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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  

International Nuclear Information System (INIS)

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  

Directory of Open Access Journals (Sweden)

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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Salt intake, knowledge of salt intake, and blood pressure control in Chinese hypertensive patients.  

Science.gov (United States)

A cross-sectional study involving 2502 subjects was conducted to evaluate salt intake, knowledge of salt intake, and blood pressure control in hypertensive patients. The blood pressure control rate was 33.5% among the hypertensive patients. Of the patients, 69.9% had salt intake higher than 6 g/d. Overall 35.0% knew the recommended salt intake, and 94.9% knew that "excess salt intake can result in hypertension." Altogether, 85.8% of patients had received health education related to a low-salt diet at some time. Patients who consumed less than 6 g/d of salt had a higher control rate than those who consumed more than 6 g/d (48.7% vs. 27.0%; ?(2) = 111.0; P salt intake had a higher control rate than those without (45.8% vs. 26.9%; ?(2) = 91.3; P salt intake and low blood pressure control rate among Chinese hypertensive patients. Knowledge of recommended salt intake is inappropriate for patients with education of a low-salt diet. PMID:25492834

Qin, Yu; Li, Ting; Lou, Peian; Chang, Guiqiu; Zhang, Pan; Chen, Peipei; Qiao, Cheng; Dong, Zongmei

2014-12-01

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

DEFF Research Database (Denmark)

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.

Freil, M; Nielsen, MA

2006-01-01

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The Time Delay Between Drug Intake and Bronchospasm for Nonsteroidal Antiinflammatory Drugs Sensitive Patients  

OpenAIRE

A study was performed to assess the time between drug intake and drug induced hypersensitivity reaction for patients sensitive to nonsteroidal antiinflammatory drugs (NSAID) in clinical patient history and after oral provocation tests. Drug hypersensitivity ENDA questionnaires were filled for the patients with suspected sensitivity to NSAID. Oral provocation tests were performed with suspected NSAID according to the ENDA/EAACI recommendations. There were 76 patients with his...

Grigiene, Giedre; Norku?niene?, Jolita; Kvedariene, Violeta

2010-01-01

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Nutritional intake of gut failure patients on home parenteral nutrition  

International Nuclear Information System (INIS)

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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Nutritional intake of gut failure patients on home parenteral nutrition  

Energy Technology Data Exchange (ETDEWEB)

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.

DiCecco, S.; Nelson, J.; Burnes, J.; Fleming, C.R.

1987-11-01

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Food intakes and preferences of hospitalised geriatric patients  

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Full Text Available Abstract Background A cross sectional survey was carried out on 120 hospitalised geriatric patients aged 60 and above in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur to investigate their nutrient intakes and food preferences. Methods Food intakes were recorded using a one day weighed method and diet recall. Food preferences were determined using a five point hedonic score. Food wastages and factors affecting dietary adequacy were also investigated. Results The findings indicated that the mean intakes of energy and all nutrients investigated except for vitamin C and fluid were below the individual requirement for energy, protein and fluid, and the Malaysian Recommendation of Dietary Allowances (RDA for calcium, iron, vitamin A, thiamin, riboflavin, niacin and acid ascorbic. In general, subjects preferred vegetables, fruits and beans to red meat, milk and dairy products. There was a trend of women to have a higher percentage for food wastage. Females, diabetic patients, subjects who did not take snacks and subjects who were taking hospital food only, were more likely to consume an inadequate diet (p Conclusions Food service system in hospital should consider the food preferences among geriatric patients in order to improve the nutrient intake. In addition, the preparation of food most likely to be rejected such as meat, milk and dairy products need some improvements to increase the acceptance of these foods among geriatric patients. This is important because these foods are good sources of energy, protein and micronutrients that can promote recovery from disease or illness.

Wan Chik Wan Chak

2002-08-01

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Comparisons of food intake between breast cancer patients and controls in Korean women  

OpenAIRE

The purpose of this study was to compare food intakes between Korean breast cancer patients and a healthy control group. We compared the intake of nutrients of 117 food items between Korean breast cancer patients (n=97) and age matched healthy controls (n=97). Nutrient intake was estimated using a quantitative food frequency questionnaire. The mean caloric intake of breast cancer patients and healthy controls was not significantly different. Breast cancer patients consumed significantly less ...

Kim, Eun-young; Hong, Yeong-seon; Jeon, Hae-myung; Sung, Mi-kyung; Sung, Chung-ja

2007-01-01

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Modifications in food intake by myocardial infarct patients.  

Science.gov (United States)

Post myocardial infarct (MI) patients made significant dietary changed in accordance with the principles of the Prudent Diet. Patients reported changing their intake of selected food items; specifically, consumption of eggs, high-fat meat, whole milk, and butter significantly decreased. A number of food preparation techniques changes, leading to decreases in total fat and saturated fat consumption. Patients reported frying food less, trimming fat from meat, and using more polyunsaturated fat. These changes were unaffected by the length of time since the MI. PMID:6863782

Kris-Etherton, P M; Miller, R; Remick, B A; Wilkinson, W

1983-07-01

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

OpenAIRE

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 fem...

Naoto Nakamura; Goji Hasegawa; Michiaki Fukui; Masashi Kuwahata; Hina Tatsumi; Mayuko Kadono; Sayori Wada; Hiroya Iwase; Mikako Hattori; Yukiko Kobayashi; Yasuhiro Kido

2013-01-01

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Maternal History of Hypertension and Blood Pressure Response to Potassium Intake: The GenSalt Study  

OpenAIRE

The relation between parental history of hypertension and blood pressure response to potassium intake is unknown. A 7-day high-sodium followed by a 7-day high-sodium plus potassium dietary-feeding study was conducted from 2003 to 2005 among 1,871 Chinese participants. Those with a maternal history of hypertension had larger systolic blood pressure responses to potassium compared with those without: ?4.31 (95% confidence interval (CI): ?4.99, ?3.62) mm Hg versus ?3.35 (95% CI: ?4.00,...

Kelly, Tanika N.; Gu, Dongfeng; Rao, D. C.; Chen, Jing; Chen, Jichun; Cao, Jie; Li, Jianxin; Lu, Fonghong; Ma, Jixiang; Mu, Jianjun; Whelton, Paul K.; He, Jiang

2012-01-01

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Room service improves patient food intake and satisfaction with hospital food.  

Science.gov (United States)

Cancer therapy causes side effects that interfere with oral intake. Frequently, patients undergoing such therapy suffer from anorexia, nausea, vomiting, food aversions, dysgeusia, and xerostomia, all which adversely affect oral intake. Adequate nutrition intake is an important part of therapy for the cancer patient, especially when that patient is a child. Children who are well nourished are better able to withstand infection and tolerate therapy. Parents and staff at our hospital have worked diligently to improve patient's oral intake with limited success. Hence, a multidisciplinary team was organized to develop a new approach to food services that would improve patients' oral intake. The team initiated patient "room service," and patients were allowed to call the kitchen when they were ready to eat. The system works much like room service in a hotel. After the introduction of room service, patients' caloric intake improved significantly (P = .008), and protein intake increased by 18%. Patient satisfaction with hospital food service also improved; excellent ratings increased by as much as 35%. We conclude that room service is a viable alternative to traditional food services in the pediatric oncology setting and may be useful in other patient populations, such as maternity and general pediatrics. PMID:9699455

Williams, R; Virtue, K; Adkins, A

1998-07-01

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

DEFF Research Database (Denmark)

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

International Nuclear Information System (INIS)

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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Changes in Dietary Intake, Body Weight, Nutritional Status, and Metabolic Rate in a Pancreatic Cancer Patient  

OpenAIRE

Pancreatic cancer patients often have a poor prognosis and suffer from nutritional problems. Malnutrition is characterized by weight loss and decreased dietary intake, and is common among pancreatic cancer patients. The objective of this report was to describe the changes in dietary intake, body weight, nutritional status, and metabolic rate on a continuum from the time of diagnosis until the end of life in a patient with pancreatic cancer. In summary, the patient's nutritional status gradual...

Kim, So Young; Wie, Gyung Ah; Lee, Woo Jin; Park, Sang-jae; Woo, Sang Myung

2013-01-01

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Clinical application of the second morning urine method for estimating salt intake in patients with hypertension.  

Science.gov (United States)

Estimation of salt intake by cumbersome 24-h urine collection is not suitable for individual patients because of substantial daily variation in intake. We developed the second morning urine (SMU) method for monitoring daily salt intake in healthy subjects by calculating the daily creatinine excretion and measuring the ratio of sodium to creatinine in the SMU specimen. To determine whether the SMU method was applicable to hypertensive patients, we tested it in hospitalized patients under an equilibrated sodium balance as a model population. This review focuses on application of the SMU method in hypertensive patients with mild target organ damage. PMID:24785300

Kawamura, Minoru; Kawasaki, Terukazu

2015-01-01

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Intake of dietary iron is low in patients with Crohn's disease: a case-control study.  

Science.gov (United States)

Patients with Crohn's disease (CD) often experience Fe deficiency (ID) and frequently alter their diet to relieve abdominal symptoms. The present study set out to assess whether patients with CD have dietary habits that lead to low Fe intakes and/or reduced bioavailable Fe compared with control subjects. Patients with asymptomatic CD were matched to controls (n 91/group). Dietary intakes of Fe and contributions from different food groups were compared using a 7 d food diary. Promoters and inhibitors of non-haem Fe absorption were investigated and a recently published algorithm was applied to assess bioavailable Fe. Fewer patients than controls met the reference nutrient intake for Fe (32% CD patients v. 42% controls). Overall, patients had significantly lower mean Fe intakes (by 2.3 mg/d) and Fe density (by 0.26 mg/MJ (1.1 mg/1000 kcal)) compared with controls (both PCD patients for low-fibre non-Fe fortified cereals, particularly breakfast cereals. In particular, control subjects had higher Fe intakes than matched CD subjects for men (PCD, but these had no overall effect on the predicted percentage of bioavailable Fe. Thus total bioavailable Fe was reduced in patients with CD due to lower intakes (PCD patients, which may contribute to an increased risk of ID and anaemia. Changing dietary advice may compromise perceived symptoms of the disease so the need for Fe supplementation should be carefully considered. PMID:14748947

Lomer, Miranda C E; Kodjabashia, Kamelia; Hutchinson, Carol; Greenfield, Simon M; Thompson, Richard P H; Powell, Jonathan J

2004-01-01

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

Science.gov (United States)

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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Another History for Another Psychiatry. The Patient’s View  

OpenAIRE

This article aims to summarise, in the first instance, some of the historiographical trends which have built a “critical” history of psychiatry from the 1960s onwards. Thereafter, it will demonstrate, with suitably significant examples, how methods and discourses were being refined and updated, before reaching a proposal for a new cultural history of psychiatry and subjectivity. In our analysis, special emphasis is placed on the “patient's view”. This renders necessary the task of ide...

Huertas, Rafael

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  

Directory of Open Access Journals (Sweden)

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 needs from time of transplant to time of engraftment. More research is needed to provide insight into strategies to increase 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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Estimation of salt intake from spot urine samples in patients with chronic kidney disease  

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Full Text Available Abstract Background High salt intake in patients with chronic kidney disease (CKD may cause high blood pressure and increased albuminuria. Although, the estimation of salt intake is essential, there are no easy methods to estimate real salt intake. Methods Salt intake was assessed by determining urinary sodium excretion from the collected urine samples. Estimation of salt intake by spot urine was calculated by Tanaka’s formula. The correlation between estimated and measured sodium excretion was evaluated by Pearson´s correlation coefficients. Performance of equation was estimated by median bias, interquartile range (IQR, proportion of estimates within 30% deviation of measured sodium excretion (P30 and root mean square error (RMSE.The sensitivity and specificity of estimated against measured sodium excretion were separately assessed by receiver-operating characteristic (ROC curves. Results A total of 334 urine samples from 96 patients were examined. Mean age was 58?±?16?years, and estimated glomerular filtration rate (eGFR was 53?±?27?mL/min. Among these patients, 35 had CKD stage 1 or 2, 39 had stage 3, and 22 had stage 4 or 5. Estimated sodium excretion significantly correlated with measured sodium excretion (R?=?0.52, P?170?mEq/day (AUC 0.835. Conclusions The present study demonstrated that spot urine can be used to estimate sodium excretion, especially in patients with low eGFR.

Ogura Makoto

2012-06-01

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

OpenAIRE

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 ...

Peter van den Berg; Haard, Paul M. M.; Den Bergh, Joop P. W.; Dieu Donné Niesten; Maarten van der Elst; Schweitzer, Dave H.

2014-01-01

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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  

DEFF Research Database (Denmark)

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

DEFF Research Database (Denmark)

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 Udgivelsesdato: 2008/8

Hansen, T.S.; Engberg, Anders

2008-01-01

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Sleep duration in elderly obese patients correlated negatively with intake fatty  

OpenAIRE

Abstract Study objectives The purpose of the present study was to evaluate the relationship between sleep duration and dietary habits in elderly obese patients treated at an institute of cardiology. Methods The fifty-eight volunteers were elderly patients with obesity (classified as obese according to BMI) of both genders, between 60 and 80?years of age. All participants were subjected to assessments of food intake, anthropometry, level of physical activity, and duration of sleep. Results T...

Santana Aline; Pimentel Gustavo; Romualdo Monica; Oyama Lila; Santos Ronaldo; Pinho Ricardo; de Souza Claudio; Rodrigues Bruno; Caperuto Erico; Lira Fabio

2012-01-01

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Energy intake, nutritional status and weight reduction in patients one year after laparoscopic sleeve gastrectomy  

OpenAIRE

Background: Laparoscopic sleeve gastrectomy (LSG) is increasingly popular due to its efficiency in reducing excess weight, however little is known about the nutritional status in patients after surgery.

Purpose: To investigate how LSG affects energy intake, nutritional status and body weight one year after surgery.

Methods: A total of 150 patients (116 women) were enrolled in the study. Data on body weight, waist circumference and blood samples were registered ...

Gjessing, Hanne Rosendahl; Nielsen, Hans Jørgen; Mellgren, Gunnar; Gudbrandsen, Oddrun Anita

2013-01-01

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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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Long-Term Methadone Intake and Genotoxicity in Addicted Patients  

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Background: It is well known that contact with some physical, chemical or biological compounds can increase the incidence of mutation. Among these compounds, are pharmaceuticals that meet long duration of use and potentially could be misused and taken more than the ordered dosage. Objectives: The aim of this study was to evaluate mutagenic effect of methadone in addicted patients referred to Imam Khomeini Hospital in Ahvaz by single cell gel electrophoresis technic or comet assay. Patients and Methods: In this study, 90 subjects were divided into dichromate treated group, no treated healthy volunteers group and test group. Each group included 30 subjects. Screening was performed according to questionnaire and qualified subjects were entered the study. Blood samples were collected and lymphocytes were isolated, mixed with low melting point agarose for slide preparation according to standard method. Slides were analyzed using fluorescence microscope and comet patterns were assessed. Results: The mutagenicity index in addicted group was robustly higher than healthy volunteers. Fortunately, this significant difference was lower than positive control. Conclusions: Genome instability in addicted patients was demonstrated in this study. Controversially, considering incoherent results of previous studies and our data, more studies in longer duration of methadone use are needed to elucidate the consequence.

Rezaei, Mohsen; Khodaei, Forouzan; Sayah Bargard, Mehdi; Abasinia, Mahsa

2015-01-01

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Sleep duration in elderly obese patients correlated negatively with intake fatty  

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Full Text Available Abstract Study objectives The purpose of the present study was to evaluate the relationship between sleep duration and dietary habits in elderly obese patients treated at an institute of cardiology. Methods The fifty-eight volunteers were elderly patients with obesity (classified as obese according to BMI of both genders, between 60 and 80?years of age. All participants were subjected to assessments of food intake, anthropometry, level of physical activity, and duration of sleep. Results The men had significantly greater weight, height, and waist circumference than women. Sleep durations were correlated with dietary nutrient compositions only in men. We found a negative association between short sleep and protein intake (r?=?-0.43; p?=?0.02, short sleep and monounsaturated fatty acids intake (r?=?-0.40; p?=?0.03, and short sleep and cholesterol dietary intake (r?=?-0.50; p?=?0.01. Conclusions We conclude that mainly in men, volunteers that had short sleep duration showed a preference for high energy-density as fatty food, at least in part, may explain the relationship between short sleep duration and the development of metabolic abnormalities.

Santana Aline

2012-08-01

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Energy expenditure and substrate metabolism in patients with cirrhosis of the liver: effects of the pattern of food intake.  

OpenAIRE

Patients with liver cirrhosis are often undernourished. In healthy subjects, the pattern of food intake is one of the variables that can influence energy balance and substrate metabolism. The short term (two day) effect of the pattern of food intake in patients with cirrhosis and controls was compared. In a respiration chamber, eight patients with cirrhosis of the liver and 23 controls were fed to estimated energy balance in two meals daily ('gorging' pattern) and four to seven meals daily ('...

Verboeket-van Venne, W. P.; Westerterp, K. R.; Hoek, B.; Swart, G. R.

1995-01-01

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Transient thyrotoxicosis in endemic goitre patients following exposure to a normal iodine intake.  

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Twenty-three endemic goitrous subjects (goitre grade: III and IV) that were living in a chronic iodine-deficient area (iodine intake: less than 40 micrograms I/d) were submitted to clinical and laboratory evaluation within 3-8 weeks of arrival at the metropolitan area of São Paulo, where daily iodine intake is estimated to be 150-200 micrograms I/d. Eight patients developed a mild thyrotoxic state (T4 = 14.7 +/- 2.3 micrograms/dl, T3 = 279 +/- 55 ng/dl, no TSH response to TRH). Five additional subjects, although euthyroid, had a blunted TSH-response to TRH, and the remaining ten patients were euthyroid and had a normal TSH response to TRH. Thyrotoxicosis was associated with larger goitres (mean thyroid weight: 133 +/- 46 g), with high thyroid uptake of RAI (mean 24 h 131I uptake: 40 +/- 15%) but not with increased urinary iodine excretion. Serum Tg levels were more elevated in the first two groups of patients (respectively, geometric means 68 and 72 ng/ml), than in the euthyroid, TRH-responsive group (52 ng/ml). Thyrotoxicosis resolved spontaneously after three to six months without the need for any specific medication. It was concluded that a relatively small and normal iodide intake due to regular consumption of iodized salt and industrialized foods may induce a transient form of thyrotoxicosis in endemic goitre patients arriving into urban areas. PMID:6439440

Lima, N; Medeiros-Neto, G

1984-12-01

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Antioxidant intake, plasma antioxidants and oxidative stress in a randomized, controlled, parallel, Mediterranean dietary intervention study on patients with rheumatoid arthritis  

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Full Text Available Abstract Background Previously we have reported that patients with rheumatoid arthritis (RA obtained a significant reduction in disease activity by adopting a Mediterranean-type diet. The present study was carried out to investigate the antioxidant intake, the plasma levels of antioxidants and a marker of oxidative stress (malondialdehyde during the study presented earlier. Methods RA patients randomized to either a Mediterranean type diet (MD group; n = 26 or a control diet (CD group; n = 25 were compared during a three month dietary intervention study. Their antioxidant intake was assessed by means of diet history interviews and their intake of antioxidant-rich foods by a self-administered questionnaire. The plasma levels of retinol, antioxidants (?- and ?-tocopherol, ?-carotene, lycopene, vitamin C and uric acid and urinary malondialdehyde (MDA, a marker for oxidative stress, were determined using high performance liquid chromatography. The Student's t-test for independent samples and paired samples were used to test differences between and within groups. For variables with skewed distributions Mann-Whitney U-test and Wilcoxon signed ranks test were performed. To evaluate associations between dietary intake of antioxidants, as well as between disease activity, MDA and antioxidants we used Pearson's product moment correlation or Spearman's rank correlation. Results The MD group had significantly higher intake frequencies of antioxidant-rich foods, and also higher intakes of vitamin C (p = 0.014, vitamin E (p = 0.007 and selenium (p = 0.004, and a lower intake of retinol (p = 0.049, compared to the CD group. However, the difference between the groups regarding vitamin C intake was not significant when under- and over-repoters were excluded (p = 0.066. There were no changes in urine MDA or in the plasma levels of antioxidants (after p-lipid adjustments of the tocopherol results, from baseline to the end of the study. The levels of retinol, vitamin C and uric acid were negatively correlated to disease activity variables. No correlation was found between antioxidant intake and the plasma levels of antioxidants. Conclusions Despite an increase in reported consumption of antioxidant-rich foods during the Mediterranean diet intervention, the levels of plasma antioxidants and urine MDA did not change. However, the plasma levels of vitamin C, retinol and uric acid were inversely correlated to variables related to RA disease activity.

Andersson Jan

2003-07-01

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Oxidative stress and nutritional intakes in lung patients with bronchiolitis obliterans syndrome.  

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Survival after lung transplantation is limited by bronchiolitis obliterans syndrome (BOS). Oxidative stress (OxS) can be associated with BOS due to chronic inflammation. The type of fat and antioxidant intakes may also contribute to OxS. Our aim was to compare OxS and nutritional intakes in non-BOS versus various stages of BOS. Fifty-eight lung recipients with versus without BOS were prospectively classified as: non-BOS; BOS Op-1 (mild), and BOS 2-3 (severe). We measured nutritional intake and plasma vitamins A, C, and E. Among a subgroup of 37 patients, OxS was assessed by measuring lipid peroxidation (LPO micromol/L MDA) and oxidized glutathione (GSSG) in bronchoalveolar lavage BAL fluid (BALF). One-way analysis of variance was used to compare groups. Results are reported as mean values +/- standard errors of the mean. There was no significant difference in demographic features on time posttransplant among groups. Although there were comparable cell counts in BALF, severe BOS patients showed significantly higher BALF LPO concentrations when compared with milder stage of BOS or with non-BOS (P = .001, for both). Severe BOS recipients also displayed higher BALF GSSG concentrations compared to milder stage of BOS (P = .001) or non-BOS (P = .007). In conclusion, patients with severe BOS were more oxidatively stressed compared with mild and non-BOS recipients. PMID:19917398

Madill, J; Aghdassi, E; Arendt, B M; Gutierrez, C; Singer, L; Chow, C-W; Keshavjee, S; Allard, J P

2009-11-01

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Effect of calcium intake on urinary oxalate excretion in calcium stone-forming patients  

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Full Text Available Dietary calcium lowers the risk of nephrolithiasis due to a decreased absorption of dietary oxalate that is bound by intestinal calcium. The aim of the present study was to evaluate oxaluria in normocalciuric and hypercalciuric lithiasic patients under different calcium intake. Fifty patients (26 females and 24 males, 41 ± 10 years old, whose 4-day dietary records revealed a regular low calcium intake (<=500 mg/day, received an oral calcium load (1 g/day for 7 days. A 24-h urine was obtained before and after load and according to the calciuria under both diets, patients were considered as normocalciuric (NC, N = 15, diet-dependent hypercalciuric (DDHC, N = 9 or diet-independent hypercalciuric (DIHC, N = 26. On regular diet, mean oxaluria was 30 ± 14 mg/24 h for all patients. The 7-day calcium load induced a significant decrease in mean oxaluria compared to the regular diet in NC and DIHC (20 ± 12 vs 26 ± 7 and 27 ± 18 vs 32 ± 15 mg/24 h, respectively, P<0.05 but not in DDHC patients (22 ± 10 vs 23 ± 5 mg/24 h. The lack of an oxalate decrease among DDHC patients after the calcium load might have been due to higher calcium absorption under higher calcium supply, with a consequent lower amount of calcium left in the intestine to bind with oxalate. These data suggest that a long-lasting regular calcium consumption <500 mg was not associated with high oxaluria and that a subpopulation of hypercalciuric patients who presented a higher intestinal calcium absorption (DDHC tended to hyperabsorb oxalate as well, so that oxaluria did not change under different calcium intake.

Nishiura J.L.

2002-01-01

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Awareness of salt restriction and actual salt intake in hypertensive patients at a hypertension clinic and general clinic.  

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The purpose of the present study was to investigate awareness of salt restriction and actual salt intake in hypertensive patients at a hypertension clinic and general clinic. Subjects included 330 patients, with a mean age of 69?±?12 years, who were followed at a hypertension clinic and 200 patients, with a mean age of 67?±?11 years, who were followed at a general clinic. We estimated 24-h salt excretion using spot urine samples and checked the awareness of salt intake using a self-description questionnaire. The number of antihypertensive drugs available at the hypertension clinic was significantly higher than that at the general clinic (2.2?±?1.1 versus 1.6?±?0.9, p?salt excretion was significantly lower at the hypertension clinic than at the general clinic (8.7?±?2.5 versus 9.3?±?2.5?g/d, p?salt intake hypertension clinic and 6% at the general clinic. In patients with excessive salt intake (?10?g/d), 28% of patients at the hypertensive clinic and 23% at the general clinic thought that their salt intake was low. Urinary salt excretion in hypertensive patients was lower at a hypertensive clinic than at a general clinic. This may be due to the professional nutritional guidance at the hypertension clinic. However, most patients could not comply with the guidelines, and the awareness of salt restriction in patients with excessive salt intake was low. PMID:25496285

Ohta, Yuko; Ohta, Kazuhiro; Ishizuka, Azusa; Hayashi, Shinichiro; Kishida, Masatsugu; Iwashima, Yoshio; Yoshihara, Fumiki; Nakamura, Satoko; Kawano, Yuhei

2015-01-01

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Assessing Sexual Abuse/Attack Histories with Bariatric Surgery Patients  

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This study assessed sexual abuse/attack histories in 537 bariatric surgery patients using the PsyBari. The prevalence rates found were lower (15.5%, 19.3% of women, 5.2% of men) than other studies that used bariatric surgery patients but consistent with studies that used nonbariatric obese subjects. Furthermore, bariatric surgery patients who…

Mahony, David

2010-01-01

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Association of n-3 long-chain PUFA and fish intake with depressive symptoms and low dispositional optimism in older subjects with a history of myocardial infarction  

OpenAIRE

Individuals with CHD are at increased risk of poor mental well-being. Dietary intake of EPA and DHA, the main n-3 fatty acids from fish, may be beneficial to mental well-being. We examined the association of EPA+DHA and fish intake with mental well-being in 644 participants, aged 60–80 years, with a history of myocardial infarction. Habitual food intake was assessed with a 203-item FFQ. Depressive symptoms were assessed with the self-report geriatric depression scale, and dispositional opti...

Rest, O.; Goede, J.; Sytsma, F.; Oude Griep, L. M.; Geleijnse, J. M.; Kromhout, D.; Giltay, E. J.

2010-01-01

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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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Full Text Available 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 intervention study presented earlier. Results From baseline to the end of the study, changes in the reported consumption of various food groups were observed in the Mediterranean diet group. The change in diet resulted in a number of differences between the Mediterranean diet group and the control diet group regarding the fatty acid intake. For instance, a lower ratio of n-6 to n-3 fatty acids was observed in the Mediterranean diet group, both assessed by diet history interviews (dietary intake and measured in serum phospholipids. Moreover, the patients in the Mediterranean diet group that showed a moderate or better clinical improvement during the study (diet responders, had a higher reported intake of n-3 fatty acids and a lower ratio of n-6 to n-3 fatty acids compared to the patients with minor or no improvement. Also the fatty acid profile in serum phospholipids differed in part between the diet responders and the diet non-responders. Conclusion The changes in the fatty acid profile, indicated both by dietary assessments and through fatty acids in s-phospholipids may, at least in part, explain the beneficial effects of the Cretan Mediterranean diet that we have presented earlier.

Sköldstam Lars

2005-10-01

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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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Effect of Ethnicity, Dietary Intake and Physical Activity on Plasma Adiponectin Concentrations Among Malaysian Patients with Type 2 Diabetes Mellitus  

Science.gov (United States)

Background The Malaysian Health and morbidity Survey (2006) reported the highest prevalence of type 2 diabetes mellitus (T2DM) among the Indian population compared to the Malay and Chinese populations. Many studies have supported the important role of adiponectin in insulin-sensitizing, which is associated with T2DM. These studies have raised a research question whether the variation in prevalence is related to the adiponectin concentrations or the lifestyle factors. Objectives The purpose of this study is to determine whether the adiponectin concentrations differ between the Malay, Chinese and the Indian populations with T2DM. It is to investigate the association of adiponectin concentrations with ethnicity, dietary intake and physical activity too. Materials and Methods In this cross-sectional study, a total of 210 T2DM patients with mean (SD) age of 56.73 (10.23) years were recruited from Penang, Malaysia. Data on demographic background, medical history, anthropometry (weight, height, visceral fat, percentage of body fat and waist circumference), dietary intake (3 days 24 hours diet recall) and physical activity (International Physical Activity Questionnaire) were obtained accordingly. Plasma adiponectin and routine laboratory tests (fasting blood sugar, HbA1c, total cholesterol, LDL, HDL and triglyceride) were performed according to standard procedure. Results After adjustment for physical activity and dietary intakes, the Indian population had significantly lower adiponectin concentrations (P = 0.003) when compared with the Malay and the Chinese populations, The Indian population also had significantly higher value of HbA1c (P = 0.017) and significantly lower HDL (P = 0.013). Plasma adiponectin concentrations was significantly associated with ethnicity (P = 0.011), dietary carbohydrate (P = 0.003) and physical activity total MET score (P = 0.026), after medical history, age, sex, total cholesterol and visceral fat adjusted. However, dietary carbohydrate and physical activity did not show significantly difference among the various ethnic groups. Conclusions In conclusion, lower concentration of adiponectin in the Indian population when compared with the Malay and the Chinese populations is not associated with lifestyle factors. The possibility of adiponectin gene polymorphism should be discussed further. PMID:24348588

Chin, Koo Hui; Sathyasurya, Daniel Robert; Abu Saad, Hazizi; Jan Mohamed, Hamid Jan B

2013-01-01

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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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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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The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake  

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Full Text Available OBJECTIVE: To assess the relation between blood pressure control and the following: the Morisky-Green test, the patient's consciousness regarding high blood pressure, the patient's attitude in face of medicine intake, the patient's attendance at medical consultations, and the subjective physician's judgment. METHODS: We studied 130 hypertensive patients with the following characteristics: 73% females, 60±11 years, 58% married, 70% white, 45% retired, 45% with incomplete elementary schooling, 64% had a familial income of 1 to 3 minimum wages, body mass index of 30±7 kg/m², consciousness regarding the disease for a mean period of 11±9.5 years, and mean treatment duration of 8 ±7 years. RESULTS: Only 35% of the hypertensive individuals had blood pressure under control and a longer duration of treatment (10±7 vs 7±6.5 years; P<0.05. The retiree predominated. The result of the Morisky-Green test did not relate to blood pressure control. In evaluating the attitude in face of medicine intake, the controlled patients achieved significantly higher scores than did the noncontrolled patients (8±1.9 vs 7 ±2, P<0.05. The hypertensive patients had higher levels of consciousness regarding their disease and its treatment, and most (70% patients attended 3 or 4 medical consultations, which did not influence blood pressure control. The physicians attributed significantly higher scores regarding adherence to treatment to controlled patients (6±0.8 vs 5±1.2; P<0.05. CONCLUSION: Consciousness regarding the disease, the Morisky-Green test, and attendance to medical consultations did not influence blood pressure control.

Maria Aparecida A Moura Strelec

2003-10-01

46

Family History in Patients Who Present with Functional Articulation Disorders  

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This study aimed to examine family history of functional articulation disorders (FAD) among Jordanian patients who present with FAD, as well as to investigate the relation of other factors related to the disorder (age, gender, genetic connection between parents, sounds affected, and type of disorder). A convenience sample of 45 patients (ages…

Alaraifi, Jehad Ahmad; Kamal, Sana Mohammed; Qa'dan, Wa'el Nafith; Haj-Tas, Maisa Atef

2014-01-01

47

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 | Languages: English, 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

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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

49

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

50

Lessons from history: asylum patients' Christmas experience.  

Science.gov (United States)

This article outlines the asylum building programme of the mid-to-late nineteenth century and focuses on case studies of the two Hampshire asylums built during this period, the subject of the author's doctoral thesis. It demonstrates the plight of 'pauper lunatic' before asylum reform and contrasts this with the improved quality of life provided by the Hampshire County Lunatic Asylum and the Borough of Portsmouth Lunatic Asylum respectively. Asylum care during this period followed the moral treatment regime which became the Victorian blueprint for mental health, components of which are illustrated. Criticism of this regime is addressed briefly and arguments are made against anachronistic analysis. Comparison with contemporary in-patient care and treatment is made concluding with a call to reconsider some of the better aspects of earlier care delivery. The particular experience of patients in Hampshire asylums at Christmas is used to exemplify the points raised. PMID:22241488

Carpenter, Diane

51

Is serum gamma-glutamyl transferase a good marker of alcohol intake in stroke patients?  

