (n=8 890) drawn from a 1988 national survey on addictions in Mexico City's urban population. Data analysis consisted of freq [...] uency and association measures, using family history of alcohol abuse as the exposure factor. RESULTS: Prevalence of heavy drinking was 13.7% for males and 0.6% for females. Alcohol dependence syndrome was found in 9.9% of males and 0.6% of females. Men with HF+ were twice more likely to develop dependence syndrome than HF- males. The odds ratio for women was 1.27. CONCLUSIONS: Differential patterns by gender were found for familial transmission of alcohol abuse; parental alcohol intake is a main risk factor for developing alcohol dependence syndrome. The English version of this paper is available at: http://www.insp.mx/salud/index.html

Guillermina, Natera-Rey; Guilherme, Borges; Ma. Elena, Medina-Mora Icaza; Luis, Solís-Rojas; Marcela, Tiburcio-Sainz.

2001-02-01

105

Natural History of Intestinal Microsporidiosis among Patients Infected with Human Immunodeficiency Virus  

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A chart review of 73 human immunodeficiency virus (HIV)-infected patients with enteric microsporidiosis was conducted to define the natural history of microsporidiosis. A substantial proportion of patients remained symptomatic after 6 months (54.8% with persistent diarrhea and 51.2% with weight loss). Predictors for persistent diarrhea included high HIV RNA viral load and no initiation of protease inhibitor therapy.

Dascomb, Kristin; Clark, Rebecca; Aberg, Judith; Pulvirenti, Joseph; Hewitt, Ross G.; Kissinger, Patricia; Didier, Elizabeth S.

1999-01-01

106

CAROTID AND VERTEBRAL ARTERY STENOSIS IN PATIENT WITH HISTORY OF CORONARY ARTERY BYPASS GRAFTING  

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Full Text Available ntroduction: Athrosclerosis and cerebrovascular events are from the main causes of human modality and disability. The purpose of this paper is to investigate atherosclerotic plagues and stenos is in carotid and vertebral arteries in patient with history of coronary artery bypass grafting (CABG Methods: In a cross -sectional study, 100 patient who had history of CABG in last 2 years were evaluated by duplex sonography for carotid and vertebral artery pluge and stenosis and result were analyzed by spss 10. Results: 25% of patients had carotid plague and 20% of them had vertebral plague. The only difinit risk factor for carotid artery stenosis was aging (P < 0.05. Discussion: Periodic cervical artries examination with duplex sonography in patient with history of coronary artery bypass grafting is essential.

M EATEMADIF

2003-12-01

107

Discrepancies between N-Acetyl Cysteine Prescription based on Patient’s History and Plasma Acetaminophen Level  

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Full Text Available Background: Fatalities from acetaminophen poisoning are common, but they arepreventable by timely treatment with N-acetyl cysteine (NAC. In many medicalcenters, NAC is prescribed in keeping with the ingested dose of the drug asrevealed through medical history. It seems to significantly differ from the realindications of NAC administration based on plasma level of acetaminophen.Overtreatment increases adverse drug reactions and it is time- consuming andcostly.Methods: Acetaminophen plasma level was checked by HPLC method in 170admitted patients who had history of acute ingestion of more than 7.5 gacetaminophen within 4 to 24 hours prior to hospital admission. Indications forNAC prescription according to patient’s history and adaptation fromacetaminophen plasma level in Romack-Mathew nomogram were matched. Datawere analyzed by SPSS software version 16.0.Results: Mean age of the patients was 21.8±6.05 years. In 75.8% of the patients,poisoning had occurred after suicidal attempts. Acetaminophen plasma level wasbetween less than 2 and 265 ?g/ml (18.7±28.88, mean± SD. Only in 18 (10.6%cases, overtreatment had been performed. Multiple logistic regression analysisshowed that the number of suicidal attempts, number of ingested pills, and time ofreferral had positive relationships with acetaminophen plasma level.Conclusion: If NAC is prescribed only based on patient's medical history,overtreatment may take place.

Fakhreddin Taghaddosi-Nejad

2012-09-01

108

Characteristics of tuberculosis patients at intake in Cambodia, two provinces in China, and Viet Nam  

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Full Text Available Abstract Background The tuberculosis register is a critical data source for the information system of national tuberculosis control programs. From the information in the tuberculosis case register, it is possible to extend the standard analysis of age and sex characteristics among sputum smear-positive cases to all tuberculosis case categories. National tuberculosis programs might utilize such information to identify problems related to referral and access to diagnosis and treatment. Objectives Based on the electronic database we created, our objectives were to provide a detailed description of age and sex characteristics of tuberculosis patients at registration and to provide a comparison of age-specific sex characteristics among incident and prevalent sputum smear-positive cases. Methods A representative sample of tuberculosis case registers from 1 January 2003 to 31 December 2005 was selected in Cambodia, two provinces in China and Viet Nam. Age and sex characteristics of cases in the three separate prevalence surveys in the three jurisdictions (Cambodia: year 2002; China: year 2000; and Viet Nam: year 2006-2007 were obtained for comparison. Results A total 37,635 patients had been registered during the period in the selected units in the three countries. Cases were more frequently male in all three countries with 53%, 71%, and 69% in Cambodia, China, and Viet Nam, respectively. The ratios of the female-to-male odds in the notification system to that in the prevalence survey in smear-positive cases in Cambodia, China and Viet Nam were 2.1, 0.9, and 1.8, respectively. Because of the small proportion of extrapulmonary tuberculosis registered in China, we limited the analysis on age and sex distribution for extrapulmonary cases to Cambodia and Viet Nam. The proportion with extrapulmonary tuberculosis among all cases was 18.5% in Cambodia and 15.7% in Viet Nam, decreasing in frequency with increasing age. Conclusions Characteristics of patients greatly differed between countries and between patient categories. In Cambodia and Viet Nam, efforts should be made for improved case-finding of sputum smear-positive tuberculosis among males.

Lauritsen Jens M

2011-05-01

109

History of sexual abuse and suicide attempts in alcohol-dependent patients.  

Science.gov (United States)

History of child abuse is considered one of the important risk factors of suicide attempt in general population. At the same time it has been shown that suicide attempts appear significantly more frequently in alcoholics than in healthy individuals. The objective of this study was to investigate associations between history of childhood sexual abuse and suicide attempts in a sample of Polish alcohol dependent patients. A sample of 364 alcohol-dependent subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, family history of psychiatric problems, history of suicide attempts, sexual and physical abuse during childhood and adulthood and severity of alcohol problems. When analyzed by gender, 7.4% of male and 39.2% of female patients had a lifetime history of sexual abuse; 31.9% of the study group reported at least one suicide attempt during their lifetime. Patients who reported suicide attempts were significantly younger (p=0.0008), had greater severity of alcohol dependence (p=0.0002), lower social support (p=0.003), and worse economic status (p=0.002). Moreover, there was a significant association between history of suicide attempts and family history of psychiatric problems (p=0.00025), suicide attempts in the family (p=0.0073), childhood history of sexual abuse (p=0.009) as well as childhood history of physical abuse (p=0.002). When entered into linear regression analysis with other dependent variables history of childhood sexual abuse remained a significant predictor of suicide attempt (OR=2.52; p=0.035). Lifetime experience of sexual abuse is a significant and independent risk factor of suicide attempts in alcohol-dependent individuals. PMID:24997776

Jakubczyk, A; Klimkiewicz, A; Krasowska, A; Kopera, M; S?awi?ska-Ceran, A; Brower, K J; Wojnar, M

2014-09-01

110

Does the usual dietary intake of patients with depression require vitamin-mineral supplementation?  

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Full Text Available Introduction. Research on diet and nutrition of patients with depression show that their eating habits are frequently irrational and result in the inconsistent supply of nutrients, especially vitamins and minerals, the deficiency of which leads to nervous system dysfunction. Aim. The aim of the study was to evaluate the content of selected vitamins and minerals in daily food rations of patients suffering from recurrent depressive disorders. Methods. The study involved a group of 69 people (54 women and 15 men, aged 18-65 years, mean age of women 45.7 ± 12.2 years, men 46.0 ± 12.2 years, treated for recurrent depressive disorders. A questionnaire designed in the Department of Dietetics and Clinical Nutrition, Medical University of Bialystok was used to collect dietary data. The quantitative assessment of eating habits used a 24-hour diet recall including 3 weekdays and 1 weekend day. Results. The study showed that the supply of most nutrients assessed was inconsistent with recommendations. Conclusions. The results indicate that the need for vitamin-mineral supplementation should be considered individually. Nutritional education related to the proper choice of groups of food products is indicated at the time of clinical improvement to ensure the optimum supply of vitamins and minerals.

Stefa?ska, Ewa

2014-02-01

111

Minor physical anomalies are more common in schizophrenia patients with the history of homicide.  

Science.gov (United States)

Minor physical anomalies may be external markers of abnormal brain development, so the more common appearance of these signs in homicidal schizophrenia might suggest the possibility of a more seriously aberrant neurodevelopment in this subgroup. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with schizophrenia with the history of committed or attempted homicide comparing them to patients with schizophrenia without homicide in their history and to normal control subjects. Using a list of 57 minor physical anomalies, 44 patients with the diagnosis of schizophrenia were examined with the history of committed or attempted homicide, as a comparison 22 patients with the diagnosis of schizophrenia without the history of any kind of homicide and violence and 21 normal control subjects were examined. Minor physical anomalies are more common in homicidal schizophrenia patients compared to non-homicidal schizophrenia patients and normal controls, which could support a stronger neurodevelopmental component of etiology in this subgroup of schizophrenia. The higher rate of minor physical anomalies found predominantly in the head and mouth regions in homicidal schizophrenia patients might suggest the possibility of a more seriously aberrant brain development in the case of homicidal schizophrenia. PMID:25500346

Tényi, Tamás; Halmai, Tamás; Antal, Albert; Benke, Bálint; Jeges, Sára; Tényi, Dalma; Tóth, Ákos Levente; Csábi, Györgyi

2015-02-28

112

Cervical smear screening: questionnaire study of histories and attitudes of patients with squamous cervical carcinoma  

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OBJECTIVE. To determine why invasive cervical carcinoma still occurs despite the availability of cervical smear screening. DESIGN. Questionnaire survey and retrospective study of patient records of women who attended a gynaecological oncology out-patients clinic from 13 February 1997 to 30 June 1997. SETTING. Public hospital, Hong Kong. PATIENTS. Ninety-nine women (median age 53 years; range, 30-79 years) who gave a history of squamous cervical carcinoma. MAIN OUTCOME MEASURES...

Lee, Ssn; Wong, Rlc

1999-01-01

113

BRCA1 status in Pakistani breast cancer patients with moderate family history  

International Nuclear Information System (INIS)

Objective: To determine BRCA1 status in breast carcinoma patients of Pakistani origin. Study Design: Observational study. Place and Duration of Study: The Oncology Clinics of the Aga Khan University Hospital, Karachi, between May 2005 and December 2009. Methodology: Fifty three breast cancer patients based on clinical and laboratory diagnosis were recruited for this study. Moderate family history was defined as having a close relative (mother, daughter, sister) diagnosed with breast cancer under 45 years. Peripheral blood samples were collected from each patient in a 5 ml tube containing EDTA as anticoagulant. Subsequent to DNA extraction, mutational analysis of BRCA1 exons 2, 5, 6, 16, 20 and 22 was carried out using single strand conformation polymorphism (SSCP) assay while protein truncation test (PTT) was used to examine mutations in exon 11. All BRCA1 sequence variants were confirmed by DNA sequencing. Results: Twenty-three patients were diagnosed with early onset breast cancer, 30 patients had moderate family history. At the time of diagnosis, the median age of enrolled patients was 39 years (range 24-65 years). Out of 53 patients, analyzed by SSCP assay, mobility shift was detected in exon 6, 16 and 20 of three patients, whereas one patient was tested positive for mutation in exon 11 by PTT assays. All patients with BRCA1 mutations were further confirmed by DNA sequencing analysis. In exon 16 c.4837A > G was confirmed, which is a common polymorphism reported inwhich is a common polymorphism reported in several populations including Asians. Moreover, mutations in exon 6 (c.271T > G), exon 20 (c.5231 del G) and exon 11 (c.1123 T > G) were reported first time in the Pakistani population. Several BRCA1 mutations were observed in Pakistani breast cancer patients with moderate family history. Therefore, mutation-based genetic counselling for patients with moderate family history can facilitate management, if one first or second degree relative or early onset disease is apparent. (author)

114

Central venous stenosis in haemodialysis patients without a previous history of catheter placement  

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Objective: To evaluate dialysis history, imaging findings and outcome of endovascular treatment in six patients with central venous stenosis without a history of previous catheter placement. Material and methods: Between April 2000 and June 2004, six (10%) of 57 haemodialysis patients had stenosis of a central vein without a previous central catheter placement. Venography findings and outcome of endovascular treatment in these six patients were retrospectively evaluated. Patients were three women (50%) and three men aged 32-60 years (mean age: 45 years) and all had massive arm swelling as the main complaint. The vascular accesses were located at the elbow in five patients and at the wrist in one patient. Results: Three patients had stenosis of the left subclavian vein and three patients had stenosis of the left brachiocephalic vein. The mean duration of the vascular accesses from the time of creation was 25.1 months. Flow volumes of the vascular access were very high in four patients who had flow volume measurement. The mean flow volume was 2347 ml/min. One of three patients with brachiocephalic vein stenosis had compression of the vein by the brachiocephalic artery. All the lesions were first treated with balloon angioplasty and two patients required stent placement on long term. Number of interventions ranged from 1 to 4 (mean: 2.1). Symptoms resolved in five patients and improved in one patient who had a stent placed in the left BCV. Conclusion: Central venous stenosis in haemodialysis patients without a history of central venous catheterization tends to occur or be manifested in patients with a proximal permanent vascular access with high flow rates. Balloon angioplasty with or without stent placement offers good secondary patency rates in mid-term.

Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Centre, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Centre, Department of Radiology, Adana (Turkey); Yildirim, Sedat [Baskent University, Adana Teaching and Medical Research Centre, Department of Surgery, Adana (Turkey); Torun, Dilek [Baskent University, Adana Teaching and Medical Research Centre, Department of Nephrology, Adana (Turkey)

2005-08-01

115

Information Visualisation and the Electronic Health Record :Visualising Collections of Patient Histories from General Practice  

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This thesis investigates the question: "How can we use information visualisation to support retrospective, explorative analysis of collections of patient histories?" Building on experience from previous projects, we put forth our answer to the question by making the following contributions: * Reviewing relevant literature. * Proposing a novel design for visual exploration of collections of histories, motivated in a specific problem within general practice health care and exis...

Nordbø, Stein Jakob

2006-01-01

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Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure  

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The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharm...

Ajdukovic M; Crook M; Angley C; Stupans I; Soulsby N; Doecke C; Anderson B; Angley M

2007-01-01

117

Hysteroscopic Findings in Patients with A History of Two Implantation Failures Following In Vitro Fertilization  

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Full Text Available Background: This study was designed to evaluate the incidence of uterine pathologiesin infertile women with a history of two implantation failures after in vitro fertilization(IVF and estimate the effect of hysteroscopic correction on achieving a pregnancy inthese patients.Materials and Methods: The retrospective study population included 238 infertilewomen attended the outpatient infertility clinic between November 2007 and December2008. Patients with at least two previous IVF failures were eligible for this study.All patients had normal findings on hysterosalpingography performed prior their firstattempt for IVF. Standard transvaginal ultrasonography and diagnostic hysteroscopywere performed in patients before the subsequent IVF attempt.Results: Out of 238 patients with previous IVF failure who underwent hysteroscopicevaluation, 158 patients (66.4% showed normal uterine cavity. Abnormal cavity wasfound in 80 patients (33.6%. We found polyp as the most common abnormality (19.7%in the patients with previous history of IVF failure. The pregnancy rate was similar betweenIVF failure patients who treated by hysteroscopy for a detected uterine abnormality(24.6% and similar patients with normal uterine cavity (21.2% in hysteroscopicexaminations.Conclusion: The intrauterine lesions diagnosed by hysteroscopy in patients with previousIVF failure ranges from 0.8%-19.7%. Correction of abnormalities such as myoma and polypshowed good outcome, similar to that achieved in patients with a normal hysteroscopy.

Ashraf Moini

2012-01-01

118

Hansen's disease in a patient with a history of sarcoidosis.  

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We report a rare case of concomitant Hansen's disease (HD) and sarcoidosis. Reticulin staining may be a helpful diagnostic tool in establishing the diagnosis of sarcoidosis in skin lesions. The diagnosis of HD can be established despite negative polymerase chain reaction results for the detection of Mycobacterium leprae DNA. Finally, a well-established diagnosis of sarcoidosis does not preclude the development of another granulomatous disorder. Hence, when new lesions developed in a patient with sarcoidosis despite appropriate therapy, other concurrent diagnoses should be pursued. PMID:11221094

Burdick, A E; Hendi, A; Elgart, G W; Barquin, L; Scollard, D M

2000-09-01

119

Unstimulated whole salivary flow rate and anxiolytics intake are independently associated with oral Candida infection in patients with oral lichen planus.  

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Many factors have been proposed to influence oral infection with yeast. The aim of this study was to determine the prevalence of oral yeasts in oral lichen planus (OLP) patients and control subjects, and to perform a multiple logistic regression analysis to identify factors that influence oral Candida infection in OLP patients. In this cross-sectional study, 90 new patients with OLP and 90 sex- and age-matched control subjects with no mucosal lesions were interviewed about their health status, use of medication, and smoking and alcohol habits. Swab and unstimulated whole saliva samples were collected and salivary pH was measured. A positive Candida culture was more prevalent among OLP patients (48.9%) than among control subjects (26.7%). Candida albicans was the most frequently isolated species in both groups. By logistic regression analysis, unstimulated whole salivary flow rates of 0.11-0.24 ml min(-1) (OR = 5.90) and 0.25-0.32 ml min(-1) (OR = 3.51) and benzodiazepine anxiolytics intake (OR = 8.30) were independently associated with the presence of Candida among OLP patients. Age, denture wearing, levels of dentition, decreased salivary pH, antihypertensive drugs, and alcohol consumption were not associated with oral Candida infection in OLP patients. The results indicate that data on benzodiazepine anxiolytics intake and evaluation of unstimulated whole salivary flow rate should be considered as part of the clinical evaluation to identify OLP patients at risk for Candida infection. PMID:24028590

Bokor-Bratic, Marija; Cankovic, Milos; Dragnic, Natasa

2013-10-01

120

[The development of protracted pneumonias in patients with a history of influenza and acute respiratory diseases].  

Science.gov (United States)

A study is presented of 582 patients with acute viral-bacterial pneumonia in those with a history of influenza and acute respiratory disease (ARD). Protracted course of the disease was observed in 121 (20.8%) and 461 (79.2%) the course of pneumonia was acute. It is shown that the formation of protracted of acute pneumonia in patients with influenza and ARD is furthered by several factors: age, foci of chronic infection, a history of inflammation, increased level of circulating immune complexes, late hospitalization and inadequate therapy. Experiments on Syrian hamsters with induced parainfluenzal infection showed that mixed viral-bacterial infection is more severe than monoinfection. PMID:2169144

Trinus, E K; Rudenko, A A; Sidorova, Zh P; Shapiro, A V; Vasilenko, L G; Zharkova, L D; Kruglikov, V T; Marchenko, N E; Ilashchuk, I D; Volkova, T M

1990-06-01

 
 
 
 
121

Associação entre o estado nutricional e a ingestão dietética em pacientes com fibrose cística Association between nutritional status and dietary intake in patients with cystic fibrosis  

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Full Text Available OBJETIVO: Determinar a relação entre o estado nutricional e a ingestão dietética de pacientes com fibrose cística. MÉTODOS: Estudo transversal com 85 pacientes com fibrose cística entre 6 e 18 anos de idade. A ingestão dietética foi avaliada pelo registro alimentar de 3 dias com a pesagem dos alimentos consumidos. Os desfechos avaliados foram os seguintes indicadores do estado nutricional: percentual da relação peso/estatura (%P/E, percentil do índice de massa corpórea (IMC, escore Z para estatura/idade (E/I e peso/idade (P/I, e percentual de ingestão dietética comparada a Recommended Dietary Allowances (RDAs. RESULTADOS: A prevalência de pacientes eutróficos foi de 77,7%, considerando o IMC acima do percentil 25 como ponto de corte, e 83,5% estavam acima de 90% do %P/E. A média de ingestão, avaliada em 82 pacientes, foi de 124,5% da RDA. Nas análises de regressão logística univariada, encontrou-se uma associação significativa entre a variável independente ingestão calórica e o desfecho escore Z E/I. O modelo de análise multivariado, elaborado a partir do desfecho escore Z E/I e ajustado para idade, VEF1, colonização por Staphylococcus aureus resistente à meticilina e número de internações hospitalares, demonstrou que um aumento de 1% da ingestão calórica em relação à RDA diminui em 2% a chance de ter déficit de estatura (OR = 0,98; IC95%: 0,96-1,00. A escolaridade materna demonstrou uma associação limítrofe (p = 0,054. CONCLUSÕES: Houve baixa prevalência de desnutrição nesta amostra. O modelo de estudo demonstrou evidências da associação entre a ingestão dietética e o estado nutricional, sendo esta ingestão um fator preditor de crescimento nesses pacientes.OBJECTIVE: To determine the relationship between nutritional status and dietary intake in patients with cystic fibrosis. METHODS: Cross-sectional study involving 85 cystic fibrosis patients between 6 and 18 years of age. Dietary intake was evaluated by the 3-day diet record (weighing the food consumed. The outcome measures were the following nutritional status indicators: weight/height (W/H% percentage, body mass index (BMI percentiles, Z score for weight/age (W/A, Z score for height/age (H/A and percentage of dietary intake compared with the Recommended Dietary Allowance (RDA. RESULTS: The prevalence of well-nourished patients was 77.7%, using BMI above the 25th percentile as the cut-off value, and the W/H% was above 90% in 83.5%. The mean dietary intake, evaluated in 82 patients, was 124.5% of the RDA. In the univariate logistic regression analyses, we found a significant association between the independent variable calorie intake and the Z score for W/A. The multivariate analysis, based on the Z score for H/A and adjusted for FEV1, methicillin-resistant Staphylococcus aureus colonization and number of hospitalizations, demonstrated that a 1% increase in the calorie intake decreases the chance of having short stature by 2% (OR: 0.98; 95% CI: 0.96-1.00. Maternal level of education showed a borderline association (p = 0.054. CONCLUSIONS: The prevalence of malnutrition was low in this sample of patients. The study model demonstrated an association between dietary intake and nutritional status. Dietary intake was a predictive factor of statural growth in patients with cystic fibrosis.

Míriam Isabel Souza dos Santos Simon

2009-10-01

122

Associação entre o estado nutricional e a ingestão dietética em pacientes com fibrose cística / Association between nutritional status and dietary intake in patients with cystic fibrosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Determinar a relação entre o estado nutricional e a ingestão dietética de pacientes com fibrose cística. MÉTODOS: Estudo transversal com 85 pacientes com fibrose cística entre 6 e 18 anos de idade. A ingestão dietética foi avaliada pelo registro alimentar de 3 dias com a pesagem dos alimen [...] tos consumidos. Os desfechos avaliados foram os seguintes indicadores do estado nutricional: percentual da relação peso/estatura (%P/E), percentil do índice de massa corpórea (IMC), escore Z para estatura/idade (E/I) e peso/idade (P/I), e percentual de ingestão dietética comparada a Recommended Dietary Allowances (RDAs). RESULTADOS: A prevalência de pacientes eutróficos foi de 77,7%, considerando o IMC acima do percentil 25 como ponto de corte, e 83,5% estavam acima de 90% do %P/E. A média de ingestão, avaliada em 82 pacientes, foi de 124,5% da RDA. Nas análises de regressão logística univariada, encontrou-se uma associação significativa entre a variável independente ingestão calórica e o desfecho escore Z E/I. O modelo de análise multivariado, elaborado a partir do desfecho escore Z E/I e ajustado para idade, VEF1, colonização por Staphylococcus aureus resistente à meticilina e número de internações hospitalares, demonstrou que um aumento de 1% da ingestão calórica em relação à RDA diminui em 2% a chance de ter déficit de estatura (OR = 0,98; IC95%: 0,96-1,00). A escolaridade materna demonstrou uma associação limítrofe (p = 0,054). CONCLUSÕES: Houve baixa prevalência de desnutrição nesta amostra. O modelo de estudo demonstrou evidências da associação entre a ingestão dietética e o estado nutricional, sendo esta ingestão um fator preditor de crescimento nesses pacientes. Abstract in english OBJECTIVE: To determine the relationship between nutritional status and dietary intake in patients with cystic fibrosis. METHODS: Cross-sectional study involving 85 cystic fibrosis patients between 6 and 18 years of age. Dietary intake was evaluated by the 3-day diet record (weighing the food consum [...] ed). The outcome measures were the following nutritional status indicators: weight/height (W/H%) percentage, body mass index (BMI) percentiles, Z score for weight/age (W/A), Z score for height/age (H/A) and percentage of dietary intake compared with the Recommended Dietary Allowance (RDA). RESULTS: The prevalence of well-nourished patients was 77.7%, using BMI above the 25th percentile as the cut-off value, and the W/H% was above 90% in 83.5%. The mean dietary intake, evaluated in 82 patients, was 124.5% of the RDA. In the univariate logistic regression analyses, we found a significant association between the independent variable calorie intake and the Z score for W/A. The multivariate analysis, based on the Z score for H/A and adjusted for FEV1, methicillin-resistant Staphylococcus aureus colonization and number of hospitalizations, demonstrated that a 1% increase in the calorie intake decreases the chance of having short stature by 2% (OR: 0.98; 95% CI: 0.96-1.00). Maternal level of education showed a borderline association (p = 0.054). CONCLUSIONS: The prevalence of malnutrition was low in this sample of patients. The study model demonstrated an association between dietary intake and nutritional status. Dietary intake was a predictive factor of statural growth in patients with cystic fibrosis.

Míriam Isabel Souza dos Santos, Simon; Michele, Drehmer; Sérgio Saldanha, Menna-Barreto.

2009-10-01

123

Natural history and prognostic factors in 305 Swedish patients with primary sclerosing cholangitis.  

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BACKGROUND/AIMS--The course of primary sclerosing cholangitis (PSC) is highly variable and unpredictable. This study describes the natural history and outcome of PSC. These data were used to construct a prognostic model for patients with PSC. METHODS--A total of 305 Swedish patients with PSC were studied. The median follow up time was 63 (1-194) months and all patients could be traced for follow up. Some 79 patients died or had a liver transplant. The prognostic significance of clinical, bioc...

Broome?, U.; Olsson, R.; Lo?o?f, L.; Bodemar, G.; Hultcrantz, R.; Danielsson, A.; Prytz, H.; Sandberg-gertze?n, H.; Wallerstedt, S.; Lindberg, G.

1996-01-01

124

Hysteroscopic Findings in Patients with A History of Two Implantation Failures Following In Vitro Fertilization  

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Background: This study was designed to evaluate the incidence of uterine pathologiesin infertile women with a history of two implantation failures after in vitro fertilization(IVF) and estimate the effect of hysteroscopic correction on achieving a pregnancy inthese patients.Materials and Methods: The retrospective study population included 238 infertilewomen attended the outpatient infertility clinic between November 2007 and December2008. Patients with at least two previous IVF failures were...

Ashraf Moini; Kiandokht Kiani; Firouzeh Ghaffari; Fatemeh Hosseini

2012-01-01

125

Predicting utility of exercise tests based on history/holter in patients with premature ventricular contractions.  

Science.gov (United States)

Premature ventricular contractions (PVCs) are considered benign in patients with structurally normal hearts, particularly if they suppress with exercise. Catecholaminergic polymorphic ventricular tachycardia (CPVT) requires exercise testing to unmask the malignant phenotype. We studied risk factors and Holter monitor variables to help predict the necessity of exercise testing in patients with PVCs. We retrospectively reviewed 81 patients with PVCs that suppressed at peak exercise and structurally normal hearts referred to the exercise laboratory in 2011. We reviewed 11 patients from 2003 to 2012 whose PVCs were augmented at peak exercise (mean age 13 ± 4 years; 52 % male, 180 exercise studies). We recorded clinical risk factors and comorbidities (family history of arrhythmia or sudden unexpected death [SUD], presence of syncope) and Holter testing parameters. Family history of VT or SUD (P = 0.011) and presence of VT on Holter (P = 0.011) were significant in predicting failure of PVCs to suppress at peak heart rate on exercise testing. Syncope was not statistically significant in predicting suppression (P = 0.18); however, CPVT was diagnosed in four patients with syncope during exercise. Quantity of PVCs, Lown grade, couplets on Holter, monomorphism, and PVC elimination at peak heart rate on Holter were not predictors of PVC suppression on exercise testing. Patients with syncope during exercise, family history of arrhythmia or SUD, or a Holter monitor showing VT warrant exercise testing to assess for CPVT. PMID:25135604

Robinson, Brad; Xie, Li; Temple, Joel; Octavio, Jenna; Srayyih, Maytham; Thacker, Deepika; Kharouf, Rami; Davies, Ryan; Gidding, Samuel S

2015-01-01

126

The use of nationwide on-line prescription records improves the drug history in hospitalized patients  

DEFF Research Database (Denmark)

BACKGROUND Structured medication interviews improve the medication history in hospitalized patients. In Denmark, a nationwide electronic version of individual pharmacy records (PR) has recently been introduced. Use of these records could improve the medication lists in hospitalized patients. METHODS We prospectively included 500 patients admitted to an acute medical department. In individual patients, the PR was compared with (i) the medication list written in the patient chart and (ii) drug information provided by the patient during a structured drug interview upon admission and during a home visit after discharge. RESULTS Median patient age was 72 years. Upon admission, patients reported using 1958 prescription-only medications (POM) (median four drugs per patient, range 0-14), of which 114 (6%) were not registered in PR. In PR, 1153 POM (median one per patient, range 0-11) were registered during the month preceding admission. The patients did not report 309 (27%) of these upon admission. Home visits were performed in a subgroup of 115 patients. During home visits, 18% of POM registered in PR during the preceding month were not reported. Drug type was predictive of reporting irrespective of patient sex or age. Cardiovascular drugs were reported most and dermatologicals were reported less frequently. Underreporting might be due to recall bias, non-adherence or discontinuation of drugs. CONCLUSIOBS Omission errors are frequent despite structured medication interviews. Pharmacy records or medication lists from all treating doctors must be included in medication reviews in order to reduce recall bias Udgivelsesdato: 2008/2

Glintborg, Bente; Poulsen, Henrik E

2008-01-01

127

Patient Impression and Satisfaction of a Self-administered, Automated Medical History-taking Device in the Emergency Department  

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Introduction: We evaluated patient impressions and satisfaction of an innovative self-administered, hand-held touch-screen tablet to gather detailed medical information from emergency department (ED) patients in the waiting room prior to physician contact. Methods: Adult, medically stable patients presenting to the ED at Los Angeles County Hospital used the PatientTouche system to answer a series of questions about their current history of present illness and past medical/surgical histori...

Sanjay Arora; Goldberg, Andrew D.; Michael Menchine

2014-01-01

128

Personality organization in borderline patients with a history of suicide attempts.  

Science.gov (United States)

Suicide attempts (SA) are common in patients with Borderline Personality Disorder (BPD). Recent studies focus on aspects of personality associated with risk for SA such as deficits in affect regulation including impulse control and aggression. The current study examines associations of dysfunctional personality organization, psychiatric comorbidities as well as non-suicidal self-injury (NSSI) with SA in a sample of 68 BPD outpatients. Patients with a history of SA yielded higher scores in personality domains of aggression, especially self-directed aggression. Further, a history of SA was associated with a worse general level of personality organization and a higher prevalence rate of NSSI and substance abuse disorder. The results demonstrate that SA in BPD patients might be regarded as a manifestation of impaired personality functioning rather than mere state variables and symptoms. Moreover, these findings might have implications for indication, treatment, and prognosis of Borderline Personality Disorder. PMID:24746393

Baus, Nicole; Fischer-Kern, Melitta; Naderer, Andrea; Klein, Jakob; Doering, Stephan; Pastner, Barbara; Leithner-Dziubas, Katharina; Plener, Paul L; Kapusta, Nestor D

2014-08-15

129

A History of Alcohol Dependence Increases the Incidence and Severity of Postoperative Cognitive Dysfunction in Cardiac Surgical Patients  

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Full Text Available Postoperative cognitive dysfunction (POCD commonly occurs after cardiac surgery. We tested the hypothesis that a history of alcohol dependence is associated with an increased incidence and severity of POCD in male patients undergoing cardiac surgery using cardiopulmonary bypass. Recent verbal and nonverbal memory and executive functions were assessed before and one week after surgery in patients with or without a history of alcohol dependence. Cognitive function was significantly reduced after cardiac surgery in patients with versus without a history of alcohol dependence. The results suggest that a history of alcohol dependence increases the incidence and severity of POCD after cardiac surgery.

Paul S. Pagel

2009-10-01

130

Protein intake and the use of levodopa in patients with Parkinson's disease / Ingesta de proteínas y el uso de la levodopa en pacientes con enfermedad de Parkinson  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: English Abstract in spanish La levodopa es el principal tratamiento farmacológico para la enfermedad de Parkinson, sin embargo, la proteína de la dieta puede comprometer su eficacia. El objetivo de este estudio fue investigar la ingesta de proteínas y el uso de la levodopa en pacientes con enfermedad de Parkinson tratados en r [...] égimen ambulatorio, 34 pacientes fueron evaluados. Evaluación de la ingesta de alimentos por los registros, tomas de 1762 kcal/día, 70.9 g/día, el 16,6% del total de energía y 1.1 g/kg/dia de energía y proteína, respectivamente, y que la ingesta de proteínas durante el día era 70,4% del total de proteínas diario. Todos los pacientes estaban tomando levodopa y 47,1% consumían sus medicamentos con las comidas. Se concluyó que, según las recomendaciones para la enfermedad de Parkinson, los pacientes estudiados consumían una dieta rica en proteínas y con una mayor concentración de este nutriente durante el día. Aproximadamente la mitad de la muestra ingiere los medicamentos con la comida, costumbre que puede afectar el tratamiento farmacológico de la enfermedad. Abstract in english Levodopa is the principal pharmacological treatment for Parkinson's disease (PD); however the protein content in diet may compromise its effectiveness. The aim of this study was to investigate the relationship of protein intake and the use of levodopa in ambulatory patients with PD. Thirty four PD p [...] atients were assessed for protein intake, evaluating the relation energy-protein intake by means of a register. An intake of 1762 kcal/day, 70.9 g of protein/day equivalent to 16.6% of the total energy intake as protein at a level of 1.1 g/kg bw/day. Of all patients, 47.1% took their medications with meals. We conclude that the studied patients consume more protein in their diet than those recommended for PD, with half the sample taking the medications with meals, which may affect the treatment.

Bianca, de Moraes Fracasso; Maite, Barcelos Morais; Rosane, Gomez; Arlete, Hilbig; Estela, Iraci Rabito.

2013-06-01

131

Fluid intake of elderly Europeans.  

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Dehydration is a common fluid disorder which occurs in residents, hospitalised and community-dwelling elderly people. In this study the intake of water and fluids of community-dwelling elderly Europeans is presented in relation to risk factors of dehydration: mental state, ability to perform activities of daily living (ADL), medicine use and body composition. As part of the SENECA-study of 1993, data were collected from a random age-stratified sample (birth cohorts 1913-1918) of inhabitants of small traditional towns in Europe. Food intake data were collected by using the dietary history method. The study population consisted of 629 men and 696 women of the following towns: Hamme/Belgium, Roskilde/Denmark, Haguenau/France, Romans/France, Padua/Italy, Culemborg/the Netherlands, Lisbon/Portugal, Yverdon/Switzerland, Marki/Poland and Ballymoney-Limavady-Portstewart/Northern Ireland/United Kingdom. Fluid intake of elderly people varied between the towns of Europe and between men and women. A high percentage of the female population had a water intake below the cut-off value of 1,700 g. In most towns about 70 percent of daily water intake came from the food groups 'Milk products', 'Alcoholic drinks', 'Juices' and 'Other non-alcoholic drinks'. The consumption of 'Other non-alcoholic drinks' contributed most to daily fluid intake. In the total female population, women with the lowest water intake (first tertile) scored negatively on factors influencing fluid intake (mental state, ADL) in comparison to women of the second and third tertile. However, in the distinct towns no unequivocal relationship emerged between those factors and fluid intake. Yet, women were found to be at higher risk of dehydration because of much lower water intakes than men and because of the overall relationship between a low fluid intake and a poor mental state and ADL problems. PMID:10995083

Haveman-Nies, A; de Groot, L C; Van Staveren, W A

1997-01-01

132

ColoPulse tablets perform comparably in healthy volunteers and Crohn's patients and show no influence of food and time of food intake on bioavailability.  

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ColoPulse tablets are an innovative development in the field of oral drug delivery and are characterized by a colon-specific release. Until now ColoPulse dosage forms (only capsules) have been studied in healthy volunteers having a standardized breakfast three hours after administration but not in specific patient groups and not with a shorter interval between administration and breakfast. Information on bioavailability and release characteristics of ColoPulse tablets in Crohn's patients and the influence of food and time of food intake is a prerequisite to properly design future clinical studies with active substances in these patients. In the current cross-over study bioavailability and drug release characteristics of ColoPulse tablets were compared in healthy volunteers and in Crohn's patients in remission. Furthermore the influence of food and time of food intake on the in vivo drug release behavior of ColoPulse tablets was investigated. In this study the dual label isotope strategy was used which means that a ColoPulse tablet containing (13)C-urea and an uncoated, immediate release tablet containing (15)N2-urea were taken simultaneously. Breath and urine samples were collected during the test day for isotope analysis. The appearance of the stable isotopes in breath and/or urine provides information on the site of release from the dosage form, release characteristics and bioavailability. Both tablets were administered on two different days in a cross-over design: the first day with a breakfast (non-standardized) one hour after administration and the second day with a standardized breakfast three hours after administration of the tablets. There was no difference in instructions for administration between both days. Results of 16 healthy volunteers and 14 Crohn's patients were evaluated. At least 86% (51 out of 59) of all ColoPulse tablets administered in this study released their contents at the desired intestinal region. There was no significant difference in bioavailability between healthy volunteers and Crohn's patients on both days (day 1 75.8% vs 90.2%, p=0.070 and day 2 83.4% vs 91.4%, p=0.265). There was also no significant influence of food and time of food intake on bioavailability in healthy volunteers (75.8% and 83.4%, p=0.077) and in Crohn's patients (90.2% and 91.4%, p=0.618) when day 1 and day 2 were compared. Release characteristics did not significantly differ between healthy volunteers and Crohn's patients. However, food and time of food intake had some, clinically non-relevant, influence on the release characteristics within both groups which is in line with the fact that food affects gastro-intestinal transit times. This study shows that ColoPulse tablets enable the site-specific delivery of drugs or other compounds (e.g. diagnostics) deep in the ileo-colonic region of the intestine of Crohn's patients in a comparable amount and rate as in healthy volunteers. Food and time of food intake had no relevant influence on bioavailability. In conclusion ColoPulse delivery systems are promising and deserve further research for local therapy with immunosuppressive drugs in Crohn's patients in the near future. PMID:24096020

Maurer, J M; Schellekens, R C A; van Rieke, H M; Stellaard, F; Wutzke, K D; Buurman, D J; Dijkstra, G; Woerdenbag, H J; Frijlink, H W; Kosterink, J G W

2013-12-28

133

Vitamin D intake is negatively associated with promoter methylation of the Wnt antagonist gene DKK1 in a large group of colorectal cancer patients  

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Diet and lifestyle help mediate colorectal cancer (CRC) risk but the molecular events that mediate these effects are poorly characterized. Several dietary and lifestyle factors can modulate DNA methylation suggesting that they may influence CRC risk through epigenetic regulation of cancer-related genes. The Wnt regulatory genes DKK1 and Wnt5a are important contributors to colonic carcinogenesis and are often silenced by promoter hypermethylation in CRC; however, the dietary contributions to these events have not been explored. To investigate the link between dietary/lifestyle factors and epigenetic regulation of these Wnt signaling genes, we assessed promoter methylation of these genes in a large cohort of Canadian CRC patients from Ontario (n=549) and Newfoundland (n=443) and examined associations to dietary/lifestyle factors implicated in CRC risk and/or DNA methylation including intake of vitamins, fats, cholesterol, fibre, and alcohol as well as BMI and smoking status. Several factors were associated with methylation status including alcohol intake, BMI, and cigarette smoking. Most significantly however, dietary vitamin D intake was strongly negatively associated with DKK1 methylation in Newfoundland (p=0.001) and a similar trend was observed in Ontario. These results suggest that vitamin D and other dietary/lifestyle factors may alter CRC risk by mediating extracellular Wnt inhibition. PMID:22966878

Rawson, James B.; Sun, Zhouyu; Dicks, Elizabeth; Daftary, Darshana; Parfrey, Patrick S.; Green, Roger C.; Gallinger, Steven; McLaughlin, John R.; Wang, Peizhong P.; Knight, Julia A.; Bapat, Bharati

2015-01-01

134

Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure  

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Full Text Available The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED. The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. Methods: The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Results: Twenty four participants were classified as ‘language barrier’; 12 participants were from residential aged care facilities, and 64 participants were classified as ‘general’. The number of correctly recorded medications was lowest in the ‘language barrier’ group (13.8% compared with 18% and 19.6% of medications for ‘general’ patients and patients from residential aged care facilities respectively. Seven of the patients (29.2% with ‘language barrier’; 1 from a residential aged care facility (8.3% and 13 of the (20.3% patients from the ‘general’ category were suspected as having a medication related ED presentation. Conclusion: This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation.

