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Sample records for patient history intake

  1. 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

    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

  2. Food intake in patients on hemodialysis

    Inaiana Marques Filizola Vaz

    2014-12-01

    Full Text Available Objective: To evaluate the intake of energy and nutrients by individuals on hemodialysis, following especific recommendations for this population and according to Food Guide for the Brazilian Population. Methods: A cross-sectional study, 118 adult patients, considered stable from, ten dialysis centers in Goiânia, Goiás. Dietary intake was estimated by six 24-hour recalls, and classified as adequate or inadequate, according to specific recommendations for individuals undergoing dialysis and that recommended for a healthy diet. A descriptive analysis was performed. Results: Average dietary intake of 2022.40 ± 283.70 kcal/day; 31.18 kcal/kg/day; 55.03 ± 4.20% carbohydrate; 30.23 ± 3.71% lipid, 1.18 ± 0.23 g protein/kg/day. Important prevalences of inadequacy were observed for the intake of calories (39.0%, protein (39.0% and other nutrients such as retinol (94.9%, saturated fat (87.3%, cholesterol (61,9%, iron (61.0%, potassium (60.2% and zinc (45.0%. Patients had a low intake of fruit food group (1.22 ± 0.89 servings and vegetables (1.76 ± 1.01 servings, dairy products (0.57 ± 0.43 servings and high intake of food group of oils and fats (3.45 ± 0.95 servings, sugars and sweets (1.55 ± 0.77 servings. Conclusion: Observed food consumption imbalance, characterized by excess of oils and fats, especially saturated oils and cholesterol, sugars and sweets, parallel to low intake of fruits and vegetables and dairy products. A considerable percentage of patients did not intake the minimum recommended of calories, protein, retinol, iron, zinc and potassium.

  3. Assessment of daily food and nutrient intake in Japanese type 2 diabetes mellitus patients using dietary reference intakes.

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

    2013-07-01

    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. PMID:23803740

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

    Grigiene, Giedre; Norkūnienė, Jolita; Kvedariene, Violeta

    2010-01-01

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

  5. Caffeine intake by patients with autosomal dominant polycystic kidney disease

    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

  6. Caffeine intake by patients with autosomal dominant polycystic kidney disease

    Vendramini, L.C.; Nishiura, J.L.; Baxmann, A.C.; Heilberg, I.P. [Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP (Brazil)

    2012-07-20

    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.

  7. Evaluation of Food Intake in Ulcerative Colitis Patients

    Z Faghfoori

    2010-04-01

    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.

  8. Dietary intakes and some biochemical markers in hemodialysis patients

    Emine Yassibas

    2016-03-01

    Full Text Available Purpose: Intake of energy and some nutrients is frequently inadequate in dialysis patients because of eating and appetite disorders due to uremic syndrome. Inadequate energy and protein intake cause to malnutrition. Anthropometric measurements, biochemical markers and dietary intake records have great importance in determining the nutritional status of hemodialysis (HD patients. Therefore this study was planned to determination of daily energy, nutrient intake and some biochemical markers of adult hemodialysis patients. Method and Material:  A hundred and thirty six (male = 73, female = 63 clinically stable HD patients were enrolled in this study. All patients were taken 24-hour dietary recall. The daily energy and nutrient intakes of patients were calculated by food consumption records and anthropometric measurements were taken. Results: The mean age was found 45.5±13.51 years. The ratio of patients with body mass index (BMI below 18.5 kg/m2 was 7.4% and 25 kg/m2 or upper was 16.9%. Blood hemoglobin, hematocrit, albumin and total protein levels were below the normal levels. The daily dietary energy and protein intakes were found under the recommended level in the study period. A significant positive correlation was found between daily protein intake and serum albumin levels (r=0.210, p=0.014, daily protein intake and serum total protein levels (r=0.201, p=0.019, daily energy intake and serum total protein levels (r=0.178, p=0.039. Conclusions: HD patients often have low protein and energy intakes and most of them suffer from malnutrition. Therefore nutritional status of patients should be evaluated and periodically nutrition education should be given for improving eating habits and increasing dietary compliance is recommended.

  9. Dietary intake of minerals in the patients with stroke

    Shekoofe Ghasemi

    2013-01-01

    Full Text Available Background: Experimental studies provide evidence of a relationship between stroke and mineral intake but this information in human are still limited and inconsistent. The purpose of this study was to investigate sodium, calcium and iron intake and stroke in Iranian patient and control population. Materials and Methods: In a case-control study with 46 stroke men (aged 56 ± 18 years and stroke women (aged 52 ± 7 years and 60 healthy people, we investigated the sodium, calcium and iron intake inthe patients. Results: After adjustment for age, sex and cardiovascular disease we found that a high sodium intake was associated with a statistically significant higher risk of stroke (P 0/05. Conclusion: These findings in men and women suggest that a low sodium intake may play a role in primary prevention of stroke.

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

    Freil, M; Nielsen, MA; Blitz, B; Gut, C; Almdal, Thomas Peter

    2006-01-01

    , 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......, 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......-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...

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

    Freil, M.; Nielsen, M. A.; Biltz, C.; Gut, R.; Mikkelsen, Bent Egberg; Almdal, T.

    2006-01-01

    , 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...... 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......-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...

  12. Nutritional intake of gut failure patients on home parenteral nutrition

    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

  13. Food intakes and preferences of hospitalised geriatric patients

    Wan Chik Wan Chak; Chee Kan; Shahar Suzana

    2002-01-01

    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...

  14. Food intakes and preferences of hospitalised geriatric patients

    Wan Chik Wan Chak

    2002-08-01

    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.

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

    Kim, Eun-Young; Hong, Yeong-Seon; Jeon, Hae-Myung; Sung, Mi-Kyung; Sung, Chung-Ja

    2007-01-01

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

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

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

    2012-01-01

    The relation between parental history of hypertension and blood pressure response to potassium intake is unknown. A 7-day high-sodium followed by a 7-day high-sodium plus potassium dietary-feeding study was conducted from 2003 to 2005 among 1,871 Chinese participants. Those with a maternal history of hypertension had larger systolic blood pressure responses to potassium compared with those without: ?4.31 (95% confidence interval (CI): ?4.99, ?3.62) mm Hg versus ?3.35 (95% CI: ?4.00, ?2.70) mm...

  17. Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry

    Fujii, Hiroki; Iwase, Masanori; Ohkuma, Toshiaki; Ogata-Kaizu, Shinako; Ide, Hitoshi; Kikuchi, Yohei; Idewaki, Yasuhiro; Joudai, Tamaki; Hirakawa, Yoichiro; Uchida, Kazuhiro; Sasaki, Satoshi; Nakamura, Udai; Kitazono, Takanari

    2013-01-01

    Background Dietary fiber is beneficial for the treatment of type 2 diabetes mellitus, although it is consumed differently in ethnic foods around the world. We investigated the association between dietary fiber intake and obesity, glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese type 2 diabetic patients. Methods A total of 4,399 patients were assessed for dietary fiber intake using a brief self-administered diet history questionnaire. The associations betwee...

  18. Sodium intake in men and potassium intake in women determine the prevalence of metabolic syndrome in Japanese hypertensive patients: OMEGA Study

    Teramoto, Tamio; Kawamori, Ryuzo; Miyazaki, Shigeru; Teramukai, Satoshi

    2011-01-01

    Dietary intake affects hypertension and metabolic syndrome (MS) and their management. In Japanese hypertensive patients, little evidence exists regarding the relation between diet and MS. A self-administered lifestyle questionnaire was completed by each patient at the baseline. Three dietary scores were calculated for each patient: sodium intake, potassium intake and soybean/fish intake. The relationships between dietary scores and systolic blood pressure (SBP) and diastolic blood pressure (D...

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

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

    2014-01-01

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

  20. Intake of antioxidants in patients with rheumatoid arthritis

    Bruna Nolasco Siqueira Silva

    2014-12-01

    Full Text Available Objective: to investigate dietary intake of antioxidants in patients with rheumatoid arthritis. Methods: this is a cross-sectional case series study with 53 women accompanied at the Rheumatology Outpatient Clinic, Hospital das Clnicas/UFPE, from January to October 2012. Demographic and anthropometric parameters (weight, height, body mass index, weight change were collected by means of a form. The assessment of food consumption was conducted using a semi-quantitative food frequency survey, analyzed according to a food composition table. Database construction and statistical analysis were performed using Excel and SPSS version 18.0, using chi-squared test, Anova, and Students t-test, at a confidence level of 5%. Results: the sample was composed of 53 women with a mean age of 54.51 4.24 years and BMI of 25.97 5.94 kg/m. In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant. Conclusion: the sample was composed of 53 women with a mean age of 54.51 4.24 years and BMI of 25.97 5.94 kg/m. In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant.

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

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

    2008-01-01

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

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

    Vanessa Rosa Brito Oliveira; Raquel Rocha; Mirella Brasil Lopes; Fernanda Gomes Coqueiro; Naiade Silveira Almeida; Sandra Santos Valois; Genoile Oliveira Santana

    2014-01-01

    Inflammatory bowel disease patients reduce their intake of foods rich in dietary fibers in an attempt to prevent recurrence of the disease, predisposing these patients to nutritional losses. The aim of this study was to evaluate the intake of dietary fiber and associated factors in a group of patients with inflammatory bowel disease. This was a cross-sectional study with 61 inflammatory bowel disease patients, and all participants were outpatients in Salvador, Bahia. Patients completed a semi...

  3. Association of Dietary Phosphorus Intake and Phosphorus to Protein Ratio with Mortality in Hemodialysis Patients

    Noori, Nazanin; Kalantar-Zadeh, Kamyar; Csaba P Kovesdy; BROSS, RACHELLE; Benner, Debbie; Kopple, Joel D.

    2010-01-01

    Background and objectives: Epidemiologic studies show an association between higher predialysis serum phosphorus and increased death risk in maintenance hemodialysis (MHD) patients. The hypothesis that higher dietary phosphorus intake and higher phosphorus content per gram of dietary protein intake are each associated with increased mortality in MHD patients was examined.

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

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

  5. [Calcium intake and glucose and lipids concetrations in overweight and obese patients].

    Pachocka, Lucyna M; Nowak, Agnieszka; Targosz, Urszula; Kłosiewicz-Latoszek, Longina; Stolarska, Irena

    2007-01-01

    Well-balanced diet is one of the determinants of the health and wellbeing. Inadequate nutrients' intake can promote disease development. The purpose of this study was to assess the intake of calcium, phosphorus and protein and relation between calcium intake and lipids and glucose serum concentration in patients with obesity. The studied group consisted of 57 subjects, aged 21-63 years. Dietary assessment was based on 3-d dietary record. Serum lipids concentrations were assessed by enzymatic methods, serum calcium concentrations were assessed by Vitros 250. The mean calcium intake in men was 588.8 mg/d, in women 549.3 mg/d. Calcium intake was statistically significant correlated with glucose concentration in women and men, but not with lipids concentrations. Dietary calcium intake in studied group was below the RDA. Calcium intake could be one of determinants of glucose concentration in obese persons. PMID:17711128

  6. Validity of a self-administered diet history questionnaire for estimating vitamin D intakes of Japanese pregnant women.

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

    2015-10-01

    Maternal vitamin D status is important for fetal development and the prevention of pregnancy complications. Mothers require both sufficient intakes and skin production of this vitamin. We investigated the validity and test-retest reliability of a self-administered diet history questionnaire (DHQ) to establish a method of assessing vitamin D intakes of Japanese pregnant women, using a serum marker. A total of 245 healthy pregnant women in the second trimester, who were not taking vitamin D supplements, were recruited at a university hospital in Tokyo between June 2010 and July 2011. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured as an indicator of vitamin D status. To assess the test-retest reliability of the DHQ, 58 pregnant women completed it twice within a 4-5-week interval. Significant positive correlations between intakes and serum concentrations of vitamin D were found (r?=?0.266 for daily intakes and r?=?0.249 for energy-adjusted intakes). In the winter investigation in which the serum 25(OH)D concentrations were less likely to be affected by sunlight exposure, the correlation coefficients were 0.304 for both daily and energy-adjusted intakes. After excluding participants with pregnancy-associated nausea, the coefficients increased. The intraclass correlation coefficient between vitamin D intakes estimated from the two-time DHQ was 0.638. The DHQ provides an acceptable validity and reliability of the vitamin D intake of Japanese pregnant women. However, the data of women with nausea should be interpreted with caution. We believe that the DHQ is a useful questionnaire to grasp and improve vitamin D intakes during pregnancy. PMID:24118748

  7. Effects of dietary flavonoids intake in Saudi patients with coronary heart disease

    Alsaif, Mohammed A.; Khan, Latifa A.; Adel A.H. Alhamdan; Saada Alorf; Al-Othman, Abdulaziz M.; Shatha Alawami

    2007-01-01

    Objectives: The aim of the study was to assess the dietary intake of flavonoids and their effect on serum lipid levels in Saudi patients with coronary heart disease (CHD). Methodology: A cross-sectional study with a sample of 50 CHD patients and 50 controls. A 24-hour recall method was used to collect data on the dietary intake of macronutrients, flavonoids, and antioxidant vitamins. A food frequency questionnaire (FFQ) was used to collect data on habitual consumption during the year prec...

  8. Dietary Intake Assessment and Biochemical Characteristics of Blood and Urine in Patients with Chronic Gastritis

    Choi, Mi-Kyeong; Kang, Myung-Hwa; Kim, Mi-hyun

    2015-01-01

    Chronic gastritis is a prevalent gastroentestinal disease in Korea. The purpose of this study was to investigate status of foods and nutrients intake and health related biochemical indicators in the patients with chronic gastritis. Daily food and nutrient intake, blood lipids, and antioxidant indicators in the urine, were compared between a group of 19 patients diagnosed with chronic gastritis and a control group of 27 subjects having normal gastroscopy. No significant differences were found ...

  9. A J-shaped relationship between caloric intake and survival in critically ill patients

    Crosara, Isabel Carolina Reis; Mélot, Christian; Preiser, Jean-Charles

    2015-01-01

    Background There is much controversy around the optimal caloric intake in intensive care unit (ICU) patients, based on the diverging results of prospective studies. Therefore, we assessed the presence of an association between caloric intake and outcome in a large cohort included in the Glucontrol study. Methods Patients (n = 1004) were divided into four quartiles (q1–q4) according to the daily caloric intake (n = 251/quartile). ICU, hospital and 28-day mortality and the length of stay (LOS) ...

  10. Daily intake of antioxidants in relation to survival among adult patients diagnosed with malignant glioma

    Il'yasova Dora

    2010-05-01

    Full Text Available Abstract Background Malignant glioma is a rare cancer with poor survival. The influence of diet and antioxidant intake on glioma survival is not well understood. The current study examines the association between antioxidant intake and survival after glioma diagnosis. Methods Adult patients diagnosed with malignant glioma during 1991-1994 and 1997-2001 were enrolled in a population-based study. Diagnosis was confirmed by review of pathology specimens. A modified food-frequency questionnaire interview was completed by each glioma patient or a designated proxy. Intake of each food item was converted to grams consumed/day. From this nutrient database, 16 antioxidants, calcium, a total antioxidant index and 3 macronutrients were available for survival analysis. Cox regression estimated mortality hazard ratios associated with each nutrient and the antioxidant index adjusting for potential confounders. Nutrient values were categorized into tertiles. Models were stratified by histology (Grades II, III, and IV and conducted for all (including proxy subjects and for a subset of self-reported subjects. Results Geometric mean values for 11 fat-soluble and 6 water-soluble individual antioxidants, antioxidant index and 3 macronutrients were virtually the same when comparing all cases (n = 748 to self-reported cases only (n = 450. For patients diagnosed with Grade II and Grade III histology, moderate (915.8-2118.3 mcg intake of fat-soluble lycopene was associated with poorer survival when compared to low intake (0.0-914.8 mcg, for self-reported cases only. High intake of vitamin E and moderate/high intake of secoisolariciresinol among Grade III patients indicated greater survival for all cases. In Grade IV patients, moderate/high intake of cryptoxanthin and high intake of secoisolariciresinol were associated with poorer survival among all cases. Among Grade II patients, moderate intake of water-soluble folate was associated with greater survival for all cases; high intake of vitamin C and genistein and the highest level of the antioxidant index were associated with poorer survival for all cases. Conclusions The associations observed in our study suggest that the influence of some antioxidants on survival following a diagnosis of malignant glioma are inconsistent and vary by histology group. Further research in a large sample of glioma patients is needed to confirm/refute our results.

  11. Dietary intake of nutrients and its correlation with fatigue in multiple sclerosis patients.

    Sama Bitarafan

    2014-03-01

    Full Text Available The role of nutrition in the progression of multiple sclerosis (MS and related complications such as fatigue has been reported by several studies. The aim of this study is the assessment of nutritional status and its relationship with fatigue in multiple sclerosis patients.This is a cross-sectional study, in which 101 relapsing-remitting MS patients were enrolled. The fatigue status was determined using the validated Persian version of of the Modified Fatigue Impact Scale (MFIS. Dietary intake was assessed using a 3-day food record questionnaire and compared to dietary reference intake (DRI values. Association between variables was determined using Pearson Correlation Coefficient.In the preset study, 25 men and 76 women (total = 101 were enrolled. Analysis of dietary intake showed that daily intake of vitamin D, folate, calcium, and magnesium were significantly lower than DRI in all of patients. In men, zinc intake was significantly lower than DRI; while, in women, iron was significantly below the DRI level. After adjusting for energy, MFIS and its physical subscale were highly correlated with intake of folate and magnesium.Our findings support that lower magnesium and folate diets are correlated with higher fatigue scores in MS patients.

  12. Water intake disorder in a DEND syndrome afflicted patient with R50P mutation.

    Maejima, Yuko; Hasegawa, Shinji; Horita, Shoichiro; Kumamoto, Kensuke; Galvanovskis, Juris; Takenoshita, Seiichi; Shimomura, Kenju

    2015-01-01

    In this study, we present a case of developmental delay, epilepsy and neonatal diabetes (DEND) syndrome in a young male patient with the R50P mutation located in the Kir6.2 subunit of the ATP-sensitive K(+) (KATP) channel. Whereas most patients with DEND syndrome are resistant to sulfonylurea therapy, our patient was responsive to sulfonylurea, lacked the most common neurological symptoms, such as epilepsy, but refused to drink water. His serum electrolytes and plasma osmolarity were normal but the serum vasopressin level was increased. To investigate the underlying mechanism of his water intake disorder, a 5 μL aliquot of 340 μM KATP channel opener diazoxide or 100 μM KATP channel inhibitor glibenclamide was injected into the third ventricle of the rat brain, and water intake was monitored. Although the injection of glibenclamide had no effect, injection of diazoxide significantly increased water intake by about 1.5 fold without affecting food intake. This result indicates that the KATP channel activity in the brain may have an influence on water intake. Here, we present the first case of a DEND syndrome-afflicted patient with water intake disorder and increased serum vasopressin level, possibly related to altered KATP channel activity. PMID:25739471

  13. Dietary Vitamin K Intake Is Associated with Cognition and Behaviour among Geriatric Patients: The CLIP Study

    Justine Chouet

    2015-08-01

    Full Text Available Our objective was to determine whether dietary vitamin K intake was associated with cognition and behavior among older adults. 192 consecutive participants ?65 years, recruited in the cross-sectional CLIP (Cognition and LIPophilic vitamins study, were separated into two groups according to the tertiles of dietary phylloquinone intake (i.e., lowest third below 207 g/day versus the other two thirds combined. Daily dietary phylloquinone intake was estimated from 50-item interviewer-administered food frequency questionnaire. Cognition was assessed with Mini-Mental State Examination (MMSE; behaviour with Frontotemporal Behavioral Rating Scale (FBRS. Age, gender, social problems, education, body mass index (BMI, comorbidities, history of stroke, use vitamin K antagonists, inadequate fatty fish intake, serum thyroid-stimulating hormone (TSH, vitamin B12, albumin, and estimated glomerular filtration rate were used as confounders. Compared to participants in the lowest third of dietary phylloquinone intake (n = 64, those with higher intake had higher (i.e., better mean MMSE score (22.0 5.7 versus 19.9 6.2, p = 0.024 and lower (i.e., better FBRS score (1.5 1.2 versus 1.9 1.3, p = 0.042. In multivariate linear regressions, log dietary phylloquinone intake was positively associated with MMSE score (adjusted ? = 1.66, p = 0.013 and inversely associated with FBRS score (adjusted ? = ?0.33, p = 0.037. Specifically, log dietary phylloquinone intake correlated negatively with FBRS subscore of physical neglect (r = ?0.24, p = 0.001. Higher dietary phylloquinone intake was associated with better cognition and behavior among older adults.

  14. Sodium intake prediction with health promotion model constructs in rural hypertensive patients

    Aziz Kamran; Gholamreza Sharifirad; Yousef Shafaeei; Leila Azadbakht

    2015-01-01

    Background: Hypertension is the most common cause of cardiovascular disease, and the growing epidemic is a serious warning to pay more attention to this disease. The aims of this study were to examine the relationships between the health promotion model (HPM) constructs and sodium intake, and to determine the predictive power of the HPM constructs as the possible mediators of sodium intake in rural Iranian hypertensive patients. Materials and Methods: This cross-sectional study was conducted ...

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

    Zhi-Quan Lu

    2013-12-01

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

  16. Estimation of salt intake from spot urine samples in patients with chronic kidney disease

    Ogura Makoto

    2012-06-01

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

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

    Høidrup, S.; Andreasen, A. H.; Osler, M.; Pedersen, Agnes Nadelmann; Jørgensen, L. M.; Jørgensen, T.; Schroll, M.; Heitmann, B. L.

    2002-01-01

    Objective: To examine the quantitative agreement between a 7 day food record and a diet history interview when these are conducted under the same conditions and to evaluate whether the two methods assess habitual diet intake differently among subgroups of age and body mass index (BMI). Design......: Cross-sectional study. Setting: Population study, Denmark. Subjects: A total of 175 men and 173 women aged 30-60 y, selected randomly from a larger population sample of Danish adults. Interventions: All subjects had habitual diet intake assessed by a diet history interview and completed a 7 day food....... Difference between reported energy intake from both methods and estimated energy expenditure in different subgroups. Results: Energy and macronutrient intake was assessed slightly higher by the 7 day food record than by the diet history interview, but in absolute terms the differences were negligible. The...

  18. Long-Term Methadone Intake and Genotoxicity in Addicted Patients

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

    2015-01-01

    Background: It is well known that contact with some physical, chemical or biological compounds can increase the incidence of mutation. Among these compounds, are pharmaceuticals that meet long duration of use and potentially could be misused and taken more than the ordered dosage. Objectives: The aim of this study was to evaluate mutagenic effect of methadone in addicted patients referred to Imam Khomeini Hospital in Ahvaz by single cell gel electrophoresis technic or comet assay. Patients an...

  19. History of Abuse and Neglect in Patients with Schizophrenia Who Have a History of Violence

    Bennouna-Greene, Mehdi; Bennouna-Greene, Valerie; Berna, Fabrice; Defranoux, Luc

    2011-01-01

    Objective: To determine the prevalence of five forms of abuse/neglect during childhood and adolescence in a group of schizophrenic patients with a history of violence. Methods: Twenty-eight patients hospitalized in a highly secured psychiatric unit were included. Abuse and neglect during patients' growth were evaluated with the childhood trauma…

  20. History of Abuse and Neglect in Patients with Schizophrenia Who Have a History of Violence

    Bennouna-Greene, Mehdi; Bennouna-Greene, Valerie; Berna, Fabrice; Defranoux, Luc

    2011-01-01

    Objective: To determine the prevalence of five forms of abuse/neglect during childhood and adolescence in a group of schizophrenic patients with a history of violence. Methods: Twenty-eight patients hospitalized in a highly secured psychiatric unit were included. Abuse and neglect during patients' growth were evaluated with the childhood trauma

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

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

    2013-01-01

    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

  2. Low Response of Renin-Angiotensin System to Sodium Intake Intervention in Chinese Hypertensive Patients.

    Feng, Weijing; Cai, Qingqing; Yuan, Woliang; Liu, Yu; Bardeesi, Adham Sameer A; Wang, Jingfeng; Chen, Jie; Huang, Hui

    2016-02-01

    The interactions of sodium balance and response of renin-angiotensin-aldosterone system are important for maintaining the hemodynamic stability in physiological conditions. However, the influence of short-term sodium intake intervention in the response of renin-angiotensin system (RAS) on hypertensive patients is still unclear. Thus, we conducted a clinical trial to investigate the effects of short-term sodium intake intervention on the response of RAS in hypertensive patients.One hundred twenty-five primary Chinese hypertensive patients were divided into high, moderate, and low sodium groups by 24-hour urinary sodium excretion (UNa). All the patients received a 10-day dietary sodium intake intervention with standardized sodium (173.91mmol/day) and potassium (61.53mmol/day). Blood pressure, urinary sodium, urinary potassium, plasma sodium, potassium, creatinine, the levels of plasma renin activity, plasma angiotensin II concentrations (AT-II), and plasma aldosterone concentrations were detected before and after the intervention.Before the intervention, no differences were found in blood pressure and RAS among 3 groups. After standardized dietary sodium intake intervention, both UNa excretion and systolic pressure decreased in high-sodium group, while they increased in moderate and low-sodium groups. Intriguingly, there were no changes in the levels of plasma renin activity, AT-II, and plasma aldosterone concentrations among 3 groups during the intervention.The present study demonstrated that the influenced sodium excretion and blood pressure by short-term sodium intake intervention were independent of RAS quick response in Chinese hypertensive patients. PMID:26871780

  3. Assessing Sexual Abuse/Attack Histories with Bariatric Surgery Patients

    Mahony, David

    2010-01-01

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

  4. Evaluation of nutrient intake and diet quality of gastric cancer patients in Korea

    Lim, Heesook; Cho, Gyuseok; Kim, Soonkyung

    2012-01-01

    This study was conducted to identify dietary factors that may affect the occurrence of gastric cancer in Koreans. Preoperative daily nutrition intake and diet quality of patients diagnosed with gastric cancer were evaluated. Collected data were comparatively analyzed by gender. The results were then used to prepare basic materials to aid in the creation of a desirable postoperative nutrition management program. The subjects of this study were 812 patients (562 men and 250 women) who were diag...

  5. Relationship between family meal frequency and individual dietary intake among diabetic patients

    Ruhee, Divya; Mahomoodally, Fawzi

    2015-01-01

    Background Notoriously, the island of Mauritius has one of the highest prevalence of diabetes in the world. Management of the disease is very important and family meals are undoubtedly beneficial to patients as they promote the development of healthy eating behaviours and food choices. This study has aimed to probe into potential relationship(s) between family meal frequency and individual dietary intake among diabetic patients and to establish whether family cohesion may be a plausible media...

  6. Evaluation of dysphagia risk, nutritional status and caloric intake in elderly patients with Alzheimer's

    Vanessa Fernanda Goes

    2014-04-01

    Full Text Available OBJECTIVE: to evaluate the risk of dysphagia and its relationship with the stage of Alzheimer's Disease, as well as the relationship between the risk of dysphagia and nutritional status and caloric intake in elderly people with Alzheimer's disease.METHODS: the sample consisted of 30 subjects of both genders with probable Alzheimer's disease. The stage of the disease, nutritional status, energy intake, and risk of dysphagia were assessed.RESULTS: it was found that increased risk of dysphagia is associated with the advance in the stages of Alzheimer's disease and that even patients in the early stages of disease have a slight risk of developing dysphagia. No association was found between nutritional status and the risk of dysphagia. High levels of inadequate intake of micronutrients were also verified in the patients.CONCLUSION: an association between dysphagia and the development of Alzheimer's disease was found. The results indicate the need to monitor the presence of dysphagia and the micronutrient intake in patients with Alzheimer's disease.

  7. Sodium intake prediction with health promotion model constructs in rural hypertensive patients

    Aziz Kamran

    2015-01-01

    Full Text Available Background: Hypertension is the most common cause of cardiovascular disease, and the growing epidemic is a serious warning to pay more attention to this disease. The aims of this study were to examine the relationships between the health promotion model (HPM constructs and sodium intake, and to determine the predictive power of the HPM constructs as the possible mediators of sodium intake in rural Iranian hypertensive patients. Materials and Methods: This cross-sectional study was conducted on 671 hypertensive patients in Ardabil, Iran in 2013. The data were obtained during a 25-40 min face-to-face conversation by validated and reliable instruments. The nutritional data were assessed with Nutritionist version 4 (N4 software. Descriptive statistics, Spearman?s correlations were calculated using SPSS Statistics version 18.0. Structural equation modeling was conducted using AMOS version 18. Results: Sodium intake was negatively correlated with perceived benefits (r = -0.707; P < 0.01, perceived self-efficacy (r = -0.719; P < 0.01, situational influences (r = -0.590; P < 0.01, interpersonal influences (r = -0.637; P < 0.01, commitment to action (r = -0.605; P < 0.01, affects related behavior (r = -0.499; P < 0.01, and positively associated with the perceived barriers score (r = 0.563; P < 0.01. The structural equation modeling showed that the model explained 63.0% of the variation in sodium intake. Conclusions: HPM constructs were significantly associated with sodium intake and dietary perceptions based on HPM constructs can predict acceptable rate of the variation of sodium intake. Therefore, we suggest using this model constructs to improve the effectiveness of nutritional interventions.

  8. Nutrient intake and nutritional status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia

    Menon, Kavitha; RAZAK, Shariza Abdul; Ismail, Karami A; Krishna, Bhavaraju Venkata Murali

    2014-01-01

    Background Cancer therapy in Malaysia primarily focuses on the clinical management of patients with cancer and malnutrition continues to be one of the major causes of death in these patients. There is a dearth of information on the nutrient intake and status of newly diagnosed patients with cancer prior to the initiation of treatment. The present study aims to assess the nutrient intake and status of newly diagnosed patients with cancer from the East Coast of Peninsular Malaysia. Methods A cr...

  9. Does Preoperative Carbohydrate Intake Reduces Postoperative Stress Response in Patients Undergoing Valve Replacement Surgeries

    Hoda Shokri

    2015-01-01

    Full Text Available Background Cardiac surgery is a stress that causes insulin resistance leading to increased insulin requirements. The aim of our study was to evaluate whether preoperative oral intake of carbohydrate rich drinks could improve outcomes and reduce stress response post valve replacement cardiac surgeries. Methods Our prospective study included 20 ASA 1-3 patients undergoing valve replacement cardiac surgeries.10 patients were fasted after midnight while the other 10 patients received 600 ml of carbohydrate bevering in the evening before the procedure and 150 ml of the drink 2 hours before operation. The following was monitored in all patients: hemodynamics after induction of anesthesia till 24 hours postoperative, insulin resistance (exogenous insulin requirement to keep blood sugar below or equal to 10 mmol/l was used as marker, postoperative discomfort using visual analogue scales, and length of ICU stay. Results Preoperative intake of carbohydrate rich drinks significantly reduced the length of ICU stay (p=0.019 due to reduced postoperative inotropic support requirements and time of mechanical ventilation. Significant reduction in postoperative discomfort and reduced stress response .No significant difference in postoperative level of insulin sensitivity between the two groups. Conclusion Our study showed that although preoperative carbohydrate intake does not reduce insulin resistance postoperatively, it significantly improved other aspects of clinical outcome, in terms of reduced ICU stay, reduced postoperative stress and patient discomfort.

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

    Hansen, T.S.; Engberg, Anders; Larsen, K.

    2008-01-01

    . 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...... planning rehabilitation, giving information to patients and relatives, and designing efficacy studies of facial oral tract therapy, which are highly recommended Udgivelsesdato: 2008/8...

  11. Nutritional status of cancer patients in chemotherapy; dietary intake, nitrogen balance and screening

    Geirsdóttir, Ólöf Guðný; Thorsdottir, Inga

    2008-01-01

    Objective: To evaluate a short screening sheet (SSM) for malnutrition and to investigate the nutritional status of patients receiving chemotherapy for cancer of the lungs, colon or breast at an outpatient clinic. Design: Full nutritional assessment was conducted to define malnutrition and validate the SSM. Additionally, weight change from earlier healthy weight was evaluated, and calculations for intake of energy-giving nutrients (three-day-weighed food records) and protein balance were perfo...

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

    Leila Yazdanpanah

    2010-12-01

    Full Text Available 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.

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

    Nishiura J.L.

    2002-01-01

    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.

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

    Andersson Jan

    2003-07-01

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

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

    Sköldstam Lars

    2005-10-01

    Full Text Available Abstract Background We have previously reported that rheumatoid arthritis patients, who adopted a modified Cretan Mediterranean diet, obtained a reduction in disease activity and an improvement in physical function and vitality. This shift in diet is likely to result in an altered intake of fatty acids. Therefore, the objective of the present study was to examine the dietary intake of fatty acids, as well as the fatty acid profile in serum phospholipids, during the dietary intervention study presented earlier. Results From baseline to the end of the study, changes in the reported consumption of various food groups were observed in the Mediterranean diet group. The change in diet resulted in a number of differences between the Mediterranean diet group and the control diet group regarding the fatty acid intake. For instance, a lower ratio of n-6 to n-3 fatty acids was observed in the Mediterranean diet group, both assessed by diet history interviews (dietary intake and measured in serum phospholipids. Moreover, the patients in the Mediterranean diet group that showed a moderate or better clinical improvement during the study (diet responders, had a higher reported intake of n-3 fatty acids and a lower ratio of n-6 to n-3 fatty acids compared to the patients with minor or no improvement. Also the fatty acid profile in serum phospholipids differed in part between the diet responders and the diet non-responders. Conclusion The changes in the fatty acid profile, indicated both by dietary assessments and through fatty acids in s-phospholipids may, at least in part, explain the beneficial effects of the Cretan Mediterranean diet that we have presented earlier.

  16. 37?Features of 51 Patients With Perioperative Anaphylaxis History

    Garro, Laila Sabino; Rodrigues, Adriana Teixeira; Ribeiro, Marisa Rosimeire; Aun, Marcelo Vivolo; Motta, Antonio Abilio; Kalil, Jorge; Giavina-Bianchi, Pedro

    2012-01-01

    Background To evaluate the prevalence and the etiology of perioperative anaphylaxis (APEO) referred to an outpatient clinic specialized in adverse drug reactions. Methods We evaluated 806 patients throw the questionnaire European Network for Drug Allergy (ENDA) in the period from October 2006 to June 2011. Patients with a history of APEO were selected. The diagnostic criteria for anaphylaxis were based on the World Allergy Organization. Etiological investigation was made with skin tests for latex, neuromuscular blockers (NMBs), antibiotics, hypnotics, opioids and local anesthetics. Provocation tests for antibiotics, NSAIDs, local anesthetics and latex were also done. Specific IgE was tested for antibiotics (Penicillin G and V, Ampicillin and amoxicillin) and latex. Results We identified 51 (6%) patients with a history of APEO. Among them, 16 patients (31%) had hypersensitivity reactions with positive cutaneous test, 14 patients (27%) abandoned the investigation and 8 patients (16%) completed the investigation with all tests negative. Currently 12 patients (23%) are being investigated and one of them (2%) performed tests to drugs to use in the next sirgury. The main cause of APEO was latex allergy (22%), followed by NMB hypersensitivity (6%). Three patients had positive tests for 2 different agents. Conclusions Latex allergy is the main cause of APEO in this study. The importance of testing all the possible agents involved was demonstrated by the occurrence of 3 cases with positive test for 2 agents.

  17. Ingesto alimentar em pacientes com doena inflamatria intestinal / Food intake in patients with inflammatory bowel disease

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

    2011-09-01

    Full Text Available RACIONAL: Pacientes com doena inflamatria intestinal podem apresentar deficincias nutricionais. OBJETIVO: Verificar a adequao da ingesto alimentar de pacientes com doena de Crohn e retocolite ulcerativa inespecfica. MTODOS: Para avaliao da ingesto alimentar de 55 pacientes, 28 com doena [...] de Crohn e 27 com retocolite ulcerativa atendidos em ambulatrio de gastroenterologia, utilizou-se o Recordatrio Alimentar de 24 Horas e o Questionrio de Frequncia Alimentar. A atividade inflamatria da doena foi avaliada pelos nveis sricos de protena C reativa e o ndice de Harvey e Bradshaw. Para comparao de mdias foi usado o teste t no pareado e, para as mdias no paramtricas, o teste de Mann-Whitney, considerando nvel de significncia valor de p Abstract in english BACKGROUND: Patients with inflammatory bowel disease may have nutritional deficiencies. AIM: To verify the adequacy of dietary intake of patients with Crohn's disease and ulcerative colitis. METHODS: To assess food intake of 55 patients, 28 with Crohn's disease and 27 with ulcerative colitis treated [...] in the gastroenterology clinic, was used the 24-Hour Food Recall and Food Frequency Questionnaire. The inflammatory activity of the disease was evaluated by serum C-reactive protein and Harvey and Bradshaw Index. For comparison of means t test was used, and the average on non-parametric, the Mann-Whitney test, with level of significance p

  18. Electronic nutritional intake assessment in patients with urolithiasis: A decision impact analysis

    Heningburg, Avory M.; Mohapatra, Anand; Potretzke, Aaron M.; Paradis, Alethea G.; Vetter, Joel; Kuxhausen, Adrienne N.; McIntosh, Leslie D.; Juehne, Anthony; Desai, Alana C.; Andriole, Gerald L.; Benway, Brian M.

    2016-01-01

    Purpose To evaluate a physician's impression of a urinary stone patient's dietary intake and whether it was dependent on the medium through which the nutritional data were obtained. Furthermore, we sought to determine if using an electronic food frequency questionnaire (FFQ) impacted dietary recommendations for these patients. Materials and Methods Seventy-six patients attended the Stone Clinic over a period of 6 weeks. Seventy-five gave consent for enrollment in our study. Patients completed an office-based interview with a fellowship-trained endourologist, and a FFQ administered on an iPad. The FFQ assessed intake of various dietary components related to stone development, such as oxalate and calcium. The urologists were blinded to the identity of patients' FFQ results. Based on the office-based interview and the FFQ results, the urologists provided separate assessments of the impact of nutrition and hydration on the patient's stone disease (nutrition impact score and hydration impact score, respectively) and treatment recommendations. Multivariate logistic regressions were used to compare pre-FFQ data to post-FFQ data. Results Higher FFQ scores for sodium (odds ratio [OR], 1.02; p=0.02) and fluids (OR, 1.03, p=0.04) were associated with a higher nutritional impact score. None of the FFQ parameters impacted hydration impact score. A higher FFQ score for oxalate (OR, 1.07; p=0.02) was associated with the addition of at least one treatment recommendation. Conclusions Information derived from a FFQ can yield a significant impact on a physician's assessment of stone risks and decision for management of stone disease. PMID:27195318

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

    Mupere Ezekiel

    2012-12-01

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

  20. Evaluation of nutrient intake and diet quality of gastric cancer patients in Korea.

    Lim, Heesook; Cho, Gyuseok; Kim, Soonkyung

    2012-06-01

    This study was conducted to identify dietary factors that may affect the occurrence of gastric cancer in Koreans. Preoperative daily nutrition intake and diet quality of patients diagnosed with gastric cancer were evaluated. Collected data were comparatively analyzed by gender. The results were then used to prepare basic materials to aid in the creation of a desirable postoperative nutrition management program. The subjects of this study were 812 patients (562 men and 250 women) who were diagnosed with gastric cancer and admitted for surgery at Soonchunhyang University Hospital between January 2003 and December 2010. Nutrition intake and diet quality were evaluated by the 24-hr recall method, the nutrient adequacy ratio, mean adequacy ratio (MAR), nutrient density (ND), index of nutritional quality (INQ), dietary variety score (DVS), and dietary diversity score (DDS). The rate of skipping meals and eating fast, alcohol consumption, and smoking were significantly higher in males than those in females. The levels of energy, protein, fat, carbohydrate, phosphorous, sodium, potassium, vitamin B(1), vitamin B(2), niacin, and cholesterol consumption were significantly higher in males than those in females. Intake of fiber, zinc, vitamin A, retinol, carotene, folic acid were significantly higher in females than those in males. MAR in males was significantly higher (0.83) than that in females (0.79). INQ values were higher in females for zinc, vitamin A, vitamin B(2), vitamin B(6), and folic acid than those in males. The average DVS was 17.63 for females and 13.19 for males. The average DDS was 3.68 and the male's average score was 3.44, whereas the female's average score was 3.92. In conclusion, males had more dietary habit problems and poor nutritional balance than those of females. Our findings suggest that proper nutritional management and adequate dietary education for the primary prevention of gastric cancer should be emphasized in men. PMID:22808345

  1. An experimental approach to the effects of reproductive strategy and food intake on early life-history traits in a brood-care Mediterranean polychaete

    Martin, Daniel; Cha, Jae-Hoon; Nozais, Christian; Bhaud, Michel

    1998-01-01

    We examined the effects of reproductive strategy and food Intake on the early life history traits of a Mediterranean population of Eupolyrnn~a nebulosa, a deposit-feeding, tubicolous polychaete. In the ~Vediterranean E. nebulosa are brood-caring, maturlty is attained at 2 yr and up to 4 cocoons are produced per female each year, whlch reduces larval dispersal. In the Atlantic E nebulosa are freespawning, they mature in their first year of life and they produce larger offspring, wh...

  2. Intake of ruminant trans-fatty acids, assessed by diet history interview, and changes in measured body size, shape and composition

    Plambeck Hansen, Camilla; Heitmann, Berit L; Sørensen, Thorkild Ia; Overvad, Kim; Jakobsen, Marianne U

    2016-01-01

    and body composition (body fat percentage). DESIGN: A 6-year follow-up study. Information on dietary intake was collected through diet history interviews, and anthropometric and bioelectrical impedance measurements were obtained by trained technicians at baseline (1987-1988) and at follow-up (1993...... the range present in the Danish population was not significantly associated with subsequent changes in body size, shape or composition and the 95 % confidence intervals indicate that any relevant associations are unlikely to have produced these observations....

  3. Does pragmatically structured outpatient dietary counselling reduce sodium intake in hypertensive patients? Study protocol for a randomized controlled trial

    Ruzicka, Marcel; Ramsay, Tim; Bugeja, Ann; Edwards, Cedric; Fodor, George; Kirby, Anne; Magner, Peter; McCormick, Brendan; van der Hoef, Gigi; Wagner, Jessica; Hiremath, Swapnil

    2015-01-01

    Background Hypertension is highly prevalent among adults, and is the most important modifiable risk factor for cardiovascular events, in particular stroke. Decreasing sodium intake has the potential to prevent or delay the development of hypertension and improve blood pressure control, independently of blood pressure lowering drugs, among hypertensive patients. Despite guidelines recommending a low sodium diet, especially for hypertensive individuals, sodium intake remains higher than recomme...

  4. Food Intake of Selenium and Sulphur AminoAcids in Tuberculosis Patients and Healthy Adults in Malawi

    Eick, Frode

    2007-01-01

    Background Tuberculosis is a world wide pandemic and a major problem for people in low income countries. The intracellular infection has a bidirectional link with under nutrition, and wasting is a common symptom of the disease. Wasting in tuberculosis patients is associated with the severity of lung disease, low serum level of selenium and higher mortality. Low serum levels may be due to low intake or high body consumption of the components. No assessment of intake of selenium and sulphur ami...

  5. The art of history-taking in a headache patient

    K Ravishankar

    2012-01-01

    Full Text Available Headache is a common complaint that makes up for approximately 25% of any neurologists outpatient practice. Yet, it is often underdiagnosed and undertreated. Ninety percent of headaches seen in practice are due to a primary headache disorder where there are no confirmatory tests, and neuroimaging studies, if done, are normal. In this situation, a good headache history allows the physician to recognize a pattern that in turn leads to the correct diagnosis. A comprehensive history needs time, interest, focus and establishment of rapport with the patient. When to ask what question to elicit which information, is an art that is acquired by practice and improves with experience. This review discusses the art of history-taking in headache patients across different settings. The nuances of headache history-taking are discussed in detail, particularly the questions related to the time, severity, location and frequency of the headache syndrome in general and the episode in particular. An emphasis is made on the recognition of red flags that help in the identification of secondary headaches.

  6. Bone Health History in Breast Cancer Patients on Aromatase Inhibitors

    Kwan, Marilyn L.; Lo, Joan C; TANG, Li; Laurent, Cecile A.; Roh, Janise M; Chandra, Malini; Hahn, Theresa E.; HONG, CHI-CHEN; Sucheston-Campbell, Lara; Hershman, Dawn L.; QUESENBERRY, Charles P.; Ambrosone, Christine B.; Kushi, Lawrence H; Yao, Song

    2014-01-01

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

  7. Evaluation of fiber intake in diabetes 2 patients of an asistencial center of Rosario city

    María Elisa Zapata

    2013-09-01

    Full Text Available Introduction: a diet high in fiber has associated with better glycaemic control in diabetes 2 patients, being the soluble fraction of the most effective in the control of blood sugar levels. The aim of the study is determine the amount of total, soluble and insoluble dietary fiber intake by patients with type 2 diabetes who attended a medical centre for diabetics in Rosario.Material and methods: descriptive, observational, cross-sectional study was conducted. It was determined a sample of 60 adults with a diagnosis of diabetes type 2 >6 months, 18 to 70 years old, with no disease or intestinal disorders. A semiquantitative food frequency questionnaire of foods source of dietary fiber, and a photo album was used to identify the portion size. Descriptive statistical analysis was performed and Chi-square and ANOVA test was used to evaluate the association.Results: the average consumption of total fiber was 18,8±5,9 g/d, 14, 8±4,6 g/d corresponded to insoluble fiber and 4,0±1,5 g/d to soluble fiber. Fruits and vegetables contributed 82% of soluble fiber. Most patients (62% had a consumption of fiber total less than the recommendation of the ADA, and 60% presented an inadequate relationship between intake of soluble and insoluble fiber.Conclusions: it is necessary to increase the contribution of total dietary fiber, especially the soluble fraction in diabetes 2 patients, because there are evidences that supports its benefits.

  8. Prognostic factors of epilepsy in patients with neonatal seizures history

    Banani Sidiq

    2013-07-01

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

  9. Usual Dietary Intake Among Female Breast Cancer Survivors is Not Significantly Different From Women With No Cancer History: Results of the National Health and Nutrition Examination Survey, 2003–2006

    Milliron, Brandy-Joe; Vitolins, Mara Z.; Tooze, Janet A.

    2013-01-01

    Dietary intake is a modifiable behavior that may reduce the risk of recurrence and death among breast cancer survivors. Cancer survivors are encouraged to consume a diet rich in fruit, vegetables, and whole grains; and limit red meat, processed meat, and alcohol intake. Using the National Health and Nutrition Examination Survey (2003–2006), this study examined whether breast cancer survivors and women with no history of cancer differed in the distribution of usual intake of foods included in ...

  10. The cardiometabolic benefits of flavonoids and dark chocolate intake in patients at risk

    Andra-Iulia Suceveanu

    2014-02-01

    Full Text Available Scientific research proves that the cardiac and the metabolic functions are improved by the consumption of flavonoids, natural elements found in cocoa. The dark chocolate is the main alimentary compound rich in flavonoids, and for this reason it can be used to prevent some cardiometabolic disorders. This study aims to demonstrate the relationship between chocolate consumption and the cardiometabolic disorders risk in 85 patients hospitalized in Internal Medicine Unit of Emergency Hospital “St. Apostle Andrew” of Constanta. Patients were split according to the quantity of the dark chocolate consumption into 2 groups. The study groups were matched by the demographic parameters, the BMI, the physical activity and other risk factors (fats, saturated lipids, etc. We found that the daily consumption of dark chocolate, with content of cocoa > 35% according to European recommendations, had cardiometabolic benefits. The risk of coronary heart disease was reduced with 23% by the daily dark chocolate intake. The cardiovascular disease mortality and the risk of any cardiovascular disease were decreased with 19%, respectively with 38%. The risk of incident diabetes decreased with 28% after daily dark chocolate consumption, regardless the gender of patients. The number of ischemic cerebral events was reduced with 32%. In summary, the daily consumption of dark chocolate rich in flavonoids decreases the cardiometabolic disorders in patients at risk [1].

  11. The association of functional oral intake and pneumonia in patients with severe Traumatic Brain Injury

    Schow, Trine; Larsen, Klaus; Engberg, Aase Worså

    2008-01-01

    identified patients at highest risk of pneumonia: Glasgow Coma score (GCS) <9 (one day after cessation of sedation); Ranchos Los Amigos scale (RLA) <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...

  12. Pre-hospital dietary intake correlates with muscle mass at the time of fracture in older hip fractured patients

    Francesco Landi

    2014-11-01

    Conclusions. A low intake of calories, protein and leucine is associated with reduced muscle mass in hip fractured elderly. Given the relevance of sarcopenia as a risk factor for adverse outcomes in this patient population, our findings highlight the importance of a comprehensive dietary assessment for the detection of nutritional deficits predisposing to or aggravating muscle atrophy.

