WorldWideScience

Sample records for 8-year clinical study

  1. Drug eruptions: An 8-year study including 106 inpatients at a dermatology clinic in Turkey

    Directory of Open Access Journals (Sweden)

    Fatma Akpinar

    2012-01-01

    Full Text Available Background: Few clinical studies are found in the literature about patients hospitalized with a diagnosis of cutaneous drug eruption. Aims: To determine the clinical types of drug eruptions and their causative agents in a hospital-based population. Materials and Methods: This retrospective study was performed in the Dermatology Department of Haseki General Hospital. Through 1751 patients hospitalized in this department between 2002 and 2009, inpatients diagnosed as drug eruption were evaluated according to WHO causality definitions. 106 patients composed of probable and possible cases of cutaneous drug eruptions were included in this study. Results: Seventy one females and 35 males were evolved. Mean age was 44.03±15.14. Duration between drug intake and onset of reaction varied from 5 minutes to 3 months. The most common clinical type was urticaria and/or angioedema in 48.1% of the patients, followed by maculopapular rash in 13.2%, and drug rash with eosinophilia and systemic symptoms in 8.5%. Drugs most frequently associated with cutaneous drug eruptions were antimicrobial agents in 40.5% of the patients, followed by antipyretic/anti-inflammatory analgesics in 31.1%, and antiepileptics in 11.3%. Conclusion: Urticaria and/or angioedema and maculopapular rash comprised majority of the drug eruptions. Rare reactions such as acute generalized exanthematous pustulosis, sweet syndrome, oral ulceration were also found. Antimicrobial agents and antipyretic/anti-inflammatory analgesics were the most commonly implicated drugs. Infrequently reported adverse reactions to myorelaxant agents, newer cephalosporins and fluoroquinolones were also detected. We suppose that studies on drug eruptions should continue, because the pattern of consumption of drugs is changing in every country at different periods and many new drugs are introduced on the market continuously.

  2. Clinical Significance of Optic Disc Progression by Topographic Change Analysis Maps in Glaucoma: An 8-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    D. Kourkoutas

    2014-01-01

    Full Text Available Aim. To investigate the ability of Heidelberg Retina Tomograph (HRT3 Topographic Change Analysis (TCA map to predict the subsequent development of clinical change, in patients with glaucoma. Materials. 61 eyes of 61 patients, which, from a retrospective review were defined as stable on optic nerve head (ONH stereophotographs and visual field (VF, were enrolled in a prospective study. Eyes were classified as TCA-stable or TCA-progressed based on the TCA map. All patients underwent HRT3, VF, and ONH stereophotography at 9–12 months intervals. Clinical glaucoma progression was determined by masked assessment of ONH stereophotographs and VF Guided Progression Analysis. Results. The median (IQR total HRT follow-up period was 8.1 (7.3, 9.1 years, which included a median retrospective and prospective follow-up time of 3.9 (3.1, 5.0 and 4.0 (3.5, 4.7 years, respectively. In the TCA-stable eyes, VF and/or photographic progression occurred in 5/13 (38.4% eyes compared to 11/48 (22.9% of the TCA-progressed eyes. There was no statistically significant association between TCA progression and clinically relevant (photographic and/or VF progression (hazard ratio, 1.18; P=0.762. The observed median time to clinical progression from enrollment was significantly shorter in the TCA-progressed group compared to the TCA-stable group (P=0.04. Conclusion. Our results indicate that the commercially available TCA progression criteria do not adequately predict subsequent photographic and/or VF progression.

  3. CLINICAL OUTCOMES AND SELF-REPORTED SYMPTOMS IN PATIENTS WITH ACROMEGALY: AN 8-YEAR FOLLOW-UP OF A LANREOTIDE STUDY.

    Science.gov (United States)

    Khairi, Shafaq; Sagvand, Babak Torabi; Pulaski-Liebert, Karen J; Tritos, Nicholas A; Klibanski, Anne; Nachtigall, Lisa B

    2017-01-01

    The aim of this study was to evaluate the proportion of patients with acromegaly who remained on long-term lanreotide depot after completion of an open-label multicenter phase III clinical trial (SALSA: A Multi Center Open Label Study to Assess the Ability of Subjects With Acromegaly or Their Partners to Administer Somatuline Autogel), compare baseline and long-term follow-up symptoms scores, and correlate scores with individual longitudinal clinical outcomes. Records of all subjects previously enrolled at the Massachusetts General Hospital site of SALSA were reviewed. Those who remained on lanreotide were interviewed and asked to complete a questionnaire that they had filled out in SALSA in 2007 regarding their current symptomatology and injection side effects, as well as to complete the Acromegaly Quality of Life Questionnaire. Furthermore, clinical, biochemical, and radiographic data related to acromegaly and its comorbidities were tracked throughout follow-up. Six out of 7 patients chose to remain on lanreotide, and 5 of them continued lanreotide depot through last follow-up, for up to 8 years or in 1 case until death. In all cases, lanreotide remained well tolerated, and insulin-like growth factor-1 levels and pituitary imaging remained well controlled on stable doses. While comorbidities persisted or developed, the self-reported symptom score after up to 8 years of therapy showed a significant decrease in frequency or resolution in symptoms that were reported at baseline. This study shows a significant decrease in frequency or resolution in self-reported symptoms in well-controlled patients receiving long-term lanreotide therapy. AcroQoL = Acromegaly Quality of Life Questionnaire GH = growth hormone GI = gastrointestinal IGF-1 = insulin-like growth factor-1 SALSA = A Multi Center Open Label Study to Assess the Ability of Subjects With Acromegaly or Their Partners to Administer Somatuline Autogel.

  4. Evidence That Onset of Clinical Psychosis Is an Outcome of Progressively More Persistent Subclinical Psychotic Experiences: An 8-Year Cohort Study

    Science.gov (United States)

    Dominguez, M.D.G.; Wichers, Marieke; Lieb, Roselind; Wittchen, Hans-Ulrich; van Os, Jim

    2011-01-01

    This study examined the hypothesis that developmental expression of psychometric risk in the form of subclinical psychotic experiences in the general population is usually transitory but in some instances may become abnormally persistent and progress to a clinical psychotic state. A prospective cohort study was conducted in a general population sample of 845 adolescents, aged 14–17 years, in Munich, Germany (Early Developmental Stages of Psychopathology Study). Expression of psychosis was assessed 4 times (T0–T3) over a period of 8.4 years. Transition from subclinical psychosis at T0–T2 to clinical psychosis in terms of impairment at T3 was examined as a function of the level of prior persistence of subclinical psychosis (present never, once, twice, or thrice). The more the subclinical psychosis persisted over the period T0–T2, the greater the risk of transition to clinical psychosis at T3 in a dose-response fashion (subclinical psychosis expression once over T0–T2: odds ratio [OR] = 1.5 [95% confidence interval {CI} = 0.6–3.7], posttest probability [PP] = 5%; twice: OR = 5.0 [95% CI = 1.6–15.9], PP = 16%; at all 3 measurements: OR = 9.9 [95% CI = 2.5–39.8], PP = 27%). Of all clinical psychosis at T3, more than a third (38.3%) was preceded by subclinical psychotic experiences at least once and a fifth (19.6%) at least twice. Consequently, a significant proportion of psychotic disorder may be conceptualized as the rare poor outcome of a common developmental phenotype characterized by persistence of psychometrically detectable subclinical psychotic experiences. This may be summarized descriptively as a psychosis proneness-persistence-impairment model of psychotic disorder. PMID:19460881

  5. Clinical characteristics and consequences of hand eczema - an 8-year follow-up study of a population-based twin cohort

    DEFF Research Database (Denmark)

    Lerbaek, Anne; Kyvik, Kirsten Ohm; Ravn, Henrik;

    2008-01-01

    /METHODS: A total of 274 individuals with and without hand eczema were examined, patch tested, and interviewed in 1997-1998 and 2005-2006. Data on 188 individuals with hand eczema in 2005-2006 were analysed. RESULTS: Erythema and scaling were the most frequent symptoms, and fingers and palms were most often...... affected. Mean hand eczema severity index score in individuals with clinical symptoms was 12.0. Sick leave was reported by 12.4%; job change by 8.5%. Being in the lowest socio-economic group and atopic dermatitis were risk factors for sick leave [odds ratio (OR) = 5.6; 95% confidence interval (95% CI) 1...

  6. Success and Survival Rates of Dental Implants Restored at an Undergraduate Dental Clinic: A 13-Year Retrospective Study with a Mean Follow-up of 5.8 Years.

    Science.gov (United States)

    Daneshvar, Shahrzad S; Matthews, Debora C; Michuad, Pierre-Luc; Ghiabi, Edmond

    2016-01-01

    The purpose of this study was to evaluate the clinical, radiographic, and patient-based outcomes of dental implants placed at an undergraduate student dental clinic. A retrospective study was performed to determine the success and survival rates of dental implants placed at the undergraduate dental clinic at Dalhousie University between January 1999 and January 2012. Only patients with a minimum of 1-year follow-up were included. Clinical and radiographic assessments determined implant success and survival rates. Questionnaires recorded patients' satisfaction with esthetics, comfort, and ease of hygiene. Of the 352 patients (n = 591 implants) who received implants over 13 years, 165 patients completed the clinical and radiographic examinations. By the end of the study period, demographic information and implant characteristics were collected for 111 (n = 217 implants; 47.5% in the maxilla, 52.6% in the mandible) of these patients. Of those assessed clinically, 36.4% were males and 63.6% females, with a mean age of 56.1 ± 14.15 years (range, 17 to 86 years) at the time of implant placement. The mean follow-up period was 5.8 years (range, 1 to 13 years). The overall implant success and survival rates were 88.0% and 97.2%, respectively. No observable bone loss was evident in 88.0% of the surviving implants. There were no implant fractures. Most patients (91.2%) were very satisfied with the implant restoration appearance, 88.0% were very comfortable with the implant, 92.6% were very satisfied with their ability to chew, and 84.8% reported easy hygiene maintenance at the implant sites. Implant success and survival in an undergraduate student clinic were comparable to those reported in the literature. It seems that inexperienced students were able to provide restorations that were very satisfying to the patients.

  7. Neurodevelopmental, educational and behavioral outcome at 8 years after neonatal ECMO: a nationwide multicenter study

    NARCIS (Netherlands)

    Madderom, M.J.; Reuser, J.J.C.M.; Utens, E.M.; Rosmalen, J. van; Raets, M.; Govaert, P.; Steiner, K.; Gischler, S.J.; Tibboel, D.; Heijst, A.F.J. van; Ijsselstijn, H.

    2013-01-01

    PURPOSE: Reporting neurodevelopmental outcome of 8-year-old children treated with neonatal extracorporeal membrane oxygenation (ECMO). METHODS: In a follow-up study in 135 8-year-old children who received neonatal ECMO between 1996 and 2001 we assessed intelligence (Revised Amsterdam Intelligence Te

  8. Early pituitary-gonadal activation before clinical signs of puberty in 5- to 8-year-old adopted girls: a study of 99 foreign adopted girls and 93 controls

    DEFF Research Database (Denmark)

    Teilmann, Grete Katrine; Boas, Malene; Petersen, Jørgen H

    2007-01-01

    Recent studies have indicated that internationally adopted girls are at high risk of developing precocious puberty. Clinical studies including a contemporary control group are lacking.......Recent studies have indicated that internationally adopted girls are at high risk of developing precocious puberty. Clinical studies including a contemporary control group are lacking....

  9. Effects of pets on asthma development up to 8 years of age : the PIAMA study

    NARCIS (Netherlands)

    Kerkhof, M.; Wijga, A. H.; Brunekreef, B.; Smit, H. A.; de Jongste, J. C.; Aalberse, R. C.; Hoekstra, M. O.; Gerritsen, J.; Postma, D. S.

    2009-01-01

    Background: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. Methods: Event history analysis was

  10. Effects of pets on asthma development up to 8 years of age: the PIAMA study.

    NARCIS (Netherlands)

    Kerkhof, M. van de; Wijga, A.H.; Brunekreef, B.; Smit, H.A.; Jongste, J.C. de; Aalberse, R.; Hoekstra, M.O.; Gerritsen, J.; Postma, D.S.

    2009-01-01

    BACKGROUND: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. METHODS: Event history analysis was

  11. Effects of pets on asthma development up to 8 years of age : the PIAMA study

    NARCIS (Netherlands)

    Kerkhof, M.; Wijga, A. H.; Brunekreef, B.; Smit, H. A.; de Jongste, J. C.; Aalberse, R. C.; Hoekstra, M. O.; Gerritsen, J.; Postma, D. S.

    2009-01-01

    Background: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. Methods: Event history analysis was

  12. The Georges Pompidou University Hospital Clinical Data Warehouse: A 8-years follow-up experience.

    Science.gov (United States)

    Jannot, Anne-Sophie; Zapletal, Eric; Avillach, Paul; Mamzer, Marie-France; Burgun, Anita; Degoulet, Patrice

    2017-06-01

    When developed jointly with clinical information systems, clinical data warehouses (CDWs) facilitate the reuse of healthcare data and leverage clinical research. To describe both data access and use for clinical research, epidemiology and health service research of the "Hôpital Européen Georges Pompidou" (HEGP) CDW. The CDW has been developed since 2008 using an i2b2 platform. It was made available to health professionals and researchers in October 2010. Procedures to access data have been implemented and different access levels have been distinguished according to the nature of queries. As of July 2016, the CDW contained the consolidated data of over 860,000 patients followed since the opening of the HEGP hospital in July 2000. These data correspond to more than 122 million clinical item values, 124 million biological item values, and 3.7 million free text reports. The ethics committee of the hospital evaluates all CDW projects that generate secondary data marts. Characteristics of the 74 research projects validated between January 2011 and December 2015 are described. The use of HEGP CDWs is a key facilitator for clinical research studies. It required however important methodological and organizational support efforts from a biomedical informatics department. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study.

    Science.gov (United States)

    Nelemans, Stefanie A; Hale, William W; Branje, Susan J T; Raaijmakers, Quinten A W; Frijns, Tom; van Lier, Pol A C; Meeus, Wim H J

    2014-02-01

    In this study, we prospectively examined developmental trajectories of five anxiety disorder symptom dimensions (generalized anxiety disorder, panic disorder, school anxiety, separation anxiety disorder, and social anxiety disorder) from early to late adolescence in a community sample of 239 adolescents, assessed annually over 8 years. Latent growth modeling indicated different developmental trajectories from early into late adolescence for the different anxiety disorder symptoms, with some symptoms decreasing and other symptoms increasing over time. Sex differences in developmental trajectories were found for some symptoms, but not all. Furthermore, latent class growth analysis identified a normal developmental profile (including a majority of adolescents reporting persistent low anxiety disorder symptoms over 8 years) and an at-risk developmental profile (including a minority of adolescents reporting persistent high anxiety disorder symptoms over 8 years) for all of the anxiety disorder symptom dimensions except panic disorder. Additional analyses longitudinally supported the validity of these normal and at-risk developmental profiles and suggested differential associations between different anxiety disorder symptom dimensions and developmental trajectories of substance use, parenting, and identity development. Taken together, our results emphasize the importance of examining separate dimensions of anxiety disorder symptoms in contrast to a using a global, one-dimensional approach to anxiety.

  14. Clinical audits in a postgraduate general practice training program: an evaluation of 8 years' experience.

    Directory of Open Access Journals (Sweden)

    Abeer Al-Baho

    Full Text Available BACKGROUND: Clinical audit can be of valuable assistance to any program which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at evaluating audits' effectiveness, valuable opportunities will be overlooked. Clinical audit projects are required as a part of the formative assessment of trainees in the Family Medicine Residency Program (FMRP in Kuwait. This study was undertaken to draw a picture of trainees' understanding of the audit project with attention to the knowledge of audit theory and its educational significance and scrutinize the difficulties confronted during the experience. METHODOLOGY/PRINCIPAL FINDINGS: The materials included the records of 133 audits carried out by trainees and 165 post course questionnaires carried out between 2004 and 2011. They were reviewed and analyzed. The majority of audit projects were performed on diabetic (44.4% and hypertensive (38.3% care. Regarding audits done on diabetic care, they were carried out to assess doctors' awareness about screening for smoking status (8.6%, microalbuminuria (19.3%, hemoglobin A1c (15.5%, retinopathy (10.3%, dyslipidemia (15.8%, peripheral neuropathy (8.8%, and other problems (21.7%. As for audits concerning hypertensive care, they were carried out to assess doctors' awareness about screening for smoking status (38.0%, obesity (26.0%, dyslipidemia (12.0%, microalbuminuria (10.0% and other problems (14.0%. More than half the participants (68.48% who attended the audit course stated that they 'definitely agreed' about understanding the meaning of clinical audit. Most of them (75.8% 'definitely agreed' about realizing the importance of clinical audit in improving patients' care. About half (49.7% of them 'agreed' that they can distinguish between 'criteria' and 'standards'. CONCLUSION: The eight years of experience were beneficial. Trainees showed a good understanding of the idea behind auditing the services provided. They

  15. A STUDY OF LUNG PATHOLOGY IN PEDIATRICS AUTOPSIES: AN 8 YEAR STUDY

    Directory of Open Access Journals (Sweden)

    Majethia Nikhil

    2014-11-01

    Full Text Available BACKGROUND: Pneumonia remains the number one killer of children, taking the lives of 1.3 million in 2011 alone. More than 99% of all pneumonia deaths occur in developing countries. The majority of pneumonia cases are preventable and treatable, but clinical diagnosis is highly fallible in many cases and the frequency of morbid state is best assessed by post-mortem examination that may reveal diagnosis which may not be suspected clinically or may, in some way, discredit. AIMS: 1. To ascertain various pulmonary lesions in paediatric deaths. 2. To find incidence of pulmonary lesions. 3. To study the incidence of pulmonary tuberculosis, 4. To find incidence of pulmonary pathology directly and indirectly contributing to the death. SETTINGS: Lokmanya Tilak Municipal General Hospital, Sion, Mumbai. DESIGN: A retrospective observational study. METHODS AND MATERIAL: In this study pediatric age group of (0-15 years admitted in IPCU,NICU and Pediatric, Medicine and Surgery unit are included from the period of 2006-2013. The lung pathology in various diseases entities were studied and co-related with age, sex and clinical history. RESULTS: Of total 3606 autopsies, 642 were pediatric autopsies i.e. 17.8% of all autopsies, and 111 were neonatal autopsies. Of 642, 531(82.7% had primary lung pathology and 157(24.4% had secondary lung pathology. The common age group affected is < 5 years. Bronchopneumonia was the commonest pathology observed as primary lung pathology. Interstitial/viral pneumonia was 2nd most common of primary lung pathology Infective pathology was the most common lesions, of which bronchopneumonia was the most common pathology observed and tuberculosis contributed to 3%of primary lung pathologies. CONCLUSION: The most common lung lesion in pediatric age is infections, which are preventable and curative with appropriate measures. This study will help to improve mother child health services

  16. An ERP study of conflict monitoring in 4-8-year old children: associations with temperament.

    Science.gov (United States)

    Buss, Kristin A; Dennis, Tracy A; Brooker, Rebecca J; Sippel, Lauren M

    2011-04-01

    Although there is great interest in identifying the neural correlates of cognitive processes that create risk for psychopathology, there is a paucity of research in young children. One event-related potential (ERP), the N2, is thought to index conflict monitoring and has been linked cognitive and affective risk factors for anxiety. Most of this research, however, has been conducted with adults, adolescents, and older children, but not with younger children. To address this gap, the current study examined 26 4-8-year-olds, who completed a cued flanker task while EEG was continuously recorded. We assessed whether the N2 was detectable in this group of young children and examined associations between the N2 and factors reflecting affective risk (e.g., reduced executive attention, temperamental effortful control, and temperamental surgency). We documented an N2 effect (greater N2 amplitude to incongruent versus congruent flankers), but only in children older than 6 years of age. Increases in the N2 effect were associated with less efficient executive attention and lower temperamental effortful control. We discuss the implications of these findings and consider how they may inform future studies on biomarkers for cognitive and affective risk factors for anxiety.

  17. Creation of an Adiposity Index for Children Aged 6–8 Years: The Gateshead Millennium Study

    Directory of Open Access Journals (Sweden)

    Mark S. Pearce

    2013-01-01

    Full Text Available Objective. A number of measures of childhood adiposity are in use, but all are relatively imprecise and prone to bias. We constructed an adiposity index (AI using a number of different measures. Methods. Detailed body composition data on 460 of the Gateshead Millennium Study cohort at the age of 6–8 years were analysed. The AI was calculated using factor analysis on age plus thirteen measures of adiposity and/or size. Correlations between these variables, the AI, and more traditional measures of adiposity in children were investigated. Results. Based on the factor loading sizes, the first component, taken to be the AI, consisted mainly of measures of fat-mass (the skinfold measurements, fat mass score, and waist circumference. The second comprised variables measuring frame size, while the third consisted mainly of age. The AI had a high correlation with body mass index (BMI (rho = 0.81. Conclusions. While BMI is practical for assessing adiposity in children, the AI combines a wider range of data related to adiposity than BMI alone and appears both valid and valuable as a research tool for studies of childhood adiposity. Further research is necessary to investigate the utility of AI for research in other samples of children and also in adults.

  18. Relationships matter in personality development: evidence from an 8-year longitudinal study across young adulthood.

    Science.gov (United States)

    Neyer, Franz J; Lehnart, Judith

    2007-06-01

    Personality-relationship transactions were investigated in a general population sample of young German adults with three assessments over 8 years. Four general findings were obtained. First, personality development was characterized by substantive individual differences in change. Second, bivariate latent growth models indicated that individual differences in personality change were substantially associated with change in peer and family relationships. Third, forming a partner relationship for the first time moderated the maturation of personality. This finding was replicated over two subsequent time intervals with independent subgroups. Fourth, higher neuroticism and higher sociability predicted which of the singles began a partner relationship during the next 8 years. The results confirm that individual differences in personality development predict and result from life transitions and relationship experiences.

  19. An 8-year review of barium studies in the diagnosis of gastroparesis

    Energy Technology Data Exchange (ETDEWEB)

    Levin, A.A. [Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA (United States); Levine, M.S. [Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)], E-mail: marc.levine@uphs.upenn.edu; Rubesin, S.E.; Laufer, I. [Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA (United States)

    2008-04-15

    Aim: To determine the utility of barium studies for diagnosing gastroparesis in patients with nausea, vomiting, or other related symptoms. Materials and methods: Radiology files revealed gastroparesis without gastric outlet obstruction on upper gastrointestinal tract barium studies in 50 patients with nausea, vomiting, and other related symptoms. Original reports and images were reviewed to determine whether gastric peristalsis was decreased/absent and to investigate gastric dilatation, fluid or debris, and delayed emptying of barium. Twenty patients (40%) had nuclear gastric emptying studies. Medical records were reviewed to determine the presentation, treatment, and course. The diagnosis of gastroparesis was considered accurate if patients with gastroparesis on barium studies responded to treatment. Results: Forty-six patients (92%) had predisposing factors for gastroparesis, including narcotics and diabetes. Forty-five patients (90%) presented with nausea or vomiting, and 40 patients (80%) had one or more other symptoms, including bloating, early satiety, postprandial fullness, and abdominal pain. Barium studies revealed decreased gastric peristalsis in 46 (92%) of the 50 patients and absent peristalsis in four (8%); 46 patients (92%) had additional findings, including gastric dilatation in 30 (60%), delayed emptying of barium in 27 (54%), debris in 28 (56%; bezoars in three), and retained fluid in 13 (26%). Thirteen (65%) of 20 patients with nuclear gastric emptying studies had delayed emptying of solids and seven (35%) had normal emptying. Thirty-five (83%) of 42 patients treated for gastroparesis had symptomatic improvement versus two (25%) of eight patients not treated. Conclusion: Patients with nausea, vomiting, or other related symptoms who have gastroparesis without gastric outlet obstruction on barium studies can be treated for this condition on the basis of the clinical and radiographic findings.

  20. SLE disease patterns in a Danish population-based lupus cohort: an 8-year prospective study

    DEFF Research Database (Denmark)

    Laustrup, H; Voss, A; Green, A;

    2009-01-01

    Scandinavian ancestry. Incident cases were subsequently identified by surveillance of these sources. Established and new cases underwent annual, structured interviews, clinical examination and blood sampling. The Systemic Lupus Erythematosus Diseases Activity Index SLEDAI and Systemic Lupus International...

  1. Tracing Children's Vocabulary Development from Preschool through the School-Age Years: An 8-Year Longitudinal Study

    Science.gov (United States)

    Song, Shuang; Su, Mengmeng; Kang, Cuiping; Liu, Hongyun; Zhang, Yuping; McBride-Chang, Catherine; Tardif, Twila; Li, Hong; Liang, Weilan; Zhang, Zhixiang; Shu, Hua

    2015-01-01

    In this 8-year longitudinal study, we traced the vocabulary growth of Chinese children, explored potential precursors of vocabulary knowledge, and investigated how vocabulary growth predicted future reading skills. Two hundred and sixty-four (264) native Chinese children from Beijing were measured on a variety of reading and language tasks over…

  2. Tracing Children's Vocabulary Development from Preschool through the School-Age Years: An 8-Year Longitudinal Study

    Science.gov (United States)

    Song, Shuang; Su, Mengmeng; Kang, Cuiping; Liu, Hongyun; Zhang, Yuping; McBride-Chang, Catherine; Tardif, Twila; Li, Hong; Liang, Weilan; Zhang, Zhixiang; Shu, Hua

    2015-01-01

    In this 8-year longitudinal study, we traced the vocabulary growth of Chinese children, explored potential precursors of vocabulary knowledge, and investigated how vocabulary growth predicted future reading skills. Two hundred and sixty-four (264) native Chinese children from Beijing were measured on a variety of reading and language tasks over…

  3. Adjustment to cancer in the 8 years following diagnosis : A longitudinal study comparing cancer survivors with healthy individuals

    NARCIS (Netherlands)

    Schroevers, Maya; Ranchor, A.V; Sanderman, R.

    2006-01-01

    This longitudinal study examined the long-term impact of a diagnosis of cancer on physical and psychological functioning, by comparing 8-year cancer survivors (n = 206) to a randomly selected sample of similar-aged references without cancer (n = 120) in the Netherlands. Comparisons were made at thre

  4. Adjustment to cancer in the 8 years following diagnosis : A longitudinal study comparing cancer survivors with healthy individuals

    NARCIS (Netherlands)

    Schroevers, Maya; Ranchor, A.V; Sanderman, R.

    This longitudinal study examined the long-term impact of a diagnosis of cancer on physical and psychological functioning, by comparing 8-year cancer survivors (n = 206) to a randomly selected sample of similar-aged references without cancer (n = 120) in the Netherlands. Comparisons were made at

  5. Renal histology in pauci-immune rapidly progressive glomerulonephritis: 8-year retrospective study

    Directory of Open Access Journals (Sweden)

    Ranjana W Minz

    2012-01-01

    Full Text Available Context: The need to perform reporting of renal biopsies of antineutrophil cytoplasmic antibodies (ANCA-associated vasculitides in a more uniform manner required relook at our eight-year data. Aims: To document detailed renal histopathology of pauci-immune rapidly progressive glomerulonephritis (RPGN and also to seek any significant differences in renal histology of C-ANCA-positive, P-ANCA-positive, and ANCA-negative patients. Materials and Methods: A detailed analysis of the histopathologic features of renal biopsies of 48 patients in whom a diagnosis of pauci-immune glomerulonephritis was concluded on renal biopsy and who presented clinically as rapidly progressive renal failure was done. Statistical Analysis Used: One-way ANOVA and Pearson Chi square tests. Results: Compared with ANCA +ve patients, the ANCA -ve patients were much younger (46.85 ± 16.12 years vs 34.28±15.94 years. No significant differences were found between renal lesions of C-ANCA, P-ANCA, and ANCA-negative patients, except for diffuse tubular atrophy which was more severe and more frequently present with P-ANCA positivity (P value=0.013. Conclusions: Pauci-immune RPGN (irrespective of ANCA status is a relatively rare disorder in patients who are undergoing the renal biopsy at our institute, constituting 2% of all renal biopsies submitted. It is mandatory to have ANCA serology status during reporting of a kidney biopsy showing pauci-immune crescentic or necrotizing glomerulonephritis. Also, if a uniform reporting strategy is followed throughout the country, the studies from this vast country will be comparable.

  6. Speech Characteristics of 8-Year-Old Children: Findings from a Prospective Population Study

    Science.gov (United States)

    Wren, Yvonne; McLeod, Sharynne; White, Paul; Miller, Laura L.; Roulstone, Sue

    2013-01-01

    Speech disorder that continues into middle childhood is rarely studied compared with speech disorder in the early years. Speech production in single words, connected speech and nonword repetition was assessed for 7390 eight-year-old children within the Avon Longitudinal Study of Parents and Children (ALSPAC). The majority (n=6399) had typical…

  7. Speech Characteristics of 8-Year-Old Children: Findings from a Prospective Population Study

    Science.gov (United States)

    Wren, Yvonne; McLeod, Sharynne; White, Paul; Miller, Laura L.; Roulstone, Sue

    2013-01-01

    Speech disorder that continues into middle childhood is rarely studied compared with speech disorder in the early years. Speech production in single words, connected speech and nonword repetition was assessed for 7390 eight-year-old children within the Avon Longitudinal Study of Parents and Children (ALSPAC). The majority (n=6399) had typical…

  8. Heterogeneity in development of adolescent anxiety disorder symptoms in an 8-year longitudinal community study

    NARCIS (Netherlands)

    Nelemans, S.A.; Hale III, W.W.; Branje, S.T.J.; Raaijmakers, Q.A.W.; Frijns, T.; van Lier, P.A.C.; Meeus, W.H.J.

    2014-01-01

    In this study, we prospectively examined developmental trajectories of five anxiety disorder symptom dimensions (generalized anxiety disorder, panic disorder, school anxiety, separation anxiety disorder, and social anxiety disorder) from early to late adolescence in a community sample of 239 adolesc

  9. Occupation, work organization conditions, and alcohol misuse in Canada: an 8-year longitudinal study.

    Science.gov (United States)

    Marchand, Alain; Blanc, Marie-Eve

    2011-01-01

    This study investigated the specific contribution of occupations and work organization conditions to the onset and recurrent alcohol misuse in Canadian workers between 1994-1995 and 2002-2003. Longitudinal data were derived from Statistics Canada's National Population Health Survey, totaling 6,526 and 6,582 workers (45% females) nested in 1,337 and 1,413 neighborhoods for onset and recurrent alcohol misuse, respectively. Data were analyzed with multilevel logistic regression models. Results suggested a limited contribution for work factors to the onset of alcohol misuse, a stronger influence for them on recurrent alcohol misuse. The study's limitations are discussed.

  10. Childhood diet and asthma and atopy at 8 years of age: the PIAMA birth cohort study.

    Science.gov (United States)

    Willers, S M; Wijga, A H; Brunekreef, B; Scholtens, S; Postma, D S; Kerkhof, M; de Jongste, J C; Smit, H A

    2011-05-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort enrolled 4,146 participants at baseline, who were followed up to 8 yrs of age. Dietary intakes of interest were fruit, vegetables, brown/wholemeal bread, fish, milk, butter and margarine. Associations between food intake at early (2-3 yrs) and later (7-8 yrs) age, and long-term intake, asthma and atopy at 8 yrs of age were calculated by logistic regression. Complete longitudinal dietary data for at least one of the food groups were available for 2,870 children. Fruit consumption at early age was associated with reduced asthma symptoms (OR per 1 consumption day per week increase 0.93, 95% CI 0.85-1.00). Long-term fruit intake was inversely associated with asthma symptoms (OR 0.90, 95% CI 0.82-0.99) and sensitisation to inhaled allergens (OR 0.90, 95% CI 0.82-0.99). We found no consistent associations between diet and outcomes for other foods. This study indicates no consistent effects of increased early or late consumption, or long-term intake of certain foods on asthma and atopy in 8-yr-olds, with a possible exception for fruit.

  11. Low body condition predisposes cattle to lameness: An 8-year study of one dairy herd.

    Science.gov (United States)

    Randall, L V; Green, M J; Chagunda, M G G; Mason, C; Archer, S C; Green, L E; Huxley, J N

    2015-06-01

    Lameness in dairy cows is a multifactorial and progressive disease with complex interactions between risk factors contributing to its occurrence. Detailed records were obtained from one United Kingdom dairy herd over an 8-yr period. Weekly locomotion scores were used to classify cows as not lame (score 1 to 2), mildly lame (score 3) and severely lame (score 4 to 5). These outcomes were used to investigate the hypothesis that low body condition score (BCS) is associated with an increased risk of lameness in dairy cows. Mixed effect multinomial logistic regression models were used to investigate the association between prior BCS and repeat lameness events during the longitudinal period of the study. Discrete time survival models were used to explore the relationship between prior BCS and first lifetime lameness events. In total, 79,565 cow weeks at risk were obtained for 724 cows. The number of lameness events was 17,114, of which 8,799 were categorized as mildly lame and 8,315 as severely lame. The median BCS was 2.25 (range, 0.75 to 4.25) and the mean body weight (BW) and age at first calving were 619.5 kg (range, 355.6 to 956.4 kg) and 25.8 mo (range, 20.5 to 37.8 mo), respectively. Subsets of the data were used in the discrete time survival models: 333 mild and 211 severe first lifetime lameness events in heifers (first lactation cows), and 81 mild and 49 severe first lifetime lameness events in cows second lactation or greater. Low BCS 3 wk before a repeated lameness event was associated with a significantly increased risk of lameness. Cows with BCS<2 were at greatest risk of mild or severe lameness, and an increased BCS above 2 was associated with a reduced risk of mild or severe lameness. Low BCS 16 or 8 wk before a first mild or severe lifetime lameness event, respectively, also had a positive association with risk of lameness in cows second lactation or greater. This provides evidence to support targeting management toward maintaining BCS to minimize the

  12. Stability of the Framingham Nutritional Risk Score and its component nutrients over 8 years: the Framingham Nutrition Studies.

    Science.gov (United States)

    Kimokoti, R W; Newby, P K; Gona, P; Zhu, L; Campbell, W R; D'Agostino, R B; Millen, B E

    2012-03-01

    Diet quality indices are increasingly used in nutrition epidemiology as dietary exposures in relation to health outcomes. However, literature on the long-term stability of these indices is limited. We aimed to assess the stability of the validated Framingham Nutritional Risk Score (FNRS) and its component nutrients over 8 years, as well as the validity of the follow-up FNRS. Framingham Offspring/Spouse Study women and men (n=1734) aged 22-76 years were evaluated over 8 years. Individuals' nutrient intake and nutritional risk scores were assessed using 3-day dietary records administered at baseline (1984-1988) and at follow-up (1992-1996). Agreement between baseline and follow-up FNRS and nutrient intakes was evaluated by Bland-Altman method; stability was assessed using intra-class correlation (ICC) and weighted Kappa statistics. The effect of diet quality (as assessed by the FNRS) on cardiometabolic risk factors was evaluated using analysis of covariance. Modest changes from baseline (15%) were observed in nutrient intake. The stability coefficients for the FNRS (ICC: women, 0.49; men, 0.46; P1 quartile. The FNRS was directly associated with body mass index in women (P<0.01) and high-density lipoprotein cholesterol among both women (P<0.001) and men (P<0.01). The FNRS and its constituent nutrients remained relatively stable over 8 years of follow-up. The stability of diet quality has implications for prospective epidemiological investigations.

  13. Training and education in religion/spirituality within APA-accredited clinical psychology programs: 8 years later.

    Science.gov (United States)

    Schafer, Rachel M; Handal, Paul J; Brawer, Peter A; Ubinger, Megan

    2011-06-01

    This study was a follow up investigation of Brawer et al.'s (Prof Psychol Res Pr 33(2):203-206, 2002) survey of education and training of clinical psychologists in religion/spirituality. Directors of clinical training were surveyed to determine whether changes had occurred in the coverage of religion and spirituality through course work, research, supervision, and in the systematic coverage of the content area. Results indicated an increased coverage in the areas of supervision, dedicated courses, inclusion as part of another course, and research. There was no increase in systematic coverage, but significantly more programs provided at least some coverage. The current study also assesses other areas of incorporation as well as directors' opinions regarding the importance of religion/spirituality in the field of psychology.

  14. Kidney diseases associated with anti-vascular endothelial growth factor (VEGF): an 8-year observational study at a single center.

    Science.gov (United States)

    Izzedine, Hassan; Escudier, Bernard; Lhomme, Catherine; Pautier, Patricia; Rouvier, Philippe; Gueutin, Victor; Baumelou, Alain; Derosa, Lisa; Bahleda, Rastilav; Hollebecque, Antoine; Sahali, Djillali; Soria, Jean Charles

    2014-11-01

    Expanded clinical experience with patients taking antiangiogenic compounds has come with increasing recognition of the renal adverse effects. Because renal histology is rarely sought in those patients, the renal consequences are underestimated. Antiangiogenic-treated-cancer patients, who had a renal biopsy for renal adverse effects from 2006 to 2013, were included in the current study. Clinical features and renal histologic findings were reviewed. Our cohort was 100 patients (58 women) with biopsy-proven kidney disease using anti-vascular endothelial growth factor (VEGF) therapy with a mean age of 59.8 years (range, 20-85 yr). Patients were referred for proteinuria, hypertension, and/or renal insufficiency. Kidney biopsy was performed 6.87 ± 7.18 months after the beginning of treatment. Seventy-three patients experienced renal thrombotic microangiopathy (TMA) and 27 patients had variable glomerulopathies, mainly minimal change disease and/or collapsing-like focal segmental glomerulosclerosis (MCN/cFSGS). MCN/cFSGS-like lesions developed mainly with tyrosine-kinase inhibitors, whereas TMA complicated anti-VEGF ligand. Thirty-one percent of TMA patients had proteinuria up to 1 g/24 h. Half of TMA cases are exclusively renal localized. Pathologic TMA features are intraglomerular exclusively. MCN/cFSGS glomeruli displayed a high abundance of KI-67, but synaptopodin was not detected. Conversely, TMA glomeruli exhibited a normal abundance of synaptopodin-like control, whereas KI-67 was absent. Median follow-up was 12 months (range, 1-80 mo). Fifty-four patients died due to cancer progression. Hypertension and proteinuria resolved following drug discontinuation and antihypertensive agents. No patient developed severe renal failure requiring dialysis. Drug continuation or reintroduction resulted in a more severe recurrence of TMA in 3 out of 4 patients requiring maintenance of anti-VEGF agents despite renal TMA. In conclusion, TMA and MCN/cFSGS are the most

  15. Metal-on-metal hip prostheses and systemic health: a cross-sectional association study 8 years after implantation.

    Directory of Open Access Journals (Sweden)

    Jennifer R Prentice

    Full Text Available There is public concern over the long term systemic health effects of metal released from hip replacement prostheses that use large-diameter metal-on-metal bearings. However, to date there has been no systematic study to determine which organs may be at risk, or the magnitude of any effect. We undertook a detailed cross-sectional health screen at a mean of 8 years after surgery in 35 asymptomatic patients who had previously received a metal-on-metal hip resurfacing (MoMHR versus 35 individually age and sex matched asymptomatic patients who had received a conventional hip replacement. Total body bone mineral density was 5% higher (mean difference 0.05 g/cm², P = 0.02 and bone turnover was 14% lower (TRAP 5b, mean difference -0.56IU/L, P = 0.006; osteocalcin, mean difference -3.08 ng/mL, P = 0.03 in the hip resurfacing versus conventional hip replacement group. Cardiac ejection fraction was 7% lower (mean absolute difference -5%, P = 0.04 and left ventricular end-diastolic diameter was 6% larger (mean difference 2.7 mm, P = 0.007 in the hip resurfacing group versus those patients who received a conventional hip replacement. The urinary fractional excretion of metal was low (cobalt 5%, chromium 1.5% in patients with MoMHR, but creatinine clearance was normal. Diuretic prescription was associated with a 40% increase in the fractional excretion of chromium (mean difference 0.5%, P = 0.03. There was no evidence of difference in neuropsychological, renal tubular, hepatic or endocrine function between groups (P>0.05. Our findings of differences in bone and cardiac function between patient groups suggest that chronic exposure to low elevated metal concentrations in patients with well-functioning MoMHR prostheses may have systemic effects. Long-term epidemiological studies in patients with well-functioning metal on metal hip prostheses should include musculoskeletal and cardiac endpoints to quantitate the risk of clinical disease.

  16. The 8-year follow-up of the PIAMA intervention study assessing the effect of mite-impermeable mattress covers.

    Science.gov (United States)

    Gehring, U; de Jongste, J C; Kerkhof, M; Oldewening, M; Postma, D; van Strien, R T; Wijga, A H; Willers, S M; Wolse, A; Gerritsen, J; Smit, H A; Brunekreef, B

    2012-02-01

    Exposure to high levels of house dust mite (HDM) allergens is associated with the development of allergic sensitization to HDM, a risk factor for the development of asthma, rhinitis, and allergic dermatitis. We studied the effect of an early intervention with mite-impermeable mattress covers on HDM allergen levels and the development of asthma and mite allergy throughout the first 8 years of life. High-risk children (allergic mother) were prenatally recruited and randomly allocated to two groups receiving mite allergen-impermeable (n = 416) and placebo mattress covers (n = 394) or no intervention (n = 472). Asthma and allergies were assessed yearly by questionnaire. Specific immunoglobulin E and bronchial hyper-responsiveness were measured at the age of 8 years. Mattress dust samples collected at different time points were analyzed for HDM allergens. At the age of 8 years, levels of HDM allergen Der f1 but not Der p1 were lower in the active than the placebo mattress cover group. In repeated measures analyses, we found a temporary decreased risk of asthma symptoms at the age of 2 years in the intervention group compared to the placebo group and a temporary association between higher HDM allergen exposure at the age of 3 months and more asthma symptoms. Early intervention with mite-impermeable mattress covers is successful in reducing exposure to Der f1; it only temporarily reduces the risk of asthma symptoms and does not reduce the risk of hay fever, eczema, and allergic sensitization. © 2011 John Wiley & Sons A/S.