Ajdukovic M

2007-12-01

135

Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure  

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The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking background, have been identified as patient groups vulnerable to medication misadventure. Objective to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. Methods The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Results Twenty four participants were classified as ‘language barrier’; 12 participants were from residential aged care facilities, and 64 participants were classified as ‘general’. The number of correctly recorded medications was lowest in the ‘language barrier’ group (13.8%) compared with 18% and 19.6% of medications for ‘general’ patients and patients from residential aged care facilities respectively. Seven of the patients (29.2%) with ‘language barrier’; 1 from a residential aged care facility (8.3%) and 13 of the (20.3%) patients from the ‘general’ category were suspected as having a medication related ED presentation. Conclusion This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services at all stages of their hospitalisation, in particular at the point of ED presentation. PMID:25170353

Ajdukovic, Maja; Crook, Meredith; Angley, Christopher; Stupans, Ieva; Soulsby, Natalie; Doecke, Christopher; Anderson, Barbara; Angley, Manya

136

Cancer history and other personal factors affect quality of life in patients with hepatitis C  

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Background Although patients with chronic hepatitis C (CHC) have been found to have reduced quality of life, little is known about how other characteristics affect their quality of life. The purpose of this study was to investigate the effect of other characteristics, including history of cancer, on quality of life in patients with CHC. Methods One hundred forty patients from clinics at three hospitals in New York City completed a detailed epidemiologic interview about demographic and lifestyle characteristics and the SF-36 measuring health-related quality of life. We compared results from our patients to normative data using t-tests of differences between means. We used multivariate analyses to determine other personal and health-related factors associated with quality of life outcomes. Results Compared to normative data, these patients had reduced quality of life, particularly on physical functioning. The summary Physical Component Score (PCS) was 45.4 ± 10.6 and the Mental Component Score (MCS) was 48.2 ± 11.1, vs norms of 50 ± 10.0; p-values were <0.0001 and <0.05, respectively. In multivariate analyses, the PCS was significantly lower among those with cancer history, ? 2 other chronic conditions, less education, low physical activity, and higher alanine aminotransferase (ALT) levels. Cancer was more important for men, while other chronic conditions were more important for women. On the MCS, history of depression, low physical activity, alcohol use, and female gender were independently associated with poorer scores. Conclusion Several health and lifestyle factors independently influence quality of life in CHC patients. Different factors are important for men and women. PMID:15960844

Olson, Sara H; Iyer, Sandy; Scott, Jennifer; Erez, Orry; Samuel, Shelby; Markovits, Temima; Schwartz, Myron; Toro, Charlene; Gambarin-Gelwan, Maya; Kurtz, Robert C

2005-01-01

137

Clinicopathological Characteristics and Prognosis of Non-Small Cell Lung Cancer Patients Associated with a Family History of Lung Cancer  

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Introduction: Clinicopathological characteristics and prognosis of non-small cell lung cancer (NSCLC) patients with a family history of lung cancer (FHLC) have not been well established.Methods: Clinical records of patients with NSCLC treated at our institute from 1982 to 2010 were reviewed with special reference to family history of lung cancer and clinicopathological factors including patient's outcome. Univariate analyses of the factors between the groups of FHLC an...

Shuji Haraguchi, Kiyoshi Koizumi

2012-01-01

138

A Case of a Laryngeal MALT Lymphoma in a Patient with a History of Gastric MALT  

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We are reporting a case of a 62-year-old African American woman with a history of gastric MALT lymphoma successfully treated with radiation who presented with a laryngeal MALT lymphoma 4 years after her original diagnosis. She received definitive radiation with a complete response. The case presented is unique for the rare presentation of a MALT lymphoma in the larynx, especially in light of the patient's previously treated gastric MALT lymphoma years ago. PMID:25664189

Ashamalla, Mark; Teng, Marita S.; Brody, Joshua; Parikh, Rahul; Dharmarajan, Kavita

2015-01-01

139

Study of Cognitive Disorders in Stroke-free Patients with a History of Atrial Fibrillation  

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Full Text Available Atrial fibrillation is associated with cerebral stroke, congestive heart insufficiency and mortality. The present study aimed at evaluating of cognitive disorders in patients with history of atrial fibrillation without cerebral stroke. In a case-control study, 100 patients with first-ever atrial fibrillation seizure without history of cerebral stroke were evaluated. One hundred healthy subjects with normal sinus rhythm matched with the patients in terms of age and gender were regarded as the control group. The case and control groups were followed up for at least one year after occurring of atrial fibrillation. Cognitive disorders were evaluated at the last visit. The case group was consisted of 51 men and 42 women with mean age of 71.08±5.35 years and there were 53 men and 43 women with mean age of 71.34±5.04 years in the control group. Previous history of hypertension, diabetes mellitus, hyperlipidemia, hypercholesterolemia, smoking, consuming of alcohol and warfarin in the case group were 49.5, 23.7, 18.3, 31.2, 14, 7.5 and 9.7% and in the control group 6.4, 35.4, 24, 36.5, 21.9, 13.5 and 12.5%, respectively. In this regard, there was not statistically meaningful difference between these two groups. Dementia was detected in 3 (3.2% of the case and 1 (1% of the control group subjects (p = 0.29. Comparing two groups with and without dementia demonstrated that there was not any meaningful risk factor. According to the results, dementia in patients with positive history of atrial fibrillation was more than normal population.

Mohamad Goldust

2013-01-01

140

Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers  

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Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To investigate and compare the influence of a previous history of foot ulcers on plantar pressure variables during gait of patients with diabetic neuropathy. INTRODUCTION: Foot ulcers may be an indicator of worsening diabetic neuropathy. However, the behavior of plantar pressure patterns [...] over time and during the progression of neuropathy, especially in patients who have a clinical history of foot ulcers, is still unclear. METHODS: Subjects were divided into the following groups: control group, 20 subjects; diabetic neuropathy patients without foot ulcers, 17 subjects; and diabetic neuropathy patients with at least one healed foot ulcer within the last year, 10 subjects. Plantar pressure distribution was recorded during barefoot gait using the Pedar-X system. RESULTS: Neuropathic subjects from both the diabetic neuropathy and DNU groups showed higher plantar pressure than control subjects. At midfoot, the peak pressure was significantly different among all groups: control group (139.4±76.4 kPa), diabetic neuropathy (205.3±118.6 kPa) and DNU (290.7±151.5 kPa) (p=0.008). The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3±11.4 kPa.s; DN: 43.3±9.1 kPa.s; DNU: 68.7±36.5 kPa.s; p=0.002) and rearfoot (CG: 83.3±21.2 kPa.s; DN: 94.9±29.4 kPa.s; DNU: 102.5±37.9 kPa.s; p=0.048). CONCLUSION: A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait. The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

Tatiana Almeida, Bacarin; Isabel C. N., Sacco; Ewald M., Hennig.

2009-02-01

 
 
 
 
141

Plantar pressure distribution patterns during gait in diabetic neuropathy patients with a history of foot ulcers  

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Full Text Available OBJECTIVE: To investigate and compare the influence of a previous history of foot ulcers on plantar pressure variables during gait of patients with diabetic neuropathy. INTRODUCTION: Foot ulcers may be an indicator of worsening diabetic neuropathy. However, the behavior of plantar pressure patterns over time and during the progression of neuropathy, especially in patients who have a clinical history of foot ulcers, is still unclear. METHODS: Subjects were divided into the following groups: control group, 20 subjects; diabetic neuropathy patients without foot ulcers, 17 subjects; and diabetic neuropathy patients with at least one healed foot ulcer within the last year, 10 subjects. Plantar pressure distribution was recorded during barefoot gait using the Pedar-X system. RESULTS: Neuropathic subjects from both the diabetic neuropathy and DNU groups showed higher plantar pressure than control subjects. At midfoot, the peak pressure was significantly different among all groups: control group (139.4±76.4 kPa, diabetic neuropathy (205.3±118.6 kPa and DNU (290.7±151.5 kPa (p=0.008. The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3±11.4 kPa.s; DN: 43.3±9.1 kPa.s; DNU: 68.7±36.5 kPa.s; p=0.002 and rearfoot (CG: 83.3±21.2 kPa.s; DN: 94.9±29.4 kPa.s; DNU: 102.5±37.9 kPa.s; p=0.048. CONCLUSION: A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait. The progression of diabetic neuropathy was not found to influence plantar pressure distribution.

Tatiana Almeida Bacarin

2009-02-01

142

Natural history of Barth syndrome: a national cohort study of 22 patients  

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BACKGROUND: This study describes the natural history of Barth syndrome (BTHS). METHODS: The medical records of all patients with BTHS living in France were identified in multiple sources and reviewed. RESULTS: We identified 16 BTHS pedigrees that included 22 patients. TAZ mutations were observed in 15 pedigrees. The estimated incidence of BTHS was 1.5 cases per million births (95%CI: 0.2--2.3). The median age at presentation was 3.1 weeks (range, 0--1.4 years), and the median age at last foll...

Rigaud, Charlotte; Lebre, Anne-sophie; Touraine, Renaud; Beaupain, Blandine; Ottolenghi, Chris; Chabli, Allel; Ansquer, Helene; Ozsahin, Ayse Hulya; Di Filippo, Sylvie; Lonlay, Pascale; Borm, Betina; Rivier, Francois; Vaillant, Marie-catherine; Mathieu-dramard, Miche?le; Goldenberg, Alice

2013-01-01

143

Suicide attempts via drug intake  

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Full Text Available Objective: In this study, socio-demographic and psychiatric evaluation of the patients who attempted suicide by drug intake was aimed. Material and Methods: Patients over the age of 18, who agreed to participate in our study, and admitted to the emergency department with conscious suicidal behavior between January 2009-January 2011 were enrolled in this prospective study. Results: A total of 122 patients were enrolled in the study. The most majority of the patients were consisted of female gender (68.9%, in the 18-24 age group, single, unemployed, graduate from elementary or high school, a member of a large family including 4-5 people, with a monthly income below TL 1000, and the individuals were found to be in economic distress. Chronic systemic disease, psychiatric disorders, and suicide attempts in the past, and a family history of suicide attempts were statistically significantly increased the assets of suicidal thinking. Most of the patients were diagnosed as depression and anxiety disorders, and they were recommended to use psychiatric drug therapy and psychiatric follow-up support to come again. Conclusion: Suicide motion, a method that is applied as a result of the social, economic, familial and psychiatric problems, with which individual faces, is a way of expressing oneself or a way of alternative solution according to the individual. Through the support given to individuals having suicide tendency, a decrease in suicide risk among the mentioned people can be actualized. For this purpose, the socio -demographic features of patients attempted suicide must be well known and must be evaluated by psychiatry.

Ufuk Saraço?lu

2014-01-01

144

Suicide attempts via drug intake  

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Full Text Available Objective In this study socio-demographic and psychiatric evaluation of the patients who attempted suicide by drug intake was aimed. Material and Methods Patients over the age of 18 who agreed to participate in our study and admitted to the emergency department with conscious suicidal behavior between January 2009-January 2011 were enrolled in this prospective study. Results A total of 122 patients were enrolled in the study. The most majority of the patients were consisted of female gender (68.9% in the 18-24 age group single unemployed graduate from elementary or high school a member of a large family including 4-5 people with a monthly income below TL 1000 and the individuals were found to be in economic distress. Chronic systemic disease psychiatric disorders and suicide attempts in the past and a family history of suicide attempts were statistically significantly increased the assets of suicidal thinking. Most of the patients were diagnosed as depression and anxiety disorders and they were recommended to use psychiatric drug therapy and psychiatric follow-up support to come again. Conclusion Suicide motion a method that is applied as a result of the social economic familial and psychiatric problems with which individual faces is a way of expressing oneself or a way of alternative solution according to the individual. Through the support given to individuals having suicide tendency a decrease in suicide risk among the mentioned people can be actualized. For this purpose the socio -demographic features of patients attempted suicide must be well known and must be evaluated by psychiatry.

Ufuk Saracoglu

2014-01-01

145

Comparison of patients by family history with gastric and non-gastric cancer  

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Full Text Available AIM: To compare the gastric cancer (GC patients by their family history with gastric and non-GC.METHODS: Positive family histories within second-degree relatives and clinicopathological features were obtained for 256 patients.RESULTS: Of the 256 probands, 112 (76 male, 36 female were incorporated into familial GC (FGC group: at least two GC members; 144 (98 male, 46 female were included in the non-FGC group (relatives only affected with non-GCs. Of 399 tumors in relatives (181 from FGC against 212 from non-FGC, GC was the most frequent, followed by esophageal, hepatocellular, and colorectal cancer. Nasopharyngeal cancer was next to lung cancer but prior to breast and urogenital cancers. Most affected members aggregated within first-degree relatives (FGC: 66 siblings, 48 fathers, 31 mothers, four offspring; non-FGC: 56 fathers, 55 siblings, 43 mothers, and 15 offspring. The ratio of males to females in affected first-degree relatives was usually higher in male probands. Paternal history of GC was a slight risk for GC in males (OR = 1.19, 95% CI: 0.53-2.69, while risk of GC by maternal history of non-GCs was increased in females (OR = 0.46, 95% CI: 0.22-0.97. Diffuse-GC was the major histological type in all subgroups. Difference in tumor sites between the two groups was derived from an excess of upper sites in non-FGC female probands.CONCLUSION: Distribution of associated non-GCs in a family history of GC may vary with geographic areas. GC may have different genetic and/or environmental etiology in different families, and a certain subtype may be inherited in a female-influenced fashion.

Xue-Fu Zhou, Yu-Long He, Wu Song, Jian-Jun Peng, Chang-Hua Zhang, Wen Li, Hui Wu

2009-06-01

146

Influencia de la temperatura en la ingesta de pacientes hospitalizados Influence of temperature on food intake in hospitalized patients  

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Full Text Available Antecedentes y objetivos: La prevalencia de desnutrición en los pacientes hospitalizados es muy elevada y se ha demostrado que constituye un factor pronóstico importante. La mayoría de los pacientes ingresados dependen de la comida hospitalaria para cubrir sus requerimientos nutricionales siendo importante el análisis de los factores que influyen en la ingesta y que se puedan modificar, para conseguir mejorarla y así evitar las consecuencias derivadas de una nutrición inadecuada. En anteriores trabajos se ha demostrado que una de las características de la comida peor valoradas por los pacientes es la temperatura. El objetivo de este trabajo fue evaluar la influencia de la temperatura en la satisfacción y cantidad ingerida en función de que se sirviese o no en carros isotérmicos que mantienen una temperatura adecuada de la comida. Material y métodos: Se realizaron encuestas de satisfacción a pacientes del hospital con y sin carros isotérmicos con dietas basales. Se recogieron los siguientes datos: edad, sexo, peso, número de visitas, movilidad, autonomía, cantidad de medicación por vía oral, ingestión de alimentos traídos de fuera del hospital, calificación de la temperatura, presentación y humedad, cantidad de comida ingerida y motivos por los que no se ingirió todo el contenido del carro isotérmico. Resultados: De las 363 encuestas, 134 de ellas (37,96% se realizaron en pacientes con bandeja térmica y 229 (62,04% en pacientes sin ella. El 60% de los pacientes referían haber comido menos de lo normal en la última semana siendo la causa más frecuente la disminución de apetito. En el almuerzo y cena comieron la mitad o menos del contenido de la bandeja el 69,3% y 67,7% respectivamente, siendo las causas más frecuentes las siguientes: la falta de apetito (42% en almuerzo y 40% en cena, no gustarles la comida (24,3 y 26,2% y el sabor (15,3 y 16,8%. Otras causas menos frecuentes fueron el olor, la cantidad de comida, presentar náuseas o vómitos, cansancio y falta de autonomía. No hubo diferencias significativas en la cantidad de ingesta en función del sexo, peso, número de visitas, cantidad de medicación y grado de actividad. La temperatura de la comida fue clasificada como buena por el 62% de los pacientes, la presentación por el 95% y la humedad por el 85%. Al comparar a los pacientes con y sin carro isotérmico, no hubo diferencias en las características basales analizadas que pudiesen influir en la cantidad ingerida. Calificaron la temperatura como buena un 90% de los pacientes con carro isotérmico y un 57,2% sistema tradicional, siendo esta diferencia estadísticamente significativa (P = 0,000. Además hubo diferencias en la cantidad de comida ingerida entre los pacientes con y sin carro isotérmico, de modo que se lo comieron todo un 41% frente al 27,7% respectivamente siendo esta diferencia estadísticamente significativa (P = 0,007. No hubo diferencias en la calificación de humedad y presentación. Conclusiones: La mayoría de los pacientes (60% presentan disminución de apetito durante el ingreso. La proporción de ingresados que califican la temperatura como buena es mayor en los pacientes con el sistema de carros isotérmicos. La cantidad ingerida por los pacientes con carros isotérmicos es significativamente mayor que en los pacientes sin ellos.Background and objectives: Prevalence of hyponutrition in hospitalized patients is very high and it has been shown to be an important prognostic factor. Most of admitted patients depend on hospital food to cover their nutritional demands being important to assess the factors influencing their intake, which may be modified in order to improve it and prevent the consequences of inadequate feeding. In previous works, it has been shown that one of the worst scored characteristics of dishes was the temperature. The aim of this study was to assess the influence of temperature on patient's satisfaction and amount eaten depending on whether the food was served in isothermal trolleys keeping proper food temperature or not.

I. González Molero

2008-02-01

147

Dietary intake of female bariatric patients after anti-obesity gastroplasty Ingestão dietética de pacientes bariátricas femininas após gastroplastia anti-obesidade  

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Full Text Available PURPOSE: Roux-en-Y gastric bypass is a popular and successful operation for the treatment of morbid obesity. However, it greatly restricts ingestion and moderately interferes with absorption of food, thus potentially paving the way for undernutrition, especially during the first year before patients adapt to the new condition. Aiming to document actual dietary intake during this period, a prospective observational study was performed. METHODS: Forty consecutive patients were investigated using a 24-hour dietary recall technique every 3 months after surgery for 1 year. Females only were accepted for greater homogeneity of the sample. All received a vitamin and mineral supplement on a daily basis as a postoperative routine. A questionnaire was employed regarding general, nutritional, and gastrointestinal changes as well as consumption of medications. Dietary intake was analyzed after data processing using the Virtual Nutri software package (São Paulo, SP, Brazil. RESULTS: The surgical response was within the expected range, with about 67% excess weight loss at the end of the 1st year, and the same occurred with gastrointestinal symptoms and drug requirements. Daily energy intake on the 4 analyzed occasions was 529.4 ± 47.4, 710.9 ± 47.6, 833.2 ± 72.0, and 866.2 ± 95,1 kcal/day (mean ± SEM; protein intake was increased in the same proportion at 6 and 9 months, but reduced at 12 months. Thus, patients did not meet standard recommendations regarding calories and proteins, even at the end of the 1st year; iron and zinc intake were also inadequate, although deficiencies were probably staved off by the prescribed supplement preparation. CONCLUSIONS: 1 The risk for postoperative undernutrition was evidenced up to 1 year, while spontaneous improvement in food intake was slow and inefficient; 2 Specific protocols should be devised to improve nutrition and health during the postoperative phase until successful dietary adaptation is achieved.OBJETIVO: A gastroplastia com anastomose gastrojejunal em Y de Roux é uma operação popular e bem sucedida no tratamento da obesidade grave. Ela restringe seriamente a ingestão e moderadamente a absorção do alimento, potencialmente abrindo caminho para desnutrição especialmente no primeiro ano, antes que o paciente se adapte à nova condição. Com o propósito de documentar a real ingestão neste período, um estudo prospectivo observacional foi executado. MÉTODO: Quarenta pacientes consecutivos foram investigados por recordatório de 24 horas a cada três meses após a operação, até um ano. Apenas mulheres foram arroladas para maior homogeneidade da amostra. Todas receberam diariamente um suplemento vitamínico-mineral, como rotina pós-operatória. Um questionário foi empregado abordando alterações gerais, nutricionais e gastrointestinais assim como consumo de medicamentos. Os ganhos dietéticos foram analisados mediante o programa Virtual Nutri (São Paulo, SP, Brasil. RESULTADOS: A resposta cirúrgica situou-se dentro da faixa esperada, com perda de cerca de 67% do excesso de peso após um ano, e o mesmo ocorreu com sintomas gastrointestinais e necessidades medicamentosas. A quantidade de energia diária nas quatro ocasiões foi de 529,4±47,5, 710,9± 47,7, 833,2± 72,0 e 866,2± 95,1 kcal/dia (média ± erro padrão da média, e o aumento do consumo de proteína foi da mesma proporção nos 6 e 9 meses e com redução em 12 meses. Consequentemente mesmo após um ano as pacientes estavam abaixo das recomendações usuais de calorias e proteínas. A contribuição da dieta no tocante a ferro e zinco também mostrou-se inadequada, embora quadros deficitários tenham provavelmente sido abortados pelo suplemento utilizado. CONCLUSÕES: 1 O risco para desnutrição pos-operatória ficou demonstrado até um ano, e a melhora espontânea da ingestão de alimentos revelou-se lenta e ineficiente; 2 Protocolos específicos deveriam ser elaborados visando melhorar a nutrição e a saúde na fase pós-ope

Maria Carolina G. Dias

2006-04-01

148

Dietary intake of female bariatric patients after anti-obesity gastroplasty / Ingestão dietética de pacientes bariátricas femininas após gastroplastia anti-obesidade  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese OBJETIVO: A gastroplastia com anastomose gastrojejunal em Y de Roux é uma operação popular e bem sucedida no tratamento da obesidade grave. Ela restringe seriamente a ingestão e moderadamente a absorção do alimento, potencialmente abrindo caminho para desnutrição especialmente no primeiro ano, antes [...] que o paciente se adapte à nova condição. Com o propósito de documentar a real ingestão neste período, um estudo prospectivo observacional foi executado. MÉTODO: Quarenta pacientes consecutivos foram investigados por recordatório de 24 horas a cada três meses após a operação, até um ano. Apenas mulheres foram arroladas para maior homogeneidade da amostra. Todas receberam diariamente um suplemento vitamínico-mineral, como rotina pós-operatória. Um questionário foi empregado abordando alterações gerais, nutricionais e gastrointestinais assim como consumo de medicamentos. Os ganhos dietéticos foram analisados mediante o programa Virtual Nutri (São Paulo, SP, Brasil). RESULTADOS: A resposta cirúrgica situou-se dentro da faixa esperada, com perda de cerca de 67% do excesso de peso após um ano, e o mesmo ocorreu com sintomas gastrointestinais e necessidades medicamentosas. A quantidade de energia diária nas quatro ocasiões foi de 529,4±47,5, 710,9± 47,7, 833,2± 72,0 e 866,2± 95,1 kcal/dia (média ± erro padrão da média), e o aumento do consumo de proteína foi da mesma proporção nos 6 e 9 meses e com redução em 12 meses. Consequentemente mesmo após um ano as pacientes estavam abaixo das recomendações usuais de calorias e proteínas. A contribuição da dieta no tocante a ferro e zinco também mostrou-se inadequada, embora quadros deficitários tenham provavelmente sido abortados pelo suplemento utilizado. CONCLUSÕES: 1) O risco para desnutrição pos-operatória ficou demonstrado até um ano, e a melhora espontânea da ingestão de alimentos revelou-se lenta e ineficiente; 2) Protocolos específicos deveriam ser elaborados visando melhorar a nutrição e a saúde na fase pós-operatória, até que se verifique uma adaptação dietética satisfatória; Abstract in english PURPOSE: Roux-en-Y gastric bypass is a popular and successful operation for the treatment of morbid obesity. However, it greatly restricts ingestion and moderately interferes with absorption of food, thus potentially paving the way for undernutrition, especially during the first year before patients [...] adapt to the new condition. Aiming to document actual dietary intake during this period, a prospective observational study was performed. METHODS: Forty consecutive patients were investigated using a 24-hour dietary recall technique every 3 months after surgery for 1 year. Females only were accepted for greater homogeneity of the sample. All received a vitamin and mineral supplement on a daily basis as a postoperative routine. A questionnaire was employed regarding general, nutritional, and gastrointestinal changes as well as consumption of medications. Dietary intake was analyzed after data processing using the Virtual Nutri software package (São Paulo, SP, Brazil). RESULTS: The surgical response was within the expected range, with about 67% excess weight loss at the end of the 1st year, and the same occurred with gastrointestinal symptoms and drug requirements. Daily energy intake on the 4 analyzed occasions was 529.4 ± 47.4, 710.9 ± 47.6, 833.2 ± 72.0, and 866.2 ± 95,1 kcal/day (mean ± SEM); protein intake was increased in the same proportion at 6 and 9 months, but reduced at 12 months. Thus, patients did not meet standard recommendations regarding calories and proteins, even at the end of the 1st year; iron and zinc intake were also inadequate, although deficiencies were probably staved off by the prescribed supplement preparation. CONCLUSIONS: 1) The risk for postoperative undernutrition was evidenced up to 1 year, while spontaneous improvement in food intake was slow and inefficient; 2) Specific protocols should be devised

Maria Carolina G., Dias; Angela G., Ribeiro; Veruska M, Scabim; Joel, Faintuch; Bruno, Zilberstein; Joaquim José, Gama-Rodrigues.

2006-04-01

149

Prevalencia de hipertensión arterial en población mayor de 65 años ingresada en un Servicio de Medicina Interna / Incidence of hypertension in elderly patients intaked on Internal Medicine Department  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivos: Conocer la prevalencia de hipertensión arterial y de hipertensión sistólica aislada en los pacientes mayores de 65 años ingresados en un Servicio de Medicina Interna. Material y métodos: Estudio descriptivo trasversal, en el que se incluyeron los pacientes mayores de 65 años que ingresaro [...] n durante el año 2002 en el Servicio de Medicina Interna del Hospital Clínico Universitario de Santiago de Compostela. Las variables recogidas fueron: sexo, edad, tiempo de ingreso, factores de riesgo cardiovascular, cifras de presión arterial (PA), cifras de glucemia, cifras de colesterolemia, patología cardiovascular coexistente, exitus intrahospitalario y tratamientos al alta. Se emplearon índices estadísticos descriptivos de variables cualitativas y cuantitativas, Chi-cuadrado, Mann-Withney-Wilcoxon y Regresión logística. Resultados: Se obtuvo una población de 770 pacientes. La prevalencia de hipertensión arterial (HTA) fue de 37,0% y la de hipertensión sistólica aislada (HSA) de 25,9%. La prevalencia de HSA es mayor en los pacientes con mal control de PA (67,5 vs. 8,9%), p Abstract in english Objetives: To know the arterial hypertension prevalence and isolated systolic hypertension in elderly patients intaked on internal medicine department. Material and methods: A cross-sectional study of elderly hypertensive patients intaked between 1 to January 2002 to 31 December 2002 in a Internal M [...] edicine Service of the Hospital Clinico Universitario de Santiago de Compostela. The recorded variables were: sex, age, number of days in hospital, hospital exitus, cardiovascular risk factors, number of blood pressure, glucose, cholesterolemia, cardiovascular disease and treatments. It was used descriptive statistic rates of quantitative and qualitative variables, Mann-Withney-Wilcoxon and logistic regresion. Results: The study included 770 patients. The arterial hypertension (HTA) prevalence was 37% and the isolated systolic hypertension (ISH) prevalence were 25.9%. The ISH prevalence was greater in the patients with bad control of blood pressures (67.5 vs. 8.9%), p

S., Cinza Sanjurjo; A., Cabarcos Ortiz de Barrón; E., Nieto Pol; J. A., Torre Carballada.

2006-12-01

150

Assessment of Risk of Violent Behavior in Female Psychiatric Patients with a Criminal History  

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Full Text Available We present the results of study of illegal actions predictors in individuals with mental disorders and discuss the specific features of female criminality. On a sample of 69 patients with a diagnosis of organic mental disorder and schizophrenia, with criminal histories, we applied clinical and psychological hermeneutic analysis, used questionnaires to determine the self-assessments of patients, self-control diagnosis, self-regulation style features, diagnosis of aggression and hostility, coping strategies, destructive attitudes in interpersonal relationships. It made possible to identify clinical, social and pathopsychological factors of aggressive behavior in forensic patients. These individual psychological characteristics of mentally ill women will improve the prognosis of their aggressive behavior, implement differentiated preventive measures in the hospital and to establish appropriate intervention programs

Makurina A.P.,

2014-11-01

151

CORRELATIONS BETWEEN AWARENESS OF ILLNESS (INSIGHT AND HISTORY OF ADDICTION IN HEROIN-ADDICTED PATIENTS  

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Full Text Available In a group of 1066 heroin addicts, who were seeking treatment for opioid agonist treatment, we looked for differences in historical, demographic and clinical characteristics, between patients with different levels of awareness of illness (insight. The results showed that, in the cohort studied, a majority of subjects lacked insight into their heroin-use behaviour. Compared with the impaired-insight group, those who possessed insight into their illness showed significantly greater awareness of past social, somatic and psychopathological impairments, and had a greater number of past treatment-seeking events for heroin addiction. In contrast with other psychiatric illnesses, the presence of awareness appears to be related to the passing of time and to the worsening of the illness. Methodologies to improve the insight of patients should, therefore, be targeted more directly on patients early in their history of heroin dependence, because the risk of lack of insight is greatest during this period.

IcroMaremmani

2012-07-01

152

A cough conundrum in a patient with a previous history of BCG immunotherapy for bladder cancer.  

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We describe a non-smoker who presented with a persistent cough, weight loss and general malaise, and had a medical history of bladder carcinoma that had been successfully treated with intravesical BCG immunotherapy. Radiology revealed hilar lymphadenopathy, a predominantly mid-zone and lower-zone lung parenchymal nodular pattern with a perilymphatic distribution, a few thickened interlobular septae, and small pleural effusions bilaterally. The T-SPOT.TB blood test was negative. Video-assisted thoracoscopic surgery showed multiple pleural nodules, the histopathology of which showed multiple well-defined non-caseating granulomata. The patient was started on antituberculosis medication for presumed BCGosis--a systemic complication of previous BCG immunotherapy--and the patient showed an excellent clinical and radiological response. This case further adds to previous reports and reinforces the recommendation that all patients should be made fully aware of the potential systemic and delayed complications of BCG immunotherapy when they are consented for treatment. PMID:23097577

Mehta, Arpan R; Mehta, Puja R; Mehta, Rajesh L

2012-01-01

153

Psychiatric comorbidity of patients on methadone maintenance treatment with a history of sexual abuse.  

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The aim of this study was to assess the prevalence of a history of sexual abuse and its relation to psychiatric comorbidity among former opiate addicts currently on methadone maintenance treatment (MMT). We evaluated the history of sexual abuse and current clinical obsessive compulsive disorder (OCD), dissociative identity disorder (DID), and complex posttraumatic distress disorder (cPTSD), and administered the Life Events Inventory Questionnaire among 125 MMT patients (76 females and 49 males). Eighty (64%) patients had experienced sexual abuse, 69 (55.2%) met the criteria for clinical OCD, 20 (16.0%) for cPTSD and 13 (10.4%) for DID. More females had clinical OCD than males (63.2% vs. 42.9%, respectively, p=0.03). Sexually abused patients had higher rates of clinical OCD than their non-abused counterparts (67.5% vs. 33.3%, respectively, pDissociative Experiences Scale score (17.6±10.1 vs. 14.6±8.1, p=0.08) and rate of DID (13.8% vs. 4.4%, p=0.1), but no significant difference in the rate of cPTSD (17.5% vs. 13.3%, p=0.6) compared to non-abused subjects. The 80 sexually abused patients were mostly female (85%), and 57.5% of them were abused by a family member. In summary, more sexually abused MMT patients were diagnosed with clinical OCD and fewer with cPTSD and DID. Those with cPTSD were characterized by more negative life events, higher dissociation scores, and assaults by a family member. We conclude that sexually abused MMT patients should be screened for clinical OCD. PMID:22564825

Peles, Einat; Potik, David; Schreiber, Shaul; Bloch, Miki; Adelson, Miriam

2012-12-01

154

The difference of anti phenolic glycolipid-1 (PGL-1 immunoglobulin-M (IgM level and nutritional intake in subclinical leprosy patients who reside at home and in the orphanage  

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Full Text Available Leprosy patients can be found in the orphanage, and ordinary house holds. The different living conditions in different places might cause differences in the environments, nutritional intake, and immunity, which in the end would affect the transmission of M. leprae. The aim of this study was to find out the difference in anti PGL-1 IgM level and nutritional intake between sub-clinical leprosy patients residing at home with their families and those living in the orphanage. This cross-section observational study was done in Semarang, Central Java, Indonesia. Thirty one sub-clinical leprosy patients living in an orphanage and 30 sub-clinical leprosy patients living at home were included in this study. Venous blood was taken from all of the subjects, the level of anti PGL-1 IgM was measured, and daily nutrient intake was analyzed. Differential test between the 2 groups was performed using independent t-test or Mann Whitney test, when the distribution was not normal. There was significant differences (P < 0.05 in the level of anti PGL-1 IgM, protein, zinc, and vitamin C intake between the 2 groups. (Med J Indones 2007;16:233-6Keywords: nutrient intake, protein, zinc, vitamin C

Mohammad Z. Rahfiludin

2007-11-01

155

Gene expression changes in mononuclear cells in patients with metabolic syndrome after acute intake of phenol-rich virgin olive oil  

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Full Text Available Abstract Background Previous studies have shown that acute intake of high-phenol virgin olive oil reduces pro-inflammatory, pro-oxidant and pro-thrombotic markers compared with low phenols virgin olive oil, but it still remains unclear whether effects attributed to its phenolic fraction are exerted at transcriptional level in vivo. To achieve this goal, we aimed at identifying expression changes in genes which could be mediated by virgin olive oil phenol compounds in the human. Results Postprandial gene expression microarray analysis was performed on peripheral blood mononuclear cells during postprandial period. Two virgin olive oil-based breakfasts with high (398 ppm and low (70 ppm content of phenolic compounds were administered to 20 patients suffering from metabolic syndrome following a double-blinded, randomized, crossover design. To eliminate the potential effect that might exist in their usual dietary habits, all subjects followed a similar low-fat, carbohydrate rich diet during the study period. Microarray analysis identified 98 differentially expressed genes (79 underexpressed and 19 overexpressed when comparing the intake of phenol-rich olive oil with low-phenol olive oil. Many of these genes seem linked to obesity, dyslipemia and type 2 diabetes mellitus. Among these, several genes seem involved in inflammatory processes mediated by transcription factor NF-?B, activator protein-1 transcription factor complex AP-1, cytokines, mitogen-activated protein kinases MAPKs or arachidonic acid pathways. Conclusion This study shows that intake of virgin olive oil based breakfast, which is rich in phenol compounds is able to repress in vivo expression of several pro-inflammatory genes, thereby switching activity of peripheral blood mononuclear cells to a less deleterious inflammatory profile. These results provide at least a partial molecular basis for reduced risk of cardiovascular disease observed in Mediterranean countries, where virgin olive oil represents a main source of dietary fat. Admittedly, other lifestyle factors are also likely to contribute to lowered risk of cardiovascular disease in this region.

Lopez-Miranda Jose

2010-04-01

156

A History of Alcohol Dependence Increases the Incidence and Severity of Postoperative Cognitive Dysfunction in Cardiac Surgical Patients  

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Postoperative cognitive dysfunction (POCD) commonly occurs after cardiac surgery. We tested the hypothesis that a history of alcohol dependence is associated with an increased incidence and severity of POCD in male patients undergoing cardiac surgery using cardiopulmonary bypass. Recent verbal and nonverbal memory and executive functions were assessed before and one week after surgery in patients with or without a history of alcohol dependence. Cognitive function was significantly reduced aft...

Pagel, Paul S.; Warltier, David C.; Gandhi, Sweeta D.; Zafar Iqbal; Byrne, Alison J.; Hudetz, Judith A.; Patterson, Kathleen M.

2009-01-01

157

Isolation of pathogenic Escherichia coli from stool samples of diarrhoeal patients with history of raw milk consumption  

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Aim: To detect the occurrence of pathogenic Escherichia coli from stool samples of diarrhoeal patients with history of raw milk consumption and to determine the public health significance of isolates, especially their role in causing human diseases.Materials and Methods: Atotal of 100 stool samples from diarrhoeal patients, with history of raw milk consumption were collected from primary health centres in and around Anand city, under aseptic conditions and a total of 50 raw milk samples were ...

Brahmbhatt, M. N.; Thaker, H. C.; Nayak, J. B.; Virpari, Paresh K.

2013-01-01

158

Are there differences in zonal distribution and tumor volume of prostate cancer in patients with a positive family history?  

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Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: To determine if there are any differences in the zonal distribution and tumor volumes of familial and sporadic prostate cancers (PC) in men undergoing radical prostatectomy. MATERIAL AND METHODS: 839 patients underwent a radical prostatectomy in the absence of prior neoadjuvant therapy betw [...] een 1987 and 1996. Telephone interviews were conducted to obtain an updated family history. A positive family history was defined as the diagnosis of PC in at least one first degree relative. Prostatectomy specimens were examined to determine the number of tumor foci, zonal origin of the dominant tumor focus, tumor volume of the largest cancer focus, total tumor volume, Gleason score and stage, and the surgical margin status. Results were stratified according to family history and ethnicity. RESULTS: We successfully contacted 437 patients (52%). Prostatectomy specimens from 55 patients were excluded from review due to a history of prior transurethral resection of the prostate (n = 26) or uncertain pathological stage (n = 29). Of the remaining 382 patients, 76 (20%) reported having a first-degree relative with PC. Statistical analysis revealed no significant differences in the pathologic variables between the two groups of patients with or without a family history of PC. CONCLUSIONS: Familial and sporadic PC share similar characteristics. No histopathological differences account for the increased positive predictive value of PC screening tests among patients with a family history of PC.

Wade J., Sexton; Philippe E., Spiess; Louis L., Pisters; Scott, Carpenter; Lydia T., Madsen; Robin, Zagone; Xuemei, Wang; Patricia, Troncoso.

2010-10-01

159

The difference of anti phenolic glycolipid-1 (PGL-1) immunoglobulin-M (IgM) level and nutritional intake in subclinical leprosy patients who reside at home and in the orphanage  

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Leprosy patients can be found in the orphanage, and ordinary house holds. The different living conditions in different places might cause differences in the environments, nutritional intake, and immunity, which in the end would affect the transmission of M. leprae. The aim of this study was to find out the difference in anti PGL-1 IgM level and nutritional intake between sub-clinical leprosy patients residing at home with their families and those living in the orphanage. This cross-section...

Rahfiludin, Mohammad Z.; Nugraheni, Sri A.; Holy Ametati; Aniek Prihatin; Endang Purwaningsih

2007-01-01

160

How can I maintain my patient with diabetes and history of foot ulcer in remission?  

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Patients with diabetes and previous history of ulceration occupy the highest category of risk for reulceration and amputation. Annual recurrence rates of diabetic ulcerations have been reported as high as 34%, 61%, and 70% at 1, 3, and 5 years, respectively, with studies reporting 20% to 58% recurrence rate within 1 year. As the ever growing epidemic of diabetes expands globally, this sequelae of diabetic complication will continue to require increasing resources from the healthcare community to effectively manage. Recent data suggest that removal of preventative podiatric care from statewide reimbursement systems lead to significant and sustained increases in hospital admission (37%), charges (38%), length of stay (23%), and severe aggregate outcomes including amputation, sepsis and death (49%). The addition of comorbidities such as peripheral artery disease, poor nutrition, and non-adherence to preventive therapies not only increase a patient's likelihood for ulcer recurrence, but also cost of care and certainty of hospital admission. Currently, numerous efforts, guidelines, and industry generated products exist to prolong remission from ulceration; however, the clinical science for treating this patient population calls for much more effort. Despite this, data continue to suggest to demonstrate that appropriate follow-up care, shoe and insole modification, and patient education play a central role in reducing reulceration and amputation. Novel modalities for offloading and wearable sensor technologies offer the advantage of round-the-clock, patient specific and active response healthcare. These have the potential to detect, or even prevent, many wounds before they begin. PMID:25143315

Miller, John D; Salloum, Michelle; Button, Alex; Giovinco, Nicholas A; Armstrong, David G

2014-12-01

 
 
 
 
161

Suicide attempts via drug intake  

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Objective: In this study, socio-demographic and psychiatric evaluation of the patients who attempted suicide by drug intake was aimed. Material and Methods: Patients over the age of 18, who agreed to participate in our study, and admitted to the emergency department with conscious suicidal behavior between January 2009-January 2011 were enrolled in this prospective study. Results: A total of 122 patients were enrolled in the study. The most majority of the patients were consisted of f...

Ufuk Saraço?lu; Yüksel Gökel; Mehmet O?uzhan Ay; Akkan Avc?; Meliha Zengin Ero?lu; Müge Elarslan Kara; Mehmet Canacankatan; Mediha Do?an; Selen Acehan

2014-01-01

162

Celiac disease diagnosed after uncomplicated pregnancy in a patient with history of bulimia nervosa  

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Full Text Available Introduction. The association between celiac disease and eating disorders has been very rarely reported. This is the first report on celiac disease associated with bulimia in this part of Europe. Case report. An adult female patient with history of bulimia and one uncomplicated pregnancy was admitted to the Gastroenterology Department, due to long lasting dyspeptic symptoms, constipation, major weight loss and fatigue. After positive serological screening, the diagnosis of celiac disease was confirmed with histopathology examination of duodenal biopsy specimen. Conclusion. Complicated interactions between celiac disease and bulimia can make them difficult to diagnose and treat. It is important to consider the presence of celiac disease in patients with bulimia and gastrointestinal symptoms.

Milisavljevi? Nemanja

2013-01-01

163

Extrafine beclomethasone/formoterol in severe COPD patients with history of exacerbations.  

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The FORWARD study is a randomised, double-blind trial that compares the efficacy and safety of 48 weeks treatment with extrafine beclomethasone dipropionate/formoterol fumarate (BDP/FOR), 100/6 ?g pMDI, 2 inhalations BID, vs. FOR 12 ?g pMDI, 1 inhalation BID, in severe COPD patients with a history of exacerbations. Co-primary endpoints were exacerbation rate over 48 weeks and pre-dose morning FEV(1) at 12 weeks. The ITT population included 1186 patients (69% males, mean age 64 years) with severe airflow limitation (mean post-bronchodilator FEV(1) 42% predicted). Salbutamol as rescue therapy, theophylline and tiotropium (if stable regimen prior to screening) were allowed. Compared to FOR, BDP/FOR: (1) reduced the exacerbation rate (rate ratio: 0.72 [95% confidence interval 0.62-0.84], p < 0.001); (2) improved pre-dose morning FEV(1) (mean difference: 0.069 L [0.043-0.095] p < 0.001); (3) prolonged the time to first exacerbation; (4) improved the SGRQ total score. The percentage of patients with adverse events was similar (52.1% with BDP/FOR and 49.2% with FOR). Pneumonia incidence was low, slightly higher with BDP/FOR (3.8%) than with FOR (1.8%). No difference for laboratory values, ECG or vital signs. Extrafine BDP/FOR significantly reduces the exacerbation rate and improves lung function of patients with severe COPD and history of exacerbations as compared to FOR alone. PMID:24953015

Wedzicha, J A; Singh, D; Vestbo, J; Paggiaro, P L; Jones, P W; Bonnet-Gonod, F; Cohuet, G; Corradi, M; Vezzoli, S; Petruzzelli, S; Agusti, A

2014-08-01

164

[Open heart surgery in a patient with a history of Takotsubo cardiomyopathy].  

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An 81-year-old man had a history of Takotsubo cardiomyopathy induced by general fatigue after travel and acute gastritis 2 years previously. Recently, dyspnea on effort had been worsening. Since preoperative echocardiography showed severe aortic valve regurgitation (AR) with left ventricular (LV) dilatation, aortic valve replacement (AVR) by the standard procedure was indicated. Since the safety of the perioperative clinical course including recurrence of Takotsubo syndrome and hemodynamic compromise was unclear, a thorough examination was performed before surgical intervention. AVR with a 21 mm Mosaic bioprosthesis was performed. Transesophageal echocardiography (TEE) during operation did not demonstrate any sign of Takotsubo syndrome and good LV function was maintained. The patient was discharged on postoperative day 18 without any cardiac events including arrhythmia or clinical symptoms such as chest pain. Based on these results, open heart surgery under cardiopulmonary bypass (CPB) and cardiac arrest could be safely performed in patients with a history of Takotsubo cardiomyopathy with minimum use of cardiac agents including cathecholamine and sufficient perioperative removal of emotional and physical stress. PMID:22314170

Furukawa, Hiroshi; Aono, Hitoshi; Samukawa, Masanobu; Ichikawa, Sei-ichi

2012-02-01

165

Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU per day on biochemical responses and the wellbeing of patients  

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Full Text Available Abstract Background For adults, vitamin D intake of 100 mcg (4000 IU/day is physiologic and safe. The adequate intake (AI for older adults is 15 mcg (600 IU/day, but there has been no report focusing on use of this dose. Methods We compared effects of these doses on biochemical responses and sense of wellbeing in a blinded, randomized trial. In Study 1, 64 outpatients (recruited if summer 2001 25(OHD Results In Study 1, basal summer 25-hydroxyvitamin D [25(OHD] averaged 48 ± 9 (SD nmol/L. Supplementation for more than 6 months produced mean 25(OHD levels of 79 ± 30 nmol/L for the 15 mcg/day group, and 112 ± 41 nmol/L for the 100 mcg/day group. Both doses lowered plasma parathyroid hormone with no effect on plasma calcium. Between December and February, wellbeing score improved more for the 100-mcg/day group than for the lower-dosed group (1-tail Mann-Whitney p = 0.036. In Study 2, 25(OHD averaged 39 ± 9 nmol/L, and winter wellbeing scores improved with both doses of vitamin D (two-tail p Conclusion The highest AI for vitamin D brought summertime 25(OHD to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D3 in patients who needed additional vitamin D.

