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1

Numeracy and dietary intake in patients with type 2 diabetes.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study is to describe the association between numeracy and self-reported dietary intake in patients with type 2 diabetes. METHODS: Numeracy and dietary intake were assessed with the validated Diabetes Numeracy Test and a validated food frequency questionnaire in a cross-sectional study of 150 primary care patients enrolled in a randomized clinical trial at an academic medical center between April 2008 and October 2009. Associations between numeracy and caloric and macronutrient intakes were examined with linear regression models. RESULTS: Patients with lower numeracy consumed a higher percentage of calories from carbohydrates and lower percentages from protein and fat. However, no differences in energy consumption or the percentage of energy intake owing to carbohydrates, fat, or protein were observed in adjusted analyses. Patients with lower numeracy were significantly more likely to report extremely high or low energy intake inconsistent with standard dietary intake. CONCLUSIONS: Numeracy was not associated with dietary intake in adjusted analyses. Low numeracy was associated with inaccurate dietary reporting. Providers who take dietary histories in patients with diabetes may need to consider numeracy in their assessment of dietary intake.

Bowen ME; Cavanaugh KL; Wolff K; Davis D; Gregory B; Rothman RL

2013-03-01

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

Energy Technology Data Exchange (ETDEWEB)

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.

Kiyosawa, K.; Imai, H.; Sodeyama, T.; Franca, S.T.; Yousuf, M.; Furuta, S.; Fujisawa, K.; Kido, C. (Shinshu Univ. School of Medicine, Matsumoto (Japan))

1989-08-01

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Inadequate dietary intake in patients with thalassemia.  

UK PubMed Central (United Kingdom)

BACKGROUND: Patients with thalassemia have low circulating levels of many nutrients, but the contribution of dietary intake has not been assessed. OBJECTIVE: Our objective was to assess dietary intake in a large contemporary sample of subjects with thalassemia. DESIGN: A prospective, longitudinal cohort study using a validated food frequency questionnaire was conducted. PARTICIPANTS/SETTING: Two hundred and twenty-one subjects (19.7±11.3 years, 106 were female) were categorized into the following age groups: young children (3 to 7.9 years), older children/adolescents (8 to 18.9 years), and adults (19 years or older); 78.8% had ?-thalassemia and 90% were chronically transfused. This study took place at 10 hematology outpatient clinics in the United States and Canada. MAIN OUTCOME MEASURES: We conducted a comparison of intake with US Dietary Reference Intakes and correlated dietary intake of vitamin D with serum 25-OH vitamin D and dietary iron with total body iron stores. STATISTICAL ANALYSES PERFORMED: Intake was defined as inadequate if it was less than the estimated average requirement. ?(2), Fisher's exact, and Student's t test were used to compare intake between age categories and logistic regression analysis to test the relationship between intake and outcomes, controlling for age, sex, and race. RESULTS: More than 30% of subjects consumed inadequate levels of vitamin A, D, E, K, folate, calcium, and magnesium. The only nutrients for which >90% of subjects consumed adequate amounts were riboflavin, vitamin B-12, and selenium. Dietary inadequacy increased with increasing age group (P<0.01) for vitamins A, C, E, B-6, folate, thiamin, calcium, magnesium, and zinc. More than half of the sample took additional supplements of calcium and vitamin D, although circulating levels of 25-OH vitamin D remained insufficient in 61% of subjects. Dietary iron intake was not related to total body iron stores. CONCLUSIONS: Subjects with thalassemia have reduced intake of many key nutrients. These preliminary findings of dietary inadequacy are concerning and support the need for nutritional monitoring to determine which subjects are at greatest risk for nutritional deficiency. Future research should focus on the effect of dietary quality and nutritional status on health outcomes in thalassemia.

Fung EB; Xu Y; Trachtenberg F; Odame I; Kwiatkowski JL; Neufeld EJ; Thompson AA; Boudreaux J; Quinn CT; Vichinsky EP

2012-07-01

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Paralytic ileus accompanied by pneumatosis cystoides intestinalis after acarbose treatment in an elderly diabetic patient with a history of heavy intake of maltitol.  

Science.gov (United States)

An 87-year-old woman, diagnosed with diabetes mellitus at age 73, exhibited abdominal distention and appetite loss in March 1998. She had received acarbose as well as 5 mg per day of glibenclamide and had habitually used about 100 g of maltitol daily from 1997. She was diagnosed as having paralytic ileus accompanied by pneumatosis cystoides intestinalis (PCI). This condition subsided quickly with discontinuation of diet or cessation of acarbose and maltitol usage. The patient's condition appears to be attributable to increased gas levels produced by fermentation of disaccharides and maltitol. Decreased intestinal motility may be a result of pre-existing diabetic autonomic neuropathy and hypothyroidism. The patient's clinical course suggests that paralytic ileus and PCI should be listed as rare side effects of alpha-glucosidase inhibitors and that the drug should be used with great caution for those who consume non-digestive sugar substitutes. PMID:11030208

Azami, Y

2000-10-01

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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.

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

2013-01-01

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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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Interpersonal psychosocial factors associated with underreported dietary energy intake in hemodialysis patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine the association between degree of underreporting energy intake and psychosocial (including interpersonal and personal) factors among hemodialysis patients in Japan. DESIGN: We conducted a cross-sectional study. Predictors of difference were identified using multiple linear regression analysis. SETTING: Study was conducted at a public hospital and a dialysis clinic in a single district in northeast Honshu, Japan. SUBJECTS: Participants were hemodialysis outpatients. Patients aged more than 20 years and undergoing treatment for end-stage renal disease for at least 6 months were included. Exclusion criteria were diagnosis of depression, a mental disease, or dementia. MAIN OUTCOME: The outcome measure was the difference in reported energy intake defined by the differences between a brief administered dietary history questionnaire and diet record stratified by standardized weight. RESULTS: Seventy patients undergoing hemodialysis participated (44 men [62.9%] and 26 women [37.1%]). Of these, 54.3% underreported energy intake (by >10%). Sex (male) and employment status (employed) were statistically associated with energy intake underreporting. A lower score of dialysis staff encouragement was associated with greater energy intake underreporting (? coefficient = 3.89 kcal/standardized weight, 95% confidence interval: 0.89 to 6.90; P = .012). CONCLUSION: Degree of underreporting energy intake is significantly associated with interpersonal psychosocial factors among hemodialysis patients in Japan. The interpersonal relationship with encouragement by the dialysis staff is important in improving the accuracy of reporting energy intake among dialysis patients.

Yokoyama Y; Sasaki S; Suzukamo Y; Yamazaki S; Takegami M; Kakudate N; Hasegawa T; Haga M; Kawaguchi T; Moriya T; Hotta O; Fukuhara S

2013-01-01

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Evaluation of Food Intake in Ulcerative Colitis Patients  

Directory of Open Access Journals (Sweden)

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

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

2010-01-01

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[Antioxidant and fat intake in patients with polinic asthma].  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVE: The aim of our work was to evaluate the dietary intake of patients with asthma. PATIENTS AND METHOD: A total of 54 subjects with asthma were enrolled (average age 23.59 +/- 9.6 years). In all patients, we determined weight, height and the body mass index and a three days nutritional questionnaire was administered. RESULTS: The total calories intake was normal. Distribution of calories was: 39.7% carbohydrates, 19.4% proteins and 40.9% lipids. Low intakes of vitamin A, D, E, thiamine and folic acid were detected, and an adequate intake of vitamin K, C, niacin and B12 was observed. The mineral intake showed an increase in calcium and a decrease in magnesium, zinc, iodine and selenium. The intake of polyunsaturated omega-9 fatty acids was 34.8(12.7) g/day, that of polyunsaturated omega-6 fatty acids was 5.7(3.1) g/day, and the intake of polyunsaturated omega-3 fatty acids was 0.85(0.31) g/day. Saturated fats represented a 18.4%. The omega6/omega3 ratio was 6.63. CONCLUSIONS: Asthmatic patients have a low intake of vitamins A and E but an increase in the intake of saturated fatty acids.

de Luis DA; Izaola O; Aller R; Armentia A; Cuéllar L

2003-11-01

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Caffeine intake by patients with autosomal dominant polycystic kidney disease  

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Full Text Available Because caffeine may induce cyst and kidney enlargement in autosomal dominant polycystic kidney disease (ADPKD), we evaluated caffeine intake and renal volume using renal ultrasound in ADPKD patients. Caffeine intake was estimated by the average of 24-h dietary recalls obtained on 3 nonconsecutive days in 102 ADPKD patients (68 females, 34 males; 39 ± 12 years) and compared to that of 102 healthy volunteers (74 females, 28 males; 38 ± 14 years). The awareness of the need for caffeine restriction was assessed. Clinical and laboratory data were obtained from the medical records of the patients. Mean caffeine intake was significantly lower in ADPKD patients versus controls (86 vs 134 mg/day), and 63% of the ADPKD patients had been previously aware of caffeine restriction. Caffeine intake did not correlate with renal volume in ADPKD patients. There were no significant differences between the renal volumes of patients in the highest and lowest tertiles of caffeine consumption. Finally, age-adjusted multiple linear regression revealed that renal volume was associated with hypertension, chronic kidney disease stage 3 and the time since diagnosis, but not with caffeine intake. The present small cross-sectional study indicated a low level of caffeine consumption by ADPKD patients when compared to healthy volunteers, which was most likely due to prior awareness of the need for caffeine restriction. Within the range of caffeine intake observed by ADPKD patients in this study (0-471 mg/day), the renal volume was not directly associated with caffeine intake.

L.C. Vendramini; J.L. Nishiura; A.C. Baxmann; I.P. Heilberg

2012-01-01

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Factors associated to salt intake in chronic hemodialysis patients.  

UK PubMed Central (United Kingdom)

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, clinical 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 < 0.01) and discretionary salt (r = -0.30, p < 0.01). With FFQ food items, there was a positive correlation with the %IDWG (r = 0.26, p < 0.01) and negative with age (r = -0.35, p < 0.001). Direct relationship between salt intake with %IDWG was found in the anuric subgroup (r = 0.26, p < 0.05) and with medium BP in those with no prescription of hypotensive drugs (r = 0.35, p < 0.05). CONCLUSION: Salt intake was high mainly due to discretionary salt. It was associated with education and adversely affected %IDWG in anuric patients and medium BP in those not taking hypotensive drugs.

Nerbass FB; Morais JG; dos Santos RG; Kruger TS; Sczip AC; da Luz Filho HA

2013-04-01

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High food wastage and low nutritional intakes in hospital patients.  

UK PubMed Central (United Kingdom)

BACKGROUND AND AIMS: The aim of this study was to investigate the cause of continuing weight-loss in hospitalized patients. We determined 1. whether the hospital menu was able to meet the patients' minimum nutritional requirements, 2. the proportion of food being wasted and 3. the mean nutritional intakes of patients. METHODS: This study was carried out in a University hospital (1200 beds). All the food supplied and wasted was measured over a 28 day period on one ward in each of 4 different specialties. Average food intake per patient was calculated and checked against individual food intake measurements. RESULTS: The hospital menu provided over 2000 kcal/day and could meet patients' nutritional requirements. However, high wastage rates of greater than 40% resulted in energy and protein intakes within all specialties being less than 80% of that recommended. The cost of this waste was 139,655 pounds sterling in these four specialties. CONCLUSIONS: More than 40% of hospital food was wasted. Energy and protein intakes were low and patients did not, therefore, meet their recommended intakes. This helps to explain continuing weight-loss in hospital patients and represents a large waste of resources. Hospital feeding policies therefore need reviewing and made more appropriate to the needs of the sick.

Barton AD; Beigg CL; Macdonald IA; Allison SP

2000-12-01

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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.

1987-01-01

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Caffeine intake by patients with autosomal dominant polycystic kidney disease  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Because caffeine may induce cyst and kidney enlargement in autosomal dominant polycystic kidney disease (ADPKD), we evaluated caffeine intake and renal volume using renal ultrasound in ADPKD patients. Caffeine intake was estimated by the average of 24-h dietary recalls obtained on 3 nonconsecutive days in 102 ADPKD patients (68 females, 34 males; 39 ± 12 years) and compared to that of 102 healthy volunteers (74 females, 28 males; 38 ± 14 years). The awareness of the nee (more) d for caffeine restriction was assessed. Clinical and laboratory data were obtained from the medical records of the patients. Mean caffeine intake was significantly lower in ADPKD patients versus controls (86 vs 134 mg/day), and 63% of the ADPKD patients had been previously aware of caffeine restriction. Caffeine intake did not correlate with renal volume in ADPKD patients. There were no significant differences between the renal volumes of patients in the highest and lowest tertiles of caffeine consumption. Finally, age-adjusted multiple linear regression revealed that renal volume was associated with hypertension, chronic kidney disease stage 3 and the time since diagnosis, but not with caffeine intake. The present small cross-sectional study indicated a low level of caffeine consumption by ADPKD patients when compared to healthy volunteers, which was most likely due to prior awareness of the need for caffeine restriction. Within the range of caffeine intake observed by ADPKD patients in this study (0-471 mg/day), the renal volume was not directly associated with caffeine intake.

Vendramini, L.C.; Nishiura, J.L.; Baxmann, A.C.; Heilberg, I.P.

2012-09-01

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Dietary calcium intake in patients with inflammatory bowel disease.  

UK PubMed Central (United Kingdom)

BACKGROUND & AIMS: Osteopenia and increased risk for fractures in IBD result from several factors. AIM OF THE STUDY: To investigate the dietary intake of calcium in IBD patients. METHODS: A 22-item quantitative validated frequency food questionnaire was used for quantifying dietary calcium in relation to gender and age, in 187 IBD patients, 420 normal- and 276 diseased controls. STATISTICAL ANALYSIS: Mann-Whitney, chi-square- and T-tests. RESULTS: The mean calcium intake was 991.0±536.0 (105.8% Recommended Daily Allowances) and 867.6±562.7SDmg/day (93.8% RDA) in healthy and diseased controls, and 837.8±482.0SDmg/day (92.7% RDA) in IBD, P<0.001. Calcium intake was high in celiac disease (1165.7±798.8SDmg/day, 120% RDA), and non-significantly lower in ulcerative colitis than in Crohn's disease (798.7±544.1SDmg/day vs 881.9±433.0). CD and UC females, but not males, had a mean calcium intake well under RDA. In all study groups the intake was lower in patients believing that consumption of lactose-containing food induced symptoms, versus those who did not (105.8% vs 114.3% RDA in normal controls; 100.4% vs 87.6% RDA in IBD). CONCLUSIONS: Diet in IBD patients contained significantly less calcium than in healthy controls. Gender and age, more than diagnosis, are central in determining inadequate calcium intake, more so in IBD. Self-reported lactose intolerance, leading to dietary restrictions, is the single major determinant of low calcium intake. Inadequate calcium intake is present in one third of IBD patients and represents a reversible risk factor for osteoporosis, suggesting the need for tailored nutritional advice in IBD.

Vernia P; Loizos P; Di Giuseppantonio I; Amore B; Chiappini A; Cannizzaro S

2013-09-01

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Is vitamin C intake too low in dialysis patients?  

UK PubMed Central (United Kingdom)

Vitamin C has several well-established roles in physiology including synthesis of collagen, carnitine and epinephrine, absorption of dietary iron, and mobilization of storage iron for erythropoeisis. Loss of several of these functions explains the pathology of scurvy, where defective collagen synthesis and anemia are major symptoms. Vitamin C deficiency is very common in dialysis patients and may arise from dialytic vitamin C clearance, restricted intake of vitamin C-rich foods, and increased vitamin C catabolism in vivo from inflammation. In the dialysis population, greater vitamin C intake may be needed for optimal health. Relationships between intake, body distribution, inflammation, and dialytic losses are complex and need further study. Concern about vitamin C metabolism leading to accumulation of tissue oxalate has led to the recommendation that vitamin C intake equals, but not exceeds, the intake recommended for the general population. Vitamin C deficiency in dialysis patients may have clinical consequences; a study in Renal Research Institute clinics found an association with periodontal disease. Data also support a role for vitamin C in prevention of dialysis-related anemia. New research questions are proposed in this editorial, with a discussion of strategies to determine the optimal provision of vitamin C for CKD patients.

Raimann JG; Levin NW; Craig RG; Sirover W; Kotanko P; Handelman G

2013-01-01

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A recipe for improving food intakes in elderly hospitalized patients.  

UK PubMed Central (United Kingdom)

BACKGROUND & AIMS: The aim of this study was to compare food wastage and intake between the normal hospital menu and one where more energy dense but smaller portions were provided. METHODS: This study was carried out on an Elderly Rehabilitation ward in a University hospital. Patients were randomly allocated to receive either a normal or a reduced portion size fortified menu for a 14 day cycle and then swapped-over at the end of each cycle for the 56 day study. One group received a cooked breakfast and normal menus throughout the study. RESULTS: All the menu combinations could meet the patients recommended intake. The fortified menu provided 14% more energy than the normal menu. Food wastage was highest in the cooked breakfast group (32%) and lowest in the Fortified group (27%). The total weight of wasted food was less than in the previous study. Nutritional intakes were 25% higher on the fortified menu compared with the normal menu. The mean protein intakes were still below that recommended. All patients had higher energy intakes on the Fortified menu compared with their intake on the normal menu despite being served a lower weight of food. CONCLUSIONS: We conclude from our own data and that of others that it is possible for elderly patients to achieve their nutritional targets using a combination of smaller portions of increased energy and protein density and between-meal snacks. The needs of other groups of patients also needs to be assessed in a similar way to make hospital food appropriate to the needs of the sick.

Barton AD; Beigg CL; Macdonald IA; Allison SP

2000-12-01

18

Assessment of Mineral Intake by Kidney Stone Patients of Kangra District, Himachal Pradesh with Respect to their Gender, Age and Income.  

Science.gov (United States)

OBJECTIVES: To assess the family history of stones and association of mineral intake with gender, age and income of kidney stone patients. METHODS: A total of 130 kidney stone patients were selected randomly from Kangra district of Himachal Pradesh and family history of stones and mineral intake was assessed. RESULTS: Out of selected patients, majority (80.77 %) were first time stone sufferers. There was significant (at 1 % level) association between family history of kidney stone patients with respect to gender of patients. Further study revealed that the intake of sodium, calcium, magnesium and phosphorous was higher than recommended dietary allowances (RDA). Among male patients, the intake of sodium, calcium and magnesium was higher for age group III (above 45 y) and intake of potassium and phosphorous was higher for age group I. In female kidney stone patients, intake of sodium, calcium and phosphorous was high for age group II, intake of potassium was high in case of age group I and intake of magnesium was high for age group III. Regression studies revealed that there was significantly higher intake of calcium and phosphorous by male kidney stone patients than female kidney stone patients. With the increase in age, the intake of calcium and phosphorous decreased. CONCLUSIONS: Assessment of mineral intake is necessary to enable the health care providers, to give advice and suggestions to the patients to carry out preventive measures in reducing the risk of prevalence of kidney stones in this area and further advice to the suffering patients to prevent the recurrence of stone formation. PMID:23525976

Awasthi, Madhvi; Malhotra, S R

2013-03-24

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Assessment of Mineral Intake by Kidney Stone Patients of Kangra District, Himachal Pradesh with Respect to their Gender, Age and Income.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To assess the family history of stones and association of mineral intake with gender, age and income of kidney stone patients. METHODS: A total of 130 kidney stone patients were selected randomly from Kangra district of Himachal Pradesh and family history of stones and mineral intake was assessed. RESULTS: Out of selected patients, majority (80.77 %) were first time stone sufferers. There was significant (at 1 % level) association between family history of kidney stone patients with respect to gender of patients. Further study revealed that the intake of sodium, calcium, magnesium and phosphorous was higher than recommended dietary allowances (RDA). Among male patients, the intake of sodium, calcium and magnesium was higher for age group III (above 45 y) and intake of potassium and phosphorous was higher for age group I. In female kidney stone patients, intake of sodium, calcium and phosphorous was high for age group II, intake of potassium was high in case of age group I and intake of magnesium was high for age group III. Regression studies revealed that there was significantly higher intake of calcium and phosphorous by male kidney stone patients than female kidney stone patients. With the increase in age, the intake of calcium and phosphorous decreased. CONCLUSIONS: Assessment of mineral intake is necessary to enable the health care providers, to give advice and suggestions to the patients to carry out preventive measures in reducing the risk of prevalence of kidney stones in this area and further advice to the suffering patients to prevent the recurrence of stone formation.

Awasthi M; Malhotra SR

2013-03-01

20

Food intakes and preferences of hospitalised geriatric patients.  

UK PubMed Central (United Kingdom)

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 < 0.05 for all values). 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.

Shahar S; Chee KY; Wan Chik WC

2002-08-01

 
 
 
 
21

Food intakes and preferences of hospitalised geriatric patients  

Directory of Open Access Journals (Sweden)

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.

Shahar Suzana; Chee Kan; Wan Chik Wan Chak

2002-01-01

22

[The patient throughout history since Hippokrates].  

UK PubMed Central (United Kingdom)

Throughout history, the patient's dependency on the social group in which he or she happens to be born, has remained unchanged. The period in the 19th to the 20th century, during which the authority of physicians over patients grew markedly, seems to have passed. As in the classical period, a wealthy western patient is again able to choose the most suitable one from the healthcare service providers. Since the 18th century medicine and religion have diverged from each other in the life of a western patient. The decisive position of the medical industry towards the end of the 20th century is a new phenomenon in the history of patient.

Vuorinen HS

2013-01-01

23

Validity of a diet history questionnaire estimating ?-carotene, vitamin C and ?-tocopherol intakes in Japanese pregnant women.  

Science.gov (United States)

We investigated the validity and reproducibility of a self-administered diet history questionnaire (DHQ) that estimates the intakes of ?-carotene, vitamin C and ?-tocopherol. Ninety-five healthy women with singleton pregnancies in the second trimester were examined at a university hospital in Tokyo. The intakes of ?-carotene, vitamin C and ?-tocopherol assessed by the DHQ were compared to the corresponding serum concentrations. To assess the reproducibility, 58 pregnant women completed it in two sessions within a 4-5 week interval. We found significantly positive correlations between the energy-adjusted intakes and serum concentrations of ?-carotene and vitamin C (r?=?0.254 and r?=?0.323, respectively). However, ?-tocopherol intake was not associated with the corresponding serum concentration. The intraclass correlation coefficients of the two-time DHQ were 0.743 (?-carotene), 0.665 (vitamin C) and 0.718 (?-tocopherol). DHQ has acceptable validity and reproducibility for ?-carotene and vitamin C intakes in Japanese pregnant women. PMID:23506338

Shiraishi, Mie; Haruna, Megumi; Matsuzaki, Masayo; Murayama, Ryoko; Sasaki, Satoshi

2013-03-19

24

Validity of a diet history questionnaire estimating ?-carotene, vitamin C and ?-tocopherol intakes in Japanese pregnant women.  

UK PubMed Central (United Kingdom)

We investigated the validity and reproducibility of a self-administered diet history questionnaire (DHQ) that estimates the intakes of ?-carotene, vitamin C and ?-tocopherol. Ninety-five healthy women with singleton pregnancies in the second trimester were examined at a university hospital in Tokyo. The intakes of ?-carotene, vitamin C and ?-tocopherol assessed by the DHQ were compared to the corresponding serum concentrations. To assess the reproducibility, 58 pregnant women completed it in two sessions within a 4-5 week interval. We found significantly positive correlations between the energy-adjusted intakes and serum concentrations of ?-carotene and vitamin C (r?=?0.254 and r?=?0.323, respectively). However, ?-tocopherol intake was not associated with the corresponding serum concentration. The intraclass correlation coefficients of the two-time DHQ were 0.743 (?-carotene), 0.665 (vitamin C) and 0.718 (?-tocopherol). DHQ has acceptable validity and reproducibility for ?-carotene and vitamin C intakes in Japanese pregnant women.

Shiraishi M; Haruna M; Matsuzaki M; Murayama R; Sasaki S

2013-09-01

25

Nutrient intake in patients with irritable bowel syndrome compared with the general population.  

UK PubMed Central (United Kingdom)

BACKGROUND: Food and diet are central issues that concern patients with irritable bowel syndrome (IBS). Few studies have thoroughly analyzed dietary intake in IBS. Our aims were to determine the nutrient intake in IBS patients in comparison to the general population, assess nutritional differences between IBS subgroups based on the predominant bowel habit or symptom severity, as well as to evaluate if their nutrient intake meet nutrition recommendations. METHODS: We included 187 IBS patients (mean 40.2 years; 139 women). They completed a 4-days food registration record, which was compared with an age-, and gender-matched control group (n = 374; 278 women) from a nation-wide dietary survey and with Nordic Nutrient Recommendations. KEY RESULTS: Daily nutrient intake in IBS patients was similar to the general population and met national nutrients recommendations. Irritable bowel syndrome patients had similar energy distribution from macronutrients compared to the control group, but the protein percentage tended to be higher. Irritable bowel syndrome patients also had significantly higher daily intake of vitamin E, folate, iron, vitamin C, and dietary fibers, as well as lower intake of vitamin A, riboflavin, calcium, and potassium. There was no association between nutrient intake and IBS subtypes or symptom severity. CONCLUSIONS & INFERENCES: Although many IBS patients state that they avoid food items, this does not seem to influence their intake of nutrients to any large extent. The observed minor differences in nutrient intake indicate a tendency toward higher intake of fruit and vegetables and a lower intake of meat and dairy products in IBS patients.

Böhn L; Störsrud S; Simrén M

2013-01-01

26

Bereaved relatives' perspectives of the patient's oral intake towards the end of life: a qualitative study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Patients approaching death often have a decreasing oral intake, which can be distressing for relatives. Little is known about the relatives' experiences with and perceptions of oral intake at the end of life. AIM: This study aims to contribute to a more thorough understanding of relatives' concerns regarding decreased oral intake of the patient at the end of life. DESIGN: Qualitative interview study: semi-structured interviews were transcribed verbatim and analysed using qualitative content analysis. SETTING/PARTICIPANTS: Twenty-three bereaved relatives of patients who had been referred to a New Zealand palliative care service were interviewed. RESULTS: All relatives experienced significant changes in patients' oral intake at the end of life. Oral intake towards the end of life was considered important and is perceived as meaningful by relatives in different ways, such as nutritional value, enjoyment, social time, daily routine and a way of caring. Relatives responded differently to decreasing oral intake; some accepted it as inherent to the dying process, others continued efforts to support the patient's oral intake. Some relatives perceived decreasing oral intake as the patient's choice, and some viewed maintaining oral intake as part of the battle against the disease. Relatives recalled limited communication with health-care professionals concerning oral intake at the end of life. CONCLUSIONS: This study revealed the complexity of meaning relatives' experiences with dying patients' decreasing oral intake. Their perceptions and concerns were related to their awareness of the imminent death. These findings can guide staff involved in care delivery to better support relatives.

Raijmakers NJ; Clark JB; van Zuylen L; Allan SG; van der Heide A

2013-07-01

27

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

UK PubMed Central (United Kingdom)

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 (< 0.5 ml/min) and in age and sex matched controls with normal 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, beta-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, beta-carotene, vitamin E, zinc, selenium, and iron did not reach recommended levels, in neither the experimental nor the control group. There was a slight positive correlation between energy intake and saliva secretion rate in the control group, but the energy intake was totally independent of variations in secretion rate in the irradiated patients with low secretion rate.

Bäckström I; Funegård U; Andersson I; Franzén L; Johansson I

1995-07-01

28

A culture-specific nutrient intake assessment instrument in patients with pulmonary tuberculosis.  

UK PubMed Central (United Kingdom)

BACKGROUND & AIM: To develop and evaluate a culture-specific nutrient intake assessment tool for use in adults with pulmonary tuberculosis (TB) in Tbilisi, Georgia. METHODS: We developed an instrument to measure food intake over 3 consecutive days using a questionnaire format. The tool was then compared to 24 h food recalls. Food intake data from 31 subjects with TB were analyzed using the Nutrient Database System for Research (NDS-R) dietary analysis program. Paired t-tests, Pearson correlations and intraclass correlation coefficients (ICC) were used to assess the agreement between the two methods of dietary intake for calculated nutrient intakes. RESULTS: The Pearson correlation coefficient for mean daily caloric intake between the 2 methods was 0.37 (P = 0.04) with a mean difference of 171 kcals/day (p = 0.34). The ICC was 0.38 (95% CI: 0.03-0.64) suggesting the within-patient variability may be larger than between-patient variability. Results for mean daily intake of total fat, total carbohydrate, total protein, retinol, vitamins D and E, thiamine, calcium, sodium, iron, selenium, copper, and zinc between the two assessment methods were also similar. CONCLUSIONS: This novel nutrient intake assessment tool provided quantitative nutrient intake data from TB patients. These pilot data can inform larger studies in similar populations.

Frediani JK; Tukvadze N; Sanikidze E; Kipiani M; Hebbar G; Easley KA; Shenvi N; Ramakrishnan U; Tangpricha V; Blumberg HM; Ziegler TR

2013-03-01

29

Patient satisfaction and energy intakes are enhanced by point of service meal provision  

UK PubMed Central (United Kingdom)

This systemic review aimed to investigate the effects of various methods of point of service meal provision on patient satisfaction and energy intakes of hospital patients. 'Medline' and 'Wiley Interscience' online databases (1999-2008) were consulted using search terms such as 'food service' and 'food delivery in hospital'. Cross-referencing was also used to select studies that compared the provision of full diets to hospital patients using two different methods of food service delivery. Searching yielded 268 studies, of which 18 met the inclusion criteria (hospitals, all ages, oral intake only). Patient satisfaction was measured in 12 studies, while 9 studies measured energy intake, 9 measured food wastage and 4 studies measured costs. There is evidence to suggest that a more personalised meal service system in hospitals has the ability to improve energy intakes and patient satisfaction. Further research is necessary to evaluate the long-term implications on cost-effectiveness.

MAHONEY Sarah; ZULLI Amanda; WALTON Karen

2009-12-01

30

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

Energy Technology Data Exchange (ETDEWEB)

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 (< 0.5 ml/min) and in age and sex matched controls with normal 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, {beta}-carotene, vitamin E, vitamin B{sub 6}, 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, {beta}-carotene, vitamin E, zinc, selenium, and iron did not reach recommended levels, in neither the experimental nor the control group. (Author).

Baeckstroem, I.; Funegard, U.; Andersson, I.; Franzen, L.; Johansson, I. [Umeaa Univ. (Sweden). Dept. of Oncology

1995-07-01

31

Garlic intake is an independent predictor of endothelial function in patients with ischemic stroke.  

UK PubMed Central (United Kingdom)

Objetives: To investigate the effects of garlic on endothelial function in patients with ischemic stroke (ISS). Design: Cross-sectional study. Participants: 125 Chinese patients with prior ISS due to athero-thrombotic disease were recruited from the outpatient clinics during July 2005 to December 2006. Measurements: Daily allium vegetable intake (including garlic, onions, Chinese chives and shallots) was ascertained by means of a validated food frequency questionnaire for Chinese and brachial artery flow-mediated dilatation (FMD) was measured using high-resolution ultrasound in all subjects. Results: The mean age of the study population was 65.9±11.1 years and 69% were males. Mean allium vegetable intake and garlic intake of the study population was 7.5±12.7g/day and 2.9±8.8g/day respectively. Their mean FMD was 2.6±2.3%. Daily intake of total allium vegetable (r=0.36, P<0.01) and garlic (r=0.34, P<0.01) significantly correlated with FMD. Using the median daily allium intake as cut-off (3.37g/day), patients with a low allium intake <3.37g/day was noted to have a lower FMD compared to those with a normal allium intake (2.1±2.1% versus 3.0±2.4%, P<0.05). After adjusting for confounding factors, multi-variate analysis identified that daily allium vegetable (B=0.05, 95% confidence interval: 0.02, 0.09, P<0.01) and garlic (B=0.07, 95% confidence interval: 0.02, 0.12, P<0.01) intake, but not onions, Chinese chives and shallots were independent predictors for changes in FMD in patients with ISS. Conclusions: Daily garlic intake is an independent predictor of endothelial function in patients with ISS and may play a role in the secondary prevention of atherosclerotic events.

Lau KK; Chan YH; Wong YK; Teo KC; Yiu KH; Liu S; Li LS; Shu XO; Ho SL; Chan KH; Siu CW; Tse HF

2013-01-01

32

Inadequate nutrient intake in patients with celiac disease: results from a german dietary survey.  

UK PubMed Central (United Kingdom)

BACKGROUND: Currently, the only treatment for celiac disease (CD) is a lifelong gluten-free diet (GFD). Research has been carried out in various countries into the nutritional adequacy of the GFD in terms of macro- and micronutrients, mostly presenting conflicting results. However, no data for Germany are available to date. AIM: To elucidate the nutritional composition of a GFD and to compare it with non-GFD in a representative German non-CD population. METHODS AND PATIENTS: A total of 1,000 patients who were members of the German Celiac Society (DZG) were invited to fill out a prospective 7-day food diary and a questionnaire. Data from 88 patients aged 14-80 years were analyzed and compared to the DACH reference values and to data from the German National Diet and Nutrition Survey (NVS II). Results: No significant difference was observed for the intake of energy and macronutrients in male celiac patients compared to the NVS II. Only the fiber intake of male patients was significantly lower than that of the general population. Female patients, however, showed a significantly higher fat intake, but lower carbohydrate consumption. The average daily micronutrient intake of male and female patients, specifically of vitamin B1, B2, B6, folic acid, magnesium and iron, was significantly lower in celiac patients compared to the NVS II. CONCLUSION: This study reveals inadequate nutrient intake by male and female celiac patients in Germany. Based on our findings, regular (laboratory) monitoring of celiac patients should be recommended.

Martin J; Geisel T; Maresch C; Krieger K; Stein J

2013-01-01

33

Dietary Calcium Intake and Calcium Supplementation in Hungarian Patients with Osteoporosis  

Science.gov (United States)

Purpose. Adequate calcium intake is the basis of osteoporosis therapy—when this proves insufficient, even specific antiosteoporotic agents cannot exert their actions properly. Methods. Our representative survey analyzed the dietary intake and supplementation of calcium in 8033 Hungarian female and male (mean age: 68 years) (68.01 (CI95: 67.81–68.21)) patients with osteoporosis. Results. Mean intake from dietary sources was 665 ± 7.9?mg (68.01 (CI95: 67.81–68.21)) daily. A significant positive relationship could be detected between total dietary calcium intake and lumbar spine BMD (P = 0.045), whereas such correlation could not be demonstrated with femoral T-score. Milk consumption positively correlated with femur (P = 0.041), but not with lumbar BMD. The ingestion of one liter of milk daily increased the T-score by 0.133. Average intake from supplementation was 558 ± 6.2?mg (68.01 (CI95: 67.81–68.21)) daily. The cumulative dose of calcium—from both dietary intake and supplementation—was significantly associated with lumbar (r = 0.024, P = 0.049), but not with femur BMD (r = 0.021, P = 0.107). The currently recommended 1000–1500?mg total daily calcium intake was achieved in 34.5% of patients only. It was lower than recommended in 47.8% of the cases and substantially higher in 17.7% of subjects. Conclusions. We conclude that calcium intake in Hungarian osteoporotic patients is much lower than the current recommendation, while routinely applied calcium supplementation will result in inappropriately high calcium intake in numerous patients.

Szamosujvari, Pal; Dombai, Peter; Csore, Katalin; Mikofalvi, Kinga; Steindl, Timea; Streicher, Ildiko; Tarsoly, Julia; Zajzon, Gergely; Somogyi, Peter; Szamosujvari, Pal; Lakatos, Peter

2013-01-01

34

Dietary calcium intake and calcium supplementation in hungarian patients with osteoporosis.  

UK PubMed Central (United Kingdom)

Purpose. Adequate calcium intake is the basis of osteoporosis therapy-when this proves insufficient, even specific antiosteoporotic agents cannot exert their actions properly. Methods. Our representative survey analyzed the dietary intake and supplementation of calcium in 8033 Hungarian female and male (mean age: 68 years) (68.01 (CI95: 67.81-68.21)) patients with osteoporosis. Results. Mean intake from dietary sources was 665 ± 7.9?mg (68.01 (CI95: 67.81-68.21)) daily. A significant positive relationship could be detected between total dietary calcium intake and lumbar spine BMD (P = 0.045), whereas such correlation could not be demonstrated with femoral T-score. Milk consumption positively correlated with femur (P = 0.041), but not with lumbar BMD. The ingestion of one liter of milk daily increased the T-score by 0.133. Average intake from supplementation was 558 ± 6.2?mg (68.01 (CI95: 67.81-68.21)) daily. The cumulative dose of calcium-from both dietary intake and supplementation-was significantly associated with lumbar (r = 0.024, P = 0.049), but not with femur BMD (r = 0.021, P = 0.107). The currently recommended 1000-1500?mg total daily calcium intake was achieved in 34.5% of patients only. It was lower than recommended in 47.8% of the cases and substantially higher in 17.7% of subjects. Conclusions. We conclude that calcium intake in Hungarian osteoporotic patients is much lower than the current recommendation, while routinely applied calcium supplementation will result in inappropriately high calcium intake in numerous patients.

Speer G; Szamosujvári P Jr; Dombai P; Csóré K; Mikófalvi K; Steindl T; Streicher I; Tarsoly J; Zajzon G; Somogyi P; Szamosújvári P; Lakatos P

2013-01-01

35

Recommending salt intake reduction to the hypertensive patient: more than just lip service.  

UK PubMed Central (United Kingdom)

The average individual dietary salt intake largely exceeds the physiological needs almost worldwide. A direct causal association between salt intake and blood pressure levels has been clearly established. Furthermore, there is increasing evidence for additional blood pressure-independent pathways linking excess salt intake to the process of atherosclerosis. Recent meta-analyses of randomized controlled trials showed that moderate reduction of salt intake is associated with reduction of blood pressure and, in perspective, with reduction of cardiovascular and cerebrovascular events in hypertensive individuals. According to the European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines for the management of hypertension, instructions to reduce dietary salt intake to the level of 5 g/day based on the WHO recommendation should be provided to all patients, regardless of their requirement for drug treatment. Unfortunately, the patients' response to this measure is heterogeneous, mainly due to variable compliance with the doctor's prescription and to a lesser extent to different individual BP salt sensitivity. This article discusses the factors affecting the probability of a successful intervention focusing in particular on the doctor's commitment to evaluate the patient's dietary habits, to point out the main sources of salt in the patient's diet, to provide the patient with adequate motivation and with proper instructions to implement gradual reduction of his/her salt intake, not disregarding the need for regular follow-up.

Strazzullo P; D'Elia L; Cairella G; Scalfi L; Schiano di Cola M

2012-06-01

36

[Characteristics of patients with wet age-related macular degeneration and low intake of lutein and zeaxanthin].  

UK PubMed Central (United Kingdom)

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 ?1,400 mg/day intake in women and 1,700 mg/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.

Olea JL; Aragón JA; Zapata ME; Tur JA

2012-04-01

37

Garlic intake is an independent predictor of endothelial function in patients with ischemic stroke.  

Science.gov (United States)

Objetives: To investigate the effects of garlic on endothelial function in patients with ischemic stroke (ISS). Design: Cross-sectional study. Participants: 125 Chinese patients with prior ISS due to athero-thrombotic disease were recruited from the outpatient clinics during July 2005 to December 2006. Measurements: Daily allium vegetable intake (including garlic, onions, Chinese chives and shallots) was ascertained by means of a validated food frequency questionnaire for Chinese and brachial artery flow-mediated dilatation (FMD) was measured using high-resolution ultrasound in all subjects. Results: The mean age of the study population was 65.9±11.1 years and 69% were males. Mean allium vegetable intake and garlic intake of the study population was 7.5±12.7g/day and 2.9±8.8g/day respectively. Their mean FMD was 2.6±2.3%. Daily intake of total allium vegetable (r=0.36, Pmulti-variate analysis identified that daily allium vegetable (B=0.05, 95% confidence interval: 0.02, 0.09, P<0.01) and garlic (B=0.07, 95% confidence interval: 0.02, 0.12, P<0.01) intake, but not onions, Chinese chives and shallots were independent predictors for changes in FMD in patients with ISS. Conclusions: Daily garlic intake is an independent predictor of endothelial function in patients with ISS and may play a role in the secondary prevention of atherosclerotic events. PMID:23933870

Lau, K-K; Chan, Y-H; Wong, Y-K; Teo, K-C; Yiu, K-H; Liu, S; Li, L S-W; Shu, X-O; Ho, S-L; Chan, K H; Siu, C-W; Tse, H-F

2013-01-01

38

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

Science.gov (United States)

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 gradually declined, accompanied by extreme weight loss and decreased dietary intake. Conversely, resting energy expenditure, measured by indirect calorimetry, increased from 24 kcal/kg/day to 35 kcal/kg/day. Nutritional management during cancer treatment is important but may be challenging in pancreatic cancer patients.

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

2013-01-01

39

Changes in dietary intake, body weight, nutritional status, and metabolic rate in a pancreatic cancer patient.  

UK PubMed Central (United Kingdom)

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 gradually declined, accompanied by extreme weight loss and decreased dietary intake. Conversely, resting energy expenditure, measured by indirect calorimetry, increased from 24 kcal/kg/day to 35 kcal/kg/day. Nutritional management during cancer treatment is important but may be challenging in pancreatic cancer patients.

Kim SY; Wie GA; Lee WJ; Park SJ; Woo SM

2013-07-01

40

Hepatic Steatosis, Carbohydrate Intake, and Food Quotient in Patients with NAFLD.  