  17. Prevalence of neuroleptic-induced movement disorders: an 8-year follow-up study in chronic schizophrenia inpatients.

    Science.gov (United States)

    Parksepp, Madis; Ljubajev, Ülle; Täht, Karin; Janno, Sven

    2016-10-01

    Atypical antipsychotic drug use by schizophrenia patients in Estonia increased from 32% in 2004 to 61% in 2009. To assess the prevalence of neuroleptic-induced movement disorders in the Estonian institutionalized population of schizophrenia patients twice over a period of eight years, before and after introduction of atypical antipsychotic drugs using DSM-IV criteria. DSM-IV criteria and specific rating scales were used to evaluate the prevalence of neuroleptic-induced movement disorders among 72 patients who participated in the study in 2009 compared to 99 patients who participated in 2001. Despite increased use of atypical antipsychotics in the study population (up to 30% from 20%), the proportion of movement disorder-free population remained the same over 8 years - 38.9% in 2001 versus 38.4% in 2009. There were significant intra-individual fluctuations. Use of a typical antipsychotic resulted in an almost seven times higher risk of tardive dyskinesia after 8 years. Doses of antipsychotic drugs had no effect on the severity of neuroleptic-induced movement disorders. Unfortunately, in 18% of patients the switch of medication from typical to atypical did not change the overall prevalence of neuroleptic-induced movement disorders in the group. The long-term benefit of atypical antipsychotics requires further research in patients who are treated with antipsychotics for years.

  18. Tracing children's vocabulary development from preschool through the school-age years: an 8-year longitudinal study.

    Science.gov (United States)

    Song, Shuang; Su, Mengmeng; Kang, Cuiping; Liu, Hongyun; Zhang, Yuping; McBride-Chang, Catherine; Tardif, Twila; Li, Hong; Liang, Weilan; Zhang, Zhixiang; Shu, Hua

    2015-01-01

    In this 8-year longitudinal study, we traced the vocabulary growth of Chinese children, explored potential precursors of vocabulary knowledge, and investigated how vocabulary growth predicted future reading skills. Two hundred and sixty-four (264) native Chinese children from Beijing were measured on a variety of reading and language tasks over 8 years. Between the ages of 4 to 10 years, they were administered tasks of vocabulary and related cognitive skills. At age 11, comprehensive reading skills, including character recognition, reading fluency, and reading comprehension were examined. Individual differences in vocabulary developmental profiles were estimated using the intercept-slope cluster method. Vocabulary development was then examined in relation to later reading outcomes. Three subgroups of lexical growth were classified, namely high-high (with a large initial vocabulary size and a fast growth rate), low-high (with a small initial vocabulary size and a fast growth rate) and low-low (with a small initial vocabulary size and a slow growth rate) groups. Low-high and low-low groups were distinguishable mostly through phonological skills, morphological skills and other reading-related cognitive skills. Childhood vocabulary development (using intercept and slope) explained subsequent reading skills. Findings suggest that language-related and reading-related cognitive skills differ among groups with different developmental trajectories of vocabulary, and the initial size and growth rate of vocabulary may be two predictors for later reading development.

  19. Hypoadiponectinemia predicts impaired endothelium-independent vasodilation in newly diagnosed type 2 diabetic patients: an 8-year prospective study

    Institute of Scientific and Technical Information of China (English)

    LI Hui; XIAO Yang; LIU Hui; CHEN Xiao-yan; LI Xin-ying; TANG Wei-li; LIU Shi-ping; XU Ai-min; ZHOU Zhi-guang

    2011-01-01

    Background Adiponectin is an adipokine with insulin-sensitising and anti-atherogenic properties.The aim of this study was to investigate whether low adiponectin levels predict the impairment of endothelial function in newly diagnosed type 2 diabetic patients in an 8-year prospective study.Methods In the prospective study,we enrolled 133 newly diagnosed type 2 diabetic patients without subclinical atherosclerosis and gave them intensive therapy; the mean treatment period was 8 years.Intensive treatment was a stepwise implementation of behavior modification and pharmacological therapy targeting hyperglycaemia,hypertension,dyslipidaemia and obesity.We measured baseline circulating adiponectin with an enzyme-linked immunosorbent assay,endothelium-dependent and -independent vasodilation by high-resolution vascular ultrasound.At year 8,102 patients were reexamined for endothelium-dependent and -independent vasodilation.Results Sex-adjusted adiponectin level was positively correlated with endothelium-independent vasodilation both at baseline (r=0.150,P=0.043) and at year 8 (r=0.339,P=0.001),whereas no association was found between adiponectin and endothelium-dependent vasodilation.In a stepwise multivariate linear regression model,adiponectin was an independent predictor for impaired endothelium-independent vasodilation at year 8 (P=0.001).Conclusions Plasma adiponectin concentration was associated with endothelium-independent vasodilation and hypoadiponectinemia predicted the impairment of endothelium-independent vasodilation in newly diagnosed type 2 diabetic patients under multifactorial intervention.These data support the causative link of impairment of endothelium-independent vasodilation with hypoadiponectinemia.

  20. On the relationship between phonological awareness, morphological awareness and Chinese literacy skills: evidence from an 8-year longitudinal study.

    Science.gov (United States)

    Pan, Jinger; Song, Shuang; Su, Mengmeng; McBride, Catherine; Liu, Hongyun; Zhang, Yuping; Li, Hong; Shu, Hua

    2016-11-01

    The present study reported data on phonological awareness, morphological awareness, and Chinese literacy skills of 294 children from an 8-year longitudinal study. Results showed that mainland Chinese children's preliterate syllable awareness at ages 4 to 6 years uniquely predicted post-literate morphological awareness at ages 7 to 10 years. Preliterate syllable awareness directly contributed to character reading and writing at age 11 years, while post-literate phonemic awareness predicted only character reading at age 11 years. In addition, preliterate syllable and morphological awareness at ages 4 to 6 years had indirect effects on character reading and writing, reading fluency, and reading comprehension at age 11 years, through post-literate morphological awareness at ages 7 to 10 years. Findings underscore the significant role of syllable awareness in Chinese character reading and writing, and the importance of morphological awareness in character-level processing and high-level literacy skills. More importantly, our results suggest the unique relation of syllable awareness and morphological awareness in Chinese as they focus on the same unit, which is also likely to map directly onto a character, the basic unit for high-level Chinese reading skills. © 2015 John Wiley & Sons Ltd.

  1. Triglycerides are a predictive factor for arterial stiffness: a community-based 4.8-year prospective study.

    Science.gov (United States)

    Wang, Xiaona; Ye, Ping; Cao, Ruihua; Yang, Xu; Xiao, Wenkai; Zhang, Yun; Bai, Yongyi; Wu, Hongmei

    2016-05-18

    Epidemiological studies have disclosed an independent effect of triglycerides on coronary heart disease despite achievement of low-density lipoprotein cholesterol goals with statin therapy. Arterial stiffness has been increasingly recognized as a strong predictor of cardiovascular disease and atherosclerotic disease. The association between triglycerides and arterial stiffness is not well characterized. We aimed to determine the relationship between triglycerides and arterial stiffness in a community-based longitudinal sample from Beijing, China. We related levels of plasma TGs to measures of arterial stiffness (carotid-femoral pulse wave velocity [PWV] and carotid-radial PWV) in 1447 subjects (mean age, 61.3 years) from a community-based population in Beijing, China. After a median follow-up interval of 4.8 years, multiple linear regression analysis revealed that TGs were independently associated with carotid-femoral PWV (β = 0.747, P triglyceride levels were significantly associated with decreases in carotid-femoral PWV, indicating that achieving low TG levels may be an additional therapeutic consideration in subjects with atherosclerotic disease.

  2. Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study.

    Science.gov (United States)

    Pietrzak, R H; Feder, A; Singh, R; Schechter, C B; Bromet, E J; Katz, C L; Reissman, D B; Ozbay, F; Sharma, V; Crane, M; Harrison, D; Herbert, R; Levin, S M; Luft, B J; Moline, J M; Stellman, J M; Udasin, I G; Landrigan, P J; Southwick, S M

    2014-01-01

    Longitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders. A total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks. Among police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories. Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of

  3. Prospective study of the cementless "New Wave" total knee mobile-bearing arthroplasty: 8-year follow-up.

    Science.gov (United States)

    Normand, Xavier; Pinçon, Jean-Louis; Ragot, Jean-Marie; Verdier, Régis; Aslanian, Thierry

    2015-02-01

    One of the main factors affecting the survival of a total knee arthroplasty (TKA) is the fixation method. The constraints placed on the bone-implant interface of a mobile-bearing TKA must be taken in account during the design and evaluation phases. For more than two decades, calcium phosphate ceramics, particularly hydroxyapatitis, have been used in Europe to accelerate the bone integration of cementless implants. A prospective study of patients continuously recruited by three senior surgeons at three French private hospitals has been carried out. There were no exclusion criteria. Eighty-four (84) cementless mobile-bearing total knee prosthesis of the brand "New Wave" were implanted in 74 patients over a 2-year period (2004-2005). Implant survival at 8 years was 95% [with a confidence interval of 95%: 80.2-96.4%] when revision for any cause was defined as the endpoint. Five implants required surgical revision to exchange all or part of the implant: two for aseptic loosening of tibial component, one for osteolysis, one for persistent flessum (30°) and one for tibial periprosthetic fracture. Completely integrated implants and event-free outcomes were recorded in 91.4% of the cases at eight-year follow-up. The Hospital for Special Surgery score significantly improved from 56.8/100 points before the surgery to 83.9/100 points at the last follow-up (p < 0.05). Radiologically, only one patient had radiolucent lines around the tibial and femoral components. This cementless total knee prosthesis yielded good medium-term survival. Cementless arthroplasty can generate solid and durable bone fixation in this total weight-bearing implant, and it seems that the hidroxyapathitis surface in this series stimulate the bone integration at the bone-implant interface.

  4. Prognostic impact of isolated right ventricular dysfunction in sepsis and septic shock: an 8-year historical cohort study.

    Science.gov (United States)

    Vallabhajosyula, Saraschandra; Kumar, Mukesh; Pandompatam, Govind; Sakhuja, Ankit; Kashyap, Rahul; Kashani, Kianoush; Gajic, Ognjen; Geske, Jeffrey B; Jentzer, Jacob C

    2017-09-07

    Echocardiographic myocardial dysfunction is reported commonly in sepsis and septic shock, but there are limited data on sepsis-related right ventricular dysfunction. This study sought to evaluate the association of right ventricular dysfunction with clinical outcomes in patients with severe sepsis and septic shock. Historical cohort study of adult patients admitted to all intensive care units at the Mayo Clinic from January 1, 2007 through December 31, 2014 for severe sepsis and septic shock, who had an echocardiogram performed within 72 h of admission. Patients with prior heart failure, cor-pulmonale, pulmonary hypertension and valvular disease were excluded. Right ventricular dysfunction was defined by the American Society of Echocardiography criteria. Outcomes included 1-year survival, in-hospital mortality and length of stay. Right ventricular dysfunction was present in 214 (55%) of 388 patients who met the inclusion criteria-isolated right ventricular dysfunction was seen in 100 (47%) and combined right and left ventricular dysfunction in 114 (53%). The baseline characteristics were similar between cohorts except for the higher mechanical ventilation use in patients with isolated right ventricular dysfunction. Echocardiographic findings demonstrated lower right ventricular and tricuspid valve velocities in patients with right ventricular dysfunction and lower left ventricular ejection fraction and increased mitral E/e' ratios in patients with combined right and left ventricular dysfunction. After adjustment for age, comorbidity, illness severity, septic shock and use of mechanical ventilation, isolated right ventricular dysfunction was independently associated with worse 1-year survival-hazard ratio 1.6 [95% confidence interval 1.2-2.1; p = 0.002) in patients with sepsis and septic shock. Isolated right ventricular dysfunction is seen commonly in sepsis and septic shock and is associated with worse long-term survival.

  5. One year treatment effects of the eruption guidance appliance in 7- to 8-year-old children: a randomized clinical trial.

    Science.gov (United States)

    Myrlund, Rita; Dubland, Mari; Keski-Nisula, Katri; Kerosuo, Heidi

    2015-04-01

    The eruption guidance appliance (EGA) aims to correct sagittal and vertical occlusal relations concomitantly with alignment of the incisors. Few reports have been published on treatment effects with the EGA but no randomized studies have been available. The aim was to find out if 1 year active treatment time with EGA was sufficient for achieving normal occlusal relationships and dental alignment in 7- to 8-year-old children. Eligibility criteria for participants were: fully erupted upper central incisors, and Angle's Class I or Class II molar relationship combined with any of the following traits: deep bite, increased overjet ≥5mm, moderate anterior crowding with overjet ≥4mm. After screening of 148 children, 48 7- to 8-year-old children were recruited in the study. The participants were randomly assigned into a treatment group (N = 25) and a control group (N = 23). Children in the treatment group received treatment with the EGA for 1 year. The controls had no orthodontic treatment. Changes in overjet, overbite, Angle's Class, and crowding were used as primary outcome measures. Occlusal assessments were performed on dental casts obtained from all subjects at start of the study (T1) and after 1 year (T2). Lateral cephalograms were obtained from all subjects at T1 and from the treatment group at T2. All measurements on dental casts and cephalograms were carried out blinded. Forty-six children completed the study. Mean overjet and overbite decreased significantly in the treated subjects during 1 year, in contrast to a slight increase in the controls. Class II molar relationship decreased from 46 to 4 per cent in the treatment group, with no significant change in the control group. Mandibular anterior crowding decreased significantly in the treated subjects, while the controls showed a slight increase. In short term, the EGA seems to be effective in correcting increased overjet and overbite, Class II malocclusion, and lower anterior crowding in the early mixed

  6. Factors Associated With 8-Year Mortality in Older Patients With Cerebral Small Vessel Disease: The Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) Study.

    Science.gov (United States)

    van der Holst, Helena M; van Uden, Ingeborg W M; Tuladhar, Anil M; de Laat, Karlijn F; van Norden, Anouk G W; Norris, David G; van Dijk, Ewoud J; Rutten-Jacobs, Loes C; de Leeuw, Frank-Erik

    2016-04-01

    Gait and cognition have been related to mortality in population-based studies. This association is possibly mediated by cerebral small vessel disease (SVD), which has been associated with mortality as well. It is unknown which factors can predict mortality in individuals with SVD. Identification of high-risk patients may provide insight into factors that reflect their vital health status. To assess mortality in patients with cerebral SVD and identify potential clinical and/or imaging factors associated with mortality. A prospective, single-center cohort study was conducted. The present investigation is embedded in the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) study. Between January 17, 2006, and February 27, 2007, all participants underwent a cognitive and motor assessment and cerebral magnetic resonance imaging (MRI) including a diffusion tensor imaging sequence to assess microstructural integrity of the white matter. Participants were followed up until their death or November 24, 2014. Participants included 503 older adults with SVD noted on brain imaging. Data analysis was performed from November 26, 2014, to February 2, 2015. Eight-year all-cause mortality. Of 503 participants (mean [SD] age, 65.7 [8.8] years; range, 50-85 years; 284 [56.5%] were male), 80 individuals (15.9%) died during a mean (SD) follow-up of 7.8 (1.5) years. In the final analysis, 494 (98.2%) were included, of whom 78 (15.8%) died. Gait speed, cognitive index, conventional MRI markers of SVD (white matter hyperintensity volume, brain volume, and lacunes), and diffusion measures of the white matter were associated with an 8-year risk of mortality independent of age, sex, and vascular risk factors. The prediction of mortality was determined using Cox proportional hazards models with backward stepwise selection and including age, sex, vascular risk factors, gait speed, cognitive index, MRI, and diffusion measures. Results are reported as hazard ratios

  7. Total hip replacements done without cement after acetabular fractures: a 4- to 8-year follow-up study.

    Science.gov (United States)

    Huo, M H; Solberg, B D; Zatorski, L E; Keggi, K J

    1999-10-01

    Twenty-one patients (21 hips) underwent cementless total hip replacement surgeries for previous acetabular fractures. The mean age at the time of hip replacement was 52 years (range, 23-78 years). The mean follow-up was 65 months (range, 48-104 months). One hip required revision of the stem secondary to a periprosthetic femur fracture from a fall at 3 months after surgery. Good to excellent clinical rating was achieved and maintained in 19 hips. Radiographic evaluation demonstrated stable cup and stem fixation in 17 and 15 hips. Only 1 patient with radiographic loosening of the components was sufficiently symptomatic. The results in this series appeared slightly better than those reported previously in hip replacements done with cement at comparable medium-term follow-up. The mechanical failure rates remained high in this patient population: 19% for the cups and 29% for the stems.

  8. More-than-minimal-trauma fractures are associated with low bone density: an 8-year prospective study.

    Science.gov (United States)

    Pereira, L; Bliuc, D; Stanford, P; Eisman, J A; Center, J R

    2017-01-01

    Few studies have examined the relationship between more-than-minimal-trauma fractures and bone density. This study demonstrated that more-than-minimal-trauma fractures are associated with lower bone density similar to that seen in minimal trauma fractures. Men and women over 50 years with a more-than-minimal-trauma fracture should be investigated to exclude low bone density.

  9. Early risk factors for depressive symptoms among Korean adolescents: a 6-to-8 year follow-up study.

    Science.gov (United States)

    Shin, Kyoung Min; Cho, Sun-Mi; Shin, Yun Mi; Park, Kyung Soon

    2013-11-01

    Depression during adolescence is critical to the individual's own development. Hence, identifying individuals with high-risk depression at an early stage is necessary. This study aimed to identify childhood emotional and behavioral risk factors related to depressive symptoms in Korean adolescents through a longitudinal study. The first survey took place from 1998 to 2000, and a follow-up assessment conducted in 2006, as the original participants reached 13-15 yr of age. The first assessment used the Korean version of Child Behavior Checklist and a general questionnaire on family structure, parental education, and economic status to evaluate the participants. The follow-up assessment administered the Korean Children's Depression Inventory. Multiple regression analysis revealed that childhood attention problems predicted depressive symptoms during adolescence for both boys and girls. For boys, family structure also predicted adolescent depressive symptoms. This study suggests that adolescents with attention problems during childhood are more likely to experience depressive symptoms.

  10. The 8-year follow-up of the PIAMA intervention study assessing the effect of mite-impermeable mattress covers

    NARCIS (Netherlands)

    Gehring, U.|info:eu-repo/dai/nl/304831344; de Jongste, J.C.; Kerkhof, M.; Oldewening, M.; Postma, D.; van Strien, R.T.; Wijga, A.H.; Willers, S.M.|info:eu-repo/dai/nl/304834696; Wolse, A.; Gerritsen, J.|info:eu-repo/dai/nl/336510160; Smit, H.A.; Brunekreef, B.|info:eu-repo/dai/nl/067548180

    2012-01-01

    Background: Exposure to high levels of house dust mite (HDM) allergens is associated with the development of allergic sensitization to HDM, a risk factor for the development of asthma, rhinitis, and allergic dermatitis. We studied the effect of an early intervention with mite-impermeable mattress co

  11. Family socioeconomic status and nutrition habits of 7-8 year old children: cross-sectional Lithuanian COSI study.

    Science.gov (United States)

    Petrauskienė, Aušra; Žaltauskė, Vilma; Albavičiūtė, Edita

    2015-04-23

    Nutritional habits are a useful way to characterize whole diets and they are also known to be influenced by a wide range of social and economic factors. The above factors in each country may have different effect on children's eating habits. In Lithuania the data of children nutrition in association with socio-economic status of family is poor. There are few studies done, where links between nutrition habits of children and socio-economic status of family was evaluated. The aim of this paper is to evaluate association among nutrition habits of first-formers and family socio-economic status in Lithuania. Data were obtained participating in the international study, which was performed in all ten districts of Lithuania. A cross-sectional study was carried out in 2010, using the protocol and methodology prepared by the experts from the WHO and countries participating in the Initiative. The data were collected by means of COSI standardized questionnaire, which was filled out by parents of selected first-formers'. In this paper a part of questions regarding children nutrition habits and parents' socio-economic status is presented. Statistical analysis was performed by using SPSS 20.0 software for Windows. Correlation among variables was evaluated by χ (2). Links among nutrition habits of first-formers and family socioeconomic status were determined using binary logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI). For all tests p role in breakfast, fresh fruit and soft drinks with sugar consumption among younger school age children.

  12. A Study on the Validity of a Computer-Based Game to Assess Cognitive Processes, Reward Mechanisms, and Time Perception in Children Aged 4-8 Years

    Science.gov (United States)

    Hurks, Petra PM; Aldenkamp, Albert P; van der Spek, Erik D; Rauterberg, GWM; Vles, Johan SH; Hendriksen, Jos GM

    2016-01-01

    Background A computer-based game, named Timo’s Adventure, was developed to assess specific cognitive functions (eg, attention, planning, and working memory), time perception, and reward mechanisms in young school-aged children. The game consists of 6 mini-games embedded in a story line and includes fantasy elements to enhance motivation. Objective The aim of this study was to investigate the validity of Timo’s Adventure in normally developing children and in children with attention-deficit/hyperactivity disorder (ADHD). Methods A total of 96 normally developing children aged 4-8 years and 40 children with ADHD were assessed using the game. Clinical validity was investigated by examining the effects of age on performances within the normally developing children, as well as performance differences between the healthy controls and the ADHD group. Results Our analyses in the normally developing children showed developmental effects; that is, older children made fewer inhibition mistakes (r=−.33, P=.001), had faster (and therefore better) reaction times (r=−.49, P<.001), and were able to produce time intervals more accurately than younger children (ρ=.35, P<.001). Discriminant analysis showed that Timo’s Adventure was accurate in most classifications whether a child belonged to the ADHD group or the normally developing group: 78% (76/97) of the children were correctly classified as having ADHD or as being in the normally developing group. The classification results showed that 72% (41/57) children in the control group were correctly classified, and 88% (35/40) of the children in the ADHD group were correctly classified as having ADHD. Sensitivity (0.89) and specificity (0.69) of Timo’s Adventure were satisfying. Conclusions Computer-based games seem to be a valid tool to assess specific strengths and weaknesses in young children with ADHD. PMID:27658428

  13. Motivational interviewing for screening and feedback and encouraging lifestyle changes to reduce relative weight in 4-8 year old children: design of the MInT study

    Directory of Open Access Journals (Sweden)

    Taylor Barry J

    2010-05-01

    Full Text Available Abstract Background Because parental recognition of overweight in young children is poor, we need to determine how best to inform parents that their child is overweight in a way that enhances their acceptance and supports motivation for positive change. This study will assess 1 whether weight feedback delivered using motivational interviewing increases parental acceptance of their child's weight status and enhances motivation for behaviour change, and 2 whether a family-based individualised lifestyle intervention, delivered primarily by a MInT mentor with limited support from "expert" consultants in psychology, nutrition and physical activity, can improve weight outcomes after 12 and 24 months in young overweight children, compared with usual care. Methods/Design 1500 children aged 4-8 years will be screened for overweight (height, weight, waist, blood pressure, body composition. Parents will complete questionnaires on feeding practices, physical activity, diet, parenting, motivation for healthy lifestyles, and demographics. Parents of children classified as overweight (BMI ≥ CDC 85th will receive feedback about the results using Motivational interviewing or Usual care. Parental responses to feedback will be assessed two weeks later and participants will be invited into the intervention. Additional baseline measurements (accelerometry, diet, quality of life, child behaviour will be collected and families will be randomised to Tailored package or Usual care. Parents in the Usual care condition will meet once with an advisor who will offer general advice regarding healthy eating and activity. Parents in the Tailored package condition will attend a single session with an "expert team" (MInT mentor, dietitian, physical activity advisor, clinical psychologist to identify current challenges for the family, develop tailored goals for change, and plan behavioural strategies that best suit each family. The mentor will continue to provide support to the

  14. Comparison of clinical characteristics and laboratory findings of malaria, dengue, and enteric fever in returning travelers: 8-year experience at a referral center in Tokyo, Japan.

    Science.gov (United States)

    Kutsuna, Satoshi; Hayakawa, Kayoko; Kato, Yasuyuki; Fujiya, Yoshihiro; Mawatari, Momoko; Takeshita, Nozomi; Kanagawa, Shuzo; Ohmagari, Norio

    2015-04-01

    Without specific symptoms, diagnosis of febrile illness in returning travelers is challenging. Dengue, malaria, and enteric fever are common causes of fever in returning travelers and timely and appropriate treatment is important. However, differentiation is difficult without specific diagnostic tests. A retrospective study was conducted at the National Centre for Global Health and Medicine (NCGM) from April 2005 to March 2013. Febrile travelers returning from overseas who were diagnosed with dengue, malaria, or enteric fever were included in this study. Clinical characteristics and laboratory findings were compared for each diagnosis. During the study period, 86 malaria, 85 dengue, and 31 enteric fever cases were identified. The mean age of the study cohort was 33.1 ± 12 years and 134 (66.3%) study participants were male. Asia was the most common area visited by returning travelers with fevers (89% of dengue, 18.6% of malaria, and 100% of enteric fever cases), followed by Africa (1.2% of dengue and 70.9% of malaria cases). Clinical characteristics and laboratory findings were significantly different among each group with each diagnosis. Decision tree models revealed that returning from Africa and CRP levels dengue fever, respectively. Clinical manifestations, simple laboratory test results, and regions of travel are helpful to distinguish between dengue, malaria, and enteric fever in febrile returning travelers with non-specific symptoms. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Early-life determinants of total and HDL cholesterol concentrations in 8-year-old children; the PIAMA birth cohort study.

    Directory of Open Access Journals (Sweden)

    Marga B M Bekkers

    Full Text Available BACKGROUND: Adult cholesterol concentrations might be influenced by early-life factors, such as breastfeeding and birth weight, referred to as "early programming". How such early factors exert their influence over the life course is still poorly understood. Evidence from studies in children and adolescents is scarce and conflicting. We investigated the influence of 6 different perinatal risk factors on childhood total and HDL cholesterol concentrations and total-to-HDL cholesterol ratio measured at 8 years of age, and additionally we studied the role of the child's current Body Mass Index (BMI. METHODS: Anthropometric measures and blood plasma samples were collected during a medical examination in 751 8-year-old children participating in the prospective Prevention and Incidence of Asthma and Mite Allergy (PIAMA birth cohort study. Linear and logistic regression were performed to estimate associations of total and HDL cholesterol concentrations with breastfeeding, birth weight, infant weight gain, maternal overweight before pregnancy, gestational diabetes and maternal smoking during pregnancy, taking into account the child's current BMI. RESULTS: Linear regressions showed an association between total-to-HDL cholesterol ratio and maternal pre-pregnancy overweight (β = 0.15, Confidence Interval 95% (CI: 0.02, 0.28, rapid infant weight gain (β = 0.13, 95%CI: 0.01, 0.26, and maternal smoking during pregnancy (β = 0.14, 95%CI: 0.00, 0.29. These associations were partly mediated by the child's BMI. CONCLUSION: Total-to-HDL cholesterol ratio in 8-year-old children was positively associated with maternal pre-pregnancy overweight, maternal smoking during pregnancy and rapid infant weight gain.

  16. The usage of playing studies for development of spatial reasoning of 5-8-year-old children with spastic diplegi.

    Directory of Open Access Journals (Sweden)

    Shlapachenko O.A.

    2012-09-01

    Full Text Available In the article is shown the influence of rehabilitation-correction program with the usage of outdoor games on the level of influence of spatial thinking and constructive activity of 5-8-year-old children with spastic diplegi. 64 children took part in the experiment, all had main diagnosis - children cerebral paralysis, spastic diplegi. The experiment was conducted in a few phases during the year. It is proved that conducting of outdoor games promote positive influence on forming the level of influence of spatial thinking of children, increasing capacity of work. It is revealed that the level of development of spatial thinking of children with spastic diplegi depends on clinical display of an illness. It is mentioned that involving parents for participation in games with children promote rehabilitation of children in home conditions.

  17. Can the impact of pelvic inflammatory disease on fertility be prevented? Epidemiology, clinical features and surgical treatment: evolution over 8 years.

    Science.gov (United States)

    Patrelli, Tito Silvio; Franchi, Laura; Gizzo, Salvatore; Salvati, Maria Antonietta; Berretta, Roberto; Piantelli, Giovanni; Modena, Alberto Bacchi

    2013-01-01

    To assess the epidemiological features and the trend of care of patients diagnosed with pelvic inflammatory disease (PID) and to assess most predictive parameters of severe disease, for which surgical management is warranted, in particular when surgery is certain to cause permanent infertility. The study population was divided into 3 groups: medical therapy only, conservative surgery, and destructive surgery (surgical procedures that impaired fertility). Data from the 3 groups were compared with respect to general and medical history data, clinical signs on admission, laboratory tests, and ultrasound findings. The p value was considered significant when disease severity. Ultrasound evidence of ovaritis generally led to medical therapy. Conversely, when sonography revealed pyosalpinx or tuboovarian abscesses, surgery was performed. Clinical presentation is fundamental in diagnostic counseling but should be supplemented with further laboratory tests to detect inflammation and sonograms. The latter, along with CRP and D-dimer assays, may represent useful parameters to consider when planning patient management because they appear indicative of the need for surgical treatment.

  18. Peripheral bone mineral density and different intensities of physical activity in children 6-8 years old: the Copenhagen School Child Intervention study

    DEFF Research Database (Denmark)

    Hasselstrøm, H; Karlsson, K M; Hansen, S E

    2007-01-01

    This study aimed to evaluate the association between objectively measured habitual physical activity and calcaneal and forearm bone mineral density (BMD, g/cm(2)), one mechanically more loaded and one less loaded skeletal region, in children aged 6-8 years. BMD was measured in 297 boys and 265...... girls by peripheral dual-energy X-ray absorptiometry in the forearm and calcaneus. An accelerometer registered the level of physical activity during 4 days (2 weekdays and the weekend). Weight, height, and skinfold thickness were measured. In order to establish thresholds (count . min(-1)) for bone......-stimulating physical activity, we evaluated different definitions of vigorous physical activity. The boys had 3.2% higher distal forearm bone mineral content (BMC, P physical activity and spent 14.6-19.0% more...

  19. Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up.

    Science.gov (United States)

    Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

    2016-01-01

    This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70-2.34, p urinary tract stones (both p-values urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76-2.26, p urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones.

  20. Does Preschool Physical Activity and Electronic Media Use Predict Later Social and Emotional Skills at 6 to 8 Years? A Cohort Study.

    Science.gov (United States)

    Hinkley, Trina; Timperio, Anna; Salmon, Jo; Hesketh, Kylie

    2017-04-01

    Little is known about the associations of preschoolers' health behaviors with their later psychosocial wellbeing. This study investigates the association of 3- to 5-year-old children's physical activity and electronic media use with their later social-emotional skills (6-8 years). Data were collected in 2008-2009 and 2011-2012 for the Healthy Active Preschool and Primary Years (HAPPY) Study in metropolitan Melbourne. Participants were a random subsample (n = 108) of the 567 children at follow-up. Physical activity was objectively measured using ActiGraph GT1M accelerometers; electronic media use (television viewing, sedentary electronic games and active electronic games) was parent proxy-reported. Social and emotional skills were child-reported using the Bar-On Emotional Quotient Inventory-Youth Version. Regression analyses controlled for sex, clustering by center of recruitment, and accelerometer wear time (for physical activity analyses). Sedentary electronic games were positively associated with intrapersonal and stress management skills and total emotional quotient. Computer/internet use was inversely associated with interpersonal, and positively associated with stress management, skills. Findings suggest that physical activity is not associated with children's psychosocial health while some types of electronic media use are. Future research should investigate the contexts in which preschoolers participate in these behaviors and potential causal mechanisms of associations.

  1. Electrophysiological assessment of glaucomatous visual dysfunction during treatment with cytidine-5'-diphosphocholine (citicoline): a study of 8 years of follow-up.

    Science.gov (United States)

    Parisi, Vincenzo

    2005-01-01

    In this study we assessed, by simultaneous recordings of visual evoked potentials (VEPs) and pattern-electroretinograms (PERGs), the effects cytidine-5'-diphosphocholine (citicoline) on retinal function and/or visual cortical responses in glaucoma patients. Thirty glaucoma patients were randomly divided into two age-matched groups: patients in group GC (15 patients) were treated with citicoline (1,000 mg/die intramuscularly) for 2 months; patients in group GP (15 patients) were treated with placebo for 2 months. After 4 months of wash-out (month 6), GC patients underwent a further 2-month period of citicoline treatment (months 7-8) followed by another 4-month period of wash-out (months 9-12). In GP patients the wash-out was extended for a further 6 months (months 7-12). During the following 13-96 months, GC patients received additional 2-month periods of treatment with citicoline (each period followed by 4 months of wash-out) for a total of 16 periods in 8 years. GP patients were also examined at months 24, 26, 48, 60, 72, 84 and 96. In GC patients the first two treatments with citicoline induced a significant (p citicoline treatment in GC patients during the subsequent 13-96 months induced a greater (p citicoline significantly improves retinal and cortical bioelectrical responses in glaucoma patients, suggesting a potential use of this substance in the medical treatment of glaucoma, as a complement to hypotensive therapy.

  2. Aortic valve calcification and mild tricuspid regurgitation but no clinical heart disease after 8 years of dopamine agonist therapy for prolactinoma

    NARCIS (Netherlands)

    M. Kars; V. Delgado (Victoria); E.R. Holman (Eduard); R.A. Feelders (Richard); J.W.A. Smit (Jan); J.A. Romijn (Johannes); J.J. Bax (Jeroen); A.M. Pereira (Alberto)

    2008-01-01

    textabstractObjective: Treatment with ergot-derived dopamine agonists, pergolide, and cabergoline has been associated with an increased frequency of valvular heart disease in Parkinson's disease. The aim of the present study was to assess the prevalence of valvular heart disease in patients treated

  3. Associations between built environment and physical activity of 7–8-year-old children. Cross-sectional results from the Lithuanian COSI study

    Directory of Open Access Journals (Sweden)

    Vilma Žaltauskė

    2016-01-01

    Conclusions: Results from the national survey of 7–8-year-old children of Lithuania reveal that urban living area of families, availability of playgrounds and recreational facilities were associated with higher possibilities of children to be sufficiently physically active.

  4. Different sensitization profile for asthma, rhinitis, and eczema among 7-8-year-old children: report from the Obstructive Lung Disease in Northern Sweden studies.

    Science.gov (United States)

    Rönmark, Eva; Perzanowski, Matthew; Platts-Mills, Thomas; Lundbäck, Bo

    2003-04-01

    Sensitization to different airborne allergens in relation to asthma, rhinitis, and eczema has been studied. A cross-sectional study was performed among 7-8-year-old children living in northern Sweden. The ISAAC-questionnaire with additional questions were sent to the parents, and 3431 (97%) participated. Two-thirds of the children were invited to undergo a skin test with 10 common airborne allergens, and 2148 (88%) participated. The prevalence rates of all three diseases were significantly higher among the children who were sensitized to any of the tested allergens. Among asthmatics, 40% were sensitized to cat, 34% to dog, 28% to horse, 23% to birch and 16% to timothy. The corresponding figures for rhinitis were: cat 49%, dog 33%, horse 37%, birch 46%, timothy 32%; and for eczema: cat 29%, dog 21%, horse 15%, birch 20%, and timothy 11%. Only a few children were sensitized to mites or moulds. The main risk factors for all three diseases were type-1 allergy and a family history of the disease. Independently from other risk factors, sensitization to dog (OR 2.4) and horse (OR 2.2) were significant risk factors for asthma. Sensitization to birch (OR 6.0), horse (OR 4.1), and timothy (OR 2.8) were significant risk factors for rhinitis, while birch (OR 2.4), dog (OR 2.0) and cat (OR 1.6) were significant risk factors for eczema. Despite a large over-lapping of the diseases the pattern of sensitization was different for asthma, rhinitis and eczema. Sensitization to cat was most common among all children, but sensitization to dog and horse was associated with the highest risk for asthma, and sensitization to birch showed the highest risk for rhinitis and eczema. The different risk factor pattern for the often coexisting diseases; asthma, rhinitis, and eczema, may indicate differences in the etiology.

  5. Evaluation of retention of pit and fissure sealants placed with and without air abrasion pretreatment in 6-8 year old children – An in vivo study

    Science.gov (United States)

    Goswami, Mridula

    2017-01-01

    Background The success of pit and fissure sealants is directly related to their retention. The purpose of this study was to assess and compare the retention of pit and fissure sealants placed using acid etch alone and a combination of air abrasion and acid etch techniques. Material and Methods 50 subjects aged 6-8 years were included in the study. Primary second molars and permanent first molars were sealed in all four quadrants using split mouth design. The right maxillary and mandibular molars (Group A) were treated by acid etching alone while the left maxillary and mandibular molars (Group B) were pretreated with air abrasion followed by acid etching before application of pit and fissure sealant. Retention of sealants was checked using Simonsen’s criteria of sealant retention after three and six months of sealant application. Results There was no significant difference in retention of sealants in Group A and Group B (p0.05). Maxillary molars showed superior retention compared to mandibular molars, which was statistically significant at both three and six months (p<0.05). Conclusions Combining air abrasion pretreatment with subsequent acid etching did not result in statistically significant difference in sealant retention compared to acid etching alone in both primary and permanent molars after 3 and 6 months follow up. An additional air abrasion pretreatment step can be avoided in pediatric patients when placing sealants and the procedure can be completed faster with better behavior management using acid etching alone. Key words:Pit and fissure sealant, acid etching, air abrasion. PMID:28210438

  6. Food sources of energy and nutrients in Finnish girls and boys 6–8 years of age – the PANIC study

    Directory of Open Access Journals (Sweden)

    Aino-Maija Eloranta

    2016-09-01

    Full Text Available Background: Data on food sources of nutrients are needed to improve strategies to enhance nutrient intake among girls and boys in Western countries. Objective: To identify major food sources of energy, energy nutrients, dietary fibre, and micronutrients, and to study gender differences in these food sources among children. Design: We assessed food consumption and nutrient intake using 4-day food records in a population sample of Finnish girls (n=213 and boys (n=217 aged 6–8 years from the Physical Activity and Nutrition in Children Study. We calculated the percentual contribution of 55 food groups for energy and nutrient intake using the population proportion method. Results: Low-fibre grain products, skimmed milk, and high-fibre bread provided almost 23% of total energy intake. Skimmed milk was the top source of protein (18% of total intake, vitamin D (32%, potassium (20%, calcium (39%, magnesium (17%, and zinc (16%. Vegetable oils (15% and high-fat vegetable oil–based spreads (14% were the top sources of polyunsaturated fat. High-fibre bread was the top source of fibre (27% and iron (12%. Non-root vegetables were the top source of folate (14% and vitamin C (22%. Sugar-sweetened beverages provided 21% of sucrose intake. Pork was a more important source of protein and sausage was a more important source of total fat and monounsaturated fat in boys than in girls. Vegetable oils provided a higher proportion of unsaturated fat and vitamin E among boys, whereas high-fat vegetable oil–based spreads provided a higher proportion of these nutrients among girls. Conclusion: Commonly recommended foods, such as skimmed milk, high-fibre grain products, vegetables, vegetable oil, and vegetable oil–based spreads, were important sources of several nutrients, whereas sugar-sweetened beverages provided the majority of sucrose intake among children. This knowledge can be used in improving health among children by dietary interventions, nutrition education

  7. Eating behaviour is associated with eating frequency and food consumption in 6-8 year-old children: The Physical Activity and Nutrition in Children (PANIC) study.

    Science.gov (United States)

    Jalkanen, H; Lindi, V; Schwab, U; Kiiskinen, S; Venäläinen, T; Karhunen, L; Lakka, T A; Eloranta, A M

    2017-07-01

    The association between eating behaviour and dietary factors has been studied narrowly in children. Therefore, we investigated whether eating frequency and food consumption are influenced by eating behaviour in a population sample of 406 children aged 6-8 years. We assessed features of eating behaviour by the Children's Eating Behaviour Questionnaire and dietary factors by a 4-day food record. The results showed that enjoyment of food was directly associated with a number of main meals (p = 0.041) and consumption of vegetables (p = 0.041), cheese (p = 0.005), and meat (p = 0.002). Food responsiveness was directly associated with consumption of fruit and berries (p = 0.013) and meat (p = 0.016). Desire to drink was directly associated with consumption of fat-containing milk (p = 0.002) and inversely associated with consumption of skimmed milk (p = 0.001). Food fussiness was inversely associated with a number of main meals (p = 0.013) and consumption of vegetables (p consumption of vegetables (p = 0.031), cheese (p = 0.010), and meat (p consumption of candies and chocolate (p = 0.026). Slowness in eating was inversely associated with consumption of meat (p = 0.018). Where sex differences existed the associations tended to be observed mostly in girls but not in boys. Our study shows that enjoyment of food and food responsiveness are directly associated with consumption of protein-rich foods and vegetables, fruit and berries, whereas food fussiness and satiety responsiveness are inversely associated with consumption of these foods. Assessment of eating behaviour can help in identifying children with various dietary needs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Food sources of energy and nutrients in Finnish girls and boys 6–8 years of age – the PANIC study

    Science.gov (United States)

    Eloranta, Aino-Maija; Venäläinen, Taisa; Soininen, Sonja; Jalkanen, Henna; Kiiskinen, Sanna; Schwab, Ursula; Lakka, Timo A.; Lindi, Virpi

    2016-01-01

    Background Data on food sources of nutrients are needed to improve strategies to enhance nutrient intake among girls and boys in Western countries. Objective To identify major food sources of energy, energy nutrients, dietary fibre, and micronutrients, and to study gender differences in these food sources among children. Design We assessed food consumption and nutrient intake using 4-day food records in a population sample of Finnish girls (n=213) and boys (n=217) aged 6–8 years from the Physical Activity and Nutrition in Children Study. We calculated the percentual contribution of 55 food groups for energy and nutrient intake using the population proportion method. Results Low-fibre grain products, skimmed milk, and high-fibre bread provided almost 23% of total energy intake. Skimmed milk was the top source of protein (18% of total intake), vitamin D (32%), potassium (20%), calcium (39%), magnesium (17%), and zinc (16%). Vegetable oils (15%) and high-fat vegetable oil–based spreads (14%) were the top sources of polyunsaturated fat. High-fibre bread was the top source of fibre (27%) and iron (12%). Non-root vegetables were the top source of folate (14%) and vitamin C (22%). Sugar-sweetened beverages provided 21% of sucrose intake. Pork was a more important source of protein and sausage was a more important source of total fat and monounsaturated fat in boys than in girls. Vegetable oils provided a higher proportion of unsaturated fat and vitamin E among boys, whereas high-fat vegetable oil–based spreads provided a higher proportion of these nutrients among girls. Conclusion Commonly recommended foods, such as skimmed milk, high-fibre grain products, vegetables, vegetable oil, and vegetable oil–based spreads, were important sources of several nutrients, whereas sugar-sweetened beverages provided the majority of sucrose intake among children. This knowledge can be used in improving health among children by dietary interventions, nutrition education, and

  9. Chemical profiling: A tool to decipher the structure and organisation of illicit drug markets: An 8-year study in Western Switzerland.