Hu Amanda

2004-07-01

166

Pharmacist elicited medication histories in the Emergency Department: Identifying patient groups at risk of medication misadventure  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Las guías del Comité Consultivo Farmacéutico Australiano establecen que se lleve una historia de medicación detallada desde el primer punto de entrada en un servicio de urgencias (SU). Los ancianos, en particular los que residen en Residencias de Ancianos y los que no son hablantes nativos ingleses, [...] se han identificado como grupos de pacientes vulnerables a las desgracias medicamentosas. Objetivo: Analizar la incidencia de discrepancias en las historias de medicación en estos grupos demográficos cuando el farmacéutico obtuvo el historial farmacoterapéutico comparado con los recopilados por los médicos del Servicio de Urgencias. También trató de investigar la incidencia de visitas al SU relacionadas con medicamentos. Métodos. Este estudio se condujo en un periodo de seis semanas e incluyó 100 pacientes de edad superior a 70 años, que tomaban regularmente 5 o más medicamentos, tenían 3 o mas comorbilidades clínicas y/o habían sido dados de alta del hospital en los 3 meses anteriores al estudio. Resultados: 24 participantes fueron calificados con ‘barreras lingüísticas'; 12 participantes estaban en residencias de ancianos, y 64 participantes fueron calificados de ‘generales'. El número de medicaciones correctamente registradas fue menor en los de ‘barreras lingüísticas' (13,8%) comparado con el 18% y el 19,6% de las medicaciones para los ‘generales' y los pacientes de residencias de ancianos, respectivamente. En 7 de los pacientes (29,2%) con ‘barreras lingüísticas', 1 de residencias de ancianos (8,3%) y 13 (20,3%) de los ‘generales' se sospechó que tenían una visita al SU relacionada con los medicamentos. Conclusiones: Este estudio ensalza la contribución positiva que un farmacéutico de urgencias puede realizar para elevar la gestión de la medicación en el continuum de cuidados. Este estudio también confirma la vulnerabilidad e los pacientes con barreras lingüísticas ante las desgracias medicamentosas y su necesidad de servicios de interpretes en todas las etapas de su hospitalización, en particular en el punto de entrada al SU. Abstract in english The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to an Emergency Department (ED). The elderly, in particular those residing in Residential Aged Care Facilities and those with a non-English speaking backgrou [...] nd, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demographic groups when pharmacist elicited medication histories were compared with those taken by ED physicians. It also aimed to investigate the incidence of medication related ED presentations. Methods: The study was conducted over a six week period and included 100 patients over the age of 70, who take five or more regular medications, have three or more clinical co-morbidities and/or have been discharged from hospital in three months prior to the study. Results: Twenty four participants were classified as ‘language barrier'; 12 participants were from residential aged care facilities, and 64 participants were classified as ‘general'. The number of correctly recorded medications was lowest in the ‘language barrier' group (13.8%) compared with 18% and 19.6% of medications for ‘general' patients and patients from residential aged care facilities respectively. Seven of the patients (29.2%) with ‘language barrier'; 1 from a residential aged care facility (8.3%) and 13 of the (20.3%) patients from the ‘general' category were suspected as having a medication related ED presentation. Conclusion: This study further highlights the positive contribution an ED pharmacist can make to enhancing medication management along the continuum of care. This study also confirms the vulnerability of patients with language barrier to medication misadventure and their need for interpreter services a

Maja, Ajdukovic; Meredith, Crook; Christopher, Angley; Ieva, Stupans; Natalie, Soulsby; Christopher, Doecke; Barbara, Anderson; Manya, Angley.

2007-12-01

167

Ingestão de fibra alimentar e tempo de trânsito colônico em pacientes com constipação funcional / Fiber intake and colonic transit time in functional constipated patients  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese RACIONAL: Pacientes com constipação funcional que não melhoram com suplementação de fibras dietéticas, representam importante problema clínico. OBJETIVOS: Avaliar as relações entre as quantidades de fibras ingeridas, intensidade da constipação e o tempo de trânsito colônico em pacientes com constipa [...] ção funcional. MÉTODOS: Foram avaliados 30 pacientes constipados funcionais, sem melhoras após suplementação dietética com fibras e 18 pessoas controle, sadias, sem queixas digestivas, utilizando inquéritos individuais quanto à ingestão de fibras e a intensidade da constipação e, por meio da técnica dos marcadores radiopaco, o tempo de trânsito colônico, total e segmentar. RESULTADOS: Apesar da maior ingestão diária de fibras (26,3 ± 12,9 g, constipados x 9,3 ± 5,2 g, controles), os sintomas da constipação mostraram-se intensos nos constipados (escore médio = 21,3 ± 4,07). O tempo normal para o trânsito colônico foi de 58,8h. O trânsito colônico total, em média, foi mais lento nos constipados (41,0 ± 22,8h, constipados x 21,8 ± 18,5h, controles). Constipados com trânsito lento (>58,8h) apresentaram inércia colônica (oito), obstrução de saída (um) e lentificação no cólon esquerdo (um). Constipados com trânsito normal ( Abstract in english BACKGROUND: Patients with functional constipation presenting no response to treatment using fibers supplement represents important clinical issue. AIMS: To evaluate the relations among the amount of ingested fiber, the constipation intensity and the colonic transit time in patients with functional c [...] onstipation. METHODS: We evaluated 30 patients, presenting no response to treatment using fibers supplement, and 18 healthy volunteers conducting individual inquiry into fibers intake, constipation intensity and the total and segmental colonic transit evaluation using radiopaque markers. RESULTS: In the constipated, despite the good level of fiber intake (26.3 ± 12.9 g, constipated x 9.3 ± 5,2 g, control), the symptoms of constipation was serious (score = 21.3 ± 4.07). Mean total colonic transit was 58.8h. The colonic transit was slower in the constipated group (41.0 ± 22.8 hours, constipated x 21.8 ± 18.5h, control). In constipated patients with slow colonic transit (>58.8h) there were colonic inertia (eight), outlet constipation (one) and slow transit in left colon (one), and among constipated patients with normal colonic transit (

Adriana Cruz, Lopes; Carlos Roberto, Victoria.

2008-03-01

168

Perception and knowledge about dietary intake in patients with liver cirrhosis and its relationship with the level of education  

International Nuclear Information System (INIS)

Objective: To determine patients perception and knowledge regarding diet in cirrhosis and its relationship with the level of patients education. Study Design: Cross-sectional observational study. Place and Duration of Study: This study was conducted at Gastroenterology Outpatient Clinics at the Aga Khan University Hospital, Karachi, the Aga Khan Health Services, Malir, Karachi and Hamdard University, Karachi, from January to December 2010. Methodology: Consecutive adult patients with compensated cirrhosis were enrolled. Demographic data, level of education, type and reason of food restriction as well as the source of dietary information was asked. Baseline laboratory test were performed, and nutritional status was assessed by BMI normogram. Results: Ninety patients, 58% male were enrolled. Mean age of the patient was 49 +- 11 years. Overall 73% of the patients were restricting fat, meat, fish and eggs in their diet; 53% were in uneducated group and 47% were in educated group (CI, 0.24-1.62, p-0.34). Twenty two patients (62.8%) in uneducated and 21 in educated group (68%) were restricting diet on the advice of their doctors, whereas 13 in uneducated group (37%) and 11 in educated group (32%) believed these dietary components to be harmful for the liver. Thirty two of uneducated patient (71.1%) and 28 of educated patients (62.2%) believed that vegetables, fruits and sugarcane had a beneficial effect on the liver. Main source of dietary information to the patients was thdietary information to the patients was the doctor. On sub-group analysis those who restricted diet irrespective of their educational level, had more patients with BMI less than 18.5 kg/m/sup 2/, (CI 0.01-0.94, p-0.001), haemoglobin less than 12 g/dl (CI 0- 0.03, p-0.001) and serum albumin less than 3 g/dl (CI 0.1- 03, p-0.001). Conclusion: Both educated and uneducated classes of the patients have improper knowledge and perception of diet in cirrhosis. Patients with cirrhosis who restricted diet, had relatively low BMI, haemoglobin and albumin as compared to those who did not restrict. Main source of dietary information to cirrhotic patients were health care personnels. (author)

169

Clinical Management of Adult Patients with a History of Nonsteroidal Anti-Inflammatory Drug-Induced Urticaria/Angioedema: Update  

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Full Text Available In the large majority of previous studies, patients with a history of acute urticaria induced by nonsteroidal anti-inflammatory drugs (NSAIDs seeking safe alternative drugs have undergone tolerance tests uniquely with compounds exerting little or no inhibitory effect on the cyclooxygenase 1 enzyme. In light of recently published studies, however, this approach seems inadequate and should be changed. The present article critically reviews the clinical management of patients presenting with a history of urticaria induced by a single NSAID or multiple NSAIDs and suggests a simple, updated diagnostic algorithm that may assist clinicians in correctly classifying their patients.

Asero Riccardo

2007-03-01

170

Terapia nutricional enteral em politraumatizados sob ventilação mecânica e oferta energética / Enteral nutritional therapy in mechanically-ventilated multiple-trauma patients and energy intake  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: O objetivo deste estudo foi avaliar a adequação energética dos pacientes politraumatizados em suporte ventilatório internados na unidade de terapia intensiva de um hospital público de Porto Alegre (RS), por meio da comparação entre as calorias prescritas e as efetivamente administradas, as [...] sim como entre as calorias estimadas pela equação de Harris-Benedict e a prescrição energética de cada paciente. MÉTODOS: Estudo de coorte prospectivo de pacientes politraumatizados, simultaneamente sob ventilação mecânica e terapia nutricional enteral. Verificou-se o tempo de permanência sob ventilação mecânica e a oferta energética durante o período de terapia nutricional enteral. A associação entre as variáveis quantitativas foi avaliada através do teste de correlação de Spearman devido à assimetria das variáveis. RESULTADOS: Foram acompanhados 60 pacientes, na faixa etária de 18 a 78 anos, sendo 81,7% do sexo masculino. Os tempos medianos de internação hospitalar, permanência na unidade de terapia intensiva e ventilação mecânica foram de 29, 14 e 6 dias, respectivamente. A média do percentual de dieta administrada foi de 68,6% (DP=18,3%). Da amostra total, 16 (26,7%) pacientes receberam no mínimo 80% de suas necessidades diárias. Não houve associação estatisticamente significativa entre o valor energético total administrado e os tempos de ventilação mecânica (r s=0,130; p=0,321), de unidade de terapia intensiva (r s=-0,117; p=0,372) e de internação hospitalar (r s=-0,152; p=0,246). CONCLUSÃO: Os pacientes incluídos neste estudo não receberam com precisão o aporte energético prescrito, ficando expostos aos riscos da desnutrição e seus desfechos clínicos desfavoráveis. Abstract in english OBJECTIVE: The objective of this study was to asssess the adequacy of energy intake of multiple trauma patients in the intensive care unit of a public hospital in the city of Porto Alegre, Southern Brazil, who require ventilatory support, by comparing prescribed energy intake with effectively admini [...] stered energy, and energy requirement estimated by the Harris-Benedict equation with the energy prescription of each patient. METHODS: This is a prospective cohort study of patients with multiple trauma simultaneously on mechanical ventilation and enteral nutrition. Duration of mechanical ventilation and energy intake during enteral nutrition were verified. The association between quantitative variables was assessed by the Spearman correlation test due to variable asymmetry. RESULTS: Sixty patients aged 18 to 78 years were studied, 81.7% of them males. Median length of hospital stay, intensive care unit stay, and duration of mechanical ventilation was 29, 14, and 6 days, respectively. The mean percentage of administered calories was 68.6% (SD=18.3%). Of the entire sample, 16 (26.7%) patients received at least 80% of their daily energy requirement. There was no significant association between total energy administered and duration of mechanical ventilation (r s=0.130; p=0.321), length of intensive care unit stay (r s=-0.117; p=0.372) and length of hospital stay (r s=-0.152; p=0.246). CONCLUSION: The study patients did not receive the prescribed energy. Therefore, they were at risk of malnutrition and its adverse clinical outcomes.

Cecília Flávia Lopes, Couto; José da Silva, Moreira; Jorge Amilton, Hoher.

2012-12-01

171

Limited influence of aspirin intake on mast cell activation in patients with food-dependent exercise-induced anaphylaxis: comparison using skin prick and histamine release tests.  

Science.gov (United States)

Food-dependent exercise-induced anaphylaxis (FDEIA) is a severe systemic syndrome induced by physical exercise after ingesting causative food. Aspirin is a well-known trigger for anaphylaxis in patients with FDEIA. Possible mechanisms by which symptoms are aggravated by aspirin include enhanced antigen absorption and mast cell activation. The aim of this study was to determine whether aspirin intake has an influence on mast cell/basophil activation in patients with FDEIA. Provocation tests revealed that adding aspirin to the causative food challenge in 7 of 9 (77.8%) patients with FDEIA provoked symptoms. In most cases, pretreatment with aspirin did not enhance skin tests (71.4%) or histamine release tests (88.9%) with food allergen challenges. The study confirms that histamine release and skin prick tests can be adjunctive tools for diagnosing FDEIA. In addition, our results suggest that exacerbation of FDEIA symptoms by aspirin is not mediated by direct effects of aspirin on mast cell/basophil activation. PMID:22068206

Fukunaga, Atsushi; Shimizu, Hideki; Tanaka, Mami; Kikuzawa, Ayuko; Tsujimoto, Mariko; Sekimukai, Akiko; Yamashita, Junji; Horikawa, Tatsuya; Nishigori, Chikako

2012-09-01

172

Características de la población con ingesta baja en luteína y zeaxantina en pacientes con degeneración macular asociada a la edad variante húmeda / Characteristics of patients with wet age-related macular degeneration and low intake of lutein and zeaxanthin  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Averiguar las características de los pacientes con DMAE húmeda que ingieren suficiente luteína y zeaxantina en nuestra población. Métodos: Estudio protocolizado, prospectivo, observacional, transversal, en pacientes diagnosticados de DMAE húmeda activa. Se efectúa hemograma, perfil lipídic [...] o, y perfil hepático; una entrevista dietética sobre los hábitos alimentarios a partir de la realización de un recordatorio de 24h y estudio antropométrico. Se dividen en dos grupos en función de la ingesta de luteína-zeaxantina (L-Z). Grupo 1 (ingesta «suficiente»): pacientes con ingesta diaria > 1.400mg/día en mujeres y 1.700mg/día en hombres (2/3 de la ingesta media diaria en población normal). Grupo 2: pacientes con ingesta diaria inferior a las del grupo 1. Se efectúa un estudio estadístico descriptivo y comparativo entre ambos grupos. Resultado: Un total de 52 pacientes, con una edad media de 78,9 años. Grupo 1: 11 pacientes (21% de la muestra). Grupo 2: 41. Los pacientes con ingesta suficiente de L-Z tienen mayor índice de masa corporal y perímetro de cintura. El 70-80% de los pacientes del grupo 1 presentan ingesta insuficiente de vitaminas A, C y E, y zinc. Conclusiones: El 79% de los pacientes tienen ingesta diaria de L-Z baja. Los pacientes con aporte suficiente tienen un aumento en el índice de masa corporal y perímetro de cintura, y además la mayoría tienen una ingesta insuficiente de vitaminas A, C y E, y zinc. Abstract in english Objective: To assess the characteristics of patients with wet AMD and low intake of lutein and zeaxanthin in our population. Methods: A prospective, observational, cross-sectional study was conducted on patients with active wet AMD. A full blood count, a lipid and liver profile, a dietary interview [...] (24-hour recall), and an anthropometric study were performed. Lutein-zeaxanthin (LZ) intake results split the patents in two groups. Group 1 ("sufficient" intake): patients with > 1,400mg/day intake in women and 1,700mg/day in men (2/3 of the average daily intake in a normal population). Group 2: patients with daily intakes below that of group 1. A descriptive and comparative statistical study was performed. Results: Fifty-two patients with a mean age of 78.9 years. Group 1: eleven patients (21% of the sample). Group 2: forty-one patients. The subjects with adequate intake of LZ had higher a body mass index and waist circumference. Between 70-80% of patients in group 1 had inadequate intake of vitamin A, C and E and zinc. Conclusions: Seventy-nine per cent of the patients with wet AMD have a deficient daily intake in lutein-zeaxanthin. The population with adequate intake is associated with an increased body mass index and waist circumference, and in addition, most of them have an insufficient intake of vitamin A, C, E and zinc.

J.L., Olea; J.A., Aragón; M.E., Zapata; J.A., Tur.

2012-04-01

173

Características de la población con ingesta baja en luteína y zeaxantina en pacientes con degeneración macular asociada a la edad variante húmeda Characteristics of patients with wet age-related macular degeneration and low intake of lutein and zeaxanthin  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivo: Averiguar las características de los pacientes con DMAE húmeda que ingieren suficiente luteína y zeaxantina en nuestra población. Métodos: Estudio protocolizado, prospectivo, observacional, transversal, en pacientes diagnosticados de DMAE húmeda activa. Se efectúa hemograma, perfil lipídico, y perfil hepático; una entrevista dietética sobre los hábitos alimentarios a partir de la realización de un recordatorio de 24h y estudio antropométrico. Se dividen en dos grupos en función de la ingesta de luteína-zeaxantina (L-Z. Grupo 1 (ingesta «suficiente»: pacientes con ingesta diaria > 1.400mg/día en mujeres y 1.700mg/día en hombres (2/3 de la ingesta media diaria en población normal. Grupo 2: pacientes con ingesta diaria inferior a las del grupo 1. Se efectúa un estudio estadístico descriptivo y comparativo entre ambos grupos. Resultado: Un total de 52 pacientes, con una edad media de 78,9 años. Grupo 1: 11 pacientes (21% de la muestra. Grupo 2: 41. Los pacientes con ingesta suficiente de L-Z tienen mayor índice de masa corporal y perímetro de cintura. El 70-80% de los pacientes del grupo 1 presentan ingesta insuficiente de vitaminas A, C y E, y zinc. Conclusiones: El 79% de los pacientes tienen ingesta diaria de L-Z baja. Los pacientes con aporte suficiente tienen un aumento en el índice de masa corporal y perímetro de cintura, y además la mayoría tienen una ingesta insuficiente de vitaminas A, C y E, y zinc.Objective: To assess the characteristics of patients with wet AMD and low intake of lutein and zeaxanthin in our population. Methods: A prospective, observational, cross-sectional study was conducted on patients with active wet AMD. A full blood count, a lipid and liver profile, a dietary interview (24-hour recall, and an anthropometric study were performed. Lutein-zeaxanthin (LZ intake results split the patents in two groups. Group 1 ("sufficient" intake: patients with > 1,400mg/day intake in women and 1,700mg/day in men (2/3 of the average daily intake in a normal population. Group 2: patients with daily intakes below that of group 1. A descriptive and comparative statistical study was performed. Results: Fifty-two patients with a mean age of 78.9 years. Group 1: eleven patients (21% of the sample. Group 2: forty-one patients. The subjects with adequate intake of LZ had higher a body mass index and waist circumference. Between 70-80% of patients in group 1 had inadequate intake of vitamin A, C and E and zinc. Conclusions: Seventy-nine per cent of the patients with wet AMD have a deficient daily intake in lutein-zeaxanthin. The population with adequate intake is associated with an increased body mass index and waist circumference, and in addition, most of them have an insufficient intake of vitamin A, C, E and zinc.

J.L. Olea

2012-04-01

174

Intestinal obstruction due to primary intestinal melanoma in a patient with a history of rectal cancer resectioning: A case report  

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The vast majority of the cases of intestinal melanomas are metastatic lesions, originating from an occult primary cutaneous or ocular lesion, whereas primary small intestinal melanomas are extremely rare. This is a rare case of primary small intestinal malignant melanoma with intestinal obstruction in a patient with a prior history of rectal cancer resection. The patient was admitted for abdominal pain and obstipation. Following an overall inspection, the patient was subjected to surgical tre...

Li, Gang; Tang, Xiaojiang; He, Jianjun; Ren, Hong

2013-01-01

175

Uncommon case of brain metastasis in a patient with a history of heavy smoking.  

Science.gov (United States)

Primary sarcomas of the aorta are extremely uncommon. Depending on histomorphology and immunohistochemical pattern, intimal sarcomas can show angiosarcomatous differentiation. Here, we describe the case of a 60-year-old woman with a primary intimal sarcoma of the aortic arch and signs of cerebral metastatic disease as the initial manifestation. After the patient experienced the onset of severe headaches, ataxia, and left-sided weakness, magnetic resonance imaging showed several brain lesions. Histologic assessment of a brain biopsy specimen revealed a malignant tumour composed of large pleomorphic cells that were positive for pancytokeratin and CD10. Radiation to the brain did not significantly improve the patient's symptoms, and cranial computed tomography (ct) imaging revealed several metastases, indicating lack of response. Because of the patient's smoking history, the presence of central nervous system and skeletal metastases on combined positron-emission tomography and ct imaging, and the focal pan-cytokeratin positivity of the tumour, carcinoma of the lung was favoured as the primary tumour. Despite chemotherapy with cisplatin and etoposide, the patient's neurologic symptoms and general condition deteriorated rapidly, and she died within a few days. At autopsy, an undifferentiated intimal sarcoma of the aortic arch was diagnosed. The primary tumour in the aorta consisted of large pleomorphic cells. Immunohistochemical analysis of the aortic tumour and brain metastases demonstrated diffuse positivity for vimentin and p53 and focal S-100 staining. In summary, we report a challenging case of advanced intimal sarcoma of the aortic arch with brain and bone metastases at initial presentation. Our report demonstrates the difficulties in diagnosing and treating this disease, and the need for multicentre studies to accrue more patients for investigations of optimal therapy. PMID:25302044

Scharl, M; Bode, B; Rushing, E; Knuth, A; Rordorf, T

2014-10-01

176

Effects of anticoagulant therapy on pregnancy outcomes in patients with thrombophilia and previous poor obstetric history.  

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This study investigates the effects of anticoagulant therapy on pregnancy outcomes in 204 patients with thrombophilia and previous poor obstetric outcomes. Patients with poor obstetric history (pre-eclampsia, intrauterine growth retardation, fetal death, placental abruption, recurrent pregnancy loss) and having hereditary thrombophilia were included in this study. Poor obstetric outcomes were observed more frequently in patients who had not taken anticogulant therapy compared with treated group. Live birth rate, gestational age at birth and Apgar scores were significantly higher in the treated group when compared with the untreated group. There were no significant differences in terms of birthweight, mode of delivery and admission rates to the neonatal intensive care unit (NICU). Low-molecular-weight heparin (LMWH) plus acetylsalicylic acid (ASA) had higher gestational age at birth, Apgar scores, live birth rate and a lower abortion rates when compared with controls; in contrast, no significant difference was observed in terms of birthweight, mode of delivery, obstetric complications and admission rates to NICU. There were no significant differences between control group and both LMWH only and ASA only groups in terms of gestational age at birth, Apgar scores, birthweight, mode of delivery, obstetric complications and admission rates to NICU. Only LMWH group had higher live birth rate as compared with control group. The use of only ASA did not seem to affect the perinatal complication rates and outcomes. In conclusion, anticoagulant therapy with both LMWH and ASA seems to provide better obstetric outcomes in pregnant women with thrombophilia and previous poor obstetric outcomes. PMID:25268607

Mutlu, Ilknur; Mutlu, Mehmet Firat; Biri, Aydan; Bulut, Berk; Erdem, Mehmet; Erdem, Ahmet

2014-09-27

177

Metacognition and general functioning in patients with schizophrenia and a history of criminal behavior.  

Science.gov (United States)

Metacognitive difficulties have been linked to social dysfunction in schizophrenia. However, research examining the role of metacognition in the social functioning of patients with a history of violence and criminality is very limited. This research is especially important for this group given their relatively poor prognosis and their risk to reoffend, as well as the promising benefits of integrating metacognitive approaches in psychosocial treatments. In this study, the association between metacognition and global social functioning was examined in 79 patients with schizophrenia with a criminal background. We also examined the association of positive, negative and disorganized symptoms with social functioning and the extent to which metacognition mediates this association. The results indicate that poor social functioning is associated with metacognitive difficulties and higher levels of delusions and Conceptual Disorganization. In addition, meditation analyses showed that metacognition accounted for about 11% of the total effect size of the association between delusions and social dysfunction, suggesting that the relationship between delusions and social dysfunction is partially driven by impaired metacognition. These findings underscore the importance of interventions designed to enhance the patients? metacognitive capacities, that is, the more proximal capacities linked to poorer social functioning. PMID:25582967

Bo, Sune; Kongerslev, Mickey; Dimaggio, Giancarlo; Lysaker, Paul H; Abu-Akel, Ahmad

2015-02-28

178

Analyzing complex patients' temporal histories: new frontiers in temporal data mining.  

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In recent years, data coming from hospital information systems (HIS) and local healthcare organizations have started to be intensively used for research purposes. This rising amount of available data allows reconstructing the compete histories of the patients, which have a strong temporal component. This chapter introduces the major challenges faced by temporal data mining researchers in an era when huge quantities of complex clinical temporal data are becoming available. The analysis is focused on the peculiar features of this kind of data and describes the methodological and technological aspects that allow managing such complex framework. The chapter shows how heterogeneous data can be processed to derive a homogeneous representation. Starting from this representation, it illustrates different techniques for jointly analyze such kind of data. Finally, the technological strategies that allow creating a common data warehouse to gather data coming from different sources and with different formats are presented. PMID:25417081

Sacchi, Lucia; Dagliati, Arianna; Bellazzi, Riccardo

2015-01-01

179

Preoperative oral rehydration solution intake volume does not affect relative change of mean arterial blood pressure and crystalloid redistribution during general anesthesia in low-risk patients: an observational cohort study.  

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Despite the implementation of liberal preoperative fasting routines, it is unclear whether preoperative oral rehydration solution intake volume affects blood pressure during general anesthesia. We enrolled 60 patients (American Society of Anesthesiologists status I/II) undergoing tympanoplasty. Patients drank 200-1,000 ml oral rehydration solution until 2-3 h before anesthesia induction. Anesthesia was induced by propofol and maintained with sevoflurane and remifentanil. Coinciding with anesthesia induction, 15 ml/kg Ringer's acetate solution was administered intravenously over 60 min followed by 1 ml/kg Ringer's acetate solution over the next 30 min. Mean arterial blood pressure (MAP) and whole-body bioelectrical resistance for extracellular fluid (R e) during anesthesia were compared between retrospectively classified intake groups of oral rehydration solution. There were no differences in mean MAP during the 30-90 min period relative to baseline [0.67 (0.60-0.74), 0.65 (0.61-0.76), 0.64 (0.60-0.70), P = 0.96] and relative R e at 90 min [0.945 (0.018), 0.944 (0.021), 0.943 (0.021), P = 0.95] between the small (n = 14), intermediate (n = 29), and large (n = 17) intake groups. The intake volume of preoperative oral rehydration solution does not affect the magnitude of hypotension during general anesthesia in low-risk patients undergoing minor surgery. PMID:23828452

Iwayama, Sachiko; Tatara, Tsuneo; Osugi, Toshihiro; Hirose, Munetaka

2014-02-01

180

Desnutrição e inadequação alimentar de pacientes aguardando transplante hepático / Malnutrition and inadequate food intake of patients in the waiting list for liver transplant  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: O estado nutricional de pacientes em lista de espera para transplante hepático deve ser avaliado devido ao risco elevado de deficiências nutricionais desses doentes, sendo este o objetivo do presente estudo. MÉTODOS: Em 13 meses, pacientes candidatos a transplante de fígado foram avaliados [...] nutricionalmente pela técnica de Avaliação Global Subjetiva (AGS) e a ingestão alimentar foi quantificada pelo recordatório de 24 horas. RESULTADOS: Foram avaliados 159 pacientes, média de idade de 50 ± 10,6 anos, sendo 71,1% homens. A desnutrição foi encontrada em 74,7% dos pacientes, com 28% de desnutridos graves. Essa foi associada à gravidade da doença por Child-Pugh, à presença de edema e/ou ascite, aos episódios prévios de encefalopatia hepática, ao uso de mais de três medicamentos e aos baixos níveis de atividade física (p Abstract in english OBJECTIVE: Nutritional status of patients in the waiting list for liver transplant must be assessed due to the many risk factors associated with nutritional deficiencies. This was the aim of the study. METHODS: Throughout a period of 13 months, patients on the waiting list for liver transplantation [...] were nutritionally assessed by the Subjective Global Assessment (SGA) and food intake was assessed by using the 24 hour recall instrument. RESULTS: 159 patients were included, mean age 50.5 +10.6 years and 71.1% were men. Overall malnutrition according to SGA was 74.7%, with 28% of patients considered severely malnourished. Malnutrition was associated with Child-Pugh score, presence of ascites and/or edema, previous episodes of encephalopathy and use of three or more medications and lower levels of physical activity. Socio-economic aspects, etiology of the disease and MELD score did not affect the nutritional status (p = NS). Calorie needs were not reached by 90.7% of patients and 75.7% of them did not reach protein requirements. CONCLUSIONS: In conclusion, malnutrition is highly prevalent amongst patients on the waiting list for liver transplantation and most do not meet nutritional requirements which certainly contribute to the vicious cycle leading to a deranged nutritional status.

Lívia Garcia, Ferreira; Lucilene Rezende, Anastácio; Agnaldo Soares, Lima; Maria Isabel Toulson Davisson, Correia.

 
 
 
 
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Usefulness of dietary enrichment on energy and protein intake in elderly patients at risk of malnutrition discharged to home / Utilidad del enriquecimiento de la dieta sobre la ingesta energética y protéica en pacientes ancianos en riesgo de desnutrición dados de alta a domicilio  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Introducción: La desnutrición es causa de preocupación en muchos pacientes ingresados, siendo frecuente al ingreso y alta hospitalaria. Objetivos: El objetivo de este estudio fue valorar si el enriquecimiento de la dieta con pequeñas raciones de alimentos densos en energía y nutrientes mejora la ing [...] esta energética y de nutrientes en pacientes ancianos con riesgo de desnutrición dados de alta al domicilio. Métodos: Estudio retrospectivo de una serie de casos en paciente ancianos con riesgo de desnutrición tratados con enriquecimiento de la dieta. Se revisaron los datos de la historia clínica y dietética de pacientes ancianos dados de alta a domicilio. Cuarenta-y-un pacientes, con una edad media de 83 ± 5 años, cumplieron los criterios de inclusión; 13 pacientes se perdieron después de 4 semanas de tratamiento y un total de 24 después de 12 semanas. El historial contenía datos de la ingesta de alimentos valorada a nivel basal, y después de 4 y 12 semanas de tratamiento. El Mini Nutritional Assessment, las medidas antropométricas, los parámetros bioquímicos rutinarios y el Índice de Barthel fueron valorados a nivel basal y después de 12 semanas. Resultados: En comparación al inicio, los pacientes mejoraron significativamente su ingesta energética y proteica después de 4 semanas de tratamiento, cumpliendo con los requerimientos nutricionales medios. La mejora en la ingesta de energía y proteínas todavía era manifiesta en la semana 12. Después de 12 semanas de enriquecimiento de la dieta, también se observó un incremento significativo en el peso (4.1%, p = 0.011). No se detectaron cambios significativos en el estado funcional. Conclusiones: El uso de pequeñas raciones de alimentos con elevada densidad energética y proteica para enriquecer las comidas parece ser un tratamiento nutricional factible para incrementar la ingesta energética y proteica y cumplir con los objetivos nutricionales en paciente ancianos dados de alta al domicilio. Abstract in english Introduction: Malnutrition is a cause for concern among many admitted elderly patients, being common at hospital admission and discharge. Objectives: The objective of this study was to assess if diet enrichment with small servings of energy and protein dense foods, improves energy and nutrient intak [...] e in elderly patients at risk of malnutrition discharged to home. Methods: This was a retrospective case series study in elderly patients at risk of malnutrition treated with diet enrichment. There was a data review of dietary and health records of elderly patients discharged to home. Forty-one patients, mean age of 83 ± 5 years, met the inclusion criteria; 13 patients had been lost after 4 weeks of treatment and a total of 24 patients after 12 weeks. Records contained food intake data assessed at baseline, and after 4 and 12 weeks of treatment. Mini Nutritional Assessment, anthropometric measurements, routine biochemical parameters and the Barthel Index were assessed at baseline and after 12 weeks. Results: Compared to baseline, patients significantly improved their energy and protein intake after 4 weeks of treatment, fulfilling the mean nutritional requirements. The improvement in energy and protein intake was still manifest at week 12. After 12 weeks of dietary enrichment, a significant weight gain was observed (4.1%, p = 0.011), as well. No significant changes were detected in functional status. Conclusions: Using small servings of energy and protein dense foods to enrich meals seems a feasible nutritional treatment to increase energy and protein intake and meet nutritional goals among elderly patients discharged to home.

Joan, Trabal; Sonia, Hervas; Maria, Forga; Pere, Leyes; Andreu, Farran-Codina.

2014-02-01

182

Obesity coexists with malnutrition?: adequacy of food consumption by severely obese patients to dietary reference intake recommendations / ¿Obesidad coexiste con la desnutrición?: adecuación del consumo de alimentos de los pacientes obesos a las recomendaciones de ingesta dietética de referencia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Evaluar la adecuación de la dieta de los pacientes con obesidad severa y describir las principales deficiencias nutricionales a través del DRI. Los pacientes fueron seleccionados de forma secuencial, lo que indica la cirugía bariátrica en el periodo de marzo 2010 a noviembre 2011. Todos los paciente [...] s fueron sometidos a la evaluación del estado nutricional (antropometría y la ingesta dietética) y metabólicos (perfiles de lípidos, hormonas y glucosa). Se evaluaron 77 pacientes (edad media ± DE) de 44,48 ± 12,55 años. Cincuenta pacientes (76,6% de la muestra) eran mujeres. Las comorbilidades más frecuentes fueron la hipertensión arterial (72,4%), trastorno por atracón (47,4%), diabetes mellitus (32.9%), apnea del sueño (30,3%) y la dislipemia (18,4%). El consumo de nutrientes fue generalmente adecuada, teniendo en cuenta la ingesta calórica alta. Sin embargo, se identificaron algunas deficiencias de micronutrientes. Sólo 19,5% de los pacientes alcanzar la ingesta recomendada mínima de potasio, de calcio 26,0%, y 66,2% de hierro. En cuanto a sodio, toda la muestra alcanza el mínimo recomendado, sin embargo, llegar a la UL 98,7% para el sodio. Las vitaminas del grupo B han evaluado el consumo satisfactorios, llegando a más del 80% de las necesidades, pero las vitaminas liposolubles A, D y E se consume a menudo por debajo de la ingesta diaria recomendada. La dieta del paciente obeso no está equilibrado. Un gran consumo de calorías se acompaña de una ingesta deficiente de micronutrientes. En la evaluación de estos pacientes, cambios en la dieta cualitativos deben ser considerados simultáneamente con la restricción calórica. Abstract in english To assess the adequacy of food intake in severely obese patients and describe their main nutritional deficiencies on the basis of Dietary Reference Intakes (DRIs). Patients on a waiting list for bariatric surgery were sequentially recruited from March 2010 to November 2011. All subjects underwent nu [...] tritional status assessment (anthropometry, dietary recall and semi-structured interview), socioeconomic evaluation (Brazilian Association of Research Companies criteria) and laboratory testing (glucose/hormone/lipid panel). A total of 77 patients were assessed, 50 of whom (76.6%) were female. Mean age was 44.48±12.55 years. The most common comorbidities were hypertension (72.4%), binge eating disorder (47.4%), type 2 diabetes mellitus (32.9%), sleep apnea (30.3%) and dyslipidemia (18.4%). Macronutrient intake was largely adequate, in view of the high calorie intake. However, some micronutrient deficiencies were present. Only 19.5% of patients had an adequate intake of potassium, 26.0% of calcium, and 66.2% of iron. All subjects consumed more than the minimum recommended intake of sodium, with 98.7% reaching the upper limit. B-complex vitamin intake was satisfactory (adequate in >80% of subjects), but lipid-soluble vitamin (A, D, E) intake often fell short of the RDI. The diet of severely obese patients is unbalanced, with high calorie intake paralleled by insufficient micronutrient intake. When these patients are assessed and managed, qualitative dietary changes should be considered in addition to routine caloric restriction.

Jaqueline, Driemeyer Correia Horvath; Mariana, Laitano Dias de Castro; Natália, Kops; Natasha, Kruger Malinoski; Rogério, Friedman.

2014-02-01

183

Double balloon endoscopy increases the ERCP success rate in patients with a history of Billroth II gastrectomy  

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AIM: To evaluate the effect of double balloon endoscope (DBE) on the endoscopic retrograde cholangiopancreatography (ERCP) success rate in patients with a history of Billroth II (B II) gastrectomy.METHODS: From April 2006 to March 2007, 32 patients with a B II gastrectomy underwent 34 ERCP attempts. In all cases, the ERCP procedures were started using a duodenoscope. If intubation of the afferent loop or reaching the papilla failed, we changed to DBE for the ERCP procedure (DBE-ERCP). We asse...

Cheng-hui Lin, Jui-hsiang Tang

2010-01-01

184

Loss of FHIT expression in gastric mucosa of patients with family histories of gastric cancer and Helicobacter pylori infection  

Science.gov (United States)

AIM: To answer the question whether FHIT gene expression is affected by the family history of gastric carcinoma and the presence of Helicobacter pylori (H pylori) in the gastric mucosa of patients with dyspepsia. METHODS: FHIT gene expression in two different topographic sites of the gastric mucosa of twenty-one patients with dyspepsia and with or without familial gastric carcinoma, infected or not infected with H pylori, was evaluated by reverse transcription-PCR (RT-PCR) and IMAGE QUANT methods. A rapid urease test and histopathological examination were used to determine H pylori colonization. RESULTS: In the gastric mucosa of patients with family histories of gastric carcinoma, the amount of FHIT protein mRNA was reduced down to 32%, and for patients with H pylori colonization, to 24% in comparison to controls with dyspepsia and without cancer in the family. FHIT expression was independent of the topography of specimens (corpus vs antrum), and for the control patients it was less sensitive to infection with H pylori. A considerable statistical difference in FHIT levels was observed in the gastric mucosa from the corpus of patients with family histories of gastric carcinoma in respect to H pylori colonization (P = 0.06). Macroscopic evaluation of the gastric mucosa demonstrated that pathologic changes classified according to the Sydney system had no significant influence on FHIT expression within each tested group of patients. CONCLUSION: Loss of FHIT expression was observed in patients with dyspepsia and family histories of gastric carcinoma, especially those infected with H pylori. Such results may constitute an early indication of the development of gastric carcinoma, which is associated with family factors including heredity and H pylori infection. The loss of the FHIT gene may serve as a marker for early diagnosis and prevention of gastric carcinoma, especially in context of early monitoring of H pylori infection in individuals with a record of familial stomach cancer. PMID:15609389

Stec-Michalska, Krystyna; Antoszczyk, Slawomir; Klupinska, Grazyna; Nawrot, Barbara

2005-01-01

185

Mortality in cancer patients with a history of cutaneous squamous cell carcinoma--a nationwide population-based cohort study  

DEFF Research Database (Denmark)

Cutaneous squamous cell carcinoma (SCC) is associated with underlying immunosuppression, so it may be a prognostic marker in patients with subsequent cancer. We therefore conducted a nationwide population-based Danish cohort study to evaluate whether a history of cutaneuos SCC has prognostic impact in patients with one of the following index cancers: non-Hodgkin's lymphoma (NHL), or cancer of the lung, colon, rectum, breast, or prostate.

Johannesdottir, Sigrun Alba; Lash, Timothy L

2012-01-01

186

Clinical Management of Adult Patients with a History of Nonsteroidal Anti-Inflammatory Drug-Induced Urticaria/Angioedema: Update  

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In the large majority of previous studies, patients with a history of acute urticaria induced by nonsteroidal anti-inflammatory drugs (NSAIDs) seeking safe alternative drugs have undergone tolerance tests uniquely with compounds exerting little or no inhibitory effect on the cyclooxygenase 1 enzyme. In light of recently published studies, however, this approach seems inadequate and should be changed. The present article critically reviews the clinical management of patients presenting...

Asero Riccardo

2007-01-01

187

Association of Dietary Vitamin C and E Intake and Antioxidant Enzymes in Type 2 Diabetes Mellitus Patients  

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Full Text Available Background: Diabetes mellitus consist of a various metabolic diseases such as hyperglycemia, increase glycosylated hemoglobin (HbA1c and disorder in antioxidant enzymes activity, hence supplementing with antioxidant nutrients, mainly vitamin C and E seems to reduce oxidative injure in patients with type 2 diabetes mellitus (T2DM. Aim: To evaluate outcome of vitamin C and E supplementation on type 2 DM patients. Setting and Design: The study was completed in 170 T2DM on consumption of vitamin C, E, combination of C & E and placebo. Materials and Methods: The cases groups of this study consist of two major groups, which were named supplementation and placebo group. The group of supplementation consisted of 3 sub-groups, which received three capsules per day for a phase of three months. The parameters such as HbA1c, glucose, superoxide dismutase (SOD and glutathione peroxides (GSH were evaluated in baseline and after three months with supplementation. Statistical Analyses: The statistical analyses were evaluated with the use of mean ± SD, ANOVA-test and paired-sample t-test. Results: Mean age of 170 patients, 84 male and 86 female were 53.82±5.26 in the range of 30-60 years. The blood pressure results showed significant differences between the all supplement groups in baseline as compared to after receiving supplements (p<0.05. Use of vitamin C, E, and E & C showed significant differences in concentration of plasma FBS and HbA1c (p<0.05 & <0.001, but there was no significant differences in placebo groups. SOD and GSH enzymes levels showed a significant increased after consumption of vitamins in supplementation groups (p<0.001. Conclusion: This research confirmed that subjects with T2DM after three months supplementation of vitamins demonstrated significantly low level of hypertension, decrease levels of blood glucose, and increase SOD and GSH enzyme activity that can probably reduce insulin resistance by enhanced lowering oxidative stress parameters.