UK PubMed Central (United Kingdom)

Is steatosis related to the spontaneous carbohydrate intake in patients with NAFLD? We performed dietary records for 24 patients with NAFLD, 3 months after their liver biopsy was performed and before the deliverance of a dietary advice. The food quotient, indicator of the proportion of calories from carbohydrates, was calculated as (1.00×%??calories from carbohydrates/100) + (0.70×%??calories from lipids/100) + (0.81×%??calories from proteins/100). The associations between diet variables and steatosis% on the hepatic biopsies were tested by regression analysis, and diet variables were compared according to the presence of fibrosis. The subjects displayed a large range of steatosis, 50.5%?±?25.5 [10-90], correlated with their energy intake (1993?±?597?kcal/d, r = 0.41, P < 0.05) and food quotient (0.85?±?0.02, r = 0.42, P < 0.05), which remained significant with both variables by a multivariate regression analysis (r = 0.51, P < 0.05). For the 17/24 patients with a hepatic fibrosis, the energy intake was lower (fibrosis: 1863?±?503 versus others: 2382?±?733?kcal/d, P < 0.05), and their food quotients did not differ from patients without fibrosis. Hepatic steatosis was related to the energy and carbohydrate intakes in our patients; the role of dietary carbohydrates was detectable in the range of usual carbohydrate intake: 32% to 58% calories.

Gonzalez C; de Ledinghen V; Vergniol J; Foucher J; Le Bail B; Carlier S; Maury E; Gin H; Rigalleau V

2013-01-01

 
 
 
 
41

Hepatic Steatosis, Carbohydrate Intake, and Food Quotient in Patients with NAFLD.  

Science.gov (United States)

Is steatosis related to the spontaneous carbohydrate intake in patients with NAFLD? We performed dietary records for 24 patients with NAFLD, 3 months after their liver biopsy was performed and before the deliverance of a dietary advice. The food quotient, indicator of the proportion of calories from carbohydrates, was calculated as (1.00×%??calories from carbohydrates/100) + (0.70×%??calories from lipids/100) + (0.81×%??calories from proteins/100). The associations between diet variables and steatosis% on the hepatic biopsies were tested by regression analysis, and diet variables were compared according to the presence of fibrosis. The subjects displayed a large range of steatosis, 50.5%?±?25.5 [10-90], correlated with their energy intake (1993?±?597?kcal/d, r = 0.41, P < 0.05) and food quotient (0.85?±?0.02, r = 0.42, P < 0.05), which remained significant with both variables by a multivariate regression analysis (r = 0.51, P < 0.05). For the 17/24 patients with a hepatic fibrosis, the energy intake was lower (fibrosis: 1863?±?503 versus others: 2382?±?733?kcal/d, P < 0.05), and their food quotients did not differ from patients without fibrosis. Hepatic steatosis was related to the energy and carbohydrate intakes in our patients; the role of dietary carbohydrates was detectable in the range of usual carbohydrate intake: 32% to 58% calories. PMID:23737773

Gonzalez, Concepcion; de Ledinghen, Victor; Vergniol, Julien; Foucher, Juliette; Le Bail, Brigitte; Carlier, Sabrina; Maury, Elisa; Gin, Henri; Rigalleau, Vincent

2013-05-02

42

Hemodialysis duration impairs food intake and nutritional parameters in chronic kidney disease patients.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The aim of this study was to evaluate the effect of hemodialysis (HD) duration on food intake and nutritional markers in patients with chronic kidney disease (CKD). METHODS: Twenty CKD patients received maintenance HD over a 9-year period. At the beginning of the study (T0) and at 3-year intervals (T1, T2, and T3) during the 9-year follow-up, a nutritional survey using the 24-h recall and record method was repeated for 4 days, and the blood samples were drawn. The results from T0 were used as references. Nutritional status was assessed through food intake, nutritional markers (urea, uric acid, creatinine, cholesterol, total protein, and albumin), and anthropometric measurements (height, dry weight, and body mass index). RESULTS: HD duration was correlated with energy intake (r = -0.89, P < 0.01), protein intake (r = -0.50, P < 0.05), and body mass index (r = -0.50, P < 0.05). Albuminemia decreased over time. Reduced carbohydrate intakes were noted in patients at T1 (-8%), T2 (-38%), and T3 (-59%) with decreased fiber intakes. Lipid intake was diminished by 11, 17, and 25% in patients, respectively, at T1, T2, and T3. The consumption of milk and dairy products, meats, fish, eggs, fruits, vegetables, and fat was reduced at T1, T2, and T3. In conclusion, long-term HD fails to correct undernutrition caused by CKD. Long-term dialysis complications could be reduced with preventive measures, including the use of biocompatible membranes and high-dose dialysis. Consequently, patients could experience a decreased prevalence of protein-energy malnutrition.

Mekki K; Remaoun M; Belleville J; Bouchenak M

2012-02-01

43

Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To report on the development and psychometric evaluation of a clinical scale to document change in functional oral intake of food and liquid in stroke patients. DESIGN: Validity and reliability study. SETTING: Tertiary care, academic medical center, metropolitan stroke unit. PARTICIPANTS: Acute stroke patients (N=302). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Interrater reliability, validity, and sensitivity to change assessments were completed on a 7-point ordinal scale-the Functional Oral Intake Scale (FOIS)-developed to document the functional level of oral intake of food and liquid in stroke patients. Interrater reliability was drawn from FOIS ratings applied to dietary information from patient medical charts. Consensual validity was estimated by rankings from judges against predefined scale scores. Criterion validity was evaluated by comparison to the Modified Rankin Scale, the Modified Barthel Index, and Mann Assessment of Swallowing Ability. Cross-validation was assessed via comparison to 2 physiologic measures of swallowing function. Change in functional oral intake over time was assessed descriptively by applying the scale to dietary information from a cohort of 302 acute stroke patients followed up for 6 months. RESULTS: Interrater reliability was high, with perfect agreement on 85% of ratings. Kappa statistics ranged from .86 to .91. Consensual validity was high (.90). Criterion validity was high at onset and 1 month poststroke. Significant associations were identified between the FOIS and stroke handicap scales. The FOIS was significantly associated with 2 physiologic measures of swallowing. Scores on the FOIS from the cohort of stroke patients showed a shift toward increased oral intake over a 6-month period. CONCLUSIONS: The FOIS had adequate reliability, validity, and sensitivity to change in functional oral intake. These findings suggest that the FOIS may be appropriate for estimating and documenting change in the functional eating abilities of stroke patients over time.

Crary MA; Mann GD; Groher ME

2005-08-01

44

Drug and environmental exposure histories in selective patient populations  

Energy Technology Data Exchange (ETDEWEB)

Drug histories and environmental exposures are an important part of all medical histories and are particularly significant in specific at-risk primary care patient populations such as obstetrical patients, primary care genetic referrals, and pediatric patients being evaluated in developmental centers. A review of genetic referrals made by primary care physicians to a satellite genetics clinic over a one-year period showed that 29 percent of all referrals had a significant history of single drug exposure, single environmental exposure, or multiple environmental and drug exposures. Drug and environmental exposures must be an important consideration in all at-risk groups.

Van Dyke, D.C.; Trabilcy, E.T.; Moran, E.S.; Hartzog, S.H.

1985-01-01

45

Affective temperament, history of suicide attempt and family history of suicide in general practice patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Untreated major affective disorders are strongly associated with suicidal behaviour; however, clinical, psychological and psycho-social risk factors also play a contributory role. Personal history and family history of suicide are also important predictors of suicidal behaviours, and are also a powerful marker of current major depressive episode in general practice patients. Affective temperaments, which can be considered the subaffective manifestations of major mood disorders also show a specific pattern of association with suicidal behaviour. In the present study our aim was to investigate the association between affective temperaments, personal history of suicide attempts and family history of completed suicide in primary practice patients. METHODS: Five hundred and nine patients from 6 primary care practices completed the TEMPS-A, and were assessed concerning self-reported history of personal or family suicide. RESULTS: We found that among those answering questions concerning suicide, 9.1% reported a family history of suicide in first and second degree relatives and 4.8% had at least one prior suicide attempt. Among those giving a positive answer to both questions, those who had a positive family history had significantly more frequent suicide attempts (15.4% vs. 4.0%). Patients with prior suicide attempts had a significantly higher score on the cyclothymic and depressive, and those with positive family history of suicide had on cyclothymic and anxious subscales. LIMITATIONS: In the present study, personal and family history of suicide was assessed retrospectively and in a self-report way. The cross-sectional nature of this study and the facts that no current psychiatric morbidity has been investigated and only the documented history of depressive and anxiety disorders have been detected limit the generalisability of this study. DISCUSSION: We found a significant relationship between depressive and cyclothymic affective temperament and personal history of suicide attempts, and between cyclothymic and anxious temperament and family history of completed suicide in first and second degree relatives. This is in line with previous findings showing a strong relationship between these affective temperaments and major mood episodes and that these temperaments are overrepresented among suicide attempters. Our findings also suggest that the presence of cyclothymic (and to lesser extent depressive) affective temperament in a patient with family history of completed suicide indicates a very high risk of suicidal behaviour.

Rihmer Z; Gonda X; Torzsa P; Kalabay L; Akiskal HS; Eory A

2013-07-01

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Another History for Another Psychiatry. The Patient’s View  

Directory of Open Access Journals (Sweden)

Full Text Available 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 identifying little consulted sources, such as the writings of the mad, and the incorporation of interdisciplinary hermeneutic tools, including, most notably, those taken from cultural studies and, in particular, written culture. Finally, it will offer a reflection on the epistemic role that this historiographical approach could play in the construction of new ways of understanding mental health, such as that represented by so-called post-psychiatry.Este artículo pretende revisar, en primer lugar, algunas de las tendencias historiográficas que han configurado una historia “crítica” de la psiquiatría a partir de los años sesenta del siglo XX. Se muestra a continuación, con algunos ejemplos suficientemente significativos, de qué manera los métodos y los discursos se fueron afinando y actualizando hasta llegar a la propuesta de una novedosa historia cultural de la psiquiatría y de la subjetividad. Especial importancia se concede, en nuestro análisis, al “punto de vista del paciente”. Esto obliga a una labor de identificación de fuentes escasamente trabajadas -como los escritos de los locos-, y a la incorporación de herramientas hermenéuticas de características interdisciplinares, entre las que destacan las procedentes de los estudios culturales y, de manera particular, de la cultura escrita. Finalmente, se ofrece una reflexión sobre el papel epistemológico que este enfoque historiográfico puede tener en la construcción de nuevas formas de entender la salud mental, como la representada por la llamada post-psiquiatría.

Huertas, Rafael

2013-01-01

47

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

UK PubMed Central (United Kingdom)

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

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

2013-03-01

48

Dietary fructose intake and severity of liver disease in hepatitis C virus-infected patients.  

UK PubMed Central (United Kingdom)

BACKGROUND AND GOALS: Dietary fructose intake in the United States has been increasing, and fructose intake has been associated with the metabolic syndrome and hepatic steatosis. This study aimed to determine whether dietary fructose intake is associated with advanced hepatic fibrosis and inflammation in an hepatitis C virus (HCV)-infected male population. STUDY: We conducted a cross-sectional study of HCV-infected male veterans. The main exposure variable was daily dietary fructose calculated from the National Cancer Institute Diet History Questionnaire and the main outcome variables were FibroSURE-ActiTest determined hepatic fibrosis (F0-F3=mild vs. F3/F4-F4=advanced) and inflammation (A0-A2=mild vs. A2/A3-A3=advanced). We examined this association in logistic regression adjusting for demographic, clinical, and other dietary variables. RESULTS: Among 313 HCV* males, 103 (33%) had advanced fibrosis and 89 (28%) had advanced inflammation. Median daily fructose intake was 46.8 g (interquartile range, 30.4 to 81.0). Dietary fructose intake across quartiles among males with advanced versus mild fibrosis was 21.4% versus 25.2%, 32.0% versus 24.8%, 24.3% versus 25.2%, and 22.3% versus 24.8%, respectively, and among males with advanced versus mild inflammation was 20.2% versus 25.5%, 41.6% versus 21.4%, 22.5% versus 25.9%, and 15.7% versus 27.2%, respectively. In multivariate analysis, there were no significant associations between daily fructose intake and advanced fibrosis. There was a significant association only between the second quartile of daily fructose intake (30 to 48 g) and advanced inflammation. CONCLUSIONS: There were no significant associations between dietary fructose intake and hepatic fibrosis risk, as assessed by FibroSURE, in HCV-infected males. Additional research is needed to clarify the potential role of fructose intake and HCV-related hepatic inflammation.

Tyson GL; Richardson PA; White DL; Kuzniarek J; Ramsey DJ; Tavakoli-Tabasi S; El-Serag HB

2013-07-01

49

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.

Hansen, Trine S; Engberg, Aase W

2008-01-01

50

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

UK PubMed Central (United Kingdom)

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

Hansen TS; Engberg AW; Larsen K

2008-08-01

51

Nutrient intake, peripheral edema, and weight change in elderly recuperative care patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: It is unclear whether serial measures of body weight are valid indicators of nutritional status in older patients recovering from illness. Objectives. Investigate the relative influence of nutrient intake and changes in peripheral edema on weight change. METHODS: A prospective cohort study of 404 older men (mean age = 78.7±7.5 years) admitted to a transitional care unit of a Department of Veterans Affairs nursing home. Body weight and several indicators of lower extremity edema were measured at both unit admission and discharge. Complete nutrient intake assessments were performed daily. RESULTS: Over a median length of stay of 23 days (interquartile range: 15-41 days), 216 (53%) participants gained or lost more than or equal to 2.5% of their body weight. Two hundred eighty-two (70%) participants had recognizable lower extremity pitting edema at admission and/or discharge. The amount of weight change was strongly and positively correlated with multiple indicators of both nutrient intake and the change in the amount of peripheral edema. By multivariable analysis, the strongest predictor of weight change was maximal calf circumference change (partial R (2) = .35, p < .0001), followed by average daily energy intake (partial R (2) = .14, p < .0001), and the interaction of energy intake by time (partial R (2) = .02, p < .0001). CONCLUSIONS: Many older patients either gain or lose a significant amount of weight after admission to a transitional care unit. Because of the apparent high prevalence of co-occurring changes in total body water, the weight changes do not necessarily represent changes in nutritional status. Although repeat calf circumference measurements may provide some indication as to how much of the weight change is due to changes in body water, there is currently no viable alternative to monitoring the nutrient intake of older recuperative care patients in order to ensure that their nutrient needs are being met.

Sullivan DH; Johnson LE; Dennis RA; Roberson PK; Garner KK; Padala PR; Padala KP; Bopp MM

2013-06-01

52

Choline intake in a large cohort of patients with nonalcoholic fatty liver disease.  

UK PubMed Central (United Kingdom)

BACKGROUND: There is significant histologic and biochemical overlap between nonalcoholic fatty liver disease (NAFLD) and steatohepatitis associated with choline deficiency. OBJECTIVE: We sought to determine whether subjects with biopsy-proven NAFLD and evidence of an inadequate intake of choline had more severe histologic features. DESIGN: We performed a cross-sectional analysis of 664 subjects enrolled in the multicenter, prospective Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN) with baseline data on diet composition (from a recall-based food-frequency questionnaire) within 6 mo of a liver biopsy. Food questionnaires were analyzed with proprietary software to estimate daily intakes of choline. Liver biopsies were centrally read, and consensus was scored with the NASH CRN-developed scoring system. Because choline needs vary by age, sex, and menopausal status, participants were segregated into corresponding categories (children 9-13 y old, males ?14 y old, premenopausal women ?19 y old, and postmenopausal women) on the basis of the Institute of Medicine's definition of adequate intake (AI) for choline. Deficient intake was defined as <50% AI. RESULTS: Postmenopausal women with deficient choline intake had worse fibrosis (P = 0.002) once factors associated with NAFLD (age, race-ethnicity, obesity, elevated triglycerides, diabetes, alcohol use, and steroid use) were considered in multiple ordinal logistic regression models. Choline intake was not identified as a contributor to disease severity in children, men, or premenopausal women. CONCLUSION: Decreased choline intake is significantly associated with increased fibrosis in postmenopausal women with NAFLD. The Pioglitazone vs Vitamin E vs Placebo for Treatment of Non-Diabetic Patients With Nonalcoholic Steatohepatitis trial was registered at clinicaltrials.gov as NCT00063622, and the Treatment of Nonalcoholic Fatty Liver Disease in Children trial was registered at clinicaltrials.gov as NCT00063635.

Guerrerio AL; Colvin RM; Schwartz AK; Molleston JP; Murray KF; Diehl A; Mohan P; Schwimmer JB; Lavine JE; Torbenson MS; Scheimann AO

2012-04-01

53

Higher dietary lycopene intake is associated with longer cardiac event-free survival in patients with heart failure.  

UK PubMed Central (United Kingdom)

BACKGROUND: The antioxidant lycopene may be beneficial for patients with heart failure (HF). Processed tomato products are a major source of lycopene, although they are also high in sodium. Increased sodium intake may counter the positive antioxidant effect of lycopene. METHODS: This was a prospective study of 212 patients with HF. Dietary intake of lycopene and sodium was obtained from weighted 4-day food diaries. Patients were grouped by the median split of lycopene of 2471 µg/day and stratified by daily sodium levels above and below 3 g/day. Patients were followed for 1 year to collect survival and hospitalization data. Cox proportional hazards modeling was used to compare cardiac event-free survival between lycopene groups within each stratum of sodium intake. RESULTS: Higher lycopene intake was associated with longer cardiac event-free survival compared with lower lycopene intake (p = 0.003). The worst cardiac event-free survival was observed in the low lycopene intake group regardless of sodium intake (> 3 g/day HR = 3.01; p = 0.027 and ? 3 g/day HR= 3.34; p = 0.023). CONCLUSION: These findings suggest that increased lycopene intake has the potential to improve cardiac event-free survival in patients with HF independent of sodium intake.

Biddle M; Moser D; Song EK; Heo S; Payne-Emerson H; Dunbar SB; Pressler S; Lennie T

2013-08-01

54

Variations in Dietary Intake Between Newly Diagnosed Gallstone Patients and Controls  

Directory of Open Access Journals (Sweden)

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

Mohammed A. Alsaif

2005-01-01

55

Patients' lived experiences of a reduced intake of food and drinks during illness: a literature review.  

UK PubMed Central (United Kingdom)

AIM: This study aims to identify patients' lived experiences of having a reduced intake of food and drink during illness, through a literature review. METHODS: Scientific studies were selected through a systematic search of CINAHL, PubMed, SweMed, British Nursing Index, Psycinfo and EMBASE. A deductive thematic analysis was performed on the studies included. The analysis provided three main themes: (i) serving of food and drink - patient experiences. (ii) Modifications related to illness - patient experiences. (iii) Nutritional care provided by healthcare professionals nutritional care - patient experiences. FINDINGS: Generally speaking, the findings showed high satisfaction with the food served at hospitals. However, patients' individual tastes and preferences as to when and where to eat were found to affect their intake of food and drink. Physical changes because of illness were stated as the main reason for the patients' lived experiences of a reduced intake of food and drink. These experiences seemed to be related to negative feelings, such as anxiety and shame during meals. Furthermore, the literature review revealed a lack of professional assistance during meals and insufficient guidance on how to handle specific nutritional problems. CONCLUSIONS: Patients expect committed nursing care in regard to nutritional advice during illness and assistance in meal-related situations. Nurses need to refocus on fundamental caring.

Larsen LK; Uhrenfeldt L

2013-03-01

56

The prevalence of high sodium intake among hypertensive patients at hypertension clinic, Siriraj Hospital.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To find the prevalence of excessive salt intake among hypertensive patients in hypertension (HT) clinic at Siriraj Hospital. In addition, to correlate the epidemiologic characteristics of the studied group with high salt diet. MATERIAL AND METHOD: A cross-sectional study was conducted among 320 hypertensive patients in HT clinic at Siriraj Hospital from September 2010 to January 2011. Epidemiologic data, e.g., age, sex, body mass index, duration of treatment, education level, salary, frequency of salty food consumed/week and clinical data, e.g., renal function, (creatinine clearance, CCr) and anti-hypertensive drug(s) received were collected using pre-defined questionnaires. All volunteers were asked to collect 24-hour urine for 2 days to determine average daily amount of urine sodium (UNa). Those 24-hour UNa > or = 100 mmol/ day were considered high salt intake. Correlations of high daily salt intake with all data collected were done. RESULTS: The prevalence of high salt intake was 73.4%. The mean total daily Na intake was 148 mmol/day i.e. 3.4 g of Na/day When the influence of clinical characteristics on the risks of high salt intake was carried out, there were 2.42, 4.00 and 2.88 fold increases among those who have higher education level, those who have CCr > or = 60 ml/min/1.73 m2, and those who knew that salt could increase blood pressure (BP), respectively. About three-quarters (76.3%) of those patients who knew the effect of salt on BP consumed high salt diet. CONCLUSION: The present study revealed that nearly three-quarters of hypertensive patients who attended the HT clinic still consumed high salt diet. Most patients who knew the effect of dietary salt on BP level ignored restriction about salt intake. In addition, those patients with higher education and CCr > or = 60 ml/min/1.73 m2 also consumed high Na diet.

Buranakitjaroen P; Phoojaroenchanachai M

2013-02-01

57

Estimation of milk, dairy products and calcium intake in nutrition of the celiac patients  

Directory of Open Access Journals (Sweden)

Full Text Available Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye, barley and possibly oats. The smallest amount of gluten in food damages the small intestine of these patients. In Croatia there is no data about nutrition and dietary habits of people with celiac disease. In celiac disease there is one and only cure: a gluten-free diet. Milk and dairy products are major source of calcium, and this population, because of malapsorptive syndrome is especially sensitive and predisposed for osteoporosis and osteopenya. Therefore, the purpose of this research was to establish milk, dairy products and calcium intake in celiac patients nutrition. Milk and dairy products was determined by using 3-day-dietary record (3DD) combined with food frequency questionnaire (FFQ) in 15 celiac patients. Energy share of milk and dairy products were 11,82 % kJ, twice less than recommendation. Average daily intake of calcium was also below the recommendation (62,64 % DRI), and 67 % of examinees did not achieve neither 2/3 of daily recommendation intake (DRI) for calcium. From milk and dairy group examinees use milk and pudding the most, yoghurt and fruit yoghurt less. It is necessary to increase intake of calcium from milk and dairy products group because they are the best source of this nutrient.

Ines Panjkota Krbav?i?; Martina Su?i?

2007-01-01

58

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

Directory of Open Access Journals (Sweden)

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; Maria Eliana Madalozzo Schieferdecker; Heda Maria Barska dos Santos Amarante

2011-01-01

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Increased dietary fruit intake was associated with lower burden of carotid atherosclerosis in Chinese patients with Type 2 diabetes mellitus.  

UK PubMed Central (United Kingdom)

BACKGROUND: Previous studies demonstrated that high fruit consumption was associated with a lower risk of cardiovascular events in patients with Type 2 diabetes mellitus. However, the relationship between fruit intake and carotid atherosclerosis in these patients is unknown. We studied the relationship between dietary fruit intake and carotid intima-media thickness in patients with Type 2 diabetes. METHODS: A total of 255 Chinese patients with Type 2 diabetes were recruited. Dietary fruit intake was assessed by a validated food-frequency questionnaire, and carotid intima-media thickness was measured by high-resolution ultrasonography. RESULTS: Among patients with three different tertiles of fruit intake (14.5 ± 8.6 vs. 41.5 ± 7.1 vs. 92.6 ± 39.7 g/day), there was no difference in their clinical characteristics (all P > 0.05). Patients with the highest tertile of fruit intake had a significantly higher BMI and diastolic blood pressure than those with the lowest tertile intake. Furthermore, serum high-sensitivity C-reactive protein, 8-isoprostane and superoxide dismutase were similar among the three tertiles of patients (all P > 0.05). However, patients with the highest tertile of fruit intake had lower carotid intima-media thickness (0.97 ± 0.02 vs. 1.08 ± 0.03 mm, P = 0.046) and prevalence of carotid plaque (11.76 vs. 1.18%, P = 0.022) than those with the lowest tertile of fruit intake. Multivariate regression analysis revealed the highest tertile of fruit intake (? = -0.086, P = 0.049) was independently associated with carotid intima-media thickness. CONCLUSIONS: Our results demonstrated that, in Chinese patients with Type 2 diabetes, higher dietary fruit intake was associated with a lower burden of carotid atherosclerosis as reflected by lower carotid intima-media thickness and prevalence of carotid plaque.

Chan HT; Yiu KH; Wong CY; Li SW; Tam S; Tse HF

2013-01-01

60

Sleep duration in elderly obese patients correlated negatively with intake fatty  

Directory of Open Access Journals (Sweden)

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; 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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Removing salt sachets from ward meal-trays does not affect patients' nutritional intake.  

UK PubMed Central (United Kingdom)

BACKGROUND: Reducing dietary salt intake lowers blood pressure and proteinuria, both of which are beneficial in preventing renal disease progression. Hospital meals are often accompanied by salt sachets, providing patients with additional salt. OBJECTIVES: The aim of this study was to determine the effects of salt sachet provision by request only (i.e., the patient must ask for a salt sachet rather than the sachet being placed automatically on the tray), on meal consumption and salt intake. A secondary aim was to determine policy on salt sachet provision in other hospitals. DESIGN: Salt sachet use and meal consumption was assessed on a renal ward over two weeks. Salt sachets were then provided 'by request only' and the assessment was repeated. Renal Nutrition Group members were surveyed to determine the policy of sachet provision in other hospitals. RESULTS: Salt intake was significantly reduced during the period when salt was provided by request only compared with routine salt provision (p?intake without affecting meal consumption. This is now the adopted policy on the renal ward at our hospital.

Ward J; Batt E

2013-06-01

62

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

DEFF Research Database (Denmark)

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

Funch-Jensen, Peter; Oster, M J

1982-01-01

63

Low fat intake is associated with pathological manifestations and poor recovery in patients with hepatocellular carcinoma.  

UK PubMed Central (United Kingdom)

BACKGROUND: This study aimed to clarify whether dietary deviation is associated with pathological manifestations in hepatocellular carcinoma (HCC) patients. METHODS: Dietary intake was estimated in 35 HCC cases before and after hospitalization by referencing digital camera images of each meal. Pathological conditions were evaluated in nitrogen balance, non-protein respiratory quotient (npRQ), neuropsychiatric testing and recovery speed from HCC treatment. RESULTS: On admission, nitrogen balance and npRQ were negative and less than 0.85, respectively. Five patients were judged to have suffered from minimal hepatic encephalopathy that tended to be associated with a lowered value of npRQ (p?=?0.082). The energy from fat intake showed a tendency of positive correlation with npRQ (p?=?0.11), and the patients with minimal hepatic encephalopathy took significantly fewer energy from fat (p?=?0.024). The energy difference from fat between diets at home versus those in the hospital showed a significant positive correlation with npRQ change after admission (p?=?0.014). The recovery speed from invasive treatments for HCC showed a significant negative correlation with npRQ alteration after admission (p?=?0.0002, r?=?-0.73). CONCLUSIONS: These results suggest the lower fat intake leads to deterioration of energy state in HCC patients, which associates with poor recovery from invasive treatments and various pathological manifestations.

Yamada K; Suda T; Komoro YS; Kanefuji T; Kubota T; Murayama T; Nakayama H; Aoyagi Y

2013-01-01

64

Low fat intake is associated with pathological manifestations and poor recovery in patients with hepatocellular carcinoma  

Science.gov (United States)

Background This study aimed to clarify whether dietary deviation is associated with pathological manifestations in hepatocellular carcinoma (HCC) patients. Methods Dietary intake was estimated in 35 HCC cases before and after hospitalization by referencing digital camera images of each meal. Pathological conditions were evaluated in nitrogen balance, non-protein respiratory quotient (npRQ), neuropsychiatric testing and recovery speed from HCC treatment. Results On admission, nitrogen balance and npRQ were negative and less than 0.85, respectively. Five patients were judged to have suffered from minimal hepatic encephalopathy that tended to be associated with a lowered value of npRQ (p?=?0.082). The energy from fat intake showed a tendency of positive correlation with npRQ (p?=?0.11), and the patients with minimal hepatic encephalopathy took significantly fewer energy from fat (p?=?0.024). The energy difference from fat between diets at home versus those in the hospital showed a significant positive correlation with npRQ change after admission (p?=?0.014). The recovery speed from invasive treatments for HCC showed a significant negative correlation with npRQ alteration after admission (p?=?0.0002, r?=??0.73). Conclusions These results suggest the lower fat intake leads to deterioration of energy state in HCC patients, which associates with poor recovery from invasive treatments and various pathological manifestations.

2013-01-01

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

UK PubMed Central (United Kingdom)

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

Yazdanpanah L; Shidfar F; Moosavi AJ; Heidarnazhad H; Haghani H

2010-11-01

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

Science.gov (United States)

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

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

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

UK PubMed Central (United Kingdom)

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 preoperatively and after surgery. Food intake was reported 3 and 12 months postoperatively. RESULTS: The preoperative median BMI was 44.3 (inter quartile range 41.4-47.1), and was significantly reduced to 35.4 (32.6-38.6) after 3 months and further reduced to 30.5 (27.4-33.8) 12 months after surgery (p?intake was significantly increased from 2971 (1982-3687) kJ after three months to 3840 (3046-4625) kJ twelve months postoperatively. One year after surgery, serum levels of folate, cobalamin, PTH and HDL cholesterol were significantly increased, whereas calcium, albumin, haemoglobin, creatinine, uric acid, CRP, glucose, insulin, insulin c-peptide, HOMA-IR, HbA1c and triacylglycerol were significantly decreased. Serum levels of vitamins E and D were unchanged after one year. The prevalence of patients with medically regulated type 2 diabetes was significantly reduced one year post surgery however no changes were seen in the prevalence of patients taking lipid lowering drugs or thyroxin. CONCLUSION: Based on the data obtained 12 months after surgery, LSG appears to be an effective treatment of morbid obesity without worsening the nutritional status despite the very low energy intake.

Gjessing HR; Nielsen HJ; Mellgren G; Gudbrandsen OA

2013-01-01

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Subgroups of haemodialysis patients in relation to fluid intake restrictions: a cluster analytical approach.  

UK PubMed Central (United Kingdom)

AIMS: To determine whether definable subgroups exist in a sample of haemodialysis patients with regard to self-efficacy, attentional style and depressive symptomatology and to compare whether interdialytic weight gain varies between patients in groups with different cognitive profiles. BACKGROUND: Theory-based research suggests that cognitive factors (e.g. self-efficacy and attentional style) and depressive symptomatology undermine adherence to health protective regimens. Preventing negative outcomes of fluid overload is essential for haemodialysis patients but many patients cannot achieve fluid control, and nursing interventions aimed to help the patients reduce fluid intake are ineffective. Understanding the interaction between cognitive factors and how this is related to adherence outcomes might therefore lead to the development of helpful nursing interventions. DESIGN: Explorative cross-sectional multicentre survey. METHODS: The sample consisted of 133 haemodialysis patients. Data were collected using structured questionnaires. A brief self-report form and data on interdialytic weight gain was also used. Two-step cluster analysis was used to identify subgroups. One-way analysis of variance (anova) or Pearson's chi-square test was used for comparing subgroups. RESULTS: Three distinct subgroups were found and subsequently labelled: (1) low self-efficacy, (2) distraction and depressive symptoms and (3) high self-efficacy. The subgroups differed in fluid intake, but not in age, dialysis vintage, gender, residual urine output or in receiving any fluid intake advice. CONCLUSIONS: Clinically relevant subgroups of haemodialysis patients could be defined by their profiles regarding self-efficacy, attentional style and depressive symptoms. RELEVANCE TO CLINICAL PRACTICE: Based on this study, we would encourage clinical practitioners to take into account cognitive profiles while performing their work. This is especially important when a targeted nursing intervention, which aims to encourage and maintain the patient's fluid control, is introduced.

Lindberg M; Wikström B; Lindberg P

2010-11-01

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

Directory of Open Access Journals (Sweden)

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.; Martini L.A.; Mendonça C.O.G.; Schor N.; Heilberg I.P.

2002-01-01

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Prescription History of Emergency Department Patients Prescribed Opioids  

Directory of Open Access Journals (Sweden)

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; John Houghland; Michael Yaron; Kennon Heard

2013-01-01

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

Directory of Open Access Journals (Sweden)

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; Haruna Megumi; Matsuzaki Masayo; Murayama Ryoko; Sasaki Satoshi; Murashima Sachiyo

2012-01-01

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Estimation of eicosapentaenoic acid and docosahexaenoic acid intakes in pregnant Japanese women without nausea by using a self-administered diet history questionnaire.  

UK PubMed Central (United Kingdom)

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intakes during pregnancy affect fetal development and maternal mental health; therefore, an accurate assessment of EPA and DHA intakes is required. We hypothesized that a self-administered diet history questionnaire (DHQ) that was developed for non-pregnant adults could be used for estimating EPA and DHA intakes in pregnant Japanese women; thus, we evaluated the validity and reproducibility of the DHQ during pregnancy. We recruited 262 healthy participants with singleton pregnancies during their second trimester at a university hospital in Tokyo between June 2010 and July 2011. Plasma concentrations of EPA and DHA were measured as reference values. Fifty-eight women completed the DHQ twice, within a 4- to 5-week period to assess the reproducibility of the results. Among the participants without pregnancy-associated nausea (n = 180), significantly positive correlations were observed between energy-adjusted intakes and plasma concentrations of EPA (r(s) = 0.388), DHA (r(s) = 0.264), and EPA + DHA (r(s) = 0.328). More than 60% of the participants without nausea fell into the same or adjacent quintiles according to energy-adjusted intakes and plasma concentrations of EPA, DHA, and EPA + DHA. Meanwhile, among the participants with nausea, a low correlation for EPA and no correlation for DHA and EPA + DHA were found. Intraclass correlation coefficients for the 2-time DHQ measurements were 0.691 (EPA) and 0.663 (DHA). The results indicate that the DHQ has an acceptable level of validity and reproducibility for assessing EPA, DHA, and EPA + DHA intakes in pregnant Japanese women without nausea.

Shiraishi M; Haruna M; Matsuzaki M; Murayama R; Yatsuki Y; Sasaki S

2013-06-01

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Estimation of eicosapentaenoic acid and docosahexaenoic acid intakes in pregnant Japanese women without nausea by using a self-administered diet history questionnaire.  

Science.gov (United States)

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intakes during pregnancy affect fetal development and maternal mental health; therefore, an accurate assessment of EPA and DHA intakes is required. We hypothesized that a self-administered diet history questionnaire (DHQ) that was developed for non-pregnant adults could be used for estimating EPA and DHA intakes in pregnant Japanese women; thus, we evaluated the validity and reproducibility of the DHQ during pregnancy. We recruited 262 healthy participants with singleton pregnancies during their second trimester at a university hospital in Tokyo between June 2010 and July 2011. Plasma concentrations of EPA and DHA were measured as reference values. Fifty-eight women completed the DHQ twice, within a 4- to 5-week period to assess the reproducibility of the results. Among the participants without pregnancy-associated nausea (n = 180), significantly positive correlations were observed between energy-adjusted intakes and plasma concentrations of EPA (r(s) = 0.388), DHA (r(s) = 0.264), and EPA + DHA (r(s) = 0.328). More than 60% of the participants without nausea fell into the same or adjacent quintiles according to energy-adjusted intakes and plasma concentrations of EPA, DHA, and EPA + DHA. Meanwhile, among the participants with nausea, a low correlation for EPA and no correlation for DHA and EPA + DHA were found. Intraclass correlation coefficients for the 2-time DHQ measurements were 0.691 (EPA) and 0.663 (DHA). The results indicate that the DHQ has an acceptable level of validity and reproducibility for assessing EPA, DHA, and EPA + DHA intakes in pregnant Japanese women without nausea. PMID:23746563

Shiraishi, Mie; Haruna, Megumi; Matsuzaki, Masayo; Murayama, Ryoko; Yatsuki, Yuko; Sasaki, Satoshi

2013-05-07

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Novel diet for patients with impaired mastication evaluated by consumption rate, nutrition intake, and questionnaire.  

UK PubMed Central (United Kingdom)

OBJECTIVE: "iEat(®)" (EN Otsuka Pharmaceutical Co. Ltd.; study diet), a food product that resembles an ordinary meal in appearance but is cooked to soften, was compared with foods provided to patients with impaired mastication (modified traditional diet) to investigate the influence of the appearance of foods on the consumption rate, dietary nutrition intake, and satisfaction level. METHODS: After serving the study participants the modified traditional diet on days 1 and 2, the study diet on days 3, 4, and 5, and the modified traditional diet on days 6 and 7, the consumption rates were measured by weight difference. The amounts of dietary nutrition intake were calculated from the consumption rates. Satisfaction levels were evaluated by a questionnaire completed by the participants and their health care professionals after each meal. RESULTS: No significant difference in consumption rates was observed between the study diet and the modified traditional diet. The amounts of dietary nutrition intake of energy and protein were significantly higher for the study diet than for the modified traditional diet. The study diet showed higher satisfaction levels in terms of "appearance" when evaluated by the participants, and "joy of eating" and "overall satisfaction level" when evaluated by the health care professionals. CONCLUSION: The study diet has potential to become a new dietary option for patients with impaired mastication.

Higashiguchi T

2013-06-01

75

Anthropometric and dietary intake indicators as predictors of pulmonary function in cystic fibrosis patients.  

UK PubMed Central (United Kingdom)

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 FEV(1). Prevalence ratios for the outcome studied (FEV(1) < 80% of predicted) were calculated by indicator. RESULTS: In patients with MAMC and TST below the 25th percentile, the prevalence of FEV(1) < 80% of predicted was significantly higher than in those with higher MAMC and TST (p < 0.001 and p = 0.011, respectively). In comparison with other patients, those with a BMI below the 50th percentile showed a 4.43 times higher prevalence of FEV(1) < 80% of predicted (95% CI: 1.58-12.41), and that prevalence was 2.54 times higher in those colonized with methicillin-resistant Staphylococcus aureus (MRSA) than in those not so colonized (95% CI: 1.43-4.53). The association between dietary intake and the prevalence of FEV1 < 80% of predicted was of only borderline significance (95% CI: 0.95-3.45). CONCLUSIONS: Not being colonized with MRSA and having a BMI above the 50th percentile appear to preserve pulmonary function in CF patients.

Forte GC; Pereira JS; Drehmer M; Simon MI

2012-07-01

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

Directory of Open Access Journals (Sweden)

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

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

2012-01-01

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

DEFF Research Database (Denmark)

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

Hansen, Trine Schow; Larsen, Klaus

2008-01-01

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Energy intake and sources of nutritional support in patients with head and neck cancer--a randomised longitudinal study.  

UK PubMed Central (United Kingdom)

BACKGROUND/OBJECTIVES: Malnutrition decreases the cancer patient's ability to manage treatment, affects quality of life and survival, and is common among head and neck (HN) cancer patients due to the tumour location and the treatment received. In this study, advanced HN cancer patients were included and followed during 2 years in order to measure their energy intake, choice of energy sources and to assess problems with dysphagia. The main purpose was to explore when and for how long the patients had dysphagia and lost weight due to insufficient intake and if having a PEG (percutaneous endoscopic gastrostomy) in place for enteral nutrition made a difference. SUBJECTS/METHODS: One hundred thirty-four patients were included and randomised to either a prophylactic PEG for early enteral feeding or nutritional care according to clinical praxis. At seven time points weight, dysphagia and energy intake (assessed as oral, nutritional supplements, enteral and parenteral) were measured. RESULTS: Both groups lost weight the first six months due to insufficient energy intake and used enteral nutrition as their main intake source; no significant differences between groups were found. Problems with dysphagia were vast during the 6 months. At the 6-, 12- and 24-month follow-ups both groups reached estimated energy requirements and weight loss ceased. Oral intake was the major energy source after 1 year. CONCLUSIONS: HN cancer patients need nutritional support and enteral feeding for a long time period during and after treatment due to insufficient energy intake. A prophylactic PEG did not significantly improve the enteral intake probably due to treatment side effects.

Silander E; Jacobsson I; Bertéus-Forslund H; Hammerlid E

2013-01-01

79

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

Scientific Electronic Library Online (English)

Full Text Available 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 Fre (more) quência 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 p (more) rotein 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

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

2011-09-01

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Patient-clinician ethnic concordance and communication in mental health intake visits.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This study examines how communication patterns vary across racial and ethnic patient-clinician dyads in mental health intake sessions and its relation to continuance in treatment, defined as attending the next scheduled appointment. METHODS: Observational study of communication patterns among ethnically/racially concordant and discordant patient-clinician dyads. Primary analysis included 93 patients with 38 clinicians in race/ethnic concordant and discordant dyads. Communication was coded using the Roter Interaction Analysis System (RIAS) and the Working Alliance Inventory Observer (WAI-O) bond scale; continuance in care was derived from chart reviews. RESULTS: Latino concordant dyad patients were more verbally dominant (p<.05), engaged in more patient-centered communication (p<.05) and scored higher on the (WAI-O) bond scale (all p<.05) than other groups. Latino patients had higher continuance rates than other patients in models that adjusted for non-communication variables. When communication, global affect, and therapeutic process variables were adjusted for, differences were reversed and white dyad patients had higher continuance in care rates than other dyad patients. CONCLUSION: Communication patterns seem to explain the role of ethnic concordance for continuance in care. PRACTICE IMPLICATIONS: Improve intercultural communication in cross cultural encounters appears significant for retaining minorities in care.

Alegría M; Roter DL; Valentine A; Chen CN; Li X; Lin J; Rosen D; Lapatin S; Normand SL; Larson S; Shrout PE

2013-07-01

 
 
 
 
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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  

Directory of Open Access Journals (Sweden)

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; Angela M. G. Pierin; Décio Mion Jr.