  13. Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients

    Chan, Annie On On; Leung, Gigi; Tong, Teresa; Wong, Nina YH

    2007-01-01

    AIM: To investigate if increased dietary fiber, in terms of kiwifruit, is effective in Chinese constipated patients. METHODS: 33 constipated patients and 20 healthy volunteers were recruited for a 4-wk treatment of kiwi fruit twice daily. Response during wk 1-4 was defined as an increase in complete spontaneous bowl, motion (CSBM) ≥ 1/wk. Secondary efficacy included response during wk 1-4, individual symptoms and scores of bowel habits and constipation. Responses were compared with the baseline run-in period. Colonic transit time and anorectal manometry were performed before and after treatment. RESULTS: Responder rate was 54.5% in the constipated group. The mean CSBM increased after treatment (2.2 ± 2.6 vs 4.4 ± 4.6, P = 0.013). There was also improvement in the scores for bothersomeness of constipation (P = 0.02), and satisfaction of bowel habit (P = 0.001), and decreased in days of laxative used (P = 0.003). There was also improvement in transit time (P = 0.003) and rectal sensation (P < 0.05). However, there was no change in the bowel symptoms or anorectal physiology in the healthy subjects. CONCLUSION: Increasing dietary fiber intake is effective in relieving chronic constipation in Chinese population. PMID:17729399

  14. More than Just Not Being Alone: The Number, Nature, and Complementarity of Meal-Time Social Interactions Influence Food Intake in Hospitalized Elderly Patients

    Paquet, Catherine; St.-Arnaud-McKenzie, Danielle; Ma, Zhenfeng; Kergoat, Marie-Jeanne; Ferland, Guylaine; Dube, Laurette

    2008-01-01

    Purpose: This study evaluated the social facilitation of elderly patients' food intake beyond the presence of mealtime companions by assessing various relationships. The study examined the relationships between patients' intake and (a) the number of interpersonal exchanges with mealtime fellows, (b) the nature of behaviors expressed by the…

  15. History of Nutrition: The Long Road Leading to the Dietary Reference Intakes for the United States and Canada.

    Murphy, Suzanne P; Yates, Allison A; Atkinson, Stephanie A; Barr, Susan I; Dwyer, Johanna

    2016-01-01

    The Dietary Reference Intakes (DRIs) are reference values to guide the planning and assessing of nutrient intakes in the United States and Canada. The DRI framework was conceptualized in 1994, and the first reports were issued from 1997–2004, based on work by expert panels and subcommittees under the guidance of the Food and Nutrition Board of the Institute of Medicine. Numerous conventions, challenges, and controversies were encountered during the process of defining and setting the DRIs, including the definition of the framework, the use of chronic disease endpoints, lack of data on requirements for children and youth, and methods for addressing nonessential bioactive substances with potential health benefits. DRIs may be used to plan and assess the nutrient intakes of both individuals and population groups, but the new paradigm particularly improved methods used for groups. It is now possible to estimate both the prevalence of inadequate intake and the prevalence of potentially excessive intake within a group. The DRIs have served as a potent influence on national nutrition policies, including those related to dietary guidance, food labeling, nutrition monitoring, food assistance programs, and military nutrition standards. Because of this important impact on nutrition policy, the DRIs must be based on the best possible and most up-to-date science. Unfortunately, no updates to specific DRIs are currently planned. Despite the long and challenging road that led to the current DRIs, it must not finish in a dead end. Monetary resources and political will are crucial to maintaining and continuously updating the DRIs. PMID:27180379

  16. Relationship between selenium intake and inflammatory markers in newly-diagnosed patients with B-cell non-Hodgkin lymphoma

    Mourad Aribi; Naima Mesli

    2013-01-01

    Background: Non-Hodgkin lymphoma (NHL) is the seventh most common cancer in the world. They are malignancies that develop from lymphoid cells. Selenium can modulate the expression of multiple cellular signaling pathways leading to decreased inflammatory gene expression. Objectives: To determine the relationship between selenium intake and inflammatory markers in newly-diagnosed patients with B-cell NHL. Materials and Methods: Newly-diagnosed patients with B-cell NHL and healthy age- and sex...

  17. Effect of high fiber intake in fish oil-treated patients with non-insulin-dependent diabetes mellitus.

    Sheehan, J P; Wei, I W; Ulchaker, M; Tserng, K Y

    1997-11-01

    The short-term effect of high fiber intake on fish-oil treatment in 15 free-living, non-insulin-dependent diabetic patients was evaluated by using a controlled, sequential study design. During an 8-wk fish-oil-treatment period when patients received 20 g fish oil/d, the usual daily fiber intake was increased with a 15-g pectin supplement at midpoint. Fish oil alone lowered triacylglycerol and very-low-density-lipoprotein-cholesterol concentrations by 41% and 36%, respectively (both P cholesterol concentrations. When the fiber intake was increased, however, total and low-density-lipoprotein-cholesterol concentrations decreased significantly (P cholesterol ester fraction of plasma lipids was reduced by 34% when compared with fish oil alone (P < 0.05). The plasma triacylglycerol fraction decreased further by 44% (P < 0.001). Other beneficial effects observed included a 30% decline in the fatty acid fraction (P < 0.002) by end of the treatment period. Diabetic control was maintained during the 12-wk study. In conclusion, a high fiber intake may be beneficial in fish oil-treated diabetic patients. PMID:9356537

  18. The Metabolic Effects of Oats Intake in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

    Qingtao Hou

    2015-12-01

    Full Text Available The present study aimed to comprehensively assess if oats intake is beneficial for diabetic patients. The literature search was conducted in PubMed database up to 23 August 2015. Fourteen controlled trials and two uncontrolled observational studies were included. Compared with the controls, oats intake significantly reduced the concentrations of glycosylated hemoglobin A1c (HbA1c (MD, −0.42%; 95% CI, −0.61% to −0.23%, fasting blood glucose (FBG (MD, −0.39 mmol/L; 95% CI, −0.58 to −0.19 mmol/L, total cholesterol (TC (MD, −0.49 mmol/L; 95% CI, −0.86 to −0.12 mmol/L, low-density lipoprotein cholesterol (LDL-C (MD, −0.29 mmol/L; 95% CI, −0.48 to −0.09 mmol/L. Oatmeal significantly reduced the acute postprandial glucose and insulin responses compared with the control meal. The present study has revealed a beneficial effect of oats intake on glucose control and lipid profiles in type 2 diabetic patients. Further investigations of oats intake in patients with type 1 diabetes and the safety of oats consumption are required.

  19. The Malnutrition Universal Screening Tool (MUST) and a nutrition education program for high risk cancer patients: strategies to improve dietary intake in cancer patients.

    Chao, Pei-Chun; Chuang, Hui-Ju; Tsao, Li-Yen; Chen, Pei-Ying; Hsu, Chia-Fen; Lin, Hsing-Chun; Chang, Chiu-Yueh; Lin, Cheau-Feng

    2015-09-01

    Four hundred and forty-four high-risk oncology patients with malnutrition participated in this study aimed at assessing the effectiveness of nutrition education on improving an oncology patient's dietary intake. We used a nutritional risk screening to select oncology patients in need of nutritional care. Team Nutrition provides technical assistance for foodservice, nutrition education for patients and their caregivers, and support for healthy eating and physical activity to improve their diets and their lives. The average contribution of protein and total energy of each patient increased after imparting the nutritional education to them. Thus, nutritional education is an effective measure to bring about a favorable and significant change in oncology patients' nutrient intake. PMID:26264480

  20. A history of arterial hypertension does not affect mortality in patients hospitalised with congestive heart failure

    Gustafsson, F; Torp-Pedersen, C; Seibaek, M; Burchardt, H; Nielsen, O Wendelboe; Køber, L

    2006-01-01

    OBJECTIVES: To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF). DESIGN: Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients had...... studies, could not be confirmed. CONCLUSION: A history of arterial hypertension did not affect mortality in patients hospitalised with CHF....

  1. The Malnutrition Universal Screening Tool (MUST) and a nutrition education program for high risk cancer patients: strategies to improve dietary intake in cancer patients

    Chao, Pei-Chun; Chuang, Hui-Ju; Tsao, Li-Yen; Chen, Pei-Ying; Hsu, Chia-Fen; Lin, Hsing-Chun; Chang, Chiu-Yueh; Lin, Cheau-Feng

    2015-01-01

    Four hundred and forty-four high-risk oncology patients with malnutrition participated in this study aimed at assessing the effectiveness of nutrition education on improving an oncology patient’s dietary intake. We used a nutritional risk screening to select oncology patients in need of nutritional care. Team Nutrition provides technical assistance for foodservice, nutrition education for patients and their caregivers, and support for healthy eating and physical activity to improve their diet...

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

    Powell Jonathan J

    2013-01-01

    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.

  3. Ingesta oral do paciente hospitalizado com disfagia orofarngea neurognica Oral Intake of hospitalized patient with neurogenic oropharyngeal dysphagia

    Carolina Castelli Silvrio

    2010-12-01

    Full Text Available OBJETIVO: verificar a evoluo na ingesta oral e a ocorrncia de broncopneumonias (BCP em pacientes hospitalizados com disfagia orofarngea neurognica, aps atuao fonoaudiolgica. MTODOS: 50 pacientes adultos, divididos em grupos: I: 31 pacientes ps-acidente vascular enceflico; II: sete pacientes ps-traumatismo crnio-enceflico; III: 12 pacientes com demncia. Foram levantadas as informaes antes e aps a atuao fonoaudiolgica: nvel da Functional Oral Intake Scale (FOIS, ocorrncia de BCP; nmero de atendimentos fonoaudiolgicos e motivo de interrupo destes. RESULTADOS: houve aumento significativo dos nveis da escala FOIS e reduo do percentual de ocorrncia de BCP nos trs grupos estudados. Nos grupos ps-AVE e demncia a interrupo da fonoterapia ocorreu devido alta hospitalar, enquanto que no grupo ps-TCE devido alta fonoaudiolgica. CONCLUSO: os pacientes deste estudo demonstraram avanar das consistncias alimentares na ingesta oral, e reduo da ocorrncia de BCP, aps a interveno fonoaudiolgica com relao disfagia.PURPOSE: to investigate the development in oral intake and the incidence of bronchopneumonia (BCP in hospitalized patients with neurogenic oropharyngeal dysphagia, after speech and language therapy intervention. METHODS: 50 adult patients, divided in three groups: I: 31 post stroke patients; II: seven brain injury patients ; III: 12 dementia patients. Data collected before and after the speech and language therapy intervention were: staff classification in Functional Oral Intake Scale (FOIS, incidence of BCP, number of therapies and reason for their interruption. RESULTS: significant increase in the levels of FOIS scale and reduction in incidence of pneumonia in the three studied groups. In the post stroke and dementia groups the reason for therapy interruption was hospital discharge, and in the group of brain injury the reason was speech and language therapy discharge. CONCLUSION: the studied patients show increase in food consistency as for oral intake and reductions of BCP after speech and language therapy intervention related to swallowing disorders.

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

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

    2012-01-01

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

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

    C.L. Battaglini

    2008-08-01

    Full Text Available The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake (TCI of breast cancer patients undergoing treatment. A secondary purpose was to determine whether or not a relationship existed between changes in TCI, body fat composition (%BF, and fatigue during the study, which lasted 6 months. Twenty females recently diagnosed with breast cancer, scheduled to undergo chemotherapy or radiation, were assigned randomly to an experimental (N = 10 or control group (N = 10. Outcome measures included TCI (3-day food diary, %BF (skinfolds, and fatigue (revised Piper Fatigue Scale. Each exercise session was conducted as follows: initial cardiovascular activity (6-12 min, followed by stretching (5-10 min, resistance training (15-30 min, and a cool-down (approximately 8 min. Significant changes in TCI were observed among groups (F1,18 = 8.582; P = 0.009, at treatments 2 and 3, and at the end of the study [experimental (1973 ± 419, control (1488 ± 418; experimental (1946 ± 437, control (1436 ± 429; experimental (2315 ± 455, control (1474 ± 294, respectively]. A significant negative correlation was found (Spearman rho(18 = -0.759; P < 0.001 between TCI and %BF and between TCI and fatigue levels (Spearman rho(18 = -0.541; P = 0.014 at the end of the study. In conclusion, the results of this study suggest that an exercise intervention administered to breast cancer patients undergoing medical treatment may assist in the mitigation of some treatment side effects, including decreased TCI, increased fatigue, and negative changes in body composition.

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

    Bruna Nolasco Siqueira, Silva; sis Luclia Santos Borges de, Arajo; Pedrita Mirella Albuquerque, Queiroz; Angela Luzia Branco Pinto, Duarte; Maria Goretti Pessoa de Arajo, Burgos.

    2014-12-01

    Full Text Available Objectivo: investigar o consumo alimentar de antioxidantes em pacientes portadores de artrite reumatoide. Mtodos: estudo transversal do tipo srie de casos com 53 mulheres acompanhadas no [...] Ambulatrio de Reumatologia do Hospital das Clnicas da Universidade Federal de Pernambuco (HC-UFPE), de janeiro a outubro de 2012. Por meio de formulrio, foram coletados parmetros sociodemogrficos e antropomtricos (peso, estatura, ndice de massa corprea [IMC], alterao ponderal). A avaliao do consumo alimentar foi realizada por questionrio de frequncia alimentar semiquantitativo, analisado por tabela de composio de alimentos. A construo do banco de dados e a anlise estatstica foram realizadas por Excel e SPSS verso 18.0, com aplicao de testes Qui-quadrado, Anova e t-Student, com nvel de confiana de 5%. Resultados: demonstrou-se que os pacientes apresentaram baixo consumo de vitaminas A, C e zinco. Portanto, ressalta-se a importncia de maior consumo de alimentos fontes em antioxidantes, a fim de contribuir para a preveno da leso articular e a perda da funo reumtica, melhorando a qualidade de vida do paciente. Concluso: demonstrou-se que os pacientes apresentaram baixo consumo de vitaminas A, C e zinco. Portanto, ressalta-se a importncia de maior consumo de alimentos fontes em antioxidantes, a fim de contribuir para a preveno da leso articular e a perda da funo reumtica, melhorando a qualidade de vida do paciente. Abstract in english Objective: to investigate dietary intake of antioxidants in patients with rheumatoid arthritis. Methods: this is a cross-sectional case series study with 53 women accompanied at the [...] Rheumatology Outpatient Clinic, Hospital das Clnicas/UFPE, from January to October 2012. Demographic and anthropometric parameters (weight, height, body mass index, weight change) were collected by means of a form. The assessment of food consumption was conducted using a semi-quantitative food frequency survey, analyzed according to a food composition table. Database construction and statistical analysis were performed using Excel and SPSS version 18.0, using chi-squared test, Anova, and Students t-test, at a confidence level of 5%. Results: the sample was composed of 53 women with a mean age of 54.51 4.24 years and BMI of 25.97 5.94 kg/m. In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant. Conclusion: the sample was composed of 53 women with a mean age of 54.51 4.24 years and BMI of 25.97 5.94 kg/m. In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant.

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

    Huang Jui-Hua

    2012-06-01

    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.

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

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

    2011-01-01

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

  9. Acute psychological stress affects glucose concentrations in patients with type 1 diabetes following food intake but not in the fasting state

    Wiesli, P; Schmid, C; Kerwer, O; Nigg-Koch, C; Klaghofer, R; Seifert, Burkhardt; Spinas, G A; Schwegler, K

    2005-01-01

    OBJECTIVE: To compare the effect of acute psychosocial stress on glucose concentrations in the fasting state and following food intake in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: In study 1, 20 patients were exposed to moderate psychosocial stress by means of the Trier Social Stress Test (TSST) in the fasting state. In study 2, the TSST was applied to 20 additional patients 75 min after intake of a standard meal. Glucose concentrations (by continuous glucose monitoring syst...

  10. A PDA-based dietary self-monitoring intervention to reduce sodium intake in an in-center hemodialysis patient

    Sevick, Mary Ann; Stone, Roslyn A; Novak, Matthew; Piraino, Beth; Snetselaar, Linda; Marsh, Rita M; Hall, Beth; Lash, Heather; Bernardini, Judith; Burke, Lora E

    2008-01-01

    Objective The purpose of the BalanceWise-hemodialysis study is to determine the efficacy of a dietary intervention to reduce dietary sodium intake in patients receiving maintenance, in-center hemodialysis (HD). Personal digital assistant (PDA)-based dietary self-monitoring is paired with behavioral counseling. The purpose of this report is to present a case study of one participant’s progression through the intervention. Methods The PDA was individually programmed with the nutritional require...

  11. [The effect of food intake, atropine and No-spa on autonomic tonus and hemodynamic indices in patients with peptic ulcer].

    Dotsenko, N Ia

    1989-10-01

    A study of 40 patients with duodenal ulcer by means of methods of variational pulsimetry and tetrapolar rheography revealed noncoordination of the regulation of the central and regional hemodynamics after intake of food. Atropin produced an inhibitory effect on the central hemodynamics, reduction of blood volume in the abdominal cavity after No-spa intake. PMID:2617974

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

    Bonfils, Peter K; Taskiran, Mustafa; Damgaard, Morten; Goetze, Jens P; Floyd, Andrea K; Funch-Jensen, Peter; Kristiansen, Viggo B; Gadsbøll, Niels

    2013-01-01

    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...

  13. Dietary calcium intake in a cohort of elderly patients already in drug therapy for osteoporosis. Is it possible and how to modify the eating habits before calcium supplementation?

    Ciro Manzo

    2015-08-01

    Full Text Available Inadequate intake of calcium via the diet is very common in patients taking drugs for osteoporosis. We have evaluated 302 consecutive elderly patients (68.6 median age attending our Rheumatological and Orthopedic Outpatient Clinics using a questionnaire for evaluation of dietary calcium intake. Two hundred and forty of these had a questionnaire score 7 in 205/240 after an average period of 3-6 months. In the 35 patients in which this was not possible, the exact knowledge of calcium dietary intake (poor or absent has allowed a tailored calcium supplementation.

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

    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

  15. Improvement of functional constipation with kiwifruit intake in a Mediterranean patient population: An open, non-randomized pilot study

    Oriol Cunillera

    2015-07-01

    Full Text Available Introduction: Kiwifruit consumption has shown to improve functional constipation in healthy elderly population, according to studies in New Zealand and China. The aim of this study was to evaluate the effect of kiwifruit intake on functional constipation in a Mediterranean patient population characterized by its distinctive nutritional habits.Material and Methods: An open, non-controlled and non-randomized longitudinal study was conducted in 46 patients with constipation (Rome III criteria. Patients monitored for five weeks: weeks 1 and 2 no kiwifruit and weeks 3-5 three kiwifruit per day (Green kiwifruit, Actinidia deliciosa var Hayward. Bristol Scale, volume of stools, and ease of defecation was self- reported daily. The evolution of the categorical variables was tested using the Bhapkar test; functional data methodology was used for continuous variables, and Generalized Estimating Equation (GEE models were adjusted.Results: The percentage of patients with ≥3 stools per week increased from 82.61% (95% CI: 69–91.2 at week 1 to 97.78% (95% CI: 87.4–99.9 at week 2 of kiwifruit intake, with 76.09% (95% CI: 61.9–86.2 responding during the first week. The reporting of stable ideal stools increased from 17.39% (95% CI: 8.8–31 at week 2 to 33.33% (95% CI: 21.3–48 at week 5. According to GEE models, the number of depositions increased significantly (p-values<0.001 in 0.398 daily units at week 1 the first week of intake, up to 0.593 daily units at week 5; significant improvements on facility in evacuation and volume of evacuation were found from the firstweek of intake (all p-values<0.001.Conclusions: The intake of three kiwifruits per day significantly improves the quality of evacuation (number of depositions, volume, consistency and ease in a Mediterranean patient population suffering from functional constipation.

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

    Hosein Khosravi-Broojeni

    2008-01-01

    Full Text Available Introduction: To evaluate the dietary content of micronutrients in first-degree relatives of type II diabetic patients, with respect to the influence of dietary composition on the development of diabetes. Methods and Materials: 210 first-degree relatives of type II diabetic patients were divided into 2 groups (normal and IGT+ diabetic, according to the results of OGTT. 3-Day food recall questionnaire was completed by skilled nutritionists from all subjects. The participants intake of calorie, magnesium, zinc, calcium, phosphorus, chromium and vitamins B1, B6, C and E was calculated and the results were compared between 2 groups. Results: The mean of age and BMI were 48.9 ? 5.2, 43.6 ? 6.7 years (P=0.373 and 29.3 ? 0.7, 28.7 ? 0.8 kg/m2 in impaired and normal groups, respectively. No significant difference was observed in energy, magnesium, zinc, calcium, phosphorus, chromium and vitamins B1, B6, C and E intake between 2 groups. Conclusion: Although the micronutrient intake between studied groups didnt differ significantly, the dietary content of chromium, magnesium, zinc and vitamin E was less than recommended daily allowance values. This finding can be taken into consideration with respect to the influence of some micronutrients, including magnesium and chromium, on glucose tolerance and insulin resistance.

  17. Successful use of clozapine in a patient with a history of neuroleptic malignant syndrome.

    Stoudemire, A; Clayton, L

    1989-01-01

    Reinstitution of antipsychotic medication is problematic in patients with a history of neuroleptic malignant syndrome (NMS). In this case, a patient with a history of probable neuroleptic malignant syndrome caused by administration, as single agents, of haloperidol, molindone, and lithium was later treated successfully with the novel antipsychotic clozapine. The propensity of various antipsychotic agents to cause NMS is discussed. PMID:2577714

  18. Optical coherence tomography plaque characterization in a patient with ST segment elevation myocardial infarction after cocaine intake.

    Hansen, Morten Steen Svarer; Antonsen, Lisbeth; Jensen, Lisette Okkels

    2016-01-01

    A 28-year old man presented to the Emergency Department with malaise after cocaine intake. After arrival he developed retrosternal chest pain and the electrocardiogram showed ST segment elevations in V1-V2 and ST segment depressions in V5-V6. An acute coronary angiogram revealed a focal non-occlusive lesion with thrombus in the left anterior descending artery. Supplementary optical coherence tomography (OCT) detected plaque erosion with adherent thrombus to be the responsible underlying pathophysiological mechanism. The patient received an effective antithrombotic regimen. Repeat angiogram with additional OCT one month later documented thrombus resolution and complete restoration of the previously eroded coronary vascular surface area. PMID:26905053

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

    D. A. De, Luis; A., Armentia; P. L., Muoz; A., Dueas-Laita; B., Martn; B. De la, Fuente; O., Izaola.

    2010-08-01

    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 mtodos: Se incluyeron un total de 32 varones. La edad med [...] ia fue de 37,25 8,8 aos. A todos los pacientes se les determin el peso corporal, la talla y el ndice de masa corporal y se realiz una encuesta nutricional. Resultados: La ingesta calrica total fue de 3.350,1 979 kcal/da. La distribucin de caloras fue de un 44,3% en forma de hidratos de carbono, un 14% en protenas y un 41,7% en grasas (50,6% grasas monoinsaturadas, 36,3% grasas saturadas y el 13,1% grasas polinsaturadas). La ingesta absoluta de protenas fue evelada (109,6 38,5 g/da) as como la ingesta corregida por peso (1,62 0,73). Con referencia a los minerales y vitaminas, existi una baja ingesta de vitamina D, E, cido flico, 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 estadsticamente significativas en la ingesta diettica ni en el peso entre los dos grupos de consumidores de marihuana en funcion de la mediana de tiempo de consumo (19 aos). Conclusiones: Los pacientes fumadores de marihuana realizan una dieta hipercalorica e hiperproteica, rica en grasas y con un aporte por encima de lo recomendado de micronutrientes. Todo ello sin relacionarse con el peso del paciente. Abstract in english Background: Marihuana use has effects on appetite; studies in the literature on this topic area are limited. The aim of our work was to evaluate the dietary intake of marihuana smoking patietns. Patients and methods: A total of 32 male subjects were enrolled (average age 37.25 8.8 years). In all p [...] atients were determined weight, height and body mass index and a three days nutritional questionnaire. Results: Total calories intakes were higher (3,350.1 979 kcal/day). Distribution of calories was 44.3% of carbohydrates, 14% of proteins and 41.7% of lipids (50.6% mono-unsaturate fats, 36.3% saturate fats and 13.1% poluunsaturated fats). Total protein intake was 109.6 38.5 g/day and corrected by weight was 1.62 0.73 g/kg. Low intake of vitamin D, E, folic, magnesium and iodine were detected. High intake of vitamin A, C, K, thiamine, riboflavine, B6, niacin, B12, calcium, iron and zinc were observed. No statistical differences in dietary ntake or weight were detected between groups of marihuana users by median of consumtion time of this drug. Conclusions: Marihuana smoking patients realized a hipercloric and hiperproteic diet, with high amounts of fats and with an intake of micronutrients above international recommendations. This dietary intake has not related with weight.

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

    Vanessa Fernanda Goes

    2014-04-01

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

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

    Sköldstam Lars; Nilsson Ingela; Hagfors Linda; Johansson Gunnar

    2005-01-01

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

  2. Improving Students’ Sexual History Inquiry and HIV Counseling with an Interactive Workshop Using Standardized Patients

    Haist, Steven A; Griffith, Charles H; Hoellein, Andrew R; Talente, Gregg; Montgomery, Thomas; Wilson, John F

    2004-01-01

    Sexual history and HIV counseling are essential clinical skills. Our project's purpose was to evaluate a standardized patient (SP) educational intervention teaching third-year medical students sexual history taking and HIV counseling. A 4-hour SP workshop was delivered to one-half of the class. Four weeks later, all students engaged in an SP examination including one station on assessing sexual history taking and HIV counseling. Workshop participants scored one standard deviation higher on se...

  3. Does a physician's specialty influence the recording of medication history in patients' case notes?

    Yusuff, Kazeem B; Tayo, Fola

    2008-01-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECTPhysicians undertake the documentation of medication history during clerking; where all the necessary information that guides the diagnostic and patient management tasks are obtained.Medication histories documented by physicians are often incomplete and generally sketchy; however, the impact of a physician's specialty on the frequency and depth of medication history they document has not been studied.WHAT THIS STUDY ADDSThe depth and frequency of medica...

  4. Completeness of pedigree and family cancer history for ovarian cancer patients

    Son, Yedong; Lim, Myong Cheol; Seo, Sang Soo; Kang, Sokbom; Park, Sang-yoon

    2014-01-01

    Objective To investigate the completeness of pedigree and of number of pedigree analysis to know the acceptable familial history in Korean women with ovarian cancer. Methods Interview was conducted in 50 ovarian cancer patients for obtaining familial history three times over the 6 weeks. The completeness of pedigree is estimated in terms of familial history of disease (cancer), health status (health living, disease and death), and onset age of disease and death. Results The completion of pedi...

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

    Manisha Singh

    2011-12-01

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

  6. Platelet function in patients with a history of unexplained recurrent miscarriage who subsequently miscarry again.

    Dempsey, Mark Anthony

    2015-05-01

    This study was designed to evaluate platelet aggregation in pregnant women with a history of unexplained recurrent miscarriage (RM) and to compare platelet function in such patients who go on to have either another subsequent miscarriage or a successful pregnancy.

  7. Prevalence of Dysglycemia Among Coronary Artery Bypass Surgery Patients with No Previous Diabetic History

    Farid Mina

    2011-09-01

    Full Text Available Abstract Background Dysglycemia is a major risk factor for atherosclerosis. In many patient populations dysglycemia is under-diagnosed. Patients with severe coronary artery disease commonly have dysglycemia and there is growing evidence that dysglycemia, irrespective of underlying history of diabetes, is associated with adverse outcome in coronary artery bypass graft (CABG surgery patients, including longer hospital stay, wound infections, and higher mortality. As HbA1c is an easy and reliable way of checking for dysglycemia we routinely screen all patients undergoing CABG for elevations in HbA1c. Our hypothesis was that a substantial number of patients with dysglycemia that could be identified at the time of cardiothoracic surgery despite having no apparent history of diabetes. Methods 1045 consecutive patients undergoing CABG between 2007 and 2009 had HbA1c measured pre-operatively. The 2010 American Diabetes Association (ADA diagnostic guidelines were used to categorize patients with no known history of diabetes as having diabetes (HbA1c ? 6.5% or increased risk for diabetes (HbA1c 5.7-6.4%. Results Of the 1045 patients with pre-operative HbA1c measurements, 40% (n = 415 had a known history of diabetes and 60% (n = 630 had no known history of diabetes. For the 630 patients with no known diabetic history: 207 (32.9% had a normal HbA1c ( Conclusion Among individuals undergoing CABG with no known history of diabetes, there is a substantial amount of undiagnosed dysglycemia. Even though labeling these patients as "diabetic" or "increased risk for diabetes" remains controversial in terms of perioperative management, pre-operative screening could lead to appropriate post-operative follow up to mitigate short-term adverse outcome and provide high priority medical referrals of this at risk population.

  8. The Accuracy of Self-Reported Drug Ingestion Histories In Emergency Department Patients

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

    2014-01-01

    Inaccuracies in self-reports may lead to duplication of therapy, failure to appreciate non-compliance leading to exacerbation of chronic medical conditions, or inaccurate research conclusions. Our objective is to determine the accuracy of self-reported drug ingestion histories in patients presenting to an urban academic emergency department (ED). We conducted a prospective cohort study in ED patients presenting for pain or nausea. We obtained a structured drug ingestion history including all ...

  9. Reinstitution of neuroleptic treatment with molindone in a patient with a history of neuroleptic malignant syndrome.

    Slack, T; Stoudemire, A

    1989-09-01

    The decision to reinstitute neuroleptic treatment in patients with a history of neuroleptic treatment is fraught with hazards. A case is reported in which neuroleptic treatment was successfully reintroduced with molindone after previous bouts of neuroleptic malignant syndrome (NMS) with trifluoperazine and thioridazine. Molindone may represent an alternative neuroleptic to consider in patients with a history of NMS, although all neuroleptics including clozapine and molindone may potentially precipitate this syndrome. PMID:2507394

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

    Li-Chuan Ma

    2004-12-01

    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.

  11. The History of Patient-Reported Outcomes in Rheumatology.

    Callahan, Leigh F

    2016-05-01

    The rheumatology community began incorporating patient-reported outcomes in the early 1980s, helping shift the care of chronic diseases from a narrower biomedical model to a broader biopsychosocial model of health. Early efforts were focused primarily in clinical trials and clinical research, but over the last decade there has been increasing use in routine rheumatology clinical care. More than 250 valid and reliable scales to assess domains of importance to patients with rheumatic conditions have been developed. The approach to measurement continues to be refined. Rheumatology has much to be proud of in contributions to the important field of patient-reported outcomes. PMID:27133485

  12. Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis

    Stella Maris Costa Castro

    2013-07-01

    Full Text Available Objective It was to investigate visual field (VF abnormalities in a group of multiple sclerosis (MS patients in the remission phase and the presence of magnetic resonance imaging (MRI lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years: 35 relapsing-remitting MS patients [20 optic neuritis (+, 15 optic neuritis (-] and 25 controls. MRI (3-Tesla was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

  13. Greater Calcium Intake is Associated with Better Bone Health Measured by Quantitative Ultrasound of the Phalanges in Pediatric Patients Treated with Anticonvulsant Drugs

    Vicente Vera

    2015-12-01

    Full Text Available We aimed to investigate and compare the effects of chronic antiepileptic therapy on bone health in pediatric patients using quantitative ultrasound of the phalanges (QUS and controlling for potential confounding factors, particularly nutrient intake. The amplitude-dependent speed of sound (Ad-SoS was measured in 33 epileptic children and 32 healthy children aged 6.5 ± 3.1 and 6.3 ± 1.1 (mean ± SD years, respectively. There were no significant differences in the demographics such as age, weight and height between epileptic children and the control group children. None of the children in the epileptic or the treatment group were found to have a vitamin D deficiency. There were no significant differences in laboratory tests between groups. Lower QUS figures were found in the epileptic children (p = 0.001. After further adjustment for potential confounders such age, height, weight, calcium intake, vitamin D intake, physical activity and sex, the differences remained significant (p < 0.001. After further classification of the participants based on the tertile of calcium intake, no significant differences were found between patients and healthy controls in the greatest tertile of calcium intake (p = 0.217. We conclude that anticonvulsant therapy using valproate may lead to low bone mass in children and that an adequate intake of calcium might counteract such deleterious effects.

  14. Neurodegenerative changes in patients with clinical history of bipolar disorders.

    Shioya, Ayako; Saito, Yuko; Arima, Kunimasa; Kakuta, Yukio; Yuzuriha, Takefumi; Tanaka, Noriko; Murayama, Shigeo; Tamaoka, Akira

    2015-06-01

    Neurodegeneration in bipolar disorder (BPD) is poorly understood. Therefore, the current study was designed to assess the immunohistochemical changes in neurodegenerative markers in patients with BPD. Eleven consecutive autopsy cases diagnosed with BPD were analyzed. Sections were obtained from archival paraffin blocks of representative areas and stained using conventional methods, as well as immunostained with several antibodies to screen for neurodegenerative diseases. Age- and non-argyrophilic grains (AGs) degeneration matched controls were selected for each case. Clinical information was retrospectively collected from medical charts. All patients were men, and the average age of death was 70 years. Neuropathological diagnoses included dementia with grains (2), argyrophilic grain disease (2), corticobasal degeneration (CBD, 1), Lewy body disease (1), hypoxic encephalopathy (1) and cerebral infarction (1). All cases showed AGs to various degrees. Three patients died in their 50s; one demonstrated dementia with Lewy bodies, while the other two showed abundant AGs in the thalamus and amygdala. Of the three patients who died in their 60s, one showed AGs preferentially in the thalamus and amygdala, while the others demonstrated limbic predominance. The patients who died in/after their 70s demonstrated AGs similar to controls, except for the patient with CBD. Our data provides potentiality that neurodegenerative diseases may be an underlying pathology in certain cases of BPD. PMID:25819679

  15. Family History and Functional Outcome in Korean Stroke Patients: A Preliminary Study

    Park, Hee Jung; Kim, Tae Uk; Hyun, Jung Keun

    2015-01-01

    Objective To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. Methods A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage. Stroke severity as assessed with the National Institutes of Health Stroke Scale (NIHSS), functional outcomes using the Korean version of the Modified Barthel index (K-MBI), Functional Independence Measurement (FIM), and cognitive function using the Korean version of Mini-Mental State Examination (K-MMSE) were assessed at admission and discharge. Results Subjects with a family history of stroke were more likely to have an ischemic stroke (90.7%) than were those without a family history (70.9%). The K-MBI, FIM, NIHSS, and K-MMSE scores did not show significant differences between patients with or without family history. Conclusion Family history of stroke was significantly associated with ischemic stroke, but not with functional outcomes. Other prognostic factors of stroke were not distributed differently between patients included in this study with or without a family history of stroke. PMID:26798613

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

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

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

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

    2011-01-01

    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

  18. The importance of a travel history in the preoperative assessment of an elective surgical patient

    Shao, Emily Han; Hayes, Ellen Martina; Khwaja, Haris A; Efthimiou, Evangelos

    2011-01-01

    The authors present the case of a 43-year-old gentleman who was admitted for an elective surgical removal of an eroded gastric band. The patient reported no medical concerns and other than a mild anaemia of haemoglobin of 10.6, his preoperative assessment was non-significant. Postoperatively, the patient spiked temperatures on multiple occasions. When a travel history was subsequently taken, the patient revealed he had returned from Nigeria the night before his elective surgery. The patient t...

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

    Glintborg, Bente; Poulsen, Henrik E; Dalhoff, Kim P

    2008-01-01

    What is already known about this subject: Structured medication interviews improve the medication history upon hospitalization. Pharmacy records are valid lists of the prescribed medications available to individual patients. In Denmark, treating doctors now have access to their patients' pharmacy...... records through a real-time online electronic database What this study adds: Omission errors are frequent among hospitalized patients despite structured drug interviews and home visits. Pharmacy records may be used to minimize patients' recall bias and improve the medication lists....

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

    Hansen, T.S.; Larsen, K.; Engberg, Anders

    2008-01-01

    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...

  1. [Haemolytic crisis of blackwater fever following artemether-lumefantrine intake].

    Aloni, N M; Nsangu, M; Kunuanunua, T; Kadima, T B; Muanda, T F

    2010-12-01

    A second haemolytic crisis of blackwater fever (BWF) following a combination of artemether-lumefantrine intake, in an 8-year-old Congolese boy is reported. The patient had a history of BWF after quinine intake. He was given artemether-lumefantrine treatment for malaria. He was free from G6PD deficiency and abnormal haemoglobin. Sepsis was eliminated. Haemolysis was noted with 5.6 g/dl of haemoglobin, negative direct antiglobulin test, and LDH at 893 IU/l. Low-level Plasmodium falciparum was found. The outcome was favourable with rehydration. BWF has been described with quinine, mefloquine and halofantrine. Several case reports have been published of haemolysis after lumefantrine, but it is quite rare. This case has a major therapeutic implication: aryl-amino-alcohol should be strictly contraindicated in patients with history of BWF with aryl-amino-alcohols intake. PMID:20658275

  2. Effects of Intake of Milk Enriched with Aloe vera on Patients with Gastrointestinal Reflux Disease

    Marta Sangil-Monroy; Lluís Serra-Majem; José M. Marrero Monroy; Adriana Ortiz Andrellucchi; Almudena Sánchez-Villegas; Jorge Doreste; Paul Knipschild

    2014-01-01

    Background: Aloe vera has been used by many civilizations throughout history due to the numerous properties attributed. Gastro oesophageal reflux disease is a common disorder with consequences for the patient’s health related quality of life. Aims: The purpose of this study was to assess the benefits of the Aloe vera in 80 patients with gastro oesophageal reflux. Methods: This is probably the first randomised and double-blind trail ever performed on this subject. The st...

  3. Comparison of patients rehospitalized for heart failure with versus without a history of habitual alcohol consumption.

    Panikkath, Ragesh; Suvorava, Natalia; Ngo, Neena; Panikkath, Deepa; Lim, Sian Yik; Umyarova, Elvira; Meyerrose, Gary

    2014-07-01

    Alcohol paradoxically is known to have a protective and a deleterious effect on the heart. The effect of alcoholism on the growing problem of heart failure (HF) readmissions is not known. This study addressed this issue with a population of adult patients (>20 years old) who were readmitted for HF within 30 days after a hospitalization for HF at a university hospital in West Texas for a period of 5 years. Of the 204 patients with HF who were readmitted, 130 were admitted for HF exacerbations and 74 for unrelated medical conditions. Seventy-two (55%) were men, and the patients' mean age was 67 ± 15 years. Only 32 patients (24%) had a history of alcoholism. The mean age was significantly lower in patients with a history of alcoholism than in those without (62 ± 11 vs. 67 ± 15 years; P = 0.03), and there were more men in the group with a history of alcoholism (78% vs. 52%; P = 0.006). The mean ejection fraction was significantly lower in patients with a history of alcoholism than in those without (35 ± 19% vs. 39 ± 16%, P = 0.04). The length of stay was slightly longer in patients with a history of alcoholism, although the difference was not statistically significant (6 ± 5 vs. 5 ± 4 days; P = 0.52). Although alcohol contributed to only less than one quarter of hospital admissions, these patients were relatively younger and were predominantly males, compared to the sex-matched distribution of patients without a history of alcoholism. PMID:24982560

  4. Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care.

    Lim, Jennifer N W; Hewison, Jenny; Chu, Carol E; Al-Habsi, Hamdan

    2011-03-01

    Patient self-initiated consultations to discuss family history of cancer in primary care and the factors leading to these consultations have not been investigated. Seventy-one out of 150 asymptomatic patients with a family history of cancer at the Yorkshire Cancer Genetics Service participated in this study. A semi-structured questionnaire was administered. The results show that (1) family cancer events, doctors' advice and reaching the age of cancer-affected relatives were more salient in raising awareness of the added cancer risk due to family history than media and publicity, and knowledge of the genetics services; (2) knowledge of family medical history and its clinical value is not easy to ascertain; (3) the inter-relationships with other causal beliefs are of interest and could provide insights to understand the factors motivating patients to discuss family history or cancer risk; (4) the belief that 'cancer runs in the family' or is 'a family thing' may not be sufficient to heighten perceived cancer risk and motivate patients to seek medical advice; and (5) understanding of the medical concept and clinical value of family history is poor even in this group of patients who initiated the GP consultations. In conclusion, because most primary care practitioners are likely to rely on patient initiated discussion to identify individuals at an increased risk of cancer because of their family history, these findings are therefore important to help doctors and health providers understand the reasons influencing asymptomatic patients to self-refer themselves in primary care and discuss cancer risk in order to provide appropriate care. PMID:22109720

  5. Beneficial effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials.

    Harima-Mizusawa, Naomi; Kamachi, Keiko; Kano, Mitsuyoshi; Nozaki, Daisuke; Uetake, Tatsuo; Yokomizo, Yuji; Nagino, Takayuki; Tanaka, Akira; Miyazaki, Kouji; Nakamura, Shinichiro

    2016-01-01

    This study aimed to examine whether daily intake of citrus juice containing heat-killed Lactobacillus plantarum YIT 0132 (LP0132-fermented juice) alleviates symptoms of atopic dermatitis. This was a natural extension of our previous study in which LP0132 was shown to enhance IL-10 production in vitro and LP0132-fermented juice was found to alleviate symptoms and enhance quality of life (QOL) in patients with Japanese cedar pollinosis. In two open trials, Trial 1 and Trial 2, 32 and 18 adult patients with mild to moderate atopic dermatitis consumed LP0132-fermented juice for 8 weeks. Skin conditions and QOL were subjectively evaluated using Skindex-16 before intake of the juice (Pre-treatment), 8 weeks after starting intake (Treatment) and 8 weeks after termination of intake (Post-treatment). Blood parameters were also analyzed. Comparison of the Treatment and Post-treatment time points with the Pre-treatment time point revealed significant reductions in the Skindex-16 overall score and the 3 domain subscores (symptoms, emotions, and functioning domains) in both trials. Moreover, blood levels of eosinophil cationic protein (ECP), total immunoglobulin E (IgE) and specific IgEs for Japanese cedar and cypress pollen were significantly attenuated in Trial 2. The findings suggest that daily intake of citrus fermented juice containing heat-killed LP0132 has beneficial effects on symptoms and QOL in patients with mild to moderate atopic dermatitis due to an immunomodulatory effect via attenuation of IgE and ECP. PMID:26858928

  6. Achieving Activity Transitions in Physician-Patient Encounters: From History Taking to Physical Examination.

    Robinson, Jeffrey D.; Stivers, Tanya

    2001-01-01

    Examines how physicians and patients interactionally accomplish the transition from the activity of history taking to that of physical examination. Finds implications for: the theoretic relationship between verbal and nonverbal behavior in social meaning; what it means to explain transitions and reduce patients' uncertainty; the organization of

  7. 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

    Guillermina Natera-Rey

    2001-02-01

    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 MTODOS: Los datos corresponden a una muestra de poblacin general (n= 8 890 y fueron recopilados a partir de una encuesta nacional de adicciones en poblacin urbana de Mxico, realizada en 1988. Se determinaron medidas epidemiolgicas de frecuencia y asociacin considerando los antecedentes de HF+ como factor de exposicin. 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 sndrome de dependencia fueron 9.9% para hombres y 0.6% para las mujeres. Los hombres con HF+ tienen dos veces ms probabilidad de desarrollar el sndrome de dependencia que aquellos con HF-. La razn de momios en el grupo de mujeres fue de 1.27. CONCLUSIONES: Se observaron patrones diferenciales por sexo en la transmisin de problemas de consumo. El consumo de los padres representa un factor de riesgo importante para el desarrollo del sndrome de dependencia de los hijos. El texto completo en ingls de este artculo est 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

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

    Hansen, Trine S; Engberg, Aase W; Larsen, Klaus

    2008-01-01

    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...

  9. A study on first intake assessments of in-patient referrals to psychiatric rehabilitation services

    Geetha Desai

    2014-01-01

    Full Text Available Background: Psychiatric rehabilitation is an important component in mental health services. The rehabilitation needs of patients with mental illness have been highlighted in various studies. The studies on in-patient referrals to rehabilitation services however are sparse. This study describes the clinical and demographic details and the reasons for referrals to rehabilitation services during the in-patients stay. Materials and Methods: A semi-structured pro forma was used for the assessment of in-patients referred for the psychiatric rehabilitation services. The pro forma included socio-demographic details such as background, family resources, illness related details such as symptom status, risk assessment, medication details. The total number of referrals for a period of 5 months was collected and coded. Results: The total number of referrals for a period of 5 months was 216 and there were 197 forms available for the study. The mean age of the sample was 31.48 ± 10.46 years. Vocational rehabilitation was the commonest reason for referral to the in-patient services. Severe mental disorders were the most common diagnosis of patients refereed to the services. Conclusions: Patients with severe mental illness were most often referred to the in-patient services. This indicates that we need include to rehabilitation in the management plan at the earliest. Vocational rehabilitation is the most common reason for referrals and there is a need to develop services to cater to these needs.

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

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

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

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

    2010-01-01

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

  12. Psychiatric History and Adaptation in Burn Injured Patients

    Dyster-Aas, Johan

    2006-01-01

    The intertwined relationship between physical and psychological problems is a topic of much interest in the rehabilitation of severely injured patients, e.g. after a burn. The present study aims at gaining further knowledge concerning the impact of psychological factors and psychiatric morbidity on short and long-term adaptation after burn injury. Outcome was assessed for three main areas: pruritus, return to work and psychiatric health. Three separate samples of previous or current adult pat...

  13. [Metabolic response of cirrhotic patients (Child A) to the increase of protein and/or caloric intake. Nitrogen balance study].

    Dichi, J B; Dichi, I; Papini-Berto, S J; Bicudo, M H; Angeleli, A Y; Rezende, T A; Burini, R C

    1992-01-01

    The dietary protein assimilation by cirrhotic undernourished patients (lower lean body mass and plasma TBPA and RBP levels) was investigated in five-adult male subjects suffering from histologically diagnosed liver cirrhosis, in its clinically mild stage (Child-Turcotte-Pugh grade A). During the 9 day-dietary study the patients received orally a sequence of complete-regional diets containing different protein-energy compositions identified as (g prot/Cal/kg/day): D0 = 0.42/20.9; D1 = 0.91/37.5; D2 = 0.99/47.9 and D3 = 1.60/40.5. The respective N-balance values (g/day) found were (mean +/- SD): low protein calorie (D0) = -4.24 +/- 2.46; normal protein calorie (D1) = 0.66 +/- 1.99; normal protein-high calorie (D2) = 1.14 +/- 2.54; high protein normal calorie (D3) = 5.12 +/- 2.48. The correspondent urea-N output (g/kg/day) were D0 = 0.22 +/- 0.100; D1 = 0.238 +/- 0.099; D = 0.20 +/- 0.063 and D3 = 0.310 +/- 0.121. The present data thus suggest that protein rather than energy intake would be the limited factor for increasing the N-retention in (mild) cirrhotic patients whom tolerate well dietary protein at either normal or elevated levels. PMID:1340747

  14. Aberrant crypt foci in patients with a positive family history of sporadic colorectal cancer.

    Stevens, Richard G; Swede, Helen; Heinen, Christopher D; Jablonski, Melissa; Grupka, Michael; Ross, Barry; Parente, Melissa; Tirnauer, Jennifer S; Giardina, Charles; Rajan, Thiruchandurai V; Rosenberg, Daniel W; Levine, Joel

    2007-04-18

    Early detection is crucial in the prevention of colorectal cancer (CRC) deaths. The earliest detectable neoplastic lesion in the colon is the aberrant crypt foci (ACF). A major question is whether ACF are precursors of CRC, and thus, early biomarkers for CRC risk. If so, we hypothesized that the number of ACF would be higher in patients who had a family history of CRC compared to patients without. We counted ACF in the distal 20cm of colon/rectum during 103 colonoscopic examinations using a prototype Close Focus Colonoscope (Olympus Corp.) with methylene blue chromendoscopy. Each patient was asked whether they had a family history of CRC in a first degree relative, or a personal history of CRC or adenoma. Patients answering 'no' to these questions (n=17) had a mean number of ACF of 4.4; the mean was significantly higher in the patients with a positive family history of CRC (9.0, p<0.01; n=43) or a personal history of advanced adenoma (7.5, p<0.05; n=34). PMID:16950561

  15. ASSOCIATION OF CAFFEINE INTAKE AND LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C

    Kalinca da Silva OLIVEIRA

    2015-03-01

    Full Text Available Background Caffeine consumption has been associated to decreased levels of liver enzymes and lower risk of fibrosis in patients with hepatitis C virus. Objectives This study aimed to evaluate the association between caffeine consumption and inflammatory activity or degree of liver fibrosis in patients with hepatitis C virus infection. Methods A cross-sectional study of patients with chronic hepatitis C virus infection treated in an outpatient Gastroenterology Unit of Santa Casa Hospital (Porto Alegre - Brasil. Patients were interviewed regarding the consumption of caffeine and anthropometric assessment was performed. Liver biopsy was performed in a maximum period of 36 months before inclusion in the study Results There were 113 patients, 67 (59.3% females, 48 (42.5% were aged between 52 and 62 years, and 101 (89.4% were white. The average caffeine consumption was 251.41 ± 232.32 mg/day, and 70 (62% patients consumed up to 250 mg/day of caffeine. There was no association between caffeine consumption and inflammatory activity on liver biopsy. On the other hand, when evaluating the caffeine consumption liver fibrosis an inverse association was observed. Conclusions The greater consumption of caffeine was associated with lower liver fibrosis. There was no association between caffeine consumption and inflammatory activity.

  16. The Natural History and Predictors for Intervention in Patients with Small Renal Mass Undergoing Active Surveillance

    Zaher Bahouth; Sarel Halachmi; Gil Meyer; Ofir Avitan; Boaz Moskovitz; Ofer Nativ

    2015-01-01

    Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients wi...

  17. BRCA1 status in Pakistani breast cancer patients with moderate family history

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

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

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

    2005-08-01

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

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

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

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

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

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

    Ashraf Moini

    2012-01-01

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

  2. The relationship between vegetables and fruits intake and glycosylated hemoglobin values, lipids profiles and nitrogen status in type II inactive diabetic patients

    Marjan Tabesh

    2013-01-01

    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.

  3. The cardiometabolic benefits of flavonoids and dark chocolate intake in patients at risk

    Andra-Iulia Suceveanu; Laura Mazilu; A. Suceveanu; Irinel Parepa; Doina Catrinoiu; Paris, S; F. Voinea

    2014-01-01

    Scientific research proves that the cardiac and the metabolic functions are improved by the consumption of flavonoids, natural elements found in cocoa. The dark chocolate is the main alimentary compound rich in flavonoids, and for this reason it can be used to prevent some cardiometabolic disorders. This study aims to demonstrate the relationship between chocolate consumption and the cardiometabolic disorders risk in 85 patients hospitalized in Internal Medicine Unit of Emergency Hospital “St...