Zahra Rafighi

2013-01-01

188

Technical difficulties of laparoscopic common bile duct exploration and their countermeasures for patients with history of upper abdominal surgery  

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Full Text Available ObjectiveTo investigate the technical difficulties of laparoscopic common bile duct exploration (LCBDE and their countermeasures for patients with a history of upper abdominal surgery. MethodsA retrospective analysis was performed on the clinical data of 72 patients with a history of upper abdominal surgery who underwent LCBDE at our hospital from January 2008 to October 2013. The intraoperative difficulties and their countermeasures were summarized and analyzed. ResultsIntraoperative difficulties occurred in 16 patients; severe adhesions in the abdominal cavity and operation region were found in 9 cases, difficult identification of the common bile duct in 4 cases, and difficult removal of stones in 3 cases. The operative time was 164.36±19.06 min for all patients, 179.31±13.25 min for patients encountering intraoperative difficulties, and 160.09±18.37 min for those not encountering intraoperative difficulties; the operative time was significantly longer in patients encountering intraoperative difficulties than in those not encountering intraoperative difficulties and in all patients (t=-3.898, P=0.000; t=-2.976, P = 0.004, but the operative time of patients not encountering intraoperative difficulties was not significantly different from that of all patients (t=-1.278, P=0.204. ConclusionFor patients with a history of upper abdominal surgery, LCBDE is an operation with high difficulty, high risk, and high technical requirement. In case of intraoperative difficulties, which would prolong the operative time, individualized countermeasures should be taken to ensure successful surgery.

MEI Yong

2014-08-01

189

Immunoepidemiological profiling of onchocerciasis patients reveals associations with microfilaria loads and ivermectin intake on both individual and community levels.  

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Mass drug administration (MDA) programmes against Onchocerca volvulus use ivermectin (IVM) which targets microfilariae (MF), the worm's offspring. Most infected individuals are hyporesponsive and present regulated immune responses despite high parasite burden. Recently, with MDA programmes, the existence of amicrofilaridermic (a-MF) individuals has become apparent but little is known about their immune responses. Within this immunoepidemiological study, we compared parasitology, pathology and immune profiles in infection-free volunteers and infected individuals that were MF(+) or a-MF. The latter stemmed from villages in either Central or Ashanti regions of Ghana which, at the time of the study, had received up to eight or only one round of MDA respectively. Interestingly, a-MF patients had fewer nodules and decreased IL-10 responses to all tested stimuli. On the other hand, this patient group displayed contrary IL-5 profiles following in vitro stimulation or in plasma and the dampened response in the latter correlated to reduced eosinophils and associated factors but elevated neutrophils. Furthermore, multivariable regression analysis with covariates MF, IVM or the region (Central vs. Ashanti) revealed that immune responses were associated with different covariates: whereas O. volvulus-specific IL-5 responses were primarily associated with MF, IL-10 secretion had a negative correlation with times of individual IVM therapy (IIT). All plasma parameters (eosinophil cationic protein, IL-5, eosinophils and neutrophils) were highly associated with MF. With regards to IL-17 secretion, although no differences were observed between the groups to filarial-specific or bystander stimuli, these responses were highly associated with the region. These data indicate that immune responses are affected by both, IIT and the rounds of IVM MDA within the community. Consequently, it appears that a lowered infection pressure due to IVM MDA may affect the immune profile of community members even if they have not regularly participated in the programmes. PMID:24587458

Arndts, Kathrin; Specht, Sabine; Debrah, Alexander Y; Tamarozzi, Francesca; Klarmann Schulz, Ute; Mand, Sabine; Batsa, Linda; Kwarteng, Alexander; Taylor, Mark; Adjei, Ohene; Martin, Coralie; Layland, Laura E; Hoerauf, Achim

2014-02-01

190

The prognostic importance of a history of hypertension in patients with symptomatic heart failure is substantially worsened by a short mitral inflow deceleration time  

DEFF Research Database (Denmark)

Hypertension is a common comorbidity in patients with heart failure and may contribute to development and course of disease, but the importance of a history of hypertension in patients with prevalent heart failure remains uncertain.

Andersson, Charlotte; Gislason, Gunnar H

2012-01-01

191

Fixed full-arch implant-supported prostheses in a patient with epidermolysis bullosa: a clinical case history report.  

Science.gov (United States)

Epidermolysis bullosa (EB) is a rare skin disorder characterized by blister formation in response to minor trauma and accompanied by extracutaneous manifestations. The use of endosseous implants to support fixed prostheses for the rehabilitation of patients with recessive dystrophic EB might provide a considerably better clinical treatment outcome than traditional prosthodontic interventions. This case history report describes the clinical management of such an afflicted patient. Implants were placed immediately following teeth extractions and subsequently loaded with fixed full-arch prostheses. This treatment option is proposed for patients with recessive dystrophic EB to preclude mucosal irritation associated with wearing removable prostheses. PMID:25588170

Agustín-Panadero, Rubén; Gomar-Vercher, Sonia; Peñarrocha-Oltra, David; Guzmán-Letelier, Marcelo; Peñarrocha-Diago, Miguel

2015-01-01

192

Improving students' confidence levels in communicating with patients and introducing students to the importance of history taking  

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Background: Radiographers can have a marked impact on the way patients deal with their illness because they are often one of the first health professionals that patients see. Therefore, it is essential that radiographers have effective communication skills and are able to provide patients with the information they require. The purpose of this study was to test whether the introduction of additional education on communication and history taking improved students' communication skills. Methods: A short program on communication skills and history taking was introduced to third year undergraduate students prior to a clinical placements period. Three workshops were run; the third included a role play exercise using professional actors as simulated patients. Students completed questionnaires at baseline, following the three workshops and after their subsequent clinical placement. Descriptive statistics were calculated and logistic regression Generalized Estimating Equations models were fitted to test for differences over time in students' confidence levels. Results: Twenty-seven out of 36 students completed the baseline and final surveys. Students indicated they were highly satisfied with the workshops provided. Statistically significant differences were observed for seven items relating to student's confidence levels in communicating with patients after they had participated in the workshops and their subsequent clinical placement. Conclusion: The use of communication skills workshops involving actor/patients is an effective method of assisting students to develop their communication and history taking skills. This program has now been implemented into the mentioned undergraduate course and it is recommended that radiography students at other institutions be provided with the opportunity to develop their communication and history taking skills.

Halkett, Georgia K.B., E-mail: g.halkett@curtin.edu.a [WA Centre for Cancer and Palliative Care/Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia (Australia); Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); McKay, Janice [Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia (Australia); Shaw, Therese [Child Health Promotion Research Centre, School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Western Australia (Australia)

2011-02-15

193

Patrón de ingesta en un grupo de pacientes con síndrome de intestino irritable: relación de la ingesta de fibra con los síntomas / Dietary intake of a group of patients with irritable bowel syndrome: relation between dietary fiber and symptoms  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivos: El objetivo de nuestro estudio fue evaluar la ingesta de un grupo de pacientes con síndrome de intestino irritable y compararla con las ingestas internacionales recomendadas. Pacientes y métodos: Se incluyeron un total de 53 pacientes con síndrome de intestino irritable seleccionados con [...] un muestreo no probabilístico consecutivo. Los pacientes habían sido diagnosticados de síndrome de intestino irritable (SII) siguiendo los Criterios de Roma II. A todos los pacientes se les determinó el peso, talla, índice de masa corporal, encuesta dietética de 3 días y un test de evaluación de síntomas. Resultados: Los 53 pacientes pesentaban una edad media de 45,67+13,6 años y una distribución por sexo de (22 varones/31 mujeres). La ingesta calórica total fue adecuada en valores absolutos y al corregir por peso del paciente. La distribución de calorías fue un 41,5% en forma de carbohidratos, un 19,8 en proteinas y un 38,7% en lípidos, estos datos muestran un claro exceso en el consumo de grasas y defecto en el consumo de hidratos de carbono. Existió una baja ingesta de vitaminas A y D. La ingesta de vitamina B12, vitamina C y niacina fue superior que las recomendaciones internacionales. Con respecto a los minerales, existió un claro déficit de la ingesta de calcio, magnesio, yodo y zinc. Al realizar el análisis en fibra soluble e insoluble, la primera fue inferior (fibra soluble 1,46 ± 0,74 g/día) (19%), la fibra insoluble representó 6,21 ± 2,67 g/día (71%). La ingesta corregida de fibra por calorías fue baja 4,5 ± 1,2 por cada 1.000 calorías. En el análisis de correlación sólo se correlacionó la fibra insoluble (r=-0,46; p Abstract in english Objectives: The aim of our study was to evaluate the oral dietary intake of a group of patients with irritable bowel syndrome and to compate with international recommendations. Patients and methods: A total of 53 patients with irritable bowel syndrome was enrolled in a non-propabilistic sample. Pati [...] ens were diagnose with Roma II criteria. In all patients were determined, weight, height, body mass index, dietary intake of 3 days and a symptoms scoring system. Results: The average age of 53 patients was 45.67±13.6 years with a distribution of sex (22 males/31 females). Caloric intakes was righ in absolut terms and corrected by weight. Distribution of calories was 41.5% of carbohidrates, a 19.8% of proteins, and a 38.7% of lipids, showing a high intake of lipids and low of carbohidrates. A low intake of vitamin A and D was detected. High intake of vitamin B12, vitamin C and niacine was observed. A low intake of calcium, magnesium, yodo and zinc was detected. Intake of soluble fiber was lower than insoluble fiber (1.46±0.74 g/day) (19%) vs 6.21±2.67 g/day (71%). Intake of fiber corrected by calories was low 4.5±1.2 g/1000 calories. In correlation analysis, insoluble fiber (r=0.46; p

R., Aller; D. A. de, Luis; O., Izaola; F., La Calle; L. del, Olmo; L., Fernández; T., Arranz; J. M., González Hernández.

2004-12-01

194

Inflammatory markers in patients with metabolic syndrome after the intake of fatty acids n-3 and conjugated linoleic acid (CLA  

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Full Text Available ABSTRACTIntroduction: The metabolic syndrome (MS increa -ses the odds of dying for cardiovascular disease, theworld’s leading cause of death. It has been shown thatpolyunsaturated fatty acids have a protective role in cardiovascular disease and its comorbidities.Objective: To assess the effect of three kinds ofpolyunsaturated fatty acids on the chronic inflammation in MS.Methods: The study group was 45 adults with MSdiagnose according to IDF criteria. Each group of treatment was assigned cuasi-randomly to 15 subjects during six weeks: a 1.8 g/d n-3 (1.08 g eicosapentoaenoicacid EPA + 0.72 g docosahexaenoic acid DHA, b 2.0g/d conjugated linoleic acid (CLA, 50:50, cis9:trans11,trans10:cis12, c 40 g/d walnut Juglans regia. The results at the beginning and the end of the essay werecompared in each group, using the t-Student test and p <0.01 as statistical signification value.Results:In the patients supplemented with n-3 fattyacids, significantly decreased the level of IL-6 (from9.81 ±1.28 to 8.47 ±0.81 pg/ml, p=0.002, leptin(from 25.94 ±5.06 ng/ml to 20.53 ±3.96 ng/ml,p=0.003 and homocysteine (from 18.80 ±1.95 to16.72 ±1.99 µmol/l, p=0.007, in erythrocytes decreased the percentage ?-linolenic content (from 1.90±0.77 to 1.26 ±0.17 %, p=0.004 and the n6/n3 rate(from 4.48 ±1.06 to 3.11 a ±0.60, p=0.000, while increased the percentage of EPA (from 1.13 ±0.45 to1.58 ±0.42 %, p=0.009 and DHA (from 2.61 ±0.36 to4.64 ±0.91 %, p=0.000. In the group that consumedwalnut declined the levels of TNF-? (from 8.75 ±2.06pg/ml to 6.68 ±0.97 pg/ml, p=0.002 and IL-6 (from10.61 ±1.45 to 8.72 ±0.79 pg/ml, p=0.000, in erythrocytes increased the ?-linolenic content (from 1.86±0.65 to 2.62 ±0.72 %, p=0.005. In the group thatconsumed CLA decreased the level of homocysteine(from 18.01 ±2.65 to 15.34 ±2.26 µmol/l, p=0.006.Conclusions: The groups that consumed n-3 fattyacids in supplements (EPA/DHA and in walnut, becameevident the modification in the erythrocyte fatty acidscontent, which could be associated to the reduction ofpro inflammatory state. In the group that consumedCLA the homocysteine level decreased without changesin the other markers or erythrocyte fatty acids.

Campos Mondragón, M.G; Oliart Ros, R. M. ; Angulo Guerrero, J. O.

2013-03-01

195

Underuse of long-term routine hospital follow-up care in patients with a history of breast cancer?  

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Full Text Available Abstract Background After primary treatment for breast cancer, patients are recommended to use hospital follow-up care routinely. Long-term data on the utilization of this follow-up care are relatively rare. Methods Information regarding the utilization of routine hospital follow-up care was retrieved from hospital documents of 662 patients treated for breast cancer. Utilization of hospital follow-up care was defined as the use of follow-up care according to the guidelines in that period of time. Determinants of hospital follow up care were evaluated with multivariate analysis by generalized estimating equations (GEE. Results The median follow-up time was 9.0 (0.3-18.1 years. At fifth and tenth year after diagnosis, 16.1% and 33.5% of the patients had less follow-up visits than recommended in the national guideline, and 33.1% and 40.4% had less frequent mammography than recommended. Less frequent mammography was found in older patients (age > 70; OR: 2.10; 95%CI: 1.62-2.74, patients with comorbidity (OR: 1.26; 95%CI: 1.05-1.52 and patients using hormonal therapy (OR: 1.51; 95%CI: 1.01-2.25. Conclusions Most patients with a history of breast cancer use hospital follow-up care according to the guidelines. In older patients, patients with comorbidity and patients receiving hormonal therapy yearly mammography is performed much less than recommended.

Schaapveld Michael

2011-06-01

196

Patient Impression and Satisfaction of a Self-administered, Automated Medical History-taking Device in the Emergency Department  

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Full Text Available Introduction: We evaluated patient impressions and satisfaction of an innovative self-administered, hand-held touch-screen tablet to gather detailed medical information from emergency department (ED patients in the waiting room prior to physician contact. Methods: Adult, medically stable patients presenting to the ED at Los Angeles County Hospital used the PatientTouche system to answer a series of questions about their current history of present illness and past medical/surgical histories in English or Spanish. Patients then completed a survey rating their experience. Results: Among 173 participants, opinion of PatientTouche was strongly positive; 93.6% (95%CI 90.0–97.3% felt the physical product was easy to hold and handle, and 97.1% (94.6–99.6% felt the questions were detailed enough for them to fully describe their condition; 97.8% (95.4–100.0% felt using PatientTouche would help them organize their thoughts and communicate better with their physician, 94.8% (91.4–98.1% thought it would improve the quality of their care, and 97.1% (94.6– 99.6% expressed desire to use the product again in the future. Conclusion: The study was conducted at a largely Hispanic county ED, and only patients with 1 of 6 pre-determined chief complaints participated. We did not include a control group to assess if perceived improvements in communication translated to measurable differences. In this pilot study, patients were highly satisfied with all aspects of the PatientTouche self-administered, hand-held, touch-screen tablet. Importantly, subjects felt it would help them better communicate with their doctor, would improve their overall quality of care and overwhelmingly expressed a desire to use it in the future. [West J Emerg Med. 2014;15(1:35–40.

Sanjay Arora

2014-02-01

197

Ingestión de sodio en pacientes litiásicos y su relación con variables demográficas y nutricionales / Sodium intake in lithiasic patients and its relationship to demographic and nutritional variables  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: la medición de la excreción urinaria de sodio es importante en pacientes con litiasis urinaria, pues su excreción elevada predispone a hipercalciuria, el trastorno metabólico urinario más frecuente. Objetivo: determinar la ingestión (igual a excreción) de sodio e identificar su posible [...] relación con variables demográficas y nutricionales, en pacientes con litiasis urinaria. Métodos: se desarrolló un estudio analítico, transversal, de los pacientes con litiasis urinaria que se hicieron estudio metabólico renal en el Instituto de Nefrología, entre enero 2011 y diciembre 2012. Se excluyeron los pacientes con factores que modifican la excreción de sodio. Las determinaciones de creatinina fueron realizadas por el método cinético de Jaffé, con espectrofotómetro Jenway®; las mediciones del sodio urinario, con analizador electrolítico marca Roche®. La información fue procesada de forma automatizada (SPSS versión 15.0). En cada categoría de las variables fueron calculadas media y desviación estándar de la excreción de sodio (mEq/d). Las comparaciones de los promedios se realizaron mediante la prueba t o mediante ANOVA. Resultados: de 1 985 pacientes estudiados, 1 363 fueron del sexo masculino (68,7 %) y 622, del femenino (31,3 %). La excreción urinaria media de sodio fue 235,29 mEq/d, globalmente, y resultó mayor en los hombres (252,69 mEq/d), al ser comparada con la de las mujeres (197,14 mEq/d) (p= 0,00). También se encontraron diferencias al comparar la excreción de sodio entre las categorías de valoración nutricional (p= 0,00) y de excreción de creatinina (p= 0,0). Conclusiones: la excreción urinaria de sodio es elevada en pacientes urolitiásicos, mayor en los hombres y en los sujetos con sobrepeso y obesidad. Abstract in english Introduction: measurement of urinary sodium excretion is important in patients with urolithiasis, for a high level of excretion leads to hypercalciuria, the most common urinary metabolic disorder. Objective: to determine sodium intake (equal to excretion) and identify its possible relationship to de [...] mographic and nutritional variables in patients with urinary lithiasis. Methods: an analytical cross-sectional study was conducted in patientes with urinary lithiasis undergoing metabolic renal study at the Institute of Nephrology from January 2011 to December 2012. Patients with factors modifying sodium excretion were excluded. Creatinine determinations were made with Jaffé's kinetic method using a Jenway™ spectrophotometer. Urinary sodium was measured with a Roche™ electrolytic analyzer. Data was processed with the statistical software SPSS version 15.0. Variables for each category were estimated as mean and standard deviation of sodium excretion (mEq/d). Comparisons of averages were made with the t test or ANOVA. Results: of the 1 985 patients studied, 1 363 were male (68.7 %) and 622 were female (31.3 %). Global mean sodium urinary excretion was 235.29 mEq/d, greater in men (252.69 mEq/d) than in women (197.14 mEq/d) (p= 0.00). Differences were also found when sodium excretion was compared by nutritional assessment (p= 0.00) and creatinine excretion (p= 0.0). Conclusions: urinary sodium excretion is high in patients with urolithiasis. Values are higher in men, and in overweight and obese individuals.

Raymed, Antonio Bacallao Méndez; Reinaldo, Mañalich Comas; Francisco, Gutiérrez García; Betsy, Llerena Ferrer.

2014-09-01

198

Study of myocardial viability using thallium-201 in patients with a history of infarctions: Is reinjection necessary?  

International Nuclear Information System (INIS)

An analysis was performed of 84 patients with a history of myocardial infarction using the thallium-single photon emission computed tomography (SPECT) test and employing the technique of reinjection of the radioisotope 201Tl at rest. A study was conducted during the period of maximum stress, four hours and one hour after reinjection of 37 MBq of 201Tl. The presence and extent of reperfusion was determined. In addition, the incidence of ischaemia was correlated with four clinical parameters which might influence its occurrence: development period of the infarction (greater or less than 30 days), Q wave in the electrocardiogram, prior use of streptokinase, and angina. Twenty-seven patients exhibited partial reperfusion at rest which increased significantly in 14 of the patients after thallium reinjection. Moreover, 22 patients only exhibited reperfusion with reinjection. There was no relation between the clinical parameters evaluated and the incidence of ischaemia. In conclusion, with thallium reinjection 43% more patients can be detected with viable areas of myocardium which are not evident at rest. The clinical parameters evaluated are no help in predicting ischaemia with thallium. The routine use of reinjection is recommended to evaluate myocardial viability in patients with a history of infarction. (author). 14 refs, 2 figs

199

Significance of cardiac sympathetic nervous system abnormality for predicting origin of tachyarrhythmia in patients with a history of paroxysmal palpitation  

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Cardiac sympathetic nervous system abnormality can predict sudden cardiac death due to arrhythmia. However, it is unknown whether the sympathetic nerve abnormality is related to the origin of tachyarrhythmia. We hypothesized that such a relationship exists and tested it by uptake of iodine-123 metaiodobenzylguanidine (123I-MIBG) in 184 patients (mean±standard deviation, age: 52.7±18.8 years, 106 males) with a history of paroxysmal palpitation. Patients with organic heart disease or left ventricular dysfunction were excluded. Cardiac sympathetic nerve abnormality was assessed from the heart/mediastinum (H/M) later index and washout ratio (WR). Sustained ventricular tachycardia (VT) in 46 patients and sustained supraventricular tachycardia (SVT) in 103 patients were diagnosed by electrocardiogram (ECG) during onset of arrhythmia or by electrophysiologic tests employing programmed cardiac stimulation. The tachyarrhythmia was not proven in 35 patients (Control groups). The H/M index was significantly lower and WR significantly higher in tachyarrhythmia groups compared to controls (H/M index: 2.75±0.55 in VT group, 3.01±0.78 in SVT group vs. 3.34±0.48 in control group, p123I-MIBG scintigraphy as an important tool to discriminate the life-threatening tachyarrhythmia from benign episodes in patients with a history of palpitation. (author)

200

Oxytocin prolongs the gastric emptying time in patients with diabetes mellitus and gastroparesis, but does not affect satiety or volume intake in patients with functional dyspepsia  

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Abstract Background Oxytocin is released in response to a fatty meal. Blockage of the oxytocin receptor led to slower gastric emptying whereas stimulation resulted in less satiety in healthy volunteers. Patients with diabetes mellitus and gastroparesis lack oxytocin elevation, and dyspepsia is partly caused by reduced fundus accommodation causing early satiety and related symptoms. The aim of this study was thus to examine the effect of oxytocin on gastric emptying, satiety a...

Borg Julia; Ohlsson Bodil

2012-01-01

 
 
 
 
201

MDHAQ/RAPID3 scores: quantitative patient history data in a standardized "scientific" format for optimal assessment of patient status and quality of care in rheumatic diseases.  

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Quantitative measurement according to a laboratory test such as hemoglobin A1c or creatinine provides a "gold standard" for care of every individual with a specific diagnosis. By contrast, no single "gold standard" quantitative measure is available in rheumatic diseases. Laboratory tests are limited, and clinical decisions are based more on patient history and physical examination than laboratory tests. A quantitative patient history is provided by a self-report questionnaire as standardized, "scientific" data to compare from one visit to the next. Patient questionnaires for usual clinical care emphasize feasibility, acceptability to patients and physicians, and clinical utility, which are not considered in research questionnaires. Development of a multidimensional health assessment questionnaire (MDHAQ) over 27 years is seen as a continuous quality improvement (CQI) rather than research activity, to account for all rather than a few selected patients for a research study. Both the traditional HAQ and MDHAQ are 2-page questionnaires, easily completed by patients in 5 to 10 minutes, although scoring a HAQ disability index (HAQ-DI) requires 42 seconds, compared to 5 seconds for an MDHAQ/RAPID3. The MDHAQ includes, within 2 pages: complex activities, psychological queries, visual analog scales (VAS) as 21 numbered circles rather than 10-cm lines, a fatigue VAS, RADAI (rheumatoid arthritis disease activity index) self-report joint count, traditional "medical" review of systems and recent medical history, and demographic data, as well as a data management system that incorporates medication data and laboratory tests, reports for physicians and patients, and flow sheets to compare a current visit with a previous visit. PMID:22035430

Pincus, Theodore; Castrejón, Isabel

2011-01-01

202

Lower CSF homovanillic acid levels in depressed patients with a history of alcoholism.  

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Major depression and alcoholism are often comorbid, resulting in more impairment and more suicidal behavior compared with either diagnosis alone. This study compared clinical features and cerebrospinal fluid (CSF) monoamine metabolites in depressed subjects with and without a history of alcoholism and healthy volunteers. We hypothesized that depressed subjects with a history of alcoholism would be more aggressive, impulsive, and suicidal than depressed subjects without a history of alcoholism, and would have lower CSF monoamine metabolite levels. We compared 63 subjects with a current major depressive episode (MDE) and a history of alcoholism, 72 subjects with a current MDE but without a history of alcoholism, and 22 healthy volunteers. Participants with a history of alcoholism were in remission for at least 6 months. All subjects were free from prescribed medications known to affect brain serotonin, dopamine, or norepinephrine systems for a minimum of 14 days. Depressive symptoms, lifetime aggression, impulsivity, Axis II disorders, and suicidal behavior were assessed. CSF was sampled and homovanillic acid (HVA), 5-hydroxyindolacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) were assayed by high-performance lipid chromatography with electrochemical detection. Depressed subjects with a history of alcoholism did not differ from depressed subjects without a history of alcoholism in current severity of depressive symptoms, or in past suicidal behavior. Depressed subjects with a history of alcoholism had lower CSF HVA levels, and higher lifetime aggression and current suicide ideation scale scores and were more likely to be tobacco smokers compared with depressed subjects without a history of alcoholism. Low HVA was present after adjustment for sex, aggression and depression scores, cigarette smoking, antisocial and borderline personality disorders, psychomotor retardation, and delusions. Controls had CSF HVA levels intermediate between the two depressed groups. We found no group difference in CSF 5-HIAA and MHPG levels. In individuals with current MDE, those with a history of comorbid alcoholism had lower CSF HVA levels compared with those without a history of alcoholism. Low CSF HVA suggests that impaired dopaminergic activity is associated with a history of alcoholism in persons with current MDE. PMID:12825091

Sher, Leo; Oquendo, Maria A; Li, Shuhua; Huang, Yung-yu; Grunebaum, Michael F; Burke, Ainsley K; Malone, Kevin M; Mann, J John

2003-09-01

203

Risk of significant cytopenias after treatment with tocilizumab in systemic juvenile arthritis patients with a history of macrophage activation syndrome  

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Full Text Available Abstract Tocilizumab (TCZ is the first FDA- approved treatment for systemic juvenile idiopathic arthritis (sJIA. We report 3 cases of cytopenias in children with sJIA treated with TCZ. Two of the children who developed significant cytopenias shortly after initiation of TCZ had a history of macrophage activation syndrome. We raise the possibility that patients with a tendency towards MAS have an increased risk of developing cytopenias when treated with tocilizumab.

Kessler Elizabeth A

2012-08-01

204

Risk of significant cytopenias after treatment with tocilizumab in systemic juvenile arthritis patients with a history of macrophage activation syndrome  

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Abstract Tocilizumab (TCZ) is the first FDA- approved treatment for systemic juvenile idiopathic arthritis (sJIA). We report 3 cases of cytopenias in children with sJIA treated with TCZ. Two of the children who developed significant cytopenias shortly after initiation of TCZ had a history of macrophage activation syndrome. We raise the possibility that patients with a tendency towards MAS have an increased risk of developing cytopenias when treated with tocilizumab.

Kessler Elizabeth A; Vora Sheetal S; Verbsky James W

2012-01-01

205

Tocilizumab-induced neutropenia in rheumatoid arthritis patients with previous history of neutropenia: case series and review of literature.  

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One of the adverse events of tocilizumab (TCZ) is a transient, dose-dependent neutropenia. The recommendations of the Summary of Product Characteristics state that this neutropenia should be managed according to the absolute neutrophil count (ANC). However, the approach to a patient who had a history of neutropenia induced by previous DMARDs and developed TCZ-induced neutropenia remains unclear. We would like to report a series of four patients with rheumatoid arthritis who developed Grade 2 neutropenia (ANC 1-1.5 × 10(9)/L) following intravenous TCZ treatment at a dose of 8 mg/kg. All of them had a previous history of neutropenia (Grade 2 or Grade 3) due to Etanercept (three patients) and Sulfasalazine (one patient). Therefore, we decided to decrease the TCZ dosage by 10-20 % approximately. Reducing of the dosage did not have any influence on the efficacy of TCZ, and all of our patients remained in clinical remission. The mechanisms underlying neutropenia induced by Tocilizumab, Etanercept and Sulfasalazine are also discussed in this article. PMID:25403696

Shovman, O; Shoenfeld, Y; Langevitz, P

2014-11-18

206

A case-control study on the relationship between salt intake and salty taste and risk of gastric cancer  

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AIM: To investigate the relationship between salt intake and salty taste and risk of gastric cancer. METHODS: A 1:2 matched hospital based case-control study including 300 patients with gastric cancer and 600 cancer-free subjects as controls. Subjects were interviewed with a structured questionnaire containing 80 items, which elicited information on dietary, lifestyle habits, smoking and drinking histories. Subjects were tested for salt taste sensitivity threshold (STST) using concentrated sa...

Wan-Guang Yang; Chuan-Bo Chen; Zhi-Xin Wang; Yu-Pei Liu; Xiao-Yuan Wen; Shan-Feng Zhang; Tong-Wen Sun

2011-01-01

207

Uterine adenosarcoma in a patient with history of breast cancer and long-term tamoxifen consumption.  

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Adenosarcoma is a rare tumour which usually originates from endometrium. This paper presents a 69-year-old woman with adenosarcoma of uterus and a history of breast cancer and 10 years tamoxifen therapy. PMID:23087268

Akhavan, Ali; Akhavan Tafti, Mahmood; Aghili, Farhad; Navabii, Hossein

2012-01-01

208

[Salt intake in children].  

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Very early in life, sodium intake correlates with blood pressure level. This warrants limiting the consumption of sodium by children. However, evidence regarding exact sodium requirements in that age range is lacking. This article focuses on the desirable sodium intake according to age as suggested by various groups of experts, on the levels of sodium intake recorded in consumption surveys, and on the public health strategies implemented to reduce salt consumption in the pediatric population. Practical recommendations are given by the Committee on nutrition of the French Society of Pediatrics in order to limit salt intake in children. PMID:24686038

Girardet, J-P; Rieu, D; Bocquet, A; Bresson, J-L; Briend, A; Chouraqui, J-P; Darmaun, D; Dupont, C; Frelut, M-L; Hankard, R; Goulet, O; Simeoni, U; Turck, D; Vidailhet, M

2014-05-01

209

Hemophilia in the newborn without family history: Pattern of clinical presentation of three patients  

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Full Text Available Introduction. Hemophilia is the most frequently diagnosed inborn clotting factor deficiency in the newborn. In about half of the cases diagnosis is made during neonatal period. However, due to different clinical presentation comparing to older children, hemophilia in the newborn could be misdiagnosed, especially in the setting of negative family history. Case report. Clinical features of three newborns with negative family history for hemophilia are described. All three newborns were the first born children with uneventful perinatal history, and they were referred for investigation of convulsions, soft tissue tumorous mass and sepsis, respectively. Prompt diagnosis of underlying bleeding disorder and adequate substitution therapy lead to the good outcome in all three boys. Conclusion. Symptoms and signs of hemophilia in the newborn could be at time misleading and contribute to delayed treatment. High index of suspicion on inherited bleeding disorder is warranted in every neonate with intracranial bleeding.

Kuzmanovi? Miloš

2010-01-01

210

Meningococcal meningitis with meningococcemia: A rare sporadic case in an elderly patient with no history of contact.  

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An 89 year-old Japanese woman with no history of contact with infected patients developed meningococcal meningitis with meningococcemia. Invasive meningococcal disease is relatively rare in Japan compared to other countries. The annual incidence has been a total of 10-20 cases per year for more than two decades, representing approximately 1% of the number in the United States and United Kingdom. The most prevalent serotypes in Japan are serotypes B and Y. This patient's strain was serotype Y. The meningococcal vaccine has not yet been approved for use in Japan. The only possible transmission route for this patient was a visit by her grandchild a few days prior to the onset of symptoms. Due to its low incidence, clinicians do not have sufficient experience to manage this potentially fatal illness. This case serves as an important reminder to always consider a complete differential diagnosis for invasive meningococcal disease. PMID:25420647

Gomi, Harumi; Unuma, Nahoko; Nakao, Koichi; Morisawa, Yuji

2014-11-25

211

Dietary intakes, resting metabolic rates, and body composition in benign and malignant gastrointestinal disease.  

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Dietary protein and energy intakes were assessed in 42 patients with cancer and 24 with benign conditions of the gastrointestinal tract. The relations of dietary intake to body composition was examined. Resulting metabolic rate was measured in 51 patients. No significant differences in dietary intake or metabolic rate were found between patients with cancer and those with benign disease. There were significant positive correlations between protein and energy intakes and the ratio of total bod...

Burke, M.; Bryson, E. I.; Kark, A. E.

1980-01-01

212

Quality of life, dietary intake and nutritional status assessment in hospital admitted cancer patients / Calidad de vida, ingesta dietética y valoración del estado nutricional en pacientes ingresados con cáncer  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Objetivos: Los objetivos de este estudio fueron valorar la calidad de vida (QoL), el estado nutricional y la ingesta dietética cuantitativa realizada en pacientes oncológicos no terminales ingresados que recibieron alimentación oral. Así mismo evaluar qué tipo de relación existe entre la calidad de [...] vida, y el estado nutricional y la ingesta actual. Ámbito: Servicio de Oncología Médica y Radioterapia del Hospital Clínic de Barcelona. Sujetos: Cincuenta pacientes ingresados en el Servicio. Intervenciones: Se realizó un seguimiento de la ingesta dietética durante 3 días hábiles mediante observación directa, así como una valoración de los parámetros antropométricos y bioquímicos, un registro de datos relativos a la sintomatología, y una valoración de la calidad de vida mediante el cuestionario EORTC QLQ-C30. Resultados: Nuestros datos muestran que un 32.6% de los pacientes no alcanzaron 25 kcal/kg/día, y un 23.3% no llegaron a cubrir 1 g proteína/kg/día. Respecto a la QoL, la puntuación media para el estado de salud global y la QoL global para todos los pacientes fue 46.2. Comparado con la población general, hubo déficits importantes entre los pacientes oncológicos respecto a la funcionalidad física, de rol y social. Las diferencias más pronunciadas en la escala de síntomas fueron para la fatiga y en los ítems simples, para la pérdida de apetito y el estreñimiento. La baja ingesta de proteínas se asoció con una percepción disminuida en la función física (p=0.01), la fatiga estuvo cerca de la significación estadística (p=0.058). No se encontraron diferencias significativas respecto a la ingesta calórica y la QoL. Conclusión: Un porcentaje significativo de pacientes que recibieron alimentación oral exclusiva no cubrieron una cantidad aceptable mínima de sus requerimientos energético-proteicos. Nuestros resultados apuntan que ingestas dietéticas escasas pueden afectar la QoL por sí mismas. Abstract in english Objectives: The objectives of this study were to assess the quality of life (QoL), nutritional status, and quantitative food intakes of non-terminal admitted cancer patients receiving oral feeding. As well as to evaluate what kind of relation exists between the quality of life, and the nutritional s [...] tatus and current intake Scope: Medical Oncology and Radiotherapy Service ward at the Hospital Clínic de Barcelona. Subjects: Fifty admitted patients in the Service ward. Interventions: There was a follow-up of the dietary intake during 3 working days through direct observation, as well as an assessment of anthropometrical and biochemical parameters, a record of symptomatology related data, and a QoL assessment through the EORTC QLQC30 questionnaire. Results: Our data show that 32.6% of the patients did not reach 25 kcal/kg/day, and 23.3% did not even fulfill 1g protein/kg/day. Concerning QoL, mean score for global health status and overall QoL for all patients was 46.2. Compared to the general population, there were important deficits among cancer patients regarding physical, role and social functioning. The most pronounced differences in the symptom scales were for fatigue, and in single items for appetite loss and constipation. A low protein intake was associated to a poorer perception on physical functioning (p=0.01), and fatigue was close to significance (p=0.058). No significant differences were found regarding caloric intake and QoL. Conclusions: A significant percentage of patients who received exclusive oral feeding did not cover a minimum acceptable quantity of their protein-energy requirements. Our results point-out that poor food intakes can affect QoL by themselves.

J., Trabal; P., Leyes; M.ª T., Forga; S., Hervás.

2006-08-01

213

Predictive Value of Having Positive Family History of Cardiovascular Disorders, Diabetes Mellitus, Dyslipidemia, and Hypertension in Non-Alcoholic Fatty Liver Disease Patients  

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Full Text Available In the present study, we examined the relationship between family history of cardiovascular diseases (CVD, dyslipidemia, hypertension, and diabetes with laboratorial abnormalities and syndromes in Iranian patients with non-alcoholic fatty liver disease (NAFLD. A total of 332 NAFLD patients from our outpatient clinic were consecutively entered into analysis. Exclusion criteria were having diabetes mellitus and fasting blood glucose over 126, active hepatitis B virus infection, having HCV positive serology, and to be under corticosteroid therapy. Family history of CVD, diabetes, dyslipidemia, and hypertension were taken from patients and related to the study variables. Family history of cardiovascular diseases (CVD was associated with low HDL levels (P=0.05. Patients with positive family history of diabetes mellitus were significantly more likely to have AST/ALT levels proportion of higher than one (P=0.044. Family history of dyslipidemia was a predictor for hypertriglyceridemia (P=0.02, higher prothrombin time levels (P=0.013, lower albumin (P=0.024 and T4 (P=0.043 levels. Family history of hypertension was associated with dysglycemia/diabetes (P=0.038, high ALT (P=0.008, and low TIBC (P=0.007 and albumin levels (P=0.001. Family history for CVD, diabetes, dyslipidemia, and hypertension were of clinical importance in the Iranian patients with NAFLD. We therefore recommend that physicians should precisely get family history of main disorders in all NAFLD patients; and to pay more attention to those having the mentioned family histories. Further studies with larger patient population and prospective approach are needed for confirming our findings.

Hossein Khedmat

2013-05-01

214

Chromosome aberrations and transforming genes in leukemic and non-leukemic patients with a history of atomic bomb exposure  

International Nuclear Information System (INIS)

To investigate leukemogenesis in atomic bomb (A-bomb) survivors, chromosome aberrations in bone marrow cells, and T- and B-lymphocytes from 135 healthy persons who had been exposed within 1,000 m of the hypocenter of the Hiroshima A-bomb were sequentially examined. Leukemic marrow cells from 468 patients with acute or chronic type of leukemias, including 25 acute leukemias exposed to 1 rad or more of radiation were also studied cytogenetically. Analysis of breakpoints observed in T-lymphocytes with stable types of abnormalities revealed a nonrandom distribution, and clustering in specific regions of chromosomes such as 22q1, 14q3, and 5q3. Statistical analysis revealed a higher incidence of translocations in 50 bands, including those containing cellular oncogenes such as 8q22, 8q24, and 9q34. Of these 50 bands, 20 were matched with bands specific for leukemia and cancer and 14 with constitutive fragile sites. In leukemic marrow, all 10 patients who had been exposed to radiation of more than 200 rad and then developed acute non-lymphocytic leukemia had chromosome aberrations. Their aberrations were more complex than those in patients exposed to less than 200 rad (33 patients) and in the non-exposed patients (134 patients). DNA samples extracted from bone marrow cells of 13 survivors, including 4 healthy survivors with more than 30% chromosome abnormalities in the bone marrow and 9 leukemia patients were used for in vivo selection assay of transforming genes. Tumor formon assay of transforming genes. Tumor formation in nude mice was observed in 3 of the 4 healthy survivors and 9 leukemia patients. All of the transfectants were shown to contain Alu sequences. The transforming N-ras gene was detected for the first time in the bone marrow cells from 3 heavily exposed survivors and from 7 leukemia patients with a history of radiation exposure

215

Usual Intake of Poultry  

Science.gov (United States)

Usual Intake of Poultry Table A26. Poultry: Means, percentiles and standard errors of usual intake, 2007-2010 Age (Years) N1 oz equivalents3 Mean (SE)2 5% (SE) 10% (SE) 25% (SE) 50% (SE) 75% (SE) 90% (SE) 95% (SE) Males 1-3 774 0.9 (0.03) 0.3 (0.05) 0.4

216

Usual Intake of Tomatoes  

Science.gov (United States)

Usual Intake of Tomatoes Table A10. Tomatoes: Means, percentiles and standard errors of usual intake, 2007-2010 Age (Years) N1 cup equivalents3 Mean (SE)2 5% (SE) 10% (SE) 25% (SE) 50% (SE) 75% (SE) 90% (SE) 95% (SE) Males 1-3 774 0.2 (0.01) 0.1 (0.01) 0.1

217

Usual Intake of Energy  

Science.gov (United States)

Usual Intake of Energy Table A44. Energy: Means, percentiles and standard errors of usual intake, 2007-2010 Age (Years) N1 kilocalories Mean (SE)2 5% (SE) 10% (SE) 25% (SE) 50% (SE) 75% (SE) 90% (SE) 95% (SE) Males 1-3 774 1426.1 (17.93) 963.7 (18.47) 1052.5

218

Usual Intake of Cheese  

Science.gov (United States)

Usual Intake of Cheese Table A36. Cheese: Means, percentiles and standard errors of usual intake, 2007-2010 Age (Years) N1 cup equivalents3 Mean (SE)2 5% (SE) 10% (SE) 25% (SE) 50% (SE) 75% (SE) 90% (SE) 95% (SE) Males 1-3 774 0.4 (0.03) 0.1 (0.02) 0.1

219

Intake of Dairy Products in Relation to Periodontitis in Older Danish Adults  

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This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment lo...

Heitmann, Berit L.; Boucher, Barbara J.; Kirsten Avlund; Poul Holm-Pedersen; Christensen, Lisa B.; Adegboye, Amanda R. A.

2012-01-01

220

Incidence, Natural History, and Patterns of Locoregional Recurrence in Gastric Cancer Patients Treated With Preoperative Chemoradiotherapy  

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Purpose: To retrospectively determine the incidence and patterns (in-field, marginal, or out-of-field) of locoregional gastric cancer recurrence in patients who received preoperative chemoradiotherapy and to determine the outcome in these patients. Methods and Materials: Between 1994 and 2004, 149 patients with gastric carcinoma were treated according to institutional protocols with preoperative chemoradiotherapy. Ultimately, 105 patients had an R0 resection. Of these 105 patients, 65 received preoperative chemotherapy followed by chemoradiotherapy and 40 received preoperative chemoradiotherapy. Most (96%) of these patients received 5-fluorouracil-based chemotherapy during radiotherapy, and the median radiation dose was 45 Gy. We retrospectively identified and classified the patterns of locoregional recurrence. Results: The 3-year actuarial incidence of locoregional recurrence was 13%, with locoregional disease recurring as any part of the failure pattern in 14 patients. Most (64%) of the evaluable locoregional recurrences were in-field. Of the 4 patients with a marginal recurrence, 2 had had inadequate coverage of the regional nodal volumes on their oblique fields. The pathologic complete response rate was 23%. A pathologic complete response was the only statistically significant predictor of locoregional control. Conclusion: Patients with gastric cancer who received preoperative chemoradiotherapy had low rates of locoregional recurrence. This strategy merits prospecl recurrence. This strategy merits prospective multi-institutional and randomized evaluation

 
 
 
 
221

First episode of psychosis in a middle-aged patient with a 14-year history of conversion disorder.  