2003-01-01

82

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in english 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 (more) 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

Strelec, Maria Aparecida A Moura; Pierin, Angela M. G.; Mion Jr., Décio

2003-10-01

83

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

UK PubMed Central (United Kingdom)

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 PK; Taskiran M; Damgaard M; Goetze JP; Floyd AK; Funch-Jensen P; Kristiansen VB; Gadsbøll N

2013-07-01

84

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

UK PubMed Central (United Kingdom)

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

Ijarotimi OS; Keshinro OO

2008-04-01

85

Decreased dietary fiber intake and structural alteration of gut microbiota in patients with advanced colorectal adenoma.  

UK PubMed Central (United Kingdom)

BACKGROUND: Accumulating evidence indicates that diet is one of the most important environmental factors involved in the progression from advanced colorectal adenoma (A-CRA) to colorectal cancer. OBJECTIVE: We evaluated the possible effects of dietary fiber on the fecal microbiota of patients with A-CRA. DESIGN: Patients with a diagnosis of A-CRA by pathological examination were enrolled in the A-CRA group. Patients with no obvious abnormalities or histopathological changes were enrolled in the healthy control (HC) group. Dietary fiber intake was assessed in all patients. Short-chain fatty acids (SCFAs) in feces were detected by gas chromatography. The fecal microbiota community was analyzed by 454 pyrosequencing based on 16S ribosomal RNA. RESULTS: Lower dietary fiber patterns and consistently lower SCFA production were observed in the A-CRA group (n = 344). Principal component analysis showed distinct differences in the fecal microbiota communities of the 2 groups. Clostridium, Roseburia, and Eubacterium spp. were significantly less prevalent in the A-CRA group (n = 47) than in the HC group (n = 47), whereas Enterococcus and Streptococcus spp. were more prevalent in the A-CRA group (n = 47) (all P < 0.05). Butyrate and butyrate-producing bacteria were more prevalent in a subgroup of HC subjects with a high fiber intake than in those in both the low-fiber HC subgroup and the high-fiber A-CRA subgroup (all P < 0.05). CONCLUSION: A high-fiber dietary pattern and subsequent consistent production of SCFAs and healthy gut microbiota are associated with a reduced risk of A-CRA. This trial was registered at www.chictr.org as ChiCTR-TRC-00000123.

Chen HM; Yu YN; Wang JL; Lin YW; Kong X; Yang CQ; Yang L; Liu ZJ; Yuan YZ; Liu F; Wu JX; Zhong L; Fang DC; Zou W; Fang JY

2013-05-01

86

[Towards a history of the family care of psychiatric patients].  

UK PubMed Central (United Kingdom)

INTRODUCTION: Inserting adults with psychic problems into families has recently been practiced in various European countries and also in Italy, where some mental health departments support such families. Beyond the well known story of Gheel, the etero and omofamily care of psychiatric patients has a forgotten history. METHODS: On the basis of unexplored and exceptionally rich sources from the archives of the asylums in Florence, as well as of the Province di Florence, which funded assistance to the mentally ill--this research focuses on the subsidized "domestic custody" of hundreds of psychiatric patients, who had already been institutionalized. Beginning in 1866, outboarding was supported by the provincial administration in Florence with the collaboration of the asylum medical direction. RESULTS: In the late 19th C. and in the early 20th C. prestigious psychiatrists sought alternatives to the institutionalisation. These alternatives involved varied participants in a community (the patients and their families, the administrators and the medical specialists, the neighborhood and the police). The families played a special role that historians of the psychiatry exclusively dedicated to the insane asylums have not really seen. CONCLUSIONS: The role of the families in the interaction with the psychiatric staff is not, even on a historiographical level, simply an additional and marginal chapter of the practices and of the culture of the mental health. These archival evidence contradicts some common places on the past of the Italian psychiatry before 1978, and provokes new reflections of possible relevance to the present.

Guarnieri P

2009-01-01

87

High sodium intake is associated with masked hypertension in Japanese patients with type 2 diabetes and treated hypertension.  

UK PubMed Central (United Kingdom)

BACKGROUND: Knowledge regarding the association between dietary sodium intake and the incidence of masked hypertension is limited. METHODS: A total of 193 Japanese type 2 diabetic outpatients who had been treated with antihypertensive agents and with office blood pressures <140/90 mm Hg were recruited. Masked hypertension was defined as having office blood pressure <140/90 mm Hg and 24-h mean ambulatory blood pressure ?130/80 mm Hg. The dietary sodium intake was estimated by measuring the 24-h urinary sodium excretion. RESULTS: Masked hypertension was found in 128 (66.3%) patients. An age- and sex-adjusted univariate logistic regression analysis showed that urinary albumin excretion, renin-angiotensin system inhibitor use, office systolic blood pressure, and amount of dietary sodium intake were significantly associated with masked hypertension. A multivariate logistic regression analysis also identified an older age, renin-angiotensin system inhibitor use, an office elevated systolic blood pressure, and high dietary sodium intake to be independently associated with masked hypertension. When compared with those who consumed a low salt diet (sodium <120 mEq/day), the odds ratio for the risk of exhibiting masked hypertension in patients who consumed a medium salt diet (sodium 120 to <200 mEq/day) or a high salt diet (sodium ?200 mEq/day) were 5.3 (P < 0.001) and 12.6 (P < 0.001), respectively. CONCLUSIONS: Masked hypertension is a common feature in type 2 diabetic patients being treated for hypertension. The observed association with sodium intake raised the hypothesis that excessive sodium intake may play a part in the genesis of masked hypertension in these patients.

Uzu T; Nakao K; Kume S; Araki H; Isshiki K; Araki S; Kawai H; Ugi S; Kashiwagi A; Maegawa H

2012-11-01

88

Food intake and social habits in male patients and its relationship to intracytoplasmic sperm injection outcomes.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the influence of the male partner's lifestyle, including eating and social habits, on semen quality and intracytoplasmic sperm injection (ICSI) success. DESIGN: Observational study. SETTING: Private fertility clinic. PATIENT(S): Two hundred fifty male patients undergoing ICSI cycles. INTERVENTION(S): We recorded dietary and social habits using a food frequency questionnaire adapted to meet specific study objectives. Evaluation of semen parameters and ICSI outcomes were performed. MAIN OUTCOME MEASURE(S): Frequency of intake of food items and social habits were registered on a scale with five categories ranging from no consumption to repeated daily consumption. RESULT(S): The sperm concentration was negatively influenced by body mass index (BMI) and alcohol consumption and was positively influenced by cereal consumption and the number of meals per day. The sperm motility was also negatively influenced by BMI, alcohol consumption, and smoking habit, whereas it was positively influenced by the consumption of fruits and cereals. The consumption of alcohol had a negative influence on the fertilization rate. The consumption of red meat as well as being on a weight loss diet had a negative impact on the implantation rate. In addition, the consumption of red meat and being on a weight loss diet had an effect on the pregnancy chance. CONCLUSION(S): Couples seeking assisted reproduction treatments must be advised about the drastic effect of both the male and female lifestyle on treatment success.

Braga DP; Halpern G; Figueira Rde C; Setti AS; Iaconelli A Jr; Borges E Jr

2012-01-01

89

History of Religious Delusions and Psychosocial Functioning Among Mexican Patients with Paranoid Schizophrenia.  

UK PubMed Central (United Kingdom)

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.

Robles-García R; López-Luna S; Páez F; Escamilla R; Camarena B; Fresán A

2013-05-01

90

Pilot study on the effect of reducing dietary FODMAP intake on bowel function in patients without a colon.  

UK PubMed Central (United Kingdom)

BACKGROUND: Poorly absorbed short-chain carbohydrates (FODMAPs) in the diet should, by virtue of their osmotic effects, increase fecal output following colectomy and ileal pouch formation or ileorectal anastomosis (IRA). The aim was to perform a proof-of-concept evaluation of this hypothesis. METHODS: Fifteen patients (13 pouch, 2 IRA) had dietary and symptomatic evaluation before and during a low FODMAP diet. Carbohydrate malabsorption was evaluated by breath tests. Pouchitis was assessed clinically/endoscopically or by fecal lactoferrin. RESULTS: Of 8 patients with a breath hydrogen response to lactulose, 7 had fructose malabsorption, 3 with lactose malabsorption, and 1 had lactose malabsorption alone. Five of 7 studied retrospectively improved stool frequency (from median 8 to 4 per day; P = 0.02), this being sustained over 0.5-3 years of follow-up. Five of 8 patients completed a prospective arm of the study. One patient had sustained improvement in stool frequency and 1 had reduced wind production. Overall, none of 8 patients who had pouchitis improved. In contrast, median daily stool frequency fell from 8 to 4 (P = 0.001) in the 7 without pouchitis. The degree of change in FODMAP intake also predicted response. There was a tendency for pouchitis to be associated with low baseline FODMAP intake. CONCLUSIONS: There is a high prevalence of carbohydrate malabsorption in these patients. Reduction of the intake of FODMAPs may be efficacious in reducing stool frequency in patients without pouchitis, depending on dietary adherence and baseline diet.

Croagh C; Shepherd SJ; Berryman M; Muir JG; Gibson PR

2007-12-01

91

What is the patient really taking? Discrepancies between surgery and anesthesiology preoperative medication histories  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: Surgical patients may be at risk for medication discrepancies that may lead to medication errors because both the anesthesiologist and the surgeon write separate preoperative medication histories.

Burda, S; Hobson, D; Pronovost, P

92

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

Scientific Electronic Library Online (English)

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

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

2007-10-01

93

Bone turnover response to changes in calcium intake is altered in girls and adult women in families with histories of osteoporosis.  

UK PubMed Central (United Kingdom)

Heredity and environmental factors contribute to the development of osteoporosis. Because calcium is the major mineral in bone and adolescence is a key period in bone acquisition, we hypothesized that bone turnover would be less responsive to alterations in dietary calcium intake in both girls and adult women from families with histories of osteoporosis. To address this issue, we studied calcium kinetics in the maternal grandmother (age range 56-81 years), mother (age range 32-47 years), and granddaughter (age range 8-15 years) in 10 multigenerational families. In five families, the mother and/or grandmother had osteoporosis (bone mineral density > or = 2 SD below the age-specific mean). To examine both active and passive calcium absorption, families consumed low- (279 +/- 64 mg/day) and high- (1580 +/- 385) calcium diets for 10 days prior to administration of oral (46Ca) and intravenous (42Ca) stable isotopes. Using repeated measures analysis of variance, fractional calcium absorption, true calcium absorption, bone calcium deposition, and the balance in bone calcium turnover were all significantly affected by diet (p < 0.01). Females from nonosteoporotic families had decreased bone calcium resorption with little change in bone calcium deposition during the high-calcium study. In contrast, girls and adult women from osteoporotic families had increased both bone calcium deposition and resorption during the high-calcium period, leading to a less positive balance in bone calcium turnover. A significant interaction between bone status and diet was found for bone calcium resorption (p < 0.05) and approached significance for bone calcium deposition (p < 0.07), effects which were independent of generation. We conclude that girls and women from osteoporotic families have a significantly altered bone turnover response to acute changes in calcium intake.

O'Brien KO; Abrams SA; Liang LK; Ellis KJ; Gagel RF

1998-03-01

94

Assessing Nutrient Intake and Nutrient Status of HIV Seropositive Patients Attending Clinic at Chulaimbo Sub-District Hospital, Kenya.  

UK PubMed Central (United Kingdom)

Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT) and mean corpuscular volume (MCV)). Results. Among the 497 patients recruited (M?:?F sex ratio: 1.4, mean age: 39?years ± 10.5?y), Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49?±?3.49?mg). All the biochemical assessment indicators were within normal range except for haemoglobin 11.2?g/dL (11.4?±?2.60 male and 11.2?±?4.25 female). Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life.

Onyango AC; Walingo MK; Mbagaya G; Kakai R

2012-01-01

95

Iron status is inversely associated with dietary iron intakes in patients with inactive or mildly active inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Patients with inflammatory bowel disease (IBD) frequently appear iron deplete but whether this is a reflection of dietary iron intakes is not known. Methods Dietary data were collected from 29 patients with inactive or mildly-active IBD and 28 healthy controls using a validated food frequency questionnaire that measured intakes of iron and its absorption modifiers. Non-haem iron availability was estimated using a recently developed algorithm. Subjects were classified for iron status based upon data from a concomitant and separately published study of iron absorption. Absorption was used to define iron status because haematological parameters are flawed in assessing iron status in inflammatory conditions such as IBD. Results Dietary intakes of total iron, non-haem iron and vitamin C were significantly greater in IBD patients who were iron replete compared to those who were iron deplete (by 48%, 48% and 94% respectively; p?0.05). The predicted percentage of available non-haem iron did not differ between these groups (19.7 ± 2.0% vs 19.3 ± 2.0% respectively; p=0.25). However, because of the difference in iron intake, the overall amount of absorbed iron did (2.4 ± 0.8 mg/d vs 1.7 ± 0.5 mg/d; p=0.013). No such differences were observed in the healthy control subjects. Conclusions In IBD, iron status is more closely related to the quality and quantity of dietary iron intake than in the general healthy population.

Powell Jonathan J; Cook William B; Chatfield Mark; Hutchinson Carol; Pereira Dora IA; Lomer Miranda CE

2013-01-01

96

Iron status is inversely associated with dietary iron intakes in patients with inactive or mildly active inflammatory bowel disease.  

UK PubMed Central (United Kingdom)

UNLABELLED: BACKGROUND: Patients with inflammatory bowel disease (IBD) frequently appear iron deplete but whether this is a reflection of dietary iron intakes is not known. METHODS: Dietary data were collected from 29 patients with inactive or mildly-active IBD and 28 healthy controls using a validated food frequency questionnaire that measured intakes of iron and its absorption modifiers. Non-haem iron availability was estimated using a recently developed algorithm. Subjects were classified for iron status based upon data from a concomitant and separately published study of iron absorption. Absorption was used to define iron status because haematological parameters are flawed in assessing iron status in inflammatory conditions such as IBD. RESULTS: Dietary intakes of total iron, non-haem iron and vitamin C were significantly greater in IBD patients who were iron replete compared to those who were iron deplete (by 48%, 48% and 94% respectively; p?0.05). The predicted percentage of available non-haem iron did not differ between these groups (19.7 ± 2.0% vs 19.3 ± 2.0% respectively; p=0.25). However, because of the difference in iron intake, the overall amount of absorbed iron did (2.4 ± 0.8 mg/d vs 1.7 ± 0.5 mg/d; p=0.013). No such differences were observed in the healthy control subjects. CONCLUSIONS: In IBD, iron status is more closely related to the quality and quantity of dietary iron intake than in the general healthy population.

Powell JJ; Cook WB; Chatfield M; Hutchinson C; Pereira DIa; Lomer MC

2013-01-01

97

Dietary fortificant iron intake is negatively associated with quality of life in patients with mildly active inflammatory bowel disease  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Iron deficiency anaemia and oral iron supplementation have been associated negatively with quality of life, and with adverse effects, respectively, in subjects with inflammatory bowel disease (IBD). Hence, the risk-benefit ratio of oral iron is not understood in this patient group. The present case–control study investigated whether dietary iron intake impacts on quality of life in IBD patients. Methods Quality of life, habitual dietary iron intakes and iron requirements were assessed in 29 patients with inactive or mildly active IBD as well as in 28 healthy control subjects. Results As expected, quality of life was worse in IBD patients as a whole in comparison to healthy controls according to EuroQol score and EuroQol VAS percentage (6.9 ± 1.6 vs 5.3 ± 0.6; pvs 88 ± 12%; p=0.004 respectively). For IBD subjects, 21/29 were iron deplete based upon serum iron responses to oral iron but, overall, were non-anaemic with mean haemoglobin of 13.3 ± 1.5 g/dL, and there was no difference in their quality of life compared to 8/29 iron replete subjects (Hb 14.0 ± 0.8 g/dL). Interestingly, total dietary iron intake was significantly negatively associated with quality of life in IBD patients, specifically for non-haem iron and, more specifically, for fortificant iron. Moreover, for total non-haem iron the negative association disappeared when fortificant iron values were subtracted. Finally, further sub-analysis indicated that the negative association between (fortificant) dietary iron intake and quality of life in IBD patients is driven by findings in patients with mildly active disease rather than in patients with quiescent disease. Conclusions Iron deficiency per se (i.e. without concomitant anaemia) does not appear to further affect quality of life in IBD patients with inactive or mildly active disease. However, in this preliminary study, dietary iron intake, particularly fortificant iron, appears to be significantly negatively associated with quality of life in patients with mildly active disease.

Powell Jonathan J; Cook William B; Hutchinson Carol; Tolkien Zoe; Chatfield Mark; Pereira Dora IA; Lomer Miranda CE

2013-01-01

98

Association of dietary sodium intake with atherogenesis in experimental diabetes and with cardiovascular disease in patients with Type 1 diabetes.  

Science.gov (United States)

It is recommended that individuals with diabetes restrict their dietary sodium intake. However, although salt intake is correlated with BP (blood pressure), it also partly determines the activation state of the RAAS (renin-angiotensin-aldosterone system), a key mediator of diabetes-associated atherosclerosis. apoE KO (apolipoprotein E knockout) mice were allocated for the induction of diabetes with streptozotocin or citrate buffer (controls) and further randomized to isocaloric diets containing 0.05%, 0.3% or 3.1% sodium with or without the ACEi [ACE (angiotensin-converting enzyme) inhibitor] perindopril. After 6 weeks of study, plaque accumulation was quantified and markers of atherogenesis were assessed using RT-PCR (reverse transcription-PCR) and ELISA. The association of sodium intake and adverse cardiovascular and mortality outcomes were explored in 2648 adults with Type 1 diabetes without prior CVD (cardiovascular disease) from the FinnDiane study. A 0.05% sodium diet was associated with increased plaque accumulation in diabetic apoE KO mice, associated with activation of the RAAS. By contrast, a diet containing 3.1% sodium suppressed atherogenesis associated with suppression of the RAAS, with an efficacy comparable with ACE inhibition. In adults with Type 1 diabetes, low sodium intake was also associated with an increased risk of all-cause mortality and new-onset cardiovascular events. However, high sodium intake was also associated with adverse outcomes, leading to a J-shaped relationship overall. Although BP lowering is an important goal for the management of diabetes, off-target actions to activate the RAAS may contribute to an observed lack of protection from cardiovascular complications in patients with Type 1 diabetes with low sodium intake. PMID:23216128

Tikellis, Chris; Pickering, Raelene J; Tsorotes, Despina; Harjutsalo, Valma; Thorn, Lena; Ahola, Aila; Wadén, Johan; Tolonen, Nina; Saraheimo, Markku; Gordin, Daniel; Forsblom, Carol; Groop, Per-Henrik; Cooper, Mark E; Moran, John; Thomas, Merlin C

2013-05-01

99

Association of dietary sodium intake with atherogenesis in experimental diabetes and with cardiovascular disease in patients with Type 1 diabetes.  

UK PubMed Central (United Kingdom)

It is recommended that individuals with diabetes restrict their dietary sodium intake. However, although salt intake is correlated with BP (blood pressure), it also partly determines the activation state of the RAAS (renin-angiotensin-aldosterone system), a key mediator of diabetes-associated atherosclerosis. apoE KO (apolipoprotein E knockout) mice were allocated for the induction of diabetes with streptozotocin or citrate buffer (controls) and further randomized to isocaloric diets containing 0.05%, 0.3% or 3.1% sodium with or without the ACEi [ACE (angiotensin-converting enzyme) inhibitor] perindopril. After 6 weeks of study, plaque accumulation was quantified and markers of atherogenesis were assessed using RT-PCR (reverse transcription-PCR) and ELISA. The association of sodium intake and adverse cardiovascular and mortality outcomes were explored in 2648 adults with Type 1 diabetes without prior CVD (cardiovascular disease) from the FinnDiane study. A 0.05% sodium diet was associated with increased plaque accumulation in diabetic apoE KO mice, associated with activation of the RAAS. By contrast, a diet containing 3.1% sodium suppressed atherogenesis associated with suppression of the RAAS, with an efficacy comparable with ACE inhibition. In adults with Type 1 diabetes, low sodium intake was also associated with an increased risk of all-cause mortality and new-onset cardiovascular events. However, high sodium intake was also associated with adverse outcomes, leading to a J-shaped relationship overall. Although BP lowering is an important goal for the management of diabetes, off-target actions to activate the RAAS may contribute to an observed lack of protection from cardiovascular complications in patients with Type 1 diabetes with low sodium intake.

Tikellis C; Pickering RJ; Tsorotes D; Harjutsalo V; Thorn L; Ahola A; Wadén J; Tolonen N; Saraheimo M; Gordin D; Forsblom C; Groop PH; Cooper ME; Moran J; Thomas MC

2013-05-01

100

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

Directory of Open Access Journals (Sweden)

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

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

2007-01-01

 
 
 
 
101

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

Directory of Open Access Journals (Sweden)

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

2012-01-01

102

B vitamin status, dietary intake and length of stay in a sample of elderly rehabilitation patients.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To investigate the relationships between previous diet, biomarkers of selected B vitamins, nutritional status and length of stay. DESIGN: Cross sectional study. SETTING: Geriatric rehabilitation patients, Sydney, Australia. PARTICIPANTS: Fifty two consenting patients with normal serum creatinine levels and no dementia. MEASUREMENTS: Serum vitamin B12, plasma vitamin B6, serum and erythrocyte folate, homocysteine and methylmalonic acid (MMA) concentrations; dietary intake using a validated semi-quantitative food frequency questionnaire and nutritional assessment using the Mini Nutritional Assessment (MNA). Length of stay data were collected from medical records after discharge. RESULTS: The age was 80 ± 8 year (mean ± SD), BMI 26.4 ± 6.8 kg/m2 and MNA score 22 ± 3 indicating some risk of malnutrition. Deficiencies of vitamins B6, B12 and folate were found in 30, 22 and 5 subjects respectively. Length of stay was positively correlated with age and MMA (Spearman's correlation 0.4, p<0.01 and 0.28, p<0.05 respectively) and negatively correlated with albumin, vitamin B6 and MNA score (Spearman's correlation -0.35, -0.33 and -0.29, p<0.05). After adjustment for age and sex, ln vitamin B6 and ln MMA concentrations were significant in predicting ln LOS (p=0.006 and p=0.014 respectively). CONCLUSION: The study indicates a high risk of vitamin B deficiencies in the elderly and suggests that deficiencies of vitamins B6 and B12 are associated with length of stay. This is concerning as B vitamin status is rarely fully assessed.

O'Leary F; Flood VM; Petocz P; Allman-Farinelli M; Samman S

2011-01-01

103

Retrospective ratings of 100 first time-documented stroke patients on the Functional Oral Intake Scale.  

UK PubMed Central (United Kingdom)

PURPOSE: This study investigated whether patients originally evaluated on the swallowing portion of the Functional Assessment Measure (SFAM), an instrument that when used independently of the Functional Assessment Measure (FAM) has questionable reliability and validity, would demonstrate clinically and statistically significant gains if measured on an instrument such as the Functional Oral Intake Scale (FOIS), which is valid and reliable. Second, this study questioned how easily the FOIS could be adopted at Rancho Los Amigos National Rehabilitation Center (RLANRC), a rehabilitation facility currently utilising the Functional Independence Measure and the SFAM. Additionally, this research addressed inter-rater reliability, the relationship between the SFAM and FOIS at admission and at discharge, and the clinical and statistical difference in ratings between the two scales. METHOD: Treatment was given at RLANRC in Downey, California. Subjects for this study consisted of 100 first time-documented acute stroke patients with swallowing disorders. Inter-item correlation, intraclass correlation coefficients and Spearman Rho Correlations were used to establish inter-rater reliability, and descriptive statistics, Spearman Rho Correlations and the Wilcoxon Signed Ranks Test were used to explore relationships between the two scales. RESULTS: It was found that there was high inter-rater reliability, strong significant relationships between the SFAM and FOIS at admission and discharge, and statistically significant differences and clinical change in scores between admission and discharge on the FOIS. CONCLUSION: The FOIS is a valid and reliable instrument that is similar in design to the SFAM and requires minimal training for implementation. The transition from the SFAM to the FOIS will provide RLANRC with a reliable and valid assessment protocol.

McMicken BL; Muzzy CL; Calahan S

2010-01-01

104

Somatic, affective, and pain characteristics of chronic TMD patients with sexual versus physical abuse histories.  

UK PubMed Central (United Kingdom)

AIMS: This study examined whether temporomandibular disorder (TMD) patients with sexual versus physical abuse histories differ in their pain report, psychological distress, and somatic symptoms. METHODS: Participants were 114 female TMD patients. The sample was divided into 3 groups based on abuse history: sexual abuse, physical abuse, or no abuse. Abuse histories were assessed with a structured clinical interview. Measures used included the McGill Pain Questionnaire, the State-Trait Anxiety Inventory, the Beck Depression Inventory, and the Pennebaker Inventory of Limbic Languidness. Group differences were analyzed by analysis of variance and Bonferroni post hoc comparisons. RESULTS: Temporomandibular disorder patients with a history of physical abuse reported significantly more pain, anxiety, and depressive symptoms than did patients with a history of sexual abuse or no history of abuse. Furthermore, the results suggest that TMD patients with a sexual abuse history are not significantly different from patients with no abuse history across the domains studied. CONCLUSION: Based on the differences found, it can be argued that assessment of physical abuse histories by appropriately trained clinicians should be a routine part of any multimodal assessment of female chronic TMD patients.

Campbell LC; Riley JL 3rd; Kashikar-Zuck S; Gremillion H; Robinson ME

2000-01-01

105

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

Directory of Open Access Journals (Sweden)

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

Borg Julia; Ohlsson Bodil

2012-01-01

106

[Effect of a positive family history on the prognosis in patient with Bechterew disease  

UK PubMed Central (United Kingdom)

The objective of the present study was to evaluate whether the patients with a family history of ankylosing spondylitis might have a milder course of the disease than patients with a negative family history. We investigated a group of 197 patients with ankylosing spondylitis who had been suffering from symptoms of the disease for > or = 20 years. After exclusion of the patients with a history, or current evidence of colitis or urethritis, the remaining 148 patients with ankylosing spondylitis (none with psoriasis) were divided into 2 groups on the basis of a positive (25 patients) or a negative (123 patients) family history of ankylosing spondylitis. The variables of mobility were compared. Furthermore, the present height was compared with the former (maximum) height. All variables measured in the present study showed slightly better results in the patients with a positive family history, but the differences were not significant. The decrease of height was slightly larger in patients with a positive family history. Evidently, a positive family history does not appear to give a reliable prediction of the long-term prognosis in Austrian and German patients with ankylosing spondylitis.

Falkenbach A; Griessmayer H; Tripathi R

1998-01-01

107

[Effect of a positive family history on the prognosis in patient with Bechterew disease].  

Science.gov (United States)

The objective of the present study was to evaluate whether the patients with a family history of ankylosing spondylitis might have a milder course of the disease than patients with a negative family history. We investigated a group of 197 patients with ankylosing spondylitis who had been suffering from symptoms of the disease for > or = 20 years. After exclusion of the patients with a history, or current evidence of colitis or urethritis, the remaining 148 patients with ankylosing spondylitis (none with psoriasis) were divided into 2 groups on the basis of a positive (25 patients) or a negative (123 patients) family history of ankylosing spondylitis. The variables of mobility were compared. Furthermore, the present height was compared with the former (maximum) height. All variables measured in the present study showed slightly better results in the patients with a positive family history, but the differences were not significant. The decrease of height was slightly larger in patients with a positive family history. Evidently, a positive family history does not appear to give a reliable prediction of the long-term prognosis in Austrian and German patients with ankylosing spondylitis. PMID:9499474

Falkenbach, A; Griessmayer, H; Tripathi, R

1998-01-16

108

Utility of penicillin allergy testing in patients presenting with a history of penicillin allergy.  

UK PubMed Central (United Kingdom)

BACKGROUND: Current statistics show that approximately 10% of patients claim to be allergic to penicillin yet only 10% of these have demonstrable allergy. The most appropriate and cost-effective antibiotics are sometimes withheld on the basis of patient history of drug allergy. OBJECTIVE: Investigation of IgE hypersensitivity and delayed hypersensitivity in patients with a history of penicillin allergy to a teaching hospital allergy clinic. METHODS: Patients underwent skin prick and intradermal testing (IDT) with major and minor penicillin determinants. Those with negative skin tests were administered a three-day oral challenge. Demographic and clinical details about the reactions were noted. RESULTS: One hundred twenty eight patients underwent testing, of these, one hundred and ten had self-reported histories of penicillin allergy and eighteen were referred because of other antibiotic allergies. Seventeen patients with self-reported penicillin allergy had either positive skin tests or oral challenge results, corresponding to 15% of patients having proven allergy. None reacted on skin prick testing, four reacted to IDT, thirteen reacted to oral challenge (five immediate and eight delayed). Analysis of clinical histories showed that patients with a well-defined history of allergy and a history of anaphylaxis were more likely to have a positive test compared to patients with vague histories. Skin testing proved to be less sensitive than oral challenge. CONCLUSION: A minority of patients presenting with a history of penicillin allergy have evidence of immune-mediated hypersensitivity (17/110, 15%) in this study. Of these, eight out of seventeen (47%) had delayed reactions, demonstrating the usefulness and discriminating power of objective testing, which must include three-day oral challenge. Discriminating factors for immune-mediated allergy from patient history were a clear description of the original reaction and a history of anaphylaxis. Negative allergy testing enables the use of penicillin as first-line treatment when necessary and this can significantly reduce costs of antibiotics.

Sagar PS; Katelaris CH

2013-04-01

109

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 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 mu (more) scular 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 radiotherapy. Results: Of the 62 patients, significant reductions were found in arm muscle area (p = 0.001) and arm muscle circumference (p (more) ight loss of 5.7% in three weeks. With regards to their dietary intake, reductions were found in energy (26.5 kcal/kg/d-21.3 kcal/kg/d, p

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

2012-12-01

110

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 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

2002-10-02

111

Physical inactivity and insufficient dietary intake are associated with the frequency of sarcopenia in patients with compensated viral liver cirrhosis.  

UK PubMed Central (United Kingdom)

AIM: The association between sarcopenia and nutritional status is thought to be an important problem in patients with cirrhosis. In this study, we investigated whether nutritional factors were related to sarcopenia in patients with liver cirrhosis. METHODS: The subjects were 50 patients with cirrhosis aged 41 years or older. In this study, the subjects were interviewed about their dietary habits, and their daily physical activity was surveyed using a pedometer. The skeletal muscle mass index (SMI) was calculated using the appendicular skeletal muscle mass (ASM) measured by bioelectric impedance analysis. The handgrip strength was measured using a hand dynamometer. Sarcopenia was defined by SMI and handgrip strength. The patients with cirrhosis were categorized as normal group or sarcopenia group, and the two groups were compared. Univariate and multivariate logistic regression modeling were used to identify the relevance for sarcopenia in patients with cirrhosis. RESULTS: Height (odds ratio (OR), 5.336; 95% confidence interval [CI], 1.063-26.784; P?=?0.042), energy intake per ideal bodyweight (IBW) (OR, 5.882; 95% CI, 1.063-32.554; P?=?0.042) and number of steps (OR, 4.767; 95% CI, 1.066-21.321; P?=?0.041) were independent relevant factors for sarcopenia. Moreover, a significantly greater number of the patients in the sarcopenia group had low values for both parameters' energy intake per IBW and number of steps. CONCLUSION: Our results suggest that walking 5000 or more steps per day and maintaining a total energy intake of 30?kcal/IBW may serve as a reference for lifestyle guidelines for compensated cirrhotic patients.

Hayashi F; Matsumoto Y; Momoki C; Yuikawa M; Okada G; Hamakawa E; Kawamura E; Hagihara A; Toyama M; Fujii H; Kobayashi S; Iwai S; Morikawa H; Enomoto M; Tamori A; Kawada N; Habu D

2013-02-01

112

The associations between oxygen radical absorbance capacity of dietary intake and hypertension in type 2 diabetic patients.  

UK PubMed Central (United Kingdom)

The objective of this study was to investigate the potential associations between oxygen radical absorbance capacity (ORAC) of fruits, vegetables, legumes and nuts, and blood pressure in type 2 diabetic patients in Tehran. In a cross-sectional study of 506 type 2 diabetic patients, aged 28-75 years, usual dietary intakes were assessed by means of a 168-item food-frequency questionnaire. To calculate the estimated hydrophilic-ORAC, total ORAC, and total phenolics (TP) of fruits, vegetables, legumes and nuts for each participant, we used the United States Department of Agriculture Database for ORAC. We examined the associations between total ORAC and TP scores, and hypertension using logistic regression. After adjustment for potential confounders, a higher total ORAC score was associated with lower risk of hypertension. The odds ratios (ORs) of systolic blood pressure (SBP) >140 mm Hg across increasing quartiles of the total ORAC score were 1.0, 0.71, 0.38 and 0.56 (P for trend=0.016). The ORs of diastolic blood pressure (DBP) >90 mm Hg across increasing quartiles of the total ORAC score were 1.0, 0.59, 0.47 and 0.35 (P for trend=0.008). Further adjustment for energy, protein and sodium intakes slightly strengthened these associations. Multivariate ORs of elevated SBP across quartiles of TP score were 1.0, 0.83, 0.41 and 0.63 (P for trend=0.027), and for elevated DBP were 1.0, 0.50, 0.40 and 0.38 (P for trend=0.006). Further adjustment for energy, protein and sodium intakes did not change the results materially. Our findings suggest that total antioxidant capacity of the dietary intake was negatively associated with hypertension in type 2 diabetic patients.

Farvid MS; Homayouni F; Kashkalani F; Shirzadeh L; Valipour G; Farahnak Z

2013-03-01

113

Influence of a nutritional intervention on dietary intake and quality of life in cancer patients: A randomized controlled trial.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Weight loss is common in patients with malignant tumors and it can adversely affect quality of life and survival. The aim of the present study was to investigate the effects of a nutritional intervention in cancer patients in an outpatient setting. METHODS: Cancer outpatients (N = 58) who were classified as undernourished or at high risk for undernutrition by the Nutritional Risk Screening 2002 tool were randomized into two groups. One group (n = 30) received standardized individual nutritional therapy, including counseling by a dietitian, food fortification, and oral nutritional supplements if required. The second group (n = 28) received standard care. The nutritional intervention lasted 3 mo. Dietary intake (3-d dietary record), nutritional status (body weight), physical functioning (performance status, hand-grip strength) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire version 3.0) were assessed at baseline and after 6 wk and 3 mo. An additional follow-up assessment was carried out 3 mo post-intervention. RESULTS: Nutritional intervention led to a significantly higher average energy and protein intake in the nutritional therapy group (+379 kcal; 95% confidence interval [CI], 117-642; P = 0.007, respectively; +10.4 g; 95% CI, 2.3-18.5; P = 0.016). However, the increased dietary intake was not associated with improvements in nutritional status, physical functioning, or quality of life. CONCLUSIONS: Individual nutritional counseling significantly and positively influenced energy and protein intake, but did not improve nutritional or physical outcome or quality of life. These results indicate that nutritional therapy alone is of limited efficacy in cancer patients whose nutritional status has already deteriorated.

Uster A; Ruefenacht U; Ruehlin M; Pless M; Siano M; Haefner M; Imoberdorf R; Ballmer PE

2013-11-01

114

Severe odynophagia in a patient developing after azithromycin intake: a case report.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Drug-induced esophageal ulcers most commonly cause heartburn, midsternal pain and dysphagia. In our clinic azithromycin is a relative widely used antibiotic for respiratory tract infections and otitis media because of its activity against Haemophilus influenzae and atypical pathogens, and its ease of administration. After a thorough search in Pubmed the present case is the first one to report azithromycin-induced esophageal ulcer and associated symptoms in the literature. CASE PRESENTATION: A 61-year-old Caucasian man was admitted to our endoscopy unit for the investigation of odynophagia and retrosternal pain of new onset. His past medical history was unremarkable but had used azithromycin 500 mg/d for three days in the previous week. An upper endoscopy revealed an extensive serpiginous midesophageal ulcer in the presence of a normal squamocolumnar junction and biopsies from the edges and center of the lesion disclosed no neoplasia or infectious causes but a dense acute inflammatory infiltrate. The patient was put on a liquid diet, sucralfate proton pump inhibitor treatment and was symptom-free within two weeks. After four weeks on therapy a repeated upper endoscopic control examination demonstrated normal findings. CONCLUSION: To our knowledge this is the first such a case of azithromycin -induced esophageal ulceration. We think that a little time taken by the physician to warn the patients for taking every oral drug with sufficient amount of water might prevent this kind of complications.

Akyuz U; Erzin Y; Yalniz FF; Senkal IV; Ekici ID; Pata C

2010-01-01

115

Advising patients to increase fluid intake for treating acute respiratory infections.  

UK PubMed Central (United Kingdom)

BACKGROUND: Acute respiratory infection is a common reason for people to present for medical care. Advice to increase fluid intake is a frequent treatment recommendation. Attributed benefits of fluids include replacing increased insensible fluid losses, correcting dehydration from reduced intake and reducing the viscosity of mucus. However, there are theoretical reasons for increased fluid intake to cause harm. Anti-diuretic hormone secretion is increased in lower respiratory tract infections of various aetiologies. This systematic examination of the evidence sought to determine the benefit versus harm from increasing fluid intake. OBJECTIVES: To answer the following questions.1. Does recommending increased fluid intake as a treatment for acute respiratory infections improve duration and severity of symptoms? 2. Are there adverse effects from recommending increased fluids in people with acute respiratory infections? 3. Are any benefits or harms related to site of infection (upper or lower respiratory tract) or a different severity of illness? SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 4), which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to November Week 3, 2010), EMBASE (1974 to December 2010), Current Contents (2000 to December 2010) and CINAHL (1982 to December 2010). We searched reference lists of articles identified and contacted experts in the relevant disciplines. SELECTION CRITERIA: Randomised controlled trials (RCTs) that examined the effect of increasing fluid intake in people with acute respiratory infections. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the identified studies to determine eligibility for inclusion. MAIN RESULTS: No RCTs assessing the effect of increasing fluid intake in acute respiratory infections were found. AUTHORS' CONCLUSIONS: There is currently no evidence from RCTs for or against the recommendation to increase fluids in acute respiratory infections. The implications for fluid management of acute respiratory infections in the outpatient or primary care setting have not been studied in any RCTs to date. Some non-experimental (observational) studies report that increasing fluid intake in acute respiratory infections of the lower respiratory tract may cause harm. RCTs need to be done to determine the true effect of this very common medical advice.

Guppy MP; Mickan SM; Del Mar CB; Thorning S; Rack A

2011-01-01

116

Merging health literacy with computer technology: self-managing diet and fluid intake among adult hemodialysis patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The Dietary Intake Monitoring Application (DIMA) is an electronic dietary self-monitor developed for use on a personal digital assistant (PDA). This paper describes how computer, information, numerical, and visual literacy were considered in development of DIMA. METHODS: An iterative, participatory design approach was used. Forty individuals receiving hemodialysis at an urban inner-city facility, primarily middle-aged and African American, were recruited. RESULTS: Computer literacy was considered by assessing abilities to complete traditional/nontraditional PDA tasks. Information literacy was enhanced by including a Universal-Product-Code (UPC) scanner, picture icons for food with no UPC code, voice recorder, and culturally sensitive food icons. Numerical literacy was enhanced by designing DIMA to compute real-time totals that allowed individuals to see their consumption relative to their dietary prescription. Visual literacy was considered by designing the graphical interface to convey intake data over a 24-h period that could be accurately interpreted by patients. Pictorial icons for feedback graphs used objects understood by patients. PRACTICE IMPLICATIONS: Preliminary data indicate the application is extremely helpful for individuals as they self-monitor their intake. If desired, DIMA could also be used for dietary counseling.

Welch JL; Siek KA; Connelly KH; Astroth KS; McManus MS; Scott L; Heo S; Kraus MA

2010-05-01

117

Comprehensive orofacial pain analysis: a structured approach to patient history.  

UK PubMed Central (United Kingdom)

A structured approach to pain analysis is described. This format for obtaining a complete history is useful to persons involved in the diagnosis and management of painful conditions involving the head and neck. Key components and rationale for their inclusion in a thorough evaluation process are discussed.

Gremillion HA; Reams MT

1997-05-01

118

Comprehensive orofacial pain analysis: a structured approach to patient history.  

Science.gov (United States)

A structured approach to pain analysis is described. This format for obtaining a complete history is useful to persons involved in the diagnosis and management of painful conditions involving the head and neck. Key components and rationale for their inclusion in a thorough evaluation process are discussed. PMID:9515424

Gremillion, H A; Reams, M T

119

Prognostic impact of family history in southern Chinese patients with undifferentiated nasopharyngeal carcinoma.  

Science.gov (United States)

Background:Family history of cancer is associated with developing nasopharyngeal carcinoma (NPC); however, the impact of it on survival among established NPC patients remains unknown.Methods:We retrospectively analysed 1773 southern Chinese patients. Associations between a first-degree family history of NPC and overall survival (OS), locoregional relapse-free survival (LRFS) and distant metastasis-free survival (DMFS) were estimated by Cox regression.Results:Among 1773 patients, 207 (11.7%) reported a first-degree family history of NPC. Compared with patients without a family history, the adjusted hazard ratios among those with it were 0.60 (95% confidence interval (CI), 0.37-0.98; P=0.040) for OS, 0.52 (95% CI, 0.24-1.12; P=0.096) for LRFS and 0.51 (95% CI, 0.27-0.97; P=0.040) for DMFS. There were trends for improving OS, LRFS and DMFS with increasing number of affected relatives (Ptrend: 0.050, 0.114 and 0.044, respectively). But no significant benefits of family history in second- or third-degree relatives were observed. In subgroup analysis, we observed the effects of family history with restriction to male patients and those of advanced stage and treated with conventional radiotherapy and addition of chemotherapy.Conclusion:A first-degree family history of NPC is associated with improved survival of patients. PMID:23807164

Ouyang, P-Y; Su, Z; Mao, Y-P; Liang, X-X; Liu, Q; Xie, F-Y

2013-06-27

120

Diplopia after laser in situ keratomileusis (LASIK) in a patient with a history of strabismus.  