  4. Serum carnitine as an independent biomarker of malnutrition in patients with impaired oral intake

    Iwamoto, Junichi; Honda, Akira; Miyamoto, Yasunori; Miyazaki, Teruo; Murakami, Masashi; Saito, Yoshifumi; Ikegami, Tadashi; Miyamoto, Jiro; Matsuzaki, Yasushi

    2014-01-01

    Carnitine is a vitamin-like compound that plays important roles in fatty acid ?-oxidation and the control of the mitochondrial coenzyme A/acetyl-CoA ratio. However, carnitine is not added to ordinary enteral nutrition or total parenteral nutrition. In this study, we determined the serum carnitine concentrations in subjects receiving ordinary enteral nutrition (EN) or total parenteral nutrition (TPN) and in patients with inflammatory bowel diseases to compare its levels with those of other nutritional markers. Serum samples obtained from 11 EN and 11 TPN patients and 82 healthy controls were examined. In addition, 10 Crohns disease and 10 ulcerative colitis patients with malnutrition who were barely able to ingest an ordinary diet were also evaluated. Carnitine and its derivatives were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The carnitine concentrations in EN and TPN subjects were significantly lower compared with those of the control subjects. Neither the serum albumin nor the total cholesterol level was correlated with the carnitine concentration, although a significant positive correlation was found between the serum albumin and total cholesterol levels. Indeed, patients with CD and UC showed significantly reduced serum albumin and/or total cholesterol levels, but their carnitine concentrations remained normal. In conclusion, only a complete blockade of an ordinary diet, such as EN or TPN, caused a reduction in the serum carnitine concentration. Serum carnitine may be an independent biomarker of malnutrition, and its supplementation is needed in EN and TPN subjects even if their serum albumin and total cholesterol levels are normal. PMID:25411530

  5. Serum carnitine as an independent biomarker of malnutrition in patients with impaired oral intake

    Iwamoto, Junichi; Honda, Akira; Miyamoto, Yasunori; Miyazaki, Teruo; Murakami, Masashi; Saito, Yoshifumi; Ikegami, Tadashi; Miyamoto, Jiro; Matsuzaki, Yasushi

    2014-01-01

    Carnitine is a vitamin-like compound that plays important roles in fatty acid β-oxidation and the control of the mitochondrial coenzyme A/acetyl-CoA ratio. However, carnitine is not added to ordinary enteral nutrition or total parenteral nutrition. In this study, we determined the serum carnitine concentrations in subjects receiving ordinary enteral nutrition (EN) or total parenteral nutrition (TPN) and in patients with inflammatory bowel diseases to compare its levels with those of other nut...

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

    Nakao,Hiroko

    1988-01-01

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

  7. Dietary intake of female bariatric patients after anti-obesity gastroplasty Ingesto diettica de pacientes baritricas femininas aps gastroplastia anti-obesidade

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

    2006-01-01

    PURPOSE: Roux-en-Y gastric bypass is a popular and successful operation for the treatment of morbid obesity. However, it greatly restricts ingestion and moderately interferes with absorption of food, thus potentially paving the way for undernutrition, especially during the first year before patients adapt to the new condition. Aiming to document actual dietary intake during this period, a prospective observational study was performed. METHODS: Forty consecutive patients were investigated usin...

  8. The single intake of levodopa modulates implicit learning in drug naïve, de novo patients with idiopathic Parkinson's disease.

    Geffe, Sarah; Schindlbeck, Katharina A; Mehl, Arne; Jende, Johann; Klostermann, Fabian; Marzinzik, Frank

    2016-06-01

    Although dopamine is known to aggravate implicit learning, the exact impact on behaviour when feedback is unavailable remains unclear. Previous studies revealed that non-rewarded learning habits are affected in long-term dopaminergic treated patients with Parkinson's disease (PD). We studied the influence of a onetime levodopa intake on implicit learning in de novo, untreated PD patients. De novo PD patients (n = 22) before and after the single intake of levodopa and control subjects (n = 23) took part in a Go/NoGo paradigm. One stimulus was defined as target, which was first consistently preceded by one of three non-target stimuli (conditioning). This coupling was dissolved thereafter (deconditioning). In the 'Go version' subjects were asked to respond to the target by pressing a key, whereas in the 'NoGo version' response had to be inhibited. PD patients and controls (n = 14/n = 19) with an initial learning effect due to the target were included for further statistical analysis. Within the subgroup incorrect responses upon NoGo stimuli increased during the deconditioning phase. In contrast, the same patients failed to show any change after receiving 200 mg of levodopa. During the Go version, no change of the overall error rate between conditioning and deconditioning was detectable over all groups. Learning behaviour in untreated PD patients and healthy controls was indistinguishable. In contrast, the same patients varied in their implicit learning after one-time intake of levodopa, when actions had to be inhibited. Hence, the single intake of levodopa appears to modulate implicit learning behaviour in de novo PD patients. PMID:27106907

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

    Lauritsen Jens M

    2011-05-01

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

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

    Ines Panjkota Krbavčić; Martina Sučić

    2007-01-01

    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...

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

    Stefańska, Ewa

    2014-02-01

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

  12. Approaches to the History of Patients: From the Ancient World to Early Modern Europe.

    Stolberg, Michael

    2016-01-01

    This chapter looks from an early modernist's perspective at some of the major questions and methodological issues that writing the history of patients in the ancient world shares with similar work on Patientengeschichte in medieval and early modern Europe. It addresses, in particular, the problem of finding adequate sources that give access to the patients' experience of illness and medicine and highlights the potential as well as the limitations of using physicians' case histories for that purpose. It discusses the doctor-patient relationship as it emerges from these sources, and the impact of the patient's point of view on learned medical theory and practice. In conclusion, it pleads for a cautious and nuanced approach to the controversial issue of retrospective diagnosis, recommending that historians consistently ask in which contexts and in what way the application of modern diagnostic labels to pre-modern accounts of illness can truly contribute to a better historical understanding rather than distort it. PMID:26946692

  13. The importance of a travel history in the preoperative assessment of an elective surgical patient.

    Shao, Emily Han; Hayes, Ellen Martina; Khwaja, Haris A; Efthimiou, Evangelos

    2011-01-01

    The authors present the case of a 43-year-old gentleman who was admitted for an elective surgical removal of an eroded gastric band. The patient reported no medical concerns and other than a mild anaemia of haemoglobin of 10.6, his preoperative assessment was non-significant. Postoperatively, the patient spiked temperatures on multiple occasions. When a travel history was subsequently taken, the patient revealed he had returned from Nigeria the night before his elective surgery. The patient tested positive for Plasmodium falciparum malaria for which he was successfully managed with oral quinine and doxycycline, and recuperated well both from malaria and the surgery. P falciparum malaria is a medical emergency and increases the morbidity and mortality of anaesthesia and surgery. Travel histories are not currently routinely taken as part of the preoperative assessment for elective surgical admissions; the authors argue that it should become a mandatory part. PMID:22674102

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

    Alice Freitas da Silva

    2011-09-01

    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.

  15. Asymmetrical F-18 Flurorodeoxyglucose uptake in the breasts: A dilemma solved by patient history

    Gupta, Ravi Kant; Tripathi, Madhavi; Sahoo, Manas Kumar; Nazar, Aftab Hasan; Agarwal, Krishankant; Kumar, Kunal; Damle, Nishikant; Bal, Chandrasekhar

    2016-01-01

    The present case highlights the importance of history taking in solving the dilemmas of variant F-18 FDG uptake on PET/CT. Asymmetrically increased, abnormal looking, FDG uptake in the right breast of our patient was related to her breast feeding practice. Because of personal preference the patient suckled her child from the right breast only. This resulted in asymmetry of size, increase in glandular breast parenchyma and FDG uptake in the breast that was suckled. PMID:26917909

  16. Radionuclide ventriculographic assessment of myocardial contractile function in patients with the history of myocardial infarction

    Radionuclide ventriculography (RNVG) was used to assess the changes of the left ventricle myocardium contractile function in 95 patients with the history of myocardial infarction Balanced cardio synchronized RNVG with 99mTc complex compounds was performed by means of LFOV-IV gamma-camera. The developed complex approach to estimation of regional contractile myocardial infarction allows to perform objective evaluation of normo-, hypo-, hyper kinetic areas and visualize asynergy of contraction, increases diagnostic RNVG informativity in the cardiologic patients

  17. Eye disorders in patients with multiple sclerosis: natural history and management

    Graves, Jennifer; Balcer, Laura J.

    2010-01-01

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system and leading cause of disability in young adults. Vision impairment is a common component of disability for this population of patients. Injury to the optic nerve, brainstem, and cerebellum leads to characteristic syndromes affecting both the afferent and efferent visual pathways. The objective of this review is to summarize the spectrum of eye disorders in patients with MS, their natural history, and current stra...

  18. Natural history and survival of 14 patients with corticobasal degeneration confirmed at postmortem examination

    Wenning, G; Litvan, I; J. Jankovic; Granata, R; Mangone, C; A. McKee; Poewe, W.; JELLINGER, K; Chaudhuri, K.; D'Olhaberriague, L; Pearce, R.

    1998-01-01

    OBJECTIVETo analyse the natural history and survival of corticobasal degeneration by investigating the clinical features of 14 cases confirmed by postmortem examination.?METHODSPatients with definite corticobasal degeneration were selected from the research and clinical files of seven tertiary medical centres in Austria, the United Kingdom, and the United States. Clinical features were analysed in detail.?RESULTSThe sample consisted of eight female and six male patients; ...

  19. Diet History Is a Reliable Predictor of Suboptimal Docosahexaenoic Acid Levels in Adult Patients with Phenylketonuria

    Bosdet, T.; Branov, J.; Selvage, C.; Yousefi, M.; Sirrs, S

    2015-01-01

    Background: Omega-3 long-chain polyunsaturated fatty acids (n3LCPUFA) levels are reduced in phenylketonuria (PKU). Recent care guidelines recommend essential fatty acid status is monitored in patients with PKU but access to such testing is limited. We hypothesized that information obtained on diet history would identify PKU adults with suboptimal levels of n3LCPUFA.

  20. Dietary intake of selenium and serum selenium in patients with chronic hepatitis B, liver cirrhosis and acute-on-chronic liver failure

    ZHAO Juan

    2015-07-01

    Full Text Available ObjectiveTo analyse dietary intake of selenium and serum selenium levels in patients with different types of chronic liver diseases, and to explore the relationship between selenium and severity of liver diseases. MethodsSeventy-four patients admitted to Beijing YouAn Hospital from August 2008 to October 2014, as well as 16 healthy persons as healthy control (HC group, were recruited in this study. Based on liver disease types, these patients were divided into chronic hepatitis (CH group (n=23, liver cirrhosis (LC group (n=27, and acute-on-chronic liver failure (ACLF group (n=24. Dietary intake of selenium was calculated on admission by dietary assessment software, and serum selenium levels were measured by inductively coupled plasma-atomic emission spectroscopy. Comparison of continuous data between groups was made by one-way ANOVA; comparison of categorical data between groups was made by ?2 test; the correlation between variables was determined by Pearson correlation analysis. ResultsThe dietary selenium intake in the HC group was 45?4518.10 ?g. Compared with the HC group, the CH group, LC group, and ACLF group had insufficient dietary intake of selenium (37?6911.30 ?g, 32?6513.55 ?g, and 28.9513.30 ?g, respectively. Dietary selenium intake gradually decreased with the progression of liver disease. Compared with the HC group, the LC group and ACLF group had significantly lower dietary selenium intake (P=0.004 and 0.000, respectively. Serum selenium in the HC group was 0.170.04 ?g/ml. Compared with the HC group, the CH group, LC group, and ACLF group had significantly lower serum selenium levels (0.120.05 ?g/ml, P=0.007; 0.110.06 ?g/ml, P=0?000; 0.130.05 ?g/ml, P=0.015. Serum selenium in the LC group was reduced most among these groups. Furthermore, serum selenium was significantly associated with prealbumin level, white blood cell count, and platelet count (r=0.229, P=0.030; r=0.213, P=0.044; r=0.255, P=0.015. ConclusionWith the progression of liver disease, serum selenium and dietary intake of selenium decrease gradually. It is meaningful to monitor and provide supplementary selenium in patients with chronic liver diseases during clinical practice.

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

    Nakao,Hiroko

    1988-08-01

    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.

  2. Two Paradigmatic Approaches to Borderline Patients With a History of Trauma

    LEWIS, JUDITH L.

    1996-01-01

    A significant number of patients with the diagnosis of borderline personality disorder have a history of childhood trauma. This article attempts to integrate the treatment approach of Judith Herman to traumatized patients with the psychodynamic approach of Otto Kernberg to borderline patients. To facilitate paradigm shifts between these two approaches, they are presented side by side with one set of terms translated into the other. Aspects of the therapeutic relationship and process are compared and contrasted, and a preliminary attempt is made to integrate these two treatment models. PMID:22700260

  3. The prevalence and impact of trauma history in eating disorder patients

    Klas Backholm

    2013-11-01

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

  4. Result of oral intake of glucose by healthy subjects and patients with essential hypertension on the binding and degradation of 125I-insulin by erythrocyte receptors

    The work presents the results of researches of binding and degradation of 125I-insulin by erythrocyte receptors in the patients with essential hypertension and healthy patients after glucose intake. In order to obtain full representation of the pattern of changes the serum IRI and glucose concentrations were assayed. Binding and degradation of 125I-insulin by erythrocyte receptors were determined with the method described by Gambhir (1977), modified by the authors. The modification consisted in usage of constant concentrations of iodized insulin (0.9 pg/0.1 ml) and bovine insulin (2.4 I.U./0.1 ml). Before administration of glucose and in 30, 60 and 120 minutes after, venous blood was collected from ulnar vein. All examined persons were in sitting position during the trial of glucose intake. Obtained results show, that blood insulin level in the patients with essential hypertension is statistically significantly higher than in healthy persons of similar anthropometric characteristics. Binding of 125-I-insulin to erythrocyte receptors in fasting state is statistically significantly lower. Degradation after glucose intake in the patients shows decreasing tendency, while in healthy persons-growing tendency. (author). 19 refs, 4 figs, 3 tabs

  5. Completeness of Information Sources Used to Prepare Best Possible Medication Histories for Pediatric Patients

    Dersch-Mills, Deonne; Hugel, Kimberly; Nystrom, Martha

    2011-01-01

    Background: Medication reconciliation can reduce medication errors and mortality. With limited availability of clinical pharmacists, it is important to determine the resources that will yield the most complete information about a patient’s medication history. Objective: To identify the most time-efficient sources of information about medication history for use by clinicians in a pediatric care setting. Methods: In July and August 2009, newly admitted pediatric patients (under 18 years of age) were identified, and a best possible medication history (BPMH) was compiled from the admission history in each patient’s chart, a provincial prescription database, a community pharmacy record, and an “informed interview”. Each individual source of information was compared with the BPMH and given a completeness score based on 3 pieces of information about each medication (name, dose, and frequency). Results: Data were collected for 99 pediatric patients. Of these, 76 (77%) were taking at least one medication, and 49 (50%) were taking at least one prescription medication. Among patients who were taking at least one medication, the informed interview, based on background information from other sources, resulted in the most comprehensive medication history, with a median completeness score of 100% (interquartile range [IQR] 90% to 100%). The admission history had a median completeness score of 33% (IQR 4% to 56%), with documentation of dose and frequency lacking most frequently. Information from community pharmacies had a median completeness score of 67% (IQR 42% to 87%), but this source was available for only 24 of the 99 patients. The prescription database was the least complete source, with a median completeness score of 0% (IQR 0% to 37%). Conclusion: An informed interview by a trained professional resulted in the most complete medication history. Admission histories represented the next most complete source. The data from this study indicated a need for education on the performance of medication reconciliation that would emphasize the use of all available background information, documentation of dose and frequency for each medication, and inclusion of both over-the-counter and herbal products. PMID:22479023

  6. Patients undergoing elective coronary artery bypass grafting exhibit poor pre-operative intakes of fruit, vegetables, dietary fibre, fish and vitamin D.

    Ruiz-Nez, B; van den Hurk, G H A M; de Vries, J H M; Mariani, M A; de Jongste, M J L; Dijck-Brouwer, D A J; Muskiet, F A J

    2015-05-14

    CHD may ensue from chronic systemic low-grade inflammation. Diet is a modifiable risk factor for both, and its optimisation may reduce post-operative mortality, atrial fibrillation and cognitive decline. In the present study, we investigated the usual dietary intakes of patients undergoing elective coronary artery bypass grafting (CABG), emphasising on food groups and nutrients with putative roles in the inflammatory/anti-inflammatory balance. From November 2012 to April 2013, we approached ninety-three consecutive patients (80% men) undergoing elective CABG. Of these, fifty-five were finally included (84% men, median age 69 years; range 46-84 years). The median BMI was 27 (range 18-36) kg/m(2). The dietary intake items were fruits (median 181 g/d; range 0-433 g/d), vegetables (median 115 g/d; range 0-303 g/d), dietary fibre (median 22 g/d; range 9-45 g/d), EPA+DHA (median 0.14 g/d; range 0.01-1.06 g/d), vitamin D (median 4.9 ?g/d; range 1.9-11.2 ?g/d), saturated fat (median 13.1% of energy (E%); range 9-23 E%) and linoleic acid (LA; median 6.3 E%; range 1.9-11.3 E%). The percentages of patients with dietary intakes below recommendations were 62% (fruits; recommendation 200 g/d), 87 % (vegetables; recommendation 150-200 g/d), 73% (dietary fibre; recommendation 30-45 g/d), 91% (EPA+DHA; recommendation 0.45 g/d), 98% (vitamin D; recommendation 10-20 ?g/d) and 13% (LA; recommendation 5-10 E%). The percentages of patients with dietary intakes above recommendations were 95% (saturated fat; recommendation < 10 E%) and 7% (LA). The dietary intakes of patients proved comparable with the average nutritional intake of the age- and sex-matched healthy Dutch population. These unbalanced pre-operative diets may put them at risk of unfavourable surgical outcomes, since they promote a pro-inflammatory state. We conclude that there is an urgent need for intervention trials aiming at rapid improvement of their diets to reduce peri-operative risks. PMID:25827177

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

    Paul S. Pagel

    2009-10-01

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

  8. The Relationship between Thyroid Function and Recent History of Suicide Attempt in Patients with Major Depression

    Abbas Eshraghi

    2016-03-01

    Full Text Available Background and Objectives: Todays, evaluation of the relationship between thyroid function and some psychiatric diseases have been identified. However, studies on the relationship between thyroid function and suicide attempt are limited. The present study was carried out with the aim of evaluating thyroid function in patients attempting suicide. Methods: In this descriptive analytical study during the years 2011 and 2012, 88 patients with major depression and recent history of suicide attemp and 89 patients with major depression without history of recent suicide, who were hospitalized in the psychiatric ward of Hazrat Rasoul Akram Hospital in Tehran, were included in the study. The studied variables in this research included demographic variables, such as age, gender as well as clinical findings, such as thyroid function tests, including TSH, T3, T4. thyroid function tests were requested for patients when hospitalized with a diagnosis of major depression during the years 2011 and 2012, that these values were extracted from the patients medical records. Results: The two groups were matched in terms of age and gender. In patients with recent suicide attempt, 5 (5.6% cases of clinical hypothyroidism and 6 (6.8% cases of subclinical hypothyroidism, were reported. In the major depression patients without recent suicide attempt, there were 3 (3.3% cases of clinical hypothyroidism and 6 (6.7% cases of subclinical hypothyroidism, and the two groups had no significant difference in terms of the incidence of thyroid disease (p=0.75. Conclusion: According to the results of the present study, lower levels of T3 and T3 to T4 ratio can be one of the factors related to the recent history of suicide in patients with major depression.

  9. Preserved skeletal muscle protein anabolic response to acute exercise and protein intake in well-treated rheumatoid arthritis patients

    Mikkelsen, Ulla Ramer; Dideriksen, Kasper; Andersen, Mads Bisgaard; Boesen, Anders; Malmgaard-Clausen, Nikolai Mølkjær; Sørensen, Inge Juul; Schjerling, Peter; Kjær, Michael; Holm, Lars

    2015-01-01

    INTRODUCTION: Rheumatoid arthritis (RA) is often associated with diminished muscle mass, reflecting an imbalance between protein synthesis and protein breakdown. To investigate the anabolic potential of both exercise and nutritional protein intake we investigated the muscle protein synthesis rate...

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

    I. González Molero

    2008-02-01

    Full Text Available Antecedentes y objetivos: La prevalencia de desnutrición en los pacientes hospitalizados es muy elevada y se ha demostrado que constituye un factor pronóstico importante. La mayoría de los pacientes ingresados dependen de la comida hospitalaria para cubrir sus requerimientos nutricionales siendo importante el análisis de los factores que influyen en la ingesta y que se puedan modificar, para conseguir mejorarla y así evitar las consecuencias derivadas de una nutrición inadecuada. En anteriores trabajos se ha demostrado que una de las características de la comida peor valoradas por los pacientes es la temperatura. El objetivo de este trabajo fue evaluar la influencia de la temperatura en la satisfacción y cantidad ingerida en función de que se sirviese o no en carros isotérmicos que mantienen una temperatura adecuada de la comida. Material y métodos: Se realizaron encuestas de satisfacción a pacientes del hospital con y sin carros isotérmicos con dietas basales. Se recogieron los siguientes datos: edad, sexo, peso, número de visitas, movilidad, autonomía, cantidad de medicación por vía oral, ingestión de alimentos traídos de fuera del hospital, calificación de la temperatura, presentación y humedad, cantidad de comida ingerida y motivos por los que no se ingirió todo el contenido del carro isotérmico. Resultados: De las 363 encuestas, 134 de ellas (37,96% se realizaron en pacientes con bandeja térmica y 229 (62,04% en pacientes sin ella. El 60% de los pacientes referían haber comido menos de lo normal en la última semana siendo la causa más frecuente la disminución de apetito. En el almuerzo y cena comieron la mitad o menos del contenido de la bandeja el 69,3% y 67,7% respectivamente, siendo las causas más frecuentes las siguientes: la falta de apetito (42% en almuerzo y 40% en cena, no gustarles la comida (24,3 y 26,2% y el sabor (15,3 y 16,8%. Otras causas menos frecuentes fueron el olor, la cantidad de comida, presentar náuseas o vómitos, cansancio y falta de autonomía. No hubo diferencias significativas en la cantidad de ingesta en función del sexo, peso, número de visitas, cantidad de medicación y grado de actividad. La temperatura de la comida fue clasificada como buena por el 62% de los pacientes, la presentación por el 95% y la humedad por el 85%. Al comparar a los pacientes con y sin carro isotérmico, no hubo diferencias en las características basales analizadas que pudiesen influir en la cantidad ingerida. Calificaron la temperatura como buena un 90% de los pacientes con carro isotérmico y un 57,2% sistema tradicional, siendo esta diferencia estadísticamente significativa (P = 0,000. Además hubo diferencias en la cantidad de comida ingerida entre los pacientes con y sin carro isotérmico, de modo que se lo comieron todo un 41% frente al 27,7% respectivamente siendo esta diferencia estadísticamente significativa (P = 0,007. No hubo diferencias en la calificación de humedad y presentación. Conclusiones: La mayoría de los pacientes (60% presentan disminución de apetito durante el ingreso. La proporción de ingresados que califican la temperatura como buena es mayor en los pacientes con el sistema de carros isotérmicos. La cantidad ingerida por los pacientes con carros isotérmicos es significativamente mayor que en los pacientes sin ellos.Background and objectives: Prevalence of hyponutrition in hospitalized patients is very high and it has been shown to be an important prognostic factor. Most of admitted patients depend on hospital food to cover their nutritional demands being important to assess the factors influencing their intake, which may be modified in order to improve it and prevent the consequences of inadequate feeding. In previous works, it has been shown that one of the worst scored characteristics of dishes was the temperature. The aim of this study was to assess the influence of temperature on patient's satisfaction and amount eaten depending on whether the food was served in isothermal trolleys keeping proper food temperature or not. Material and methods: We carried out satisfaction surveys to hospitalized patients having regular diets, served with or without isothermal trolleys. The following data were gathered: age, gender, weight, number of visits, mobility, autonomy, amount of orally taken medication, intake of out-of-hospital foods, qualification of food temperature, presentation and smokiness, amount of food eaten, and reasons for not eating all the content of the tray. Results: Of the 363 surveys, 134 (37.96% were done to patients with isothermal trays and 229 (62.04% to patients without them. Sixty percent of the patients referred having eaten less than the normal amount within the last week, the most frequent reason being decreased appetite. During lunch and dinner, 69.3% and 67.7%, respectively, ate half or less of the tray content, the main reasons being as follows: lack of appetite (42% at lunch time and 40% at dinner, do not like the food (24.3 and 26.2% or taste (15.3 and 16.8%. Other less common reasons were the odor, the amount of food, having nausea or vomiting, fatigue, and lack of autonomy. There were no significant differences in the amount eaten by gender, weight, number of visits, amount of medication, and level of physical activity. The food temperature was classified as adequate by 62% of the patients, the presentation by 95%, and smokiness by 85%. When comparing the patients served with or without isothermal trays, there were no differences with regards to baseline characteristics analyzed that might have had an influence on amount eaten. Ninety percent of the patients with isothermal trolley rated the food temperature as good, as compared with 57.2% of the patients with conventional trolley, the difference being statistically significant (P = 0.000. Besides, there were differences in the amount of food eaten between patients with and without isothermal trolley, so that 41% and 27.7% ate all the tray content, respectively, difference being statistically significant (P = 0.007. There were no differences in smokiness or presentation rating. Conclusions: Most of the patients (60% had decreased appetite during hospital admission. The percentage of hospitalized patients rating the food temperature as being good is higher among patients served with isothermal trolleys. The amount of food eaten by the patients served with isothermal trolleys is significantly higher that in those without them.

  11. Influence of Family History of Diabetes on Health Care Provider Practice and Patient Behavior Among Nondiabetic Oregonians

    Zlot, Amy I.; Bland, Mary Pat; Silvey, Kerry; Epstein, Beth; Leman, Richard F; Mielke, Beverly

    2008-01-01

    Introduction People with a family history of diabetes are at increased risk of developing diabetes; however, the effect of family history of diabetes on health care provider practice and patient behavior has not been well defined. Methods We analyzed data from the 2005 Oregon Behavioral Risk Factor Surveillance System, a state-based, random-digit–dialed telephone survey, to evaluate, among people with diabetes, associations between family history of diabetes and 1) patients' reports of health...

  12. History of sexual, emotional or physical abuse and psychiatric comorbidity in substance-dependent patients.

    Daigre, Constanza; Rodríguez-Cintas, Laia; Tarifa, Núria; Rodríguez-Martos, Lola; Grau-López, Lara; Berenguer, Marta; Casas, Miguel; Roncero, Carlos

    2015-10-30

    Sexual, emotional or physical abuse history is a risk factor for mental disorders in addicted patients. However, the relationship between addiction and abuse lifespan is not well known. This study aims to compare clinical and psychopathological features of addicted patients according to the experience of abuse and to the number of different types of abuse suffered. Bivariate and multivariate analyses were conducted. 512 addicted patients seeking treatment were included, 45.9% reported abuse throughout life (38.9% emotional, 22.3% physical and 13.5% sexual abuse). It was found that female gender; depressive symptoms and borderline personality disorder were independently associated with history of any abuse throughout life. As well, it was found that 14% have been suffered from all three types of abuse (sexual, emotional and physical), 34.5% from two and 55.5% from one type. Female gender and borderline personality disorder were independently associated independently with a greater number of different types of abuse. Results suggest that history of abuse is frequent among substance-dependent patients and these experiences are more prevalent in women and are associated with more psychiatric comorbidity. PMID:26279128

  13. Clinical analysis of esophageal cancer patients with a history of metachronous primary cancer.

    Kudou, Michihiro; Shiozaki, Atsushi; Fujiwara, Hitoshi; Kosuga, Toshiyuki; Konishi, Hirotaka; Morimura, Ryo; Murayama, Yasutoshi; Komatsu, Shuhei; Kuriu, Yoshiaki; Ikoma, Hisashi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Okamoto, Kazuma; Sakakura, Chouhei; Otsuji, Eigo

    2014-11-01

    Esophageal cancer (EC) is often associated with multiple primary cancers, and the frequency of EC in patients with a history of metachronous primary cancers (HMPC) was reported as 7.8%. The clinical characteristics of these cases have not yet been elucidated in detail. Therefore, we analyzed 36 EC patients with HMPC among 370 cases that underwent curative resection in our hospital between 1996 and 2013. The most frequent HMPC was gastric cancer (36.1%). The group with HMPC was significantly older than the group without HMPC, whereas no significant differences were observed in other background factors. The stomach was used for reconstruction more frequently reconstructed in the group without HMPC (psafety of surgery for and prognosis of EC patients with HMPC were similar to those of EC patients without HMPC; therefore, curative surgery should be considered for EC patients with HMPC. PMID:25731412

  14. Effect of Oat ?-Glucan Intake on Glycaemic Control and Insulin Sensitivity of Diabetic Patients: A Meta-Analysis of Randomized Controlled Trials

    Shen, Xiao Li; Zhao, Tao; Zhou, Yuanzhong; Shi, Xiuquan; Zou, Yan; Zhao, Guohua

    2016-01-01

    Many individual studies on oat ?-glucan (OBG) confirmed its functionality in improving type 2 diabetes mellitus (T2DM), but disagreements were identified among those results. To derive a pooled estimate of these results, relevant articles, published before 5 September 2015, were collected from four electronic databases (Pubmed, Cochrane Library, Scopus, and Web of Science) and subjected to meta-analysis in the present work. In total, four articles, dealing with 350 T2DM patients combined, met the inclusion criteria. Compared to control, T2DM patients administrated OBG from 2.5 to 3.5 g/day for 3 to 8 weeks presented significantly lowered concentrations in fasting plasma glucose (FPG) by ?0.52 (95% CI: ?0.94, ?0.10) mmol/L (p = 0.01) and glycosylated hemoglobin (HbA1c) by ?0.21% (95% CI: ?0.40, ?0.02) (p = 0.03). However, OBG intake did not significantly lower the fasting plasma insulin (FPI) concentration. In conclusion, mediate-term OBG intake (38 weeks) favored the glycaemic control of T2DM patients but did not improve their insulin sensitivity. Regrettably, data upon the effects of long-term OBG intake on glycaemic control and insulin sensitivity were scarce, which is of much importance and should be addressed in future research. PMID:26771637

  15. Effect of Oat ?-Glucan Intake on Glycaemic Control and Insulin Sensitivity of Diabetic Patients: A Meta-Analysis of Randomized Controlled Trials.

    Shen, Xiao Li; Zhao, Tao; Zhou, Yuanzhong; Shi, Xiuquan; Zou, Yan; Zhao, Guohua

    2016-01-01

    Many individual studies on oat ?-glucan (OBG) confirmed its functionality in improving type 2 diabetes mellitus (T2DM), but disagreements were identified among those results. To derive a pooled estimate of these results, relevant articles, published before 5 September 2015, were collected from four electronic databases (Pubmed, Cochrane Library, Scopus, and Web of Science) and subjected to meta-analysis in the present work. In total, four articles, dealing with 350 T2DM patients combined, met the inclusion criteria. Compared to control, T2DM patients administrated OBG from 2.5 to 3.5 g/day for 3 to 8 weeks presented significantly lowered concentrations in fasting plasma glucose (FPG) by -0.52 (95% CI: -0.94, -0.10) mmol/L (p = 0.01) and glycosylated hemoglobin (HbA1c) by -0.21% (95% CI: -0.40, -0.02) (p = 0.03). However, OBG intake did not significantly lower the fasting plasma insulin (FPI) concentration. In conclusion, mediate-term OBG intake (3-8 weeks) favored the glycaemic control of T2DM patients but did not improve their insulin sensitivity. Regrettably, data upon the effects of long-term OBG intake on glycaemic control and insulin sensitivity were scarce, which is of much importance and should be addressed in future research. PMID:26771637

  16. Association of Self-efficacy and Decisional Balance with Stages of Change for Fiber Intake and Glycemic Control in Patients with Type 2 Diabetes

    Parisa Keshani

    2015-09-01

    Full Text Available Background and Objectives: Constructs of behavioral models such as trans-theoretical model can be associated with healthy eating behaviors like increasing fiber intake. They can also be effective in improving these behaviors in patients with diabetes. This study aimed to assess the association of self-efficacy and decisional balance with stages of change for fiber intake and glycemic control in patients with type 2 diabetes. Materials and Methods: A cross-sectional study was conducted on 145 literate male and female patients with type 2 diabetes (aged 30 to 65 years they were randomly selected from the patients’ list of “Charity Foundation for Special Diseases” and ”Iranian Diabetes Society” in Tehran-Iran. Stages of change, self-efficacy, and decisional balance questionnaires were filled out, and three food records were used to assess their nutritional status. Blood samples were taken to assess fasting blood glucose, HbA1c, serum insulin, and insulin resistance. One-way ANOVA and logistic regression were used to analyze the data. The tests were done using the SPSS software (ver. 16. P<0.05 was considered significant. Results: 126 patients with type 2 diabetes completed the study. Participants’ mean age was 53.5±6.02 and 65% were men. Patients in post-action stages revealed higher self-efficacy than did those in pre-action stages (P=0.035. A relationship was observed between insulin resistance and self-efficacy (P=0.040. One unit increase in self-efficacy decreased the risk of insulin resistance by 12%, and each unit increase in decisional balance increased the chance of eating sufficient fiber by 2.2 times. There was also a significant relationship between the perceived cons (P<0.0001 and self-efficacy (P=0.037 with fiber intake after adjustment with confounders. Conclusions: This study suggests that there is a relationship between transtheoretical model constructs such as self-efficacy and decisional balance, especially cons, with fiber intake in patients with type 2 diabetes. So it seems that considering these constructs in educational interventions could be effective in increasing the fiber intake in such population.

  17. Associao entre o estado nutricional e a ingesto diettica em pacientes com fibrose cstica Association between nutritional status and dietary intake in patients with cystic fibrosis

    Mriam Isabel Souza dos Santos Simon

    2009-10-01

    Full Text Available OBJETIVO: Determinar a relao entre o estado nutricional e a ingesto diettica de pacientes com fibrose cstica. MTODOS: Estudo transversal com 85 pacientes com fibrose cstica entre 6 e 18 anos de idade. A ingesto diettica 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 relao peso/estatura (%P/E, percentil do ndice de massa corprea (IMC, escore Z para estatura/idade (E/I e peso/idade (P/I, e percentual de ingesto diettica comparada a Recommended Dietary Allowances (RDAs. RESULTADOS: A prevalncia de pacientes eutrficos 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 mdia de ingesto, avaliada em 82 pacientes, foi de 124,5% da RDA. Nas anlises de regresso logstica univariada, encontrou-se uma associao significativa entre a varivel independente ingesto calrica e o desfecho escore Z E/I. O modelo de anlise multivariado, elaborado a partir do desfecho escore Z E/I e ajustado para idade, VEF1, colonizao por Staphylococcus aureus resistente meticilina e nmero de internaes hospitalares, demonstrou que um aumento de 1% da ingesto calrica em relao RDA diminui em 2% a chance de ter dficit de estatura (OR = 0,98; IC95%: 0,96-1,00. A escolaridade materna demonstrou uma associao limtrofe (p = 0,054. CONCLUSES: Houve baixa prevalncia de desnutrio nesta amostra. O modelo de estudo demonstrou evidncias da associao entre a ingesto diettica e o estado nutricional, sendo esta ingesto 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.

  18. Tracking Cancer Patients Medical History Using Wireless Emerging Technology : Near Field Communication

    Shivang Bhagat

    2015-02-01

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

  19. Relationship Between Family History of Breast Cancer and Clinicopathological Features in Moroccan Patients

    Tazzite, Amal; Jouhadi, Hassan; Saiss, Kamal; Benider, Abdellatif; Nadifi, Sellama

    2013-01-01

    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 dia...

  20. Family history of chronic renal failure is associated with malnutrition in Korean hemodialysis patients

    Hwang, Ji-Yun; Cho, Ju-Hyun; Lee, Yoon Jung; Jang, Sang Pil; Kim, Wha Young

    2009-01-01

    The present study was to investigate the nutritional status and factors related to malnutrition in end-stage renal disease (ESRD) patients requiring hemodialysis (HD) in South Korea. Subjects were ESRD outpatients from general hospitals or HD centers in Seoul referred to the dialysis clinic for maintenance HD care. A total of 110 patients (46 men and 64 women; mean ages 58.6 1.0 y) were eligible for this study. The family history of chronic renal failure (CRF) was considered positive if a p...

  1. Reduction of sodium intake is a prerequisite for preventing and curing high blood pressure in hypertensive patients - first part: therapy.

    De Santo, Natale Gaspare

    2014-01-01

    The studies on the relation between Na intake and blood pressure were started at the Brookhaven National Laboratories in Upton (New York) by Lewis K Dahl in 1961, however the story goes back to our hunter-gatherer predecessors who, between 750,000 and 10,000 years ago, ate diets proving a Na intake of 690 mg/day. The relevance of this finding became evident when the data of the studies on Yanomamo Indians of Brazil and Venezuela (living in the tropical forest) became available. They showed that in these populations sodium intake averages 1.34±2.01 mEq/24 hours,and that their blood pressure increases from the first to the second decade of life and then tapers down. Studies inc himpanzees, a species genetically similar to humans, the DASH Trial, the Intersalt Study, various meta-analyses, the data in persons with stroke, the blood pressure profile of newborns on low Na intake, and various studies in hypertensives with and without Chronic Kidney Disease, have demonstrated the beneficial effects of a restricted low salt intake alone or as an adjunct to drug therapy on blood pressure profiles. PMID:25729796

  2. A Rare Reason of Ileus in Renal Transplant Patients With Peritoneal Dialysis History: Encapsulated Peritoneal Sclerosis.

    Gke, Ali Murat; zel, Leyla; ?bi?o?lu, Sevin; Ata, P?nar; ?ahin, Glizar; Gcn, Murat; Kara, V Melih; zdemir, Ebru; Titiz, M ?zzet

    2015-12-01

    Encapsulating peritoneal sclerosis is a rare complication of long-term peritoneal dialysis ranging from moderate inflammation of peritoneal structures to severe sclerosing peritonitis and encapsulating peritoneal sclerosis. Complicated it, ileus may occur during or after peritoneal dialysis treatment or after kidney transplant. We sought to evaluate 3 posttransplant encapsulating peritoneal sclerosis through clinical presentation, radiologic findings, and outcomes. We analyzed 3 renal transplant patients with symptoms of encapsulating peritoneal sclerosis admitted posttransplant to our hospital with ileus between 2012 and 2013. Conservative treatment was applied to the patients whenever necessary to avoid surgery. One patient improved with medical therapy. Surgical treatment was delayed and we decided it as a last resort, in 2 cases with no response to conservative treatment for a long time. Finally, patients with peritoneal dialysis history should be searched carefully before renal transplant for intermittent bowel obstruction story. PMID:25343532

  3. Association between fish and shellfish, and omega-3 PUFAs intake and CVD risk factors in middle-aged female patients with type 2 diabetes

    Kim, Hyesook; Park, Seokyung; Yang, Hyesu; Choi, Young Ju; Huh, Kap Bum; Chang, Namsoo

    2015-01-01

    BACKGROUND/OBJECTIVES This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The diet...

  4. Short communication: Use of single nucleotide polymorphism genotypes and health history to predict future phenotypes for milk production, dry matter intake, body weight, and residual feed intake in dairy cattle.

    Yao, C; Armentano, L E; VandeHaar, M J; Weigel, K A

    2015-03-01

    As feed prices have increased, the efficiency of feed utilization in dairy cattle has attracted increasing attention. In this study, we used residual feed intake (RFI) as a measurement of feed efficiency along with its component traits, adjusted milk energy (aMilkE), adjusted dry matter intake (aDMI), and adjusted metabolic body weight (aMBW), where the adjustment was for environmental factors. These traits may also be affected by prior health problems. Therefore, the carryover effects of 3 health traits from the rearing period and 10 health traits from the lactating period (in the same lactation before phenotype measurements) on RFI, aMilkE, aDMI, and aMBW were evaluated. Cows with heavier birth weight and greater body weight at calving of this lactation had significant increases in aMilkE, aDMI, and aMBW. The only trait associated with RFI was the incidence of diarrhea early in the lactation. Mastitis and reproductive problems had negative carryover effects on aMilkE. The aMBW of cows with metabolic disorders early in the lactation was lower than that of unaffected cows. The incidence of respiratory disease during lactating period was associated with greater aMBW and higher aDMI. To examine the contribution of health traits to the accuracy of predicted phenotype, genomic predictions were computed with or without information regarding 13 health trait phenotypes using random forests (RF) and support vector machine algorithms. Adding health trait phenotypes increased prediction accuracies slightly, except for prediction of RFI using RF. In general, the accuracies were greater for support vector machine than RF, especially for RFI. The methods described herein can be used to predict future phenotypes for dairy replacement heifers, thereby facilitating culling decisions that can lead to decreased feed costs during the rearing period. For these decisions, prediction of the animal's own phenotype is of greater importance than prediction of the genetic superiority or inferiority that will transmit to its offspring. PMID:25529426

  5. Altered sodium intake affects plasma concentrations of BNP but not proBNP in healthy individuals and patients with compensated heart failure

    Damgaard, Morten; Goetze, Jens Peter; Norsk, Peter; Gadsbøll, Niels

    2007-01-01

    AIMS: Plasma B-type natriuretic peptide (BNP) and proBNP are promising markers for treatment of heart failure (HF), but the intra-individual biological variation is high. We investigated whether changes in sodium intake and posture contribute to this variation. METHODS AND RESULTS: A total of 12...... healthy individuals and 12 patients with medically treated compensated HF were examined after 1 week of low (70 mmol [1.61 g] per day) and 1 week of high (250 mmol [5.75 g] per day) sodium intake. Plasma volume and plasma concentrations of BNP and proBNP were determined after 1 h in seated and 1 h in...... supine position. In healthy individuals, the plasma BNP concentration increased significantly on high sodium intake with a ratio (high sodium/low sodium) of 2.00 (1.32-3.03, P = 0.004). The corresponding values for HF patients were 1.69 (1.25-2.29, P = 0.003). The plasma BNP concentration changed...

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

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

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

    Riccardo Caccialanza

    2015-03-01

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

  8. Correlations Between Awareness of Illness (Insight) and History of Addiction in Heroin-Addicted Patients

    Maremmani, Angelo Giovanni Icro; Rovai, Luca; Rugani, Fabio; Pacini, Matteo; Lamanna, Francesco; Bacciardi, Silvia; Perugi, Giulio; Deltito, Joseph; DellOsso, Liliana; Maremmani, Icro

    2012-01-01

    In a group of 1066 heroin addicts, who were seeking treatment for opioid agonist treatment, we looked for differences in historical, demographic, and clinical characteristics, between patients with different levels of awareness of illness (insight). The results showed that, in the cohort studied, a majority of subjects lacked insight into their heroin-use behavior. Compared with the impaired-insight group, those who possessed insight into their illness showed significantly greater awareness of past social, somatic, and psychopathological impairments, and had a greater number of past treatment-seeking events for heroin addiction. In contrast with other psychiatric illnesses, the presence of awareness appears to be related to the passing of time and to the worsening of the illness. Methodologies to improve the insight of patients should, therefore, be targeted more directly on patients early in their history of heroin dependence, because the risk of lack of insight is greatest during this period. PMID:22787450

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

    Makurina A.P.,

    2014-11-01

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

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

    IcroMaremmani

    2012-07-01

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

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

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

    2012-12-01

    The aim of this study was to assess the prevalence of a history of sexual abuse and its relation to psychiatric comorbidity among former opiate addicts currently on methadone maintenance treatment (MMT). We evaluated the history of sexual abuse and current clinical obsessive compulsive disorder (OCD), dissociative identity disorder (DID), and complex posttraumatic distress disorder (cPTSD), and administered the Life Events Inventory Questionnaire among 125 MMT patients (76 females and 49 males). Eighty (64%) patients had experienced sexual abuse, 69 (55.2%) met the criteria for clinical OCD, 20 (16.0%) for cPTSD and 13 (10.4%) for DID. More females had clinical OCD than males (63.2% vs. 42.9%, respectively, p=0.03). Sexually abused patients had higher rates of clinical OCD than their non-abused counterparts (67.5% vs. 33.3%, respectively, pDissociative Experiences Scale score (17.610.1 vs. 14.68.1, p=0.08) and rate of DID (13.8% vs. 4.4%, p=0.1), but no significant difference in the rate of cPTSD (17.5% vs. 13.3%, p=0.6) compared to non-abused subjects. The 80 sexually abused patients were mostly female (85%), and 57.5% of them were abused by a family member. In summary, more sexually abused MMT patients were diagnosed with clinical OCD and fewer with cPTSD and DID. Those with cPTSD were characterized by more negative life events, higher dissociation scores, and assaults by a family member. We conclude that sexually abused MMT patients should be screened for clinical OCD. PMID:22564825

  12. Parental History of Type 2 Diabetes in Patients with Nonaffective Psychosis

    Fernandez-Egea, Emilio; Miller, Brian; Bernardo, Miguel; Donner, Thomas; Kirkpatrick, Brian

    2009-01-01

    Introduction We attempted to replicate two previous studies which found an increased risk of diabetes in the relatives of schizophrenia probands. Methods N=34 patients with newly-diagnosed nonaffective psychosis and N=52 non-psychiatric controls were interviewed for parental history of Type 2 diabetes. Results In a logistic regression model that included multiple potential confounders, psychosis was a significant predictor of Type 2 diabetes in either parent (p<0.04). Discussion We found an increased prevalence of Type 2 diabetes in the parents of nonaffective psychosis subjects. This association may be due to shared environmental or genetic risk factors, or both. PMID:18031995

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

    Tatiana Almeida Bacarin

    2009-02-01

    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.

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

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

    2013-01-01

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

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

    D. A. De Luis

    2010-08-01

    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.

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

    M. M. Tavares

    2007-10-01

    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.

  17. Genetic instability persists in non-neoplastic urothelial cells from patients with a history of urothelial cell carcinoma.

    de Castro Marcondes, João Paulo; de Oliveira, Maria Luiza Cotrim Sartor; Gontijo, Alisson M; de Camargo, João Lauro Viana; Salvadori, Daisy Maria Fávero

    2014-01-01

    Bladder cancer is one of the most common genitourinary neoplasms in industrialized countries. Multifocality and high recurrence rates are prominent clinical features of this disease and contribute to its high morbidity. Therefore, more sensitive and less invasive techniques could help identify individuals with asymptomatic disease. In this context, we used the micronucleus assay to evaluate whether cytogenetic alterations could be used as biomarkers for monitoring patients with a history of urothelial cell carcinoma (UCC). We determined the frequency of micronucleated urothelial cells (MNC) in exfoliated bladder cells from 105 patients with (n = 52) or without (n = 53) a history of UCC, all of whom tested negative for neoplasia by cytopathological and histopathological analyses. MNC frequencies were increased in patients with a history of UCC (non-smoker and smoker/ex-smoker patients vs non-smoker and smoker/ex-smoker controls; pMNC frequency compared to patients with non-recurrent neoplasia. However, logistic regression using smoking habits, age and gender as confounding factors did not confirm MNC frequency as a marker for UCC recurrence. Fluorescent in situ hybridization analysis (using a pan-centromeric probe) showed that micronuclei (MN) arose mainly from clastogenic events regardless of UCC and/or smoking histories. In conclusion, our results confirm previous indications that subjects with a history of UCC harbor genetically unstable cells in the bladder urothelium. Furthermore, these results support using the micronucleus assay as an important tool for monitoring patients with a history of UCC and tumor recurrence. PMID:24465937

  18. Beneficial effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials

    HARIMA-MIZUSAWA, Naomi; KAMACHI, Keiko; KANO, Mitsuyoshi; Nozaki, Daisuke; UETAKE, Tatsuo; YOKOMIZO, Yuji; Nagino, Takayuki; Tanaka, Akira; MIYAZAKI, Kouji; Nakamura, Shinichiro

    2015-01-01

    This study aimed to examine whether daily intake of citrus juice containing heat-killed Lactobacillus plantarum YIT 0132 (LP0132-fermented juice) alleviates symptoms of atopic dermatitis. This was a natural extension of our previous study in which LP0132 was shown to enhance IL-10 production in vitro and LP0132-fermented juice was found to alleviate symptoms and enhance quality of life (QOL) in patients with Japanese cedar pollinosis. In two open trials, Trial 1 and Trial 2, 32 and 18 adult p...

  19. Mannose-binding Lectin Deficiency in Patients with a History of Recurrent Infections.

    Rashidi, Elahe; Fazlollahi, Mohammad Reza; Zahedifard, Sara; Talebzadeh, Azadeh; Kazemnejad, Anoshirvan; Saghafi, Shiva; Pourpak, Zahra

    2016-02-01

    Mannose-binding lectin (MBL) is a protein of innate immune system that is involved in opsonization and complement activation. MBL deficiency is associated with predisposition to infectious diseases; however subnormal levels are also seen in healthy subjects. The aim of this study was to investigate the prevalence and clinical manifestation of MBL deficiency in patients with increased susceptibility to infection. We studied the MBL serum concentration of 104 patients with a history of recurrent and/or severe infections referred to Immunology, Asthma and Allergy Research Institute (IAARI) in order to evaluate the primary immunodeficiency (PID). The distribution of MBL deficiency in these patients and 593 healthy subjects of previous study were analyzed. The frequency of individuals with MBL deficiency was significantly higher in patients with recurrent and/or severe infections (13.5% [14/104]) compared with healthy subjects (4.7% [28/593]; p=0.001; OR 3.1, 95% CI 1.5-6.1). However, in 10.9% (7/64) of patients with recurrent infections without any immunodeficiency background, the MBL deficiency was detected. On the whole, our findings indicate an association between MBL deficiency and increased susceptibility to infections. PMID:26996114

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

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

    2014-12-01

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

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

    Milisavljević Nemanja

    2013-01-01

    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.