OpenAIRE

Serial serum gamma-glutamyl transferase (GGT) levels were estimated in 23 consecutive patients admitted to hospital with a diagnosis of acute stroke. The proportion of patients with elevated GGT levels in the initial, 36-hour and 72-hour samples was 13%, 30% and 24% respectively, suggesting a transient rise following a stroke. Patients with a history of diabetes mellitus had an initial serum GGT level 21 IU/l (95% confidence interval 6 to 37) higher than non-diabetics. We conclude that GGT le...

Peck, K.; Shinton, R.; Beevers, G.

1990-01-01

52

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

53

Phosphorus homeostasis in normal health and in chronic kidney disease patients with special emphasis on dietary phosphorus intake.  

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Elevated serum phosphorus has been identified as a cardiovascular risk factor in chronic kidney disease (CKD) patients and a clear understanding of phosphorus homeostasis is very important for practicing nephrologists. At any particular point, serum phosphorus levels reflect the balance between movements of this mineral from and into the intestine, bone, intracellular space, and kidneys. We briefly review here all these exchanges with a particular emphasis on dietary phosphorus intake. Despite all the oral phosphorus binders currently available in the market, dietary restriction of this mineral remains a cornerstone for the prevention and treatment of hyperphosphatemia. An effective restriction of dietary intake of phosphorus requires prescription of a moderate protein intake (0.9-1.0 g/kg/day) and restricted consumption of highly processed fast and convenience foods. Phosphorus added during food processing is an important source of this mineral because of its magnitude and high bioavailabilty. Moreover, as food manufacturers are not required to label the amount of phosphorus added during food processing, a significant amount of the current daily phosphorus intake remains unaccounted when estimating phosphorus intake in CKD patients. The recent development of low phosphorus-containing food products represents a very useful addition for CKD patients. PMID:17635818

Uribarri, Jaime

2007-01-01

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

OpenAIRE

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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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

56

Plant Protein Intake Is Associated with Fibroblast Growth Factor 23 and Serum Bicarbonate in Patients with CKD: The Chronic Renal Insufficiency Cohort Study  

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Background Protein from plant, as opposed to animal, sources may be preferred in chronic kidney disease (CKD), due to lower bioavailability of phosphate and lower nonvolatile acid load. Study Design Observational cross-sectional study. Setting & Participants 2938 participants with chronic kidney disease and information on dietary intake at the baseline visit in the Chronic Renal Insufficiency Cohort Study. Predictors Percentage of total protein from plant sources (% plant protein) was determined by scoring individual food items from the National Cancer Institute Diet History Questionnaire (DHQ). Outcomes Metabolic parameters, including serum phosphate, bicarbonate (HCO3), potassium, and albumin, plasma fibroblast growth factor 23 (FGF23), and parathyroid hormone (PTH), and hemoglobin. Measurements We modeled the association between % plant protein and metabolic parameters using linear regression. Models were adjusted for age, sex, race, diabetes, body mass index, eGFR, income, smoking, total energy intake, total protein intake, 24 hour urinary sodium, use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers and use of diuretics. Results Higher % plant protein was associated with lower FGF23 (p=0.05) and higher HCO3 (p=0.01), but not with serum phosphate or PTH (p=0.9 and 0.5, respectively). Higher % plant protein was not associated with higher serum potassium (p=0.2), lower serum albumin (p=0.2) or lower hemoglobin (p=0.3). The associations of % plant protein with FGF23 and HCO3 did not differ by diabetes status, sex, race, CKD stage (2/3 vs. 4/5) or total protein intake (? 0.8 g/kg/d vs. >0.8 g/kg/d) (p-interaction > 0.10 for each). Limitations Cross-sectional study; Determination of % plant protein using the DHQ has not been validated. Conclusions Consumption of a higher percentage of protein from plant sources may lower FGF23 and raise HCO3 in patients with CKD. PMID:22480598

Scialla, Julia J.; Appel, Lawrence J; Wolf, Myles; Yang, Wei; Zhang, Xiaoming; Sozio, Stephen M.; Miller, Edgar R.; Bazzano, Lydia A.; Cuevas, Magdalena; Glenn, Melanie J.; Lustigova, Eva; Kallem, Radhakrishna R.; Porter, Anna C.; Townsend, Raymond R.; Weir, Matthew R.; Anderson, Cheryl A.M.

2012-01-01

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Lipid malnutrition of patients with liver cirrhosis: effect of low intake of dietary lipid on plasma fatty acid composition.  

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Full Text Available The plasma fatty acid composition of cirrhotic patients and their dietary intake of fatty acids were determined. Significantly lower plasma arachidonic, docosahexaenoic, dihomo-gamma-linolenic and eicosapentaenoic acid levels were observed in cirrhotic patients than in healthy controls. A remarkably low dietary intake of polyunsaturated fatty acids supplied from fish, vegetable oil and pulses was shown in cirrhotic patients. Positive correlations were observed between plasma arachidonic acid concentrations and clearance rate of indocyanine green (KICG (r = 0.826, p less than 0.05 and between dihomo-gamma-linolenic acid levels and cholinesterase activities (r = 0.841, p less than 0.05. From these results, we conclude that a supply of polyunsaturated fatty acids is necessary for the nutritional treatment of patients with liver cirrhosis.

Okita,Misako

1989-02-01

58

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

59

Bone Health History in Breast Cancer Patients on Aromatase Inhibitors  

OpenAIRE

A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI) users before breast cancer (BC) diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC). Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health hist...

Kwan, Marilyn L.; Lo, Joan C.; Tang, Li; Laurent, Cecile A.; Roh, Janise M.; Chandra, Malini; Hahn, Theresa E.; Hong, Chi-chen; Sucheston-campbell, Lara; Hershman, Dawn L.; Quesenberry, Charles P.; Ambrosone, Christine B.; Kushi, Lawrence H.; Yao, Song

2014-01-01

60

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

OpenAIRE

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

Validity and reproducibility of folate and vitamin B12 intakes estimated from a self-administered diet history questionnaire in Japanese pregnant women  

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Full Text Available Abstract Background No validated dietary questionnaire for assessing folate and vitamin B12 intakes during pregnancy is available in Japan. We evaluated the validity and reproducibility of intakes of folate and vitamin B12 estimated from a self-administered diet history questionnaire (DHQ in Japanese pregnant women. Methods A sample of 167 healthy subjects with singleton pregnancies in the second trimester was recruited at a private obstetric hospital in metropolitan Tokyo from June to October 2008 (n = 76, and at a university hospital in Tokyo from June 2010 to June 2011 (n = 91. The dietary intakes of folate and vitamin B12 were assessed using the DHQ. The serum concentrations of folate and vitamin B12 were measured as reference values in the validation study. To assess the reproducibility of the results, 58 pregnant women completed the DHQ twice within 4-5 week interval. Results Significantly positive correlations were found between energy-adjusted intakes and serum concentrations of folate and vitamin B12 (r = 0.286, p p = 0.004, respectively. After excluding the participants with nausea (n = 121, the correlation coefficient for vitamin B12 increased to 0.313 (p = 0.001. When participants were classified into quintiles based on intakes and serum concentrations of folate and vitamin B12 , approximately 60% were classified in the same or adjacent quintile. The intraclass correlation coefficients of the two-time DHQ were 0.725 for folate and 0.512 for vitamin B12 . Conclusion The present study indicated that the DHQ had acceptable validity and reproducibility for assessing folate and vitamin B12 intakes in Japanese pregnant women.

Shiraishi Mie

2012-03-01

62

Comparative research for the dietary pattern of patients with esophageal cancer at different developing stages and the daily intake of vitamin A, E and ?-carotene.  

Science.gov (United States)

This paper discusses the different stages of normal esophageal's developing to esophageal cancer, and the difference among dietary patterns of patients with esophageal cancer and acceptable daily intake of vitamin A, E and beta carotene intake in diet. This paper takes advantage of food composition table, calculates the intake amount of dietary vitamin A, E and beta carotene in all kinds of food for patients with esophageal cancer, and analyzes the intake amount difference of dietary vitamin A, E and beta carotene in each kind of food for different groups of people. Research conclusions: the low content level of dietary vitamin A, E beta-carotene and low intake amount of beans, vegetables and fruit intake may increase the risk of esophageal cancer' occurring, while the relationship among dietary vitamin E, the occurrence and development of esophageal cancer needs further discussion. PMID:25016272

Hu, Jigang; Qi, Qingbin; Zhang, Yanli

2014-07-01

63

Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients: a cross-sectional study  

OpenAIRE

Abstract Background Type 2 diabetes mellitus is a major global public health problem in the worldwide and is increasing in aging populations. Magnesium intake may be one of the most important factors for diabetes prevention and management. Low magnesium intake may exacerbate metabolic abnormalities. In this study, the relationships of magnesium intake with metabolic parameters, depression and physical activity in elderly patients with type 2 diabetes were investigated. Methods This cross-sect...

Huang Jui-Hua; Lu Yi-Fa; Cheng Fu-Chou; Lee John; Tsai Leih-Ching

2012-01-01

64

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

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

Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients: a cross-sectional study  

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Full Text Available Abstract Background Type 2 diabetes mellitus is a major global public health problem in the worldwide and is increasing in aging populations. Magnesium intake may be one of the most important factors for diabetes prevention and management. Low magnesium intake may exacerbate metabolic abnormalities. In this study, the relationships of magnesium intake with metabolic parameters, depression and physical activity in elderly patients with type 2 diabetes were investigated. Methods This cross-sectional study involved 210 type 2 diabetes patients aged 65?years and above. Participants were interviewed to obtain information on lifestyle and 24-hour dietary recall. Assessment of depression was based on DSM-IV criteria. Clinical variables measured included anthropometric measurements, blood pressure, and biochemical determinations of blood and urine samples. Linear regression was applied to determine the relationships of magnesium intake with nutritional variables and metabolic parameters. Results Among all patients, 88.6% had magnesium intake which was less than the dietary reference intake, and 37.1% had hypomagnesaemia. Metabolic syndromes and depression were associated with lower magnesium intake (p??0.05. A positive relationship was found between magnesium intake and HDL-cholesterol (p?=?0.005. Magnesium intake was inversely correlated with triglyceride, waist circumference, body fat percent and body mass index (p?p for trend?=?0005. Waist circumference, body fat percentage, and body mass index were significantly lower with increase quartile of magnesium intake (p for trend?p for trend? Conclusions The majority of elderly type 2 diabetes who have low magnesium intake may compound this deficiency with metabolic abnormalities and depression. Future studies should determine the effects of increased magnesium intake or magnesium supplementation on metabolic control and depression in elderly people with type 2 diabetes.

Huang Jui-Hua

2012-06-01

67

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 fatigue 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 < 0.001 between TCI and %BF and between TCI and fatigue levels (Spearman rho(18 = -0.541; P = 0.014 at the end of the study. In conclusion, the results of this study suggest that an exercise intervention administered to breast cancer patients undergoing medical treatment may assist in the mitigation of some treatment side effects, including decreased TCI, increased fatigue, and negative changes in body composition.

C.L. Battaglini

2008-08-01

68

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

Scientific Electronic Library Online (English)

Full Text Available 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

69

Management of inflammatory bowel disease patients with a cancer history.  

Science.gov (United States)

In inflammatory bowel disease (IBD) patients, thiopurines promote carcinogenesis of Epstein-Barr Virus (EBV)-related lymphomas, non-melanoma skin cancers and urinary tract cancers, while anti-TNF agents could promote carcinogenesis of melanomas. Patients with IBD and previous cancer are at a higher risk of developing new or recurrent cancer than IBD patients without a history of cancer, irrespective of the use of immunosuppressants. In transplant recipients, the use of thiopurines is associated with a high rate of cancer recurrence, particularly within the first two years following transplantation. In patients with chronic inflammatory disease, limited data suggest that no dramatic incidence of cancer recurrence is associated with the use of thiopurines or anti-TNF agents. However, there is a rationale for a two-year drug holiday from immunosuppressants after the diagnosis and treatment of the majority of incident cancers, as often as possible. Extending the duration of the immunosuppressant drug holiday to 5 years in patients with previous cancers associated with a high risk of recurrence in the post-transplant state should be considered. The immunosuppressants that can be initiated or resumed after cancer treatment should be chosen according to the type of the previous cancer. All individual decisions should be made on a case-by-case basis, together with the oncologist, according to characteristics and expected evolution of the index cancer, expected impact of the immunosuppressants on cancer evolution, and intrinsic severity of IBD, with its associated risks. PMID:25146698

Beaugerie, Laurent

2014-01-01

70

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

71

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.  

Science.gov (United States)

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

72

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

OpenAIRE

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

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

Directory of Open Access Journals (Sweden)

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

74

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

Directory of Open Access Journals (Sweden)

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

75

History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.  

Science.gov (United States)

The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia. PMID:23674244

Robles-García, Rebeca; López-Luna, Sonia; Páez, Francisco; Escamilla, Raúl; Camarena, Beatriz; Fresán, Ana

2014-12-01

76

Family History of Affective Illness in Schizophrenia Patients: Symptoms and Cognition  

OpenAIRE

This study examined the relationship between having a family history of affective disorder and neuropsychological functioning and PANSS symptoms in schizophrenia patients falling into four exclusive family history groups (affective spectrum disorders, schizophrenia spectrum disorders, both, or neither). Schizophrenia patients with a family history of affective illness had the best performance on IQ tests and executive function measures. Symptoms showed fewer family history group differences. ...

Anglin, Deidre; Stanford, Arielle D.; Harkavy-friedman, Jill M.; Goetz, Raymond; Rosenfield, Paul; Malaspina, Dolores

2009-01-01

77

Natural history and visual outcome in patients with APMPPE.  

Science.gov (United States)

We undertook a retrospective study of the files of 21 patients (42 affected eyes) with acute posterior multifocal placoid pigment epitheliopathy to obtain details on the natural history of the disease and on the functional and visual outcome (mean follow up: 17 months). The final visual acuities were 8/10 or better in 34 eyes (81.0%), 7/10 to 2/10 in 6 eyes (14.2%) and 1/10 in two eyes (4.8%). Although the final visual acuity was good in most eyes, 24 eyes (57.2%) were still symptomatic due to scotomas (33.3%), metamorphosia (21.4%), decreased vision (16.6%), floaters (4.8%) and chronic redness (2.4%). Recurrences did not occur in this group of patients. Electrophysiological and color vision tests were performed in the initial phase of the disease, but we found no correlation between the test results and the final visual acuity. PMID:8044336

Vianna, R; van Egmond, J; Priem, H; Kestelyn, P

1993-01-01

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

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

Directory of Open Access Journals (Sweden)

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

80

Falling Prey to the Sunk Cost Bias: A Potential Harm of Patient Radiation Dose Histories  

OpenAIRE

Although patient dose histories will make valuable contributions to quality improvement and research initiatives, care must be taken to avoid misuse by physicians when making imaging decisions for individual patients.

Eisenberg, Jonathan D.; Harvey, H. Benjamin; Moore, Donald A.; Gazelle, G. Scott; Pandharipande, Pari V.

2012-01-01

81

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 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

82

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.)

83

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

84

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

International Nuclear Information System (INIS)

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)

85

A case-control study on the dietary taurine intake, nutrient status and life stress of functional constipation patients in Korean male college students  

OpenAIRE

Abstract Background Constipation is a common gastrointestinal symptom in Korea as well as in Western countries. This study was performed to investigate the dietary taurine intake, nutrient status, and life stress of functional constipation (FC) patients in Korean male college students. Methods Research data were collected in 2008 and a total of 104 male students (52 with FC patients and 52 healthy controls without FC) were included. FC patients were defined by the codes for the Rome? Modula...

You Jeong-Soon; Park Ji-Yeon; Chang Kyung-Ja

2010-01-01

86

Influence of brucellosis history on serological diagnosis and evolution of patients with acute brucellosis.  

Science.gov (United States)

Serological diagnosis of human brucellosis is problematic in endemic brucellosis regions and with patients having a history of brucellosis. The aim of this study is to ascertain the serologic and evolutionary behavior of the tests of serum agglutination, Coombs anti-Brucella, immunocapture-agglutination, enzyme-linked immunosorbent assay (ELISA) IgG, IgA, IgM and ELISA-IgG avidity against Brucella lipopolysaccharide (S-LPS), in patients with acute brucellosis based on whether or not a history of brucellosis exists. Titers and seropositivity in all the tests assayed were higher in the patients having brucellosis history (from 90.9% in ELISA-IgM to 100% in ELISA-IgG) than in the patients lacking such history (from 79.3% in ELISA-IgM to 86.2% in Coombs, immunocapture-agglutination, and ELISA-IgG). IgG S-LPS avidity results in patients with brucellosis history were significantly higher (always over 84%) than in patients without brucellosis history (from 48.0% in the initial sera to 81% ten months later) (pELISA-IgG avidity against S-LPS may allow distinguishing patients with brucellosis caused by primary infection in the initial stages of the disease from patients seropositive due to prior infections from Brucella. PMID:18834635

Mantecón, María de Los Angeles; Gutiérrez, María Purificación; Zarzosa, María Del Pilar; Fernández-Lago, Luis; Colmenero, Juan de Dios; Vizcaíno, Nieves; Bratos, Miguel Angel; Almaraz, Ana; Cubero, Africa; Muñoz, Maria Fe; Rodríguez Torres, A; Orduña, Antonio

2008-11-01

87

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

Scientific Electronic Library Online (English)

Full Text Available 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

88

History of spine surgery in older obese patients  

OpenAIRE

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 II (BMI >=35 kg/m2) and obese-class III (BMI >=40 kg/m2). Patients' age was categorized into the following age groups: =66. T-test and Chi-square test were applied using SPSS v16.Results: In lumbar patients aged >=66 years with previous spine surgery, the ...

Walid, Ms; Zaytseva, N.

2011-01-01

89

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

OpenAIRE

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 usin...

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

2006-01-01

90

Hypoproteinaemia, ascites and a tumour marker rise in a patient with a history of cancer  

OpenAIRE

Ascites and lower limb edema in a patient with a history of intra-hepatic cholangiocarcinoma and breast cancer raised suspicion of cancer recurrence. Although CA 125 and CA 19.9 were elevated and initial cytologic findings for the ascitic fluid were consistent with this diagnosis, further tests revealed that the patient suffered from proteinlosing enteropathy, a benign, unusual condition.

Duhoux, Franc?ois; Weynand, Birgit; Baurain, Jean-franc?ois; Mano, Max

2007-01-01

91

[What the patient's history tells us about their nonepileptic seizures].  

Science.gov (United States)

The aetiology of "psychogenic" non-epileptic seizures (NES) remains poorly understood and the differentiation of NES from epilepsy can be a difficult. In the first part of this review article we focus on recent insights into the neurobiological underpinnings of NES. We summarise a number of studies demonstrating the importance of abnormalities of emotion regulation in patients with NES. Evidence for abnormal emotion regulation comes from both self-report and experimental studies of pre-conscious cognitive processes. These studies show that NES are not the only manifestation of abnormal mental processing in these patients and that excessive social threat avoidance and emotional dysregulation are also evident between seizures and may therefore contribute to disability beyond the seizures themselves. In the second part of this review, we describe the findings of a number of studies, which have examined differences between the communication behaviour of patients with NES and those with epilepsy. We argue, that, whilst these studies initially aimed to help clinicians with the differential diagnosis of NES and epilepsy, close sociolinguistic analysis of patient's talk can also provide clues about the aetiology of NES. We conclude that the interaction of patient with NES with the doctor can be interpreted as a manifestation of avoidance and a demonstration of helplessness perhaps intended to secure active support from the doctor. In the third part of this review, we suggest that a close reading of a transcript of the interaction between a patient with NES and her doctor (and perhaps attentive listening to how patients' talk about themselves and their disorder) can yield clues to the causes of NES in individual cases. PMID:25306078

Reuber, M; Micoulaud-Franchi, J-A; Gülich, E; Bartolomei, F; McGonigal, A

2014-10-01

92

Significance of dietary folate intake, homocysteine levels and MTHFR 677 C>T genotyping in South African patients diagnosed with depression: test development for clinical application.  

Science.gov (United States)

Low folate intake in the presence of the functional MTHFR 677 C > T (rs1801133) polymorphism is an important cause of elevated homocysteine levels previously implicated in major depressive disorder (MDD) and many other chronic diseases. In this study the clinical relevance and inter-relationship of these aspects were evaluated in 86 South African patients diagnosed with MDD and 97 population-matched controls participating in a chronic diseases screening program. A questionnaire-based clinical and nutrition assessment was performed, homocysteine levels determined, and all study participants genotyped for MTHFR 677 C > T (rs1801133) using allele-specific TaqMan technology. The folate score was found to be significantly lower in the patient group compared to controls (p?=?0.003) and correlated with increased body mass index (BMI), particularly in females with MDD (p?=?0.009). BMI was significantly higher in the MDD patients compared with controls after adjustment for age and sex (p?=?0.015), but this association was no longer significant after further adjustment for the level of folate intake in the diet. In MDD patients but not controls, the minor T-allele of MTHFR 677 C > T was associated with increased BMI (p?=?0.032), which in turn correlated significantly with increased homocysteine levels. The significant association between BMI and homocysteine levels was observed in both the MDD patient (p?=?0.049) and control (p?=?0.018) study groups. The significantly higher homocysteine levels observed in MDD patients compared to controls after adjustment for age and sex (p?=?0.030), therefore appears to be mediated by the effects of MTHFR 677 C > T and low folate intake on BMI. Detection of the low-penetrance MTHFR 677 C > T mutation reinforces the importance of folate intake above the recommended daily dose to prevent or restore dysfunction of the methylation pathway. PMID:24532086

Delport, Darnielle; Schoeman, Renata; van der Merwe, Nicole; van der Merwe, Lize; Fisher, Leslie R; Geiger, Dieter; Kotze, Maritha J

2014-06-01

93

Norwegian PUQE (Pregnancy-Unique Quantification of Emesis and Nausea) Identifies Patients with Hyperemesis Gravidarum and Poor Nutritional Intake: A Prospective Cohort Validation Study  

Science.gov (United States)

Objective The English questionnaire Pregnancy-Unique Quantification of Emesis and nausea (PUQE) identifies women with severe Hyperemesis Gravidarum. Our aim was to investigate whether scores from the translated Norwegian version; SUKK (SvangerskapsUtløst Kvalme Kvantifisering) was associated with severity of hyperemesis and nutritional intake. Design A prospective cohort validation study. Setting Hospital cohort of Hyperemesis Gravidarum (HG) patients from western Norway and healthy pregnant women from Bergen, Norway. Sample 38 women hospitalized due to HG and 31 healthy pregnant controls attending routine antenatal check-up at health centers. Methods Data were collected May 2013-January 2014. The study participants answered the Norwegian PUQE-questionnaire (scores ranging from 3 to15) and registered prospectively 24-hours nutritional intake by a food list form. Main outcome measures Differences of PUQE-scores, QOL-score and nutritional intake between hyperemesis patients and controls. Results Hyperemesis patients had shorter gestational age compared to controls (median 9.7 weeks; 95% CI 8.6-10.6 versus 11.9; 95% CI 10.1-12.9, p=0.004), and larger weight-change from pre-pregnant weight (loss of median 3 kg; 95% CI 3-4 versus gain of 2 kg; 95% CI 0.5-2, p<0.001) otherwise groups were similar regarding pre-pregnant BMI, age, gravidity, and inclusion weight. Compared to controls, hyperemesis patients had significant higher PUQE-score (median 13; 95% CI 11-14 vs. 7; 95% CI 4-8), lower QOL (median score 3; 95% CI 2-4 vs. 6; 95% CI 4.5-8) and lower nutritional intake (energy intake median 990 kcal/24 hours; 95% CI 709-1233 vs. 1652; 95% CI 1558-1880 all p<0.001). PUQE-score was inversely correlated to nutritional intake (-0.5, p<0.001). At discharge PUQE-score had fallen to median 6 (95% CI 5-8) and QOL score risen to 7 (95% CI 6-8) in the HG group, (both p<0.001 compared to admission values). Conclusion PUQE-scoring has been validated as a robust indicator of severe hyperemesis gravidarum and insufficient nutritional intake in a Norwegian setting. PMID:25830549

Birkeland, Elisabeth; Stokke, Guro; Tangvik, Randi J.; Torkildsen, Erik A.; Boateng, Jane; Wollen, Anne L.; Albrechtsen, Susanne; Flaatten, Hans; Trovik, Jone

2015-01-01

94

Natural history of asplenism in APECED--patient report.  

Science.gov (United States)

Only a few reports on patients with hypo/ asplenism associated with APECED have been published, yet hyposplenism has been found in approximately half of the studied patients. The 7-year follow-up in our only patient with APECED revealed a decrease of spleen size from normal to half-size by ultrasound and CT examinations. Scintigraphy of the liver and spleen demonstrated a progressively diminishing splenic uptake of the tracer from low to complete absence. Peripheral blood smears revealed permanent thrombocytosis with the presence of Howell-Jolly bodies when functional asplenism was reached. The cause of autoimmunization and hyposplenism in APECED is unknown. We hypothesize that hyposplenism depends primarily on local AIRE gene dysfunction in the spleen, and secondarily on an AIRE gene-mediated autoagressive process. In our opinion, hypo/asplenism in APECED disease might not be noticed in patients with APECED if not directly examined. Thus we emphasize the necessity of searching for hyposplenism in all patients with APECED, and recommend scintigraphy. PMID:11327379

Starzyk, J; Kumorowicz-Kopiec, M; Kowalczyk, M; Starzyk, B; Rybakowa, M; Dziatkowiak, H

2001-04-01

95

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

Directory of Open Access Journals (Sweden)

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

96

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

97

TRACKING CANCER PATIENTS MEDICAL HISTORY USING WIRELESS EMERGING TECHNOLOGY : NEAR FIELD COMMUNICATION  

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Full Text Available The principal objective of this paper is to present an effective solution for storing and retrieving a cancer patient’s medical history in hospitals, clinics and wherever else need be. We have used latest technologies like Near Field Communication (NFC as a medium for communication, MySQL server for storing the database i.e. EHR (Electronic Health Record of patients and lastly an Android application which will provide the interface for the same.

Shivang Bhagat

2015-02-01

98

Fifteen-year-old colon cancer patient with a 10-year history of ulcerative colitis  

OpenAIRE

Inflammatory bowel disease (IBD) is regarded as one of the risk factors for colorectal cancer, and early detection of cancer in these patients may be difficult, especially in pediatric patients. Prognosis of pediatric colorectal cancer is known to be poor, because of delayed diagnosis and unfavorable differentiation. We report a case of a pediatric patient with a 10-year history of ulcerative colitis who was diagnosed with sigmoid colon cancer when he was 15 years old. He underwent proctocole...

Seung Yeon Noh; Seung Young Oh; Soo-Hong Kim; Hyun-Young Kim; Sung-Eun Jung; Kwi-Won Park

2013-01-01

99

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)

100

The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis  

OpenAIRE

Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP) using population-based registry. Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER) database and reviewed. Results. 79% of all patients with known SEER stage were classified as having region...

Anne Kessinger; Fen Wei Wang; Jue Wang

2011-01-01

101

"Transferred to another institution": clinical histories of psychiatric patients murdered in the Nazi "euthanasia" killing program.  

Science.gov (United States)

This study aims to examine the practice of medical reporting in a totalitarian environment including systematic killing of people with mental illness in Nazi Germany. The historical analysis is based on patient documents and administrative files at today's District Hospital, Günzburg, as well as on patient documents of inventory R 179 of the branch office of the Federal Archives (Bundesarchiv) in Berlin/Lichterfelde. The paper describes four patient histories and attempts to reconstruct some aspects of patients' (mostly institutional) histories against the background of the Günzburg State Hospital serving as an assembly institution in the context of "Aktion T4." There is no certainty regarding the places of death of the four patients whose medical documentation is reported. In the patient records examined, the practice of medical description and reporting was characterized by a mixture of medical terminology, ideological diction and common language. The type of medical description and documentation used is an expression of stigmatization and discrimination of patients and of traumatizing institutional practice, and it reflects institutional violence. It is an ethical responsibility to reconstruct and commemorate the individual histories of mentally ill patients who were victims of the program of organized mass killings of people with mental illness. Places of death were camouflaged by the "Aktion T4," and there is uncertainty for many patients regarding where they were killed. PMID:22572090

Steger, Florian; Görgl, Andreas; Strube, Wolfgang; Winckelmann, Hans-J; Becker, Thomas

2011-01-01

102

Radiological and scintigraphic findings in patients with a clinical history of chronic inflammatory back pain  

International Nuclear Information System (INIS)

The prevalence of radiological abnormalities of the sacroiliac joints, the manubriosternal joint, and the lumbar spine were assessed, and quantitative sacroiliac scintigraphy was performed in 151 patients with a history of chronic inflammatory back pain and in 31 controls with non-inflammatory back pain. Sacroiliitis was found in 124 patients (82%), manubriosternal lesions in 84 patients (56%), and lesions of the lumbar spine in 58 patients (38%). In 19 patients (13%), manubriosternal lesions provided the sole radiological abnormality and in five patients (3%) no radiological abnormality could be demonstrated at any of these sites. Quantitative sacroiliac scintigraphy showed increased values in 69 of 137 patients examined (50%), but also in 10 out of 12 control patients with disc degeneration (83%) and is, therefore, nonspecific for inflammatory lesions. Radiological examination of the manubriosternal joint is recommended in patients with inflammatory back pain without radiographic evidence of sacroiliitis. (orig.)

103

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

Directory of Open Access Journals (Sweden)

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

104

Validation of a computer based system for assessing dietary intake.  

OpenAIRE

Dietary intake was assessed in 50 patients in hospital by using a dietary history method and computer based system for data collection and standard food tables to calculate the composition of nutrients. The results were compared with those from a weighed assessment that was calculated by using both food tables and manufacturers' food analyses. The use of the food tables overestimated mean (SEM) individual nutrient intakes by between 2.5% (1.5%) and 15.5% (3.0%). The mean errors associated wit...

Levine, J. A.; Madden, A. M.; Morgan, M. Y.

1987-01-01

105

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

OpenAIRE

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

106

Colorectal cancer screening in patients at moderately increased risk due to family history  

OpenAIRE

Patients with a positive family history have an increased risk of colorectal cancer (CRC) and, in many countries, more intensive screening regimens, sometimes involving the use of colonoscopy as opposed to sigmoidoscopy or fecal occult blood testing, are recommended. This review discusses current screening guidelines in the United States and other countries, data on the magnitude of CRC risk in the presence of a family history and the efficacy of recommended screening programs, as well as anc...

Lin, Otto S.

2012-01-01

107

Season of birth of breast cancer patients and its relation to patients' reproductive history in Tokyo, Japan.  

OpenAIRE

Seasonal distribution of the birth dates of 405 pre-menopausal and 285 post-menopausal breast cancer patients was investigated in order to determine whether or not the season of their birth was related to various reproductive risk factors of breast cancer, including nulliparity, late age at first birth, early age at menarche, late age at menopause, and a history of benign breast diseases. The seasonal distributions of births were compared between groups of patients categorized according to wh...

Nakao, Hiroko

1988-01-01

108

Fatal case of Reye's syndrome associated with H3N2 influenza virus infection and salicylate intake in a 12-year-old patient.  

Science.gov (United States)

We describe a fatal case of Reye's syndrome in a 12-year-old male patient during an influenza A (H3N2) infection for which he received salicylates. In the current situation of the novel A/H1N1 virus pandemic, we believe that it is of high importance to emphasize the risks associated with salicylate intake to avoid the reappearance of Reye's syndrome. PMID:20167009

Ninove, L; Daniel, L; Gallou, J; Cougard, P-A; Charpentier, A; Viard, L; Roquelaure, B; Paquis-Flucklinger, V; de Lamballerie, X; Zandotti, C; Charrel, R N

2011-01-01

109

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

Science.gov (United States)

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

110

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  

Directory of Open Access Journals (Sweden)

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

111

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

OpenAIRE

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

112

Season of birth of breast cancer patients and its relation to patients' reproductive history in Tokyo, Japan.  