UK PubMed Central (United Kingdom)

In patients with a history of strabismus, refractive surgery can result in decompensation of ocular alignment, with subsequent diplopia. Refractive surgery in the management of strabismus has been described, although it remains controversial. We present a young adult with past history of strabismus surgery and new-onset diplopia after refractive surgery. Binocular diplopia was treated surgically with laser in situ keratomileusis.

Heinmiller LJ; Wasserman BN

2013-02-01

 
 
 
 
121

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

Directory of Open Access Journals (Sweden)

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

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

2001-01-01

122

History of spine surgery in older obese patients  

Directory of Open Access Journals (Sweden)

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

Walid, M. Sami; Zaytseva, Nadezhda

2011-01-01

123

[Anesthetic management of two patients with the history of SMON].  

UK PubMed Central (United Kingdom)

Patients of subacute myelo-optico-neuropathy (SMON) suffer from neurological disorders for a long time. The authors report anesthetic management of two patients with SMON. One patient was a 82-year-old woman suffering from SMON for 49 years. Sensory examination revealed numbness and hypesthesia in the both lower extremities. She underwent open reduction for femoral neck fracture. The other patient was a 91-year-old man suffered from SMON for 31 years. Sensory examination revealed weakness of leg muscles. He underwent transurethral resection of prostate. We chose general anesthesia for both patients instead of spinal anesthesia because of reported complications related to spinal anesthesia in patients with the disease. Intraoperative courses were uneventful and there were no neurological deteriorations postoperatively in both patients. One of the chief symptoms of patients with SMON is numbness of the lower extremity. Therefore patients of SMON may feel uncomfortable to the numbness by spinal or epidural anesthesia. This is the main reason we recommend general anesthesia for patients with SMON.

Sato H; Okawa I; Sasuga M; Mitani S; Matsukawa T; Kumazawa T

2002-08-01

124

Assessment of alcohol histories obtained from patients with liver disease: opportunities to improve early intervention.  

UK PubMed Central (United Kingdom)

BACKGROUND: Alcohol is an important primary and co-morbid cause of liver injury in patients referred for investigation and management of liver disease. Early assessment and documentation of alcohol consumption is therefore essential, and recommended in both general practice and hospital settings. AIMS: To determine the extent and accuracy of documentation of alcohol consumption in patients referred for evaluation of liver disease. METHODS: Patients were interviewed using a structured questionnaire. The medical records of all patients interviewed were reviewed to obtain information from the referral letter and the hepatology consultations. RESULTS: 83 patients were surveyed. Only 14 referrals had an informative alcohol history, despite 27 patients admitting risky alcohol consumption at the initial hepatology consultation. 90% of initial consultations had an informative alcohol history documented, whereas only 56% of patients attending a follow-up appointment had informative documentation. Assessment of alcohol consumption was comparable between the hepatology consultation and the structured questionnaire, but 4 subjects had substantially different alcohol histories. AUDIT identified all patients reporting harmful alcohol consumption on the questionnaire. CONCLUSIONS: Hazardous alcohol use is prevalent in subjects attending hepatology clinics, but informative alcohol histories which are crucial to patient management, are rarely documented in referrals. Screening tools improve documentation and accuracy of alcohol histories and their use by general practitioners and hospital clinicians would improve detection rates of hazardous drinking and allow earlier intervention. Systematic use of screening tools in hepatology clinics will provide opportunities for education and reinforce recommendations to reduce hazardous or harmful alcohol consumption.

Fagan KJ; Irvine KM; Kumar S; Bates A; Horsfall LU; Feeney GF; Powell EE

2013-07-01

125

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

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

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

2010-01-01

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Protein intake in relation to risk of hypertension and microalbuminuria in patients with type 1 diabetes: the EURODIAB Prospective Complications Study.  

UK PubMed Central (United Kingdom)

BACKGROUND: A beneficial association between dietary protein intake (especially from plant sources) with incident hypertension, being strongly correlated to microalbuminuria, has been suggested in healthy populations. Evidence from diabetic populations, in which the prevalence of these diseases is high, is lacking. We examined the associations of total, animal and plant protein intake with incident hypertension (n?=?1319) and microalbuminuria (n?=?1045) in patients from 16 European countries with type 1 diabetes from the clinic-based EURODIAB Prospective Complications study. METHODS: Odds ratios (OR) with 95% confidence intervals (CI) for incident hypertension after 7 years of follow-up were calculated in tertiles of protein intake (energy%) with adjustments for age, sex, diabetes duration, HbA1c, BMI, physical activity, smoking, alcohol, total energy, total fat and carbohydrate intake. RESULTS: After adjustment for potential confounders, total, animal and plant protein intakes were not related to incident hypertension (298 cases). OR's (95% CI) across increasing tertiles of total protein were 1.00 (ref), 0.86 (0.60-1.25) and 0.91 (0.59-1.43). Furthermore, no relation was observed with incident microalbuminuria (135 cases), with ORs (95% CI) across increasing tertiles of total protein being 1.00 (ref), 0.88 (0.53-1.48) and 1.08 (0.57-2.04). CONCLUSION: Results from our study did not provide evidence that a protein intake commonly consumed by European patients with type 1 diabetes is associated with incident hypertension or microalbuminuria. Prospective studies with more detailed information on dietary intake (including mineral intake) are needed to confirm these findings, and to investigate the impact on vascular and renal complications of a long-term very high protein intake in patients with type 1 diabetes.

Altorf-van der Kuil W; Engberink MF; Ijpma I; Verberne LD; Toeller M; Chaturvedi N; Fuller JH; Soedamah-Muthu SS

2013-06-01

127

Plasma Endothelin-1 Levels in Patients with Rheumatic Mitral Stenosis and A History of Cerebral Thromboembolism.  

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Full Text Available Background: Increased plasma endothelin-1 concentrations have been observed in patientswith rheumatic mitral stenosis. Endothelin-1 levels have never been investigatedin patients with mitral stenosis and history of cerebral thromboembolism.Methods: We measured plasma concentrations of endothelin-1 in the peripheral venousblood samples obtained from 20 patients with moderate to severe rheumaticmitral stenosis (16 with permanent atrial fibrillation and 4 with sinusrhythm). Six patients had history of thromboembolism. The remaining 14patients did not have history of thromboembolism. Plasma endothelin-1 concentrationswere measured using solid phase sandwich enzyme linkedimmuno-sorbent assay.Results: The peripheral venous concentrations of endothelin-1 of the six patients withhistory of thromboembolism did not differ from the concentrations of the 14patients without history of thromboembolism (2.40 1.39 pg/ml vs. 2.490.66 pg/ml, p = 0.9).Conclusions: Although plasma endothelin-1 concentrations were increased in patients withmitral stenosis, plasma endothelin-1 concentrations were not further elevatedin patients with mitral stenosis and history of thromboembolism.

Li-Chuan Ma; Mien-Cheng Chen; Hsueh-Wen Chang

2004-01-01

128

Plasma Endothelin-1 Levels in Patients with Rheumatic Mitral Stenosis and A History of Cerebral Thromboembolism.  

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Full Text Available Background: Increased plasma endothelin-1 concentrations have been observed in patientswith rheumatic mitral stenosis. Endothelin-1 levels have never been investigatedin patients with mitral stenosis and history of cerebral thromboembolism.Methods: We measured plasma concentrations of endothelin-1 in the peripheral venousblood samples obtained from 20 patients with moderate to severe rheumaticmitral stenosis (16 with permanent atrial fibrillation and 4 with sinusrhythm). Six patients had history of thromboembolism. The remaining 14patients did not have history of thromboembolism. Plasma endothelin-1 concentrationswere measured using solid phase sandwich enzyme linkedimmuno-sorbent assay.Results: The peripheral venous concentrations of endothelin-1 of the six patients withhistory of thromboembolism did not differ from the concentrations of the 14patients without history of thromboembolism (2.40 +- 1.39 pg/ml vs. 2.49 +- 0.66 pg/ml, p = 0.9).Conclusions: Although plasma endothelin-1 concentrations were increased in patients withmitral stenosis, plasma endothelin-1 concentrations were not further elevatedin patients with mitral stenosis and history of thromboembolism.

Li-Chuan Ma; Mien-Cheng Chen; Hsueh-Wen Chang

2004-01-01

129

Data-to-text summarisation of patient records: using computer-generated summaries to access patient histories.  

UK PubMed Central (United Kingdom)

OBJECTIVE: We assess the efficacy and utility of automatically generated textual summaries of patients' medical histories at the point of care. METHOD: Twenty-one clinicians were presented with information about two cancer patients and asked to answer key questions. For each clinician, the information on one of the patients comprised their official hospital records, and for the other patient it comprised summaries that were computer-generated by a natural language generation system from data extracted from the official records. We measured the accuracy of the clinicians' responses to the questions, the time they took to complete them, and recorded their attitude to the computer-generated summaries. RESULTS: Results showed no significant difference in the accuracy of responses to the computer-generated records over the official records, but a significant difference in the time taken to assess the patients' condition from the computer-generated records. Clinicians expressed a positive attitude towards the computer-generated records. CONCLUSION: AI-based computer-generated textual summaries of patient histories can be as accurate as, and more efficient than, human-produced patient records for clinicians seeking to accurately identify key information about a patients overall history. PRACTICE IMPLICATIONS: Computer-generated textual summaries of patient histories can contribute to the management of patients at the point-of-care.

Scott D; Hallett C; Fettiplace R

2013-08-01

130

Psychological characteristics and outcomes of elective cosmetic surgery patients: the influence of cosmetic surgery history.  

Science.gov (United States)

The early cosmetic surgery literature suggested that individuals re-presenting for aesthetic surgical procedures (referred to as "insatiable patients") display poorer psychological functioning and satisfaction with surgical outcomes than those who request one procedure. The aim of the study was to compare 284 patients with and without a history of cosmetic procedures on demographic characteristics, appearance concerns, expectations of surgery, psychosocial dysfunction, and postoperative dissatisfaction. There were few differences between the groups, suggesting that the group of patients with a history of aesthetic surgeries did not represent the population that has been described as "surgery insatiable." Post hoc analyses of subgroups of patients with a history of surgeries also revealed few differences except for lower self-esteem and postoperative satisfaction. Further research is required to fully explore the applicability of the "insatiable patient" label in the context of increasing societal acceptance of cosmetic surgery. PMID:22157610

Dowling, Nicki A; Jackson, Alun C; Honigman, Roberta J; Francis, Kate L

131

Epidemiology and Natural History of Patients with NAFLD.  

UK PubMed Central (United Kingdom)

Non-alcoholic fatty liver disease (NAFLD) currently represents the most common liver disease in Western countries, being found in 25-30% of the general population. NAFLD embraces a wide range of metabolic hepatic damage characterised by steatosis and, in some cases, associated non-alcoholic steatohepatitis (NASH). The long-term hepatic prognosis of NAFLD patients depends on the histological stage at diagnosis: simple steatosis has a favourable outcome, whereas patients with NASH can develop cirrhosis and other liver-related complications, including hepatocellular carcinoma. Progression of fibrosis is thought to develop in up to one third of NASH patients, including the development of cirrhosis, but regression is also possible in pre-cirrhotic stages. Independent predictors of fibrosis are older age, diabetes, obesity, hypertension, and the degree of insulin resistance. Patients with NAFLD, particularly those with NASH, have a higher prevalence and incidence of clinically manifested cardiovascular disease, independently of classical cardiometabolic risk factors. Hepatocellular carcinoma (HCC) is usually diagnosed at a late stage, but it may also occur in non-cirrhotic NASH, as obesity and diabetes both independently increases the risk of developing HCC. Liver-related mortality is increased up to ten-fold in patients with NASH.

Bhala N; Jouness RI; Bugianesi E

2013-01-01

132

Epidemiology and Natural History of Patients with NAFLD.  

Science.gov (United States)

Non-alcoholic fatty liver disease (NAFLD) currently represents the most common liver disease in Western countries, being found in 25-30% of the general population. NAFLD embraces a wide range of metabolic hepatic damage characterised by steatosis and, in some cases, associated non-alcoholic steatohepatitis (NASH). The long-term hepatic prognosis of NAFLD patients depends on the histological stage at diagnosis: simple steatosis has a favourable outcome, whereas patients with NASH can develop cirrhosis and other liver-related complications, including hepatocellular carcinoma. Progression of fibrosis is thought to develop in up to one third of NASH patients, including the development of cirrhosis, but regression is also possible in pre-cirrhotic stages. Independent predictors of fibrosis are older age, diabetes, obesity, hypertension, and the degree of insulin resistance. Patients with NAFLD, particularly those with NASH, have a higher prevalence and incidence of clinically manifested cardiovascular disease, independently of classical cardiometabolic risk factors. Hepatocellular carcinoma (HCC) is usually diagnosed at a late stage, but it may also occur in non-cirrhotic NASH, as obesity and diabetes both independently increases the risk of developing HCC. Liver-related mortality is increased up to ten-fold in patients with NASH. PMID:23394091

Bhala, Neeraj; Jouness, Ramy Ibrahim Kamal; Bugianesi, Elisabetta

2013-01-01

133

Acute severe hypothyroidism is not associated with hyponatremia even with increased water intake: a prospective study in thyroid cancer patients  

Science.gov (United States)

Background Hypothyroidism, commonly induced in preparation for radioiodine treatment of differentiated thyroid cancer, is a text-book cause for hyponatremia. Nausea, stress, and increased fluid intake associated with the treatment are expected to exacerbate hyponatremia. Methods We prospectively studied 212 (80% females) consecutive thyroid cancer patients for the incidence of hypothyroidism-induced hyponatremia and associated risk factors. Results Mean(SD) age was 39.7(14.1) year, creatinine 82.0(20.8) ?mol/l, TSH 141.6(92.0) mU/l, pre- and post-isolation sodium 139.5(2.3) and 137.8(3.0) mEq/l, respectively, and estimated fluid intake during isolation 9.7(6.2) L. Mild hyponatremia (?130 mEq/l) was present in 18 patients (8.5%) and moderate hyponatremia (?120 mEq/l) in 4(1.9%), 3 of the latter had elevated creatinine concentration and 2 were on diuretics. There was no significant correlation between post-isolation sodium concentration and TSH concentration (r?=?0.03, p?=?0.69) or estimated fluid intake (r?=?0.10, p =0.17). There was significant correlation between post-isolation sodium concentration and age (r?=??0.24, p?patients, hyponatremic patients were more likely to have pre-isolation hyponatremia (9% vs. 0.5%, p?=?0.03), elevated creatinine concentration (36% vs. 13%, p?=?0.008), and to be on diuretics (23% vs. 1%, p?=?0.0001). Conclusions In the setting of acute severe hypothyroidism: 1) clinically-important hyponatremia is uncommon; sodium concentration may not need to be monitored unless patients have impaired renal function or are on diuretics, 2) age and female gender are associated with lower sodium concentration. Uncomplicated acute severe hypothyroidism didn’t cause clinically-important hyponatremia/SIADH in this cohort of patients.

2013-01-01

134

Acute severe hypothyroidism is not associated with hyponatremia even with increased water intake: a prospective study in thyroid cancer patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Hypothyroidism, commonly induced in preparation for radioiodine treatment of differentiated thyroid cancer, is a text-book cause for hyponatremia. Nausea, stress, and increased fluid intake associated with the treatment are expected to exacerbate hyponatremia. METHODS: We prospectively studied 212 (80% females) consecutive thyroid cancer patients for the incidence of hypothyroidism-induced hyponatremia and associated risk factors. RESULTS: Mean(SD) age was 39.7(14.1) year, creatinine 82.0(20.8) mumol/l, TSH 141.6(92.0) mU/l, pre- and post-isolation sodium 139.5(2.3) and 137.8(3.0) mEq/l, respectively, and estimated fluid intake during isolation 9.7(6.2) L. Mild hyponatremia (>=130 mEq/l) was present in 18 patients (8.5%) and moderate hyponatremia (>=120 mEq/l) in 4(1.9%), 3 of the latter had elevated creatinine concentration and 2 were on diuretics. There was no significant correlation between post-isolation sodium concentration and TSH concentration (r = 0.03, p = 0.69) or estimated fluid intake (r = 0.10, p =0.17). There was significant correlation between post-isolation sodium concentration and age (r = -0.24, p < 0.0001) and creatinine concentration (r = -0.22, p = 0.001). Pre-post-isolation drop in sodium concentration was more in females (mean difference 1.21, p = 0.02). Compared to eunatremic patients, hyponatremic patients were more likely to have pre-isolation hyponatremia (9% vs. 0.5%, p = 0.03), elevated creatinine concentration (36% vs. 13%, p = 0.008), and to be on diuretics (23% vs. 1%, p = 0.0001). CONCLUSIONS: In the setting of acute severe hypothyroidism: 1) clinically-important hyponatremia is uncommon; sodium concentration may not need to be monitored unless patients have impaired renal function or are on diuretics, 2) age and female gender are associated with lower sodium concentration. Uncomplicated acute severe hypothyroidism didn't cause clinically-important hyponatremia/SIADH in this cohort of patients.

Hammami MM; Almogbel F; Hammami S; Faifi J; Alqahtani A; Hashem W

2013-07-01

135

The role of soluble fiber intake in patients under highly effective lipid-lowering therapy  

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Full Text Available Abstract Background It has been demonstrated that statins can increase intestinal sterol absorption. Augments in phytosterolemia seems related to cardiovascular disease. Objective We examined the role of soluble fiber intake in endogenous cholesterol synthesis and in sterol absorption among subjects under highly effective lipid-lowering therapy. Design In an open label, randomized, parallel-design study with blinded endpoints, subjects with primary hypercholesterolemia (n = 116) were assigned to receive during 12 weeks, a daily dose of 25 g of fiber (corresponding to 6 g of soluble fibers) plus rosuvastatin 40 mg (n = 28), rosuvastatin 40 mg alone (n = 30), sinvastatin 40 mg plus ezetimibe 10 mg plus 25 g of fiber (n = 28), or sinvastatin 40 mg plus ezetimibe 10 mg (n = 30) alone. Results The four assigned therapies produced similar changes in total cholesterol, LDL-cholesterol, and triglycerides (p Conclusion Among subjects treated with highly effective lipid-lowering therapy, the intake of 25 g of fibers added favorable effects, mainly by reducing phytosterolemia. Additional benefits include improvement in blood glucose and anthropometric parameters.

Ramos Silvia C; Fonseca Francisco A; Kasmas Soraia H; Moreira Flávio T; Helfenstein Tatiana; Borges Ney C; Moreno Ronilson A; Rezende Vinicius M; Silva Fernanda C; Izar Maria C

2011-01-01

136

[Hereditary angioedema. Family history and clinical manifestations in 58 patients].  

UK PubMed Central (United Kingdom)

Hereditary angioedema (HAE) is a rare autosomal dominant disease, characterized by episodes of edema typically involving the skin, gastrointestinal tract and larynx. We here describe the epidemiologic and clinical characteristic of a series of 58 patients with diagnosis of HAE, 53 (91%) type I and 5 (9%) type II. The mean age at first symptom was 10.8 +/- 9.5 years and the mean age at diagnosis was 25.8 +/- 16.2 years old, with a diagnosis delay of 15.3 +/- 14.3 years. The mean number of attacks in the previous 6 months was 7.4 +/- 7.6 range 0 to 40. Fifty four (93%) had cutaneous attacks, 50 (86%) abdominal attacks, 24 (41%) laryngeal attacks and 24 (41%) combined cutaneous and abdominal attacks. Twenty seven (46.5%) patients never received preventive treatments and 17 (29%) received danazol in different doses for different periods of time. During the attacks, 15 (26%) patients were treated with C1 inhibitor at least once, 7 (12%) with fresh frozen plasma and 40 (69%) received only supportive treatment. Stress and trauma were identified as attacks triggers. Six (10%) patients were first mutation and 52 (90%) had HAE ancestors. We reconstructed 20 kindred, identifying 205 individuals at risk of inheriting the disease, 109 (53 %) of them had signs or laboratory diagnosis of HAE. The total number of identified HAE individuals was 145, 19 (13%) died with asphyxia. So, shortening of diagnosis delay and appropriate treatment of HAE are a challenge to be fulfilled.

Romero DS; Di Marco P; Malbrán A

2009-01-01

137

[Ophthalmologic screening history and vision-targeted health status of patients suffering from chloroquine maculopathy].  

UK PubMed Central (United Kingdom)

BACKGROUND: Maculopathy or retinopathy can develop as a side effect of chloroquine intake. Despite recommendations for ophthalmologic screening by the American Academy of Ophthalmology (AAO) severe toxic retinal damage still occurs. This study aims to clarify how maculopathy affects patient quality of life and whether it arises only due to non-compliance with screening guidelines. METHODS: Patients suffering from chloroquine maculopathy were questioned about the ophthalmologic examinations that took place under therapy and completed a German version of the 25 item visual function questionnaire (VFQ-25). RESULTS: A total of ten female patients were included in the analysis. Weighted visual acuity ranged from 0.09 to 0.8. Median composite score of the VFQ-25 was 33.9. All patients were periodically screened for ocular toxicity with a median trimestrial screening frequency but five patients did not receive all recommended methods of examination. There was suspicion of retinal damage in only one patient even without the patient reporting complaints. Median time span between onset of visual complaints and the cessation of the drug was 12 months. All patients with complaints reported a continuing deterioration of vision even after cessation. CONCLUSIONS: Chloroquine maculopathy has a major impact on the vision-related health status of affected patients, emphasizing the need for its anticipation. Although patients were screened even more frequently than recommended by the AAO only half were examined properly and nine out of ten patients had a delay in diagnosis and in drug cessation. The continuing deterioration of vision even after termination of intake further contributes to the severity of the disease.

Bergholz R; Rüther K; Tillack H; Joussen AM; Schroeter J

2013-07-01

138

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

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

M EATEMADIF; F GHADIRI; M SADEGHI

2003-01-01

139

A study of smart card for radiation exposure history of patient.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The purpose of this article is to undertake a study on developing a prototype of a smart card that, when swiped in a system with access to the radiation exposure monitoring server, will locate the patient's radiation exposure history from that institution or set of associated institutions to which it has database access. CONCLUSION: Like the ATM or credit card, the card acts as a secure unique "token" rather than having cash, credit, or dose data on the card. The system provides the requested radiation history report, which then can be printed or sent by e-mail to the patient. The prototype system is capable of extending outreach to wherever the radiation exposure monitoring server extends, at county, state, or national levels. It is anticipated that the prototype shall pave the way for quick availability of patient exposure history for use in clinical practice for strengthening radiation protection of patients.

Rehani MM; Kushi JF

2013-04-01

140

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 st...

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

 
 
 
 
141

Diet and paraoxonase 1 enzymatic activity in diabetic foot patients from Romania and Belgium: favorable association of high flavonoid dietary intake with arylesterase activity.  

UK PubMed Central (United Kingdom)

BACKGROUND/AIMS: The antiatherosclerotic enzyme paraoxonase (PON1) is affected by disease and lifestyle. We investigated the impact of diet in diabetic foot patients from 2 European countries. METHODS: Dietary intake and serum PON1 activity, using as substrate paraoxon (paraoxonase) or phenylacetate (arylesterase), were assessed in patients from Bucharest (n = 40) and Antwerp (n = 30) and in 34 healthy controls. RESULTS: The diabetic patients had lower paraoxonase and arylesterase activities than the controls. Arylesterase was lowest in the Bucharest patients, 116 +/- 42 U/ml, versus 141 +/- 43 and 184 +/- 49 U/ml in the Antwerp patients and controls, respectively (p < 0.0005). The Bucharest patients had worse glycemic control, higher blood pressure, lower HDL cholesterol and a diet richer in cholesterol and poorer in monounsaturated fats and fish. In contrast, their median intake of vitamins E and C, folic acid and flavonoids was higher, 82 mg (range: 4-259 mg), versus 28 mg (range: 5-169 mg) aglycone units in Antwerp (p = 0.005). Flavonoid intake predicted arylesterase independently of HDL cholesterol, region and sex (beta = 0.27; p = 0.03), and patients with high intake achieved normal levels of arylesterase (30.1 +/- 10.0 U/micromol in the highest versus 21.0 +/- 8.2 U/micromol total cholesterol in the lowest tertile; p = 0.02). CONCLUSION: A flavonoid-rich diet is positively associated with PON1 arylesterase activity in diabetic foot patients.

Lixandru D; Mohora M; Coman A; Stoian I; van Gils C; Aerts P; Manuel-Y-Keenoy B

2010-01-01

142

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

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

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

2012-01-01

143

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

2007-01-01

144

Laser in situ keratomileusis in patients with a history of ocular herpes.  

UK PubMed Central (United Kingdom)

PURPOSE: To report the outcomes of laser in situ keratomileusis (LASIK) in patients with a history of ocular herpes simplex virus (HSV) or herpes zoster ophthalmicus (HZO). SETTING: Clínica Baviera, Instituto Oftalmológico Europeo, Madrid, Spain. METHODS: In this retrospective case series, the records of eyes with a history of ocular herpes that had LASIK from 2003 through 2005 were reviewed. The main outcome measure was postoperative recurrence of ocular herpes. RESULTS: Forty-nine eyes (48 patients) with a history of ocular herpes (HSV keratitis, 28 eyes; HSV eyelid lesions, 17 eyes; HZO, 4 eyes) were identified. All LASIK procedures were uneventful. Herpetic disease was inactive at the time of surgery in all eyes and for more than 1 year in 31 eyes. Perioperative antiviral systemic prophylaxis was used in 13 patients with a history of HSV keratitis. No eye developed reactivation of herpetic keratitis during the follow-up (range 1 to 28 months). CONCLUSIONS: Laser in situ keratomileusis was safe in patients with a history of ocular herpes; no recurrences occurred during the follow-up period. However, candidates should be selected with caution and surgery performed only in eyes in which the herpes has been inactive for 1 year before surgery, without stromal disease, and with regular topography and pachymetry maps and normal corneal sensitivity. The most reasonable clinical strategy is perioperative systemic antiviral prophylaxis.

de Rojas Silva V; Rodríguez-Conde R; Cobo-Soriano R; Beltrán J; Llovet F; Baviera J

2007-11-01

145

Patient questionnaires in rheumatoid arthritis: advantages and limitations as a quantitative, standardized scientific medical history.  

Science.gov (United States)

In many chronic diseases, objective gold standard measures such as blood pressure, cholesterol, and bone densitometry often provide most of the information used to establish a diagnosis and guide therapy. By contrast, in inflammatory rheumatic diseases, information from a patient history usually is considerably more prominent in clinical management. Patient history data can be recorded as standardized, quantitative scientific data through use of validated self-reported questionnaires. Patient questionnaires address the primary concerns of patients and their families. Questionnaire scores distinguish active from control treatments in clinical trials at similar levels to swollen and tender joint counts or laboratory tests. Patient questionnaire data are correlated significantly with joint counts, radiographic scores, and laboratory tests, but usually are far more significant than these measures in the prognosis of severe outcomes of rheumatoid arthritis (RA), including work disability, costs, and premature death. Limitations of patient questionnaires are based on cultural features involving variation in responses among ethnic groups, and a need for translation, although translated questionnaires can be as valuable as a translator. Patient questionnaires do not replace further medical history, physical examination, laboratory tests, and imaging data, and they require interpretation in a context of these standard sources of information at any clinical encounter. Patient questionnaires are useful to monitor patient status in usual clinical care, with almost no effort on the part of the physician and staff if distributed by the receptionist in the infrastructure of office practice. PMID:19962618

Pincus, Theodore; Yazici, Yusuf; Bergman, Martin J

2009-11-01

146

Patient questionnaires in rheumatoid arthritis: advantages and limitations as a quantitative, standardized scientific medical history.  

UK PubMed Central (United Kingdom)

In many chronic diseases, objective gold standard measures such as blood pressure, cholesterol, and bone densitometry often provide most of the information used to establish a diagnosis and guide therapy. By contrast, in inflammatory rheumatic diseases, information from a patient history usually is considerably more prominent in clinical management. Patient history data can be recorded as standardized, quantitative scientific data through use of validated self-reported questionnaires. Patient questionnaires address the primary concerns of patients and their families. Questionnaire scores distinguish active from control treatments in clinical trials at similar levels to swollen and tender joint counts or laboratory tests. Patient questionnaire data are correlated significantly with joint counts, radiographic scores, and laboratory tests, but usually are far more significant than these measures in the prognosis of severe outcomes of rheumatoid arthritis (RA), including work disability, costs, and premature death. Limitations of patient questionnaires are based on cultural features involving variation in responses among ethnic groups, and a need for translation, although translated questionnaires can be as valuable as a translator. Patient questionnaires do not replace further medical history, physical examination, laboratory tests, and imaging data, and they require interpretation in a context of these standard sources of information at any clinical encounter. Patient questionnaires are useful to monitor patient status in usual clinical care, with almost no effort on the part of the physician and staff if distributed by the receptionist in the infrastructure of office practice.

Pincus T; Yazici Y; Bergman MJ

2009-11-01

147

Movement disorders in patients with schizophrenia and a history of substance abuse.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The movement disorders acute dystonia, akathisia, Parkinsonian symptoms and tardive dyskinesia [extrapyramidal side effects (EPSs)] are recognized adverse effects of antipsychotic medication. Previous studies have indicated that substance abuse in patients with schizophrenia can worsen EPS. This study therefore investigated the relationship between drug and alcohol use and EPS in a group of patients with schizophrenia. METHODS: Seventy patients with schizophrenia assessed for drug and alcohol use, global functioning, EPS and suicidality. Chlorpromazine equivalents were correlated to levels of EPS and substance abuse. RESULTS: Current EPS were found in 65% of the sample despite three-quarters of the patients receiving second-generation antipsychotics. An even higher level of patients, 87%, was found to have a history of EPS. A long history of schizophrenia independently predicted presence of any EPS, particularly akathisia, controlling for history of substance abuse which was a non-significant predictor. CONCLUSIONS: History or current use of alcohol or drug abuse did not predict EPS, except for alcohol abuse at the time of diagnosis which was associated with current akathisia. Length of illness was correlated with EPS, whereas suicidality was not linked to akathisia. Neither chlorpromazine equivalent antipsychotic dose nor whether the patient received first-generation or second-generation antipsychotic medication was significantly associated with EPS or substance abuse.

Hansen LK; Nausheen B; Hart D; Kingdon D

2013-03-01

148

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

Directory of Open Access Journals (Sweden)

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

Fakhreddin Taghaddosi-Nejad; Meysamie Alipash; Shahin Shadnia; Mahmoud Ghazi; Hossein Hassanian; Arash Okazi

2012-01-01

149

Anthropometric Evaluation and Micronutrients Intake in Patients Submitted to Laparoscopic Roux-en-Y Gastric Bypass with a Postoperative Period of ?1 Year.  

UK PubMed Central (United Kingdom)

BACKGROUND: Bariatric surgery is indicated as the most effective treatment for morbid obesity; the Roux-en-Y gastric bypass (RYGB) is considered the procedure of choice. However, nutritional deficiency may occur in the postoperative period as a result of reduced gastric capacity and change in nutrients absorption in the gastrointestinal tract. The prescription of vitamin and mineral supplementation is a common practice after RYGB; however, it may not be sufficient to prevent micronutrient deficiencies. The aim of this study was to quantify the micronutrient intake in patients undergoing RYGB and verify if the intake of supplementation would be enough to prevent nutritional deficiencies. METHODS: The study was conducted on 60 patients submitted to RYGB. Anthropometric, analytical, and nutritional intake data were assessed preoperatively and 1 and 2 years postoperatively. The dietary intake was assessed using 24-h food recall; the values of micronutrients evaluated (vitamin B12, folic acid, iron, and calcium) were compared to the dietary reference intakes (DRI). RESULTS: There were significant differences (p?patients, respectively, took the supplements as prescribed. Micronutrient deficiencies were detected in the three evaluation periods. At the first year, there was a significant reduction (p?intake. CONCLUSIONS: Despite taking vitamin and mineral supplementation, micronutrient deficiencies are common after RYGB. In the second year after surgery, micronutrient intake remains below the DRI.

Mercachita T; Santos Z; Limão J; Carolino E; Mendes L

2013-08-01

150

PREVALENCE OF DIETARY SUPPLEMENTS AND AYURVEDIC MEDICINES’ INTAKE BY PATIENTS TAKING PRESCRIBED ALLOPATHIC MEDICINES AT LUCKNOW  

Directory of Open Access Journals (Sweden)

Full Text Available Aim: Present study was done to know the prevalence of the use of dietary supplements and ayurvedic drugs by patients taking allopathic drugs.Introduction: Allopathic drugs are likely to act with ayurvedic drugs and dietary supplements and concurrently used. This concept is usually not recognized by the patients and physicians. Sometimes this may prove dangerous. Present study was done to find out the prevalence of concurrent administration of these produce so that a message can be spread to reduce these habits in patients and physicians.Method: We did study among private practitioners of medicine, general surgery and gynaecology specialities. The patients were interviewed by our team members and requested to fill a proforma. After completion of study data were segregated and analyzed for various parameters.Results: Results showed that 25.6% patients attending physician, 39.9% attending surgeons and 41.4% attending gynaecologists were taking some or other preparations in various forms. Out of all patients only 18.2% patients knew that these preparations were also a form of drug. Only 9.1% of all patients told this information to their treating doctors. Only 15.2% doctors asked the patients about this type of possibility. Conclusion: Study shows that considerable proportions of patients have been taking dietary supplements and ayurvedic preparations without knowing that this may be harmful when taken along with allopathic medicines. This needs considerations for rational therapy.

Rakesh verma et al

2012-01-01

151

[Evaluation of the intake of a low daily amount of soybeans in oxidative stress, lipid and inflammatory profile, and insulin resistance in patients with metabolic syndrome].  

UK PubMed Central (United Kingdom)

OBJECTIVE: Studies show that regular consumption of soybeans reduces the risk of diabetes and cardiovascular diseases. However, most of these studies recommend daily intake of 25 g or more of soy protein, an amount considered high and not well tolerated by patients. The objective of this study was to assess the effect of low daily intake of soybeans in oxidative stress and in components of the metabolic syndrome (MS). SUBJECTS AND METHODS: Forty individuals with MS were selected and divided into two groups: control group (n = 20) and soybean-treated group (n = 20), which consumed 12.95 g of soy protein for 90 days. RESULTS: After the treatment, the soybean-treated group showed a decrease in fasting glucose and increase in serum HDL and adiponectin. CONCLUSION: Low intake of soy protein for 90 days, besides being well tolerated by the patients, was able to improve several parameters related to the pathophysiology of MS.

Bahls LD; Venturini D; Scripes Nde A; Lozovoy MA; Simão TN; Simão AN; Dichi I; Morimoto HK

2011-08-01

152

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

International Nuclear Information System (INIS)

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

1988-01-01

153

Increased folate intake with no changes in serum homocysteine and decreased levels of C-reactive protein in patients with inflammatory bowel diseases.  

UK PubMed Central (United Kingdom)

In order to increase dietary folic acid intake and to improve nutritional status regarding folate by controlling homocysteine concentrations, ten patients with inflammatory bowel diseases (Crohn's disease in the colon and ulcerative colitis) received individualized nutritional guidance and were followed up as outpatients for 2 months. The following procedures were performed at the beginning of the study (T0), after 1 month (T1) and at the end of the study (T2): collection of anthropometric data (weight and height), dietary data (24 h diet recall), and blood under fasting condition for the determination of serum folic acid, homocysteine, C-reactive protein, and vitamin B12. Plasma folic acid deficiency was not detected but hyperhomocysteinemia was present in six individuals and C-reactive protein (CRP) was increased (>0.5 mg/dl) in seven patients. After the patients were instructed there was a significant increase in vitamin B6 intake (about 35%) and in folate intake (49.6%). Mean plasma levels of folic acid, homocysteine, and vitamin B12 did not change, but there was a significant decrease of CRP at T1, 0.36 mg dl(-1) on average (P = 0.01), which was maintained at T2. We conclude that the increased folate intake reported by this group of patients was not reflected in improved serum concentrations of folic acid and homocysteine. However, the guidelines for the patients probably induced them to choose a more adequate diet, providing nutrients that help control the inflammatory process.

Chiarello PG; Penaforte FR; Japur CC; Souza CD; Vannucchi H; Troncon LE

2009-03-01

154

'Coming down the line'-- patients' understanding of their family history of common chronic disease.  

UK PubMed Central (United Kingdom)

PURPOSE: The family history is becoming an increasingly important feature of health promotion and early detection of common chronic diseases in primary care. Previous studies of patients from genetics clinics suggest a divergence between how persons with a family history perceive and understand their risk and the risk information provided by health professionals. This interview study aimed to explore how patients in primary care understand and come to terms with their family history of cancer, heart disease, or diabetes and how family history might affect consultations about disease risk and management. METHODS: Thirty semistructured interviews were conducted with general practice patients who had a family history of cancer, heart disease, or diabetes. The transcript data underwent a qualitative constant comparative analysis. RESULTS: What exactly constitutes having a family history of an illness varied among participants. The development of a personal sense of vulnerability to the illness in the family depended not only on the biomedical approach of counting affected relatives but also on a sophisticated interplay of other factors. The emotional impact of witnessing the illness in the family, particularly if the illness was sudden, premature, or fatal, and the nature of personal relationships within a family that determine a sense of emotional closeness and personal likeness with the affected relative, all contributed to the perception of disease risk. Different beliefs about the contributions of nature and nurture to disease can affect patients' views on the degree of control they can exert over their risk. CONCLUSION: This study highlights potential differences between the way patients and medical professionals assess and understand familial risk of cancer, heart disease, and diabetes. Our previous systematic review findings are enhanced by showing that personal experience of disease and the emotional impact can also influence familial risk perceptions. Eliciting the patient's perspective when discussing risk of chronic disease, particularly in the context of a family history, could inform a more patient-centered approach to risk assessment and communication and support patients to make informed decisions about the management of their disease risk.

Walter FM; Emery J

2005-09-01

155

Dietary Cholesterol Intake is Associated with Progression of Liver Disease in Patients With Chronic Hepatitis C: Analysis of the HALT-C trial.  

UK PubMed Central (United Kingdom)

BACKGROUND: & Aims: Little is known about whether dietary cholesterol affects disease progression in patients with chronic hepatitis C virus (HCV) infection. METHODS: We analyzed data from the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) trial, which included patients with advanced fibrosis and compensated cirrhosis. Cholesterol intake was determined for 608 participants based on responses to Food Frequency Questionnaires, administered at baseline and 1.8 years later. We investigated whether cholesterol intake was associated with clinical progression (death, variceal bleeding, encephalopathy, ascites, peritonitis, Child-Turcotte-Pugh score ?7, or hepatocellular carcinoma) or histologic progression of disease (an increase in Ishak fibrosis score of 2 or more points in a second liver biopsy compared with the first). RESULTS: After adjustments for age, sex, race, presence of cirrhosis, body mass index, treatment with peginterferon, lifetime alcohol consumption, smoking, health status, and coffee and macronutrient intake, each higher quartile of cholesterol intake was associated with a 46% increase in the risk of clinical or histological progression (adjusted hazard ratio [AHR], 1.46; 95% confidence interval [CI], 1.13-1.87; P for the trend=.004). Compared with patients in the lowest quartile of cholesterol intake (32-152 mg/day), those in the 3rd (224-310 mg/day; AHR, 2.83; 95% CI, 1.45-5.51) and 4th quartile (>310 mg/day; AHR, 2.74; 95% CI, 1.22-6.16) had significantly increased risk of disease progression. CONCLUSION: Based on analysis of data from the HALT-C trial, higher dietary cholesterol intake is associated with higher risk of disease progression in HCV-infected patients with advanced fibrosis or compensated cirrhosis.

Yu L; Morishima C; Ioannou GN

2013-05-01

156

Systemic folate status, rectal mucosal folate concentration and dietary intake in patients at differential risk of bowel cancer (The FAB2 Study).  

UK PubMed Central (United Kingdom)

BACKGROUND/OBJECTIVES: Folate has been strongly implicated in the aetiology of colorectal cancer. However, the relationship between dietary folate intake, rectal mucosal folate status and colorectal cancer risk is uncertain. The study aimed to estimate nutrient intakes and measure systemic folate status and rectal mucosal folate concentration in people at differential risk of developing colorectal cancer. METHODS: Two hundred and twenty-eight individuals were recruited from gastroenterology clinics and subdivided into three patient groups: untreated colorectal cancer (n = 43), adenomatous polyps (n = 90) or normal bowel (n = 95). Biopsies from macroscopically normal rectal mucosa and blood were collected and used for the measurement of rectal mucosal 5-methyltetrahydrofolate (5-MeTHF) and systemic markers of folate status, respectively. Nutrient intake was estimated using a validated food frequency questionnaire. RESULTS: Dietary intake variables, plasma 5-MeTHF and red cell folate and plasma homocysteine concentrations were similar in all three subject groups and 95 % CI fell within normal range for each variable. Rectal mucosal 5-MeTHF concentration was higher in the normal mucosa of adenomatous polyp patients than in normal subjects (P = 0.055). Rectal mucosal 5-MeTHF was associated significantly with plasma folate (P < 0.001, r = 0.294), red cell folate (P = 0.014, r = 0.305), plasma homocysteine (P = 0.017, r = -0.163) and dietary folate intake (P = 0.036, r = 0.152). CONCLUSIONS: This study demonstrates adequate folate status of patients attending gastroenterology clinics for the investigation of bowel symptoms, with no significant difference in dietary intakes or systemic folate status indices according to diagnosis. Rectal mucosal 5-MeTHF concentrations were elevated in adenomatous polyp patients, but failed to reach significance. Further studies are required to determine the biological significance of this observation.