  2. Differences between patients with borderline personality disorder who do and do not have a family history of bipolar disorder.

    Zimmerman, Mark; Martinez, Jennifer; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy

    2014-10-01

    Diagnostic confusion sometimes exists between bipolar disorder and borderline personality disorder (BPD). To improve the recognition of bipolar disorder researchers have identified nondiagnostic factors that point toward bipolar disorder. One such factor is the presence of a family history of bipolar disorder. In the current report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we compared the demographic, clinical, and psychosocial characteristics of patients with BPD who did and did not have a family history of bipolar disorder. A large sample of psychiatric outpatients were interviewed with semi-structured interviews. Three hundred seventeen patients without bipolar disorder were diagnosed with DSM-IV borderline personality disorder. Slightly less than 10% of the 317 patients with BPD (9.5%, n=30) reported a family history of bipolar disorder in their first-degree relatives. There were no differences between groups in any specific Axis I or Axis II disorder. The patients with a positive family history were significantly less likely to report excessive or inappropriate anger, but there was no difference in the frequency of other criteria for BPD such as affective instability, impulsivity, or suicidal behavior. The patients with a positive family history reported a significantly higher rate of increased appetite and fatigue. There was no difference in overall severity of depression, scores on the Global Assessment of Functioning, history of psychiatric hospitalizations, suicide attempts, time unemployed due to psychiatric reasons during the 5 years before the evaluation, and ratings of current and adolescent social functioning. There was no difference on any of the 5 subscales of the childhood trauma questionnaire. Overall, we found few differences between BPD patients with and without a family history of bipolar disorder thereby suggesting that a positive family history of bipolar disorder was not a useful marker for occult bipolar disorder in these patients. PMID:24962449

  3. Safety of an immune-enhancing nutrition supplement in cirrhotic patients with history of encephalopathy.

    Abou-Assi, Souheil G; Mihas, Anastasios A; Gavis, Edith A; Gilles, HoChong S; Haselbush, Amy; Levy, James R; Habib, Adil; Heuman, Douglas M

    2006-01-01

    Malnutrition in advanced cirrhosis may worsen liver function and increase susceptibility to infections. Immune-enhancing nutrition supplements (IENS) may be of value, but their safety in patients with decompensated cirrhosis and history of encephalopathy is unknown. We assessed the safety of Impact Recover (Novartis, St. Louis Park, MN), an orally palatable IENS, in 12 men with hepatic cirrhosis of Child-Turcotte-Pugh (CTP) class B or C, ages 40-60. On day 0, patients were evaluated serially for 6 hours after ingestion of 2 packets of Impact Recover. Despite a transient doubling of the blood ammonia, no cognitive abnormalities were noted on clinical assessment or psychometric testing. Subsequently, patients were instructed to ingest 3 packets per day of Impact Recover for 56 days, after which supplements were stopped. Patients were evaluated in a fasting state on days 0 (baseline), 56 (end of treatment), and 112 (follow-up). One patient was transplanted on day 21, and another died after an urgent cholecystectomy on day 30. The remaining 10 patients completed the study. Mean value of CTP score was 9 (range, 7-11) and mean value of model for end-stage liver disease (MELD) score was 14 (7-21), and there was no change after 8 weeks of IENS. Only 1 experienced transient worsening of encephalopathy after omitting lactulose. Performances on psychometric tests did not change. Transferrin levels increased rapidly with IENS, then returned toward baseline after IENS was stopped. Fasting insulin and peptide YY (PYY) levels also increased, but fasting glucose and hemoglobin A1C did not change. Trends in other nutrition and immune parameters did not reach significance. We conclude that acute and chronic administration of Impact Recover was well tolerated in cirrhotic patients with controlled encephalopathy. Further studies are justified to assess potential efficacy of long-term IENS in preventing infection and slowing progression in advanced cirrhosis. PMID:16517953

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

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

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

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

    2012-10-15

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

  6. [Anesthetic management for electroconvulsive therapy in the patients with a history of neuroleptic malignant syndrome].

    Setoyama, Keiko; Hirata, Takao; Saeki, Hitoshi; Morimoto, Yasuhiro; Tsuruta, Syunsuke; Matsumoto, Mishiya; Sakabe, Takefumi

    2009-05-01

    We report three patients with a history of neuroleptic malignant syndrome for whom modified electroconvulsive therapy (m-ECT) was scheduled. Two patients suffered from schizophrenia, and one suffered from depression. Their symptoms, such as hyperthermia, consciousness disturbance, myotonus, tremor, sweating, and tachycardia, improved gradually with administration of dantrolene and fluid infusion. However, their psychotic state was exacerbated. Therefore, m-ECT was scheduled. When patients were restless at the hospital ward, they were sedated with propofol and transferred to the operating room. General anesthesia was induced with thiopental 2.5-5 mg x kg(-1). After loss of consciousness, vecuronium bromide 0.01 mg x kg(-1) followed by a dose of 0.1 mg x kg(-1) was administered and ventilation was assisted using a face mask and 100% oxygen. After the ECT stimulus, the patients were sedated with propofol until full recovery from muscle relaxation. Although anesthesia time (mean 38 min) was slightly longer (19 min) than in those anesthetized with thiopental and suxamethonium chloride, m-ECT was performed safely and effectively. PMID:19462806

  7. Analyzing the History of Falls in Patients with Severe Knee Osteoarthritis

    Tsonga, Theano; Michalopoulou, Maria; Malliou, Paraskevi; Godolias, George; Gkasdaris, Grigorios; Soucacos, Panagiotis

    2015-01-01

    Background One out of three adults over the age of 65 years and one out of two over the age of 80 falls annually. Fall risk increases for older adults with severe knee osteoarthritis, a matter that should be further researched. The main purpose of this study was to investigate the history of falls including frequency, mechanism and location of falls, activity during falling and injuries sustained from falls examining at the same time their physical status. The secondary purpose was to determine the effect of age, gender, chronic diseases, social environment, pain elsewhere in the body and components of health related quality of life such as pain, stiffness, physical function, and dynamic stability on falls frequency in older adults aged 65 years and older with severe knee osteoarthritis. Methods An observational longitudinal study was conducted on 68 patients (11 males and 57 females) scheduled for total knee replacement due to severe knee osteoarthritis (grade 3 or 4) and knee pain lasting at least one year or more. Patients were personally interviewed for fall history and asked to complete self-administered questionnaires, such as the 36-item Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and physical performance test was performed. Results The frequency of falls was 63.2% for the past year. The majority of falls took place during walking (89.23%). The main cause of falling was stumbling (41.54%). There was a high rate of injurious falling (29.3%). The time patients needed to complete the physical performance test implied the presence of disability and frailty. The high rates of fall risk, the high disability levels, and the low quality of life were confirmed by questionnaires and the mobility test. Conclusions Patients with severe knee osteoarthritis were at greater risk of falling, as compared to healthy older adults. Pain, stiffness, limited physical ability, reduced muscle strength, all consequences of severe knee osteoarthritis, restricted patient's quality of life and increased the fall risk. Therefore, patients with severe knee osteoarthritis should not postpone having total knee replacement, since it was clear that they would face more complicated matters when combining with fractures other serious injuries and disability. PMID:26640627

  8. Usefulness of patient's history and non-invasive electrocardiographic parameters in prediction of ajmaline test results in patients with suspected Brugada syndrome

    Uziębło-Życzkowska, Beata; Gielerak, Grzegorz; Michałkiewicz, Dariusz

    2013-01-01

    Introduction The aim of the work was to assess the usefulness of patient's history and non-invasive electrocardiographic parameters in the prediction of ajmaline test results in patients with suspected Brugada syndrome. Material and methods The study involved a group of 59 patients (37 men) at average age of 31.6 ±12.2 years with suspected concealed form of Brugada syndrome. Pharmacological provocation with intravenous ajmaline administration was performed. The patients were divided into two ...

  9. Expanded IT-15 genes in patients without known family history of Huntington Disease

    Buchanan, J.A.; Klock, R.J.; Kennedu, D. [North York General Hospital, Toronto (Canada)] [and others

    1994-09-01

    The NYGH laboratory is funded by the Ontario Ministry of Health to provide DNA-based diagnostic and predictive testing for HD through a network of provincial Genetics centres. To date, samples from 146 apparently independent kindreds were received to test and/or bank for HD. Not all have been assayed for size of the IT-15 gene, but in 19 cases an expansion (> 39 CAG repeats) was found despite lack of known family history. These cases were classified according to the likelihood that they are true {open_quotes}new{close_quotes} full expansions in IT-15. Six were unlikely, due to a lack of information (adoption, history uncertain, or pedigree not provided). Ten cases were considered possible or probable based on a good negative family history with parents who were asymptomatic beyond age 50 but family samples unavailable. For one of those, parents are deceased, but inference of parental alleles from the proband`s sibship suggests a pre-mutation allele of approximately 30 repeats. In 3 cases, a new expansion was considered proven. One was first ascertained by another laboratory and reported elsewhere. For another, the proband`s father has one allele of about 35 repeats. In a third remarkable case, the proband has an expanded allele near 50 repeats and a normal sized allele that matches one maternal allele. The father`s larger allele has 30+/-1 repeats. Paternity was established by concordance of 10 independent polymorphic alleles. Additional family samples may help to assess the allelic stability. This prevalence of new HD cases was unanticipated before discovery of the predisposing gene, but has emerged over the first year of direct diagnostic testing and may foreshadow greater demand for testing as the extended families become aware of their risks. These cases provoke new questions about interpretation of DNA data for patients, raise ethical concerns about informing extended families, and special counselling issues for families to whom HD is a new entity.

  10. Medical History for Prognostic Risk Assessment and Diagnosis of Stable Patients with Suspected Coronary Artery Disease

    Min, James K.; Dunning, Allison; Gransar, Heidi; Achenbach, Stephan; Lin, Fay Y.; Al-Mallah, Mouaz; Budoff, Matthew J.; Callister, Tracy Q.; Chang, Hyuk-Jae; Cademartiri, Filippo; Chinnaiyan, Kavitha; Chow, Benjamin J. W.; DAgostino, Ralph; DeLago, Augustin; Friedman, John; Hadamitzky, Martin; Hausleiter, Joerg; Hayes, Sean; Kaufmann, Philipp; Raff, Gilbert L.; Shaw, Leslee J.; Thomson, Louise; Villines, Todd; Cury, Ricardo C.; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Berman, Daniel S.; Pencina, Michael

    2014-01-01

    Aims To develop a clinical cardiac risk algorithm for stable patients with suspected CAD based upon angina typicality and CAD risk factors. Methods and Results Between 2004 and 2011, 14,004 adults with suspected CAD referred for cardiac imaging were followed: 1) 9,093 patients for CCTA (CCTA-1) followed for 2.0 years; 2) 2,132 patients for CCTA (CCTA-2) followed for 16 years, and 3) 2,779 patients for exercise myocardial perfusion scintigraphy followed for 5.0 years. A best-fit model from CCTA-1 for prediction of death or myocardial infarction (MI) was developed, with integer values proportional to regression coefficients. Discrimination was assessed using C-statistic. The validated model was also tested for estimation of the likelihood of obstructive CAD, defined as ?50% stenosis, as compared to method of Diamond and Forrester (D-F). Primary outcomes included all-cause mortality and non-fatal MI. Secondary outcomes included prevalence of angiographically obstructive CAD. In CCTA-1, best-fit model discriminated individuals at risk of death or MI (C-statistic 076). The integer model ranged from 3-13, and corresponded to 3-year death risk or MI of 025% to 538%. When applied to the CCTA-2 and MPS, the model demonstrated C-statistics of 071 and 077. Both best-fit (C=076, 95% CI 0746-0771) and integer model (C=071, 95% CI 0693-0719) performed better than D-F (C=064; 95% CI, 0628-0659) for estimating obstructive CAD. Conclusions For stable symptomatic patients with suspected CAD, we developed a history-based method for prediction of death and obstructive CAD. PMID:25865923

  11. Agreement between medical record data and patients' accounts of their medical history and treatment for dyspepsia.

    Westbrook, J I; McIntosh, J H; Rushworth, R L; Berry, G; Duggan, J M

    1998-03-01

    We examined agreement between data abstracted from medical records and interview data for patients with dyspepsia admitted to hospital for endoscopy, to determine the extent to which health records could be used to validate self-reports of dyspepsia and the management of this condition. Results from the sample of 220 patients showed that there was poor agreement between data sources for information about duration of dyspepsia (k=0.34) and previous barium meal examination (k=0.34). Patients reported significantly longer dyspepsia histories (Wilcoxon sign test Z=4.13, precords. There was also disagreement between data sources regarding the number of drugs taken before and after endoscopy (k=0.28 and k=0.31, respectively). Where there was disagreement for number of drugs there was no significant difference in the direction of the disagreement. There was moderate agreement regarding the name of pre-endoscopy medication (k=0.55) and substantial agreement for the name of medication used post-endoscopy (k=0.62). There was very poor agreement regarding diagnosis. The medical record was the gold standard for this information. Choice of data source, medical records or self-reports, will in many instances provide significantly different results and it is likely that this may also be true for other variables of interest to researchers. Thus in the case where no gold standards are available researchers need to consider carefully the implication of choice of data source on their results. PMID:9495689

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

    Lopez-Miranda Jose

    2010-04-01

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

  13. 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

    Dimopoulos Meletios

    2011-07-01

    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.

  14. Necrotizing sialometaplasia of the palatal mucosa in patient with history of anorexia: review and case report.

    Gilowski, ?ukasz; Wiench, Rafa?; Polakiewicz-Gilowska, Anna; Dwornicka, Katarzyna

    2014-01-01

    Necrotizing sialometaplasia is a self-limiting disorder affecting minor salivary glands resembling a malignant process both clinically and histopathologically. The etiology of this rare inflammatory` disorder is related to an ischemic event. Identified risk factors include alcohol abuse, smoking, drugs, denture wearing, injury and systemic diseases. Also reported are cases of necrotizing sialometaplasia associated with bulimia. This paper identifies the whole body incitement among additional risk factors by presenting a case of necrotizing sialometaplasia in an 18 year old patient with the history of anorexia nervosa. Furthermore it describes the effects of extreme cooling of palatal mucosa with ice chips resulting in constriction of blood vessels as the direct cause, reinforcing ischemic etiology of necrotizing sialometaplasia. PMID:24667056

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

    Sacchi, Lucia; Dagliati, Arianna; Bellazzi, Riccardo

    2015-01-01

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

  16. Clinical phenotype clustering in cardiovascular risk patients for the identification of responsive metabotypes after red wine polyphenol intake.

    Vázquez-Fresno, Rosa; Llorach, Rafael; Perera, Alexandre; Mandal, Rupasri; Feliz, Miguel; Tinahones, Francisco J; Wishart, David S; Andres-Lacueva, Cristina

    2016-02-01

    This study aims to evaluate the robustness of clinical and metabolic phenotyping through, for the first time, the identification of differential responsiveness to dietary strategies in the improvement of cardiometabolic risk conditions. Clinical phenotyping of 57 volunteers with cardiovascular risk factors was achieved using k-means cluster analysis based on 69 biochemical and anthropometric parameters. Cluster validation based on Dunn and Figure of Merit analysis for internal coherence and external homogeneity were employed. k-Means produced four clusters with particular clinical profiles. Differences on urine metabolomic profiles among clinical phenotypes were explored and validated by multivariate orthogonal signal correction partial least-squares discriminant analysis (OSC-PLS-DA) models. OSC-PLS-DA of (1)H-NMR data revealed that model comparing "obese and diabetic cluster" (OD-c) against "healthier cluster" (H-c) showed the best predictability and robustness in terms of explaining the pairwise differences between clusters. Considering these two clusters, distinct groups of metabolites were observed following an intervention with wine polyphenol intake (WPI; 733 equivalents of gallic acid/day) per 28days. Glucose was significantly linked to OD-c metabotype (Pfucose and 3-hydroxyphenylacetate showed a significant trend. Interestingly, 4-hydroxyphenylacetate significantly increased in H-c_WPI compared to OD-c_WPI and to basal groups (P<.05)-gut microbial-derived metabolite after polyphenol intake-, thereby exhibiting a clear metabotypic intervention effect. Results revealed gut microbiota responsive phenotypes to wine polyphenols intervention. Overall, this study illustrates a novel metabolomic strategy for characterizing interindividual responsiveness to dietary intervention and identification of health benefits. PMID:26878788

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

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

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

    Patrcia Constante, Jaime; Alex Antonio, Florindo; Maria do Rosrio Dias de Oliveira, Latorre; Alusio Augusto Cotrim, Segurado.

    2006-08-01

    Full Text Available OBJETIVO: Avaliar a associao entre consumo alimentar e presena de obesidade abdominal em indivduos infectados pelo HIV/Aids, em uso de terapia antiretroviral de alta potncia. MTODOS: Trata-se de estudo transversal envolvendo 223 indivduos adultos, realizado no municpio de So Paulo, em 2002. [...] A populao de estudo foi classificada de acordo com a obesidade abdominal, definida pela razo das circunferncias da cintura e quadril >0,95 para os homens e >0,85 para mulheres. As variveis dietticas 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 confuso examinados foram sexo, raa, idade, escolaridade, renda, ndice de massa corporal, nvel de atividade fsica, tabagismo, contagem de linfcitos T CD4+ e tempo de uso de inibidor de protease. Estimou-se modelo de regresso logstica para avaliar a relao entre obesidade abdominal e consumo alimentar. RESULTADOS: A prevalncia de obesidade abdominal foi de 45,7% e esteve associada ao maior consumo de lipdeos: para cada aumento de 10 g de lipdio na dieta a chance aumentou 1,28 vezes. O consumo de carboidratos mostrou-se negativamente associado (OR=0,93) com a presena de obesidade abdominal aps ajuste pelas variveis de controle. CONCLUSES: Os resultados sugerem que a quantidade de carboidratos e lipdeos na dieta, independente do consumo energtico, pode modificar a chance de desenvolver obesidade abdominal na populao estudada. Intervenes nutricionais podem ser benficas na preveno 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 So Paulo city in 2002. The study popula [...] tion was classified according to central obesity, defined as waist-to-hip ratio >0.95 for men and >0.85 for women. The dietary variables studied were energy consumption (in calories and calories/kilo of body weight), macronutrients (in grams and % of energy intake), total fiber (grams) and fruit and vegetables intake (grams). The potential confounders examined were sex, skin color, age, schooling, income, body mass index, physical activity, smoking habits, peripheral CD4+ T lymphocyte count and length of protease inhibitor use. The multiple logistic regression model was performed in order to evaluate the association between central obesity and dietary intake. RESULTS: The prevalence of central obesity was 45.7% and it was associated with greater consumption of lipids: for every increase of 10g of lipid intake the odds of central obesity increased 1.28 times. Carbohydrate consumption showed negative association (OR=0.93) with central obesity after adjustment for control variables. CONCLUSIONS: The results suggest that the amount of carbohydrates and lipids in the diet, regardless of total energy intake, may modify the chance of developing central obesity in the studied population. Nutritional interventions may be beneficial for preventing central obesity among HIV/AIDS patients.

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

    Patrícia Constante Jaime

    2006-08-01

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

  20. The risk for bloodstream infections is associated with increased parenteral caloric intake in patients receiving parenteral nutrition

    Dissanaike, Sharmila; Shelton, Marilyn; Warner, Keir; O'Keefe, Grant E.

    2007-01-01

    Background Patients receiving total parenteral nutrition (TPN) are at high risk for bloodstream infections (BSI). The notion that intravenous calories and glucose lead to hyperglycemia, which in turn contributes to BSI risk, is widely held but is unproven. We therefore sought to determine the role that hyperglycemia and parenteral calories play in the development of BSI in hospitalized patients receiving TPN. Methods Two hundred consecutive patients initiated on TPN between June 2004 and Augu...

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

    Hu Amanda

    2004-07-01

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

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

    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)

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

    Asero Riccardo

    2007-01-01

    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...

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

    Eze-Nliam Chete

    2012-03-01

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

  5. Caractersticas de la poblacin con ingesta baja en lutena y zeaxantina en pacientes con degeneracin macular asociada a la edad variante hmeda / Characteristics of patients with wet age-related macular degeneration and low intake of lutein and zeaxanthin

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

    2012-04-01

    Full Text Available Objetivo: Averiguar las caractersticas de los pacientes con DMAE hmeda que ingieren suficiente lutena y zeaxantina en nuestra poblacin. Mtodos: Estudio protocolizado, prospectivo, observacional, transversal, en pacientes diagnosticados de DMAE hmeda activa. Se efecta hemograma, perfil lipdic [...] o, y perfil heptico; una entrevista diettica sobre los hbitos alimentarios a partir de la realizacin de un recordatorio de 24h y estudio antropomtrico. Se dividen en dos grupos en funcin de la ingesta de lutena-zeaxantina (L-Z). Grupo 1 (ingesta suficiente): pacientes con ingesta diaria > 1.400mg/da en mujeres y 1.700mg/da en hombres (2/3 de la ingesta media diaria en poblacin normal). Grupo 2: pacientes con ingesta diaria inferior a las del grupo 1. Se efecta un estudio estadstico descriptivo y comparativo entre ambos grupos. Resultado: Un total de 52 pacientes, con una edad media de 78,9 aos. Grupo 1: 11 pacientes (21% de la muestra). Grupo 2: 41. Los pacientes con ingesta suficiente de L-Z tienen mayor ndice de masa corporal y permetro 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 ndice de masa corporal y permetro de cintura, y adems la mayora tienen una ingesta insuficiente de vitaminas A, C y E, y zinc. Abstract in english Objective: To assess the characteristics of patients with wet AMD and low intake of lutein and zeaxanthin in our population. Methods: A prospective, observational, cross-sectional study was conducted on patients with active wet AMD. A full blood count, a lipid and liver profile, a dietary interview [...] (24-hour recall), and an anthropometric study were performed. Lutein-zeaxanthin (LZ) intake results split the patents in two groups. Group 1 ("sufficient" intake): patients with > 1,400mg/day intake in women and 1,700mg/day in men (2/3 of the average daily intake in a normal population). Group 2: patients with daily intakes below that of group 1. A descriptive and comparative statistical study was performed. Results: Fifty-two patients with a mean age of 78.9 years. Group 1: eleven patients (21% of the sample). Group 2: forty-one patients. The subjects with adequate intake of LZ had higher a body mass index and waist circumference. Between 70-80% of patients in group 1 had inadequate intake of vitamin A, C and E and zinc. Conclusions: Seventy-nine per cent of the patients with wet AMD have a deficient daily intake in lutein-zeaxanthin. The population with adequate intake is associated with an increased body mass index and waist circumference, and in addition, most of them have an insufficient intake of vitamin A, C, E and zinc.

  6. Risk of colorectal adenomas in patients with a family history of colorectal cancer: some implications for screening programmes.

    Aitken, J F; Bain, C J; Ward, M; Siskind, V; MacLennan, R

    1996-01-01

    BACKGROUND AND AIMS: Most colorectal cancers (CRC) arise in colorectal adenomas. A case-control study was conducted to see whether a family history of CRC is associated with a higher prevalence of colorectal adenomas. SUBJECTS: Subjects were drawn from all patients who underwent colonoscopy at the Royal Brisbane Hospital between 1980-1982 and 1985, and included 141 cases with colorectal adenomas diagnosed at colonoscopy and 882 controls who were free of polyps at colonoscopy. METHODS: The prevalence of family history of CRC was compared between patients with adenomas and negative colonoscopy controls. RESULTS: Overall, patients with one first degree relative with CRC were at no greater risk for adenomas at colonoscopy than patients with no family history (odds ratio (OR) = 0.8, 95% confidence intervals (CI) = 0.4, 1.5). Patients with two or more affected first degree relatives had a more than doubled risk for adenomas (OR = 2.3, 95% CI = 0.5, 8.2), and were also more likely to carry moderately or severely dysplastic adenomas (OR = 14.1, 95% CI = 2.0, 62.9). CONCLUSIONS: These findings are consistent with the hypothesis that some families, in addition to those with familial adenomatous polyposis, have an increased susceptibility to develop colorectal adenomas, and that adenomas in such families may have a greater tendency to undergo malignant transformation. PMID:8881819

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

    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.

  8. Germline BAP1 Mutational Landscape of Asbestos-Exposed Malignant Mesothelioma Patients with Family History of Cancer.

    Ohar, Jill A; Cheung, Mitchell; Talarchek, Jacqueline; Howard, Suzanne E; Howard, Timothy D; Hesdorffer, Mary; Peng, Hongzhuang; Rauscher, Frank J; Testa, Joseph R

    2016-01-15

    Heritable mutations in the BAP1 tumor suppressor gene predispose individuals to mesothelioma and other cancers. However, a large-scale assessment of germline BAP1 mutation incidence and associated clinical features in mesothelioma patients with a family history of cancer has not been reported. Therefore, we examined the germline BAP1 mutation status of 150 mesothelioma patients with a family history of cancer, 50 asbestos-exposed control individuals with a family history of cancers other than mesothelioma, and 153 asbestos-exposed individuals without familial cancer. No BAP1 alterations were found in control cohorts, but were identified in nine of 150 mesothelioma cases (6%) with a family history of cancer. Alterations among these cases were characterized by both missense and frameshift mutations, and enzymatic activity of BAP1 missense mutants was decreased compared with wild-type BAP1. Furthermore, BAP1 mutation carriers developed mesothelioma at an earlier age that was more often peritoneal than pleural (five of nine) and exhibited improved long-term survival compared to mesothelioma patients without BAP1 mutations. Moreover, many tumors harboring BAP1 germline mutations were associated with BAP1 syndrome, including mesothelioma and ocular/cutaneous melanomas, as well as renal, breast, lung, gastric, and basal cell carcinomas. Collectively, these findings suggest that mesothelioma patients presenting with a family history of cancer should be considered for BAP1 genetic testing to identify those individuals who might benefit from further screening and routine monitoring for the purpose of early detection and intervention. Cancer Res; 76(2); 206-15. ©2015 AACR. PMID:26719535

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

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

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

    ENJOJI, MUNECHIKA; NAKAMUTA, MAKOTO

    2010-01-01

    In our examination of the distribution of abdominal fat, dietary intake and biochemical data in patients with nonalcoholic fatty liver disease (NAFLD), non-obese NAFLD patients without insulin resistance presented a characteristic pattern of dietary intake. Dietary cholesterol intake was superabundant in non-obese patients compared with obese patients, although total energy and carbohydrate intake was not excessive. Namely, excess cholesterol intake appears to be one of the main factors assoc...

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

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

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

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

  13. Assessment of time interval between tramadol intake and seizure and second drug-induced attack

    Bahareh Abbasi

    2015-11-01

    Full Text Available Background: Tramadol is a synthetic drug which is prescribed in moderate and severe pain. Tramadol overdose can induce severe complications such as consciousness impairment and convulsions. This study was done to determine the convulsions incidence after tramadol use until one week after hospital discharge. Methods: This prospective study was done in tramadol overdose patients without uncontrolled epilepsy and head injury history. All cases admitted in Loghman and Rasol Akram Hospitals, Tehran, Iran from 1, April 2011 to 1, April 2012 were included and observed for at least 12 hours. Time interval between tramadol intake and first seizure were record. Then, patients with second drug-induced seizure were recognized and log time between the first and second seizure was analyzed. The patients were transferred to the intensive care unit (ICU if clinical worsening status observed. One week after hospital discharge, telephone follow-up was conducted. Results: A total of 150 patients with a history of tramadol induced seizures (141 men, 9 women, age: 23.23±5.94 years were enrolled in this study. Convulsion was seen in 104 patients (69.3%. In 8 out of 104 patients (7.6% two or more convulsion was seen. Time interval between tramadol use and the onset of the first and second seizure were 0.93±0.17 and 2.5±0.75 hours, respectively. Tramadol induced seizures are more likely to occur in males and patients with a history of drug abuse. Finally, one hundred forty nine patients (99.3% were discharged with good condition and the only one patient died from tramadol overdose. Conclusion: The results of the study showed tramadol induced seizure most frequently occurred within the first 4 hours of tramadol intake. The chance of experiencing a second seizure exists in the susceptible population. Thus, 4 hours after drug intake is the best time for patients to be hospital discharged.

  14. Patients with history of hyperemesis gravidarum have similar symptoms during egg stimulation and develop ovarian hyperstimulation syndrome: case series

    Fejzo, Marlena S.; Romero, Roberto; Goodwin, T. Murphy

    2009-01-01

    Objective To investigate the symptoms and outcomes of ovarian stimulation in patients with a history of hyperemesis gravidarum. Design Retrospective case series. Setting Research laboratory of a university hospital. Patients Participants in an ongoing study on hyperemesis gravidarum that reported ovarian stimulation for gestational surrogacy. Interventions Review of medical records. Main Outcome Measures Pregnancy history, symptoms, estradiol level and mature oocyte number in cases, and nausea and vomiting level reported in surrogate. Results Three cases in their early thirties with a history of hyperemesis gravidarum presented with severe nausea and vomiting during ovarian stimulation and ovarian hyperstimulation syndrome. Gestational carriers reported normal nausea and vomiting of pregnancy. Conclusions This series provides lessons for in vitro fertilization for cases with a history of hyperemesis gravidarum and their gestational carriers as well as insight into the cause of hyperemesis gravidarum and its potential role in fertility. A link between hyperemesis gravidarum and an evolutionary advantage of increased fertility suggests a novel theory to explain the selection for nausea and vomiting in pregnancy. PMID:19878938

  15. Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. TRACE study group

    Gustafsson, F; Køber, L; Torp-Pedersen, C; Hildebrandt, P; Ottesen, M M; Sonne, B; Carlsen, J

    1998-01-01

    AIMS: The objective of the study was to investigate the influence of a history of arterial hypertension on long-term prognosis after an acute myocardial infarction in a representative population, and secondly to assess the impact on prognosis of left ventricular systolic function in hypertensives...... patients had a history of arterial hypertension. During the time of observation 763 (50.6%) hypertensives and 2253 (43.7%) normotensives died, corresponding to a risk ratio for death in hypertensives of 1.23 (1.13-1.33, P < 0.0001). In a multivariate analysis considering 12 other major risk factors after...... myocardial infarction, the risk ratio for death in hypertensives was 1.14 (1.04-1.24). There was a significant interaction between hypertension and age. Thus, hypertension only increased risk in patients aged 65 years or less (P < 0.001). No interaction with left ventricular systolic function was found...

  16. Abdominal aortic aneurysms do not develop more aggressively among patients with a positive family history of the disease

    Mejnert Jørgensen, Trine; Wemmelund, Holger; Green, Anders; Lindholt, Jes Sanddal; Houlind, Kim Christian

    information on family history of AAA, diameter of AAA throughout follow-up, surgery, ruptures, comorbidity, smoking, and use of medication. Methods: Patients with and without a family history of AAA were compared regarding mean age at diagnosis and surgery, diameter of AAA at diagnosis, risk of surgery and...... disease (69.8 vs. 72.4 years, p=0.032), but we found no significant differences regarding age at operation (72.2 vs. 70.6, p=0.204) or regarding the proportion of patients experiencing rupture (16.0 vs. 10.6%, p=0.226) or undergoing surgery (78.2 % vs. 81.7 %, p=0.484). We found no significant difference...

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

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

    2012-01-01

    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

  18. A study on the natural history of scanning behaviour in patients with visual field defects after stroke

    Loetscher, Tobias; Chen, Celia; Wignall, Sophie; Bulling, Andreas; Hoppe, Sabrina; Churches, Owen; Thomas, Nicole A; Nicholls, Michael E. R.; Lee, Andrew

    2015-01-01

    Background A visual field defect (VFD) is a common consequence of stroke with a detrimental effect upon the survivors’ functional ability and quality of life. The identification of effective treatments for VFD is a key priority relating to life post-stroke. Understanding the natural evolution of scanning compensation over time may have important ramifications for the development of efficacious therapies. The study aims to unravel the natural history of visual scanning behaviour in patients wi...

  19. Endothelial Lipase Plasma Levels are Increased in Patients With Significant Carotid Artery Stenosis and History of Neurological Impairment

    Riederer, Monika; Trbušić, Matias; Degoricija, Vesna; Frank, Saša

    2012-01-01

    Background Endothelial lipase (EL) is a phospholipase expressed predominantly by vascular endothelial cells. The goal of the present study was to examine whether EL plasma levels in patients with carotid artery stenosis differ between those with previous history of neurological impairment and those without neurological symptoms. Methods EL plasma levels were measured by a competitive ELISA assay. Results EL plasma levels were significantly higher in the symptomatic, compared with the asymptom...

  20. Risk of colorectal adenomas in patients with a family history of colorectal cancer: some implications for screening programmes.

    Aitken, J F; Bain, C J; Ward, M.; Siskind, V.; MacLennan, R

    1996-01-01

    BACKGROUND AND AIMS: Most colorectal cancers (CRC) arise in colorectal adenomas. A case-control study was conducted to see whether a family history of CRC is associated with a higher prevalence of colorectal adenomas. SUBJECTS: Subjects were drawn from all patients who underwent colonoscopy at the Royal Brisbane Hospital between 1980-1982 and 1985, and included 141 cases with colorectal adenomas diagnosed at colonoscopy and 882 controls who were free of polyps at colonoscopy. METHODS: The pre...

  1. Activity in Pregnancy for Patients with a History of Preterm Birth

    Satterfield, Nichelle; Newton, Edward R.; May, Linda E.

    2016-01-01

    Preterm birth remains a leading cause of neonatal morbidity and mortality throughout the world. Numerous risk factors for preterm birth have been identified, including non-Hispanic black race, a variety of social and behavioral factors, infections, and history of a prior preterm delivery. Of these, a history of prior spontaneous preterm birth is one of the strongest risk factors. Traditionally, women with a history of preterm birth or those deemed at high risk for preterm delivery have been placed on bed rest or a reduced activity regimen during their pregnancy. However, there is little evidence to support this recommendation. Recent research has suggested that regular physical activity and exercise during pregnancy is safe and does not increase the risk of preterm delivery. Therefore, physicians should encourage women with a history of preterm birth to exercise throughout pregnancy according to guidelines published by the American College of Obstetricians and Gynecologists as long as they are receiving regular prenatal care and their current health status permits exercise. However, there are no randomized controlled trials evaluating exercise prescription in women with a history of preterm birth, hence additional research is needed in this area. PMID:27226741

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

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

    2013-03-01

    Full Text Available ABSTRACTIntroduction: The metabolic syndrome (MS increa -ses the odds of dying for cardiovascular disease, theworlds leading cause of death. It has been shown thatpolyunsaturated fatty acids have a protective role in cardiovascular disease and its comorbidities.Objective: To assess the effect of three kinds ofpolyunsaturated fatty acids on the chronic inflammation in MS.Methods: The study group was 45 adults with MSdiagnose according to IDF criteria. Each group of treatment was assigned cuasi-randomly to 15 subjects during six weeks: a 1.8 g/d n-3 (1.08 g eicosapentoaenoicacid EPA + 0.72 g docosahexaenoic acid DHA, b 2.0g/d conjugated linoleic acid (CLA, 50:50, cis9:trans11,trans10:cis12, c 40 g/d walnut Juglans regia. The results at the beginning and the end of the essay werecompared in each group, using the t-Student test and p <0.01 as statistical signification value.Results:In the patients supplemented with n-3 fattyacids, significantly decreased the level of IL-6 (from9.81 1.28 to 8.47 0.81 pg/ml, p=0.002, leptin(from 25.94 5.06 ng/ml to 20.53 3.96 ng/ml,p=0.003 and homocysteine (from 18.80 1.95 to16.72 1.99 mol/l, p=0.007, in erythrocytes decreased the percentage ?-linolenic content (from 1.900.77 to 1.26 0.17 %, p=0.004 and the n6/n3 rate(from 4.48 1.06 to 3.11 a 0.60, p=0.000, while increased the percentage of EPA (from 1.13 0.45 to1.58 0.42 %, p=0.009 and DHA (from 2.61 0.36 to4.64 0.91 %, p=0.000. In the group that consumedwalnut declined the levels of TNF-? (from 8.75 2.06pg/ml to 6.68 0.97 pg/ml, p=0.002 and IL-6 (from10.61 1.45 to 8.72 0.79 pg/ml, p=0.000, in erythrocytes increased the ?-linolenic content (from 1.860.65 to 2.62 0.72 %, p=0.005. In the group thatconsumed CLA decreased the level of homocysteine(from 18.01 2.65 to 15.34 2.26 mol/l, p=0.006.Conclusions: The groups that consumed n-3 fattyacids in supplements (EPA/DHA and in walnut, becameevident the modification in the erythrocyte fatty acidscontent, which could be associated to the reduction ofpro inflammatory state. In the group that consumedCLA the homocysteine level decreased without changesin the other markers or erythrocyte fatty acids.

  3. 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

    Aung Myo

    2012-09-01

    Full Text Available Abstract Background Decreasing salt consumption can prevent cardiovascular diseases (CVD. Practically, it is difficult to promote peoples 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

  4. [Pregnancy in patients with a history of ischaemic heart disease - Case series and literature review].

    Matura-Bedouhene, M; Maatouk, A; Moulin, F; Welter, E; Morel, O; Perdriolle-Galet, E

    2016-04-01

    Heart diseases complicate 1 to 3% of pregnancies and are the leading cause of indirect maternal deaths. Prior ischaemic heart event in pregnant patients is increasing. Most knowledge is based on few reports and there are no French nor international recommendations about the specific management of these patients. The specificity of the management of these patients during pregnancy, delivery and post-partum depends on the severity of the prior cardiac event and its consequences. This will be illustrated by the report of four recent cases managed in our hospital. First patient had myocardial infarction with normal left ventricular ejection fraction (LVEF). Second patient had a Tako-Tsubo syndrome with LVEF 45%. Third patient had ischemic cardiopathy with LVEF 30%. Fourth patient had myocardial infarction with LVEF 20%. A multidisciplinary follow-up should be required, especially in patients with severe ventricular dysfunction. The risk of fetal growth restriction appears to be increased, suggesting that closer ultrasound monitoring is necessary. PMID:26321610

  5. Tailoring iron chelation by iron intake and serum ferritin : the prospective EPIC study of deferasirox in 1744 patients with transfusion-dependent anemias

    Cappellini, M. D.; Porter, J.; A. El-Beshlawy; Li, C. K.; Seymour, J.F.; Elalfy, M.; Gattermann, N; Giraudier, S.; Lee, J. W.; Chan, L L; Lin, K H; Rose, C.; Taher, A; Thein, S L; Viprakasit, V

    2010-01-01

    BackgroundFollowing a clinical evaluation of deferasirox (Exjade (R)) it was concluded that, in addition to baseline body iron burden, ongoing transfusional iron intake should be considered when selecting doses. The 1-year EPIC study, the largest ever investigation conducted for an iron chelator, is the first to evaluate whether fixed starting doses of deferasirox, based on transfusional iron intake, with dose titration guided by serum ferritin trends and safety markers, provides clinically a...

  6. Processing of decision-making and social threat in patients with history of suicidal attempt: A neuroimaging replication study.

    Oli, Emilie; Ding, Yang; Le Bars, Emmanuelle; de Champfleur, Nicolas Menjot; Mura, Thibault; Bonaf, Alain; Courtet, Philippe; Jollant, Fabrice

    2015-12-30

    Suicidal vulnerability has been related to impaired value-based decision-making and increased sensitivity to social threat, mediated by the prefrontal cortex. Using functional magnetic resonance imaging, we aimed at replicating these previous findings by measuring brain activation during the Iowa Gambling Task and an emotional faces viewing task. Participants comprised 15 euthymic suicide attempters (history of depression and suicidal behavior) who were compared with 23 euthymic patient controls (history of depression without suicidal history) and 35 healthy controls. The following five model-based regions of interest were investigated: the orbitofrontal cortex (OFC), ventrolateral prefrontal cortex (VLPFC), anterior cingulate cortex (ACC), medial (MPFC) and dorsal prefrontal cortex (DPFC). Suicide attempters relative to patient controls showed (1) increased response to angry vs. neutral faces in the left OFC and the VLPFC, as previously reported; (2) increased response to wins vs. losses in the right OFC, DPFC and ACC; (3) decreased response to risky vs. safe choices in the left DPFC; and (4) decreased response to sad vs. neutral faces in the right ACC. This study links impaired valuation processing (here for signals of social threat, sadness and reward) to prefrontal cortex dysfunction in suicide attempters. These long-term deficits may underlie the impaired decision-making and social difficulties found in suicide attempters. PMID:26483212

  7. Dissociative symptoms are associated with reduced neuropsychological performance in patients with recurrent depression and a history of trauma exposure

    Melissa Parlar

    2016-02-01

    Full Text Available Background: Although preliminary work suggests that dissociative symptoms may impact neuropsychological performance in trauma-exposed populations, the relation between dissociation and cognitive performance has not been explored in patients with depression. Objective: The present study examined dissociative symptoms in relation to neuropsychological performance in participants with a primary diagnosis of recurrent major depressive disorder (MDD and a history of trauma exposure. Method: Twenty-three participants with MDD and 20 healthy controls who did not differ in age, sex, education, or IQ were assessed. In addition to a standardized neuropsychological battery assessing frontotemporally mediated cognitive processes, participants completed clinical measures assessing dissociative symptoms, illness severity, and past history of trauma exposure. Results: Among participants with MDD, greater severity of derealization was associated with reduced performance on measures of delayed visuospatial recall and recognition on a task of verbal memory recognition. In addition, more severe depersonalization was associated with slower processing speed and a response style lending itself toward better performance in a less active environment. Conclusions: These findings point toward dissociative symptoms as a transdiagnostic factor associated with neuropsychological dysfunction in patients with depression and a history of trauma. Limitations and recommendations for future research are discussed.

  8. Cognitive function in euthymic bipolar disorder (BP I) patients with a history of psychotic symptoms vs. schizophrenia.

    Nenadic, Igor; Langbein, Kerstin; Dietzek, Maren; Forberg, Anne; Smesny, Stefan; Sauer, Heinrich

    2015-11-30

    Patients with bipolar disorder show cognitive deficits including executive function, which appear to be related to social functioning and outcome. However, subgroups within the spectrum as well as psychopathological features, current mood state/euthymia and disease stage might be confounding factors. We analysed data tests from the Wechsler Intelligence Scale (WIE), verbal fluency (COWA) and trail making tests (TMT-A and TMT-B) obtained in a selected subgroup of currently bipolar I disorder patients, who were currently euthymic and had a history of psychotic symptoms, and compared them to patients with schizophrenia (in remission) and healthy controls, all matched for age, gender, and handedness. Schizophrenia patients showed more severe cognitive impairment, including digit symbol and arithmetic tests, as well as TMT-B (compared to healthy controls), but bipolar patients had stronger impairment on the letter number sequencing test, an indicator of working memory and processing speed. There were no group effects on most verbal fluency tasks (except impairment of schizophrenia patients on one subscale of category fluency). Within the limitations of the study design, our results suggest that even in subgroups of presumably more severely impaired bipolar patients, some cognitive dimensions might achieve remission, possibly related to considerable state effects at testing. PMID:26319738

  9. Adjunctive therapies to reduce thrombotic events in patients with a history of myocardial infarction: role of vorapaxar

    Farag M

    2015-07-01

    Full Text Available Mohamed Farag,1,2 Hiten Patel,1 Diana A Gorog1–3 1Department of Cardiology, East and North Hertfordshire NHS Trust, Stevenage, 2Postgraduate Medical School, University of Hertfordshire, Hatfield, 3National Heart and Lung Institute, Imperial College, London, UK Abstract: Acute myocardial infarction (AMI is generally attributed to coronary atherothrombotic disease. Platelet activation is essential for thrombus formation and is thus an important target for pharmacological intervention to prevent and treat AMI. Despite contemporary treatment with dual antiplatelet therapy, including acetylsalicylic acid and adenosine diphosphate receptor antagonists, patients with prior AMI remain at increased risk of future thrombotic events. This has stimulated the search for more potent antithrombotic agents. Among these is the oral protease-activated receptor-1 antagonist vorapaxar, which represents a new oral antiplatelet agent to reduce thrombotic risk in patients with atherothrombotic disease. The TRACER and the TRA 2°P-TIMI 50 trials concluded that vorapaxar in addition to standard therapy reduced ischemic adverse cardiac events. A remarkable benefit was observed in patients with stable atherosclerotic disease, particularly those with a previous history of AMI. Although favorable effects were seen in reduction of adverse cardiac events, this was associated with excess major and intracranial bleeding, particularly in patients at high risk of bleeding and those with a history of stroke or transient ischemic attack. Currently, the lack of a reliable individualized risk stratification tool to assess patients for thrombotic and bleeding tendencies in order to identify those who might gain most net clinical benefit has led to limited use of vorapaxar in clinical practice. Vorapaxar may find a niche as an adjunct to standard care in patients at high risk of thrombotic events and who are at low risk of bleeding. Keywords: myocardial infarction, thrombosis, antiplatelet agents, protease-activated receptor-1, vorapaxar

  10. Intake of dairy products and the risk of breast cancer.

    Knekt, P.; Järvinen, R.; Seppänen, R.; Pukkala, E; Aromaa, A.

    1996-01-01

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

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

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

    2014-04-01

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

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

    Hossein Khedmat

    2013-05-01

    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.

  13. Should a family history of papillary thyroid carcinoma indicate more aggressive therapy in patients with this tumor?

    Pedro Weslley Rosario

    2014-11-01

    Full Text Available Objective To determine whether the currently recommended therapy for papillary thyroid carcinoma (PTC that show no classical factors indicating a poor prognosis is also effective in cases with a family history of this tumor. Subjects and methods: Forty-two patients were studied; 10 were submitted to lobectomy and 32 to total thyroidectomy, including 23 without lymph node dissection and 9 with lymph node dissection. None of the patients received radioiodine or was maintained under TSH suppression. Results No case of recurrence was detected by imaging methods and there was no increase in thyroglobulin or antithyroglobulin antibodies during follow-up (24 to 72 months. Conclusion The treatment usually recommended for patients with PTC does not need to be modified in the presence of a family history of this tumor if no factors indicating a poor prognosis are present (tumor ≤2 cm, non-aggressive histology, no extensive extrathyroid invasion or important lymph node involvement, complete tumor resection, no evidence of persistent disease after surgery.

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

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

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

    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

  16. Discrepancies between sources providing the medication histories of acutely hospitalised patients

    Karkov, Louise Lindved; Schytte-Hansen, Simon; Nørgaard, Lotte Stig

    2010-01-01

    Objective The aim of this study was to clarify the number and type of discrepancies between four medication sources as well as their potential clinical significance to the patient. Method The study was conducted as a cross-sectional study comprising all patients hospitalised with hip fractures in...

  17. Frailty is associated with a history with more falls in elderly hospitalised patients

    Schultz, Martin; Rosted, Elizabeth; Sanders, Suzanne

    2015-01-01

    INTRODUCTION: When elderly people are admitted to hospital, their risk of falling may often not be recognised. The risk of falling in the elderly is linked to frailty. In a Danish study, it was found that the "Identification of Seniors at Risk" screen (ISAR) predicted the patients' amount of health...... problems, days in hospital and readmission. It may therefore also be a predictor of frailty. This study aimed to evaluate how many elderly patients were admitted to an emergency department (ED) because of a fall and to examine if there was a correlation between these patients and their ISAR score. METHODS...... was found between patients' ISAR score and falls (p = 0.03). CONCLUSION: To prevent further falls and readmissions, it is crucial not only to focus on elderly people's presenting problems, but also on their dizziness and falls, especially in cognitively impaired elderly patients, and to make a plan...

  18. Evaluating trial of scar in patients with a history of caesarean section

    Aliya Islam

    2011-01-01

    Full Text Available Aims: To analyze the outcome of trial of scar in patients with previous caesarean section and to assess the fetal and maternal complications after trial of scar. Patients and Methods : The study was conducted at Military Hospital, Rawalpindi, Pakistan, with 375 pregnant patients who had a previous delivery by caesarean and who had regular antenatal checkup. Data were recorded on special pro-forms designed for the purpose. Results : The results from the 375 patients who had one previous lower segment caesarean section due to non-recurrent causes were analyzed and compared with national and international studies. Indications of previous caesarean section (non-recurrent causes included malpresentations, fetal distress/cord prolapse, failure to progress, severe pregnancy-induced hypertension/eclampsia and twins with abnormal lie of the first twin. 0 218 patients reported spontaneous labor. Among these patients, 176 delivered vaginally and 42 patients had repeat caesarean sections. There were a total of 157 patients who experienced induction of labor. 97 patients were induced by cervical ripening with mechanical method, followed by artificial rupture of membranes and augmentation (if required with syntocinon infusion. 60 patients were induced with prostaglandin E 2 vaginal tablet. Conclusion : This study concludes that females with a prior caesarean are at increased risk for subsequent caesareans, regardless of mode of delivery. Eliminating vaginal-birth-after-caesarean will not eliminate the risk. Therefore, vaginal birth after caesarean should be encouraged in selected cases from obstetric units to reduce the risks of repeated caesarean sections. Failed vaginal-birth-after-caesarean can result in increased morbidity than that with elective caesarean section.

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

    Rasouli Mahboobeh

    2011-10-01

    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.