    Science.gov (United States)

    Broséus, Julian; Baechler, Simon; Gentile, Natacha; Esseiva, Pierre

    2016-09-01

    Illicit drug analyses usually focus on the identification and quantitation of questioned material to support the judicial process. In parallel, more and more laboratories develop physical and chemical profiling methods in a forensic intelligence perspective. The analysis of large databases resulting from this approach enables not only to draw tactical and operational intelligence, but may also contribute to the strategic overview of drugs markets. In Western Switzerland, the chemical analysis of illicit drug seizures is centralised in a laboratory hosted by the University of Lausanne. For over 8 years, this laboratory has analysed 5875 cocaine and 2728 heroin specimens, coming from respectively 1138 and 614 seizures operated by police and border guards or customs. Chemical (major and minor alkaloids, purity, cutting agents, chemical class), physical (packaging and appearance) as well as circumstantial (criminal case number, mass of drug seized, date and place of seizure) information are collated in a dedicated database for each specimen. The study capitalises on this extended database and defines several indicators to characterise the structure of drugs markets, to follow-up on their evolution and to compare cocaine and heroin markets. Relational, spatial, temporal and quantitative analyses of data reveal the emergence and importance of distribution networks. They enable to evaluate the cross-jurisdictional character of drug trafficking and the observation time of drug batches, as well as the quantity of drugs entering the market every year. Results highlight the stable nature of drugs markets over the years despite the very dynamic flows of distribution and consumption. This research work illustrates how the systematic analysis of forensic data may elicit knowledge on criminal activities at a strategic level. In combination with information from other sources, such knowledge can help to devise intelligence-based preventive and repressive measures and to discuss

  10. 八年制医学生临床技能培训的实践与体会%Practice and understanding of clinical skill training of 8-year program medical students

    Institute of Scientific and Technical Information of China (English)

    廖晖; 史雯静; 何晓峰; 舒涛; 姚颖; 李光辉

    2013-01-01

    介绍了华中科技大学附属同济医院在八年制医学生临床技能培训中的一些做法.指出通过重视床边教学,并联合应用模拟教学平台、PBL教学法以及OSCE等多种教学、培训和考核手段,有助于强化临床基本技能,提高临床教学质量.%The paper introduces the practice of clinical skill training of 8-year program medical students at Affiliated Tongji Hospital, Huazhong University of Science and Technology. It suggests stressing bedside teaching and using diverse teaching, training and assessment methods, including the simulation teaching platform, problem-based learning and objective structure clinical examination. They will help enhance students'basic clinical skills and improve quality of clinical teaching.

  11. Lifestyles and socio-cultural factors among children aged 6-8 years from five Italian towns: the MAPEC_LIFE study cohort.

    Science.gov (United States)

    Bagordo, Francesco; De Donno, Antonella; Grassi, Tiziana; Guido, Marcello; Devoti, Gabriele; Ceretti, Elisabetta; Zani, Claudia; Feretti, Donatella; Villarini, Milena; Moretti, Massimo; Salvatori, Tania; Carducci, Annalaura; Verani, Marco; Casini, Beatrice; Bonetta, Sara; Carraro, Elisabetta; Schilirò, Tiziana; Bonizzoni, Silvia; Bonetti, Alberto; Gelatti, Umberto

    2017-03-07

    Lifestyles profoundly determine the quality of an individual's health and life since his childhood. Many diseases in adulthood are avoidable if health-risk behaviors are identified and improved at an early stage of life. The aim of the present research was to characterize a cohort of children aged 6-8 years selected in order to perform an epidemiological molecular study (the MAPEC_LIFE study), investigate lifestyles of the children that could have effect on their health status, and assess possible association between lifestyles and socio-cultural factors. A questionnaire composed of 148 questions was administered in two different seasons to parents of children attending 18 primary schools in five Italian cities (Torino, Brescia, Pisa, Perugia and Lecce) to obtain information regarding the criteria for exclusion from the study, demographic, anthropometric and health information on the children, as well as some aspects on their lifestyles and parental characteristics. The results were analyzed in order to assess the frequency of specific conditions among the different seasons and cities and the association between lifestyles and socio-economic factors. The final cohort was composed of 1,164 children (50.9 boys, 95.4% born in Italy). Frequency of some factors appeared different in terms of the survey season (physical activity in the open air, the ways of cooking certain foods) and among the various cities (parents' level of education and rate of employment, sport, traffic near the home, type of heating, exposure to passive smoking, ways of cooking certain foods). Exposure to passive smoking and cooking fumes, obesity, residence in areas with heavy traffic, frequency of outdoor play and consumption of barbecued and fried foods were higher among children living in families with low educational and/or occupational level while children doing sports and consuming toasted bread were more frequent in families with high socio-economic level. The socio-economic level seems to

  12. Maternal alcohol consumption during pregnancy and child’s cognitive performance at 6–8 years of age in rural Burkina Faso: an observational study

    Directory of Open Access Journals (Sweden)

    Anselme Simeon Sanou

    2017-06-01

    Full Text Available Background In Burkina Faso, it is not uncommon for mothers to drink alcohol, even during pregnancy. We aimed to study the association between maternal alcohol consumption during pregnancy and the child’s cognitive performance using the Kaufman Assessment Battery for Children, 2nd edition (KABC-II and the Children’s Category Test Level 1 (CCT-1 in rural Burkina Faso. Methods We conducted a follow-up study of a community cluster-randomised Exclusive breastfeeding trial, and re-enrolled the children in rural Burkina Faso. A total of 518 children (268 boys and 250 girls aged 6–8 years were assessed using the KABC-II and the CCT-1. We examined the effect size difference using Cohen’s d and conducted a linear regression analysis to examine the association. Results Self-reported alcohol consumption during pregnancy was 18.5% (96/518. Children whose mothers reported alcohol consumption during pregnancy performed significantly poorly for memory and spatial abilities tests from small effect size difference for ‘Atlantis’ (0.27 and ‘Triangle’ (0.29 to moderate effect size difference for ‘Number recall’ (0.72 compared to children whose mothers did not consume alcohol during pregnancy; the exposed children scored significantly higher errors with a small effect size (0.37 at problem solving (CCT-1 test compared to unexposed children. At unstandardized and standardized multivariable analysis, children whose mothers reported alcohol consumption during pregnancy performed significantly poorer for memory-‘Atlantis’ (p = 0.03 and ‘Number recall’ (p = 0.0001, and spatial ability tests-‘Triangle’ (p = 0.03; they scored significantly higher errors at problem solving CCT-1 test (p = 0.002; all the results were adjusted for age, sex, schooling, stunting, father’s education, mother’s employment and the promotion of exclusive breastfeeding. No statistical association was found for visual abilities-‘Conceptual Thinking’,

  13. Transcranial Doppler, MRA, and MRI as a screening examination for cerebrovascular disease in patients with sickle cell anemia: an 8-year study

    Energy Technology Data Exchange (ETDEWEB)

    Seibert, J.J.; Glasier, C.M.; Allison, J.W.; James, C.A.; Kinder, D.L.; Cox, K.S.; Lairry, F.; Graves, R.A. [Arkansas Children`s Hospital, Little Rock, AR (United States). Dept. of Radiology; Kirby, R.S.; Flick, E.L. [Center for Ambulatory Research, Univ. of Arkansas for Medical Sciences, Little Rock, AR (United States); Becton, D.L.; Jackson, F.J. [Dept. of Hematology, Univ. of Arkansas for Medical Sciences, Little Rock, AR (United States)

    1998-03-01

    Objective. The authors previously reported five transcranial Doppler ultrasonography (TCD) findings as significant in detecting clinical cerebrovascular disease in a 4-year study in patients with sickle cell disease. This is a follow-up to evaluate the validity of the original findings over another 4-year period during which the study population doubled. A clinical follow-up of the original asymptomatic sickle cell patients with positive TCD, MRA, and MRI was also made. Results. Of the 4 out of original 46 control patients in 1992 who had positive MRA and TCD, 3 have subsequently had clinical stroke. None of the 9 original patients with positive TCD and positive MRI but negative MRA have developed stroke. All five original TCD indicators of disease were still significant (P<0.05) for detecting clinical disease: maximum velocity in ophthalmic artery (OA)>35 cm/s, mean velocity in middle cerebral artery (MCA) >170 cm/s, resistive index (RI) in OA<50, velocity in OA greater than in MCA, and velocity in posterior cerebral (PCA), vertebral, or basilar arteries greater than in MCA. Four additional factors were also significant: turbulence, PCA or ACA without MCA, RI<30, and maximum velocity in MCA>200 cm/s. (orig.)

  14. Efficacy of single and multi-metric fish-based indices in tracking anthropogenic pressures in estuaries: An 8-year case study.

    Science.gov (United States)

    Martinho, Filipe; Nyitrai, Daniel; Crespo, Daniel; Pardal, Miguel A

    2015-12-15

    Facing a generalized increase in water degradation, several programmes have been implemented for protecting and enhancing the water quality and associated wildlife, which rely on ecological indicators to assess the degree of deviation from a pristine state. Here, single (species number, Shannon-Wiener H', Pielou J') and multi-metric (Estuarine Fish Assessment Index, EFAI) community-based ecological quality measures were evaluated in a temperate estuary over an 8-year period (2005-2012), and established their relationships with an anthropogenic pressure index (API). Single metric indices were highly variable and neither concordant amongst themselves nor with the EFAI. The EFAI was the only index significantly correlated with the API, indicating that higher ecological quality was associated with lower anthropogenic pressure. Pressure scenarios were related with specific fish community composition, as a result of distinct food web complexity and nursery functioning of the estuary. Results were discussed in the scope of the implementation of water protection programmes.

  15. Long-term Reduction in Coronary Artery Disease and Stroke with 7,8 Years of Intensified, Multifactorial Intervention in Patients with Type 2 Diabetes and Microalbuminuria in the Steno-2 Study

    DEFF Research Database (Denmark)

    Oellgaard, Jens; Gæde, Peter; Rossing, Peter

    2016-01-01

    approaches. After 7.8 years the study continued as an observational follow-up with all patients offered treatment as for the original intensive-therapy group. The primary end-point of this sub-analysis of the follow-up, 21.2 years after intervention start was the relative risk reduction in CAD (defined...... primary events was significantly decreased in the intensive-therapy group (p = 0.049 for CAD and p = 0.003 for stroke). Conclusions: At 21.2 years of follow up of 7.8 years of intensified, multifactorial, target driven treatment of type 2 diabetes mellitus with microalbuminuria, we demonstrate significant......Introduction: Intensified multifactorial intervention for 7.8 years in patients with type 2 diabetes mellitus and microalbuminuria increased life length and reduces complication rates. The present analysis is a sub-study examining the long-term effects specifically on coronary artery disease (CAD...

  16. Evaluation of candidemia in epidemiology and risk factors among cancer patients in a cancer center of China: an 8-year case-control study.

    Science.gov (United States)

    Li, Ding; Xia, Rui; Zhang, Qing; Bai, Changsen; Li, Zheng; Zhang, Peng

    2017-08-03

    Candidemia is the worldwide life-threaten disease, especially in cancer patients. This study was aimed to identify and evaluate the risk factors of candidemia in cancer patients, which will prompt the improvement on current therapeutic strategies and prognosis. A retrospective, case-control study was conducted from inpatients of Tianjin Medical University Cancer Institute and Hospital, during 2006 to 2013. Analyses were performed between cancer patients with candidemia as study case, and patients with bacterial bloodstream infections as control. Each case was matched up with two controls, for gender and inpatient duration. Candida species, clinical characteristics, risk factors and outcomes were reviewed in details. Total number of 80 cases and 160 controls were enrolled and analyzed in this study. Candida albicans was identified as the most prevalent species and account for 55.0% candidemia, followed by Candida parapsilosis complex (21.3%), Candida tropicalis (8.8%), Candida glabrata complex (7.5%), Candida lusitaniae (3.8%), and Candida famata (3.8%). The crude mortality at 30-days of candidemia was up to 30.0%, which is significantly higher than bacterial bloodstream infections (p = 0.006). Logistical analysis demonstrated that total parenteral nutrition >5 days (p = 0.036), urinary catheter >2 days (p = 0.001), distant organ metastasis of cancer (p = 0.002) and gastrointestinal cancer (p = 0.042) were the independent risk factors for candidemia. Candidemia showed significant higher mortality than bacterial bloodstream infections, C. albicans was cited as the primary pathogen. Total parenteral nutrition, urinary catheter, distant organ metastasis of cancer and gastrointestinal cancer are independent predictors for candidemia, this findings provides potential therapeutic targets for improving the outcome.

  17. Suicidal Behavior During Lithium and Valproate Treatment: A Within-Individual 8-Year Prospective Study of 50,000 Patients With Bipolar Disorder.

    Science.gov (United States)

    Song, Jie; Sjölander, Arvid; Joas, Erik; Bergen, Sarah E; Runeson, Bo; Larsson, Henrik; Landén, Mikael; Lichtenstein, Paul

    2017-08-01

    Conclusions regarding lithium's antisuicidal effect for bipolar disorder have been limited due to nonrepresentative subjects and potential confounding factors, including varying severity of illness. Findings regarding the effect of valproate, the most common alternative to lithium, are inconsistent for suicidal behavior. This study investigated the associations of these two drugs with the risk of suicide-related events, and possible differences between drugs, by using within-individual designs in a register-based longitudinal cohort. Through linkage of multiple Swedish national registers, 51,535 individuals with bipolar disorder were followed from 2005 to 2013 for treatment with lithium and valproate. Stratified Cox regression was used to estimate the hazard ratios of suicide-related events during treated periods compared with untreated periods. For significant associations between medication and suicide-related events, the population attributable fraction was estimated to assess the public health impact for patients with bipolar disorder. During follow-up, 10,648 suicide-related events occurred. The incidence rate was significantly decreased by 14% during lithium treatment (hazard ratio 0.86, 95% confidence interval [CI] 0.78-0.95) but not during valproate treatment (hazard ratio 1.02, 95% CI 0.89-1.15). The difference in hazard ratios of suicide-related events between lithium and valproate was statistically significant. Estimates of the population attributable fraction suggested that 12% (95% CI 4%-20%) of suicide-related events could have been avoided if patients had taken lithium during the entire follow-up. The results suggest that lithium should be considered for patients with bipolar disorder with suspected suicidal intentions, although risk for suicide is only one of the considerations when providing clinical care.

  18. Treatment of intrabony defects with an enamel matrix protein derivative or bioabsorbable membrane: an 8-year follow-up split-mouth study.

    NARCIS (Netherlands)

    Sculean, A.; Schwarz, F.; Miliauskaite, A.; Kiss, A.; Arweiler, N.B.; Becker, J.M.; Brecx, M.

    2006-01-01

    BACKGROUND: Treatments with either an enamel matrix protein derivative (EMD) or guided tissue regeneration (GTR) have been shown to promote periodontal regeneration. However, until recently, only limited data have been available on the long-term clinical results following these regenerative techniqu

  19. High beverage sugar as well as high animal protein intake at infancy may increase overweight risk at 8 years: a prospective longitudinal pilot study.

    NARCIS (Netherlands)

    Weijs, J.M. Peter; Kool, M. Laura; Baar, M. van Nicolien; Zee, C. van der Saskia

    2011-01-01

    Background: Combined effects of early exposure to beverage sugar and animal protein and later life overweight risk have not been studied. Methods: A prospective longitudinal study was initiated in 2001 with 226 infants between 4 and 13 months of age. Dietary intake was assessed with a 2 day food rec

  20. Evaluation of candidemia in epidemiology and risk factors among cancer patients in a cancer center of China: an 8-year case-control study

    OpenAIRE

    Li, Ding; Xia, Rui; Zhang, Qing; Bai, Changsen; Li, Zheng; Zhang, Peng

    2017-01-01

    Background Candidemia is the worldwide life-threaten disease, especially in cancer patients. This study was aimed to identify and evaluate the risk factors of candidemia in cancer patients, which will prompt the improvement on current therapeutic strategies and prognosis. Methods A retrospective, case-control study was conducted from inpatients of Tianjin Medical University Cancer Institute and Hospital, during 2006 to 2013. Analyses were performed between cancer patients with candidemia as s...

  1. The MTA at 8 Years: Prospective Follow-Up of Children Treated for Combined-Type ADHD in a Multisite Study

    Science.gov (United States)

    Molina, Brooke S. G.; Hinshaw, Stephen P.; Swanson, James W.; Arnold, L. Eugene; Vitiello, Benedetto; Jensen, Peter S.; Epstein, Jeffery N.; Hoza, Betsy; Hechtman, Lily; Abikoff, Howard B.; Elliott, Glen R.; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wells, Karen C.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan; Houck, Patricia R.

    2009-01-01

    Participants of the Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (ADHD) eight years earlier do not differ significantly in repeated measures or newly analyzed variables that include school grades and psychiatric hospitalization. The treatment of childhood ADHD does not predict functioning six to eight…

  2. Factors Associated With 8-Year Mortality in Older Patients With Cerebral Small Vessel Disease: The Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) Study

    NARCIS (Netherlands)

    Holst, H.M. van der; Uden, I.W.M. van; Tuladhar, A.M.; Laat, K.F. de; Norden, A.G. van; Norris, D.G.; Dijk, E.J. van; Rutten-Jacobs, L.C.A.; Leeuw, F.E. de

    2016-01-01

    IMPORTANCE: Gait and cognition have been related to mortality in population-based studies. This association is possibly mediated by cerebral small vessel disease (SVD), which has been associated with mortality as well. It is unknown which factors can predict mortality in individuals with SVD.

  3. Early-Life Determinants of Total and HDL Cholesterol Concentrations in 8-Year-Old Children; The PIAMA Birth Cohort Study

    NARCIS (Netherlands)

    Bekkers, Marga B. M.; Brunekreef, Bert; Smit, Henriette A.; Kerkhof, Marjan; Koppelman, Gerard H.; Oldenwening, Marieke; Wijga, Alet H.

    2011-01-01

    Background: Adult cholesterol concentrations might be influenced by early-life factors, such as breastfeeding and birth weight, referred to as "early programming". How such early factors exert their influence over the life course is still poorly understood. Evidence from studies in children and

  4. Early-Life Determinants of Total and HDL Cholesterol Concentrations in 8-Year-Old Children; The PIAMA Birth Cohort Study

    NARCIS (Netherlands)

    Bekkers, Marga B. M.; Brunekreef, Bert; Smit, Henriette A.; Kerkhof, Marjan; Koppelman, Gerard H.; Oldenwening, Marieke; Wijga, Alet H.

    2011-01-01

    Background: Adult cholesterol concentrations might be influenced by early-life factors, such as breastfeeding and birth weight, referred to as "early programming". How such early factors exert their influence over the life course is still poorly understood. Evidence from studies in children and adol

  5. Resistance patterns of nosocomial urinary tract infections in urology departments: 8-year results of the global prevalence of infections in urology study.

    Science.gov (United States)

    Tandogdu, Zafer; Cek, Mete; Wagenlehner, Florian; Naber, Kurt; Tenke, Peter; van Ostrum, Edgar; Johansen, Truls Bjerklund

    2014-06-01

    To present the worldwide antibiotic resistance rates of uropathogens reported in nosocomial urinary tract infections (NAUTI) during the period of 2003-2010. Data from the Global Prevalence Study of Infections in Urology from the period of 2003-2010 were analyzed to evaluate the resistance rates of pathogens causing NAUTI. The web-based application was used to record data of investigators from urology departments participating in the study every year during the days allocated in November. Each center was allowed to enter data on a single day of the study. The point prevalence data was used to find differences among geographic regions and years by utilizing multiple logistic regression analysis. A total of 19,756 patients were hospitalized during the study period, and in 1,866 of them, NAUTI was reported. Proof of infection was reported in 1,395 patients. Resistance rates of all antibiotics tested other than imipenem against the total bacterial spectrum were higher than 10 % in all regions. Resistance to almost all pathogens was lowest in North Europe, and there is no single year where an outbreak of resistance has been detected. The resistance rates of most of the uropathogens against the antibiotics tested did not show significant trends of increase or decrease with Asia exhibiting the highest rates in general. The only antibiotic tested with an overall resistance rate below 10 % was imipenem. Knowledge of regional and local resistance data and prudent use of antibiotics are necessary to optimize antibiotic therapy in urological patients with NAUTI.

  6. The MTA at 8 Years: Prospective Follow-Up of Children Treated for Combined-Type ADHD in a Multisite Study

    Science.gov (United States)

    Molina, Brooke S. G.; Hinshaw, Stephen P.; Swanson, James W.; Arnold, L. Eugene; Vitiello, Benedetto; Jensen, Peter S.; Epstein, Jeffery N.; Hoza, Betsy; Hechtman, Lily; Abikoff, Howard B.; Elliott, Glen R.; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wells, Karen C.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan; Houck, Patricia R.

    2009-01-01

    Participants of the Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (ADHD) eight years earlier do not differ significantly in repeated measures or newly analyzed variables that include school grades and psychiatric hospitalization. The treatment of childhood ADHD does not predict functioning six to eight…

  7. Predictive value of coronary calcifications for future cardiac events in asymptomatic patients with diabetes mellitus: A prospective study in 716 patients over 8 years

    Directory of Open Access Journals (Sweden)

    Tittus Janine

    2008-10-01

    Full Text Available Abstract Background To establish an efficient prophylaxis of coronary artery disease reliable risk stratification is crucial, especially in the high risk population of patients suffering from diabetes mellitus. This prospective study determined the predictive value of coronary calcifications for future cardiovascular events in asymptomatic patients with diabetes mellitus. Methods We included 716 patients suffering from diabetes mellitus (430 men, 286 women, age 55.2 ± 15.2 years in this study. On study entry all patients were asymptomatic and had no history of coronary artery disease. In addition, all patients showed no signs of coronary artery disease in ECG, stress ECG or echocardiography. Coronary calcifications were determined with the Imatron C 150 XP electron beam computed tomograph. For quantification of coronary calcifications we calculated the Agatston score. After a mean observation period of 8.1 ± 1.1 years patients were contacted and the event rate of cardiac death (CD and myocardial infarction (MI was determined. Results During the observation period 40 patients suffered from MI, 36 patients died from acute CD. The initial Agatston score in patients that suffered from MI or died from CD (475 ± 208 was significantly higher compared to those without cardiac events (236 ± 199, p Conclusion By determination of coronary calcifications patients at risk for future MI and CD could be identified within an asymptomatic high risk group of patients suffering from diabetes mellitus. On the other hand future events could be excluded in patients without coronary calcifications.

  8. Association between Cognition and Serum Insulin-Like Growth Factor-1 in Middle-Aged & Older Men: An 8 Year Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Shankar Tumati

    Full Text Available Low levels of insulin-like growth factor-1 (IGF-1, an essential neurotrophic factor, have been associated with worse cognitive function in older adults. However, few studies have assessed the prospective association of serum IGF-1 with cognitive function. We aimed to determine the association between serum IGF-1 on concurrent and prospective cognitive function in a population sample of men aged 40-80 years. Blood samples were assessed for IGF-1 levels at baseline and neuropsychological assessments were performed at baseline (n = 400 and at follow-up after a mean duration of 8.3 years (n = 286. Linear regression analyses were carried out to determine the associations between quintiles of IGF-1 and cognitive function at the baseline and follow-up visits. Results showed that those in the top quintile of IGF-1 had lower processing capacity and global cognition scores at follow-up after controlling for cognitive function at baseline and other confounding factors. Additional analyses exploring associations with IGF-1 separately in middle-aged and older participants, and with quartiles of IGF-1 produced similar results. In those older than 60 years, high IGF-1 levels were also associated with lower baseline processing capacity. These results suggest that high IGF-1 levels are associated with worse long-term cognition in men. Together with past studies, we suggest that both, high and low levels of IGF-1 may be associated with poor cognitive function and that optimum levels of IGF-1 (quintile 2 and 3 in current study may be associated with better cognitive function.

  9. Association between Cognition and Serum Insulin-Like Growth Factor-1 in Middle-Aged & Older Men: An 8 Year Follow-Up Study.

    Science.gov (United States)

    Tumati, Shankar; Burger, Huibert; Martens, Sander; van der Schouw, Yvonne T; Aleman, André

    2016-01-01

    Low levels of insulin-like growth factor-1 (IGF-1), an essential neurotrophic factor, have been associated with worse cognitive function in older adults. However, few studies have assessed the prospective association of serum IGF-1 with cognitive function. We aimed to determine the association between serum IGF-1 on concurrent and prospective cognitive function in a population sample of men aged 40-80 years. Blood samples were assessed for IGF-1 levels at baseline and neuropsychological assessments were performed at baseline (n = 400) and at follow-up after a mean duration of 8.3 years (n = 286). Linear regression analyses were carried out to determine the associations between quintiles of IGF-1 and cognitive function at the baseline and follow-up visits. Results showed that those in the top quintile of IGF-1 had lower processing capacity and global cognition scores at follow-up after controlling for cognitive function at baseline and other confounding factors. Additional analyses exploring associations with IGF-1 separately in middle-aged and older participants, and with quartiles of IGF-1 produced similar results. In those older than 60 years, high IGF-1 levels were also associated with lower baseline processing capacity. These results suggest that high IGF-1 levels are associated with worse long-term cognition in men. Together with past studies, we suggest that both, high and low levels of IGF-1 may be associated with poor cognitive function and that optimum levels of IGF-1 (quintile 2 and 3 in current study) may be associated with better cognitive function.

  10. An 8-year longitudinal sero-epidemiological study of bovine leukaemia virus (BLV) infection in dairy cattle in Turkey and analysis of risk factors associated with BLV seropositivity.

    Science.gov (United States)

    Şevik, Murat; Avcı, Oğuzhan; İnce, Ömer Barış

    2015-04-01

    Enzootic bovine leukosis (EBL) which is caused by bovine leukaemia virus (BLV) has an important economic impact on dairy herds due to reduced milk production and restrictions on livestock exports. This study was conducted to determine the BLV infection status in Central Anatolia Region of Turkey, an important milk production centre, and to examine the risk factors such as purchasing cattle, increasing cattle age, cattle breed and herd size associated with transmission of BLV infection. To estimate the rate of BLV infection, a survey for specific antibodies in 28,982 serum samples from animals belonging to 1116 different herds situated in Central Anatolia Region of Turkey were tested from January 2006 to December 2013. A generalized mixed linear model was used to evaluate the risk factors that influenced BLV seroprevalence. Antibodies against BLV were detected in 431 (2.28 %) of 18,822 Holstein and 29 (0.28 %) of 10,160 Brown Swiss cows. Among 1116 herds, 132 herds (11.82 %) had one or more positive animals. Also results of our study show that the prevalence of BLV infection increased from 2006 to 2011, and it tends to reduce with BLV control programme. Furthermore, we found positive associations between percentage of seropositive animal and increasing cattle age, herd size, cattle breed and purchased cattle. Age-specific prevalence showed that BLV prevalence increased with age. These factors should be taken into consideration for control of BLV infection.

  11. Body Dissatisfaction Measured with a Figure Preference Task and Self-Esteem in 8 Year Old Children - a Study within the ABIS-Project

    Directory of Open Access Journals (Sweden)

    A. Sepa

    2008-01-01

    Full Text Available Body dissatisfaction has been related to low self-esteem and depression in adolescents. With regard to the current world wide rise in childhood obesity and common stigmatization of adults and children with obesity, easy to use and cost effective measurements of body dissatisfaction would be helpful in epidemiological research. In the current study, detailed data on body measurements with regard to perceived and ideal body size and body dissatisfaction, as measured with the figure preference task, are presented for a population based sample of 3837 children. Perceived body size correlations to weight, body mass index [BMI], and waist circumference were between 0.41 and 0.54; and to height between 0.12 and 0.21. Odds ratios for lower self-esteem increased with increase in body dissatisfaction. Gender differences in body dissatisfaction were present but not found in relation to self-esteem. It is concluded that the figure preference task yields valuable information in epidemiological studies of children as young as 7.5 years of age. It is argued, that the figure preference task is an additional measurement which theoretically relates to psychological stress in childhood.

  12. Effects of Early Childhood Peer Relationships on Adolescent Mental Health: A 6- to 8-Year Follow-Up Study in South Korea

    Science.gov (United States)

    Shin, Kyoung Min; Shin, Yun Mi; Park, Kyung Soon

    2016-01-01

    Objective Peer relationships are one of the important factors in children's development. The present study examines the relationship between the effects of early peer relationships and adolescent psychological adjustment. Methods The first survey took place from 1998 to 2000, and a follow-up assessment obtained data in 2006, as the original participants reached 13–15 years of age. The first assessment used the Korean version of the Child Behavior Checklist (K-CBCL) and simple questions about peer relationships to evaluate the participants. The follow-up assessment administered the Korean Youth Self Report (K-YSR). Results Children's peer relationships have longitudinal effects on mental health and adjustment. Children who had qualitative peer-relation problems were more likely to exhibit internalizing problems as adolescents. Conclusion Children who have poor peer relationships might become more vulnerable to emotional problems and social adjustment as adolescents. PMID:27482238

  13. Fungal infections in neutropenic patients: a 8-year prospective study Infecções fúngicas em pacientes neutropênicos: estudo prospectivo de 8 anos

    Directory of Open Access Journals (Sweden)

    Marcio Nucci

    1995-10-01

    Full Text Available In this paper we report a eight-year prospective study designed to further characterize incidence, epidemiology, specific syndromes, treatment and prognosis associated with fungal infections in neutropenic patients. During the study period 30 fungal infections were diagnosed in 30 patients among 313 episodes of fever and neutropenia (10%. There were 15 cases of candidiasis, 5 pulmonary aspergillosis, 3 sinusitis by Aspergillus fumigatus, 5 infections by Fusarium sp., one infection by Trichosporon sp., and one infection due to Rhodotorula rubra. Blood cultures were positive in 18 cases (60%. The predisposing factors for fungal infection in multivariate analysis were the presence of central venous catheter (pCom o objetivo de melhor caracterizar incidência, epidemiologia, síndromes específicas, tratamento e prognóstico associado com infecções fúngicas sistêmicas em pacientes neutropênicos foi feito um estudo prospectivo de 8 anos. Durante este período foram diagnosticadas 30 infecções fúngicas em 30 pacientes neutropênicos febris (10%. Houve 15 casos de candidíase, 5 aspergiloses pulmonares, 3 sinusites por Aspergillus fumigatus, 5 infecções por Fusarium sp., uma infecção por Trichosporon sp., e uma infecção por Rhodotorula rubra. As hemoculturas foram positivas em 18 casos (60%. Os fatores de risco para infecção fúngica em análise multivariada foram: presença de cateter venoso central (p<0,001, duração maior de neutropenia <100/mm³ (p<0,001, uso de corticosteróides (p<0,001, bacteremia por germes gram-positivos (p=0,002 e idade menor (p=0.03. Em análise multivariada apenas recuperação da neutropenia (p<0,001 esteve associada com bom prognóstico, enquanto que o diagnóstico de infecção por Fusarium sp. (p=0,006 se correlacionou com um mau prognóstico. A taxa de óbito foi de 43%. Não houve diferença estatisticamente significante nas taxas de óbito em pacientes que receberam (52% ou não (50% terapia anti

  14. Patterns of Multiple Risk Exposures for Low Receptive Vocabulary Growth 4-8 Years in the Longitudinal Study of Australian Children.

    Science.gov (United States)

    Christensen, Daniel; Taylor, Catherine L; Zubrick, Stephen R

    2017-01-01

    Risk exposures and predictions of child development outcomes typically estimate the independent effects of individual exposures. As a rule though, children are not exposed piecemeal to individual or single risks but, rather, they are exposed to clusters of risk. Many of these clusters of risks are better thought of as comprising a developmental "circumstance" with a substantial duration, over which period, additional risk exposures also accumulate. In this paper we examined the distribution of 16 single risk exposures for low language ability using latent class analysis across a sample of approximately 4000 children from the Longitudinal Study of Australian Children. The best fitting model identified six distinct classes. 46% of children were in a Developmentally Enabled group, 20% were in a group typified as Working Poor families, 10% of children were in group typified as Overwhelmed group, 9% of children were in a group defined by Child Developmental Delay, 8% of children were in a group defined by Low Human Capital, and 7% of children were in a group defined by Resource Poor non-English Speaking background families. These groups had quantitatively and qualitatively distinct patterns of risk factors and showed different onward trajectories of receptive vocabulary. Our results demonstrate a range of multiple risk profiles in a population-representative sample of Australian children and highlight the mix of risk factors faced by children. Children with distinct patterns of risk factors have different onward trajectories of receptive vocabulary development.

  15. Patterns of Multiple Risk Exposures for Low Receptive Vocabulary Growth 4-8 Years in the Longitudinal Study of Australian Children

    Science.gov (United States)

    Taylor, Catherine L.; Zubrick, Stephen R.

    2017-01-01

    Risk exposures and predictions of child development outcomes typically estimate the independent effects of individual exposures. As a rule though, children are not exposed piecemeal to individual or single risks but, rather, they are exposed to clusters of risk. Many of these clusters of risks are better thought of as comprising a developmental “circumstance” with a substantial duration, over which period, additional risk exposures also accumulate. In this paper we examined the distribution of 16 single risk exposures for low language ability using latent class analysis across a sample of approximately 4000 children from the Longitudinal Study of Australian Children. The best fitting model identified six distinct classes. 46% of children were in a Developmentally Enabled group, 20% were in a group typified as Working Poor families, 10% of children were in group typified as Overwhelmed group, 9% of children were in a group defined by Child Developmental Delay, 8% of children were in a group defined by Low Human Capital, and 7% of children were in a group defined by Resource Poor non-English Speaking background families. These groups had quantitatively and qualitatively distinct patterns of risk factors and showed different onward trajectories of receptive vocabulary. Our results demonstrate a range of multiple risk profiles in a population-representative sample of Australian children and highlight the mix of risk factors faced by children. Children with distinct patterns of risk factors have different onward trajectories of receptive vocabulary development. PMID:28114381

  16. Elbow Flexion Contractures in Childhood in Obstetric Brachial Plexus Lesions: A Longitudinal Study of 20 Neurosurgically Reconstructed Infants with 8-Year Follow-up.

    Science.gov (United States)

    van der Sluijs, Maaike J; van Ouwerkerk, Willem-Jan R; van der Sluijs, Johannes A; van Royen, Barend J

    2015-12-01

     Little knowledge exists on the development of elbow flexion contractures in children with obstetrical brachial plexus lesion (OBPL). This study aims to evaluate the prognostic significance of several neuromuscular parameters in infants with OBPL regarding the later development of elbow flexion contractures.  Twenty infants with OBPL with insufficient signs of recovery in the first months of life who were neurosurgically reconstructed were included. At a mean age of 4.6 months, the following neuromuscular parameters were assessed: existence of flexion contractures, cross-sectional area (CSA) of upper arm muscles on MRI, Narakas classification, EMG results, and elbow muscle function using the Gilbert score. In childhood at follow-up at mean age of 7.7 years, we measured the amount of flexion contractures and the upper arm peak force (Newton). Statistical analysis is used to assess relations between these parameters.  Flexion contractures of greater than 10 degrees occurred in 55% of our patient group. The relation between the parameters in infancy and the flexion contractures in childhood is almost nonexistent. Only the Narakas classification was related to the development of flexion contractures in childhood (p = 0.006). Infant muscle CSA is related to childhood peak muscle force.  The role of infancy upper arm muscle hypotrophy/hypertrophy, reinnervation, and early elbow muscle function in the development of childhood elbow contractures remains unclear. In this cohort prediction of childhood flexion, contractures were not possible using infancy neuromuscular parameters. We suggest that contractures might be an adaptive process to optimize residual muscle function.

  17. Change in HbA1c levels between the age of 8 years and the age of 12 years in Dutch children without diabetes: the PIAMA birth cohort study.

    Directory of Open Access Journals (Sweden)

    Hanneke Jansen

    Full Text Available HbA1c is associated with cardiovascular risk in persons without diabetes and cardiovascular risk accumulates over the life course. Therefore, insight in factors determining HbA1c from childhood onwards is important. We investigated (lifestyle determinants of HbA1c at age 12 years and the effects of growth on change in HbA1c and the tracking of HbA1c between the age of 8 and 12 years.Anthropometric measurements were taken and HbA1c levels were assessed in 955 children without diabetes aged around 12 years participating in the PIAMA birth cohort study. In 363 of these children HbA1c was also measured at age 8 years. Data on parents and children were collected prospectively by questionnaires.We found no significant association between known risk factors for diabetes and HbA1c at age 12 years. Mean(SD change in HbA1c between ages 8 and 12 years was 0.6(0.7 mmol/mol per year (or 0.1(0.1 %/yr. Anthropometric measures at age 8 and their change between age 8 and 12 years were not associated with the change in HbA1c. 68.9% of the children remained in the same quintile or had an HbA1c one quintile higher or lower at age 8 years compared to age 12 years.The lack of association between known risk factors for diabetes and HbA1c suggest that HbA1c in children without diabetes is relatively unaffected by factors associated with glycaemia. HbA1c at age 8 years is by far the most important predictor of HbA1c at age 12. Therefore, the ranking of HbA1c levels appear to be fairly stable over time.

  18. Efficacy and Safety of a Lidocaine Gel in Patients from 6 Months up to 8 Years with Acute Painful Sites in the Oral Cavity: A Randomized, Placebo-Controlled, Double-Blind, Comparative Study

    Directory of Open Access Journals (Sweden)

    Dörte Wolf

    2015-01-01

    Full Text Available Lidocaine is a well-accepted topical anaesthetic, also used in minors to treat painful conditions on mucosal membranes. This randomized, double-blind, placebo-controlled study (registered prospectively as EudraCT number 2011-005336-25 was designed to generate efficacy and safety data for a lidocaine gel (2% in younger children with painful conditions in the oral cavity. One hundred sixty-one children were included in two subgroups: 4–8 years, average age 6.4 years, treated with verum or placebo and 6 months–<4 years, average age 1.8 years, treated only with verum. Pain reduction was measured from the time prior to administration to 10 or 30 minutes after. In addition, adverse events and local tolerability were evaluated. In group I, pain was reduced significantly after treatment with verum compared to placebo at both time points. In group II, the individual pain rating shift showed statistically significant lower pain after treatment. Only seven out of 161 patients reported an adverse event but none were classified as being related to the study medication. The local tolerability was assessed as very good in over 97% of cases. For painful sites in the oral cavity, a 2% lidocaine gel is a meaningful tool for short-term treatment in the paediatric population.

  19. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    and repair? Have new materials improved longevity? Are there still clinical and material problems to be solved? And what has the highest impact on longevity of posterior resin restorations – the material, the dentist, the patient or the tooth? These matters will be discussed on the basis of the literature......Within the last 25 years composite resin materials have in many countries successively replaced amalgam as a restorative for posterior teeth. Resin materials and bonding systems are continuously being improved by the manufactures, adhesive procedures are now included in the curriculum of most...... universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...

  20. Four Years Prospective Study of Natural History of Atopic Dermatitis Aged 7~8 Years at an Individual Level: A Community-Based Survey by Dermatologists' Skin Examination in Childhood

    Science.gov (United States)

    Kim, Young Jee; Yun, Sook Jung; Lee, Jee-Bum; Kim, Seong Jin; Won, Young Ho

    2016-01-01

    Background The age-dependent change in atopic dermatitis (AD) at an individual level has mostly performed in a hospital-setting. Objective We evaluated the age-dependent change of AD symptoms at an individual level in a community-setting. Methods For the diagnostic accuracy, all participants of schoolchildren were received skin examination by dermatologists (twice a year for the same group), instead of questionnaire-based surveys. For this study, sequential check-ups of 273 elementary school children, aged 7~8 years, were performed for 4 years up to the age of 10~11 years. Results Among the 47 AD children, who had been diagnosed as having AD at the first-year check-up, spontaneous remission was detected in nine children during the follow-up periods (remission rate of 19.1%). As a consequence, the one-year AD prevalence was decreased by 5.9% in the elementary schoolchildren over four years. Unexpectedly, late onset (after 8 years of age) AD was observed in 21.7% of AD children. There was no statistically significant relationship between spontaneous remission and host factors including sex and family history of atopic diseases. Conclusion We observed that 19.1% of AD children in the age group of 7~11 years showed spontaneous remission based on skin examination by dermatologists. There might be an increase in the prevalence of late onset AD in Korea. PMID:27904266

  1. Asthma in Hispanics. An 8-year update.

    Science.gov (United States)

    Rosser, Franziska J; Forno, Erick; Cooper, Philip J; Celedón, Juan C

    2014-06-01

    This review provides an update on asthma in Hispanics, a diverse group tracing their ancestry to countries previously under Spanish rule. A marked variability in the prevalence and morbidity from asthma remains among Hispanic subgroups in the United States and Hispanic America. In the United States, Puerto Ricans and Mexican Americans have high and low burdens of asthma, respectively (the "Hispanic Paradox"). This wide divergence in asthma morbidity among Hispanic subgroups is multifactorial, likely reflecting the effects of known (secondhand tobacco smoke, air pollution, psychosocial stress, obesity, inadequate treatment) and potential (genetic variants, urbanization, vitamin D insufficiency, and eradication of parasitic infections) risk factors. Barriers to adequate asthma management in Hispanics include economic and educational disadvantages, lack of health insurance, and no access to or poor adherence with controller medications such as inhaled corticosteroids. Although considerable progress has been made in our understanding of asthma in Hispanic subgroups, many questions remain. Studies of asthma in Hispanic America should focus on environmental or lifestyle factors that are more relevant to asthma in this region (e.g., urbanization, air pollution, parasitism, and stress). In the United States, research studies should focus on risk factors that are known to or may diverge among Hispanic subgroups, including but not limited to epigenetic variation, prematurity, vitamin D level, diet, and stress. Clinical trials of culturally appropriate interventions that address multiple aspects of asthma management in Hispanic subgroups should be prioritized for funding. Ensuring high-quality healthcare for all remains a pillar of eliminating asthma disparities.