Williams EA; Welfare M; Spiers A; Hill MH; Bal W; Gibney ER; Duckworth Y; Powers HJ; Mathers JC

2013-10-01

157

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

UK PubMed Central (United Kingdom)

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

Veien NK; Hattel T; Justesen O; Nørholm A

1985-05-01

158

Severe cerebral white matter hyperintensities predict severe cognitive decline in patients with cerebrovascular disease history.  

UK PubMed Central (United Kingdom)

BACKGROUND AND PURPOSE: Cerebral white matter hyperintensities (WMHs) are believed to be the consequence of small vessel disease, and it is uncertain whether their extent predicts the risk of dementia in patients with vascular disease history. Method- Brain MRI was performed in 226 participants of the PROGRESS study. WMH severity was assessed using a visual rating scale. During follow-up, patients were classified for incident severe cognitive deterioration (including dementia) using standard criteria. RESULTS: Over 4-year follow-up, the incidence of severe cognitive deterioration ranged from 1.1 to 9.1 per 100 person-years in patients with respectively no or severe WMHs at baseline. In multivariable analysis, incident severe cognitive deterioration was associated with baseline severe WMHs (odds ratio=7.7, P<0.005). CONCLUSIONS: Higher WMH load is a strong predictor of dementia and cognitive decline in patients with cerebrovascular disease history.

Dufouil C; Godin O; Chalmers J; Coskun O; MacMahon S; Tzourio-Mazoyer N; Bousser MG; Anderson C; Mazoyer B; Tzourio C

2009-06-01

159

A familial history of pulmonary fibrosis in patients with chronic hypersensitivity pneumonitis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease induced by the inhalation of a variety of antigens. Patients with chronic HP often have a family history of pulmonary fibrosis. This strongly suggests that both genetic and environmental factors play an important role in the pathogenesis of chronic HP. OBJECTIVES: We aimed to investigate the epidemiology and clinical features of chronic HP patients with a family history of pulmonary fibrosis. METHODS: We retrospectively reviewed the clinical information of 114 cases diagnosed with chronic HP with insidious onset between 1992 and 2009. RESULTS: Twenty cases (17.5%) were identified as having a family history of pulmonary fibrosis. All of these patients had lived apart from their afflicted relatives for at least several decades. The familial cases were younger than the nonfamilial cases at onset (57.5 ± 9.6 vs. 64.0 ± 7.0 years old, p = 0.008). The predicted vital capacity percentage and partial pressure of oxygen in arterial blood gas were significantly higher in the familial cases. There were no differences between the 2 groups in gender, smoking history, bronchoalveolar lavage fluid profile, radiologic findings or other clinical features. CONCLUSIONS: We found a familial clustering in patients with chronic HP. Various factors including genetic susceptibility to pulmonary fibrosis and environmental factors may contribute to the development of familial chronic HP.

Okamoto T; Miyazaki Y; Tomita M; Tamaoka M; Inase N

2013-01-01

160

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

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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 admi...

Milisavljevi? Nemanja; Cvetkovi? Mirjana; Nikoli? Goran; Filipovi? Branka; Milini? Nikola

 
 
 
 
161

[History of treatment of schizophrenic forensic patients prior to admission: a comparison with schizophrenic general psychiatric patients].  

UK PubMed Central (United Kingdom)

BACKGROUND: The number of schizophrenic patients admitted to forensic hospitals according to section 63 of the German Criminal Code has increased continuously over the past years. Prior to admission to a forensic ward, two thirds of schizophrenic patients have been admitted to a general psychiatric institution at least once. Among other factors, forensic admission is seen as a consequence of insufficient pretreatment in general psychiatry. This study aims to identify differences regarding the history of treatment of forensic and general psychiatric patients diagnosed with schizophrenia. METHOD: The matched samples include 72 male patients from forensic wards and 72 male patients from general psychiatry diagnosed with schizophrenia. The history of psychiatric treatment was reconstructed by interviewing the patients as well as the outpatient psychiatrists and by analyzing these patients' medical records. RESULTS: Both groups showed similar risk factors, however, forensic patients had a higher number of previous convictions and were convicted more often for violent offences. Furthermore, the data indicate that forensic patients are less integrated into psychiatric care and showed a lower rate of treatment compliance prior to admission to a forensic ward. CONCLUSIONS: The results provide support for the arrangement of an intensive outpatient aftercare, especially for schizophrenic patients with comorbid substance abuse disorders and previous convictions for violent offences.

Piontek K; Kutscher SU; König A; Leygraf N

2013-01-01

162

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 ancillary issues such as compliance, cost-effectiveness and accuracy of family history ascertainment. We focus on the relatively common “sporadic” family histories of CRC, which typically imparts a mild to moderate elevation in the risk for CRC development in the proband. Defined familial syndromes associated with extremely high risks of CRC, such as hereditary non-polyposis colorectal syndrome or familial adenomatous polyposis, require specialized management approaches and are beyond the scope of this article. We will also not discuss colonoscopic surveillance in patients with a personal history of adenomas or CRC.

Otto S Lin

2012-01-01

163

Long-term effect of dietary fibre intake on glycosylated haemoglobin A1c level and glycaemic control status among Chinese patients with type 2 diabetes mellitus.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Dietary fibre has been linked to lower levels of glycosylated haemoglobin A1c (HbA1c) among diabetes patients. The present study aimed to evaluate the long-term effect of dietary fibre on HbA1c levels among Chinese patients with type 2 diabetes mellitus. DESIGN: Two cross-sectional surveys were conducted in 2006 and 2011, with the second one being a repeat survey on a sub-sample from the initial one. In both surveys, an in-person interview was conducted to collect information on demographic characteristics and lifestyles following a similar protocol. Dietary intake was assessed with a validated FFQ. Anthropometric measures and biochemical assays were performed at the interview. SETTING: Communities in Pudong New Area of Shanghai, China. SUBJECTS: Chinese patients (n 934) with type 2 diabetes mellitus. RESULTS: An inverse association was observed between dietary fibre and glycaemic status indicated by HbA1c level in both surveys, although it was significant only in the first survey. Among 497 patients participating in both surveys, dietary fibre intake at the first survey was inversely associated with uncontrolled glycaemic status at the second survey, with adjusted odds ratios across the tertiles of intake being 1·00, 0·72 (95 % CI 0·43, 1·21) and 0·58 (95 % CI 0·34, 0·99; P trend = 0·048). The change in fibre intake was slightly associated with glycaemic status, with each increase in tertile scores of intake linked to a 0·138 % (? = -0·138; 95 % CI -0·002, 0·278) decrease in HbA1c value and a 19 % (OR = 0·81; 95 % CI 0·65, 1·02) reduced risk of uncontrolled glycaemic status at the second survey. CONCLUSIONS: Dietary fibre may have a long-term beneficial effect on HbA1c level among Chinese diabetes patients.

Yang L; Shu L; Jiang J; Qiu H; Zhao G; Zhou Y; Jiang Q; Sun Q; Qin G; Wu H; Yang L; Ruan X; Xu WH

2013-07-01

164

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

Directory of Open Access Journals (Sweden)

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

2013-01-01

165

The natural history of familial cerebral cavernomas: a retrospective MRI study of 40 patients  

International Nuclear Information System (INIS)

Our objective was to determine the natural history and prognostic factors of familial forms of cerebral cavernous malformations (CCM). Cavernomas are one of the most common central nervous system vascular malformations. Familial CCM is increasingly diagnosed, but little is known about its natural history. In a national survey, we analysed clinical and MRI features of 173 patients from 57 unrelated French families. Of these 40 had undergone at least two clinical and MRI examinations. Occurrence of haemorrhage, new lesions, change in signal intensity and size of lesions have been studied by comparison between first and last MRI studies. The CCM were classified according to Zabramski et al. Mean follow-up was 3.2 years (range 0.5-6.5 years). We followed 232 cavernomas (mean 5.9 per patient, range 1-17). Serial MRI demonstrated changes in 28 patients (70 %). Bleeding occurred in 21 lesions (9.1 %) in 14 patients (35 %). The haemorrhagic risk was 2.5 % per lesion-year, higher in type I and brain-stem CCM. We saw 23 new lesions appear in 11 patients (27.5 %), with an incidence of 0.2 lesions per patient year. Signal change was observed in 11 patients (27.5 %), in 14 lesions (6 %), while 9 lesions (3.9 %) in 9 patients (22.5 %) changed significantly in size. (orig.)

2000-01-01

166

The natural history of familial cerebral cavernomas: a retrospective MRI study of 40 patients  

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Our objective was to determine the natural history and prognostic factors of familial forms of cerebral cavernous malformations (CCM). Cavernomas are one of the most common central nervous system vascular malformations. Familial CCM is increasingly diagnosed, but little is known about its natural history. In a national survey, we analysed clinical and MRI features of 173 patients from 57 unrelated French families. Of these 40 had undergone at least two clinical and MRI examinations. Occurrence of haemorrhage, new lesions, change in signal intensity and size of lesions have been studied by comparison between first and last MRI studies. The CCM were classified according to Zabramski et al. Mean follow-up was 3.2 years (range 0.5-6.5 years). We followed 232 cavernomas (mean 5.9 per patient, range 1-17). Serial MRI demonstrated changes in 28 patients (70 %). Bleeding occurred in 21 lesions (9.1 %) in 14 patients (35 %). The haemorrhagic risk was 2.5 % per lesion-year, higher in type I and brain-stem CCM. We saw 23 new lesions appear in 11 patients (27.5 %), with an incidence of 0.2 lesions per patient year. Signal change was observed in 11 patients (27.5 %), in 14 lesions (6 %), while 9 lesions (3.9 %) in 9 patients (22.5 %) changed significantly in size. (orig.)

Labauge, P.; Laberge, S. [INSERM U25, Faculte de Medecine Necker-Enfants Malades, Paris (France); Brunereau, L. [Service de Radiologie Adultes Bretonneau, Tours (France); Levy, C. [Service de Radiologie, CHU Saint-Antoine, Paris (France); Houtteville, J.P. [Service de Neurochirurgie, CHU Cote de Nacre, Caen (France)

2000-05-01

167

Water swallow screening test for patients after surgery for head and neck cancer: early identification of Dysphagia, aspiration and limitations of oral intake.  

Science.gov (United States)

Patients with head and neck cancer (HNC) are at high risk for oropharyngeal dysphagia (OD) following surgical therapy. Early identification of OD can improve outcomes and reduce economic burden. This study aimed to evaluate the validity of a water screening test using increasing volumes postsurgically for patients with HNC (N=80) regarding the early identification of OD in general, and whether there is a need for further instrumental diagnostics to investigate the presence of aspiration as well as to determine the limitations of oral intake as defined by fiberoptic endoscopic evaluation of swallowing. OD in general was identified in 65%, with aspiration in 49%, silent aspiration in 21% and limitations of oral intake in 56%. Despite a good sensitivity, for aspiration of 100% and for limitations of oral intake of 97.8%, the presented water screening test did not satisfactorily predict either of these reference criteria due to its low positive likelihood ratio (aspiration=2.6; limitations of oral intake=3.1). However, it is an accurate tool for the early identification of OD in general, with a sensitivity of 96.2% and a positive likelihood ratio of 5.4 in patients after surgery for HNC. PMID:24023344

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

2013-09-01

168

Water swallow screening test for patients after surgery for head and neck cancer: early identification of Dysphagia, aspiration and limitations of oral intake.  

UK PubMed Central (United Kingdom)

Patients with head and neck cancer (HNC) are at high risk for oropharyngeal dysphagia (OD) following surgical therapy. Early identification of OD can improve outcomes and reduce economic burden. This study aimed to evaluate the validity of a water screening test using increasing volumes postsurgically for patients with HNC (N=80) regarding the early identification of OD in general, and whether there is a need for further instrumental diagnostics to investigate the presence of aspiration as well as to determine the limitations of oral intake as defined by fiberoptic endoscopic evaluation of swallowing. OD in general was identified in 65%, with aspiration in 49%, silent aspiration in 21% and limitations of oral intake in 56%. Despite a good sensitivity, for aspiration of 100% and for limitations of oral intake of 97.8%, the presented water screening test did not satisfactorily predict either of these reference criteria due to its low positive likelihood ratio (aspiration=2.6; limitations of oral intake=3.1). However, it is an accurate tool for the early identification of OD in general, with a sensitivity of 96.2% and a positive likelihood ratio of 5.4 in patients after surgery for HNC.

Hey C; Lange BP; Eberle S; Zaretsky Y; Sader R; Stöver T; Wagenblast J

2013-09-01

169

The association between dietary sodium intake, ESRD, and all-cause mortality in patients with type 1 diabetes.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Many guidelines recommend reduced consumption of salt in patients with type 1 diabetes, but it is unclear whether dietary sodium intake is associated with mortality and end-stage renal disease (ESRD). RESEARCH DESIGN AND METHODS: In a nationwide multicenter study (the FinnDiane Study) between 1998 and 2002, 2,807 enrolled adults with type 1 diabetes without ESRD were prospectively followed. Baseline urinary sodium excretion was estimated on a 24-h urine collection. The predictors of all-cause mortality and ESRD were determined by Cox regression and competing risk modeling, respectively. RESULTS: The median follow-up for survival analyses was 10 years, during which 217 deaths were recorded (7.7%). Urinary sodium excretion was nonlinearly associated with all-cause mortality, such that individuals with the highest daily urinary sodium excretion, as well as the lowest excretion, had reduced survival. This association was independent age, sex, duration of diabetes, the presence and severity of chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] and log albumin excretion rate), the presence of established cardiovascular disease, and systolic blood pressure. During follow-up, 126 patients developed ESRD (4.5%). Urinary sodium excretion was inversely associated with the cumulative incidence of ESRD, such that individuals with the lowest sodium excretion had the highest cumulative incidence of ESRD. CONCLUSIONS: In patients with type 1 diabetes, sodium was independently associated with all-cause mortality and ESRD. Although we have not demonstrated causality, these findings support the calls for caution before applying salt restriction universally. Clinical trials must be performed in diabetic patients to formally test the utility/risk of sodium restriction in this setting.

Thomas MC; Moran J; Forsblom C; Harjutsalo V; Thorn L; Ahola A; Wadén J; Tolonen N; Saraheimo M; Gordin D; Groop PH

2011-04-01

170

[Estimation of brain atrophic processes among patients with past history of TBE (with EEG evaluation)].  

Science.gov (United States)

The aim of the study was estimation of brain atrophic processes among patients with past history long lasting, or encephalitic course (8-10 years after) TBE with using planimetric measurements of CT scans in connection with EEG evaluation. 34 patients were enrolled to the study. First results suggest the presence of sequel past TBE as increased percentage pathology in EEG evaluation as well increasing of anterior horns lateral ventricules, dilatation the III ventricule as a result of fastened brain atrophy in relation to the age of the patients. PMID:22320047

Targo?ski, Arkadiusz; Zajkowskat, Joanna; Chorazy, Monika; Pancewicz, S?awomir; Drozdowski, Wies?aw

2008-01-01

171

Antroduodenal motility before, during, and after food intake in patients with X-ray-negative dyspepsia and abnormal duodenal loop and in healthy people  

DEFF Research Database (Denmark)

Antroduodenal motility was studied before, during, and after food intake in patients with X-ray-negative dyspepsia and abnormal duodenal loop and in normals. No differences were observed between X-ray-negative dyspepsia and a proximally located abnormal duodenal loop. Patients with a distal duodenal anomaly had significantly higher food-stimulated duodenal activity than any of the other groups studied, whereas no differences were observed in antral motility.

Funch-Jensen, Peter; Kraglund, K

1982-01-01

172

Characteristics and outcome of acute myeloid leukemia in patients with a prior history of autoimmune disease.  

UK PubMed Central (United Kingdom)

Although associations between autoimmune disorders (AIs) and the development of myeloid neoplasms have been described, the pathologic features and natural history of these malignancies have not been well characterized. We evaluated whether patients with AIs with acute myeloid leukemia (AML) were similar in nature to patients traditionally considered to have therapy-related AML (t-AML). Twenty-three patients with AML with a documented prior AI were included in our analysis. Median age at AML diagnosis was 59 years (range 32-78 years), and four patients were men (17%). Median latency between AI diagnosis and AML was 7.0 years. Ten patients (43%) had normal cytogenetics and six patients (26%) had favorable risk disease. In patients older than 65, all four patients had a normal karyotype. Median follow-up for all patients was 19.8 months (range 1.8-100.4 months), with 12 patients alive at last follow-up and median overall survival for all patients of 68.1 months. The encouraging survival data lend support to the notion that AML in patients with AIs appears to have characteristics and outcome more analogous to de novo than t-AML.

DiNardo CD; Ogdie A; Hexner EO; Frey NV; Loren AW; Luger SM

2013-06-01

173

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

1988-01-01

174

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

Directory of Open Access Journals (Sweden)

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

C. Martín Villares; J. Domínguez Calvo; J. San Román Carbajo; M. E. Fernández Pello; P. Pomar Blanco; M. Tapia Risueño

2004-01-01

175

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

UK PubMed Central (United Kingdom)

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

Hoa NB; Wei C; Sokun C; Lauritsen JM; Rieder HL

2011-01-01

176

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

Directory of Open Access Journals (Sweden)

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

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

2007-01-01

177

An ex utero intrapartum treatment procedure in a patient with a family history of malignant hyperthermia.  

UK PubMed Central (United Kingdom)

In the EXIT (ex utero intrapartum treatment) procedure, after uterine incision, uterine relaxation is maintained to prevent placental separation and the fetus is supported via the placenta until the airway is successfully established. The traditional method to maintain uterine relaxation is with the use of high-dose potent inhaled anesthetics during general anesthesia. A patient with a family history of malignant hyperthermia required an EXIT procedure. The history of malignant hyperthermia precluded the use of potent inhaled anesthetics and an alternate plan using propofol and remifentanil infusions for anesthesia and nitroglycerin 16 ?g/kg/min for uterine relaxation allowed for good surgical conditions. The presence of malignant hyperthermia required an alternate plan and close collaboration in order to ensure good patient outcome.

Hofer IS; Mahoney B; Rebarber A; Beilin Y

2013-04-01

178

An ex utero intrapartum treatment procedure in a patient with a family history of malignant hyperthermia.  

Science.gov (United States)

In the EXIT (ex utero intrapartum treatment) procedure, after uterine incision, uterine relaxation is maintained to prevent placental separation and the fetus is supported via the placenta until the airway is successfully established. The traditional method to maintain uterine relaxation is with the use of high-dose potent inhaled anesthetics during general anesthesia. A patient with a family history of malignant hyperthermia required an EXIT procedure. The history of malignant hyperthermia precluded the use of potent inhaled anesthetics and an alternate plan using propofol and remifentanil infusions for anesthesia and nitroglycerin 16 ?g/kg/min for uterine relaxation allowed for good surgical conditions. The presence of malignant hyperthermia required an alternate plan and close collaboration in order to ensure good patient outcome. PMID:23481416

Hofer, I S; Mahoney, B; Rebarber, A; Beilin, Y

2013-03-06

179

Rehabilitation of a patient with an elusive medical history and loss of occlusal vertical dimension.  

UK PubMed Central (United Kingdom)

In this clinical report, we describe the medical history, diagnosis and prosthodontic treatment of a 61-year-old man with a previous history of oral cancer. Loss of a full upper denture and severe erosion of his teeth prompted the patient to seek treatment at the dental clinic at the British Columbia Cancer Agency. Although he stated that he was being treated for a sleeping disorder, hospital records revealed multiple recent admissions for alcoholism and depression. The patient's limited finances prevented complex restoration of worn lower dentition; thus, definitive treatment consisted of extraction of teeth with a poor prognosis, removal of a glandular odontogenic cyst and fabrication of a full maxillary prosthesis and a removable mandibular cast-metal overlay.

Wong AT; Nguyen CT

2013-01-01

180

Rehabilitation of a patient with an elusive medical history and loss of occlusal vertical dimension.  

Science.gov (United States)

In this clinical report, we describe the medical history, diagnosis and prosthodontic treatment of a 61-year-old man with a previous history of oral cancer. Loss of a full upper denture and severe erosion of his teeth prompted the patient to seek treatment at the dental clinic at the British Columbia Cancer Agency. Although he stated that he was being treated for a sleeping disorder, hospital records revealed multiple recent admissions for alcoholism and depression. The patient's limited finances prevented complex restoration of worn lower dentition; thus, definitive treatment consisted of extraction of teeth with a poor prognosis, removal of a glandular odontogenic cyst and fabrication of a full maxillary prosthesis and a removable mandibular cast-metal overlay. PMID:23763727

Wong, Angela T T; Nguyen, Caroline T

2013-01-01

 
 
 
 
181

Epidemiologic profile, sexual history, pathologic features, and human papillomavirus status of 103 patients with penile carcinoma.  

UK PubMed Central (United Kingdom)

PURPOSE: The incidence of penile cancer is four times higher in Paraguay than in the United States or Europe. There are no adequate scientific explanations for this geographical variation. The goal of this study was to evaluate the interplay among risk factors, morphology of the primary tumor, and HPV status. METHODS: Information on socioeconomic status, education level, habits, and sexual history was obtained in 103 Paraguayan patients with penile cancer. All patients were then treated by surgery, and specimens were evaluated histopathologically. RESULTS: Patients usually dwelled in rural/suburban areas (82%), lived in poverty (75%), had a low education level (91%), and were heavy smokers (76%). Phimosis (57%), moderate/poor hygienic habits (90%), and history of sexually transmitted diseases (74%) were frequently found. Patients with >10 lifetime female partners had an odds ratio of 3.8 (95% CI 1.1, 12.6; P-trend = .03) for presenting HPV-positive tumors when compared to patients with <6 partners. However, this trend was not significant when the number of sexual partners was adjusted for age of first coitus and antecedents of sexually transmitted diseases. HPV-related tumors (found in 36% of the samples) were characterized by a warty and/or basaloid morphology and high histological grade in most cases. CONCLUSIONS: In our series, patients with penile cancer presented a distinctive epidemiologic and pathologic profile. These data might help explaining the geographical differences in incidence and aid in the design of strategies for cancer control in Paraguay.

Chaux A; Netto GJ; Rodríguez IM; Barreto JE; Oertell J; Ocampos S; Boggino H; Codas R; Xavier Bosch F; de Sanjose S; Muñoz N; Hildesheim A; Cubilla AL

2013-08-01

182

Automated ancillary cancer history classification for mesothelioma patients from free-text clinical reports.  

UK PubMed Central (United Kingdom)

BACKGROUND: Clinical records are often unstructured, free-text documents that create information extraction challenges and costs. Healthcare delivery and research organizations, such as the National Mesothelioma Virtual Bank, require the aggregation of both structured and unstructured data types. Natural language processing offers techniques for automatically extracting information from unstructured, free-text documents. METHODS: Five hundred and eight history and physical reports from mesothelioma patients were split into development (208) and test sets (300). A reference standard was developed and each report was annotated by experts with regard to the patient's personal history of ancillary cancer and family history of any cancer. The Hx application was developed to process reports, extract relevant features, perform reference resolution and classify them with regard to cancer history. Two methods, Dynamic-Window and ConText, for extracting information were evaluated. Hx's classification responses using each of the two methods were measured against the reference standard. The average Cohen's weighted kappa served as the human benchmark in evaluating the system. RESULTS: Hx had a high overall accuracy, with each method, scoring 96.2%. F-measures using the Dynamic-Window and ConText methods were 91.8% and 91.6%, which were comparable to the human benchmark of 92.8%. For the personal history classification, Dynamic-Window scored highest with 89.2% and for the family history classification, ConText scored highest with 97.6%, in which both methods were comparable to the human benchmark of 88.3% and 97.2%, respectively. CONCLUSION: We evaluated an automated application's performance in classifying a mesothelioma patient's personal and family history of cancer from clinical reports. To do so, the Hx application must process reports, identify cancer concepts, distinguish the known mesothelioma from ancillary cancers, recognize negation, perform reference resolution and determine the experiencer. Results indicated that both information extraction methods tested were dependant on the domain-specific lexicon and negation extraction. We showed that the more general method, ConText, performed as well as our task-specific method. Although Dynamic- Window could be modified to retrieve other concepts, ConText is more robust and performs better on inconclusive concepts. Hx could greatly improve and expedite the process of extracting data from free-text, clinical records for a variety of research or healthcare delivery organizations.

Wilson RA; Chapman WW; Defries SJ; Becich MJ; Chapman BE

2010-01-01

183

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

Directory of Open Access Journals (Sweden)

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

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

2009-01-01

184

Lytic lesions in a patient with past history of renal cancer.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study lytic lesions in a patient with past history of renal cancer. METHODS: A 62 year-old man was admitted to hospital for investigation of the cause of polyostotic bone pain. RESULTS: Brown tumors due to hyperparathyroidism turned out to be the cause of bone pain. CONCLUSIONS: Differential diagnosis is important in daily practice in order to provide a correct treatment for each condition.

Sebio A; Robert L; Ovejero D; Murata P; Sullivan I; Stradella A; Maroto P

2013-04-01

185

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

Scientific Electronic Library Online (English)

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

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

2009-02-01

186

Family history of Type 1 diabetes affects insulin secretion in patients with 'Type 2' diabetes.  

UK PubMed Central (United Kingdom)

AIMS: The aim was to evaluate the impact of family history of diabetes on the phenotype of patients diagnosed with Type 2 diabetes and the frequency of susceptibility genotypes. METHODS: Patients with Type 2 diabetes with family history for both Type 1 and Type 2 diabetes (FH(MIX, n) = 196) or Type 2 diabetes only (FH(T2), n = 139) matched for age, sex, BMI and age at diagnosis, underwent an oral glucose tolerance test and a combined glucagon test and insulin tolerance test. Glutamic acid decarboxylase (GAD) antibodies and major Type 1 and Type 2 diabetes susceptibility gene variants were analysed. Patients were stratified into groups according to family history or GAD antibody positivity (GADA+, GADA-) or a combination of these (GADA+/FH(MIX), GADA+/FH(T2), GADA-/FH(MIX), GADA-/FH(T2)). RESULTS: Compared with other patients, those with FH(MIX) more often had GAD antibodies (14.3 vs. 4.3%, P = 0.003), and those with both FH(MIX) and GAD antibodies had the highest frequency of insulin deficiency (stimulated serum C-peptide < 0.7 nmol/l, GADA+/FH(MIX) 46.4% vs. GADA-/FH(MIX) 9.5% (P < 0.00001), GADA-/FH(T2) 4.5% (P < 0.00001), GADA+/FH(T2) 0%). Patients with GADA+/FH(MIX) more often had HLA-DQB1 risk genotypes compared with patients with GADA-/FH(MIX) or GADA-/FH(T2D) (47 vs. 23 or 14%, P = 0.05 and P < 0.00001, respectively). In logistic regression analyses, FH(MIX), GAD antibody positivity and HLA risk genotypes were independently associated with insulin deficiency. CONCLUSION: A family history for both type 1 and type 2 diabetes was associated with higher prevalence of GAD antibodies and HLA-DQB1 risk genotypes than a family history of type 2 diabetes only, and was associated with earlier and more severe development of insulin deficiency, which was only partially explained by GAD antibodies and HLA.

Lundgren VM; Andersen MK; Isomaa B; Tuomi T

2013-05-01

187

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

UK PubMed Central (United Kingdom)

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

Olson SH; Iyer S; Scott J; Erez O; Samuel S; Markovits T; Schwartz M; Toro C; Gambarin-Gelwan M; Kurtz RC

2005-01-01

188

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

Science.gov (United States)

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

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

2005-01-01

189

Service utilization by schizophrenic patients in Groningen and South-Verona: an event-history analysis.  

UK PubMed Central (United Kingdom)

The question addressed to in this paper is whether severely mentally ill patients are treated differently in a community mental health service without the back-up of a mental hospital (south-Verona, Italy) compared with an institution-based system in which mental hospitals, although highly modernized, are still predominant (Groningen, The Netherlands). Using the psychiatric case-registers in both areas, the patterns of care in 2 years of follow-up of schizophrenic patients were constructed. Survival analysis was used to analyse in-, day- and out-patient episodes of care. Three-quarters of the Groningen and half of the south-Verona patients experienced at least one episode of hospitalization; 20% of the Groningen and 5% of the south-Verona patients were long-stay patients at the end of the observation period. The south-Verona patients had more episodes of in-patient and especially of day-patient and out-patient care. Cox's regression showed that the duration of episodes controlled for the history of events and sociodemographic characteristics, was significantly shorter in south-Verona. One of the main conclusion was that hospitalizations for the severely mental ill are also needed in a community-based system of care, supporting the assumption of a 'bed-rock' of mental illness. However, the south-Verona community mental health service seems to be able to reduce the duration of hospitalizations considerably.

Sytema S; Micciolo R; Tansella M

1996-01-01

190

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

Directory of Open Access Journals (Sweden)

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

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

2009-01-01

191

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

UK PubMed Central (United Kingdom)

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

Zhou XF; He YL; Song W; Peng JJ; Zhang CH; Li W; Wu H

2009-06-01

192

Perceptions of malaysian colorectal cancer patients regarding dietary intake: a qualitative exploration.  

UK PubMed Central (United Kingdom)

Background: Changes in dietary practices are known to be associated with changes in the health and disease pattern of a population. This study aimed to qualitatively explore the perception of colorectal cancer patients regarding causes of colorectal cancer and the influence of diet. Materials and Methods: Twelve respondents from three major ethnicities in Malaysia were selected from the quantitative study on dietary pattern and colorectal cancer carried out earlier in this study. In-depth interviews (IDI), conducted from April until June 2012, were mainly in the Malay language with additional use of English and continued until the saturation point was reached. All interviews were autorecorded so that verbatim transcriptions could be created. Results: Causes of colorectal cancer were categorized into internal and external factors. The majority of respondents agreed that there is an association between Western foods and colorectal cancer. Malaysian traditional diet was not related to colorectal cancer as less preservative agents were used. Malaysian diet preparation consisting of taste of cooking (spicy, salty and sour foods) plus type of cooking (fry, grilled and smoked) were considered causes of colorectal cancer. All respondents changed their dietary pattern to healthy food after being diagnosed with colorectal cancer. Advice from doctors regarding suitable food for colorectal cancer was useful in this regard. Conclusions: Eating outside, use of food flavoring ingredients and preservative agents were considered to be the main factors causing colorectal cancer. All respondents admitted that they changed to a healthy diet after being diagnosed with colorectal cancer.

Yusof AS; Isa ZM; Shah SA

2013-01-01

193

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

UK PubMed Central (United Kingdom)

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? N; Cvetkovi? M; Nikoli? G; Filipovi? B; Milini? N

2013-01-01

194

Natural history of exercise function in patients with Ebstein anomaly: A serial study.  

UK PubMed Central (United Kingdom)

BACKGROUND: The clinical manifestations of Ebstein anomaly (EA) vary greatly; criteria for surgical intervention remain undefined. Decisions regarding surgical intervention in asymptomatic/mildly symptomatic patients would be helpfully informed by a detailed, quantitative understanding of the natural history of exercise intolerance in these patients. However, past studies of exercise function in EA have been of a cross-sectional, rather than a serial, nature. We, therefore, analyzed serial cardiopulmonary exercise (CPX) tests from patients with unrepaired EA to better appreciate the natural history of their exercise function. METHODS: All patients with EA who had had at least 2 CPX tests, separated by at least 6 months, between November 2002 and October 2010 were identified. Patients with prior tricuspid valve surgery were excluded from the study. RESULTS: Cardiopulmonary exercise data from 23 patients (64 CPX tests; 2.8 ± 1.0 tests/patient) were analyzed. The median time interval between the first and last CPX tests was 3.3 (range, 0.6-7.3) years. The percentage of predicted peak oxygen consumption declined slowly (1.87 ± 8.04 percentage points/y) during the follow-up period. The decline was more pronounced (3.04 ± 6.78 percentage points/y) in patients <18 years old. On multivariate modeling, only the change in oxygen pulse at peak exercise (a surrogate for forward stroke volume) and the change in peak heart rate over time emerged as statistically significant correlates of the change in percentage of predicted peak oxygen consumption. CONCLUSION: The exercise function of patients with EA tends to deteriorate over time. This deterioration appears to be related to a progressive decline in their ability to augment their forward stroke volume and heart rate during exercise.

Kipps AK; Graham DA; Lewis E; Marx GR; Banka P; Rhodes J

2012-03-01

195

Laparoscopic adrenalectomy by the lateral transperitoneal approach in patients with a history of previous abdominal surgery.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Even the half of patients undergoing laparoscopic adrenalectomy has history of previous abdominal surgeries. However, it is still uncertain if this fact has an impact on the operation itself as well as the postoperative course. AIM: To analyze the effects of previous abdominal surgery on surgical outcomes in adrenal tumor patients subjected to laparoscopic adrenalectomy. MATERIAL AND METHODS: This study included 268 patients with adrenal gland tumors operated on by means of laparoscopic lateral transperitoneal adrenalectomy: 1) previously subjected to at least one abdominal surgery (group A, n = 101), or 2) with no history of previous abdominal operations (group B, n = 167). RESULTS: Groups A and B did not differ in terms of tumor size (p = 0.132), mean operation time (p = 0.456), mean intraoperative blood loss (p = 0.754), or perioperative complication rate (p = 0.833). Dissection of intraperitoneal adhesions was considered difficult in 32 patients from group A (31.6%) and 8 subjects from group B (4.7%, p < 0.001). Conversion was required in three subjects from group A (2.9%) and 3 patients from group B (1.8%, p = 0.529). CONCLUSIONS: Previous abdominal surgery does not constitute a contraindication to laparoscopic transperitoneal adrenalectomy.

P?dziwiatr M; Mat?ok M; Kulawik J; Major P; Budzy?ski P; Zub-Pokrowiecka A; Budzy?ski A

2013-06-01

196

High nutritional risk is associated with worse health-related quality of life in patients with heart failure beyond sodium intake.  

UK PubMed Central (United Kingdom)

BACKGROUND: The most desirable outcome in heart failure (HF) management is to improve health-related quality of life (HRQoL) as a patient-centred health outcome. Nutrition is assumed to be important in HF management, whereas there is little evidence that nutritional risk affects HRQoL, except for sodium. PURPOSE: We aimed to determine whether nutritional risk is associated with worse HRQoL after controlling for daily sodium intake. METHODS: A total of 134 consecutive patients with HF [age 63 ± 11 years, 35% female, 45% New York Heart Association (NYHA) class III/IV, ejection fraction (EF) 33 ± 13%] completed the Nutrition Screening Initiative (NSI) to assess nutritional risk and a 24-h urine sodium excretion assessment to estimate daily sodium intake at baseline. The Minnesota Living with HF Questionnaire was used to evaluate HRQoL at baseline and 6 months later. Hierarchical linear regressions were used to determine whether nutritional risk predicted HRQoL at baseline and 6 months later. RESULTS: Seventy-eight (58.2%) patients had high nutritional risk as indicated by a total NSI score ? 6. Increased nutritional risk was independently associated with worse HRQoL at baseline and 6 months later (? = 0.33, p < 0.001; ? = 0.35, p < 0.001, respectively), after controlling for age, gender, aetiology, body mass index, NYHA class, EF, total comorbidity score, prescribed medications, and daily sodium intake. CONCLUSION: These findings show that higher nutritional risk beyond sodium intake affects worse HRQoL in patients with HF. Further work is required to provide specific dietary guidelines to improve health outcomes for patients with HF.

Son YJ; Song EK

2013-04-01

197

The Relationship Between Vegetables and Fruits Intake and Glycosylated Hemoglobin Values, Lipids Profiles and Nitrogen Status in Type II Inactive Diabetic Patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: The prevalence of obesity and associated chronic disease such as diabetes is rapidly increasing in all part of the world. The World Health Organization has predicted that between 1997 and 2025 the number of diabetic patients will increase from 143 million to about 300 million. In diabetic patients, oxidative stress leads to non-enzymatic glycosylation of proteins such as hemoglobin and albumin, these proteins can play a significant role in pathogenesis of diabetes and development of chronic disorders in diabetic patients. Antioxidant nutrients can reduce the chronic disorders and complications of diabetes by inhibiting the oxidative reactions. Some important antioxidant such as vitamin A, vitamin C, vitamin E and selenium occur in vegetables and fruits. Our objective of this study was investigation of the relationship between vegetables and fruits intake ssand glycosylated hemoglobin (HbA1C) values in diabetic patients. METHODS: One hundred and five diabetic patients participated in this cross-sectional study. The patients were referred to health center in Khomeini shahr. Glycosylated hemoglobin (HbA1C) values were measured by chromatography method. Data on dietary intake and vegetables and fruits consumption were obtained from validated food frequency questionnaires. RESULTS: The unadjusted mean glycosylated hemoglobin (HbA1C) is significantly associated with the amount of vegetables and fruits intake (P = 0.014), but the relationship between consumption of fruits and HbA1C is not significant and the relationship between consumption of vegetables and HbA1C was roughly significant (P = 0.049). There were no significant relationship between vegetables and fruits intake and lipids profiles, BUN/creatinine and 24 h urinary protein (P > 0.05). CONCLUSIONS: Intake of vegetables and fruits may reduce the glycosylated hemoglobin, therefore choosing the appropriate diet with high fruits and vegetables may help to develop antioxidant defense and reduce the HbA1C in diabetic patients but it did not have any impact on lipids profiles, BUN/creatinine and urine protein 24 h.

Tabesh M; Hariri M; Askari G; Ghiasvand R; Tabesh M; Heydari A; Darvishi L; Khorvash F

2013-04-01

198

Natural history of low grade dysplasia in patients with primary sclerosing cholangitis and ulcerative colitis.  

UK PubMed Central (United Kingdom)

BACKGROUND AND AIM: Patients with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC) are at increased risk of colon cancer. The aim of this study was to determine the natural history of LGD and its progression to high grade dysplasia (HGD)/colorectal cancer (CRC) in PSC-UC patients. METHODS: Ten PSC-UC patients with LGD who underwent surveillance colonoscopy from 1996 to 2011 were evaluated. Raised dysplasia was defined as a discrete raised lesion located in an area involved by either quiescent or active colitis that was endoscopically resected, while flat dysplasia was defined as the absence of documentation of a raised lesion. RESULTS: Of the 10 patients with LGD, 3 (30%) progressed to raised HGD over a mean follow-up of 13±11months. Three of 10 patients had initial raised LGD while 7 had flat LGD. The location of HGD was in the proximal colon in all 3 patients. However all 3 patients who progressed to HGD had initial dysplasia located in the distal colon and had flat morphology. The incidence rate for detection of HGD/CRC was 9.4 cases per 100 person years at risk. Patients with LGD with flat morphology had an incidence rate of 17.8 cases per 100 person years at risk. HGD occurred more frequently within the first year of initial detection of LGD (23.5 per 100 patient years of follow-up). CONCLUSIONS: One-third of patients with LGD progressed to HGD/CRC in PSC-UC. Most patients progress within the first year of diagnosis of LGD supporting early colectomy in PSC-UC patients with LGD.

Venkatesh PG; Jegadeesan R; Gutierrez NG; Sanaka MR; Navaneethan U

2013-02-01

199

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; Michele Drehmer; Sérgio Saldanha Menna-Barreto

2009-01-01

200

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: Determinar a relação entre o estado nutricional e a ingestão dietética de pacientes com fibrose cística. MÉTODOS: Estudo transversal com 85 pacientes com fibrose cística entre 6 e 18 anos de idade. A ingestão dietética foi avaliada pelo registro alimentar de 3 dias com a pesagem dos alimentos consumidos. Os desfechos avaliados foram os seguintes indicadores do estado nutricional: percentual da relação peso/estatura (%P/E), percentil do índice de mass (more) a corpórea (IMC), escore Z para estatura/idade (E/I) e peso/idade (P/I), e percentual de ingestão dietética comparada a Recommended Dietary Allowances (RDAs). RESULTADOS: A prevalência de pacientes eutróficos foi de 77,7%, considerando o IMC acima do percentil 25 como ponto de corte, e 83,5% estavam acima de 90% do %P/E. A média de ingestão, avaliada em 82 pacientes, foi de 124,5% da RDA. Nas análises de regressão logística univariada, encontrou-se uma associação significativa entre a variável independente ingestão calórica e o desfecho escore Z E/I. O modelo de análise multivariado, elaborado a partir do desfecho escore Z E/I e ajustado para idade, VEF1, colonização por Staphylococcus aureus resistente à meticilina e número de internações hospitalares, demonstrou que um aumento de 1% da ingestão calórica em relação à RDA diminui em 2% a chance de ter déficit de estatura (OR = 0,98; IC95%: 0,96-1,00). A escolaridade materna demonstrou uma associação limítrofe (p = 0,054). CONCLUSÕES: Houve baixa prevalência de desnutrição nesta amostra. O modelo de estudo demonstrou evidências da associação entre a ingestão dietética e o estado nutricional, sendo esta ingestão um fator preditor de crescimento nesses pacientes. Abstract in english OBJECTIVE: To determine the relationship between nutritional status and dietary intake in patients with cystic fibrosis. METHODS: Cross-sectional study involving 85 cystic fibrosis patients between 6 and 18 years of age. Dietary intake was evaluated by the 3-day diet record (weighing the food 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 (more) 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.