Directory of Open Access Journals (Sweden)

Full Text Available Seasonal distribution of the birth dates of 405 pre-menopausal and 285 post-menopausal breast cancer patients was investigated in order to determine whether or not the season of their birth was related to various reproductive risk factors of breast cancer, including nulliparity, late age at first birth, early age at menarche, late age at menopause, and a history of benign breast diseases. The seasonal distributions of births were compared between groups of patients categorized according to whether they possessed each risk factor or not, separately for pre- and post-menopausal patients. Patients with the same menopausal status generally had the same seasonal distribution of births, irrespective of whether or not they possessed a risk factor. Moreover, low-risk patients exhibited more deviation in the seasonal distribution of birth from general births than the high-risk patients. These results suggest that the distinctive seasonal distribution of birth observed in breast cancer patients is basically a phenomenon independent from the effect of the reproductive history on the occurrence of breast cancer, and that specific seasonal factors are involved at the fetal or neonatal stage in the etiology of breast cancer.

Nakao,Hiroko

1988-08-01

113

A primary care audit of familial risk in patients with a personal history of breast cancer.  

Science.gov (United States)

Breast cancer is the most common cancer diagnosed in women, both in the UK and worldwide. A small proportion of women are at very high risk of breast cancer, having a particularly strong family history. The National Institute for Health and Clinical Excellence (NICE) has advised that practitioners should not, in most instances, actively seek to identify women with a family history of breast cancer. An audit was undertaken at an urban primary care practice of 15,000 patients, using a paper-based, self-administered questionnaire sent to patients identified with a personal history of breast cancer. The aim of this audit was to determine whether using targeted screening of relatives of patients with breast cancer to identify familial cancer risk is worthwhile in primary care. Since these patients might already expected to have been risk assessed following their initial diagnosis, this audit acts as a quality improvement exercise. The audit used a validated family history questionnaire and risk assessment tool as a screening approach for identifying and grading familial risk in line with the NICE guidelines, to guide referral to the familial cancer screening service. The response rate to family history questionnaires was 54 % and the majority of patients responded positively to their practitioner seeking to identify familial cancer risks in their family. Of the 57 returned questionnaires, over a half (54 %) contained pedigrees with individuals eligible for referral. Patients and their relatives who are often registered with the practice welcome the discussion. An appropriate referral can therefore be made. The findings suggest a role for primary care practitioners in the identification of those at higher familial risk. However integrated systems and processes need designing to facilitate this work. PMID:25096803

Nathan, Paul; Ahluwalia, Aneeta; Chorley, Wendy

2014-12-01

114

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

115

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

116

Dietary intake of n-3 long-chain polyunsaturated fatty acids and risk of myocardial infarction in coronary artery disease patients with or without diabetes mellitus:a prospective cohort study  

OpenAIRE

Background: A beneficial effect of a high n-3 long-chain polyunsaturated fatty acid (LCPUFA) intake has been observed in heart failure patients, who are frequently insulin resistant. We investigated the potential influence of impaired glucose metabolism on the relation between dietary intake of n-3 LCPUFAs and risk of acute myocardial infarction (AMI) in patients with coronary artery disease.

Methods: This prospective cohort study was based on the Western Norway B-Vitamin...

Strand, Elin; Pedersen, Eva Ringdal; Svingen, Gard Frodal; Schartum-hansen, Hall; Rebnord, Eirik Wilberg; Bjørndal, Bodil; Seifert, Reinhard; Bohov, Pavol; Meyer, Klaus; Hiltunen, J. Kalervo; Nordrehaug, Jan Erik; Nilsen, Dennis W. T.; Berge, Rolf K.; Nyga?rd, Ottar

2013-01-01

117

Dietary intake of n-3 long-chain polyunsaturated fatty acids and risk of myocardial infarction in coronary artery disease patients with or without diabetes mellitus: a prospective cohort study  

OpenAIRE

Background: A beneficial effect of a high n-3 long-chain polyunsaturated fatty acid (LCPUFA) intake has been observed in heart failure patients, who are frequently insulin resistant. We investigated the potential influence of impaired glucose metabolism on the relation between dietary intake of n-3 LCPUFAs and risk of acute myocardial infarction (AMI) in patients with coronary artery disease.Methods: This prospective cohort study was based on the Western Norway B-Vitamin Intervention...

Strand, Elin; Pedersen, Eva R.; Svingen, Gard Ft; Schartum-hansen, Hall; Rebnord, Eirik W.; Bjørndal, Bodil; Seifert, Reinhard; Bohov, Pavol; Meyer, Klaus; Hiltunen, J. Kalervo; Nordrehaug, Jan E.; Nilsen, Dennis Wt; Berge, Rolf K.; Nyga?rd, Ottar

2013-01-01

118

The natural history of interferon-? induced thyroiditis in chronic hepatitis c patients: a long term study  

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Full Text Available Abstract Background Autoimmune thyroid disease is a common complication of patients with chronic hepatitis C undergoing combination pegylated interferon-? and ribavirin treatment. A small proportion develops interferon-induced thyroiditis of which the long term natural history is unknown and how it compares with de novo thyroiditis. The aim of the study is to determine the natural history of thyroid disease including antibody profile in this particular setting 36 months from the completion of therapy. Methods A cohort of 18 hepatitis C patients (mean age 45 ± 8 years (standard deviation who developed exclusively thyroiditis in this setting was followed every 12 months after the completion of therapy for 36 months. Investigations included thyrotropin, free tetra-iodothyronine, free tri-iodothyronine levels and thyroid autoantibodies. Results None of the patients developed any long term thyroid disease. Two patients had a prolonged hypothyroid phase of the thyroiditis early after the completion of treatment but recovered fully. The remaining 16 patients remained euthyroid. Similarly, thyroid autoantibodies all declined and returned to reference range. Conclusions The long term natural history in this small series of interferon induced thyroiditis was benign. If a larger series confirms a similar outcome then there is no long term residual effect on thyroid function and follow-up testing would not be warranted.

Tran Huy A

2011-01-01

119

Fifteen-year-old colon cancer patient with a 10-year history of ulcerative colitis  

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Inflammatory bowel disease (IBD) is regarded as one of the risk factors for colorectal cancer, and early detection of cancer in these patients may be difficult, especially in pediatric patients. Prognosis of pediatric colorectal cancer is known to be poor, because of delayed diagnosis and unfavorable differentiation. We report a case of a pediatric patient with a 10-year history of ulcerative colitis who was diagnosed with sigmoid colon cancer when he was 15 years old. He underwent proctocolectomy with ileal pouch anal anastomosis. Postoperative pathological examination of the tumor revealed adenocarcinoma. The pericolic tissue layer was infiltrated, but metastases were not found in either of the two lymph nodes. Children with a long history of predisposing factors such as IBD need particular attention to the possibility of colorectal cancer. Early diagnosis through regular screening with colonoscopy is one of the most important critical factors for a good prognosis. PMID:23613641

Noh, Seung Yeon; Oh, Seung Young; Kim, Soo-Hong; Kim, Hyun-Young; Jung, Sung-Eun; Park, Kwi-Won

2013-01-01

120

Fifteen-year-old colon cancer patient with a 10-year history of ulcerative colitis  

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Full Text Available Inflammatory bowel disease (IBD is regarded as one of the risk factors for colorectal cancer, and early detection of cancer in these patients may be difficult, especially in pediatric patients. Prognosis of pediatric colorectal cancer is known to be poor, because of delayed diagnosis and unfavorable differentiation. We report a case of a pediatric patient with a 10-year history of ulcerative colitis who was diagnosed with sigmoid colon cancer when he was 15 years old. He underwent proctocolectomy with ileal pouch anal anastomosis. Postoperative pathological examination of the tumor revealed adenocarcinoma. The pericolic tissue layer was infiltrated, but metastases were not found in either of the two lymph nodes. Children with a long history of predisposing factors such as IBD need particular attention to the possibility of colorectal cancer. Early diagnosis through regular screening with colonoscopy is one of the most important critical factors for a good prognosis.

Seung Yeon Noh

2013-01-01

121

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

122

Phase Angle and Handgrip Strength Are Sensitive Early Markers of Energy Intake in Hypophagic, Non-Surgical Patients at Nutritional Risk, with Contraindications to Enteral Nutrition  

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Full Text Available The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA and handgrip strength normalized for skeletal muscle mass (HG/SMM are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20, while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10. The mean adjusted difference and 95% CI were +1.4° (0.5–2.3 (p = 0.005 for PhA and +0.23 (0.20–0.43 (p = 0.033 for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23–0.77; p = 0.0023. PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of PhA variations as early markers of anabolic/catabolic fluctuations.

Riccardo Caccialanza

2015-03-01

123

Phase angle and handgrip strength are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition.  

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The assessment of nutritional intakes during hospitalization is crucial, as it is known that nutritional status tends to worsen during the hospital stay, and this can lead to the negative consequences of malnutrition. International guidelines recommend the use of parenteral nutrition (PN) in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. However, to date, there are no published data regarding either energy intake or objective measurements associated with it in this patient population. The aim of the present exploratory methodological study was to evaluate whether phase angle (PhA) and handgrip strength normalized for skeletal muscle mass (HG/SMM) are sensitive early markers of energy intake in hypophagic, non-surgical patients at nutritional risk, with contraindications to enteral nutrition. We evaluated 30 eligible patients, who were treated with personalized dietary modifications and supplemental PN for at least one week during hospitalization. In a liner regression model adjusted for age, gender, basal protein intake and the basal value of each variable, a trend toward improvement of PhA and preservation of HG/SMM was observed in patients satisfying the estimated calorie requirements (N = 20), while a significant deterioration of these parameters occurred in those who were not able to reach the target (N = 10). The mean adjusted difference and 95% CI were +1.4° (0.5-2.3) (p = 0.005) for PhA and +0.23 (0.20-0.43) (p = 0.033) for HG/SMM. A significant correlation between PhA and HG/SMM variations was also observed (r = 0.56 (95% CI, 0.23-0.77); p = 0.0023). PhA and HG/SMM were able to distinguish between hypophagic, non-surgical patients at nutritional risk who satisfied their estimated caloric requirements and those who did not after a one-week personalized nutritional support. Clinical studies are warranted, in order to verify these preliminary observations and to validate the role of PhA variations as early markers of anabolic/catabolic fluctuations. PMID:25768953

Caccialanza, Riccardo; Cereda, Emanuele; Klersy, Catherine; Bonardi, Chiara; Cappello, Silvia; Quarleri, Lara; Turri, Annalisa; Montagna, Elisabetta; Iacona, Isabella; Valentino, Francesco; Pedrazzoli, Paolo

2015-01-01

124

The prevalence and impact of trauma history in eating disorder patients  

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Full Text Available Background: Early experiences of traumatic events (TEs may be associated with subsequent eating disturbance. However, few studies have investigated overall exposure and trauma-type frequency in various types of eating disorders (EDs. Objective: This study aimed to investigate the prevalence and type of TEs in a nationally representative sample of Swedish ED patients. Method: Data from a database (Stepwise for specialized ED care were used. Trauma history was assessed as a part of the routine, initial assessment. Participants over the age of 18 with a diagnosed DSM-IV ED were included (N=4,524. Results: The number of patients having experienced at least one TE was 843 (18.6%, and 204 (24.2% reported at least one additional trauma. Sexual trauma was the most common form of TE (6.3%. There was no difference in overall traumatic exposure or in type of experienced trauma between the ED diagnostic subgroups (AN, BN, EDNOS, and BED. Overall traumatic exposure was linked to self-reported severity of ED symptoms, more secondary psychosocial impairment, psychiatric comorbidity, and negative self-image. Conclusions: Trauma history in ED patients merits attention. Results are partly in line with and partly in contrast to previous research. Measurement of trauma history has varied substantially in research on EDs, and this study adds to the indistinct literature on trauma history in ED.

Klas Backholm

2013-11-01

125

The prevalence and impact of trauma history in eating disorder patients  

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Background Early experiences of traumatic events (TEs) may be associated with subsequent eating disturbance. However, few studies have investigated overall exposure and trauma-type frequency in various types of eating disorders (EDs). Objective This study aimed to investigate the prevalence and type of TEs in a nationally representative sample of Swedish ED patients. Method Data from a database (Stepwise) for specialized ED care were used. Trauma history was assessed as a part of the routine, initial assessment. Participants over the age of 18 with a diagnosed DSM-IV ED were included (N=4,524). Results The number of patients having experienced at least one TE was 843 (18.6%), and 204 (24.2%) reported at least one additional trauma. Sexual trauma was the most common form of TE (6.3%). There was no difference in overall traumatic exposure or in type of experienced trauma between the ED diagnostic subgroups (AN, BN, EDNOS, and BED). Overall traumatic exposure was linked to self-reported severity of ED symptoms, more secondary psychosocial impairment, psychiatric comorbidity, and negative self-image. Conclusions Trauma history in ED patients merits attention. Results are partly in line with and partly in contrast to previous research. Measurement of trauma history has varied substantially in research on EDs, and this study adds to the indistinct literature on trauma history in ED. PMID:24273636

Backholm, Klas; Isomaa, Rasmus; Birgegård, Andreas

2013-01-01

126

Primary (AL) hepatic amyloidosis: clinical features and natural history in 98 patients.  

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The liver is a common site of amyloid deposition in primary systemic amyloidosis. We reviewed the clinical features and natural history of patients with primary systemic amyloidosis and biopsy-proven hepatic involvement who were evaluated at Mayo Clinic from January 1, 1975, to December 31, 1997. The median age of the study group (68 men; 30 women) was 58.5 years. Seventy-one patients (72%) had involuntary weight loss. Hepatomegaly was found in 79 patients (81%). Eighty-two patients (89%) had proteinuria, and 81 patients (86%) had elevated serum alkaline phosphatase levels. Seventy-six patients (83%) had either a serum or urine monoclonal protein. Before liver biopsy, clinicians considered amyloidosis in the differential diagnosis for only 14 patients (26%). None of our patients experienced hepatic rupture or death due to liver biopsy, and only 4 (4%) bled after liver biopsy. The median survival of the 98 patients was 8.5 months. Predictors of a poor prognosis were congestive heart failure, elevated concentrations of bilirubin, and a platelet count greater than 500 x 109/L. In conclusion, clinicians should consider the diagnosis of primary hepatic amyloidosis in patients who present with involuntary weight loss or hepatomegaly. Other clues to the diagnosis include an unexplained elevated serum alkaline phosphatase level, proteinuria, and evidence for hyposplenism (for example, Howell-Jolly bodies on peripheral blood smear). Liver biopsy was safe. Some patients benefit from systemic chemotherapy. PMID:14530778

Park, Miguel A; Mueller, Paul S; Kyle, Robert A; Larson, Dirk R; Plevak, Matthew F; Gertz, Morie A

2003-09-01

127

Natural history and surgical results in patients with unruptured intracranial aneurysms  

International Nuclear Information System (INIS)

The management of patients with unruptured intracranial aneurysms (UIAs) is controversial. We aimed to assess the natural history of UIAs and evaluate the surgical results. We analyzed 154 patients (181 saccular UIAs) with no history of subarachnoid hemorrhage (SAH) from a different aneurysm. Aneurysms were detected by magnetic resonance angiography (MRA) or by 3-dimensional CT angiography. Although the most frequent reason for the diagnosis was routine brain examinations of healthy patients or a vague symptom such as headache or dizziness, 15 patients were symptomatic. The natural history in patients who did not have surgery (follow-up group: 76 cases, 95 aneurysms) was assessed, and the surgical outcome of UIAs (surgical group: 78 cases, 86 aneurysms) was evaluated. Among 76 patients in the follow-up group, 7 had SAH. The mean latency period to aneurysm rupture was 3.2 months. The aneurysms with subsequent bleeding ranged from 5 to 25 mm (19.3 mm on average), whereas those without ranged from 1 to 28 mm (4.5 mm on average). The rupture rates of UIAs in anterior and posterior circulation were 6.2% and 14.3%, respectively. All ruptured cases were females. Mortality and morbidity associated with UIAs in the follow-up group were 3.9% and 3.9%, respectively. In the surgical group, no mortality was noted. Permanent morbidity associated with prospective repair of UIAs was 5.1%, although the morbidity of the patients with preoperative Rankin scores of 0 or 1 was 1.3%. Transve Rankin scores of 0 or 1 was 1.3%. Transient morbidity was observed in 6 patients (7.7%) with the size of the aneurysm 19.8 mm on average. The natural history and surgical results in patients with UIAs are modified by several factors including aneurysm size and location, the patient's age and gender, the medical status and the patient's preoperative Rankin score. The present results indicated that these factors should be considered in deciding whether to treat UIAs, and that careful assessment of the surgical benefits might be essential especially in the cases of larger aneurysm size (more than 15 mm) because they are associated either with a greater risk of rupture or with a higher surgical risk. (author)

128

Folate and Homocysteine Levels and Their Association with Dietary Intakes in Iranian Patients Infected with Helicobacter pylori:a Case-Control Study.  

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The association between Helicobacter pylori (HP) infection and concentration of folate or homocysteine are still unclear. The aim of the present study was to assess the effect of  HP infection on folate and homocysteine concentrations in patients infected with HP and healthy participants. We also assessed dietary intakes of folate, vitamins B6 and B12 in two groups. In this case-control study, 44 participants with HP-infection and 46 healthy controls were studied. Participants were recruited from those referred to the central laboratory of Tabriz University of Medical Sciences. Blood samples were collected to determine serum folate and homocysteine levels. The presence of both IgG and IgA in serum was considered as HP positive. Dietary intakes were assessed in all participants by 24-hour dietary recalls by trained interviewers for three days. The mean concentration of serum folate was significantly lower in HP-positive patients than in controls (8.49 nmol/L vs. 10.95 nmol/L, respectively; P=0.01). Although the mean concentration of serum homocysteine differed between groups, statistical significance was missed (HP infected patients: 9.35 µmol/L; healthy participants: 8.96 µmol/L; P=0.064). Macro- and micronutrient intakes showed no significant difference between participants with and without HP infection. In logistic regression models, there was a negative correlation between folate concentration and HP infection even after controlling for confounding factors (OR=0.82; CI95%=0.79-0.97). In this study, authors showed that a negative association presents between HP infection and serum  folate concentrations, but the homocysteine status was not differed significantly between HP-positive and HP-negative participants. PMID:25796022

Javadi, Leila; Pourghassem Gargari, Bahram; Salekzamani, Shabnam; Yousefzadeh, Rana

2015-03-01

129

Concomitants of family histories of mood disorders and alcoholism in a clinical cohort of patients with bipolar I and II disorder.  

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We diagnosed 191 secondary-care outpatients and inpatients with DSM-IV BD I or II. Sociodemographic and clinical characteristics, including axis I and II comorbidity, neuroticism, and prospective life-chart were evaluated at intake and at 6 and 18 months. The family history (FH) of mood disorders, alcoholism, or any major psychiatric disorders among first-degree relatives was investigated in a semistructured interview. Most (74%) patients had some positive FH; 55% of mood disorder, 36% of alcoholism. Positive FH was associated with psychiatric comorbidity and depressive course in the proband. Based on a multinomial logistic regression model, patients with an FH of mood disorder and alcoholism had an odds ratio of 4.8 (p = 0.001) for having an anxiety disorder. Overall, the first-degree relatives of patients with BD have multiple types of mental disorders, which correlate with bipolar patients' course of illness and psychiatric comorbidity. The strongest associations are between FH of mood disorders and presence of comorbid anxiety disorders. PMID:22551791

Mantere, Outi; Suominen, Kirsi; Valtonen, Hanna M; Arvilommi, Petri; Leppämäki, Sami; Paunio, Tiina; Isometsä, Erkki T

2012-05-01

130

Grado de control de hipertensión arterial en población mayor de 65 años ingresada en un servicio de Medicina Interna / Control of hypertension in elderly patients intaked on Internal Medicine  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivos: Conocer el grado de control de la presión arterial (PA) en los pacientes hipertensos mayores de 65 años que ingresaron en un servicio de Medicina Interna a lo largo del año 2002. Identificar los factores de riesgo cardiovascular y las patologías cardiovasculares asociadas al mal control d [...] e la presión arterial. Valorar el tratamiento farmacológico necesario para un adecuado control de la hipertensión arterial. Analizar la existencia de datos suficientes en la historia clínica que permitan una adecuada valoración del riesgo cardiovascular. Material y métodos: Estudio descriptivo transversal, en el que se incluyeron los pacientes mayores de 65 años que fueron ingresados, a lo largo del año 2002, en el Servicio de Medicina Interna del Hospital Clínico Universitario de Santiago de Compostela. La PA se midió siguiendo normas estandarizadas y se consideró que había un buen control si eran los valores Abstract in english Objectives: To investigate hypertension control in elderly patients. To identify the cardiovascular risk factors and cardiovascular diseases associated with poor control of hypertension. To evaluate the pharmacologic treatment needed for the good control of hypertension. To analyse the existence of [...] date in the medical history to evaluate the cardiovascular risk. Methods: A coss-sectional study of elderly hypertensive patients intaked between 1 to January 2002 to 31 December 2002 in a Internal Medicine Service. Blood pressure was measured in the standard manner. Blood pressure control was regarded as optimum if pressure averaged less than 140/90 mmHg or, in diabetics, less than 130/80 mmHg. Results: The study included 484 hipertensive patients. In the hypertensive patients, both systolic and diastolic blood pressures were well controlled in 53.9% of patients, systolic blood pressure alone in 2,1% and diastolic blood pressure alone in 30.8%. The isolated systolic arterial hypertension prevalence is bigger in the group with poor control, p

S., Cinza Sanjurjo; A., Cabarcos Ortiz de Barrón; E., Nieto Pol; V., Lorenzo Zúñiga.

2006-08-01

131

The natural history of postoperative venous thromboemboli in gynecologic oncology: a prospective study of 382 patients  

International Nuclear Information System (INIS)

Three hundred eighty-two patients who underwent major operations for gynecologic malignancy were studied prospectively to determine the natural history of postoperative venous thromboemboli. Iodine 125-labeled fibrinogen leg counting, to diagnose deep venous thrombosis, was performed daily. Sixty-three patients (17%) developed postoperative venous thromboembolic complications. Deep venous thrombosis initially arose in the calf veins in 52 patients. Twenty-seven percent of these thrombi lysed spontaneously. Four percent of thrombi in the calf veins progressed to deep venous thrombosis in the femoral vein, and 4% resulted in pulmonary emboli. Nine other patients developed proximal deep venous thrombosis without prior thrombosis in the calf veins. One patient with proximal deep venous thrombosis also had a pulmonary embolus. Two patients with no evidence of deep venous thrombosis on prospective 125I-labeled fibrinogen leg counting developed pulmonary emboli, including one fatal pulmonary embolus that was found at autopsy to have arisen from the internal iliac veins. Fifty percent of all venous thromboemboli were detected within 48 hours of operation, although two patients developed significant deep venous thrombosis and pulmonary emboli after discharge from the hospital. These results add important information to our understanding of this disease process, and raise issues related to appropriate treatment and prophylaxis of venous thromboembolism in patients afs of venous thromboembolism in patients after gynecologic operations

132

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, biochemical, and histological findings at the time of diagnosis were evaluated using multivariate analysis. RESULTS--The estimated median survival from time of diagnosis to death or liver transplantation was 12 years. Cholangiocarcinoma was found in 24 (8%) of the patients and 134 (44%) of the patients were asymptomatic at the time of diagnosis. The estimated survival rate was significantly higher in the asymptomatic group (p < 0.001). However, 29 (22%) of the asymptomatic patients became symptomatic during the study period. It was found that age, serum bilirubin concentration, and histological stage at the time of diagnosis were independent predictors of a bad prognosis. These variables were used to construct a prognostic model. CONCLUSIONS--This prognostic model developed from a large homogeneous population of PSC patients should be of value for the timing of transplantation and patient counselling in PSC. PMID:8707097

Broomé, U; Olsson, R; Lööf, L; Bodemar, G; Hultcrantz, R; Danielsson, A; Prytz, H; Sandberg-Gertzén, H; Wallerstedt, S; Lindberg, G

1996-04-01

133

Granulomatous lung disease in a patient with a family history of hematological disorders.  

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A 29-year old patient presented with granulomatous lung disease and a family history of myelodysplastic syndrome/acute myeloid leukemia. She appeared to be a carrier of a mutation in the transcription factor GATA2. The case adds to the recent described heterogeneous clinical manifestations and syndromes in which, against a background of hematologic disorders, GATA2 mutations have been demonstrated, such as the Monomac and Emberger syndromes. In patients with a granulomatous disease and a history of (familial) hematologic disorders, the occurence of GATA2 mutations should be considered, as to gain further insight in the occurrence of granulomatous disease in a possible distinct phenotype among GATA2 mutation carriers. PMID:25591147

Overbeek, Maria; Van de Loosdrecht, Arjen; Vonk-Noordegraaf, Anton

2015-01-01

134

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 and non-FHLC were performe...

Shuji Haraguchi, Kiyoshi Koizumi

2012-01-01

135

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

136

Risk factors for medication non-adherence among psychiatric patients with substance misuse histories.  

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Medication non-adherence among psychiatric patients is known to be associated with poorer treatment outcomes. The study examined a comprehensive set of modifiable risk factors for non-adherence in a theoretical framework among a diverse, high risk sample of psychiatric patients with substance misuse histories (N=299). Medication side effects and excessive alcohol use were related to lower medication adherence and higher motivation for mental health treatment and recovery support were related to greater adherence. The results suggest that a multifaceted model for intervention to increase psychiatric medication adherence should be developed and tested. PMID:25309623

Magura, Stephen; Mateu, Pedro F; Rosenblum, Andrew; Matusow, Harlan; Fong, Chunki

2014-11-01

137

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

138

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

139

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

Scientific Electronic Library Online (English)

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

140

Dietary intake of n-3 long-chain polyunsaturated fatty acids and risk of myocardial infarction in coronary artery disease patients with or without diabetes mellitus: a prospective cohort study  

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Background A beneficial effect of a high n-3 long-chain polyunsaturated fatty acid (LCPUFA) intake has been observed in heart failure patients, who are frequently insulin resistant. We investigated the potential influence of impaired glucose metabolism on the relation between dietary intake of n-3 LCPUFAs and risk of acute myocardial infarction (AMI) in patients with coronary artery disease. Methods This prospective cohort study was based on the Western Norway B-Vitamin Intervention Trial and included 2,378 patients with coronary artery disease with available baseline glycosylated hemoglobin (HbA1c) and dietary data. Patients were sub-grouped as having no diabetes (HbA1c <5.7%), pre-diabetes (HbA1c ?5.7%), or diabetes (previous diabetes, fasting baseline serum glucose ?7.0, or non-fasting glucose ?11.1 mmol/L). AMI risk was evaluated by Cox regression (age and sex adjusted), comparing the upper versus lower tertile of daily dietary n-3 LCPUFA intake. Results The participants (80% males) had a mean age of 62 and follow-up of 4.8 years. A high n-3 LCPUFA intake was associated with reduced risk of AMI (hazard ratio 0.38, 95%CI 0.18, 0.80) in diabetes patients (median HbA1c = 7.2%), whereas no association was observed in pre-diabetes patients. In patients without diabetes a high intake tended to be associated with an increased risk (hazard ratio1.45, 95%CI 0.84, 2.53), which was significant for fatal AMI (hazard ratio 4.79, 95%CI 1.05, 21.90) and associated with lower HbA1c (mean ± standard deviation 4.55 ±0.68 versus 4.92 ±0.60, P = 0.02). No such differences in HbA1c were observed in those with pre-diabetes or diabetes. Conclusions A high intake of n-3 LCPUFAs was associated with a reduced risk of AMI, independent of HbA1c, in diabetic patients, but with an increased risk of fatal AMI and lower HbA1c among patients without impaired glucose metabolism. Further studies should investigate whether patients with diabetes may benefit from having a high intake of n-3 LCPUFAs and whether patients with normal glucose tolerance should be careful with a very high intake of these fatty acids. Trial registration This trial is registered at clinicaltrials.gov as NCT00354081. PMID:24103380

2013-01-01

141

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

142

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

143

Effects of feed composition on life history developments in feed intake, metabolism, growth and body composition of European eel, Anguilla anguilla  

OpenAIRE

To examine the effect of feed composition on changes in feed intake and subsequent feed utilization with age, five populations of European eel, with an average initial body weight of 5 g each fed a different diet, were monitored for 302 d. The five feeds differed in their content of crude protein (33¿63% DM), crude fat (6¿28% DM) and calculated carbohydrates (NFE; 15¿42% DM) such that five levels of digestible protein/digestible energy (DP/DE) were realised: 13, 16, 21, 28 and 29 g MJ¿ 1....

Heinsbroek, L. T. N.; Hooff, P. L. A.; Swinkels, W.; Tanck, M. W. T.; Schrama, J. W.; Verreth, J. A. J.

2007-01-01

144

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

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Full Text Available Abstract 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 Conclusion Several health and lifestyle factors independently influence quality of life in CHC patients. Different factors are important for men and women.

Toro Charlene

2005-06-01

145

Olive oil intake is inversely related to cancer prevalence: a systematic review and a meta-analysis of 13800 patients and 23340 controls in 19 observational studies  

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Full Text Available Abstract Dietary fat, both in terms of quantity and quality, has been implicated to cancer development, either positively or negatively. The aim of this work was to evaluate whether olive oil or monounsaturated fat intake was associated with the development of cancer. A systematic search of relevant studies, published in English, between 1990 and March 1, 2011, was performed through a computer-assisted literature tool (i.e., Pubmed. In total 38 studies were initially allocated; of them 19 case-control studies were finally studied (13800 cancer patients and 23340 controls were included. Random effects meta-analysis was applied in order to evaluate the research hypothesis. It was found that compared with the lowest, the highest category of olive oil consumption was associated with lower odds of having any type of cancer (log odds ratio = -0.41, 95%CI -0.53, -0.29, Cohran's Q = 47.52, p = 0.0002, I-sq = 62%; the latter was irrespective of the country of origin (Mediterranean or non-Mediterranean. Moreover, olive oil consumption was associated with lower odds of developing breast cancer (logOR = -0,45 95%CI -0.78 to -0.12, and a cancer of the digestive system (logOR = -0,36 95%CI -0.50 to -0.21, compared with the lowest intake. The strength and consistency of the findings states a hypothesis about the protective role of olive oil intake on cancer risk. However, it is still unclear whether olive oil's monounsaturated fatty acid content or its antioxidant components are responsible for its beneficial effects.

Dimopoulos Meletios

2011-07-01

146

MSH6 germline mutations in early-onset colorectal cancer patients without family history of the disease  

OpenAIRE

Germline MLH1 and MSH2 mutations are scarce in young colorectal cancer patients with negative family history of the disease. To evaluate the contribution of germline MSH6 mutations to early-onset colorectal cancer, we have analysed peripheral blood of 38 patients diagnosed with this disease before 45 years of age and who presented no family history of hereditary nonpolyposis colorectal cancer-related cancers. Blood samples from 108 healthy volunteers were analysed for those genetic alteration...

Pinto, C.; Veiga, I.; Pinheiro, M.; Mesquita, B.; Jeronimo, C.; Sousa, O.; Fragoso, M.; Santos, L.; Moreira-dias, L.; Baptista, M.; Lopes, C.; Castedo, S.; Teixeira, M. R.

2006-01-01

147

Supportive periodontal therapy and periodontal biotype as prognostic factors in implants placed in patients with a history of periodontitis  

OpenAIRE

Objectives: To evaluate bone loss around implants placed in patients with a history of treated chronic periodontitis and who did or did not attend supportive periodontal therapy, after one year in function. Furthermore, the influence of periodontal biotype and level of plaque was also evaluated. Material and Methods: Forty-nine patients participated voluntarily in the study. All subjects had a history of chronic periodontitis, which had been previously treated. After the active treatment, ...

Aguirre-zorzano, Luis A.; Vallejo-aisa, Francisco J.; Estefani?a-fresco, Ruth

2013-01-01

148

Life-history chronicle for a patient with the recently described chromosome 4q21 microdeletion syndrome.  