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

    Vallejo-Aisa, Francisco J.; Estefanía-Fresco, Ruth

    2013-01-01

    Objectives: To evaluate bone loss around implants placed in patients with a history of treated chronic periodontitis and who did or did not attend supportive periodontal therapy, after one year in function. Furthermore, the influence of periodontal biotype and level of plaque was also evaluated. Material and Methods: Forty-nine patients participated voluntarily in the study. All subjects had a history of chronic periodontitis, which had been previously treated. After the active treatment, 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. Key words:Peri-implantitis, chronic periodontitis, bacterial plaque, periodontal biotype. PMID:23722147

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

    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)

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

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

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

    Ivanete Ribeiro do Nascimento

    2013-12-01

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

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

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

    2013-01-01

    BACKGROUND AND OBJECTIVE: Despite animal studies having shown a generalisation of the bupropion cue to cocaine, this drug has been used in cocaine abuse with mixed results. We here aimed at describing two cases which contradict current knowledge. CASE REPORTS: We describe two cases of former cocaine abusers who reported a cocaine-like sensation upon taking bupropion. Bupropion improved patients' depression without any increase in cocaine craving. One of the patients increased without doctor c...

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

    Johannesdottir Sigrun

    2012-03-01

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

  6. Dietary intake of phytoestrogens

    Bakker MI; SIR (CRV)

    2004-01-01

    The dietary intake of phytoestrogens supposedly influences a variety of diseases, both in terms of beneficial and adverse effects. This report describes current knowledge on dietary intakes of phytoestrogens in Western countries, and briefly summarizes the evidence for health effects. The predominant phytoestrogens in the Western diet are the isoflavones and the lignans. The consumer groups with the highest dietary intake of isoflavones are consumers taking dietary phytoestrogen containing su...

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

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

    2015-03-01

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

  8. AB101. Neonatal form of Isovaleric acidemia in Vietnamese patients: clinical history and outcomes

    Nguyen, Khanh Ngoc; Vu, Dung Chi; Can, Ngoc Thi Bich; Bui, Thao Phuong; Nguyen, Mai Chi; Yamaguchi, Seiji

    2015-01-01

    Background and objective Isovaleric academia (IVA) is an autosomal recessive inborn error of leucine metabolism caused by a deficiency of the mitochondrial enzyme isovaleryl-CoA dehydrogenase (IVD). The clinical presentation of IVA appears to be highly variable ranging from severely affected to asymptomatic subjects. This is the first report of Vietnamese patients with IVA. Describe clinical features and outcome of Vietnamese patients with IVA. Methods Case series report including three Vietnamese patients who were diagnosed IVA with the criteria of elevation of C5 and urinary isovalerylglycines, 3-OH-isovalerate using Tandem Mass and GC/MS. Results Three probands (2 female and 1 male) from three unrelated families were born to non-consanguinity parents. The age of onset was within the first 2 weeks of age (8, 9 and 10 days). The male patient had older brother died due to unknown comma at 18 days old. The initial symptom was poor feeding (3/3). After 1-2 days of the onset, they appeared lethargy/comma (3/3), convulsion (1/3) and respiratory failure required mechanical ventilation in one case. The investigations revealed metabolic acidosis (PH: 7.2-7.3) in 3 cases, thrombopenia in 3 cases; ketonuria in 3 cases and hyperammonemia in 3 cases. Management for acute crisis and long-term follow up of IVA was started after 2-3 days of the onset: coma was released after 2-3 days of treatment. All patients have normal development at 16 months of age; at 15 months of age and at 10 months of age, respectively. Conclusions Three Vietnamese patients with IVA presented early initial symptoms within 2 weeks of age and have good outcome.

  9. [Controlled release melatonin (Circadin) in the treatment of insomnia in older patients: efficacy and safety in patients with history of use and non-use of hypnotic drugs].

    Zisapel, Nava

    2009-05-01

    Circadin is a prolonged-release 2 mg melatonin formulation which, when taken before bedtime, mimics the physiological pattern of the endogenous hormone excreted during the night. It was approved by the EU-EMEA in June 2007 for the short-term treatment of primary insomnia characterized by poor quality of sleep in patients aged 55 or over. Placebo controlled clinical trials demonstrated, beyond the shortening of sleep Latency seen with traditional hypnotics, concomitant improvements in sleep quality and next day alertness and subsequently, quality of life. In contrast to traditional sedative hypnotics, Circadin has shown no evidence of impairing cognitive and psychomotor skills, of rebound, dependence or abuse potential and no significant adverse events compared to placebo. It can be used concomitantly with most medications but may potentiate the effects of GABA-A receptor modulators. Analyses presented here show that Circadin has comparable efficacy and safety in patients with and without history of hypnotic drug use. PMID:19630367

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

    Eibye, Simone; Jensen, Hans Mrch

    2014-01-01

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

  11. The natural history of EGFR and EGFRvIII in glioblastoma patients

    Shi Weiming

    2005-10-01

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

  12. Histrico de violncia intrafamiliar em pacientes psiquitricos / Family violence history in psychiatric patients / Histrico de violencia intrafamiliar en pacientes psiquitricos

    Ricardo da Costa, Padovani; Lcia Cavalcanti de Albuquerque, Williams.

    Full Text Available O objetivo da presente pesquisa foi caracterizar o histrico de violncia intrafamiliar em pacientes psiquitricos inseridos em tratamento de regime ambulatorial. Pretendeu-se, mais especificamente, identificar o tipo de violncia vivenciada pelos usurios. Participaram do estudo 23 pacientes de amb [...] os os sexos, em tratamento ambulatorial. A coleta de dados envolveu a aplicao de um roteiro de entrevista individual, com informaes sobre o histrico de internao e violncia intrafamiliar e com descrio da infncia, dentre outros itens. Apenas um dentre 23 participantes relatou ausncia de histrico de violncia intrafamiliar, 20 participantes indicaram histrico infantil de maus tratos fsicos e psicolgicos. Na fase adulta, dos 13 participantes que declararam viver com parceiros/parceiras no presente ou no passado, 8 participantes do sexo feminino relataram agressividade por parte do companheiro e 2 participantes do sexo masculino afirmaram ter agredido as esposas no passado. Com relao violncia sexual, 5 participantes relataram ter experienciado relao sexual forada por parte do parceiro e um participante relatou ter abusado sexualmente da parceira. Os resultados chamam a ateno pela alta freqncia e pela gravidade de episdios de violncia intrafamiliar, que evidenciam a necessidade de se replicar o estudo com amostras maiores e, na prtica clnica, investigar tais questes rotineiramente, uma vez que sua esquiva pode contribuir para o processo de adoecimento psquico. Abstract in spanish El objetivo de la presente pesquisa fue caracterizar el histrico de violencia intrafamiliar en pacientes psiquitricos inseridos en tratamiento de rgimen ambulatorial. Se pretendi, ms especficamente, identificar el tipo de violencia vivida por los usuarios. Participaron del estudio 23 pacientes [...] de ambos los sexos, en tratamiento ambulatorial. La recogida de datos implic en la aplicacin de un guin de entrevista individual, con informaciones sobre el histrico de internacin y violencia intrafamiliar y con descripcin de la infancia, entre otros apartados. Apenas uno entre 23 participantes relat ausencia de histrico de violencia intrafamiliar. 20 participantes indicaron histrico infantil de maltratos fsicos y psicolgicos. En la fase adulta, de los 13 participantes que declararon vivir con compaeros/compaeras en el presente o en el pasado, 8 participantes del sexo femenino relataron agresividad por parte del compaero, y 2 participantes del sexo masculino afirmaron haber agredido las esposas en el pasado. Con relacin a la violencia sexual, 5 participantes relataron haber probado relacin sexual forzada por parte del compaero y un participante relat haber abusado sexualmente de la compaera. Los resultados llaman la atencin por la alta frecuencia y por la gravedad de episodios de violencia intrafamiliar, que evidencian la necesidad de repetir el estudio con muestras mayores y, en la prctica clnica, investigar tales cuestiones rutinariamente, una vez que su esquiva puede aportar para el proceso de enfermedad psquica. Abstract in english The goal of this study was to characterize the family violence history among psychiatric patients in a mental health outpatient clinic. More specifically, identification of the modality of violence experienced by the patients was intended. Twenty three psychiatric patients who attended the clinic to [...] ok part of the study. The instrument used to collect data was a semi-structured interview, with questions related to patients mental health and family violence history, as well as childhood description, among other topics. Only one out of 23 patients reported an absence of family violence history. Twenty participants indicated a history of physical or emotional abuse during childhood. In their adult phase, of the 13 participants who reported having lived with an intimate partner, eight female participants reported aggressive behavior by partners, and two male participants

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

    Hansen, Thomas V O; Bisgaard, Marie Luise; Jønson, Lars; Albrechtsen, Anders; Filtenborg-Barnkob, Bettina; Eiberg, Hans; Ejlertsen, Bent; Nielsen, Finn C

    2008-01-01

    BACKGROUND: BRCA2 germ-line mutations predispose to breast and ovarian cancer. Mutations are widespread and unclassified splice variants are frequently encountered. We describe the parental origin and functional characterization of a novel de novo BRCA2 splice site mutation found in a patient exh...

  14. Transient Facial Swellings in a Patient With a Remote African Travel History

    Richardson, Eugene T; Luo, Robert; Fink, Doran L.; Nutman, Thomas B; Geisse, John K.; Barry, Michele

    2012-01-01

    We present a case of Loa loa infection in a patient, 21 years after visiting an endemic area for only 4 days. To our knowledge, this case represents the longest time for the diagnosis of loiasis to be made post-exposure in a traveler and emphasizes that even short exposures can place travelers at risk.

  15. Transient facial swellings in a patient with a remote African travel history.

    Richardson, Eugene T; Luo, Robert; Fink, Doran L; Nutman, Thomas B; Geisse, John K; Barry, Michele

    2012-01-01

    We present a case of Loa loa infection in a patient, 21 years after visiting an endemic area for only 4 days. To our knowledge, this case represents the longest time for the diagnosis of loiasis to be made post-exposure in a traveler and emphasizes that even short exposures can place travelers at risk. PMID:22530826

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

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

    2015-05-01

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

  17. Lifetime suicide attempt history, quality of life, and objective functioning among HIV/AIDS patients with alcohol and illicit substance use disorders.

    Walter, Kimberly N; Petry, Nancy M

    2016-05-01

    This cross-sectional study evaluated lifetime prevalence of suicide attempts in 170 HIV/AIDS patients with substance use disorders and the impact of suicide attempt history on subjective indices of quality of life and objective indices of cognitive and physical functioning. All patients met the diagnostic criteria for past-year cocaine or opioid use disorders and 27% of patients also had co-occurring alcohol use disorders. Compared to their counterparts without a history of a suicide attempt, patients with a history of a suicide attempt (n = 60, 35.3%) had significantly poorer emotional and cognitive quality of life scores (ps suicide attempt status was unrelated to objective indices of cognitive functioning, but there was a non-significant trend (p = .07) toward lower viral loads in those with a lifetime suicide attempt relative to those without. The findings indicate that suicide attempt histories are prevalent among HIV/AIDS patients with substance use disorders and relate to poorer perceived emotional and cognitive quality of life, but not objective functioning. HIV/AIDS patients with substance use disorders should be screened for lifetime histories of suicide attempts and offered assistance to improve perceived emotional and cognitive functioning. PMID:25953963

  18. CMT subtypes and disease burden in patients enrolled in the Inherited Neuropathies Consortium natural history study: a cross-sectional analysis.

    Fridman, V.; Bundy, B; Reilly, M. M.; D. Pareyson; Bacon, C.; Burns, J.; Day, J.; Feely, S.; Finkel, R S; Grider, T; Kirk, C A; Herrmann, D N; Laur, M.; Li, J.; Lloyd, T

    2014-01-01

    The international Inherited Neuropathy Consortium (INC) was created with the goal of obtaining much needed natural history data for patients with Charcot-Marie-Tooth (CMT) disease. We analysed clinical and genetic data from patients in the INC to determine the distribution of CMT subtypes and the clinical impairment associated with them.

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

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

    2013-12-01

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

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

    Alessandro E. Vento

    2013-12-01

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

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

    Simone Eibye; Hans Mørch Jensen

    2014-01-01

    We report a case of a woman suffering from persistent genital arousal disorder (PGAD) after paroxetine cessation. She was admitted to a psychiatric department and diagnosed with agitated depression. Physical investigation showed no gynaecological or neurological explanation; however, a pelvic MRI scan revealed a Tarlov cyst. Size and placement of the cyst could not explain the patient's symptoms; thus neurosurgical approach would not be helpful. Her depression was treated with antidepressant ...

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

    IcroMaremmani; FrancescoLamanna; JosephDeltito

    2012-01-01

    In a group of 1066 heroin addicts, who were seeking treatment for opioid agonist treatment, we looked for differences in historical, demographic and clinical characteristics, between patients with different levels of awareness of illness (insight). The results showed that, in the cohort studied, a majority of subjects lacked insight into their heroin-use behaviour. Compared with the impaired-insight group, those who possessed insight into their illness showed significantly greater awareness o...

  3. Natural history of neck disease in patients with squamous cell carcinoma of oropharynx and pharyngolarynx

    1666 patients with squamous cell carcinoma of oropharynx and pharyngolarynx, were evaluated on admission regarding the characteristic metastases patterns to their cervical lymph nodes. Preliminary therapeutic implications are derived from this nodal distribution. Comparisons are established between the 1978 UICC and 1976 AJC classifications, showing a good correlation despite multiple differences in staging criteria. It is shown that assessment combining both the multiplicity and the volume of cervical metastases allows to evaluate more accurately the aggressiveness of the primary. (Auth.)

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

    Azadeh Ghaheri; Farzane Jamdar; Mohammad Ali Roghaei

    2013-01-01

    Background: Immune-mediated recurrent pregnancy loss (RPL) has received more attention than any other single etiologic classification. Individuals with rare blood group P have an antipp1pk antibody in their serum, which causes recurrent abortion in the early stages. Materials and Methods: In this case series study, 11 patients with unexplained RPL who had anti-P antibody in their serum were treated by plasma exchange during their next pregnancies. To evaluate the efficacy of the treatment, we...

  5. A Study of Inflammatory Status in Nephropathy Patients with History of Type-II Diabetes Mellitus Undergoing Haemodialysis

    Nath, Indrajit; Nath, Chandan Kumar; Baruah, Mriganka; Pathak, Moushumi; Banerjee, R.; Goyal, Sapna

    2013-01-01

    Introduction and Objective: Diabetic nephropathy is one of the leading cause of chronic kidney failure. Local vascular inflammation is increased in diabetes mellitus (DM), which results in higher burden of microvascular and macrovascular complications. The present study was carried out to assess the importance of inflammatory status in nephropathy patients with Type-II DM. Methodology: Eighty diagnosed cases of type II DM who had end stage renal disease (Nephropathy Stage-5) were selected for the study, they were further divided equally into 2 sub-categories; Group I (patients who were undergoing haemodialysis) and Group II (patients who were not undergoing haemodialysis). The control group comprised of 40 individuals who were age and sex matched healthy individuals. Inflammatory status was assessed by estimating serum C-reactive protein (CRP) and serum albumin. Results: A significant increase in serum CRP and a significant decrease in serum albumin were seen in test group- I and test group-2 as compared to controls. There was a positive correlation between serum albumin and GFR with r=0.904 in the Test Group-I and r=0.946 in Test Group-II. A negative correlation was observed between serum CRP and GFR r= -0.597 in Test Group-I and with r= -0.6231 in Test Group-II. Also, the correlation between CRP and albumin showed a negative trend with r= -0.848 in Test Group-I and with r= -0.78 in Test Group-II. Conclusion: Microinflammation is a common finding in haemodialysis patients who have a history of nephropathy with Type-II diabetes mellitus. With a proper knowledge on factors which lead to this microinflammation, we can employ preventive strategies for a better management of Type-II diabetic nephropathy patients and thereby, for improving their survival. PMID:24298459

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

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

    2012-07-15

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

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

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

    2015-01-01

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

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

    Pascal Wabnitz

    2013-11-01

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

  9. Alcohol intake and prognosis of atrial fibrillation

    Overvad, Thure Filskov; Rasmussen, Lars Hvilsted; Skjøth, Flemming; Overvad, Kim; Albertsen, Ida Ehlers; Lane, Deirdre A; Lip, Gregory Y.H.; Larsen, Torben Bjerregaard

    2013-01-01

    OBJECTIVE: To assess alcohol intake as a risk factor for adverse events among patients with incident atrial fibrillation (AF). DESIGN: Prospective cohort study. SETTING: Population based cohort study and nationwide Danish registries. PATIENTS: The Danish Diet, Cancer and Health study included 57...

  10. High 15-F2t-Isoprostane Levels in Patients with a Previous History of Nonmelanoma Skin Cancer: The Effects of Supplementary Antioxidant Therapy

    Freitas, Betânia de Jesus e Silva de Almendra; Lloret, Gustavo Rafaini; Visacri, Marília Berlofa; Tuan, Bruna Taliani; Amaral, Lais Sampaio; Baldini, Daniele; de Sousa, Vanessa Marcílio; de Castro, Laís Lima; Aguiar, Jordana Rayane Sousa; Pincinato, Eder de Carvalho; Mazzola, Priscila Gava; Moriel, Patricia

    2015-01-01

    Background. Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC), previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. Materials and Methods. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with history of NMSC previously treated with surgery. In Phase II, the 60 patients with history of NMSC were randomized into two subgroups, one receiving placebo (n = 34) and the other (n = 26) receiving vitamin C, vitamin E, and zinc supplementation for 8 weeks, followed by reevaluation of biomarkers. Results. In Phase I, patients with history of NMSC showed increased plasma concentrations of all biomarkers, but only 15-F2t-isoprostane was significantly higher than in the healthy subjects. Risk of NMSC increased by 4% for each additional 1 pg/mL increase in 15-F2t-isoprostane. In Phase II, supplementation did not significantly reduce levels of oxidative stress biomarkers. Conclusion. Patients with history of NMSC had significantly high 15-F2t-isoprostane plasma levels; supplementation did not result in significant reduction of oxidative stress biomarkers. This trial was registered with ClinicalTrials.gov (ID NCT02248584). PMID:26509174

  11. [Useful device for hepatectomy in patients with a surgical history of bile duct-GI tract anastomosis at the porta hepatis].

    Amikura, Katsumi; Sakamoto, Hirohiko; Takahashi, Amane; Ogura, Toshiro; Omichi, Kiyohiko; Ehara, Kazuhisa; Fukuda, Takashi; Yatsuoka, Toshimasa; Kawashima, Yoshiyuki; Tanaka, Yoichi

    2014-11-01

    We experienced three hepatectomies in patients with a history of bile duct-gastrointestinal (GI) tract anastomosis at the porta hepatis. Patient 1 had a history of pancreaticoduodenectomy for bile duct cancer. Because the third liver metastasis of cecal cancer postoperatively invaded the right kidney, after 5 courses of FOLFOX we performed partial resection of the liver (S6) and the right kidney using microwave pre-coagulation and a cavitron ultrasonic surgical aspirator (CUSA) without the Pringle method. Patient 2 had a history of splenectomy for congenital spherocytosis, cholecystectomy, choledocholithotomy, and bile duct duodenal anastomosis for hepatolithiasis. Partial (S5) liver resection was performed to treat hepatocellular carcinoma. Patient 3 had a history of bile duct resection and choledochojejunostomy for congenital cystic dilatation of the common bile duct. She had repeated episodes of cholangitis in the year following surgery. Extended liver segmental (S4) resection was performed to treat intrahepatic bile duct carcinoma. Bile duct jejunum anastomosis was performed, and the portal vein and the hepatic artery in the porta hepatis were exfoliated. Hepatectomy was performed using the Pringle method and a CUSA. Surgical procedures using various devices are necessary for hepatectomy in patients with a history of bile duct-GI tract anastomosis at the porta hepatis. PMID:25731231

  12. The natural history of EGFR and EGFRvIII in glioblastoma patients

    Shi Weiming; Yang David; Suki Dima; Heimberger Amy B; Aldape Kenneth

    2005-01-01

    Abstract Background The epidermal growth factor receptor (EGFR) is over expressed in approximately 50–60% of glioblastoma (GBM) tumors, and the most common EGFR mutant, EGFRvIII, is expressed in 24–67% of cases. This study was designed to address whether over expressed EGFR or EGFRvIII is an actual independent prognostic indicator of overall survival in a uniform body of patients in whom gross total surgical resection (GTR; ≥ 95% resection) was not attempted or achieved. Methods Biopsed or pa...

  13. Mindfulness-Based Cognitive Therapy (MBCT) Reduces the Association Between Depressive Symptoms and Suicidal Cognitions in Patients With a History of Suicidal Depression

    Barnhofer, Thorsten; Crane, Catherine; Brennan, Kate; Duggan, Danielle S.; Crane, Rebecca S; Eames, Catrin; Radford, Sholto; Silverton, Sarah; Fennell, Melanie J.V.; Williams, J. Mark G

    2015-01-01

    Objective: In patients with a history of suicidal depression, recurrence of depressive symptoms can easily reactivate suicidal thinking. In this study, we investigated whether training in mindfulness, which is aimed at helping patients decenter from negative thinking, could help weaken the link between depressive symptoms and suicidal cognitions. Method: Analyses were based on data from a recent randomized controlled trial, in which previously suicidal patients were allocated to mindfulness...

  14. Two Paradigmatic Approaches to Borderline Patients With a History of Trauma : The Expressive Psychotherapy of Otto Kernberg and the Trauma Model of Judith Lewis Herman

    LEWIS, JUDITH L.

    1996-01-01

    A significant number of patients with the diagnosis of borderline personality disorder have a history of childhood trauma. This article attempts to integrate the treatment approach of Judith Herman to traumatized patients with the psychodynamic approach of Otto Kernberg to borderline patients. To facilitate paradigm shifts between these two approaches, they are presented side by side with one set of terms translated into the other. Aspects of the therapeutic relationship ...

  15. Small intestine and ovarian metastasis in a patient with a history of cardiac fibrosacoma

    Metastatic tumors involving the small bowel are much more common than primary neoplasms. The most common metastases to the small intestine are those arising from other intra-abdominal organs. Metastases from extra-abdominal tumors are rare but may be found in patients with adenocarcinoma of the breast and carcinoma of the lung. Cutaneous melanoma is the most common extra-abdominal source involving the small intestine, with involvement of the small intestine noted in more than half of the patients dying from malignant melanoma [1]. While intestinal metastasis from sarcoma has been described, this is an extremely rare occurrence especially from a rare malignant sarcoma of cardiac origin. The dismal prognosis of cardiac sarcomas results from extensive local invasion at presentation or distant metastasis. Metastasis to the small bowel may cause obstruction, bleeding, or incapacitates in which the diagnosis may be delayed because of rarity of the condition and mild and vague abdominal symptoms at early presentation. In this report, a 35 year old woman a known case of cardiac fibrosarcoma was admitted to the emergency ward with abdominal pain and distension, bloody diarrhea, and recurrent nausea and vomiting. Jejuna-jejunal invagination was diagnosed at laparotomy along with tumoral involvement of the left ovary. Histopathological study showed that there was a fibrosarcoma compatible with the earlier diagnosis of primary cardiac tumor. We have described some aspects of diagnosis and treatment of this rare cause of intestinal intussusception

  16. Small intestine and ovarian metastasis in a patient with a history of cardiac fibrosacoma.

    Esfehani, Maryam Hassan; Mahmoodzadeh, Habibollah; Omranipour, Ramesh

    2015-09-01

    Metastatic tumors involving the small bowel are much more common than primary neoplasms. The most common metastases to the small intestine are those arising from other intra-abdominal organs. Metastases from extra-abdominal tumors are rare but may be found in patients with adenocarcinoma of the breast and carcinoma of the lung. Cutaneous melanoma is the most common extra-abdominal source involving the small intestine, with involvement of the small intestine noted in more than half of the patients dying from malignant melanoma [1]. While intestinal metastasis from sarcoma has been described, this is an extremely rare occurrence especially from a rare malignant sarcoma of cardiac origin. The dismal prognosis of cardiac sarcomas results from extensive local invasion at presentation or distant metastasis. Metastasis to the small bowel may cause obstruction, bleeding, or intussusception in which the diagnosis may be delayed because of rarity of the condition and mild and vague abdominal symptoms at early presentation. In this report, a 35 year old woman a known case of cardiac fibrosarcoma was admitted to the emergency ward with abdominal pain and distention, bloody diarrhea, and recurrent nausea and vomiting. Jejuno-jejunal invagination was diagnosed at laparotomy along with tumoral involvement of the left ovary. Histopathological study showed that there was a fibrosarcoma compatible with the earlier diagnosis of primary cardiac tumor. We have described some aspects of diagnosis and treatment of this rare cause of intestinal intussusception. PMID:25936897

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

    Azadeh Ghaheri

    2013-01-01

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

  18. The sexuality and social performance of androgen-deprived (castrated) men throughout history: implications for modern day cancer patients.

    Aucoin, Michael William; Wassersug, Richard Joel

    2006-12-01

    Androgen-deprivation therapy (ADT) via either surgical or chemical castration is the standard treatment for advanced prostate cancer (PCa). In North America, it is estimated that more than 40,000 men start ADT each year. The side effects of this treatment are extensive and include gynecomastia, erectile dysfunction, and reduced libido. These changes strongly challenge patients' self-identity and sexuality. The historical term for a man who has been castrated is 'eunuch', now a pejorative term implying overall social and sexual impotence. In this paper, we review key historical features of eunuch social performance and sexuality from a variety of cultures in order to assess the validity of contemporary stereotypes of the androgen-deprived male. Data were taken from secondary sources on the history of Byzantium, Roman Antiquity, Early Islamic societies, the Ottoman Empire, Chinese Dynasties, and the Italian Castrati period. This cross-cultural survey shows that castrated men consistently held powerful social positions that yielded great political influence. Many eunuchs were recognized for their loyalty, managerial style, wisdom, and pedagogical skills. Furthermore, rather than being consistently asexual and celibate, they were often sexually active. In certain cultures, they were objects of sexual desire for males, or females, or both. Collectively, the historical accounts suggest that, given the right cultural setting and individual motivation, androgen deprivation may actually enhance rather than hinder both social and sexual performance. We conclude that eunuch history contradicts the presumption that androgen deprivation necessarily leads to social and sexual impotence. The capabilities and accomplishments of eunuchs in the past gives patients on ADT grounds for viewing themselves in a positive light, where they are neither socially impotent nor sexually chaste. PMID:16989928

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

    Giuseppe Aiosa

    2007-10-01

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

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

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

    2013-09-01

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

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

    Massi-Benedetti Massimo

    2009-05-01

    Full Text Available Abstract Background The aim of this study was to project health-economic outcomes relevant to the German setting for the addition of pioglitazone to existing treatment regimens in patients with type 2 diabetes, evidence of macrovascular disease and at high risk of cardiovascular events. Methods Event rates corresponding to macrovascular outcomes from the Prospective Pioglitazone Clinical Trial in Macrovascular Events (PROactive study of pioglitazone were used with a modified version of the CORE Diabetes Model to simulate outcomes over a 35-year time horizon. Direct medical costs were accounted from a healthcare payer perspective in year 2005 values. Germany specific costs were applied for patient treatment, hospitalization and management. Both costs and clinical benefits were discounted at 5.0% per annum. Results Over patient lifetimes pioglitazone treatment improved undiscounted life expectancy by 0.406 years and improved quality-adjusted life expectancy by 0.120 quality-adjusted life years (QALYs compared to placebo. Direct medical costs (treatment plus complication costs were marginally higher for pioglitazone treatment and calculation of the incremental cost-effectiveness ratio (ICER produced a value of €13,294 per QALY gained with the pioglitazone regimen versus placebo. Acceptability curve analysis showed that there was a 78.2% likelihood that pioglitazone would be considered cost-effective in Germany, using a "good value for money" threshold of €50,000 per QALY gained. Sensitivity analyses showed that the results were most sensitive to changes in the simulation time horizon. After adjustment for the potential stabilization of pancreatic β-cell function with pioglitazone treatment, the ICER was €6,667 per QALY gained for pioglitazone versus placebo. Conclusion The findings of this modelling analysis indicated that, for patients with a history of macrovascular disease, addition of pioglitazone to existing therapy reduces the long-term cumulative incidence of diabetes-complications at a cost that would be considered to represent good value for money in the German setting.

  2. Relation Between Family History of Premature Coronary Artery Disease and the Risk of Death in Patients With Coronary Artery Disease.

    Abdi-Ali, Ahmed; Shaheen, AbdelAziz; Southern, Danielle; Zhang, Mei; Knudtson, Merril; White, James; Graham, Michelle; James, Mathew T; Wilton, Stephen B

    2016-02-01

    Family history (FHx) of premature coronary artery disease (CAD) is a risk factor for development of incident cardiovascular disease. However the association between FHx and outcomes in patients with established CAD is unclear. We followed 84,373 patients with angiographic CAD enrolled in the inclusive Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease registry between April 2002 and March 2013. Overall, 25,566 (30%) self-reported an FHx of CAD, defined as a first-degree relative with premature CAD (men, age <55 years; women, age <65years). We tested the association between FHx and all-cause mortality using multivariable Cox proportional hazards regression. After adjusting for baseline differences in clinical characteristics, indication, and extent of CAD, FHx was associated with reduced all-cause mortality over a median 5.6years in follow-up (hazard ratio [HR] 0.77 [95% CI 0.73 to 0.80]). The magnitude of this protective association was weaker in those with versus without a previous myocardial infarction (HR 0.87 [95% CI 0.81 to 0.93] versus 0.72 [0.69 to 0.76], interaction p <0.0001) and slightly stronger in those presenting with versus without an acute coronary syndrome (HR 0.74 [0.70 to 0.79] versus 0.80 [0.75 to 0.85], interaction p= 0.08). There was attenuation of association with increasing age, but FHx remained protective even in those aged older than 80 years (HR 0.86 [0.77 to 0.95]). In conclusion, in patients with angiographic CAD, self-reported FHx of premature CAD is associated with improved long-term survival rate, independent of clinical characteristics, mode of presentation, and extent of disease. Further investigation of potential patient- and system-level mediators of this seemingly paradoxical relation is required. PMID:26723106

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

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

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

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

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

    M. N. Brahmbhatt

    2013-07-01

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

  6. Prevalence of benign and malignant thyroid nodules in patients with previous history of radiotherapy for Tinea capitis in childhood (in khorosan province)

    Increased prevalence of thyroid cancer was noted in patients with previous history of radiotherapy of the head and neck region in childhood. According to previous research, radiotherapy for Ti nia capitis was using up to 30 years ago in Khorasan Province. This study tries to evaluate prevalence of benign and malignant thyroid nodules and detect and treat these patients earlier to prevent more complications and increased cost. Methods and patients: Using mass media, we recalled all patients with history of radiotherapy for Tinea capitis in childhood. A questionnaire was filled for each patient and thyroid examination, thyroid scan and thyroid sonography were performed. Fine needle aspiration biopsy (FNAB) was done if a thyroid nodule larger than 1 cm was palpable. Serum TSH was measured in all patients. Also thyroid surgery was recommended for all patients with thyroid nodules more than 1 cm. A control group was defined from a group of patients who referred for non thyroidal sonography to radiology department of Ghaem hospital. These patients also were evaluated by clinical examination and thyroid sonography. Results: We studied 180 patients with mean age of 47.7 years and 127 age and sex m etched controls. Thyroid nodules was palpated in 45.5% of patients and 7% of controls (P0.01). The mean largest diameter of nodules were 24.8 mm in patients and 10.8 mm in control group (P<0.001). 75% of patients were agreed with FNAB and 5% of them had suspicious cytology results. No suspicious or malignant results was noted in control group. Twenty seven patients (33.7%) were operated. Pathological results were benign in 89.9% and malignant in 1% of patients. His study showed that thyroid nodules and thyroid neo plasma were significantly more larger in the patients group. Thyroid neoplasm were more frequent in younger patients with latent thyroid (from radiotherapy) of less than 40 years, so aggressive evaluation is recommended in these group

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

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

    2006-01-01

    OBJECTIVE: To assess the association between dietary intake and central obesity among people living with HIV/AIDS and receiving highly active antiretroviral therapy. METHODS: A cross-sectional study was conducted involving 223 adult individuals in the city of São Paulo city in 2002. The study population was classified according to central obesity, defined as waist-to-hip ratio >0.95 for men and >0.85 for women. The dietary variables studied were energy consumption (in calories and calories/ki...

  8. Intake Ground Vortex Aerodynamics

    Murphy, John

    2008-01-01

    When an aircraft is operating in static or near static conditions during taxiing or take-o a vortex can form between the ground and the intake. With engine diameters increasing, intakes are moving non-dimensionally closer to the ground and as a consequence the likelihood of vortex formation during the aircraft operating envelope is set to increase. To date there is little quantitative knowledge therefore a greater understanding is required. This research is aimed at providing ...

  9. Voluntary Alcohol Intake following Blast Exposure in a Rat Model of Mild Traumatic Brain Injury.

    Lim, Yi Wei; Meyer, Nathan P; Shah, Alok S; Budde, Matthew D; Stemper, Brian D; Olsen, Christopher M

    2015-01-01

    Alcoholism is a frequent comorbidity following mild traumatic brain injury (mTBI), even in patients without a previous history of alcohol dependence. Despite this correlational relationship, the extent to which the neurological effects of mTBI contribute to the development of alcoholism is unknown. In this study, we used a rodent blast exposure model to investigate the relationship between mTBI and voluntary alcohol drinking in alcohol nave rats. We have previously demonstrated in Sprague Dawley rats that blast exposure leads to microstructural abnormalities in the medial prefrontal cortex (mPFC) and other brain regions that progress from four to thirty days. The mPFC is a brain region implicated in alcoholism and drug addiction, although the impact of mTBI on drug reward and addiction using controlled models remains largely unexplored. Alcohol nave Sprague Dawley rats were subjected to a blast model of mTBI (or sham conditions) and then tested in several common measures of voluntary alcohol intake. In a seven-week intermittent two-bottle choice alcohol drinking test, sham and blast exposed rats had comparable levels of alcohol intake. In a short access test session at the conclusion of the two-bottle test, blast rats fell into a bimodal distribution, and among high intake rats, blast treated animals had significantly elevated intake compared to shams. We found no effect of blast when rats were tested for an alcohol deprivation effect or compulsive drinking in a quinine adulteration test. Throughout the experiment, alcohol drinking was modest in both groups, consistent with other studies using Sprague Dawley rats. In conclusion, blast exposure had a minimal impact on overall alcohol intake in Sprague Dawley rats, although intake was increased in a subpopulation of blast animals in a short access session following intermittent access exposure. PMID:25910266

  10. Evaluation of safety and effectiveness of factor VIII treatment in haemophilia A patients with low titre inhibitors or a personal history of inhibitor. Patient Data Meta-analysis of rAFH-PFM Post-Authorization Safety Studies.

    Romanov, Vadim; Marcucci, Maura; Cheng, Ji; Thabane, Lehana; Iorio, Alfonso

    2015-07-01

    There is no prospective evidence on inhibitor recurrence among haemophilia A patients with low titre inhibitors or history of inhibitors, and whether or how therapeutic choices affect the risk of recurrence. The aims of this study were to synthesise safety data in patients with moderate-severe haemophilia A and with low titre inhibitors or inhibitor history enrolled in the rAHF PFM (ADVATE) - Post-Authorization Safety Studies (ADVATE-PASS) international programme. The study was conducted in clinics participating to the ADVATE PASS programme. The patient population consisted of patients entering the studies with low titre (??5 BU) inhibitors or a positive personal history of inhibitors. Patients on Immune Tolerance Induction at study entry were excluded. Primary outcome was new or recurrent inhibitor titre >?5 BU. Secondary outcomes were any increase of inhibitor titre not reaching 5 BU; any unexplained change in treatment regimen. Primary analysis was done by two-stage random effects meta-analysis. Secondary analysis was done by a hierarchical Bayesian random effects logistic model. A total of 219 patients from seven studies were included. Of these 214 (97.7?%) patients had been previously treated for more than 50 exposure days. Two hundred ten patients had positive history for inhibitors, nine a baseline measurable titre. No patient presented a primary outcome event (95?% confidence interval [CI] 0-1.6?%). Six patients with previous history developed a low titre recurrence (overall rate 2.2, 95?%CI 0-4.8?%). When any increase of inhibitor titre or any treatment change was accounted for, overall 3.7?% (95?% CI 0?%-8.0?%) of patients experienced the outcome. In conclusion, the observed rate of events does not support the definition of this population as at high risk for inhibitor development. PMID:26017627

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

    Ted Melcer, PhD

    2011-01-01

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

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

    Mak, George J

    2012-02-01

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

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

    J. Abilés

    2005-04-01

    Full Text Available Introducción y objetivos: El enfermo crítico es especialmente susceptible a la desnutrición debido a que su situación hipermetabólica conlleva a un aumento de los requerimientos nutricionales, que muchas veces no se cubren con el aporte de las fórmulas enterales suministradas. El estudio de la ingesta nutricional resulta imprescindible en este tipo de paciente para conocer en qué medida se cubren sus necesidades energético-nutricionales, mejorando y monitorizando la terapia clínico-nutricional a seguir de la manera m��s personalizada posible. Metodología: Es un estudio retrospectivo en el que se evaluaron todos los pacientes ingresados en la Unidad de Cuidados Intensivos del Hospital Virgen de las Nieves desde enero a diciembre de 2003, mayores de 18 años bajo tratamiento nutricional enteral. Se estudiaron un total de 90 pacientes (52 hombres y 38 mujeres, el 81% de los mismos eran mayores de 50 años de edad, el 57% tuvieron estancias superiores a 8 días con una mortalidad del 21%. Se valoró la ingesta desde el ingreso y durante todo el período de hospitalización. Los requerimientos energéticos se calcularon a partir de la fórmula de Long modificada y se compararon las ingestas de micronutrientes con las recomendaciones generales existentes tanto para la población española como la europea la americana, y los requerimientos vitamínicos para pacientes en estado grave. Resultados: En la figura 1 se presentan los porcentajes de ingestas medias de energía y nutrientes con relación a los requerimientos teóricos calculados para ambos sexos. El aporte energético medio fue para los hombres de 1.326 cal y de 917 cal para las mujeres. Con respecto a la ingesta de macronutrientes, los valores encontrados tanto para las proteínas como para las grasas y los carbohidratos fueron inferiores al 50% de los requerimientos en ambos sexos. En la figura 2 se observa el porcentaje de adecuación a los requerimientos en el consumo de vitaminas y minerales. Las recomendaciones utilizadas como referencia corresponden a ingestas suficientes para cubrir requerimientos de individuos sanos, por lo tanto, los valores obtenidos en nuestro estudio muestran una adecuación superior al 75%, salvo casos particulares como la vitamina A y el magnesio. Sin embargo al observar la figura 3, el cual nos muestra la adecuación de las ingestas vitamínicas a las dosis recomendadas para pacientes enfermos, la ingesta es inferior al 25% de lo requerido en todos los casos, estas deficiencias repercuten de manera significativa en la cicatrización, el sistema inmune, el cardiovascular y el nervioso así como en el metabolismo del resto de macronutrientes, provocando un desequilibrio en el sistema antioxidante y empeorando la situación clínica del paciente. Conclusiones: El presente estudio nos confirma la necesidad de monitorizar de una manera personalizada las necesidades nutricionales en el paciente crítico y adaptar las recomendaciones a sus cambios metabólicos, ya que las mismas no están claramente definidas para estas situaciones en la actualidad. Es necesario aportar dosis de micronutrientes que se acerquen más a sus necesidades y así preservar o mejorar el estado nutricional y el equilibrio del sistema antioxidante, haciendo más eficaz el tratamiento clínico aplicado.Introduction and objectives: The critically ill patient is especially susceptible to malnutrition due to his/her hypermetabolic state that leads to an increase in the nutritional requirementes, which many times are not compensated with the administered enteral formulas. The assessment of nutritional intake is essential in this kind of patients to know to what level their energetic and nutritional requirements are fulfilled, improving and monitoring in the most individualized possible way to indicated clinical and nutritional therapu. Methodology: This is a retrospective study in which all patients admitted to the Intensive Care Unit of Virgen de las Nieves Hospital were studied from January to December of 2003, aged more than 18 years, and on enteral nutrition. A total of 90 patients (52 men and 38 women were studied, 81% of which were older than 50 years, and 57% had hospital stays longer than 8 days, with a 21% mortality rate. Intake was assessed from time of admission and throughout the whole hospitalization period. Energetic requirements were calculated according to the modified Long's formula and micronutrients intakes were compared to existing general recommendations for the Spanish, European and American populations, and to vitaminic requirements in critically ill patients. Results: Percentages of mean energy and nutrients intakes in relation to theoretical calculated requirements for both genders are presented in figure 1. Mean energy intake was 1,326 cal in men and 917 cal in women. With regards to micronutrients intake, the values found for proteins, falts, and carbohydrates were lower than 50% of the requirements for both genders. The percentage of adequacy as referred to requirements for vitamins and minerals intake is shown in figure 2. Reference recommendations used correspond to sufficient intakes to cover the healthy individual requirements, therefore, the values obtained in our study show and adequacy greater than 75%, with the exception of particular elements such as vitamin A and magnesium. However, by taking a look at figure 3, which shows the adequacy of vitamins intake at recommended does for sick patients, the intake is lower than 25% of the requirements in all cases, and these deficiencies significantly interfere with wound healing, the immune, cardiovascular and nervous systems, as well as with metabolism of the remaining macronutrients leading to an unbalanced situation of the antioxidant system, worsening the patient's clinical status. Conclusions: the present study confirms the need for monitoring individually the nutritional requirements in the critically ill patient and adapting recommendations to his/her metabolic changes, since currently these recommendations are not clearly defined for these situations. It is necessary to provide micronutrients doses closer to the patient's demands, so that the nutritional status and the balance of the antioxidant system may be preserved or improved, making the adopted clinical treatment more effective.

  14. Detection of K-ras mutations in mucinous pancreatic duct hyperplasia from a patient with a family history of pancreatic carcinoma.

    DiGiuseppe, J. A.; Hruban, R.H.; Offerhaus, G.J.; Clement, M J; Van den Berg, F M; Cameron, J. L.; Mansfeld, A D

    1994-01-01

    Mutations in the K-ras oncogene and in the p53 tumor suppressor gene are commonly identified in sporadic cases of pancreatic adenocarcinoma. Although these genes might serve as useful markers for early diagnosis of pancreatic carcinoma in patients at risk for the development of this disease, familial pancreatic carcinomas have not been studied for these mutations. We recently had the opportunity to examine a pancreas prophylactically removed from a patient with a strong family history of panc...

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

    Martin A. Lee

    2011-11-01

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

  16. High 15-F2t-Isoprostane Levels in Patients with a Previous History of Nonmelanoma Skin Cancer: The Effects of Supplementary Antioxidant Therapy

    Betânia de Jesus e Silva de Almendra Freitas; Gustavo Rafaini Lloret; Marília Berlofa Visacri; Bruna Taliani Tuan; Lais Sampaio Amaral; Daniele Baldini; Vanessa Marcílio de Sousa; Laís Lima de Castro; Jordana Rayane Sousa Aguiar; Eder de Carvalho Pincinato; Priscila Gava Mazzola; Patricia Moriel

    2015-01-01

    Background. Phase I of this study was aimed at comparing the profiles of oxidative stress biomarkers in patients with history of nonmelanoma skin cancer (NMSC), previously treated with surgery, to the healthy subjects. Phase II aimed to evaluate the effects of supplementary antioxidant therapy on the levels of biomarkers in the case group. Materials and Methods. In Phase I, oxidative stress biomarkers were measured in blood samples obtained from 24 healthy subjects and 60 patients with histor...

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

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

    2013-01-01

    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 p...

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

    Kravariti, Eugenia

    2009-05-01

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

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

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

  20. Surface electromyography studies in standing position confirm that ankle strategy remains disturbed even following successful treatment of patients with a history of sciatica.

    Huber, Juliusz; Lisiński, Przemysław; Ciesielska, Jagoda; Kulczyk, Aleksandra; Lipiec, Joanna; Bandosz, Agata

    2016-01-01

    [Purpose] It is hypothesized that ankle strategy can be changed in patients with a history of sciatica. The aim of this study was to detect residual disturbances following successful treatment. [Subjects and Methods] In patients with a history of sciatica (N=11) and pseudo-sciatica (N=9), differences in muscle activity were recorded with bilateral surface polyelectromyography and stability measurements (center of foot pressure sway and center of spectrum) in normal standing and tandem positions. Results were compared with recordings in healthy people (N=9) to identify abnormalities in electromyographic and postural studies. [Results] Increased amplitude of electromyographic recordings from the gastrocnemius and extensor digiti muscles on the affected side was detected more in patients with a history of sciatica than pseudo-sciatica syndromes in tandem position. Fewer amplitude fluctuations were observed in both positions preferably in patients following sciatica. Changes in center of foot pressure sway and center of spectrum during balance platform studies were detected in normal standing position in this group of patients. No similar abnormalities in electromyographic and postural studies were detected in healthy people. [Conclusion] Sciatica and pseudo-sciatica evoke persistent disturbances in activity of muscles responsible for ankle strategy. Electromyography differentiates the two groups of patients better than postural studies. PMID:27065544

  1. Nutrient intake of pregnant women at high risk of gestational diabetes

    Jelena Meinil

    2015-05-01

    Full Text Available Background: The prevalence of gestational diabetes (GDM has been increasing along with the obesity pandemic. It is associated with pregnancy complications and a risk of type 2 diabetes. Objective: To study nutrient intake among pregnant Finnish women at increased risk of GDM due to obesity or a history of GDM. Design: Food records from obese women or women with GDM history (n=394 were examined at baseline (?20 weeks of pregnancy of the Finnish Gestational Diabetes Prevention Study. Results: The pregnant women had a mean fat intake of 33 en% (SD 7, saturated fatty acids (SFA 12 en% (SD 3, and carbohydrate 46 en% (SD 6. Sucrose intake among pregnant women with GDM history was 7 en% (SD 3, which was different from the intake of the other pregnant women, 10 en% (SD 4 (p<0.001. Median intakes of folate and vitamins A and D provided by food sources were below the Finnish national nutrition recommendation, but, excluding vitamin A, supplements raised the total intake to the recommended level. The frequency of use of dietary supplements among pregnant women was 77%. Conclusions: The observed excessive intake of SFA and low intake of carbohydrates among women at high risk of GDM may further increase their risk of GDM. A GDM history, however, seems to reduce sucrose intake in a future pregnancy. Pregnant women at high risk of GDM seem to have insufficient intakes of vitamin D and folate from food and thus need supplementation, which most of them already take.

  2. Habitual rapid food intake and ineffective esophageal motility

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

    2013-01-01

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

  3. Monosodium Glutamate Intake, Dietary Patterns and Asthma in Chinese Adults

    Shi, Zumin; Yuan, Baojun; Wittert, Gary A.; Pan, Xiaoqun; Dai, Yue; Adams, Robert; Taylor, Anne W.

    2012-01-01

    Objectives Emerging evidence shows that diet is related to asthma. The aim of this analysis was to investigate the association between monosodium glutamate (MSG) intake, overall dietary patterns and asthma. Methods Data from 1486 Chinese men and women who participated in the Jiangsu Nutrition Study (JIN) were analyzed. In this study, MSG intake and dietary patterns were quantitatively assessed in 2002. Information on asthma history was collected during followed-up in 2007. Results Of the samp...

  4. [Beyond the treatment and care: the History of the doctor-patient relationship as a source to think the nurse-patient relationship in the XXIst century].

    Poisson, Michel

    2015-09-01

    The history of the relationship between doctors and patients shows that it is possible to find traces of attention from doctors towards patients as far back as the Antiquity. Nevertheless, at that time, this solicitude is made essentially in the name of nature through the sick individual. With the Middle Ages and the rise and growing importance of Christianity, the notion of person appeared, rising beyond the physical limits of the individual. At that time, the solicitude is then made in the name of God transcending, in that way, the sick person. It is only at the end of the XIXth century, with the movement of social transformation and secularization of the medical care, that it is possible to detect the notion of subject in the medical relation as proved by the emergence of the psychoanalysis. But at the same time, the spectacular evolution of medicine in its scientific component and its increasing importance during the next century made that it focused mainly on a naturalistic vision of the world of the medical care, to the detriment, most of the time, of a personal vision taking into account the deep-rooted social characters of the sick subject. From then on, the nursing profession could be seen, at the beginning of the XXIth century, as complementary to the medicine, through the development and the implementation of a dominant personal relation type without neglecting the naturalistic relation type. This prospect could be possible on the condition of developing the scientific knowledge allowing to give consistency and thickness to this way of seeing and acting centered on the person. An approach doubtless inspired by the care, yet going further its emotional and ethical meaning, in order to understand and to act better. PMID:26685551

  5. Nutritional Adequacy of Dietary Intake in Women with Anorexia Nervosa

    Raatz, Susan K.; Jahns, Lisa; Johnson, LuAnn K.; Crosby, Ross; Mitchell, James E.; Crow, Scott; Peterson, Carol; Le Grange, Daniel; Wonderlich, Stephen A.

    2015-01-01

    Understanding nutrient intake of anorexia nervosa (AN) patients is essential for the treatment. Therefore, estimates of total energy and nutrient consumption were made in a group of young women (19 to 30 years) with restricting and binge purge subtypes of AN participating in an ecological momentary assessment study. Participants completed three nonconsecutive 24-hour diet recalls. Mean nutrient intakes were stratified by subtype and by quartiles of energy intake and compared to the age specific Dietary Reference Intake (DRI) levels, as well as to the reported intakes from the What We Eat In America (WWEIA) dietary survey 20112012. Reported intake was determined for energy, macronutrients, and micronutrients. The mean body mass index (BMI) for all participants was 17.2 0.1 kg/m2. Reported nutrient intake was insufficient for participants in quartiles 13 of both AN subtypes when compared to the DRIs. Intake reported by participants in quartile 4 of both subgroups met requirements for most nutrients and even met or exceeded estimated energy needs. Counseling of AN patients should be directed to total food consumption to improve energy intake and to reduce individual nutritional gaps. PMID:25988761

  6. Nutritional Adequacy of Dietary Intake in Women with Anorexia Nervosa

    Susan K. Raatz

    2015-05-01

    Full Text Available Understanding nutrient intake of anorexia nervosa (AN patients is essential for the treatment. Therefore, estimates of total energy and nutrient consumption were made in a group of young women (19 to 30 years with restricting and binge purge subtypes of AN participating in an ecological momentary assessment study. Participants completed three nonconsecutive 24-hour diet recalls. Mean nutrient intakes were stratified by subtype and by quartiles of energy intake and compared to the age specific Dietary Reference Intake (DRI levels, as well as to the reported intakes from the What We Eat In America (WWEIA dietary survey 2011–2012. Reported intake was determined for energy, macronutrients, and micronutrients. The mean body mass index (BMI for all participants was 17.2 ± 0.1 kg/m2. Reported nutrient intake was insufficient for participants in quartiles 1–3 of both AN subtypes when compared to the DRIs. Intake reported by participants in quartile 4 of both subgroups met requirements for most nutrients and even met or exceeded estimated energy needs. Counseling of AN patients should be directed to total food consumption to improve energy intake and to reduce individual nutritional gaps.