Science.gov (United States)

We present a case of a middle-aged male patient with a long history of conversion disorder and histrionic personality, who presented with newly onset psychotic symptoms while being engaged to treatment with a community mental health team in a primary care setting. The symptoms could not be attributed to an organic cause. After a short course of olanzapine treatment which caused adverse effects, the symptomatology responded well to low dose amisulpride. Conversion symptoms were stable throughout the psychotic episode. This case illustrates the complex interplay between disorders classified in different categories (somatoform versus psychotic disorders). PMID:25580341

Peritogiannis, Vaios; Manthopoulou, Thiresia; Mavreas, Venetsanos

2014-01-01

222

Age at onset versus family history and clinical outcomes in 1,665 international bipolar-I disorder patients  

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Early onset in bipolar disorder (BPD) has been associated with greater familial risk and unfavorable clinical outcomes. We pooled data from seven international centers to analyze the relationships of family history and symptomatic as well as functional measures of adult morbidity to onset age, or onset in childhood (age <12), adolescence (12-18), or adulthood (19-55 years). In 1,665 adult, DSM-IV BPD-I patients, onset was 5% in childhood, 28% in adolescence, and 53% at peak ...

Baldessarini, Ross J.; Tondo, Leonardo; Vazquez, Gustavo H.; Undurraga, Juan; Bolzani, Lorenza; Yildiz, Aysegul; Khalsa, Hari-mandir K.; Lai, Massimo; Lepri, Beatrice; Lolich, Maria; Maffei, Pier Mario; Salvatore, Paola; Faedda, Gianni L.; Vieta, Eduard; Mauricio, Tohen

2012-01-01

223

Gene expression changes in mononuclear cells in patients with metabolic syndrome after acute intake of phenol-rich virgin olive oil  

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Abstract Background Previous studies have shown that acute intake of high-phenol virgin olive oil reduces pro-inflammatory, pro-oxidant and pro-thrombotic markers compared with low phenols virgin olive oil, but it still remains unclear whether effects attributed to its phenolic fraction are exerted at transcriptional level in vivo. To achieve this goal, we aimed at identifying expression changes in genes which could be mediated by virgin olive oil phenol compounds in...

Lopez-Miranda Jose; Uceda Marino; Perez-Martinez Pablo; Marin Carmen; Santos-Gonzalez Monica; Jimenez Anabel; Parnell Laurence D; Fernandez Juan M; Ruano Juan; Camargo Antonio; Perez-Jimenez Francisco

2010-01-01

224

Family history of the cancer on the survival of the patients with gastrointestinal cancer in northern Iran, using frailty models  

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Full Text Available Abstract Background Gastrointestinal (GI tract cancer is one of the common causes of the mortality due to cancer in most developing countries such as Iran. The digestive tract is the major organ involved in the cancer. The northern part of the country, surrounded the Caspian Sea coast, is well known and the region with highest regional incidence of the GI tract cancer. In this paper our aim is to study the most common risk factors affecting the survival of the patients suffering from GI tract cancer using parametric models with frailty. Methods This research was a prospective study. Information of 484 cases with GI cancer was collected from Babol Cancer Registration Center during 1990-1991. The risk factors we studied are age, sex, family history of cancer, marital status, smoking status, occupation, race, medication status, education, residence (urban, rural, type of cancer, migration status (indigenous, non-native. The studied cases were followed up until 2006 for 15 years. Hazard ratio was used to interpret the death risk. The effect of the factors in the study on the patients survival are studied under a family of parametric models including Weibull, Exponential, Log-normal, and the Log-logistic model. The models are fitted using with and without frailty. The Akaike information criterion (AIC was considered to compare between competing models. Results Out of 484 patients in the study, 321 (66.3% were males and 163 (33.7% were females. The average age of the patient at the time of the diagnosis was 59 yr and 55 yr for the males and females respectively. Furthermore, 359 (74.2% patients suffered from esophageal, 110 (22.7% patients recognized with gastric, and 15 (3.1% patients with colon cancer. Survival rates after 1, 3, and 5 years of the diagnosis were 24%, 16%, and 15%, respectively. We found that the family history of the cancer is a significant factor on the death risk under all statistical models in the study. The comparison of AIC using the Cox and parametric models showed that the overall fitting was improved under parametric models (with and without frailty. Among parametric models, we found better performance for the log-logistic model with gamma frailty than the others. Using this model, gender and the family history of the cancer were found as significant predictors. Conclusions Results suggested that the early preventative care for patients with family history of the cancer may decrease the risk of the death in the patients with GI cancer. The gender appeared to be an important factor as well so that men experiencing lower risk of death than the women in the study. Since the proportionality assumption of the Cox model was not held (p = 0.0014, the Cox regression model was not an appropriate choice for analysing our data.

Rasouli Mahboobeh

2011-10-01

225

Unilateral Twin Ectopic Pregnancy in a Patient With a History of Multiple Sexually Transmitted Infections  

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Background. The incidence of unilateral twin ectopic pregnancy is a rare condition. Several factors increase the risk of ectopic pregnancy, the most important of which is pelvic inflammatory disease, followed by operative trauma, congenital anomalies, tumors, and adhesions resulting in anatomically distorted fallopian tubes. We present a case of a woman with a history of four confirmed sexually transmitted infections (STIs) including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simple...

Barbara Hoffman; Rigoberto Santos-Ramos; Roger Bawdon; Wai, Clifford Y.; Rolle, Charles J.

2006-01-01

226

Natural history of cervical epithelial abnormalities in patients with vulval warts. A colposcopic study.  

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The natural history of intraepithelial abnormalities of the cervix associated with human papillomavirus infection was investigated in a prospective study of 50 women with vulval warts, of whom 28 had colposcopic evidence of a cervical epithelial abnormality and 22 a normal cervix. Of the 28 with a cervical abnormality, 26 were re-examined by colposcopy after three months; the epithelial abnormality had persisted in 23 women. Nineteen women who had initially shown abnormality by colposcopy wer...

Walker, P. G.; Singer, A.; Dyson, J. L.; Oriel, J. D.

1983-01-01

227

A cough conundrum in a patient with a previous history of BCG immunotherapy for bladder cancer.  

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We describe a non-smoker who presented with a persistent cough, weight loss and general malaise, and had a medical history of bladder carcinoma that had been successfully treated with intravesical BCG immunotherapy. Radiology revealed hilar lymphadenopathy, a predominantly mid-zone and lower-zone lung parenchymal nodular pattern with a perilymphatic distribution, a few thickened interlobular septae, and small pleural effusions bilaterally. The T-SPOT.TB blood test was negative. Video-assisted...

Mehta, Ar; Mehta, Pr; Mehta, Rl

2012-01-01

228

[School and occupational history of 30 patients with Klinefelter's syndrome. Significance of early diagnosis].  

Science.gov (United States)

Thirty men aged 17-48 years with pure 47,XXY Klinefelter syndrome have been studied. The group was a positive selection diagnosed not on account of behavior problems but infertility or hypogonadism. Interviews and additional information revealed, almost without exception, the characteristic personality traits of XXY patients. At school, problems arose early, particularly in relation to language. Routine administrative acts such as 15 class repetitions had predominantly negative effects, thus increasing the patients' tendency towards social isolation. In manually oriented professions the patients were quite successful, but in apprenticeship several had to drop out due to problems in theoretical courses, especially foreign languages and mathematics. The diagnosis could nearly always have been suspected by pediatricians, school doctors or school psychologists when the patients were aged 4-8. Early diagnosis is crucial for counselling of parents and teachers, for vocational guidance and for timely testosterone replacement therapy. Patients, and their parents, could thus be spared much unnecessary suffering. PMID:6658427

Schmid, W; Widmer, O

1983-12-01

229

How patients built up the practice of the lay homeopath Clemens von Bönninghausen: Quantitative and qualitative aspects of patient history  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in english Statistics seem to give little information about individuals' fates. With the help of patient journals, the interwoven connections between quantitative and qualitative aspects of historical research work can be shown. This example focuses on the patients who, between 1829 and 1864, built up the prac [...] tice of the lay homeopath Clemens Maria Franz von Bönninghausen in Münster, Westphalia. Questions of practice, the social structure of the clientele, and the diseases Bönninghausen treated are also considered.

Marion, Baschin.

230

Effects of salt supplementation on the albuminuric response to telmisartan with or without hydrochlorothiazide therapy in hypertensive patients with type 2 diabetes are modulated by habitual dietary salt intake.  

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OBJECTIVE This prospective randomized double-blind placebo-controlled crossover study examined the effects of sodium chloride (NaCl) supplementation on the antialbuminuric action of telmisartan with or without hydrochlorothiazide (HCT) in hypertensive patients with type 2 diabetes, increased albumin excretion rate (AER), and habitual low dietary salt intake (LDS; 200 mmol sodium/24 h on two of three consecutive occasions). RESEARCH DESIGN AND METHODS Following a washout period, subjects (n = 32) received 40 mg/day telmisartan for 4 weeks followed by 40 mg telmisartan plus 12.5 mg/day HCT for 4 weeks. For the last 2 weeks of each treatment period, patients received either 100 mmol/day NaCl or placebo capsules. After a second washout, the regimen was repeated with supplements in reverse order. AER and ambulatory blood pressure were measured at weeks 0, 4, 8, 14, 18, and 22. RESULTS In LDS, NaCl supplementation reduced the anti-albuminuric effect of telmisartan with or without HCT from 42.3% (placebo) to 9.5% (P = 0.004). By contrast, in HDS, NaCl supplementation did not reduce the AER response to telmisartan with or without HCT (placebo 30.9%, NaCl 28.1%, P = 0.7). Changes in AER were independent of changes in blood pressure. CONCLUSIONS The AER response to telmisartan with or without HCT under habitual low salt intake can be blunted by NaCl supplementation. By contrast, when there is already a suppressed renin angiotensin aldosterone system under habitual high dietary salt intake, the additional NaCl does not alter the AER response. PMID:19549737

Ekinci, Elif I; Thomas, Georgina; Thomas, David; Johnson, Cameron; Macisaac, Richard J; Houlihan, Christine A; Finch, Sue; Panagiotopoulos, Sianna; O'Callaghan, Chris; Jerums, George

2009-08-01

231

Allergic contact dermatitis associated with the use of facemask on a patient with a history of atopy.  

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Allergic contact dermatitis (ACD) is a skin inflammation caused by an allergic reaction after contact with small external substances capable of being absorbed by the skin. There are several studies describing allergic reactions to intraoral orthodontic appliances, especially those containing nickel. Allergic reactions due to extraoral appliances are not as frequent, and there are relatively few studies about them. Extraoral eactions are attributed to metallic, elastic, or textile parts of the extraoral appliances. This article's purpose was to report the appearance of an allergic contact dermatitis reaction in a 9-year, 2-month-old female patient, with a history of atopic dermatitis, after an orthodontic facemask was fitted. Rapid maxillary expansion was also performed with a Hyrax appliance while a facemask was used. Early diagnosis of this pathology is essential in order to achieve a total regression of the reaction. Orthodontists should be aware that ACD can be caused by facemasks in predisposed patients. PMID:22044472

Paredes, Vanessa; Paredes, Carlos

2010-01-01

232

Ruptured Heterotopic Tubal Pregnancy for a Patient with a History of Segmental Salpingectomy from Ectopic Pregnancy: A Case Report  

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Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.

Nam, Kyung Bum; Namkung, Sook; Hong, Myung Sun; Kim, Heung Cheol; Cho, Young; Choi, Young Hee [Chuncheon Sacred Heart Hospital, Chyncheon (Korea, Republic of)

2012-06-15

233

Mortality in cancer patients with a history of cutaneous squamous cell carcinoma - a nationwide population-based cohort study  

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Full Text Available Abstract Background Cutaneous squamous cell carcinoma (SCC is associated with underlying immunosuppression, so it may be a prognostic marker in patients with subsequent cancer. We therefore conducted a nationwide population-based Danish cohort study to evaluate whether a history of cutaneuos SCC has prognostic impact in patients with one of the following index cancers: non-Hodgkin's lymphoma (NHL, or cancer of the lung, colon, rectum, breast, or prostate. Methods We used Danish medical databases, which cover the entire Danish population of 5.6 million inhabitants and linked them using the unique personal identification number assigned to all Danish residents. From 1982 through 2003, we identified 745 index cancer patients with and 79,143 without previous cutaneous SCC. Using Cox proportional hazards regression, we calculated adjusted mortality rate ratios (MRRs with 95% confidence intervals (CIs. Results Overall, previous SCC was associated with an increased mortality of cancer (MRR 1.13, 95% CI: 1.04-1.23. When examining index cancers separately, increased MRRs were found for cancer of the lung (MRR 1.23, 95% CI: 1.05-1.43, colon (MRR 1.13, 95% CI: 0.92-1.40, rectum (MRR 1.29, 95% CI: 1.00-1.67, breast (MRR 1.09, 95% CI: 0.82-1.43, and NHL (MRR 1.09, 95% CI: 0.81-1.47, but not for prostate cancer (MRR 0.99, 95% CI: 0.83-1.18. Conclusions Our results suggest that previous cutaneous SCC is associated with poor prognosis of some cancers. This finding stresses the importance of adherence to the existing recommendations of screening, diagnosis, and treatment of cancer in patients with a history of SCC.

Johannesdottir Sigrun

2012-03-01

234

Impact of liver transplantation on the natural history of oculopathy in Portuguese patients with transthyretin (V30M) amyloidosis.  

Science.gov (United States)

Abstract Purpose: Evaluation of the impact of liver transplantation in the natural history of ocular disorders in familial amyloidotic polyneuropathy (FAP) amyloidosis TTR V30M related (ATTR V30M) patients. Design: A clinical, retrospective and cross-sectional study of 64 Portuguese FAP ATTR V30M patients was carried out between January 2005 and December 2011. Methods: Thirty-two liver transplanted patients (both eyes) aged 39.6-53.8 years old, 32/32 male/female, were paired with an equal number of non-transplanted patients, matching for age, gender, age at onset, disease duration and gender of transmitting parent. Intervention or observation procedure: Routine ophthalmological observation. Main outcome measures: Slit-lamp observation for abnormal conjunctival vessels (ACV), tears break-up time, iris, lens; fundus observation for vitreous, retina and optic disc; Schirmer test. Results: Liver transplantation had no influence on tears break-up time, deposition of amyloid on the iris and retinal amyloid angiopathy. Slight, non-statistically significant protective effects of liver transplantation were noted in the first years for some ocular manifestations (ACV and scalloped iris), except for the abnormal Schirmer test, which was significantly more prevalent in non-transplanted patients' eyes (81% versus 56%, p?=?0.002). On the other hand, deposition of amyloid on the lens, vitreous amyloidosis and glaucoma were apparently more common in transplanted patients. Those differences tended to disappear with time. Conclusions: Ocular manifestations of FAP were not influenced by liver transplantation in a meaningful way. Both transplanted and non-transplanted FAP patients need similar regular follow-up due to long-term risk of serious ocular disease. PMID:25475560

Beirão, João Melo; Malheiro, Jorge; Lemos, Carolina; Matos, Eduarda; Beirão, Idalina; Pinho-Costa, Paulo; Torres, Paulo

2014-12-01

235

Indicadores antropométricos e de ingestão alimentar como preditores da função pulmonar em pacientes com fibrose cística / Anthropometric and dietary intake indicators as predictors of pulmonary function in cystic fibrosis patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar se indicadores antropométricos e de ingestão alimentar são preditores da função pulmonar em pacientes com fibrose cística (FC). MÉTODOS: Estudo transversal com 69 pacientes (variação, 5,4-16,5 anos de idade) diagnosticados com FC e em acompanhamento no Hospital de Clínicas de Porto [...] Alegre, em Porto Alegre (RS). A avaliação antropométrica consistiu nas medidas do índice de massa corpórea (IMC), da circunferência muscular do braço (CMB) e da dobra cutânea tricipital (DCT). A ingestão alimentar foi avaliada pelo recordatório de ingestão habitual e comparada com recommended dietary allowances. A avaliação da função pulmonar foi realizada através da capacidade ventilatória, representada pelo VEF1. Razões de prevalência foram calculadas entre os preditores e o desfecho estudado (VEF1 Abstract in english OBJECTIVE: To evaluate whether anthropometric and dietary intake indicators are predictors of pulmonary function in cystic fibrosis (CF) patients. METHODS: This was a cross-sectional study involving 69 patients (age range, 5.4-16.5 years) diagnosed with CF under follow-up at the Hospital de Clínicas [...] de Porto Alegre, located in the city of Porto Alegre, Brazil. Anthropometric assessment was based on body mass index (BMI), mid-arm muscle circumference (MAMC), and triceps skinfold thickness (TST). Dietary intake was assessed by using recall data, which were compared with the recommended dietary allowances. Pulmonary function was assessed by ventilatory capacity, expressed as FEV1. Prevalence ratios for the outcome studied (FEV1

Gabriele Carra, Forte; Juliane Silva, Pereira; Michele, Drehmer; Miriam Isabel Souza dos Santos, Simon.

2012-08-01

236

PATIENTS WITH END STAGE CANCER: LIFE HISTORY, PSYCHO-EMOTIONAL ASPECTS, RELATIONSHIP WITH THE NURSING STAFF.  

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Full Text Available Breast cancer is one of the cancers most feared by women for its high incidence and its psychological effects that affect the perception of sexuality and self-image. Objective: To identify the difficulties of nursing professionals in the treatment of patients with cancer, from the standpoint of a terminally ill patient of breast cancer. Methodology: This is a case study of a patient who is in the terminal stages of breast cancer. We carried out the survey of literature in journals indexed the databases LILACS and SciELO Open Access and English, on terminally ill cancer. Results: Feelings of loneliness and sadness were softened and smoothed by the attitude and disposition of nursing professionals. In moments of intervention needs of physical care, nursing care was provided. Conclusion: The nursing staff has always demonstrated skills in treating patients with cancer, providing quality care, humane and comprehensive, meeting all your needs biopsicoespiritual.

Ivanete Ribeiro do Nascimento

2013-12-01

237

The Natural History of the Non-Nephrotic Membranous Nephropathy Patient  

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Background and objectives: Although early studies suggest that patients with idiopathic membranous nephropathy (MGN) and subnephrotic range proteinuria overall do well, these studies were small and follow-up was short or difficult to discern.

Hladunewich, Michelle A.; Troyanov, Stephan; Calafati, Jennifer; Cattran, Daniel C.

2009-01-01

238

Impacto da adequação da oferta energética sobre a mortalidade em pacientes de UTI recebendo nutrição enteral Impact of the adequacy of energy intake on intensive care unit mortality in patients receiving enteral nutrition  

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Full Text Available OBJETIVO: Investigar a relação entre adequação da oferta energética e mortalidade na unidade de terapia intensiva em pacientes sob terapia nutricional enteral exclusiva. MÉTODOS: Estudo observacional prospectivo conduzido em uma unidade de terapia intensiva em 2008 e 2009. Foram incluídos pacientes >18 anos que receberam terapia nutricional enteral por >72h. A adequação da oferta de energia foi estimada pela razão administrado/prescrito. Para a investigação da relação entre variáveis preditoras (adequação da oferta energética, escore APACHE II, sexo, idade e tempo de permanência na unidade de terapia intensiva e o desfecho mortalidade na unidade de terapia intensiva, utilizou-se o modelo de regressão logística não condicional. RESULTADOS: Foram incluídos 63 pacientes (média 58 anos, mortalidade 27%, 47,6% dos quais receberam mais de 90% da energia prescrita (adequação média 88,2%. O balanço energético médio foi de -190 kcal/dia. Observou-se associação significativa entre ocorrência de óbito e as variáveis idade e tempo de permanência na unidade de terapia intensiva, após a retirada das variáveis adequação da oferta energética, APACHE II e sexo durante o processo de modelagem. CONCLUSÃO: A adequação da oferta energética não influenciou a taxa de mortalidade na unidade de terapia intensiva. Protocolos de infusão de nutrição enteral seguidos criteriosamente, com adequação administrado/prescrito acima de 70%, parecem ser suficientes para não interferirem na mortalidade. Dessa forma, pode-se questionar a obrigatoriedade de atingir índices próximos a 100%, considerando a elevada frequência com que ocorrem interrupções no fornecimento de dieta enteral devido a intolerância gastrointestinal e jejuns para exames e procedimentos. Pesquisas futuras poderão identificar a meta ideal de adequação da oferta energética que resulte em redução significativa de complicações, mortalidade e custos.OBJECTIVE: To investigate the relationship between adequacy of energy intake and intensive care unit mortality in patients receiving exclusive enteral nutrition therapy. METHODS: Observational and prospective study conducted during 2008 and 2009. Patients above 18 years with exclusive enteral nutrition therapy for at least 72 hours were included. The adequacy of energy intake was estimated by the administered/prescribed ratio. Non-conditional logistic regression was used to assess the relationship between predictive variables (adequacy of energy intake, APACHE II, gender, age, and intensive care unit length of stay and intensive care unit mortality. RESULTS: Sixty-three patients (mean 58 years, 27% mortality were included, 47.6% of whom received more than 90% of the energy prescribed (mean adequacy 88.2%. Mean energy balance was -190 kcal/day. Significant associations between death in the intensive care unit and the variables age and intensive care unit length of stay were observed, after removing the variables adequacy of energy intake, APACHE II, gender and age during the modeling process. CONCLUSION: In our study, adequacy of energy intake did not affect intensive care unit mortality. Carefully followed enteral nutrition protocols, resulting in an administered/prescribed ratio above 70%, are apparently not sufficient to impact the mortality rates in the intensive care unit. Therefore, it may not be necessary to achieve 100% of the targeted energy, considering the high frequency of enteral feeding interruptions due to gastrointestinal intolerance and fasting for tests and procedures. Additional research is needed to identify the optimal energy intake for improved outcomes and reduced costs.

Natália Sanchez Oliveira

2011-06-01

239

Impacto da adequação da oferta energética sobre a mortalidade em pacientes de UTI recebendo nutrição enteral / Impact of the adequacy of energy intake on intensive care unit mortality in patients receiving enteral nutrition  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Investigar a relação entre adequação da oferta energética e mortalidade na unidade de terapia intensiva em pacientes sob terapia nutricional enteral exclusiva. MÉTODOS: Estudo observacional prospectivo conduzido em uma unidade de terapia intensiva em 2008 e 2009. Foram incluídos pacientes [...] >18 anos que receberam terapia nutricional enteral por >72h. A adequação da oferta de energia foi estimada pela razão administrado/prescrito. Para a investigação da relação entre variáveis preditoras (adequação da oferta energética, escore APACHE II, sexo, idade e tempo de permanência na unidade de terapia intensiva e o desfecho mortalidade na unidade de terapia intensiva, utilizou-se o modelo de regressão logística não condicional. RESULTADOS: Foram incluídos 63 pacientes (média 58 anos, mortalidade 27%), 47,6% dos quais receberam mais de 90% da energia prescrita (adequação média 88,2%). O balanço energético médio foi de -190 kcal/dia. Observou-se associação significativa entre ocorrência de óbito e as variáveis idade e tempo de permanência na unidade de terapia intensiva, após a retirada das variáveis adequação da oferta energética, APACHE II e sexo durante o processo de modelagem. CONCLUSÃO: A adequação da oferta energética não influenciou a taxa de mortalidade na unidade de terapia intensiva. Protocolos de infusão de nutrição enteral seguidos criteriosamente, com adequação administrado/prescrito acima de 70%, parecem ser suficientes para não interferirem na mortalidade. Dessa forma, pode-se questionar a obrigatoriedade de atingir índices próximos a 100%, considerando a elevada frequência com que ocorrem interrupções no fornecimento de dieta enteral devido a intolerância gastrointestinal e jejuns para exames e procedimentos. Pesquisas futuras poderão identificar a meta ideal de adequação da oferta energética que resulte em redução significativa de complicações, mortalidade e custos. Abstract in english OBJECTIVE: To investigate the relationship between adequacy of energy intake and intensive care unit mortality in patients receiving exclusive enteral nutrition therapy. METHODS: Observational and prospective study conducted during 2008 and 2009. Patients above 18 years with exclusive enteral nutrit [...] ion therapy for at least 72 hours were included. The adequacy of energy intake was estimated by the administered/prescribed ratio. Non-conditional logistic regression was used to assess the relationship between predictive variables (adequacy of energy intake, APACHE II, gender, age, and intensive care unit length of stay) and intensive care unit mortality. RESULTS: Sixty-three patients (mean 58 years, 27% mortality) were included, 47.6% of whom received more than 90% of the energy prescribed (mean adequacy 88.2%). Mean energy balance was -190 kcal/day. Significant associations between death in the intensive care unit and the variables age and intensive care unit length of stay were observed, after removing the variables adequacy of energy intake, APACHE II, gender and age during the modeling process. CONCLUSION: In our study, adequacy of energy intake did not affect intensive care unit mortality. Carefully followed enteral nutrition protocols, resulting in an administered/prescribed ratio above 70%, are apparently not sufficient to impact the mortality rates in the intensive care unit. Therefore, it may not be necessary to achieve 100% of the targeted energy, considering the high frequency of enteral feeding interruptions due to gastrointestinal intolerance and fasting for tests and procedures. Additional research is needed to identify the optimal energy intake for improved outcomes and reduced costs.

Natália Sanchez, Oliveira; Lúcia, Caruso; Denise Pimentel, Bergamaschi; Flávia de Conti, Cartolano; Francisco Garcia, Soriano.

2011-06-01

240

Family History of Autoimmune Disease in Patients with Aicardi-Goutières Syndrome  

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Purpose. The purpose of this study was to explore anecdotal evidence for an increase in the prevalence of autoimmune diseases in family members of patients with Aicardi-Goutières syndrome (AGS). Methods. Pedigrees of patients and controls were analyzed using chi-square and logistic regression to assess differences in reports of autoimmune disease among family members of cases and controls. Data was collected at Children's National Medical Center in Washington, DC, USA and at the Internationa...

Schmidt, Johanna L.; Olivieri, Ivana; Vento, Jodie M.; Fazzi, Elisa; Gordish-dressman, Heather; Orcesi, Simona; Vanderver, Adeline

2012-01-01

 
 
 
 
241

Is nutrient intake a gender-specific cause for enhanced susceptibility to alcohol-induced liver disease in women?  

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Aim: Women have a higher susceptibility to alcohol-induced liver disease (ALD) than men. Gender-related differences in food preference were described in previous studies for several populations, but not in alcohol abusers. As certain micronutrients are reported to take influence on the development of ALD in animal experiments, the hypothesis of the present retrospective cross-sectional study was that gender-dependent (micro-) nutrient intake in patients with ALD may cause the higher susceptibility of women to this disease. Methods: In 210 patients (male: 158, female: 52) with different stages of ALD (ALD1: mild stage of liver damage; ALD2: moderately severe changes of the liver with signs of hepatic inflammation; ALD3: severely impaired liver function) and in 336 controls (male: 208, female: 128), nutrient intake was determined by a computer-guided diet history, and related to the severity of ALD in dependence on the sex of the patients. Results: No significant differences between males and females with ALD were calculated for the intake (per kg body weight/day) of protein, carbohydrates, fat, and the intake (per kg body weight/day) of most micronutrients. In females with ALD, higher intake was found for vitamin C (ALD3), calcium (ALD2), iron (ALD1 and ALD2), and zinc (ALD1), but the consumption of none of these micronutrients seems to contribute to a higher susceptibility to ALD in females. Conclusion: Though the present study confirms the higher susceptibility to ALD in women, the data of calculated daily macro- and micronutrient intake do not suggest any explicit influence of gender-specific nutrition in the development of ALD.

Wagnerberger, S.; Schafer, C.

2008-01-01

242

RUNX3 Methylation reveals that Bladder Tumors are Older in Patients with a History of Smoking  

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Exposure to tobacco smoke is associated with increased DNA methylation at certain genes in both lung and bladder tumors. We sought to identify interactions in bladder cancer between DNA methylation and a history of smoking, along with any possible effect of aging. We measured DNA methylation in 342 transitional cell carcinoma (TCC) tumors at BCL2, PTGS2 (COX2), DAPK, CDH1 (ECAD), EDNRB, RASSF1A, RUNX3, TERT, and TIMP3. The prevalence of methylation at RUNX3, a polycomb target gene, increased ...

Wolff, Erika M.; Liang, Ganging; Cortez, Connie C.; Tsai, Yvonne C.; Castelao, J. Esteban; Cortessis, Victoria K.; Tsao-wei, Denice D.; Groshen, Susan; Jones, Peter A.

2008-01-01

243

Clinical presentation, natural history, and cumulative death rates of 230 adults with primary cryptococcal meningitis in Zambian AIDS patients treated under local conditions  

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SETTING—Inpatient medical wards, Department of Medicine, University Teaching Hospital, Lusaka, Zambia.?OBJECTIVE—To define the natural history, clinical presentation, and management outcome of microbiologically confirmed cryptococcal meningitis in adult AIDS patients treated under local conditions where antifungal and antiretroviral therapies are not routinely available.?DESIGN—A descriptive, longitudinal, observational study.?METHODS—All adult patients admitted to the medical w...

Mwaba, P.; Mwansa, J.; Chintu, C.; Pobee, J.; Scarborough, M.; Portsmouth, S.; Zumla, A.

2001-01-01

244

Histórico de violência intrafamiliar em pacientes psiquiátricos Histórico de violencia intrafamiliar en pacientes psiquiátricos Family violence history in psychiatric patients  

Directory of Open Access Journals (Sweden)

Full Text Available O objetivo da presente pesquisa foi caracterizar o histórico de violência intrafamiliar em pacientes psiquiátricos inseridos em tratamento de regime ambulatorial. Pretendeu-se, mais especificamente, identificar o tipo de violência vivenciada pelos usuários. Participaram do estudo 23 pacientes de ambos os sexos, em tratamento ambulatorial. A coleta de dados envolveu a aplicação de um roteiro de entrevista individual, com informações sobre o histórico de internação e violência intrafamiliar e com descrição da infância, dentre outros itens. Apenas um dentre 23 participantes relatou ausência de histórico de violência intrafamiliar, 20 participantes indicaram histórico infantil de maus tratos físicos e psicológicos. Na fase adulta, dos 13 participantes que declararam viver com parceiros/parceiras no presente ou no passado, 8 participantes do sexo feminino relataram agressividade por parte do companheiro e 2 participantes do sexo masculino afirmaram ter agredido as esposas no passado. Com relação à violência sexual, 5 participantes relataram ter experienciado relação sexual forçada por parte do parceiro e um participante relatou ter abusado sexualmente da parceira. Os resultados chamam a atenção pela alta freqüência e pela gravidade de episódios de violência intrafamiliar, que evidenciam a necessidade de se replicar o estudo com amostras maiores e, na prática clínica, investigar tais questões rotineiramente, uma vez que sua esquiva pode contribuir para o processo de adoecimento psíquico.El objetivo de la presente pesquisa fue caracterizar el histórico de violencia intrafamiliar en pacientes psiquiátricos inseridos en tratamiento de régimen ambulatorial. Se pretendió, más específicamente, identificar el tipo de violencia vivida por los usuarios. Participaron del estudio 23 pacientes de ambos los sexos, en tratamiento ambulatorial. La recogida de datos implicó en la aplicación de un guión de entrevista individual, con informaciones sobre el histórico de internación y violencia intrafamiliar y con descripción de la infancia, entre otros apartados. Apenas uno entre 23 participantes relató ausencia de histórico de violencia intrafamiliar. 20 participantes indicaron histórico infantil de maltratos físicos y psicológicos. En la fase adulta, de los 13 participantes que declararon vivir con compañeros/compañeras en el presente o en el pasado, 8 participantes del sexo femenino relataron agresividad por parte del compañero, y 2 participantes del sexo masculino afirmaron haber agredido las esposas en el pasado. Con relación a la violencia sexual, 5 participantes relataron haber probado relación sexual forzada por parte del compañero y un participante relató haber abusado sexualmente de la compañera. Los resultados llaman la atención por la alta frecuencia y por la gravedad de episodios de violencia intrafamiliar, que evidencian la necesidad de repetir el estudio con muestras mayores y, en la práctica clínica, investigar tales cuestiones rutinariamente, una vez que su esquiva puede aportar para el proceso de enfermedad psíquica.The goal of this study was to characterize the family violence history among psychiatric patients in a mental health outpatient clinic. More specifically, identification of the modality of violence experienced by the patients was intended. Twenty three psychiatric patients who attended the clinic took part of the study. The instrument used to collect data was a semi-structured interview, with questions related to patient’s mental health and family violence history, as well as childhood description, among other topics. Only one out of 23 patients reported an absence of family violence history. Twenty participants indicated a history of physical or emotional abuse during childhood. In their adult phase, of the 13 participants who reported having lived with an intimate partner, eight female participants reported aggressive behavior by partners, and two male participants reported perpetrating aggressive episodes to their wives, in

Ricardo da Costa Padovani

2008-01-01

245

Persistent genital arousal disorder: confluent patient history of agitated depression, paroxetine cessation, and a tarlov cyst.  

Science.gov (United States)

We report a case of a woman suffering from persistent genital arousal disorder (PGAD) after paroxetine cessation. She was admitted to a psychiatric department and diagnosed with agitated depression. Physical investigation showed no gynaecological or neurological explanation; however, a pelvic MRI scan revealed a Tarlov cyst. Size and placement of the cyst could not explain the patient's symptoms; thus neurosurgical approach would not be helpful. Her depression was treated with antidepressant with little effect. Electroconvulsive therapy improved the patient's symptoms though they did not fully resolve. More awareness of PGAD and thorough interdisciplinary conferences are necessary to insure an unequivocal treatment strategy. PMID:25525548

Eibye, Simone; Jensen, Hans Mørch

2014-01-01

246

Persistent Genital Arousal Disorder: Confluent Patient History of Agitated Depression, Paroxetine Cessation, and a Tarlov Cyst  

Science.gov (United States)

We report a case of a woman suffering from persistent genital arousal disorder (PGAD) after paroxetine cessation. She was admitted to a psychiatric department and diagnosed with agitated depression. Physical investigation showed no gynaecological or neurological explanation; however, a pelvic MRI scan revealed a Tarlov cyst. Size and placement of the cyst could not explain the patient's symptoms; thus neurosurgical approach would not be helpful. Her depression was treated with antidepressant with little effect. Electroconvulsive therapy improved the patient's symptoms though they did not fully resolve. More awareness of PGAD and thorough interdisciplinary conferences are necessary to insure an unequivocal treatment strategy.

Jensen, Hans Mørch

2014-01-01

247

Habitual rapid food intake and ineffective esophageal motility  

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AIM: To study non-cardiac chest pain (NCCP) in relation to ineffective esophageal motility (IEM) and rapid food intake. METHODS: NCCP patients with a self-reported habit of fast eating underwent esophageal manometry for the diagnosis of IEM. Telephone interviews identified eating habits of additional IEM patients. Comparison of manometric features was done among IEM patients with and without the habit of rapid food intake and healthy controls. A case study investigated the effect of 6-mo gum ...

Kong-Ling Li; Ji-Hong Chen; Qian Zhang; Huizinga, Jan D.; Shawn Vadakepeedika; Yu-Rong Zhao; Wen-Zhen Yu; He-Sheng Luo

2013-01-01

248

Countertransference : Condensed History and Personal View of Issues With Regressed Patients  

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Freud’s ambivalently negative attitude toward countertransference discouraged systematic study until some psychoanalysts, predominantly Kleinians, began to treat patients with narcissistic neuroses. Recognizing the need to understand the unconscious and conscious contribution of the analyst to the therapeutic process, Heimann, Rosenfeld, Balint, and Racker pioneered in serious study of countertransference. Racker and Boyer found that unresolved countertransference probl...

Boyer, L. Bryce

1994-01-01

249

Sperm macrocephaly syndrome in a patient without AURKC mutations and with a history of recurrent miscarriage.  

Science.gov (United States)

This paper reports a case of recurrent miscarriage in a patient affected by a variant phenotype of sperm macrocephaly syndrome (SMS). SMS is usually related to specific sperm characteristics (large head, multiple tail) and homozygous mutations in the aurora kinase C gene (AURKC). However, the present case observed large-headed spermatozoa with no flagellar abnormalities and no mutations detectable by AURKC sequencing. Furthermore, the patient had repeatedly conceived by intracytoplasmic sperm injection, but pregnancy always aborted. This study performed morphological analysis (Papanicolau staining), annexin V/propidium iodide staining, sperm chromatin structure assay (SCSA), fluorescence in-situ hybridization (FISH) and transmission electron microscopy. This study observed large-headed, mono-tailed, mono-centriolar spermatozoa characterized by abnormal chromatin and swollen mitochondria. SCSA revealed a high ratio of late apoptotic cells with fairly intact amount of DNA. The FISH analysis showed 100% disomy rate. As far as is known, this is the first study to include gene sequencing, TEM, cytogenetic analysis and sperm DNA fragmentation in a case of SMS and also to report recurrent miscarriage related to this specific condition. SMS may be associated with important abnormalities of the sperm subcellular structure and with disomy even in the absence of mutations in the AURKC coding sequence. Sperm macrocephaly syndrome (SMS) is a rare condition that affects spermatozoa and is related to infertility. It is characterized by a specific phenotype of large-headed, multi-tailed spermatozoa with an abnormal chromosomal status. A very few pregnancies have been obtained so far in SMS patients by means of IVF procedures. We present a case of SMS that differs from the classical syndrome as we observed large-headed spermatozoa without tail abnormalities. The affected patient had achieved three pregnancies following IVF, but all aborted. We carried out a detailed examination of the patient's spermatozoa - morphological, cytogenetic, DNA fragmentation and ultrastructural analysis - and we observed that his spermatozoa are characterized by a large head whose texture appears apoptotic, a single tail and a midpiece whose mitochondria appear swollen. The DNA content within the spermatozoa was altered, as well as the chromosomal status, suggesting that some error must have occurred during spermatogenesis. Interestingly, the genetic sequencing of the specific gene usually related to SMS syndrome (AURKC) revealed no mutations in our patient, suggesting that other genes may be involved in determining this syndrome. As far as is known, this is the first study in which spermatozoa of a SMS patient have been observed using morphological analysis, ultrastructural analysis, cytogenetic analysis and sperm DNA fragmentation analysis together. Moreover, it is believed that this is first report of recurrent miscarriage due to this specific syndrome. PMID:23273756

Molinari, Emanuela; Mirabelli, Marzia; Raimondo, Stefania; Brussino, Alessandro; Gennarelli, Gianluca; Bongioanni, Francesca; Revelli, Alberto

2013-02-01

250

Inverse relationship between moderate alcohol intake and rectal cancer: Analysis of the North Carolina Colon Cancer Study  

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Background The relationship between alcohol intake and rectal cancer is uncertain Objective We sought to evaluate whether alcohol consumption is associated with distal colorectal cancer and rectal cancer specifically. Design Data on alcohol intake were examined from the North Carolina Colon Cancer Study, a population-based case control study of distal colorectal cancer. Setting 33 counties in the central and eastern part of North Carolina Patients Cases had adenocarcinoma of the rectum, rectosigmoid, and sigmoid colon. Controls were frequency-matched on age, race, and gender. Interventions Demographic and dietary intake data were collected using a validated questionnaire. Main outcome measures Logistic regression was used to estimate odds ratios for the relationship between alcohol consumption and distal colorectal cancer. Results 1,033 cases and 1,011 controls participated. The odds ratio for rectal cancer comparing any vs. no alcohol intake was 0.73 (95% confidence interval 0.60, 0.90), adjusted for age, gender, race, smoking status, obesity, education, red meat intake, use of non-steroidal anti-inflammatory medications and family history of colorectal cancer. The odds ratio for moderate alcohol (?14 grams/day) was 0.66 (0.53, 0.82), while the odds ratio for heavy alcohol (>14 grams/day) was 0.93 (0.70, 1.23). Moderate beer and wine intakes were also inversely associated with distal colorectal cancer: odds ratios 0.76 (0.60, 0.96) and 0.69 (0.56, 0.86) respectively. Limitations This was a retrospective, observational study. Residual confounding is possible. Conclusions In this study, moderate alcohol intake (especially wine) was inversely associated with distal colorectal cancer. PMID:21654257

Crockett, Seth D.; Long, Millie D.; Dellon, Evan S.; Martin, Christopher F.; Galanko, Joseph A.; Sandler, Robert S.

2011-01-01

251

Diagnostic role of fine-needle aspiration of bone lesions in patients with a previous history of malignancy.  

Science.gov (United States)

At the present time fine-needle aspiration (FNA) is considered a routine diagnostic procedure in evaluating neoplastic vs. nonneoplastic lesions in many organs, with high sensitivity and specificity. The purpose of this study was to assess the utility of FNA in areas of diagnostic difficulty and its limitations in evaluating bone lesions in patients with a previous history of malignancy. From 1989 to 2000, 249 CT-guided FNAs of bone lesion were performed at our institutions; 187/249 (75.1%) patients had a previous history of malignancy. Aspirated material was air-dried for Diff-Quik stain or fixed in ethanol for Papanicolaou staining. Subsequent surgical tissue was available in 69/187 (36.9%) of the cases. There were 114 males and 73 females, ages 14-86 yr (mean, 64 yr). The primary tumor site was lung 49, genitourinary 46, breast 31, gastrointestinal 28, hematopoietic 26, soft tissue/skin 5, and thyroid 2. There were 125 FNAs of the vertebral spine, 19 from the pelvis, 11 from the ribs, 9 from the sternum, 5 from the femur, and 18 from miscellaneous bone sites. Out of 187, 166 (88.7%) were malignant aspirates confirming the patients' primary malignancies. The most common malignancy encountered was adenocarcinoma, 126/187 (67.4%). Surgical tissue was available for review in 69 patients and the results were in agreement with the FNAs diagnosis in all cases. Nine out of 187 (4.8%) cases were diagnosed as marrow elements on cytological material. These patients have been followed for 1-9 yr and have failed to reveal signs or symptoms of clinical recurrence. Three out of 187 (1.6%) cases showed osteomyelitis. Nine out of 187 (4.8%) were unsatisfactory specimens, with biopsy follow-up available in four cases, showing three metastatic tumors and one case of osteomyelitis. FNA of metastatic bone lesions is a major step in pretreatment diagnosis. On satisfactory specimens, the cytological diagnosis viewed in the clinical-radiological context proves to be similar to surgical diagnosis. FNA is an excellent technique with a high accuracy rate in assessing metastatic bone lesions. PMID:12112828

Treaba, Diana; Assad, Lina; Govil, Hema; Sariya, Dinesh; Reddy, Vijaya B; Kluskens, Larry; Green, Linda; Selvaggi, Suzanne M; Gattuso, Paolo

2002-06-01

252

Ultrasound diagnosis for retrojugular lymphadenopathy in the patient having a history of total thyroidectomy due to thyroid malignancy  

International Nuclear Information System (INIS)

This study aimed to assess the accuracy of ultrasound (US) diagnosis for retrojugular lymphadenopathy in patients who had undergone total thyroidectomy, due to thyroid malignancy. During a follow up period after total thyroidectomy, due to known thyroid malignancy, 41 patients underwent US diagnosis and US guided fine needle aspiration for retrojugular lymphadenopathy. Each lymphadenopathy was prospectively classified by a single radiologist into 1 of 3 diagnostic categories: 'benign', 'indeterminate for malignancy', and 'malignant'. Based on the cytohistopathology result, thyroglobulin tittering, and sonographic follow up, the adequacy of US diagnosis for retrojugular lymphadenopathy was assessed. Of the 41 retrojugular lymphadenopathies, malignant (n = 25) and benign (n = 16) lymphadenopathy were finally confirmed. Excluding 15 lymph nodes with indeterminate US diagnosis, the sensitivity, specificity, positive and negative predictive values, accuracy, and false positive and negative rates of US diagnosis were 100%, 66.7%, 95.8%, 100%, 96.2%, 0%, and 10%, respectively. There was no significant difference in the incidence of retrojugular lymphadenopathy, according to age, sex, and location (p > 0.05). In the patient with a history of total thyroidectomy, due to thyroid malignancy, US diagnosis for retrojugular lymphadenopathy showed a high accuracy

253

Ultrasound diagnosis for retrojugular lymphadenopathy in the patient having a history of total thyroidectomy due to thyroid malignancy  

Energy Technology Data Exchange (ETDEWEB)

This study aimed to assess the accuracy of ultrasound (US) diagnosis for retrojugular lymphadenopathy in patients who had undergone total thyroidectomy, due to thyroid malignancy. During a follow up period after total thyroidectomy, due to known thyroid malignancy, 41 patients underwent US diagnosis and US guided fine needle aspiration for retrojugular lymphadenopathy. Each lymphadenopathy was prospectively classified by a single radiologist into 1 of 3 diagnostic categories: 'benign', 'indeterminate for malignancy', and 'malignant'. Based on the cytohistopathology result, thyroglobulin tittering, and sonographic follow up, the adequacy of US diagnosis for retrojugular lymphadenopathy was assessed. Of the 41 retrojugular lymphadenopathies, malignant (n = 25) and benign (n = 16) lymphadenopathy were finally confirmed. Excluding 15 lymph nodes with indeterminate US diagnosis, the sensitivity, specificity, positive and negative predictive values, accuracy, and false positive and negative rates of US diagnosis were 100%, 66.7%, 95.8%, 100%, 96.2%, 0%, and 10%, respectively. There was no significant difference in the incidence of retrojugular lymphadenopathy, according to age, sex, and location (p > 0.05). In the patient with a history of total thyroidectomy, due to thyroid malignancy, US diagnosis for retrojugular lymphadenopathy showed a high accuracy.