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[Bonnet et al. (2010); J Med Genet 47: 377-384] recently suggested a 4q21 microdeletion syndrome with several common features, including severe intellectual disability, lack of speech, hypotonia, significant growth restriction, and distinctive facial features. Overlap of the deleted regions of 13 patients, including a patient we previously reported, delineates a critical region, with PRKG2 and RASGEF1B emerging as candidate genes. Here we provide a detailed clinical report and photographic life history of our previously reported patient. Previous case reports of this new syndrome have not described the prognosis or natural history of these patients. PMID:22903878

Tsang, Erica; Rupps, Rosemarie; McGillivray, Barbara; Eydoux, Patrice; Marra, Marco; Arbour, Laura; Langlois, Sylvie; Friedman, Jan M; Zahir, Farah R

2012-10-01

149

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

150

Central obesity and dietary intake in HIV/AIDS patients Obesidade abdominal e consumo alimentar em portadores de HIV/Aids  

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Full Text Available OBJECTIVE: To assess the association between dietary intake and central obesity among people living with HIV/AIDS and receiving highly active antiretroviral therapy. METHODS: A cross-sectional study was conducted involving 223 adult individuals in the city of São Paulo city in 2002. The study population was classified according to central obesity, defined as waist-to-hip ratio >0.95 for men and >0.85 for women. The dietary variables studied were energy consumption (in calories and calories/kilo of body weight, macronutrients (in grams and % of energy intake, total fiber (grams and fruit and vegetables intake (grams. The potential confounders examined were sex, skin color, age, schooling, income, body mass index, physical activity, smoking habits, peripheral CD4+ T lymphocyte count and length of protease inhibitor use. The multiple logistic regression model was performed in order to evaluate the association between central obesity and dietary intake. RESULTS: The prevalence of central obesity was 45.7% and it was associated with greater consumption of lipids: for every increase of 10g of lipid intake the odds of central obesity increased 1.28 times. Carbohydrate consumption showed negative association (OR=0.93 with central obesity after adjustment for control variables. CONCLUSIONS: The results suggest that the amount of carbohydrates and lipids in the diet, regardless of total energy intake, may modify the chance of developing central obesity in the studied population. Nutritional interventions may be beneficial for preventing central obesity among HIV/AIDS patients.OBJETIVO: Avaliar a associação entre consumo alimentar e presença de obesidade abdominal em indivíduos infectados pelo HIV/Aids, em uso de terapia antiretroviral de alta potência. MÉTODOS: Trata-se de estudo transversal envolvendo 223 indivíduos adultos, realizado no município de São Paulo, em 2002. A população de estudo foi classificada de acordo com a obesidade abdominal, definida pela razão das circunferências da cintura e quadril >0,95 para os homens e >0,85 para mulheres. As variáveis dietéticas estudadas foram consumo de energia (calorias e calorias/quilo de peso corporal, macronutrientes (em gramas e % da energia ingerida, fibra total (gramas e consumo de frutas, verduras e legumes (gramas. Potenciais fatores de confusão examinados foram sexo, raça, idade, escolaridade, renda, índice de massa corporal, nível de atividade física, tabagismo, contagem de linfócitos T CD4+ e tempo de uso de inibidor de protease. Estimou-se modelo de regressão logística para avaliar a relação entre obesidade abdominal e consumo alimentar. RESULTADOS: A prevalência de obesidade abdominal foi de 45,7% e esteve associada ao maior consumo de lipídeos: para cada aumento de 10 g de lipídio na dieta a chance aumentou 1,28 vezes. O consumo de carboidratos mostrou-se negativamente associado (OR=0,93 com a presença de obesidade abdominal após ajuste pelas variáveis de controle. CONCLUSÕES: Os resultados sugerem que a quantidade de carboidratos e lipídeos na dieta, independente do consumo energético, pode modificar a chance de desenvolver obesidade abdominal na população estudada. Intervenções nutricionais podem ser benéficas na prevenção de obesidade abdominal entre pacientes vivendo com HIV/Aids.

Patrícia Constante Jaime

2006-08-01

151

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

152

Transmesocolic hernia with strangulation in a patient without surgical history: Case report  

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Full Text Available Transmesenteric hernias have bimodal distribution and occur in both pediatric and adult patients. In the adult population, the cause is iatrogenic, traumatic, or inflammatory. We report a case of transmesocolic hernia in an elderly person without any preoperative history. An 84-year-old Korean female was admitted with mid-abdominal pain and distension for 1 d. On abdominal computed tomography, we diagnosed transmesocolic hernia with strangulated small bowel obstruction, and performed emergency surgery. The postoperative period was uneventful and she was discharged 11 d after surgery. Hence, it is important to consider the possibility of transmesocolic hernia in elderly patients with signs and symptoms of intestinal obstruction, even in cases with no previous surgery.

Peel Jung

2013-01-01

153

History of trauma and dissociative symptoms among patients with obsessive-compulsive disorder and social anxiety disorder.  

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We aimed to compare the history of trauma and the profile and severity of dissociative symptoms of patients with obsessive-compulsive disorder (OCD) to those of patients with social anxiety disorder (SAD). Patients with OCD (n = 34) and patients with SAD (n = 30) were examined with the following instruments: Trauma History Questionnaire (THQ), Dissociative Experience Scale (DES), Obsessive-Compulsive Inventory (OCI), Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Patients with OCD reported significantly lower rates of exposure to traumatic events. Nevertheless, the severity of dissociative symptoms was not significantly different between the groups. Regression analyses showed that, while the OCI scores better predicted the variance on DES scores in the OCD sample, the LSAS and the BAI better predicted the variance on the DES among patients with SAD. Patients with OCD are probably less vulnerable to some types of traumatic experiences. Dissociative symptoms may cut across different anxiety disorders. PMID:17453345

Fontenelle, Leonardo F; Domingues, Aline M; Souza, Wanderson F; Mendlowicz, Mauro V; de Menezes, Gabriela B; Figueira, Ivan L; Versiani, Marcio

2007-09-01

154

The natural history of interstitial cystitis: a survey of 374 patients.  

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A survey directed at determining the natural history of interstitial cystitis was conducted at our clinic. Information on demographics, risk factors, symptoms, pain and psychosocial factors was elicited from 374 patients who satisfied the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases criteria for interstitial cystitis and had all been diagnosed as having interstitial cystitis by a urologist. With regard to demographics, patients were predominantly female (89.8%) and white (94.1%), with a mean age of 53.8 +/- 0.7 years (standard error) and age at the first symptoms of 42.5 +/- 0.8 years. Information on 25 potential risk factors included 44.4% of the women reporting hysterectomy, 38.2% of the patients having strong sensitivities or allergic reactions to medication and only 2.7% being diabetic. With regard to interstitial cystitis symptoms, frequency and urgency were reported by 91.7% and 89.3% of the patients, respectively, while pelvic pain, pelvic pressure and bladder spasms were reported by more than 60% of respondents and burning by 56%. Location and degree of pain were also reported. Urination relieved or lessened interstitial cystitis pain for 73.6% of the patients and medication was effective for 46.8%. Other behaviors (for example hot baths, heating pads, lying down or sitting) were less effective. Conversely, stress, constrictive clothing and intercourse increased interstitial cystitis pain in more than 50% of the patients. In addition, acidic, alcoholic or carbonated beverages, and coffee or tea increased interstitial cystitis pain in more than 50% of the patients. More than 60% of the patients were unable to enjoy usual activities or were excessively fatigued and 53.7% reported depression. Travel, employment, leisure activities and sleeping were adversely affected in more than 80% of the patients. Pain location and degree differed significantly between patients with and without ulcers in the bladder. In addition, there was an apparent plateau in the frequency and urgency among patients after approximately 5 years with symptoms. PMID:8437248

Koziol, J A; Clark, D C; Gittes, R F; Tan, E M

1993-03-01

155

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

156

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

Scientific Electronic Library Online (English)

Full Text Available 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 at all stages of their hospitalisation, in particular

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

2007-12-01

157

Clinicopathologic Presentation and Natural History of Anorectal Melanoma: A Case Series of 18 Patients.  

Science.gov (United States)

Anorectal melanoma is a rare malignant neoplasm with variable natural history and nonspecific presentation. We describe the clinicopathologic and prognostic parameters of a series of 18 patients (16 [88.9%] white; 10 [55.6%] male; median age, 64.0 years [interquartile range, 45.8-74.3 years]) with histologically proven anorectal melanoma treated at our institution during a 21-year period between October 1991 and August 2012. Late diagnosis was common (44.5% of patients had stage II disease or worse at diagnosis), likely owing to a delay in presentation, nonspecific presenting symptoms, and frequent incorrect diagnoses (16 cases [88.9%]). Overall disease-specific mortality was 66.7% (12 of 18 patients), with a median time to death of 15.5 months (interquartile range, 7.3-25.5 months). Disease-specific survival was significantly better following wide local excision vs abdominoperineal resection (P?=?.04), although patients undergoing the former tended to have fewer rectal lesions (P?=?.04), smaller lesions (P?=?.02), and a trend toward less advanced stage (P?=?.06). Larger studies assessing optimal medical and surgical management for anorectal melanoma are needed to improve outcomes. PMID:24848283

Hicks, Caitlin W; Pappou, Emmanouil P; Magruder, Jonathan T; Gazer, Benny; Fang, Sandy; Wick, Elizabeth C; Gearhart, Susan L; Ahuja, Nita; Efron, Jonathan E

2014-05-21

158

Structural and functional cerebral impairments in cirrhotic patients with a history of overt hepatic encephalopathy  

International Nuclear Information System (INIS)

Objective: Diffuse brain atrophy has been observed in cirrhotic patients and recent reports have revealed the persistence of cognitive impairment after clinical resolution of overt hepatic encephalopathy. We sought to explore the continued influence of overt hepatic encephalopathy on neurological function by measuring brain resting-state inherent connectivity, based on an investigation of structural abnormalities. Methods: Neuropsychological tests and structural and functional magnetic resonance scanning were conducted in 20 healthy controls and 21 cirrhotic patients with a history of overt hepatic encephalopathy. The analysis of voxel-based morphometry and functional connectivity were performed to detect the alterations in brain structure and function, respectively. Results: Patients showed significantly worse performance in neuropsychological tests as compared with controls, despite apparently normal mental status. Analysis of voxel-based morphometry revealed a decrease in gray matter volume primarily in the midline regions, bilateral insular cortex and caudates, left parahippocampal gyrus, and right cerebellum posterior lobe, while the volume of the bilateral thalamus showed an increase. Of these regions, the posterior cingulate cortex with peak atrophy was selected as the origin for the analysis of functional connectivity. Typical patterns of a default mode network were identified in both groups. Decreased functional connectivity was found in the medial prefrontal gyrus, left inferior parietal lobule, and left middle temporal gyrus in the patients. Conclusions: Both functional and structural impairments were evident after apparent recovery from overt hepatic encephalopathy, demonstrating that brain dysfunction induced by hepatic encephalopathy persisted after clinical resolution and provided a basis for further evolution of the disease

159

Structural and functional cerebral impairments in cirrhotic patients with a history of overt hepatic encephalopathy  

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Objective: Diffuse brain atrophy has been observed in cirrhotic patients and recent reports have revealed the persistence of cognitive impairment after clinical resolution of overt hepatic encephalopathy. We sought to explore the continued influence of overt hepatic encephalopathy on neurological function by measuring brain resting-state inherent connectivity, based on an investigation of structural abnormalities. Methods: Neuropsychological tests and structural and functional magnetic resonance scanning were conducted in 20 healthy controls and 21 cirrhotic patients with a history of overt hepatic encephalopathy. The analysis of voxel-based morphometry and functional connectivity were performed to detect the alterations in brain structure and function, respectively. Results: Patients showed significantly worse performance in neuropsychological tests as compared with controls, despite apparently normal mental status. Analysis of voxel-based morphometry revealed a decrease in gray matter volume primarily in the midline regions, bilateral insular cortex and caudates, left parahippocampal gyrus, and right cerebellum posterior lobe, while the volume of the bilateral thalamus showed an increase. Of these regions, the posterior cingulate cortex with peak atrophy was selected as the origin for the analysis of functional connectivity. Typical patterns of a default mode network were identified in both groups. Decreased functional connectivity was found in the medial prefrontal gyrus, left inferior parietal lobule, and left middle temporal gyrus in the patients. Conclusions: Both functional and structural impairments were evident after apparent recovery from overt hepatic encephalopathy, demonstrating that brain dysfunction induced by hepatic encephalopathy persisted after clinical resolution and provided a basis for further evolution of the disease.

Chen, Hua-Jun [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Zhu, Xi-Qi [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Department of Radiology, The Second Hospital of Nanjing, Medical School of Southeast University, Nanjing 210002 (China); Shu, Hao [Department of Neurology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Yang, Ming; Zhang, Yi; Ding, Jie; Wang, Yu [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China); Teng, Gao-Jun, E-mail: gjteng@vip.sina.com [Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing 210009 (China)

2012-10-15

160

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

161

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)

162

Low-dose rate prostate brachytherapy is well tolerated in patients with a history of inflammatory bowel disease  

International Nuclear Information System (INIS)

Purpose: We report on the follow-up of 24 patients with a prior history of inflammatory bowel disease (IBD) treated with brachytherapy for early-stage prostate cancer. Methods and Materials: Twenty-four patients with a history of inflammatory bowel disease (17 with ulcerative colitis (UC), 7 with Crohn's disease [CD]) underwent prostate brachytherapy between 1992 and 2004. Fifteen patients were treated with I-125 implantation and 6 patients were treated with Pd-103 alone or in combination with 45 Gy external beam radiation. Charts were reviewed for all patients, and all living patients were contacted by phone. National Cancer Institute common toxicity scores for proctitis were assigned to all patients. Actuarial risk of late toxicity was calculated by the Kaplan-Meier method. Statistical analysis was performed using SPSS software. Follow-up ranged from 3 to 126 months (median, 48.5 months; mean, 56.8 months). Results: None of the patients experienced Grade 3 or 4 rectal toxicity. Four patients experienced Grade 2 late rectal toxicity. The 5-year actuarial freedom from developing late Grade 2 rectal toxicity was 81%. At a median follow-up of 48.5 months, 23 patients were alive and had no evidence of disease with a median prostate-specific antigen for the sample of 0.1 ng/mL (range, <0.05-0.88 ng/mL). One patient died of other causes unrelated to his prostate cancer. Conclusions: Prostate brachytherapy is well tolerated in patients with a history of controlled IBD. Thernts with a history of controlled IBD. Therefore, brachytherapy should be considered a viable therapeutic option in this patient population

163

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 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 constipação 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 (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 constipation. 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 (<58.8h, there were isolated slow transit, in the right colon (nine, left colon (three and in the rectosigmoid segment (eight. There were no relation among the amount of ingested fiber, constipation intensity and the colon transit. CONCLUSIONS: In the functional constipation the gravity of symptoms does not depend only on the dietary fibers intake, which is not the only responsible for the differences in the colonic transit. The colonic transit can differentiate normal from constipated patients and, among them, those with altered transit that demand approaches distinct of fiber supplementation.

Adriana Cruz Lopes

2008-03-01

164

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 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

165

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  

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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

166

Metabolic and cardiovascular risk in patients with a history of differentiated thyroid carcinoma: A case-controlled cohort study  

OpenAIRE

Abstract Hyperthyroidism seems to increase metabolic and cardiovascular risk, while the effects of sub-clinical hyperthyroidism are controversial. We evaluated metabolic and cardiovascular parameters in differentiated thyroid carcinoma (DTC) patients with suppressed thyrotropin (TSH) due to levo-thyroxine (L-T4) therapy. We studied DTC patients and, as a control group, patients with a history of surgery for non-malignant thyroid pathology. Significantly higher insulin and lower HDL-cholestero...

Giusti Massimo; Mortara Lorenzo; Degrandi Roberta; Cecoli Francesca; Mussap Michele; Rodriguez Guido; Ferone Diego; Minuto Francesco

2008-01-01

167

Gastro-duodenal injury associated with intake of 100-325 mg aspirin daily.  

OpenAIRE

During the year 1991, 43 patients with upper gastrointestinal bleeding and one with severe epigastric pain associated with intake of non-steroidal anti-inflammatory drugs were admitted for emergency endoscopy to our unit. Fourteen patients (33%) had been treated with 100-325 mg aspirin daily, 11 of them for at least one year. The mean age of this group was 71. Only two patients had a previous history of peptic ulcer. Five patients used anticoagulants or antiplatelet drugs concomitantly with a...

Jolobe, O. M.; Price, N. S.

1993-01-01

168

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

Science.gov (United States)

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

2015-04-01

169

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

Science.gov (United States)

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

170

Frequency of persistant backache in patients of spinal anaesthesia in the absence of prior history of backache  

International Nuclear Information System (INIS)

To determine the frequency of persistant backache in patients of spinal anaesthesia in the absence of prior history of bachache. Study Design: Quasi experimental study. Place and Duration of Study: CMH Kharian from May 2008 to Sep 2009. Methods: Total 150 patients who were admitted at CMH Kharian during the study period were included in the study. The selection criteria included male and female patients above twenty years of age due for elective gynaecological, orthopaedics, urology and general surgical procedures. Only 112 patients reported for complete follow up for one year. Out of 112 patients, 61.6% were males while 38.4% were females. All patients with prior history of back pain were excluded from the study. Results: At the end of one year the frequency of persistent back pain after one year of spinal anaesthesia is (1/112) 0.89% in the absence of previous history of back pain. Conclusion: The results of this study indicate that frequency of persistant back pain after spinal anaesthesia in the absence of previous history of back pain is very low. (author)

171

von Willebrand Factor is elevated in HIV patients with a history of thrombosis  

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Background: Arterial and venous thrombotic events are more prevalent in HIV infected individuals compared to the general population, even in the era of combination antiretroviral therapy. Although the mechanism is not fully understood, recent evidence suggests a role for chronic immune activation. Methods: We reviewed the Dutch National HIV registry database for HIV infected patients in Rotterdam with a history of arterial or venous thrombosis and calculated the incidence. We collected samples from patients with and without thrombosis and compared plasma levels of lipopolysaccharide (LPS), LPS binding protein (LBP), soluble CD14 (sCD14), and von Willebrand Factor antigen level (vWF). Results: During a 10-year period, a total of 60 documented events in 14,026 person years of observation (PYO) occurred, resulting in an incidence rate of 2.50, 2.21, and 4.28 for arterial, venous and combined thrombotic events per 1000 PYO, respectively. The vWF was elevated in the majority of study subjects (mean 2.36 SD ± 0.88 IU/ml); we found a significant difference when comparing venous cases to controls (mean 2.68 SD ± 0.82 IU/ml vs. 2.20 SD ± 0.77 IU/ml; p = 0.024). This difference remained significant for recurrent events (mean 2.78 SD ± 0.75; p = 0.043). sCD14 was positively correlated with LPS (r = 0.255; p = 0.003). Conclusion: The incidence of venous thrombosis was two-fold higher in HIV infected patients compared to age-adjusted data from general population cohort studies. We couldn't find a clear association between immune activation markers to either arterial or venous thrombotic events. We observed a marked increase in vWF levels as well as a correlation of vWF to first and recurrent venous thrombo-embolic events. These findings suggest that HIV infection is an independent risk factor for coagulation abnormalities and could contribute to the observed high incidence in venous thrombosis. This could be a reason to prolong anti-thrombotic treatment in HIV patients with a history of thrombosis. PMID:25814984

van den Dries, Lennert W. J.; Gruters, Rob A.; Hövels–van der Borden, Sascha B. C.; Kruip, Marieke J. H. A.; de Maat, Moniek P. M.; van Gorp, Eric C. M.; van der Ende, Marchina E.

2015-01-01

172

Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis  

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Full Text Available Abstract Background Prescription of non-steroidal anti-inflammatory drugs (NSAIDs should be based on the assessment of both gastrointestinal (GI and cardiovascular (CV risk for the individual patient. We aimed to assess the GI/CV risk profile and the pharmacological management of patients with osteoarthritis (OA in clinical practice. Methods We conducted a cross-sectional, multicentre, observational study of consecutive OA patients that visited 1,760 doctors throughout the Spanish National Health System (NHS in a single day. The presence of GI risk factors, CV histories, hypertension and current pharmacological treatments was recorded. Results Of the 60,868 patients, 17,105 had a diagnosis of OA and were evaluable. The majority (93.4% had more than one GI risk factor and 60.3% were defined to be at high-GI risk. Thirty-two percent had a history of CV events, 57.6% were treated with anti-hypertensive therapy and 22.6% had uncontrolled hypertension. One-fifth of patients were treated with non-NSAID therapies, whereas the remaining patients received NSAIDs. Non-selective NSAIDs (nsNSAID plus proton pump inhibitor (PPI or cyclooxigenase-2 (COX-2-selective NSAIDs alone were more frequently prescribed in patients at increased GI risk. Patients with a positive CV history received nsNSAIDs or COX-2-selective NSAIDs in 41.3% and 31.7% of cases, respectively. When both the GI and CV histories were combined, 51% of the overall population was being prescribed drugs that were either not recommended or contraindicated. Conclusions Over 90% of patients with OA are at increased GI and/or CV risk. In over half of these patients, the prescription of NSAIDs was not in accordance with current guidelines or recommendations made by regulatory agencies.

Armada Beatriz

2011-04-01

173

Vitamin E intake and quality of life in amyotrophic lateral sclerosis patients: a follow-up case series study.  

Science.gov (United States)

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder involving both upper and lower motor neurons, leading inexorably to death within a few years. Although our understanding of the pathogenesis of this disease has grown at a very fast rate in recent years, we do not yet have effective treatment options that can positively impact the quality of life (QoL) of these patients. Interestingly, increasing experimental evidence suggests that oxidative stress is involved in the pathogenesis of ALS and that vitamin E could reduce neuronal damage. Hence, in this observational study we determined the QoL in 33 ALS patients taking or not taking vitamin E supplementation (600 mg/day), using the Italian version of the Short-Form 36-Item Health Survey (SF-36). No differences were seen between the two groups of patients, therefore we do not recommend routine use of vitamin E in ALS patients, at least in the absence of randomised clinical trials specifically designed for addressing this issue. PMID:16897634

Galbussera, A; Tremolizzo, L; Brighina, L; Testa, D; Lovati, R; Ferrarese, C; Cavaletti, G; Filippini, G

2006-07-01

174

Clinical Characteristics and Treatment Outcome of Depression in Patients with and without a History of Emotional and Physical Abuse  

OpenAIRE

Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were initially randomized to IPT or SSRI and then augmented with the second treatment if they did not remit with monotherapy. Assessments included the SCID-I, the SCID-II for DSM-IV diagnoses, the HRSD, the QIDS and the Mood Spectrum Self-Report (MOODS-SR). Seventy-eight (25%) patients reported a history of ...

Miniati, M.; Rucci, P.; Benvenuti, A.; Frank, E.; Buttenfield, J.; Giorgi, G.; Cassano, G. B.

2009-01-01

175

[Dietary intake assessments: for who? why?].  

Science.gov (United States)

The use of dietary intake assessment and questionnaires in clinical practice is largely debated, particularly for obese patients. The time needed to carry out them is very long, and the results are little or not at all workable due to the underreporting which may represent up to 50% of intakes for some patients. The usual methods and tools to evaluate dietary intakes are presented, they should not be used to calculate energy intake, but they permit to initiate a dialogue with the patient on his/her dietary pattern. The analysis of the dietary pattern is the first step in diet prescription and is essential to weight management and follow-up. This analysis must consider 3 important components: type of food usually eaten and preferred, the circumstances and environment of food intakes and meals, possible disorders of eating behaviour. Some results on food consumption in adults and children from the Fleurbaix Laventie Ville Santé Study are presented. PMID:12733326

Romon, M; Borys, J M

2002-12-01

176

Discrepancies between the medical record and the reports of patients with acute coronary syndrome regarding important aspects of the medical history  

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Full Text Available Abstract Background Many critical treatment decisions are based on the medical history of patients with an acute coronary syndrome (ACS. Discrepancies between the medical history documented by a health professional and the patient's own report may therefore have important health consequences. Methods Medical histories of 117 patients with an ACS were documented. A questionnaire assessing the patient's health history was then completed by 62 eligible patients. Information about 13 health conditions with relevance to ACS management was obtained from the questionnaire and the medical record. Concordance between these two sources and reasons for discordance were identified. Results There was significant variation in agreement, from very poor in angina (kappa Conclusion Discrepancies in aspects of the medical history may have important effects on the care of ACS patients. Future research focused on identifying the most effective and efficient means to obtain accurate health information may improve ACS patient care quality and safety.

Eze-Nliam Chete

2012-03-01

177

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 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.

178

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 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

179

Association of folate intake, dietary habits, smoking and COX-2 promotor-765G > C polymorphism with K-ras mutation in patients with colorectal cancer  

International Nuclear Information System (INIS)

Background: Understanding the role of environmental and molecular influences on the nature and rate of K-ras mutations in colorectal neoplasms is crucial. COX-2 polymorphisms -765G > C may play a role in carcinogenic processes in combination with specific life-style conditions or dependent on the racial composition of a particular population. If mutational events play an important role in colorectal carcinogenesis sequence, one can hypothesize that modification of these events by life-style or other factors would be a useful prevention strategy. Aim of work: To explore the association between K-ras mutation and potential variables known or suspected to be related to the risk of colorectal cancer (CRC) as well as determining the possible modulating effect of the COX-2 polymorphism, —765G > C. Subjects and methods: The study was conducted on 80 patients with colorectal cancer from Tropical Medicine and Gastrointestinal Tract endoscopy Departments and those attending clinic of the National Cancer Institute, Cairo University during the period extending from April 2009 to March 2010. Full history taking with emphasis on the risk factors of interest, namely age, sex, family history, smoking and dietary history. Serum CEA and CA19-9, RBCs folic acid and occult blood in stool were done to all samples. K-ras protooncogene mutation at codon 12 (exon 1) and cyclooxygenase 2 (COX-2) —765G > C polymorphism were determined by PCR-RFLP. Results: The K-ras mutation was positive in 23 (28.7%) patients. COX-2 polymorphism revealed GG in 62.5%, GC in 26.2 % and CC genotype was found in 11.3 % of cases. The mean red blood cell folic acid level was lower in the K-ras positive group (100.96 ± 51.3 ng/ml) than the negative group (216.6 ± 166.4 ng/ml), (P < 0.01). Higher folate levels were found in males than females (median = 173 ng/ml and 85 ng/ml; respectively, P = 0.002) with adjusted odds ratio (OR) of 0.984. Only, the RBCs folate (P = 0.0018) followed by gender (P = 0.036) contributed significantly in the discrimination between patients prone to develop K-ras mutation and those who are not. Conclusion: RBC folic acid was significantly deficient in CRC (colorectal cancer) patients with K- ras mutations in comparison with CRC patients free of the mutations, suggesting that folic acid may be a risk factor for K-ras mutation development

180

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

181

Reducing salt intake for prevention of cardiovascular diseases in high-risk patients by advanced health education intervention (RESIP-CVD study, Northern Thailand: study protocol for a cluster randomized trial  

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Full Text Available Abstract Background Decreasing salt consumption can prevent cardiovascular diseases (CVD. Practically, it is difficult to promote people’s awareness of daily salt intake and to change their eating habits in terms of reducing salt intake for better cardiovascular health. Health education programs visualizing daily dietary salt content and intake may promote lifestyle changes in patients at high risk of cardiovascular diseases. Methods/Design This is a cluster randomized trial. A total of 800 high-CVD-risk patients attending diabetes and hypertension clinics at health centers in Muang District, Chiang Rai province, Thailand, will be studied with informed consent. A health center recruiting 100 participants is a cluster, the unit of randomization. Eight clusters will be randomized into intervention and control arms and followed up for 1?year. Within the intervention clusters the following will be undertaken: (1 salt content in the daily diet will be measured and shown to study participants; (2 24-hour salt intake will be estimated in overnight-collected urine and the results shown to the participants; (3 a dietician will assist small group health education classes in cooking meals with less salt. The primary outcome is blood pressure change at the 1-year follow-up. Secondary outcomes at the 1-year follow-up are estimated 24-hoursalt intake, incidence of CVD events and CVD death. The intention-to-treat analysis will be followed. Blood pressure and estimated 24-hour salt intake will be compared between intervention and control groups at the cluster and individual level at the 1-year follow-up. Clinical CVD events and deaths will be analyzed by time-event analysis. Retinal blood vessel calibers of CVD-risk patients will be assessed cross-sectionally. Behavioral change to reduce salt intake and the influencing factors will be determined by structured equation model (SEM. Multilevel regression analyses will be applied. Finally, the cost effectiveness of the intervention will be analyzed. Discussion This study is unique as it will recruit the individuals most vulnerable to CVD morbidity and mortality by applying the general Framingham CVD risk scoring system. Dietary salt reduction will be applied as a prioritized, community level intervention for the prevention of CVD in a developing country. Trial registration ISRCTN39416277

Aung Myo

2012-09-01

182

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

183

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

Energy Technology Data Exchange (ETDEWEB)

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

184

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

International Nuclear Information System (INIS)

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 skil 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.

185

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

186

Effect of Family History on Outcomes in Patients Treated With Definitive Brachytherapy for Clinically Localized Prostate Cancer  

International Nuclear Information System (INIS)

Purpose: To determine the impact familial prostate cancer has on prognosis in men treated with brachytherapy for clinically localized prostate cancer. Methods and Materials: A total of 1,738 consecutive patients with prostate cancer (cT1-3, N0/X, M0) received low-dose-rate brachytherapy alone or in combination with external beam radiation therapy or hormone ablation from 1992 to 2005. The primary end-point was freedom from biochemical failure (FFBF) using the Phoenix definition. Minimum follow-up was 2 years and the median follow-up was 60 months (range, 24-197 months). Results: A total of 187 of 1,738 men (11%) had a family history of prostate cancer in a first-degree relative. For the low-risk patients, both groups had similar actuarial 5-year FFBF (97.2% vs. 95.5%, p = 0.516). For intermediate-risk patients, there was a trend toward improved biochemical control in men positive for family history (5-yr FFBF 100% vs. 93.6%, p = 0.076). For the high-risk patients, men with a positive family history had similar 5-year FFBF (92.8% vs. 85.2%, p = 0.124). On multivariate analysis, family history was not significant; use of hormones, high biologic effective dose, initial prostate-specific antigen value, and Gleason score were the significant variables predicting biochemical control. Conclusions: This is the first study to examine the relationship of familial prostate cancer and outcomed in men treated with brachytherapy alone or in combination therapy. Men with a positive combination therapy. Men with a positive family history have clinicopathologic characteristics and biochemical outcomes similar to those with sporadic disease

187

Suboptimal intake of nutrients after esophagectomy with gastric tube reconstruction.  

Science.gov (United States)

Esophagectomy with gastric tube reconstruction results in a variety of postoperative nutrition-related complaints that can impair nutritional intake and nutritional status. The aim of this study was to determine to what extent patients reached the recommended intake of various nutrients at 6 and 12 months after esophagectomy. It was also analyzed whether a suboptimal intake could be explained by the most clinically significant nutrition-related complaints after esophagectomy. In a prospective cohort study (2002 to 2006), the nutrient intake of 96 patients, recorded in preprinted nutritional diaries, was compared with the recommended energy intake in The Netherlands and Recommended Dietary Allowance of protein and micronutrients. Energy and protein intake remained below recommendations in 24% and 7% of the patients, respectively. Less than 10% of the patients had a sufficient intake of all micronutrients. Folic acid, vitamin D, copper, calcium, and vitamin B-1 were the micronutrients most often reported to have a suboptimal intake. Multivariate logistic regression, corrected for preoperative epigastric pain and energy intake, showed that the number of nutrition-related complaints was not an independent risk factor for the presence of a suboptimal intake of nutrients (adjusted odds ratio=1.11; 95% CI: 0.94 to 1.31; P = 0.22). This study shows that the intake of micronutrients remains below recommendations in the majority of patients 12 months after esophagectomy. This problem requires special attention and care by registered dietitians. PMID:22889637

Haverkort, Elizabeth B; Binnekade, Jan M; de Haan, Rob J; Busch, Olivier R C; van Berge Henegouwen, Mark I; Gouma, Dirk J

2012-07-01

188

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

189

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

190

Xerophthalmia and acquired night blindness in a patient with a history of gastrointestinal neoplasia and normal serum vitamin A levels.  

Science.gov (United States)

A 69-year-old male patient presented to our department with a 3-month history of nyctalopia. Reviewing of his general health revealed a history of gastrointestinal tumor treated with a modified WHIPPLE operation. Ocular findings at presentation included mild xerophthalmic features and nonspecific pigmentary retinal changes. A standard full-field electroretinogram (ERG) was obtained that showed normal photopic function and extinguished scotopic function. The ocular symptoms, the history and the ERG findings suggested vitamin A deficiency as a possible cause for his complaints. Serum vitamin A levels were subsequently requested, but the results were within normal limits. Despite the normal serum vitamin A levels, the patient was instructed to commence treatment with high doses of oral vitamin A supplements. One month after the onset of the treatment, the patient reported that his visual function has significantly improved, while repeat ERG testing revealed that scotopic function has improved to normal levels. This case highlights that in patients with acquired night blindness due to vitamin A deficiency, the ERG responses possibly represent a more sensitive marker compared to the serum levels of vitamin A. PMID:23334438

Anastasakis, Anastasios; Plainis, Sotiris; Giannakopoulou, Trisevgeni; Papadimitraki, Elisavet; Fanouriakis, Charalambos; Tsilimbaris, Miltiadis K

2013-04-01

191

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

192

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

193

Intake of dairy products and the risk of breast cancer.  