  7. Two paradigmatic approaches to borderline patients with a history of trauma : the expressive psychotherapy of otto kernberg and the trauma model of judith lewis herman.

    Lewis, J L

    1996-01-01

    A significant number of patients with the diagnosis of borderline personality disorder have a history of childhood trauma. This article attempts to integrate the treatment approach of Judith Herman to traumatized patients with the psychodynamic approach of Otto Kernberg to borderline patients. To facilitate paradigm shifts between these two approaches, they are presented side by side with one set of terms translated into the other. Aspects of the therapeutic relationship and process are compared and contrasted, and a preliminary attempt is made to integrate these two treatment models. PMID:22700260

  8. Estado nutricional e ingesto alimentar de pacientes em dilise peritoneal contnua com e sem hiperparatireoidismo secundrio / Nutritional status and food intake of continuous peritoneal dialysis patients with and without secondary hyperparathyroidism

    Sara Ribeiro, Campos; Maria Helena Lima, Gusmo; Alessandra Fortes, Almeida; Lus Jos Cardoso, Pereira; Lilian Ramos, Sampaio; Jairza Maria Barreto, Medeiros.

    2012-06-01

    Full Text Available INTRODUO: O hiperparatireoidismo secundrio (HPT2) uma complicao comum e precoce em pacientes com doena renal crnica (DRC). Estudos tm sugerido que os altos nveis de paratormnio (PTH) podem exercer efeitos deletrios no estado nutricional de pacientes com DRC. Assim, o objetivo deste estu [...] do foi comparar o estado nutricional de pacientes com DRC em dilise peritoneal contnua (DPC) com e sem HPT2. OBJETIVO: O objetivo deste estudo comparar o estado nutricional de pacientes com DRC em dilise peritoneal contnua (DPC) com e sem HPTS. MTODOS: Foram avaliados 74 pacientes, entre adultos e idosos, divididos em dois grupos, de acordo com os nveis de PTH. No grupo 1 (n = 18) os nveis de PTH eram maiores do que 300 pg/mL e, no grupo 2, menores ou iguais a 300 pg/mL. O estado nutricional dos pacientes foi avaliado atravs da antropometria, exames bioqumicos e avaliao subjetiva global (ASG). O consumo alimentar foi avaliado atravs do registro alimentar de 3 dias. Foram coletados tambm dados clnicos, como clcio e fsforo sricos, e a presena de inflamao foi avaliada atravs da dosagem de protena C reativa ultrassensvel (PCR US). RESULTADOS: A mdia de idade da populao estudada foi de 54,97 17,06 anos, com predominncia de pacientes adultos (58,1%) e do sexo feminino (56,8%). O tempo de DPC expresso em mediana foi de 17 meses (7,75-33). Atravs da ASG, demonstrou-se prevalncia de 36,5% de desnutridos na populao. Na anlise de diferena entre os grupos, em relao antropometria, indicadores bioqumicos e ASG, bem como ingesto alimentar, no foram evidenciadas diferenas entre os grupos estudados. CONCLUSO: No houve diferenas no estado nutricional e na ingesto alimentar entre os pacientes com e sem HPT2. Abstract in english INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients. Studies have suggested that high levels of parathyroid hormone (PTH) may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this stud [...] y was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. OBJECTIVE: The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. METHODS: 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18) levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA). Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US). RESULTS: The average age of the population studied was 54.97 17.06 years, with predominance of adult patients (58.1%) and females (56.8%). The time of CPD expressed in median was 17 months (7.75-33). Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. CONCLUSION: There were no differences in nutritional status and dietary intake between patients with and without SHPT.

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

    Napoleon Waszkiewicz

    2013-08-01

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

  10. Daily Pomegranate Intake Has No Impact on PSA Levels in Patients with Advanced Prostate Cancer - Results of a Phase IIb Randomized Controlled Trial

    Stenner-Liewen, Frank; Liewen, Heike; Cathomas, Richard; Renner, Christoph; Petrausch, Ulf; Sulser, Tullio; Spanaus, Katharina; Seifert, Hans Helge; Strebel, Räto Thomas; Knuth, Alexander; Samaras, Panagiotis; Müntener, Michael

    2013-01-01

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

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

    Stenner-Liewen, Frank; Liewen, Heike; Cathomas, Richard; Renner, Christoph; Petrausch, Ulf; Sulser, Tullio; Spanaus, Katharina; Seifert, Hans Helge; Strebel, Räto Thomas; Knuth, Alexander; Samaras, Panagiotis; Müntener, Michael

    2013-01-01

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

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

    Verdonck, K.; González, E.; Schrooten, W.; Vanham, G; Gotuzzo, E

    2008-01-01

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

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

    Glaucia C. Duarte

    2009-02-01

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

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

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

    2011-01-01

    We report a case of Wernicke’s encephalopathy in a patient with nasopharyngeal carcinoma with a 3-month history of poor oral intake related to nausea and vomiting due to chemotherapy. The patient later developed deep coma while receiving in-patient therapy. Magnetic resonance imaging of the brain revealed typical findings of Wernicke’s encephalopathy. The patient was treated with thiamine injections, which resulted in subsequent partial recovery of neurological function. This paper stresses t...

  15. Long-term nutritional assessment of patients with severe short bowel syndrome managed with home enteral nutrition and oral intake / Evaluacin nutricional a largo plazo de pacientes con grave sndrome de intestino corto controlada con nutricin enteral e ingestin oral

    V., Chaer Borges; M. de L., Teixeira da Silva; M. C., Gonalves Dias; M. C., Gonzlez; D., Linetzky Waitzberg.

    2011-08-01

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

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

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

  17. Family history of psychiatric disorders and alcohol and substance misuse in patients with bipolar I disorder, substance use disorder, or both.

    Sbrana, Alfredo; Bizzarri, Jacopo V; Rucci, Paola; Gonnelli, Chiara; Massei, Jacopo G; Ravani, Laura; Endicott, Jean; Maser, Jack D; Cassano, Giovanni B

    2007-01-01

    Family history data were collected on first-degree relatives of 78 patients with bipolar I disorder (BD) and substance use disorder (SUD), 47 with BD only, and 35 with SUD only. The prevalence of psychiatric disorders was significantly higher in first-degree relatives of patients with BD + SUD (64%) and BD (61%) compared with first-degree relatives of SUD patients (20%). The prevalence of alcohol misuse was significantly higher in first-degree relatives of patients with BD + SUD (23.1%) and SUD alone (28.6%) compared to first-degree relatives of patients with BD (4.3%). Our findings suggest that BD and SUD do not share familial risk factors. PMID:17612828

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

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

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

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

    2014-06-15

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

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

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

  1. Patient-generated aspects in oral rehabilitation decision making I. Comparison of traditional history taking and an individual systematic interview method

    Øzhayat, Esben Boeskov; Gotfredsen, Klaus; Elverdam, Beth; Öwall, Bengt

    2009-01-01

    traditional history taking, in generating information to be used in decision making in oral rehabilitation. Fifty-seven participants in need of oral rehabilitation were enrolled in the study. The participants underwent a traditional history taking and were interviewed using the SEIQoL-DW method. The SEIQo...... percentage of the participants were positive towards the use of the SEIQoL-DW method in their treatment planning. The SEIQoL-DW was considered to be a viable tool for decision making in oral rehabilitation.......Decision making in oral rehabilitation is often based on diagnoses related to impairment of different oral functions. In making the decision when to treat, the dentist must work in cooperation with the patient. By incorporating patient-generated aspects into the decision making process, the dentist...

  2. The Contribution of Proprioceptive Information to Postural Control in Elderly and Patients with Parkinsons Disease with a History of Falls

    Bekkers, Esther M. J.; Dockx, Kim; Heremans, Elke; Vercruysse, Sarah; Verschueren, Sabine M. P.; Mirelman, Anat; Nieuwboer, Alice

    2014-01-01

    Proprioceptive deficits negatively affect postural control but their precise contribution to postural instability in Parkinsons disease (PD) is unclear. We investigated if proprioceptive manipulations differentially affect balance, measured by force plates, during quiet standing in 13 PD patients and 13 age-matched controls with a history of falls. Perceived limits of stability (LoS) were derived from the differences between maximal center of pressure (CoP) displacement in anteriorposterior...

  3. Nutritient intake of young children with PraderWilli syndrome

    Marianne Lindmark

    2010-03-01

    Full Text Available Background: PraderWilli syndrome (PWS is a rare genetic disorder resulting in obesity. The diets for young children with PWS must balance the importance of preventing development of obesity with the need to supply sufficient energy and essential nutrients. Objective: To investigate the nutritional intake for children with PWS 2, 3, and 4 years of age and compare it with Nordic Nutritional Recommendations (NNR and intake of healthy controls. Design: Assessments of food intake for six children 24 years of age were performed twice a year. At the age of 2 and 3 years data was obtained by using food recall interviews and at 4 year of age a pre-coded food-diary was used. Results: The energy intake for the 2-year-old children was 3.25 MJ/day (SD 0.85 and for the 3- and 4-year olds 3.62 MJ/day (SD 0.73 and 4.07 MJ/day (SD 0.39 MJ, respectively. These intakes are 61%, 68%, and 77% of the estimated energy requirements in NNR for healthy 2-, 3- and 4-year-old children, respectively, and 60% and 66% of the energy intakes of 2- and 4-year-old children in reference populations. The children's BMI-for-age score and length growth was within the normal range during the study period. The intake of fat was about 25 E% in all age groups and reduced when compared with reference populations. In 25% of the assessments the fat intake was 20 E% or below. The intake of iron was below recommendations in all age groups both with and without supplementation. The mean intake of vitamin D and tocopherol was below recommendations when intakes were determined excluding dietary supplementations. Conclusions: More large-scale investigations on nutritional intake are needed to further investigate dietary challenges for this patient group.

  4. Leiomyosarcoma of the distal femur in a patient with a history of bilateral retinoblastoma: a case report and review of the literature

    We report a case of primary leiomyosarcoma of the distal femoral shaft arising in a patient who had undergone bilateral orbital enucleation for bilateral retinoblastoma several years previously. Radiography demonstrated an osteolytic, expansive lesion with cortical destruction anteriorly in the distal femoral shaft, and these findings were confirmed on CT. MR imaging revealed an expansive intramedullary lesion with cortical breakthrough and soft tissue extension. The occurrence of a second malignancy in patients with a history of bilateral retinoblastoma is well documented. Many different histological types have been described, with osteosarcoma and leiomyosarcoma occurring with the greatest frequency. (orig.)

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

    Mazzone Annamaria

    2009-07-01

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

  6. Structural changes in the brain as evidenced by computerized tomography in patients with a history of multiple-modality treatment for hemispheric gliomas

    Basing on CT data, analysis is given of the qualitative changes in the brain of patients with a history of multiple-modality treatment for immature neuroectodermal tumors. Plani- and volumetric parameters of the total brain, the involved and the contralateral hemispheres are compared with the same parameters in the reference group. The pattern and degree of structural changes were found related to the side of the tumor and surgery. The brain matter in both hemispheres was lost mostly in the intersitial and end portions predominantly on the side of the tumor and surgery. Changes of the brain were individual in the patients

  7. Initial clinical validation of Health Heritage, a patient-facing tool for personal and family history collection and cancer risk assessment.

    Baumgart, Leigh A; Postula, Kristen J Vogel; Knaus, William A

    2016-04-01

    Personal and family health histories remain important independent risk factors for cancer; however they are currently not being well collected or used effectively. Health Heritage was designed to address this need. The purpose of this study was to validate the ability of Health Heritage to identify patients appropriate for further genetic evaluation and to accurately stratify cancer risk. A retrospective chart review was conducted on 100 random patients seen at an adult genetics clinic presenting with concern for an inherited predisposition to cancer. Relevant personal and family history obtained from the patients' medical records was entered into Health Heritage. Recommendations by Health Heritage were compared to national guidelines of eligibility for genetic evaluation. Agreement between Health Heritage referral for genetic evaluation and guideline eligibility for genetic evaluation was 97 % (sensitivity 98 % and specificity 88 %). Risk stratification for cancer was also compared between Health Heritage and those documented by a geneticist. For patients at increased risk for breast, ovarian, or colorectal cancer as determined by the geneticist, risk stratification by Health Heritage agreed 90, 93, and 75 %, respectively. Discordances in risk stratification were attributed to both complex situations better handled by the geneticist and Health Heritage's adherence to incorporating all information into its algorithms. Health Heritage is a clinically valid tool to identify patients appropriate for further genetic evaluation and to encourage them to confirm the assessment and management recommendations with cancer genetic experts. Health Heritage also provides an estimate of cancer risk that is complementary to a genetics team. PMID:26711915

  8. Peptides and Food Intake

    EduardoArilla; VicenteBarrios

    2014-01-01

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

  9. Multicentric Primary Angiosarcoma of Bone Mimicking Metastasis on (18)F-FDG PET/CT in a Patient with a History of Sigmoid Colon Cancer: a Case Report.

    Yoo, Min Young; Lee, Eun Seong; Kim, Seok-Ki; Park, Seog-Yun; Kwon, Youngmee; Yun, Tak; Kim, Tae Sung

    2015-12-01

    Primary angiosarcoma of the bone (PAB) is a rare and fatal high-grade malignant vascular bone tumor. We report a rare case of multicentric PAB mimicking bone metastasis in a 59-year-old female patient with a history of sigmoid colon cancer. This patient complained of lower back and pelvic pain and presented with multiple osteolytic bone lesions on plain radiography and pelvic computed tomography. First, bone metastasis of sigmoid colon cancer was suspected. However, on the (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) scan, the patient presented unusual multiple hypermetabolic osteolytic bone lesions involving contiguous bones of the lower half of the body. After bone biopsy, these lesions were confirmed to be multicentric PAB. To the best of our knowledge, this is the first case report of an (18)F-FDG PET/CT scan in a patient with multicentric primary bone angiosarcoma. PMID:26550053

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

    Maria Carolina G. Dias

    2006-04-01

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

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

    Buhl, Sussi F; Andersen, Aino L; Andersen, Jens Rikardt; Andersen, Ove; Jensen, Jens-Erik B; Rasmussen, Anne Mette L; Pedersen, Mette M; Damkjær, Lars; Gilkes, Hanne; Petersen, Janne

    2016-01-01

    BACKGROUND & AIM: Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient. The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than ...... differences were found. CONCLUSION: No significant effect on muscle mass was observed in this group of acutely ill old medical patients. High compliance was achieved with the dietary intervention, but resistance training was challenging. Clinical trials identifier NCT02077491.......BACKGROUND & AIM: Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient. The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than...... standard care. Secondary outcomes were changes in muscle strength, functional ability and body weight. METHODS: 29 acutely admitted old (>65 years) patients were randomly assigned to the intervention (n = 14) or to standard care (n = 15). The Intervention Group received 1.7 g protein/kg/day during...

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

    Ryskjaer, Jakob; Deacon, Carolyn F.; Carr, Richard D; Krarup, Thure; Madsbad, Sten; Holst, Jens Juul; Vilsbøll, Tina

    2006-01-01

    hormones are metabolized quickly by the enzyme dipeptidyl peptidase-IV (DPP-IV). It is well known that type-2 diabetic patients have an impaired incretin effect. Therefore, the aim of the present study was to investigate plasma DPP-IV activity in the fasting and the postprandial state in type-2 diabetic...... patients and control subjects. DESIGN: The study included two protocols. Protocol one involved 40 fasting type-2 diabetic patients (28 men); age 61 +/- 1.4 (mean +/- s.e.m.) years; body mass index (BMI) 31 +/- 0.6 kg/m(2); HbAlc 7.2 +/- 0.2%; and 20 matched control subjects (14 men) were studied. Protocol...... two involved eight type-2 diabetic patients (six men); age 63 +/- 1.2 years; BMI 33 +/- 0.5 kg/m(2); HbAlc 7.5 +/- 0.4%; eight matched control subjects were included. METHODS: In protocol one, fasting values of DPP-IV activity were evaluated and in protocol two, postprandial DPP-IV activity during a...

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

    Feunekes, G.I.J.

    1996-01-01

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

  14. No influence of increased intake of orange and blackcurrant juices and dietary amounts of vitamin E on paraoxonase-1 activity in patients with peripheral arterial disease

    Dalgrd, Christine; Christiansen, Lene; Jonung, Torbjrn; Mackness, Michael I; de Maat, Moniek P M; Hrder, Mogens

    2007-01-01

    dietary factors like the antioxidants. AIM OF THE STUDY: We examined the effect of antioxidant-rich orange and blackcurrant juices and vitamin E supplement on PON1 activity in patients with peripheral arterial disease. Furthermore, we studied whether genetic polymorphisms in the PON1 gene predicted the...... change in PON1 activity. METHODS: The study was designed as a cross-over trial with 48 participants who received two of the four possible treatments: (1) 250 ml orange juice and 250 ml blackcurrant juice; (2) 15 mg vitamin E; (3) 250 ml orange juice and 250 ml blackcurrant juice and 15 mg vitamin E; or...... significant interaction was observed between treatment and PON1 genotype, such that PON1 activity increased after juice alone in patients carrying the PON1 L55-allele. Results need to be interpreted with care since the study population was relatively small. CONCLUSION: Consumption of orange and blackcurrant...

  15. Association between Dietary Betaine Intake and Circulating Levels of Parameters Related to Choline Oxidation and Lipid Metabolism in Patients with Stable Angina Pectoris

    Arnesen, Håkon

    2015-01-01

    Cardiovascular disease (CVD) is among the leading causes of death worldwide, and is strongly influenced by lifestyle. Thus, promoting a healthy lifestyle, which includes having a healthy diet, is among the primary preventive strategies for reducing future risk of cardiovascular events. Elevated circulating total homocysteine (tHcy) is an independent risk factor for CVD. However, Hcy lowering treatment has not proven to reduce mortality or cardiovascular events among patients with CVD, and the...

  16. Assessment of family history of substance abuse for preventive interventions with patients experiencing chronic pain: A quality improvement project.

    Pestka, Elizabeth; Nash, Virginia; Evans, Michele; Cronin, Joan; Bee, Susan; King, Susan; Osborn, Kristine; Gehin, Jessica; Weis, Karen; Loukianova, Larissa

    2016-04-01

    This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings. PMID:25963926

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

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

    1991-01-01

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

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

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

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

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

    2011-10-15

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

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

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

  1. Sodium intake and cardiovascular health.

    O'Donnell, Martin; Mente, Andrew; Yusuf, Salim

    2015-03-13

    Sodium is an essential nutrient. Increasing sodium intake is associated with increasing blood pressure, whereas low sodium intake results in increased renin and aldosterone levels. Randomized controlled trials have reported reductions in blood pressure with reductions in sodium intake, to levels of sodium intake 6-month duration). It is assumed that the blood pressure-lowering effects of reducing sodium intake to low levels will result in large reductions in cardiovascular disease globally. However, current evidence from prospective cohort studies suggests a J-shaped association between sodium intake and cardiovascular events, based on studies from >300 000 people, and suggests that the lowest risk of cardiovascular events and death occurs in populations consuming an average sodium intake range (3-5 g/d). The increased risk of cardiovascular events associated with higher sodium intake (>5 g/d) is most prominent in those with hypertension. A major deficit in the field is the absence of large randomized controlled trials to provide definitive evidence on optimal sodium intake for preventing cardiovascular events. Pending such trials, current evidence would suggest a recommendation for moderate sodium intake in the general population (3-5 g/d), with targeting the lower end of the moderate range among those with hypertension. PMID:25767289

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

    Lívia Garcia Ferreira

    2009-01-01

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

  3. The Presence of Gastric Intestinal Metaplasia in Patients Undergoing EGD with Biopsy is Associated with a Family History of Gastric Cancer in the United States

    Justin M Gomez

    2013-08-01

    Full Text Available AIM: Gastric intestinal metaplasia (IM is a pre-malignant lesionthat can develop into adenocarcinoma through a sequential cascadeinvolving non-atrophic gastritis, atrophic gastritis, IM, gastricdysplasia, and ultimately carcinoma. To estimate the prevalence ofgastric IM in patients undergoing EGD with biopsy at an academicmedical center; and determine what clinical factors might beassociated with gastric IM.METHODS: Three hundred consecutive patients presenting forEGD with biopsy at a tertiary-care medical center were enrolled in aretrospective single-center cohort study.RESULTS: Gastric biopsies found H. pylori infection in 2% (n=6,chronic gastritis in 20% (n=61, and gastric IM in 5% (n=15of patients. A first-degree family history of gastric cancer was arisk factor for having gastric IM (OR 8.51, 95% CI: 1.52-40.22,P=0.018 on age-adjusted multivariate analysis. Uninsured patients(OR 5.1, 95% CI: 2.4-11.2, P<0.001 and those with Medicaid (OR3.6, 95% CI: 1.3-9.7, P=0.014 were more likely to have chronicgastritis as compared to those with private insurance on age-adjustedmultivariate analysis.CONCLUSION: A family history of gastric cancer significantlyincreased the odds of having gastric IM. Uninsured patients andthose with Medicaid were at increased risk of having chronic gastritisand trended towards having IM on gastric biopsies. As guidelinesregarding the screening and surveillance of premalignant gastriclesions emerge, attention should be paid to patients with a familyhistory of gastric cancer, and possibly those with lower socioeconomicstatus who might be at increased risk for gastric IM.

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

    Gabriel, Iwona; Olejek, Anita

    2014-06-01

    Women using hormonal therapy for breast cancer are often encountered in clinical practice of breast surgeons, oncologists and gynecologists. Some of them during the course of therapy develop abnormal uterine bleeding or have ultrasound abnormalities detected. In Poland, most of them are still diagnosed using blind curettage, which does not bring a definitive diagnosis or requires repeating the diagnostic procedure. This produces unnecessary fear of malignancy in patients and increases economic costs (double curettage, unnecessary hysterectomy and its social consequences). Therefore, we studied the usefulness of hysteroscopy with targeted biopsies for further management of women treated with tamoxifen. Our goal is to provide evidence that women before entering, during and after tamoxifen treatment have hysteroscopy for endometrial assessment. PMID:25097696

  5. No influence of increased intake of orange and blackcurrant juices and dietary amounts of vitamin E on paraoxonase-1 activity in patients with peripheral arterial disease

    Dalgård, Christine; Christiansen, Lene; Jonung, Torbjörn; Mackness, Michael I; de Maat, Moniek P M; Hørder, Mogens

    2007-01-01

    dietary factors like the antioxidants. AIM OF THE STUDY: We examined the effect of antioxidant-rich orange and blackcurrant juices and vitamin E supplement on PON1 activity in patients with peripheral arterial disease. Furthermore, we studied whether genetic polymorphisms in the PON1 gene predicted the...... change in PON1 activity. METHODS: The study was designed as a cross-over trial with 48 participants who received two of the four possible treatments: (1) 250 ml orange juice and 250 ml blackcurrant juice; (2) 15 mg vitamin E; (3) 250 ml orange juice and 250 ml blackcurrant juice and 15 mg vitamin E; or...... (4) control/placebo (energy-equivalent sugar-containing beverage). The treatments were given for 28 days, separated by a 4-week wash-out period. RESULTS: The PON1 activity was not affected by juice or vitamin E supplement neither was there evidence of synergetic effects. However, a statistically...

  6. Relation between occupational asthma case history, bronchial methacholine challenge, and specific challenge test in patients with suspected occupational asthma.

    Baur, X; Huber, H; Degens, P O; Allmers, H; Ammon, J

    1998-02-01

    Inhalative methacholine challenge (MC) was performed in 229 subjects presumed to suffer from occupational asthma due to exposure to airborne latex allergens (n = 62), flour (n = 28), isocyanates (n = 114), or irritants in hairdressers' salons (n = 25). They were also subjected to specific challenges with the occupational agents they were exposed to, completed a questionnaire using an abbreviated version of the ATS-DLD, and were interviewed by an experienced physician. Bronchial hyperresponsiveness in MC was defined by the results obtained in a previous study with 81 healthy volunteers. The threshold in these controls was set at a cumulative MC dose of 0.3 mg, corresponding to a sensitivity of 95%. The main purpose of the study was to investigate whether the MC and/or the occupational asthma case history are reliable predictors of the specific challenge test outcomes. In 40-72% of examined subjects, workplace-related asthma complaints occurred, with bronchial hyperreactivity in the MC ranging from 48% to 61%. However, only 12-25% demonstrated a significant bronchoconstructive reaction in the specific challenge test. MC results are only moderately associated with workplace-related asthma case histories. Positive outcomes of challenges with occupational agents are well correlated with positive MC results plus occupational asthma case histories. The combination of MC and occupational asthma case history shows a relatively high specificity (62%, 86%, 80%), but the sensitivity was moderately low (83%, 71%, 52%). MC sensitivities were 92%, 71%, and 62% (case histories of hairdressers were not available). We conclude that in most cases, occupational asthma (as defined by a specific challenge test response) is combined with bronchial hyperresponsiveness and workplace-related asthmatic symptoms. However, subjects of each exposure group demonstrated bronchial hyperresponsiveness and complained of workplace-related asthmatic symptoms, but occupational asthma could not be proved in the specific challenge test. In subjects with a positive occupational asthma case history, a negative MC test result can almost rule out a positive specific challenges test result. Hence, the MC test can reduce performance of the laborious specific challenge test. PMID:9438044

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

    N. Jara

    2012-08-01

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

  8. Relative Importance of History of Heart Failure Hospitalization and N-Terminal Pro-B-Type Natriuretic Peptide Level as Predictors of Outcomes in Patients With Heart Failure and Preserved Ejection Fraction

    Kristensen, Søren L; Jhund, Pardeep S; Køber, Lars; McKelvie, Robert S; Zile, Michael R; Anand, Inder S; Komajda, Michel; Cleland, John G F; Carson, Peter E; McMurray, John J V

    2015-01-01

    about the value of a history of HF hospitalization as a predictor of adverse cardiovascular outcomes in patients with HF and HF-PEF. METHODS: We estimated rates and adjusted hazard ratios (HRs) for the composite endpoint of cardiovascular death or HF hospitalization, according to history of recent HF...

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

    Yoshimoto D

    2014-12-01

    Full Text Available Daisuke Yoshimoto,1 Yasutaka Nakano,2 Katsuya Onishi,3 Gerry Hagan,4 Paul Jones5 1GlaxoSmithKline, Tokyo, 2Division of Respiratory Medicine, Department of Medicine, Shiga University of Medical Science, Otsu, 3Onishi Heart Clinic, Tsu, Japan; 4Independent consultant, Marbella, Spain; 5Division of Clinical Science, St Georges Hospital, University of London, London, UK Background: A large number of chronic obstructive pulmonary disease (COPD patients in Japan remain undiagnosed, primarily due to the underuse of spirometry. Two studies were conducted to see whether the COPD Assessment Test (CAT in primary care has the potential to identify those patients who need spirometry for a diagnosis of COPD and to determine whether patients with cardiovascular disease had airflow limitation, which could be detected by CAT. Materials and methods: Two multicenter, noninterventional, prospective studies (studies 1 and 2 were conducted across Japan. Patients in both studies were ?40 years old with a smoking history. Those in study 1 were seen in primary care and had experienced repeated respiratory tract infections, but had no diagnosis of COPD. Patients in study 2 were identified in cardiovascular disease clinics when routinely visiting for their cardiovascular disease. All patients completed the CAT prior to lung-function testing by hand-held spirometry. The presence of airflow limitation was defined as a forced expiratory volume in 1 second (FEV1/FEV6 ratio <0.73. Results: A total of 3,062 subjects completed the CAT (2,067 in study 1, 995 in study 2; 88.8% were male, and the mean age ( standard deviation was 61.511.6 years. Airflow limitation was found in 400 (19.4% patients in study 1, and 269 (27.0% in study 2. The CAT score in patients with airflow limitation was significantly higher than in patients without airflow limitation in both studies: 8.6 (95% confidence interval [CI] 7.99.2 versus 7.4 (95% CI 7.17.6 in study 1, and 8.3 (95% CI 7.59.2 versus 6.4 (95% CI 6.06.8 in study 2 (both P<0.001. Conclusion: These findings suggest that the CAT has the potential to identify patients with cardiovascular disease or a history of frequent chest infections who need spirometry to diagnose COPD. Keywords: COPD, CAT, spirometry, airflow limitation

  10. Sarcomatoid carcinoma of the jejunum presenting as obscure gastrointestinal bleeding in a patient with a history of gliosarcoma

    Alfonso Puentes, Nidia; Jimenez-Alfaro Larrazabal, Carmen; García Higuera, Maria Isabel

    2014-01-01

    Small bowel malignant tumors are rare and sarcomatoid carcinomas have rarely been reported at this site. We report a 56-year-old woman, with history of an excised gliosarcoma, who presented with recurrent obscure gastrointestinal bleeding. She underwent endoscopy and colonoscopy, which failed to identify the cause of the bleeding. The abdominal computed tomography scan located a tumor in the small bowel. Pathology revealed a jejunal sarcomatoid carcinoma. She developed tumor recurrence and mu...

  11. New-Onset Panic, Depression with Suicidal Thoughts, and Somatic Symptoms in a Patient with a History of Lyme Disease

    Amir Garakani; Andrew G. Mitton

    2015-01-01

    Lyme Disease, or Lyme Borreliosis, caused by Borrelia burgdorferi and spread by ticks, is mainly known to cause arthritis and neurological disorders but can also cause psychiatric symptoms such as depression and anxiety. We present a case of a 37-year-old man with no known psychiatric history who developed panic attacks, severe depressive symptoms and suicidal ideation, and neuromuscular complaints including back spasms, joint pain, myalgias, and neuropathic pain. These symptoms began 2 years...

  12. A Case of Extensive Spinal Cysticercosis Involving the Whole Spinal Canal in a Patient with a History of Cerebral Cysticercosis

    Shin, Dong Ah; Shin, Hyun Chul

    2009-01-01

    Although cysticercosis is the most common parasitic disease affecting the central nervous system, spinal cysticercosis is rare. A rare form of spinal cysticercosis involving the whole spinal canal is presented. A 45-year-old Korean male had a history of intracranial cysticercosis and showed progressive paraparesis. Spinal magnetic resonance scan showed multiple cysts compressing the spinal cord from C1 to L1. Three different levels (C1-2, T1-3, and T11-L1) required operation. Histopathologica...

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

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

    2006-01-01

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

  14. Family history based approach in risk prediction for Parkinson's disease: Additional contribution of familial associated disorders

    Vrecar Irena

    2015-01-01

    Full Text Available The aim of our study was to examine the contribution of family history of Parkinson's disease and its associated disorders in the assessment of predictive capacity of risk models for Parkinson’s disease. In a population of 192 patients with Parkinson’s disease and 1659 healthy individuals we investigated the impact of environmental factors and the effects of family history on Parkinson's disease risk. Pesticides exposure, positive family history of Parkinson’s disease and a positive family history of dementia and melanoma were associated to an increased risk for Parkinson’s disease, with results regarding family history of depression near to statistical significance. Smoking and caffeine intake were associated to a decreased risk for Parkinson’s disease. Three risk prediction models were assessed using the area under the curve approach: first model was based on known environmental risk factors, in the second model we added family history of Parkinson’s disease and in the third model we additionally included family history of dementia, melanoma and depression. We showed that inclusion of data on family history of associated disorders (AUC 0.76 improves predictive capacity of risk model for Parkinson’s disease in comparison with the first (AUC 0.62 and the second model (AUC 0.71. We concluded that family history of associated disorders: dementia, depression and melanoma improves predictive capacity of risk models for Parkinson’s disease.

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

    The literature suggests that a history of depression is associated with an increased risk of developing Alzheimer's disease (AD). The aim of this study was to examine brain amyloid accumulation in patients with lifetime major depression using 18F-florbetapir (AV-45/Amyvid) PET imaging in comparison with that in nondepressed subjects. The study groups comprised 25 depressed patients and 11 comparison subjects who did not meet the diagnostic criteria for AD or amnestic mild cognitive impairment. Vascular risk factors, homocysteine and apolipoprotein E (ApoE) genotype were also examined. The standard uptake value ratio (SUVR) of each volume of interest was analysed using whole the cerebellum as the reference region. Patients with a lifetime history of major depression had higher 18F-florbetapir SUVRs in the precuneus (1.06 ± 0.08 vs. 1.00 ± 0.06, p = 0.045) and parietal region (1.05 ± 0.08 vs. 0.98 ± 0.07, p = 0.038) than the comparison subjects. Voxel-wise analysis revealed a significantly increased SUVR in depressed patients in the frontal, parietal, temporal and occipital areas (p 18F-florbetapir SUVRs and prior depression episodes, age at onset of depression, or time since onset of first depression. Increased 18F-florbetapir binding values were found in patients with late-life major depression relative to comparison subjects in specific brain regions, despite no differences in age, sex, education, Mini Mental Status Examination score, vascular risk factor score, homocysteine and ApoE ε4 genotype between the two groups. A longitudinal follow-up study with a large sample size would be worthwhile. (orig.)

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

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

    2014-04-15

    The literature suggests that a history of depression is associated with an increased risk of developing Alzheimer's disease (AD). The aim of this study was to examine brain amyloid accumulation in patients with lifetime major depression using {sup 18}F-florbetapir (AV-45/Amyvid) PET imaging in comparison with that in nondepressed subjects. The study groups comprised 25 depressed patients and 11 comparison subjects who did not meet the diagnostic criteria for AD or amnestic mild cognitive impairment. Vascular risk factors, homocysteine and apolipoprotein E (ApoE) genotype were also examined. The standard uptake value ratio (SUVR) of each volume of interest was analysed using whole the cerebellum as the reference region. Patients with a lifetime history of major depression had higher {sup 18}F-florbetapir SUVRs in the precuneus (1.06 ± 0.08 vs. 1.00 ± 0.06, p = 0.045) and parietal region (1.05 ± 0.08 vs. 0.98 ± 0.07, p = 0.038) than the comparison subjects. Voxel-wise analysis revealed a significantly increased SUVR in depressed patients in the frontal, parietal, temporal and occipital areas (p < 0.01). There were no significant associations between global {sup 18}F-florbetapir SUVRs and prior depression episodes, age at onset of depression, or time since onset of first depression. Increased {sup 18}F-florbetapir binding values were found in patients with late-life major depression relative to comparison subjects in specific brain regions, despite no differences in age, sex, education, Mini Mental Status Examination score, vascular risk factor score, homocysteine and ApoE ε4 genotype between the two groups. A longitudinal follow-up study with a large sample size would be worthwhile. (orig.)

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

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

  18. Estradiol valerate and alcohol intake: dose-response assessments

    Aguilar-Vazquez Azucena

    2007-03-01

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

  19. Selected micronutrient intake and the risk of colorectal cancer.

    M. Ferraroni; La Vecchia, C.; D'Avanzo, B; E. Negri; Franceschi, S.; Decarli, A.

    1994-01-01

    The relationship between estimated intake of selected micronutrients and the risk of colorectal cancer was analysed using data from a case-control study conducted in northern Italy. The study was based on 828 patients with colon cancer, 498 with rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract diseases. Relative risks (RRs) of intake quintiles were computed after allowance for age, sex and other major potential confounding factors, including an estim...

  20. Influence of antecedent radionuclide intake upon assessment of subsequent intakes

    The nature of NPP personnel's operation under conditions of chronic internal irradiation requires multiple measurements of the whole-body inhaled radionuclide contents. The decrease in the time span between two consequent measurements causes a substantial growth in the influence of the antecendent intakes on the evaluation of the intake between the two measurements. This influence has to be corrected since otherwise an overestimate of intakes will result, and thus an overestimate of internal radiation doses. A technique has been developed for correcting the influence of antecedent intakes upon the estimate of subsequent radionuclide inhalations. Based on this technique, a program in MathCAD environment was written, and is being applied for assessing intakes and doses from internal radiation exposure to Kozloduy NPP personnel. (author)

  1. Factors Associated with Attrition from Mindfulness-Based Cognitive Therapy in Patients with a History of Suicidal Depression

    Crane, Catherine; Williams, J. Mark G.

    2010-01-01

    We report data from a randomised controlled trial of mindfulness-based cognitive therapy to pilot procedures for people with a history of suicidal ideation or behaviour, focusing in particular on the variables that distinguish those who complete an adequate ‘dose’ of treatment, from those who drop out. Sixty-eight participants were randomised to either immediate treatment with mindfulness-based cognitive therapy (MBCT) (n = 33) or to the waitlist (n = 36) arm of the trial. In addition to coll...

  2. Sarcomatoid carcinoma of the jejunum presenting as obscure gastrointestinal bleeding in a patient with a history of gliosarcoma

    Alfonso Puentes, Nidia; Jimenez-Alfaro Larrazabal, Carmen; García Higuera, Maria Isabel

    2014-01-01

    Small bowel malignant tumors are rare and sarcomatoid carcinomas have rarely been reported at this site. We report a 56-year-old woman, with history of an excised gliosarcoma, who presented with recurrent obscure gastrointestinal bleeding. She underwent endoscopy and colonoscopy, which failed to identify the cause of the bleeding. The abdominal computed tomography scan located a tumor in the small bowel. Pathology revealed a jejunal sarcomatoid carcinoma. She developed tumor recurrence and multiple liver metastases shortly after surgery. Immunohistochemistry is required for accurate diagnosis. Sarcomatoid carcinoma is a rare cause of obscure gastrointestinal bleeding, which is associated with a poor prognosis. PMID:24759341

  3. Episodic sucrose intake during food restriction increases synaptic abundance of AMPA receptors in nucleus accumbens and augments intake of sucrose following restoration of ad libitum feeding.

    Peng, X-X; Lister, A; Rabinowitsch, A; Kolaric, R; Cabeza de Vaca, S; Ziff, E B; Carr, K D

    2015-06-01

    Weight-loss dieting often leads to loss of control, rebound weight gain, and is a risk factor for binge pathology. Based on findings that food restriction (FR) upregulates sucrose-induced trafficking of glutamatergic AMPA receptors to the nucleus accumbens (NAc) postsynaptic density (PSD), this study was an initial test of the hypothesis that episodic "breakthrough" intake of forbidden food during dieting interacts with upregulated mechanisms of synaptic plasticity to increase reward-driven feeding. Ad libitum (AL) fed and FR subjects consumed a limited amount of 10% sucrose, or had access to water, every other day for 10 occasions. Beginning three weeks after return of FR rats to AL feeding, when 24-h chow intake and rate of body weight gain had normalized, subjects with a history of sucrose intake during FR consumed more sucrose during a four week intermittent access protocol than the two AL groups and the group that had access to water during FR. In an experiment that substituted noncontingent administration of d-amphetamine for sucrose, FR subjects displayed an enhanced locomotor response during active FR but a blunted response, relative to AL subjects, during recovery from FR. This result suggests that the enduring increase in sucrose consumption is unlikely to be explained by residual enhancing effects of FR on dopamine signaling. In a biochemical experiment which paralleled the sucrose behavioral experiment, rats with a history of sucrose intake during FR displayed increased abundance of pSer845-GluA1, GluA2, and GluA3 in the NAc PSD relative to rats with a history of FR without sucrose access and rats that had been AL throughout, whether they had a history of episodic sucrose intake or not. A history of FR, with or without a history of sucrose intake, was associated with increased abundance of GluA1. A terminal 15-min bout of sucrose intake produced a further increase in pSer845-GluA1 and GluA2 in subjects with a history of sucrose intake during FR. Generally, neither a history of sucrose intake nor a terminal bout of sucrose intake affected AMPA receptor abundance in the NAc PSD of AL subjects. Together, these results are consistent with the hypothesis, but the functional contribution of increased synaptic incorporation of AMPA receptors remains to be established. PMID:25800309

  4. Resurgence of anorexic symptoms during smoking cessation in patients with a history of anorexia nervosa: An unseen problem?--Report of two cases.

    Simioni, Nicolas; Cottencin, Olivier

    2015-09-01

    This report describes a resurgence of anorexic symptoms during a smoking cessation program in two patients with a history of anorexia nervosa. These two events were identified among patients lost to follow-up by using a strategy implemented to limit early drop out. In both cases, the resurgence of anorexic symptoms occurred rapidly after having reached abstinence from tobacco and was described as a response to the weight gain they had experienced just after the start of smoking cessation. The smoking cessation process itself was considered as the most plausible explanation for these two events. Given the potential serious consequences, further research is needed to determine whether such events are frequent during smoking cessation but being unseen because of being hidden in the loss to follow-up. This report also suggests that systematic screening for both binge eating and anorexic behaviors during smoking cessation is warranted. PMID:26016609

  5. New aspects of clinical pathology and electro-physiological muscle disturbances in patients with history of trichinellosis

    Kociecka W.

    2001-06-01

    Full Text Available Clinical studies performed in 44 patients, one, three, four, six or seven years after they had experienced trichinellosis demonstrated the persistence of various general and motor ailments in 88.7 % of the patients. The persisting for many years antibodies against E/S antigen of Trichinella in 86.4 % of examined patients seem to reflect chronic stimulation by the larvae which, as shown by parasitological and histopathological tests, survived longer and underwent gradual destruction in muscles. Bio-electric disturbances in muscles were most frequently of a mixed type, with prevalence of a neural type record. These observations illustrate a disturbed function of motor neurones and of impulse transmission at the myoneural junction in patients chronically infected with Trichinella.

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

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

    2013-01-01

    Cross-sectional studies in dialysis demonstrate muscle wasting associated with loss of function, increased morbidity and mortality. The relative drivers are poorly understood. There is a paucity of data regarding interval change in muscle in pre-dialysis and dialysis-dependant patients. This study aimed to examine muscle and fat mass change and elucidate associations with muscle wasting in advanced CKD. 134 patients were studied (60 HD, 28 PD, 46 CKD 45) and followed up for two years. Gr...

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

    Serhan P??K?NPA?A

    2013-05-01

    Full Text Available OBJECTIVE: Hepatitis B (HBV and hepatitis C (HCV viruses are significant causes of morbidity and mortality in patients with chronic kidney disease (CKD. There is insufficient data on seroprevalence of HBV and HCV in CKD patients without renal replacement therapy (RRT. MATERIAL and METHODS: Patients diagnosed as having CKD without RRT were analyzed. Seven hundred and eighty cases included study. RESULTS: The seroprevalence of HbsAg and Anti-HCV were 3.5% and 1.3%, respectively. The seroprevalence of Anti-HBsAb analyzed in 456 (58.4% patients was 39.3%. The seroprevalence of HBsAg and Anti-HCV did not differ between the patients in early stage (stage 3 and advanced stage CKD (Stage 4 and 5 (p=0.26 and p=0.88, respectively. Seropositivity of Anti-HBsAb was 41.9% in early stage and 33.6% in advanced stage CKD (p=0.88. No difference was detected in seroprevalence of HbsAg and Anti-HCV when patients were grouped regarding the underlying disorders of CKD (p=0.95 and p=0.25, respectively. CONCLUSION: Higher seroprevalence of Anti-HCV in hemodialysis patients, according to studies carried out in our country, may be secondary to the exposure to HCV during hemodialysis procedure. High seropositivity of Anti-HBsAb in early stage CKD, although not statistically significant, may point out the necessity of hepatitis B immunization earlier in the course of CKD. Screening the patients with CKD without RRT for HBsAg and Anti-HCV serologies would be applicable although there is no established consensus in guidelines.

  8. Job strain and alcohol intake

    Heikkilä, Katriina; Nyberg, Solja T; Fransson, Eleonor I; Alfredsson, Lars; De Bacquer, Dirk; Bjørner, Jakob; Bonenfant, Sébastien; Borritz, Marianne; Burr, Hermann; Clays, Els; Casini, Annalisa; Dragano, Nico; Erbel, Raimund; Geuskens, Goedele A; Goldberg, Marcel; Hooftman, Wendela E; Houtman, Irene L; Joensuu, Matti; Jöckel, Karl-Heinz; Kittel, France; Knutsson, Anders; Koskenvuo, Markku; Koskinen, Aki; Kouvonen, Anne; Leineweber, Constanze; Lunau, Thorsten; Madsen, Ida E H; Magnusson Hanson, Linda L; Marmot, Michael G; Nielsen, Martin L; Nordin, Maria; Pentti, Jaana; Salo, Paula; Rugulies, Reiner; Steptoe, Andrew; Siegrist, Johannes; Suominen, Sakari; Vahtera, Jussi; Virtanen, Marianna; Väänänen, Ari; Westerholm, Peter; Westerlund, Hugo; Zins, Marie; Theorell, Töres; Hamer, Mark; Ferrie, Jane E; Singh-Manoux, Archana; Batty, G David; Kivimäki, Mika

    2012-01-01

    The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job...... strain) and alcohol intake....

  9. Vitamin K Intake and Atherosclerosis

    It has been hypothesized that insufficient intake of vitamin K may increase soft tissue calcification due to impaired gamma-carboxylation of the vitamin K-dependent protein, matrix gamma-carboxyglutamic acid (MGP). The evidence to support this putative role of vitamin K intake in atherosclerosis is ...

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

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

    1999-10-01

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

  11. Effectiveness of L-thyroxine treatment on TSH suppression during pregnancy in patients with a history of thyroid carcinoma after total thyroidectomy and radioiodine ablation

    There are scarce data about the optimal increase of L-thyroxine dose during pregnancy in patients with a history of thyroid carcinoma. The first aim of the study was to find out if routine therapeutic measures enable adequate TSH suppression in pregnancy. The other aim was to find out the optimal dose of L-thyroxine for TSH suppression in pregnant women. In this retrospective observational study, we analysed 36 pregnancies of 32 women with a history of thyroid carcinoma. Before pregnancy, all of them underwent total thyroidectomy and radioiodine ablation of thyroid remnant, and they were on suppressive doses of L-thyroxine. Thyroid function tests were obtained before, during and after pregnancy. Mean L-thyroxine dose before pregnancy, in the first, second and, third trimester and after delivery was 149, 147, 155, 165 and 158 micrograms daily, respectively. TSH concentration remained suppressed in 9 pregnancies, it was within normal range in 22 and elevated in 5 pregnancies. The mean dose of L-thyroxine in patients with suppressed TSH before pregnancy, in the first, second and, third trimester and after delivery was 154, 154, 164, 160 and 161 micrograms daily, respectively. When the dose had to be changed, the mean increase of the dose was 31.5 micrograms daily. The range of changes in TSH concentration during pregnancy in the patients who have been on suppressive L-thyroxine therapy before conception is quite wide. TSH was adequately suppressed in only 25% of pregnancies. The dose of L-thyroxine in patients with suppressed TSH in the first, second and third trimester was 154, 164 and 160 micrograms daily, respectively

  12. The prophylactic reduction of aluminium intake.

    Lione, A

    1983-02-01

    The use of modern analytical methods has demonstrated that aluminium salts can be absorbed from the gut and concentrated in various human tissues, including bone, the parathyroids and brain. The neurotoxicity of aluminium has been extensively characterized in rabbits and cats, and high concentrations of aluminium have been detected in the brain tissue of patients with Alzheimer's disease. Various reports have suggested that high aluminium intakes may be harmful to some patients with bone disease or renal impairment. Fatal aluminium-induced neuropathies have been reported in patients on renal dialysis. Since there are no demonstrable consequences of aluminium deprivation, the prophylactic reduction of aluminium intake by many patients would appear prudent. In this report, the major sources of aluminium in foods and non-prescription drugs are summarized and alternative products are described. The most common foods that contain substantial amounts of aluminium-containing additives include some processed cheeses, baking powders, cake mixes, frozen doughs, pancake mixes, self-raising flours and pickled vegetables. The aluminium-containing non-prescription drugs include some antacids, buffered aspirins, antidiarrhoeal products, douches and haemorrhoidal medications. The advisability of recommending a low aluminium diet for geriatric patients is discussed in detail. PMID:6337934

  13. Power plant intake entrainment analysis

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

  14. Impact of Histopathological Factors, Patient History and Therapeutic Variables on Recurrence-free Survival after Ductal Carcinoma in Situ: 8-Year Follow-up and Questionnaire Survey

    van Mackelenbergh, M. T.; Lindner, C. M.; Heilmann, T.; Alkatout, I.; Elessawy, M.; Mundhenke, C.; Maass, N.; Schem, C.

    2016-01-01

    Introduction: Ductal carcinoma in situ (DCIS) is a premalignant lesion of the glandular component of the breast and a precursor lesion of invasive breast cancer. In recent decades the incidence of DCIS has risen continuously, mainly because of more extensive screening and more advanced diagnostic procedures. There is an increasing need for evidence-based treatment guidelines which will protect patients as far as possible from recurrence or invasive cancer but also from overtreatment. This retrospective single-center clinical trial analyzed recurrence-free survival times, rates of invasive and non-invasive events, and the impact of patient history, histopathological variables and therapeutic factors on recurrence-free survival times. Material and Methods: A total of 200 patients who underwent surgery between 2000 and 2007 for pure DCIS were included in the study. As part of follow-up a questionnaire was sent to patients and their respective gynecologists. Results: In the follow-up period, 12.5?% (n?=?25) of the 200 patients had recurrence (invasive or non-invasive event). Menopausal status, tumor grade and tumor size were significantly associated with recurrence. Low-grade DCIS was significantly more often hormone receptor-positive than high-grade DCIS. Patients who had postoperative radiotherapy significantly more often also received endocrine drug treatment. There was a significant association between younger patient age and drug treatment. The study found that in the investigated cohort, premenopausal women had a significantly shorter recurrence-free time compared to postmenopausal women. Conclusion: This paper summarizes the current literature on DCIS. There is a need for more prospective clinical trials to improve the prognosis of premenopausal women with large and hormone receptor-positive DCIS.