Nam, Seung Min; Kim, Dong Wook [Busan Paik Hospital/Inje Univ. College of Medicine, Busan (Korea, Republic of)

2012-07-15

254

Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders  

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Full Text Available Background: The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods: Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results: Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion: Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

Pascal Wabnitz

2013-11-01

255

Bupropion perceived as a stimulant by two patients with a previous history of cocaine misuse  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in english BACKGROUND AND OBJECTIVE: Despite animal studies having shown a generalisation of the bupropion cue to cocaine, this drug has been used in cocaine abuse with mixed results. We here aimed at describing two cases which contradict current knowledge. CASE REPORTS: We describe two cases of former cocaine [...] abusers who reported a cocaine-like sensation upon taking bupropion. Bupropion improved patients' depression without any increase in cocaine craving. One of the patients increased without doctor consultation his dose on an as needed basis. CONCLUSIONS: The issue of bupropion cue generalisation to cocaine needs further elucidation. People with past cocaine addiction need to be informed on the potential of bupropion to elicit cocaine-like cues and be invited to adhere to medical prescription, because bupropion has been associated with fatalities in some cases.

Alessandro E., Vento; Fabrizio, Schifano; Federica, Gentili; Francesco, Pompei; John M., Corkery; Georgios D., Kotzalidis; Paolo, Girardi.

2013-12-01

256

[The history of poliomyelitis in Norway--disease, society and patients].  

Science.gov (United States)

The first epidemic of poliomyelitis in Norway was reported in 1868. Over the course of the 20th century, a total of 23,000 cases of acute poliomyelitis were registered, and the disease caused much suffering and fear before vaccination was introduced in 1956. After 1960, treatment and rehabilitation facilities for polio patients were gradually converted to other uses. Today there are 5,000-10,000 persons with sequelae poliomyelitis in Norway, many of them suffering from late effects of poliomyelitis, so-called postpolio syndrome. Thus there is still a need for multidisciplinary services for these patients, even though the poliovirus could be eradicated in a few years' time. PMID:11808020

Lobben, B

2001-12-10

257

A young patient affected by hypertensive crises: when medical history lies  

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A 21 years old man was admitted to the Emergency Department for throbbing headache and flushing associated with very high blood pressure, as confirmed by the ABPM performed in hospital. These symptoms are usually due to the excess of circulating catecholamines, so the differential diagnosis included pheocromocytoma and street drugs abuse, in particular cocaine. The patient repeatedly denied drugs absumption and the urine toxicological test at the time of the admission was negative.The laborat...

Sara Ferrillo; Eliana Giuffrè; Giuseppe Aiosa; Dalio Cecconi

2007-01-01

258

Searching Electronic Health Records for Temporal Patterns in Patient Histories: A Case Study with Microsoft Amalga  

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As electronic health records (EHR) become more widespread, they enable clinicians and researchers to pose complex queries that can benefit immediate patient care and deepen understanding of medical treatment and outcomes. However, current query tools make complex temporal queries difficult to pose, and physicians have to rely on computer professionals to specify the queries for them. This paper describes our efforts to develop a novel query tool implemented in a large operational system at th...

Plaisant, Catherine; Lam, Stanley; Shneiderman, Ben; Smith, Mark S.; Roseman, David; Marchand, Greg; Gillam, Michael; Feied, Craig; Handler, Jonathan; Rappaport, Hank

2008-01-01

259

Influence of family history, irradiation and anti-cancer drug (mitomycin C) on the occurrence of multiple primary neoplasms in breast carcinoma patients  

International Nuclear Information System (INIS)

The influence of family history, irradiation and anti-cancer drug (Mitomycin C) on the occurrence of multiple primary neoplasms was analysed using the person-year method in 1359 Japanese breast carcinoma patients. There were 111 multiple primary neoplasms, including bilaterl breast cancer, in 109 patients; the incidence rate was 0.0072 per person-year. The incidence rate in patients with a family history of cancer was 1.29 times higher than in those without. In the bilateral breast cancer group there was about a 3 times higher frequency of family history of breast cancer. Irradiation therapy raised the occurrence of multiple primary neoplasms 1.28 fold, and Mitomycin C (40 mg) had no effect on the occurrence of neoplasms during a 10-year observation period. (author)

260

Novel de novo BRCA2 mutation in a patient with a family history of breast cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background BRCA2 germ-line mutations predispose to breast and ovarian cancer. Mutations are widespread and unclassified splice variants are frequently encountered. We describe the parental origin and functional characterization of a novel de novo BRCA2 splice site mutation found in a patient exhibiting a ductal carcinoma at the age of 40. Methods Variations were identified by denaturing high performance liquid chromatography (dHPLC and sequencing of the BRCA1 and BRCA2 genes. The effect of the mutation on splicing was examined by exon trapping in COS-7 cells and by RT-PCR on RNA isolated from whole blood. The paternity was determined by single nucleotide polymorphism (SNP microarray analysis. Parental origin of the de novo mutation was determined by establishing mutation-SNP haplotypes by variant specific PCR, while de novo and mosaic status was investigated by sequencing of DNA from leucocytes and carcinoma tissue. Results A novel BRCA2 variant in the splice donor site of exon 21 (nucleotide 8982+1 G?A/c.8754+1 G?A was identified. Exon trapping showed that the mutation activates a cryptic splice site 46 base pairs 3' of exon 21, resulting in the inclusion of a premature stop codon and synthesis of a truncated BRCA2 protein. The aberrant splicing was verified by RT-PCR analysis on RNA isolated from whole blood of the affected patient. The mutation was not found in any of the patient's parents or in the mother's carcinoma, showing it is a de novo mutation. Variant specific PCR indicates that the mutation arose in the male germ-line. Conclusion We conclude that the novel BRCA2 splice variant is a de novo mutation introduced in the male spermatozoa that can be classified as a disease causing mutation.

Eiberg Hans

2008-07-01

 
 
 
 
261

Alcohol intake and prognosis of atrial fibrillation  

DEFF Research Database (Denmark)

OBJECTIVE: To assess alcohol intake as a risk factor for adverse events among patients with incident atrial fibrillation (AF). DESIGN: Prospective cohort study. SETTING: Population based cohort study and nationwide Danish registries. PATIENTS: The Danish Diet, Cancer and Health study included 57 053 participants (27 178 men and 29 875 women) aged between 50 and 64 years. The study population for this study included the 3107 participants (1999 men, 1108 women) who developed incident AF after inclusion. MAIN OUTCOME MEASURES: A composite of thromboembolism or death. RESULTS: During a median follow-up of 4.9 years 608 deaths and 211 thromboembolic events occurred. Of those who developed AF, 690 (35%) men and 233 (21%) women had a high intake of alcohol (>20 drinks/week for men and >13 drinks/week for women). After adjustment for use of oral anticoagulation and components of the CHA2DS2-VASc score, men with an intake of >27 drinks/week had a higher risk for thromboembolism or death (hazard ratio (HR) 1.33, 95% CI1.08 to 1.63) than men with an intake of 20 drinks/week also had a higher risk (HR 1.23, 95% CI 0.78 to 1.96) than women in the low intake category. The higher risk among men was primarily driven by mortality (HR 1.51, 95% CI 1.20 to 1.89), whereas the risk found among women was driven by thromboembolism (HR 1.71, 95% CI 0.81 to 3.60). CONCLUSIONS: High alcohol intake predicts thromboembolism or death, even after adjustment for established clinical risk factors, and may help identify high risk AF patients who could be targeted for stroke and cardiovascular prevention strategies.

Overvad, Thure Filskov; Rasmussen, Lars Hvilsted

2013-01-01

262

Association between ACE Gene I/D Polymorphism and Unstable Angina in Uzbek Patients with Family History of Coronary Heart Disease  

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Full Text Available Objective: To study the distribution of I/D polymorphic marker of the ACE gene in Uzbek patients with unstable angina, depending on the presence of family history of CHD compared with healthy individuals. Materials and methods: There were examined 125 Uzbek patients with unstable angina (class IIB by E. Braunwald et al., 1989. In patients with unstable angina 63 patients (the 1st group had and 62 patients (the 2nd group had no a family history of CHD. Control group included 45 healthy Uzbek subjects without CHD and family history of CHD. The genomic DNA was isolated from the peripheral blood lymphocytes following standard protocol using the DiatomTM DNA Prep 200 kit (produced by LLC "Laboratory IsoGene". I/D polymorphism of the ACE gene was detected according to Cambian F. et al. (1992. Results: In a comparative analysis of both groups, patients showed similarity in the baseline clinical, hemodynamic and biochemical parameters; however, the 1st group had significant higher IMC thickness of the carotid arteries and hsCRP levels. Simultaneously, patients with a family history of CHD, compared with the healthy group of individuals, were noted to have a significantly higher prevalence of the D/D genotype [OR: 3.46 (95% CI: 1.18-8.11; P=0.035] and "damaging" D-allele [OR: 2.47 (95% CI: 1.40-4.34; P=0.002]. Conclusion: The presence of a family history of the coronary heart disease among Uzbek patients with unstable angina was associated with the higher frequency of the "damaging” D-allele of the ACE I/D gene polymorphism, accompanied by an increase in the thickness of the intima-media complex of the carotid arteries and level of high-sensitivity C-reactive protein.

Feruza M. Bekmetova*, PhD

2012-12-01

263

Is Early Treatment with a Cervical Pessary an Option in Patients with a History of Surgical Conisation and a Short Cervix?  

Science.gov (United States)

Objective: Patients with a history of one or more conizations have an increased risk of spontaneous preterm birth (SPTB). The aim of this study was to investigate the outcome of pregnancies in patients with a history of conization and early treatment with a cervical pessary. Methods: In this pilot observational study we included 21 patients and evaluated the obstetric history, the interval between pessary placement and delivery, gestational age at delivery, the neonatal outcome and the number of days of maternal and neonatal admission. Results: Among the study group of 21 patients, 20 patients had a singleton and one had a dichorionic/diamniotic twin pregnancy. At insertion, the mean gestational age was 17?+?2 (10?+?5-24?+?0) weeks and the mean cervical length was 19 (4-36) mm. Six patients presented with funneling at insertion with a mean funneling width of 19.7 (10-38) mm and funneling length of 19.9 (10-37) mm. Five patients had already lost at least one child due to early spontaneous preterm birth and another five had at least one previous abortion, who have now delivered beyond 34 weeks. The mean gestational age at delivery was 38 (31?+?1-41?+?0) gestational weeks and the mean interval between insertion and delivery was 145 (87-182) days. Conclusion: Our findings suggest a beneficial effect of an early pessary placement for patients at high-risk for preterm birth due to conization. PMID:25484374

Kyvernitakis, I; Khatib, R; Stricker, N; Arabin, B

2014-11-01

264

Predictors of Barefoot Plantar Pressure during Walking in Patients with Diabetes, Peripheral Neuropathy and a History of Ulceration  

Science.gov (United States)

Objective Elevated dynamic plantar foot pressures significantly increase the risk of foot ulceration in diabetes mellitus. The aim was to determine which factors predict plantar pressures in a population of diabetic patients who are at high-risk of foot ulceration. Methods Patients with diabetes, peripheral neuropathy and a history of ulceration were eligible for inclusion in this cross sectional study. Demographic data, foot structure and function, and disease-related factors were recorded and used as potential predictor variables in the analyses. Barefoot peak pressures during walking were calculated for the heel, midfoot, forefoot, lesser toes, and hallux regions. Potential predictors were investigated using multivariate linear regression analyses. 167 participants with mean age of 63 years contributed 329 feet to the analyses. Results The regression models were able to predict between 6% (heel) and 41% (midfoot) of the variation in peak plantar pressures. The largest contributing factor in the heel model was glycosylated haemoglobin concentration, in the midfoot Charcot deformity, in the forefoot prominent metatarsal heads, in the lesser toes hammer toe deformity and in the hallux previous ulceration. Variables with local effects (e.g. foot deformity) were stronger predictors of plantar pressure than global features (e.g. body mass, age, gender, or diabetes duration). Conclusion The presence of local deformity was the largest contributing factor to barefoot dynamic plantar pressure in high-risk diabetic patients and should therefore be adequately managed to reduce plantar pressure and ulcer risk. However, a significant amount of variance is unexplained by the models, which advocates the quantitative measurement of plantar pressures in the clinical risk assessment of the patient. PMID:25647421

Barn, Ruth; Waaijman, Roelof; Nollet, Frans; Woodburn, James; Bus, Sicco A.

2015-01-01

265

Protein intakes in India.  

Science.gov (United States)

Indian diets derive almost 60 % of their protein from cereals with relatively low digestibility and quality. There have been several surveys of diets and protein intakes in India by the National Nutrition Monitoring Board (NNMB) over the last 25 years, in urban and rural, as well as in slum dwellers and tribal populations. Data of disadvantaged populations from slums, tribals and sedentary rural Indian populations show that the protein intake (mainly from cereals) is about 1 gm/kg/day. However, the protein intake looks less promising in terms of the protein digestibility corrected amino acid score (PDCAAS), using lysine as the first limiting amino acid, where all populations, particularly rural and tribal, appear to have an inadequate quality to their protein intake. The protein: energy (PE) ratio is a measure of dietary quality, and has been used in the 2007 WHO/FAO/UNU report to define reference requirement values with which the adequacy of diets can be evaluated in terms of a protein quality corrected PE ratio. It is likely that about one third of this sedentary rural population is at risk of not meeting their requirements. These levels of risk of deficiency are in a population with relatively low BMI populations, whose diets are also inadequate in fruits and vegetables. Therefore, while the burden of enhancing the quality of protein intake in rural India exists, the quality of the diet, in general, represents a challenge that must be met. PMID:23107548

Swaminathan, Sumathi; Vaz, Mario; Kurpad, Anura V

2012-08-01

266

Estado nutricional e ingestão alimentar de pacientes em diálise peritoneal contínua com e sem hiperparatireoidismo secundário Nutritional status and food intake of continuous peritoneal dialysis patients with and without secondary hyperparathyroidism  

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Full Text Available INTRODUÇÃO: O hiperparatireoidismo secundário (HPT2 é uma complicação comum e precoce em pacientes com doença renal crônica (DRC. Estudos têm sugerido que os altos níveis de paratormônio (PTH podem exercer efeitos deletérios no estado nutricional de pacientes com DRC. Assim, o objetivo deste estudo foi comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC com e sem HPT2. OBJETIVO: O objetivo deste estudo é comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC com e sem HPTS. MÉTODOS: Foram avaliados 74 pacientes, entre adultos e idosos, divididos em dois grupos, de acordo com os níveis de PTH. No grupo 1 (n = 18 os níveis de PTH eram maiores do que 300 pg/mL e, no grupo 2, menores ou iguais a 300 pg/mL. O estado nutricional dos pacientes foi avaliado através da antropometria, exames bioquímicos e avaliação subjetiva global (ASG. O consumo alimentar foi avaliado através do registro alimentar de 3 dias. Foram coletados também dados clínicos, como cálcio e fósforo séricos, e a presença de inflamação foi avaliada através da dosagem de proteína C reativa ultrassensível (PCR US. RESULTADOS: A média de idade da população estudada foi de 54,97 ± 17,06 anos, com predominância de pacientes adultos (58,1% e do sexo feminino (56,8%. O tempo de DPC expresso em mediana foi de 17 meses (7,75-33. Através da ASG, demonstrou-se prevalência de 36,5% de desnutridos na população. Na análise de diferença entre os grupos, em relação à antropometria, indicadores bioquímicos e ASG, bem como ingestão alimentar, não foram evidenciadas diferenças entre os grupos estudados. CONCLUSÃO: Não houve diferenças no estado nutricional e na ingestão alimentar entre os pacientes com e sem HPT2.INTRODUCTION: Secondary hyperparathyroidism (SHPT is a common and early complication in chronic kidney disease (CKD patients. Studies have suggested that high levels of parathyroid hormone (PTH may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD with and without SHPT. OBJECTIVE: The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD with and without SHPT. METHODS: 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18 levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA. Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US. RESULTS: The average age of the population studied was 54.97 ± 17.06 years, with predominance of adult patients (58.1% and females (56.8%. The time of CPD expressed in median was 17 months (7.75-33. Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. CONCLUSION: There were no differences in nutritional status and dietary intake between patients with and without SHPT.

Sara Ribeiro Campos

2012-06-01

267

Estado nutricional e ingestão alimentar de pacientes em diálise peritoneal contínua com e sem hiperparatireoidismo secundário / Nutritional status and food intake of continuous peritoneal dialysis patients with and without secondary hyperparathyroidism  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: O hiperparatireoidismo secundário (HPT2) é uma complicação comum e precoce em pacientes com doença renal crônica (DRC). Estudos têm sugerido que os altos níveis de paratormônio (PTH) podem exercer efeitos deletérios no estado nutricional de pacientes com DRC. Assim, o objetivo deste estu [...] do foi comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPT2. OBJETIVO: O objetivo deste estudo é comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPTS. MÉTODOS: Foram avaliados 74 pacientes, entre adultos e idosos, divididos em dois grupos, de acordo com os níveis de PTH. No grupo 1 (n = 18) os níveis de PTH eram maiores do que 300 pg/mL e, no grupo 2, menores ou iguais a 300 pg/mL. O estado nutricional dos pacientes foi avaliado através da antropometria, exames bioquímicos e avaliação subjetiva global (ASG). O consumo alimentar foi avaliado através do registro alimentar de 3 dias. Foram coletados também dados clínicos, como cálcio e fósforo séricos, e a presença de inflamação foi avaliada através da dosagem de proteína C reativa ultrassensível (PCR US). RESULTADOS: A média de idade da população estudada foi de 54,97 ± 17,06 anos, com predominância de pacientes adultos (58,1%) e do sexo feminino (56,8%). O tempo de DPC expresso em mediana foi de 17 meses (7,75-33). Através da ASG, demonstrou-se prevalência de 36,5% de desnutridos na população. Na análise de diferença entre os grupos, em relação à antropometria, indicadores bioquímicos e ASG, bem como ingestão alimentar, não foram evidenciadas diferenças entre os grupos estudados. CONCLUSÃO: Não houve diferenças no estado nutricional e na ingestão alimentar entre os pacientes com e sem HPT2. Abstract in english INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients. Studies have suggested that high levels of parathyroid hormone (PTH) may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this stud [...] y was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. OBJECTIVE: The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. METHODS: 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18) levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA). Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US). RESULTS: The average age of the population studied was 54.97 ± 17.06 years, with predominance of adult patients (58.1%) and females (56.8%). The time of CPD expressed in median was 17 months (7.75-33). Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. CONCLUSION: There were no differences in nutritional status and dietary intake between patients with and without SHPT.

Sara Ribeiro, Campos; Maria Helena Lima, Gusmão; Alessandra Fortes, Almeida; Luís José Cardoso, Pereira; Lilian Ramos, Sampaio; Jairza Maria Barreto, Medeiros.

2012-06-01

268

Avaliação nutricional e consumo alimentar de pacientes com doença celíaca com e sem transgressão alimentar / Nutritional evaluation and food intake of celiac disease patients compliant or not with a gluten-free diet  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar o estado nutricional e a ingestão de energia e de macronutrientes de pacientes com diagnóstico de doença celíaca que transgrediam ou não a dieta isenta de glúten. MÉTODOS: Foram estudados 63 pacientes com doença celíaca: 34 crianças e 29 adolescentes. Transgressão à dieta isenta de [...] glúten foi caracterizada por meio da dosagem sérica do anticorpo antitransglutaminase tissular recombiante humana. O estado nutricional foi avaliado com base nos escores-Z de peso/idade, estatura/idade e no índice de massa corporal. A ingestão alimentar foi avaliada por meio do inquérito alimentar de 24 horas. RESULTADOS: A transgressão à dieta sem glúten foi constatada em 41,2% das crianças e em 34,5% dos adolescentes. Nas crianças com transgressão alimentar, a média do escore-Z de estatura/idade foi inferior à das crianças do grupo que não transgredia (p=0,024). Todavia, o grupo com transgressão apresentou maior escore-Z do índice de massa corporal em relação aos que não transgrediam (p=0,021). Os adolescentes que não transgrediam apresentaram maior índice de massa corporal quando comparados aos que transgrediam a dieta (p=0,037). Em relação à ingestão alimentar, não se observou diferença estatística entre os grupos. Todavia, cerca de 70,0% das crianças e adolescentes apresentaram consumo de energia acima de 120,0% da recomendação. CONCLUSÃO: As crianças que transgrediam a dieta apresentaram menor escore-Z de estatura/idade e maior escore-Z para índice de massa corporal do que crianças que seguem sem transgressões alimentares. Os adolescentes que não transgrediam a dieta apresentaram maior média de índice de massa corporal quando comparados aos que transgrediam a dieta. Consumo energético elevado foi observado tanto nas crianças quanto nos adolescentes. Abstract in english OBJECTIVE: This study evaluated the nutritional status and intakes of energy and macronutrients of celiac disease patients compliant or not with a gluten-free diet. METHODS: We studied 63 patients with celiac disease, 34 children and 29 adolescents. Noncompliance with a gluten-free diet was characte [...] rized by detection of antibodies to tissue transglutaminase in serum by recombinant human tissue transglutaminase antigen. Nutritional status was classified according to the weight-for-age, height-for-age, and body mass index Z-scores. Dietary intake was assessed by a 24-hour recall. RESULTS: The percentages of children and adolescents noncompliant with a gluten-free diet were 41.2% and 34.5%, respectively. Noncompliant children had a lower mean height-for-age Z-score than compliant children (p=0.024). However, noncompliant children had higher mean body mass index Z-score than compliant children (p=0.021). On the other hand, compliant adolescents had higher BMI than noncompliant adolescents (p=0.037). The food intake between the groups did not differ, but the energy intakes of 70.0% of the children and adolescents exceeded 120.0% of their requirements. CONCLUSION: Children who do not comply with a gluten-free diet have lower height-for-age Z-scores and higher body mass index Z-scores than children who comply. Compliant adolescents have a higher mean body mass index than noncompliant adolescents. High energy intake was observed in both children and adolescents.

Cristiana Santos, Andreoli; Ana Paula Bidutte, Cortez; Vera Lucia, Sdepanian; Mauro Batista de, Morais.

2013-06-01

269

A young patient affected by hypertensive crises: when medical history lies  

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Full Text Available A 21 years old man was admitted to the Emergency Department for throbbing headache and flushing associated with very high blood pressure, as confirmed by the ABPM performed in hospital. These symptoms are usually due to the excess of circulating catecholamines, so the differential diagnosis included pheocromocytoma and street drugs abuse, in particular cocaine. The patient repeatedly denied drugs absumption and the urine toxicological test at the time of the admission was negative.The laboratory and imaging tests excluded a pheocromocytoma. The cocaine use was confirmed by the hair toxicological test. A few number of cases is available in literature where a long duration of symptoms from the last cocaine absumption can be found. In these cases the hair toxicological test is resolutive for diagnosis.

Sara Ferrillo

2007-10-01

270

Gray platelet syndrome: natural history of a large patient cohort and locus assignment to chromosome 3p.  

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Gray platelet syndrome (GPS) is an inherited bleeding disorder characterized by macrothrombocytopenia and absence of platelet ?-granules resulting in typical gray platelets on peripheral smears. GPS is associated with a bleeding tendency, myelofibrosis, and splenomegaly. Reports on GPS are limited to case presentations. The causative gene and underlying pathophysiology are largely unknown. We present the results of molecular genetic analysis of 116 individuals including 25 GPS patients from 14 independent families as well as novel clinical data on the natural history of the disease. The mode of inheritance was autosomal recessive (AR) in 11 and indeterminate in 3 families. Using genome-wide linkage analysis, we mapped the AR-GPS gene to a 9.4-Mb interval on 3p21.1-3p22.1, containing 197 protein-coding genes. Sequencing of 1423 (69%) of the 2075 exons in the interval did not identify the GPS gene. Long-term follow-up data demonstrated the progressive nature of the thrombocytopenia and myelofibrosis of GPS resulting in fatal hemorrhages in some patients. We identified high serum vitamin B(12) as a consistent, novel finding in GPS. Chromosome 3p21.1-3p22.1 has not been previously linked to a platelet disorder; identification of the GPS gene will likely lead to the discovery of novel components of platelet organelle biogenesis. This study is registered at www.clinicaltrials.gov as NCT00069680 and NCT00369421. PMID:20709904

Gunay-Aygun, Meral; Zivony-Elboum, Yifat; Gumruk, Fatma; Geiger, Dan; Cetin, Mualla; Khayat, Morad; Kleta, Robert; Kfir, Nehama; Anikster, Yair; Chezar, Judith; Arcos-Burgos, Mauricio; Shalata, Adel; Stanescu, Horia; Manaster, Joseph; Arat, Mutlu; Edwards, Hailey; Freiberg, Andrew S; Hart, P Suzanne; Riney, Lauren C; Patzel, Katherine; Tanpaiboon, Pranoot; Markello, Tom; Huizing, Marjan; Maric, Irina; Horne, McDonald; Kehrel, Beate E; Jurk, Kerstin; Hansen, Nancy F; Cherukuri, Praveen F; Jones, Marypat; Cruz, Pedro; Mullikin, Jim C; Nurden, Alan; White, James G; Gahl, William A; Falik-Zaccai, Tzippora

2010-12-01

271

A case of diaphragmatic clear cell carcinoma in a patient with a medical history of ovarian endometriosis.  

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We present a case of clear cell carcinoma located in the diaphragm in a patient with a medical history of ovarian endometriosis. Ultrasonography revealed the presence of a 2.5-cm nodule on the surface of the liver in a 65-year-old woman. She had undergone right salpingo-oophorectomy for treatment of an endometrial cyst of the right ovary at the age of 43 years and hysterectomy for treatment of a myoma of the uterus at the age of 51 years. We performed laparotomy and found that the tumor had originated from the diaphragm and invaded the liver. The diaphragm and liver were partially resected. Histopathological examination revealed the presence of clear cells and hobnail cells. The clear cells contained pale or eosinophilic cytoplasm and were arranged in a solid pattern. The hobnail cells lined the lumen and papillae. Immunohistochemical examination of the tumor cells showed positive staining for CK-7 and CA-125; negative staining for CK-20, TTF-1, and CA19-9; and weak positive staining for CEA. The findings were compatible with those of ovarian clear cell carcinoma. After 1 year, the patient had metastasis in the lung, and right lower lobectomy was performed. PMID:20221659

Fujiu, Koichi; Miyamoto, Hideaki; Hashimoto, Satoshi; Suzuki, Nobuyasu; Takano, Yoshinao; Teranishi, Yasushi; Sakuma, Hideo; Suzuki, Hiroyuki

2010-10-01

272

Relationship between flow volume curve and CT findings in non-smoking patients with long histories of bronchial asthma  

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This study was conducted to verify whether bronchial asthma (BA) alone causes pulmonary emphysema (PE), and to examine the computed tomography (CT) findings in non-smokers with BA demonstrating the flow volume curve (FV curve) characteristic of PE. Non-smoking patients with a history of BA for more than 20 years were divided into 2 groups: the dogleg pattern group (n=5), with an FV curve characteristic of PE, and the concave pattern group (n=16) with an FV curve characteristic of BA. CT scans was performed using CT values (level, 900 H.U.; width, 400 H.U.) that facilitate detection of a low attenuation area (LAA), and using conventional CT values (level, 700 H.U.; width, 1,300 H.U.). LAA (including air trapping), thickness of the bronchial wall, and partial atelectasis were compared between the 2 groups. PE was not detected, although air trapping was found in all subjects. The thickness of the airway was greater in the dogleg pattern than in the concave pattern. The incidences of air trapping and partial atelectasis were higher in the former than in the latter. BA alone may not cause PE. Some BA patients without PE show the FV curve characteristic of PE, reflecting an increase in the thickness of the airway wall and a decrease in the pulmonary ventilation probably due to the air trapping and the partial atelectasis. (author)

Kawamoto, Hitoshi; Kambe, Masayuki; Yamagata, Mitsunori; Nakajima, Hidekatsu [Hiroshima Univ. (Japan). School of Medicine; Yamane, Kousuke; Kuraoka, Toshihiko; Miyamura, Isao

2001-08-01

273

Relationship between flow volume curve and CT findings in non-smoking patients with long histories of bronchial asthma  

International Nuclear Information System (INIS)

This study was conducted to verify whether bronchial asthma (BA) alone causes pulmonary emphysema (PE), and to examine the computed tomography (CT) findings in non-smokers with BA demonstrating the flow volume curve (FV curve) characteristic of PE. Non-smoking patients with a history of BA for more than 20 years were divided into 2 groups: the dogleg pattern group (n=5), with an FV curve characteristic of PE, and the concave pattern group (n=16) with an FV curve characteristic of BA. CT scans was performed using CT values (level, 900 H.U.; width, 400 H.U.) that facilitate detection of a low attenuation area (LAA), and using conventional CT values (level, 700 H.U.; width, 1,300 H.U.). LAA (including air trapping), thickness of the bronchial wall, and partial atelectasis were compared between the 2 groups. PE was not detected, although air trapping was found in all subjects. The thickness of the airway was greater in the dogleg pattern than in the concave pattern. The incidences of air trapping and partial atelectasis were higher in the former than in the latter. BA alone may not cause PE. Some BA patients without PE show the FV curve characteristic of PE, reflecting an increase in the thickness of the airway wall and a decrease in the pulmonary ventilation probably due to the air trapping and the partial atelectasis. (author)

274

Dietary iron intake of pregnant Nigerian women with anemia.  

Science.gov (United States)

The daily dietary iron intake of nine pregnant Nigerian women with confirmed iron deficiency anemia was determined. The daily dietary iron intake from hospital meals served to ten other pregnant women was also assessed to serve as a control. The mean daily iron intake of the group of anemic patients on home diet was 14.6 mg (range of individual means = 8.37-25.28 mg), whereas the group of patients served hospital meals had a mean daily dietary iron intake of 36.92 mg (range of individual means = 25.09-46.47 mg). It is, therefore, clear that the etiology of iron deficiency in the patients studied was mainly dietary. Thus, our pregnant patients, many of whom are on diets similar to those of the group studied, should receive iron supplements during pregnancy. PMID:42589

Ogunbode, O; Akinyele, I O; Hussain, M A

1979-01-01

275

Isolation of pathogenic Escherichia coli from stool samples of diarrhoeal patients with history of raw milk consumption  

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Full Text Available Aim: To detect the occurrence of pathogenic Escherichia coli from stool samples of diarrhoeal patients with history of raw milk consumption and to determine the public health significance of isolates, especially their role in causing human diseases.Materials and Methods: Atotal of 100 stool samples from diarrhoeal patients, with history of raw milk consumption were collected from primary health centres in and around Anand city, under aseptic conditions and a total of 50 raw milk samples were collected from milk vendors, retail shops located in Anand city in sterilized sample bottles. MacConkey broth was used for the enrichment of all the samples and inoculation was done on MacConkey agar and EMB agar was used as the selective media. This was followed by the confirmation of isolates using biochemical tests. For the serotyping,E. coli isolates were sent to the National Salmonella and Escherichia Centre, Central Research Institute (CRI, Kasauli, Himachal Pradesh.Detection of virulence genes was performed using PCR technique.Results: During the present investigation, 26 (52% E. coli isolates from 50 milk samples and 59 (59% E. coli isolates from 100 stool samples were recovered. Out of 85 E. coli isolates sent for serotyping, 74 isolates could be typed which were further distributed into 13 different serogroups O2, O4, O8, O17, O22, O25, O29, O36, O45, O60, O90, O116 and O172, whereas 8 isolates were found untypable and 3 isolates were reported rough isolates. Of the 59 E. coli isolates from stool samples of diarrhoeal patients tested, 15 isolates (25.42% were reported to be positive for stx genes, among that 6 (10.16% were positive for stx1 gene, 9 (15.25% isolates were positive for stx2 gene, while 3 isolates (5.08% were positive for eaeA gene. In this study, 21 E. coliisolates were found to be Shiga toxin producing E. coli (STEC while none of the isolates were positive for the serotype O157. Conclusions: Our present findings indicate that raw milk may act as a source of pathogenic E. coli and it may be responsible for the occurrence of diarrhoea and various other health-related complications in humans. We therefore recommend proper managemental practices and effective control measures for improved hygiene and sanitation.

M. N. Brahmbhatt

2013-07-01

276

The Prevalence of Thyroid Dysfunction in Elderly Cardiology Patients with Mild Excessive Iodine Intake in the Urban Area of São Paulo  

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OBJECTIVES: To evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting. SUBJECTS AND METHODS: A total of 399 consecutive patients (268 women, age range 60-92 years) who were followed at Heart Institute were evaluated for thyroid dysfunction with serum free T4, TSH, anti-Peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound. RESULTS: Hyperthyroidism (overt and subclinical) was present in 29 patients (6.5%), whereas hypot...

Duarte, Glaucia C.; Tomimori, Eduardo K.; Camargo, Rosalinda Y. A.; Rubio, Ileana G. S.; Mauricio Wajngarten; Rodrigues, Amanda G.; Meyer Knobel; Geraldo Medeiros-Neto

2009-01-01

277

Daily Pomegranate intake has no impact on PSA levels in patients with advanced prostate cancer - Results of a phase IIb randomized controlled trial  

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Pomegranate has been shown to prolong PSA doubling time in early prostate cancer, but no data from a placebo controlled trial has been published yet. The objective of this study was to prospectively evaluate the impact of pomegranate juice in patients with prostate cancer. We conducted a phase IIb, double blinded, randomized placebo controlled trial in patients with histologically confirmed prostate cancer. Only patients with a PSA value ? 5ng/ml were included. The subjects consumed 500 ml ...

Stenner-liewen, Frank; Liewen, Heike; Cathomas, Richard; Renner, Christoph; Petrausch, Ulf; Sulser, Tullio; Spanaus, Katharina; Seifert, Hans Helge; Strebel, Ra?to Thomas; Knuth, Alexander; Samaras, Panagiotis; Mu?ntener, Michael

2013-01-01

278

Heterotopic ossification in combat amputees from Afghanistan and Iraq wars: Five case histories and results from a small series of patients  

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Full Text Available Heterotopic ossification (HO is excess bone growth in soft tissues that frequently occurs in the residual limbs of combat amputees injured in Operation Iraqi Freedom and Operation Enduring Freedom, or Iraq and Afghanistan wars, respectively. HO can interfere with prosthetic use and walking and delay patient rehabilitation. This article describes symptomatic and/or radiographic evidence of HO in a patient series of combat amputees rehabilitating at a military amputee care clinic (27 patients/33 limbs. We conducted a retrospective review of patient records and physician interviews to document evidence of HO symptoms in these limbs (e.g., pain during prosthetic use, skin breakdown. Results showed HO-related symptoms in 10 of the 33 residual limbs. Radiographs were available for 25 of the 33 limbs, and a physician identified at least moderate HO in 15 of the radiographs. However, 5 of the 15 patients who showed at least moderate radiographic HO did not report adverse symptoms. Five individual patient histories described HO onset, symptoms, treatments, and outcomes. These case histories illustrated how HO location relative to pressure-sensitive/pressure-tolerant areas of the residual limb may determine whether patients experienced symptoms. These histories revealed the uncommon but novel finding of potential benefits of HO for prosthetic suspension.

Ted Melcer, PhD

2011-01-01

279

The prevalence of thyroid dysfunction in elderly cardiology patients with mild excessive iodine intake in the urban area of São Paulo  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVES: To evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting. SUBJECTS AND METHODS: A total of 399 consecutive patients (268 women, age range 60-92 years) who were followed at Heart Institute were evaluated for thyroid dysfunction with serum free [...] T4, TSH, anti-Peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound. RESULTS: Hyperthyroidism (overt and subclinical) was present in 29 patients (6.5%), whereas hypothyroidism (overt and subclinical) was found in 32 individuals (8.1%). Cysts were detected in 11 patients (2.8%), single nodules were detected in 102 (25.6%), and multinodular goiters were detected in 34 (8.5%). Hashimoto's thyroiditis was present in 16.8% patients, most of whom were women (83.6%). The serum TSH increased with age and was significantly higher (p= 300 µg/L) was observed in one-third of patients (30.8%). CONCLUSIONS: Elderly patients have a higher prevalence of both hypo- and hyperthyroidism as well as thyroid nodules when compared with the general population. About one-third of the older patients had elevated urinary secretion of iodine and a higher prevalence of chronic Hashimoto's thyroiditis. It is recommended that ultrasonographic studies, tests for thyroid function and autoimmunity should be evaluated in elderly patients.

Glaucia C., Duarte; Eduardo K., Tomimori; Rosalinda Y. A., Camargo; Ileana G.S., Rubio; Mauricio, Wajngarten; Amanda G., Rodrigues; Meyer, Knobel; Geraldo, Medeiros-Neto.

2009-02-01

280

The prevalence of thyroid dysfunction in elderly cardiology patients with mild excessive iodine intake in the urban area of São Paulo  

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Full Text Available OBJECTIVES: To evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting. SUBJECTS AND METHODS: A total of 399 consecutive patients (268 women, age range 60-92 years who were followed at Heart Institute were evaluated for thyroid dysfunction with serum free T4, TSH, anti-Peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound. RESULTS: Hyperthyroidism (overt and subclinical was present in 29 patients (6.5%, whereas hypothyroidism (overt and subclinical was found in 32 individuals (8.1%. Cysts were detected in 11 patients (2.8%, single nodules were detected in 102 (25.6%, and multinodular goiters were detected in 34 (8.5%. Hashimoto's thyroiditis was present in 16.8% patients, most of whom were women (83.6%. The serum TSH increased with age and was significantly higher (p= 300 µg/L was observed in one-third of patients (30.8%. CONCLUSIONS: Elderly patients have a higher prevalence of both hypo- and hyperthyroidism as well as thyroid nodules when compared with the general population. About one-third of the older patients had elevated urinary secretion of iodine and a higher prevalence of chronic Hashimoto's thyroiditis. It is recommended that ultrasonographic studies, tests for thyroid function and autoimmunity should be evaluated in elderly patients.

Glaucia C. Duarte

2009-02-01

 
 
 
 
281

A Simple Tool for Diet Evaluation in Primary Health Care: Validation of a 16-Item Food Intake Questionnaire  

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Our aim was to validate a 16-item food intake questionnaire (16-FIQ) and create an easy to use method to estimate patients’ nutrient intake in primary health care. Participants (52 men, 25 women) completed a 7-day food record and a 16-FIQ. Food and nutrient intakes were calculated and compared using Spearman correlation. Further, nutrient intakes were compared using kappa-statistics and exact and opposite agreement of intake tertiles. The results indicated that the 16-FIQ reliably categori...

Katri Hemiö; Auli Pölönen; Kirsti Ahonen; Mikko Kosola; Katriina Viitasalo; Jaana Lindström

2014-01-01

282

Acompanhamento nutricional de cirróticos com história pregressa de alcoolismo / Nutrition follow-up o cirrhotic patients with history of alcoholism  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A desnutrição proteíco-energética é freqüente nos pacientes cirróticos e representa um sério risco no aumento das taxas de morbi-mortalidade desta população. Independente do fator etiológico sua prevalência é alta e repercute em ambos os sexos. Este estudo de casos objetivou verificar o impacto da i [...] njúria cirrose alcoólica no estado nutricional e a eficácia do tratamento dietoterápico na reversão da depleção nutricional. Foram estudados 50 pacientes (47 homens e 3 mulheres) atendidos no Ambulatório de Nutrição onde foi realizada avaliação nutricional objetiva com os parâmetros antropométricos, bioquímicos, clínicos e história dietética em três momentos distintos (início, 8º e 18º mês de tratamento). Os resultados iniciais revelaram que 96% dos cirróticos apresentavam algum nível de desnutrição e, no 18º mês tiveram normalização dos parâmetros nutricionais. Abstract in english The protein-calorie malnutrition is very common in the cirrhotic patients and it represents a risk in the morbidity and mortality rates increase. Independently of the etiologic factor, its prevalence is high and has repercussions in both sexes. This cases study had the objective of verifying the imp [...] act of alcoholic cirrhosis in the nutritional status and the efficacy of the diet therapy in the reversion of malnutrition. Fifty patients (47 men and 3 women) were studied. They were attended at the Nutrition Ambulatory, where an objective nutritional assessment was carried out wish anthropometric, biochemical and clinical parameters and dietetic history in three distinct moments (beginning, 8th and 18th month of treatment). The first results revealed that 96% of the cirrhotic patients presented some level of malnutrition and in the 18th month the nutritional parameters were normalized.

Nelzir Trindade, Reis; Cláudia dos Santos, Cople.

1998-12-01

283

A high grade pleural based sarcoma in a patient with rheumatoid arthritis and a 7-year history of anti-TNF alpha therapy  

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Full Text Available The use of anti-tumour necrosis factor alpha (anti-TNF? therapies has increased over the past few years. Concerns have been raised about the theoretical increased risk of malignancy in patients receiving these therapies. We report a case of an extremely rare high grade pleural based sarcoma in a patient with rheumatoid arthritis and a 7-year history of anti-TNF? therapy.