OpenAIRE

The relationship between intake of dairy products and risk of breast cancer was studied in 4697 initially cancer-free women, aged 15 years or over. During a 25 year follow-up period after the collection of food consumption data, 88 breast cancers were diagnosed. Intakes of foods were calculated from dietary history interviews covering the habitual diet of examinees over the preceding year. There was a significant inverse gradient between milk intake and incidence of breast cancer, the age-adj...

Knekt, P.; Ja?rvinen, R.; Seppa?nen, R.; Pukkala, E.; Aromaa, A.

1996-01-01

194

First Episode of Psychosis in a Middle-Aged Patient with a 14-Year History of Conversion Disorder  

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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 througho...

Peritogiannis, Vaios; Manthopoulou, Thiresia; Mavreas, Venetsanos

2014-01-01

195

Chronic thromboembolic pulmonary hypertension as a cause of dyspnoea in an older patient with a complex history  

OpenAIRE

A full diagnostic work-up for patients with pulmonary hypertension (PH) is vital. Classification and diagnosis of the underlying cause is important to ensure optimal management, but may be complicated by overlapping signs and symptoms. This case study describes how a full work-up identified chronic thromboembolic PH (CTEPH) as the cause of dyspnoea in a 68-yr-old male with a history of pulmonary embolism and an original diagnosis of chronic obstructive pulmonary disease. Key indicators includ...

Ka?hler, C. M.

2009-01-01

196

Patients with a history of arson admitted to medium security: characteristics on admission and follow-up postdischarge.  

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Patients who set fires are a perennial cause of concern with psychiatric services although perhaps rather neglected in the clinical research literature. The current study considered the characteristics on admission of 129 patients, 93 men and 36 women, with a known history of arson who had been admitted to a medium secure psychiatric hospital. The distinguishing characteristics of the sample were high numbers of patients with extensive criminal histories, most probably due to high levels of prison transfer and a higher occurrence of mental illness than psychopathic disorder. Aside from return to prison, most patients were discharged either to another psychiatric hospital or directly to the community. There was a high rate of re-conviction after discharge, mainly for minor offences, with about one in 10 of discharged patients committing arson. It was established, however, that not all incidents of arson led to a prosecution. It is concluded that there are weaknesses in the areas of both risk assessment and evidence-based treatment for arsonists. PMID:23185072

Hollin, Clive R; Davies, Steffan; Duggan, Conor; Huband, Nick; McCarthy, Lucy; Clarke, Martin

2013-07-01

197

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

2015-02-01

198

Problem solving deteriorates following mood challenge in formerly depressed patients with a history of suicidal ideation.  

OpenAIRE

The authors divided 34 participants who had a history of depression into 2 groups, those having previous suicidal ideation or behavior (n=19) and those having no such symptoms (n=15), then compared the 2 groups with a group of participants who had no history of depression (n=22). Assessment of interpersonal problem-solving performance using the Means-Ends Problem-Solving (MEPS) task before and after a mood-induction procedure showed that only those formerly depressed people with a history of ...

Williams, Jm; Barnhofer, T.; Crane, C.; Beck, At

2005-01-01

199

Fatty fish and fish omega-3 fatty acid intakes decrease the breast cancer risk: a case-control study  

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Abstract Background Although it is believed that fish ?-3 fatty acids may decrease breast cancer risk, epidemiological evidence has been inconclusive. This study examined the association between fish and fish ?-3 fatty acids intake with the risk of breast cancer in a case-control study of Korean women. Methods We recruited 358 incident breast cancer patients and 360 controls with no history of malignant neoplasm from the National Cancer Center Hospital between July 2007 and April 2008. The ...

Lee Keun; Kang Han-Sung; Ro Jungsil; Sung Mi-Kyung; Shin Aesun; Lim Sun-Young; Kim Jeongseon; Kim Seok-Won; Lee Eun-Sook

2009-01-01

200

Nutritional habits of patients suffering from seropositive rheumatoid arthritis: a screening of 93 Dutch patients.  

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Although the nutritional status of patients suffering from rheumatoid arthritis is considered to be poor and inversely related to disease activity, information on nutritional habits of these patients is scanty. Dietary habits of 93 patients suffering from active seropositive rheumatoid arthritis, functional class 2 or 3, confirmed by an interview with a dietician (dietary history method), revealed a significant gap between energy, carbohydrate, and fat intakes and recommended amounts, adjusted for age, sex, body weight and physical activity. PMID:2088645

van de Laar, M A; Nieuwenhuis, J M; Former-Boon, M; Hulsing, J; van der Korst, J K

1990-12-01

201

When patients report diseases that prescribers seem unaware of: discordance between patient and physician reporting of risk-related previous history in NSAID users from the CADEUS study.  

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Prescribers are often unaware of possibly dangerous previous medical histories (PMHs) of their patients. Data from a study of nonsteroidal anti-inflammatory drug (NSAID) users served to identify factors associated with this lack of awareness. In this study, we analyzed the factors that may have led prescribers to report the absence of some PMHs that the patients reported as being present. Of 26,618 patients prescribed an NSAID, 469 (1.7%) reported a PMH of unstable angina, 648 (2.4%) reported heart failure, 2,244 (8.4%) reported gastric or duodenal ulcer, 489 (1.8%) reported upper gastrointestinal tract bleeding (UGIB), 5,343 (20.0%) reported gastroesophageal reflux disease (GERD), and 7,832 (29.4%) reported dyspepsia. Between 64 (GERD) and 92% (UGIB) of these patient-reported PMHs were absent in the corresponding prescribers' reports. This discordance was associated with the following factors: patients of younger age, female patients, less frequent patient-prescriber contact, prescription of NSAID by a specialist, no recent specialist consultation, hospitalization or surgery related to the PMH, and no dispensation of proton-pump inhibitors (PPIs) for digestive disorder-related PMHs. The study showed that a substantial proportion of prescribers seemed unaware of the presence of risk-related PMHs that the patient reported when asked. PMID:20861835

Fourrier-Réglat, A; Lacoin, L; Pariente, A; Lassalle, R; Robinson, P; Droz-Perroteau, C; Bégaud, B; Blin, P; Moore, N D

2010-11-01

202

Associações entre ingestão energética, proteica e de fósforo em pacientes portadores de doença renal crônica em tratamento hemodialítico / Associations between energy, protein, and phosphorus intakes in patients with chronic kidney disease on hemodialysis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese INTRODUÇÃO: A nutrição desempenha papel fundamental nas doenças renais. A recomendação nutricional deve ofertar uma dieta hiperproteica, adequada em energia e fósforo segundo o Kidney Disease Outcomes Quality Initiative (K/DOQI). É necessário controlar e/ou prevenir as complicações da Doença Renal C [...] rônica (DRC), pois ela impõe desafios clínicos diretamente ligados ao estado nutricional. OBJETIVO: Investigar as associações entre a ingestão energética, proteica e de fósforo em pacientes em hemodiálise (HD). PACIENTES E MÉTODOS: Estudo observacional envolvendo 72 pacientes em HD, em dois hospitais de Porto Alegre/RS/Brasil. Foram coletados dados referentes ao perfil antropométrico (peso, altura e índice de massa corporal - IMC) e do registro alimentar de três dias (ingestão de energia, proteína e fósforo). O teste de correlação de Spearman foi utilizado para avaliar as associações entre as variáveis do registro alimentar (p Abstract in english INTRODUCTION: Nutrition plays an important role in kidney disease. The nutritional recommendation is to offer a high-protein diet, adequate in energy and phosphorus according to the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. Control and/or prevention of the complications of chro [...] nic kidney disease (CKD) are essential, because CKD poses clinical challenges directly related to the nutritional status. OBJECTIVE: To investigate the possible associations between energy, protein, and phosphorus intakes in hemodialysis (HD) patients. METHODS: Observational study involving 72 HD patients from two hospitals in the city of Porto Alegre, Brazil. Anthropometric data [weight, height, body mass index (IMB)] were collected and three-day food intake (daily energy, protein, and phosphorus intakes) was recorded. Spearman correlation was used to evaluate associations between food intake variables (p

Denise Entrudo, Pinto; Laura Sulzbach, Ullmann; Mariana Marroni, Burmeister; Ivan Carlos Ferreira, Antonello; Alessandra, Pizzato.

2009-12-01

203

Chemical gastritis after chronic bromazepam intake: a case report  

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Full Text Available Abstract Background We describe a rare case of diffuse macroscopic discoloration and chemical gastritis due to chronic bromazepam intake. The chemical composition of pharmaceuticals has to be considered at endoscopy and it is evident that some chemical substances damage the epithelial tissue and lead to clinical symptoms. Case Presentation Endoscopy was performed in an 82-year-old patient due to gastroesophageal reflux symptoms and epigastric pain. Gastroscopy showed a hiatal hernia and a scarred duodenal bulb. More striking was the yellow-brownish discoloration of the gastric and the duodenal mucosa. The gastric antrum and the duodenal bulb showed local discoloration that could not be rinsed off. The medical history indicated that bromazepam (6 mg had been used daily as a sleeping aid in the previous two years. The histopathological findings showed appearances of chemical gastritis. Within the lamina propria and on the epithelial surface there were granules. There was no foreign body reaction to these granules. Corpus mucosa showed a mild chronic gastritis. Conclusions If discoloration of the mucosa at endoscopy is seen, a careful drug history must be sought. This is the first case in literature that shows a chemical gastritis after bromazepam intake.

Krakamp Bernd

2010-07-01

204

Why should we study human food intake behaviour?  

Science.gov (United States)

Several aspects of human eating behaviour may be relevant for identifying effective measures to treat or prevent diseases like obesity, diabetes, or the metabolic syndrome, whose natural history is strongly influenced by nutritional factors. Physiological factors determine hunger, satiety and satiation, and a biological learning mechanism supports the acquisition of food likes and dislikes. The paradigm of "conditioned taste aversion" refers to the acquisition of a strong rejection response after the intake of a food has been followed by digestive disorder. Food likes are acquired following the experience of the beneficial post-ingestive effects of intake. Physiological mechanisms reinforce the liking for energy-rich foods and both environmental and biological conditions facilitate "passive overconsumption". Sensory factors are important determinants of appetite and food choices from birth to old age. The human newborn exhibits an innate repertoire of acceptance or rejection for taste substances. The progressive change of sensory functions associated with ageing affects appetite and the pleasure of eating. Many individual psychological characteristics affect food intake behaviour in a significant way. These include chronic dietary restraint, disinhibition, etc. These psychological traits can be objectively assessed using validated psychometric instruments. Various stimuli present in the environment also affect ingestive behaviours in humans. Portion size is one potent environmental determinant of how much a person eats, regardless of hunger. The general increase in portion sizes observed in North America over the last decades might have played an important role in the rapid rise of obesity prevalence. Socio-economic factors also affect food selection and food intake in human societies. Factors such as education level and income determine food choices and behaviours in a way that does affect the risk of obesity. Behavioural science has provided many insights about crucial cause-and-effect relationships that affect nutrition and health. Therefore, clinicians and nutritionists cannot neglect this important area if they wish to effectively modify the habitual diet of individual patients or the general population. PMID:14650350

Bellisle, F

2003-08-01

205

Multiple markers of hypercoagulation in patients with history of venous thromboembolic disease.  

Science.gov (United States)

Markers for hypercoagulation can be used to explain why some patients may have had thromboembolic disease (TED). This information may then be applied to estimate risk for additional TED that may afflict these patients following subsequent surgeries. This investigation was to determine the frequency of hypercoagulation parameters among patients having had TED, and how frequently these occur in multiples. Consulting hematologists were asked to comment upon potential risk for recurrent TED that may be associated with additional surgeries. The consulting hematologist determined which laboratory tests were to be ordered for each patient. This retrospective study probed the hospital computer logs for patients having had homocysteine, protein C, factor V Leiden or anticardiolipin antibodies measured during a 6-year period. The laboratory records for patients having had any one of these tests were then examined further for any additional hypercoagulation laboratory studies performed. Five hundred and twenty patients were identified in this survey. Abnormal diagnostic results were found for 293 (56.3%) of these patients. Two or more abnormalities (up to 5) were found for 103 (35.6%) of these patients. Laboratory explanations for TED may be found in a large proportion of patients with TED. It is not uncommon to find more than one abnormality among these patients. This information may be used in advising patients and their physicians as to the risks of additional TED following future surgical procedures and can be the basis for recommending life style changes. PMID:23147472

Bern, Murray; McCarthy, Nancy

2013-01-01

206

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

OpenAIRE

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

207

An fMRI study of reward circuitry in patients with minimal or extensive history of major depression.  

Science.gov (United States)

Functional abnormalities in regions associated with reward processing are apparent in people with depression, but the extent to which disease burden impacts on the processing of reward is unknown. This research examined the neural correlates of reward processing in patients with major depressive disorder and varying degrees of past illness burden. Twenty-nine depressed patients and twenty-five healthy subjects with no lifetime history of psychiatric illness completed the study. Subsets of fourteen patients were presenting for first lifetime treatment of a depressive episode, and fifteen patients had at least three treated episodes of depression. We used functional magnetic resonance imaging to study blood oxygen level-dependent signals during the performance of a contingency reversal reward paradigm. The results identified group differences in the response to punishers bilaterally in the orbitofrontal and medial prefrontal regions. In addition, areas such as the nucleus accumbens, anterior cingulate and ventral prefrontal cortices were activated greatest by controls during reward processing, less by patients early in the course of illness and least by patients with highly recurrent illness-suggesting that these areas are sensitive to the impact of disease burden and repeated episodes of depression. Reward processing in people with depression may be associated with diminished signaling of incentive salience, a reduction in the formation of reward-related associations and heightened sensitivities for negatively valenced stimuli, all of which could contribute to symptoms of depression. PMID:23990079

Hall, Geoffrey B C; Milne, Andrea M B; Macqueen, Glenda M

2014-04-01

208

Stroke Patients with a Past History of Cancer Are at Increased Risk of Recurrent Stroke and Cardiovascular Mortality  

Science.gov (United States)

Background and Purpose Cancer patients are at increased risk of cardiovascular and cerebrovascular events. It is unclear whether cancer confers any additional risk for recurrent stroke or cardiovascular mortality after stroke. Methods This was a single center, observational study of 1,105 consecutive Chinese ischemic stroke patients recruited from a large stroke rehabilitation unit based in Hong Kong. We sought to determine whether patients with cancer are at higher risk of recurrent stroke and cardiovascular mortality. Results Amongst 1,105 patients, 58 patients (5.2%) had cancer, of whom 74% were in remission. After a mean follow-up of 76±18 months, 241 patients developed a recurrent stroke: 22 in patients with cancer (38%, annual incidence 13.94%/year), substantially more than those without cancer (21%, 4.65%/year) (p<0.01). In a Cox regression model, cancer, age and atrial fibrillation were the 3 independent predictors of recurrent stroke with a hazard ratio (HR) of 2.42 (95% confidence interval (CI): 1.54–3.80), 1.01 (1.00–1.03) and 1.35 (1.01–1.82) respectively. Likewise, patients with cancer had a higher cardiovascular mortality compared with those without cancer (4.30%/year vs. 2.35%/year, p?=?0.08). In Cox regression analysis, cancer (HR: 2.08, 95% CI: 1.08–4.02), age (HR: 1.04, 95% CI 1.02–1.06), heart failure (HR: 3.06, 95% CI 1.72–5.47) and significant carotid atherosclerosis (HR: 1.55, 95% CI 1.02–2.36) were independent predictors for cardiovascular mortality. Conclusions Stroke patients with a past history of cancer are at increased risk of recurrent stroke and cardiovascular mortality. PMID:24523883

Lau, Kui-Kai; Wong, Yuen-Kwun; Teo, Kay-Cheong; Chang, Richard Shek-Kwan; Hon, Sonny Fong-Kwong; Chan, Koon-Ho; Cheung, Raymond Tak-Fai; Li, Leonard Sheung-Wai; Tse, Hung-Fat; Ho, Shu-Leong; Siu, Chung-Wah

2014-01-01

209

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

210

Adult-onset presentation of a hyperornithinemia-hyperammonemia-homocitrullinuria patient without prior history of neurological complications.  

Science.gov (United States)

The Hyperornithinemia-Hyperammonemia-Homocitrullinuria (HHH) syndrome is a disorder of the urea cycle and ornithine degradation pathway caused by mutations in the mitochondrial ornithine transporter, ORNT1 (SLC25A15). In general, the majority of patients with HHH syndrome come to medical attention during infancy or early school years with symptoms such as learning disabilities, changes in cognitive development, spasticity, or liver dysfunction. In this report, we describe a 35-year-old male of Indian descent who was diagnosed with HHH syndrome after he presented to the emergency room with gastroenteritis, disorientation, and slurred speech. Molecular analysis revealed that this patient was heterozygous for two ORNT1 mutations, p.[Gly220Arg(+)Arg275X] (c.[658G>A(+)823C>T]) that had been previously reported in homozygous probands who presented during the first year of life. Cellular studies revealed that the ORNT1 p.Gly220Arg mutation was nonfunctional but targeted to the mitochondria. Given that this patient was a successful college graduate on a vegetarian diet without a prior history of learning or neurological impairment, additional factors such as gene redundancy, environmental, and epigenetic factors may have contributed to the delay in onset of presentation and lack of any previous symptoms. To the best of our knowledge, this is the first reported case of an adult-onset HHH syndrome presentation without a prior history of neurological or cognitive deficiency. PMID:23430880

Tezcan, Kamer; Louie, Kristal T; Qu, Yong; Velasquez, Jorge; Zaldivar, Frank; Rioseco-Camacho, Natalia; Camacho, José Angel

2012-01-01

211

[Salt intake in children].  

Science.gov (United States)

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

212

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

International Nuclear Information System (INIS)

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

213

Gestation in patients with high levels of anticardiolipin antibodies, a history of deep venous thrombosis and miscarriages  

Directory of Open Access Journals (Sweden)

Full Text Available The aim is to stress the importance of prophylaxis against deep venous thrombosis in gravidas with high levels of anticardiolipin antibodies with or without a history of repetitive miscarriages. The evolutions of two gravidas who were treated in pre-natal and vascular surgery outpatients’ clinics and who suffered from deep venous thrombosis, miscarriages and high anticardiolipin antibody levels are reported. The gestations terminated at full term after prophylaxis for miscarriages was applied. The report suggests that patients with deep venous thrombosis and high anticardiolipin antibody levels may present with miscarriages and, therefore, prophylactic treatment is recommended.

José Maria Pereira de Godoy

2006-09-01

214

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

Manthopoulou, Thiresia; Mavreas, Venetsanos

2014-01-01

215

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

OpenAIRE

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

216

Death from axillary haemorrhage during haemodialysis in a patient with a history of microscopic polyangiitis  

OpenAIRE

An older female with a history of microscopic polyangiitis underwent haemodialysis through an end-to-side anastomosis between the left basilica vein and brachial artery. During the last haemodialysis session, repeated punctures induced haemorrhage that required brachial compression. Twenty min posthaemodialysis, haemorrhage had expanded from the axilla to the left lateral thorax. Autopsy disclosed axillary haematoma. The haemorrhage was not derived from punctured vessels or the left axillary ...

Unuma, Kana; Uozaki, Hiroshi; Kuroda, Ryouhei; Uemura, Koichi; Yoshida, Ken-ichi

2012-01-01

217

KCNQ1 mutations in patients with a family history of lethal cardiac arrhythmias and sudden death  

OpenAIRE

Long QT syndrome (LQTS) is the prototype of the cardiac ion channelopathies which cause syncope and sudden death. LQT1, due to mutations of KCNQ1 (KVLQT1), is the most common form. This study describes the genotype–phenotype characteristics in 10 families with mutations of KCNQ1, including 5 novel mutations. One hundred and two families with a history of lethal cardiac events, 55 LQTS, 9 Brugada syndrome, 18 idiopathic ventricular fibrillation (IVF), and 20 acquired LQTS, were studied by si...

Chen, S.; Zhang, L.; Bryant, Rm; Vincent, Gm; Flippin, M.; Lee, Jc; Brown, E.; Zimmerman, F.; Rozich, R.; Szafranski, P.; Oberti, C.; Sterba, R.; Marangi, D.; Tchou, Pj; Chung, Mk

2003-01-01

218

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

Energy Technology Data Exchange (ETDEWEB)

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

219

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

International Nuclear Information System (INIS)

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.

220

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.  

Science.gov (United States)

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

221

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

222

Mutation of ras oncogenes in leukemic patients with a history of atomic bomb exposure  

International Nuclear Information System (INIS)

To examine the involvement of ras oncogenes in the development of leukemia in A-bomb survivors, ras oncogene mutation was examined in 25 A-bomb survivors exposed within 3,000 m from the hypocenter in Hiroshima and 47 non-exposed patients. Twenty five A-bomb survivors consisted of 8 with chronic myelocytic leukemia (CML), 4 with refractory anemia with excess of blasts (RAEB), 9 with acute myelocytic leukemia (AML), and 4 with acute lymphocytic leukemia (ALL). For the non-exposed group, CML was seen in 25, one in RAEB, 13 in AML, and 8 in ALL. In vivo selection assay for the exposed group detected N-ras oncogenes in one each patient with CML, ALL and RAEB, and 2 AML patients; and K-ras oncogenes in one CML patient. According to subtypes of leukemia, there was no significant difference in either the incidence of ras oncogenes or mutation site between the exposed and non-exposed groups. Using the combined PCR method and synthetic oligodeoxynucleotides, patients with RAEB+AML and ALL in the exposed group were found to have a tendency for slightly decreased incidence of ras oncogene mutation. Overall, 8 patients (33%) in the exposed group had ras oncogene mutation, consisting of 2 CML, 2 RAEB, 3 AML, and one ALL patients. (N.K.)

223

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

Directory of Open Access Journals (Sweden)

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

224

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 | Languages: English, 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

225

Mysterious "Monsieur Leborgne": The mystery of the famous patient in the history of neuropsychology is explained.  

Science.gov (United States)

As of spring 2011, 150 years have passed since the death of one of the most famous neurological patients of the nineteenth century. A Frenchman, "Monsieur Leborgne" also known by the nickname "Tan," was hospitalized due to an almost complete loss of speech. His case was presented in 1861, during a seating of the Société d'Anthropologie de Paris by a physician, Pierre Paul Broca (1824-1880), who used this occasion to report that he had discovered, in the middle part of patient's left frontal lobe, the cortical speech center. This area was later named "Broca's area." Both the patient and his medical records were the subject of numerous descriptions and citations in the medical literature. The patient's full identity and social background has remained a mystery until now. This article presents biographical data concerning Leborgne and his family based on archive registers in France. PMID:23323531

Domanski, Cezary W

2013-01-01

226

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

Directory of Open Access Journals (Sweden)

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

227

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  

Directory of Open Access Journals (Sweden)

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

228

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 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

229

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

OpenAIRE

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

230

Wernicke’s Encephalopathy in a Patient with Nasopharyngeal Carcinoma: Magnetic Resonance Imaging Findings  

OpenAIRE

We report a case of Wernicke’s encephalopathy in a patient with nasopharyngeal carcinoma with a 3-month history of poor oral intake related to nausea and vomiting due to chemotherapy. The patient later developed deep coma while receiving in-patient therapy. Magnetic resonance imaging of the brain revealed typical findings of Wernicke’s encephalopathy. The patient was treated with thiamine injections, which resulted in subsequent partial recovery of neurological function. This paper stress...

Law, Huong Ling; Tan, Suzet; Sedi, Rosleena

2011-01-01

231

Radiology clinical synopsis: a simple solution for obtaining an adequate clinical history for the accurate reporting of imaging studies on patients in intensive care units  

Energy Technology Data Exchange (ETDEWEB)

Lack of clinical history on radiology requisitions is a universal problem. We describe a simple Web-based system that readily provides radiology-relevant clinical history to the radiologist reading radiographs of intensive care unit (ICU) patients. Along with the relevant history, which includes primary and secondary diagnoses, disease progression and complications, the system provides the patient's name, record number and hospital location. This information is immediately available to reporting radiologists. New clinical information is immediately entered on-line by the radiologists as they are reviewing images. After patient discharge, the data are stored and immediately available if the patient is readmitted. The system has been in routine clinical use in our hospital for nearly 2 years. (orig.)

Cohen, Mervyn D. [Riley Hospital for Children, Indianapolis, IN (United States); Alam, Khurshaid [Indiana University, School of Medicine, Indianapolis, IN (United States)

2005-09-01

232

Radiology clinical synopsis: a simple solution for obtaining an adequate clinical history for the accurate reporting of imaging studies on patients in intensive care units  

International Nuclear Information System (INIS)

Lack of clinical history on radiology requisitions is a universal problem. We describe a simple Web-based system that readily provides radiology-relevant clinical history to the radiologist reading radiographs of intensive care unit (ICU) patients. Along with the relevant history, which includes primary and secondary diagnoses, disease progression and complications, the system provides the patient's name, record number and hospital location. This information is immediately available to reporting radiologists. New clinical information is immediately entered on-line by the radiologists as they are reviewing images. After patient discharge, the data are stored and immediately available if the patient is readmitted. The system has been in routine clinical use in our hospital for nearly 2 years. (orig.)

233

Metabolic and cardiovascular risk in patients with a history of differentiated thyroid carcinoma: A case-controlled cohort study  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Hyperthyroidism seems to increase metabolic and cardiovascular risk, while the effects of sub-clinical hyperthyroidism are controversial. We evaluated metabolic and cardiovascular parameters in differentiated thyroid carcinoma (DTC patients with suppressed thyrotropin (TSH due to levo-thyroxine (L-T4 therapy. We studied DTC patients and, as a control group, patients with a history of surgery for non-malignant thyroid pathology. Significantly higher insulin and lower HDL-cholesterol levels were recorded in DTC subjects. In both groups, insulin levels were significantly related with body mass index (BMI but not with age or L-T4 dosage. In DTC patients, a significant negative correlation was seen between HDL-cholesterol and BMI or L-T4 dosage. In both groups, intima-media thickness (IMT correlated positively with age, BMI, glucose levels and systolic blood pressure. In DTC patients, increased IMT was significantly correlated with glycated hemoglobin (HbA1c, cholesterol and triglycerides. In DTC patients, C-reactive protein correlated positively with insulin, insulin resistance, triglycerides and systolic blood pressure, and negatively with HDL-cholesterol. In both DTC and control subjects, fibrinogen correlated positively with age, BMI, increased IMT, HbA1c and systolic blood pressure. In DTC subjects, plasma fibrinogen concentrations correlated positively with insulin resistance, cholesterol and LDL-cholesterol, and negatively with TSH levels. Our data confirm that the favorable evolution of DTC can be impaired by a high incidence of abnormal metabolic and cardiovascular data that are, at least in part, related to L-T4 therapy. These findings underline the need for adequate L-T4 titration.

Giusti Massimo

2008-09-01

234

Occurrence of anti-prothrombin and anti-beta2-glycoprotein I antibodies in patients with history of thrombosis.  

Science.gov (United States)

New evidence indicates that antibodies to beta2-glycoprotein I (anti-beta2GPI) or to human prothrombin (anti-II)(or to both of these) are specific markers of the antiphospholipid syndrome (APS). They have been mainly associated with thrombotic complications in patients with APS. However, some studies have reported that elevated levels of anti-II, but not of anfi-beta2GPI, imply a risk of venous thrombosis (VT) or arterial thrombosis (AT) in subjects with no previous thrombosis and no antiphospholipid antibodies (aPL) by ELISA. The present study Included 180 patients with a history of thrombosis, 83 of them without aPL (group I) and the remaining 97 diagnosed as having APS (group II). Anti-beta2GPI was found in only 1 of the 83 patients from group I but was found in approximately 50% of those from group II (P < .0001). In contrast, positive anti-II was detected with a high prevalence in patients from group I (VT, 22.6%; AT, 26.7%) and in those from group II (VT, 37.5%; AT, 14.6%). No statistical differences were found in the prevalence of anti-II between the two groups of patients. On the other hand, such a difference was significant when compared with results in a normal group (1/67, 1.4%, P < .0001). These data Indicate that anti-II occurs frequently in patients with previous thrombosis either with or without lupus anticoagulant activity. Accordingly, testing of anti-II might be clinically useful in the evaluation for thrombophilla. PMID:10595789

Forastiero, R; Martinuzzo, M; Adamczuk, Y; Carreras, L O

1999-12-01

235

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

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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

236

Jaw movements in patients with a history of pain: an exploratory study.  

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The aims were to determine whether individuals with a past history of pain exhibit (i) altered jaw movement (e.g. reduced amplitude, increased jaw movement variability) in comparison with matched asymptomatic controls, and (ii) correlations between psychological measures (e.g. catastrophising) and altered jaw movement variables. Sixteen participants with a history of trigeminal neuropathic pain (TNP) and 15 age- and gender-matched healthy controls had jaw movements recorded during open/close, free gum chewing and chewing at standardised rates. All completed the Pain Catastrophising Scale (PCS), the Pain Self-Efficacy Questionnaire (PSEQ), and the Depression, Anxiety and Stress Scales (DASS). Velocity and amplitude for open/close and chewing, as well as variability, bias and mean square error for open/close jaw movements were compared between groups. Spearman's rank correlation coefficient was used to relate kinematic variables with psychological variables. Statistical significance: P pain have altered patterns of jaw movements in comparison with asymptomatic control participants and that catastrophising may play a role in the manifestation of these altered jaw movements. PMID:25146890

Bhaskaracharya, M; Memon, S M; Whittle, T; Murray, G M

2015-01-01

237

EPIDEMIOLOGY OF DIETARY NUTRIENT INTAKE IN ESRD  

OpenAIRE

Protein-energy wasting (PEW) is one of the strongest risk factors of adverse outcomes in patients with chronic kidney disease (CKD) including those with end stage renal disease (ESRD) who undergo maintenance dialysis treatment. One important determinant of PEW in this patient population is an inadequate amount of protein and energy intake. Compounding the problem are the many qualitative nutritional deficiencies that arise because of the altered dietary habits of dialysis patients. Many of th...

Kovesdy, Csaba P.; Shinaberger, Christian S.; Kalantar-zadeh, Kamyar

2010-01-01

238

Clinical features and pregnancy outcome in antiphospholipid syndrome patients with history of severe pregnancy complications.  

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Abstract Objective. To clarify the clinical significance of antiphospholipid antibody (aPL) profile in patients with obstetric antiphospholipid syndrome (APS). Methods. Clinical records of 13 pregnant patients (15 pregnancies) with obstetrical APS were reviewed over 10 years. Patients who met the Sapporo Criteria fully were studied, whereas those with only early pregnancy loss were excluded. In addition to classical aPL: lupus anticoagulant (LA), anticardiolipin antibody (aCL), and anti-?2-glycoprotein I (a?2GPI); phosphatidylserine-dependent anti-prothrombin antibody (aPS/PT) and kininogen-dependent anti-phosphatidylethanolamine antibody (aPE) were also examined in each case. Results. Cases were divided into two groups according to patient response to standard treatment: good and poor outcome groups. All cases with poor outcome presented LA, with IgG a?2GPI and IgG aPS/PT were also frequently observed. IgG aPE did not correlate with pregnancy outcome. Conclusion. aPL profile may predict pregnancy outcome in patients with this subset of obstetric APS. PMID:25146551

Matsuki, Yuko; Atsumi, Tatsuya; Yamaguchi, Koushi; Hisano, Michi; Arata, Naoko; Oku, Kenji; Watanabe, Noriyoshi; Sago, Haruhiko; Takasaki, Yoshinari; Murashima, Atsuko

2015-03-01

239

Spontaneous simultaneous bilateral malignant glaucoma of a patient with no antecedent history of medical or surgical eye diseases  

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Full Text Available Elias F Jarade,1,2 Ali Dirani,3 Elyse Jabbour,3 Joelle Antoun,3 Karim F Tomey11Beirut Eye Specialist Hospital, Beirut, Lebanon; 2Mediclinic Dubai Mall, Dubai, United Arab Emirates; 3Hotel Dieu de France Hospital, Saint Joseph University, Beirut, LebanonPurpose: Malignant glaucoma, or aqueous misdirection syndrome, is a condition characterized by sudden intraocular pressure (IOP elevation, and it is usually unilateral and induced by ocular surgical intervention or by medical therapy. Here, we report a case of simultaneous bilateral malignant glaucoma in a young patient with no history of any ocular diseases.Case report: A case of a 24-year-old female with no apparent previous history of ocular medical or surgical conditions was referred to our hospital because of recent bilateral IOP elevation associated with a severe drop in vision and shallow anterior chamber with no posterior segment anomalies detected by ocular ultrasound in both eyes. Yttrium aluminum garnet (YAG laser iridotomy dropped the IOP only temporarily and the patient received topical atropine treatment with combined trabeculectomy and anterior vitrectomy.Results: In this case, the patient had a typical presentation of bilateral malignant glaucoma and her IOP dropped only temporarily following laser iridotomy to rise again shortly thereafter. Also, deepening of the anterior chamber and IOP decrease after topical atropine was very supportive of the diagnosis of malignant glaucoma. Successful management with trabeculectomy and limited vitrectomy also affirmed the diagnosis of malignant glaucoma.Conclusion: This is a very rare case of bilateral malignant glaucoma in a young adult without any prior eye conditions; only one similar case has been reported in the literature. We propose our own theory regarding this simultaneous occurrence of the pathology based on previously published studies about the presence of communication between the two eyes along the ­cerebrospinal fluid pathways.Keywords: intraocular pressure, iridotomy, malignant glaucoma, young adult

Jarade EF

2014-05-01

240

Chronic Cavitary Pulmonary Histoplasmosis in a Non-HIV and Immunocompromised Patient without Overseas Travel History.  