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

    Serkan Emre EROĞLU

    2012-01-01

    Full Text Available Objective: Warfarin is the most commonly used oral anticoagulant agent. In overdose situations, serious complications may occur. The aim of the study was to determine the correlation between the international normalized ratio (INR levels and complications due to warfarin.Patients and Methods: The study was performed prospectively at the Department of Emergency Medicine, Marmara University Hospital between July 2006 and July 2007. Patients whose complaints were due to warfarin overdose were included in the study. The presentations and outcomes of these patients were analyzed. SPSS 15.0 was used for the analysis. The Chi-square test was used for the statistical analysis. The statistical difference p0.05.Conclusion: There is no significant correlation between the INR levels and the severity of the bleeding (p>0.05. (Marmara Medical Journal 2012;25:138-42

  16. Family History

    ... Brain Aneurysm Statistics and Facts Seeking Medical Attention Pediatric Aneurysms Brain Aneurysm Causes and Risk Factors Family History ... Brain Aneurysm Statistics and Facts Seeking Medical Attention Pediatric Aneurysms Brain Aneurysm Causes and Risk Factors Family History ...

  17. Evaluation of an intake of plutonium 238: A case history

    In July 1991 a plutonium worker at the Savannah River Site (SRS) was exposed to airborne plutonium-238 from a contaminated shipping container. She was chelated with Zn-DTPA shortly after the incident and placed on a special bioassay program. Based on early urinary and fecal excretion, an initial dose estimate of 1525 mrem committed effective dose equivalent (CEDE) was reported 20 days later. As additional bioassay data were collected the dose was revised to 1840 mrem CEDE on day 88 and to 3660 mrem CEDE on day 245. This last estimate was officially reported to the Department of Energy (DOE). The urinary excretion data and expectation curve for the model are shown. Only the data to the left of the first vertical line (3/92 Evaluation) were available at the time of the initial dose estimate

  18. Long-term nutritional assessment of patients with severe short bowel syndrome managed with home enteral nutrition and oral intake Evaluacin nutricional a largo plazo de pacientes con grave sndrome de intestino corto controlada con nutricin enteral e ingestin oral

    V. Chaer Borges

    2011-08-01

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

  19. Avoidant/Restrictive Food Intake Disorder

    ... Avoidant/Restrictive Food Intake Disorder Binge Eating Disorder Bulimia Nervosa Pica Rumination Disorder Avoidant/restrictive food intake disorder ... Avoidant/Restrictive Food Intake Disorder Binge Eating Disorder Bulimia Nervosa Pica Rumination Disorder NOTE: This is the Consumer ...

  20. Mandibular lesion differential diagnoses in a patient with a previous history of locally advanced head and neck carcinoma

    Eighteen months after completion of a radio chemotherapy treatment for a T4 tonsil cancer, a patient presented with a piece of bone coming out through a submandibular fistula and increasing pain. A CT scan, a bone scintigraphy and an 18-fluorodeoxyglucose positron-emission tomography were performed. Both diagnoses of osteoradionecrosis and tumor recurrence were suspected and then confirmed after mandibulectomy. (authors)

  1. A Study of Inflammatory Status in Nephropathy Patients with History of Type-II Diabetes Mellitus Undergoing Haemodialysis

    Nath, Indrajit; Nath, Chandan Kumar; Baruah, Mriganka; Pathak, Moushumi; Banerjee, R.; Goyal, Sapna

    2013-01-01

    Introduction and Objective: Diabetic nephropathy is one of the leading cause of chronic kidney failure. Local vascular inflammation is increased in diabetes mellitus (DM), which results in higher burden of microvascular and macrovascular complications. The present study was carried out to assess the importance of inflammatory status in nephropathy patients with Type-II DM.

  2. Semi-quantitative assessment of cerebral blood flow with 99mTc-HMPAO SPET in type I diabetic patients with no clinical history of cerebrovascular disease

    In 65 type I diabetic patients we prospectively evaluated brain perfusion by means of single-photon emission tomography after the injection of 740- 1110 MBq of technetium-99m hexamethylpropylene amine oxime. Thirty-five of the patients presented complications secondary to their diabetes. None showed CNS symptoms. A semiquantitative analysis was performed drawing 50 symmetrical regions of interest (ROIs) per patient. The relative contribution of each ROI to the total blood flow in each slice was compared with the relative contribution of the same ROI in a control group of ten healthy volunteers. Relative values of any ROI in the study group higher or lower than the mean ±2 SD in respect of the same ROI in the control group were considered abnormal. The results revealed hypoperfusion in 207 ROIs in the 65 patients with diabetes mellitus: of these ROIs, 113 were frontal, 10 frontotemporal, 20 temporal, 18 parietal, 11 occipital and 35 cerebellar. A total of 137 ROIs showed hyperperfusion: 17 frontal, 3 frontotemporal, 19 temporal, 18 parietal, 19 parieto-occipital, 29 occipital and 32 cerebellar. Out of 65 type I diabetic patients, 61 showed at least one hypoperfused ROI (P = 0.0064 vs. controls) and 25 showed more than three hypoperfused ROIs. None of the control subjects showed more than three hypoperfused regions (P<0.001). The results obtained demonstrate the existence of subclinical abnormalities of brain blood perfusion in patients with type I diabetes mellitus and no history of cerebrovascular disease, thereby allowing the initiation of intensive preventive measures. (orig.)

  3. Stigma, social reciprocity and exclusion of HIV/AIDS patients with illicit drug histories: A study of Thai nurses' attitudes

    Stoové Mark A

    2008-08-01

    Full Text Available Abstract Background Stigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA. In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention. Methods Semi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA. Results The analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally. Conclusion Decreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting government injecting drug policy to harm reduction are discussed as some of the ways for stigma intervention to move forward.

  4. Behavioral health in the Department of Defense Patient-Centered Medical Home: history, finance, policy, work force development, and evaluation.

    Hunter, Christopher L; Goodie, Jeffrey L

    2012-09-01

    Integrating behavioral health services into the patient-centered medical home (PCMH) is an important component for meeting the goals of easy access, whole person, coordinated, and integrated care. Unlike most PCMH initiatives, the Department of Defense's (DoD) Military Health System (MHS) launched its PCMH initiative with integrated behavioral health services. This integration facilitates the MHS's goal to meet its strategic imperatives under the "Quadruple Aim" of (1) maximizing readiness, (2) improving the health of the population, (3) enhancing the patient experience of care (including quality, access, and reliability), and (4) responsibly managing per capita cost of care. The MHS experience serves as a guide to other organizations. We discuss the historical underpinnings, funding, policy, and work force development strategies that contributed to integrated behavioral healthcare being a mandated component of the MHS's PCMH. PMID:24073135

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

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

    2016-02-01

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

  6. Behavioral health in the Department of Defense Patient-Centered Medical Home: history, finance, policy, work force development, and evaluation

    Hunter, Christopher L; Goodie, Jeffrey L

    2012-01-01

    Integrating behavioral health services into the patient-centered medical home (PCMH) is an important component for meeting the goals of easy access, whole person, coordinated, and integrated care. Unlike most PCMH initiatives, the Department of Defense’s (DoD) Military Health System (MHS) launched its PCMH initiative with integrated behavioral health services. This integration facilitates the MHS’s goal to meet its strategic imperatives under the “Quadruple Aim” of (1) maximizing readiness, (...

  7. Multidetector-row computed tomography (MDCT) in patients with a history of previous urothelial cancer or painless macroscopic haematuria

    The sensitivity and specificity of MDCT for depiction and localization of urothelial carcinoma (UC) was determined retrospectively. Axial and coronal four-row MDCT of the urinary tract (unenhanced, contrast-enhanced nephrographic, CT urography) was independently reviewed for UC by a radiologist (R1) and a urologist (R2), without other patient information, in 27 patients (22 male, five female; age, 72 ± 11 years) with previous UC and/or painless macroscopic haematuria. Urinary tract segments included bladder, right and left upper, middle, and lower caliceal groups, renal pelvis, uretero-pelvic junction, upper, middle, and lower ureter. MDCT findings were corroborated by surgery, other invasive procedures, and 1-year follow-up, including MDCT, intravenous urography, and cystoscopy. Receiver-operating characteristic analysis was undertaken and the the area under the curve (AUC) calculated. Eighteen of 27 patients had evidence of UC (pTa, n = 3; pT1-pT3, n = 15; TNM 2002). Tumor was correctly located by both R1 and R2 in 17 patients (sensitivity, 94%; 95% confidence interval, 84-100%) and ruled out in seven (specificity, 78%; 95% confidence interval, 51-100%), with complete agreement. Each detected ten of 11 upper urinary tracts affected by UC. For 35 urinary tract segments with UC and 308 without, the AUC was 0.910 ± 0.035 (R1) and 0.74 ± 0.055 (R2), z 2.4772, Bonferroni-corrected P = 0.022. MDCT depicts urinary tracts affected by UC with high sensitivity and substantial agreement between readers with different training. (orig.)

  8. After history of combined treatment of patients with hysterocarcinoma using 5-Fu radiomodification in preoperative course of radioactive therapy

    Authors assessed influence of such procedure on a rate of tumor cells detection in operative field and on vaginal scar during surgical operation. Authors made analysis of immediate and distant data of combined treatment of patients with hysterocarcinoma using 5-fluorouracil radiomodification on preoperative course of radioactive therapy.It is defined that application proposed method significantly improves ablastics of surgical operation and lads to increasing of recurrence-free period on 12.2% in comparison with control group

  9. Anesthetic management of a patient with a history of Batista procedure for dilated cardiomyopathy undergoing gastric surgery.

    Honda, Aki; Arai, Tamie; Akiyama, Maki; Masuda, Eriko; Kobayashi, Mizuka; Hoka, Sumio

    2006-01-01

    We experienced anesthetic management for an operation to remove a hemorrhagic gastric submucosal tumor in a patient who had undergone left ventricular volume reduction (the Batista procedure) for dilated cardiomyopathy (DCM) 2 years previously. Preoperative evaluations indicated the relapse of severe DCM. Intravenous and epidural anesthesia was employed with the aid of an intraaortic balloon pump (IABP). Safe anesthetic management was achieved under the guidance of a Swan-Ganz catheter without inducing overreduction of afterload or excessive preload. PMID:16897245

  10. Anti-N-methyl-d-aspartate receptor encephalitis in a patient with a 7-year history of being diagnosed as schizophrenia: complexities in diagnosis and treatment

    Huang C

    2015-06-01

    Full Text Available Chaohua Huang,1,2,4,* Yukun Kang,1,* Bo Zhang,1 Bin Li,1 Changjian Qiu,1 Shanming Liu,1 Hongyan Ren,1,2 Yanchun Yang,1 Xiehe Liu,1 Tao Li,1–3 Wanjun Guo1,21Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Mental Health Education Center, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 4Mental Health Center, Affiliated Hospital of Luzhou Medical College, Luzhou, People’s Republic of China*These authors contributed equally to this workAbstract: Anti-N-methyl-d-aspartate receptor (NMDAR encephalitis is a form of autoimmune encephalitis associated with antibodies against the NR1 subunits of NMDARs. Although new-onset acute prominent psychotic syndromes in patients with NMDAR encephalitis have been well documented, there is a lack of case studies on differential diagnosis and treatment of anti-NMDAR encephalitis after a long-term diagnostic history of functional psychotic disorders. The present study reports an unusual case of anti-NMDAR encephalitis. The patient had been diagnosed with schizophrenia 7 years earlier, and was currently hospitalized for acute-onset psychiatric symptoms. The diagnosis became unclear when the initial psychosis was confounded with considerations of other neurotoxicities (such as neuroleptic malignant syndrome. Finally, identification of specific immunoglobulin G NR1 autoantibodies in the cerebrospinal fluid and greater effectiveness of immunotherapy over antipsychotics alone (which has been well documented in anti-NMDAR encephalitis indicated the diagnosis of anti-NMDAR encephalitis in this case. Based on the available evidence, however, the relationship between the newly diagnosed anti-NMDAR encephalitis and the seemingly clear, long-term history of schizophrenia in the preceding 7 years is uncertain. This case report illustrates that psychiatrists should consider anti-NMDAR encephalitis and order tests for specific immunoglobulin G NR1 autoantibodies in patients presenting with disorientation, disturbance of consciousness, cognitive deficit, dyskinesia, autonomic disturbance, or rapid deterioration, even with a seemingly clear history of a psychiatric disorder and no specific findings on routine neuroimaging, electroencephalography, or cerebrospinal fluid tests in the early stage of the illness.Keywords: anti-N-methyl-d-aspartate receptor encephalitis, schizophrenia, differential diagnosis, treatment

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

    Norton Sandra

    2006-10-01

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

  12. Fiber Intake and Childhood Appendicitis.

    Brender, Jean D.; And Others

    1985-01-01

    Parents of 135 children with appendicitis and of 212 comparison children were interviewed about their children's diet. Results suggest that a liberal intake of whole-grain breads and cereals may decrease the risk of appendicitis during childhood. (KH)

  13. Radioactive iodine intake through foodstuff

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

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

    Verdonck, K; González, E; Schrooten, W; Vanham, G; Gotuzzo, E

    2008-08-01

    The purpose of this study was to assess the association between human T-lymphotropic virus 1 (HTLV-1) and a lifetime history of active tuberculosis (TB) among relatives of HTLV-1-infected patients. We reviewed clinical charts of all relatives of HTLV-1-infected index cases who attended our institute in Lima from 1990-2004. The data of 1233 relatives was analysed; 394 (32.0%) were HTLV-1 positive. Eighty-one subjects (6.6%) had a history of active TB, including 45/394 (11.4%) HTLV-1-positive and 36/839 (4.3%) HTLV-1-negative relatives (Phistory: HTLV-1 infection (adjusted OR 2.5, 95% CI 1.6-3.9), age (adjusted OR 1.3, 95% CI 1.1-1.5 per 10-year age increase) and relation to the index case (adjusted OR 2.6, 95% CI 1.3-5.1, for siblings vs. spouses of index cases). In conclusion, HTLV-1 infection may increase the susceptibility to active TB. In populations where both infections are frequent, such an association could affect the dynamics of TB. PMID:17892632

  15. Bridging Developmental Boundaries: Lifelong Dietary Patterns Modulate Life Histories in a Parthenogenetic Insect

    Roark, Alison M.; Bjorndal, Karen A

    2014-01-01

    Determining the effects of lifelong intake patterns on performance is challenging for many species, primarily because of methodological constraints. Here, we used a parthenogenetic insect (Carausius morosus) to determine the effects of limited and unlimited food availability across multiple life-history stages. Using a parthenogen allowed us to quantify intake by juvenile and adult females and to evaluate the morphological, physiological, and life-history responses to intake, all without the ...

  16. Food and nutrient intake in relation to mental wellbeing

    Albanes Demetrius

    2004-09-01

    Full Text Available Abstract Background We studied food consumption and nutrient intake in subjects with depressed mood, anxiety and insomnia as indices of compromised mental wellbeing. Methods The study population consisted of 29,133 male smokers aged 50 to 69 years who entered the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study in 1985–1988. This was a placebo-controlled trial to test whether supplementation with alpha-tocopherol or beta-carotene prevents lung cancer. At baseline 27,111 men completed a diet history questionnaire from which food and alcohol consumption and nutrient intake were calculated. The questionnaire on background and medical history included three symptoms on mental wellbeing, anxiety, depression and insomnia experienced in the past four months. Results Energy intake was higher in men who reported anxiety or depressed mood, and those reporting any such symptoms consumed more alcohol. Subjects reporting anxiety or depressed mood had higher intake of omega-3 fatty acids and omega-6 fatty acids. Conclusions Our findings conflict with the previous reports of beneficial effects of omega-3 fatty acids on mood.

  17. Discovery of a sexual stage in Trichophyton onychocola, a presumed geophilic dermatophyte isolated from toenails of patients with a history of T. rubrum onychomycosis

    Hubka, Vit; Nissen, Christoffer V; Jensen, Rasmus Hare; Arendrup, Maiken C; Cmokova, Adela; Kubatova, Alena; Skorepova, Magdalena; Kolarik, Miroslav

    2015-01-01

    Trichophyton onychocola is a recently described geophilic dermatophyte that has been isolated from a toenail of Czech patient with a history of onychomycosis due to T. rubrum and clinical suspicion of relapse. In this study, we report a similar case from Denmark in an otherwise healthy 56-year-old...... and the two isolates were successfully mated. The mating experiments with related heterothallic species T. thuringiense and Arthroderma melis were negative. The sexual state showed all typical signs of arthroderma-morph and is described by using optical as well as scanning electron microscopy. The...... sexual state was induced on a set of agar media, however low cultivation temperature and the presence of keratin source were crucial for the success rather than formulation of medium....

  18. Alectinib induced CNS radiation necrosis in an ALK+NSCLC patient with a remote (7 years) history of brain radiation.

    Ou, Sai-Hong Ignatius; Weitz, Michael; Jalas, John R; Kelly, Daniel F; Wong, Vanessa; Azada, Michele C; Quines, Oliver; Klempner, Samuel J

    2016-06-01

    Alectinib is a second generation ALK inhibitor that has significant clinical activity in central nervous system (CNS) metastases in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC). Pseudoprogression (PsP) due to radiation necrosis during alecitnib treatment of central nervous system (CNS) metastases from ALK-rearranged NSCLC as been reported. Hence, distinguishing radiation-related PsP from alectinib-induced radiographic changes is important to avoid erroneous early trial discontinuation and abandonment of an effective treatment. However, it remains difficult to assess casuality of radiation necrosis is related to recent direct radiation or induced by alectinib treatment or both. It is also unknown how long from previous radiation can alectinib still induce radiation necrosis. Here we reported a crizotinib-refractory ALK-positive NSCLC patient who develop radiation necrosis in one of his metastatic CNS lesions after approximately 12 months of alectinib treatment who otherwise had on-going CNS response on alectinib. His most recent radiation to his CNS metastases was 7 years prior to the start of alectinib. This case illustrates that in the setting of pror CNS radiation, given the significant clinical activity of alectinib in CNS metastases in ALK-positive NSCLC patients the risk of CNS radiation necrosis remains long after previous radiation to the CNS metastases has been completed and can occur after durable response of treatment. PMID:27133743

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

    The distinction between primary and secondary ovarian tumors may be challenging for pathologists. The purpose of the present work was to develop genomic and transcriptomic tools to further refine the pathological diagnosis of ovarian tumors after a previous history of breast cancer. Sixteen paired breast-ovary tumors from patients with a former diagnosis of breast cancer were collected. The genomic profiles of paired tumors were analyzed using the Affymetrix GeneChip® Mapping 50 K Xba Array or Genome-Wide Human SNP Array 6.0 (for one pair), and the data were normalized with ITALICS (ITerative and Alternative normaLIzation and Copy number calling for affymetrix Snp arrays) algorithm or Partek Genomic Suite, respectively. The transcriptome of paired samples was analyzed using Affymetrix GeneChip® Human Genome U133 Plus 2.0 Arrays, and the data were normalized with gc-Robust Multi-array Average (gcRMA) algorithm. A hierarchical clustering of these samples was performed, combined with a dataset of well-identified primary and secondary ovarian tumors. In 12 of the 16 paired tumors analyzed, the comparison of genomic profiles confirmed the pathological diagnosis of primary ovarian tumor (n = 5) or metastasis of breast cancer (n = 7). Among four cases with uncertain pathological diagnosis, genomic profiles were clearly distinct between the ovarian and breast tumors in two pairs, thus indicating primary ovarian carcinomas, and showed common patterns in the two others, indicating metastases from breast cancer. In all pairs, the result of the transcriptomic analysis was concordant with that of the genomic analysis. In patients with ovarian carcinoma and a previous history of breast cancer, SNP array analysis can be used to distinguish primary and secondary ovarian tumors. Transcriptomic analysis may be used when primary breast tissue specimen is not available

  20. Design of seawater intake facilities

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

  1. Hypothalamic food intake regulation in a cancer-cachectic mouse model

    Dwarkasing, Jvalini T; van Dijk, Miriam; Dijk, Francina J.; Boekschoten, Mark V.; Faber, Joyce; Argilès, Josep M.; Laviano, Alessandro; Müller, Michael; Witkamp, Renger F.; van Norren, Klaske

    2013-01-01

    Background Appetite is frequently affected in cancer patients leading to anorexia and consequently insufficient food intake. In this study, we report on hypothalamic gene expression profile of a cancer-cachectic mouse model with increased food intake. In this model, mice bearing C26 tumour have an increased food intake subsequently to the loss of body weight. We hypothesise that in this model, appetite-regulating systems in the hypothalamus, which apparently fail in anorexia, are still able t...

  2. Association of Aspirin Intake and Myocardial Infarction Size

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

    2012-01-01

    Myocardial infarction (MI) is one of the most important health burdens worldwide. Aspirin as an non- Steroid Antiinflammatory drug, has been proven to be a protective factor to decrease the incidence, however its effect of MI size is still unknown. We designed this study to compare the biomarkers after MI in patients with and without aspirin intake. 378 patients were enrolled and the results showed lower cardiac troponin T and Creatine Kinases in patients with protective dose of aspirin inta...

  3. La relacin mdico-enfermo a travs de la historia The doctor-patient relationship in history

    J. Lzaro

    2006-01-01

    Full Text Available En las ltimas dcadas del siglo veinte la forma de relacionarse los mdicos y los enfermos cambi ms que en los veinticinco siglos anteriores. El paso del modelo paternalista al autonomista supuso una transformacin con escasos precedentes histricos. La evolucin de este fenmeno a lo largo del tiempo afect a los tres elementos involucrados: 1. El enfermo, que tradicionalmente haba sido considerado como receptor pasivo de las decisiones que el mdico tomaba en su nombre y por su bien, lleg a finales del siglo veinte transformado en un agente con derechos bien definidos y amplia capacidad de decisin autnoma sobre los procedimientos diagnsticos y teraputicos que se le ofrecen, pero ya no se le imponen. 2. El mdico, que de ser padre sacerdotal (como corresponda al rol tradicional de su profesin se fue transformando en un asesor tcnico de sus pacientes, a los que ofrece sus conocimientos y consejos, pero cuyas decisiones ya no asume. 3. La relacin clnica, que de ser bipolar, vertical e infantilizante, se fue colectivizando (con la entrada en escena de mltiples profesionales sanitarios, se fue horizontalizando y se fue adaptando al tipo de relaciones propias de sujetos adultos en sociedades democrticas.In the final decades of the XX century the way doctors and patients related to each other changed more than in the twenty-five preceding centuries. The change from a paternalistic to an autonomous model represented a transformation with few historical precedents. The evolution of this phenomenon over time affected the three elements involved: 1. The patient, who had traditionally been considered as a passive receiver of the decisions that the doctor took in his name and for his benefit, was transformed at the end of the XX century into an agent with well-defined rights and a broad capacity for autonomous decision-making on the diagnostic and therapeutic procedures, which were offered to him and no longer imposed on him. 2. The doctor, from being a priestly father-figure (as corresponded to the traditional role of his profession was transformed into a technical adviser to his patients, to whom he offered his knowledge and advice, but whose decisions were no longer taken for granted. 3. The clinical relationship, from being bipolar, vertical and infantilising, became more collective (with the involvement of numerous health professionals, more horizontal and better adapted to the type of relationship appropriate to adult subjects in democratic societies.

  4. Nutrient intakes in relation to cancer incidence in Hawaii.

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

    1981-01-01

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

  5. Analysis of patients admitted with history of road traffic accidents to surgical unit B Teaching Hospital Anuradhapura, Sri Lanka

    WAK Weerawardena

    2013-10-01

    Full Text Available Background Road Traffic Accidents (RTA is a leading cause of morbidity, mortalityand disability in Sri Lanka. Identification of factors associated with RTA in local settings is essential in redusing the burden of this conditionMethods We analyzed consecutive patients admitted with RTA toSurgical Unit-B,Teaching Hospital Anuradhapura from 01/10/ 2012 to 31/03/2013. Epidemiology, injury pattern, vehicle type, cause for accident and contributory factors were noted.Results Altogether, 214 consecutive patients with an age range of 01- 75 years were studied. Males accounted for 77.6%(n=166 of the study sample.. Vehicle type involved with the injury included, motorcycle 138(65%, bicycles 23(11%, three wheelers 23(11%, tractors 11(5%, buses 5(2%, lorries 6(3%, cars 2(1% and other3(1%. There were 135(64% drivers /riders, 59(28% passengers and 17(08%pedestrians.Causes for accidents included wrong driving/riding 54(25%, other vehicle collided 46(22%, animal crossing road 39(18%, mechanical failure 14(7%, poor road 18(9%, glare 4(2%, man crossing road 8(4%, garment trapping the wheel 5(2%, rain 6(3%. Contributory factors included alcohol use in 32%, no helmet 39% of riders, no driving license for 47% in recorded cases. There were 33 fractures, 2 intracranial hemorrhages.Conclusion Majority of RTA involved motor bicycles. Lack of driving license for 47% of rider/drivers itself explain wrong driving/ridding to be the main cause for accidents. Alcohol is a major contributory factor for RTA in this population.

  6. Response to Proximal Restorations Placed Either Subgingivally or Following Crown Lengthening in Patients with No History of Periodontal Disease.

    Oppermann, Rui Vicente; Gomes, Sabrina Carvalho; Cavagni, Juliano; Cayana, Ezymar Gomes; Conceição, Ewerton Nocchi

    2016-01-01

    The purpose of this study was to compare the impact of resin restorations placed supragingivally or impinging periodontal biologic width (PBW). Ten patients (aged 19 to 35 years) with at least two contralateral teeth (premolars and molars) in need of proximal subgingival restorations participated. Test group (TG) (impingement of PBW with transsurgical restorations) and control croup (CG) (supragingival restorations after crown lengthening) were randomly assigned. Visible plaque (VP), bleeding on probing (BOP), periodontal probing depth (PPD), and clinical attachment loss (CAL) were evaluated at baseline and at 45, 90, and 180 days, and by transperiodontal probing at baseline and 180 days. Generalized estimating equations, Wald test, and t test were used (P ≤ .05). VP and BOP were reduced and maintained at low levels (less than 10% from day 45 on). PPD initially reduced in the TG. At day 180, no intra- or intergroup differences were observed (P > .05). CAL was higher in the CG after surgery (P < .05) and remained stable for both groups throughout the study. In conclusion, proximal bonded restorations infringing on the PBW may not require clinical crown lengthening. PMID:26697548

  7. Intellectual History

    In the 5 Questions book series, this volume presents a range of leading scholars in Intellectual History and the History of Ideas through their answers to a brief questionnaire. Respondents include Michael Friedman, Jacques le Goff, Hans Ulrich Gumbrecht, Jonathan Israel, Phiip Pettit, John Pocock...

  8. Romerrigets historie

    Christiansen, Erik

    Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t.......Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t....

  9. The contribution of proprioceptive information to postural control in elderly and patients with Parkinsons disease with a history of falls

    Esther Maria Johanna Bekkers

    2014-11-01

    Full Text Available Proprioceptive deficits negatively affect postural control but their precise contribution to postural instability in Parkinsons disease (PD is unclear. We investigated if proprioceptive manipulations differentially affect balance, measured by force plates, during quiet standing in 13 PD patients and 13 age-matched controls with a history of falls. Perceived limits of stability (LoS were derived from the differences between maximal center of pressure (CoP displacement in anterior-posterior (AP and medio-lateral (ML direction during a maximal leaning task. Task conditions comprised standing with eyes open (EO and eyes closed (EC, (1 on a stable surface; (2 an unstable surface and (3 with Achilles tendon vibration. CoP displacements were calculated as a percentage of their respective LoS. Perceived LoS did not differ between groups. PD patients showed greater ML CoP displacement than elderly fallers (EF across all conditions (p = 0.043 and tended to have higher postural sway in relation to the LoS (p = 0.050. Both groups performed worse on an unstable surface and during tendon vibration compared to standing on a stable surface with EO and even more so with EC. Both PD and EF had more AP sway in all conditions with EC compared to EO (p < 0.001 and showed increased CoP displacements when relying on proprioception only compared to standing with normal sensory input. This implies a similar role of the proprioceptive system in postural control in fallers with and without PD. PD fallers showed higher ML sway after sensory manipulations disturbing postural control, as a result of which these values approached their perceived LoS more closely than in EF. We conclude that despite a similar fall history, PD patients showed more ML instability than EF, irrespective of sensory manipulation, but had a similar reliance on ankle proprioception. Hence, we recommend that rehabilitation and fall prevention for PD should focus on motor rather than on sensory aspects.

  10. Serum Malondialdehyde and Lipid Profile Levels of Young Patients "Havent a Family History of Hypertension": A New Study for Cases in the Civic Society

    *R. H. Jasim

    2011-09-01

    Full Text Available This study was designed to evaluate the effect of the oxidative stress in sera of young patients without a family history of hypertension, then find the relation of it to lipid profile. The study involved 56 young healthy (30.5 4.7 years and 23 healthy elderly volunteers (66.3 3.5 years, these individuals were compared with 67 patients (28.6 5.0 years, attending the Gastro Intestinal and Liver Centre at Al Sader Medical City and several specialized clinics in Najaf government. Malondialdehyde level was measured by TBARS assay as reflection to the oxidative stress effect. Using standard enzymatic assays, TG, TC, HDL-C, VLDL- -C, and LDL-C values were measured for patients and controls on the same day of sample obtainment. Levels of serum MDA, TG, VLDL-C, and LDL-C were significantly raised (p<0.005 in hypertensive patients group when compared with young and elderly controls, while non significant variations were obtained when the control groups were compared together. Daytime SBP and DBP were both strong positive correlated (r=0.82, p<0.005 for SBP, and r=0.95, p<0.005 for DBP with the MDA in hypertensive patients, but in elderly controls only the correlation between SBP and MDA levels was statistically significant (r=0.61, p<0.005. Sera TG, VLDL-C, and LDL-C levels showed the same of MDA results when they were correlated to SBP and DBP, while correlations between blood pressure with sera TC were moderate positively in the study groups. In spite of; HDL-C levels in hypertensive patients were within the levels of those of two control groups, HDL-C levels showed negatively correlation with both SBP and DBP. Notably, there was a positive correlation (r=0.60, p<0.005 between serum LDL-C levels and SBP of elderly controls, no such correlations were observed when the relation was between Daytime SBP and DBP and VLDL-C or LDL-C of young controls the highly significant positive correlation (r = 0.94 at p<0.005 of MDA and TG of the hypertensive patients. Significant positive correlations were also observed for MDA with VLDL-C (r = 0.74 at p<0.005, and with LDL-C (r = 0.71 at p<0.005. It is well known that the endogenous female sex hormones have significant effect on lipid levels, according to that, testing the gender effect was occurred. MDA level in the study subgroups revealed a significant increase (p<0.005 in male patients when compared to females, while, student's t-test failed to exhibit significant changes among male and female subgroups in the control groups. Except for the significantly variation (p<0.005 of TG in the patient subgroups, all the other lipid profile parameters showed no significant differences between male and female subgroups. Concerning the controls subgroups, TG, TC, HDL-C, VLDL-C, and LDL-C were comparabltween male and female subgroups. Finally, treatment for hypertension is similar for all demographic groups, but socioeconomic factors and lifestyle may be barriers to BP control in some patients, therefore; dealing with transitory hardships and arrangement of food style may be consider as a prim factors in the hypertension treatment.

  11. Correlation of nutritional status and food intake in hemodialysis patients Correlação entre estado nutricional e ingestão alimentar em pacientes de hemodiálise

    Alvaro A. C. Morais

    2005-06-01

    Full Text Available BACKGROUND: Patients in end-stage renal disease often suffer from poor appetite, various comorbidities, and dietary restrictions. Despite regular hemodialysis, nutritional imbalances are frequently reported. Aiming to correlate nutritional status with food ingestion, a prospective study was done in an outpatient group. METHODS: Stable patients undergoing chronic hemodialysis for at least 3 months (n = 44 were investigated by dietary recall and standard anthropometric, biochemical, and bioimpedance determinations, including subjective and objective global assessment. The mean age of the group was 47.0 ± 16.9 years, and 63.6% were men. Body mass index was 22.2 ± 3.9 kg/m² (mean ± SD, calorie intake was 1471 ± 601 kcal/day (20.7 ± 6.7 kcal/kg/day, and protein ingestion was 74.3 ± 16.6 g protein/day (1.2 g/kg/day. Dietary and clinical findings were correlated with nutritional indices by linear regression analysis. RESULTS: Malnutrition estimated by subjective global assessment was very common (>90%, despite the fact that body mass index and serum albumin were within an acceptable range in the majority of the population. Objective global assessment yelded roughly comparable numerical findings, with 6.8% being well nourished, 61.4% at nutritional risk or lightly undernourished, 29.6% moderately malnourished, and 2.3% severely malnourished. Total calorie intake was devoid of associations, but protein, carbohydrate, and lipid input positively correlated with triceps skinfold (P=.02. Lipid ingestion was the only marker directly associated with arm circumference, and it correlated with body mass index, as well as with total body fat (bioimpedance analysis (P OBJETIVOS: Pacientes em fase final de enfermidade renal frequentemente sofrem de falta de apetite, várias comorbidades e restrições dietéticas, e a despeito de hemodiálise regular, desequilíbrios nutricionais são frequentemente relatados. Com o propósito de correlacionar estado nutricional com ingestão alimentar, um estudo prospectivo foi realizado com pacientes ambulatoriais. MÉTODOS: Doentes estáveis sibmetidos a hemodiálise crônica por no mínimo 3 meses (n= 44 foram investigados mediante recordatório alimentar e determinações convencionais antropométricas, bioquímicas e de bioimpedância , incluindo-se avaliação global subjetiva e também objetiva. A idade do grupo era de 47.0 ± 16.9 anos com 63.6% de homens. O índice de massa corporal situava-se em 22.2 ± 3.9 kg/m2, a ingestão calórica foi de 1471 ± 601 kcal/dia (20.7 ± 6.7 kcal/kg/dia e o consumo proteico atingiu 74.3 ± 16.6 g proteina/dia (1.2 g/kg/dia . As variáveis dietéticas e clínicas foram correlacionadas com os índices nutricionais através da análise de regressão linear. RESULTADOS: A desnutrição estimada pela avalia;áo global subjetiva foi muito comum (>90%, apesar de que o índice de massa corporal e a taxa de albumina estavam aceitáveis na maioria da população. A avaliação objetiva global evidenciou resultados numericamente parecidos, com 6,8% bem nutridos, 61,4% com risco nutricional ou desnutrição leve, 29,6% no patamar moderado e 2,3% exibindo desnutrição grave. O ganho calórico total não apresentou associações, todavia ingressos de proteina, carboidratos e lípides se correlacionaram positivamente com a prega cutânea do tríceps (P=0.02. Apenas a ingestão lipídica associou-se diretamente com a circunferência do braço, demonstrando ainda correlação com o índice de massa corporal bem como com a gordura corpórea total (bioimpedância (P<0.001. CONCLUSÕES: 1 0s teores de proteinas, lípides e carboidratos na dieta exibiram um certo número de correlações com variáveis antropométricas e de bioimpedância; 2 A ingestão lipídica foi o melhor índice nesta experiência, ultrapassando a proteina ou o ganho energético total; 3 Em que pesem algumas limitações, o recordatório alimentar foi útil na avaliação destes pacientes de hemodiálise.

  12. Salty Food Preference and Intake and Risk of Gastric Cancer: The JACC Study

    Mitsumasa Umesawa

    2016-01-01

    Background: High sodium intake is a potential risk factor of gastric cancer. However, limited information is available on the relationship between salty food preference or intake and risk of gastric cancer. The aim of the present study was to determine the association between these variables among the Japanese population. Methods: Between 1988 and 1990, 15 732 men and 24 997 women aged 4079 years old with no history of cancer or cardiovascular disease completed a lifestyle questionnaire t...

  13. Salty Food Preference and Intake and Risk of Gastric Cancer: The JACC Study

    Mitsumasa Umesawa

    2016-01-01

    Background: High sodium intake is a potential risk factor of gastric cancer. However, limited information is available on the relationship between salty food preference or intake and risk of gastric cancer. The aim of the present study was to determine the association between these variables among the Japanese population. Methods: Between 1988 and 1990, 15 732 men and 24 997 women aged 40–79 years old with no history of cancer or cardiovascular disease completed a lifestyle questionnaire t...

  14. Prevalencia del sndrome metablico en pacientes dislipidmicos con antecedentes de revascularizacin miocrdica / Prevalence of the metabolic syndrome in dyslipidemia patients with a history of myocardial revascularization

    Mara Beatriz, Cabal Vilario; Daniel, Snchez Serrano; Elain, Gutirrez Carbonell; Amaury, Flores Snchez.

    2011-12-01

    Full Text Available Introduccin: El sndrome metablico se caracteriza por la convergencia de varios factores de riesgo en un mismo individuo. Ha sido objeto de inters en los ltimos aos debido a su alta prevalencia tanto en poblaciones sanas como en aquellas con antecedentes de afecciones cardiovasculares. Objetivo [...] : Determinar la prevalencia del sndrome metablico en pacientes dislipidmicos con revascularizacin miocrdica. Mtodos: Se realiz un estudio descriptivo que incluy a 100 pacientes dislipidmicos revascularizados. Se utiliz el criterio diagnstico establecido por la OMS para la clasificacin de los pacientes. Resultados: El 43 % de la poblacin present sndrome metablico, cuya presencia estuvo en relacin inversa con la edad. La prevalencia de sus componentes fue mayor en el sexo masculino. Conclusiones: La prevalencia de SM obtenida es alta lo que coincide con estudios internacionales de prevencin secundaria. Abstract in english Introduction: The metabolic syndrome is characterized by the convergence of some risk factors in the same subject which has been the object of interest in past years due to its high prevalence in healthy populations and in those with a history of cardiovascular affections. Objective: To determine th [...] e prevalence of metabolic syndrome in dyslipidemia patients with myocardial revascularization. Methods: A descriptive study was conducted including 100 dyslipidemia patients and with revascularization. Authors used the diagnostic criterion established by WHO for the classification of patients. Results: The 43 % of population had metabolic syndrome whose presence was in an inverse relation to age. The prevalence of its components was greater in male sex. Conclusions: The obtained prevalence of the MS is high coinciding with international studies on secondary prevention.

  15. Nutritional adequacy of dietary intake in women with anorexia nervosa

    Background: Understanding nutrient intake of anorexia nervosa (AN) patients is essential for the establishment of dietary treatment. Design: Women, aged 19 to 30 years, with both restricting and binge purge types of AN, participating in an ecological momentary assessment study, completed three nonc...

  16. Mapping low intake of micronutrients across Europe

    Mensink, G. B. M.; Fletcher, R.; Gurinovic, M.; Huybrechts, I.; Lafay, L.; Serra-Majem, L.; Szponar, L.; Tetens, Inge; Verkaik-Kloosterman, J.; Baka, A.; Stephen, A. M.

    2013-01-01

    dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B1, B2, B6, B12, C, D, E and folate. The mean and 5th percentile of the intake...... distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations....... The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current...

  17. Effects of caffeine intake and smoking on neurocognition in schizophrenia.

    Nez, Christian; Stephan-Otto, Christian; Cuevas-Esteban, Jorge; Maria Haro, Josep; Huerta-Ramos, Elena; Ochoa, Susana; Usall, Judith; Brbion, Gildas

    2015-12-30

    Although most studies support the beneficial effects of caffeine on neurocognition, its effects have never been assessed in psychiatric patients. In addition, results from studies in smokers are contradictory. Moreover, there are no data available about the neurocognitive effects of caffeine and tobacco together. We explored the concomitant effects of regular caffeine and tobacco intake on neurocognition in 52 schizophrenic patients and 61 healthy controls. Verbal fluency, processing speed, and working, visual and verbal memory were assessed. For each measurement, two tasks with two levels of complexity were administered. Our results showed that caffeine intake had beneficial effects on male schizophrenic patients only in complex tasks requiring deeper cognitive processing (semantic fluency, cognitive speed, working memory, and visual memory). Female patients and controls were unaffected. In contrast, smoking had a negative effect on male, but not on female, schizophrenic patients in semantic fluency. The effects of smoking in controls were inconsistent. In conclusion, our data showed, for the first time, beneficial effects of caffeine intake on neurocognition in male schizophrenic patients. These data suggest that further research of therapeutics based on caffeine is needed, as this could be beneficial for schizophrenic patients. In contrast, smoking appears to be detrimental. PMID:26614014

  18. Family History

    Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, ... as heart disease, stroke, and cancer. Having a family member with a disease raises your risk, but ...

  19. Historia natural del carcinoma hepatocelular en una cohorte de pacientes de un hospital comarcal Natural history of hepatocellular carcinoma in a cohort of patients from a county hospital

    M. Vergara

    2008-11-01

    Full Text Available Introducción: el carcinoma hepatocelular (CHC es una neoplasia con una elevada incidencia y una alta mortalidad. Objetivo: nuestro objetivo es la descripción de la historia natural de una cohorte de pacientes con CHC e identificar variables asociadas a supervivencia. Material y métodos: estudio retrospectivo y descriptivo de pacientes diagnosticados de CHC entre 1995-2002. Las variables cualitativas se expresaron mediante frecuencias y porcentajes y las cuantitativas con mediana y desviación típica. La supervivencia se estimó mediante el método de Kaplan Meyer y la prueba de Log Rank. Resultados: se analizaron un total de 154 pacientes con CHC. La ratio hombre-mujer fue de 2,9/1. La edad media de 68 ± 9 años. El 82% de los pacientes fueron exitus en un tiempo medio de seguimiento de 28 meses. La mediana de supervivencia fue de 21,5 meses (IC 95%: 16,98-26,04. Se realizó tratamiento con intención curativa en un 40,3% y el resto tratamiento paliativo. Las variables asociadas a la supervivencia fueron: presencia o no de ascitis, el número de lesiones en el momento del diagnóstico y si el tratamiento realizado fue con intención curativa o no. No hubieron diferencias estadísticamente significativas respecto a: sexo, edad, etiología de la cirrosis y estadio de Child en el momento del diagnóstico. Conclusiones: los factores asociados a una menor supervivencia en los pacientes con carcinoma hepatocelular fueron la presencia de ascitis y el número de lesiones en el momento del diagnóstico. La realización de tratamiento con intención curativa se asocia a una mayor supervivencia.Background: hepatocellular carcinoma (HCC is a cancer with high incidence and mortality. Objective: our aim was to describe the natural history of a patient cohort with HCC, and to identify the factors associated with survival. Patients and methods: a retrospective and descriptive study of patients diagnosed with HCC between 1995 and 2002. Qualitative variables were expressed as frequencies and percentages. Quantitative variables were expressed as medians and standard deviations. Survival was calculated using the Kaplan-Meier method and log rank. Results: a total of 154 patients were analyzed. The men-to-women ratio was 2.9/1. Mean age was 68 ± 9 years. 82% of patients died during a median follow-up of 28 months. Median survival was 21.5 months (95% CI: 16.98-26.04. Curative treatment was done in 40.3% of diagnosed patients, and 59.7% of patients received palliative treatment. Factors associated with survival were: ascites, number of lesions at diagnosis, and curative treatment. No statistical differences were found for the next factors: age, sex, etiology of cirrhosis, and Child-Pugh stage at diagnosis. Conclusions: factors associated with low survival in patients with HCC were ascites and number of lesions. Curative treatment is associated with a higher survival when compared to palliative treatment.

  20. Relationship Between Carotid Intima-Media Thickness and the Presence and Extent of Coronary Stenosis in Type 2 Diabetic Patients With Carotid Atherosclerosis but Without History of Coronary Artery Disease

    Kasami, Ryuuichi; Kaneto, Hideaki; Katakami, Naoto; Sumitsuji, Satoru; Yamasaki, Keita; Kuroda, Tadashi; Tachibana, Kouichi; Yasuda, Tetsuyuki; Kuroda, Akio; Matsuoka, Taka-Aki; Matsuhisa, Munehide; Shimomura, Iichiro

    2011-01-01

    OBJECTIVE We examined the relationship between the presence and extent of coronary stenosis and carotid intima-media thickness (CIMT) in type 2 diabetic patients without history of coronary artery disease (CAD) but with carotid atherosclerosis. RESEARCH DESIGN AND METHODS A total of 91 type 2 diabetic patients underwent multi-slice computed tomography coronary angiography. RESULTS Max-IMT in the ≥50% stenosis group by multi-slice computed tomography coronary angiography estimation was signifi...

  1. Evaluation of Nutrient Intake in Early Post Kidney Transplant Recipients

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

    2013-01-01

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

  2. Necrotizing RPGN with linear anti IgG deposits in a patient with history of granulomatosis with polyangiitis: a case report

    Parekh N

    2014-11-01

    Full Text Available Ninad Parekh, Edward Epstein, Suzanne El-Sayegh Department of Medicine, Division of Nephrology, Staten Island University Hospital, Staten Island, NY, USA Introduction: Diagnosing the etiology of a rapidly progressive glomerulonephritis is of vital importance to guide appropriate therapeutic management. This case highlights the complexity involved in establishing diagnosis when presentation is atypical. In certain cases diagnosis cannot be established based on clinical presentation or biopsy findings alone, and critical analysis of biopsy findings in context of clinical presentation is crucial to guide the clinical decision-making process.Case presentation: A 47-year-old Hispanic male with history of granulomatosis with polyangiitis (GPA in remission on azathioprine, presented with fatigue and lethargy. Physical examination was unremarkable. Laboratory data revealed elevated creatinine and otherwise normal electrolytes. Urinalysis showed numerous dysmorphic red blood cells with few red cell casts. His serologic results were all negative except anti-proteinase-3 antibody at very low titers. Kidney biopsy showed necrotizing crescentic glomerulonephritis with linear immunoglobulin G staining along the basement membrane.Conclusion: This case presented conflicting serologic and histopathologic findings. The presence of anti-proteinase-3 antibody supported diagnosis of recurrence of GPA. However, linear staining of immunoglobulin G (IgG on immunofluorescence (IF staining of renal biopsy supported anti-glomerular basement membrane (GBM disease. The treatment of anti-GBM disease and GPA both involve immunosuppression with prednisone and cyclophosphamide. However, patients with anti-GBM disease are also treated with plasmapheresis early in the disease presentation to prevent further damage. The patient with GPA, on the other hand, was shown to benefit from plasmapheresis only in the case of severe renal disease (serum creatinine level more than 5 mg/dL or pulmonary hemorrhage. In this case, since the patient did not have detectable circulating anti-GBM antibody, the decision was made not to proceed with plasmapheresis. The patient was treated with a standard immunosuppressive regimen consisting of prednisone and cyclophosphamide with partial renal recovery at 2 months. Keywords: Necrotizing RPGN, Anti-GBM disease, GPA, ANCA - associated vasculitis, dual antibody-positive disease

  3. MR stress perfusion for the detection of flow-limiting stenoses in symptomatic patients with known coronary artery disease and history of stent implantation; MR-Stressperfusion zur Vorhersage flusslimitierender Stenosen bei symptomatischen Patienten mit bekannter KHK nach Stentimplantation

    Seeger, A.; Klumpp, B.; Kramer, U.; Fenchel, M.; Claussen, C.D.; Miller, S. [Universitaetsklinikum Tuebingen (Germany). Radiologische Diagnostik; Doesch, C.; Hoevelborn, T.; Gawaz, M.; May, A.E. [Universitaetsklinikum Tuebingen (Germany). Innere Medizin III

    2007-10-15

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

  4. Breakfast intake among adults with type 2 span class="hlt">diabetes: is bigger better?

    Jarvandi, Soghra; Schootman, Mario; Racette, Susan B.

    2015-01-01

    Objective To assess the association between breakfast energy and total daily energy intake among individuals with type 2 diabetes. Design Cross-sectional study. Daily energy intake was computed from a 24-h dietary recall. Multiple regression models were used to estimate the association between daily energy intake (dependent variable) and quartiles of energy intake at breakfast (independent variable) expressed as either absolute or relative (% of total daily energy intake) terms. Orthogonal polynomial contrasts were used to test for linear and quadratic trends. Models were controlled for sex, age, race/ethnicity, body mass index, physical activity and smoking. In addition, we used separate multiple regression models to test the effect of quartiles of absolute and relative breakfast energy on intake at lunch, dinner, and snacks. Setting The 1999–2004 National Health and Nutrition Examination Survey (NHANES). Subjects Participants aged ≥ 30 years with self-reported history of diabetes (N = 1,146). Results Daily energy intake increased as absolute breakfast energy intake increased (linear trend, P type 2 diabetes. PMID:25529061

  5. Preventing accidents at intake towers

    Villegas, F. (INTEGRAL S.A., Medellin, CO (United States))

    1994-03-01

    Strong air blow-outs occurring in the intake tower of Guatape Hydroelectric Power Plant in Colombia have caused two serious accidents recently. The causes of the accidents were investigated and recommendations are made here to prevent future repetitions of these dangerous events. (UK)

  6. Measurement error and dietary intake.

    Carroll, R J; Freedman, L S; Kipnis, V

    1998-01-01

    This chapter reviews work of Carroll, Freedman, Kipnis, and Li (1998) on the statistical analysis of the relationship between dietary intake and health outcomes. In the area of nutritional epidemiology, there is some evidence from biomarker studies that the usual statistical model for dietary measurements may break down due to two causes: (a) systematic biases depending on a person's body mass index; and (b) an additional random component of bias, so that the error structure is the same as a one-way random effects model. We investigate this problem, in the context of (1) the estimation of the distribution of usual nutrient intake; (2) estimating the correlation between a nutrient instrument and usual nutrient intake; and (3) estimating the true relative risk from an estimated relative risk using the error-prone covariate. While systematic bias due to body mass index appears to have little effect, the additional random effect in the variance structure is shown to have a potentially important impact on overall results, both on corrections for relative risk estimates and in estimating the distribution usual of nutrient intake. Our results point to a need for new experiments aimed at estimation of a crucial parameter. PMID:9781387

  7. Cultural history as polyphonic history

    Burke, Peter

    2010-06-01

    Full Text Available This texts offers a reflection on the origins and actual development of the field of cultural history through a comparison with the term that has served as title for this seminar: polyphonic history. The author provides an overview of the themes that have structured the seminar (the history of representations, the history of the body and the cultural history of science with the aim of making explicit and clarifying this plurality of voices in the field of history as well as its pervasiveness in other research areas.