Dinesh Shrikrishna

2011-01-01

284

MR stress perfusion for the detection of flow-limiting stenoses in symptomatic patients with known coronary artery disease and history of stent implantation  

International Nuclear Information System (INIS)

Purpose: The aim of the present study was to determine the correlation of myocardial perfusion MR imaging (MPMRI) and coronary angiography for the detection of flow-limiting stenosis in symptomatic patients with known coronary artery disease and a history of intervention. Materials and Methods: MPMRI was performed in 51 symptomatic patients (44 male, 64.7 ± 9.5 years) with known coronary artery disease and a history of stent implantation (between 5 years and 2 weeks prior to MRI). Malperfused myocardial regions were correlated with findings of coronary angiography. A stenosis of > 70 % was regarded as hemodynamically significant. Results: In MPMRI 37 patients (73 %) showed a stress induced perfusion deficit. In 35 of these patients coronary angiography revealed a stenosis of > 70 %. A total of 38 patients (75 %) showed stenoses of > 70 %. MPMRI yielded a sensitivity of 92 % with a specificity of 85 %. The positive predictive value was 95 % and negative predictive value was 79 %. The assignment of malperfused segments to coronary artery territories was carried out according to the standardized myocardial model of the American Heart Association (sensitivity/specificity was 59/85 % for RCA, 79/81 % for LAD and 54/68 % for LCX). Conclusion: MPMRI is a suitable non-invasive method for detecting flow-limiting coronary artery stenoses in patients with a history of stent implantation. (orig.)

285

Natural history of markers of collagen turnover in patients with early diastolic dysfunction and impact of eplerenone.  

LENUS (Irish Health Repository)

OBJECTIVES: This study was designed to evaluate the impact of eplerenone on collagen turnover in preserved systolic function heart failure (HFPSF). BACKGROUND: Despite growing interest in abnormal collagen metabolism as a feature of HFPSF with diastolic dysfunction, the natural history of markers of collagen turnover and the impact of selective aldosterone antagonism on this natural history remains unknown. METHODS: We evaluated 44 patients with HFPSF, randomly assigned to control (n = 20) or eplerenone 25 mg daily (n = 24) for 6 months, increased to 50 mg daily from 6 to 12 months. Serum markers of collagen turnover and inflammation were analyzed at baseline and at 6 and 12 months and included pro-collagen type-I and -III aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha. Doppler-echocardiographic assessment of diastolic filling indexes and tissue Doppler analyses were also obtained. RESULTS: The mean age of the patients was 80 +\\/- 7.8 years; 46% were male; 64% were receiving an angiotensin-converting enzyme inhibitor, 34% an angiotensin-II receptor blocker, and 68% were receiving beta-blocker therapy. Pro-collagen type-III and -I aminoterminal peptides, matrix metalloproteinase type-2, interleukin-6 and -8, and tumor necrosis factor-alpha increased with time in the control group. Eplerenone treatment had no significant impact on any biomarker at 6 months but attenuated the increase in pro-collagen type-III aminoterminal peptide at 12 months (p = 0.006). Eplerenone therapy was associated with modest effects on diastolic function without any impact on clinical variables or brain natriuretic peptide. CONCLUSIONS: This study demonstrates progressive increases in markers of collagen turnover and inflammation in HFPSF with diastolic dysfunction. Despite high background utilization of renin-angiotensin-aldosterone modulators, eplerenone therapy prevents a progressive increase in pro-collagen type-III aminoterminal peptide and may have a role in management of this disease. (The Effect of Eplerenone and Atorvastatin on Markers of Collagen Turnover in Diastolic Heart Failure; NCT00505336).

Mak, George J

2012-02-01

286

Intake of energy and nutrients. Euronut SENECA investigators.  

Science.gov (United States)

As part of the Euronut SENECA study, food consumption has been assessed in 1217 men and 1241 women, born between 1913 and 1918 and living in 18 towns in 12 European countries. The method used was a standardized modified dietary history, including a 3-day estimated record and a food frequency list based on local food patterns. Intakes of energy, protein, fat, carbohydrate, fatty acids, cholesterol and alcohol are described in this paper. As expected, a difference between men and women in energy and nutrient intake was observed in all towns. There was a great variation between towns in mean dietary intakes of all dietary components. Mean energy intake of men ranged from 12.7 MJ in Marki (Poland) to 8.2 MJ in Yverdon (Switzerland) and Chateau Renault-Amboise (France). For women the range was from 10.9 MJ in Marki (Poland) to 6.3 MJ in Yverdon (Switzerland) and Vila Franca de Xira (Portugal). A geographical pattern can be detected for the intake of fatty acids. Intakes of saturated fat were lower in southern than in northern European towns. The calculated ratio for intakes of unsaturated and saturated fatty acids (polyunsaturated fatty acids plus monounsaturated fatty acids/saturated fatty acids) for all participants was higher in the southern European centres than in the northern centres and ranged from 2.7 in Markopoulo (Greece) to 1.2 in Elverum (Norway) and Marki (Poland). Alcohol consumption was considerable higher in men than in women. In men a north-south gradient in alcohol intake can be detected, with the highest intake in the two centres in Italy, where, on average 11% of energy intake was derived from alcohol. PMID:1809560

Moreiras, O; van Staveren, W A; Cruz, J A; Nes, M; Lund-Larsen, K

1991-12-01

287

The activity of serum beta-galactosidase in colon cancer patients with a history of alcohol and nicotine dependence: preliminary data  

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Full Text Available Introduction: Beta-galactosidase (GAL is a lysosomal exoglycosidase involved in the catabolism of glycoconjugates through the sequential release of beta-linked terminal galactosyl residues. The stimulation of activity of exoglycosidases and other degradative enzymes has been noted in cancers as well as in alcohol and nicotine addiction separately. This is the first study to evaluate the activity of the serum senescence marker GAL in colon cancer patients with a history of alcohol and nicotine dependence, as a potential factor of worse cancer prognosis.Material and Methods: The material was serum of 18 colon cancer patients and 10 healthy volunteers. Ten colon cancer patients met alcohol and nicotine dependence criteria. The activity of beta-galactosidase (pkat/ml was determined by the colorimetric method. Comparisons between groups were made using the Kruskal-Wallis analysis and differences evaluated using the Mann-Whitney U test. Spearman’s rank correlation coefficient was used to measure the statistical dependence between two variables.Results: The activity of serum GAL was significantly higher in colon cancer patients with a history of alcohol and nicotine dependence, in comparison to colon cancer patients without a history of drinking/smoking (p=0.015; 46?0increase, and the controls (p=0.0002; 81?0increase. The activity of serum GAL in colon cancer patients without a history of alcohol/nicotine dependence was higher than the activity in the controls (p = 0.043; 24?0increase.Discussion/Conclusion: Higher activity of beta-galactosidase may potentially reflect the accelerated growth of the cancer, invasion, metastases, and maturation, when alcohol and nicotine dependence coincide with colon cancer. For a better prognosis of colon cancer, alcohol and nicotine withdrawal seems to be required.

Napoleon Waszkiewicz

2013-08-01

288

Impaired DNA repair as assessed by the 'comet' assay in patients with thyroid tumors after a history of radiation therapy: A preliminary study  

International Nuclear Information System (INIS)

Purpose: Patients with a history of head and neck irradiation in childhood are at risk to develop thyroid tumors. The aim of this study was to determine if an impairment of DNA strand breaks repair could account for this observation. Methods and Materials: Circulating unstimulated lymphocytes of a group of 13 patients who developed thyroid tumors after radiotherapy were submitted to the alkaline single-cell gel electrophoresis assay (SCGE or 'comet' assay) after in vitro exposure to 2 and 5 Gy of ?-rays. A control group of 8 healthy donors and 2 cases with a history of neck irradiation who did not develop a thyroid tumor were also analysed. The immediate response was compared to that observed after 15, 30, and 60 min of postexposure incubation periods. Results: Induction of DNA strand breaks is a dose-dependent process. The SCGE assay parameters did not differ significantly between patients and controls immediately (t = 0) after irradiation at the two doses used. As compared to healthy donors, a slower kinetics of repair was found in the patients. The proportion of residual damage at 60 min postirradiation was significantly (p < 0.01) higher in patients than in controls, at both doses analysed. Flow cytometric analysis of apoptosis and p53 protein status studied before and after irradiation showed no apparent relationship with the repair capacity. Conclusion: This preliminary study suggests that a subgroup of patients who develop thyroid tumors after a history of irrlop thyroid tumors after a history of irradiation are partially defective in the late restitution of in vitro radiation-induced DNA strand breaks. This deficiency could be a predisposing factor to radiation-associated thyroid tumorigenesis. Detection of susceptible individuals using the simple and rapid comet assay, especially children receiving radiotherapeutic treatment, may allow a preventive surveillance for radiation-associated epithelial thyroid tumor development

289

Plasma dipeptidyl peptidase-IV activity in patients with type-2 diabetes mellitus correlates positively with HbAlc levels, but is not acutely affected by food intake  

DEFF Research Database (Denmark)

OBJECTIVE: Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide are incretin hormones, secreted in response to meal ingestion. The incretin hormones stimulate insulin secretion and are essential for the maintenance of normal plasma glucose concentrations. Both incretin hormones are metabolized quickly by the enzyme dipeptidyl peptidase-IV (DPP-IV). It is well known that type-2 diabetic patients have an impaired incretin effect. Therefore, the aim of the present study was to investigate plasma DPP-IV activity in the fasting and the postprandial state in type-2 diabetic patients and control subjects. DESIGN: The study included two protocols. Protocol one involved 40 fasting type-2 diabetic patients (28 men); age 61 +/- 1.4 (mean +/- s.e.m.) years; body mass index (BMI) 31 +/- 0.6 kg/m(2); HbAlc 7.2 +/- 0.2%; and 20 matched control subjects (14 men) were studied. Protocol two involved eight type-2 diabetic patients (six men); age 63 +/- 1.2 years; BMI 33 +/- 0.5 kg/m(2); HbAlc 7.5 +/-0.4%; eight matched control subjects were included. METHODS: In protocol one, fasting values of DPP-IV activity were evaluated and in protocol two, postprandial DPP-IV activity during a standard meal test (566 kcal) was estimated. RESULTS: Mean fasting plasma DPP-IV activity (expressed as degradation of GLP-1) was significantly higher in this patient group compared with the control subjects (67.5 +/- 1.9 vs 56.8 +/- 2.2 fmol GLP-1/h (mean +/- s.e.m.); P=0.001). In the type-2 diabetic patients, DPP-IV activity was positively correlated to FPG and HbAlc and negatively to the duration of diabetes and age of the patients. No postprandial changes were seen in plasma DPP-IV activity in any of the groups. CONCLUSIONS: Plasma DPP-IVactivity increases in the fasting state and is positively correlated to FPG and HbAlc levels, but plasma DPP-IV activity is not altered following meal ingestion and acute changes in plasma glucose.

Ryskjaer, Jakob; Deacon, Carolyn F

2006-01-01

290

Clinical impact of abnormal FDG uptake in pulmonary nodules detected by CT in patients with only history of non-lung cancers  

International Nuclear Information System (INIS)

Objective: The aim is to assess the clinical impact of positive FDG uptake in single (SPN) or multiple (MPN) pulmonary nodules detected by CT in patients with known past history of non-lung cancers (but no known lung cancers). Materials and Methods: Twenty-eight sequential patients with non-lung cancers (15 breast, 8 colon, 5 prostate) referred for evaluation of SPN or MPN by PET over a period of two years were included. F-18 FDG PET images, covering chest and upper abdomen, were interpreted blindly and then correlated with CT findings for the precise location of abnormal FDG uptake in the chest. Results: There was a significant number of abnormal FDG uptake in both SPN or MPN. Positive abnormal uptake suggestive of malignancy was found in 25% of patients in the form of SPN and 39% of patients in the form of MPN (p<0.03). Positive cases in the pattern of multiple foci of pulmonary uptake were attributed to metastatic disease. Otherwise positive cases were followed by tissue diagnosis and/or surgical attention. The negative cases were followed clinically. Of the 11 positive cases of MPN, 2 patients (18%) showed only abnormal FDG uptake in just one of the nodules, which was later confirmed at surgery to be a primary cancer of lung in both patients. Conclusion: These results suggest that PET scan would be just as useful in patients with SPN and known non-lung cancers as other patients with no history of any cancers. Not all patients with non-lung cancer and MPN have pulmnts with non-lung cancer and MPN have pulmonary metastasis by PET criteria. PET may single out a primary lung malignancy in patients with non-lung cancer and MPN. PET has thus great clinical impact in these patients with pulmonary nodules and known non-lung cancers as the management would otherwise be completely different in situations revealed by the study

291

Is the control of dietary cholesterol intake sufficiently effective to ameliorate nonalcoholic fatty liver disease?  

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Full Text Available In our examination of the distribution of abdominal fat, dietary intake and biochemical data in patients with nonalcoholic fatty liver disease (NAFLD, non-obese NAFLD patients without insulin resistance presented a characteristic pattern of dietary intake. Dietary cholesterol intake was superabundant in non-obese patients compared with obese patients, although total energy and carbohydrate intake was not excessive. Namely, excess cholesterol intake appears to be one of the main factors associated with NAFLD development and liver injury. Therefore, the control of dietary cholesterol intake may lead to an improvement in NAFLD, and the NPC1L1 inhibitor ezetimibe might be a promising treatment for NAFLD. We review one pathogenic aspect of lipid metabolism dysregulation in NAFLD and survey new strategies for NAFLD treatment based on the modification of cholesterol metabolism.

Munechika Enjoji, Makoto Nakamuta

2010-02-01

292

Estimates of food and macronutrient intake in a random sample of Northern Ireland adolescents.  

Science.gov (United States)

Estimates of food consumption and macronutrient intake were obtained from a randomly selected population sample (2%) of 1015 adolescents aged 12 and 15 years in Northern Ireland during the 1990/1991 school year. Dietary intake was assessed by diet history with photographic album to estimate portion size. Reported median energy intakes were 11.0 and 13.1 MJ/d for boys aged 12 and 15 years respectively and 9.2 and 9.1 MJ/d for girls of these ages. Protein, carbohydrate and total sugars intakes as a percentage of total energy varied little between the age and sex groups and were approximately 11, 49 and 20% respectively of daily total energy intakes. Median dietary fibre intakes were approximately 20 and 24 g/d for boys aged 12 and 15 years respectively and 18 and 19 g/d for girls of these ages. Major food sources of energy (as a percentage of total energy intakes) were bread and cereals (15-18%), cakes and biscuits (12-14%), chips and crisps (13-14%), dairy products (9-11%), meat and meat products (9-11%) and confectionery (9%). Fruit and vegetable intakes were low at about 2.5% and 1.5% respectively of total energy intakes. Median fat intakes were high at 39% of total daily energy intakes. Major food sources of fat as a percentage of total fat intakes were from the food groupings: chips and crisps (16-19%), meat and meat products (14-17%), fats and oils (14-16%), cakes and biscuits (13-16%) and dairy products (12-15%). Median intakes of saturated fatty acids were also high at approximately 15% of daily total energy intake while intakes of monounsaturated fatty acids averaged 12% of daily total energy intake. Median polyunsaturated fatty acid (PUFA) intakes were low, comprising 5.2 and 5.5% of daily total energy intake for boys aged 12 and 15 years respectively and were lower than the PUFA intakes (5.9 and 6.3% of daily total energy intake) for girls of these ages. About 1.3% for boys and 1.4% for girls of daily total energy intake was in the form of n-3 PUFA. Ca and Mg intakes were adequate for both sexes. Based on these results, some concern about the dietary habits and related health consequences in Northern Ireland adolescents appears justified. PMID:7947651

Strain, J J; Robson, P J; Livingstone, M B; Primrose, E D; Savage, J M; Cran, G W; Boreham, C A

1994-09-01

293

Long-term nutritional assessment of patients with severe short bowel syndrome managed with home enteral nutrition and oral intake / Evaluación nutricional a largo plazo de pacientes con grave síndrome de intestino corto controlada con nutrición enteral e ingestión oral  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Antecedentes: La nutrición parenteral (NP) se emplea para controlar el estado nutricional después de resecciones intestinales extensas. Siempre que sea posible, se empleará la nutrición enteral (NE) para favorecer la rehabilitación intestinal y reducir la dependencia de la NP. Nuestro propósito fue [...] verificar si la NE + ingesta oral (IO) en el síndrome del intestino corto (SIC) grave en pacientes adultos quirúrgicos puede mantener un estado nutricional adecuado a largo plazo. Métodos: Este estudio longitudinal retrospectivo incluyó 10 pacientes seguidos durante 7 años tras la intervención quirúrgica. Se evaluaron el índice de masa corporal (IMC), el porcentaje de pérdida involuntaria del peso corporal habitual (PCH), la masa grasa libre (MGL) y la composición de la masa grasa (MG) mediante impedancia bioeléctrica, así como los datos de laboratorio a los 6, 12, 24, 36, 48, 60, 72 y 84 meses tras la cirugía. Se evaluaron en los mismos periodos la energía y las proteínas aportadas con la NPD y a largo plazo con la NED + ingesta oral (IO). Se utilizó un modelo estadístico de ecuaciones estimativas generalizadas con una p Abstract in english Background: Parenteral nutrition (PN) is used to control the nutritional state after severe intestinal resections. Whenever possible, enteral nutrition (EN) is used to promote intestinal rehabilitation and reduce PN dependency. Our aim is to verify whether EN + oral intake (OI) in severe short bowel [...] syndrome (SBS) surgical adult patients can maintain adequate nutritional status in the long term. Methods: This longitudinal retrospective study included 10 patients followed for 7 post-operative years. Body mass index (BMI), percentage of involuntary loss of usual body weight (UWL), free fat mass (FFM), and fat mass (FM) composition assessed by bioelectric impedance, and laboratory tests were evaluated at 6, 12, 24, 36, 48, 60, 72, and 84 months after surgery. Energy and protein offered in HPN and at long term by HEN+ oral intake (OI), was evaluated at the same periods. The statistical model of generalized estimating equations with p

V., Chaer Borges; M.ª de L., Teixeira da Silva; M.ª C., Gonçalves Dias; M.ª C., González; D., Linetzky Waitzberg.

2011-08-01

294

The long-term perspective: a study of psychopathology and health status of patients with a history of depression more than 15 years after the first episode.  

Science.gov (United States)

This article examines psychopathology, functioning, well-being, social support, and coping-behavior of family practice patients with a history of depressive illness, both with and without recurrences. Results of depressive patients were compared with each other and with those of "normal" controls. The patients belonged to the four practices of the Continuous Morbidity Registry of the University of Nijmegen, Netherlands. Their first episode of depression for each patient was more than 15 years ago. Data were collected with the Symptom Checklist (SCL-90) the RAND-36, the Social Support List (SSL-12), and the short Utrecht Coping List (UCL-k). Psychopathology scores of patients without recurrences were higher than "normal" controls and lower than patients with recurrences. The same pattern was found concerning health status. No significant differences were found between the groups in social support but patients with recurrences had a lower score of emotional coping than patients without recurrences or normal patients. That even a long time after an episode of depression, patients have higher levels of a variety of psychopathology than controls has implications for every-day practice as it calls for a longer and more critical follow-up of depression by clinicians. PMID:11072055

van Weel-Baumgarten, E M; van den Bosch, W J; van den Hoogen, H J; Zitman, F G

2000-01-01

295

Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT  

International Nuclear Information System (INIS)

A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation

296

Solitary Plasmacytoma of the Sternum Mimicking Bone Metastasis in a Patient with a History of Breast Cancer Evaluated by F-18-FDG PET/CT  

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A 65-year-old woman with a history of breast cancer (stage T2N0M0 treated with left breast conservative therapy 7 years previously followed by hormone therapy) underwent fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) for restaging due to increased serum tumour markers levels (CA15-3, 37 U/ml and CEA, 8 ng/ml). The patient presented thoracic pain before performing F-18-FDG PET/CT. PET/CT demonstrated an area of increased F-18-FDG uptake corresponding to an osteolytic lesion occupying the upper sternum suspicious for bone metastasis. No other areas of abnormal F-18-FDG uptake were detected in the rest of the body. Based on this PET/CT finding, the patient performed biopsy of the sternal lesion. Histology demonstrated the presence of a sternal plasmacytoma and the patient was addressed to radiation therapy. The role of F-18-FDG PET/CT in patients with multiple myeloma is well known, whereas only some articles evaluated the usefulness of this method in patients with solitary plasmacytomas. In particular, F-18-FDG PET/CT may be useful in demonstrating the evolution of solitary plasmacytomas in multiple myeloma. In our case F-18-FDG PET/CT was useful in detecting a solitary plasmacytoma of the sternum mimicking bone metastasis in a patient with history of breast cancer, correctly addressing to further histological evaluation.

Treglia, Giorgio; Luca, Giovanella [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Barbara, Muoio; Carmelo, Caldarella [Catholic Univ., Rome (Italy)

2014-06-15

297

Dietary intake increases serum levels of carboxymethil-lysine (CML in diabetic patients La ingesta dietaria de carboximetil-lisina (CML aumenta los niveles plasmáticos de este compuesto en pacientes diabéticos  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Advanced glycation end products are produced endogenously, in association with hyperglycemia and oxidative stress. They can also be generated during cooking or food processing and, once absorbed, alter protein function and promote inflammation. Methods: We selected 40 healthy male subjects, 17 patients with type 2 diabetes of both sexes and 15 patients with type 1 diabetes of both sexes. Each participant underwent both a food frequency questionnaire (FFQ and 24-hour dietary recall specially adapted for measuring CML intake, anthropometry, measurement of blood pressure and biochemical parameters in blood and urine. Results: Serum CML levels were significantly higher in patients with diabetes compared to healthy subjects (p 0.04, showing a direct relationship between dietary intake and serum levels of CML in T2D patients (r 0.53 p 0.03. sCML levels correlated positively with length of diabetes mellitus, and inversely with body mass index (BMI. The most important dietary factor contributing to raise CML levels in these patients with diabetes was the consumption of milk powder. Conclusion: Serum levels of CML were found to be higher among diabetic subjects, associated to length of diabetes as expected, but also with the ingestion of foods containing higher amounts of ML. The consumption of milk powder in this group is a major determinant of increased serum levels.Introducción: Los productos avanzados de la glicación se producen de forma endógena en relación con la hiperglucemia y el estrés oxidativo. También pueden generarse durante el cocinado o el procesamiento de los alimentos; una vez absorbidos, alteran la función proteica y favorecen la inflamación. Métodos: Seleccionamos a 40 hombres sanos, 17 pacientes con diabetes tipo 2 de ambos sexos y 15 pacientes con diabetes tipo 1 de ambos sexos. A cada participante se le realizó un cuestionario de frecuencia de consumo de alimentos (CFA y un recordatorio de 24 horas especialmente adaptado para medir el consumo de CML, antropometría, medición de la presión sanguínea y parámetros bioquímicos en la sangre y la orina. Resultados: Las concentraciones séricas de CML fueron significativamente mayores en pacientes con diabetes en comparación con los individuos sanos (p = 0,04. Se encontró una relación directa entre el consumo dietético y las concentraciones séricas de CML en los pacientes con diabetes tipo 2 (r = 0,53; p = 0,03. Las concentraciones séricas de CML se correlacionan positivamente con la duración de la diabetes mellitus e inversamente con el índice de masa corporal (IMC. El alimento que más contribuye al aumento de las concentraciones plasmáticas de CML en estos pacientes fue el consumo de leche en polvo. Conclusión: Se encontró que las concentraciones séricas de CML eran mayores en los sujetos diabéticos, asociado con la duración de la diabetes, como era de esperar, pero también con la ingestión de alimentos que contienen mayores cantidades de CML. El consumo de leche en polvo en este grupo es un factor determinante en el aumento de las concentraciones séricas de CML.

N. Jara

2012-08-01

298

Dietary intake increases serum levels of carboxymethil-lysine (CML) in diabetic patients / La ingesta dietaria de carboximetil-lisina (CML) aumenta los niveles plasmáticos de este compuesto en pacientes diabéticos  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Introducción: Los productos avanzados de la glicación se producen de forma endógena en relación con la hiperglucemia y el estrés oxidativo. También pueden generarse durante el cocinado o el procesamiento de los alimentos; una vez absorbidos, alteran la función proteica y favorecen la inflamación. Mé [...] todos: Seleccionamos a 40 hombres sanos, 17 pacientes con diabetes tipo 2 de ambos sexos y 15 pacientes con diabetes tipo 1 de ambos sexos. A cada participante se le realizó un cuestionario de frecuencia de consumo de alimentos (CFA) y un recordatorio de 24 horas especialmente adaptado para medir el consumo de CML, antropometría, medición de la presión sanguínea y parámetros bioquímicos en la sangre y la orina. Resultados: Las concentraciones séricas de CML fueron significativamente mayores en pacientes con diabetes en comparación con los individuos sanos (p = 0,04). Se encontró una relación directa entre el consumo dietético y las concentraciones séricas de CML en los pacientes con diabetes tipo 2 (r = 0,53; p = 0,03). Las concentraciones séricas de CML se correlacionan positivamente con la duración de la diabetes mellitus e inversamente con el índice de masa corporal (IMC). El alimento que más contribuye al aumento de las concentraciones plasmáticas de CML en estos pacientes fue el consumo de leche en polvo. Conclusión: Se encontró que las concentraciones séricas de CML eran mayores en los sujetos diabéticos, asociado con la duración de la diabetes, como era de esperar, pero también con la ingestión de alimentos que contienen mayores cantidades de CML. El consumo de leche en polvo en este grupo es un factor determinante en el aumento de las concentraciones séricas de CML. Abstract in english Introduction: Advanced glycation end products are produced endogenously, in association with hyperglycemia and oxidative stress. They can also be generated during cooking or food processing and, once absorbed, alter protein function and promote inflammation. Methods: We selected 40 healthy male subj [...] ects, 17 patients with type 2 diabetes of both sexes and 15 patients with type 1 diabetes of both sexes. Each participant underwent both a food frequency questionnaire (FFQ) and 24-hour dietary recall specially adapted for measuring CML intake, anthropometry, measurement of blood pressure and biochemical parameters in blood and urine. Results: Serum CML levels were significantly higher in patients with diabetes compared to healthy subjects (p 0.04), showing a direct relationship between dietary intake and serum levels of CML in T2D patients (r 0.53 p 0.03). sCML levels correlated positively with length of diabetes mellitus, and inversely with body mass index (BMI). The most important dietary factor contributing to raise CML levels in these patients with diabetes was the consumption of milk powder. Conclusion: Serum levels of CML were found to be higher among diabetic subjects, associated to length of diabetes as expected, but also with the ingestion of foods containing higher amounts of ML. The consumption of milk powder in this group is a major determinant of increased serum levels.

N., Jara; M. J., Leal; D., Bunout; S., Hirsch; G., Barrera; L., Leiva; M. P., de la Maza.

1272-12-01

299

Impacto del acompañamiento familiar sobre la ingestión de alimentos y el estado depresivo en pacientes con cáncer cervicouterino hospitalizadas Impact of family support over food intake and depressive status in cervical cancer patients during hospitalization  

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Full Text Available Introducción: El cáncer cérvico uterino constituye un problema de salud pública en México; las pacientes sufren estrés físico y psicológico que conlleva a depresión y pérdida de peso. El comer acompañado tiene efectos positivos en la ingestión de alimentos y en el estado depresivo de pacientes hospitalizados. En nuestra sociedad, la comida es el medio más cercano que la familia tiene para ofrecer cuidados, afecto y ayuda a su ser querido que se manifiesta cada vez más inapetente conforme progresa la enfermedad. Objetivo: Establecer la relación entre la presencia familiar durante las comidas sobre el estado anímico, ingestión de alimentos, y cambio de peso durante la hospitalización. Metodología: Se estudiaron 106 mujeres que ingresaron a hospitalización del servicio de oncología del Hospital General de México, con diagnóstico de CaCu EC II y III a fin de mejorar condiciones. Se evaluó peso y talla, la dieta mediante recordatorios de 24 horas, al ingreso como al egreso y se aplicó la escala de depresión de Beck; se registró la frecuencia con la que los familiares acompañaron a la paciente durante las comidas. Resultados: Para su análisis se clasificaron en dos grupos de acuerdo al acompañamiento familiar; se encontró que 43 pacientes (40,6% tenían compañía, y 63 pacientes (59,4% se encontraron sin compañía. No se observaron diferencias significativas en la edad, y días de estancia entre los grupos (p > 0,05. Las pacientes acompañadas, contaron con una mayor disponibilidad de alimentos durante su hospitalización (p Introduction: Uterine cervical cancer represents a public health problem in Mexico; the patients suffer physical and psychological stress leading to depression and weight loss. Eating with a relative has positive effects in food ingestion and depressive status in hospitalized patients. In our society, food is the closest way that family members have to bring care and to show affection to the patient that has less appetite as diseasegoes on. Objective: To establish the relationship between presence of the family during the meals and depresion, food intake, and weight variation during hospitalization. Methodology: 106 women admitted to the Oncology Department at the General Hospital of Mexico with a diagnosis of CUCA clinical stage II and III were studied in order to improve their condition. Weight and height, diet by means of 24 hour recalls were assessed both at hospital admission and discharge, and Beck's depression inventory was applied; the frequency with which the relatives escorted the patient was recorded. Results: Patients were classified in two groups according to the frequency of family escorting; it was found that 43 patients (40.6% were accompanied, and 63 patients (59.4% were not. We did not find significant differences in age and days of hospital stay between the groups (p > 0.05. The escorted patients had more foods available during hospitalization (p < 0.05. Energy consumption (kcal in escorted patients was higher by 12.7% as compared to non-escorted patients. 76.7% of the escorted patients were depressed, as compared to 55% in the non-escorted group. Significant differences were found with regards to clinical status and presence of depression (p < 0.05 between the study groups. Conclusions: Family escorting does not have an influence on the amount of foods consumed during hospitalization or body weight variation; however, it does have an influence on the presence of depression.

M. Bejarano

2009-04-01

300

Treatment of squamous cell carcinoma of the head and neck in patients with a history of radiotherapy for cervical tuberculous lymphadenitis  

International Nuclear Information System (INIS)

Among 1,031 patients with head and neck tumors, 6 (0.6%) had a history of radiotherapy for cervical tuberculous lymphadenitis. The time from radiotherapy until occurrence of tumors was 27 to 45 years (mean, 35 years). The diagnosis was squamous cell carcinoma in all cases and consisted of hypopharyngeal (3), tongue (1), oropharyngeal (1), and laryngeal (1) cancers. Tumor control was achieved in 2 of 4 cases with radical radiotherapy and 2 of 2 cases with postoperative radiotherapy. Although reirradiation should be avoided, a full course of radiotherapy may be acceptable for a patient with a history of radiotherapy for cervical tuberculous lymphadenitis if the skin changes are not severe on the irradiated neck. (author)

 
 
 
 
301

Mesothelioma in an HIV/AIDS patient without history of asbestos exposure: possible role for immunosuppression in mesothelioma: a case report  

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We describe a 41-year-old African-American male who initially presented in respiratory distress. He had a positive history of asthma, cigarette smoking, and only recent possible asbestos exposure six months prior to onset of symptoms. Mesothelioma was suspected after chest radiography and PET-CT, and confirmed by immunohistochemical tissue analysis. We postulate that immunosuppression enhances susceptibility to mesothelioma, since weakened immune systems are present in both HIV/AIDS patients ...

James, Cleve Orian; Woods, Ashanti W.; Arya, Payam; Abuelgasim, Khadega Ahmed; Heath, Lekidelu Taddesse; Sitapati, Amy

2009-01-01

302

Ascending aortic aneurysm in a patient with bicuspid aortic valve, positive history of systemic autoimmune diseases and common genetic factors: a case report  

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Full Text Available Abstract The bicuspid aortic valve (BAV and specific systemic autoimmune diseases are associated with cardiovascular manifestation, including aortic aneurysm. We reported a case of 64 year-old patient with BAV and a history of ankylosing spondylitis (AS and systemic lupus erythematosus (SLE, and who developed ascending thoracic aortic aneurysm. The patient presented also the homozygosity for genetic variants of MMP9, ACE, MTHFR and PAI-1 genes. Gene-environmental interactions may represent an additional pathogenetic dimension in the still challenging management of the abnormalities of the aortic wall, including dilatation, aneurysm and dissection.

Mazzone Annamaria

2009-07-01

303

Age at onset versus family history and clinical outcomes in 1,665 international bipolar-I disorder patients.  

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Early onset in bipolar disorder (BPD) has been associated with greater familial risk and unfavorable clinical outcomes. We pooled data from seven international centers to analyze the relationships of family history and symptomatic as well as functional measures of adult morbidity to onset age, or onset in childhood (age adolescent > child. Onset in childhood versus adolescence had more episodes/year and more psychiatric co-morbidity. Family history was most prevalent with childhood onset, similar over onset ages 12-40 years, and fell sharply thereafter. Multivariate modeling sustained the impression that family history and poor functional, but not symptomatic, outcomes were associated with younger, especially childhood onset. Early onset was more related to poor functional outcomes than greater symptomatic morbidity, with least favorable outcomes and greater family history with childhood onset. PMID:22295008

Baldessarini, Ross J; Tondo, Leonardo; Vazquez, Gustavo H; Undurraga, Juan; Bolzani, Lorenza; Yildiz, Aysegul; Khalsa, Hari-Mandir K; Lai, Massimo; Lepri, Beatrice; Lolich, Maria; Maffei, Pier Mario; Salvatore, Paola; Faedda, Gianni L; Vieta, Eduard; Tohen, Mauricio

2012-02-01

304

Antioxidant vitamin intake and mortality: the leisure world cohort study.  

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To assess the relationship between antioxidant vitamin intake and all-cause mortality in older adults, we examined these associations using data from the Leisure World Cohort Study, a prospective study of residents of the Leisure World retirement community in Laguna Hills, California. In the early 1980s, participants (who were aged 44-101 years) completed a postal survey, which included details on use of vitamin supplements and dietary intake of foods containing vitamins A and C. Age-adjusted and multivariate-adjusted (for factors related to mortality in this cohort-smoking, alcohol intake, caffeine consumption, exercise, body mass index, and histories of hypertension, angina, heart attack, stroke, diabetes, rheumatoid arthritis, and cancer) hazard ratios for death were calculated using Cox regression for 8,640 women and 4,983 men (median age at entry, 74 years). During follow-up (1981-2013), 13,104 participants died (median age at death, 88 years). Neither dietary nor supplemental intake of vitamin A or vitamin C nor supplemental intake of vitamin E was significantly associated with mortality after multivariate adjustment. A compendium that summarizes previous findings of cohort studies evaluating vitamin intake and mortality is provided. Attenuation in the observed associations between mortality and antioxidant vitamin use after adjustment for confounders in our study and in previous studies suggests that such consumption identifies persons with other mortality-associated lifestyle and health risk factors. PMID:25550360

Paganini-Hill, Annlia; Kawas, Claudia H; Corrada, María M

2015-01-15

305

Evaluation of 14 questions detecting malnutrition in newly hospitalized patients.  

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Malnutrition of patients is an important factor of poor prognosis and outcome and long stay in hospital. Nutrition screening is of course necessary for detecting under- and malnutrition. However, appropriate rapid and easy screening tools for only acute and emergent hospitalized patients are not known. In this study, 14 questions composed with reported and new items were prepared and the utility of those questions for detecting malnutrition in novel hospitalized patients was evaluated. Combined questions on disturbance of swallowing, diarrhea and fever, and also on ageing, food intake and history of fall are very important for detecting malnutrition in newly hospitalized patients, although further study will be absolutely required. PMID:23614922

Kayashita, Atsuko; Yamato, Harue; Yoshida, Ikuko; Matsuzaki, Kazuyo; Niki, Hiroshi; Nagae, Hiroki; Miyamoto, Ken-ichi

2013-01-01

306

Factores asociados con la irregularidad de la ingesta de Dapsona en pacientes con lepra: Dapsona en pacientes con lepra / Associated factors with irregular intake of Dapsone in leprosy patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Introducción: Conocer los factores asociados al cumplimiento del tratamiento en pacientes con lepra, es muy importante para prevenir la resistencia del Mycobacterium leprae y garantizar la cura bacteriológica de estas personas. La prueba de orina para Dapsona, presente en el régimen autoadministrado [...] , es un método sencillo para establecer la regularidad del tratamiento. Objetivo: Explorar los factores asociados a la irregularidad de la ingesta del tratamiento antileproso. Métodos: Estudio de corte transversal de los enfermos que recibieron tratamiento antileproso en un centro dermatológico. La irregularidad se estableció con la prueba de dapsonuria. Se consideró irregular el que presentó la prueba negativa. Las variables sospechosas de influir en la irregularidad se analizaron con regresión logística exacta. Resultados: En el modelo final del análisis multivariado se encontraron cinco variables asociadas, entre éstas sobresalen como factores de riesgo, la ausencia de discapacidad, OR 28.56 (IC90% 1.2-2.1) y la entrega de tratamiento para tiempos mayores a un mes, por cada mes OR 3.41 (IC90% 1.4-9.2) y como factor protector, la aceptación familiar de la enfermedad OR 0.008 (IC90% 0.001-0.24). Conclusión: Aunque es posible que el pequeño tamaño de muestra no haya permitido detectar algunos factores de riesgo informados en otras investigaciones, la mayoría de esos estudios no han realizado análisis multivariado por lo cual es posible que muchos de los factores informados en la literatura no tengan importancia. Salud UIS 2013; 45 (1): 7-14 Abstract in english Introducción: To know the associated factors in the treatment compliance of leprosy patients is very important to prevent the appearance of Mycobacterium leprae resistance and achieve the bacteriological cure of these persons. The urine test for Dapsone, present in the self administered regimens, is [...] a simple method to establish the regularity. Objective: To explore the factors associated with irregular intake of leprosy treatment. Methods: Cross sectional study of patients receiving leprosy treatment in a dermatology center. The irregularity was established with the dapsonuria test. It was considered irregular the patient with a negative dapsonuria test. Variables suspected of influencing the irregular intake were analyzed using exact logistic regression. Results: In the final multivariate model there were five associated variables, among which, the absence of disability OR 28.56( CI90% 1.2-2.1) and the provision of treatment for more than a month OR 3.41 (CI 90% 1.4-9.2) stand out as risk factors and as a protective factor, family acceptance of the disease OR 0.008 (CI 90% 0.001-0.24). Conclusion: Although it is possible that the small sample size did not allow to detect some risk factors reported in other investigations, most of those studies did not use a multivariate analysis, so it is possible too, that many of the factors reported in literature are irrelevant. Salud UIS 2013; 45 (1): 7-14

Luis Carlos, Orozco Vargas; Alexandra, García Rueda; Xiomara, Becerra; Efraín, Jaimes Moreno; Luz Dary, Sierra León.

2013-04-01

307

Impacto del acompañamiento familiar sobre la ingestión de alimentos y el estado depresivo en pacientes con cáncer cervicouterino hospitalizadas / Impact of family support over food intake and depressive status in cervical cancer patients during hospitalization  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción: El cáncer cérvico uterino constituye un problema de salud pública en México; las pacientes sufren estrés físico y psicológico que conlleva a depresión y pérdida de peso. El comer acompañado tiene efectos positivos en la ingestión de alimentos y en el estado depresivo de pacientes hospi [...] talizados. En nuestra sociedad, la comida es el medio más cercano que la familia tiene para ofrecer cuidados, afecto y ayuda a su ser querido que se manifiesta cada vez más inapetente conforme progresa la enfermedad. Objetivo: Establecer la relación entre la presencia familiar durante las comidas sobre el estado anímico, ingestión de alimentos, y cambio de peso durante la hospitalización. Metodología: Se estudiaron 106 mujeres que ingresaron a hospitalización del servicio de oncología del Hospital General de México, con diagnóstico de CaCu EC II y III a fin de mejorar condiciones. Se evaluó peso y talla, la dieta mediante recordatorios de 24 horas, al ingreso como al egreso y se aplicó la escala de depresión de Beck; se registró la frecuencia con la que los familiares acompañaron a la paciente durante las comidas. Resultados: Para su análisis se clasificaron en dos grupos de acuerdo al acompañamiento familiar; se encontró que 43 pacientes (40,6%) tenían compañía, y 63 pacientes (59,4%) se encontraron sin compañía. No se observaron diferencias significativas en la edad, y días de estancia entre los grupos (p > 0,05). Las pacientes acompañadas, contaron con una mayor disponibilidad de alimentos durante su hospitalización (p Abstract in english Introduction: Uterine cervical cancer represents a public health problem in Mexico; the patients suffer physical and psychological stress leading to depression and weight loss. Eating with a relative has positive effects in food ingestion and depressive status in hospitalized patients. In our societ [...] y, food is the closest way that family members have to bring care and to show affection to the patient that has less appetite as diseasegoes on. Objective: To establish the relationship between presence of the family during the meals and depresion, food intake, and weight variation during hospitalization. Methodology: 106 women admitted to the Oncology Department at the General Hospital of Mexico with a diagnosis of CUCA clinical stage II and III were studied in order to improve their condition. Weight and height, diet by means of 24 hour recalls were assessed both at hospital admission and discharge, and Beck's depression inventory was applied; the frequency with which the relatives escorted the patient was recorded. Results: Patients were classified in two groups according to the frequency of family escorting; it was found that 43 patients (40.6%) were accompanied, and 63 patients (59.4%) were not. We did not find significant differences in age and days of hospital stay between the groups (p > 0.05). The escorted patients had more foods available during hospitalization (p

M., Bejarano; V., Fuchs; N., Fernández; O., Amancio.

2009-04-01

308

The role of the patient's remembered history and unconscious past in the evolution of Betty Joseph's 'Here and now' clinical technique (1959-1989).  