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Korea is not known as an endemic area for Histoplasma. However, we experienced a case of histoplasmosis in a person who had never been abroad. A 65-year-old female was admitted to the hospital for evaluation of multiple lung nodules. A computed tomography (CT) scan of the chest showed multiple ill-defined consolidations and cavitations in all lobes of both lungs. The patient underwent a CT-guided lung biopsy, and a histopathology study showed findings compatible with histoplasmosis. Based on biopsy results and clinical findings, the patient was diagnosed with chronic cavitary pulmonary histoplasmosis. The patient recovered completely following itraconazole treatment. This is the first case report of pulmonary histoplasmosis unconnected with either HIV infection or endemicity in Korea. PMID:25837199

Jung, Eun Ju; Park, Dae Won; Choi, Jung Woo; Choi, Won Suk

2015-05-01

241

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

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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

242

The natural history of EGFR and EGFRvIII in glioblastoma patients  

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Full Text Available Abstract Background The epidermal growth factor receptor (EGFR is over expressed in approximately 50–60% of glioblastoma (GBM tumors, and the most common EGFR mutant, EGFRvIII, is expressed in 24–67% of cases. This study was designed to address whether over expressed EGFR or EGFRvIII is an actual independent prognostic indicator of overall survival in a uniform body of patients in whom gross total surgical resection (GTR; ? 95% resection was not attempted or achieved. Methods Biopsed or partially/subtotally resected GBM patients (N = 54 underwent adjuvant conformal radiation and chemotherapy. Their EGFR and EGFRvIII status was determined by immunohistochemistry and Kaplan-Meier estimates of overall survival were obtained. Results In our study of GBM patients with less than GTR, 42.6% (n = 23 failed to express EGFR, 25.9% (n = 14 had over expression of the wild-type EGFR only and 31.5 % (n = 17 expressed the EGFRvIII. Patients within groups expressing the EGFR, EGFRvIII, or lacking EGFR expression did not differ in age, Karnofsky Performance Scale (KPS score, extent of tumor resection. They all had received postoperative radiation and chemotherapy. The median overall survival times for patients with tumors having no EGFR expression, over expressed EGFR only, or EGFRvIII were 12.3 (95% CI, 8.04–16.56, 11.03 (95% CI, 10.18–11.89 and 14.07 (95% CI, 7.39–20.74 months, respectively, log rank test p > 0.05. Patients with tumors that over expressed the EGFR and EGFRvIII were more likely to present with ependymal spread, 21.4% and 35.3% respectively, compared to those patients whose GBM failed to express either marker, 13.0%, although the difference was not statistically significant. There was no significant difference in multifocal disease or gliomatosis cerebri among EGFR expression groups. Conclusion The over expressed wild-type EGFR and EGFRvIII are not independent predictors of median overall survival in the cohort of patients who did not undergo extensive tumor resection.

Shi Weiming

2005-10-01

243

Treating mood disorders in patients with a history of intestinal surgery: a systematic review.  

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Bariatric surgery is increasingly being performed, with the intended benefits of significant and durable weight loss. Radical surgical resection can result in short bowel syndrome (SBS), a rare and devastating condition. Psychological distress is common in these patients. Relevant articles were identified by searching Pubmed and EMBASE databases with the following keywords: 'Bariatrics'[Mesh] OR 'Short Bowel Syndrome' AND 'Antidepressive Agents' OR 'Psychotropic Drugs'[Mesh]. One in-vitro study, four clinical studies and six relevant case reports were identified. Most clinical studies on antidepressant focused on the Roux-en-Y gastric bypass (RYGB); [ZERO WIDTH SPACE][ZERO WIDTH SPACE]these results are somewhat conflicting for a variety of reasons including different methodologies and small sample sizes. One month after RYGB, in patients receiving serotonin or serotonin/noradrenaline reuptake inhibitors, antidepressant levels decrease to 50% of preoperative levels and return to baseline (or greater) by 6 months in almost all patients. Other pharmacokinetic studies have shown that, 1 year after RYGB, duloxetine and sertraline levels are significantly reduced in comparison with the control population. Paradoxically, in patients with SBS and a few years after surgery, high concentration to dose ratios have been reported for citalopram and escitalopram; this may be because of an intestinal adaptation. Surgery of the intestine is likely to modify absorption and first-pass metabolism of drugs; managing the treatment of depression and anxiety in bariatric and SBS patients therefore presents a major challenge. Close clinical follow-up, associated with therapeutic drug monitoring when available, should enable the optimization of treatment response and modulate the risk of adverse events. PMID:25768383

Lloret-Linares, Célia; Bellivier, Frank; Heron, Kyle; Besson, Marie

2015-05-01

244

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

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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

245

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

246

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

Science.gov (United States)

An 89-year-old Japanese woman with no history of contact with infected individuals developed meningococcal meningitis with meningococcemia. Compared with other countries, invasive meningococcal disease is relatively rare in Japan, with an annual incidence of a total of 10-20 cases for more than 2 decades; this represents approximately 1% of the corresponding incidence in the United States and United Kingdom. The most prevalent serotypes of the causative agent Neisseria meningitidis in Japan are serotypes B and Y. The patient in this study was also infected with a strain of serotype Y. The meningococcal vaccine has not yet been approved for use in Japan. The only possible transmission route in this patient was a visit by the patient's grandchild a few days prior to the onset of symptoms. Due to its low incidence, clinicians do not have sufficient experience for managing this potentially fatal illness. This case highlights the need for considering a complete differential diagnosis of invasive meningococcal disease. PMID:25420647

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

2015-01-26

247

From comparative effectiveness research to patient-centered outcomes research: policy history and future directions.  

Science.gov (United States)

Containing growth in health care expenditures is considered to be essential to improving both the long-term fiscal outlook of the federal government and the future affordability of health care in the US. As health care expenditures have increased, so too have concerns about the quality of health care. Better information on the clinical effectiveness of alternative treatments and other interventions is needed to improve the quality of care and restrain growth in expenditures. This article explains the key role played by the federal government in defining the context and process of comparative effectiveness research as well as its funding. Subsequently, the article explores the mission, priorities, and research agenda of the Patient-Centered Outcomes Research Institute, which is an independent, nonprofit corporation established in 2010 by the Patient Protection and Affordable Care Act. PMID:22746239

D'Arcy, Laura P; Rich, Eugene C

2012-07-01

248

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)

249

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

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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

250

Application of Plasma Exchange in Patients with History of Unexplained Recurrent Abortion: A Case Series  

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Full Text Available Background: Immune-mediated recurrent pregnancy loss (RPL has received more attentionthan any other single etiologic classification. Individuals with rare blood group P have an antipp1pkantibody in their serum, which causes recurrent abortion in the early stages.Materials and Methods: In this case series study, 11 patients with unexplained RPL whohad anti-P antibody in their serum were treated by plasma exchange during their nextpregnancies. To evaluate the efficacy of the treatment, we monitored fetal developmentusing ultrasonography and intensive prenatal care. All calculations were performed withthe SPSS version 16.Results: All patients who were treated by plasma exchange progressed to live birth. Themean gestational age at the time of termination was 37.5 ± 0.69 weeks. The mean weightof the newborns was 2729.09 ± 389.88 g. None of the newborns required exchange transfusion.Conclusion: P-incompatibility is one rare but important cause of unexplained RPL and also abasis for therapeutic intervention via early antibody removal by plasma exchange.

Azadeh Ghaheri

2013-01-01

251

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

252

Ethical vulnerabilities in nursing history: conflicting loyalties and the patient as 'other'.  

Science.gov (United States)

The purpose of this article is to explore enduring ethical vulnerabilities of the nursing profession as illustrated in historical chapters of nursing's past. It describes these events, then explores two ethical vulnerabilities in depth: conflicting loyalties and duties, and relationships with patients as 'other'. The article concludes with suggestions for more ethical approaches to the other in current nursing practice. The past may be one of the most fruitful sites for examining enduring ethical vulnerabilities of the nursing profession. First of all, professional identity, which includes moral identity, comes in part from knowledge of the nursing profession's past. Second, looking to the past to understand better how events and ideologies have brought vulnerabilities to the fore raises questions about ethical nursing practice today. PMID:20801961

Lagerwey, Mary Deane

2010-09-01

253

[Premature birth in patient with cervix incompetence and history of myasthenia gravis].  

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Cervical incompetence it's a dilatation of the cervix during the third trimester of pregnancy that ends with the interruption of it. The incidence in Chile is about 0.1-2% of the total pregnancies and it's one of the causes of preterm birth. A 34 years old pregnant patient. Timectomized at age 18 to treat her miastenia gravis, previously trated with medication, had 4 previous preterm labours all of them under 25 weeks and vaginal births. All fetuses died postpartum. A cerclage was made during the third, fourth and fifth pregnancies. She didn't present hypertension during the gestation and no cervical diameter under 15mm. Since the fourth gestation the following tests are taken: Antifosfolipidic antibodies, APTT,PT. All the results are either normal or negative. Microbial cultures were negative. No amniocentesis was made. A McDonald cervical cerclage was made during pregnancies number 3, 4 and 5 on the 16th week to delay the labor. Also oral micronized progesterone, on a 400mg/24 hours dosis, was administered to avoid preterm birth. On the 24th week the pharmacological treatment started including Intramuscular Betamethasone, 12 mg/24 hours (2 doses), to induce lung maturity on the fetus. It is thought that the administration of progesterone could have improved the situation of the patient, because it acts as a labour repressants. The use of cerclage could have helped, but the factors that may influence the effectiveness of this method are unknown. Perhaps there is some immunologic factor associated with the miastenia gravis that alters the normal course of pregnancy. PMID:24187819

Fuentealba, Maximiliano; Troncoso, Miguel; Vallejos, Joaquin; Ponce, Sebastian; Villablanca, Nelson; Melita, Pablo

2013-09-01

254

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

Directory of Open Access Journals (Sweden)

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

255

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)

256

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

Energy Technology Data Exchange (ETDEWEB)

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

257

Chronic thromboembolic pulmonary hypertension as a cause of dyspnoea in an older patient with a complex history  

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Full Text Available A full diagnostic work-up for patients with pulmonary hypertension (PH is vital. Classification and diagnosis of the underlying cause is important to ensure optimal management, but may be complicated by overlapping signs and symptoms. This case study describes how a full work-up identified chronic thromboembolic PH (CTEPH as the cause of dyspnoea in a 68-yr-old male with a history of pulmonary embolism and an original diagnosis of chronic obstructive pulmonary disease. Key indicators included decreased tricuspid annular plane systolic excursion, increased Tei index and elevated systolic pulmonary artery pressure. Multi-slice spiral chest computed tomography and pulmonary angiography showed severe chronic thromboembolic pulmonary disease, both centrally and distally. Diffusing capacity of the lung for carbon monoxide was reduced and blood gas analysis revealed a wide alveolar–arterial oxygen pressure difference, which is typical of CTEPH. The patient was eligible for pulmonary endarterectomy according to established criteria. Residual PH after surgery was successfully managed with bosentan.

C. M. Kähler

2009-09-01

258

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 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

259

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

OpenAIRE

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

260

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

261

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

262

Early sensory–perceptual processing deficits for affectively valenced inputs are more pronounced in schizophrenia patients with a history of violence than in their non-violent peers  

OpenAIRE

Individuals with schizophrenia are more prone to violent behaviors than the general population. It is increasingly recognized that processing of emotionally valenced stimuli is impaired in schizophrenia, a deficit that may play a role in aggressive behavior. Our goal was to establish whether patients with a history of violence would show more severe deficits in processing emotionally valenced inputs than non-violent patients. Using event-related potentials, we measured how early during proces...

Sanctis, Pierfilippo; Foxe, John J.; Czobor, Pal; Wylie, Glenn R.; Kamiel, Stephanie M.; Huening, Jessica; Nair-collins, Mike; Krakowski, Menahem I.

2012-01-01

263

Selective deficits in semantic verbal fluency in patients with a first affective episode with psychotic symptoms and a positive history of mania.  

LENUS (Irish Health Repository)

Neurocognitive dysfunction is likely to represent a trait characteristic of bipolar disorder, but the extent to which it comprises \\'core\\' deficits as opposed to those secondary to longstanding illness or intellectual decline is unclear. We investigated neuropsychological performance in an epidemiologically derived sample of patients with a first affective episode with psychotic symptoms and a positive history of mania, compared to community controls.

Kravariti, Eugenia

2009-05-01

264

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

265

Analysis of mammographic findings and patient history data with genetic algorithms for the prediction of breast cancer biopsy outcome  

Science.gov (United States)

A decision model is presented to increase the specificity of breast biopsy directly optimized on the receiver operating characteristic (ROC) area index. ROC area has higher clinical significance as a performance measure than the traditional metric mean-squared error (MSE). Excisional biopsy as practiced is highly sensitive to cancer but nonspecific; only one in three biopsies is malignant. Data for this study consists of 500 cases randomly selected from patients who underwent excisional biopsy for definitive diagnosis of breast cancer. For each case, inputs to the model consist of mammographic findings and patient history features. Outputs from the model built may be thresholded to correspond to the decision to biopsy a suspicious breast lesion. While clinically relevant, ROC area is a discontinuous function which cannot be optimized directly so a genetic algorithm approach is used to train a nonlinear artificial neural network. Performance using the genetic algorithm method of training was similar to that of a decision model trained using the traditional approach for this data set. ROC areas were obtained after training using three different approaches: genetic algorithm training optimized on ROC area produced an ROC area of 0.845 +/- 0.039, genetic algorithm training optimized on MSE produced an ROC area of 0.845 +/- 0.039, and traditional training using backpropagation produced an ROC area of 0.848 +/- 0.039. Despite the similar performance measures for models trained on this data, it is possible that with different data sets, training on ROC instead of MSE will produce models with significantly different performance. In this case, the genetic algorithm approach will prove useful.

Frederick, Erik D.; Floyd, Carey E., Jr.

1998-06-01

266

Dietary compliance, dietary supplementation and traditional remedy usage of type 2 diabetic patients with and without cardiovascular disease.  

Science.gov (United States)

This analytical cross-sectional study examined the nutrient intakes, dietary compliance, dietary supplementation and traditional remedy usage in type 2 diabetes mellitus (T2DM) patients from selected tertiary hospitals in multi-racial Malaysia. We compared the different characteristics of T2DM patients with and without cardiovascular disease (CVD). Socio-demographic status, dietary intakes, dietary supplementation, traditional remedy use, medical history, anthropometric measurements and clinical characteristics were obtained from face-to-face interviews. A total of 313 patients who were treated for T2DM participated in this study, in which 36.1% of them had CVD. The mean age of study subjects was 55.7 ± 9.2 years; mean diabetes duration was 10.1 ± 8.1 years; 52.1% were females; and 47.0% were Malays. The mean total energy intake of the subjects was 1674 ± 694 kcal/day, and patients with CVD consumed higher total calories (p = 0.001). Likewise, the mean carbohydrate, protein and total fat intake of CVD patients were significantly higher than non-CVD patients (p < 0.05), while mean intakes of cholesterol, fibre, minerals and all vitamins were comparable between CVD and non-CVD patients. Regardless of CVD status, a notably high proportion of the subjects did not meet the recommendations of the Medical Nutrition Therapy Guidelines for Type 2 Diabetes for total energy, carbohydrate, protein, total fat, and fibre intakes. Meanwhile, 52.4% used at least one dietary supplement and 12.1% took single traditional remedy or in various combinations. Traditional remedies and supplement intake did not differ between CVD and non-CVD subjects. It is suggested that T2DM patients should be educated based on their personalized dietary intake, dietary supplementation and traditional remedy usage. The recommendations for T2DM patients shall be met to achieve the optimal metabolic goals and minimize the potential diabetic complications. PMID:25713789

Tan, Mun Chieng; Ng, Ooi Chuan; Wong, Teck Wee; Joseph, Anthony; Hejar, Abdul Rahman; Rushdan, Abdul Aziz

2015-01-01

267

Peptides and food intake.  

Science.gov (United States)

The mechanisms for controlling food intake involve mainly an interplay between gut, brain, and adipose tissue (AT), among the major organs. Parasympathetic, sympathetic, and other systems are required for communication between the brain satiety center, gut, and AT. These neuronal circuits include a variety of peptides and hormones, being ghrelin the only orexigenic molecule known, whereas the plethora of other factors are inhibitors of appetite, suggesting its physiological relevance in the regulation of food intake and energy homeostasis. Nutrients generated by food digestion have been proposed to activate G-protein-coupled receptors on the luminal side of enteroendocrine cells, e.g., the L-cells. This stimulates the release of gut hormones into the circulation such as glucagon-like peptide-1 (GLP-1), oxyntomodulin, pancreatic polypeptides, peptide tyrosine tyrosine, and cholecystokinin, which inhibit appetite. Ghrelin is a peptide secreted from the stomach and, in contrast to other gut hormones, plasma levels decrease after a meal and potently stimulate food intake. Other circulating factors such as insulin and leptin relay information regarding long-term energy stores. Both hormones circulate at proportional levels to body fat content, enter the CNS proportionally to their plasma levels, and reduce food intake. Circulating hormones can influence the activity of the arcuate nucleus (ARC) neurons of the hypothalamus, after passing across the median eminence. Circulating factors such as gut hormones may also influence the nucleus of the tractus solitarius (NTS) through the adjacent circumventricular organ. On the other hand, gastrointestinal vagal afferents converge in the NTS of the brainstem. Neural projections from the NTS, in turn, carry signals to the hypothalamus. The ARC acts as an integrative center, with two major subpopulations of neurons influencing appetite, one of them coexpressing neuropeptide Y and agouti-related protein (AgRP) that increases food intake, whereas the other subpopulation coexpresses pro-opiomelanocortin (POMC) and cocaine and amphetamine-regulated transcript that inhibits food intake. AgRP antagonizes the effects of the POMC product, ?-melanocyte-stimulating hormone (?-MSH). Both populations project to areas important in the regulation of food intake, including the hypothalamic paraventricular nucleus, which also receives important inputs from other hypothalamic nuclei. PMID:24795698

Sobrino Crespo, Carmen; Perianes Cachero, Aránzazu; Puebla Jiménez, Lilian; Barrios, Vicente; Arilla Ferreiro, Eduardo

2014-01-01

268

Food, fat, family and friends: studies on the impact of the social environment on dietary intake.  

OpenAIRE

The impact of the social environment on food and fat intake was investigated in several samples including family members, close friends, and meal time companions in the Netherlands. Firstly, a food frequency questionnaire to assess the intake of fat, fatty acids and cholesterol was developed. Biomarker-based validity (n = 99), relative validity against a dietary history (n = 191), and reproducibility (n = 93) were satisfactory for adults.Up to 40% of the variance in fat intake, expressed as %...

Feunekes, G. I. J.

1996-01-01

269

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

270

Prophylactic SSRI during interferon alpha re-therapy in patients with chronic hepatitis C and a history of interferon-induced depression.  

Science.gov (United States)

Only limited data are available on selective serotonin re-uptake inhibitor (SSRI) prophylaxis for antiviral re-treatment in hepatitis C patients with previous interferon-induced major depressive episodes. Therefore, we investigated the efficacy and safety of secondary SSRI prophylaxis in these patients. In a prospective and longitudinal study, repeated psychometric testing (Hospital Anxiety and Depression Scale) was performed before, during, and after antiviral re-treatment. Chronic hepatitis C virus (HCV)-infected patients, who had been psychometrically monitored during an unsuccessful previous antiviral therapy, and had developed major depression were included. Interferon re-therapy with SSRI prophylaxis was started (n = 8). The reference group was comprised of HCV patients without a history of interferon-associated depression and also a group who were previously unsuccessfully treated with interferon and were re-treated without SSRI prophylaxis (n = 9). All patients receiving SSRI prophylaxis were able to complete interferon re-therapy as scheduled. As in the first therapeutic course, depression scores were significantly elevated during re-treatment also (P 0.05). In conclusion, hepatitis C patients with a history of interferon-induced major depression can be successfully re-treated with peginterferon/ribavirin and concomitant SSRI prophylaxis. In these patients, SSRI prophylaxis is safe and efficacious and should be considered, if antiviral re-therapy is indicated. PMID:15655055

Kraus, M R; Schäfer, A; Al-Taie, O; Scheurlen, M

2005-01-01

271

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

272

HTLV-1 infection is associated with a history of active tuberculosis among family members of HTLV-1-infected patients in Peru  

OpenAIRE

The purpose of this study was to assess the association between human T-lymphotropic virus 1 (HTLV-1) and a lifetime history of active tuberculosis (TB) among relatives of HTLV-1-infected patients. We reviewed clinical charts of all relatives of HTLV-1-infected index cases who attended our institute in Lima from 1990–2004. The data of 1233 relatives was analysed; 394 (32.0%) were HTLV-1 positive. Eighty-one subjects (6.6%) had a history of active TB, including 45/394 (11.4%) ...

Verdonck, K.; Gonza?lez, E.; Schrooten, W.; Vanham, G.; Gotuzzo, E.

2008-01-01

273

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

274

The value of hysteroscopic-based decision-making in uterine abnormalities during tamoxifen intake in breast cancer patients – preliminary report  

OpenAIRE

Women using hormonal therapy for breast cancer are often encountered in clinical practice of breast surgeons, oncologists and gynecologists. Some of them during the course of therapy develop abnormal uterine bleeding or have ultrasound abnormalities detected. In Poland, most of them are still diagnosed using blind curettage, which does not bring a definitive diagnosis or requires repeating the diagnostic procedure. This produces unnecessary fear of malignancy in patients and increases economi...

Gabriel, Iwona; Olejek, Anita

2014-01-01

275

A Short Bowel (Small Intestine = 40?cm), No Ileocecal Valve, and Colonic Inertia Patient Works Well with Oral Intake Alone without Parenteral Nutrition  

OpenAIRE

We present a 50-year-old male who suffered from ischemic bowel disease, having undergone massive resection of small intestine and ileocecal valve. He had to cope with 40?cm proximal jejunum and 70?cm distal colon remaining. In the postoperative period parenteral nutrition (PN) was used immediately for nutrition support and electrolyte imbalance correction. We gave him home PN as regular recommendation for the short bowel status after discharge from hospital. This patient has tolerated reg...

Ming-Yi Liu; Hsiu-Chih Tang; Hui-Lan Yang; Sue-Joan Chang

2014-01-01

276

Caspofungin as secondary prophylaxis or therapy in patients undergoing allogeneic stem cell transplantation with a prior or ongoing history of systemic or invasive fungal infections  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Patients with a history of or ongoing invasive fungal infection (IFI who undergo allogeneic stem cell transplantation (SCT have a high risk of reactivation or progression.In a prospective study we evaluated the efficacy and safety of caspofungin as secondary prophylaxis or as therapy for persistent disease.Methods: Twenty-eight adult patients were included in this study, all of whom had acute leukemia. At the time of SCT 16 patients had no signs of infection, while in 12 cases radiographic signs (CT scan of florid fungal infections were noted. Caspofungin 50 mg intravenously was given daily from start of conditioning until stable engraftment.Results: No patient experienced side effects leading to the discontinuation of caspofungin. In 14 out of 16 patients (88 % without active signs of infection at start of transplantation, no fungal disease was observed after prophylaxis with caspofungin. In 10 out of 12 cases (83 % with radiographic signs of florid fungal infection pre-transplantation, complete (n=4 or partial (n=6 responses after caspofungin treatment were achieved.Conclusions: The use of caspofungin is safe and effective in high-risk patients with a history of IFI when undergoing allogeneic SCT.

A.R. Zander

2008-11-01

277

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

278

Early sensory-perceptual processing deficits for affectively valenced inputs are more pronounced in schizophrenia patients with a history of violence than in their non-violent peers.  

Science.gov (United States)

Individuals with schizophrenia are more prone to violent behaviors than the general population. It is increasingly recognized that processing of emotionally valenced stimuli is impaired in schizophrenia, a deficit that may play a role in aggressive behavior. Our goal was to establish whether patients with a history of violence would show more severe deficits in processing emotionally valenced inputs than non-violent patients. Using event-related potentials, we measured how early during processing of emotional valence, evidence of aberrant function was observed. A total of 42 schizophrenia patients (21 with history of violence; 21 without) and 28 healthy controls were tested. Participants performed an inhibitory control task, making speeded responses to pictorial stimuli. Pictures occasionally repeated twice and participants withheld responses to these repeats. Valenced pictures from the International Affective Picture System were presented. Results in controls showed modulations during the earliest phases of sensory processing (sensory and perceptual processing stages. In contrast, neither schizophrenia group showed early differentiation. Non-violent patients showed earliest modulations beginning ?150?ms. For violent patients, however, earliest modulations were further delayed and highly attenuated. The current study reveals sensory-perceptual processing dysfunction for negatively valenced inputs, which is particularly pronounced in aggressive patients. PMID:22563006

De Sanctis, Pierfilippo; Foxe, John J; Czobor, Pal; Wylie, Glenn R; Kamiel, Stephanie M; Huening, Jessica; Nair-Collins, Mike; Krakowski, Menahem I

2013-08-01

279

Peptides and Food Intake  

OpenAIRE

The mechanisms for controlling food intake involve mainly an interplay between gut, brain, and adipose tissue (AT), among the major organs. Parasympathetic, sympathetic, and other systems are required for communication between the brain satiety center, gut, and AT. These neuronal circuits include a variety of peptides and hormones, being ghrelin the only orexigenic molecule known, whereas the plethora of other factors are inhibitors of appetite, suggesting its physiological relevance in the r...

EduardoArilla; VicenteBarrios

2014-01-01

280

The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients : A randomized controlled trial  

DEFF Research Database (Denmark)

BACKGROUND & AIM: Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient. The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than standard care. Secondary outcomes were changes in muscle strength, functional ability and body weight. METHODS: 29 acutely admitted old (>65 years) patients were randomly assigned to the intervention (n = 14) or to standard care (n = 15). The Intervention Group received 1.7 g protein/kg/day during admission and a daily protein supplement (18.8 g protein) and resistance training 3 times per week the 12 weeks following discharge. Muscle mass was assessed by Dual-energy X-ray Absorptiometry. Muscle strength was assessed by Hand Grip Strength and Chair Stand Test. Functional ability was assessed by the de Morton Mobility Index, the Functional Recovery Score and the New Mobility Score. Changes in outcomes from time of admission to three-months after discharge were analysed by linear regression analysis. RESULTS: The intention-to-treat analysis showed no significant effect of the intervention on lean mass (unadjusted: ?-coefficient = -1.28 P = 0.32, adjusted for gender: ?-coefficient = -0.02 P = 0.99, adjusted for baseline lean mass: ?-coefficient = -0.31 P = 0.80). The de Morton Mobility Index significantly increased in the Control Group (?-coefficient = -11.43 CI: 0.72-22.13, P = 0.04). No other differences were found. CONCLUSION: No significant effect on muscle mass was observed in this group of acutely ill old medical patients. High compliance was achieved with the dietary intervention, but resistance training was challenging. Clinical trials identifier NCT02077491.

Buhl, Sussi F; Andersen, Aino L

2015-01-01

281

Ethanol intake and 3H-serotonin uptake II: A study in alcoholic patients using platelets 3H-paroxetine binding  

International Nuclear Information System (INIS)

The kinetic parameters of 3H-paroxetine binding and 3H-serotonin uptake were studied in platelets of alcoholic patients. There was no difference between alcoholic and non alcoholic subjects in 3H-paroxetine binding. When binding and 3H-serotonin uptake were studied, in the same plasma of the same subjects, the Vmax of serotonin uptake was increased in alcoholics. The data confirm the involvement of serotonin uptake system in alcohol dependance and suggest that serotonin uptake and paroxetine binding sites may be regulated independently in this pathology

282

Ethanol intake and sup 3 H-serotonin uptake II: A study in alcoholic patients using platelets sup 3 H-paroxetine binding  

Energy Technology Data Exchange (ETDEWEB)

The kinetic parameters of {sup 3}H-paroxetine binding and {sup 3}H-serotonin uptake were studied in platelets of alcoholic patients. There was no difference between alcoholic and non alcoholic subjects in {sup 3}H-paroxetine binding. When binding and {sup 3}H-serotonin uptake were studied, in the same plasma of the same subjects, the Vmax of serotonin uptake was increased in alcoholics. The data confirm the involvement of serotonin uptake system in alcohol dependance and suggest that serotonin uptake and paroxetine binding sites may be regulated independently in this pathology.

Daoust, M.; Boucly, P. (U.F.R. de Medecine et Pharmacie, Saint Etienne du Rouvrary (France)); Ernouf, D. (Institut du Medicament, Tours (France)); Breton, P. (Centre National de Transfusion Sanguine de Rouen (France)); Lhuintre, J.P.

1991-01-01

283

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

284

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  

Directory of Open Access Journals (Sweden)

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

285

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)

286

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

OpenAIRE

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

287

A genomic and transcriptomic approach for a differential diagnosis between primary and secondary ovarian carcinomas in patients with a previous history of breast cancer  

OpenAIRE

Abstract Background The distinction between primary and secondary ovarian tumors may be challenging for pathologists. The purpose of the present work was to develop genomic and transcriptomic tools to further refine the pathological diagnosis of ovarian tumors after a previous history of breast cancer. Methods Sixteen paired breast-ovary tumors from patients with a former diagnosis of breast cancer were collected. The genomic profiles of paired tumors were analyzed using the Affymetrix GeneCh...

Fourchotte Virginie; Weber Nina; Nicolas André; Lebigot Ingrid; Couturier Jérôme; Stern Marc-Henri; Decraene Charles; Cottu Paul H; Meyniel Jean-Philippe; Alran Séverine; Rapinat Audrey; Gentien David; Roman-Roman Sergio; Mignot Laurent; Sastre-Garau Xavier

2010-01-01

288

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

Directory of Open Access Journals (Sweden)

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

289

Effects of ranitidine treatment on patients with asthma and a history of gastro-oesophageal reflux: a double blind crossover study.  

OpenAIRE

Forty eight patients with moderate to severe asthma were enrolled in a double blind crossover study designed to evaluate the effects of ranitidine treatment, 150 mg twice daily for four weeks, on gastro-oesophageal reflux, asthma control, and bronchial reactivity. All 48 had a history of reflux symptoms and 27 had in addition reflux associated respiratory symptoms. Thirty two patients had objective evidence of acid reflux on 24 hour pH monitoring (pH of less than 4 for more than 1% of the 24 ...

Ekstro?m, T.; Lindgren, B. R.; Tibbling, L.

1989-01-01

290

Serum sodium stabilizing effect of enalapril after standard water load in a patient with a history of self-induced water intoxication.  

Science.gov (United States)

1. A 21 day prospective placebo controlled double blind cross over trial of enalapril was studied in a normonatremic patient with a known history of SIWI. 2. At the end of each prophylactic treatment, the patient was challenged with a water load of 20 ml/kg. 3. The mean serum sodium of 140.111 mmol/L on prophylactic enalapril was significantly higher than the 137.6 mmol/L on placebo (p = 0.0015). 4. After a water load, the mean serum sodium on enalapril was 137.6 mmol/L, compared to 133.833 mmol/L (p = 0.0015) on placebo. PMID:8588063

Sebastian, C S; Sinha, D; Gulati, N K

1995-07-01

291

Evaluation of nutrient intake in early post kidney transplant recipients.  