    En este texto se ofrece una reflexin sobre el origen y actual desarrollo del campo de la historia cultural a travs de una comparacin con el trmino que ha dado ttulo a este seminario: historia polifnica. El autor propone un recorrido por las reas temticas que han conformado la estructura del seminario (la historia de las representaciones, la historia del cuerpo y la historia cultural de la ciencia con el objeto de explicitar y explicar esta pluralidad de voces en el campo de la historia, as como su repercusin en otras reas del conocimiento.

  8. Adipocyte iron regulates leptin and food intake.

    Gao, Yan; Li, Zhonggang; Gabrielsen, J Scott; Simcox, Judith A; Lee, Soh-hyun; Jones, Deborah; Cooksey, Bob; Stoddard, Gregory; Cefalu, William T; McClain, Donald A

    2015-09-01

    Dietary iron supplementation is associated with increased appetite. Here, we investigated the effect of iron on the hormone leptin, which regulates food intake and energy homeostasis. Serum ferritin was negatively associated with serum leptin in a cohort of patients with metabolic syndrome. Moreover, the same inverse correlation was observed in mice fed a high-iron diet. Adipocyte-specific loss of the iron exporter ferroportin resulted in iron loading and decreased leptin, while decreased levels of hepcidin in a murine hereditary hemochromatosis (HH) model increased adipocyte ferroportin expression, decreased adipocyte iron, and increased leptin. Treatment of 3T3-L1 adipocytes with iron decreased leptin mRNA in a dose-dependent manner. We found that iron negatively regulates leptin transcription via cAMP-responsive element binding protein activation (CREB activation) and identified 2 potential CREB-binding sites in the mouse leptin promoter region. Mutation of both sites completely blocked the effect of iron on promoter activity. ChIP analysis revealed that binding of phosphorylated CREB is enriched at these two sites in iron-treated 3T3-L1 adipocytes compared with untreated cells. Consistent with the changes in leptin, dietary iron content was also directly related to food intake, independently of weight. These findings indicate that levels of dietary iron play an important role in regulation of appetite and metabolism through CREB-dependent modulation of leptin expression. PMID:26301810

  9. Matematikkens historie

    Hansen, Vagn Lundsgaard

    2009-01-01

    Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede.......Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede....

  10. A Higher Salt Intake Leads to a Lower Rate of Adequate Blood Pressure Control

    Jeonghwan LEE; Lee, Hajeong; Kim, Kiwon; Park, Jung Hwan; Kim, Suhnggwon; Oh, Jieun

    2014-01-01

    The relationship between salt intake and adequate blood pressure control is not well investigated in Korea populations, especially in patients with cardiovascular disease. This cross-sectional study enrolled 19,083 subjects who participated in the Korea National Health and Nutrition Examination Survey conducted from 2009-2011. The amount of salt intake was estimated using the Tanaka equations based on spot urine samples. Comparing patients with and without cardiovascular disease, systolic blo...

  11. Autonomic nervous system mediated effects of food intake : Interaction between gastrointestinal and cardiovascular systems.

    Orshoven, N.P. Van

    2008-01-01

    The studies presented in this thesis focused on the autonomic nervous system mediated interactions between the gastrointestinal and cardiovascular systems in response to food intake and on potential consequences of failure of these interactions. The effects of food intake on cardiovascular parameters, including muscle sympathetic nerve activity, were studied in healthy young and healthy elderly individuals, in patients who were admitted to the geriatric ward and in patients with irritable bow...

  12. Environmental history

    Pawson, Eric; Christensen, Andreas Aagaard

    2015-01-01

    Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers Geor...

  13. Business History

    Hansen, Per H.

    2012-01-01

    This article argues that a cultural and narrative perspective can enrich the business history field, encourage new and different questions and answers, and provide new ways of thinking about methods and empirical material. It discusses what culture is and how it relates to narratives. Taking a...

  14. Ildens historier

    Lassen, Henrik Roesgaard

    from a point-by-point tracing of 'the origins and history' of Hans Christian Andersen's famous fairy tales. Where did the come from? How did they become the iconic texts that we know today? On this background it becomes quite clear that "Tællelyset" is a modern pastiche and not a genuine Hans Christian...

  15. Metabolomics investigation of whey intake

    Stanstrup, Jan

    interest since it has been shown that it is possible to achieve greater weight loss on a high protein diet as oppose to a high carbohydrate diet. Furthermore, it has been demonstrated that specifically milk-derived whey proteins have certain biological properties that might be beneficial in the treatment...... and prevention of the metabolic syndrome related to obesity and diabetes. In this thesis the effects of whey intake on the human metabolome was investigated using a metabolomics approach. We demonstrated that intake of whey causes a decreased rate of gastric emptying compared to other protein sources....... This is in contrast to previous findings suggesting that whey is cleared faster than other proteins. Paradoxically, we also find disproportionately elevated levels of some amino acids (AAs) following the whey meal. This suggests that whey affects absorption of AAs in a way independent from, or at least...

  16. -Acylethanolamines, anandamide and food intake

    Hansen, Harald S.; Diep, Thi Ai

    2009-01-01

    Abstract Anandamide and the other N-acylethanolamines, e.g. oleoylethanolamide (OEA), palmitoylethanolamide (PEA), and linoleoylethanolamide (LEA), may be formed by several enzymatic pathways from their precursors, which are the N-acylated ethanolamine phospholipids. The exact enzymatic pathways involved in their biosynthesis in specific tissues are not clarified. It has been suggested that endogenous anandamide could stimulate food intake by activation of cannabinoid receptors in ...

  17. Water intake fish diversion apparatus

    A fish diversion apparatus uses a plane screen to divert fish for variety of types of water intakes in order to protect fish from injury and death. The apparatus permits selection of a relatively small screen angle, for example ten degrees, to minimize fish injury. The apparatus permits selection of a high water velocity, for example ten feet per second, to maximize power generation efficiency. The apparatus is especially suitable retrofit to existing water intakes. The apparatus is modular to allow use plural modules in parallel to adjust for water flow conditions. The apparatus has a floor, two opposite side walls, and a roof which define a water flow passage and a plane screen within the passage. The screen is oriented to divert fish into a fish bypass which carries fish to a safe discharge location. The dimensions of the floor, walls, and roof are selected to define the dimensions of the passage and to permit selection of the screen angle. The floor is bi-level with a level upstream of the screen and a level beneath screen selected to provide a uniform flow distribution through the screen. The apparatus may include separation walls to provide a water flow channel between the apparatus and the water intake. Lead walls may be used to adjust water flow conditions into the apparatus. The apparatus features stoplog guides near its upstream and downstream ends to permit the water flow passage to be dewatered. 3 figs

  18. Models of hemapoietic changes on the basis of systematically collected case histories of radiation accident victims as well as pathophysiologically evaluated patients after chronic radiation exposure

    The research project ''Models of Hematopoietic Changes on the Basis of Systematically Collected Case Histories of Radiation Accident Victims as well as Pathophysiologically Evaluated Patients after Chronic Radiation Exposure'' required the investigation of four major research problem areas. First of all, biomathematical models were improved or newly developed allowing the simulation of the radiation induced response patterns of granulocytes, lymphocytes and blood platelets. The compartment model approach allowed the establishment of the correlation of such blood cell changes to the extent of damage at the level of hemopoietic stem cells distributed throughout the skeleton. The utilization of neural-network techniques resulted in a ''synergetic'' model that enables the medical doctor - using blood cell changes within the first 5-6 days after exposure - to predict the further course of illness and to allow a rational approach to clinical management. Secondly, available information on the clinical consequences of radiation exposure on more than 800 accident victims enabled the team to develop an entirely new concept to recognize and treat such persons. For this approach the biomathematical models were used to identify ''response categories'' (rather than dosimetrically defined ''exposure categories'') with an organ specific grading code of the severity of radiation-induced damage. This grading allowed the semi-quantitative damage assessment of the hemopoiesis, the neurovascular system, the gastrointestinal as well as the cutaneous system. It forms the basis for a ''weighted'' prognosis and for the logistics of radiation accident medical management. In the third project domain, models were developed to understand pathophysiological mechanisms of biological consequences of chronic radiation in human beings (former USSR) as well as in a preclinical dog study (USA). From a large group of patients with the diagnosis of ''Chronic Radiation Sickness'' more than 80 were studied over a 40-year period. Their health impairments were systematically evaluated. The pathogenetic mechanisms responsible for tolerance or failure of hemopoiesis after chronic radiation exposure became clear from life-time radiation-exposed dogs. The rapidly renewing cell systems (such as blood cell production) can tolerate to a given limit chronic low-level radiation exposure resulting in ''excess cell loss'', which is compensated by increased cell production. Failure occurs when the stem cell pools are exhausted. The forth domain was devoted to the development of the structural principles of a computer-based assistance system to advise the medical doctor in the medical management of the radiation-induced health impairments. This system utilizes the biomathematical and biomedical radiation response models and allows the systematic assessment of any new radiation accident victims resulting then in a scientifically based strategy for treatment. (orig.)

  19. Dietary taurine intake, nutrients intake, dietary habits and life stress by depression in Korean female college students: a case-control study

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

    2010-01-01

    Abstract Background The purpose of this study was to investigate the dietary taurine intake, nutrients intake, dietary habits and life stress by depression in Korean female college students. Methods In this study, research data were collected in March 2009 and 65 patients with depression and 65 controls without depression participated. The CES-D (Center for Epidemiologic Studies Depression) scale was used for depression measure and controls were matched for age. A 3-day recall method was used...

  20. Are Reductions in Population Sodium Intake Achievable?

    Jessica L. Levings

    2014-10-01

    Full Text Available The vast majority of Americans consume too much sodium, primarily from packaged and restaurant foods. The evidence linking sodium intake with direct health outcomes indicates a positive relationship between higher levels of sodium intake and cardiovascular disease risk, consistent with the relationship between sodium intake and blood pressure. Despite communication and educational efforts focused on lowering sodium intake over the last three decades data suggest average US sodium intake has remained remarkably elevated, leading some to argue that current sodium guidelines are unattainable. The IOM in 2010 recommended gradual reductions in the sodium content of packaged and restaurant foods as a primary strategy to reduce US sodium intake, and research since that time suggests gradual, downward shifts in mean population sodium intake are achievable and can move the population toward current sodium intake guidelines. The current paper reviews recent evidence indicating: (1 significant reductions in mean population sodium intake can be achieved with gradual sodium reduction in the food supply, (2 gradual sodium reduction in certain cases can be achieved without a noticeable change in taste or consumption of specific products, and (3 lowering mean population sodium intake can move us toward meeting the current individual guidelines for sodium intake.

  1. The effects of nicotine self-administration and withdrawal on concurrently available chow and sucrose intake in adult male rats.

    Bunney, Patricia E; Burroughs, Danielle; Hernandez, Christine; LeSage, Mark G

    2016-02-01

    Carbohydrate intake, preference, and taste thresholds may be altered in current and former cigarette smokers, which may mediate weight gain and risk for obesity in individuals who quit smoking. Attempts to model these effects in rodents have primarily used noncontingent nicotine administration. The purpose of this research was to characterize changes in chow and sucrose intake in rats during a 23-h access model of i.v. nicotine self-administration (NSA), in which rats lever-pressed for chow, sucrose, and nicotine under concurrent fixed-ratio (FR) 1 schedules. Male rats were assigned to one of three groups that differed in food and drug availability. The Nicotine C+S group had concurrent access to nicotine, chow, and sucrose. The Saline C+S group had access to saline, chow, and sucrose. The Nicotine C-Only group had access to nicotine and chow, but not sucrose. Changes in food intake and weight gain were assessed during baseline, NSA, and nicotine withdrawal (i.e., saline extinction). Weight gain was significantly slowed during NSA and increased during withdrawal, but did not differ between the nicotine groups. NSA produced a significant decrease in both chow and sucrose intake. Gradual tolerance to nicotine's effects on sucrose, but not chow intake, occurred. During withdrawal, chow and sucrose intake increased, with a larger percent increase in sucrose intake compared to chow. The proportion of total food intake from sucrose was greater at the end of withdrawal compared to baseline, indicating a history of nicotine intake changed dietary preference. Combined, these results indicate that sucrose intake is more resistant to nicotine's appetite suppressant effects and withdrawal from nicotine produces a greater increase in sweet food intake alongside general increases in chow intake. Changes in overall food intake in current and ex-smokers may lead to increased risk for obesity and other health problems, potentially limiting the benefit of quitting smoking. PMID:26548500

  2. Nutrient intake of pregnant women at high risk of gestational diabetes

    Jelena Meinil; Koivusalo, Saila B.; Anita Valkama; Kristiina Rn; Maijaliisa Erkkola; Hannu Kautiainen; Beata Stach-Lempinen; Eriksson, Johan G

    2015-01-01

    Background: The prevalence of gestational diabetes (GDM) has been increasing along with the obesity pandemic. It is associated with pregnancy complications and a risk of type 2 diabetes. Objective: To study nutrient intake among pregnant Finnish women at increased risk of GDM due to obesity or a history of GDM. Design: Food records from obese women or women with GDM history (n=394) were examined at baseline (?20 weeks of pregnancy) of the Finnish Gestational Diabetes Prevention Study. Results...

  3. Dietary intake is associated with human chronotype as assessed by both morningness-eveningness score and preferred midpoint of sleep in young Japanese women.

    Sato-Mito, Natsuko; Shibata, Shigenobu; Sasaki, Satoshi; Sato, Kazuto

    2011-08-01

    We analyzed the association between dietary intake and chronotype as assessed by both Morningness-Eveningness Questionnaire (MEQ) score and preferred midpoint of sleep in 112 young Japanese women. Dietary intake was assessed by a brief, self-administered diet history questionnaire. A lower MEQ score (evening-type tendency) showed a significant association with a lower energy-adjusted intake of protein, calcium, magnesium, zinc, vitamins (D, riboflavin, and B(6)), and vegetables, and with a higher intake of noodles. Furthermore, a later midpoint of sleep showed a significant association with a lower energy-adjusted intake of protein, cholesterol, potassium, calcium, magnesium, zinc, vitamins (D, riboflavin, B(6), and B(12)), soy, fish and shellfish, and eggs, and with a higher intake of noodles, bread, and confections. These data suggest that evening chronotype is associated with inadequate dietary habits such as low vitamin and mineral intakes. PMID:21495902

  4. Adolescent intake of animal fat and red meat in relation to premenopausal mammographic density.

    Bertrand, Kimberly A; Burian, Rosemarie A; Eliassen, A Heather; Willett, Walter C; Tamimi, Rulla M

    2016-01-01

    Adolescence is hypothesized to be a time period of particular susceptibility to breast cancer risk factors. Red meat and fat intake during high school was positively associated with risk of breast cancer among premenopausal women in the Nurses' Health Study II (NHSII). High mammographic density is a strong predictor of breast cancer risk but there is limited research on dietary factors associated with breast density. To test the hypothesis that high intake of animal fat or red meat during adolescence is associated with mammographic density, we analyzed data from premenopausal women in the NHSII. Participants recalled adolescent diet on a high school food frequency questionnaire. We assessed absolute and percent mammographic density on digitized analog film mammograms for 687 premenopausal women with no history of cancer. We used generalized linear regression to quantify associations of adolescent animal fat and red meat intake with mammographic density, adjusting for age, body mass index, and other predictors of mammographic density. Adolescent animal fat intake was significantly positively associated with premenopausal mammographic density, with a mean percent density of 39.2 % in the lowest quartile of adolescent animal fat intake versus 43.1 % in the highest quartile (p trend: 0.03). A non-significant positive association was also observed for adolescent red meat intake (p trend: 0.14). These findings suggest that higher adolescent animal fat intake is weakly associated with percent mammographic density in premenopausal women. PMID:26791521

  5. Sommerferiens historie

    Lützen, Karin

    2011-01-01

    Summer holiday is a pleasure which did not become available to many people until the 20th Century. The article describes the early mountain rambles of the bourgeoisie and their holidays in seaside boarding houses. Outdoor pursuits and stays in boarding houses at bathing resorts also became favour...... pattern. Finally, the history of the special holiday camps is told, which were established by American Jews because they were excluded from many hotels....

  6. River history.

    Vita-Finzi, Claudio

    2012-05-13

    During the last half century, advances in geomorphology-abetted by conceptual and technical developments in geophysics, geochemistry, remote sensing, geodesy, computing and ecology-have enhanced the potential value of fluvial history for reconstructing erosional and depositional sequences on the Earth and on Mars and for evaluating climatic and tectonic changes, the impact of fluvial processes on human settlement and health, and the problems faced in managing unstable fluvial systems. PMID:22474674

  7. Words that make pills easier to swallow: a communication typology to address practical and perceptual barriers to medication intake behavior

    Linn, A.J.; Weert, van, MHM Maarten; Schouten, B.C.; Smit, E.G.; Bodegraven, van, A.; van Dijk

    2012-01-01

    Purpose: The barriers to patients’ successful medication intake behavior could be reduced through tailored communication about these barriers. The aim of this study is therefore (1) to develop a new communication typology to address these barriers to successful medication intake behavior, and (2) to examine the relationship between the use of the typology and the reduction of the barriers to successful medication intake behavior. Patients and methods: Based on a literature review, the practic...

  8. A prospective study of trans fat intake and risk of preeclampsia in Denmark

    Chavarro, J. E.; Halldorsson, T. I.; Leth, Torben; Bysted, Anette; Olsen, S. F.

    2011-01-01

    Association of intake of trans fatty acids in the 2nd trimester of pregnancy with risk of preeclampsia was studied by following 67 186 pregnancies of women participating in the Danish National Birth Cohort between 1998 and 2003. Diet was assessed with a food frequency questionnaire at gestation wk...... 25; preeclampsia diagnosis was obtained by linkage with the Danish National Patient Registry. 1804 cases of preeclampsia and 402 cases of severe preeclampsia were identified in the cohort. Intake of trans fats decreased during the study period as a consequence of reduction in industrial trans fat...... intake. Intake of trans fats in the 2nd trimester was unrelated to risk of preeclampsia or severe preeclampsia. Relative risk (95% confidence interval; P, trend) of preeclampsia and severe preeclampsia comparing top to bottom quintiles of trans fat intake were 0.95 (0.81; 1.11, 0.33) and 1.07 (0.78; 1...

  9. Do Negative Emotions Predict Alcohol Consumption, Saturated Fat Intake, and Physical Activity in Older Adults?

    Anton, Stephen D.; Miller, Peter M.

    2005-01-01

    This study examined anger, depression, and stress as related to alcohol consumption, saturated fat intake, and physical activity. Participants were 23 older adults enrolled in either an outpatient or in-residence executive health program. Participants completed (a) a health-risk appraisal assessing medical history and current health habits, (b)

  10. Do Negative Emotions Predict Alcohol Consumption, Saturated Fat Intake, and Physical Activity in Older Adults?

    Anton, Stephen D.; Miller, Peter M.

    2005-01-01

    This study examined anger, depression, and stress as related to alcohol consumption, saturated fat intake, and physical activity. Participants were 23 older adults enrolled in either an outpatient or in-residence executive health program. Participants completed (a) a health-risk appraisal assessing medical history and current health habits, (b)…

  11. History of Breast Reconstruction

    Uroskie, Theodore W.; Colen, Lawrence B.

    2004-01-01

    The treatment of breast cancer has evolved significantly from the original surgical technique described by Halsted. The reconstruction of the breast has also been a large interest among surgeons and patients. The history of breast reconstruction dates back to the 1800s with an attempt to transplant a lipoma to a mastectomy site. Several techniques ranging from the “walking flap” of Gilles to the free perforator flap using autogenous tissue for recreation of a breast “mound” have been establis...

  12. Dietary intakes of HIV-infected adults in urban UK.

    Klassen, K; Goff, L M

    2013-08-01

    Maintaining a good nutritional status is important for immune health and for managing metabolic comorbidities in adults with HIV infection. Little is known about the dietary habits of adults living with HIV infection in the United Kingdom. The aims of this study were to characterise their dietary intakes, and to identify subgroups of patients who may require nutritional counselling and/or food support services. An observational study of adults attending a London HIV out-patient clinic who completed a demographics questionnaire and a structured 24 h diet recall interview was conducted. In all, 196 (162 men, 34 women) adults participated. Forty-three percent (n=66) of men and thirty-six percent (n=11) of women did not consume enough energy to meet their basal metabolic requirements and activity factor. The majority of both men (64%) and women (56%) consumed more than the recommended amount of saturated fat. Self-report of lipodystrophy (B coefficient -2.27 (95% CI -3.92 to -0.61), P=0.008) was associated with lower dietary fibre intake/1000 kcal per day, and a more recent diagnosis of HIV (B coefficient -0.11 (95% CI -0.20 to -0.02), P=0.013) was associated with a higher dietary fibre/1000 kcal intake per day. Recreational drug use was associated with a higher overall calorie (P=0.003) and protein (P=0.001) intake than non-usage after adjusting for basal metabolic requirements and weight, respectively. Our data describe the dietary intakes of a diverse group of adults with HIV infection in the United Kingdom. These dietary habits may have an impact on their overall health and development of other metabolic comorbidities common in people with HIV. PMID:23820340

  13. Assessment of calcium intake by adolescents

    Cristiane Franco de Oliveira

    2014-06-01

    Full Text Available OBJECTIVE: To evaluate the daily calcium intake of adolescents in schools from Chapec, Santa Catarina, Southern Brazil, to check if calcium intake is in accordance with the Dietary Reference Intakes (DRI, and to investigate variables associated with daily calcium intake.METHODS: Cross-sectional study approved by the Institutional Review Board and developed in 2010. Students of the 8th grade completed questionnaires with personal data and questions about the calcium-rich foods intake frequency. In order to compare students with adequate (1300mg or inadequate intake of calcium/day (<1300mg, parametric and nonparametric tests were used.RESULTS: A total of 214 students with a mean age of 14.31.0 years were enrolled. The median daily calcium intake was 540mg (interquartile range - IQ: 312-829mg and only 25 students (11.7% had calcium intake within the recommendations of the DRI for age. Soft drink consumption ?3 times/week was associated with a lower intake of calcium.CONCLUSIONS: Few students ingested adequate levels of calcium for the age group. It is necessary to develop a program to encourage a greater intake of calcium-rich foods in adolescence.

  14. Relation between arterial pressure, dietary sodium intake, and renin system in essential hypertension.

    Parfrey, P. S.; Markandu, N D; Roulston, J. E.; JONES, B. E.; Jones, J. C.; MacGregor, G. A.

    1981-01-01

    Forty-one patients with mild essential hypertension, 36 patients with severe hypertension, and 28 normotensive subjects were studied on a high sodium intake of 350 mmol/day for five days and low sodium intake of 10 mmol/day for five days. The fall in mean arterial pressure on changing from the high-sodium to the low-sodium diet was 0.7 +/- 1.7 mm Hg in normotensive subjects, 8 +/- 1.4 mm Hg in patients with mild hypertension, and 14.5 +/- 1.4 mm Hg in patients with severe hypertension. The fa...

  15. Cardiometabolic Effects of Cheese Intake

    Thorning, Tanja Kongerslev

    cheese-matrix may influence the HDL-cholesterol response, while the ripening duration may affect the level of free fatty acids and insulin in the blood. Furthermore the results showed that a diet with saturated fat in cheese or meat caused a higher HDL-cholesterol, but not LDL-cholesterol, compared to a...... diet with a lower fat and higher carbohydrate content. The fecal fat excretion is unlikely affected by the ripening duration or fat content of the cheese-matrix, but is higher after intake of a diet with cheese compared to diets with meat or carbohydrates....

  16. Salt Intake Is Associated with Inflammation in Chronic Heart Failure

    Azak, Alper; Huddam, Bulent; Gonen, Namik; Yilmaz, Seref Rahmi; Kocak, Gulay; Duranay, Murat

    2014-01-01

    Background: Chronic Heart Failure (CHF) is highly prevalent and is associated with high morbidity and mortality rates. It has been well established that excessive intake of sodium chloride (salt) induced hypertension in some populations. Although salt seems to induce cardiovascular diseases through elevation of blood pressure, it has also been indicated that salt can induce cardiovascular diseases independently from blood pressure elevation. Objectives: The present study aimed to evaluate the association between salt consumption and inflammation in CHF patients. Patients and Methods: This study was conducted on 86 patients between 18 and 65 years old who were diagnosed with New York Heart Association (NYHA) functional class I and II heart failure. Salt intake was calculated by using 24 hour urine sodium excretion. Besides, the association between inflammation and daily salt intake was evaluated regarding C - reactive protein (CPR), High sensitive CRP (HsCPR), Erythrocyte Sedimentation Rate (ESR), and ferritin and fibrinogen levels using Pearson correlation analysis. Results: Our results showed a statistically significant difference between the low (n = 41) and high (n = 45) salt intake groups in terms of serum HsCRP levels (5.21 2.62 vs. 6.36 2.64) (P < 0.048). Additionally, a significant correlation was observed between the amount of salt consumption and HsCRP levels. In this study, daily salt consumption of the enrolled patients was 8.53 gram/day. The medications and even the blood pressures were similar in the two groups, but daily pill count, prevalence of hypertension, and coronary heart disease were higher in the high salt intake group; however, the differences were not statistically significant (P = 0.065). Also, no significant difference was observed between the groups concerning the inflammation markers, such as CRP, ESR, ferritin, and fibrinogen. Conclusions: Neurohumoral and inflammatory factors are thought to contribute to high mortality and morbidity rates in CHF. Yet, inflammatory markers may early diagnose CHF and predict the prognosis. Excessive salt intake also worsens the inflammation as well as volume control. PMID:25177670

  17. Salt Intake Is Associated with Inflammation in Chronic Heart Failure

    Alper Azak

    2015-09-01

    Full Text Available Background: Chronic Heart Failure (CHF is highly prevalent and is associated with high morbidity and mortality rates. It has been well established that excessive intake of sodium chloride (salt induced hypertension in some populations. Although salt seems to induce cardiovascular diseases through elevation of blood pressure, it has also been indicated that salt can induce cardiovascular diseases independently from blood pressure elevation. Objectives: The present study aimed to evaluate the association between salt consumption and inflammation in CHF patients. Patients and Methods: This study was conducted on 86 patients between 18 and 65 years old who were diagnosed with New York Heart Association (NYHA functional class I and II heart failure. Salt intake was calculated by using 24 hour urine sodium excretion. Besides, the association between inflammation and daily salt intake was evaluated regarding C - reactive protein (CPR, High sensitive CRP (HsCPR, Erythrocyte Sedimentation Rate (ESR, and ferritin and fibrinogen levels using Pearson correlation analysis. Results: Our results showed a statistically significant difference between the low (n = 41 and high (n = 45 salt intake groups in terms of serum HsCRP levels (5.21 ± 2.62 vs. 6.36 ± 2.64 (P < 0.048. Additionally, a significant correlation was observed between the amount of salt consumption and HsCRP levels. In this study, daily salt consumption of the enrolled patients was 8.53 gram/day. The medications and even the blood pressures were similar in the two groups, but daily pill count, prevalence of hypertension, and coronary heart disease were higher in the high salt intake group; however, the differences were not statistically significant (P = 0.065. Also, no significant difference was observed between the groups concerning the inflammation markers, such as CRP, ESR, ferritin, and fibrinogen. Conclusions: Neurohumoral and inflammatory factors are thought to contribute to high mortality and morbidity rates in CHF. Yet, inflammatory markers may early diagnose CHF and predict the prognosis. Excessive salt intake also worsens the inflammation as well as volume control.

  18. Anlisis transversal de la insuficiencia cardiaca en pacientes de un servicio de medicina interna de un hospital de tercer nivel de rea mixta (rural y urbana): Parte I: anlisis epidemiolgico (Primera de tres partes) / Cross - sectional analysis of heart failure in patients intaked in the Service of Internal Medicine at a third level hospital: Part 1: Epidemiologic analysis

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

    2007-06-01

    Full Text Available Objetivos: Evaluar las caractersticas epidemiolgicas de los pacientes ingresados en un servicio de medicina interna por insuficiencia cardaca descompensada a lo largo de 5 aos Material y Mtodos: Estudio descriptivo transversal, retrospectivo, de pacientes ingresados en el Servicio de Medicina I [...] nterna del Hospital Clnico Universitario de Santiago de Compostela a lo largo de 5 aos (desde 1999 hasta 2003). Se registraron las variables: sexo, edad, das de ingreso, nmero de reingresos por insuficiencia cardaca, motivo de ingreso, hipertensin arterial (HTA) previa, diabetes mellitus (DM) previa, cardiopata previa, cardiopata isqumica previa, fibrilacin auricular (FA) previa, consumo de beta-bloqueantes previos al ingreso, cifras de presin arterial (PA) al ingreso, realizacin de ecocardiografa durante el ingreso, fraccin de eyeccin (FE) segn ecocardiograma, factor desencadenante, exitus, tratamiento domiciliario al alta. Para el anlisis estadstico se emplearon los estadsticos descriptivos cuantitativos y cualitativos que correspondieran; para el anlisis bivariante se emplearon chi-cuadrado y "t-student"; y se emple el anlisis multivariante para comprobar la influencia de determinados factores en la realizacin de ecocardiogramas a los pacientes ingresados. Resultados: Se incluyeron 248 pacientes. Se observ un predominio de sexo femenino (55,2%), y una mediana de edad de 77 aos (rango intercuartlico de 13 aos) esta fue superior en mujeres (79 aos, vs 73 aos en varones, p Abstract in english Objectives: To observe the epidemiologic caractheristics of the patients intaked during five years in a internal medicine department, with heart failure. Methods: A cross-sectional study of the intaked patients in the Internal Medicine Service in the Hospital Clnico Universitario de Santiago de Com [...] postela between 1999 to 2003. The variables analized were: sex, age, days of hospital stay, number of intaked by failure cardiac, reason for admission (guide symptom), hypertension, diabetes mellitus, cardiac disease, fibrillation atrium, previous treatment with beta-blockers, blood pressure in the admission moment, to make echocardiography, disfunction systolic, etiology, deceased, treatment at the end. The statistical analysis was performed with cualitative and cuantitative measures, chi-cuadrado and t-student, and multivariant analyses. Results: 248 patients were accepted for the study. We observed more women than men (55.2%) and bigger median age (79 years oldvs. 73 years old in men, p

  19. Uncovering History for Future History Teachers

    Fischer, Fritz

    2010-01-01

    The art of history teaching is at a crossroads. Recent scholarship focuses on the need to change the teaching of history so students can better learn history, and insists that history teachers must move beyond traditional structures and methods of teaching in order to improve their students' abilities to think with history. This article presents

  20. Uncovering History for Future History Teachers

    Fischer, Fritz

    2010-01-01

    The art of history teaching is at a crossroads. Recent scholarship focuses on the need to change the teaching of history so students can better learn history, and insists that history teachers must move beyond traditional structures and methods of teaching in order to improve their students' abilities to think with history. This article presents…

  1. Primary care provider perceptions of intake transition records and shared care with outpatient cardiac rehabilitation programs

    Jamnik Veronica

    2011-09-01

    Full Text Available Abstract Background While it is recommended that records are kept between primary care providers (PCPs and specialists during patient transitions from hospital to community care, this communication is not currently standardized. We aimed to assess the transmission of cardiac rehabilitation (CR program intake transition records to PCPs and to explore PCPs' needs in communication with CR programs and for intake transition record content. Method 144 PCPs of consenting enrollees from 8 regional and urban Ontario CR programs participated in this cross-sectional study. Intake transition records were tracked from the CR program to the PCP's office. Sixty-six PCPs participated in structured telephone interviews. Results Sixty-eight (47.6% PCPs received a CR intake transition record. Fifty-eight (87.9% PCPs desired intake transition records, with most wanting it transmitted via fax (n = 52, 78.8%. On a 5-point Likert scale, PCPs strongly agreed that the CR transition record met their needs for providing patient care (4.32 ± 0.61, with 48 (76.2% reporting that it improved their management of patients' cardiac risk. PCPs rated the following elements as most important to include in an intake transition record: clinical status (4.67 ± 0.64, exercise test results (4.61 ± 0.52, and the proposed patient care plan (4.59 ± 0.71. Conclusions Less than half of intake transition records are reaching PCPs, revealing a large gap in continuity of patient care. PCP responses should be used to develop an evidence-based intake transition record, and procedures should be implemented to ensure high-quality transitional care.

  2. Visual pathway abnormalities were found in most multiple sclerosis patients despite history of previous optic neuritis / Anormalidades nas vias visuais foram encontradas na maior parte dos pacientes com esclerose multipla independentemente da historia de neurite optica

    Stella Maris Costa, Castro; Alfredo, Damasceno; Benito Pereira, Damasceno; Jose Paulo de, Vasconcellos; Fabiano, Reis; Josie Naomi, Iyeyasu; Keila Monteiro de, Carvalho.

    2013-07-01

    Full Text Available Objetivo Foi analisar o campo visual (CV) de um grupo de pacientes com esclerose mltipla (EM) na fase remissiva e a presena de leses nas imagens de ressonncia magntica (MRI) na radiao ptica. Mtodo O CV foi estudado em 60 participantes (faixa etria de 20-51 anos): 35 pacientes EM remiten [...] te-recorrente: [20 neurite ptica (+), 15 neurite ptica (-)] e 25 controles. Foram obtidas MRI (3-Tesla) de todos os pacientes. Resultados Havia alteraes visuais nos pacientes com EM quando comparados aos controles. A maioria apresentava defeitos difusos de CV. Todos os pacientes, exceo de um, apresentaram leses nas vias visuais posteriores. No foi observada diferena significativa quanto a nmero, extenso e distribuio das leses entre os pacientes com e sem histria de neurite ptica. Um paciente apresentou hemianopsia homnima. Concluso Anormalidades nas via visuais posteriores foram encontradas na maior parte dos pacientes com EM independentemente da histria de neurite ptica. Abstract in english Objective It was to investigate visual field (VF) abnormalities in a group of multiple sclerosis (MS) patients in the remission phase and the presence of magnetic resonance imaging (MRI) lesions in the optic radiations. Methods VF was assessed in 60 participants (age range 20-51 years): 35 relaps [...] ing-remitting MS patients [20 optic neuritis (+), 15 optic neuritis (-)] and 25 controls. MRI (3-Tesla) was obtained in all patients. Results Visual parameters were abnormal in MS patients as compared to controls. The majority of VF defects were diffuse. All patients except one had posterior visual pathways lesions. No significant difference in lesion number, length and distribution was noted between patients with and without history of optic neuritis. One patient presented homonymous hemianopsia. Conclusion Posterior visual pathway abnormalities were found in most MS patients despite history of previous optic neuritis.

  3. Insufficient vitamin D intakes among pregnant women.

    McGowan, C A

    2011-09-01

    Vitamin D has an important role in pregnancy in promoting fetal skeletal health. Maternal dietary intake is a key factor influencing both maternal and fetal status. There are limited data available on food groups contributing to vitamin D intake in pregnancy. The aim of this study was to determine dietary intakes of vitamin D throughout pregnancy in 64 women and to determine the main food groups contributing to vitamin D intake. Results showed that median dietary intakes of vitamin D ranged from 1.9-2.1 μg\\/d during pregnancy, and were 80% below the current recommendation. The principal food groups contributing to vitamin D intake were meat, egg and breakfast cereal groups. Oily fish, the best dietary source of vitamin D, was consumed by <25% of women. These data call for more education; they question the role of vitamin D supplementation and highlight the contribution of other food groups more frequently consumed, namely, breakfast cereals, meat and eggs.

  4. Comparison of dietary energy and macronutrient intake at different levels of glucose metabolism

    Yan, Li-Jun; JIANG, SHENG; Sun, Shi-An; Xie, Zi-Jing

    2015-01-01

    The aim of this study was to evaluate energy and glycolipid metabolism by determining the intake of energy and macronutrients in persons with differing glucose metabolisms. In total, 147 patients who were newly diagnosed with pre-diabetes, 177 patients with diabetes, 139 patients who were previously diagnosed with diabetes, and 140 patients with normal blood sugar were selected from the 103rd Regiment of Xinjiang. All patients had Han nationality and were over 30 years old. Their energy and m...

  5. Validity of U.S. Nutritional Surveillance: National Health and Nutrition Examination Survey Caloric Energy Intake Data, 1971–2010

    Archer, Edward; Hand, Gregory A.; Blair, Steven N.

    2013-01-01

    Importance Methodological limitations compromise the validity of U.S. nutritional surveillance data and the empirical foundation for formulating dietary guidelines and public health policies. Objectives Evaluate the validity of the National Health and Nutrition Examination Survey (NHANES) caloric intake data throughout its history, and examine trends in the validity of caloric intake estimates as the NHANES dietary measurement protocols evolved. Design Validity of data from 28,993 men and 34,...

  6. Breeding for feed intake capacity in pigs

    Eissen, J.J.

    2000-01-01

    This thesis deals with feed intake capacity of pigs. By selection, breeding organizations try to achieve genetic improvement in production and reproduction efficiency. Future genetic improvement may become constrained by a limited feed intake capacity of growing pigs and lactating sows, respectively. The aim of this thesis is to study the actual feed intake capacity of growing pigs and lactating sows in relation to their potential for production and reproduction in order to get a better under...

  7. Suboptimal Micronutrient Intake among Children in Europe

    Boris Kaganov; Margherita Caroli; Artur Mazur; Atul Singhal; Andrea Vania

    2015-01-01

    Adequate dietary intake of micronutrients is not necessarily achieved even in resource-rich areas of the world wherein overeating is a public health concern. In Europe, population-based data suggests substantial variability in micronutrient intake among children. Two independent surveys of micronutrient consumption among European children were evaluated. Stratified by age, the data regarding micronutrient intake were evaluated in the context of daily requirements, which are typically estimate...

  8. ESTRADIOL AND THE CONTROL OF FOOD INTAKE

    Butera, Peter C.

    2009-01-01

    Gonadal steroids are among the many factors that influence food intake and body weight in mammals. Hormonal effects on these processes are particularly striking in female rats, which show large increases in food intake and body weight after ovariectomy. A key role of estradiol in the control of food intake and energy balance in humans is evidenced by the fact that the incidence of obesity increases greatly after menopause [1]. The actions of estradiol on neural systems that regulate eating ma...

  9. Sodium and potassium intake and blood pressure.

    Burstyn, P; Hornall, D; Watchorn, C

    1980-01-01

    Sodium and potassium intakes were increased in normotensive volunteers to assess the effects on their blood pressures. An approximately threefold increase in sodium intake for eight days had no effect on the blood pressures of seven volunteers, while a two-stage increase in potassium intake, by about 40% for eight days and a further 55% for 14 days, had no effect on the blood pressures of 21 volunteers. Renal electrolyte excretions and the blood pressures of all 28 subjects showed no statisti...

  10. Evaluation of feed intake by grazing animals

    After a nuclear incident, grazing animals will be exposed to both direct and indirect contamination, the latter in proportion to the quantity of herbage eaten and its degree of contamination. The evaluation of food intake is thus important in deciding the level of contamination. After a brief survey of intake control mechanisms and intake prediction models, the various methods for the measurement or estimation of herbage intake are presented, and their suitability for use in mediterranean and alpine countries discussed, together with some of the expected errors and problems associated with their use. (author)

  11. Prevalence of malnutrition and associated factors in hemodialysis patients

    Ana Tereza Vaz de Souza Freitas

    2014-06-01

    Full Text Available OBJECTIVE: To assess the prevalence of malnutrition and associated factors in hemodialysis patients. METHODS: This is a cross-sectional study of 344 hemodialysis patients from Goiânia, Goiás aged 18 years or more. The dependent variable, malnutrition, was investigated by the Subjective Global Assessment. The independent variables included socioeconomic, demographic, and lifestyle data, clinical history, and energy and protein intakes. The patients underwent anthropometric measurements and laboratory tests. Multiple Poisson regression determined the associated factors (p60 months (PR=1.08, 95%CI=1.01-1.16, Kt/V>1.2 (RP=1.12, 95%CI=1.03-1.22, calorie intake <35 kcal/kg/day (PR=1.22, 95%CI=1.10-1.34, and normalized protein nitrogen appearance <1.0 g/kg/day (PR=1.13, 95%CI=1.05-1.21. CONCLUSION: The prevalence of malnutrition in this population was high, corroborating the literature. The prevalence was higher in patients aged less than 29 years and those with low family income, longer hemodialysis vintage, higher Kt/V, and inadequate protein and calorie intakes. Strategies to reverse this situation should include more nutritional care.

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

    Katri Hemi

    2014-03-01

    Full Text Available Our aim was to validate a 16-item food intake questionnaire (16-FIQ and create an easy to use method to estimate patients nutrient intake in primary health care. Participants (52 men, 25 women completed a 7-day food record and a 16-FIQ. Food and nutrient intakes were calculated and compared using Spearman correlation. Further, nutrient intakes were compared using kappa-statistics and exact and opposite agreement of intake tertiles. The results indicated that the 16-FIQ reliably categorized individuals according to their nutrient intakes. Methods to estimate nutrient intake based on the answers given in 16-FIQ were created. In linear regression models nutrient intake estimates from the food records were used as the dependent variables and sum variables derived from the 16-FIQ were used as the independent variables. Valid regression models were created for the energy proportion of fat, saturated fat, and sucrose and the amount of fibre (g, vitamin C (mg, iron (mg, and vitamin D (?g intake. The 16-FIQ is a valid method for estimating nutrient intakes in group level. In addition, the 16-FIQ could be a useful tool to facilitate identification of people in need of dietary counselling and to monitor the effect of counselling in primary health care.

  13. Differences in food intake of tumour-bearing cachectic mice are associated with hypothalamic serotonin signalling

    Dwarkasing, Jvalini T; Boekschoten, Mark V.; Argilès, Joseph M; van Dijk, Miriam; Busquets, Silvia; Penna, Fabio; Toledo, Miriam; Laviano, Alessandro; Witkamp, R F; van Norren, Klaske

    2015-01-01

    Background Anorexia is a common symptom among cancer patients and contributes to malnutrition and strongly impinges on quality of life. Cancer-induced anorexia is thought to be caused by an inability of food intake-regulating systems in the hypothalamus to respond adequately to negative energy balance during tumour growth. Here, we show that this impaired response of food-intake control is likely to be mediated by altered serotonin signalling and by failure in post-transcriptional neuropeptid...

  14. Cygnus History

    The Cygnus Dual Beam Radiographic Facility consists of two identical radiographic sources: Cygnus 1 and Cygnus 2. This Radiographic Facility is located in an underground tunnel test area at the Nevada Test Site. The sources were developed to produce high-resolution images for dynamic plutonium experiments. This work will recount and discuss salient maintenance and operational issues encountered during the history of Cygnus. A brief description of Cygnus systems and rational for design selections will set the stage for this historical narrative. It is intended to highlight the team-derived solutions for technical problems encountered during extended periods of maintenance and operation. While many of the issues are typical to pulsed power systems, some of the solutions are unique. It is hoped that other source teams will benefit from this presentation, as well as other necessary disciplines (e.g., source users, system architects, facility designers and managers, funding managers, and team leaders)

  15. Deficient in vitro anti-mycobacterial immunity despite successful long-term highly active antiretroviral therapy in HIV-infected patients with past history of tuberculosis infection or disease.

    Mendona, Marcelo; Tanji, Maury M; Silva, Lia C R; Silveira, Guilherme G; Oliveira, Srgio C; Duarte, Alberto J S; Benard, Gil

    2007-10-01

    We evaluated the anti-Mycobacterium tuberculosis (Mtb) immune responses of HIV patients after long-term successful HAART, presenting >500 TCD4+ cells/microl, undetectable viral load, and past history of tuberculosis infection (HIV+PPD+, n=14) or disease (HIV+CTB, n=17). Their lymphoproliferative and IFN-gamma responses were compared with those from HIV-uninfected controls either PPD+ (HIV-PPD+, n=17) or with past history of pulmonary tuberculosis (n=15). Most HIV-infected patients presented normal PHA responses while responses to the Mtb recombinant polypeptides ESAT-6 and Ag85B were markedly reduced. Responses to a whole Mtb lysate (S-Mtb) in HIV+PPD+ patients were lower than in HIV-PPD+ controls, while in HIV+CTB patients these responses were similar to that of past-tuberculosis controls. Comparison between the two HIV groups also suggested better S-Mtb responses in those cured from tuberculosis. Thus, while immune responses to single Mtb proteins are depressed even after successful HAART, reactivity to S-Mtb is high, specially in those cured from tuberculosis, possibly as a result of the survival of higher numbers of mycobacteria-specific T cell clones during the immunosuppression phase, which may afford sufficient protection against new Mtb challenges. PMID:17631053

  16. Computer assisted medical history taking

    Quaak, M.J.; Hasman, Arie

    1988-01-01

    textabstractIn this thesis a study is described which was performed to explore the possibilities of computer-assisted history taking to support patient care. A system was developed by which the patient himself enters his medical data into a computer. The system enables an unexperienced user, i.e. a patient, to answer questions asked to him by an "intelligent" computerized questionnaire. In developing this system, use has been made of a fourthgeneration programming package. The system appeared...

  17. [Botulism after intake of half-fermented fish].

    Jensen, T; Jacobsen, D; von der Lippe, E; Yndestad, M

    1998-11-20

    From 1975 to 1997, 21 cases of foodborn botulism have been reported in Norway. Half-fermented fish is the major cause. We describe one patient with botulism following intake of home-prepared half-fermented fish. Seven people had eaten fish from the same bucket, but only two developed symptoms. The fish was initially stored at 13 degrees C; this probably explains why toxin developed. Type E toxin in moderate concentrations was found in fish samples. The patient was treated with specific antitoxin and made a gradual recovery. He returned to work after eight months. PMID:9889609

  18. Hemodynamic and neuroendocrine responses to changes in sodium intake in compensated heart failure

    Damgaard, Morten; Norsk, Peter; Gustafsson, Finn; Kanters, Jørgen K; Christensen, Niels Juel; Bie, Peter; Friberg, Lars; Gadsbøll, Niels

    2005-01-01

    Patients with untreated heart failure (HF) exhibit a blunted hemodynamic and neuroendocrine response to a high sodium intake, leading to excessive sodium and water retention. However, it is not known whether this is the case for patients with compensated HF receiving angiotensin-converting enzyme...... inhibitors and beta-adrenoreceptor blockers. Therefore, we determined the hemodynamic and neuroendocrine responses to 1 wk of a low-sodium diet (70 mmol/day) and 1 wk of a high-sodium diet (250 mmol/day) in 12 HF patients and 12 age-matched controls in a randomized, balanced fashion. During steady...... unchanged. In conclusion, high sodium intake was tolerated without any excessive sodium and water retention in medically treated patients with compensated HF. The observation that high sodium intake improves cardiac performance, induces peripheral vasodilatation, and suppresses the release of...

  19. Hemodynamic and neuroendocrine responses to changes in sodium intake in compensated heart failure

    Damgaard, Morten; Norsk, Peter; Gustafsson, Finn; Kanters, Jørgen Kim; Christensen, Niels Juel; Bie, Peter; Friberg, Lars; Gadsbøll, Niels

    2006-01-01

    Patients with untreated heart failure (HF) exhibit a blunted hemodynamic and neuroendocrine response to a high sodium intake, leading to excessive sodium and water retention. However, it is not known whether this is the case for patients with compensated HF receiving angiotensin-converting enzyme...... inhibitors and beta-adrenoreceptor blockers. Therefore, we determined the hemodynamic and neuroendocrine responses to 1 wk of a low-sodium diet (70 mmol/day) and 1 wk of a high-sodium diet (250 mmol/day) in 12 HF patients and 12 age-matched controls in a randomized, balanced fashion. During steady...... unchanged. In conclusion, high sodium intake was tolerated without any excessive sodium and water retention in medically treated patients with compensated HF. The observation that high sodium intake improves cardiac performance, induces peripheral vasodilatation, and suppresses the release of...

  20. Hypokalemic paralysis and respiratory failure due to excessive intake of licorice syrup

    Mehmet Oguzhan Ay

    2014-04-01

    Full Text Available Licorice is the root of Glycyrrhiza glabra, which has a herbal ingredient, glycyrrhizic acid. Excessive intake of licorice may cause a hypermineralocorticoidism-like syndrome characterized by sodium and water retention, hypokalemia, hypertension, metabolic alkalosis, low-renin activity, and hypoaldosteronism. In this paper, an 34 years old man who admitted to the emergency department with respiratory failure and marked muscle weakness of all extremities that progressed to paralysis after excessive intake of licorice syrup was presented. It was aimed to draw attention to the necessity of questioning whether there is excessive intake of licorice or not in patients who admitted to emergency department with paralysis and dyspnea. Plasma potassium concentration of the patient was 1.4 mmol/L. The patient\\'s respiratory distress and loss of muscle strength recovered completely after potassium replacement. [Cukurova Med J 2014; 39(2.000: 387-391