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

2009-10-01

 
 
 
 
201

Patient histories, retention, and outcome models for younger and older adults in DATOS.  

UK PubMed Central (United Kingdom)

Structural equation modeling with multiple groups was used to examine relationships among pretreatment patient characteristics, treatment retention, and treatment outcomes among younger and older adults in the Drug Abuse Treatment Outcome Studies. Separate models were tested for 551 patients treated in long-term residential (LTR) programs and 571 patients treated in outpatient drug-free (ODF) programs. There was a stronger positive relationship between treatment retention and abstinence at follow-up for younger adults in both treatment modalities. Prior treatment history had a negative effect on self-efficacy to resist drug use for older adults in LTR. Negative reference group influence was reduced for all groups following treatment, however, it was more strongly related to abstinence for younger adults in LTR and for older adults in ODF. Clinical implications of age-related differences in these relationships are discussed.

Grella CE; Hser YI; Joshi V; Anglin MD

1999-12-01

202

Patient histories, retention, and outcome models for younger and older adults in DATOS.  

Science.gov (United States)

Structural equation modeling with multiple groups was used to examine relationships among pretreatment patient characteristics, treatment retention, and treatment outcomes among younger and older adults in the Drug Abuse Treatment Outcome Studies. Separate models were tested for 551 patients treated in long-term residential (LTR) programs and 571 patients treated in outpatient drug-free (ODF) programs. There was a stronger positive relationship between treatment retention and abstinence at follow-up for younger adults in both treatment modalities. Prior treatment history had a negative effect on self-efficacy to resist drug use for older adults in LTR. Negative reference group influence was reduced for all groups following treatment, however, it was more strongly related to abstinence for younger adults in LTR and for older adults in ODF. Clinical implications of age-related differences in these relationships are discussed. PMID:10617099

Grella, C E; Hser, Y I; Joshi, V; Anglin, M D

1999-12-01

203

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

Science.gov (United States)

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

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

2013-07-16

204

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

UK PubMed Central (United Kingdom)

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

Bokor-Bratic M; Cankovic M; Dragnic N

2013-10-01

205

The natural history of audiologic and tympanometric findings in patients with an unrepaired cleft palate.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To present the tympanometric findings in 552 patients (115 over 10 years of age) with unrepaired cleft palate (256 had audiologic findings) and to show the natural history and outcome of these cases. SETTING: The cleft lip and palate clinic for the Division of Cleft Lip and Palate Surgery at the West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China. DESIGN: Pure-tone audiometric and tympanometric evaluations were performed on 552 patients with an unrepaired cleft palate. Results were analyzed by looking at the patient's age and cleft palate type. RESULTS: This study demonstrated an age-related decrease in the frequency of hearing impairment and abnormal tympanometry. The frequency of hearing impairment and abnormal tympanometry in patients with submucous cleft palate was significantly lower than in patients from the other four major cleft palate categories (p = .001, p = .006, respectively). CONCLUSIONS: The middle ear function and hearing levels of unrepaired cleft palate patients improved with age, but at least 30% of the patients' ears demonstrated a hearing loss and abnormal tympanometry in each age group, including those over 19 years of age. In the crucial language-learning stage, the frequency of hearing impairment and abnormal tympanometry was as high as 60%. Considering these results, palate repair and surgical intervention, such as tube insertion, for otological problems should be considered at an early age.

Zheng W; Smith JD; Shi B; Li Y; Wang Y; Li S; Meng Z; Zheng Q

2009-01-01

206

Polycythemia vera: the natural history of 1213 patients followed for 20 years. Gruppo Italiano Studio Policitemia.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To reassess the natural history of polycythemia vera and to obtain reliable estimates of both incidence of thrombosis and survival for use in defining the sample size for therapeutic clinical trials. STUDY DESIGN: Retrospective cohort study of patients with polycythemia who had been followed for 20 years. SETTING: 11 Italian hematology institutions. PATIENTS: 1213 patients with polycythemia vera, which was diagnosed according to criteria established by the Polycythemia Vera Study Group and commonly used in clinical practice. MAIN OUTCOME MEASURES: All-cause mortality, venous and arterial thrombosis, and hematologic and nonhematologic neoplastic disease. Myocardial infarction and stroke were classified as major thrombotic events, and venous and peripheral arterial thrombosis were considered minor thrombotic events. The number of patients who died and the number of those who had major thrombotic events (combined end point) were used as a comprehensive measure of the benefit-risk ratio associated with the use of myelosuppressive agents. RESULTS: 634 fatal and nonfatal arterial and venous thromboses were recorded in 485 patients (41%); 36% of these episodes occurred during follow-up in 230 patients (19%), and 64% occurred either at presentation or before diagnosis. Thrombotic events occurred more frequently in the 2 years preceding diagnosis, suggesting a causal relation between the latent myeloproliferative disorder and the vascular event. The incidence of thrombosis during follow-up was 3.4%/y; older patients or those with a history of thrombosis had a higher risk for thrombosis. Overall mortality was 2.9/100 patients per year; thrombotic events and hematologic or nonhematologic cancers had similar effects on mortality. Patients receiving chemotherapy died three to four times more frequently than those not receiving chemotherapy. The increased risk for cancer in patients receiving myelosuppressive agents was seen approximately 6 years after diagnosis. In addition, the combined end point, computed as the sum of the hardest available events (death, nonfatal myocardial infarction, or stroke), suggests that myelosuppressive agents have an overall unfavorable effect. CONCLUSIONS: Cytoreduction favorably affects the incidence of thrombotic events, but aggressive treatment seems to be associated with increased risk for neoplasm. These results provide a basis for reevaluating the therapeutic strategy in patients with polycythemia vera and for estimating the size of clinical trials aimed at testing new therapeutic approaches.

1995-11-01

207

[Adenocarcinoma in the terminal ileum in a patient with no previous history of Crohn's disease].  

UK PubMed Central (United Kingdom)

We present a case of a 60-year-old man with no previous history of Crohn's disease who presented with abdominal pain and vomiting. X-ray examination of the abdomen showed obstructive ileus and the patient underwent emergency surgery. The resected terminal ileum was stenosed with characteristic changes of Crohn's disease. In the area of stenosis, dysplastic changes of the mucosa were present. In continuation of the dysplastic areas, a well-differentiated adenocarcinoma T3N0M0V0 was present.

Breinholt MF; Kildsig J

2011-01-01

208

The natural history of asymptomatic lumbar canal stenosis in patients undergoing surgery for cervical myelopathy.  

Science.gov (United States)

We retrospectively examined the prevalence and natural history of asymptomatic lumbar canal stenosis in patients treated surgically for cervical compressive myelopathy in order to assess the influence of latent lumbar canal stenosis on the recovery after surgery. Of 214 patients who had undergone cervical laminoplasty for cervical myelopathy, we identified 69 (32%) with myelographically documented lumbar canal stenosis. Of these, 28 (13%) patients with symptomatic lumbar canal stenosis underwent simultaneous cervical and lumbar decompression. Of the remaining 41 (19%) patients with asymptomatic lumbar canal stenosis who underwent only cervical surgery, 39 were followed up for ? 1 year (mean 4.9 years (1 to 12)) and were included in the analysis (study group). Patients without myelographic evidence of lumbar canal stenosis, who had been followed up for ? 1 year after the cervical surgery, served as controls (135 patients; mean follow-up period 6.5 years (1 to 17)). Among the 39 patients with asymptomatic lumbar canal stenosis, seven had lumbar-related leg symptoms after the cervical surgery. Kaplan-Meier analysis showed that 89.6% (95% confidence interval (CI) 75.3 to 96.0) and 76.7% (95% CI 53.7 to 90.3) of the patients with asymptomatic lumbar canal stenosis were free from leg symptoms for three and five years, respectively. There were no significant differences between the study and control groups in the recovery rate measured by the Japanese Orthopaedic Association score or improvement in the Nurick score at one year after surgery or at the final follow-up. These results suggest that latent lumbar canal stenosis does not influence recovery following surgery for cervical myelopathy; moreover, prophylactic lumbar decompression does not appear to be warranted as a routine procedure for coexistent asymptomatic lumbar canal stenosis in patients with cervical myelopathy, when planning cervical surgery. PMID:22371547

Tsutsumimoto, T; Shimogata, M; Yui, M; Ohta, H; Misawa, H

2012-03-01

209

The natural history of asymptomatic lumbar canal stenosis in patients undergoing surgery for cervical myelopathy.  

UK PubMed Central (United Kingdom)

We retrospectively examined the prevalence and natural history of asymptomatic lumbar canal stenosis in patients treated surgically for cervical compressive myelopathy in order to assess the influence of latent lumbar canal stenosis on the recovery after surgery. Of 214 patients who had undergone cervical laminoplasty for cervical myelopathy, we identified 69 (32%) with myelographically documented lumbar canal stenosis. Of these, 28 (13%) patients with symptomatic lumbar canal stenosis underwent simultaneous cervical and lumbar decompression. Of the remaining 41 (19%) patients with asymptomatic lumbar canal stenosis who underwent only cervical surgery, 39 were followed up for ? 1 year (mean 4.9 years (1 to 12)) and were included in the analysis (study group). Patients without myelographic evidence of lumbar canal stenosis, who had been followed up for ? 1 year after the cervical surgery, served as controls (135 patients; mean follow-up period 6.5 years (1 to 17)). Among the 39 patients with asymptomatic lumbar canal stenosis, seven had lumbar-related leg symptoms after the cervical surgery. Kaplan-Meier analysis showed that 89.6% (95% confidence interval (CI) 75.3 to 96.0) and 76.7% (95% CI 53.7 to 90.3) of the patients with asymptomatic lumbar canal stenosis were free from leg symptoms for three and five years, respectively. There were no significant differences between the study and control groups in the recovery rate measured by the Japanese Orthopaedic Association score or improvement in the Nurick score at one year after surgery or at the final follow-up. These results suggest that latent lumbar canal stenosis does not influence recovery following surgery for cervical myelopathy; moreover, prophylactic lumbar decompression does not appear to be warranted as a routine procedure for coexistent asymptomatic lumbar canal stenosis in patients with cervical myelopathy, when planning cervical surgery.

Tsutsumimoto T; Shimogata M; Yui M; Ohta H; Misawa H

2012-03-01

210

The natural history of liver cirrhosis in HIV-hepatitis C virus-coinfected patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To provide detailed information about the natural history of HIV-hepatitis C virus (HCV)-coinfected patients with cirrhosis. METHODS: Prospective cohort including 340 HIV-HCV-coinfected patients with compensated (n = 248) or decompensated (n = 92) cirrhosis. We evaluated predictors of survival and of first hepatic decompensation. RESULTS: The mortality rate for patients with decompensated and compensated cirrhosis was 27.14 deaths per 100 person-years [95% confidence interval (CI) 18.93-35.35] and 3.98 deaths per 100 person-years (95% CI 2.42-5.54), respectively. Rate of first hepatic decompensation in patients with compensated cirrhosis was 4.62 per 100 persons-years (95% CI 2.91-6.33). In the complete cohort, permanent HAART interruption during follow-up, CD4 cell count nadir and baseline Child-Pugh score (CPS) B or C were significantly associated with shorter survival. In patients with compensated cirrhosis factors significantly associated with decreased survival were having the first hepatic decompensation during follow-up, permanent HAART discontinuation, and CPS B and C at baseline. For patients with compensated cirrhosis, time since diagnosis of HCV infection, CPS B and C and permanent HAART discontinuation were significantly associated with the risk of first hepatic decompensation. Sustained viral response to anti-HCV therapy was not independently associated with better survival in patients with compensated cirrhosis. CONCLUSION: HIV-HCV-coinfected patients with cirrhosis have a relatively good 3-year survival (87%). In contrast, 2-year survival of patients with decompensated liver cirrhosis is only 50%. Three-year survival was mostly impacted by liver-related factors and HAART maintenance.

López-Diéguez M; Montes ML; Pascual-Pareja JF; Quereda C; Von Wichmann MA; Berenguer J; Tural C; Hernando A; González-García J; Serrano L; Arribas JR

2011-04-01

211

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

Scientific Electronic Library Online (English)

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

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

2013-06-01

212

[Management of patients with a history of late abortion or very premature delivery].  

UK PubMed Central (United Kingdom)

Patients have a very late abortion or premature delivery in 2-3 % of pregnancies. Management in a subsequent pregnancy should seek an infection, a fetal cause (aneuploidy, malformation syndrome, intrauterine death) or vascular pathology (preeclampsia, IUGR, intrauterine death). In women with a late abortion or very premature childbirth history, several preventive treatments of prematurity are now available. The main cause of prematurity is ascending infection from the vagina. Cerclage or pessary is designed to better isolate the uterine cavity. Their effectiveness has been validated in patients for whom the repeated measurement of cervical length by transvaginal ultrasound shows a cervical length <25mm. Early pregnancy vaginosis and treatment with Dalacin(®) seem to significantly reduce the risk of prematurity. Finally, the routine administration of intramuscular or vaginal progesterone at the beginning of the 2(nd) quarter also proved effective in several randomized studies.

Langer B; Gaudineau A; Sananes N; Fritz G

2013-02-01

213

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

Directory of Open Access Journals (Sweden)

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; Cvetkovi? Mirjana; Nikoli? Goran; Filipovi? Branka; Milini? Nikola

2013-01-01

214

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

Directory of Open Access Journals (Sweden)

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; Min Dae Kim; Tae Hyun Ryu; Sung Ho Choi; Han Se Kim; Kang Hun Lee; Jhong Hyun Park

2013-01-01

215

[Natural history of moderate-degree carotid stenosis in patients with peripheral artery disease].  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVE: To understand the evolution of moderate asymptomatic carotid stenosis, the factors that influence its progression and the related morbimortality. PATIENTS AND METHODS: Retrospective observational study of 133 patients with asymptomatic carotid stenosis between 50-69% in one or both carotids between 2002 and 2009. Included patients were subjected to screening for peripheral arterial disease (PAD), aneurysmal disease or carotid bruit. The monitoring was carried out using an annual duplex scan. The rate of progression, the variables related to this, the appearance of neurological events, and global and cardiovascular mortality were evaluated. Descriptive studies, univariate analysis (chi-squared test and Student's t-test), multivariate analysis (logistic regression), and survival curves (Log-Rank test) were carried out. RESULTS: With an average time of monitoring: 30.8 ± 1.7 months, stenosis progression was observed in 33% of the patients, with an average progression time of 31.3 ± 2.7 months. Greater progression was observed in the subgroup of patients with PAD and ischemic heart disease (odds ratio [OR] 2.84, confidence interval [CI] 95% 1.14-7.03). In the multivariate analysis only the PAD was identified as a risk factor for progression (P=.043). The group of patients with progression showed greater rates of neurological events: 15 vs. 1.6% (P=.01), greater global mortality: 15 vs. 3% (P=.04), and greater cardiovascular mortality: 12.1 vs. 1.5% (P=.03). CONCLUSIONS: The progression of asymptomatic carotid stenosis between 50-69% is common in patients subjected to screening, especially in those with a history of ischaemic heart disease and/or PAD. This progression is associated with an increased rate of cardiovascular complications. For this reason, we recommend clinical and echographic follow-up of these patients.

Morales-Gisbert SM; Plaza-Martínez Á; Sala-Almonacil VA; Olmos-Sánchez D; Gomez-Palonés FJ; Ortiz-Monzón E

2013-04-01

216

Metachronous colorectal cancer risk in patients with a moderate family history.  

UK PubMed Central (United Kingdom)

AIM: Lifetime risk of a metachronous colorectal cancer (mCRC) is 0.6-3% following sporadic colorectal cancer (CRC) and 15-26% in Lynch syndrome. The lifetime incidence of CRC in individuals with moderate familial risk is 8-17%. Risk of mCRC is unknown. METHOD: A retrospective longitudinal study of the Regional Familial CRC Registry was performed. Patients who had at least one CRC were categorized as follows: moderate risk (n = 383), Lynch syndrome (n = 528) and average (population) risk (n = 409). The Kaplan-Meier estimate (1-KM) and the cumulative incidence function were used to calculate the risk of mCRC. The 1-KM gives the risk for individuals remaining at risk (alive) at a given time point and thus is useful for counselling. The cumulative incidence function gives the risk for the whole population. RESULTS: The 1-KM and the cumulative incidence function demonstrated that the risk of mCRC was significantly higher in moderate-risk patients compared with average (population)-risk patients (1-KM, P = 0.008; cumulative incidence function, P = 0.00097). However, the risk of mCRC was higher in patients with Lynch syndrome than in moderate-risk or average (population)-risk patients. The 1-KM in moderate-risk patients was 2.7%, 6.3% and 23.5% at 5, 10 and 20 years, respectively. In average (population)-risk patients, the 1-KM was 1.3%, 3.1% and 7.0% at 5, 10 and 20 years, and the cumulative incidence function was 0.3%, 0.6% and 2.4% at the same time points, respectively. CONCLUSION: These data indicate that the risk of mCRC is significantly higher in patients with a moderate family history of CRC than in those with an average (population) risk. This justifies proactive lifelong surveillance.

Newton KF; Green K; Walsh S; Lalloo F; Hill J; Evans DG

2013-03-01

217

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

Science.gov (United States)

Background This study describes the natural history of Barth syndrome (BTHS). Methods The medical records of all patients with BTHS living in France were identified in multiple sources and reviewed. Results We identified 16 BTHS pedigrees that included 22 patients. TAZ mutations were observed in 15 pedigrees. The estimated incidence of BTHS was 1.5 cases per million births (95%CI: 0.2–2.3). The median age at presentation was 3.1 weeks (range, 0–1.4 years), and the median age at last follow-up was 4.75 years (range, 3–15 years). Eleven patients died at a median age of 5.1 months; 9 deaths were related to cardiomyopathy and 2 to sepsis. The 5-year survival rate was 51%, and no deaths were observed in patients ?3 years. Fourteen patients presented with cardiomyopathy, and cardiomyopathy was documented in 20 during follow-up. Left ventricular systolic function was very poor during the first year of life and tended to normalize over time. Nineteen patients had neutropenia. Metabolic investigations revealed inconstant moderate 3-methylglutaconic aciduria and plasma arginine levels that were reduced or in the low-normal range. Survival correlated with two prognostic factors: severe neutropenia at diagnosis (<0.5 × 109/L) and birth year. Specifically, the survival rate was 70% for patients born after 2000 and 20% for those born before 2000. Conclusions This survey found that BTHS outcome was affected by cardiac events and by a risk of infection that was related to neutropenia. Modern management of heart failure and prevention of infection in infancy may improve the survival of patients with BTHS without the need for heart transplantation.

2013-01-01

218

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

UK PubMed Central (United Kingdom)

BACKGROUND: This study describes the natural history of Barth syndrome (BTHS). METHODS: The medical records of all patients with BTHS living in France were identified in multiple sources and reviewed. RESULTS: We identified 16 BTHS pedigrees that included 22 patients. TAZ mutations were observed in 15 pedigrees. The estimated incidence of BTHS was 1.5 cases per million births (95%CI: 0.2-2.3). The median age at presentation was 3.1 weeks (range, 0-1.4 years), and the median age at last follow-up was 4.75 years (range, 3-15 years). Eleven patients died at a median age of 5.1 months; 9 deaths were related to cardiomyopathy and 2 to sepsis. The 5-year survival rate was 51%, and no deaths were observed in patients ?3 years. Fourteen patients presented with cardiomyopathy, and cardiomyopathy was documented in 20 during follow-up. Left ventricular systolic function was very poor during the first year of life and tended to normalize over time. Nineteen patients had neutropenia. Metabolic investigations revealed inconstant moderate 3-methylglutaconic aciduria and plasma arginine levels that were reduced or in the low-normal range. Survival correlated with two prognostic factors: severe neutropenia at diagnosis (<0.5 × 109/L) and birth year. Specifically, the survival rate was 70% for patients born after 2000 and 20% for those born before 2000. CONCLUSIONS: This survey found that BTHS outcome was affected by cardiac events and by a risk of infection that was related to neutropenia. Modern management of heart failure and prevention of infection in infancy may improve the survival of patients with BTHS without the need for heart transplantation.

Rigaud C; Lebre AS; Touraine R; Beaupain B; Ottolenghi C; Chabli A; Ansquer H; Ozsahin H; Di Filippo S; De Lonlay P; Borm B; Rivier F; Vaillant MC; Mathieu-Dramard M; Goldenberg A; Viot G; Charron P; Rio M; Bonnet D; Donadieu J

2013-01-01

219

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Las guías del Comité Consultivo Farmacéutico Australiano establecen que se lleve una historia de medicación detallada desde el primer punto de entrada en un servicio de urgencias (SU). Los ancianos, en particular los que residen en Residencias de Ancianos y los que no son hablantes nativos ingleses, se han identificado como grupos de pacientes vulnerables a las desgracias medicamentosas. Objetivo: Analizar la incidencia de discrepancias en las historias de medicación (more) 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 background, have been identified as patient groups vulnerable to medication misadventure. Objective: to analyse the incidence of discrepancies in medication histories in these demograp (more) hic 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 p

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

2007-12-01

220

Effect of Caloric Intake 25 or 30 kcal/kg/day on the Glycemic Control in Obese Patients With Type 2 Diabetes.  

UK PubMed Central (United Kingdom)

BACKGROUND: The recommended total dietary energy intake prescribed medical nutrition therapy for obese or overweight patients with type 2 diabetes in Japan is often set at 25 kcal/kg ideal body weight (IBW)/day. This study was conducted to determine the impact of the total dietary energy intake (25 or 30 kcal/kg IBW/day) on the glycemic control, lipid profile, and satisfaction level in overweight patients with type 2 diabetes. METHODS: We performed interview and a designed prospective, randomized, controlled, multicenter study trial. Recruitment for interview for doctors and hospitalization of the obese or overweight patients with type 2 diabetes began from September 2008 and continued until June 2010. The subjects were randomly assigned to 25 kcal/kg IBW/day group (25 kcal group) or 30 kcal/kg IBW/day group (30 kcal group). The primary endpoint was the body weight of the subjects at the time of hospitalization, at the time of discharge from the hospital, and at 3, 6 and 12 months after discharge from the hospital. RESULTS: The glycemic control, lipid control and body weight were similar between the 25 and 30 kcal groups during the 12-month follow-up, and the degree of satisfaction in respect of the medical treatment was significantly higher in the 30 kcal group than in the 25 kcal group at 1 year after discharge. CONCLUSIONS: It is considered to be preferable for the caloric intake to be set at 30kcal/kg IBW/day rather than at 25 kcal/kg IBW/day for obese or overweight patients with type 2 diabetes.

Masuda K; Aoki K; Kawaguchi J; Yamakawa T; Matsuba I; Terauchi Y

2013-10-01

 
 
 
 
221

Tobacco treatment outcomes in patients with and without a history of depression, Czech Republic, 2005-2010.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Higher prevalence of smoking among depressed patients, as well as the risk of depression in smokers, is well documented. The proportion of patients with a history of depression among those seeking intensive treatment of tobacco dependence is also high. In contrast, evidence of treatment success in this subgroup of patients is controversial. The aim of this study was to compare smoking abstinence rates after tobacco treatment in smokers with and without a history of depression. METHODS: We reviewed retrospective data from 1,730 smokers seeking treatment in Prague, Czech Republic. History of depression was defined as past diagnosis of depression or current treatment of depression. After a 1-year, self-reported smoking status was validated by expired-air carbon monoxide. We used logistic regression to analyze associations between abstinence rates, history of depression, and other factors (eg, age, sex, tobacco dependence). RESULTS: Of 1,730 smokers treated, 289 (16.7%) had a history of depression. The smoking abstinence rate at 1 year was 32.5% for smokers with a history of depression and 38.7% for those with no history (P = .048). Among women, abstinence did not differ between groups (35.0% vs 35.7%; P = .86). However, among men, those with a history of depression had lower rates of abstinence (27.4% vs 41.3%; P = .009). After adjustment for baseline covariates, history of depression was not significantly associated with smoking abstinence in men or women. CONCLUSION: Intensive outpatient tobacco treatment programs can achieve abstinence rates among smokers with a history of depression similar to rates among the general population.

Stepankova L; Kralikova E; Zvolska K; Kmetova A; Blaha M; Bortlicek Z; Sticha M; Anders M; Schroeder DR; Croghan IT

2013-01-01

222

Tobacco treatment outcomes in patients with and without a history of depression, czech republic, 2005-2010.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Higher prevalence of smoking among depressed patients, as well as the risk of depression in smokers, is well documented. The proportion of patients with a history of depression among those seeking intensive treatment of tobacco dependence is also high. In contrast, evidence of treatment success in this subgroup of patients is controversial. The aim of this study was to compare smoking abstinence rates after tobacco treatment in smokers with and without a history of depression. METHODS: We reviewed retrospective data from 1,730 smokers seeking treatment in Prague, Czech Republic. History of depression was defined as past diagnosis of depression or current treatment of depression. After a 1-year, self-reported smoking status was validated by expired-air carbon monoxide. We used logistic regression to analyze associations between abstinence rates, history of depression, and other factors (eg, age, sex, tobacco dependence). RESULTS: Of 1,730 smokers treated, 289 (16.7%) had a history of depression. The smoking abstinence rate at 1 year was 32.5% for smokers with a history of depression and 38.7% for those with no history (P = .048). Among women, abstinence did not differ between groups (35.0% vs 35.7%; P = .86). However, among men, those with a history of depression had lower rates of abstinence (27.4% vs 41.3%; P = .009). After adjustment for baseline covariates, history of depression was not significantly associated with smoking abstinence in men or women. CONCLUSION: Intensive outpatient tobacco treatment programs can achieve abstinence rates among smokers with a history of depression similar to rates among the general population.

Stepankova L; Kralikova E; Zvolska K; Kmetova A; Blaha M; Bortlicek Z; Sticha M; Anders M; Schroeder DR; Croghan IT

2013-01-01

223

[Post-stroke somatic pathology in patients with a history of alcohol abuse].  

UK PubMed Central (United Kingdom)

AIM: to study concomitant somatic pathology in brain stroke patients abusing alcohol before cerebral catastrophe. SUBJECTS AND METHODS: Two groups were identified according to the results of examining 255 poststroke patients. A study group included 57 (22.4%) pre-stroke alcohol abusers; a control group consisted of 198 (77.6%) alcohol non-abusers. RESULTS: Among the study group patients, lacunar and hemodynamic pathogenetic subtypes of ischemic stroke were encountered 3 times more and 2 times less frequently, respectively, than in the control groups. After cerebral stroke, the study group patients had a clinical picture with a preponderance of diminished cognitive functions, as well as motor disorders mainly as hemiparetic syndrome. Assessment of the pattern of somatic pathology in both group patients revealed a predominance of myocardial infarction by almost 2-fold, hepatobiliary diseases by 4.7-fold, duodenal ulcer disease by 1.6-fold, and bronchopulmonary pathology by 2-fold among the study group patients. Arthrosis deformans and obesity were observed by 6.4 and 3.5 times more frequently, respectively. The incidence of cardiac disease and hypertension in the acute period did not differ greatly in the compared groups. No thyroid pathology was recorded in the study group. In this group, the poststroke period was generally severer or ran as a galloping type in one third of cases. CONCLUSION: Somatic pathology aggravates the poststroke period, on the one hand, and it is decompensated in the presence of inadequate cerebral blood supply, on the other. Measures to compensate for neuropsychological disorders should be efficiently combined with rehabilitative actions on somatic pathology in poststroke patients with a history of burdened alcohol abuse.

Iastrebtseva IP; Novikov AE

2010-01-01

224

Spurious case of XX maleness in a patient with a history of Wiskott-Aldrich syndrome.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To alert endocrinologists about the potential for karyotype confusion in patients who have undergone bone marrow transplantation. METHODS: Clinical, laboratory, and imaging data are reported on a young adult male patient who initially presented because of concerns about short stature. RESULTS: An 18-year-old fully virilized male patient with a history of Wiskott-Aldrich syndrome had undergone successful bone marrow transplantation in infancy. The donor was his older sister. Many years later, he underwent evaluation because of short stature and was found to have a 46, XX karyotype. This unexpected finding led to several costly laboratory and imaging studies, as well as a new diagnosis of a disorder of sex development. The patient was referred to our medical center for further evaluation of XX sex reversal. A skin biopsy was eventually performed, which revealed a 46, XY karyotype. This unusual case highlights the fact that a peripheral blood specimen from bone marrow transplant recipients reflects the genetic makeup of the bone marrow donor. CONCLUSION: Although the cytogenetic changes that occur in recipients of bone marrow transplants are well known to hematologists and oncologists, they are not commonly recognized by other health care providers. Increased awareness of this potential situation in long-term survivors of bone marrow transplantation is needed.

Nebesio TD; Torres-Martinez W; Rink RC; Eugster EA

2011-03-01

225

Micronutrients intake is associated with improved sperm DNA quality in older men.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate whether lifestyle factors such as increased dietary intake of micronutrients reduce the risks of sperm DNA damage, and whether older men benefit more than younger men. DESIGN: Cross-sectional study design with equalized assignments into age groups. SETTING: National laboratory and university. PATIENT(S): Nonclinical group of 22-80-year-old nonsmoking men (n = 80) who reported no fertility problems. MAIN OUTCOME MEASURE(S): Sperm DNA damage measured by alkaline and neutral DNA electrophoresis (i.e., sperm Comet assay). RESULT(S): Sociodemographics, occupational exposures, medical and reproductive histories, and lifestyle habits were determined by questionnaire. The average daily dietary and supplement intake of micronutrients (vitamin C, vitamin E, b-carotene, zinc, and folate) was determined using the 100-item Modified Block Food Frequency Questionnaire (FFQ). Men with the highest intake of vitamin C had approximately 16% less sperm DNA damage (alkaline sperm Comet) than men with the lowest intake, with similar findings for vitamin E, folate, and zinc (but not ?-carotene). Older men (>44 years) with the highest vitamin C intake had approximately 20% less sperm DNA damage compared with older men with the lowest intake, with similar findings for vitamin E and zinc. The older men with the highest intake of these micronutrients showed levels of sperm damage that were similar to those of the younger men. However, younger men (<44 years) did not benefit from higher intakes of the micronutrients surveyed. CONCLUSION(S): Men with higher dietary and supplement intake of certain micronutrients may produce sperm with less DNA damage, especially among older men. This raises the broader question of how lifestyle factors, including higher intakes of antioxidants and micronutrients, might protect somatic as well as germ cells against age-associated genomic damage.

Schmid TE; Eskenazi B; Marchetti F; Young S; Weldon RH; Baumgartner A; Anderson D; Wyrobek AJ

2012-11-01

226

Family history and its association to curve size and treatment in 1,463 patients with idiopathic scoliosis.  

UK PubMed Central (United Kingdom)

PURPOSE: To study family history in relation to curve severity, gender, age at diagnosis and treatment in idiopathic scoliosis. METHODS: A self-assessment questionnaire on family history of scoliosis was administered to 1,463 untreated, brace or surgically treated idiopathic scoliosis patients. RESULTS: Out of the 1,463 patients, 51 % had one or more relatives with scoliosis. There was no significant difference between females and males, nor between juvenile and adolescent study participants in this respect (p = 0.939 and 0.110, respectively). There was a significant difference in maximum curve size between patients with one or more relatives with scoliosis (median 35°, interquartile range 25) and patients without any relative with scoliosis (median 32°, interquartile range 23) (p = 0.022). When stratifying patients according to treatment (observation, brace treatment or surgery), we found that it was more common to have a relative with scoliosis among the treated patients (p = 0.011). The OR for being treated was 1.32 (95 % CI 1.06-1.64) when the patient had a relative with scoliosis, compared to not having. CONCLUSIONS: Larger curve sizes were found in patients with a family history of scoliosis than in the ones without. No relation between family history and gender or between family history and age at onset of idiopathic scoliosis was found. Although the presence of a family history of scoliosis may not be a strong prognostic risk factor, it indicates that these patients are at higher risk of developing a more severe curve.

Grauers A; Danielsson A; Karlsson M; Ohlin A; Gerdhem P

2013-06-01

227

Late varicella-zoster virus dendriform keratitis in patients with histories of herpes zoster ophthalmicus.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the characteristics and course of late varicella-zoster virus (VZV) dendriform keratitis in patients with histories of herpes zoster ophthalmicus (HZO); to describe responses of corneal lesions to antiviral treatment; and to investigate risk factors for recurrence. DESIGN: Retrospective case series. METHODS: Included were patients known to have 1 or more episodes of dendriform lesions beginning at least 2 weeks after HZO in 2 academic practices. Epithelial lesions were evaluated for the presence of VZV DNA by a polymerase chain reaction assay. Demographic, medical, and ophthalmic data were collected for each episode. Responses to treatment with antiviral medications were evaluated. Cumulative risk of recurrence was determined using Kaplan-Meier analysis; potential risk factors for recurrence (age, systemic disease, lesion characteristics, corticosteroids) were evaluated using univariate Cox proportional hazard models. RESULTS: We identified 20 patients (14 women; median age, 65 years) who met inclusion criteria. Dendriform lesions were pleomorphic with thickened, opaque epithelium. Seven patients had systemic diseases characterized by altered immune function. VZV DNA was identified in 15 of 16 cases tested, and all lesions responded to antiviral therapy. The 1-year incidence of first recurrence was 95.8 lesions per 100 person-years of follow-up. Patients had multiple recurrences, but risk of recurrence appeared to decrease over time. No statistically significant risk factors for recurrence were identified. CONCLUSIONS: Late dendriform lesions associated with HZO are foci of productive VZV infection. Lesions can be treated effectively with topical or systemic antiviral agents. Patients can have multiple recurrences of dendriform lesions despite treatment.

Hu AY; Strauss EC; Holland GN; Chan MF; Yu F; Margolis TP

2010-02-01

228

Natural history and long-term outcomes of patients treated for early stage colorectal cancer.  

UK PubMed Central (United Kingdom)

BACKGROUND: The long-term natural history of early stage colon cancer and the outcome of long-term colonoscopic surveillance in routine specialist clinical practice after removal of the incident cancers have not been fully defined. In the present long-term evaluation up to 25 years, metachronous neoplasia, including both advanced adenomas and carcinomas, was defined. METHODS: All early stage colorectal cancer patients evaluated consecutively from a single clinical practice underwent follow-up colonoscopic evaluations after removal of the incident cancer and clearing of neoplastic disease. Colonoscopic surveillance was planned for two phases - initially on an annual basis for five years, followed by continued surveillance every three years up to 25 years with removal of any metachronous neoplastic lesion. RESULTS: A total of 128 patients (66 men and 62 women) with 129 incident early stage colorectal cancers were evaluated. Virtually all patients were symptomatic, usually with clinical evidence of blood loss. Incident early cancers were located throughout the colon, especially in the rectosigmoid, and showed no pathological evidence of nodal or other metastases. All patients evaluated during the first five years did not experience recurrent disease or have metachronous cancer detected. After five years, a total of 94 patients were evaluated up to 25 years; six of these patients were found to have seven metachronous colon cancers. All developed cancer more than seven years after removal of the incident colorectal cancer, including six asymptomatic adenocarcinomas, of which only one had evidence of single node involvement. Another patient in this cohort developed a poorly differentiated neuroendocrine carcinoma of the colon. In addition, 45% of patients had a total of 217 adenomas removed, including 11% of patients with 33 advanced adenomas. Among 14 patients with advanced adenomas, seven (50%) developed ?1 late metachronous cancers. CONCLUSIONS: Following removal of an incident symptomatic early stage colorectal cancer, the risk of later metachronous neoplasia persists for an extended period more than five years after removal of the incident colorectal cancer. Moreover, risk for late metachronous cancer appears to be predicted by the presence of multiple adenomas or advanced adenomas; most metachronous cancers in this cohort were detected using colonoscopy before onset of symptoms and at an early stage.

Freeman HJ

2013-07-01

229

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

Directory of Open Access Journals (Sweden)

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

2007-01-01

230

[Rapid aspirin desensitization in patients with a history of aspirin hypersensitivity requiring coronary angioplasty. Report of four cases].  

UK PubMed Central (United Kingdom)

Aspirin use is necessary after a coronary angioplasty. It should not be used in patients with a history of hypersensitivity. However, rapid desensitization protocols have been reported to allow its use in such patients. One of these protocols consists in the administration of progressive doses of aspirin, from 1 to 100 mg in a period of 5.5 hours, in a controlled environment. We report four male patients aged 45,49, 59 and 73 years with a history of aspirin hypersensitivity, who were subjected to a coronary angioplasty. In all, the rapid aspirin desensitization protocol was successfully applied, allowing the use of the drug after the intervention without problems.

Veas P N; Martínez G; Jalil M J; Martínez S A; Castro G P

2013-02-01

231

Should antiviral medications be considered preoperatively for microlaryngoscopy in patients with a history of recurrent herpes stomatitis?  

UK PubMed Central (United Kingdom)

Infectious complications following phonomicrosurgery are rare. Reports of herpetic laryngitis are in the literature but none following microlaryngoscopy. We present a case of a 55-year-old female who underwent microsurgical excision of a left vocal fold (VF) lesion and KTP ablation of bilateral vascular ectasias. Postoperative stroboscopy demonstrated severe bilateral VF edema, erythema, and ulcerations of the VFs, encompassing an area greater than the original surgical field. Initial management included voice rest, antibiotics, steroids, and aggressive reflux treatment. The patient experienced prolonged VF edema and poor voice outcome, which ultimately resolved over 6 months. Clinical diagnosis of herpetic laryngitis was presumptively made after the patient revealed a history of relapsing oral herpes incited by stress with a recent episode before microlaryngoscopy. This case highlights the importance of thorough review of a patient's medical history. A protocol for preoperative (prophylactic) antiviral therapy and appropriate timing of surgery is presented for patients with history of herpes infection.

Young VN; Krishna P; Rosen CA

2013-01-01

232

Algorithm to reduce unnecessary isolation days in patients with a history of colonization by antimicrobial-resistant organisms.  

UK PubMed Central (United Kingdom)

To determine the need of isolation precautions upon admission, we created and tested an algorithm based on a total of 474 patients with a history of carriage of an antibiotic-resistant organism. Using the algorithm upon patient admission reduced unnecessary isolations by almost 60% while maintaining a high sensitivity to predict persisting antibiotic-resistant organism colonization.

Mertz D; Nuri K; O'Neill C; Loeb M

2013-07-01

233

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

Directory of Open Access Journals (Sweden)

Full Text Available Background. The incidence of unilateral twin ectopic pregnancy is a rare condition. Several factors increase the risk of ectopic pregnancy, the most important of which is pelvic inflammatory disease, followed by operative trauma, congenital anomalies, tumors, and adhesions resulting in anatomically distorted fallopian tubes. We present a case of a woman with a history of four confirmed sexually transmitted infections (STIs) including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2, and Treponema pallidum. The case illustrates the potential impact of sexually transmitted infections (STIs) on the risk of a twin ectopic pregnancy. Case. A 24-year-old primigravida, presented with an unknown last menstrual period, lower abdominal pain, watery vaginal discharge, and vaginal spotting. During this hospitalization, serum β-HCG testing was 263 mIU/mL and transvaginal ultrasonographic examination suggested a nonviable unilateral twin ectopic pregnancy. At exploratory laparotomy, a 10 cm mass involving the right fallopian tube and ovary was excised. Pathological evaluation of the specimen identified a monochorionic, diamnionic twin ectopic pregnancy within the fallopian tube. Conclusions Patients with a history of multiple (STIs) are known to be at risk for the development of chronic pelvic infection and postinflammatory scarring. The resulting distortion of the normal tubal anatomy leads to an increased risk of an uncommon presentation of ectopic pregnancy.

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

2006-01-01

234

Avaliação da ingestão dietética de cálcio em indivíduos adultos portadores de hipertensão arterial idiopática/ Calcium-intake assessment in essential-arterial hypertensive patients  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Foi estudada a relação entre a ingestão dietética de cálcio e os demais parâmetros alimentares e antropométricos em 60 indivíduos adultos, portadores de hipertensão arterial idiopática (10 homens e 50 mulheres), com média etária de 48,6 anos, seguidos no Centro de Hipertensão Arterial do Hospital das Clínicas da Faculdade de Medicina de Botucatu (SP), Brasil. Foram utilizados três métodos diferentes de inquérito aumentar em três diferentes ocasiões: rec (more) ordatório de 24h, questionário de freqüência alimentar, dirigido para ingestão de cálcio, e registro alimentar de 3 dias. As médias de ingestão de cálcio, extraídas desses inquéritos, foram semelhantes, mostrando que, em relação á ingestão de cálcio, esses métodos de inquérito alimentar podem ser utilizados indistintamente com o objetivo de se mensurar à ingestão de cálcio de um grupo de indivíduos. Além da ingestão de cálcio, foi avaliada a ingestão protéico-calórica e de diversos outros nutrientes, assim como realizada a antropometria desse grupo de hipertensos em três ocasiões diferentes, com intervalos variando de duas semanas a 15 meses. Quando comparado a um grupo de referência local, constituído de indivíduos sadios, com média etária semelhante, o grupo de hipertensos mostrou ter menor ingestão média de cálcio. Comparados por sexo, os homens dos dois grupos exibiram perfis nutricional e antropométrico semelhantes. Em relação às mulheres, houve diferenças quanto à ingestão protéico-calórica, o que se supõe ser devido à ingestão menor do leite e derivados entre as hipertensas. Estas estavam mais pesadas que as mulheres do grupo de referências, à custa de maior massa muscular, provavelmente devido a maior atividade física. Concluiu-se que o cálcio dietético foi o principal item alimentar que distinguiu hipertensos de normotensos. Como existem estudos clínicos comprovando o efeito benéfico da suplementação de cálcio na redução dos níveis pressóricos de indivíduos hipertensos, sugere-se a repetição deste tipo de trabalho, em outros locais, visando ao embasamento de programa nacional de suplementação de cálcio dietético entre indivíduos hipertensos idiopáticos. Abstract in english The calcium-intake relationship with other alimentary and anthropometric variables was investigates in a group of 60 adult (19-75 year-old) subjects, 50 females and 10 males, with essential arterial hypertension (DAP > 90 mmHg). The calcium intake was assessed by three different protocols: 24-hour food intake recall, food-frequency questionaire and 3 day self-food intake register, repeated along with anthropometric measurements on three different occasions (2-15 month-int (more) ervals). The calcium intake assessed by the three methods, as well as the anthropometric data, were statistically similar on all three occasions. The mean data were then compared with those form the control, composed of 75 healthy subjects matched with the hypertensive group by age and sex. The patients ingested less calcium (mean ± SD) than the controls on the daily (517 ± 271 x 740 ± 353mg/d) and body-weight (8.1 ± 5.0 x 11.4 ± 5.9mg/kg/d) basis. Among the males the calcium intake was the only difference found between groups and could be attributed to the lower intake of calcium-rich foods. The hypertensive females showed also higher lean-body mass (Body-mass index and armmuscle circunference). Thus the calcium intake discriminated both groups being associated with changes in other nutritional parameters only in females.