  2. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007–2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe

    Science.gov (United States)

    Socolov, Demetra-Gabriela; Carauleanu, Alexandru; Ilea, Ciprian; Blidaru, Iolanda; Boiculese, Lucian; Socolov, Razvan-Vladimir

    2017-01-01

    Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20–24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth teenagers than in adults (0.75 [0.70–0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10–1.17]), low urinary tract infection (1.10 [1.03–1.18]), pediculosis (2.42 [1.90–3.00]), anogenital condyloma (1.50 [1.04–2.17]), and trichomoniasis (1.74 [1.12–2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26–0.71), 0.90 (0.85–0.96), and 0.29 (0.20–0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers. PMID:28133615

  3. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007-2014) in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe.

    Science.gov (United States)

    Socolov, Demetra-Gabriela; Iorga, Magdalena; Carauleanu, Alexandru; Ilea, Ciprian; Blidaru, Iolanda; Boiculese, Lucian; Socolov, Razvan-Vladimir

    2017-01-01

    Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20-24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth teenagers than in adults (0.75 [0.70-0.80]). The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]): anaemia (1.13 [1.10-1.17]), low urinary tract infection (1.10 [1.03-1.18]), pediculosis (2.42 [1.90-3.00]), anogenital condyloma (1.50 [1.04-2.17]), and trichomoniasis (1.74 [1.12-2.68]). The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26-0.71), 0.90 (0.85-0.96), and 0.29 (0.20-0.41), while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers.

  4. Adult intussusception: An 8 years institutional review

    Directory of Open Access Journals (Sweden)

    Isaac Assam Udo

    2016-01-01

    Full Text Available Background: Intussusception is a rare cause of intestinal obstruction in adults. Its diagnosis could be elusive based solely on clinical features because of protean presentation. Supplementary imaging allows for preoperative diagnosis, early institution of definitive management, and a better clinical outcome. Patients and Methods: Records of adults managed for intestinal obstruction by laparotomy in a surgical unit of a tertiary health facility were retrospectively examined. The subgroup having an intraoperative diagnosis of intussusception was extracted and analyzed. Data obtained included age, sex, and primary symptom at presentation. Presence of intestinal perforation, the histology of the lead point of resected tissues, and the final disposition of the patients were documented. Results: Four hundred and three patients underwent surgical management of intestinal obstruction. Eight patients (2% had an intraoperative diagnosis of intussusception at laparotomy; four males and four females (male: female = 1:1. Abdominal pain was the presentation in 7 (87.5% and anal protrusion in 1 (12.5%. Four patients (50% had bowel perforation with peritonitis. Seven of the resected intestines had lead points which were benign. Two patients (25% died from sepsis. Resection and anastomosis were done for all the patients. Conclusion: Intussusception in adults is uncommon but carries a high morbidity and mortality which can be reduced with a good clinical assessment, appropriate imaging, and early laparotomy.

  5. Five- to 8-year results of the uncemented Duracon total knee arthroplasty system.

    Science.gov (United States)

    Chana, Rishi; Shenava, Yatish; Nicholl, Alison P; Lusted, Felicity J; Skinner, Paul W; Gibb, Paul A

    2008-08-01

    We report prospective clinical and radiographic outcomes of a series of 219 hydroxyapatite-coated Duracon (Stryker Howmedica Osteonics Corporation, Kalamazoo, Mich) total knee arthroplasties with a follow-up of 5 to 8 years. Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis index (WOMAC), and SF-12 Health Status Questionnaire were used. Analysis of fluoroscopic radiographs was performed with the American Knee Society Score. All living patients (186 knees) were followed up. Twenty-eight patients (30 knees) had died. The preoperative Knee Society Score of 43.8 increased to 77.1 and the preoperative Function score of 20.3 increased to 63.4. WOMAC scores showed marked improvement (pain, 250 preoperatively to 157; stiffness, 115 preoperatively to 56; and function, 910 preoperatively to 588). There was no radiographic evidence of loosening or migration. Gaps visible at the bone-implant interface healed over the first year. Three prostheses were revised, 2 for deep infection and 1 for tibial tray subsidence. A survivorship of 98.6% has been achieved at 8 years. This intermediate-term study with 100% follow-up at 8 years demonstrates excellent clinical and radiographic outcomes. It is our opinion that these are comparable to the gold standard cemented total knee arthroplasties and may have advantages over other uncoated cementless designs.

  6. Pregnancy during Adolescence and Associated Risks: An 8-Year Hospital-Based Cohort Study (2007–2014 in Romania, the Country with the Highest Rate of Teenage Pregnancy in Europe

    Directory of Open Access Journals (Sweden)

    Demetra-Gabriela Socolov

    2017-01-01

    Full Text Available Aim. To determine pregnancy and delivery outcomes among teenagers. Materials and Methods. An 8-year retrospective comparative hospital-based cohort study is analysing singleton pregnancy comorbidities and delivery parameters of a teenage group under the age of 20 compared with a young adult group 20–24 years of age in a university hospital. Results. Teenage is a risk factor for preterm birth <37 weeks (1.21 [1.08–1.35], foetal growth restriction (1.34 [1.21–1.48], episiotomy (1.27 [1.21–1.34], uterine revision (1.15 [1.06–1.25], APGAR <7 at 1 min (2.42 [1.21–1.67], cephalopelvic disproportion (1.26 [1.07–1.48], and postpartum haemorrhage (1.42 [1.25–1.62]; however, caesarean delivery occurs less frequently in teenagers than in adults (0.75 [0.70–0.80]. The following comorbidities are risk factors for teenage pregnancy (risk ratio [CI 95%]: anaemia (1.13 [1.10–1.17], low urinary tract infection (1.10 [1.03–1.18], pediculosis (2.42 [1.90–3.00], anogenital condyloma (1.50 [1.04–2.17], and trichomoniasis (1.74 [1.12–2.68]. The risks for hepatitis B and hepatitis C, premature rupture of membranes, and placenta praevia were lower compared with those in the young adult group, respectively, 0.43 (0.26–0.71, 0.90 (0.85–0.96, and 0.29 (0.20–0.41, while the risk for gestational diabetes and preeclampsia were the same in both groups. Conclusion. Considering the high risks for teenage pregnancy, this information should be provided to pregnant adolescent women and their caregivers.

  7. Percutaneous Ethanol Sclerotherapy of Symptomatic Nodules Is Effective and Safe in Pregnant Women: A Study of 13 Patients with an Average Follow-Up of 6.8 Years

    Directory of Open Access Journals (Sweden)

    Tamas Solymosi

    2015-01-01

    Full Text Available Background. Because of the increased risk of surgery, thyroid nodules causing compression signs and/or hyperthyroidism are concerning during pregnancy. Patients and Methods. Six patients with nontoxic cystic, four with nontoxic solid, and three with overt hyperthyroidism caused by toxic nodules were treated with percutaneous ethanol injection therapy (PEI. An average of 0.68 mL ethanol per 1 mL nodule volume was administered. Mean number of PEI treatments for patients was 2.9. Success was defined as the shrinkage of the nodule by more than 50% of the pretreatment volume (V0 and the normalization of TSH and FT4 levels. The average V0 was 15.3 mL. Short-term success was measured prior to labor, whereas long-term success was determined during the final follow-up (an average of 6.8 years. Results. The pressure symptoms decreased in all but one patient after PEI and did not worsen until delivery. The PEI was successful in 11 (85% and 7 (54% patients at short-term and long-term follow-up, respectively. Three patients underwent repeat PEI which was successful in 2 patients. Conclusions. PEI is a safe tool and seems to have good short-term results in treating selected symptomatic pregnant patients. Long-term success may require repeat PEI.

  8. Retention of fetal bones 8 years following termination of pregnancy.

    Science.gov (United States)

    Topçu, Hasan Onur; Şimşek, Bilge Şener; Taşdemir, Umit; Güzel, Ali İrfan; Doğanay, Melike

    2014-01-01

    Foreign bodies; in particular, fetal bones may present with a variety of clinical symptoms and signs including infertility, vaginal discharge, disparonia, pelvic pain, abnormal uterine bleeding. Many case reports were described post- abortal removal of retained fetal bone at varying time intervals from the previous (D&E), ranging from weeks to years. In our case, a 34-year-old woman presented with abnormal uterine bleeding and secondary infertility, her only pregnancy being a termination 8 years previously at 15 weeks' gestation. A transvaginal ultrasound revealed a normal-sized, normal-shaped uterus with an echogenic scarred endometrium. After then office hysterescopy revealed fragments of the immature bone. All the immature bones were removed by operative hysterescopy. Significant numbers of patients may have endometrial pathology; the differential diagnosis of such unusual findings on ultrasound examination includes intrauterine contraceptive devices, foreign bodies, calcified submucous fibroids and Asherman's syndrome, as well as rarities such as heterotopic bone. The presence of this pathology may be a causal or contributory factor to subfertilty, and will remain undetected if the endometrium is not routinely evaluated. Indeed, these cases highlight the advantage of performing a hysteroscopy at the same time as the more invasive laparoscopy and dye insufflation, in selected cases.

  9. CPR - child 1 to 8 years old - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100215.htm CPR - child 1 to 8 years old - series—Check ... and retrieve an AED until you have performed CPR for about 2 minutes. 3. Carefully place the ...

  10. Early Mortality during Initial Treatment of Tuberculosis in Patients Co-Infected with HIV at the Yaounde Central Hospital, Cameroon: An 8-Year Retrospective Cohort Study (2006-2013.

    Directory of Open Access Journals (Sweden)

    Jean Joel R Bigna

    Full Text Available Understanding contributors to mortality during the initial phase of tuberculosis (TB treatment in patients co-infected with HIV would guide targeted interventions to improve survival. The aim of this study was to ascertain the incidence of death during the initial 2 months (new cases and 3 months (retreatment cases of TB treatment and to assess correlates of mortality in HIV co-infected patients.We conducted a hospital-based retrospective cohort study from January 2006 to December 2013 at Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify co-infected TB/HIV inpatients aged 15 years and older who died during TB treatment. Death was defined as any death occurring during TB treatment, as per World Health Organization recommendations. We collected socio-demographic, clinical and laboratory data. We conducted multivariable logistic binary regression analysis to identify factors associated with death during the intensive phase of TB treatment. Magnitudes of associations were expressed by adjusted odds ratio (aOR with 95% confidence interval. A p value < 0.05 was considered statistically significant.The 99 patients enrolled had a mean age of 39.5 (standard deviation 10.9 years and 53% were male. Patients were followed for 276.3 person-months of observation (PMO. Forty nine patients were died during intensive phase of TB treatment. Death incidence during the intensive phase of TB treatment was 32.2 per 100 PMO. Having a non-AIDS comorbidity (aOR 2.47, 95%CI 1.22-5.02, p = 0.012, having extra-pulmonary TB (aOR 1.89, 95%CI 1.05-3.43, p = 0.035, and one year increase in duration of known HIV infection (aOR 1.23, 95%CI 1.004-1.49 were independently associated with death during the intensive phase of TB treatment.Mortality incidence during intensive phase of TB treatment was high among TB/HIV co-infected patients during TB treatment; and strongly associated with extra pulmonary TB suggesting advanced stage of immunosuppression and

  11. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Children & Clinical Studies NHLBI Trials Clinical Trial Websites Children and Clinical Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to ...

  12. Changes of the Quinolones Resistance to Gram-positive Cocci Isolated during the Past 8 Years in the First Bethune Hospital

    Science.gov (United States)

    Xu, Jiancheng; Chen, Qihui; Yao, Hanxin; Zhou, Qi

    This study was to investigate the quinolones resistance to gram-positive cocci isolated in the First Bethune Hospital during the past 8 years. Disk diffusion test was used to study the antimicrobial resistance. The data were analyzed by WHONET 5 software according to Clinical and Laboratory Standards Institute (CLSI). The rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCNS) were 50.8%∼83.3% and 79.4%∼81.5%during the past 8 years, respectively. In recent 8 years, the quinolones resistance to gram-positive cocci had increased. Monitoring of the quinolones resistance to gram-positive cocci should be strengthened. The change of the antimicrobial resistance should be investigated in order to guide rational drug usage in the clinic and prevent bacterial strain of drug resistance from being transmitted.

  13. Effects of lifestyle intervention in pregnancy and anthropometrics at birth on offspring metabolic profile at 2.8 years - results from the Lifestyle in Pregnancy and Offspring (LiPO) study

    DEFF Research Database (Denmark)

    Tanvig, Mette; Vinter, Christina A; Jørgensen, Jan S

    2014-01-01

    Context: Maternal obesity and gestational weight gain are linked to offspring adverse metabolic profile, and lifestyle intervention during pregnancy in obese women may have long-term positive effect on their children. Furthermore, although the association between birth weight and later metabolic...... outcomes is well established, little is known about the predictive value of abdominal circumference at birth. Objectives: To study: i) effects of lifestyle intervention during pregnancy in obese women on offspring metabolic risk factors and ii) predictive values of birth weight (BW) and birth abdominal...... circumference (BAC). Design: Follow-up of a randomized controlled trial; the Lifestyle in Pregnancy (LiP) study Setting: Odense and Aarhus University Hospitals, Denmark Participants: Offspring of LiP study participants (n=157) and offspring of normal weight mothers (external reference group, ER, n=97...

  14. Long-term treatment of postmenopausal osteoporosis with strontium ranelate: results at 8 years.

    Science.gov (United States)

    Reginster, J Y; Bruyère, O; Sawicki, A; Roces-Varela, A; Fardellone, P; Roberts, A; Devogelaer, J P

    2009-12-01

    Strontium ranelate 2 g/day has proven efficacy against vertebral and nonvertebral fracture over 5 years in postmenopausal osteoporosis, though many women require longer-term treatment. This article describes the efficacy, safety, and tolerability of this agent over 8 years. Postmenopausal osteoporotic women having participated in the 5-year efficacy trials SOTI and TROPOS were invited to enter a 3-year open-label extension study. The results presented here focus on patients who received strontium ranelate for 8 years. At the extension baseline, the population treated for 8 years (n=879; 79.1+/-5.6 years) had femoral neck T-score of -2.61+/-0.71. The cumulative incidences of new vertebral and nonvertebral fractures (13.7% and 12.0%, respectively) over years 6 to 8 were non-statistically different from the cumulative incidences in the first 3 years of the original studies (11.5% and 9.6%). Lumbar spine, femoral neck, and total hip bone mineral density (BMD) increased throughout the 8-year period. Annual relative change in BMD was significant at every visit, except the 8-year visit for femoral neck and total hip BMD. Strontium ranelate was safe and well tolerated over 8 years. Long-term treatment with strontium ranelate 2 g/day in postmenopausal osteoporotic women leads to continued increases in BMD at all sites. The data also provide some evidence for a sustained antifracture efficacy.

  15. Clinical characteristics and molecular epidemiology of carbapenem-resistant Acinetobacter baumannii infections at Shenzhen People's Hospital during an 8-year period%深圳市人民医院近8年耐碳青霉烯鲍曼不动杆菌感染特征及其克隆变迁

    Institute of Scientific and Technical Information of China (English)

    吴伟元; 金晓菲; 吴诗品; 吴劲松; 卢月梅; 吴文苑; 陆坚; 刘映霞

    2015-01-01

    目的 调查深圳市人民医院近8年耐碳青霉烯鲍曼不动杆菌(CRAB)感染临床特征、耐药机制及其克隆变迁.方法 收集2002至2009年深圳市人民医院院内感染患者分离鲍曼不动杆菌;琼脂稀释法检测亚胺培南等抗菌药对鲍曼不动杆菌最低抑菌浓度(MICs);聚合酶链反应(PCR)和DNA测序分析CRAB碳青霉烯酶基因型;脉冲场凝胶电泳(PFGE)分析菌株同源性;依据中国鲍曼不动杆菌感染诊治与防控专家共识,回顾性调查CRAB感染患者病历资料.结果 2002至2009年共收集到87例CRAB院内感染患者,以呼吸道感染最常见,占69.0%(60/87),其次为血流感染占8.0%(7/87)、伤口感染占8.0% (7/87)和腹腔感染占6.9% (6/87).80.5% (70/87) CRAB来源于重症监护病房(ICu).2009年CRAB感染迅速增多,占48.3%(42/87),以呼吸道感染为主(34/42).87株CRAB共获8种PFGE型别.2002至2006年,CRAB感染主要流行携带blaOXA-58-like基因的CRAB克隆A;2007至2008年主要流行CRAB克隆A和携带blaOXA-23-like基因的CRAB克隆C;2009年携带blaOXA-23-like基因对碳青霉烯高度耐药的CRAB克隆D取代克隆A和C,成为深圳市人民医院CRAB病原菌的主要克隆.结论 携带blaOXA-23-1ike基因的CRAB高耐药克隆D造成深圳市人民医院2009年CRAB感染迅速流行.%Objective To investigate the clinical features,mechanism of resistance and molecular epidemiology of carbapenem-resistant Acinetobacter baumannii (CRAB) infections at Shenzhen People's Hospital during an 8-year period.Methods A.baumannii isolates were recovered from nosocomial infections patients at this hospital from 2002 to 2009.The minimum inhibitory concentrations (MICs) of antimicrobial agents against A.baumannii isolates were detected by agar dilution method.Polymerase chain reaction (PCR) and DNA sequencing were used to examine the carbapenemase genotype among CRAB.All isolates were typed by pulse field gel electrophoresis (PFGE).Clinical cases of CRAB

  16. Huge Gastric Teratoma in an 8-Year Old Boy.

    Science.gov (United States)

    Sisodiya, Rajpal S; Ratan, Simmi K; Man, Parveen K

    2016-01-01

    Gastric teratoma is very rare tumor and usually presents in early infancy. An 8-year-old boy presented with a huge mass in abdomen extending from epigastrium to the pelvis. Ultrasound and CT scan of abdomen revealed a huge mass with solid and cystic components and internal calcifications. The preoperative diagnosis was a teratoma but not specifically gastric one. At operation, it was found to be gastric teratoma. The mass was excised completely with part of the stomach wall. The histopathology confirmed it to be mature gastric teratoma. The rarity of the teratoma with delayed presentation prompted us to report the case.

  17. The sonographic appearance of acute focal pyelonephritis 8 years experience

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, Kim D.; Gellett, Laura R.; Dubbins, Paul A

    2002-06-01

    AIM: Acute focal pyelonephritis (AFP) is a variant of pyelonephritis in which single or multiple discrete areas show changes of inflammation. The reported sonographic appearances of AFP are varied but are typically described as being echopoor. The purpose of this study was to review the sonographic appearances of AFP and attempt to explain the range of findings by correlation with clinical details. MATERIALS AND METHODS: We reviewed retrospectively the sonographic findings and medical records of 17 cases of AFP. The study group consisted of 13 women and four men (mean age 20 years). Lesions were designated as echogenic, echopoor or of mixed echogenicity as compared to the adjacent renal cortex, and to the liver or spleen. RESULTS: The abnormal areas were echogenic in 12 patients, echopoor in three and of mixed echogenicity in two. An attempt was made to explain the variation in appearances by correlation with clinical details including the patient's age, the duration of symptoms, the length of antibiotic treatment and the presence of haematuria. CONCLUSION: Areas of acute focal pyelonephritis may be echogenic, echopoor or of mixed echogenicity. Our data would suggest that areas of increased echogenicity are more common. There is no discernible correlation with clinical findings. Farmer, K.D. et al. (2002)

  18. Septic Bursitis in an 8-Year-Old Boy

    Science.gov (United States)

    Marconi, Dante; Plakas, Christos; Fisher, Margaret

    2014-01-01

    Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint. PMID:24955272

  19. Septic Bursitis in an 8-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Panagiotis Kratimenos

    2014-01-01

    Full Text Available Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

  20. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

  1. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen

    2008-01-01

    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

  2. Five- to 8-Year-Old Emirati Children's and Their Teachers' Perceptions of War

    Science.gov (United States)

    Buldu, Mehmet

    2009-01-01

    This study examined 5- to 8-year-old Emirati children's and their teachers' perceptions of war. Data for this study were collected through drawings and semi-structured interviews. A phenomenological procedure was used to analyze the data. Younger children could not articulate the details of the specific nature of war. Many children defined war as…

  3. Five- to 8-Year-Old Emirati Children's and Their Teachers' Perceptions of War

    Science.gov (United States)

    Buldu, Mehmet

    2009-01-01

    This study examined 5- to 8-year-old Emirati children's and their teachers' perceptions of war. Data for this study were collected through drawings and semi-structured interviews. A phenomenological procedure was used to analyze the data. Younger children could not articulate the details of the specific nature of war. Many children defined war as…

  4. Construction and Validation of Parental Rating Scale from Children's Emotional Intelligence (4-8 Years Old)

    Science.gov (United States)

    Kajbafnezhad, Hadi

    2016-01-01

    Emotional intelligence rating tools are not available for children, but mostly for children. So, the present study investigated the measurement and assessment of Emotional Intelligence in children with the age range of 4-8 years old by parents (mothers) through a preliminary research-made questionnaire. This study was based on an…

  5. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical Studies NHLBI Trials Clinical Trial Websites News & ...

  6. Vismodegib Therapy for Basal Cell Carcinoma in an 8-Year-Old Chinese Boy with Xeroderma Pigmentosum.

    Science.gov (United States)

    Fife, Douglas; Laitinen, Marko A; Myers, David J; Landsteiner, Pamela B

    2017-03-01

    Vismodegib is an oral inhibitor of the Hedgehog signaling pathway and has been used to treat basal cell carcinoma (BCC) in adults. This article reports clearance of a nodular BCC of the nasal tip in an 8-year-old boy with xeroderma pigmentosum (XP). BCC can pose therapeutic challenges when located in areas that are not amenable to traditional therapies such as Mohs micrographic surgery or topical agents. Vismodegib was used at a dose of 150 mg/day to treat the boy's BCC. After 4 months of therapy, we achieved complete clinical clearance. During 21 months of follow-up, the patient's nose remained clinically clear of tumor. Vismodegib was successfully used to treat a child with XP and nodular BCC. Our goal in using vismodegib was tumor regression while avoiding cosmetic and functional disfigurement. Vismodegib was effective in clinically clearing the tumor, and the patient has shown no signs of recurrence. Further studies are warranted.

  7. Congenital diaphragmatic hernia with(out) ECMO: impaired development at 8 years.

    NARCIS (Netherlands)

    Madderom, M.J.; Toussaint, L.; Cammen-van Zijp, M.H. van der; Gischler, S.J.; Wijnen, R.M.H.; Tibboel, D.; Ijsselstijn, H.

    2013-01-01

    OBJECTIVE: To evaluate developmental and social-emotional outcomes at 8 years of age for children with congenital diaphragmatic hernia (CDH), treated with or without neonatal extracorporeal membrane oxygenation (ECMO) between January 1999 and December 2003. DESIGN: Cohort study with structural prosp

  8. Congenital diaphragmatic hernia with(out) ECMO: impaired development at 8 years.

    NARCIS (Netherlands)

    Madderom, M.J.; Toussaint, L.; Cammen-van Zijp, M.H. van der; Gischler, S.J.; Wijnen, R.M.H.; Tibboel, D.; Ijsselstijn, H.

    2013-01-01

    OBJECTIVE: To evaluate developmental and social-emotional outcomes at 8 years of age for children with congenital diaphragmatic hernia (CDH), treated with or without neonatal extracorporeal membrane oxygenation (ECMO) between January 1999 and December 2003. DESIGN: Cohort study with structural

  9. Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

    NARCIS (Netherlands)

    Toussaint, L.C.; Cammen-van Zijp, M.H. van der; Janssen, A.J.; Tibboel, D.; Heijst, A.F. van; Ijsselstijn, H.

    2016-01-01

    OBJECTIVE: To assess perceived motor competence, social competence, self-worth, health-related quality of life, and actual motor performancein 8-year-old survivors of neonatal extracorporeal membrane oxygenation (ECMO). METHODS: In a prospective nationwide study, 135 children completed the extended

  10. Magnesium metabolism in 4-year-old to 8-year-old children

    Science.gov (United States)

    Magnesium (Mg) is a key factor in bone health, but few studies have evaluated Mg intake or absorption and their relationship with bone mineral content (BMC) or bone mineral density (BMD) in children. We measured Mg intake, absorption, and urinary excretion in a group of children 4 to 8 years of age....

  11. Neuroimaging diagnosis for cerebral infarction An 8-year bibliometric analysis

    Institute of Scientific and Technical Information of China (English)

    Yan Du; Xiaoxia Yang; Hong Song; Bo Chen; Lin Li; Yue Pan; Qiong Wu; Jia Li

    2012-01-01

    OBJECTIVE:To identify global research trends in neuroimaging diagnosis for cerebral infarction using a bibliometric analysis of the Web of Science.DATA RETRIEVAL:We performed a bibliometric analysis of data retrieval for neuroimaging diagnosis for cerebral infarction containing the key words "CT,magnetic resonance imaging,MRI,transcranial Doppler,transvaginal color Doppler,digital subtraction angiography,and cerebral infarction" using the Web of Science.SELECTION CRITERIA:Inclusion criteria were:(a) peer-reviewed articles on neuroimaging diagnosis for cerebral infarction which were published and indexed in the Web of Science; (b) original research articles and reviews; and (c) publication between 2004-2011.Exclusion criteria were:(a) articles that required manual searching or telephone access; and (b) corrected papers or book chapters.MAIN OUTCOME MEASURES:(1)Annual publication output; (2) distribution according to country;(3) distribution according to institution; (4) top cited publications; (5) distribution according to journals; and (6) comparison of study results on neuroimaging diagnosis for cerebral infarction.RESULTS:Imaging has become the predominant method used in diagnosing cerebral infarction.The most frequently used clinical imaging methods were digital subtraction angiography,CT,MRI,and transcranial color Doppler examination.Digital subtraction angiography is used as the gold standard.However,it is a costly and time-consuming invasive diagnosis that requires some radiation exposure,and is poorly accepted by patients.As such,it is mostly adopted in interventional therapy in the clinic.CT is now accepted as a rapid,simple,and reliable non-invasive method for use in diagnosis of cerebrovascular disease and preoperative appraisal.Ultrasonic Doppler can be used to reflect the hardness of the vascular wall and the nature of the plaque more clearly than CT and MRI.CONCLUSION:At present,there is no unified standard of classification of cerebral infarction

  12. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept ... treatments based on what is known to work in adults. To improve clinical care of children, more ...

  13. A predictive radiological analysis of short stems versus both shortened and long stems in primary hip replacement: a case-control study of 100 cases of Metha versus ABG II and Omnifit HA at 2-8 years' follow-up.

    Science.gov (United States)

    Epinette, Jean-Alain; Brax, Michel; Chammaï, Yves

    2017-09-09

    Short hip stems, intended to conserve bone stock and ensure a more physiological distribution of stress in the femur under loading, are meeting with renewed interest. Radiologic semiology is not known exactly, particularly in relation to conventional implants; we therefore conducted a case-control study of 3 types of implant differing only in stem length: short, shortened or long. The aim was 1) to compare radiographic aspects, 2) to attempt to systematize medium-term radiologic status for the 3 types, and 3) to assess the impact of radiographic aspect on loosening and revision rates. The short Metha stem is better adapted to the recipient bone than longer stems, without sacrificing stability. A prospective series comprising the first 100 selected cases of hip replacement using the short Metha stem was compared to two other series of 100 "long" (Omnifit HA) and 100 "shortened" (ABG II) stems at comparable follow-up: 4.05 ± 1.44 years (range, 2-8 years) for Metha, 4.48 ± 0.97 years (range 2-8 years) for Omnifit, and 4.75 ± 2.07 years (range, 2-8 years) for ABG II. Selection criteria in this initial phase were very strict: young age and/or high activity level, with good bone stock and femoral morphology suited to fitting a Metha stem (no "stovepipe" or "champagne-flute" femurs), for which 12.8% of primary hip replacements were selected. Matching was performed by sampling on criteria of age, gender, body-mass index and etiology. Radiographic parameters were compared between the short stem group and the two control groups and classified according to Engh-Massin score (10 points for fixation and 17 for stability). The short Metha stem provided excellent fixation scores: 7.65/10, versus 7.16 (p = 0.003) and 5.92 (p = 0.0001) for ABG II and Omnifit, respectively. Likewise, stability was scored 14.23/17 for Metha, versus 14.51 (NS) and 11.83 (p = 0.0001) respectively, and the total score was higher for Metha (21.88/27) than ABG II (21.67; p = 0.03) or, more particularly

  14. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ... Clinical Studies Children have often had to accept medicines and treatments based on what is known to ...

  15. Fixed partial dentures in an up to 8-year follow-up

    Directory of Open Access Journals (Sweden)

    Maximiliano Sérgio Cenci

    2010-08-01

    Full Text Available Information on the longevity of fiber-reinforced composite fixed partial dentures (inlay FPDs should be considered in the selection of materials, operative techniques and patient instructions related to prognosis and long-term cost-effectiveness. OBJECTIVE: This study evaluated the long-term survival of fiber-reinforced, adhesively-bonded composite prostheses placed in posterior teeth. Materials and Methods: Twenty-one patients that received adhesively bonded polyethylene inlay FPDs in posterior teeth were selected from a private practice dental office and invited to evaluation. Of the eligible 21 patients, 13 (mean age 50.3 ± 11.5 years agreed to be enrolled as participants, providing 22 restorations, as several subjects presented more than one inlay FPD. One dentist placed all inlay FPDs using Ribbond as reinforcement and Tetric Ceram/Durafil or Charisma/Renamel composite combinations, according to manufacturer's instructions. Two independent calibrated operators performed the evaluation, using modified USPHS criteria. Survival functions of restorations were analyzed with Kaplan-Meier and Log Rank test (α = 0.05. RESULTS: The majority of restorations received A or B scores. Four (18.2% inlay FPDs fractured among the 22 evaluated. The mean estimate survival rate was 7 years (95% CI: 5.9 to 8.1, and the overall percentage of survival was 81.8%. There were no significant differences (p>0.05 between composite combinations or tooth location considering all clinical aspects evaluated and survival functions. CONCLUSION: Posterior fiber-reinforced fixed partial dentures exhibited acceptable clinical performance after a period up to 8 years.

  16. [Tinea capitis in the military hospital Avicenna (Morocco): Review of 8 years (2006-2013)].

    Science.gov (United States)

    El Mezouari, E; Hocar, O; Atarguine, H; Akhdari, N; Amal, S; Moutaj, R

    2016-03-01

    Tinea capitis are due to fungal infection by dermatophytes. They are common in developing countries including Morocco. The objective of this study intended to describe the epidemiology, clinical and mycological profile of tinea capitis in Avicenna military hospital of Marrakech. This is a retrospective study over an 8-year period (from 1st January 2006 to 31st December 2013). All patients targeted through this study presented to the laboratory with the suspicion of tinea capitis, they were under a detailed investigation with a careful mycological analysis; diagnosis of tinea capitis was established as the direct examination and/or the sampling proved positive. Of the 334 patients investigated, 216 had a TC with an overall prevalence of 64.67%. The average age was 6 years. The M/F sex ratio was 0.55. The isolated dermatophytes were Microsporum canis with 105 cases (63.26%), Trichophyton violaceum in 44 cases (26.51%), T. mentographytes in 8 cases (4.81%), M. langeronii in 5 cases (3.01%), T. verrucosum in 3 cases (1.8%) and T. schoenleinii in 1 case (0.61%). The contact with animals was found in 40% of cases and immunosupression in 3.47% of cases. We verify through our investigation that tineas predominate among school age children with a female predominance. The epidemiological profile of TC in our study is similar to that of other studies in Moroccan and Maghrebian countries investigations. The TC is relatively a mild infection but can be confused with other dermatoses not easy to diagnose. For this reason, their treatment necessitates a mycological analysis. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Retrospective analysis of 8 years of efavirenz drug monotoring data

    NARCIS (Netherlands)

    Roelofs, R.; Roelofsen, M.W.E.E.; Touw, D.J.

    2010-01-01

    Introduction: Efavirenz (EFV) is a NNRTI frequently used in HAART. Therapy with EFV is monitored using TDM and clinical observation. Standard starting dose for EFV is 1 dd 600 mg. This should result in a plasma level in the range of 1-4 mg/l. Plasma levels above 4 mg/l are associated with a higher

  18. Cardiac Function in 7-8-Year-Old Offspring of Women with Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Maarten Rijpert

    2011-01-01

    Full Text Available Offspring of type 1 diabetic mothers (ODMs are at risk of short-term and long-term complications, such as neonatal macrosomia (birth weight >90th percentile, hypertrophic cardiomyopathy, and cardiovascular morbidity in later life. However, no studies have been performed regarding cardiac outcome. In this study, we investigated cardiac dimensions and function in 30 ODMs at 7-8 years of age in relation to neonatal macrosomia and maternal glycemic control during pregnancy and compared these with those in a control group of 30 children of nondiabetic women. We found that cardiac dimensions and systolic and diastolic function parameters in ODMs were comparable with those in controls. Neonatal macrosomia and poorer maternal glycemic control during pregnancy were not related to worse cardiac outcome in ODM. We conclude that cardiac function at 7-8 years of age in offspring of women with type 1 diabetes is reassuring and comparable with that in controls.

  19. Maternal smoking and blood pressure in 7.5 to 8 year old offspring.

    OpenAIRE

    Morley, R; Leeson Payne, C; G Lister; Lucas, A.

    1995-01-01

    Reduced fetal growth in babies born preterm may be associated with reduced later blood pressure, but in children born at term, higher blood pressure. It was hypothesised, therefore, that maternal smoking in pregnancy, associated with reduced fetal growth, programmes later blood pressure differentially according to length of gestation. Six hundred and eighteen children born preterm and now aged 7.5 to 8 years were studied prospectively. Systolic blood pressure in children from smoking compared...

  20. EVALUATION OF PHYSICAL DEVELOPMENT DYNAMICS IN MODERN CHILDREN 7-8 YEARS OF AGE

    Directory of Open Access Journals (Sweden)

    Grebneva, N.N.

    2016-05-01

    Full Text Available The article contains the results of comparative evaluation of children’s physical development level (7-8 years old over a twelve-year period (1999-2012. The study revealed drastic decrease in the number of children with average (normal level of physical development and its disharmony, which is mainly caused by excessive body weight. Increase in body weight depends on the sex: the indicators among girls are twice as high as same indicators for boys. It is assumed that decrease in physical development level of modern children 7-8 years of age is caused by nutritional inferiority, irrational nutrition and decline in physical activity, particularly due to the start formal schooling.

  1. Clinical studies involving probiotics

    OpenAIRE

    Degnan, Fred H

    2012-01-01

    Researchers from a diverse array of scientific disciplines have focused and continue to focus on opportunities and areas for responsible clinical research involving the possible beneficial health effects of “probiotics.” Investigators and researchers should be aware that not all clinical research involving probiotics reasonably falls within the requirements of the “investigational new drug” (IND) rubric administered and enforced by the US Food and Drug Administration. In determining whether a...

  2. Clinical Nursing Records Study

    Science.gov (United States)

    1991-08-01

    for Sam Houston, Texas MAJ Joanne Burton , AN, Clinical Head Nurse, Psychiatry MAJ Shelby Christian, AN, Clinical Head Nurse, OB/GYN MAJ Melissa Opio...Specify Level) Parenting, Potential Alteration In Decubitus Ulcer Self-Care Deficit, Total (Specify Level) Social Isolation Fluid Volume Deficit. Potential...METABOLIC PATTERN Self-Care Dieficit. Total (Specify Level) SiX alizaticni Alterations ifl Decubitus ulcer S-If-Batingrla.v~qene Oeticit 601?Cif Levet

  3. Longevity of posterior resin composite restorations in permanent teeth in Public Dental Health Service: a prospective 8 years follow up.

    Science.gov (United States)

    Pallesen, Ulla; van Dijken, Jan W V; Halken, Jette; Hallonsten, Anna-Lena; Höigaard, Ruth

    2013-04-01

    To investigate in a prospective follow up the longevity of posterior resin composites (RC) placed in permanent teeth of children and adolescents attending Public Dental Health Service. All posterior RC placed, in the PDHS clinics in the cities of Copenhagen and Frederiksberg in Denmark between November 1998 and December 2002, in permanent teeth of children and adolescents up to 18 years, were evaluated in an up to 8 years follow up. The endpoint of each restoration was defined, when repair or replacement was performed. Survival analyses were performed between subgroups with Kaplan-Meier analysis. The individual contribution of different cofactors to predict the outcome was performed with Cox regression analysis. Totally 2881 children with a mean age of 13.7 years (5-18) received 4355 RC restorations placed by 115 dentists. Eighty percent were placed in molars and 49% were Class I. Two percent of restorations with base material and 1% of the restorations without base material showed postoperative sensitivity (n.s.). Replacements were made in 406 and repairs in 125 restorations. Kaplan-Meier analysis showed a cumulative survival at 8 years of 84.3%, resulting in an annual failure rate of 2%. Lower patient age, more than one restoration per patient, placement of a base material and placement of RC: in molars, in cavities with high number of surfaces, in lower jaw teeth, showed all significant higher failure rates. Five variables had significant importance for the end point, replacement/repair of the resin composite restorations: age of patient, age of operator, jaw, tooth type and cavity size. Posterior RC restorations placed in children and adolescents in Public Dental Health clinics showed an acceptable durability with annual failure rates comparable with those of randomized controlled RC studies in adults. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Reactive attachment disorder in maltreated twins follow-up: from 18 months to 8 years.

    Science.gov (United States)

    Heller, Sherryl Scott; Boris, Neil W; Fuselier, Sarah-Hinshaw; Page, Timothy; Koren-Karie, Nina; Miron, Devi

    2006-03-01

    The best means for the diagnosis and treatment of reactive attachment disorder of infancy and early childhood have not been established. Though some longitudinal data on institutionalized children is available, reports of maltreated young children who are followed over time and assessed with measures of attachment are lacking. This paper presents the clinical course of a set of maltreated fraternal twins who were assessed and treated from 19 months to 30 months of age and then seen in follow-up at 3 and 8 years of age. A summary of the early assessment and course is provided and findings from follow-up assessments of the cognitive, behavioral, and interpersonal functioning of each child is analysed. Follow-up measures, chosen to capture social-cognitive processing of these children from an attachment perspective, are highlighted. Finally, findings from the case are discussed from nosological and theoretical perspectives.

  5. Pediatric Absence Status Epilepticus: Prolonged Altered Mental Status in an 8-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Scott J. Adams

    2016-01-01

    Full Text Available Absence status epilepticus is characterized by a prolonged state of impaired consciousness or altered sensorium with generalized electroencephalographic abnormalities. It is most commonly diagnosed in patients with known idiopathic generalized epilepsy; however, it may also be the first presentation of epilepsy. Due to the subtle and variable manifestations of the condition, absence status epilepticus may be underrecognized, particularly in children. We present the case of an 8-year-old boy who experienced two episodes of prolonged altered mental status, subsequently determined to be absence status epilepticus with idiopathic generalized epilepsy with phantom absences. We discuss the classification, pathophysiology, clinical presentation, and electroencephalographic findings of pediatric absence status epilepticus and provide a practical overview for management.

  6. The Stability of Extreme Response Style and Acquiescence Over 8 Years.

    Science.gov (United States)

    Wetzel, Eunike; Lüdtke, Oliver; Zettler, Ingo; Böhnke, Jan R

    2016-06-01

    This study investigated the stability of extreme response style (ERS) and acquiescence response style (ARS) over a period of 8 years. ERS and ARS were measured with item sets drawn randomly from a large pool of items used in an ongoing German panel study. Latent-trait-state-occasion and latent-state models were applied to test the relationship between time-specific (state) response style behaviors and time-invariant trait components of response styles. The results show that across different random item samples, on average between 49% and 59% of the variance in the state response style factors was explained by the trait response style factors. This indicates that the systematic differences respondents show in their preferences for certain response categories are remarkably stable over a period of 8 years. The stability of ERS and ARS implies that it is important to consider response styles in the analysis of self-report data from polytomous rating scales, especially in longitudinal studies aimed at investigating stability in substantive traits. Furthermore, the stability of response styles raises the question in how far they might be considered trait-like latent variables themselves that could be of substantive interest.