Science.gov (United States)

The purpose of our study was to evaluate the dietary intake of kidney transplant recipients (KTRs) and assess oral intake related nutrition problems. Fifty patients who had undergone kidney transplantation were included: 24 males, 26 females. The mean age was 46.8 ± 11.2 years, height was 161.3 ± 8.3 cm, and body weight was 60.5 ± 8.7 kg. We conducted nutrition education based on the diet guideline for KTRs (energy 32 kcal/kg of ideal body weight [IBW], protein 1.3 g/kg of IBW) and neutropenic diet guideline before discharge. Dietary intake of the patients at 1 month after transplantation was investigated by 3-day food records. Body weight and laboratory values for nutritional status and graft function were also collected. Body weight was significantly decreased from admission to discharge. Body weight from discharge to 1 month and 3 months after transplantation was increased but was not significant. Biochemical measurements were generally improved but the number of patients with hypophosphatemia increased. The daily dietary intake of energy and protein was adequate (33.1 kcal/kg, 1.5 g/kg, respectively). However, the dietary intake of calcium, folate, and vitamin C did not meet the Korean Recommended Nutrient Intake of vitamins and minerals (86.8%, 62.4%, and 88.0%, respectively). Patients with low intake of calcium, folate, and vitamin C presented low intake in milk and dairy products, vegetables, and fruits, and these foods were related to restricted food items in neutropenic diet. More attention should be paid on improving quality of diet, and reconsideration of present neutropenic diet guideline is necessary. These results can be used to establish evidence-based medical nutrition therapy guideline for KTRs. PMID:23429928

Rho, Mi Ra; Lim, Jeong Hyun; Park, Jung Hwa; Han, Seung Seok; Kim, Yon Su; Lee, Young Hee; Kim, Won Gyoung

2013-01-01

292

Lumbar disc herniation: favourable outcome associated with intake of wine  

OpenAIRE

Recent research indicates that non-smoking and intake of alcoholic beverages, in particular wine, are associated with beneficial effects on several diseases, especially atherosclerosis. The aim of the study was to investigate whether smoking or the intake of different alcoholic beverages are associated with the outcome 2½ years after first-time lumbar disc surgery. The design was a follow-up study, using a questionnaire including a rating scale. All 170 patients consecutively operated upon f...

Rasmussen, C.

1998-01-01

293

Acute Hematogenous Infection of Revision Total Hip Arthroplasty by Oral Bacteria in a Patient without a History of Dental Procedures: Case Report  

Science.gov (United States)

The risk of periprosthetic joint infection from hematogenous bacterial seeding is increased in patients undergoing dental procedures that facilitate the development of bacteremia. We herein report the case of a patient without a history of dental procedures who suffered from an acute metastatic infection of a hip prosthesis by the oral bacterium Streptococcus mutans 18 months after undergoing revision total hip arthroplasty. The patient was successfully treated by two-stage revision surgery. It is important to realize that the efficacy of antibiotic prophylaxis against joint infections has not yet been convincingly proven. As a result, optimal dental hygiene and regular dental visits may be more important than antibiotic prophylaxis for maintaining joint health. Therefore, orthopedic surgeons should educate patients with joint prostheses about good oral health. PMID:24741380

Sonohata, Motoki; Kitajima, Masaru; Kawano, Syunsuke; Mawatari, Masaaki

2014-01-01

294

Girls’ Dairy Intake, Energy Intake, and Weight Status  

OpenAIRE

We explored the relationships among girls’ weight status, dairy servings, and total energy intake. The hypothesis that consuming dairy could reduce risk for overweight was evaluated by comparing energy intake and weight status of girls who met or consumed less than the recommended three servings of dairy per day. Participants included 172 11-year-old non-Hispanic white girls, assessed cross-sectionally. Intakes of dairy, calcium, and energy were measured using three 24-hour recalls. Body ma...

Fiorito, Laura M.; Ventura, Alison K.; Mitchell, Diane C.; Smiciklas-wright, Helen; Birch, Leann L.

2006-01-01

295

Effects of different glycaemic index foods and dietary fibre intake on glycaemic control in type 1 diabetic patients on intensive insulin therapy.  

Science.gov (United States)

To evaluate the influence of a low glycaemic index (GI), high GI and high fibre diet on glycaemic control and insulin requirement in Type 1 diabetic patients on intensive insulin therapy, nine well-controlled, highly-motivated Type 1 diabetic patients were put on a control diet for 12 days and then randomized in a consecutive manner to 12 days of each diet, in a crossover design. During each experimental diet, the study subjects adjusted their premeal insulin (soluble) dose to maintain their 1-h postprandial capillary glucose at or below 10 mmol l(-1). At the end of each experimental diet, they were submitted to a standardized breakfast of the diet under study, using the same premeal insulin dose as that required for the control diet. The control diet contained 16.0+/-3.0 g of fibre day(-1) with a GI of 77.4+/-2.7 compared to 15.3+/-6.3 and 66.2+/-1.2 for the low GI diet, 17.1+/-7.2 and 92.9+/-3.6 for the high GI diet, and 56.1+/-3.6 (including 15 g of guar) and 73.5+/-2.1 for the high fibre diet. Prebreakfast capillary blood glucose (6.2+/-1.2 mmol l(-1)) on the low GI diet and postbreakfast capillary blood glucose (8.7+/-1.8 mmol l(-1)) on the high fibre diet were significantly lower than the values obtained with the control diet (8.0+/-1.8 and 10.6+/-2.4, respectively; pmeals induce small but significant changes in glucose profile. In everyday life, however, these differences are blunted, and plasma glucose remains within the target range for optimal metabolic control. PMID:9827853

Lafrance, L; Rabasa-Lhoret, R; Poisson, D; Ducros, F; Chiasson, J L

1998-11-01

296

Duodenal ulcer and refined carbohydrate intake: a case-control study assessing dietary fibre and refined sugar intake.  

OpenAIRE

An association between duodenal ulceration and a low fibre intake and a high refined carbohydrate diet has been reported. We therefore compared the current diet, smoking habits, social class, and possible other risk factors of 78 patients with duodenal ulcer and a community control group matched for age and sex. Logistic regression for matched sets was used to calculate the relative risks for successive quintiles of dietary fibre and sugar intake before and after adjustment for total calorie ...

Katschinski, B. D.; Logan, R. F.; Edmond, M.; Langman, M. J.

1990-01-01

297

Peptides and Food Intake  

Directory of Open Access Journals (Sweden)

Full Text Available Nutrients created by the digestion of food are proposed to active G protein coupled receptors on the luminal side of enteroendocrine cells e.g. the L-cell. This stimulates the release of gut hormones. Hormones released from the gut and adipose tissue play an important rol in the regulation of food intake and energy expenditure (1.Many circulating signals, including gut hormones, can influence the activity of the arcuate nucleus (ARC neurons directly, after passing across the median eminence. The ARC is adjacent to the median eminence, a circumventricular organ with fenestrated capillaries and hence an incomplete blood-brain barrier (2. The ARC of the hypothalamus is believed to play a crucial role in the regulation of food intake and energy homeostasis. The ARC contains two populations of neurons with opposing effect on food intake (3. Medially located orexigenic neurons (i.e those stimulating appetite express neuropeptide Y (NPY and agouti-related protein (AgRP (4-5. Anorexigenic neurons (i.e. those inhibiting appetite in the lateral ARC express alpha-melanocyte stimulating hormone (?-MSH derived from pro-opiomelanocortin (POMC and cocaine and amphetamine-regulated transcript (CART (6. The balance between activities of these neuronal circuits is critical to body weight regulation.In contrast, other peripheral signals influence the hypothalamus indirectly via afferent neuronal pathway and brainstem circuits. In this context gastrointestinal’s vagal afferents are activated by mechanoreceptors and chemoreceptors, and converge in the nucleus of the tractus solitaries (NTS of the brainstem. Neuronal projections from the NTS, in turn, carry signals to the hypotalamus (1, 7. Gut hormones also alter the activity of the ascending vagal pathway from the gut to the brainstem. In the cases of ghrelin and Peptide tyrosine tyrosine (PYY, there are evidences for both to have a direct action on the arcuate nucleus and an action via the vagus nerve a

EduardoArilla

2014-04-01

298

The prognosis of dysphagia patients over 100 years old.  

Science.gov (United States)

Several reports have recently been published regarding dysphagia in very elderly patients, and centenarian dysphagia patients have become more common in Japan. The aim of this study was to assess the prognosis of dysphagia in very elderly patients. Participants were 24 centenarian dysphagia patients. For each patient, we collected information on age, care level, past medical history, and changes in oral intake according to the Functional Oral Intake Scale (FOIS). Patients were divided into two groups based on the mode of food intake at the time of transfer or discharge: the per oral-only group (the PO-only group, i.e., oral intake alone) and the tube feeding-dependent group (the TF-dependent group, i.e., combination of oral intake and tube feeding, or tube feeding alone). In both groups, the FOIS score decreased significantly from pre-hospitalization to the time of transfer or discharge (p=0.006 for both). The FOIS score at initial assessment was higher in the PO-only group with the TF-dependent group (p=0.0004). Furthermore, the frequency of a FOIS score of 4 at initial assessment was significantly higher in the PO-only group, and the frequency of a FOIS score of 1 was significantly higher in the TF-dependent group (p=0.0006). These findings collectively suggest that oral intake can be recovered if the FOIS score is ? 4 at initial assessment, is difficult if the score is 1, and may be possible with a FOIS score of 2. PMID:24834801

Shoji, Hirotaka; Nakane, Ayako; Omosu, Yumiko; Sawashima, Karin; Teranaka, Satoshi; Umeda, Yoshiko; Inokuchi, Nobuhiro; Takeuchi, Shuhei; Kamikawatoko, Yutaka; Minakuchi, Shunsuke

2014-01-01

299

Estradiol valerate and alcohol intake: dose-response assessments  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background An injection of estradiol valerate (EV provides estradiol for a prolonged period. Recent research indicates that a single 2.0 mg injection of EV modifies a female rat's appetite for alcoholic beverages. This research extends the initial research by assessing 8 doses of EV (from .001 to 2.0 mg/female rat, as well assessing the effects of 2.0 mg EV in females with ovariectomies. Results With the administration of EV, there was a dose-related loss of bodyweight reaching the maximum loss, when it occurred, at about 4 days after injections. Subsequently, rats returned to gaining weight regularly. Of the doses tested, only the 2.0 mg dose produced a consistent increase in intake of ethanol during the time previous research indicated that the rats would show enhanced intakes. There was, however, a dose-related trend for smaller doses to enhance intakes. Rats with ovariectomies showed a similar pattern of effects, to intact rats, with the 2 mg dose. After extensive histories of intake of alcohol, both placebo and EV-treated females had estradiol levels below the average measured in females without a history of alcohol-intake. Conclusion The data support the conclusion that pharmacological doses of estradiol can produce enduring changes that are manifest as an enhanced appetite for alcoholic beverages. The effect can occur among females without ovaries.

Aguilar-Vazquez Azucena

2007-03-01

300

Transition of historial tube flaps to free flap for 2-stage total knee arthroplasty in a patient with a history of Gustilo grade IIIB tibia fracture.  

Science.gov (United States)

We report the case of a 56-year-old patient who had posttraumatic bilateral knee arthritis and underwent sequential bilateral total knee arthroplasty (TKA). The left knee joint required 2-stage reconstruction: a free flap for enhanced soft-tissue coverage and then left knee TKA. Uniquely, at age 16 years this patient sustained a left tibia grade IIIB high-energy crush injury in a car crash and underwent reconstruction with multiple pedicle tube flaps and transfer of soft tissues. Most of that reconstruction was done between the ages of 16 and 19. At age 56 years, staged TKA was performed. To our knowledge, this is the first report of a knee reconstructed with pedicle tube flaps for a grade IIIB tibial fracture, followed years later by free-flap coverage before TKA. This report offers insights and treatment recommendations through long-term follow-up of a unique case and a historical perspective on how reconstructive options have evolved. PMID:24945485

Spence, Sean A; Doren, Erin L; Dayicioglu, Deniz; Bernasek, Thomas

2014-06-01

301

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

302

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

303

Antioxidant vitamin intake and mortality: the Leisure World Cohort Study.  

Science.gov (United States)

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

304

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

305

Nutritional status and food intake of patients with systemic psoriasis and psoriatic arthritis associated / Estado nutricional e consumo alimentar de pacientes com psoríase dos tipos sistêmica e artropática sistêmica associada  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Languages: English, Portuguese Abstract in portuguese OBJETIVO: Identificar o estado nutricional e o consumo alimentar de indivíduos com psoríase sistêmica e artropática associada. MÉTODOS: Pesquisa exploratória e transversal, na qual avaliaram-se 34 homens, de 19 a 60 anos, atendidos em um Centro de Psoríase, separando-os em Grupo PS (com psoríase sis [...] têmica) e Grupo PAS (com sistêmica mais artropática). A avaliação nutricional deu-se pelo emprego da antropometria; bioimpedância e plestimografia de corpo inteiro. Aspectos clínicos e nutricionais foram investigados pela anamnese clínica, nutricional e recordatório de 24 horas. Empregou-se o teste General Linear Model (p 25%) e com risco alto para complicações metabólicas segundo CC e índice de obesidade, sem diferença estatística significativa entre os grupos. O consumo alimentar médio de lipídio, calorias e proteína apresentou-se acima do recomendado, sendo 58,8% para os lípides (319,17 ± 241,02 mg de colesterol e 17,42 ± 11,4 g de ácidos graxos saturados); 29,4% para as calorias e 67,6% para as proteínas. Assim, independentemente do tipo de psoríase, encontrou-se consumo excessivo de calorias, lípides, colesterol e ácidos graxos, além de maior ocorrência de excesso de peso. CONCLUSÃO: A amostra apresentou estado nutricional comprometido, aumento do risco para doenças crônicas relacionadas à obesidade, agravamento das lesões e má qualidade de vida. Abstract in english OBJECTIVE: To identify the nutritional status and food intake of individuals 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 syste [...] mic psoriasis group and arthritic-systemic psoriasis associated group. For nutritional assessment we used anthropometry, bioelectrical impedance analysis and whole-body 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 for metabolic complications according to the waist circumference and the obesity index, however, there were no statistically significant differences between groups. The mean food intake, total fat, calories and protein were above recommended levels, being 58.8% for lipids (319.17 ± 241.02 mg of cholesterol and 17.42 ± 11.4 g saturated fatty acids); 29.4% for calories and 67.6% for proteins. Thus, regardless of the 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; Nathalia Stefani de, Melo; Maria Elisa Moschetti, Macedo; Fabiana Prata, Carneiro; Cid Yazigi, Sabbag; Antonio Hebert, Lancha Junior; Vera Silvia, Frangella.

2012-03-01

306

Prophylactic lithium treatment and cognitive performance in patients with a long history of bipolar illness: no simple answers in complex disease-treatment interplay.  

Science.gov (United States)

Cognitive impairment in patients with bipolar disorder (BD) is not restricted to symptomatic phases. It is also present in euthymia. There is evidence of differences in the brain's structure between bipolar patients and healthy individuals, as well as changes over time in patients. Lithium constitutes the gold standard in long-term prophylactic treatment. Appropriate therapy that prevents new episodes improves the disease's course and reduces the frequency of harmful outcomes. Interestingly, preclinical data suggest that lithium has a (additional) neuroprotective effect. There is limited data on its related effects in humans and even less on its long-term application. In this multi-center cross-sectional study from the International Group for the Study of Lithium-treated Patients (IGSLi), we compared three groups: bipolar patients without long-term lithium treatment (non-Li group; Scale-Revised (WAIS-R), the California Verbal Learning Test (CVLT), and a visual backward masking (VBM) task. A total of 142 subjects were included, 31 in the non-Li and 58 in the Li group, as well as 53 healthy controls. Treated patients with long-standing BD and controls did not differ significantly in overall cognitive functioning and verbal learning, recall, and recognition; regardless of whether lithium had been part of the treatment. Patients, however, demonstrated poorer early visual information processing than healthy controls, with the lithium-treated patients performing worse than those without. Our data suggest that bipolar patients with a long illness history and effective prophylactic treatment do not reveal significantly impaired general cognitive functioning or verbal learning and memory. However, they are worse at processing early visual information. Accompanying volumetric and spectroscopic data suggest cell loss in patients not treated with lithium that may be counterbalanced by long-term lithium treatment. PMID:25540718

Pfennig, Andrea; Alda, Martin; Young, Trevor; MacQueen, Glenda; Rybakowski, Janusz; Suwalska, Aleksandra; Simhandl, Christian; König, Barbara; Hajek, Tomas; O'Donovan, Claire; Wittekind, Dirk; von Quillfeldt, Susanne; Ploch, Jana; Sauer, Cathrin; Bauer, Michael

2014-01-01

307

Comparison of Thyroid Examination, Thyroid Scanning and Sonography in Patients with Previous History of Radiotherapy of the Head for Tinea Capitis  

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Full Text Available Introduction: In spite of large number of studies regarding relation between thyroid cancer and childhood irradiation, contraversy still exists 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% inadequate 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. Conclution: This study revealed that sonography detects 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.

M Mehrabi Bahar

2002-07-01

308

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

DEFF Research Database (Denmark)

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 loss >= 3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings.

Adegboye, Amanda Rodrigues Amorim; Christensen, L. B.

2012-01-01

309

Intake of dairy products in relation to periodontitis in older danish adults  

DEFF Research Database (Denmark)

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 loss =3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings.

Adegboye, Amanda R A; Christensen, Lisa B

2012-01-01

310

Aprendizaje de la historia clínica con pacientes simulados en el grado de Medicina / Learning to take medical histories through patients simulation in undergraduate Medical School students  

Scientific Electronic Library Online (English)

Full Text Available Objetivos. La utilización de la simulación es habitual en medicina para mejorar el conocimiento y habilidades de competencias. Se pueden utilizar pacientes virtuales, simuladores y pacientes simulados. Nosotros planteamos que alumnos de quinto y sexto curso actúen como pacientes simulados para que s [...] us compañeros de primero aprendan la anamnesis de la historia clínica. Sujetos y métodos. Un total de 207 alumnos de primer curso de grado aprendieron a realizar la historia clínica en una sala de urgencias del centro de simulación entrevistando a pacientes simulados, que eran sus compañeros de quinto y sexto curso. Se evaluaron las historias clínicas realizadas, y para conocer el grado de satisfacción de los estudiantes se pidió que cumplimentasen un cuestionario anónimo tanto a los alumnos de primer curso como a los de cursos superiores. Resultados. La valoración de la calidad de las historias clínicas fue de 8,2 sobre 10. Esta metodología ha sido muy bien valorada. A la pregunta "¿el entrenamiento con pacientes simulados ayuda al aprendizaje para la realización de la historia clínica?", los alumnos de primero puntuaron 9, y los de quinto y sexto, 9,2. Al ítem "¿trabajar con pacientes simulados mejora sus habilidades de comunicación?", ambos grupos puntuaron 8,6. Y para "¿es adecuado el aprendizaje de la historia clínica mediante pacientes simulados previo a su aprendizaje con pacientes reales?", ambos grupos puntuaron 9,3. La valoración de la experiencia como paciente simulado fue de 9,3. Conclusión. El aprendizaje de la historia clínica en primer curso del grado de Medicina mediante pacientes simulados resulta beneficioso para los alumnos. Un contacto temprano con la clínica a partir del aprendizaje basado en la simulación podría mejorar la formación de los estudiantes. Abstract in english Aims. Simulation techniques are commonly used in medical education to improve the acquisition of knowledge, abilities and competencies. Several methods have been proposed: virtual patients, high fidelity devices and standard patients. We propose the use of 5th-6th year Medical School students acting [...] as patients when teaching history taking to their 1st year colleagues. Subjects and methods. A total of 207 students from 1st year Medical School underwent training in history taking at the Simulation Center, with senior students acting as actors. The quality of the written medical records was evaluated by two medical doctors. The satisfaction of all students involved in the course was evaluated through an anonymous voluntary questionnaire. Results. The average score of the written medical histories was 8.2/10, more than satisfactory for our goals. Students' satisfaction rate was high. Mean score on questions inquiring the usefulness of patient simulation in learning how to perform a clinical history was 9/10 and 9.2/10 for first and fifth-sixth year students respectively. Questions on improvement of communication skills scored 8.6/10 and 8.6/10 respectively. The fruitfulness of training with simulated patients before practicing with real patients was 9.3/10 and 9.3/10 respectively. Finally, the assessment of the whole course with simulated patients was of 9.3/10. Conclusion. Learning history taking in first year Medical School with simulated patients acted by senior students was beneficial and user-friendly for both students and actors. An early contact with the clinical practice through simulated patients could improve performance and safety.

M. Cristina, Rodríguez-Díez; Juan J., Beunza; Cristina, López-Del Burgo; Omar, Hyder; M. Pilar, Civeira-Murillo; Nieves, Díez.

2012-03-01

311

Usual Intake of Added sugars  

Science.gov (United States)

Usual Intake of Added sugars Table A40. Added sugars: Means, percentiles and standard errors of usual intake, 2007-2010 Age (Years) N1 teaspoons3 Mean (SE)2 5% (SE) 10% (SE) 25% (SE) 50% (SE) 75% (SE) 90% (SE) 95% (SE) Males 1-3 774 9.4 (0.31) 3.1 (0.17) 4.1

312

Usual Intake of Other vegetables  

Science.gov (United States)

Usual Intake of Other vegetables Table A15. Other vegetables: 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 0.1

313

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

Science.gov (United States)

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

314

Prevalência de adenomas colorretais em pacientes com história familiar para câncer colorretal Prevalence of colorectal adenomas in patients with family history of colorectal cancer  

Directory of Open Access Journals (Sweden)

Full Text Available O câncer colorretal (CCR é uma doença comum e letal, influenciada por fatores genéticos e ambientais, e pela interação entre ambos. Seu risco está fortemente associado ao número e à idade dos parentes de primeiro grau com história de CCR. O objetivo foi estudar a prevalência de adenomas em pacientes com história familiar de câncer colorretal. Métodos: Realizou-se um estudo retrospectivo, tendo como alvo todos os pacientes submetidos à colonoscopia em um hospital de referência da cidade de Porto Alegre, entre 2003 e 2007. Resultados: Dos 2.462 pacientes estudados, 118 apresentaram história familiar para CCR e 2.344 não apresentaram. Nos dois grupos, houve predomínio do sexo feminino (P=0,001. Nos pacientes com adenomas e história familiar para CCR, houve predomínio do sexo feminino. Já nos pacientes com adenomas e sem história familiar, o sexo masculino foi mais frequente (P=0,032. O número de adenomas entre eles não foi estatisticamente significativo (P=0,187. Conclusão: O grupo com história familiar para CCR mostrou mais mulheres (P=0,001 e a idade também foi inferior (P=0,002. A comparação entre o grupo com adenomas e história familiar para CCR mostrou um número maior de mulheres que o grupo com adenomas sem história familiar para CCR (P=0,032.Colorectal cancer is a common and lethal disease, influenced by genetic and environmental factors and the interaction between both. The risk of colorectal cancer is strongly associated with the number and age of first degree relatives with colorectal cancer. Methods: A retrospective study was performed having as its objective all the patients submitted to colonoscopy in a reference hospital in the city of Porto Alegre, between 2003 and 2007. The goal is to study the prevalence of adenomas in patients with family history of colorectal cancer. Results: From the 2,462 analyzed patients, 118 had family history for colorectal cancer and 2,344 did not have. In both groups there was predominance of females (P=0.001. In the patients with adenomas and family history of colorectal cancer, there was predominance of females. In the patients with no family history of colorectal cancer there was predominance of males (P=0.032. The number of adenomas between them was not statistically significant (P=0.187. Conclusion: The group with family history of colorectal cancer has shown more women (P=0.001 and the age was also lower (P=0.002. The comparison between the group with adenomas and family history for colorectal cancer has shown a bigger number of women than the group with adenomas with no family history for colorectal cancer (P=0.032.

Bianca Zandoná

2011-06-01

315

Prevalência de adenomas colorretais em pacientes com história familiar para câncer colorretal / Prevalence of colorectal adenomas in patients with family history of colorectal cancer  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O câncer colorretal (CCR) é uma doença comum e letal, influenciada por fatores genéticos e ambientais, e pela interação entre ambos. Seu risco está fortemente associado ao número e à idade dos parentes de primeiro grau com história de CCR. O objetivo foi estudar a prevalência de adenomas em paciente [...] s com história familiar de câncer colorretal. Métodos: Realizou-se um estudo retrospectivo, tendo como alvo todos os pacientes submetidos à colonoscopia em um hospital de referência da cidade de Porto Alegre, entre 2003 e 2007. Resultados: Dos 2.462 pacientes estudados, 118 apresentaram história familiar para CCR e 2.344 não apresentaram. Nos dois grupos, houve predomínio do sexo feminino (P=0,001). Nos pacientes com adenomas e história familiar para CCR, houve predomínio do sexo feminino. Já nos pacientes com adenomas e sem história familiar, o sexo masculino foi mais frequente (P=0,032). O número de adenomas entre eles não foi estatisticamente significativo (P=0,187). Conclusão: O grupo com história familiar para CCR mostrou mais mulheres (P=0,001) e a idade também foi inferior (P=0,002). A comparação entre o grupo com adenomas e história familiar para CCR mostrou um número maior de mulheres que o grupo com adenomas sem história familiar para CCR (P=0,032). Abstract in english Colorectal cancer is a common and lethal disease, influenced by genetic and environmental factors and the interaction between both. The risk of colorectal cancer is strongly associated with the number and age of first degree relatives with colorectal cancer. Methods: A retrospective study was perfor [...] med having as its objective all the patients submitted to colonoscopy in a reference hospital in the city of Porto Alegre, between 2003 and 2007. The goal is to study the prevalence of adenomas in patients with family history of colorectal cancer. Results: From the 2,462 analyzed patients, 118 had family history for colorectal cancer and 2,344 did not have. In both groups there was predominance of females (P=0.001). In the patients with adenomas and family history of colorectal cancer, there was predominance of females. In the patients with no family history of colorectal cancer there was predominance of males (P=0.032). The number of adenomas between them was not statistically significant (P=0.187). Conclusion: The group with family history of colorectal cancer has shown more women (P=0.001) and the age was also lower (P=0.002). The comparison between the group with adenomas and family history for colorectal cancer has shown a bigger number of women than the group with adenomas with no family history for colorectal cancer (P=0.032).

Bianca, Zandoná; Luciano Pinto de, Carvalho; Julia, Schimedt; Daniela Cerqueira, Koppe; Ruy Takashi, Koshimizu; Afonso Calil Mury, Mallmann.

2011-06-01

316

Leiomyosarcoma of the breast in a patient with a 10-year-history of cyclophosphamide exposure: a case report  

OpenAIRE

A 50 year old woman with a 10-year history of systemic lupus erythematosus (SLE) and intermittent low-dose cyclophosphamide therapy developed a palpable mass at the periphery of her left breast. Ultrasound guided core biopsy revealed a spindle cell neoplasm characterized on final pathology as a low grade leiomyosarcoma.

La Pena, Jennifer; Wapnir, Irene

2008-01-01

317

Increased brain amyloid deposition in patients with a lifetime history of major depression: evidenced on {sup 18}F-florbetapir (AV-45/Amyvid) positron emission tomography  

Energy Technology Data Exchange (ETDEWEB)

The literature suggests that a history of depression is associated with an increased risk of developing Alzheimer's disease (AD). The aim of this study was to examine brain amyloid accumulation in patients with lifetime major depression using {sup 18}F-florbetapir (AV-45/Amyvid) PET imaging in comparison with that in nondepressed subjects. The study groups comprised 25 depressed patients and 11 comparison subjects who did not meet the diagnostic criteria for AD or amnestic mild cognitive impairment. Vascular risk factors, homocysteine and apolipoprotein E (ApoE) genotype were also examined. The standard uptake value ratio (SUVR) of each volume of interest was analysed using whole the cerebellum as the reference region. Patients with a lifetime history of major depression had higher {sup 18}F-florbetapir SUVRs in the precuneus (1.06 ± 0.08 vs. 1.00 ± 0.06, p = 0.045) and parietal region (1.05 ± 0.08 vs. 0.98 ± 0.07, p = 0.038) than the comparison subjects. Voxel-wise analysis revealed a significantly increased SUVR in depressed patients in the frontal, parietal, temporal and occipital areas (p < 0.01). There were no significant associations between global {sup 18}F-florbetapir SUVRs and prior depression episodes, age at onset of depression, or time since onset of first depression. Increased {sup 18}F-florbetapir binding values were found in patients with late-life major depression relative to comparison subjects in specific brain regions, despite no differences in age, sex, education, Mini Mental Status Examination score, vascular risk factor score, homocysteine and ApoE ?4 genotype between the two groups. A longitudinal follow-up study with a large sample size would be worthwhile. (orig.)

Wu, Kuan-Yi; Chen, Chia-Hsiang; Liu, Chia-Yih [Chang Gung Memorial Hospital and Chang Gung University, Department of Psychiatry, Tao-Yuan (China); Hsiao, Ing-Tsung; Hsieh, Chia-Ju [Chang Gung Memorial Hospital, Department of Nuclear Medicine and Molecular Imaging Center, Tao-Yuan (China); Chang Gung University, Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Tao-Yuan (China); Chen, Cheng-Sheng [Kaohsiung Medical University Hospital, Department of Psychiatry, Kaohsiung (China); Wai, Yau-Yau [Chang Gung Memorial Hospital, Department of Radiology, Tao-Yuan (China); Chang, Chee-Jen [Chang Gung University, Graduate Institute of Clinical Medical Science, Tao-Yuan (China); Chang Gung University, Clinical Informatics and Medical Statistics Research Center, Tao-Yuan (China); Chang Gung Memorial Hospital, Biostatistical Center for Clinical Research, Tao-Yuan (China); Tseng, Hsiao-Jung [Chang Gung Memorial Hospital, Biostatistical Center for Clinical Research, Tao-Yuan (China); Yen, Tzue-Chen; Lin, Kun-Ju [Chang Gung University, Department of Medical Imaging and Radiological Sciences and Healthy Aging Research Center, Tao-Yuan (China); Chang Gung Memorial Hospital, Department of Nuclear Medicine and Molecular Imaging Center, Tao-Yuan (China)

2014-04-15

318

Increased brain amyloid deposition in patients with a lifetime history of major depression: evidenced on 18F-florbetapir (AV-45/Amyvid) positron emission tomography  

International Nuclear Information System (INIS)

The literature suggests that a history of depression is associated with an increased risk of developing Alzheimer's disease (AD). The aim of this study was to examine brain amyloid accumulation in patients with lifetime major depression using 18F-florbetapir (AV-45/Amyvid) PET imaging in comparison with that in nondepressed subjects. The study groups comprised 25 depressed patients and 11 comparison subjects who did not meet the diagnostic criteria for AD or amnestic mild cognitive impairment. Vascular risk factors, homocysteine and apolipoprotein E (ApoE) genotype were also examined. The standard uptake value ratio (SUVR) of each volume of interest was analysed using whole the cerebellum as the reference region. Patients with a lifetime history of major depression had higher 18F-florbetapir SUVRs in the precuneus (1.06 ± 0.08 vs. 1.00 ± 0.06, p = 0.045) and parietal region (1.05 ± 0.08 vs. 0.98 ± 0.07, p = 0.038) than the comparison subjects. Voxel-wise analysis revealed a significantly increased SUVR in depressed patients in the frontal, parietal, temporal and occipital areas (p 18F-florbetapir SUVRs and prior depression episodes, age at onset of depression, or time since onset of first depression. Increased 18F-florbetapir binding values were found in patients with late-life major depression relative to comparison subjects in specific brain regions, despite no differences in age, sex, education, Mini Mental Status Examination score, vascular risk factor score, homocysteine and ApoE ?4 genotype between the two groups. A longitudinal follow-up study with a large sample size would be worthwhile. (orig.)

319

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

OpenAIRE

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

320

Smoking and sugar intake are separate but interactive risk factors in Crohn's disease.  

OpenAIRE

Previous studies have consistently found strong positive associations between refined sugar intake and Crohn's disease (CD) and recently between smoking and CD. As refined sugar intake and smoking are themselves associated we have enquired about smoking and added sugar intake (AS) and smoking in CD using a postal questionnaire sent to 104 CD patients and 153 community controls. Smoking and AS were associated with one another. After adjusting for AS, smoking showed a significant association wi...

Katschinski, B.; Logan, R. F.; Edmond, M.; Langman, M. J.

1988-01-01

321

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

322

Association of Aspirin Intake and Myocardial Infarction Size  

OpenAIRE

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 in...

Seyyed Hashem Sezavar; Behzad Farahani; Saeid Gholami; Masoud Moradi; Mina Zarei; Morsaleh Ganji; Shahnaz Miri; Neda Khalili; Scott Reza Jafarian Kerman

2012-01-01

323

Anesthetic management by laryngeal mask airway in a patient with a history of difficult intubation resulting in dental injuries.  