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The author historicizes one aspect of Betty Joseph's ongoing technical contributions in terms of its originating London kleinian context. Early on she drew upon both the patient's remembered history and unconscious past, linking these experiences in past-to-present transference interpretations in order to effect psychic change. In evolving the technique of 'here and now' analysis, Joseph came to emphasize a communicative definition of projective and introjective identification as well as the significance of enactments while marginalizing the use of part-object anatomical interpretative language. She gradually set aside directly linking the patient's past with the present, compelled now by making direct contact with her patients. She now tracked how difficult patients acted in and responded to interpretations from moment to moment. The author maintains that the explicit and implicit conceptual work of Wilfred Bion as well as Joseph's continuous group workshop for analysts led to an increased understanding of the patient's projective impact on the analyst's countertransference responses, and thereby increased the analyst's capacity with 'difficult to treat' narcissistic spectrum patients described by her colleague, Herbert Rosenfeld. In recent work, while Joseph continues to elucidate what patients recall about their early past, she formats her understanding in terms of a direct analysis of the structure of the patient's projected internal object relations in the transference. The analyst works with the patient's communications and enactments, with a greater emphasis on a more 'inside-to-outside' understanding of transference in contrast to the earlier 'past-to-present' work associated with both Freud and Klein. This investigation concludes with one example of Betty Joseph's significant impact on contemporary kleinian technique by taking up some of Michael Feldman's work. Now the analyst listens to the 'past presented,' the patient's projected internal world, as well as tracks how the patient hears and subtly mishears interpretations for defensive, equilibrium-maintaining purposes, as the analyst attempts to effect psychic change by widening the ego's perceiving functions. PMID:22014362

Aguayo, Joseph

2011-10-01

309

Usual Intake of Whole grains  

Science.gov (United States)

Usual Intake of Whole grains Table A18. Whole grains: Means, percentiles and standard errors of usual intake, 2007-2010 Age (Years) N1 oz equivalents3 Mean (SE)2 5% (SE) 10% (SE) 25% (SE) 50% (SE) 75% (SE) 90% (SE) 95% (SE) Males 1-3 774 0.6 (0.03) 0.1

310

Usual Intake of Fruit juice  

Science.gov (United States)

Usual Intake of Fruit juice Table A5. Fruit juice: Means, percentiles and standard errors of usual intake, 2007-2010 Age (Years) N1 cup equivalents3 Mean (SE)2 5% (SE) 10% (SE) 25% (SE) 50% (SE) 75% (SE) 90% (SE) 95% (SE) Males 1-3 774 0.7 (0.05) 0.1

311

Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history  

International Nuclear Information System (INIS)

To retrospectively investigate the prevalence, MR findings, natural history, and association with other hepatic lesions of focal nodular hyperplasia (FNH)-like lesions in a cohort of consecutive patients with cavernous transformation of the portal vein (CTPV). This retrospective IRB-approved study comprised 58 patients (32 men, 26 women; average age, 50 years) with CTPV who underwent liver MR imaging between 2000 and 2008. MR images were assessed by two radiologists in consensus for the presence of (a) FNH-like lesions and other liver lesions, and (b) other imaging findings. Patients were assigned to a stable or progressive clinical course based on lesion characteristics at follow-up. Twelve of 58 patients (21%) had 38 FNH-like lesions (average size, 1.3 cm). Common findings of FNH-like lesions were isointensity on T2-weighted images (82%), intense and homogeneous enhancement during the arterial phase, and lack of washout during the hepatic venous and interstitial phases (100%). FNH-like lesions were found with other benign liver lesions (1 hemangioma, 1 adenoma) in two patients. Three (25%) patients with FNH-like lesions showed a progressive clinical course. FNH-like lesions are commonly detected in patients with CTPV. Most lesions demonstrate benign imaging findings and stable clinical course. (orig.)

312

Focal nodular hyperplasia-like lesions in patients with cavernous transformation of the portal vein: prevalence, MR findings and natural history  

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To retrospectively investigate the prevalence, MR findings, natural history, and association with other hepatic lesions of focal nodular hyperplasia (FNH)-like lesions in a cohort of consecutive patients with cavernous transformation of the portal vein (CTPV). This retrospective IRB-approved study comprised 58 patients (32 men, 26 women; average age, 50 years) with CTPV who underwent liver MR imaging between 2000 and 2008. MR images were assessed by two radiologists in consensus for the presence of (a) FNH-like lesions and other liver lesions, and (b) other imaging findings. Patients were assigned to a stable or progressive clinical course based on lesion characteristics at follow-up. Twelve of 58 patients (21%) had 38 FNH-like lesions (average size, 1.3 cm). Common findings of FNH-like lesions were isointensity on T2-weighted images (82%), intense and homogeneous enhancement during the arterial phase, and lack of washout during the hepatic venous and interstitial phases (100%). FNH-like lesions were found with other benign liver lesions (1 hemangioma, 1 adenoma) in two patients. Three (25%) patients with FNH-like lesions showed a progressive clinical course. FNH-like lesions are commonly detected in patients with CTPV. Most lesions demonstrate benign imaging findings and stable clinical course. (orig.)

Marin, Daniele [Duke University Medical Center, Department of Radiology, Durham, NC (United States); University of Rome Sapienza, Department of Radiological Sciences, Rome (Italy); Galluzzo, Anna; Brancatelli, Giuseppe [Universita di Palermo, Istituto di Radiologia, Palermo (Italy); Plessier, Aurelie; Valla, Dominique [Service d' Hepatologie, Hopital Beaujon, Clichy (France); Vilgrain, Valerie [Assistance Publique des Hopitaux de Paris, APHP, Hopital Beaujon, Department of Radiology, Clichy (France); Universite Paris 7 Denis Diderot, Paris (France)

2011-10-15

313

An individual prediction of the future (disease-free) survival of patients with a history of early-stage cervical cancer, multistate model.  

Science.gov (United States)

To evaluate the possibility to give a prediction of the future (disease-free) survival, given the fact that a patient with a history of early-stage cervical cancer has been disease free for a specific period after treatment. Between January 1984 and April 2005, 615 patients with cervical cancer stages I-IIA underwent radical hysterectomy with or without adjuvant radiotherapy. The Kaplan-Meier method was used to detect statistical significance and multistate risk models to estimate the influence of covariates and to generate predicted survival curves by simulation. Simulations were done for patients with positive lymph nodes (n= 123), patients with negative lymph nodes (n= 492), and 4 hypothetical patients. The 5-year cancer-specific survival and disease-free survival of the entire group was 84% and 76%, respectively. The probability of death of the two lymph node groups and the four hypothetical patients was demonstrated in predicted cumulative probability plots. It is possible with multistate risk models to give a detailed prediction of the future (disease-free) survival, given the fact that a patient has been disease free for a specific period after treatment. This possibility is an important step forward to improve the quality of cancer care. PMID:17692087

Pieterse, Q D; Kenter, G G; Eilers, P H C; Trimbos, J B M Z

2008-01-01

314

Power plant intake entrainment analysis  

International Nuclear Information System (INIS)

Power plant condenser cooling water intake entrainment of fish eggs and larvae is becoming an issue in evaluating environmental impacts around the plants. Methods are required to evaluate intake entrainment on different types of water bodies. Presented in this paper is a derivation of the basic relationships for evaluating entrainment from the standing crop of fish eggs and larvae for different regions of a water body, and evaluating the rate of entrainment from the standing crop. These relationships are coupled with a 3D hydrodynamic and transport model that provides the currents and flows required to complete the entrainment evaluation. Case examples are presented for a simple river system, and for the more complex Delaware River Estuary with multiple intakes. Example evaluations are made for individual intakes, and for the cumulative impacts of multiple intakes

315

Comparison of thyroid examination, thyroid scanning and sonography in patients with previous history of radiotherapy of the head for Tinea Capitis  

International Nuclear Information System (INIS)

Introduction: In spite of large number of studies regarding relation between thyroid cancer and childhood irradiation, controversy still exists in management of these patients. This study tries to find optimal method of thyroid evaluation in this group. Methods and patients: In a recall program using mass media in Khorasan, all patients with childhood irradiation were invited for thyroid evaluation. One hundred and eighty patients with previous history of radiation for Tinea Capitis were studied using thyroid examination, thyroid sonography and thyroid scintigraphy. FNAB was performed in all patients with palpable nodules and surgery was recommended. Results: Eighty two cases out of 179 patients (45.8%) had nodules in thyroid examination. The number were 85 from 166 (51.2%) in sonography and 75 from 165 (45.5 %) in thyroid scintigraphy. Using chi-square tests, no significant difference was noted in detection of thyroid nodules in different methods (p=0.78) as well as between the methods (p>0.5). Sonographically detected nodules which were not palpated or were not seen in scintigraphy, were < 10 mm in size in most of cases. FNAB were performed in 60 patients which revealed benign pathology in 89.9 %, inadequated in 5 % and suspicious for malignancy in other 5 % of cases. Also 27 patients underwent surgery and pathological studies showed 3 cases (11.1 %) of papillary carcinoma. Conclusion: This study revealed that sonography detects small nonpalpable nodules which are nects small nonpalpable nodules which are not clinically significant. Very high correlation between the results of thyroid examination and thyroid scintigraphy indicates adequacy of thyroid examination in these patients. we suggest to follow these patients with physical examination and FNAB and use thyroid scanning or sonography in doubtful cases only

316

Long-term nutritional assessment of patients with severe short bowel syndrome managed with home enteral nutrition and oral intake Evaluación nutricional a largo plazo de pacientes con grave síndrome de intestino corto controlada con nutrición enteral e ingestión oral  

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Full Text Available Background: Parenteral nutrition (PN is used to control the nutritional state after severe intestinal resections. Whenever possible, enteral nutrition (EN is used to promote intestinal rehabilitation and reduce PN dependency. Our aim is to verify whether EN + oral intake (OI in severe short bowel syndrome (SBS surgical adult patients can maintain adequate nutritional status in the long term. Methods: This longitudinal retrospective study included 10 patients followed for 7 post-operative years. Body mass index (BMI, percentage of involuntary loss of usual body weight (UWL, free fat mass (FFM, and fat mass (FM composition assessed by bioelectric impedance, and laboratory tests were evaluated at 6, 12, 24, 36, 48, 60, 72, and 84 months after surgery. Energy and protein offered in HPN and at long term by HEN+ oral intake (OI, was evaluated at the same periods. The statistical model of generalized estimating equations with p Antecedentes: La nutrición parenteral (NP se emplea para controlar el estado nutricional después de resecciones intestinales extensas. Siempre que sea posible, se empleará la nutrición enteral (NE para favorecer la rehabilitación intestinal y reducir la dependencia de la NP. Nuestro propósito fue verificar si la NE + ingesta oral (IO en el síndrome del intestino corto (SIC grave en pacientes adultos quirúrgicos puede mantener un estado nutricional adecuado a largo plazo. Métodos: Este estudio longitudinal retrospectivo incluyó 10 pacientes seguidos durante 7 años tras la intervención quirúrgica. Se evaluaron el índice de masa corporal (IMC, el porcentaje de pérdida involuntaria del peso corporal habitual (PCH, la masa grasa libre (MGL y la composición de la masa grasa (MG mediante impedancia bioeléctrica, así como los datos de laboratorio a los 6, 12, 24, 36, 48, 60, 72 y 84 meses tras la cirugía. Se evaluaron en los mismos periodos la energía y las proteínas aportadas con la NPD y a largo plazo con la NED + ingesta oral (IO. Se utilizó un modelo estadístico de ecuaciones estimativas generalizadas con una p < 0,05. Resultados: Con la NE + IO a largo plazo hubo un aumento progresivo del PCH, una descenso del IMC, la MGL y la MG (p < 0,05. La retirada de la NP fue posible en ocho pacientes. La complicación más frecuente fue la infección por contaminación del catéter venoso central (CVC (1,2 episodios CVC/paciente/año. Hubo un aumento en el consumo de energía y proteínas proporcionadas por la NED + IO (p < 0,05. Todos los pacientes sobrevivieron al menos dos años, siete durante 5 años y seis durante los 7 años de seguimiento. Conclusiones: los pacientes adultos con SIC quirúrgico nutridos a largo plazo con NED + IO no pudieron mantener un adecuado estado nutricional con una pérdida de MG y de MGL.

V. Chaer Borges

2011-08-01

317

Effect of combined spironolactone-?-blocker ± enalapril treatment on occurrence of symptomatic atrial fibrillation episodes in patients with a history of paroxysmal atrial fibrillation (SPIR-AF study).  

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Angiotensin II and aldosterone are key factors responsible for the structural and neurohormonal remodeling of the atria and ventricles in patients with atrial fibrillation (AF). The aim of the present study was to evaluate the antiarrhythmic effects of spironolactone compared to angiotensin-converting enzyme inhibitors in patients with recurrent AF. A cohort of 164 consecutive patients (mean age 66 years, 87 men), with an average 4-year history of recurrent AF episodes, was enrolled in a prospective, randomized, 12-month trial with 4 treatment arms: group A, spironolactone, enalapril, and a ? blocker; group B, spironolactone and a ? blocker; group C, enalapril plus a ? blocker; and group D, a ? blocker alone. The primary end point of the trial was the presence of symptomatic AF episodes documented on the electrocardiogram. At 3-, 6-, 9-, and 12 months, a significant (p < 0.001) reduction had occurred in the incidence of AF episodes in both spironolactone-treated groups (group A, spironolactone, enalapril, and a ? blocker; and group B, spironolactone plus a ? blocker) compared to the incidence in patients treated with enalapril and a ? blocker (group C) or a ? blocker alone (group D). No significant difference was seen in AF recurrences between patients taking spironolactone and a ? blocker with (group A) and without (group B) enalapril. No significant differences were found in the systolic or diastolic blood pressure or heart rate among the groups before and after 1 year of follow-up. In conclusion, combined spironolactone plus ?-blocker treatment might be a simple and valuable option in preventing AF episodes in patients with normal left ventricular function and a history of refractory paroxysmal AF. PMID:21094362

Dabrowski, Rafal; Borowiec, Anna; Smolis-Bak, Edyta; Kowalik, Ilona; Sosnowski, Cezary; Kraska, Alicja; Kazimierska, Barbara; Wozniak, Jacek; Zareba, Wojciech; Szwed, Hanna

2010-12-01

318

The relationship between the COPD Assessment Test score and airflow limitation in Japan in patients aged over 40 years with a smoking history  

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Full Text Available Daisuke Yoshimoto,1 Yasutaka Nakano,2 Katsuya Onishi,3 Gerry Hagan,4 Paul Jones5 1GlaxoSmithKline, Tokyo, 2Division of Respiratory Medicine, Department of Medicine, Shiga University of Medical Science, Otsu, 3Onishi Heart Clinic, Tsu, Japan; 4Independent consultant, Marbella, Spain; 5Division of Clinical Science, St George’s Hospital, University of London, London, UK Background: A large number of chronic obstructive pulmonary disease (COPD patients in Japan remain undiagnosed, primarily due to the underuse of spirometry. Two studies were conducted to see whether the COPD Assessment Test (CAT in primary care has the potential to identify those patients who need spirometry for a diagnosis of COPD and to determine whether patients with cardiovascular disease had airflow limitation, which could be detected by CAT. Materials and methods: Two multicenter, noninterventional, prospective studies (studies 1 and 2 were conducted across Japan. Patients in both studies were ?40 years old with a smoking history. Those in study 1 were seen in primary care and had experienced repeated respiratory tract infections, but had no diagnosis of COPD. Patients in study 2 were identified in cardiovascular disease clinics when routinely visiting for their cardiovascular disease. All patients completed the CAT prior to lung-function testing by hand-held spirometry. The presence of airflow limitation was defined as a forced expiratory volume in 1 second (FEV1/FEV6 ratio <0.73. Results: A total of 3,062 subjects completed the CAT (2,067 in study 1, 995 in study 2; 88.8% were male, and the mean age (± standard deviation was 61.5±11.6 years. Airflow limitation was found in 400 (19.4% patients in study 1, and 269 (27.0% in study 2. The CAT score in patients with airflow limitation was significantly higher than in patients without airflow limitation in both studies: 8.6 (95% confidence interval [CI] 7.9–9.2 versus 7.4 (95% CI 7.1–7.6 in study 1, and 8.3 (95% CI 7.5–9.2 versus 6.4 (95% CI 6.0–6.8 in study 2 (both P<0.001. Conclusion: These findings suggest that the CAT has the potential to identify patients with cardiovascular disease or a history of frequent chest infections who need spirometry to diagnose COPD. Keywords: COPD, CAT, spirometry, airflow limitation

Yoshimoto D

2014-12-01

319

The relationship between the COPD Assessment Test score and airflow limitation in Japan in patients aged over 40 years with a smoking history  

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Background A large number of chronic obstructive pulmonary disease (COPD) patients in Japan remain undiagnosed, primarily due to the underuse of spirometry. Two studies were conducted to see whether the COPD Assessment Test (CAT) in primary care has the potential to identify those patients who need spirometry for a diagnosis of COPD and to determine whether patients with cardiovascular disease had airflow limitation, which could be detected by CAT. Materials and methods Two multicenter, noninterventional, prospective studies (studies 1 and 2) were conducted across Japan. Patients in both studies were ?40 years old with a smoking history. Those in study 1 were seen in primary care and had experienced repeated respiratory tract infections, but had no diagnosis of COPD. Patients in study 2 were identified in cardiovascular disease clinics when routinely visiting for their cardiovascular disease. All patients completed the CAT prior to lung-function testing by hand-held spirometry. The presence of airflow limitation was defined as a forced expiratory volume in 1 second (FEV1)/FEV6 ratio <0.73. Results A total of 3,062 subjects completed the CAT (2,067 in study 1, 995 in study 2); 88.8% were male, and the mean age (± standard deviation) was 61.5±11.6 years. Airflow limitation was found in 400 (19.4%) patients in study 1, and 269 (27.0%) in study 2. The CAT score in patients with airflow limitation was significantly higher than in patients without airflow limitation in both studies: 8.6 (95% confidence interval [CI] 7.9–9.2) versus 7.4 (95% CI 7.1–7.6) in study 1, and 8.3 (95% CI 7.5–9.2) versus 6.4 (95% CI 6.0–6.8) in study 2 (both P<0.001). Conclusion These findings suggest that the CAT has the potential to identify patients with cardiovascular disease or a history of frequent chest infections who need spirometry to diagnose COPD. PMID:25525353

Yoshimoto, Daisuke; Nakano, Yasutaka; Onishi, Katsuya; Hagan, Gerry; Jones, Paul

2014-01-01

320

Health Care–Associated Native Valve Endocarditis in Patients with no History of Injection Drug Use: Current Importance of Non-Nosocomial Acquisition  

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Background The clinical profile and outcome of nosocomial and non-nosocomial health care–associated native valve endocarditis are not well defined. Objective To describe the prevalence, clinical characteristics, and outcomes of nosocomial and non-nosocomial health care–associated native valve endocarditis. Design Prospective observational study. Setting 61 hospitals in 28 countries. Patients Patients with definite native valve endocarditis and no history of injection drug use who were enrolled in the International Collaboration on Endocarditis–Prospective Cohort Study from June 2000 to August 2005. Measurements Characteristics of nosocomial and non-nosocomial health care–associated native valve endocarditis cases were described and compared with those cases acquired in the community. Results Health care–associated native valve endocarditis was present in 557 (34%) of 1622 patients with native valve endocarditis and no history of injection drug use (nosocomial native valve endocarditis 303 patients [54%]; non-nosocomial health care–associated native valve endocarditis 254 patients [46%]). Staphylococcus aureus was the most common cause of health care-associated native valve endocarditis (nosocomial native valve endocarditis, 47%; non-nosocomial health care–associated native valve endocarditis, 42%; p=0.3), with a notable proportion of methicillin-resistant S. aureus (nosocomial native valve endocarditis, 57%; non-nosocomial health care–associated native valve endocarditis, 41%; p=0.014). Patients with health care–associated native valve endocarditis had lower rates of cardiac surgery (41% health care–associated native valve endocarditis vs 51% community-acquired native valve endocarditis, p<0.001) and higher in-hospital mortality rates than patients with community-acquired native valve endocarditis (25% health care–associated native valve endocarditis vs. 13% community-acquired native valve endocarditis vs., p<0.001). Multivariable analysis confirmed a higher mortality associated with health care–associated native valve endocarditis (incidence risk ratio=1.20 (CI 95%, 1.03–1.61). Limitations This study involves tertiary hospitals with cardiac surgery programs. The results may not be generalized to patient populations receiving care in other types of facility. Conclusions More than one-third of all cases of native valve endocarditis in non-drug users involve contact with health care. S. aureus is the leading cause of health care–associated native valve endocarditis. Non-nosocomial health care–associated native valve endocarditis is common, especially in the US. Patients with health care-associated and community-acquired native valve endocarditis differ in their presentation, microbiology, and outcome. By contrast, patients with nosocomial and non-nosocomial healthcare-associated endocarditis are similar. PMID:19414837

Benito, Natividad; Miró, José M.; de Lazzari, Elisa; Cabell, Christopher H; del Río, Ana; Altclas, Javier; Commerford, Patrick; Delahaye, Francois; Dragulescu, Stefan; Giamarellou, Helen; Habib, Gilbert; Kamarulzaman, Adeeba; Kumar, A. Sampath; Nacinovich, Francisco M.; Suter, Fredy; Tribouilloy, Christophe; Venugopal, K; Moreno, Asuncion; Fowler, Vance G.

2013-01-01

 
 
 
 
321

Seasonality, smoking and history of poor treatment compliance are strong predictors of dropout in a naturalistic 6 year follow-up of bipolar patients.  

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Bipolar disorder is a highly recurrent disease which requires long-term treatment. Dropout is a major problem, poorly understood. The objectives of this study were to know the risk of dropout of a cohort of bipolar patients under ambulatory treatment and to identify the clinical profile of patients more likely to abandon the follow-up. A sample of 285 BD I and II patients was followed up for a mean of 2.87 years. A significant proportion of patients failed regular follow-up. The dropout rates were 6.3 % at three months, 12.7 % at 6 months, and 17.6, 27.2, 37.3, 44.0, 47.2 and 49.0 % at 1, 2, 3, 4, 5 and 6 years respectively. Very few variables at baseline predicted dropout. Patients under 35 years of age were more likely to dropout than older cases. Seasonality, smoking and specially history of poor treatment compliance were strong predictors of dropout. Given the magnitude of dropout, additional early clinical interventions should be considered for high-risk patients. PMID:24986371

Ezquiaga, Elena; García-López, Aurelio; de Dios, Consuelo; Agud, Jose Luis; Albillo, David; Vega-Piris, Lorena

2014-12-01

322

Plasma Alkylresorcinols, Biomarkers of Whole-Grain Wheat and Rye Intake, and Incidence of Colorectal Cancer  

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BACKGROUND: Few studies have investigated the association between whole-grain intake and colorectal cancer. Because whole-grain intake estimation might be prone to measurement errors, more objective measures (eg, biomarkers) could assist in investigating such associations. METHODS: The association between alkylresorcinols, biomarkers of whole-grain rye and wheat intake, and colorectal cancer incidence were investigated using prediagnostic plasma samples from colorectal cancer case patients a...

Kyro, C.; Olsen, A.; Landberg, R.; Skeie, G.; Loft, S.; Aman, P.; Leenders, M.; Dik, Vk; Siersema, Pd; Pischon, T.; Christensen, J.; Overvad, K.; Boutron-ruault, Mc; Fagherazzi, G.; Cottet, V.

2014-01-01

323

Seroprevalance of the Hepatitis B and C in Patients with Chronic Kidney Disease without History of Renal Replacement Therapy  

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OBJECTIVE: Hepatitis B (HBV) and hepatitis C (HCV) viruses are significant causes of morbidity and mortality in patients with chronic kidney disease (CKD). There is insufficient data on seroprevalence of HBV and HCV in CKD patients without renal replacement therapy (RRT). MATERIAL and METHODS: Patients diagnosed as having CKD without RRT were analyzed. Seven hundred and eighty cases included study. RESULTS: The seroprevalence of HbsAg and Anti-HCV were 3.5% and 1.3%, respectively. The ...

Pi?s?ki?npas?a, Serhan; Akog?lu, Hadim; O?zkayar, Nihal; Turgut, Didem; Akyel, Fatma; Demi?r, Melik; C?i?men, Ku?bra; Turhan, Turan; Koc?, Eyu?p; Odabas?, Ali R?za; As?c?iog?lu, Sibel; Dede, Fatih

2013-01-01

324

The influence of media reporting of a celebrity suicide on suicidal behavior in patients with a history of depressive disorder.  

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BACKGROUND: Few studies have directly assessed the impact of a specific media report in vulnerable people. This study investigates possible influences of media reporting of a celebrity suicide on subsequent suicidal behaviors and associated risk factors among depressive patients. METHODS: Depressive patients (N=461) were assessed through a structured interview soon after extensive media reporting of a celebrity suicide. RESULTS: Among 438 depressive patients exposed to the media report, 38.8%...

Cheng, At; Hawton, K.; Chen, Th; Yen, Am; Chang, Jc; Chong, My; Liu, Cy; Lee, Y.; Teng, Pr; Chen, Lc

2007-01-01

325

A case-control study on the relationship between salt intake and salty taste and risk of gastric cancer  

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Full Text Available AIM: To investigate the relationship between salt intake and salty taste and risk of gastric cancer. METHODS: A 1:2 matched hospital based case-control study including 300 patients with gastric cancer and 600 cancer-free subjects as controls. Subjects were interviewed with a structured questionnaire containing 80 items, which elicited information on dietary, lifestyle habits, smoking and drinking histories. Subjects were tested for salt taste sensitivity threshold (STST using concentrated saline solutions (0.22-58.4 g/L. Conditional logistic regression was used to calculate odds ratios (ORs and 95% confidence intervals (95% CI. RESULTS: Alcohol and tobacco consumption increased the risk of gastric cancer [OR (95% CI was 2.27 (1.27-4.04 for alcohol and 2.41 (1.51-3.87 for tobacco]. A protective effect was observed in frequent consumption of fresh vegetable and fruit [OR (95% CI was 0.92 (0.58-0.98 for fresh vegetable and 0.87 (0.67-0.93 for fruit]. Strong association was found between STST ? 5 and gastric cancer [OR = 5.71 (3.18-6.72]. Increased STST score was significantly associated with salted food intake and salty taste preference (P < 0.05. CONCLUSION: A high STST score is strongly associated with gastric cancer risk. STST can be used to evaluate an inherited characteristic of salt preference, and it is a simple index to verify the salt intake in clinic.

Wan-Guang Yang

2011-01-01

326

Case of acute pancreatitis following high-dose naproxen intake  

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Non-steroid anti inflammatory drugs (NSAID) have been used extensively around the world as well as in Turkey. We present a case of 32 year-old female patient who ingested naproxen sodium for suicidal purpose. The patient developed acute pancreatitis during clinical observation period. Although development of acute pancreatitis is a rare complication of NSAID intake, it should be kept in mind as potential mechanism in young patients who develop acute pancreatitis without presence of other rele...

Coskun, Figen; Ucoz Kocasaban, Dilber; Akinci, Emine

2010-01-01

327

Hurricane Elena and Pinellas County, Florida: Some Lessons Learned from the Largest Evacuation of Nursing Home Patients in History.  

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Studied prior planning for and problems associated with evacuation of 1,860 nursing home patients in Pinellas County, Florida, due to Hurricane Elena in 1985 through questionnaires administered to nursing home administrators and public documents. Found most serious problems to be transporting patients to shelters in timely fashion, delayed passage…

Mangum, Wiley P.; And Others

1989-01-01

328

Oral burning symptoms and burning mouth syndrome-significance of different variables in 150 patients  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in english Objectives: Despite the extensive amount of published literature upon burning symptoms in patients with clinically healthy appearance of the oral mucosa, as well as burning mouth syndrome (BMS) itself, they both remain still challenging topics. The aim of this study was to determine the real prevale [...] nce of "true" BMS in comparison to other patients with burning symptoms with clinically healthy appearance of the oral mucosa and then to compare "true" BMS patients with healthy controls regarding gastritis and intake of anxiolytics and angiotensin converting enzyme inhibitors. Study design: In 150 patients with burning symptoms of clinically healthy oral mucosa, local and systemic investigations were performed and they included detection of candidal infection, salivary flow rate, presence of oral galvanism and parafunctional habits as well as complete blood count, serum ferritin, serum glucose levels, serum antibodies to Helicobacter pylori together with detailed medical history with special regard to medication intake. After "true" BMS patients were identified they have been compared to the controls with regard to the presence of gastritis and the intake of anxiolytics and angiotensin converting enzyme inhibitors. Results: Our results show that gastritis were significantly more present among "true" BMS patients and that they also significantly more intake anxiolitics, when compared to the control group. Conclusions: Our findings might lead to the conclusion that every "true" BMS patient should be referred to the gastroenterologist and psychiatrist.

Vlaho, Brailo; Vanja, Vuèiæeviæ-Boras; Iva Z., Alajbeg; Ivan, Alajbeg; Josip, Lukenda; Marko, Æurkoviæ.

2006-06-01

329

Retrospective analysis of clinicopathological characteristics and family history data of early-onset breast cancer: a single-institutional study of Hungarian patients.  

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Patients at young age (? 35 years) diagnosed with breast cancer (BC) are considered to have poor prognosis. The aim of the present study was to retrospectively analyse clinicopathological characteristics and prognosis in a group of young BC patients. We included women diagnosed with invasive breast carcinoma younger than/or at the age of 35 years. Between 1999 and 2009, 107 women with early-onset BC were selected from the database of the 2nd Department of Pathology at Semmelweis University. For clinicopathological comparison, 55 women (36-45 years), 214 women (46-65 years), 110 women (66-75 years) and 58 women (76 ? years) were also included in the analysis. Family history, clinicopathological and follow-up data were analysed. The tissue specimens were reviewed for histological type, nuclear grade, and estrogen receptor (ER), progesterone receptor (PgR), Ki67 and HER2 status (IHC4). The mean age in the study group was 31.6 years at the time of diagnosis. Histology showed a high incidence of grade III tumours in this group of patients (67.9 %), while only four cases (3.8 %) were considered grade I. According to the immunohistochemical results, 35.3 % of the study cases were considered as Luminal B (LumB: either being higly proliferative or co-expressing HER2) and 33.3 % as triple negative breast carcinomas (TNBC). The detailed questionnaire related to family history was completed and received in 49/107 cases (45.8 %). Analysis of these data revealed an affected family history of breast or ovarian carcinoma in first and second degree relatives in 51.0 %. A high proportion (52.0 %) of TNBC was observed among young women with a family history of the disease. Survival analysis of the 107 patients showed that 25 (23.3 %) women died until 31 December 2012. No significant difference in survival was detectable considering the regimen of systemic treatment (p = 0.188). Regarding clinicopathological parameters, the immunophenotypes, grade, pT and pN values differred substantially between the age groups (p = 0.001, for all), and the shortest relapse-free survival was seen among the youngest BC patients. This analysis illustrates that breast cancer arising in young women is characterized by the presence of less favorable subtypes such as LumB and TNBC. The increased proportion of TNBC was especially remarquable in the group of patients presenting with family history of the disease. The fact that a high rate of death occurred and no significant difference in OS were notable regarding the scheme of systemic therapies (neoadjuvant vs. adjuvant) highlight the necessity of the development of new treatment strategies. PMID:23709114

Madaras, Lilla; Baranyák, Zsuzsanna; Kulka, Janina; Szász, Attila Marcell; Kovács, Attila; Lan, Phan Huong; Székely, Borbála; Dank, Magdolna; Nagy, Tibor; Kiss, Orsolya; Harsányi, László; Barbai, Tamás; Kenessey, István; T?kés, Anna Mária

2013-10-01

330

Nutrient intakes in relation to cancer incidence in Hawaii.  

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A representative sample of 4657 adults greater than or equal to 45 years of age from the 5 main ethnic groups in Hawaii (Caucasians, Japanese, Chinese, Filipinos and Hawaiians) were interviewed during 1977-1979 regarding their diets. Quantitative food-consumption histories were obtained, from which average daily intakes of fat (saturated, unsaturated, cholesterol, meat, dairy, fish, animal, vegetable and total), protein (animal, meat, fish, dairy and total), carbohydrate, and vitamins A and C...

Kolonel, L. N.; Hankin, J. H.; Lee, J.; Chu, S. Y.; Nomura, A. M.; Hinds, M. W.

1981-01-01

331

Computer History  

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Some Websites Exploring the History of the Personal Computer Wow! What a lot of websites about computer history. Here's a few that I found...Check them out and then, when you get back here, go Take the Quiz . The List of Cool Sites Museum of Computer History The History of Computing Project The Computer Comes Home: A History of Personal Computing Computer History Museum ...

Cannon, Mr.

2005-12-10

332

Predictors of malignancy in EUS-guided FNA for mediastinal lymphadenopathy in patients without history of lung cancer  

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Background: Mediastinal lymphadenopathy (ML) poses a great diagnostic challenge. Objective: To investigate the predictors of malignancy in endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of ML in patients without known lung cancer. Design: Retrospective study. Setting: Tertiary referral center. Methods: One hundred eight patients without known lung cancer who underwent EUS guided-FNA for ML between 2000 and 2007. All subjects underwent EUS-g...

Luz Leticia; Moreira Daniel; Khan Mahboob; Eloubeidi Mohamad

2011-01-01

333

The Investigation of the Relation Between INR Levels and Risk of Complication in Patients with a History of Warfarin use  

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Objective: Warfarin is the most commonly used oral anticoagulant agent. In overdose situations, serious complications may occur. The aim of the study was to determine the correlation between the international normalized ratio (INR) levels and complications due to warfarin.Patients and Methods: The study was performed prospectively at the Department of Emergency Medicine, Marmara University Hospital between July 2006 and July 2007. Patients whose complaints were due to warfarin overdose were i...

Erog?lu, Serkan Emre; Altinok Deni?zbas?i, Arzu; O?zpolat, C?ig?dem; Akog?lu, Haldun; Ecmel Onur Onur, O?zge; Akog?lu U?nal, Ebru

2012-01-01

334

Valoración de la ingesta de nutrientes y energía en paciente crítico bajo terapia nutricional enteral / Nutrients and energy intake assessment in the critically ill patient on enteral nutritional therapy  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Introducción y objetivos: El enfermo crítico es especialmente susceptible a la desnutrición debido a que su situación hipermetabólica conlleva a un aumento de los requerimientos nutricionales, que muchas veces no se cubren con el aporte de las fórmulas enterales suministradas. El estudio de la inges [...] ta nutricional resulta imprescindible en este tipo de paciente para conocer en qué medida se cubren sus necesidades energético-nutricionales, mejorando y monitorizando la terapia clínico-nutricional a seguir de la manera más personalizada posible. Metodología: Es un estudio retrospectivo en el que se evaluaron todos los pacientes ingresados en la Unidad de Cuidados Intensivos del Hospital Virgen de las Nieves desde enero a diciembre de 2003, mayores de 18 años bajo tratamiento nutricional enteral. Se estudiaron un total de 90 pacientes (52 hombres y 38 mujeres), el 81% de los mismos eran mayores de 50 años de edad, el 57% tuvieron estancias superiores a 8 días con una mortalidad del 21%. Se valoró la ingesta desde el ingreso y durante todo el período de hospitalización. Los requerimientos energéticos se calcularon a partir de la fórmula de Long modificada y se compararon las ingestas de micronutrientes con las recomendaciones generales existentes tanto para la población española como la europea la americana, y los requerimientos vitamínicos para pacientes en estado grave. Resultados: En la figura 1 se presentan los porcentajes de ingestas medias de energía y nutrientes con relación a los requerimientos teóricos calculados para ambos sexos. El aporte energético medio fue para los hombres de 1.326 cal y de 917 cal para las mujeres. Con respecto a la ingesta de macronutrientes, los valores encontrados tanto para las proteínas como para las grasas y los carbohidratos fueron inferiores al 50% de los requerimientos en ambos sexos. En la figura 2 se observa el porcentaje de adecuación a los requerimientos en el consumo de vitaminas y minerales. Las recomendaciones utilizadas como referencia corresponden a ingestas suficientes para cubrir requerimientos de individuos sanos, por lo tanto, los valores obtenidos en nuestro estudio muestran una adecuación superior al 75%, salvo casos particulares como la vitamina A y el magnesio. Sin embargo al observar la figura 3, el cual nos muestra la adecuación de las ingestas vitamínicas a las dosis recomendadas para pacientes enfermos, la ingesta es inferior al 25% de lo requerido en todos los casos, estas deficiencias repercuten de manera significativa en la cicatrización, el sistema inmune, el cardiovascular y el nervioso así como en el metabolismo del resto de macronutrientes, provocando un desequilibrio en el sistema antioxidante y empeorando la situación clínica del paciente. Conclusiones: El presente estudio nos confirma la necesidad de monitorizar de una manera personalizada las necesidades nutricionales en el paciente crítico y adaptar las recomendaciones a sus cambios metabólicos, ya que las mismas no están claramente definidas para estas situaciones en la actualidad. Es necesario aportar dosis de micronutrientes que se acerquen más a sus necesidades y así preservar o mejorar el estado nutricional y el equilibrio del sistema antioxidante, haciendo más eficaz el tratamiento clínico aplicado. Abstract in english Introduction and objectives: The critically ill patient is especially susceptible to malnutrition due to his/her hypermetabolic state that leads to an increase in the nutritional requirementes, which many times are not compensated with the administered enteral formulas. The assessment of nutritional [...] intake is essential in this kind of patients to know to what level their energetic and nutritional requirements are fulfilled, improving and monitoring in the most individualized possible way to indicated clinical and nutritional therapu. Methodology: This is a retrospective study in which all patients admitted to the Intensive Care Unit of Virgen de las Nieves H

J., Abilés; G., Lobo; A., Pérez de la Cruz; M., Rodríguez; E., Aguayo; M. A., Cobo; R., Moreno-Torres; A., Aranda; J., Llopis; C., Sánchez; E., Planells.

2005-04-01

335

Valoración de la ingesta de nutrientes y energía en paciente crítico bajo terapia nutricional enteral Nutrients and energy intake assessment in the critically ill patient on enteral nutritional therapy  

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Full Text Available Introducción y objetivos: El enfermo crítico es especialmente susceptible a la desnutrición debido a que su situación hipermetabólica conlleva a un aumento de los requerimientos nutricionales, que muchas veces no se cubren con el aporte de las fórmulas enterales suministradas. El estudio de la ingesta nutricional resulta imprescindible en este tipo de paciente para conocer en qué medida se cubren sus necesidades energético-nutricionales, mejorando y monitorizando la terapia clínico-nutricional a seguir de la manera m????s personalizada posible. Metodología: Es un estudio retrospectivo en el que se evaluaron todos los pacientes ingresados en la Unidad de Cuidados Intensivos del Hospital Virgen de las Nieves desde enero a diciembre de 2003, mayores de 18 años bajo tratamiento nutricional enteral. Se estudiaron un total de 90 pacientes (52 hombres y 38 mujeres, el 81% de los mismos eran mayores de 50 años de edad, el 57% tuvieron estancias superiores a 8 días con una mortalidad del 21%. Se valoró la ingesta desde el ingreso y durante todo el período de hospitalización. Los requerimientos energéticos se calcularon a partir de la fórmula de Long modificada y se compararon las ingestas de micronutrientes con las recomendaciones generales existentes tanto para la población española como la europea la americana, y los requerimientos vitamínicos para pacientes en estado grave. Resultados: En la figura 1 se presentan los porcentajes de ingestas medias de energía y nutrientes con relación a los requerimientos teóricos calculados para ambos sexos. El aporte energético medio fue para los hombres de 1.326 cal y de 917 cal para las mujeres. Con respecto a la ingesta de macronutrientes, los valores encontrados tanto para las proteínas como para las grasas y los carbohidratos fueron inferiores al 50% de los requerimientos en ambos sexos. En la figura 2 se observa el porcentaje de adecuación a los requerimientos en el consumo de vitaminas y minerales. Las recomendaciones utilizadas como referencia corresponden a ingestas suficientes para cubrir requerimientos de individuos sanos, por lo tanto, los valores obtenidos en nuestro estudio muestran una adecuación superior al 75%, salvo casos particulares como la vitamina A y el magnesio. Sin embargo al observar la figura 3, el cual nos muestra la adecuación de las ingestas vitamínicas a las dosis recomendadas para pacientes enfermos, la ingesta es inferior al 25% de lo requerido en todos los casos, estas deficiencias repercuten de manera significativa en la cicatrización, el sistema inmune, el cardiovascular y el nervioso así como en el metabolismo del resto de macronutrientes, provocando un desequilibrio en el sistema antioxidante y empeorando la situación clínica del paciente. Conclusiones: El presente estudio nos confirma la necesidad de monitorizar de una manera personalizada las necesidades nutricionales en el paciente crítico y adaptar las recomendaciones a sus cambios metabólicos, ya que las mismas no están claramente definidas para estas situaciones en la actualidad. Es necesario aportar dosis de micronutrientes que se acerquen más a sus necesidades y así preservar o mejorar el estado nutricional y el equilibrio del sistema antioxidante, haciendo más eficaz el tratamiento clínico aplicado.Introduction and objectives: The critically ill patient is especially susceptible to malnutrition due to his/her hypermetabolic state that leads to an increase in the nutritional requirementes, which many times are not compensated with the administered enteral formulas. The assessment of nutritional intake is essential in this kind of patients to know to what level their energetic and nutritional requirements are fulfilled, improving and monitoring in the most individualized possible way to indicated clinical and nutritional therapu. Methodology: This is a retrospective study in which all patients admitted to the Intensive Care Unit of Virgen de las Nieves Hospital were studied from January to December of 2003, aged more than 18 years, and on

J. Abilés

2005-04-01

336

HPA axis dampening by limited sucrose intake: reward frequency vs. caloric consumption  

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Individuals often cope with stress by consuming calorically-dense, highly-palatable “comfort” foods. The present work explores the stress-relieving properties of palatable foods in a rat model of limited sucrose intake. In this model, adult male rats with free access to chow and water are given additional access to a small amount of sucrose drink (or water as a control). A history of such limited sucrose intake reduces the collective (HPA axis, sympathetic, and behavioral-anxiety) stress ...

Ulrich-lai, Yvonne M.; Ostrander, Michelle M.; Herman, James P.

2011-01-01

337

Dairy products and calcium intake during pregnancy and dental caries in children  

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Abstract Background Maternal nutrition status during pregnancy may affect fetal tooth development, formation, and mineralization, and may affect dental caries susceptibility in children. We investigated the association between maternal intake of dairy products and calcium during pregnancy and the risk of childhood dental caries. Methods Subjects were 315 Japanese mother-child pairs. Data on maternal intake during pregnancy were assessed through a diet history qu...

Tanaka Keiko; Miyake Yoshihiro; Sasaki Satoshi; Hirota Yoshio

2012-01-01

338

High-producing MBL2 genotypes increase the risk of acute and chronic carditis in patients with history of rheumatic fever  

DEFF Research Database (Denmark)

Rheumatic fever (RF) and its most severe sequela, chronic rheumatic heart disease (CRHD), are mediated by an abnormal immunological host response following a Streptococcus pyogenes oropharyngeal infection. Mannan-binding lectin (MBL), a collectin that activates complement, binds to N-acetylglucosamine, a molecule present on the streptococcus cell wall and on human heart valves. As high levels of MBL and MBL2 associated genotypes have previously been seen to be associated with CRHD, we investigated the association between MBL2 polymorphisms and the presence of acute carditis and arthritis in patients with a history of RF. Polymorphisms in exon 1 and in the X/Y promoter region of the MBL2 gene were determined by PCR-SSP in 149 patients with a history of RF and 147 controls. Genotypes associated with the high production of MBL (YA/YA and YA/XA) were more frequent in the patients with acute (26/35, 74%) and chronic carditis (79/107, 74%) when compared to the controls (79/147, 54%; OR 2.48, 95% CI 1.09-5.67, p=0.035 and OR 2.42, 95% CI 1.41-4.16, p=0.001, respectively). Logistic regression analysis showed that MBL levels >2,800 ng/ml increased the risk of CRHD (OR 2.91, 95% CI 1.41-6.03, p=0.003). Among the RF patients without cardiac sequela, YA/YA and YA/XA genotypes were significantly associated with acute carditis when compared to the patients without this clinical manifestation (26/28, 93% vs. 9/14, 64%, OR 7.22, 95% CI 1.18-43.98, p=0.031); on the other hand, arthritis was more frequently observed in those patients presenting MBL2 genotypes related to the low production of MBL (10/14, 71% vs. 10/28, 36%; p=0.048, OR 0.22, 95% CI 0.05-0.89). We concluded that MBL2 genotypes associated with the high production of MBL seem to be involved in the pathogenesis of rheumatic carditis and its progression to CRHD.

Schafranski, Marcelo Derbli; Pereira Ferrari, Lílian

2008-01-01

339