  7. Carotid artery stenting: a single-centre experience with up to 8 years' follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Simonetti, Giovanni; Gandini, Roberto; Pampana, Enrico; Fabiano, Sebastiano; Stefanini, Matteo; Spinelli, Alessio; Reale, Carlo Andrea; Di Primio, Massimiliano; Gaspari, Eleonora [University Hospital ' ' Tor Vergata' ' , Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, Rome (Italy); Versaci, Francesco [University Hospital ' ' Tor Vergata' ' , Department of Internal Medicine, Unit of Cardiology, Rome (Italy)

    2009-04-15

    Carotid artery stenting (CAS) may be an alternative to surgical endoarterectomy not only in high-risk patients. We report results in the endovascular treatment of carotid artery disease with up to 8 years' follow-up. In this retrospective study, we analysed data from 853 consecutive patients (946 arteries) treated for carotid artery stenosis between April 1999 and March 2007; 491 (52%) arteries were symptomatic and 455(48%) were asymptomatic. Preprocedural evaluation of the patients was performed with echo Doppler, magnetic resonance angiography (MRA) or computed tomographic angiography (CTA) and a neurological examination. A cerebral protection device was used in 879 (92.9%) procedures. Anti-platelet therapy was administered before and after the procedure. All patients were included in a follow-up of up to 8 years. Technical success was achieved in 943 (99.6%) lesions. At 30 days, there was a 0.21% (n = 2) death rate, a 0.42% major stroke rate, a 1.69% minor stroke/transient ischaemic attack (TIA) rate and a combined 2.32% TIA/stroke and death rate. During follow-up, echo Doppler evidenced restenosis in 39 (4.85%) cases; of these, only five, presenting restenosis >80%, were treated with an endovascular reintervention. At the long-term follow-up, two strokes (0.23%) were reported, which both occurred within the first 2 years. In our experience, carotid artery stenting seems to be a safe and effective treatment, providing satisfactory long-term clinical results. (orig.)

  8. Learn about Clinical Studies

    Science.gov (United States)

    ... is to make sure that the study is ethical and that the rights and welfare of participants ... trials provide the basis for the development and marketing of new drugs, biological products, and medical devices. ...

  9. The Frameless Copper IUD (GyneFix) and the TCu380A IUD : Results of an 8-year Multicenter Randomized Comparative Trial

    OpenAIRE

    Meirik, O.; Rowe, P J; Peregoudov, A.; Piaggio, G; Petzold, M.

    2009-01-01

    BACKGROUND: Clinical performance of the frameless copper IUD (GyneFix), designed to reduce side effects related to the frame of conventional IUDs, and TCu380A was compared. STUDY DESIGN: Randomized Multicenter randomized comparative trial. Parous women requesting and eligible to use IUD were admitted in 21 centers in eight countries in 1989-1993 and followed-up for up to 8 years. RESULTS: Two thousand twenty-seven women were randomized to the frameless IUD and 2036 to TCu380A; 43 insertions o...

  10. Infratentorial meningioma in an 8-year-old child as first sign of neurofibromatosis type 2.

    Science.gov (United States)

    Stettner, G M; Rostasy, K M; Ludwig, H C; Merkler, D; Fahsold, R; Gärtner, J

    2007-02-01

    Meningiomas are rare intracranial tumors in pediatric patients. In contrast to meningiomas in adults, childhood ones have a poorer prognosis because of their high growth potential and tendency to recur. Meningiomas are often associated with neurofibromatosis type 2 (NF2) which is an autosomal-dominant disorder. In contrast to adults who primarily present with symptoms due to vestibular tumors, the initial symptoms in children with NF2 are subtle skin tumors, posterior capsular cataracts, or neurological signs secondary to cranial nerve(s) schwannoma excluding vestibular nerve, and/or brainstem or spinal cord compression. Here we report on the clinical, radiological, and histological findings in an 8-year-old boy who was diagnosed with an isolated infratentorial meningioma and a novel splice site mutation in the NF2 gene. The same mutation was detected in the boy's mother who suffered from hearing loss and tinnitus due to a bilateral vestibular schwannoma. Our patient demonstrates the need for molecular testing for NF2 gene mutations even in isolated childhood meningiomas although they do not fulfill the clinical criteria of NF2.

  11. Reliability of squat and countermovement jump tests in children 6 to 8 years of age.

    Science.gov (United States)

    Acero, Rafael Martin; Fernández-del Olmo, Miguel; Sánchez, Jose Andres; Otero, Xose Luis; Aguado, Xavier; Rodríguez, Ferran A

    2011-02-01

    The aim of this study was to determine the reliability of the squat jump test (SJ) and countermovement jump test (CMJ), in fifty-six children (30 girls and 26 boys) with ages ranging from 6 to 8 years. Each subject performed two evaluation sessions (T1, T2) with seven days between tests. The results show that the CMJ test has a high intratrial reproducibility in T1 and T2 measured through intraclass correlation coefficient (ICC ≥ 0.95). The ICC for the SJ test had a high value (0.99) only in T1. The variability for both tests among children under 9 years of age is higher than those reported for adult subjects in other studies. The intersession reliability was questionable with a high methodical error (ME= 9.86-15.1%, for the SJ and CMJ, respectively) and a significant worsening of the results of CMJ in T2 (p < .05).

  12. The improvement of coordination abilities of young gymnasts aged 7-8 years

    Directory of Open Access Journals (Sweden)

    Mulligildina A.Ya.

    2012-02-01

    Full Text Available The article presents the substantive training in gymnastics by young gymnasts aged 7-8 years, the improvement of coordination abilities of gymnasts through simultaneous work with two balls is highlighted. The research has involved 20 young gymnasts and the experimental group had 10 people. The level of coordination abilities of gymnasts is underpinned, the comparative analysis of subject possession by the right and the left hand is stressed. The method of studying with two balls aimed on the development of athletes sensorimotor coordination is pointed out in the article. The authors obtain significant changes in the coordination abilities of experimental group gymnasts, a positive impact on the preparation of other events is demonstrated.

  13. ECG Changes in 8-Year-Old Boy with Pulmonary Edema after Head Injury

    Directory of Open Access Journals (Sweden)

    Bojko Bjelakovic

    2006-01-01

    Full Text Available This is a case story of an 8-year-old boy with no prior history of cardiac disease who developed acute pulmonary edema with ECG changes similar to transmural myocardial infarction after basilar skull fracture. Biochemical evaluation showed elevated total creatine kinase activity –1,350 U/L with 12% MB isoenzyme fraction. The brain scan on admission showed cerebral edema with ethmoidal sinuses hemorrhage. Neurogenic pulmonary edema following CNS damage is an extremely rare entity in the pediatric population and there are few reports. There are many proposed mechanisms and explanations of its origin. Based on previous reports and experimental studies, the cause of “neurogenic” pulmonary edema may be of cardiac as well as of noncardiac origin.

  14. Inter-relationships among physical activity, body fat, and motor performance in 6- to 8-year-old Danish children

    DEFF Research Database (Denmark)

    Morrison, Kyle M; Bugge, Anna; El-Naaman, Bianca

    2012-01-01

    This study examined the interrelationships among physical activity (PA), percent body fat (%BF), and motor performance (MP) in 498 6- to 8-year-old Danish children. PA was assessed by accelerometer, %BF was calculated from skinfolds, and the Koordinations Test für Kinder along with a throwing...

  15. Inter-relationships among physical activity, body fat, and motor performance in 6- to 8-year-old Danish children

    DEFF Research Database (Denmark)

    Morrison, Kyle M; Bugge, Anna; El-Naaman, Bianca

    2012-01-01

    This study examined the interrelationships among physical activity (PA), percent body fat (%BF), and motor performance (MP) in 498 6- to 8-year-old Danish children. PA was assessed by accelerometer, %BF was calculated from skinfolds, and the Koordinations Test für Kinder along with a throwing...

  16. Obstetric anal sphincter injury, risk factors and method of delivery - an 8-year analysis across two tertiary referral centers.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2013-10-01

    Obstetric anal sphincter injury (OASIS) represents a major cause of maternal morbidity and is a risk factor for the development of fecal incontinence. We set out to analyze the incidence of OASIS and its association with mode of delivery in two large obstetric hospitals across an 8-year study period.

  17. National Survey on Drug Use and Health: 8-Year R-DAS (NSDUH-2002-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file includes data from the 2002 through 2009 National Survey on Drug Use and Health (NSDUH) survey. The only variables included in the 8-year 2002-2009 data...

  18. Impact of Social Capital on 8-year Mortality Among Older People in 34 Danish Municipalities

    DEFF Research Database (Denmark)

    Poulsen, Tine; Siersma, Volkert Dirk; Christensen, Ulla;

    2012-01-01

    To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline.......To analyze the impact of social capital measures (bonding, bridging, and linking) on all-cause mortality at 8-year follow-up among older people aged 75 and 80 at baseline....

  19. Corneal stromal dystrophies: a clinical pathologic study

    Directory of Open Access Journals (Sweden)

    Elvira Barbosa Abreu

    2012-12-01

    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  20. Lateral shelf acetabuloplasty for severe Legg–Calvé–Perthes disease in patients older than 8 years

    Science.gov (United States)

    Li, Wen-Chao; Xu, Rui-Jiang

    2016-01-01

    Abstract The natural history of Legg–Calvé–Perthes disease (LCPD) in children older than 8 years is usually poor without treatment. The treatment goal is to prevent deformity and incongruity of the hip by achieving a stable spherical femoral head in a deep, congruent, sharp-edged acetabulum, with a good range of hip movement at skeletal maturity. Lateral shelf acetabuloplasty in LCPD can increase the coverage of the femoral head, benefiting the remodeling of the femoral head and acetabulum. The aim of this study was to evaluate the efficacy of lateral shelf acetabuloplasty for severe LCPD in patients older than 8 years. We evaluated 51 patients with severe LCPD who underwent shelf acetabuloplasty between 1994 and 2005. Clinical and radiological examinations were evaluated preoperatively and over a mean follow-up of 132.35 months (range 102–183 months). According to the Catterall classification, the LCPD was classified as grade II in 11 (21.6%) patients, grade III in 15 (29.4%), and grade IV in 25 (49.0%). According to the Herring classification, there were 12 (23.5%) patients in grade B, 24 (47.1%) in grade B/C, and 15 (29.4%) in grade C. The mean ages at the onset of signs and at surgery were 103.39 months and 110.78 months, respectively. By the end of follow-up, all patients had a normal passive range of hip movement without pain. The mean Iowa hip score was improved from 69.5 ± 7.28 to 91.6 ± 5.14 (P hips were classified as grade 1, 19 (37.3%) hips as grade 2, 14 (27.5%) hips as grade 3, and 7 (13.7%) hips as grade 4. The CE angle, Sharp angle, medial joint space ratio, epiphysis height ratio, and percentage of acetabular coverage were significantly improved by shelf acetabuloplasty (P hip. Shelf acetabuloplasty can improve femoral head coverage and reduce subluxation of the hip, with a benefit to the biological remodeling of the femoral head within the acetabulum. PMID:27828848

  1. [Clinical studies on pramipexol retard].

    Science.gov (United States)

    Klivényi, Péter; Vécsei, László

    2010-05-30

    Pramipexol retard is the newest drug for the treatment of Parkinson's disease. The prolonged release of the agent in this preparation allows a more continuous dopaminergic stimulation than previous preparations, without reducing the agent's already known and proven clinical efficiency. In addition, it has a more favourable adverse effect profile than previous preparations, and patient compliance can also be better as it needs to be taken only once daily. These benefits have been proven in recent clinical studies, of which the most important ones are reviewed here.

  2. A study on adaptation of 8-year medical education program interns on whole course management%八年制临床医学专业学生全病程管理实习模式的适应性研究

    Institute of Scientific and Technical Information of China (English)

    颜勇卿; 王天兵; 周庆环; 石淑宵; 姜保国

    2010-01-01

    目的 探讨八年制临床医学专业学生对全病程管理实习模式的适应情况.方法 自2007年6月到2008年10月,北京大学人民医院2002级、2003级2个年级共有63名医学生在创伤骨科进行临床实习,参与了全病程管理,随机抽取其中29名学生进行问卷调查,并对21名学生的书面出科小结进行了统计和分析.结果 100.0%的被调查学生基本完成了全病程管理和病例报道,52.4%的学生能够真正做到全病程管理;与传统实习模式相比,62.1%的学生认为全病程管理对提高医患沟通能力有所帮助,69.0%的学生认为全病程管理能够提高医学论文写作能力,90.4%的学生认同全病程管理的理念,71.4%的学生认为全病程管理实施细节有待改进,47.6%的学生认为全病程管理带教教师的指导有待提高.结论 全病程管理实习模式具有可行性,针对其实践过程中的问题需要进一步加以完善.%Objective To explore the degree of adaptation and the problems occurred to the 8-year medical education program interns on whole course management, as well as the solving strategies for the problems. Methods 29 interns were collected randomly in 63 8-year medical education program interns on whole course management in questionnaire survey as well as analysis of personal understanding of 21 interns about whole course management. Results 100. 0% of the investigated interns could basically finish whole course management,52.4% of the interns could really achieve the meaning of whole course management.Compared with traditional internship model, 62. 1% of the investigated interns considered whole course management could improve their communication with patients. 69.0% of the interns considered the whole course management improved their medical thesis writing skills. 90.4% of the interns agreed with the idea of whole course management, while 71.4% of the interns believed that the detailed implementation in practice should be improved

  3. Neurological aspects of HTLV-1 infection in Bahia: results from an 8-year cohort

    Directory of Open Access Journals (Sweden)

    Davi Tanajura

    2015-01-01

    Full Text Available HTLV-1 is the causal agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP, a disease observed in up to 5% of individuals infected with HTLV-1. However, infected individuals without the disease can present neurological complaints relating to sensory, motor or urinary manifestations. The aim of this study was to investigate the incidence of neurological manifestations among patients with HTLV-1. Method HTLV-1 patients in Salvador, Bahia, Brazil, were enrolled into a cohort study. Results Among 414 subjects, 76 had definite and 87 had possible or probable HAM/TSP at the baseline, whereas 251 subjects had no neurological signs or symptoms. Definite HAM/TSP developed in 5 patients (1.74%. The asymptomatic subjects were selected for analysis. The incidence rate expressed per 1,000 persons-year was calculated. It was 206 for hand numbness, 129 for nocturia and 126 for urinary urgency. In the neurological examination, leg hyperreflexia presented an average incidence rate of 76; leg paraparesis, 52; and Babinski sign, 36. Kaplan-Meyer curves categorized according to gender and proviral load showed that females and patients with proviral load of more than 100,000 copies per 106 peripheral blood mononuclear cells (PBMCs presented higher risk. Conclusion Development of neurological symptoms or signs occurred in up to 30% of asymptomatic subjects during 8 years of follow-up. Female gender and high proviral load were risk factors for neurological disease.

  4. Structural and functional reorganization of the corpus callosum between the age of 6 and 8 years.

    Science.gov (United States)

    Westerhausen, René; Luders, Eileen; Specht, Karsten; Ofte, Sonja H; Toga, Arthur W; Thompson, Paul M; Helland, Turid; Hugdahl, Kenneth

    2011-05-01

    The establishment of an efficient exchange of information between the cerebral hemispheres is of crucial importance in the developing functionally lateralized brain. The corpus callosum, the major connection between the cerebral hemispheres, grows constantly throughout childhood and adolescence. However, behavioral studies suggest the existence of a critical time period for callosal functional development starting around the age of 6 years. In the present longitudinal study, examining a cohort of 20 children at the age of 6 and 8 years, we assessed the relationship between structural and functional callosal development during this time period. The structural development was quantified by calculating the increase in callosal thickness using a shape-based computational analysis of the mid-sagittal corpus callosum as obtained with magnetic resonance imaging. The functional development was assessed with a speech discrimination task based on the dichotic presentation of consonant-vowel syllables. The statistical analysis revealed that children whose callosal isthmus increased in thickness over the course of 2 years showed a decrease in interhemispheric information transfer. However, children exhibiting a decrease in isthmus thickness revealed an increase in information transfer. These results might indicate a refinement process of the callosal connections to optimize the neuronal communication between the developing cerebral hemispheres.

  5. Estudio sobre la prevención quimioterapéutica de la caries dental con barnices de clorhexidina y timol, en niños de 5-8 años de edad, con riesgo alto de caries.: Un reporte preliminar Study on the chemotherapeutic prevention of the caries with chlorhexidine/thymol varnish in children of 5-8 years old, with high caries risk.: A preliminary report

    Directory of Open Access Journals (Sweden)

    María C García-Santos

    2004-02-01

    Full Text Available Objetivos: el propósito de este estudio fue evaluar la posibilidad de reducir la caries de fisura en las caras oclusales de los primeros molares permanentes, a través de barnices antimicrobianos, en escolares con alta incidencia de caries. Se ha realizado un ensayo clínico aleatorio a doble ciego. Sujetos: 35 niños saludables con edades comprendidas entre los 6 y 8 años, con alto riesgo de caries, fueron seleccionados en un colegio de Madrid. Par ser incluidos en el estudio cada niño debería tener como mínimo dos primeros molares permanentes sanos, y presentar caries en dentina en sus molares temporales. Métodos: después de la profilaxis dental, el grupo de estudio se le aplicaba un barniz de clorhexidina 1% y timol 1% (Cervitec, y al grupo control un barniz de placebo. El barniz era colocado sobre todos los dientes (dentición temporal y permanente cada tres meses (al inicio a los 3,6 y 9 meses y el incremento de caries era comparado a los 12 meses. Resultados: al inicio del estudio no habían diferencias entre los grupos. Al año existía una diferencia significativa entre el grupo de estudio y el de control, en CAO-D P=0,001, CAO-S P=0,000 (en los primeros molares permanentes . Conclusión: la aplicación de Cervitec cada 3 meses, es efectiva previniendo la caries en los primeros molares permanentes de escolares con alta actividad de caries.Objective: the purpose of this study, was to evaluate the possibility of reducing occlusal fissures caries development, in permanent first molars, using an antimicrobial varnish, in schoolchildren with high caries activity. Randomised, a double-blind clinical trial was developed. Subjects: 35 healthy children aged 6-8 years with high caries risk, were selected from a schools in Madrid. To be included in the study, each child had to have least 2 sound permanent molars and primary molars with carious lesions in dentin. Methods: after prophylaxis, test groups received 1% chlorhexidine and 1% thymol

  6. Benefit of the Vibrant Soundbridge device in patients implanted for 5 to 8 years.

    Science.gov (United States)

    Mosnier, Isabelle; Sterkers, Olivier; Bouccara, Didier; Labassi, Samia; Bebear, Jean-Pierre; Bordure, Philippe; Dubreuil, Christian; Dumon, Thibaud; Frachet, Bruno; Fraysse, Bernard; Lavieille, Jean-Pierre; Magnan, Jacques; Martin, Christian; Meyer, Bernard; Mondain, Michel; Portmann, Didier; Robier, Alain; Schmerber, Sébastien; Thomassin, Jean-Marc; Truy, Eric; Uziel, Alain; Vanecloo, François-Michel; Vincent, Christophe; Ferrary, Evelyne

    2008-04-01

    To assess audiological performance, satisfaction rate, and side effects of 100 patients who have been using the middle ear implant Vibrant Soundbridge (VSB) for 5 to 8 yr when compared with data collected from 3 to 18 mo postsurgery. Audiological testing and subjective evaluation using self-assessment scales were performed in 77 out of the 100 patients using the VSB for 5 to 8 years. The results were compared to data collected 3 months (audiological testing) and 18 months (self-assessment scales) after surgery. Twenty-three patients have not been evaluated for different reported reasons. Pure-tone hearing thresholds decreased similarly in both implanted and contralateral ears. The satisfaction ratings and the functional gain provided by the VSB remained stable. Speech comprehension in quiet conditions without the VSB decreased from 56 to 37% in 5 to 8 yr, but an 81% score was achieved with the VSB. This study demonstrates that the performance of the VSB does not deteriorate for more than 5 yr, without adverse effect. These results confirm the safety and the effectiveness of the VSB with a long-term follow-up.

  7. Qualitative Analysis of Dietary Behaviors in Picture Book Fiction for 4- to 8-Year-Olds.

    Science.gov (United States)

    Matvienko, Oksana

    2016-10-01

    Picture books may facilitate parents' efforts to decrease pickiness and other undesirable food habits in children. This study conducted a content analysis of dietary behaviors and feeding strategies featured in fictional picture books compared with those discussed in the research literature. Several databases were searched for fictional picture books about dietary behavior, published between 2000 and 2016, accessible in the US, available in print format, and designated for 4- to 8-year-olds. Messages about dietary behavior in picture book fiction. Stories were systematically coded using holistic, data-driven, and evaluation coding methods. The final set of codes was examined for themes and patterns. Of the 104 books, 50% featured a specific eating behavior, 21% lifestyle/eating patterns, 20% food-related sensations and emotions, and 9% table manners. Books about dietary behaviors are abundant but the topic coverage is unbalanced. Problem behaviors portrayed in books overlap those discussed in the research literature. However, problem-solving strategies and actions do not align with those endorsed by nutrition professionals. Messages vary in their complexity (in terms of their plot and/or language), ranging from clear and direct to vague, sophisticated, unresolved, conflicting, or controversial. Recommendations for practitioners are discussed. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  8. Cycling peak power in obese and lean 6- to 8-year-old girls and boys.

    Science.gov (United States)

    Aucouturier, Julien; Lazaar, Nordine; Doré, Eric; Meyer, Martine; Ratel, Sebastien; Duché, Pascale

    2007-06-01

    The purpose of this study was to investigate the possible effect of the difference in percentage body fat (%BF) and fat-free mass (FFM) on cycling peak power (CPP) in 6- to 8-year-old obese and lean untrained girls and boys. Obese (35 girls, 35 boys) and lean (35 girls, 35 boys) children were measured for obesity, %BF, calculated from skinfold measurements. FFM was calculated as body mass (BM) minus body fat. A force-velocity test on a cycle ergometer was used to measure CPP. CPP was related to anthropometric variables using standard and allometric models. CPP in absolute terms was higher in obese children than in lean children irrespective of gender. BM-related CPP was significantly lower in obese children than in lean ones, whereas no effect of obesity appeared on FFM-related CPP. Velocity at CPP (Vopt) was significantly lower and force at CPP (Fopt) was significantly higher in girls than in boys. Muscle power production was unaffected by obesity in children. Low BM-related CPP could explain the difficulty of taking up physical activities that are body-mass related in obese children. Gender difference for Vopt and Fopt shows that girls and boys may have different maturation patterns affecting CPP.

  9. Dissociating Rehearsal and Refreshing in the Maintenance of Verbal Information in 8-Year-Old Children

    Directory of Open Access Journals (Sweden)

    Gérome eMora

    2015-01-01

    Full Text Available Recent models of working memory suggest that two systems are involved in verbal working memory: one is dedicated to the maintenance of phonological representations through verbal rehearsal, while the other would maintain multimodal representations through attentional refreshing (Baddeley, 2012; Camos et al., 2009. Previous studies provided evidence on the existence of these two maintenance systems, on their independence, and how they affect recall performance in adults. However, only one study had already explored the relationships between these two systems in children (Tam et al., 2010. The aim of the present study was to further examine how the two systems account for working memory performance in children. Eight-year-old children performed complex span tasks in which the availability of either the rehearsal or the refreshing was impeded by a concurrent articulation or an attention-demanding task, respectively. Moreover, the phonological similarity of the memoranda was manipulated. Congruently with studies showing that older children can used these maintenance systems, impeding any of the two systems reduced recall performance. Moreover, the manipulation of the two mechanisms did not interact, as previously observed in adults. This suggests that the two maintenance mechanisms are independent in 8-year-old children as they are in adults. However, the results concerning the phonological similarity effect differed from what is observed in adults. Whereas the phonological similarity effect relies only on the availability of rehearsal in adults, a more complex pattern appeared in children: the concurrent articulation as well as the concurrent task modulated the emergence of the phonological similarity effect.

  10. CLINICAL STUDY OF ACUTE POISONING

    Directory of Open Access Journals (Sweden)

    Panduranga

    2014-09-01

    Full Text Available BACKGROUND AND OBJECTIVE: Acute poisoning is an important medical emergency. Studies of this nature will be useful tool in planning, early diagnosis and management of acute poisoning cases. The objective of the study are to study the clinical features, diagnosis and management, morbidity and mortality of various acute poisoning. METHODOLOGY: This study comprises of 350 patients of acute poisoning admitted to Chigateri General Hospital and Bapuji Hospital attached to J. J. M. Medical College, Davangere, between 1st March 2011 to 31st October 2011. REUSLTS: Out of 350 cases of acute poisoning studied, there were 268 males and 82 females. Males comprised 76.57%and females 23.42% of the total, in this series, Organophosphorous compounds were the commonest (30%, majority of the patients hailed from rural area 70%. Mortality is 10.57%.

  11. CLINICAL STUDY OF ECTOPIC PREGNANCY

    Directory of Open Access Journals (Sweden)

    Swami

    2015-10-01

    Full Text Available An ectopic pregnancy is one in which fertilized ovum is implanted at the site other than normal uterine cavity.[1] Incidence of ectopic pregnancy is 1:160 deliveries.[2] Clinical presentation is variable from acute to chronic type. Due to its varied clinical presentation ectopic pregnancy poses great diagnostic difficulty both to obstetrician, physician and surgeons.[3] OBJECTIVE: To find out incidence in our study population and to evaluate symptomatically and clinical presentation in these patients. MATERIALS AND METHODS: Retrospective study of 34 ectopic pregnancies admitted and treated in Medical College hospital, Ujjain from 2010 to 2015 are included in the study. RESULTS: The incidence of ectopic pregnancy is more between the age group of 21-30years (73.52% and in Multigravida 64.71%. Infertility and previous tubal surgery are the high risk factors for tubal pregnancy. Pain in abdomen was present in all 34 cases, amenorrhea in 97.05% and bleeding per vagina in 76.47% cases. Syncopal attacks, vomiting were detected in 14.70% cases. Acute ectopic pregnancy was detected in 14.71% and chronic in 85.29% cases. 82.35% cases presented with adnexal mass, 79.41% with cervical motion tenderness, 50% with pallor, 32.35% with abdominal lump and tenderness and 11.76% with fullness in POD. CONCLUSION: Ectopic pregnancy is leading cause of maternal mortality in first trimester. In spite of advanced diagnostic techniques. It poses great diagnostic difficulties due to varied signs and symptoms. Previous tubal surgery pelvic inflammatory disease and infertility are the risk factors of tubal pregnancy.

  12. Perinatal risk factors for wheezing phenotypes in the first 8 years of life

    NARCIS (Netherlands)

    Caudri, D.; Savenije, O. E. M.; Smit, H. A.; Postma, D. S.; Koppelman, G. H.; Wijga, A. H.; Kerkhof, M.; Gehring, U.; Hoekstra, M. O.; Brunekreef, B.; de Jongste, J. C.

    2013-01-01

    Background A novel data-driven approach was used to identify wheezing phenotypes in pre-schoolchildren aged 0-8 years, in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort. Five phenotypes were identified: never/infrequent wheeze, transient early wheeze, intermediate onset

  13. An 8-year experience with routine SL mix patch testing supplemented with Compositae mix in Denmark

    DEFF Research Database (Denmark)

    Paulsen, E; Andersen, Klaus Ejner; Hausen, B M

    2001-01-01

    Routine patch testing with sesquiterpene lactone (SL) mix, supplemented with Compositae mix (CM) and other Compositae extracts and allergens where appropriate, was evaluated over an 8-year period. 190 of 4386 patients tested (4.3%) were Compositae-sensitive, 143 females (mean age 51.5 years) and ...

  14. An 8-year-old boy with a Pott's puffy tumor

    NARCIS (Netherlands)

    Huijssoon, E; Woerdeman, PA; van Diemen-Steenvoorde, RAAM; Hanlo, PW; Plotz, FB

    2003-01-01

    An 8-year old boy with a history of trauma, sinusitis and a swelling of the frontal. bone with somnolence was diagnosed with a Pott's puffy tumor (PPT). Minimal invasive surgical intervention was performed together with a strict regimen of antibiotic therapy. In this case debridement of the frontal

  15. Perinatal risk factors for wheezing phenotypes in the first 8 years of life

    NARCIS (Netherlands)

    Caudri, D.; Savenije, O. E. M.; Smit, H. A.; Postma, D. S.; Koppelman, G. H.; Wijga, A. H.; Kerkhof, M.; Gehring, U.; Hoekstra, M. O.; Brunekreef, B.; de Jongste, J. C.

    2013-01-01

    Background A novel data-driven approach was used to identify wheezing phenotypes in pre-schoolchildren aged 0-8 years, in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort. Five phenotypes were identified: never/infrequent wheeze, transient early wheeze, intermediate onset

  16. Analyzing the Responses of 7-8 Year Olds When Solving Partitioning Problems

    Science.gov (United States)

    Badillo, Edelmira; Font, Vicenç; Edo, Mequè

    2015-01-01

    We analyze the mathematical solutions of 7- to 8-year-old pupils while individually solving an arithmetic problem. The analysis was based on the "configuration of objects," an instrument derived from the onto-semiotic approach to mathematical knowledge. Results are illustrated through a number of cases. From the analysis of mathematical…

  17. An 8-year-old boy with a Pott's puffy tumor

    NARCIS (Netherlands)

    Huijssoon, E; Woerdeman, PA; van Diemen-Steenvoorde, RAAM; Hanlo, PW; Plotz, FB

    2003-01-01

    An 8-year old boy with a history of trauma, sinusitis and a swelling of the frontal. bone with somnolence was diagnosed with a Pott's puffy tumor (PPT). Minimal invasive surgical intervention was performed together with a strict regimen of antibiotic therapy. In this case debridement of the frontal

  18. A bulldog clamp that was forgotten during a coronary artery bypass operation 8 years ago.

    Science.gov (United States)

    Celkan, Mehmet Adnan; Bayatli, Kivanc

    2012-10-01

    Prevention of retained foreign bodies in the pericardial cavity is critical for patient safety. We report a patient with a bulldog clamp that was forgotten during a coronary artery bypass operation 8 years ago, which was detected by chance and removed.

  19. Analysis of the seismicity in the region of Mirovo salt mine after 8 years monitoring

    Science.gov (United States)

    Dimitrova, Liliya; Solakov, Dimcho; Simeonova, Stela; Aleksandrova, Irena; Georgieva, Gergana

    2015-04-01

    Mirovo salt deposit is situated in the NE part of Bulgaria and 5 kilometers away from the town of Provadiya. The mine is in operation since 1956. The salt is produced by dilution and extraction of the brine to the surface. A system of chambers-pillars is formed within the salt body as a result of the applied technology. The mine is situated in a seismically quiet part of the state. The region is characterized with complex geological structure and several faults. During the last 3 decades a large number of small and moderate earthquakes (MVPN and MAN networks of the Bulgarian Telecommunication Company. Common processing and interpretation of the data from LSN and the national seismic network is performed. Real-time and interactive data processing are performed by the Seismic Network Data Processor (SNDP) software package. More than 700 earthquakes are registered by the LSN within 30km region around the mine during the 8 years monitoring. First we processed the data and compile a catalogue of the earthquakes occur within the studied region (30km around the salt mine). Spatial pattern of seismicity is analyzed. A large number of the seismic events occurred within the northern and north-western part of the salt body. Several earthquakes occurred in close vicinity of the mine. Concerning that the earthquakes could be tectonic and/or induced an attempt is made to find criteria to distinguish natural from induced seismicity. To characterize and distinguish the main processes active in the area we also made waveform and spectral analysis of a number of earthquakes.

  20. Persistent longitudinal variations in 8 years of CIPS/AIM polar mesospheric clouds

    Science.gov (United States)

    Liu, Xiao; Yue, Jia; Xu, Jiyao; Yuan, Wei; Russell, James M.; Hervig, M. E.; Nakamura, Takuji

    2016-07-01

    The Cloud Imaging and Particle Size (CIPS) instrument on the Aeronomy of Ice in the Mesosphere (AIM) satellite provides an opportunity to study the longitudinal variation in polar mesospheric cloud (PMC). We examined the longitudinal variation in PMC albedo using 8 years (2007-2014) of observations from the CIPS instrument. The results show that the PMC albedo in the Southern Hemisphere (SH), especially in the latitude band of 80°S-85°S, is persistently low ( 65% relative to the rest of the hemisphere) within 60°W to 150°W longitude. In the Northern Hemisphere (NH), however, PMC albedo is found to be relatively zonally asymmetry. Harmonic analyses show that the persistent longitudinal variation in the SH PMC albedo is due to zonal wave numbers 1 through 4 (WN1-WN4) processes with minima in the longitude range of 60°W-150°W. The influence of temperature and H2O on the longitudinal variation of the PMC albedo is discussed based on results obtained using a simple 0-D PMC model and temperature from the Microwave Limb Sounder (MLS) and the Sounding of the Atmosphere with Broadband Emission Radiometry (SABER) and H2O from MLS. The modeled region of low ice mass in the SH is generally consistent with that of low PMC albedo seen in CIPS. Tidal analyses using the SABER temperatures indicate that the nonmigrating semidiurnal tides with modes of S0, W1, and E1 might be the main drivers of the persistent longitudinal variations of PMC albedo in the SH. Nonmigrating tides are much weaker in the NH and consistent with the observed lack of longitudinal variability in PMC albedo.

  1. Magnesium metabolism in 4-year-old to 8-year-old children.

    Science.gov (United States)

    Abrams, Steven A; Chen, Zhensheng; Hawthorne, Keli M

    2014-01-01

    Magnesium (Mg) is a key factor in bone health, but few studies have evaluated Mg intake or absorption and their relationship with bone mineral content (BMC) or bone mineral density (BMD) in children. We measured Mg intake, absorption, and urinary excretion in a group of children 4 to 8 years of age. Mg absorption was determined using a dual-tracer stable isotope technique, with (25) Mg given intravenously and (26) Mg given orally. We found a small, but significantly greater Mg absorption efficiency (percentage absorption) in males than females (67% ± 12% versus 60% ± 8%, p = 0.02) but no difference in estimated net Mg retention (average of 37 mg/d in both males and females). Relating dietary Mg intake to estimated Mg retention showed that an intake of 133 mg/d, slightly above the current estimated average requirement (EAR) of 110 mg/d, led to a net average retention of 10 mg/d, the likely minimum growth-related need for this age group. Covariate analysis showed that Mg intake and total Mg absorption, but not calcium intake or total absorption were significantly associated with both total body BMC and BMD. These results suggest that usual Mg intakes in small children in the United States meet dietary requirements in most but not all children. Within the usual range of children's diets in the United States, dietary Mg intake and absorption may be important, relatively unrecognized factors in bone health.

  2. Pharmacological Therapy for Myocardial Infarction in the Elderly: An 8-year Analysis

    Directory of Open Access Journals (Sweden)

    Márcia Regina Pinho Makdisse

    2002-04-01

    Full Text Available OBJECTIVE:To assess the changes in the medicamentous treatment of elderly patients hospitalized with acute myocardial infarction occurring over an 8-year period. METHODS:We retrospectively analyzed 379 patients above the age of 65 years with acute myocardial infarction who were admitted to the coronary unit of a university-affiliated hospital from 1990 to 1997. The patients were divided into 2 groups, according to the period of time of hospital admission as follows: group 1 - from 1990 to 1993; and group 2 - from 1994 to 1997. RESULTS:The use of beta-blockers (40.8%chi 75.2%, p<0.0001 and angiotensin-converting enzyme inhibitors (42% chi59.5%, p=0.001 was significantly greater in group 2, while the use of calcium antagonists (42% chi 18.5%, p<0.0001 and general antiarrhythmic drugs (19.1% chi 10.8%, p=0.03 was significantly lower. No significant difference was observed in regard to the use of acetylsalicylic acid, thrombolytic agents, nitrate, and digitalis in the period studied. The length of hospitalization was shorter in group 2 (13.4±8.9 days chi 10.5±7.5 days, p<0.001. The in-hospital mortality was 35.7% in group 1 and 26.6% in group 2 (p=0.07. CONCLUSION: Significant changes were observed in the treatment of elderly patients with acute myocardial infarction, with a greater use of beta-blockers and angiotensin-converting enzyme inhibitors and a lower use of calcium antagonists and antiarrhythmic drugs in group 2. The length of hospitalization and the mortality rate were also lower in group 2, even though the reduction in mortality was not statistically significant.

  3. CLINICAL STUDY ON ACUTE PANCREATITIS

    Directory of Open Access Journals (Sweden)

    Suhaib Rehaman

    2015-07-01

    Full Text Available INTRODUCTION : Early diagnosis and severity evaluation on patients with acute pancreatitis are very important due to its potential morbidity and mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualized. Sev eral clinical, laboratory and radiologic factors and many scoring systems have been proposed for outcome prediction. AIMS AND OBJECTIVES: To study the symptomatology, clinical presentation and management in pancreatitis . To study the severity of acute panc reatitis according to Glasgow Scale . METHODS: Present study includes consecutive 38 patients hospitalized in CSI Holdsworth Memorial Hospital over the period of 2 years. All patients were thoroughly investigated and were stratified according to the Glasgow criteria. Data was collected on complications, investigations and interventions undertaken, outcome, duration of stay in hospital and ICU. STATISTICAL ANALYSIS USED: Descriptive, Chi square tests, Crosstabs (Contingency coefficient analysis . RESULTS : Mean age of presentation in our study was 43.1 years. There was a male predominance accounting for 68.4% compared to 31.6% females. Alcohol was the main etiological factor in about 50% of the patients. Sensitivity to S. amylase was about 100%. Accuracy of USG abdomen in diagnosing pancreatitis was about 88.5%. Ascitis was the commonest complication seen in 13.2%. Mean duration of hospital stay was 6.2 days. The patient were stratified according to Glasgow scoring system into mild (0 - 3 and severe (>3 panc reatitis. In our study 32 people were graded with mild pancreatitis, all improved and in 6 people who were graded with severe pancreatitis, 83.3 % improved and 2.6% expired because of complications. Test statistics showed Contingency coefficient 0.355 and P 0.019 (NS. CONCLUSION : Glasgow scoring system remains a valid predicting system for the outcome in patients with acute pancreatitis. It is simple easy to apply with

  4. Crowding in central vision in normally sighted and visually impaired [corrected] children aged 4 to 8 years: the influence of age and test design.

    NARCIS (Netherlands)

    Huurneman, B.; Boonstra, F.N.; Cillessen, A.H.; Rens, G. van; Cox, R.F.

    2012-01-01

    BACKGROUND/AIMS: To investigate crowding ratios in children with a visual impairment due to ocular disease (n = 58) and normally sighted children (n = 75) aged 4 to 8 years using several variants of two clinically available tests with different optotype spacing (fixed or proportional to the optotype

  5. Crowding in Central Vision in Normally Sighted and Visually Impared Children Aged 4 to 8 Years: The Influence of Age and Test Design

    NARCIS (Netherlands)

    Huurneman, B.; Boonstra, F.N.; Cillessen, A.H.N.; Cox, R.F.A.; Rens, G.H.M.B. van

    2012-01-01

    Background/aims: To investigate crowding ratios in children with a visual impairment due to ocular disease (n = 58) and normally sighted children (n = 75) aged 4 to 8 years using several variants of two clinically available tests with different optotype spacing (fixed or proportional to the optotype

  6. Clinical trial participants' experiences of completing questionnaires: a qualitative study.

    Science.gov (United States)

    Holmberg, Christine; Karner, Julia J; Rappenecker, Julia; Witt, Claudia M

    2014-03-24

    To improve clinical study developments for elderly populations, we aim to understand how they transfer their experiences into validated, standardised self-completed study measurement instruments. We analysed how women (mean 78±8 years of age) participating in a randomised controlled trial (RCT) cognised study instruments used to evaluate outcomes of the intervention. The interview study was nested in an RCT on chronic neck pain using common measurement instruments situated in an elderly community in Berlin, Germany, which comprised of units for independent and assisted-living options. The sample (n=20 women) was selected from the RCT sample (n=117, 95% women, mean age 76 (SD±8) years). Interview participants were selected using a purposive sampling list based on the RCT outcomes. We asked participants about their experiences completing the RCT questionnaires. Interviews were analysed thematically, then compared with the questionnaires. Interviewees had difficulties in translating complex experiences into a single value on a scale and understanding the relationship of the questionnaires to study aims. Interviewees considered important for the trial that their actual experiences were understood by trial organisers. This information was not transferrable by means of the questionnaires. To rectify these difficulties, interviewees used strategies such as adding notes, adding response categories or skipping an item. Elderly interview participants understood the importance of completing questionnaires for trial success. This led to strategies of completing the questionnaires that resulted in 'missing' or ambiguous data. To improve data collection in elderly populations, educational materials addressing the differential logics should be developed and tested. Pilot testing validated instruments using cognitive interviews may be particularly important in such populations. Finally, when the target of an intervention is a subjective experience, it seems important to create a

  7. Efficacy and Safety of Drug-Eluting Stents in the Real World: 8-Year Follow-Up

    Energy Technology Data Exchange (ETDEWEB)

    Pellegrini, Denise Oliveira, E-mail: dennizmo@yahoo.com.br; Gomes, Vitor Osório; Lasevitch, Ricardo; Smidt, Luis; Azeredo, Marco Aurélio; Ledur, Priscila; Bodanese, Rodrigo; Sinnott, Leonardo; Moriguchi, Emílio; Caramori, Paulo [Hospital São Lucas PUC, Porto Alegre, RS (Brazil)

    2014-09-15

    Drug-eluting stents have been used in daily practice since 2002, with the clear advantages of reducing the risk of target vessel revascularization and an impressive reduction in restenosis rate by 50%-70%. However, the occurrence of a late thrombosis can compromise long-term results, particularly if the risks of this event were sustained. In this context, a registry of clinical cases gains special value. To evaluate the efficacy and safety of drug-eluting stents in the real world. We report on the clinical findings and 8-year follow-up parameters of all patients that underwent percutaneous coronary intervention with a drug-eluting stent from January 2002 to April 2007. Drug-eluting stents were used in accordance with the clinical and interventional cardiologist decision and availability of the stent. A total of 611 patients were included, and clinical follow-up of up to 8 years was obtained for 96.2% of the patients. Total mortality was 8.7% and nonfatal infarctions occurred in 4.3% of the cases. Target vessel revascularization occurred in 12.4% of the cases, and target lesion revascularization occurred in 8% of the cases. The rate of stent thrombosis was 2.1%. There were no new episodes of stent thrombosis after the fifth year of follow-up. Comparative subanalysis showed no outcome differences between the different types of stents used, including Cypher®, Taxus®, and Endeavor®. These findings indicate that drug-eluting stents remain safe and effective at very long-term follow-up. Patients in the 'real world' may benefit from drug-eluting stenting with excellent, long-term results.