Science.gov (United States)

Disabled patients may face respiratory problems during general anesthesia because of head and neck anomalies. We describe a case of dental treatment under general anesthesia using a laryngeal mask airway in a disabled patient who faced difficulty in endotracheal intubation on several occasions, 5 of which resulted in dental injuries. PMID:25849470

Asahi, Yoshinao; Fujii, Ryosuke; Usui, Naoko; Kagamiuchi, Hajime; Omichi, Shiro; Kotani, Junichiro

2015-01-01

324

Histological and molecular biology diagnosis of neurocysticercosis in a patient without history of travel to endemic areas – Case report  

Science.gov (United States)

Background: in endemic areas, neurocysticercosis appears mainly as a single, large, spherical and non-enhancing intracranial cyst. Case presentation: an atypical case of neurocysticercosis (NCC) in a French Caucasian, without history of travel to endemic areas, was confirmed by histology and molecular speciation. Imaging was atypical, showing several hook-bearing scolices visible in the cyst, while the serology employed was non-contributary. Conclusions: NCC should be considered when multiple taeniid scolices are observed within the same cystic lesion. PMID:23193531

L’Ollivier, C.; González, L.M.; Gárate, T.; Martin, L.; Martha, B.; Duong, M.; Huerre, M.; Cuisenier, B.; Harrison, L.J.S.; Dalle, F.; Bonnin, A.

2012-01-01

325

Gestation in patients with high levels of anticardiolipin antibodies, a history of deep venous thrombosis and miscarriages  

OpenAIRE

The aim is to stress the importance of prophylaxis against deep venous thrombosis in gravidas with high levels of anticardiolipin antibodies with or without a history of repetitive miscarriages. The evolutions of two gravidas who were treated in pre-natal and vascular surgery outpatients’ clinics and who suffered from deep venous thrombosis, miscarriages and high anticardiolipin antibody levels are reported. The gestations terminated at full term after prophylaxis for miscarriages was appli...

José Maria Pereira de Godoy; Ligia Cosentino Junqueira Franco Spegiorin; Juliana Dallaqua; Cecília Freire de Carvalho de Carvalho; Iara Lima Costa

2006-01-01

326

Performance of adenosine "stress-only" perfusion MRI in patients without a history of myocardial infarction: a clinical outcome study.  

Science.gov (United States)

To assess the diagnostic value of adenosine "stress-only" myocardial perfusion MR for ischemia detection as an indicator for coronary angiography in patients without a prior myocardial infarction and a necessity to exclude ischemia. Adenosine perfusion MRI was performed at 1.5 T in 139 patients with a suspicion of ischemia and no prior myocardial infarction. After 3 min of adenosine infusion a perfusion sequence was started. Patients with a perfusion defect were referred to coronary angiography (CAG). Patients with a normal perfusion were enrolled in follow-up. Fourteen out of 139 patients (10.1%) had a perfusion defect indicative of ischemia. These patients underwent a coronary angiogram, which showed complete agreement with the perfusion images. 125 patients with a normal myocardial perfusion entered follow-up (median 672 days, range 333-1287 days). In the first year of follow-up one Major Adverse Coronary Event (MACE) occurred and one patient had new onset chest pain with a confirmed coronary stenosis. Reaching a negative predictive value for MACE of 99.2% and for any coronary event of 98.4%. At 2 year follow-up no additional MACE occurred. Sensitivity of adenosine perfusion MR for MACE is 93.3% and specificity and positive predictive value are 100%. Adenosine myocardial perfusion MR for the detection of myocardial ischemia in a "stress-only" protocol in patients without prior myocardial infarctions, has a high diagnostic accuracy. This fast examination can play an important role in the evaluation of patients without prior myocardial infarctions and a necessity to exclude ischemia. PMID:21279694

Lubbers, Daniel D; Rijlaarsdam-Hermsen, Dorine; Kuijpers, Dirkjan; Kerkhof, Marjan; Sijens, Paul E; van Dijkman, Paul R M; Oudkerk, Matthijs

2012-01-01

327

Use of bivalirudin to prevent thrombosis following orthotopic liver transplantation in a patient with Budd-Chiari syndrome and a history of heparin-induced thrombocytopenia.  

Science.gov (United States)

Type II heparin-induced thrombocytopenia (HIT) is an immune-mediated syndrome that may arise in a time-dependent manner following heparin therapy, placing patients at significant risk for thromboembolic events. Therapy includes anticoagulation with a direct thrombin inhibitor and avoidance of heparin. We report a patient with Budd-Chiari syndrome and a history of heparin-induced thrombocytopenia who presented for orthotopic liver transplant and required postoperative anticoagulation with bivalirudin. During the post-transplant graft function improvement, we observed a significant dose-effect alteration manifested by an increased bivalirudin dose requirement as factor V activity increased. This observation is an important consideration in the attempt to maintain an optimal balance between effective anticoagulation and a reduced risk of postoperative bleeding. PMID:18715858

Anderegg, Brent A; Baillie, G Mark; Uber, Walter E; Chavin, Kenneth D; Lin, Angello; Baliga, Prabhakar K; Lazarchick, John

2008-01-01

328

Nutrition Therapy for Liver Diseases Based on the Status of Nutritional Intake  

OpenAIRE

The dietary intake of patients with nonalcoholic fatty liver disease (NAFLD) is generally characterized by high levels of carbohydrate, fat, and/or cholesterol, and these dietary patterns influence hepatic lipid metabolism in the patients. Therefore, careful investigation of dietary habits could lead to better nutrition therapy in NAFLD patients. The main treatment for chronic hepatitis C (CHC) is interferon-based antiviral therapy, which often causes a decrease in appetite and energy intake;...

Yasutake, Kenichiro; Kohjima, Motoyuki; Nakashima, Manabu; Kotoh, Kazuhiro; Nakamuta, Makoto; Enjoji, Munechika

2012-01-01

329

Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review  

OpenAIRE

Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting epidemiological data. Methodology and Principal Findings To estimate the duration and case fatality of untreated pulmonary tuberculosis in HIV negative patients we reviewed studies from the p...

Tiemersma, E. W.; Werf, M. J.; Borgdorff, M. W.; Williams, B. G.; Nagelkerke, N. J. D.

2011-01-01

330

Natural History of Skeletal Muscle Mass Changes in Chronic Kidney Disease Stage 4 and 5 Patients: An Observational Study  

OpenAIRE

Cross-sectional studies in dialysis demonstrate muscle wasting associated with loss of function, increased morbidity and mortality. The relative drivers are poorly understood. There is a paucity of data regarding interval change in muscle in pre-dialysis and dialysis-dependant patients. This study aimed to examine muscle and fat mass change and elucidate associations with muscle wasting in advanced CKD. 134 patients were studied (60 HD, 28 PD, 46 CKD 4–5) and followed up for two years. ...

John, Stephen G.; Sigrist, Mhairi K.; Taal, Maarten W.; Mcintyre, Christopher W.

2013-01-01

331

Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events  

Energy Technology Data Exchange (ETDEWEB)

To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE). Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL). Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without. The prevalence of asymptomatic brain lesions in SLE patients is high, and shows a relationship to disease activity. (author)

Nomura, Kumiko; Yamano, Shigeru; Ikeda, Yukiko [Nara Medical Univ., Kashihara (Japan)] (and others)

1999-10-01

332

Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events  

International Nuclear Information System (INIS)

To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE). Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL). Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without. The prevalence of asymptomatic brain lesions in SLE patients is high, and shows a relationship to disease activity. (author)

333

Radioactive iodine intake through foodstuff  

International Nuclear Information System (INIS)

The transition of radioactive iodine to human bodies is affected by the amount of coexisting stable iodine. The intake of stable iodine through foodstuffs was studied from the stand point of I) discussion of the literature which states the approximate amounts of stable iodine contained in environmental materials, and II) the authors' research on the consumption of foodstuffs. For example, the amounts of iodine intake of fishermen living in Kuji-cho (Ibaragi Prefecture) was estimated from I and II, and was revealed as 2704p. The national average iodine intake was about 800p indicating that the former estimated value was remarkably high. Eighty Four per cent of the 2.7 mg iodine intake was taken from marine products, indicating that marine products are important sources of iodine supply. (Tsukamoto, Y.)

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  

Directory of Open Access Journals (Sweden)

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

J. Abilés

2005-04-01

335

Dietary Salt Intake and Hypertension  

OpenAIRE

Over the past century, salt has been the subject of intense scientific research related to blood pressure elevation and cardiovascular mortalities. Moderate reduction of dietary salt intake is generally an effective measure to reduce blood pressure. However, recently some in the academic society and lay media dispute the benefits of salt restriction, pointing to inconsistent outcomes noted in some observational studies. A reduction in dietary salt from the current intake of 9-12 g/day to the ...

Ha, Sung Kyu

2014-01-01

336

Design of seawater intake facilities  

International Nuclear Information System (INIS)

Seawater intake facilities are installed in thermal and nuclear power plants, chemical plants and others, and these consist of intakes, channels, screens, pumps, service pipings, outlets and so on. In this paper, taking the seawater intake facilities for thermal and nuclear power plants as an example, the fundamentals related to their design are described. The layout of intake facilities is determined by examining the various conditions of location, such as the form and peripheral conditions of the site and the condition of sea area. The selection of the position and the type of intakes must be carried out, considering water temperature, waves, littoral drift, suspended matter, marine organism and others. In the planning of channels, slope, the deposition of earth, the adhesion of marine organism, the variation of water level and others must be examined. The clogging and the difference of water level at screens, the requirement for pump rooms and circulating pumps, high flow velocity in seawater pipes and valves, the type of outlets and the corrosion prevention of intake facilities are discussed. (Kako, I.)

337

027. Interesting case: obese patient with chronic dyspnoea, elevation of left diaphragm and history of orthopeadic surgery on the left shoulder  

Science.gov (United States)

Objective We present an unusual cause of diaphragm elevation related to prior anesthetic procedure. Case presentation Patient 50 years old, obese, ex-smoker (40 p/y) with history of chronic obstructive pulmonary disease (COPD), hypertension and dyslipidemia was admitted to the Euroclinic complaining of dyspnoea mainly on exertion. Few years before the admission, the patient underwent a surgical treatment of left shoulder assisted by regional anesthetic procedure (interscalene brachial plexus block). Clinical and laboratory findings SpO2: 94%. After exertion: 97%. Auscultation: no breathing sounds at the left lower lobe. Chest X-ray (CXR) and Chest CT-scan: Left diaphragm elevation. Abdomen CT scan: normal. Radioscopy: delayed movement of the left diaphragm compared to the right. Normal contraction at sniff test: spirometry: mixed type (mixed pattern) with good response to bronchodilation of obstructive component. Plethysmography: TLC at lower normal limits. RV and RV/TLC increased. Nocturnal oxymetry: average SpO2: 92%, desaturation index: 4.6/h. Neurologic evaluation: normal. The patient was treated with bronchodilators. We suggested weight control, magnetic resonance imaging (MRI) of spinal cervical tract and pulmonary and neurological following. Discussion Several studies focus on respiratory complications due to regional anesthetic procedures especially on brachial plexus. The complication rate increases in case of obese and “short neck” patients. The phrenic nerve blockade is usually temporary but some patients might suffer from permanent phrenic disfunction and concomitant shortness of breath. Special attention is needed in case of COPD, obesity or sleep apnoea syndrome. The procedure is contraindicated in severe chronic respiratory obstructive or restrictive disease. Moreover, newest surgical and anesthetic procedures (such as robotic surgery of the abdomen), have an increased pulmonary adverse events in above mentioned population. Conclusions Pulmonary complications in anesthesiology and surgery are increasingly present even in modern regional procedures. The need for pulmonary consultation is of great importance in the preoperative evaluation of the patient.

Chrysocherakis, Grigoris; Papagoras, Christos; Papanikolaou, Nikolaos; Zachariades, Emmanouil

2015-01-01

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 >2800ng/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, MD; Pereira Ferrari, L

2008-01-01

339

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

340

Incidence of psychoses among drug dependent patients in primary care with no psychiatric history: a retrospective observational matched-cohort study  

Scientific Electronic Library Online (English)

Full Text Available Background and Objectives: While several studies have indicated a link between illicit drug use and the development of psychosis, the confounding role of pre-existing psychiatric illness is unclear. This study controls for this factor to a greater extent than has hitherto been possible, using a retr [...] ospective observational matched-cohort design controlling for age, gender, socioeconomic status and prior psychiatric illness. Methods: 592 cases (diagnosed with drug misuse/dependence) and 592 controls (no recorded history of drug misuse/dependence) were drawn from all patients aged 16-44 in 183 practices within the General Practice Research Database (UK). On study entry, cases and controls had never had a psychiatric diagnosis since registering with their practice. The average look-back period was 17.7 years. The main outcome measure was diagnosis of psychosis (including schizophrenia) from study entry onwards. Results: Patients with a drug misuse/dependence diagnosis are significantly more likely to be diagnosed with psychosis than those with no drug misuse/dependence history (RR = 2.10, 95% C.I. = 1.23-3.59) with the relative risk increasing as the definition of psychosis gets narrower. Conclusions: This study has established that, when the confounding presence of previous psychiatric illness is removed, the onset of problematic substance misuse severe enough to warrant primary care consultation is a risk factor for future onset of first-ever psychotic illness. Thus, there is a distinct sub-group of psychotic patients among whom drug misuse/dependence, with no prior psychiatric illness, is a risk factor for the development of psychoses.

Martin, Frisher; Orsolina I., Martino; James, Bashford; Ilana, Crome; Peter, Croft.

2013-12-01

341

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 included in the study. The presentations and outcomes of these patients were analyzed. SPSS 15.0 was used for the analysis. The Chi-square test was used for the statistical analysis. The statistical difference p0.05.Conclusion: There is no significant correlation between the INR levels and the severity of the bleeding (p>0.05. (Marmara Medical Journal 2012;25:138-42

Serkan Emre ERO?LU

2012-01-01

342

Lumbar artery pseudoaneurysm in a patient with inferior vena cava filter and history of strenuous physical exercise.  

Science.gov (United States)

Lumbar artery pseudoaneurysms (LAPs) are a rare complication of inferior vena cava (IVC) filters. The few reports in the literature describe treatment of patients presenting with ruptured LAPs. This case report describes the successful management of a symptomatic LAP because of an IVC filter, which initially presented as a retroperitoneal hematoma resulting from lumbar artery laceration by a filter strut. We hypothesize that the strenuous abdominal exercises performed by the patient may have facilitated IVC penetration by the filter, leading to development of a retroperitoneal hematoma and subsequent LAP. This case suggests that patients with IVC filters should avoid strenuous exercise and underscores the importance of timely retrieval of nonpermanent IVC filters. PMID:24246536

Tsekouras, Nikolaos; Whalen, Ralph C; Comerota, Anthony J

2015-03-01

343

Computer History  

Science.gov (United States)

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 ...

Mr. Cannon

2005-12-10

344

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

OpenAIRE

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 t...

Schaapveld Michael; Jansen Liesbeth; Lu Wenli; Baas Peter C; Wiggers Theo; de Bock Geertruida H

2011-01-01

345

Dietary sodium intake and the risk of airway hyperreactivity in a random adult population.  

OpenAIRE

BACKGROUND: High dietary sodium intake has been identified as a potential cause of asthma and airway hyperreactivity. This study was designed to test the hypothesis that dietary sodium intake is an independent determinant of the risk of hyperreactivity in the general population, and to assess the role of atopy in the association between these factors. METHODS: Airway reactivity to methacholine, atopy, 24 hour urinary sodium excretion, and self-reported smoking and symptom history were measure...

Britton, J.; Pavord, I.; Richards, K.; Knox, A.; Wisniewski, A.; Weiss, S.; Tattersfield, A.

1994-01-01

346

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

OpenAIRE

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.

2010-01-01

347

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

OpenAIRE

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 questionnaire. Outcome data was c...

Tanaka Keiko; Miyake Yoshihiro; Sasaki Satoshi; Hirota Yoshio

2012-01-01

348

Interrelationship of micro- and coronary circulatory disturbances in patients with a history of myocardial infarction (clinicoangiological examination)  

International Nuclear Information System (INIS)

The interrelationship between bulbar conjunctival microcirculation and coronary blood flow was studied with the help of selective coronarography using X-ray diagnostic complex in patients who had sustained myocardial infarction. It was shown that the trends in abnormal changes occurring in the cardiac vessels and their severity might be judged from microcirculatory alterations in the bulbar conjunctiva

349

Gastric carcinoid tumor in a patient with a past history of gastrointestinal stromal tumor of the stomach  

Directory of Open Access Journals (Sweden)

Full Text Available Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract. It may coexist with other type of cancers, and if so, the tumors usually involve the stomach. The most common associated cancers are gastrointestinal carcinomas. We report a 65-year-old woman with a history of gastric gastrointestinal stromal tumor who had undergone subtotal segmental gastrectomy. New polypoid lesions were detected on a follow-up gastroscopy one year later. The lesions were biopsied and found to be carcinoid tumors. There was serum hypergastrinemia, and type 1 gastric carcinoid tumor was diagnosed. A total gastrectomy was performed. Pathologic examination revealed both carcinoid tumors and a recurrent gastrointestinal stromal tumor.

Chien-Yuan Hung, Ming-Jen Chen, Shou-Chuan Shih, Tsang-Pai Liu, Yu-Jan Chan, Tsang-En Wang, Wen-Hsiung Chang

2008-11-01

350

Radioprotective Effect of Moderate Wine Consumption in Patients With Breast Carcinoma  

International Nuclear Information System (INIS)

Purpose: Given the high cost and side effects of radioprotective agents such as amifostine, attention has been focused on potentially equally effective but less expensive and toxic natural substances. We evaluated the potential radioprotective effects of wine in preventing skin toxicity in patients with breast cancer. Methods and Materials: Before treatment, the medical history and habits of patients were assessed and the information recorded in their clinical folders. Patients were divided into three groups based on the dose/fractionation scheme used: control group, 60.4 Gy (standard technique); Modulated Accelerated Radiotherapy in Adjuvant treatment of breast cancer (MARA)-1 protocol group, 44 Gy (concomitant boost to tumoral bed); and MARA-2 protocol group, 60 Gy (concomitant boost to tumoral bed). The impact of the following variables on acute skin toxicity was evaluated by chart review: radiotherapy protocol, planning target volume (PTV), comorbidity (e.g., hypertension and diabetes), hemoglobin level before therapy, adjuvant hormone therapy, adjuvant chemotherapy, cigarette smoking, and drinking habits. Results: The study population consisted of 348 patients. More severe skin toxicity was significantly associated with the radiotherapy protocol (p < 0.001) and median PTV (p = 0.005). In addition, the incidence of acute toxicity of Grade 2 or greater was higher in patients without alcohol intake (38.4% vs. 22.3%, p = 0.021). The daily amount of alcohol intake als1). The daily amount of alcohol intake also influenced the incidence of skin toxicity, with an incidence of 38.4% in patients with no wine intake, 31.8% in patients drinking half a glass per day, 13.6% in patients drinking one glass per day, and 35.0% in patients drinking two glasses per day. Multivariate analysis showed that wine intake, PTV, and radiotherapy protocol were all significantly correlated with acute toxicity. Conclusions: Our results indicate that wine may have a radioprotective effect; however, prospective studies are needed to confirm this beneficial effect of wine and its components.

351

Prognostic value of myocardial perfusion SPECT imaging in elderly patients without history of coronary artery disease and low prevalence of them  

International Nuclear Information System (INIS)

Elderly patients without history of coronary artery disease are difficult to characterized because the clinical symptoms are often atypical, occult or absent. On the other hand, these patients frequently cannot achieve adequate level of exercise during stress testing and this limitation can compromise the diagnostic and prognostic ability of the test. Generally the prognostic value of myocardial perfusion SPECT is well established for a general population but not for elderly patients. Aim: This study assessed the prognostic value of Tc99m-sestamibi SPECT in a group of patients older than 65 years with low prevalence of coronary artery disease. Material and Methods: Population: 161 consecutive patients older than 65 years without history of coronary artery disease and low prevalence of them were studied with Tc99m-sestamibi SPECT perfusion imaging. Mean age 71 years old (65-87), male 55%, mean pretest likelihood 11%. Risk factors: diabetes 17%, high blood pressure 74%, high cholesterol 45%, smokers 88%. Stress test: bicycle exercise 39% and dipyridamole 61%. Myocardial perfusion SPECT: semiquantitative analysis to evaluate perfusion defects with a 14-segments model and 4-point scoring system for uptake reduction. Scintigraphic indices: SSS (sum of the stress scores), SRS (sum of the rest scores) and SDS (SSS-SRS). Follow up: cardiac events: hard (acute myocardial infarction and cardiac death) and soft (need for PTCA/CABG and angina). Results: Mean follow up: 508 days. gina). Results: Mean follow up: 508 days. Events rate: hard 0.6% (1 acute myocardial infarction), soft 5.6%. Univariate analysis identified sex (p=0.017) and SDS (p=0.009) as cardiac events predictors. Complete or reduced (independent variables which predicted events) logistic regression analysis correctly predicted the absence of events but did not predict the presence of events. Conclusion: In this elderly population with a low clinical risk where the stress test is a suboptimal method of study for coronary artery disease, semiquantitative myocardial perfusion SPECT imaging is a useful tool for prognostic evaluation

352

Differences in the natural history of idiopathic (nonalcoholic) and alcoholic chronic pancreatitis. A comparative long-term study of 287 patients.  

Science.gov (United States)

Controversies in the literature regarding definition, diagnosis, and therapy of chronic pancreatitis may be related in part to differences in the natural history of alcoholic and idiopathic (nonalcoholic) chronic pancreatitis. In order to evaluate this problem the long-term course of 205 patients with alcoholic (85.4% with calcifications) (group A) and 82 patients with idiopathic (nonalcoholic) chronic pancreatitis (76.8% with calcifications) (group B) has been analyzed prospectively since 1963. The patients were studied at regular intervals with particular regard to pain, pancreatic exocrine, and endocrine function and calcifications. The observation time was 2 years or longer in 230 patients with a median observation time of 6.7 years from diagnosis in group A and 10.6 years in group B. In group B over 50% of the cases had primary painless chronic pancreatitis. Progressive deterioration of exocrine and endocrine function was observed in both groups. However, in group A the rate of progression of exocrine dysfunction after diagnosis was more rapid and the incidence of diabetes in relation to marked exocrine insufficiency was much higher than in group B. Steatorrhea preceded diabetes in 56% (group A) and 80% (group B), respectively. Onset of pancreatic calcifications was closely associated with pancreatic exocrine insufficiency in group A in contrast to group B. In addition lasting pain relief occurred spontaneously in about 30% of patients in group B despite a normal exocrine function for 6 years or longer which is in disaccord with the results in alcoholic chronic pancreatitis. In conclusion group A and B have many features in common, in particular the high incidence of pancreatic calcifications and the progressive pancreatic dysfunction. However, the long-term profile of both groups differs in some important aspects, particularly in the clinical pattern and in the rate of progression of pancreatic dysfunction and morphology. These differences should be appreciated in the discussion of problems regarding definition, diagnosis, and surgical therapy of chronic pancreatitis. PMID:3628234

Ammann, R W; Buehler, H; Muench, R; Freiburghaus, A W; Siegenthaler, W

1987-01-01

353

Association of epidermal growth factor receptor and K-Ras mutations with smoking history in non-small cell lung cancer patients.  

Science.gov (United States)

Lung cancer, a major health problem affecting the epithelial lining of the lower respiratory tract, is considered to be one of the deadliest types of cancer in males and females and it is well-known that smoking is the chief cause of lung cancer. In addition to smoking and environmental factors, genetic susceptibility may also contribute to the development of lung cancer. Previous studies have shown that certain non-small cell lung cancer (NSCLC) patients harbor gain-of-function mutations in the epidermal growth factor receptor gene (EGFR). Phosphorylated EGFR triggers the activation of intracellular signal transduction pathways, including the RAS-MAPK, PI3K-Akt and STAT pathways. However, K-Ras gene point mutations in codons 12, 13 or 61 cause the inactivation of GTPase activity which results in overstimulation of cellular growth and gives rise to neoplastic development. Our aim was to investigate the presence and association of EGFR and K-Ras mutations in 50 primary NSCLC patients with a smoking history by using real-time PCR and sequencing. EGFR mutations were detected in four patients (8%). Two of these mutations were L858R mutations and the remaining two were deletion mutations spanning between codons 746 and 750. The L858R mutation was significantly associated with smoking status (P=0.003). K-Ras codon 12 and 61 mutations were also observed in four patients. However, no association was observed between K-Ras mutations and the tumor staging, gender, histology and smoking status of the patients. PMID:23403410

Baykara, Onur; Tansarikaya, Merve; Demirkaya, Ahmet; Kaynak, Kamil; Tanju, Serhan; Toker, Alper; Buyru, Nur

2013-02-01

354

Case report of right hamate hook fracture in a patient with previous fracture history of left hamate hook: is it hamate bipartite?  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Hamate hook fracture is a common fracture in golfers and others who play sports that involve rackets or sticks such as tennis or hockey. This patient had a previous hamate fracture in the opposing wrist along with potential features of hamate bipartite. Case presentation A 19 year old male presented with a complaint of right wrist pain on the ulnar side of the wrist with no apparent mechanism of injury. The pain came on gradually one week before being seen in the office and he reported no prior care for the complaint. His history includes traumatic left hamate hook fracture with surgical excision. Conclusion The patient was found to have marked tenderness over the hamate and with a prior fracture to the other wrist, computed tomography of the wrist was ordered revealing a fracture to the hamate hook in the right wrist. He was referred for surgical evaluation and the hook of the hamate was excised. Post-surgically, the patient was able to return to normal activity within eight weeks. This case is indicative of fracture rather than hamate bipartite. This fracture should be considered in a case of ulnar sided wrist pain where marked tenderness is noted over the hamate, especially after participation in club or racket sports.

Norton Sandra

2006-10-01

355

History of chronic comorbidity and risk of chemotherapy-induced febrile neutropenia in patients with non-Hodgkin lymphoma not receiving granulocyte colony-stimulating factor prophylaxis.  

Science.gov (United States)

We conducted a cohort study to examine the association between a wide variety of chronic comorbidities and risk of febrile neutropenia (FN) in patients with non-Hodgkin lymphoma (NHL) from 2000 to 2009 treated with chemotherapy at Kaiser Permanente Southern California. History of comorbidities and FN events were identified using electronic medical records. Cox model adjusting for propensity score was used to determine the association between a comorbid condition and FN. Models that additionally adjusted for cancer stage, baseline absolute neutrophil count, chemotherapy regimen and dose reduction were also evaluated. A total of 2480 patients with NHL were included, and 60% received CHOP/R-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone, with or without rituximab). In total, 236 (9.5%) patients developed FN in the first chemotherapy cycle. Anemia (adjusted hazard ratio [HR] = 1.6, 95% confidence interval [1.2-2.2]), HIV infection (HR = 3.8 [2.0-6.7]) and rheumatoid diseases (HR = 2.4 [1.3-4.0]) were associated with significantly increased risk of FN. These results provide evidence that chronic comorbidity increases the risk of FN. PMID:24684228

Chao, Chun; Rodriguez, Roberto; Page, John H; Yang, Su-Jau; Huynh, Julie; Chia, Victoria M

2015-01-01

356

BRCA1/2 mutation screening and LOH analysis of lung adenocarcinoma tissue in a multiple-cancer patient with a strong family history of breast cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Germline mutations in BRCA1/2 greatly elevate risks of breast and ovarian cancers, but the role of these genes in tumourigenesis of other cancer types is still being investigated. Objective We report on an investigation of BRCA1/2 mutations and their loss of heterozygosity (LOH in a patient with a strong family history of breast cancer who was diagnosed with consecutive primary cervical, ovarian and lung carcinomas. Methods and results BRCA1/2 mutation screening of the proband revealed a common familial breast- and ovarian cancer-associated germline BRCA2 mutation (3034del4bp. We then performed LOH analysis for BRCA2 in lung adenocarcinoma tissue of the patient. Using the laser-capture microdissection (LCM technique, we obtained pure populations of neoplastic cells from which DNA could be extracted. Mutation analysis by denaturing high-performance liquid chromatography (DHPLC and direct sequencing revealed loss of the mutant allele in the adenocarcinoma tumour tissue. Conclusion To our knowledge, this is the first report of investigation for LOH for BRCA2 in primary lung adenocarcinoma tissue of a patient with multiple primary tumours related to a familial germline BRCA2 mutation. Interestingly, it was the mutant, not the wild-type, allele which was lost in the lung adenocarcinoma tissue.

Boettger Melanie

2003-10-01

357

Evaluation of Nutrient Intake in Early Post Kidney Transplant Recipients  

OpenAIRE

The purpose of our study was to evaluate the dietary intake of kidney transplant recipients (KTRs) and assess oral intake related nutrition problems. Fifty patients who had undergone kidney transplantation were included: 24 males, 26 females. The mean age was 46.8 ± 11.2 years, height was 161.3 ± 8.3 cm, and body weight was 60.5 ± 8.7 kg. We conducted nutrition education based on the diet guideline for KTRs (energy 32 kcal/kg of ideal body weight [IBW], protein 1.3 g/kg of IBW) and neutrop...

Rho, Mi Ra; Lim, Jeong Hyun; Park, Jung Hwa; Han, Seung Seok; Kim, Yon Su; Lee, Young Hee; Kim, Won Gyoung

2013-01-01

358

A Patient-Centered Decision-Support Tool Informed by History of Interpersonal Violence: "Will This Treatment Work for Me?"  

Science.gov (United States)

The Probability of Treatment Benefit (PTB) chart is a decision-support tool that quantifies, in absolute terms, the probability that an individual patient will benefit from a psychological treatment based on the individual's pre-treatment characteristics. The demand for such a tool has increased with the growing emphasis on personalized medicine and the need for selecting a treatment from an expanding list of evidence-based models. This method has the potential to provide clinicians and mental health consumers with a practical and interpretable means of comparing treatment options for individuals whose benefit from a particular treatment may differ substantially. We provide a practice update and demonstrate how to develop a PTB chart using data from a randomized controlled trial examining the efficacy of two approaches for treating posttraumatic stress disorder based on patients' pre-treatment exposure to multiple types of interpersonal violence. Step-by-step instructions for applying the PTB method are provided. PMID:25381284

Grasso, Damion J; Ford, Julian D; Lindhiem, Oliver

2014-11-01

359

Adult-Onset Presentation of a Hyperornithinemia-Hyperammonemia-Homocitrullinuria Patient Without Prior History of Neurological Complications  

OpenAIRE

The Hyperornithinemia-Hyperammonemia-Homocitrullinuria (HHH) syndrome is a disorder of the urea cycle and ornithine degradation pathway caused by mutations in the mitochondrial ornithine transporter, ORNT1 (SLC25A15). In general, the majority of patients with HHH syndrome come to medical attention during infancy or early school years with symptoms such as learning disabilities, changes in cognitive development, spasticity, or liver dysfunction. In this report, we describe a 35-year-old male o...

Tezcan, Kamer; Louie, Kristal T.; Qu, Yong; Velasquez, Jorge; Zaldivar, Frank; Rioseco-camacho, Natalia; Camacho, Jose? Angel

2011-01-01

360

Cost-effectiveness of pioglitazone in type 2 diabetes patients with a history of macrovascular disease: a German perspective  

OpenAIRE

Abstract Background The aim of this study was to project health-economic outcomes relevant to the German setting for the addition of pioglitazone to existing treatment regimens in patients with type 2 diabetes, evidence of macrovascular disease and at high risk of cardiovascular events. Methods Event rates corresponding to macrovascular outcomes from the Prospective Pioglitazone Clinical Trial in Macrovascular Events (PROactive) study of pioglitazone were used with a modified version of the C...

Massi-Benedetti Massimo; Erny-Albrecht Katrina M; Goodall Gordon; Scherbaum Werner A; Erdmann Erland; Valentine William J

2009-01-01

361

Plasma B vitamins and LINE-1 DNA methylation in leukocytes of patients with a history of colorectal adenomas  

OpenAIRE

Scope Low concentrations of folate, other B vitamins, and methionine are associated with colorectal cancer risk, possibly by changing DNA methylation patterns. Here, we examine whether plasma concentrations of B vitamins and methionine are associated with methylation of long interspersed nuclear element-1 (LINE-1) among those at high risk of colorectal cancer, i.e. patients with at least one histologically confirmed colorectal adenoma (CRA) in their life. Methods and results We used LINE-1 b...

Jung, A. Y.; Botma, A.; Lute, C.; Blom, H. J.; Ueland, P. M.; Kvalheim, G.; Midttun, O.; Nagengast, F.; Steegenga, W. T.; Kampman, E.

2012-01-01