Waib, Paulo H.; Papini-Berto, Silvia J.; Habermann, Francisco; Burini, Roberto C.

1992-02-01

235

[Anesthetic management of a patient with carnitine palmitoyltransferase deficiency with a history of rhabdomyolysis].  

UK PubMed Central (United Kingdom)

Carnitine palmitoyltransferase (CPT) makes the fatty acids available through beta-oxidation. Deficiency of CPT causes difficulties of muscle cells to metabolize fatty acid. In affected patients, exercise, fast for a prolonged period, and stress, lead to exhaustion of the store of glucose in the body, and rhabdomyolysis may occur, since muscle can not utilize fatty acid as an alternative energy source. Therefore, anesthetic management of CPT deficiency needs infusion of glucose continuously, avoiding the use of the drugs that cause rhabdomyolysis and suppressing the surgical stress. A 67-year-old man, who had previous history of rhabdmyolysis during the postoperative period, and diagnosed CPT deficiency was scheduled for total gastrectomy. General anesthesia was induced with remifentanil, thiamylal and rocuronium after epidural catheter insertion. During surgery, general anesthesia was maintained with remifentanil, sevoflurane, and blood glucose was monitored frequently, with continuous glucose infusion. No complications occurred during anesthesia and perioperative course was uneventful.

Nakamura S; Sugita M; Nakahara E; Yamamoto T

2013-03-01

236

Relationship between family history of breast cancer and clinicopathological features in moroccan patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Breast cancer is the most common cancer affecting women all over the world. In addition to hormonal and environmental causes, family history is emerging as an important risk factor in the etiology of this disease. The aim of the present study is thus to compare the clinico-pathological features of familial and sporadic breast cancer in Moroccan patients. METHODS: A comparative retrospective cohort study was conducted on 570 women with familial and sporadic breast cancer who were diagnosed and treated in the Oncology Center of Ibn Rochd University Hospital in 2009. Data on breast cancer risk factors and clinico-pathological characteristics of the tumors were extracted from patients' medical records. RESULTS: Familial cases represented 18.4% of breast cancer patients. The age of onset appears to be earlier in familial breast cancers (P=0.0024). There were no significant differences between familial and sporadic groups according to histological type, tumor size and estrogen receptor status. However, Scarff-Bloom-Richardson grade III was found in 43.8% of familial cases vs 26.7% of sporadic cases (P=0.0127) and the lymph node involvement was observed in 72.4% of familial cases vs 58.9% in sporadic cases (P=0.0213). Moreover, familial breast cancer patients present especially progesterone receptor-negative tumors (P=0.0380). CONCLUSIONS: Our initial significant findings show that familial breast cancer seems to affect young women and tends to present high Scarff-Bloom-Richardson grade tumors with lymph node involvement and absence of progesterone receptors. These preliminary results may be useful as clinical marker to identify familial breast cancer allowing the development of careful follow-up for this patients subtype.

Tazzite A; Jouhadi H; Saiss K; Benider A; Nadifi S

2013-07-01

237

A family history of alcoholism relates to alexithymia in substance use disorder patients.  

Science.gov (United States)

OBJECTIVES: Previous research identified alexithymia as a potential risk factor for substance use disorders (SUD). More insight into the relation between alexithymia and SUD is needed in order to treat SUD effectively. Therefore, we investigated whether a familial vulnerability to alcoholism relates to the presence and severity of alexithymia in SUD patients. METHOD: Hospitalized, abstinent SUD-patients (n=187), were assessed with the Toronto Alexithymia Scale (TAS-20) and Addiction Severity Index (EuropASI). A maternal, paternal, and total continuous measure of the Family History of Alcohol (FHA) was developed. Kruskal-Wallis tests and Spearman correlations were used to relate the composite scores of FHA to alexithymia as a categorical and continuous measure. Multivariate regression models were performed to control for the effects of confounders on the relation between FHA and alexithymia. RESULTS: Compared to moderate (33%) and low (17%) alexithymic SUD-patients, high alexithymic (50%) patients were more likely to have fathers with alcohol problems (P=0.004). Such a difference was not found for mothers with alcohol problems. The composite FHA-score was significantly associated with alexithymia (Rs=.19, P=0.01). However, only a paternal FHA, independent from disturbed family functioning, related to the degree of alexithymia (?=.13, P=0.06), especially to the Difficulty Identifying Feelings as measured by the TAS-20 (?=.16, P=0.02). CONCLUSIONS: The relation between a paternal FHA and a higher degree of alexithymia in SUD-patients suggests that alexithymia could mediate the familiality of alcoholism or SUD in the paternal line. PMID:23642633

de Haan, Hein A; Joosten, Evelien A G; de Haan, Lydia; Schellekens, Arnt F A; Buitelaar, Jan K; van der Palen, Job; De Jong, Cor A J

2013-05-01

238

A family history of alcoholism relates to alexithymia in substance use disorder patients.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Previous research identified alexithymia as a potential risk factor for substance use disorders (SUD). More insight into the relation between alexithymia and SUD is needed in order to treat SUD effectively. Therefore, we investigated whether a familial vulnerability to alcoholism relates to the presence and severity of alexithymia in SUD patients. METHOD: Hospitalized, abstinent SUD-patients (n=187), were assessed with the Toronto Alexithymia Scale (TAS-20) and Addiction Severity Index (EuropASI). A maternal, paternal, and total continuous measure of the Family History of Alcohol (FHA) was developed. Kruskal-Wallis tests and Spearman correlations were used to relate the composite scores of FHA to alexithymia as a categorical and continuous measure. Multivariate regression models were performed to control for the effects of confounders on the relation between FHA and alexithymia. RESULTS: Compared to moderate (33%) and low (17%) alexithymic SUD-patients, high alexithymic (50%) patients were more likely to have fathers with alcohol problems (P=0.004). Such a difference was not found for mothers with alcohol problems. The composite FHA-score was significantly associated with alexithymia (Rs=.19, P=0.01). However, only a paternal FHA, independent from disturbed family functioning, related to the degree of alexithymia (?=.13, P=0.06), especially to the Difficulty Identifying Feelings as measured by the TAS-20 (?=.16, P=0.02). CONCLUSIONS: The relation between a paternal FHA and a higher degree of alexithymia in SUD-patients suggests that alexithymia could mediate the familiality of alcoholism or SUD in the paternal line.

de Haan HA; Joosten EA; de Haan L; Schellekens AF; Buitelaar JK; van der Palen J; De Jong CA

2013-05-01

239

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  

Scientific Electronic Library Online (English)

Full Text Available 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 de la presión arterial. Valorar el tratamiento farmacológico necesario para un adecuado control de la hipertensión arterial. Analizar la existencia de datos suficientes e (more) n 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 Decemb (more) er 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

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

2006-08-01

240

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

Directory of Open Access Journals (Sweden)

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

I. González Molero; G. Olveira Fuster; M. I. Liébana; L. Oliva; M. Laínez López; A. Muñoz Aguilar

2008-01-01

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish 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 nutrici? (more) ?n 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. Abstract in english 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 characteris (more) tics 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 s

González Molero, I.; Olveira Fuster, G.; Liébana, M. I.; Oliva, L.; Laínez López, M.; Muñoz Aguilar, A.

2008-02-01

242

Alcohol intake.  

UK PubMed Central (United Kingdom)

Alcohol consumption and its association with health or illness states are of great interest from the nutritional genomics point of view. This interest is centered not only on investigating the genetic variants that can modulate the effects of alcoholic beverages on different intermediate and final disease phenotypes (mainly cardiovascular diseases and cancer), but also on finding out how the genome influences the amount of alcohol consumed and consumption habits. This chapter reviews the latest findings on alcohol consumption trends, the methodological limitations in the analysis of alcohol consumption, and the main genes and polymorphisms related to alcohol intake, including the inconsistent results from genome-wide association studies (GWASs). It also reviews the effects of alcohol consumption on cardiovascular diseases and cancer and the studies analyzing the interactions between different genetic polymorphisms and alcohol in phenotypes related to these diseases, discussing the studies' advantages and limitations as well as future research perspectives.

Corella D

2012-01-01

243

Interrater agreement of nasal endoscopy in patients with a prior history of endoscopic sinus surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: Nasal endoscopy is an important part of the clinical evaluation of patients with chronic rhinosinusitis. However, the objectivity and interrater agreement of the procedure related findings have not been well studied, especially in patients who have previously had sinus surgery. METHODS: Patients with a history of endoscopic sinus surgery for chronic rhinosinusitis were prospectively enrolled from a tertiary rhinology practice. Fourteen endoscopic nasal examinations were recorded using digital video capture software. Each patient also underwent computed tomography (CT) and completed the Sinonasal Outcome Test (SNOT-22). Blinded review of inflammatory and anatomic findings for each video was independently performed by 5 academic rhinologists at separate institutions. Comparisons were performed using the unweighted Fleiss' kappa statistic (K(f) ) and the prevalence- and bias-adjusted kappa (PABAK). RESULTS: There were no significant correlations between age, Lund-Mackay score, or SNOT-22 score. Interrater agreement was variable across the characteristics studied. Mean PABAK was excellent for the assessment of polyps (K(f) = 0.886); moderate for the assessments of middle turbinate (MT) integrity (K(f) = 0.543), MT position (K(f) = 0.443), maxillary sinus patency (K(f) = 0.593), and ethmoid sinus patency (K(f) = 0.429); fair for discharge (K(f) = 0.314), synechiae (K(f) = 0.257), and middle meatus patency (K(f) = 0.229); and poor for MT mucosal changes (K(f) = 0.148) and uncinate process (K(f) = 0.126). CONCLUSION: This study was notable for variability in the interrater agreement among the inflammatory and anatomic attributes that were examined. Further standardization of nasal endoscopy with regard to interpretation may improve the reliability of this procedure in clinical practice.

McCoul ED; Smith TL; Mace JC; Anand VK; Senior BA; Hwang PH; Stankiewicz JA; Tabaee A

2012-11-01

244

Benign notochordal cell tumors of the spine: natural history of 8 patients with histologically confirmed lesions.  

UK PubMed Central (United Kingdom)

BACKGROUND: Notochord-related lesions of the spinal column include benign notochordal cell tumors (BNCTs), ecchordosis physaliphora, both generally considered benign lesions, and chordomas, which represent malignant tumors. The histological similarity of these lesions to the notochord and each other and their strong predilection to the axial skeleton have led to the hypothesis that these lesions represent a continuum of malignant transformation from notochordal remnants, BNCTs, and finally chordomas. OBJECTIVE: To present a cohort of biopsy-proven BNCTs with a description of radiographic features, histology, and follow-up to help elucidate the optimal management of these lesions. METHODS: A retrospective chart review identified 13 patients with notochordal rest lesions confirmed by histology. Histologic inclusion criteria included notochordal features without evidence of septation, myxoid matrix, nuclear atypia, or mitotic figures. Tumors exhibiting evidence of cortical expansion or destruction were excluded. The natural history and histological and radiographic features were examined. RESULTS: Sixteen spinal lesions from 8 patients met the diagnostic criteria for BNCTs, identified on imaging after the patient presented with back pain. Radiographically, all lesions were hypointense on T1-weighted magnetic resonance imaging sequences and hyperintense on T2-weighted and short T1 inversion recovery. The median radiographic follow-up was 21.6 months (range, 8.5-71.2 months). None of the lesions exhibited radiographic or symptomatic progression. CONCLUSION: Although limited by short follow-up, our series confirms that these lesions may be safely observed without evidence of malignant transformation, which emphasizes the importance of distinction of BNCT from chordoma at diagnosis and the possibility of close follow-up for these lesions instead of aggressive treatment indicated in patients with chordomas. ABBREVIATION: BNCT, benign notochordal cell tumors.

Iorgulescu JB; Laufer I; Hameed M; Boland P; Yamada Y; Lis E; Bilsky M

2013-09-01

245

Age at diagnosis may trump family history in driving BRCA testing in a population of breast cancer patients.  

UK PubMed Central (United Kingdom)

Background:Standard BRCA genetic testing criteria include young age of diagnosis, family history, and Jewish ancestry. The purpose of this study was to assess the effect of these criteria on BRCA test utilization in breast cancer patients. Methods:Breast cancer patients aged 18-64yrs living in Pennsylvania in 2007 completed a survey on family history of breast and ovarian cancer and BRCA testing (N=2213). Multivariate logistic regression was used to estimate odds of BRCA testing by patient characteristics, and predicted probabilities of testing were calculated for several clinical scenarios. Results:Young age at diagnosis (<50 yrs.) was strongly associated with BRCA testing, with women diagnosed before age 50 yrs. having nearly five times the odds of receiving BRCA testing compared to women diagnosed at age 50 or older (OR=4.81, 95% CI: 3.85-6.00, p<0.001). Despite a similar BRCA mutation prevalence estimate (8-10%), a young Jewish patient <50 yrs. with no family history had markedly higher predicted probability of testing (63%) compared with an older, non-Jewish breast cancer patient with more than 1 first degree relative (FDR) (43%). Conclusions:Age at diagnosis, Jewish ancestry, and both maternal and paternal family history are strongly predictive of BRCA testing. However, among women diagnosed at age 50 or older, family history may be an underutilized criterion that may benefit from targeted intervention. Impact:Robust methods specific to ascertaining detailed family history, such as through electronic medical records (EMR), are needed to accurately identify patients for BRCA testing.

Vig H; McCarthy AM; Liao K; Bristol Demeter M; Fredericks T; Armstrong K

2013-08-01

246

Age at Diagnosis May Trump Family History in Driving BRCA Testing in a Population of Breast Cancer Patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Standard BRCA genetic testing criteria include young age of diagnosis, family history, and Jewish ancestry. The purpose of this study was to assess the effect of these criteria on BRCA test utilization in breast cancer patients. METHODS: Breast cancer patients aged 18 to 64 years living in Pennsylvania in 2007 completed a survey on family history of breast and ovarian cancer and BRCA testing (N = 2,213). Multivariate logistic regression was used to estimate odds of BRCA testing by patient characteristics, and predicted probabilities of testing were calculated for several clinical scenarios. RESULTS: Young age at diagnosis (<50 years) was strongly associated with BRCA testing, with women diagnosed before age 50 years having nearly five times the odds of receiving BRCA testing compared to women diagnosed at age 50 or older (OR = 4.81; 95% CI, 3.85-6.00; P < 0.001). Despite a similar BRCA mutation prevalence estimate (8-10%), a young Jewish patient <50 years with no family history had markedly higher predicted probability of testing (63%) compared with an older, non-Jewish breast cancer patient with more than one first-degree relative (43%). CONCLUSION: Age at diagnosis, Jewish ancestry, and both maternal and paternal family history are strongly predictive of BRCA testing. However, among women diagnosed at age 50 or older, family history may be an underused criterion that may benefit from targeted intervention. IMPACT: Robust methods specific to ascertaining detailed family history, such as through electronic medical records, are needed to accurately identify patients for BRCA testing. Cancer Epidemiol Biomarkers Prev; 22(10); 1778-85. ©2013 AACR.

Vig HS; McCarthy AM; Liao K; Demeter MB; Fredericks T; Armstrong K

2013-10-01

247

Ice blockage of water intakes  

International Nuclear Information System (INIS)

The ice blockage of water intake structures can pose serious threats to the availability of cooling water at thermal power plants. Using information gained from a literature search and general knowledge of the problem, ice blockage difficulties are described as they may occur in rivers, lakes, reservoirs, and estuaries, and as they may affect intakes either at the surface or submerged. To further enable understanding of these problems, characteristics of both surface sheet ice and frazil ice are examined, namely, formational processes, sizes, thicknesses, movement or mobility, and modes of blockage or adhesion. Case histories of incidents of ice blockage of intakes are given by means of excerpts from the technical literature. Lastly, a brief overview is provided on the matter of solving ice blockage problems, either through original design, post-construction modification, or revised operational techniques

1978-01-01

248

Usefulness of preoperative serum calcitonin in patients with nodular thyroid disease without suspicious history or cytology for medullary thyroid carcinoma.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the usefulness of preoperative serum calcitonin (sCT) in patients with nodular disease without suspicion of medullary thyroid carcinoma (MTC) in history or cytology. PATIENTS AND METHODS: sCT was measured before thyroidectomy in 494 patients with nodular disease who had no family history of MTC or multiple endocrine neoplasia type 2, and no cytological suspicion of MTC. RESULTS: Basal sCT was < 10 ng/mL in 482 patients and none of them had MTC. One patient with basal sCT > 100 pg/mL had MTC. Among the 11 patients with basal sCT between 10 and 100 pg/mL, MTC was diagnosed in only one. The two patients with MTC were submitted to total thyroidectomy, combined with elective lymph node dissection indicated exclusively based on hypercalcitoninemia, and sCT was undetectable after six months. CONCLUSIONS: Preoperative sCT is useful for the detection of sporadic MTC in patients with nodular disease, even in the absence of suspicious history or cytology.

Rosário PW; Penna GC; Brandão K; Souza BÉ

2013-06-01

249

Incidence of tuberculosis among anti-tumor necrosis factor users in patients with a previous history of tuberculosis.  

UK PubMed Central (United Kingdom)

BACKGROUND: We aimed to investigate the results of anti-tumor necrosis factor (TNF) therapy in patients with a previous history of tuberculosis (TB). METHODS: A total of 101 patients with a previous history of TB receiving TNF antagonists between December 2004 and September 2012 at the Asan Medical Center in South Korea were retrospectively analyzed. RESULTS: The mean age of the 101 subjects was 40.4 ± 16.0 years and 51 patients (50.5%) were male. The underlying immune-mediated inflammatory diseases (IMIDs) were Crohn's disease in 55 (54.5%), rheumatoid arthritis in 27 (26.7%), and ankylosing spondylitis in 13 (12.9%) patients. Chest radiography findings were suggestive of previous TB lesions in 33 (32.7%) patients. The rates of positivity in the tuberculin skin test and interferon-gamma release assay were 21.8% (22/101) and 44.6% (45/101), respectively. Latent TB infection (LTBI) treatment was initiated in 11 subjects (10.9%) based on previous inappropriate anti-TB treatments (n = 10) or recent TB contact history (n = 1), irrespective of the LTBI test results. The median follow-up duration after the initiation of TNF antagonist therapy was 31.5 months. Active TB developed, six years after the initiation of TNF antagonist, in one patient (1.0%) who had not received LTBI treatment. The incidence rate of TB was calculated at 336 per 100,000 person-year (PY). CONCLUSIONS: Patients with IMIDs who have a previous history of TB can be treated with TNF antagonists with an acceptable incidence of TB, if LTBI treatment is performed based on clinical judgments including the adequacy of previous anti-TB treatment and recent contact history.

Jo KW; Hong Y; Jung YJ; Yoo B; Lee CK; Kim YG; Yang SK; Byeon JS; Kim KJ; Ye BD; Lee SD; Kim WS; Kim DS; Shim TS

2013-08-01

250

Primary care physician management, referral, and relations with specialists concerning patients at risk for cancer due to family history.  

UK PubMed Central (United Kingdom)

BACKGROUND: Risk stratification based on family history is a feature of screening guidelines for a number of cancers and referral guidelines for genetic counseling/testing for cancer risk. AIMS: Our aim was to describe primary care physician perceptions of their role in managing cancer risk based on family history. METHODS: Structured interviews were conducted by a medical anthropologist with primary care physicians in 3 settings in 2 north-eastern states. Transcripts were systematically analyzed by a research team to identify major themes expressed by participants. RESULTS: Forty interviews were conducted from May 2003 through May 2006. Physicians provided a diversity of views on roles in management of cancer risk based on family history, management practices and patient responses to risk information. They also provided a wide range of perspectives on criteria used for referral to specialists, types of specialists referred to and expected management roles for referred patients. CONCLUSION: Some primary care physicians appeared to make effective use of family history information for cancer risk management, but many in this sample did not. Increased focus on efficient assessment tools based on recognized guidelines, accessible guides to management options, and patient education and decision aids may be useful directions to facilitate broader use of family history information for cancer risk management.

Wood ME; Flynn BS; Stockdale A

2013-01-01

251

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  

Directory of Open Access Journals (Sweden)

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.

Psaltopoulou Theodora; Kosti Rena I; Haidopoulos Dimitrios; Dimopoulos Meletios; Panagiotakos Demosthenes B

2011-01-01

252

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

UK PubMed Central (United Kingdom)

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. Therefore, brachytherapy should be considered a viable therapeutic option in this patient population.

Peters CA; Cesaretti JA; Stone NN; Stock RG

2006-10-01

253

Hydrogen water intake via tube-feeding for patients with pressure ulcer and its reconstructive effects on normal human skin cells in vitro.  

UK PubMed Central (United Kingdom)

BACKGROUND: Pressure ulcer (PU) is common in immobile elderly patients, and there are some research works to investigate a preventive and curative method, but not to find sufficient effectiveness. The aim of this study is to clarify the clinical effectiveness on wound healing in patients with PU by hydrogen-dissolved water (HW) intake via tube-feeding (TF). Furthermore, normal human dermal fibroblasts OUMS-36 and normal human epidermis-derived cell line HaCaT keratinocytes were examined in vitro to explore the mechanisms relating to whether hydrogen plays a role in wound-healing at the cellular level. METHODS: Twenty-two severely hospitalized elderly Japanese patients with PU were recruited in the present study, and their ages ranged from 71.0 to 101.0 (86.7 +/- 8.2) years old, 12 male and 10 female patients, all suffering from eating disorder and bedridden syndrome as the secondary results of various underlying diseases. All patients received routine care treatments for PU in combination with HW intake via TF for 600 mL per day, in place of partial moisture replenishment. On the other hand, HW was prepared with a hydrogen-bubbling apparatus which produces HW with 0.8-1.3 ppm of dissolved hydrogen concentration (DH) and -602 mV to -583 mV of oxidation-reduction potential (ORP), in contrast to reversed osmotic ultra-pure water (RW), as the reference, with DH of < 0.018 ppm and ORP of +184 mV for use in the in vitro experimental research. In in vitro experiments, OUMS-36 fibroblasts and HaCaT keratinocytes were respectively cultured in medium prepared with HW and/or RW. Immunostain was used for detecting type-I collagen reconstruction in OUMS-36 cells. And intracellular reactive oxygen species (ROS) were quantified by NBT assay, and cell viability of HaCaT cells was examined by WST-1 assay, respectively. RESULTS: Twenty-two patients were retrospectively divided into an effective group (EG, n = 12) and a less effective group (LG, n = 10) according to the outcomes of endpoint evaluation and the healing criteria. PU hospitalized days in EG were significantly shorter than in LG (113.3 days vs. 155.4 days, p < 0.05), and the shortening rate was approximately 28.1%. Either in EG or in LG, the reducing changes (EG: 91.4%; LG: 48.6%) of wound size represented statistically significant difference versus before HW intake (p < 0.05, p < 0.001). The in vitro data demonstrate that intracellular ROS as quantified by NBT assay was diminished by HW, but not by RW, in ultraviolet-A (UVA)-irradiated HaCaT cells. Nuclear condensation and fragmentation had occurred for UVA-irradiated HaCaT cells in RW, but scarcely occurred in HW as demonstrated by Hoechst 33342 staining. Besides, under UVA-irradiation, either the mitochondrial reducing ability of HaCaT cells or the type-I collagen construction in OUMS-36 cells deteriorated in RW-prepared culture medium, but was retained in HW-prepared culture medium as shown by WST-1 assay or immunostain, respectively. CONCLUSIONS: HW intake via TF was demonstrated, for severely hospitalized elderly patients with PU, to execute wound size reduction and early recovery, which potently ensue from either type-I collagen construction in dermal fibroblasts or the promoted mitochondrial reducing ability and ROS repression in epidermal keratinocytes as shown by immunostain or NBT and WST-1 assays, respectively.

Li Q; Kato S; Matsuoka D; Tanaka H; Miwa N

2013-09-01

254

First report of bacteremia by Asaia bogorensis, in a patient with a history of intravenous-drug abuse.  

UK PubMed Central (United Kingdom)

We report the first documented case of bacteremia caused by Asaia bogorensis in a young patient with a history of intravenous-drug abuse. A. bogorensis was identified by sequencing the 16S rRNA gene. The isolate was exceptionally resistant to almost all antibiotics that are routinely tested for gram-negative rods but was susceptible to netilmicin, gentamicin, and doxycycline.

Tuuminen T; Heinäsmäki T; Kerttula T

2006-08-01

255

Family history of stroke in patients with transient ischemic attack in relation to hypertension and other intermediate phenotypes.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Family history of stroke (FHx(stroke)) is a risk factor for ischemic stroke, but there are insufficient data on the relationship with stroke subtypes and intermediate phenotypes (IPs), such as hypertension. Specifically, there are no reliable data on the associations of FHx(stroke) in patients with ...

Flossmann, E; Rothwell, PM

256

First Report of Bacteremia by Asaia bogorensis, in a Patient with a History of Intravenous-Drug Abuse  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report the first documented case of bacteremia caused by Asaia bogorensis in a young patient with a history of intravenous-drug abuse. A. bogorensis was identified by sequencing the 16S rRNA gene. The isolate was exceptionally resistant to almost all antibiotics that are routinely tested for gram...

Tuuminen, Tamara; Heinäsmäki, Terhi; Kerttula, Tuija

257

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

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 (more) ,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. Abstract in english 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 ca (more) lories 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.

Jaime, Patrícia Constante; Florindo, Alex Antonio; Latorre, Maria do Rosário Dias de Oliveira; Segurado, Aluísio Augusto Cotrim

2006-08-01

258

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

DEFF Research Database (Denmark)

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

Johannesdottir, Sigrun Alba; Lash, Timothy L

2012-01-01

259

Suicide risk assessment received prior to suicide death by Veterans Health Administration patients with a history of depression.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine the quality of suicide risk assessment provided to veterans with a history of depression who died by suicide between 1999 and 2004. METHOD: We conducted a case-control study of suicide risk assessment information recorded in 488 medical charts of veterans previously diagnosed with major depression, depression not otherwise specified, dysthymia, or other, less common ICD-9-CM depression codes. Patients dying by suicide from April 1999 through September 2004 or comparison patients (n = 244 pairs) were matched for age, sex, entry year, and region. RESULTS: Seventy-four percent of patients with a history of depression received a documented assessment of suicidal ideation within the past year, and 59% received more than 1 assessment. However, 70% of those who died of suicide did not have a documented assessment for suicidal ideation at their final Veterans Health Administration (VHA) visit, even if that visit occurred within 0 through 7 days prior to suicide death. Most patients dying by suicide denied suicidal ideation when assessed (85%; 95% CI, 75%-92%), even just 0 through 7 days prior to suicide death (73%; 95% CI, 39%-94%). Suicidal ideation was assessed more frequently during outpatient final visits with mental health providers (60%) than during outpatient final visits with primary care (13%) or other non-mental health providers (10%, P < .0001). CONCLUSIONS: Most VHA patients with a history of depression received some suicide risk assessment within the past year, but suicide risk assessments were infrequently administered at the final visit of patients who eventually died by suicide. Among patients who had assessments, denial of suicidal ideation appeared to be of limited value. Practice changes are needed to improve suicide risk assessment among patients with histories of depression, including the development of assessment and prevention strategies that are less dependent on the presence or disclosure of suicidal ideation at scheduled medical visits.

Smith EG; Kim HM; Ganoczy D; Stano C; Pfeiffer PN; Valenstein M

2013-03-01

260

Prophylactic sternal plating with pectoralis advancement flaps after sternotomy in patients with a history of chest irradiation.  

UK PubMed Central (United Kingdom)

Deep sternal infections secondary to bony instability and malunion, can result in mediastinitis. Previous authors have described the use of prophylactic rigid plate fixation in high-risk patients. The purpose of our study is to review the use of prophylactic sternal platting with pectoralis advancement flaps in high-risk patients with a history of chest irradiation. Fourteen patients (July 2003-September 2008) with a history of chest irradiation who underwent a median sternotomy followed by prophylactic rigid plate fixation of the sternum were reviewed. Breast cancer was the most common etiology of chest irradiation (n=11, 78%). The average EuroSCORE was 24.06% with 72% of patients having a preoperative New York Heart Association (NYHA) class?III. There were no episodes of sternal non-union, mediastinitis or death. Follow-up was 100% with a 0% 30-day and a 7.1% one-year mortality rate (non-cardiac). A comparison between mean preoperative left ventricular ejection fraction (LVEF) (49.6%) and postoperative LVEF (59.7%) was statistically significant (P<0.0001). All living patients currently maintain a NYHA class I/II. Prophylactic rigid plate fixation and pectoralis flap coverage decreases the risk of developing sternal dehiscence and postoperative wound complications and should therefore be considered in high-risk patients with a history of chest irradiation.

Neaman KC; Blount AL; Kim JA; Renucci JD; Hooker RL

2011-03-01

 
 
 
 
261

Natural history of mesenteric venous thrombosis in patients treated with vitamin K antagonists: a multi-centre, retrospective cohort study.  

Science.gov (United States)

Knowledge on the natural history of mesenteric vein thrombosis (MVT) and of the efficacy and safety of long-term oral anticoagulant therapy (OAT) in this setting is based on small uncontrolled series of patients with a limited follow-up. It was the aim of the study to assess the natural history of MVT in a cohort of patients treated with OAT. The charts of all MVT patients currently attending or who have attended four anticoagulation clinics were reviewed. Information on risk factors, treatment, recurrence, major bleeding and mortality was collected. Seventy-seven patients (mean age 49.2 years; 45 males) were included with a median follow-up of 36 months (range 2-204 months). Forty-six patients were treated with long-term OAT. Seven patients had venous thromboembolism (VTE) recurrence (5 splanchnic vein thromboses and two pulmonary emboli) for an incidence rate of 23.4 events /1,000 year patients. In two patients recurrent VTE occurred during OAT, for an incidence rate of 10.5 events /1,000 year patient. Five patients had VTE recurrence when OAT was suspened for an incidence rate of 45.9 events /1,000 year patient. Two patients (2.6%) had a major bleeding event. 97.3% of patients were alive at one year, and seven patients (9.1%) died during follow up. In conclusion, patients with MTV seem to have a low risk of recurrent VTE while receiving OAT. This risk appears increased after treatment is stopped. PMID:19718470

Dentali, Francesco; Ageno, Walter; Witt, Dan; Malato, Alessandra; Clark, Nathan; Garcia, David; McCool, Kathleen; Siragusa, Sergio; Dyke, Shannon; Crowther, Mark

2009-09-01

262

Natural history of mesenteric venous thrombosis in patients treated with vitamin K antagonists: a multi-centre, retrospective cohort study.  

UK PubMed Central (United Kingdom)

Knowledge on the natural history of mesenteric vein thrombosis (MVT) and of the efficacy and safety of long-term oral anticoagulant therapy (OAT) in this setting is based on small uncontrolled series of patients with a limited follow-up. It was the aim of the study to assess the natural history of MVT in a cohort of patients treated with OAT. The charts of all MVT patients currently attending or who have attended four anticoagulation clinics were reviewed. Information on risk factors, treatment, recurrence, major bleeding and mortality was collected. Seventy-seven patients (mean age 49.2 years; 45 males) were included with a median follow-up of 36 months (range 2-204 months). Forty-six patients were treated with long-term OAT. Seven patients had venous thromboembolism (VTE) recurrence (5 splanchnic vein thromboses and two pulmonary emboli) for an incidence rate of 23.4 events /1,000 year patients. In two patients recurrent VTE occurred during OAT, for an incidence rate of 10.5 events /1,000 year patient. Five patients had VTE recurrence when OAT was suspened for an incidence rate of 45.9 events /1,000 year patient. Two patients (2.6%) had a major bleeding event. 97.3% of patients were alive at one year, and seven patients (9.1%) died during follow up. In conclusion, patients with MTV seem to have a low risk of recurrent VTE while receiving OAT. This risk appears increased after treatment is stopped.

Dentali F; Ageno W; Witt D; Malato A; Clark N; Garcia D; McCool K; Siragusa S; Dyke S; Crowther M

2009-09-01

263

The neurology and natural history of patients with indeterminate CAG repeat length mutations of the Huntington disease gene.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This study aims to understand the neurological manifestations of patients with an indeterminate CAG repeat length (36-39) of the Huntingtin gene, HTT. METHODS: A longitudinal evaluation of 10 patients was performed. Duration of follow-up was mean=4.23 years (standard deviation 1.068; 95% CI 3.466-4.994; range 3-6.4 years). Three patients had a CAG repeat length of 37, three 38 and four 39. Mean CAG repeat length=38 (standard deviation 0.88; 95% CI 37.47-38.73; range 37-39). Data from clinical histories, neurological examinations, the United Huntington's Disease Rating Scale (UHDRS) and MRI imaging were collected. RESULTS: Four patients developed facial chorea, ataxia, impaired tongue protrusion, abnormal saccades and intermittent eye pursuits, dysarthria and impaired Luria 3 hand test. Early in its natural history the neurological syndrome is dominated by perioral chorea, subtle cognitive deficits and mild ataxia. Three patients developed a formal diagnosis of HD within 5 years. The illness progression was variable and associated with different co-morbidities. MRI scans showed ventricular dilatation as a common finding. Scores from UHDRS, Total Functional Capacity (TFC) and mini-mental state examination (MMSE) suggested significant behavioural and functional impairment with compromised cognitive abilities. Two patients had subtle manifestations and four remained asymptomatic (3 patients CAG=37; 1 patient CAG=39). CONCLUSIONS: This study documents the disease manifestations and natural history of people with CAG repeat lengths within the indeterminate range. The findings reveal heterogeneity in disease progression and have implications on the advice that should be given to patients and families on risk assessment and prognosis. Long-term follow up of such patients is essential as the neurological presentation of indeterminate CAG repeat length mutation might be accelerated by associated medical disorders and treatments, environmental and modifying genetic factors.

Panegyres PK; Goh JG

2011-02-01

264

Role of gluten intake at the time of hepatitis B virus vaccination in the immune response of celiac patients.  

UK PubMed Central (United Kingdom)

Some reports have demonstrated an inadequate response to hepatitis B vaccination in patients affected by celiac disease. The aim of our study was to evaluate hepatitis B vaccination response in relation to gluten exposure status in patients with celiac disease. To measure the gluten exposure status at the time of vaccination, we considered three groups: group A (exposed to gluten), including patients vaccinated as 12-year-old adolescents (the celiac disease diagnosis was established after vaccination); group B (not exposed to gluten), including patients vaccinated as 12-year-old adolescents on a gluten-free diet at the time of vaccination; and group C (infants), including patients vaccinated at birth. The response of celiac patients to hepatitis B vaccination was compared to that of healthy subjects, i.e., those in the control group (group D). This study included 163 celiac patients (group A, 57 patients; group B, 46 patients; and group C, 60 patients) and 48 controls (group D). An inadequate response to hepatitis B immunization was present in 43.9% of patients in group A, 34.8% of patients in group B, 58.3% of patients in group C, and 8.3% of patients in group D (group A versus group D, P < 0.001; group B versus group D, P = 0.002; group C versus group D, P = 0.001) (no significant difference for group A versus group B and group A versus group C was evident). Our data suggest that gluten exposure does not influence the response to hepatitis B immunization and that the human leukocyte antigen probably plays the main immunological role in poor responses to hepatitis B-vaccinated celiac patients.

Zingone F; Capone P; Tortora R; Rispo A; Morisco F; Caporaso N; Imperatore N; De Stefano G; Iovino P; Ciacci C

2013-05-01

265

The predictive value of multi-targeted fluorescent in-situ hybridization in patients with history of bladder cancer.  

UK PubMed Central (United Kingdom)

OBJECTIVES: UroVysion (Abbott Molecular Inc., Des Plaines, IL) is a multi-target fluorescent in-situ hybridization (FISH) assay that detects aneuploidy of chromosomes 3, 7, and 17, and loss of the 9p21 locus in exfoliated cells in urine. In this study, we evaluated if UroVysion can predict tumor recurrence in patients with negative cystoscopy and urinary cytology at the time of (FISH) assay. METHODS: The study population included patients with history of non-muscle invasive bladder cancer treated by transurethral resection. Follow-up included cystoscopy, barbotage, urinary cytology, and UroVysion testing. Patients were followed for at least 6 months after their initial UroVysion testing. RESULTS: A total of 64 patients (37 males) were enrolled into the study. Mean patient age was 62 years (S.D. 13.2 years). Initial highest tumor stage was Ta in 42 patients (65.6%), T1 in 21 patients (33%), and isolated Tis in a single patient. Abnormal UroVysion results were observed in 40 patients (62.5%). After a median follow-up of 13.5 months, 21 patients (33%) developed tumor recurrence (Ta in 13 patients, T1 in 5, and Tis in 3). Recurrent tumors developed in 45% of the patients with abnormal UroVysion test compared with 12.5% of the patients with normal assay (P = 0.01). An abnormal UroVysion result preceded the diagnosis of tumor recurrence in 18/21 cases (86%), including all high-grade recurrences. CONCLUSIONS: This data suggest that UroVysion may be a useful tool for predicting tumor recurrence. Cystoscopy may be spared and surveillance intervals widened in patients with history of low grade tumors and a normal UroVysion test.

Gofrit ON; Zorn KC; Silvestre J; Shalhav AL; Zagaja GP; Msezane LP; Steinberg GD

2008-05-01

266

Representing the Patient's Therapeutic History in Medical Records and in Guideline Recommendations for Chronic Diseases Using a Unique Model.  

UK PubMed Central (United Kingdom)

Computer-interpretable guidelines (CIGs) are more likely to affect the clinician's behavior when they deliver patient-specific and just-in-time clinical advice. CIGs must take into account the data stored in the patient's electronic medical records (EMR). For chronic diseases, the outcome of past and ongoing treatments (therapeutic history) is used in the clinical guidelines. We propose a model for the conceptualization of therapeutic history, facilitating data sharing between EMRs and CIGs and the representation of therapeutic history and recommended treatments in clinical guidelines.Based on medical literature review and an existing treatment model, a core structure is first defined taking into account drug and non-drug treatment components and treatment type (e.g. bitherapy). These elements together with additional concepts obtained by analyzing a sample guideline relating to diabetes, are then organized into an object-oriented model, using UML formalism.We show how this model can be used to store the patient's therapeutic history in the EMR, together with other attributes such as treatment efficacy and tolerance. We also explain how this model can efficiently code guidelines therapeutic rules.We evaluated this model, using additional guidelines hypercholesterolemia and asthma. We found it capable for representing guideline recommendations in several domains of chronic diseases.

Ebrahiminia V; Duclos C; Toussi ME; Riou C; Cohen R; Venot A

2005-01-01

267

Representing the Patient's Therapeutic History in Medical Records and in Guideline Recommendations for Chronic Diseases Using a Unique Model.  

Science.gov (United States)

Computer-interpretable guidelines (CIGs) are more likely to affect the clinician's behavior when they deliver patient-specific and just-in-time clinical advice. CIGs must take into account the data stored in the patient's electronic medical records (EMR). For chronic diseases, the outcome of past and ongoing treatments (therapeutic history) is used in the clinical guidelines. We propose a model for the conceptualization of therapeutic history, facilitating data sharing between EMRs and CIGs and the representation of therapeutic history and recommended treatments in clinical guidelines.Based on medical literature review and an existing treatment model, a core structure is first defined taking into account drug and non-drug treatment components and treatment type (e.g. bitherapy). These elements together with additional concepts obtained by analyzing a sample guideline relating to diabetes, are then organized into an object-oriented model, using UML formalism.We show how this model can be used to store the patient's therapeutic history in the EMR, together with other attributes such as treatment efficacy and tolerance. We also explain how this model can efficiently code guidelines therapeutic rules.We evaluated this model, using additional guidelines hypercholesterolemia and asthma. We found it capable for representing guideline recommendations in several domains of chronic diseases. PMID:16160243

Ebrahiminia, Vahid; Duclos, Catherine; Toussi, Massoud E; Riou, Christine; Cohen, Regis; Venot, Alain

2005-01-01

268

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 performed using unpaired two-tailed t tests or the chi-square test. The Cox proportional hazards model was used to evaluate the hazard ratio of death.Results: Of the 1013 NSCLC patients, 124 (12.2%) had a FHLC of whom 119 (96%) were the first-degree relatives. The frequency of early stages of lung cancer was high in both groups of FHLC and non-FHLC patients. Patients with FHLC had a significantly higher frequency of early pathological stages and a prepomderance of adenocarcinoma, and a hazard ratio of death of 0.870 (95% confidence interval: 0.599-1.263, p value: 0.465) compared with the non-FHLC patients.Conclusions: NSCLC patients with FHLC could be characterized by early pathological stages and preponderance of adenocarcinoma, however they were not at a decreased hazard ratio of death. These findings emphasize the importance of early detection of lung cancer and employment of less invasive therapeutic interventions.