  8. Empyema thoracis: A clinical study

    Directory of Open Access Journals (Sweden)

    Acharya Preetam

    2007-01-01

    Full Text Available Background: Empyema thoracis is a disease that, despite centuries of study, still causes significant morbidity and mortality. Aim: The present study was undertaken to study the age-sex profile, symptomatology, microbiologic findings, etiology and the management and treatment outcome in a tertiary care hospital. Settings and Design: A prospective study of empyema thoracis was conducted on 40 consecutive patients with empyema thoracis admitted to the tuberculosis and chest diseases ward of a teaching hospital. Materials and Methods: The demographic data, clinical presentation, microbiological findings, etiology, the clinical course and management were recorded as per a planned pro forma and analyzed. Results: The peak age was in the range of 21-40 years, the male-to-female ratio was 3.4:1.0 and the left pleura was more commonly affected than the right pleura. Risk factors include pulmonary tuberculosis, chronic obstructive pulmonary diseases, smoking, diabetes mellitus and pneumonia. Etiology of empyema was tubercular in 65% cases and nontubercular in 35% cases. Gram-negative organisms were cultured in 11 cases (27.5%. Two patients received antibiotics with repeated thoracentesis only, intercostal chest tube drainage was required in 38 cases (95% and more aggressive surgery was performed on 2 patients. The average duration for which the chest tube was kept in the complete expansion cases was 22.3 days. Conclusion: It was concluded that all cases of simple empyema with thin pus and only those cases of simple empyema with thick pus where size of empyema is small should be managed by aspiration/s. Cases failed by the above method, all cases of simple empyema with thick pus and with moderate to large size of empyema and all cases of empyema with bronchopleural fistula should be managed by intercostal drainage tube connected to water seal. It was also observed that all cases of empyema complicated by bronchopleural fistula were difficult to manage and

  9. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Health Information Center Health Professionals Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development ...

  10. CLINICAL STUDY OF ANORECTAL MALFORMATIONS

    Directory of Open Access Journals (Sweden)

    Umesh

    2015-01-01

    Full Text Available BACKGROUND: A norectal malformations are relatively encountered anomalies. Presentations may vary from mild to severe and bowel control is t he main concern. AIM: To study the modes of presentation , types of anomalies , associated anomalies , reliability of clinical signs and radiological investigations in the diagnosis and the prognosis and continence in the post - operative in relation to type of anomaly and associated anomaly (s. MATERIAL AND METHODS: 50 cases of anorectal malformations admit ted to Department of Paediatric Surgery , in Medical Coll ege and Research Institute , were included in the study. Data related to the objectives of the study were collected. RESULTS: Commonest mode of presentation was failure to pass meconium 50%. 59% of mal es had high anomalies , while 53% females had intermediate anomalies. The diagnosis of low anomaly was made clinically , while high and intermediate anomalies needed further investigations. Associated anomalies were noted in 46.6% of the cases. 71.42% of the se patients had either a high or intermediate ARM. All patients with high anomalies underwent a 3 stage procedure , while low anomalies underwent a single stage procedure followed by anal dilatations. Rectal mucosal prolapse (2 cases , wound infection (4 ca ses , stenosis (3 cases , retraction of neo anus (1 case was seen. All the patients with low anomalies had a good functional result post operatively , while 57% and 28% of patients with intermediate and high anomalies had good results. CONCLUSION : Anorectal malformations are common congenital anomalies. Males are more commonly affected (1.3:1. Low anomalies are the commonest lesions noted in both the sexes (36.67%. High anomalies are more frequent in males. Invertogram offer an accurate diagnosis for planning management in patients with anorectal malformations. Low anomalies have a better outcome following surgery. For intermediate and high anomalies a staged repair offers better results

  11. A clinical study of vitiligo

    Directory of Open Access Journals (Sweden)

    Martis Jacintha

    2002-01-01

    Full Text Available A clinical study of one hundred patients having vitiligo revealed the incidence among new patients to be 1.84%. The male/female ratio was 1:1.22. Family history of vitiligo was available in 8% of our patients. The different morphological pattern consisted of vitiligo vulgaris (39 cases, focal vitiligo (27 cases, acrofacial vitiligo (18 cases, lip - tip vitiligo (7 cases, lip vitiligo (5 cases, segmental vitiligo (3 cases and universal vitiligo (1 case. Associated diseases include atopic dermatitis (2 cases, Hansen s disease (2 cases, alopecia areata (1 case, halo naevus (1 case, chronic urticaria (1 case, lichen planus (1 case, diabetes mellitus (9 cases, hypertension (4 cases, hypothyroidism (2 cases, epilepsy (1 case and IHD (1 case.

  12. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ... the general public. Last Updated: August 3, 2015 Resources Educational Website - English / Spanish ... FEAR ACT OIG CONTACT US National Institutes of Health Department of Health and Human Services USA.gov

  13. Lateral shelf acetabuloplasty for severe Legg-Calvé-Perthes disease in patients older than 8 years: A mean eleven-year follow-up.

    Science.gov (United States)

    Li, Wen-Chao; Xu, Rui-Jiang

    2016-11-01

    The natural history of Legg-Calvé-Perthes disease (LCPD) in children older than 8 years is usually poor without treatment. The treatment goal is to prevent deformity and incongruity of the hip by achieving a stable spherical femoral head in a deep, congruent, sharp-edged acetabulum, with a good range of hip movement at skeletal maturity. Lateral shelf acetabuloplasty in LCPD can increase the coverage of the femoral head, benefiting the remodeling of the femoral head and acetabulum. The aim of this study was to evaluate the efficacy of lateral shelf acetabuloplasty for severe LCPD in patients older than 8 years.We evaluated 51 patients with severe LCPD who underwent shelf acetabuloplasty between 1994 and 2005. Clinical and radiological examinations were evaluated preoperatively and over a mean follow-up of 132.35 months (range 102-183 months). According to the Catterall classification, the LCPD was classified as grade II in 11 (21.6%) patients, grade III in 15 (29.4%), and grade IV in 25 (49.0%). According to the Herring classification, there were 12 (23.5%) patients in grade B, 24 (47.1%) in grade B/C, and 15 (29.4%) in grade C. The mean ages at the onset of signs and at surgery were 103.39 months and 110.78 months, respectively.By the end of follow-up, all patients had a normal passive range of hip movement without pain. The mean Iowa hip score was improved from 69.5 ± 7.28 to 91.6 ± 5.14 (P shelf acetabuloplasty (P shelf acetabuloplasty for severe LCPD in patients older than 8 years. The procedure yields a favorable clinical outcome and Stulberg outcome for the hip. Shelf acetabuloplasty can improve femoral head coverage and reduce subluxation of the hip, with a benefit to the biological remodeling of the femoral head within the acetabulum.

  14. ATOC/Pioneer Seamount cable after 8 years on the seafloor: Observations, environmental impact

    Science.gov (United States)

    Kogan, Irina; Paull, Charles K.; Kuhnz, Linda A.; Burton, Erica J.; von Thun, Susan; Gary Greene, H.; Barry, James P.

    2006-04-01

    A study was conducted on the impacts of the presence of the Acoustic Thermometry of Ocean Climate (ATOC)/Pioneer Seamount cable on the benthos from nearshore waters adjacent to its origin at Pillar Point Air Force Station in Half Moon Bay, California to its terminus 95 km along its length on Pioneer Seamount. The coaxial Type SD cable was installed, unburied on the seafloor in 1995. Thirteen sites along the cable route were surveyed using the Monterey Bay Aquarium Research Institute (MBARI) ROVs Ventana and Tiburon equipped with cable-tracking tools. Quantitative comparisons of biological communities and seafloor features between cable and control sites were performed at nine stations. Forty-two hours of video footage and 138 push cores were collected over 15.1 km of seafloor. Approximately 12.1 km of the cable was observed (13% of the cable route). This study documents the appearance and condition of the cable and the underlying seafloor, and the effects of the cable on biological communities along its route. Limited self-burial of the cable has occurred during the 8-year deployment, particularly over the continental shelf and upper slope. Cable strumming by nearshore wave action has incised rocky siltstone outcrops. Several observations of kinks and snags in the cable on the upper slope (˜240 m depth) suggest contact with trawling gear. Few changes in the abundance or distribution of benthic fauna were detectable from video observations (epifaunal) and sediment core samples (infauna). Of 17 megafaunal groups and 19 infaunal taxa, no tests evaluating the overall effect of the cable were statistically significant. While these results indicate that the biological impacts of the cable are minor at most, three megafaunal groups exhibited cable-related changes at one or more stations. Actiniarians (sea anemones) colonized the cable when it was exposed on the seafloor, and were therefore generally more abundant on the cable than in surrounding, sediment

  15. Concurrent spinal cord and vertebral bone marrow radionecrosis 8 years after therapeutic irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Warscotte, L.; Sindic, C.J.M. [Department of Neurology, Universite Catholique de Louvain (Belgium); Duprez, T.; Lecouvet, F.E. [Department of Radiology and Medical Imaging, Universite Catholique de Louvain, Brussels (Belgium); Lonneux, M. [Department of Nuclear Medicine, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels (Belgium); Michaux, L. [Department of Hematology, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels (Belgium); Renard, L. [Department of Radiation Oncology, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels (Belgium)

    2002-03-01

    Concurrent radionecrosis within the spinal cord and the bone marrow at the same thoracic level was observed 8 years after localized therapeutic irradiation in a patient who had undergone repeated cycles of radiotherapy, glucocorticoid treatment, and chemotherapy for a non-Hodgkin's lymphoma. Mechanisms combining radiotoxic potentialization by glucocorticoids/alkylating agents and delayed radiation-induced vasculitis involving the common arterial pathways to the spinal cord and to the vertebrae were speculated to have acted in a synergistic way. (orig.)

  16. MR imaging findings of eosinophilic cystitis in an 8-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Tamai, Ken; Togashi, Kaori [Graduate School of Medicine, Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto (Japan); Koyama, Takashi [Kyoto University Hospital, Department of Radiology, Kyoto (Japan); Saida, Satoshi [Wakayama Red Cross Hospital, Department of Paediatrics, Wakayama (Japan); Nishikomori, Ryuta [Graduate School of Medicine, Kyoto University, Department of Paediatrics, Kyoto (Japan)

    2007-08-15

    Eosinophilic cystitis is a rare inflammatory condition of the urinary bladder of unknown aetiology and characterized by eosinophilic infiltration of the bladder wall. We report the unique MR findings of eosinophilic cystitis in an 8-year-old girl who presented with peripheral eosinophilia. MR imaging revealed smooth and nearly circumferential thickening of the bladder wall showing distinct low signal intensity on T2-weighted images, which may histologically represent high cellularity due to massive eosinophilic infiltration. (orig.)

  17. Maturogenesis of a complicated crown fracture: a case report with 8 years follow-up.

    Science.gov (United States)

    Parirokh, Masoud; Kakoei, Shahla; Eskandarizadeh, Ali

    2007-01-01

    This report describes a case of a 7 years old girl who suffered from complicated crown fracture of right mandibular central incisor because of a bicycle accident. For the tooth partial pulpotomy with calcium hydroxide, capping was performed in order to achieve apexogenesis and the tooth was restored with a double-seal of glass ionomer cement and composite resin. The patient was reviewed over 8 years. The tooth showed continued root development and complete apex formation.

  18. Awake Tracheal Intubation in an 8-Year-Old Girl with McCune-Albright Syndrome.

    Science.gov (United States)

    Bohman, J Kyle; Segura, Leal

    2013-10-01

    An 8-year-old girl with McCune-Albright syndrome presented for resection of a very large fibrous dysplasia mass of the face with significant distortion of the airway anatomy. She had significant obstructive sleep apnea with daytime somnolence and hemoglobin oxygen desaturations while breathing room air preoperatively. We were able to successfully manage her airway by providing IV sedation, topical anesthesia of the airway, and oral fiberoptic intubation in close collaboration with our otorhinolaryngology colleagues.

  19. POLYGON - A NEW FUNDAMENTAL MOVEMENT SKILLS TEST FOR 8 YEAR OLD CHILDREN: CONSTRUCTION AND VALIDATION

    Directory of Open Access Journals (Sweden)

    Frane Zuvela

    2011-03-01

    Full Text Available Inadequately adopted fundamental movement skills (FMS in early childhood may have a negative impact on the motor performance in later life (Gallahue and Ozmun, 2005. The need for an efficient FMS testing in Physical Education was recognized. The aim of this paper was to construct and validate a new FMS test for 8 year old children. Ninety-five 8 year old children were used for the testing. A total of 24 new FMS tasks were constructed and only the best representatives of movement areas entered into the final test product - FMS-POLYGON. The ICC showed high values for all 24 tasks (0.83-0.97 and the factorial analysis revealed the best representatives of each movement area that entered the FMS-POLYGON: tossing and catching the volleyball against a wall, running across obstacles, carrying the medicine balls, and straight running. The ICC for the FMS-POLYGON showed a very high result (0.98 and, therefore, confirmed the test's intra-rater reliability. Concurrent validity was tested with the use of the "Test of Gross Motor Development" (TGMD-2. Correlation analysis between the newly constructed FMS-POLYGON and the TGMD-2 revealed the coefficient of -0.82 which indicates a high correlation. In conclusion, the new test for FMS assessment proved to be a reliable and valid instrument for 8 year old children. Application of this test in schools is justified and could play an important factor in physical education and sport practice.

  20. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... NHLBI Entire Site Health Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The ... Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical ...

  1. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The Health Information Center Health ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural ...

  2. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Topics News & Resources Intramural Research Public Health Topics Education & Awareness Resources Contact The Health Information Center Health ... Systematic Evidence Reviews & Clinical Practice Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural ...

  3. Mental disorders, psychological symptoms and quality of life 8 years after an earthquake: findings from a community sample in Italy.

    Science.gov (United States)

    Priebe, Stefan; Marchi, Fabio; Bini, Lucia; Flego, Martina; Costa, Ana; Galeazzi, Gian

    2011-07-01

    Various studies assessed mental disorders and psychological symptoms following natural disasters, including earthquakes. Yet, samples were often non-representative, and the periods of time between earthquake and assessments were usually short. This study aims to assess the prevalence of mental disorders, level of psychological symptoms and subjective quality of life in a random sample in a rural region in Italy 8 years after an earthquake. Using a random sampling method, a pool of potential participants of working age who had experienced the earthquake were identified 8 years after the earthquake. They were sequentially approached until the target sample of 200 was reached. Mental disorders were assessed on the MINI, psychological symptoms on the Brief Symptom Inventory (BSI) and the Impact of Event Scale-Revised (IES-R), and subjective quality of life on the Manchester Short Assessment of Quality of Life (MANSA). 200 people were interviewed, and the response rate of contacted people was 43%. In the MINI, 15 participants (7.5%) had any type of mental disorder; 5 participants had PTSD at any time since the earthquake, and 1 participant at the time of the interview. Symptom levels were low (Global Severity Index of BSI mean = 0.29, SD = 0.30; IES total mean = 0.40, SD = 3.33) and subjective quality of life (MANSA mean = 5.26, SD = 0.59) was in a positive range. The distribution of mental health outcomes made it difficult to explore factors associated with them. There is no evidence that the earthquake had a negative impact on the mental health of the affected population years later. Possible reasons include the relatively weak nature of the earthquake, strong community support that helped overcome mental distress, the long period of time (8 years) between the occurrence of the earthquake and the study, and a capacity of people to maintain or restore mental health after a natural disaster in the long term.

  4. Clinical study of ectopic pregnancy.

    Science.gov (United States)

    Chhabra, S; Aher, K; Jaiswal, M

    1992-01-01

    Ectopic pregnancy remains a leading cause of maternal mortality and accounts for a sizeable proportion of infertility and ectopic recurrence. The possibility that a woman is experiencing an ectopic pregnancy must be considered when evaluating a woman, especially a sterilized woman, who has a possible pregnancy, amenorrhea, abdominal pain, or abnormal bleeding; studies have found that one in six pregnancies occurring after tubal sterilization are ectopic. The authors present a clinical study of 82 cases of ectopic pregnancy admitted to the department of Obstetrics and Gynecology of Mahatma Gandhi Institute of Medical Sciences, Sevagram. Cases of ectopic pregnancy represent 0.99% of total obstetric admissions, of whom 69.51% were diagnosed as such on admission. 40.24% of the women were older than 30 years, while 34.14% were elderly beyond third parity. 70.73% of the women presented before missing their second period. Patients presented with multiple complaints, but the most common was abdominal pain reported by 61.70%. 78.04% were admitted with an acute abdomen, but shock was present in only 7.14% of cases. The main surgical treatment modality was salpingectomy among 59.75%. There was no maternal mortality through postoperative morbidity in the form of paralytic ileus, although fever did occur in some women.

  5. Parental reported compared with measured waist circumference in 8-year-old children

    NARCIS (Netherlands)

    Bekkers, Marga B. M.; Brunekreef, Bert; Scholtens, Salome; Kerkhof, Marjan; Smit, Henriette A.; Wijga, Alet H.

    2011-01-01

    Objective. Most epidemiological, questionnaire-based studies collect data on body weight and height but not on waist circumference (WC), although WC is suggested to be clinically more relevant. It is unknown whether valid WC data of school-aged children can be obtained by questionnaires. In this stu

  6. The relation between serum insulin levels and 8-year changes in lipid, lipoprotein, and blood pressure levels.

    Science.gov (United States)

    Mitchell, B D; Haffner, S M; Hazuda, H P; Valdez, R; Stern, M P

    1992-07-01

    Hyperinsulinemia is associated with an adverse pattern of cardiovascular risk factors, including obesity, elevated triglyceride levels, low levels of high-density lipoprotein (HDL) cholesterol, and elevated blood pressure. Whether hyperinsulinemia precedes (and perhaps causes) this deterioration in the risk factors or merely accompanies the deterioration is controversial. We therefore examined the 8-year changes in lipids, lipoproteins, and blood pressure as a function of baseline levels of fasting insulin in 1,383 nondiabetic Mexican-American and non-Hispanic white subjects enrolled between October 1979 and November 1982 in the San Antonio Heart Study, a population-based longitudinal study of cardiovascular risk factors and diabetes in San Antonio, Texas. After age and concomitant changes in body mass index were adjusted for, fasting insulin at baseline was found to be correlated positively with 8-year changes in triglyceride levels and negatively with 8-year changes in HDL cholesterol levels (p less than 0.05). Among the non-Hispanic whites, insulin was more strongly correlated with a decline in HDL cholesterol levels in women than in men (p less than 0.001). Fasting insulin was also positively correlated with changes in both systolic and diastolic blood pressure in non-Hispanic whites, but not in Mexican Americans, although these correlations were slightly diminished and no longer achieved statistical significance after subjects receiving antihypertensive medications were excluded. These results support the hypothesis that in nondiabetic subjects, insulin has a direct regulatory effect on triglyceride and HDL cholesterol levels. These data provide evidence for a possible role for insulin in blood pressure regulation, at least in non-Hispanic whites, although further analysis of this issue is warranted.

  7. Frontal bone hemangioma in an 8-year-old female: A common tumor in a rare location

    Directory of Open Access Journals (Sweden)

    Abhimanyu Sharma

    2016-01-01

    Full Text Available Intraosseous hemangioma is a rare bone tumor accounting for 0.7%–1.0% of all bone tumors. In the skull, frontal bone is the commonly involved bone. An 8-year-old female presented to our outpatient department with complaints of pain and swelling over forehead for 4 months. X-ray revealed a lytic expansile lesion involving frontal bone with sunburst pattern of bony spicules radiating to periphery of the lesion. Magnetic resonance imaging revealed the presence of a well-circumscribed lesion with both intra as well as extracranial components. Histopathology revealed a vascular tumor consisting of both small (capillary and large (cavernous sized vessels. A diagnosis of mixed type of hemangioma of the frontal bone was given. Recognition of hemangioma on radiology and confirmation by histopathology is essential for proper management as it might be confused clinically with other locally aggressive/malignant lesions.

  8. A case of cerebral salt-wasting syndrome associated with aseptic meningitis in an 8-year-old boy.

    Science.gov (United States)

    Inatomi, Jun; Yokoyama, Yoshiki; Sekine, Takashi; Igarashi, Takashi

    2008-04-01

    Cerebral salt-wasting syndrome is a disorder in which excessive natriuresis and subsequent hyponatremic dehydration occur in patients with intracranial diseases. Cerebral salt-wasting syndrome often develops in patients with severe neurosurgical disorders, such as hydrocephalus, cerebral infarction, and tuberculous meningitis. Here, we report on the case of an 8-year-old boy with cerebral salt-wasting syndrome associated with aseptic meningitis. He showed mild developmental retardation and had a history of convulsion. Four days after his admission, cerebral salt-wasting syndrome abruptly started: natriuresis and hyponatremia gradually improved over 10 days. To the best of our knowledge, this is the first report on cerebral salt-wasting syndrome associated with clinically benign aseptic meningitis.

  9. La Segmentazione Grafica della Scrittura di una Storia Conosciuta. Uno Studio Descrittivo su 450 Testi di Bambini dai 6 agli 8 Anni (Graphic Segmentation of the Writing of a Familiar Story. A Descriptive Study of 450 Texts of Children from 6 to 8 Years Old).

    Science.gov (United States)

    Pontecorvo, Clotilde; Di Eduardo, Roberta

    1995-01-01

    The purpose of this study was to analyze how children in the early grades of elementary school divide words while writing. The subjects were 450 Italian children belonging either to upper-middle-class or lower-middle-class families who were asked to write the familiar story of "Little Red Riding Hood." (CFM)

  10. A clinical study of retinoblastoma

    Directory of Open Access Journals (Sweden)

    L Subha

    2015-01-01

    Full Text Available Aim: The aim was to analyze general incidence, age incidence, laterality, common mode of presentation, staging of the tumor, radiological evidence, histopathological confirmation, management and follow-up of cases, which were diagnosed as retinoblastoma. Design: Interventional case series study from April 1997 to March 2000. Materials and Methods: Detailed history regarding the symptoms such as white reflex, watering, pain, redness, protrusion of eyeball, squint, hyphema, and defective vision were obtained. Family history regarding consanguinity between parents, health of the siblings and other relatives were recorded. Ocular examination included vision, pupillary reaction, detailed fundus examination, ocular tension, and corneal diameter. Investigations included X-ray orbit and skull, computed tomography scan orbit and brain, B-scan orbit, serum and aqueous lactate dehydrogenase; enucleated eyes were subjected to holoprosencephaly (HPE. Enucleation, radiotherapy, cryotherapy and chemotherapy were modalities of treatment. The empty socket and the other apparently normal eye were examined carefully at each visit. Results: The incidence of retinoblastoma is less when compared to other diseases of the eye. There was no sex predilection. Most of the cases diagnosed were sporadic and unilateral. Age of onset is earlier for bilateral cases than unilateral cases. Consanguinity bears close relationship with bilateral involvement. Predominant clinical sign is white reflex in the pupillary area. Majority of cases presented in the second stage of the disease. Enucleation plays a greater role in the management of retinoblastoma. HPE should include several sections of the optic nerve to find out skip lesions.

  11. Acute calcific tendinitis of the flexor pollicis longus in an 8-year-old boy.

    Science.gov (United States)

    Kheterpal, Arvin; Zoga, Adam; McClure, Kristen

    2014-10-01

    Calcific tendinitis is a common source of musculoskeletal pain in adults; however, it is rarely encountered in children. Calcific tendinitis is the most commonly encountered manifestation of hydroxyapatite deposition disease, in which calcium hydroxyapatite crystal deposition occurs in tendons. It may cause acute or chronic pain, or may be entirely asymptomatic. We describe a case of acute calcific tendinitis of the flexor pollicis longus tendon in an 8-year-old boy, who initially presented to our department for workup of a mass felt along the volar aspect of the right wrist.

  12. Isolated Splenic Vein Thrombosis: 8-Year-Old Boy with Massive Upper Gastrointestinal Bleeding and Hypersplenism.

    Science.gov (United States)

    Kiani, Mohammad Ali; Forouzan, Arash; Masoumi, Kambiz; Mazdaee, Behnaz; Bahadoram, Mohammad; Kianifar, Hamid Reza; Ravari, Hassan

    2015-01-01

    We present an 8-year-old boy who was referred to our center with the complaint of upper gastrointestinal bleeding and was diagnosed with hypersplenism and progressive esophageal varices. Performing a computerized tomography (CT) scan, we discovered a suspicious finding in the venography phase in favor of thrombosis in the splenic vein. Once complementary examinations were done and due to recurrent bleeding and band ligation failure, the patient underwent splenectomy. And during the one-year follow-up obvious improvement of the esophageal varices was observed in endoscopy.

  13. Isolated Splenic Vein Thrombosis: 8-Year-Old Boy with Massive Upper Gastrointestinal Bleeding and Hypersplenism

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Kiani

    2015-01-01

    Full Text Available We present an 8-year-old boy who was referred to our center with the complaint of upper gastrointestinal bleeding and was diagnosed with hypersplenism and progressive esophageal varices. Performing a computerized tomography (CT scan, we discovered a suspicious finding in the venography phase in favor of thrombosis in the splenic vein. Once complementary examinations were done and due to recurrent bleeding and band ligation failure, the patient underwent splenectomy. And during the one-year follow-up obvious improvement of the esophageal varices was observed in endoscopy.

  14. 激素治疗6.8年后的心血管疾病结局心脏与雌/孕激素替代治疗研究随访(HERSⅡ)%Cardiovascular Disease Outcomes During 6.8 Years of Hormone Therapy Heart and Estrogen/Progestin Replacement Study Follow-up (HERS Ⅱ)

    Institute of Scientific and Technical Information of China (English)

    Deborah Grady; Steven Khan; L.Kristin Newby; David Waters; Eric Vittinghoff; Nanette Wenger; David Herrington; Vera Bittner; Roger Blumenthal; Michael Davidson; Mark Hlatky; Judith Hsia; Stephen Hulley; Alan Herd

    2003-01-01

    @@ 背景:心脏与雌、孕激素替代治疗研究(Heart and Estrogen/Progestin ReplacementStudy,HERS)发现,患有冠心病(coronary heart disease,CHD)的绝经后妇女冠心病事件总体风险并无下降.然而,研究还显示,激素组冠心病事件风险第1年增加,第3~5年下降. 目的:确定HERS后期观察到的冠心病事件风险下降是否持续存在,是否随时间的延长而致整体风险下降. 设计与地点:试验在美国20个临床中心门诊及社区医院实施.先进行为期4.1年的随机、盲法、安慰剂对照试验(HERS),随后继续非盲法随诊2.7年(HERSⅡ).对象:共计2 763例患有冠心病的绝经后妇女,入选HERS时的平均年龄为67岁;2 321例妇女(占存活者的93%)同意参加HERSⅡ随诊. 干预:在HERS期间,受试者随机分配接受0.625 mg/d结合雌激素加2.5 mg/d醋酸甲羟孕酮(1 380例)或安慰剂(1 383例).HERSⅡ期间,由经治医生决定开放标记的激素治疗的使用.坚持服用激素至少达80%的比例在激素组从第1年的81%降至第6年的45%,在安慰剂组则从第1年的0%升至第6年的8%. 主要结局指标:主要结局为非致死性心肌梗死和冠心病死亡.次要(或二级)心血管事件包括冠状动脉再通术、因不稳定心绞痛或充血性心力衰竭住院、非致死性室性心律失常、猝死、卒中或短暂缺血发作以及外周动脉疾病. 结果:在HERS、HERSⅡ或整个试验期间,激素组与安慰剂组妇女相比,主要冠心病事件或次要心血管事件的发生率均无明显下降.冠心病事件未校正的相对风险(rela-tive hazard,RH)在HERS为0.99(95%可信区间[CI],0.81~1.22),在HERSⅡ为1.0(95%CI,0.77~1.29),在整个试验为0.99(95%CI,0.84~1.17).校正潜在混淆因素及组间他汀类药物的使用差异后,其总体RH相似,为0.97(95%CI,0.82~1.14).在分析限于坚持原随机分配方案治疗的受试者时,冠心病事件的RH也相似0.96(95%CI,0.77~1.19). 结论:HERS后期

  15. Follow-up of a Case of Vitelliform Macular Dystrophy Over an 8-year Period

    Institute of Scientific and Technical Information of China (English)

    Shizhou Huang; Lezheng Wu; Feng Wen; Guangwei Luo; Futian Jiang

    2014-01-01

    Purpose: To show the follow-up of a case of vitelliform mac-ular dystrophy with morphological and visual functional tests over an 8-year period. Methods:.Retrospective review of medical records..The mor-phological examination included color photography,.fluores-cein angiography, and ocular coherence tomography (OCT). The visual functional tests included visual acuity, electro-ocu-logram (EOG) and multifocal electroretinography (mfERG). The patient was observed for 8 years, from 2003 to 2011. Results:.During the follow-up,.the improvement of sensory retinal detachment and reduction of yellow-white deposit were observed with color photography and fluorescein angiography. OCT revealed a decrease in sensory retinal detachment and subretinal hyper-reflective deposits; both of these morphologi-cal changes were correspondent. Visual acuity was maintained throughout the follow-up..The Arden ratio of EOG was de-creased. The amplitudes of mfERG were decreased but slightly increased during the follow-up. Conclusion:.The retinal morphological changes and visual function slightly improved in this case of vitelliform macu-lopathy. The prognosis is good. (Eye Science 2014; 29:165-169)

  16. Transfer of figural face aftereffects suggests mature orientation selectivity in 8-year-olds' face coding.

    Science.gov (United States)

    Jeffery, Linda; Taylor, Libby; Rhodes, Gillian

    2014-10-01

    Adult face perception mechanisms are tuned to upright faces, and this orientation selectivity is central to adult expertise with upright faces. Children are less expert than adults, and it has been argued that their face mechanisms are less orientation selective than those of adults. Here we used face aftereffects to test this hypothesis by examining whether children's aftereffects show greater transfer across changes in orientation than do adults' aftereffects. We adapted 7- to 8-year-old children and adults to figural face distortions in both upright and inverted orientations and examined the size of resulting aftereffects in both upright and inverted test faces. If children's face mechanisms are less orientation selective than those of adults, then children's aftereffects should transfer more strongly across changes in orientation. We found no evidence to support this prediction. Children's and adults' aftereffects were similarly reduced by orientation differences between adapt and test. These results indicate that children, like adults, show a high degree of orientation selectivity in face shape coding and suggest that neural tuning to face orientation may be mature by 8 years of age. Our findings are consistent with an emerging view that many of the key attributes of specialized face perception emerge much earlier in development than previously thought.

  17. Age and gender dependent development of theory of mind in 6 to 8-years old children.

    Directory of Open Access Journals (Sweden)

    Cecilia Ines Calero

    2013-06-01

    Full Text Available The ability to attribute different mental states to distinct individuals, or Theory of Mind (ToM, is widely believed to be developed mostly during preschool years. How different factors such as gender, number of siblings or coarse personality traits affect this development is not entirely agreed upon. Here, we introduce a computerized version of the scaled ToM suite of tasks introduced by Wellman and Liu (2004, which allows us to meaningfully test ToM development on children 6 to 8-years old. We find that kids this age are still not entirely proficient in all ToM tasks, and continue to show a progression of performance with age. By testing this age range, too, we are able to observe a significant advantage of girls over boys in ToM performance. Other factors such as number of siblings, birth order, and coarse personality traits show no significant relation with the ToM task results. Finally, we introduce a novel way to quantify the scaling property of the suite involving a sequence of set inclusions and also, a comparison between specially tailored sets of logistic models. These measures confirm the validity of the scale in the 6 to 8-years old range.

  18. Social Recovery Model: An 8-Year Investigation of Adolescent 12-step Group Involvement following Inpatient Treatment

    Science.gov (United States)

    Kelly, John F.; Brown, Sandra A.; Abrantes, Ana; Kahler, Christopher; Myers, Mark

    2013-01-01

    Background Despite widespread use of 12-step treatment approaches and referrals to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) by youth providers, little is known about the significance of these organizations in youth addiction recovery. Furthermore, existing evidence is based mostly on short-term follow-up and is limited methodologically. Methods Adolescent inpatients (N = 160; M age = 16, 40% female) were followed at 6-months, and at 1, 2, 4, 6, and 8 years post-treatment. Time-lagged, generalized estimating equations (GEE) modeled treatment outcome in relation to AA/NA attendance controlling for static and time-varying covariates. Robust regression (LOWESS) explored dose-response thresholds of AA/NA attendance on outcome. Results AA/NA attendance was common and intensive early post-treatment, but declined sharply and steadily over the 8-year period. Patients with greater addiction severity and those who believed they could not use substances in moderation were more likely to attend. Despite declining attendance, the effects related to AA/NA remained significant and consistent. Greater early participation was associated with better long-term outcomes. Conclusions Even though many youth discontinue AA/NA over time, attendees appear to benefit, and more severely substance-involved youth attend most. Successful early post-treatment engagement of youth in abstinence-supportive social contexts, such as AA/NA, may have long-term implications for alcohol and drug involvement into young adulthood. PMID:18557829

  19. Childhood diet and asthma and atopy at 8 years of age : the PIAMA birth cohort study

    NARCIS (Netherlands)

    Willers, S. M.; Wijga, A. H.; Brunekreef, B.; Scholtens, S.; Postma, D. S.; Kerkhof, M.; de Jongste, J. C.; Smit, H. A.

    2011-01-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA)

  20. Persistent hematologic and immunologic disturbances in 8-year-old Dutch children associated with perinatal dioxin exposure.

    Science.gov (United States)

    ten Tusscher, Gavin W; Steerenberg, Peter A; van Loveren, Henk; Vos, Joseph G; von dem Borne, Albert E G K; Westra, Matthijs; van der Slikke, Johannes W; Olie, Kees; Pluim, Hendrik J; Koppe, Janna G

    2003-09-01

    Perinatal exposure to Dutch "background" dioxin levels in 1990 was high, but comparable with that of other industrialized Western European countries. Exposure during the sensitive perinatal period may cause permanent disturbances. Therefore, we assessed the health status and various hematologic and immunologic parameters among our longitudinal cohort. A medical history was taken and venipuncture performed in a longitudinal cohort of 27 healthy 8-year-old children who had documented perinatal dioxin exposure. Linear regression revealed a decrease in allergy in relation to prenatal (p = 0.02) and postnatal (p = 0.03) dioxin exposure. Increases in CD4+ T-helper cells (p = 0.006) and in CD45RA+ cells (p = 0.02) were seen in relation to postnatal exposure. A persistently decreased platelet count (p = 0.04) and increased thrombopoietin concentration (p = 0.03) were seen in relation to postnatal exposure. This follow-up has shown a decrease in allergy, persistently decreased thrombocytes, increased thrombopoietin, and increased CD4+ T-helper and increased CD45RA+ cell counts. This study provides indications of effects at the stem cell level of perinatal dioxin exposure, persisting until minimally 8 years after birth.

  1. Development of skin conductance orienting, habituation, and reorienting from ages 3 to 8 years: a longitudinal latent growth curve analysis.

    Science.gov (United States)

    Gao, Yu; Raine, Adrian; Dawson, Michael E; Venables, Peter H; Mednick, Sarnoff A

    2007-11-01

    Little is known about the development of the skin conductance orienting response (SCOR) in childhood. This longitudinal study examines the effects of age on initial SCOR, habituation, and reorienting. Skin conductance responses to nonsignal auditory stimuli were recorded from 200 male and female children at five different time points (ages 3, 4, 5, 6, and 8 years). Longitudinal latent growth curve analyses were used to determine the trajectory of each SCOR measure during this period. Results indicated that (a) initial SCOR is present at age 3, increases thereafter to peak at age 6, and then levels off, (b) habituation is absent at age 3, but becomes apparent at age 4 years and increases thereafter with increasing age, (c) SC reorienting is absent from ages 3 to 8, and (d) boys and girls do not exhibit different developmental trajectories. Results suggest that from age 3 to 8 years, the transition from the functionally immature to mature neural network underlying orienting and habituation is a continuous process and may be related to children's cognitive development during this period.

  2. Validity and reliability of the Back-Saver Sit and Reach in girls aged 7-8 years.

    Directory of Open Access Journals (Sweden)

    Milena Boneth-Collante

    2015-12-01

    Full Text Available Background: The back saver sit and reach (BSSR test is probably the most frequently quantitative tool used to estimate hamstring flexibility in the school and physical-sporting field due to its simplicity and quickly implementation. However, there is limited scientific evidence to justify its use in colombian girls. Objective: To assess the validity and intra-rater reliability of the BSSR in girls of a school from Bucaramanga. Mathodology: A study of evaluation of diagnostic technology was done in 64 girls (7-8 years, selected by convenience. BSSR test and straight leg raising test (SLRT were conducted on two consecutive occasions by the same researchers. It was calculed the Pearson (r or intraclass (ICC correlation coefficient with their respective confidence intervals (95% CI 95%. Results: The global validity was good (r=0.61 (95% CI 0.43-0.75 – r=0.66 (95% CI 0.49-0.78, while intra-rater reliability was very good in the left lower limb [ICC= 0.90 (95% CI 0.67 to 0.96] and right lower limb [ICC = 0.88 (95% CI 0.63 to 0.95]. Conclusion: BSSR test has good reliability and validity for assessing lower limb flexibility in girls aged 7 to 8 years.

  3. POLYGON - A New Fundamental Movement Skills Test for 8 Year Old Children: Construction and Validation.

    Science.gov (United States)

    Zuvela, Frane; Bozanic, Ana; Miletic, Durdica

    2011-01-01

    Inadequately adopted fundamental movement skills (FMS) in early childhood may have a negative impact on the motor performance in later life (Gallahue and Ozmun, 2005). The need for an efficient FMS testing in Physical Education was recognized. The aim of this paper was to construct and validate a new FMS test for 8 year old children. Ninety-five 8 year old children were used for the testing. A total of 24 new FMS tasks were constructed and only the best representatives of movement areas entered into the final test product - FMS-POLYGON. The ICC showed high values for all 24 tasks (0.83-0.97) and the factorial analysis revealed the best representatives of each movement area that entered the FMS-POLYGON: tossing and catching the volleyball against a wall, running across obstacles, carrying the medicine balls, and straight running. The ICC for the FMS-POLYGON showed a very high result (0.98) and, therefore, confirmed the test's intra-rater reliability. Concurrent validity was tested with the use of the "Test of Gross Motor Development" (TGMD-2). Correlation analysis between the newly constructed FMS-POLYGON and the TGMD-2 revealed the coefficient of -0.82 which indicates a high correlation. In conclusion, the new test for FMS assessment proved to be a reliable and valid instrument for 8 year old children. Application of this test in schools is justified and could play an important factor in physical education and sport practice. Key pointsAll 21 newly constructed tasks demonstrated high intra-rater reliability (0.83-0.97) in FMS assessment. High reliability was also noted in the FMS-POLYGON test (0.98).A high correlation was found between the FMS-POLYGON and TGMD-2 which is a confirmation of the new test's concurrent validity.The research resolved the problem of long and detailed FMS assessment by adding a new dimension using quick and effective norm-referenced approach but also covering all the most important movement areas.New and validated test can be of great use

  4. Survival analysis, long-term outcomes, and percentage of recovery up to 8 years post-infection among the Houston West Nile virus cohort.

    Directory of Open Access Journals (Sweden)

    Kristy O Murray

    Full Text Available In 2012, we witnessed a resurgence of West Nile virus (WNV in the United States, with the largest outbreak of human cases reported since 2003. WNV is now endemic and will continue to produce epidemics over time, therefore defining the long-term consequences of WNV infection is critical. Over a period of eight years, we prospectively followed a cohort of 157 WNV-infected subjects in the Houston metropolitan area to observe recovery over time and define the long-term clinical outcomes. We used survival analysis techniques to determine percentage of recovery over time and the effects of demographic and co-morbid conditions on recovery. We found that 40% of study participants continued to experience symptoms related to their WNV infection up to 8 years later. Having a clinical presentation of encephalitis and being over age 50 were significantly associated with prolonged or poor recovery over time. Since the health and economic impact as a result of prolonged recovery, continued morbidity, and related disability is likely substantial in those infected with WNV, future research should be aimed at developing effective vaccines to prevent illness and novel therapeutics to minimize morbidity, mortality, and long-term complications from infection.

  5. Cognitive Function, Progression of Age-related Behavioral Changes, Biomarkers, and Survival in Dogs More Than 8 Years Old

    DEFF Research Database (Denmark)

    Schütt, T.; Berendt, M.; Toft, Nils

    2015-01-01

    patted, difficulty finding dropped food and anxiety. Thirty-three percent of dogs with a normal cognitive status progressed to MCI and 22% classified as MCI progressed to CCD during the study period. For 6 dogs diagnosed with CCD, signs of cognitive dysfunction increased with time. A diagnosis of CCD did......BackgroundCanine cognitive dysfunction (CCD) is an age-dependent neurodegenerative condition dominated by changes in behavioral patterns. Cohort studies investigating cognitive status in dogs are lacking. ObjectivesTo investigate cognitive function, progression of age-related behavioral changes......, survival, and possible biomarkers of CCD in aged dogs. AnimalsFifty-one dogs >8 years old; 21 with no cognitive deficits, 17 with mild cognitive impairments (MCI) and 13 with CCD. MethodsLongitudinal study. Recruitment period of 12 months and an observational period of 24 months including a baseline and 3...

  6. Cognitive Function, Progression of Age-related Behavioral Changes, Biomarkers, and Survival in Dogs More Than 8 Years Old

    DEFF Research Database (Denmark)

    Schütt, T.; Berendt, M.; Toft, Nils

    2015-01-01

    patted, difficulty finding dropped food and anxiety. Thirty-three percent of dogs with a normal cognitive status progressed to MCI and 22% classified as MCI progressed to CCD during the study period. For 6 dogs diagnosed with CCD, signs of cognitive dysfunction increased with time. A diagnosis of CCD did......BackgroundCanine cognitive dysfunction (CCD) is an age-dependent neurodegenerative condition dominated by changes in behavioral patterns. Cohort studies investigating cognitive status in dogs are lacking. ObjectivesTo investigate cognitive function, progression of age-related behavioral changes......, survival, and possible biomarkers of CCD in aged dogs. AnimalsFifty-one dogs >8 years old; 21 with no cognitive deficits, 17 with mild cognitive impairments (MCI) and 13 with CCD. MethodsLongitudinal study. Recruitment period of 12 months and an observational period of 24 months including a baseline and 3...

  7. [Breast cancer mass screening in the Province of Liege. Results after 8 years].

    Science.gov (United States)

    Gordenne, W; Parmentier, J C; Delleuze, J M

    2000-08-01

    Breast cancer mass screening by mobile units started in 1992 in the Province of Liège (Belgium). This project is developed for rural areas and interests all women between 40-69 years old not regularly X-rayed in traditional breast cancer diagnosis centers. Despite lots of efforts population participation is low (25%). Nevertheless, the experiment results are encouraging: in a series of 31,443 women, 213 cancers were diagnosed, corresponding to a rate of 6.9/1000, 75% of which are of good prognosis. After an 8 years experiment, it is hoped that the population concerned becomes more sensitive to this mass screening project and one should expect a better collaboration with the other actors in the field of breast diseases diagnosis.

  8. Developing formal mathematical assessment for 4- to 8-year-olds

    Science.gov (United States)

    Doig, Brian

    2005-10-01

    The assessment of children in their years before school and their first years of school has been, traditionally, informal. Further, assessment of children's mathematical skills at this level has been infrequent compared to social, emotional and physical assessments. However, there are contexts where reliable, valid, standardised data from assessment in mathematics are required. This paper outlines the development of two assessment tools for mathematics that were originally developed for such contexts. Item Response Theory (IRT) analyses enabled the construction of assessment forms that address the range of abilities of 4- to 8-year-old children, and provided the scales used for constructing formative and summative reports of achievement. A description of the development of the assessment tools and the IRT analysis that provides the reporting formats are presented together with some research uses of the tools.

  9. Pediatric renal transplantation in a highly sensitised child-8 years on.

    LENUS (Irish Health Repository)

    Quinlan, Catherine

    2012-01-26

    Highly sensitised children have markedly reduced chances of receiving a successful deceased donor renal transplant, increased risk of rejection, and decreased graft survival. There is limited experience with the long-term followup of children who have undergone desensitization. Following 2 failed transplants, our patient was highly sensitised. She had some immunological response to intravenous immunoglobulin (IVIg) but this was not sustained. We developed a protocol involving sequential therapies with rituximab, IVIg, and plasma exchange. Immunosuppressant therapy at transplantation consisted of basiliximab, tacrolimus, mycophenolate mofetil, and steroids. At the time of transplantation, historical crossmatch was ignored. Current CDC crossmatch was negative, but T and B cell flow crossmatch was positive, due to donor-specific HLA Class I antibodies. Further plasma exchange and immunoglobulin therapy were given pre- and postoperatively. Our patient received a deceased donor-kidney-bearing HLA antigens to which she originally had antibodies, which would have precluded transplant. The graft kidney continues to function well 8 years posttransplant.

  10. Emotional Understanding and Color-Emotion Associations in Children Aged 7-8 Years

    Directory of Open Access Journals (Sweden)

    Debbie J. Pope

    2012-01-01

    Full Text Available An understanding of the development of emotional knowledge can help us determine how children perceive and interpret their surroundings and color-emotion associations are one measure of the expression of a child’s emotional interpretations. Emotional understanding and color-emotion associations were examined in a sample of UK school children, aged 7-8 years. Forty primary school children (mean age = 7.38; SD = 0.49 were administered color assessment and emotional understanding tasks, and an expressive vocabulary test. Results identified significant gender differences with girls providing more appropriate and higher quality expressions of emotional understanding than boys. Children were more able to link color to positive rather than negative emotions and significant gender differences in specific color preferences were observed. The implications of adult misinterpretations of color-emotion associations in young children are discussed.

  11. [8-year experience in 40 patients with an axillary-femoral graft].

    Science.gov (United States)

    Bialostozky, L; Rish, L; Legaspi, R; Gutiérrez Bosque, R; Archundia, A; Morales, F; Oropeza, G

    1977-01-01

    The 8 years (1967-1975) experience with axillary-femoral and femoro-femoral grafts in 40 patients is presented; 6 females and 34 males, between 50 and 90 years of age, with arteriosclerosis, all complicated by chronic illnesses. The results have been satisfactory, as the grafts are functioning from 2 months to 80 months (6 years, 8 months), most of them being more than 12 months old. Twenty eight of the 40 patients operated are alive. Four patients (10%) had infection of their grafts. In 6 (15%) the graft closed because of severe progresive distal obstruction. Three patients (7.5%) died in the first 32 post-operative days. In 9 (22.5%) the deaths were not related to surgery. The indications for placement of axillary-femoral and femoro-femoral grafts is established.

  12. Trajectories and Determinants of Elder Care in Rural China During an 8-Year Period: Why Having Sons Makes a Difference.

    Science.gov (United States)

    Guo, Man; Chi, Iris; Silverstein, Merril

    2016-07-01

    Using 8-year panel data for 1,355 older adults in rural Anhui province, China, this study examined the trajectories and determinants of elder care provided by adult children to their older parents. The results of two-level latent variable growth models showed that trajectories of elder care differed by the gender of children, with an increase in care from sons but a decrease in care from daughters over time. Children's life stages influenced their care provision but differed by gender. Functional impairment of parents and care provided by siblings in the family also affected the care provided by each child. The findings reflect the patrilineal nature of Chinese family systems and demonstrate the linkages between critical life events and caregiving behaviors of adult children. Findings of this study can inform the formulation of elder care policies that meet the needs of families with different structures and at different life stages.

  13. [Follow-up studies and clinical evaluation of model cast dentures with periodontal and periodonto-gingival support].

    Science.gov (United States)

    Ebersbach, W; Lesche, M

    1977-11-01

    The authors examined 746 cast denture constructions with an average wearing time of 6 years to study the influence of cast denture constructions on caries increment. The mode of wear of the cast denture constructions had no influence on caries incidence, whereas effects exerted by the duration of wear and the presence of soft deposits could be detected. The evaluation of the functional performance of cast denture constructions showed that the clinical serviceability amounts to more than 8 years.

  14. The NIDDK Central Repository at 8 years--ambition, revision, use and impact.

    Science.gov (United States)

    Turner, Charles F; Pan, Huaqin; Silk, Gregg W; Ardini, Mary-Anne; Bakalov, Vesselina; Bryant, Stephanie; Cantor, Susanna; Chang, Kung-yen; DeLatte, Michael; Eggers, Paul; Ganapathi, Laxminarayana; Lakshmikanthan, Sujatha; Levy, Joshua; Li, Sheping; Pratt, Joseph; Pugh, Norma; Qin, Ying; Rasooly, Rebekah; Ray, Helen; Richardson, Jean E; Riley, Amanda Flynn; Rogers, Susan M; Scheper, Charlotte; Tan, Sylvia; White, Stacie; Cooley, Philip C

    2011-01-01

    The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repository makes data and biospecimens from NIDDK-funded research available to the broader scientific community. It thereby facilitates: the testing of new hypotheses without new data or biospecimen collection; pooling data across several studies to increase statistical power; and informative genetic analyses using the Repository's well-curated phenotypic data. This article describes the initial database plan for the Repository and its revision using a simpler model. Among the lessons learned were the trade-offs between the complexity of a database design and the costs in time and money of implementation; the importance of integrating consent documents into the basic design; the crucial need for linkage files that associate biospecimen IDs with the masked subject IDs used in deposited data sets; and the importance of standardized procedures to test the integrity data sets prior to distribution. The Repository is currently tracking 111 ongoing NIDDK-funded studies many of which include genotype data, and it houses over 5 million biospecimens of more than 25 types including serum, plasma, stool, urine, DNA, red blood cells, buffy coat and tissue. Repository resources have supported a range of biochemical, clinical, statistical and genetic research (188 external requests for clinical data and 31 for biospecimens have been approved or are pending). Genetic research has included GWAS, validation studies, development of methods to improve statistical power of GWAS and testing of new statistical methods for genetic research. We anticipate that the future impact of the Repository's resources on biomedical research will be enhanced by (i) cross-listing of Repository biospecimens in additional searchable databases and biobank catalogs; (ii) ongoing deployment of new applications for querying the contents of the Repository; and (iii) increased harmonization of procedures, data collection

  15. Resin-modified and conventional glass ionomer restorations in primary teeth: 8-year results

    DEFF Research Database (Denmark)

    Qvist, V.; Manscher, E.; Teglers, P.T.

    2004-01-01

    clinical trial, cariostatic effects, dental restorations, glass ionomer cement, long-term behaviour, pedodontics, resin-modified glass ionomer......clinical trial, cariostatic effects, dental restorations, glass ionomer cement, long-term behaviour, pedodontics, resin-modified glass ionomer...

  16. The End-state Comfort Effect in 3- to 8-year-old Children in two Object Manipulation Tasks

    Directory of Open Access Journals (Sweden)

    Birgit eKnudsen

    2012-10-01

    Full Text Available The aim of the study was to compare 3- to 8-year-old children’s propensity to anticipate a comfortable hand posture at the end of a grasping movement (end-state comfort effect between two different object manipulation tasks, the bar-transport task and the overturned-glass task. In the bar-transport task, participants were asked to insert a vertically positioned bar into a small opening of a box. In the overturned-glass task, participants were asked to put an overturned glass right-side-up on a coaster. Half of the participants experienced action effects (lights as a consequence of their movements (AE groups, while the other half of the participants did not (No-AE groups. While there was no difference between the AE and No-AE groups, end-state comfort performance differed across age as well as between tasks. Results revealed a significant increase in end-state comfort performance in the bar-transport task from 13% in the 3-year-olds to 94% in the 8-year-olds. Interestingly, the number of children grasping the bar according to end-state comfort doubled from 3 to 4 years and from 4 to 5 years of age. In the overturned-glass task an increase in end-state comfort performance from already 63% in the 3-year-olds to 100% in the 8-year-olds was significant as well. When comparing end-state comfort performance across tasks, results showed that 3- and 4-year-old children were better at manipulating the glass as compared to manipulating the bar, most probably, because children are more familiar with manipulating glasses. Together, these results suggest that preschool years are an important period for the development of motor planning in which the familiarity with the object involved in the task plays a significant role in children’s ability to plan their movements according to end-state comfort.

  17. Conservative medical therapy of prosthetic joint infections: retrospective analysis of an 8-year experience.

    Science.gov (United States)

    Pavoni, G L; Giannella, M; Falcone, M; Scorzolini, L; Liberatore, M; Carlesimo, B; Serra, P; Venditti, M

    2004-09-01

    Successful treatment of prosthetic joint infections often requires multiple surgical interventions and prolonged antimicrobial therapy. However, in certain situations, a surgical approach may not be in the best interest of the patient. A conservative approach was used to treat 34 patients with prosthetic joint infection between 1995 and 2003. Diagnosis of infection was based on clinical-microbiological evidence, confirmed by (99)Tc-labelled leukocyte scintigraphy, and involved 12 Staphylococcus aureus infections, nine Staphylococcus epidermidis infections, two Enterococcus faecalis infections, two mixed infections (S. aureus plus Pseudomonas aeruginosa; S. epidermidis plus E. faecalis), with the infecting pathogen being unidentified for nine patients. Most infections were treated initially with intravenous or intramuscular teicoplanin +/- ciprofloxacin or rifampicin, followed by oral ciprofloxacin or minocycline plus rifampicin. The mean duration of antimicrobial therapy was 41.2 weeks. Overall, only three patients did not respond to therapy, and infection was controlled in the remaining 31 patients. Among these, no relapse was observed in 17 patients during follow-up for 9-57 months; improvement with early (within 6 months of antibiotic discontinuation) or late relapse was observed in seven and three patients, respectively; two patients improved clinically, but continued to receive antibiotic therapy; and two patients whose condition improved initially were lost after a 6-month follow-up following discontinuation of antibiotics. No patient complained of side effects requiring discontinuation of antibiotic therapy. The study confirmed that suppression of infection, with salvage of the infected device in an acceptably functional state, can be achieved in selected cases.

  18. Motor competence and physical activity in 8-year-old school children with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Kristensen, Jens Halkjaer; Frausing, Britt;

    2009-01-01

    were clinically examined and tested for motor competence, whereas questionnaire response to items comprising musculoskeletal pain and injuries, in addition to daily level and duration of physical activity, corresponded to 377 (71.9%) children. RESULTS: In total, 29% of the children had GJH4, 19% had...... regarding motor competence, self-reported physical activity, and incidence of musculoskeletal pain and injuries. METHODS: A cross-sectional study of 524 children in the second grade from 10 public schools was performed. A positive response rate was obtained for 416 (79.4%) children, and 411 (78.4%) children......OBJECTIVE: Because the criteria used for diagnosing between generalized joint hypermobility (GJH) and musculoskeletal complaints, as well as relations between GJH and an insufficient motor development and/or a reduced physical activity level differ, the prevalence of GJH varies considerably...

  19. Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience

    Directory of Open Access Journals (Sweden)

    Mustafa Kemal Celen

    2010-02-01

    Full Text Available OBJECTIVE: the different clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis (BEO reporting to the reference hospital in Southeastern Anatolia of Turkey. MATERIAL AND METHODS: in this study, 27 male patients with brucellosis, who presented with epididymitis or epididymo-orchitis (EO at the university hospital in Diyarbakir from 1998 to 2006, were included. They were compared with the other male patients. Positive blood culture or high agglutination titers of > 1/160 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. RESULTS: fourteen patients had unilateral EO. Leukocytosis was present in 10 patients; all of them had initial agglutination titers of > 1/160 and 10 patients had a positive blood culture. All patients received combined therapy with streptomycin for the first 21 days (or oral rifampicin for 6-8 weeks with doxycycline or tetracycline for 6-8 weeks. All showed improvement, fever subsided in 3-7 days, and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year. CONCLUSION: in brucellosis-endemic areas, clinicians encountering EO should consider the likelihood of brucellosis. In this study, young age was the most common risk factor, and leukocytosis and high CRP level were the most common laboratory findings. Most cases were unilateral. All patients responded to medical management very well. Conservative management with combination antibiotic therapy was adequate for managing BEO. Conclusively, brucellosis must be considered as a cause of orchitis, especially in endemic regions like Turkey.

  20. Pediatric Renal Transplantation in a Highly Sensitised Child—8 Years On

    Directory of Open Access Journals (Sweden)

    Catherine Quinlan

    2011-01-01

    Full Text Available Highly sensitised children have markedly reduced chances of receiving a successful deceased donor renal transplant, increased risk of rejection, and decreased graft survival. There is limited experience with the long-term followup of children who have undergone desensitization. Following 2 failed transplants, our patient was highly sensitised. She had some immunological response to intravenous immunoglobulin (IVIg but this was not sustained. We developed a protocol involving sequential therapies with rituximab, IVIg, and plasma exchange. Immunosuppressant therapy at transplantation consisted of basiliximab, tacrolimus, mycophenolate mofetil, and steroids. At the time of transplantation, historical crossmatch was ignored. Current CDC crossmatch was negative, but T and B cell flow crossmatch was positive, due to donor-specific HLA Class I antibodies. Further plasma exchange and immunoglobulin therapy were given pre- and postoperatively. Our patient received a deceased donor-kidney-bearing HLA antigens to which she originally had antibodies, which would have precluded transplant. The graft kidney continues to function well 8 years posttransplant.

  1. Central precocious puberty and granulosa cell ovarian tumor in an 8-year old female

    Directory of Open Access Journals (Sweden)

    Valeria Calcaterra

    2013-07-01

    Full Text Available Ovarian tumors associated with hormonal changes of the peripheral iso-sexual precocious puberty are of common presentation. We describe here a rare case of juvenile granulosa cell tumor in a female with central precocious puberty (CPP. An 8-year old girl with CPP presented with vaginal bleeding four months after the diagnosis and before starting treatment with gonadotropin-releasing hormone (GnRH-analogs. Suppression of basal follicle-stimulating hormone (FSH level, elevation of serum estradiol, progesterone and Cancer Antigen-125 were documented. Abdominal ultrasound examination (US and magnetic resonance imaging showed a pelvic mass affecting the left ovary. A left salpingo-oophorectomy was performed and the mass was totally resected. Juvenile granulosa cell ovarian tumor was diagnosed. One month post surgery, estradiol and progesterone decreased to values of the first evaluation and FSH increased; Cancer Antigen-125 resulted normal while ultrasound pelvic examination showed absence of pelvic masses. In our patient, the tumor had grown very quickly since hormonal data demonstrated a CPP without any evidence of ovarian mass on US only four months before diagnosis. The overstimulation of the FSH or aberrant activation of FSH receptors may have contributed to the development of the mass.

  2. Picturing Perspectives: Development of Perspective-Taking Abilities in 4- to 8-Year-Olds

    Directory of Open Access Journals (Sweden)

    Andrea eFrick

    2014-04-01

    Full Text Available Although the development of perspective taking has been well researched, there is no uniform methodology for assessing this ability across a wide age span when frames of reference conflict. To address this gap, we created scenes of toy photographers taking pictures of layouts of objects from different angles, and presented them to 4- to 8-year-olds (N = 80. Children were asked to choose which one of four pictures could have been taken from a specific viewpoint. Results showed that this new technique confirmed the classic pattern of developmental progress on this kind of spatial skill: (1 4-year-olds responded near chance level, regardless of layout complexity, (2 there was a growing ability to inhibit egocentric choices around age 6 with layouts of low complexity (one object, (3 performance increased and egocentric responses decreased dramatically around age 7, (4 even at age 8, children still showed considerable individual variability. This perspective-taking task can thus be used to address important questions about the supports for early spatial development and the structure of early intellect.

  3. Long-term outcomes of entecavir monotherapy for chronic hepatitis B after liver transplantation: Results up to 8 years.

    Science.gov (United States)

    Fung, James; Wong, Tiffany; Chok, Kenneth; Chan, Albert; Cheung, Tan-To; Dai, Jeff Wing-Chiu; Sin, Sui-Ling; Ma, Ka-Wing; Ng, Kelvin; Ng, Kevin Tak-Pan; Seto, Wai-Kay; Lai, Ching-Lung; Yuen, Man-Fung; Lo, Chung-Mau

    2017-10-01

    Long-term antiviral prophylaxis is required to prevent hepatitis B recurrence for patients with chronic hepatitis B after liver transplantation. We determined the long-term outcome of 265 consecutive chronic hepatitis B liver transplant recipients treated with entecavir monotherapy without hepatitis B immune globulin. Viral serology, viral load, and liver biochemistry were performed at regular intervals during follow-up. The median duration of follow-up was 59 months. The cumulative rates of hepatitis B surface antigen (HBsAg) seroclearance were 90% and 95% at 1 and 5 years, respectively. At 1, 3, 5, and 8 years, 85%, 88%, 87.0%, and 92% were negative for HBsAg, respectively, and 95%, 99%, 100%, and 100% had undetectable hepatitis B virus (HBV) DNA, respectively. Fourteen patients remained persistently positive for HBsAg, all of whom had undetectable HBV DNA. There was no significant difference in liver stiffness for those who remained HBsAg-positive compared to those who achieved HBsAg seroclearance (5.5 versus 5.2 kPa, respectively; P = 0.52). The overall 9-year survival was 85%. There were 37 deaths during the follow-up period, of which none were due to hepatitis B recurrence. Long-term entecavir monotherapy is highly effective at preventing HBV reactivation after liver transplantation for chronic hepatitis B, with a durable HBsAg seroclearance rate of 92%, an undetectable HBV DNA rate of 100% at 8 years, and excellent long-term survival of 85% at 9 years. (Hepatology 2017;66:1036-1044). © 2017 by the American Association for the Study of Liver Diseases.

  4. Combined autologous chondrocyte implantation (ACI with supra-condylar femoral varus osteotomy, following lateral growth-plate damage in an adolescent knee: 8-year follow-up

    Directory of Open Access Journals (Sweden)

    Vijayan Sridhar

    2011-03-01

    Full Text Available Abstract We report the 8-year clinical and radiographic outcome of an adolescent patient with a large osteochondral defect of the lateral femoral condyle, and ipsilateral genu valgum secondary to an epiphyseal injury, managed with autologous chondrocyte implantation (ACI and supracondylar re-alignment femoral osteotomy. Long-term clinical success was achieved using this method, illustrating the effective use of re-alignment osteotomy in correcting mal-alignment of the knee, protecting the ACI graft site and providing the optimum environment for cartilage repair and regeneration. This is the first report of the combined use of ACI and femoral osteotomy for such a case.

  5. Successful treatment for ulcerative proctitis with rectal tacrolimus in an 8-year-old girl with intolerance to mesalamine.

    Science.gov (United States)

    Navas-López, Víctor Manuel; Blasco-Alonso, Javier; Girón Fernández-Crehuet, Francisco; Serrano Nieto, Maria Juliana; Gallego-Gutiérrez, Silvia; Luque Pérez, Silvia; Sierra Salinas, Carlos

    2014-08-01

    Ulcerative colitis (UC) is defined as a chronic inflammatory condition causing continuous mucosal inflammation of the colon without granulomas on biopsy. It affects the rectum, and, to a variable extent, the colon in continuity and is characterized by a relapsing and remitting course. Oral 5-aminosalicylic acid (5-ASA) regimens are recommended as first-line induction therapy for mild to moderately active pediatric UC and for maintenance of remission regardless of other initial treatments. In large clinical trials in adults, mesalamine intolerance was found in 2-5 % of the patients. We present a case of an 8-year-old female patient with intolerance to mesalamine and proctitis resistant to conventional therapy who responded to rectal tacrolimus treatment. The patient started with a dose of 2 mg/day at night with an excellent response. She reported feeling better than any of the previously prescribed treatments and without feeling the discomfort of previously administered enemas. After four weeks of treatment, the dose was reduced to 2 mg/week with no relapses. Tacrolimus suppositories were very well tolerated, and no adverse effects have been reported. Although only very little data has been published, rectal tacrolimus seems to be safe and of efficacy in ulcerative proctitis resistant to standard therapy.

  6. Motor neurone disease in Lancashire and South Cumbria in North West England and an 8 year experience with enteral nutrition.

    Science.gov (United States)

    Chhetri, Suresh Kumar; Bradley, Belinda Fay; Majeed, Tahir; Lea, Robert William

    2016-02-01

    Motor neurone disease (MND) is a fatal neurodegenerative disease of unknown aetiology. Malnutrition is a common occurrence and an independent risk factor for worse prognosis. However, it remains unclear whether provision of enteral nutrition (EN) through a gastrostomy tube offers any survival advantage. Our aim was to describe the demographic and clinical characteristics of MND in Lancashire and South Cumbria in North West England and the impact of EN on survival in the 8 year period of 2005-2012. Four hundred and seven patients with MND were identified through the Preston MND care and research centre registry giving a crude incidence rate of 3.15/100,000. Three hundred and forty patients with adequate information were included in the final analysis of whom 53.2% were male. The presentation was limb/spinal in 62.1% and bulbar in 37.9% of patients, bulbar onset being more common in elderly females. Mean age of onset was 67.28 years (standard deviation 11.06; range 22.78-93.06). Median survival was 1.98 years (range 1.18-3.05). Ninety-one patients received EN of whom 67% had bulbar onset disease. EN was not associated with a statistically significant survival advantage except for the subgroup who received EN more than 500 days after symptom onset. In conclusion, the early requirement for EN may indicate a prognostically less favourable subgroup.

  7. Response to hydroxycarbamide in pediatric β-thalassemia intermedia: 8 years' follow-up in Egypt.

    Science.gov (United States)

    El-Beshlawy, Amal; El-Ghamrawy, Mona; EL-Ela, Mona Abou; Said, Fadwa; Adolf, Sonia; Abdel-Razek, Abdel-Rahman Ahmed; Magdy, Rania Ismail; Abdel-Salam, Amina

    2014-12-01

    Hydroxycarbamide (hydroxyurea or HU) has been shown to increase fetal hemoglobin (HbF) in patients with β-thalassemia intermedia (TI). The reported effects of HU in increasing the total hemoglobin (Hb) have been inconsistent. Studies of long-term therapy with HU in pediatric TI are rather uncommon. A retrospective observational study was carried out to evaluate the clinical responses to HU in Egyptian patients with β-TI. One hundred patients; children (n = 82, mean age 9.9 ± 4.1 years) and adults (n = 18) were studied for the mean Hb, HbF%, median serum ferritin, transfusion history, and splenic size before and after HU therapy (mean dose 20.0 ± 4.2 mg/kg/day, range 10-29 mg/kg/day) over a follow-up period 4 to 96 months (mean 35.4 ± 19.2 months). Molecular studies were also done for group of patients (n = 42). The overall response rate to HU was 79 %; 46 % were minor responders (with a reduction in transfusion rate by 50 % or more and/or an increase in their total hemoglobin level by 1-2 g/dl) and 33 % major responders (becoming transfusion-free and/or having an increase in total hemoglobin level by >2 g/dl). Mean hemoglobin increased among responders from 6.9 ± 0.9 g/dl to 8.3 ± 1.4 g/dl (p C) in 32/42 (76 %) of studied patients; 28/32 were responders. Bivariate analysis showed no predictors of response as regards sex, pediatric and adult age, splenic status, or genotype. Hydroxycarbamide is a good therapeutic modality in the management of pediatric as in adult TI patients. It can minimize the need for blood transfusion, concomitant iron overload, and blood-born viral transmission especially in developing countries like Egypt.

  8. CLINICAL STUDY OF DUODENAL PERFORATION

    Directory of Open Access Journals (Sweden)

    Sambasiva Rao

    2016-04-01

    Full Text Available BACKGROUND The duodenal injury can pose a formidable challenge to the surgeon and failure to manage it properly may have devastating results. Over the centuries, there was little to offer the patient of acute abdomen beyond cupping, purgation and enemas, all of which did more harm than good. It was not until 1884 that Mikulicz made an attempt to repair a perforation. Recent statistics indicate roughly 10% of population develop gastric or duodenal ulcer in life time. Roughly 1-3% of population above the age of 20 years have some degree of peptic ulcer activity during any annual period. A detailed history with regards to the signs and symptoms of the patient, a meticulous examination, radiological and biochemical investigations help to arrive at a correct preoperative diagnosis. In this study, a sincere effort has been put to understand the demographic patterns, to understand the underlying aetiology and to understand the effectiveness of the standard methods of investigation and treatment in use today. METHODS This is a 24 months prospective study i.e., from September 2011 to September 2013 carried out at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation. The study included the patients presenting to Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation to emergency ward with signs and symptoms of hollow viscus perforation. The sample size included 30 cases of duodenal perforation. RESULTS Duodenal ulcer perforation commonly occurs in the age group of 30-60 years, but it can occur in any age group. Majority of the patients were male. Smoking and alcohol consumption were risk factors in most cases (53.3% for the causation of duodenal ulcer perforation. Sudden onset of abdominal pain, situated at epigastrium and right hypochondrium was a constant symptom (100%. Vomiting, constipation and fever were not so common. CONCLUSION The emergency surgical management for perforated duodenal ulcer is by

  9. [Adaptive clinical study methodologies in drug development].

    Science.gov (United States)

    Antal, János

    2015-11-29

    The evolution of drug development in human, clinical phase studies triggers the overview of those technologies and procedures which are labelled as adaptive clinical trials. The most relevant procedural and operational aspects will be discussed in this overview from points of view of clinico-methodological aspect.

  10. The status of maternal and newborn care services in Sierra Leone 8 years after ceasefire.

    Science.gov (United States)

    Oyerinde, Koyejo; Harding, Yvonne; Amara, Philip; Kanu, Rugiatu; Shoo, Rumishael; Daoh, Kizito

    2011-08-01

    To conduct a needs assessment for emergency obstetric care (EmOC) to address the unacceptably high maternal and newborn mortality indices in Sierra Leone 8 years after the end of the civil war. From June to August 2008, a cross-sectional survey was conducted of health facilities in Sierra Leone offering delivery services. Assessment tools were local adaptations of tools developed by the Averting Maternal Death and Disability program at Columbia University, New York, USA. There were enough comprehensive EmOC (CEmOC) facilities in the country but they were poorly distributed. There were no basic EmOC (BEmOC) facilities. Few facilities (37% of hospitals and 2% of health centers) were able to perform assisted vaginal delivery (AVD), and 3 potentially BEmOC facilities did not meet the standard only because they did not perform AVD. Severe shortages in staff, equipment, and supplies, and unsatisfactory supply of utilities severely hampered the delivery of quality EmOC services. Demand for maternity and newborn services was low, which may have been related to the poor quality and the high/unpredictable out-of-pocket cost of such services. Significant increases in the uptake of institutional delivery services, the linkage of remote health workers to the health system, and the recruitment of midwives, in addition to rapid expansion in the training of health workers (including training in midwifery and obstetric surgery skills), are urgently needed to improve the survival of mothers and newborns. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Trends in indications and techniques of corneal transplantation in Iran from 2006 to 2013; an 8-year review

    Directory of Open Access Journals (Sweden)

    Mozhgan Rezaei Kanavi

    2016-01-01

    Conclusion: KCN was the most common indication and PKP was the most prevalent technique used for corneal transplantation. Significant changes in surgical techniques were observed over the past 8 years; DSAEK demonstrated an increasing trend while PKP showed a decrease.

  12. Feelings of being disabled as a risk factor for mortality up to 8 years after acute myocardial infarction

    DEFF Research Database (Denmark)

    van der Vlugt, Maureen J; van Domburg, Ron T; Pedersen, Susanne S.;

    2005-01-01

    We examined the independent prognostic value of the four subscales of the Heart Patients Psychological Questionnaire (HPPQ) on mortality in acute myocardial infarction (AMI) survivors up to 8 years after the event....

  13. [Clinical research III. The causality studies].

    Science.gov (United States)

    Talavera, Juan O; Wacher-Rodarte, Niels H; Rivas-Ruiz, Rodolfo

    2011-01-01

    The need to solve a clinical problem leads us to establish a starting point to address (risk, prognosis or treatment studies), all these cases seek to attribute causality. Clinical reasoning described in the book Clinical Epidemiology. The architecture of clinical research, offers a simple guide to understanding this phenomenon. And proposes three basic components: baseline, maneuver and outcome. In this model, different systematic errors (bias) are described, which may be favored by omitting characteristics of the three basic components. Thus, omissions in the baseline characteristics cause an improper assembly of the population and susceptibility bias, omissions in the application or evaluation of the maneuver provoke performance bias, and omissions in the assessment of out-come cause detection bias and transfer bias. Importantly, if this way of thinking facilitates understanding of the causal phenomenon, the appropriateness of the variables to be selected in the studies to which attribute or not causality, require additional arguments for evaluate clinical relevance.

  14. No childhood development of viewpoint-invariant face recognition: evidence from 8-year-olds and adults.

    Science.gov (United States)

    Crookes, Kate; Robbins, Rachel A

    2014-10-01

    Performance on laboratory face tasks improves across childhood, not reaching adult levels until adolescence. Debate surrounds the source of this development, with recent reviews suggesting that underlying face processing mechanisms are mature early in childhood and that the improvement seen on experimental tasks instead results from general cognitive/perceptual development. One face processing mechanism that has been argued to develop slowly is the ability to encode faces in a view-invariant manner (i.e., allowing recognition across changes in viewpoint). However, many previous studies have not controlled for general cognitive factors. In the current study, 8-year-olds and adults performed a recognition memory task with two study-test viewpoint conditions: same view (study front view, test front view) and change view (study front view, test three-quarter view). To allow quantitative comparison between children and adults, performance in the same view condition was matched across the groups by increasing the learning set size for adults. Results showed poorer memory in the change view condition than in the same view condition for both adults and children. Importantly, there was no quantitative difference between children and adults in the size of decrement in memory performance resulting from a change in viewpoint. This finding adds to growing evidence that face processing mechanisms are mature early in childhood.

  15. Psychological Resources are Associated with Reduced Incidence of Coronary Heart Disease. An 8-Year Follow-up of a Community-Based Swedish Sample

    OpenAIRE

    Lundgren, Oskar; Garvin, Peter; Jonasson, Lena; Andersson, Gerhard; Kristenson, Margareta

    2014-01-01

    Background A large number of studies have provided clear evidence for a link between the risk of coronary heart disease and psychological risk factors. Much less attention has been given to the potential protective effect of psychological resources. Purpose The major aim of this study was to investigate the independent association between psychological resources and incidence of coronary heart disease (CHD) in an 8-year follow-up study of a Swedish community-based cohort. Methods The cohort c...

  16. Tuberculosis incidence rates during 8 years of follow-up of an antiretroviral treatment cohort in South Africa: comparison with rates in the community.

    Directory of Open Access Journals (Sweden)

    Ankur Gupta

    Full Text Available BACKGROUND: Although antiretroviral therapy (ART is known to be associated with time-dependent reductions in tuberculosis (TB incidence, the long-term impact of ART on incidence remains imprecisely defined due to limited duration of follow-up and incomplete CD4 cell count recovery in existing studies. We determined TB incidence in a South African ART cohort with up to 8 years of follow-up and stratified rates according to CD4 cell count recovery. We compared these rates with those of HIV-uninfected individuals living in the same community. METHODOLOGY/PRINCIPAL FINDINGS: Prospectively collected clinical data on patients receiving ART in a community-based cohort in Cape Town were analysed. 1544 patients with a median follow-up of 5.0 years (IQR 2.4-5.8 were included in the analysis. 484 episodes of incident TB (73.6% culture-confirmed were diagnosed in 424 patients during 6506 person-years (PYs of follow-up. The TB incidence rate during the first year of ART was 12.4 (95% CI 10.8-14.4 cases/100PYs and decreased to 4.92 (95% CI 3.64-8.62 cases/100PYs between 5 and 8 years of ART. During person-time accrued within CD4 cell strata 0-100, 101-200, 201-300, 301-400, 401-500, 501-700 and ≥700 cells/µL, TB incidence rates (95% CI were 25.5 (21.6-30.3, 11.2 (9.4-13.5, 7.9 (6.4-9.7, 5.0 (3.9-6.6, 5.1 (3.8-6.8, 4.1 (3.1-5.4 and 2.7 (1.7-4.5 cases/100PYs, respectively. Overall, 75% (95% CI 70.9-78.8 of TB episodes were recurrent cases. Updated CD4 cell count and viral load measurements were independently associated with long-term TB risk. TB rates during person-time accrued in the highest CD4 cell count stratum (>700 cells/µL were 4.4-fold higher that the rate in HIV uninfected individuals living in the same community (2.7 versus 0.62 cases/100PYs; 95%CI 0.58-0.65. CONCLUSIONS/SIGNIFICANCE: TB rates during long-term ART remained substantially greater than rates in the local HIV uninfected populations regardless of duration of ART or attainment of CD4

  17. Effect of maternal dietary counselling during the 1st year of life on glucose profile and insulin resistance at the age of 8 years: a randomised field trial.

    Science.gov (United States)

    Costa, Cintia S; Campagnolo, Paula D B; Lumey, L H; Vitolo, Marcia R

    2017-01-01

    Education interventions that stimulate complementary feeding practices can improve the nutritional status of children and may protect against future chronic diseases. We assessed the long-term effectiveness of dietary intervention during the 1st year of life on insulin resistance levels, and investigated the relationship between insulin resistance and weight changes over time. A randomised field trial was conducted among 500 mothers who gave birth to full-term infants between October 2001 and June 2002 in a low-income area in São Leopoldo, Brazil. Mother-child pairs were randomly assigned to intervention (n 200) and control groups (n 300), and the mothers in the intervention group received dietary counselling on breast-feeding and complementary feeding of their children during the 1st year of life. Fieldworkers blinded to assignment assessed socio-demographic, dietary and anthropometric data during follow-up at ages 1, 4 and 8 years. Blood tests were performed in 305 children aged 8 years to measure fasting serum glucose and insulin concentrations and the homoeostasis model assessment index of insulin resistance (HOMA-IR). At the age of 8 years, the intervention group showed no changes in glucose and insulin concentrations or HOMA-IR values (change 0·07; 95 % CI -0·06, 0·21 for girls; and change -0·07; 95 % CI -0·19, 0·04 for boys) compared with study controls. Insulin resistance was highly correlated, however, with increases in BMI between birth and 8 years of age. Although this dietary intervention had no impact on glucose profile at age 8 years, our findings suggest that BMI changes in early childhood can serve as an effective marker of insulin resistance.

  18. Precocious Puberty or Premature Thelarche: Analysis of a Large Patient Series in a Single Tertiary Center with Special Emphasis on 6- to 8-Year-Old Girls.

    Science.gov (United States)

    Varimo, Tero; Huttunen, Heta; Miettinen, Päivi Johanna; Kariola, Laura; Hietamäki, Johanna; Tarkkanen, Annika; Hero, Matti; Raivio, Taneli

    2017-01-01

    We describe the etiology, MRI findings, and growth patterns in girls who had presented with signs of precocious puberty (PP), i.e., premature breast development or early menarche. Special attention was paid to the diagnostic findings in 6- to 8-year-olds. We reviewed the medical records of 149 girls (aged 0.7-10.3 years) who had been evaluated for PP in the Helsinki University Hospital between 2001 and 2014. In 6- to 8-year-old girls, PP was most frequently caused by idiopathic gonadotropin-releasing hormone (GnRH)-dependent PP (60%) and premature thelarche (PT; 39%). The former subgroup grew faster (8.7 ± 2.0 cm/year, n = 58) than the girls with PT (7.0 ± 1.1 cm/year, n = 32) (P year (sensitivity 92% and specificity 58%) [area under the curve 0.82, 95% confidence interval (CI) 0.73-0.91, P year-old girls with GnRH-dependent PP, one (1.7%, 95% CI 0.3-9.7%) had a pathological brain MRI finding requiring surgical intervention (craniopharyngioma). In girls younger than 3 years, the most frequent cause of breast development was PT, and, in 3- to 6-year-olds, GnRH-dependent PP. In 6- to 8-year-old girls, analysis of growth velocity is helpful in differentiating between PT and GnRH-dependent PP. Although the frequency of clinically relevant intracranial findings in previously healthy, asymptomatic 6- to 8-year-old girls was low, they can present without any signs or symptoms, which favors routine MRI imaging also in this age group.

  19. Unemployment and coronary heart disease among middle-aged men in Sweden: 39 243 men followed for 8 years.

    Science.gov (United States)

    Lundin, Andreas; Falkstedt, Daniel; Lundberg, Ingvar; Hemmingsson, Tomas

    2014-03-01

    Although unemployment may be a stressful life event, its association with coronary heart disease (CHD) remains unclear. This study examines the association between unemployment and later hospitalisation due to CHD. The study was based on a Swedish military conscription cohort of 18 to 20-year-old men from 1969/1970 (n=49 321) with information provided on health status and health behaviours. Information on unemployment in middle age was obtained from national registers. CHD information was obtained from hospital registers and the cause of death register. Cox proportional hazard analyses were run on the 39 243 individuals who were in paid employment in 1996 and 1997. It was found that ≥90 days of unemployment was associated with subsequent CHD during 8 years follow-up (crude HR=1.47, 95% CI 1.23 to 1.75). Controlling for known risk factors for CHD reduced the association but a significant association remained (HR=1.24, 95% CI 1.04 to 1.48); ≥90 days of unemployment was significantly associated with CHD during the first 4 years (HR adjusted for known risk factors=1.31, 95% CI 1.01 to 1.71). Unemployment was associated with increased risk of CHD after adjustment for confounders. We interpret the increased risk of CHD associated with unemployment as potentially the somatic result of a process started by stress.

  20. An 8-year experience with routine SL mix patch testing supplemented with Compositae mix in Denmark

    DEFF Research Database (Denmark)

    Paulsen, E; Andersen, Klaus Ejner; Hausen, B M

    2001-01-01

    males (mean age 55 years), and 83% of reactions considered clinically relevant. 22% were suspected of occupational sensitization/dermatitis. 62% had a contact allergy to 2 or more compounds, most often to nickel, fragrance and colophonium. SL mix detected 65%, CM 87% of Compositae-allergic patients...

  1. Osteosynthesis of medial humeral epicondyle fractures in children. 8-year follow-up of 33 cases

    DEFF Research Database (Denmark)

    Duun, P S; Ravn, Pernille; Hansen, L B;

    1994-01-01

    33 children with a mean age of 12 (7-15) years had open reduction and osteosynthesis for a displaced fracture of the medial humeral epicondyle. 8 (2-15) years after the operation a clinical and radiographic examination was performed. 22/33 had a prominent scar. No patients had symptoms from...