Shuji Haraguchi, Kiyoshi Koizumi, Iwao Mikami, Okamoto Junichi, Yoshihito Iijima, Takayuki Ibi, Kazuo Shimizu

2012-01-01

269

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

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

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

2011-02-15

270

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 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.

2011-01-01

271

Risk of lymphoproliferative malignancy in celiac patients with a family history of lymphoproliferative malignancy.  

UK PubMed Central (United Kingdom)

BACKGROUND: Individuals with celiac disease (CD) are at increased risk of lymphoproliferative malignancy (LPM). We examined if a family history of LPM or any cancer influenced the risk of LPM in individuals with CD. METHODS: We identified 28,996 individuals with biopsy-verified CD (equal to villous atrophy, Marsh histopathology stage 3), of whom 616 had family history of LPM. Cox regression then estimated hazard ratios (HRs) for LPM in these 616 compared with two control groups. We also examined the risk of LPM in CD individuals with a family history of any cancer (n = 8,439). RESULTS: During follow-up, 2/616 CD individuals with a family history of LPM, and 235/28,380 CD individuals without a family history of LPM developed LPM themselves. CD individuals with a family history of LPM were not at increased risk of LPM compared to general population controls (HR = 1.18; 95 % CI = 0.27-5.10), or compared to CD individuals without a family history of LPM (adjusted HR = 0.31; 95 % CI = 0.08-1.23). We found no increased risk of LPM in CD individuals with a family history of any cancer. CONCLUSION: This study found no evidence that a family history of LPM or any cancer increases the risk of future LPM in individuals with CD. Despite the large number of study participants, this study is nevertheless limited by few positive events due to a low absolute risk of LPM even in individuals with CD.

Ludvigsson JF; Lebwohl B; Rubio-Tapia A; Murray JA; Green PH; Ekbom A

2013-02-01

272

Prevalence and presentation of lactose intolerance and effects on dairy product intake in healthy subjects and patients with irritable bowel syndrome.  

UK PubMed Central (United Kingdom)

BACKGROUND & AIMS: The effects of lactase deficiency on digestive symptoms and diet in patients with irritable bowel syndrome (IBS) have not been well defined. We assessed lactose absorption and tolerance and the intake of dairy products in healthy volunteers (controls) and patients with diarrhea-predominant IBS (D-IBS). METHODS: Sixty patients diagnosed with D-IBS at the Sir Run Run Shaw Hospital, Hangzhou, China and 60 controls were given hydrogen breath tests to detect malabsorption and intolerance after administration of 10, 20, and 40 g lactose in random order 7-14 days apart; participants and researchers were blinded to the dose. We assessed associations between the results and self-reported lactose intolerance (LI). RESULTS: Malabsorption of 40 g lactose was observed in 93% of controls and 92% of patients with D-IBS. Fewer controls than patients with D-IBS were intolerant to 10 g lactose (3% vs 18%; odds ratio [OR], 6.51; 95% confidence interval [CI], 1.38-30.8; P = .008), 20 g lactose (22% vs 47%; OR, 3.16; 95% CI, 1.43-7.02; P = .004), and 40 g lactose (68% vs 85%; OR, 2.63; 95% CI, 1.08-6.42; P = .03). H(2) excretion was associated with symptom score (P = .001). Patients with D-IBS self-reported LI more frequently than controls (63% vs 22%; OR, 6.25; 95% CI, 2.78-14.0; P < .001) and ate fewer dairy products (P = .040). However, self-reported LI did not correlate with results from hydrogen breath tests. CONCLUSIONS: The risk of LI is related to the dose of lactose ingested and intestinal gas production and is increased in patients with D-IBS. Self-reported LI, but not objective results from hydrogen breath tests, was associated with avoidance of dairy products.

Yang J; Deng Y; Chu H; Cong Y; Zhao J; Pohl D; Misselwitz B; Fried M; Dai N; Fox M

2013-03-01

273

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

Science.gov (United States)

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

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

2012-10-19

274

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

UK PubMed Central (United Kingdom)

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

Akhavan A; Akhavan Tafti M; Aghili F; Navabii H

2012-01-01

275

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

Directory of Open Access Journals (Sweden)

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; Carlos Roberto Victoria

2008-01-01

276

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

Directory of Open Access Journals (Sweden)

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

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

2012-01-01

277

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

International Nuclear Information System (INIS)

[en] 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 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)

2012-01-01

278

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

UK PubMed Central (United Kingdom)

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.

Anastasakis A; Plainis S; Giannakopoulou T; Papadimitraki E; Fanouriakis C; Tsilimbaris MK

2013-04-01

279

Vascular endothelial growth factor C levels are modulated by dietary salt intake in proteinuric chronic kidney disease patients and in healthy subjects.  

UK PubMed Central (United Kingdom)

BACKGROUND: Recent experimental findings demonstrate vascular endothelial growth factor C (VEGF-C)-mediated water-free storage of salt in the interstitium, which prevents a salt-sensitive blood pressure state. It is unknown whether this mechanism plays a role in salt homeostasis and regulation of blood pressure in humans as well. Therefore, we investigated circulating VEGF-C levels and blood pressure during different well-controlled salt intake in chronic kidney disease (CKD) patients and in healthy subjects. METHODS: In two crossover studies, non-diabetic proteinuric CKD patients (n = 32) and healthy subjects (n = 31) were treated with consecutively a low-sodium diet (LS, aim 50 mmol Na(+)/day) and a high-sodium diet (HS, aim 200 mmol Na(+)/day) in random order, during two 6-week (CKD patients) and two 1-week periods (healthy subjects). RESULTS: We found that VEGF-C levels are higher during HS than during LS in CKD patients (P = 0.034) with a trend towards higher VEGF-C in healthy subjects as well (P = 0.070). In CKD patients, HS was associated with higher NT-proBNP levels (P = 0.005) and body weight (P = 0.013), consistent with extracellular volume (ECV) expansion and with higher blood pressure (P < 0.001), indicating salt sensitivity. In healthy subjects, blood pressure was not affected by dietary salt (P = 0.14), despite a rise in ECV (P = 0.023). DISCUSSION: Our findings support a role for VEGF-C-mediated salt homeostasis in humans. Considering the salt sensitivity of blood pressure, this buffering mechanism appears to be insufficient in proteinuric CKD patients. Future studies are needed to provide causality and to substantiate the clinical and therapeutic relevance of this VEGF-C regulatory mechanism in humans.

Slagman MC; Kwakernaak AJ; Yazdani S; Laverman GD; van den Born J; Titze J; Navis G

2012-03-01

280

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 Abstract in spanish Objetivo: Averiguar las características de los pacientes con DMAE húmeda que ingieren suficiente luteína y zeaxantina en nuestra población. Métodos: Estudio protocolizado, prospectivo, observacional, transversal, en pacientes diagnosticados de DMAE húmeda activa. Se efectúa hemograma, perfil 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 div (more) iden 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 wit (more) h > 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.

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

2012-04-01

 
 
 
 
281

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

Directory of Open Access Journals (Sweden)

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

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

2012-01-01

282

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

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Full Text Available AIM: To evaluate the effect of double balloon endoscope (DBE) on the endoscopic retrograde cholangiopancreatography (ERCP) success rate in patients with a history of Billroth II (B II) gastrectomy.METHODS: From April 2006 to March 2007, 32 patients with a B II gastrectomy underwent 34 ERCP attempts. In all cases, the ERCP procedures were started using a duodenoscope. If intubation of the afferent loop or reaching the papilla failed, we changed to DBE for the ERCP procedure (DBE-ERCP). We assessed the success rate of afferent loop intubation, reaching the major papilla, selective cannulation, possibility of therapeutic approaches, procedure-related complications, and the overall success rate.RESULTS: Among the 32 patients with a history of B II gastrectomy, the duodenoscope was successfully passed up to the papilla in 22 patients (69%), and cannulation was successfully performed in 20 patients (63%). Six patients (2 with failure in afferent loop intubation and 4 with failure in reaching the papilla) underwent DBE-ERCP. The DBE reached the papilla in all the 6 patients (100%) and selective cannulation was successful in 5 patients (83%). Four patients (67%) who had common bile duct stones were successfully treated. One patient underwent diagnostic ERCP only and the other one, in whom selective cannulation failed, was diagnosed with papilla cancer proven by biopsy. There were no complications related to the DBE. The overall ERCP success rate increased to 88% (28/32).CONCLUSION: The overall ERCP success rate increases with DBE in patients with a previous B II gastrectomy.

Cheng-Hui Lin, Jui-Hsiang Tang, Chi-Liang Cheng, Yung-Kuan Tsou, Hao-Tsai Cheng, Mu-Hsien Lee, Kai-Feng Sung, Ching-Song Lee, Nai-Jen Liu

2010-01-01

283

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

Scientific Electronic Library Online (English)

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

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

2012-12-01

284

Comparisons of psychopathological phenomena of 422 manic-depressive patients with suicide-positive and suicide-negative family history.  

Science.gov (United States)

Psychopathological symptoms of 342 manic-depressive patients with a family history (FH) of manic-depressive illness (MDI) and suicide (FH-S-positive group) were compared with 80 manic-depressive patients with a family history of MDI but without suicide (FH-S-negative group). Frequencies of suicide tendencies, attempted suicides, rage, angry mania and delusions were evaluated. In contrast to the FH-S-positive group where suicide tendencies and attempted suicides were more frequent, the FH-S-negative group revealed a higher frequency of delusions. There was no difference between the groups concerning rage and angry mania. Comparisons regarding suicide tendencies, attempted suicides, rage, angry mania and diagnostics referring to depressive, manic, subdepressive and hypomanic phases showed no difference between the sexes. PMID:3389179

Mitterauer, B; Leibetseder, M; Pritz, W F; Sorgo, G

1988-04-01

285

Comparisons of psychopathological phenomena of 422 manic-depressive patients with suicide-positive and suicide-negative family history.  

UK PubMed Central (United Kingdom)

Psychopathological symptoms of 342 manic-depressive patients with a family history (FH) of manic-depressive illness (MDI) and suicide (FH-S-positive group) were compared with 80 manic-depressive patients with a family history of MDI but without suicide (FH-S-negative group). Frequencies of suicide tendencies, attempted suicides, rage, angry mania and delusions were evaluated. In contrast to the FH-S-positive group where suicide tendencies and attempted suicides were more frequent, the FH-S-negative group revealed a higher frequency of delusions. There was no difference between the groups concerning rage and angry mania. Comparisons regarding suicide tendencies, attempted suicides, rage, angry mania and diagnostics referring to depressive, manic, subdepressive and hypomanic phases showed no difference between the sexes.

Mitterauer B; Leibetseder M; Pritz WF; Sorgo G

1988-04-01

286

Impact of family history of cancer on the incidence of mutation in epidermal growth factor receptor gene in non-small cell lung cancer patients.  

UK PubMed Central (United Kingdom)

BACKGROUND: Epidermal growth factor receptor (EGFR) activating mutation is an important predictive biomarker of EGFR tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC), while family history of cancer also plays an important role in the neoplasia of lung cancer. This study aimed to investigate the association between family history of cancer and EGFR mutation status in NSCLC population. METHODS: From February 2008 to May 2012, 538 consecutive NSCLC patients with known EGFR mutation status were included into this study. Amplification refractory mutation system (ARMS) method was used to detect EGFR mutation. The associations between EGFR mutation and family history of cancer were evaluated using logistic regression models. RESULTS: EGFR activating mutation was found in 220 patients and 117 patients had family cancer histories among first-degree relatives. EGFR mutation was more frequently detected in adenocarcinoma patients (p < 0.001), never-smoker (p < 0.001) and with family history of cancer (p = 0.031), especially who had family history of lung cancer (p = 0.008). In multivariate analysis, the association of EGFR mutation with family history of cancer also existed (p = 0.027). CONCLUSIONS: NSCLC patients with family history of cancer, especially family history of lung cancer, might have a significantly higher incidence of EGFR activating mutation.

He Y; Li S; Ren S; Cai W; Li X; Zhao C; Li J; Chen X; Gao G; Li W; Zhou F; Zhou C

2013-08-01

287

First report of bacteremia by Asaia bogorensis, in a patient with a history of intravenous-drug abuse.  

Science.gov (United States)

We report the first documented case of bacteremia caused by Asaia bogorensis in a young patient with a history of intravenous-drug abuse. A. bogorensis was identified by sequencing the 16S rRNA gene. The isolate was exceptionally resistant to almost all antibiotics that are routinely tested for gram-negative rods but was susceptible to netilmicin, gentamicin, and doxycycline. PMID:16891542

Tuuminen, Tamara; Heinäsmäki, Terhi; Kerttula, Tuija

2006-08-01

288

Successful Outcome of a Triplet Gestation in a Patient with a History of an Open Maternal-Fetal Surgery  

Science.gov (United States)

Reproductive outcomes in women after pregnancy complicated by an open maternal-fetal surgery (OMFS) are limited. A review of the medical literature reveals only isolated cases of successful multiple pregnancies, and there are no prior documented cases of successful triplet gestations following OMFS. We report the delivery of a triplet gestation at 34-week gestation in a patient with a history of previous OMFS.

Rivers, Kathleen A.; Whitecar, Paul W.; Berry-Caban, Cristobal S.

2012-01-01

289

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

Directory of Open Access Journals (Sweden)

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

Kessler Elizabeth A; Vora Sheetal S; Verbsky James W

2012-01-01

290

Screening patterns in patients with a family history of colorectal cancer often do not adhere to national guidelines.  

UK PubMed Central (United Kingdom)

BACKGROUND: Currently, there are no data on adherence to guidelines for colorectal cancer (CRC) screening in patients with a family history. AIM: We conducted a retrospective study to assess if such patients were being appropriately screened according to American Gastroenterological Association (AGA) guidelines. METHODS: Two independent reviewers performed a comprehensive medical record review of family and CRC screening history on 362 adults with a family history of CRC in a first-degree relative who had recently undergone screening colonoscopy. The endpoint was appropriate initiation of screening and endoscopist-recommended subsequent screening intervals, as compared to AGA guideline recommendations. RESULTS: Of 362 subjects, only 146 (40.3 %) were screened appropriately; 213 (58.9 %) had late initiation of screening (i.e., screening was started ?5 years later than the age recommended by guidelines) and three (0.8 %) had premature initiation (i.e., screening was started ?1 year too early). Of cases involving delayed screening initiation, 126 were not under primary care at the time when screening was supposed to have started, while most of the remaining received either no or incorrect screening recommendations from their primary care provider. Of 270 subjects with no neoplasia found on initial screening, 112 (41.5 %) had endoscopist-recommended subsequent screening intervals that were ?2 years shorter than that recommended by guidelines. Results were similar if American Society of Gastrointestinal Endoscopy or American College of Gastroenterology guidelines were used. CONCLUSIONS: Patients with a family history often suffer from late initiation of screening and overly short endoscopist-recommended subsequent intervals for colonoscopy. Further education of patients and providers on screening recommendations may be helpful.

Lin OS; Gluck M; Nguyen M; Koch J; Kozarek RA

2013-07-01

291

[Prevalence of hepatic involvement, alcoholism, hepatis B, C and HIV in patients with background history of drug use].  

UK PubMed Central (United Kingdom)

UNLABELLED: Drug addicts frequently have liver diseases for different reasons: alcohol abuse, the drugs themselves, but more often hepatitis B and C infections. AIDS is common in this population as well and could also affect the liver directly or in the form of hepatocellular or biliary damage. We conducted this study to determine the prevalence of liver diseases, alcoholism, hepatitis B and C infections, and HIV positivity in this population. We studied a cohort of 137 persons, all with a history of drug abuse, and investigated the quantity of alcohol intake, the kind of drug used, and he routes of drug administration. RESULTS: We found liver disease in 33.6%. The prevalence of alcoholism was 65.4%, of HCV 67.3%, and of HBV 17.3%. HDV was undetectable, whereas we found HIV at a frequency of 17.3%. HCV RNA was detected in 85.4% of HCV. The drug most often used was cocaine at 90.4%, followed by marihuana at 88.3%; LSD use occurred in 17.5%. We found parenteral drug use in 43.1%. We performed 22 liver biopsies, 21 associated with HCV, and detected histological changes consistent with chronic hepatitis in 17, with cirrhosis in 4, and with hepatocellularcarcinoma in 1.

Cocozella DR; Albuquerque MM; Borzi S; Barrio M; Dascenzo V; Santecchia JC; González J; Adrover RE; Meneses C; Fraquelli E; Curciarello JO

2003-01-01

292

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.

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

2011-01-01

293

Aggressive behavior and employment histories in patients from an internal medicine outpatient clinic.  

UK PubMed Central (United Kingdom)

A number of studies have examined the relationships between aggression and various facets of the work environment. However, to our knowledge, the relationship between self-reported aggressive behaviors and corresponding employment histories has never been previously explored. Using a cross-sectional approach and a self-report survey methodology in a consecutive sample of 325 internal medicine outpatients, we examined lifetime histories of 21 aggressive behaviors and 4 employment variables. In both men and women, a higher number of aggressive behaviors correlated with a greater number of different jobs held, greater likelihood of being paid "under the table," and a greater number of firings. However, only in men was the number of aggressive behaviors related to the percentage of time employed as an adult. According to findings, a history of aggressive behavior appears to be associated with compromised employment viability in adulthood.

Sansone RA; Leung JS; Wiederman MW

2013-01-01

294

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

Directory of Open Access Journals (Sweden)

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

Kuzmanovi? Miloš; Jankovi? Borisav; Rašovi?-Gvozdenovi? Nada; Marti? Jelena; Šerbi? Olivera

2010-01-01

295

Explaining diagnostic complexity in an intake setting.  

UK PubMed Central (United Kingdom)

A one patient-one illness paradigm is implicit in the history and theory of psychiatry, and in basic research. Yet, in clinical practice and treatment populations in general, more than one diagnosis per patient is frequently encountered. How clinicians formulate comorbidity by means of DSM-III has rarely been investigated. In this study, the ideas of clinical condition and that of its diagnostic complexity are used to analyze descriptive features of a large number of patients seen in an intake setting. Axis I of DSM-III is used to measure diagnostic complexity. Complexity is analyzed in relation to demographic variables, to ratings entered in the remaining axes of DSM-III formulations, to symptom levels of patients, and to decisions involving disposition. Results indicate that analysis of diagnostic complexity by means of DSM-III yields a definable structure and that it can be related meaningfully to clinical factors. The idea of information uncertainty in diagnosis, i.e., the opacity versus transparency of a clinical condition, is also used to explain results. The ideas introduced and studied are shown to have value for social psychiatric research.

Fabrega H Jr; Pilkonis P; Mezzich J; Ahn CW; Shea S

1990-01-01

296

Explaining diagnostic complexity in an intake setting.  

Science.gov (United States)

A one patient-one illness paradigm is implicit in the history and theory of psychiatry, and in basic research. Yet, in clinical practice and treatment populations in general, more than one diagnosis per patient is frequently encountered. How clinicians formulate comorbidity by means of DSM-III has rarely been investigated. In this study, the ideas of clinical condition and that of its diagnostic complexity are used to analyze descriptive features of a large number of patients seen in an intake setting. Axis I of DSM-III is used to measure diagnostic complexity. Complexity is analyzed in relation to demographic variables, to ratings entered in the remaining axes of DSM-III formulations, to symptom levels of patients, and to decisions involving disposition. Results indicate that analysis of diagnostic complexity by means of DSM-III yields a definable structure and that it can be related meaningfully to clinical factors. The idea of information uncertainty in diagnosis, i.e., the opacity versus transparency of a clinical condition, is also used to explain results. The ideas introduced and studied are shown to have value for social psychiatric research. PMID:2297985

Fabrega, H; Pilkonis, P; Mezzich, J; Ahn, C W; Shea, S

297

Soy Protein Intake, Cardiovascular Risks, CRP-Level and Kidney Function Among Type 2 Diabetic Patients with Nephropathy  

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Full Text Available Background: There are few reports regarding the effect of long-term soy protein consumption among type 2 diabetic patients with nephropathy. This study was conducted to elucidate the effects of soy consumption for a long period of time on cardiovascular risks, C-reactive protein (CRP) and kidney function indexes among type 2 diabetic patients with nephropathy. Materials & Methods: This long-term randomized clinical trial was conducted among 41 type 2 diabetic patients with nephropathy (18 men and 23 women). Twenty patients in the soy protein group consumed a diet containing 0.8 g protein/kg body weight (35% animal proteins, 35% textured soy protein, and 30% vegetable proteins) and 21 patients in the control group consumed a similar diet containing 70% animal proteins and 30% vegetable proteins for 4 years. Results: Soy protein consumption significantly improved cardiovascular risks such as fasting plasma glucose (mean change in the soy protein versus control groups: ?18 ± 3 vs. 11 ± 2 mg/dl; P = 0.03), total cholesterol (?23 ± 5 vs. 10 ± 3 mg/dl; P = 0.01), LDL cholesterol (?20 ± 5 vs. 6 ± 2 mg/dl; P = 0.01), triglyceride (?24 ± 6 vs. ?5 ± 2 mg/dl; P = 0.01) and serum CRP (1.31 ± 0.6 vs. 0.33 ± 0.1 mg/l; P = 0.02) concentrations. Significant reductions were also seen in proteinuria (?0.15 ± 0.03 vs. 0.02 ± 0.01 g/day; P = 0.001) and urinary creatinine (?1.5 ± 0.9 vs. 0.6 ± 0.3 mg/dl, P = 0.01) by consumption of soy protein. Conclusion: Long-term soy protein consumption has beneficial effects on cardiovascular risk factors and kidney-related biomarkers among type 2 diabetic patients with nephropathy

Leila Azadbakht; Shahnaz Atabak; Somayeh Rajaie; Maryam Zahedi; Masoomeh Tehrani; Ahmad Esmaillzadeh

2012-01-01

298

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

Science.gov (United States)

Objective: 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, 27 patients attended supportive periodontal therapy (SPT) and the rest did not (No SPT). The O'Leary plaque index and periodontal biotype were recorded for each subject and 246 Astra Tech® OsseospeedTM implants were radiographically analysed (123 placed in SPT patients and 123 in No SPT patients) at the time of loading and one year later, measuring marginal bone loss with the program Dental Studio NX 6.0®. The statistical analysis was performed with Windows SPSS, applying Pearson's correlation index and the Kruskal-Wallis and U-Mann Whitney non-parametric tests. Results: Six patients were found to have periimplantitis and sixteen mucositis. The survival rate was 99.59% (100% SPT and 99.18% No SPT). Mean bone loss was 0.39 mm (range [-0.71 - 8.05]). Among SPT patients, 95% of the implants had losses less than or equal to the mean (mean bone loss of 0.16 mm) compared to 53.7% for the No SPT group (mean bone loss of 0.62 mm). A statistically significant relationship was demonstrated between bone loss around the implant and the patient's periodontal biotype and plaque index. Conclusions: The marginal bone loss around implants in patients with treated chronic periodontitis is minimal if they are in a controlled SPT programme and there is individual control of plaque index. Moreover, the presence of a thin periodontal biotype represents a risk factor for additional bone loss. PMID:23722147

Aguirre-Zorzano, L-A; Vallejo-Aisa, F-J; Estefanía-Fresco, R

2013-09-01

299

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

UK PubMed Central (United Kingdom)

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

Iwayama S; Tatara T; Osugi T; Hirose M

2013-07-01

300

Factor XII autoantibodies as a novel marker for thrombosis and adverse obstetric history in patients with systemic lupus erythematosus  

Science.gov (United States)

Aim To investigate the clinical significance of anti?factor XII (FXII) in a large cohort of patients with systemic lupus erythematosus (SLE). Patients and methods This study comprised 127 patients with SLE. IgG and IgM anti?FXII were tested by an in?house ELISA. 123 healthy donors comprised the control group. Results 51 (40%) patients with SLE and 9 (7%) healthy controls were positive for anti?FXII. IgG and IgM anti?FXII were frequently found in patients with thrombosis (28% and 13%, respectively). Levels of IgG and IgM anti?FXII were higher in patients with thrombosis than in the control group (p<0.001 and p?=?0.005, respectively). Anti?FXII was more frequent in patients with arterial thrombosis (31% vs 4% for IgG and 14% vs 3% for IgM, respectively) and venous thrombosis than in controls (37% vs 4% for IgG). IgG anti?FXII were more frequent in patients with miscarriages and fetal death (35% and 40% vs 4% for IgM). The prevalence of IgM anti?FXII was not different between groups. Conclusion Anti?FXII are frequent in patients with SLE. Their presence is associated with thrombosis and adverse obstetric history, making these antibodies a novel marker for the antiphospholipid syndrome.

Bertolaccini, Maria Laura; Mepani, Kirti; Sanna, Giovanni; Hughes, Graham R V; Khamashta, Munther A

2007-01-01

 
 
 
 
301

Natural history of cytomegalovirus infection in a series of patients diagnosed with moderate-severe ulcerative colitis  

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Full Text Available AIM: To evaluate the natural history of human cytomegalovirus (HCMV) infection in a series of 28 ulcerative colitis patients in whom the search for HCMV was positive.METHODS: A series of 85 patients with moderate-severe ulcerative colitis flare-up were evaluated for a HCMV search by performing a haematoxylin and eosin stain, immunohistochemical assay and nested polymerase chain reaction on rectal biopsies. Among 85 screened patients (19 of whom were steroid resistant/dependant), 28 were positive for HCMV; after remission the patients were followed up clinically and histologically.RESULTS: Among the 22 patients with complete follow-up, in 8 (36%) patients HCMV-DNA persisted in the intestinal specimens. Among the HCMV positive patients, 4 (50%) experienced at least one moderate-severe flare-up of colitis without evidence of peripheral HCMV. Among the 14 HCMV negative patients, 3 with pouches developed pouchitis and 5 out of 11 (45%) experienced a colitis flare-up.CONCLUSION: Our preliminary results suggest that HCMV may remain in the colon after an acute colitis flare-up despite remission; it seems that the virus is not responsible for the disease relapse.

Valeria Criscuoli; Maria Rosa Rizzuto; Luigi Montalbano; Elena Gallo; Mario Cottone

2011-01-01

302

High salt intake promotes a decline in renal function in hypertensive patients: a 10-year observational study.  

UK PubMed Central (United Kingdom)

We investigated the influence of long-term salt load on renal function in hypertensive patients. The subjects were 133 hypertensive patients (80 women and 53 men, mean age 60±9 years) who underwent at least five successful 24?h home urine collections during the 10-year observation period. Blood pressure (BP) and 24-h urinary salt and creatinine excretion levels were measured. BP decreased from 143±12/85±8 to 129±14/68±11?mm?Hg during the 10.5-year observation period, and this decrease was associated with patients taking an increased number of antihypertensive drugs (1.3±1.0 to 2.2±1.1). The estimated glomerular filtration rate (eGFR) also significantly decreased from 71.7±14.6 to 64.7±16.5?ml?min(-1) (P<0.01), and the change in eGFR was -0.68?ml?min(-1) per year on average. The average salt excretion was 8.6±2.2?g per day and showed a significant negative correlation with the change in eGFR (r=-0.21, P=0.02). Subjects with an average salt excretion<8?g per day showed a significantly slower decline in renal function than those with an average salt excretion ?8?g per day (the change in eGFR: -0.41±1.10 vs. -0.83±1.19?ml?min(-1) per year, P<0.05). In the multivariate analysis, the average salt excretion (partial r=-0.19, P=0.03) and baseline eGFR (partial r=-0.23, P=0.01) were significantly associated with the change in eGFR. This association was independent of BP change or an increased number of antihypertensive drugs. The results suggest that long-term salt load promotes a decline in renal function in hypertensive patients; thus, salt restriction is encouraged, to prevent renal damage.

Ohta Y; Tsuchihashi T; Kiyohara K; Oniki H

2013-02-01

303

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 Abstract in portuguese OBJETIVO: O estado nutricional de pacientes em lista de espera para transplante hepático deve ser avaliado devido ao risco elevado de deficiências nutricionais desses doentes, sendo este o objetivo do presente estudo. MÉTODOS: Em 13 meses, pacientes candidatos a transplante de fígado foram avaliados nutricionalmente pela técnica de Avaliação Global Subjetiva (AGS) e a ingestão alimentar foi quantificada pelo recordatório de 24 horas. RESULTADOS: Foram avaliados 1 (more) 59 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, (more) 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.

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

2009-01-01

304

Association of dietary vitamin C and e intake and antioxidant enzymes in type 2 diabetes mellitus patients.  

UK PubMed Central (United Kingdom)

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.

Rafighi Z; Shiva A; Arab S; Mohd Yousof R

2013-05-01

305

Higher blood pressure in normoalbuminuric type 1 diabetic patients with a familial history of type 2 diabetes.  

UK PubMed Central (United Kingdom)

BACKGROUND: To address whether type 1 diabetic patients with type 2 diabetic first degree relatives are different from others in terms of cardiovascular risk factors, insulin resistance and daily insulin dosage. METHODS: We studied 18 type 1 diabetic patients with type 2 diabetic first degree relatives and 36 type 1 diabetic patients without such relatives. Patients with diabetic complications (including microalbuminuria) were excluded. The groups were similar in terms of baseline characteristics. We measured systolic and diastolic blood pressures, body mass index, waist circumference, total cholesterol, triglycerides, LDL, VLDL, HDL, daily insulin dosage and insulin sensitivity. Insulin sensitivity was tested using insulin tolerance test. RESULTS: Type 1 diabetic patients having first degree relatives with type 2 diabetes had significantly higher systolic and diastolic blood pressures (although within the normal range) than others (p < 0.001). They were more insulin resistant according to insulin tolerance test and were using higher daily insulin dosages. In this group, waist circumference, triglyceride and VLDL levels also tended to be higher, but differences were not significant statistically. Total cholesterol, LDL and HDL levels were similar in both groups. CONCLUSION: Family history of type 2 diabetes increases blood pressure and decreases insulin sensitivity in type 1 diabetic patients. Thus such patients should be treated more aggressively in terms of both cardiovascular risk factors and glucose control.

Damci T; Osar Z; Ilkova H

2002-11-01

306

Nipple-sparing mastectomy in patients with a history of reduction mammaplasty or mastopexy: how safe is it?  

UK PubMed Central (United Kingdom)

BACKGROUND: Nipple-sparing mastectomy has gained popularity, but the question remains of whether it can be offered safely to women with a history of reduction mammaplasty or mastopexy. The authors present their experience with nipple-sparing mastectomy in this patient population. METHODS: Patients at the authors' institution who had reduction mammaplasty or mastopexy before nipple-sparing mastectomy were identified. Outcomes measured include nipple-areola complex viability, mastectomy flap necrosis, infection, presence of cancer in the nipple-areola complex, and breast cancer recurrence. RESULTS: The records of the nipple-sparing mastectomy patients at the authors' institution from 2006 through 2012 were reviewed. The authors identified 13 breasts in eight patients that had nipple-sparing mastectomy following reduction mammaplasty or mastopexy. Within this subset of patients, the mean age was 46.6 years and the mean body mass index was 25.1. Nine of 13 breasts had therapeutic resections, whereas the remaining four were for prophylactic indications. Average time elapsed between reduction mammaplasty or mastopexy and nipple-sparing mastectomy was 51.8 months (range, 33 days to 11 years). In all cases, prior reduction mammaplasty/mastopexy incisions were used for nipple-sparing mastectomy. Ten breasts underwent reconstruction immediately with tissue expanders, one with a latissimus dorsi flap with immediate implant and two with immediate abdominally based free flaps. Complications included one hematoma requiring evacuation and one displaced implant requiring revision. There were no positive subareolar biopsy results, and the nipple viability was 100 percent. Mean follow-up time was 10.5 months. CONCLUSIONS: The authors' experience demonstrates that nipple-sparing mastectomy can be offered to patients with a history of reduction mammaplasty or mastopexy with reconstructive outcomes comparable to those of nipple-sparing mastectomy alone. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Alperovich M; Tanna N; Samra F; Blechman KM; Shapiro RL; Guth AA; Axelrod DM; Choi M; Karp NS

2013-05-01

307

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

Directory of Open Access Journals (Sweden)

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

Mohammad Ebrahim Ghamar-Chehreh; Hossein Khedmat; Mohsen Amini; Saeed Taheri

2013-01-01

308

Predictive value of having positive family history of cardiovascular disorders, diabetes mellitus, dyslipidemia, and hypertension in non-alcoholic fatty liver disease patients.  

UK PubMed Central (United Kingdom)

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

Ghamar-Chehreh ME; Khedmat H; Amini M; Taheri S

2013-01-01

309

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  

Directory of Open Access Journals (Sweden)

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; Yuasa Motoyuki; Moolphate Saiyud; Nedsuwan Supalert; Yokokawa Hidehiro; Kitajima Tsutomu; Minematsu Kazuo; Tanimura Susumu; Fukuda Hiroshi; Hiratsuka Yoshimune; Ono Koichi; Kawai Sachio; Marui Eiji

2012-01-01

310

Hallucinations and comorbid renal tubular acidosis caused by topiramate in a patient with psychiatric history.  

UK PubMed Central (United Kingdom)

Few studies have shown that topiramate may induce psychiatric symptoms and metabolic disorders, respectively. Here, we reported a 13-year-old female who presented with topiramate-induced hallucinations and comorbid renal tubular acidosis. She had a history of psychiatric illness and had been taking the medication for 3 months without prior side effects. After the discontinuation of topiramate, she was treated with supplementary potassium and sodium bicarbonate. Subsequently, her psychiatric symptoms and biochemical findings improved. Recognition of drug-induced psychotic symptoms and renal tubular acidosis is important during concomitant topiramate therapy in psychiatric clinic.

Cheng M; Wen S; Tang X; Zhong Z

2013-03-01

311

Cyclophosphamide-induced cardiomyopathy in a patient with seminoma and a history of mediastinal irradiation  

International Nuclear Information System (INIS)

A 17-year-old man with mediastinal seminoma was treated with chemotherapy and mediastinal irradiation therapy. Then he received high-dose chemotherapy containing cyclophosphamide (CY) followed by autologous peripheral blood stem cell transplantation. He suffered from CY-induced cardiomyopathy beginning six days after the administration of high-dose CY. The predictable factors associated with the onset of CY-induced cardiomyopathy are not precisely known. It is suggested that the history of mediastinal irradiation was responsible for the onset of cardiomyopathy. (author)

2005-01-01

312

Natural history of minimal hepatic encephalopathy in patients with extrahepatic portal vein obstruction.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Minimal hepatic encephalopathy (MHE) leads to deterioration in patient quality of life and could be a marker for future episodes of clinical hepatic encephalopathy (HE) in liver cirrhosis. Whether MHE predicts HE in extrahepatic portal vein obstruction (EHPVO) is not known. We studied the incidence of overt HE in EHPVO patients with MHE. METHODS: Consecutive patients (from October 2006 to July 2007) with a diagnosis of EHPVO were followed up at 3-month intervals. MHE was diagnosed by abnormal psychometry (>2 s.d.) and/or P300 auditory event-related potential (P300 ERP) (>2.5 s.d.), and HE was diagnosed as per West-Heaven criteria. Critical flicker frequency (CFF) was also measured at baseline and after 1 year. RESULTS: Thirty-two EHPVO patients (age, 23.2+/-10.8 years; M/F 22:10) were followed up for 1 year. Of 32 patients, P300 ERP was prolonged in 8 (25%) (371.8+/-13.9 ms), 9 (28%) had abnormal psychometric tests, and CFF was <38 Hz in 8 (25%) patients after a follow-up of 13.5+/-2.4 months. Of 12 patients who had MHE at baseline, 9 (75%) patients continued to have MHE, and in 3 (25%) patients it disappeared. One (5%) of the remaining 20 patients developed MHE during the follow-up. Venous ammonia level was higher in patients with MHE (79.7+/-17.0 micromol/l; range 33-124) compared with patients without MHE (46.6+/-19.8 micromol/l; range 24-78, P<0.001) on follow-up. Similarly, patients who had spontaneous shunts (n=10) had significantly higher venous ammonia levels (82.4+/-20.3 vs. 47.1+/-16.7 micromol/l; P=0.001) than those who had no shunt (n=22). Neither patients who had MHE nor those who did not have MHE at baseline developed HE. CONCLUSIONS: Seventy-five percent of extrahepatic portal vein obstruction patients with MHE continued to have MHE, and new-onset MHE developed in 5% over 1 year. In this small sample, patients with EHPVO and MHE did not progress to overt encephalopathy within the relatively short time frame studied.

Sharma P; Sharma BC; Puri V; Sarin SK

2009-04-01

313

Genotypic classification of patients with Wolfram syndrome: insights into the natural history of the disease and correlation with phenotype.  

UK PubMed Central (United Kingdom)

PURPOSE: Wolfram syndrome is a degenerative, recessive rare disease with an onset in childhood. It is caused by mutations in WFS1 or CISD2 genes. More than 200 different variations in WFS1 have been described in patients with Wolfram syndrome, which complicates the establishment of clear genotype-phenotype correlation. The purpose of this study was to elucidate the role of WFS1 mutations and update the natural history of the disease. METHODS: This study analyzed clinical and genetic data of 412 patients with Wolfram syndrome published in the last 15 years. RESULTS: (i) 15% of published patients do not fulfill the current -inclusion criterion; (ii) genotypic prevalence differences may exist among countries; (iii) diabetes mellitus and optic atrophy might not be the first two clinical features in some patients; (iv) mutations are nonuniformly distributed in WFS1; (v) age at onset of diabetes mellitus, hearing defects, and diabetes insipidus may depend on the patient's genotypic class; and (vi) disease progression rate might depend on genotypic class. CONCLUSION: New genotype-phenotype correlations were established, disease progression rate for the general population and for the genotypic classes has been calculated, and new diagnostic criteria have been proposed. The conclusions raised could be important for patient management and counseling as well as for the development of treatments for Wolfram syndrome.

de Heredia ML; Clèries R; Nunes V

2013-07-01

314

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

Directory of Open Access Journals (Sweden)

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

Ghadimi Mahmoodreza; Mahmoodi Mahmood; Mohammad Kazem; Zeraati Hojjat; Rasouli Mahboobeh; Sheikhfathollahi Mahmood

2011-01-01

315

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 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.

1987-01-01

316

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

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

317

Influence of family history of major depression, bipolar disorder, and suicide on clinical features in patients with major depression and bipolar disorder.  

UK PubMed Central (United Kingdom)

The extent to which a family history of mood disorders and suicide could impact on clinical features of patients suffering from major depression (MD) and bipolar disorder (BD) has received relatively little attention so far. The aim of the present work is, therefore, to assess the clinical implications of the presence of at least one first- and/or second-degree relative with a history of MD, BD and suicide in a large sample of patients with MD or BD. One thousand one hundred and fifty-seven subjects with MD and 686 subjects with BD were recruited within the context of two large projects. The impact of a family history of MD, BD, and suicide-considered both separately and together-on clinical and socio-demographic variables was investigated. A family history of MD, BD, and suicide was more common in BD patients than in MD patients. A positive family history of mood disorders and/or suicide as well as a positive family history of MD and BD separately considered, but not a positive history of suicide alone, were significantly associated with a comorbidity with several anxiety disorders and inversely associated with age of onset. The clinical implications as well as the limitations of our findings are discussed.

Serretti A; Chiesa A; Calati R; Linotte S; Sentissi O; Papageorgiou K; Kasper S; Zohar J; De Ronchi D; Mendlewicz J; Amital D; Montgomery S; Souery D

2013-03-01

318

Natural history of hyperlactataemia in human immunodeficiency virus-1-infected patients during highly active antiretroviral therapy.  

UK PubMed Central (United Kingdom)

A study on the course of hyperlactataemia during highly active antiretroviral therapy (HAART) and the association between hyperlactataemia and antiretroviral drugs was conducted at the outpatient department, Rigshopitalet, Copenhagen. Lactate levels were monitored in 848 patients during a study period of 1 y. Longitudinal analysis was performed on all human immunodeficiency virus-1-infected patients who had plasma lactate > 2.1 mM. Hyperlactataemia was found in 178 patients (21%), of whom 7 patients needed treatment modification, owing to symptomatic hyperlactataemia in 3 and neuropathy in 4 patients, while 171 remained on unchanged therapy. Lactate levels increased in 20 patients during the study period, but the increases were modest with a mean of 0.6 mM (range 0.1-1.7 mM). The association between antiretroviral drugs and hyperlactataemia was studied using logistic regression in 263 patients with data on their treatment regimen available in electronic form. Only stavudine and ritonavir were significantly associated with hyperlactataemia, with odds ratios of 5.1 and 2.6, respectively. In conclusion, symptomatic hyperlactataemia is uncommon, while asymptomatic hyperlactataemia is a frequent and apparently benign condition unlikely to progress to lactic acidosis. A significant association between stavudine and hyperlactataemia was confirmed. The unexpected association between ritonavir and hyperlactataemia will need confirmation in future studies.

Huynh TK; Lüttichau HR; Roge BT; Gerstoft J

2003-01-01

319

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

International Nuclear Information System (INIS)

[en] 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.)

1990-01-01

320

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

Energy Technology Data Exchange (ETDEWEB)

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.).

Tanaka, Kimio; Takechi, Miho; Shigeta, Chiharu; Oguma, Nobuo; Kamada, Nanao (Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology); Hasegawa, Akira

1990-11-01