  2. Hirschsprung′s disease: 8 years experience in a Nigerian teaching hospital

    Directory of Open Access Journals (Sweden)

    Nasir A

    2007-01-01

    Full Text Available Background: Hirschsprung′s disease (HD is a common cause of intestinal obstruction in children. Despite increased understanding of the disease and several techniques of treatment, significant complications continued to be associated with its management. Objective: To study the outcome of management of HD in the University Teaching Hospital, Ilorin, Nigeria. Materials and Methods: The clinical records of all children managed for HD between January 1998 and December 2005 were retrospectively reviewed. Demographic data, modes of presentation, methods of diagnosis, age at colostomy formation, age and type of definitive operations were noted from patients′ records. Complications associated with colostomy, pre- and postoperative complications, final outcome and duration of follow-up were also noted. Results: Twenty-one patients (20 males, one female managed for HD were reviewed. Eight (38% were diagnosed in the neonatal period, the mean age at diagnosis being 22 months. Fourteen patients had completed the three stages of the operation, one is awaiting colostomy closure and two patients are waiting for definitive operations. Out of the 15 patients who had definitive surgery, nine had Swenson′s pull-through operations while six had Duhamel operations. At presentation, six patients had enterocolitis, one of whom had spontaneous colonic perforation, two patients had sepsis. Colostomy-related complications recorded included sixteen patients with dermatitis, nine with colostomy prolapse, one patient with colostomy diarrhea and one with enterocolitis and sepsis. Following definitive surgery, three patients had wound infection, one partial intestinal obstruction, one postDuhamel hemorrhage and two enterocolitis. Complications after colostomy closure included two wound infections and one severe enterocolitis. There were five deaths (23.8%-two from sepsis, two from enterocolitis and one from an adverse drug reaction. One of the children who had

  3. Kimura's disease: case report of an Italian young male and response to oral cyclosporine A in an 8 years follow-up.

    Science.gov (United States)

    Beccastrini, Enrico; Emmi, Giacomo; Chiodi, Michela; Di Paolo, Camilla; Benedetta Silvestri, Elena; Massi, Daniela; Maggi, Enrico; Liotta, Francesco; Emmi, Lorenzo

    2013-03-01

    Kimura's disease is a benign chronic inflammatory disease, common in Asian males and rare in Western people. Clinically, Kimura's disease is characterized by subcutaneous nodular lesions, usually localised in head and neck, often associated with regional lymphadenopathy. Peripheral blood eosinophilia and elevated serum IgE are often observed. We report a case of a 40-year-old Italian patient presenting with nodular subcutaneous lesions and peripheral eosinophilia. Based on clinical, histopathological and laboratory findings, a diagnosis of Kimura's disease was made. The patient was treated with very low doses of cyclosporine A with no evidence of disease recurrence over the following 8 years. However, the discontinuation of cyclosporine A determined a relapse of the disease. The relevance of this case is due to the rarity of the disease in Italy, to its peculiar clinical presentation and, moreover, it is the first case in literature that has a good response to treatment with low doses of cyclosporine A, documented in an 8-year follow-up.

  4. PPB | What is a Clinical Study

    Science.gov (United States)

    The Pleuropulmonary blastoma (PPB) DICER1 Syndrome Study ‹an observational clinical research study‹is enrolling children with PPB and their families. In an observational study, investigators assess health outcomes in groups of participants according to a protocol or research plan.

  5. Clinical and Epidemiological Studies on Rickettsial Infections.

    Science.gov (United States)

    1980-06-01

    EPIDEMOLOGICAL STUDIES ON RICKETTSIAL INFECTI011-"- APPLICATION FOR RENEWAL FOR TEAR-7 (1979-1980) Pase 2 Repor Page 11 effective control of the infection were...34CLINICAL AND EPIDEMOLOGICAL STUDIES ON RICKETTSIAL INFECTIONS" ANINUAL REPORT. YFAR-7(1979-1980) Page 62 Report Page 31 OFFICE OF NAVAL RESEARCH

  6. Summary reports for key Hoodia clinical studies

    CSIR Research Space (South Africa)

    Maharaj, VJ

    2011-12-01

    Full Text Available The CSIR has acquired the reports to 14 clinical studies in which Hoodia has been assesses, using crude extracts and concentrated active ingredients formulated in a number of different ways. In many of the studies Hoodia was found to be generally...

  7. Molecular characterization of HCV in a Swedish county over 8 years (2002–2009 reveals distinct transmission patterns

    Directory of Open Access Journals (Sweden)

    Josefine Ederth

    2016-02-01

    Full Text Available Background: Hepatitis C virus (HCV is a major public health concern and data on its molecular epidemiology in Sweden is scarce. We carried out an 8-year population-based study of newly diagnosed HCV cases in one of Sweden's centrally situated counties, Södermanland (D-county. The aim was to characterize the HCV strains circulating, analyze their genetic relatedness to detect networks, and in combination with demographic data learn more about transmission. Methods: Molecular analyses of serum samples from 91% (N=557 of all newly notified cases in D-county, 2002–2009, were performed. Phylogenetic analysis (NS5B gene, 300 bp was linked to demographic data from the national surveillance database, SmiNet, to characterize D-county transmission clusters. The linear-by-linear association test (LBL was used to analyze trends over time. Results: The most prevalent subtypes were 1a (38% and 3a (34%. Subtype 1a was most prevalent among cases transmitted via sexual contact, via contaminated blood, or blood products, while subtype 3a was most prevalent among people who inject drugs (PWIDs. Phylogenetic analysis revealed that the subtype 3a sequences formed more and larger transmission clusters (50% of the sequences clustered, while the 1a sequences formed smaller clusters (19% of the sequences clustered, possibly suggesting different epidemics. Conclusion: We found different transmission patterns in D-county which may, from a public health perspective, have implications for how to control virus infections by targeted interventions.

  8. Sporadic Creutzfeldt-Jacob Disease: An 8-Year Experience from a Single Center in Turkey.

    Science.gov (United States)

    Taşkapilioğlu, Özlem; Seferoğlu, Meral; Yurtoğullari, Şükran; Hakyemez, Bahattin; Erer, Sevda; Karli, Necdet; Bakar, Mustafa; Turan, Ö Faruk; Zarifoğlu, Mehmet; Tolunay, Şahsine; Bora, İbrahim

    2013-12-01

    Our aim was to conduct a retrospective review to demonstrate the clinical, radiological, and electrophysiological features of patients with sporadic Creutzfeldt-Jacob disease (sCJD). A total of 10 patients (5 female and 5 male, with a mean age of 45 years from a range of 40 to 67 years) out of 8.259 adult patients hospitalized from January 2000 to December 2008 were diagnosed with sCJD. Eight of the patients were diagnosed on the basis of clinical, radiological, electroencephalography (EEG), and cerebrospinal fluid (CSF) findings. Two other patients also had a pathological diagnosis. The most common signs and symptoms were behavioral disturbances, movement disorders, cognitive decline, myoclonus, psychosis, focal neurological deficit, and aphasia. Nine of the patients had periodic sharp wave discharges on EEG. Seven patients were positive for the 14.3.3 protein in the CSF. Five patients had pulvinar signs-a bilateral increased signal in the pulvinar thalami-on cranial magnetic resonance imaging. Eight patients were diagnosed with probable sCJD; two were diagnosed with definite sCJD. All of the patients died as a result of the disease within 24 months after the onset of symptoms. sCJD should be considered in the diagnosis of patients who present with rapidly progressive dementia. Clinical and radiological data appear to be sufficient for the diagnosis. However, detailed molecular examinations of the subtypes of the disease may be required for early diagnosis of cases given the wide spectra of CJD.

  9. Prevalence of DSM-IV disorders in a population-based sample of 5- to 8-year-old children: the impact of impairment criteria.

    Science.gov (United States)

    Rijlaarsdam, Jolien; Stevens, Gonneke W J M; van der Ende, Jan; Hofman, Albert; Jaddoe, Vincent W V; Verhulst, Frank C; Tiemeier, Henning

    2015-11-01

    This study determined the impact of impairment criteria on the prevalence and patterns of comorbidity of child DSM-IV disorders. The validity of these impairment criteria was tested against different measures of mental health care referral and utilization. We interviewed parents of 1,154 children aged 5-8 years in-depth using the Diagnostic Interview Schedule for Children in Rotterdam, the Netherlands, to establish DSM-IV diagnosis. These children were randomly selected or oversampled based on Child Behavior Checklist ratings from a large population-based study (N = 6,172). Referral data were extracted from the psychiatric interview as well as from a follow-up questionnaire. The results showed an overall prevalence of DSM-IV disorders of 31.1 % when impairment was not considered. This rate declined to 22.9 % when mild impairment was required and declined even further, to 10.3 %, for more severe levels of impairment. Similarly, the overall comorbidity rate declined from 8.5 to 6.7 and 2.7 % when mild and severe impairment were required, respectively. Virtually all children who attained symptom thresholds for a specific disorder, and had been referred to a mental health care professional because of the associated symptoms, also had mild impairment. The requirement of severe impairment criteria significantly increased diagnostic thresholds, but for most disorders, this definition captured only half of the clinically referred cases. In conclusion, prevalence was highly dependent upon the criteria used to define impairment. If severe impairment is made a diagnostic requirement, many children with psychiatric symptoms and mild impairment seeking mental health care will be undiagnosed and possibly untreated.

  10. Transient internuclear ophthalmoparesis associated with mutism following midline cerebellar tumour surgery in an 8-year boy

    Directory of Open Access Journals (Sweden)

    Satyarthee Guru Dutta

    2015-09-01

    Full Text Available Mutism and neurobehaviour symptoms are well known features, which may occur following surgical excision of mass lesion of various histopathologies in the posterior cranial fossa, during the postoperative period. Mutism may be rarely associated with ataxia of eyelid closure and paresis of external ocular muscles. However, internuclear ophthalmoparesis is not reported in association with mutism following posterior cranial fossa surgery. We report an 8-year–boy, who developed internuclear ophthalmoparesis following suboccipital craniectomy for decompression of vermian medulloblastoma. The clinical features, aetiopathogenesis, management of transient internuclear ophthalmoparesis associated with mutism and pertinent literature is reviewed in short.

  11. Marketing and clinical trials: a case study.

    Science.gov (United States)

    Francis, David; Roberts, Ian; Elbourne, Diana R; Shakur, Haleema; Knight, Rosemary C; Garcia, Jo; Snowdon, Claire; Entwistle, Vikki A; McDonald, Alison M; Grant, Adrian M; Campbell, Marion K

    2007-11-20

    Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, of 12 factors that may affect the success of the marketing and sales activities associated with clinical trials. The case study demonstrates that trials need various categories of people to buy in - hence, to be successful, trialists must embrace marketing strategies to some extent. The performance of future clinical trials could be enhanced if trialists routinely considered these factors.

  12. Endovascular treatment paradigm of carotid blowout syndrome: Review of 8-years experience

    Energy Technology Data Exchange (ETDEWEB)

    Wan, Wing Suet, E-mail: wws351@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Lai, Vincent, E-mail: vincentlai@hkcr.org [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Lau, Hin Yue, E-mail: lhy460@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Wong, Yiu Chung, E-mail: wongyc6@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Poon, Wai Lun, E-mail: poonwl@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong); Tan, Chong Boon, E-mail: tancb@ha.org.hk [Department of Radiology, Tuen Mun Hospital, Tuen Mun (Hong Kong)

    2013-01-15

    Objectives: Endovascular treatment is effective in treating carotid blowout syndrome (CBS). We reviewed our experience in addressing CBS over eight years and presented an account of the treatment paradigm and management algorithm. Method: All cases of CBS from 2003 to 2010 with endovascular treatment performed in our center were reviewed. 15 CBS in 14 patients were recruited. Based on our management algorithm, treatment regimen was stratified into deconstructive or constructive methods. Their clinical presentations, angiographic features, angiographic and clinical outcomes were reviewed. Results: 10 patients were treated with deconstructive method by means of permanent vessel occlusion (PVO) and 4 patients were treated with constructive method by means of placement of covered stent (n = 3) or flow diverting device (n = 1). Immediate hemostasis was achieved in all cases. 7 (50%) patients, in whom 5 treated with PVO and 2 with covered stent, had favorable outcomes and survived at a median follow-up period of 4 months (range: 1–84 months). Conclusion: Permanent vessel occlusion remains the gold standard of treatment and tends to show a favorable long-term outcome. Off-label use of covered stent and flow-diverting device can produce satisfactory results should balloon occlusion test fail, but long-term follow up would be required for definitive assessment.

  13. Clinical evidence for Japanese population based on prospective studies--linking clinical trials and clinical practice.

    Science.gov (United States)

    Ogawa, Hisao; Kojima, Sunao

    2009-10-01

    "Evidence-based medicine (EBM)" implies effective and high quality practice for patients based on well-grounded medical science. The success of clinical trials in Japan is essential to build original evidence specific for Japanese patients. Based on this concept, we have performed several large-scale clinical trials to provide EBM, including the Japanese Antiplatelets Myocardial Infarction Study [JAMIS; clinical improvement in acute myocardial infarction (AMI) patients with antiplatelet therapy], the Japanese beta-Blockers and Calcium Antagonists Myocardial Infarction (JBCMI; comparison of the effects of beta-blockers and calcium antagonists on cardiovascular events in post-AMI patients), a multicenter study for aggressive lipid-lowering strategy by HMG-CoA reductase inhibitors in patients with AMI (MUSASHI; effects of statin therapy on cardiovascular events in patients with AMI), and the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD trial; efficacy of low-dose aspirin therapy for primary prevention of atherosclerotic events in type 2 diabetic patients). The results of these prospective studies were directly linked with clinical practice. We have acquired the know-how of large-scale clinical trials; an important point is to have passion for "buildup evidence specific for the Japanese" and to recruit subjects for enrollment after explaining the significance of "clinical trials for the Japanese".

  14. Periods of child growth up to age 8 years in Ethiopia, India, Peru and Vietnam: key distal household and community factors.

    Science.gov (United States)

    Schott, Whitney B; Crookston, Benjamin T; Lundeen, Elizabeth A; Stein, Aryeh D; Behrman, Jere R

    2013-11-01

    Recent research has demonstrated some growth recovery among children stunted in infancy. Less is known about key age ranges for such growth recovery, and what factors are correlates with this growth. This study characterized child growth up to age 1 year, and from ages 1 to 5 and 5 to 8 years controlling for initial height-for-age z-score (HAZ), and identified key distal household and community factors associated with these growth measures using longitudinal data on 7266 children in the Young Lives (YL) study in Ethiopia, India, Peru and Vietnam. HAZ at about age 1 year and age in months predicted much of the variation in HAZ at age 5 years, but 40-71% was not predicted. Similarly, HAZ at age 5 years and age in months did not predict 26-47% of variation in HAZ at 8 years. Multiple regression analysis suggests that parental schooling, consumption, and mothers' height are key correlates of HAZ at about age 1 and also are associated with unpredicted change in HAZ from ages 1 to 5 and 5 to 8 years, given initial HAZ. These results underline the importance of a child's starting point in infancy in determining his or her growth, point to key distal household and community factors that may determine early growth in early life and subsequent growth recovery and growth failure, and indicate that these factors vary some by country, urban/rural designation, and child sex.

  15. RETINAL VEIN OCCLUSIONS - A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Ramadevi

    2015-11-01

    Full Text Available Retinal vein occlusion is the most common retinal occlusive disorder encountered by opthalmologists and is usually associated with a variable amount of visual loss.The study was conducted over a period of 22 months, we performed a combined analysis of risk factors, clinical presentation, management and complication of these 51 patients

  16. Sustained High Cure Rate of Artemether-Lumefantrine against Uncomplicated Plasmodium falciparum Malaria after 8 Years of Its Wide-Scale Use in Bagamoyo District, Tanzania.

    Science.gov (United States)

    Mwaiswelo, Richard; Ngasala, Billy; Gil, J Pedro; Malmberg, Maja; Jovel, Irina; Xu, Weiping; Premji, Zul; Mmbando, Bruno P; Björkman, Anders; Mårtensson, Andreas

    2017-08-01

    We assessed the temporal trend of artemether-lumefantrine (AL) cure rate after 8 years of its wide-scale use for treatment of uncomplicated Plasmodium falciparum malaria from 2006 to 2014 in Bagamoyo district, Tanzania. Trend analysis was performed for four studies conducted in 2006, 2007-2008, 2012-2013, and 2014. Patients with acute uncomplicated P. falciparum malaria were enrolled, treated with standard AL regimen and followed-up for 3 (2006), 28 (2014), 42 (2012-2013), or 56 (2007-2008) days for clinical and laboratory evaluation. Primary outcome was day 28 polymerase chain reaction (PCR)-adjusted cure rate across years from 2007 to 2014. Parasite clearance was slower for the 2006 and 2007-2008 cohorts with less than 50% of patients cleared of parasitemia on day 1, but was rapid for the 2012-2013 and 2014 cohorts. Day 28 PCR-adjusted cure rate was 168/170 (98.8%) (95% confidence interval [CI], 97.2-100), 122/127 (96.1%) (95% CI, 92.6-99.5), and 206/207 (99.5%) (95% CI, 98.6-100) in 2007-2008, 2012-2013, and 2014, respectively. There was no significant change in the trend of cure rate between 2007 and 2014 (χ(2)trend test = 0.06, P = 0.90). Pretreatment P. falciparum multidrug-resistant gene 1 (Pfmdr1) N86 prevalence increased significantly across years from 13/48 (27.1%) in 2006 to 183/213 (85.9%) in 2014 (P falciparum malaria despite an increase in prevalence of pretreatment Pfmdr1 N86 and Pfcrt K76 between 2006 and 2014.

  17. Associations between indoor environmental factors and parental-reported autistic spectrum disorders in children 6-8 years of age

    DEFF Research Database (Denmark)

    Larsson, Malin; Weiss, Bernard; Janson, Staffan

    2009-01-01

    ). The 2005 survey, based on the same children, now 6-8 years of age, also asked if, during the intervening period, the child had been diagnosed with Autism, Asperger's syndrome, or Tourette's syndrome. From a total of 4779 eligible children, 72 (60 boys, 12 girls) were identified with parentally reported...

  18. Improved neurosensory outcome at 8 years of age of extremely low birthweight children born in Victoria over three distinct eras

    OpenAIRE

    Doyle, L; Anderson, P.; t and,

    2005-01-01

    Aim: To determine neurosensory outcome at 8 years of age of extremely low birthweight (ELBW) children born in the 1990s, how it varies with birth weight, and how it compares with ELBW children born in the 1980s and 1970s.

  19. Pilonidal cyst involving the clitoris in an 8-year-old girl--a case report and literature review.

    Science.gov (United States)

    Maor-Sagie, Esther; Arbell, Dan; Prus, Diana; Israel, Eduardo; Benshushan, Avi

    2010-11-01

    Pilonidal disease is common among adolescents and adults, mainly located in the sacral area. Pilonidal disease involving the clitoris is extremely rare and has not been described in premenarcheal girls. We present a case of a recurrent pilonidal periclitoral cyst in an 8-year-old girl which was surgically treated. Copyright © 2010 Elsevier Inc. All rights reserved.

  20. Early Head Growth: Relation with IQ at 8 Years and Determinants in Term Infants of Low and Appropriate Birthweight

    Science.gov (United States)

    Lira, Pedro I. C.; Eickmann, Sophie H.; Lima, Marilia C.; Amorim, Rosemary J.; Emond, Alan M.; Ashworth, Ann

    2010-01-01

    Aim: To investigate the relation between head growth at different periods and IQ at 8 years, and to identify factors associated with more rapid head growth. Method: Two parallel cohorts of term low birthweight (LBW) and appropriate birthweight (ABW) infants were enrolled at birth in northeast Brazil. Anthropometric measurements were made at birth,…

  1. International Guidelines on Sexuality Education and Their Relevance to a Contemporary Curriculum for Children Aged 5-8 Years

    Science.gov (United States)

    Goldman, Juliette D. G.

    2013-01-01

    This paper evaluates UNESCO's recommended sexuality educational framework for junior school students aged 5-8 years. It also compares it to an existing state-designed Health and Physical Education curriculum that includes sexual and reproductive health for the same cohort. Based on the universal values of respect and human rights, UNESCO's"…

  2. International Guidelines on Sexuality Education and Their Relevance to a Contemporary Curriculum for Children Aged 5-8 Years

    Science.gov (United States)

    Goldman, Juliette D. G.

    2013-01-01

    This paper evaluates UNESCO's recommended sexuality educational framework for junior school students aged 5-8 years. It also compares it to an existing state-designed Health and Physical Education curriculum that includes sexual and reproductive health for the same cohort. Based on the universal values of respect and human rights, UNESCO's"…

  3. Good clinical practices in phase I studies.

    Science.gov (United States)

    Decousus, H; Perpoint, B; Mismetti, P; Ollagnier, M; Queneau, P

    1990-01-01

    In France, official guidelines for good clinical practices in clinical trials were issued in 1987. In December 1988, a law was passed that fixed the requirements for carrying out experiments in healthy subjects. It will be completed by official guidelines for the structures in which experiments on healthy subjects (and patients as well, when the investigation would not benefit the health of the patients) may be conducted. Hence a battery of recent legal instructions precisely state what good clinical practices are in the setting of phase I studies. Of particular importance are: subject recruitment and selection methods and procedures; specific competence of the investigator, in particular to interpret the pre-trial data; necessary and sufficient facilities to guarantee the subjects' safety; careful quality control to check all laboratory procedures; necessity of written standard operating procedures.

  4. Parapsoriasis in two children: a clinical, immunophenotypic, and immunogenotypic study.

    Science.gov (United States)

    Menni, S; Piccinno, R; Crosti, L; Berti, E

    1994-06-01

    Parapsoriasis has been described rarely in childhood; a few reports mention this condition as preceding early mycosis fungoides. We report a boy age 15 and a girl age 8 years with different clinical features of parapsoriasis who were followed clinically and histologically for about four years. Immunophenotyping of the skin infiltrate and a T cell receptor gene rearrangement analysis were performed on each. The infiltrate was composed mainly of CD4+ and CD45+ lymphocytes in the first patient and of CD8+ and CD45+ in the second. No T cell receptor gene rearrangements were found. The paucity of knowledge about the evolution of this entity in childhood and its relationship to mycosis fungoides makes follow-up critical. The importance of immunophenotyping and immunogenotyping is particularly stressed.

  5. The role of orbitofrontal cortex in processing empathy stories in 4-8 year-old children

    Directory of Open Access Journals (Sweden)

    Tila Tabea eBrink

    2011-04-01

    Full Text Available This study investigates the neuronal correlates of empathic processing in childrenaged 4 to 8 years, an age range discussed to be crucial for the development ofempathy. Empathy, defined as the ability to understand and share another person’sinner life, consists of two components: affective (emotion-sharing and cognitiveempathy (Theory of Mind. We examined the hemodynamic responses of pre-schooland school children (N=48, while they processed verbal (auditory and non-verbal(cartoons empathy stories in a passive following paradigm, using functional NearInfrared Spectroscopy (fNIRS. To control for the two types of empathy, childrenwere presented blocks of stories eliciting either affective or cognitive empathy, orneutral scenes which relied on the understanding of physical causalities.By contrasting the activations of the younger and older children, we expected toobserve developmental changes in brain activations when children process storieseliciting empathy in either stimulus modality towards a greater involvement ofanterior frontal brain regions. Our results indicate that children's processing of storieseliciting affective and cognitive empathy is associated with medial and bilateralorbitofrontal cortex (OFC activation. In contrast to what is known from studies usingadult participants, no additional recruitment of posterior brain regions was observed,often associated with the processing of stories eliciting empathy. Developmentalchanges were found only for stories eliciting affective empathy with increasedactivation, in older children, in medial OFC, left inferior frontal gyrus (IFG, and theleft dorsolateral prefrontal cortex (dlPFC. Activations for the two modalities differonly little, with non-verbal presentation of the stimuli having a greater impact onempathy processing in children, showing more similarities to adult processing thanthe verbal one. This might be caused by the fact that non-verbal processing developsearlier in life

  6. Changing attitudes toward needle biopsies of breast cancer in Shanghai: experience and current status over the past 8 years.

    Science.gov (United States)

    Hao, Shuang; Liu, Zhe-Bin; Ling, Hong; Chen, Jia-Jian; Shen, Ju-Ping; Yang, Wen-Tao; Shao, Zhi-Min

    2015-01-01

    Diagnostic patterns in breast cancer have greatly changed over the past few decades, and core needle biopsy (CNB) has become a reliable procedure for detecting breast cancer without invasive surgery. To estimate the changing diagnostic patterns of breast cancer in urban Shanghai, 11,947 women with breast lesions detected by preoperative needle biopsy between January 1995 and December 2012 were selected from the Shanghai Cancer Data base, which integrates information from approximately 50% of breast cancer patients in Shanghai. The CNB procedure uses an automated prone unit, biopsy gun, and 14-gauge needles under freehand or ultrasound guidance and was performed by experienced radiologists and surgeons specializing in needle biopsies. Diagnosis and classification for each patient were independently evaluated by pathologists. Over the indicated 8-year period, biopsy type consisted of 11,947 ultrasound-guided core needle biopsies (UCNBs), 2,015 ultrasound-guided vacuum-assisted biopsies (UVABs), and 654 stereotactic X-ray-guided vacuum-assisted biopsies (XVABs). For all the 11,947 women included in this study, image-guided needle biopsy was the initial diagnostic procedure. Approximately 81.0% of biopsied samples were histopathologically determined to be malignant lesions, 5.5% were determined to be high-risk lesions, and 13.5% were determined to be benign lesions. The number of patients choosing UCNB increased at the greatest rate, and UCNB has become a standard procedure for histodiagnosis because it is inexpensive, convenient, and accurate. The overall false-negative rate of CNB was 1.7%, and the specific false-negative rates for UCNB, UVAB, and XVAB, were 1.7%, 0%, and 0%, respectively. This study suggests that the use of preoperative needle biopsy as the initial breast cancer diagnostic procedure is acceptable in urban Shanghai. Preoperative needle biopsy is now a standard procedure in the Shanghai Cancer Center because it may reduce the number of surgeries

  7. Effects of drought season length on live moisture content dynamic in Mediterranean shrubs: 8 years of data

    Science.gov (United States)

    Pellizzaro, Grazia; Ventura, Andrea; Bortolu, Sara; Duce, Pierpaolo

    2017-04-01

    Mediterranean shrubs are an important component of Mediterranean vegetation communities. In this kind of vegetation, live fuel is a relevant component of the available fuel which catches fire and, consequently, its water content plays an important role in determining fire occurrence and spread. In live plant, water content patterns are related to both environmental conditions (e.g. meteorological variables, soil water availability) and ecophysiological characteristics of the plant species. According to projections on future climate, an increase in risk of summer droughts is likely to take place in Southern Europe. More prolonged drought seasons induced by climatic changes are likely to influence general flammability characteristics of fuel. In addition, variations in precipitation and mean temperature could directly affect fuel water status and length of critical periods of high ignition danger for Mediterranean ecosystems. The aims of this work were to analyse the influence of both weather seasonality and inter-annual weather variability on live fuel moisture content within and among some common Mediterranean species, and to investigate the effects of prolonged drought season on live moisture content dynamic. The study was carried out in North Sardinia (Italy). Measurements of LFMC seasonal pattern of two really common and flammable Mediterranean shrub species (Cistus monspeliensis and Rosmarinus officinalis) were performed periodically for 8 years. Meteorological variables were also recorded. Relationships between live fuel moisture content and environmental conditions (i.e. rainfall, air temperature and soil moisture) were investigated and effects of different lengths of drought season on LFMC pattern were analysed. Results showed that distribution and amount of rainfall affected seasonal variation of live fuel moisture content. In particular more prolonged drought seasons caused a longer period in which LFMC was below 95 -100% that is commonly considered as

  8. The role of orbitofrontal cortex in processing empathy stories in 4- to 8-year-old children.

    Science.gov (United States)

    Brink, Tila Tabea; Urton, Karolina; Held, Dada; Kirilina, Evgeniya; Hofmann, Markus J; Klann-Delius, Gisela; Jacobs, Arthur M; Kuchinke, Lars

    2011-01-01

    This study investigates the neuronal correlates of empathic processing in children aged 4-8 years, an age range discussed to be crucial for the development of empathy. Empathy, defined as the ability to understand and share another person's inner life, consists of two components: affective (emotion-sharing) and cognitive empathy (Theory of Mind). We examined the hemodynamic responses of preschool and school children (N = 48), while they processed verbal (auditory) and non-verbal (cartoons) empathy stories in a passive following paradigm, using functional Near-Infrared Spectroscopy. To control for the two types of empathy, children were presented blocks of stories eliciting either affective or cognitive empathy, or neutral scenes which relied on the understanding of physical causalities. By contrasting the activations of the younger and older children, we expected to observe developmental changes in brain activations when children process stories eliciting empathy in either stimulus modality toward a greater involvement of anterior frontal brain regions. Our results indicate that children's processing of stories eliciting affective and cognitive empathy is associated with medial and bilateral orbitofrontal cortex (OFC) activation. In contrast to what is known from studies using adult participants, no additional recruitment of posterior brain regions was observed, often associated with the processing of stories eliciting empathy. Developmental changes were found only for stories eliciting affective empathy with increased activation, in older children, in medial OFC, left inferior frontal gyrus, and the left dorsolateral prefrontal cortex. Activations for the two modalities differ only little, with non-verbal presentation of the stimuli having a greater impact on empathy processing in children, showing more similarities to adult processing than the verbal one. This might be caused by the fact that non-verbal processing develops earlier in life and is more familiar.

  9. Left ventricular noncompaction: Clinical-echocardiographic study

    Directory of Open Access Journals (Sweden)

    Nikolić Aleksandra

    2012-01-01

    Full Text Available Background/Aim. Left ventricular noncompaction (LVNC is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System. Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

  10. Normal-Pressure Hydrocephalus Case Report: Self-Documented Over 8 Years with the Author's Observations.

    Science.gov (United States)

    Elsabbagh, Omer

    2016-01-01

    Normal-pressure hydrocephalus is an almost curable disease, but the results of management are still not encouraging owing to the deceptive nature of the disease and its sensitivity to treatment. This has made the management of the disease controversial. The following self-documented report clarifies this. I have reported my experience in a scientific manner so that my colleagues can understand thoroughly certain facts related to intracranial hypertension. Achieving the optimal adjustment of the valve is a real challenge. I describe in detail the adjustment criteria I discovered. I believe that the use of biofeedback waves are almost the best way to make a proper adjustment of the valve, that is, if waves come from this machine and show increased tension of the facial muscles (high spiky waves) the valve adjustment has to be reduced without risking overdrainage. I have been observing my symptoms in some detail, which led me to a better understanding of the clinical pictures related to cerebrospinal fluid changes. I hope that uncovering my story can help with further research and improve management in this important and interesting field.

  11. The Economic Benefits Resulting from the First 8 Years of the Global Programme to Eliminate Lymphatic Filariasis (2000–2007)

    Science.gov (United States)

    Chu, Brian K.; Hooper, Pamela J.; Bradley, Mark H.; McFarland, Deborah A.; Ottesen, Eric A.

    2010-01-01

    Background Between 2000–2007, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) delivered more than 1.9 billion treatments to nearly 600 million individuals via annual mass drug administration (MDA) of anti-filarial drugs (albendazole, ivermectin, diethylcarbamazine) to all at-risk for 4–6 years. Quantifying the resulting economic benefits of this significant achievement is important not only to justify the resources invested in the GPELF but also to more fully understand the Programme's overall impact on some of the poorest endemic populations. Methodology To calculate the economic benefits, the number of clinical manifestations averted was first quantified and the savings associated with this disease prevention then analyzed in the context of direct treatment costs, indirect costs of lost-labor, and costs to the health system to care for affected individuals. Multiple data sources were reviewed, including published literature and databases from the World Health Organization, International Monetary Fund, and International Labour Organization Principal Findings An estimated US$21.8 billion of direct economic benefits will be gained over the lifetime of 31.4 million individuals treated during the first 8 years of the GPELF. Of this total, over US$2.3 billion is realized by the protection of nearly 3 million newborns and other individuals from acquiring lymphatic filariasis as a result of their being born into areas freed of LF transmission. Similarly, more than 28 million individuals already infected with LF benefit from GPELF's halting the progression of their disease, which results in an associated lifetime economic benefit of approximately US$19.5 billion. In addition to these economic benefits to at-risk individuals, decreased patient services associated with reduced LF morbidity saves the health systems of endemic countries approximately US$2.2 billion. Conclusions/Significance MDA for LF offers significant economic benefits. Moreover, with

  12. The economic benefits resulting from the first 8 years of the Global Programme to Eliminate Lymphatic Filariasis (2000-2007.

    Directory of Open Access Journals (Sweden)

    Brian K Chu

    Full Text Available BACKGROUND: Between 2000-2007, the Global Programme to Eliminate Lymphatic Filariasis (GPELF delivered more than 1.9 billion treatments to nearly 600 million individuals via annual mass drug administration (MDA of anti-filarial drugs (albendazole, ivermectin, diethylcarbamazine to all at-risk for 4-6 years. Quantifying the resulting economic benefits of this significant achievement is important not only to justify the resources invested in the GPELF but also to more fully understand the Programme's overall impact on some of the poorest endemic populations. METHODOLOGY: To calculate the economic benefits, the number of clinical manifestations averted was first quantified and the savings associated with this disease prevention then analyzed in the context of direct treatment costs, indirect costs of lost-labor, and costs to the health system to care for affected individuals. Multiple data sources were reviewed, including published literature and databases from the World Health Organization, International Monetary Fund, and International Labour Organization PRINCIPAL FINDINGS: An estimated US$21.8 billion of direct economic benefits will be gained over the lifetime of 31.4 million individuals treated during the first 8 years of the GPELF. Of this total, over US$2.3 billion is realized by the protection of nearly 3 million newborns and other individuals from acquiring lymphatic filariasis as a result of their being born into areas freed of LF transmission. Similarly, more than 28 million individuals already infected with LF benefit from GPELF's halting the progression of their disease, which results in an associated lifetime economic benefit of approximately US$19.5 billion. In addition to these economic benefits to at-risk individuals, decreased patient services associated with reduced LF morbidity saves the health systems of endemic countries approximately US$2.2 billion. CONCLUSIONS/SIGNIFICANCE: MDA for LF offers significant economic benefits

  13. Maternal overweight before pregnancy and asthma in offspring followed for 8 years.

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A.H.; Brunekreef, B.; Kerkhof, M.; Postma, D.S.; Oldenwening, M.; de Jongste, J.C.; Smit, H.A.

    2010-01-01

    OBJECTIVE: The aim of this study was to investigate the association between maternal overweight before pregnancy and offspring asthma in an ongoing birth cohort study. Maternal overweight may affect the pulmonary and immunological development of the fetus in utero because of the increased levels of

  14. Maternal overweight before pregnancy and asthma in offspring followed for 8 years

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A. H.; Brunekreef, B.; Kerkhof, M.; Postma, D. S.; Oldenwening, M.; de Jongste, J. C.; Smit, H. A.

    2010-01-01

    Objective: The aim of this study was to investigate the association between maternal overweight before pregnancy and offspring asthma in an ongoing birth cohort study. Maternal overweight may affect the pulmonary and immunological development of the fetus in utero because of the increased levels of

  15. A Right Middle Cerebral Artery Infarct After Frontal Eosinophilic Granuloma Resection in an 8-Year-Old Boy with Factor V Leiden.

    Science.gov (United States)

    Cakir, Ertugrul; Arslan, Erhan; Yazar, Ugur; Reis, Gokce Pinar

    2015-01-01

    Stroke in children is relatively uncommon. We describe an 8-year-old boy diagnosed with primary eosinophilic granuloma (EG) of the frontal bone. After excision of the EG, the postoperative course was eventful. The patient had an acute right middle cerebral artery (MCA) infarct and had been comatose with a diminished Glasgow Coma Scale (GCS) score of 5. Urgent decompressive hemicraniectomy with duraplasty was performed. The postoperative course after the second operation was uneventful. Hematological tests revealed a diagnosis of factor V Leiden. The patient was discharged with left hemiparesis and GCS of 15. To the best of our knowledge, no such clinical picture of MCA infarction after EG excision has been described before. Neurosurgeons should be aware of inherited thrombophilias, such as factor V Leiden, if the postoperative clinical course worsens because of cerebral artery thrombosis. Also, decompressive hemicraniectomy could be life saving and should be performed urgently without any hesitation.

  16. Comorbidity and correlates of disruptive mood dysregulation disorder in 6-8-year-old children with ADHD.

    Science.gov (United States)

    Mulraney, Melissa; Schilpzand, Elizabeth J; Hazell, Philip; Nicholson, Jan M; Anderson, Vicki; Efron, Daryl; Silk, Timothy J; Sciberras, Emma

    2016-03-01

    This study aimed to characterize the nature and impact of disruptive mood dysregulation disorder (DMDD) in children with attention-deficit/hyperactivity disorder (ADHD) including its co-occurrence with other comorbidities and its independent influence on daily functioning. Children with ADHD (6-8 years) were recruited through 43 Melbourne schools, using a 2-stage screening (parent and teacher Conners 3 ADHD index) and case-confirmation (Diagnostic Interview Schedule for Children, Version IV; [DISC-IV]) procedure. Proxy DMDD diagnosis was confirmed via items from the oppositional defiant disorder (ODD) and major depressive disorder modules of the DISC-IV. Outcome domains included comorbid mental health disorders, academic functioning, social functioning, child and family quality of life, parent mental health, and parenting behaviors. Unadjusted and adjusted linear and logistic regression were used to compare children with comorbid ADHD and DMDD and children with ADHD without DMDD. Thirty-nine out of 179 children (21.8 %) with ADHD had comorbid DMDD. Children with ADHD and DMDD had a high prevalence of ODD (89.7 %) and any anxiety disorder (41.0 %). Children with ADHD and DMDD had poorer self-control and elevated bullying behaviors than children with ADHD without DMDD. Children with ADHD and DMDD were similar to children with ADHD in the other domains measured when taking into account other comorbidities including ODD. One in five children with ADHD in their second year of formal schooling met criteria for DMDD. There was a very high diagnostic overlap with ODD; however, the use of a proxy DMDD diagnosis containing items from the ODD module of the DISC-IV may have artificially inflated the comorbidity rates. DMDD added to the burden of ADHD particularly in the area of social functioning.

  17. High Plasma Homocysteine Increases Risk of Metabolic Syndrome in 6 to 8 Year Old Children in Rural Nepal

    Directory of Open Access Journals (Sweden)

    Mohsin Yakub

    2014-04-01

    Full Text Available Little attention has been given to the association of plasma homocysteine (Hcy and metabolic syndrome (MetS in children. We have evaluated the risk of MetS with plasma Hcy in a cohort of 6 to 8 year old rural Nepalese children, born to mothers who had participated in an antenatal micronutrient supplementation trial. We assessed Hcy in plasma from a random selection of n = 1000 children and determined the relationship of elevated Hcy (>12.0 μmol/L to MetS (defined as the presence of any three of the following: abdominal adiposity (waist circumference ≥ 85th percentile of the study population, high plasma glucose (≥85th percentile, high systolic or diastolic blood pressure (≥90th percentile of reference population, triglyceride ≥ 1.7 mmol/L and high density lipoprotein < 0.9 mmol/L. and its components. There was an increased risk of low high-density lipoproteins (HDL, [odds ratios (OR = 1.77, 95% confidence intervals (CI = 1.08–2.88; p = 0.020], high blood pressure [OR = 1.60, 95% CI = 1.10–2.46; p = 0.015] and high body mass index (BMI [OR = 1.98, 95% CI = 1.33–2.96; p = 0.001] with elevated Hcy. We observed an increased risk of MetS (OR = 1.75, 95% CI = 1.06–2.90; p = 0.029 with elevated Hcy in age and gender-adjusted logistic regression models. High plasma Hcy is associated with increased risk of MetS and may have implications for chronic disease later in life.

  18. Assessment of fly ash-aided phytostabilisation of highly contaminated soils after an 8-year field trial

    Energy Technology Data Exchange (ETDEWEB)

    Pourrut, Bertrand [Universite Lille Nord de France, Lille (France); Groupe ISA, Equipe Sols et Environnement, Laboratoire Genie Civil et geoEnvironnement (LGCgE) Lille Nord de France EA 4515, 48 boulevard Vauban, 59046 Lille Cedex (France); Lopareva-Pohu, Alena [Universite Lille Nord de France, Lille (France); Groupe ISA, Equipe Sols et Environnement, Laboratoire Genie Civil et geoEnvironnement (LGCgE) Lille Nord de France EA 4515, 48 boulevard Vauban, 59046 Lille Cedex (France); Universite du Littoral-Cote d' Opale, Unite de Chimie Environnementale et Interaction sur le Vivant (UCEIV), EA 4492, Maison de la Recherche en Environnement Industriel de Dunkerque 2, avenue Maurice Schumann, 59140 Dunkerque (France); Pruvot, Christelle [Universite Lille Nord de France, Lille (France); Groupe ISA, Equipe Sols et Environnement, Laboratoire Genie Civil et geoEnvironnement (LGCgE) Lille Nord de France EA 4515, 48 boulevard Vauban, 59046 Lille Cedex (France); Garcon, Guillaume; Verdin, Anthony [Universite Lille Nord de France, Lille (France); Universite du Littoral-Cote d' Opale, Unite de Chimie Environnementale et Interaction sur le Vivant (UCEIV), EA 4492, Maison de la Recherche en Environnement Industriel de Dunkerque 2, avenue Maurice Schumann, 59140 Dunkerque (France); Waterlot, Christophe; Bidar, Geraldine [Universite Lille Nord de France, Lille (France); Groupe ISA, Equipe Sols et Environnement, Laboratoire Genie Civil et geoEnvironnement (LGCgE) Lille Nord de France EA 4515, 48 boulevard Vauban, 59046 Lille Cedex (France); Shirali, Pirouz [Universite Lille Nord de France, Lille (France); Universite du Littoral-Cote d' Opale, Unite de Chimie Environnementale et Interaction sur le Vivant (UCEIV), EA 4492, Maison de la Recherche en Environnement Industriel de Dunkerque 2, avenue Maurice Schumann, 59140 Dunkerque (France); and others

    2011-10-01

    Aided phytostabilisation is a cost-efficient technique to manage metal-contaminated areas, particularly in the presence of extensive pollution. Plant establishment and survival in highly metal-contaminated soils are crucial for phytostabilisation success, as metal toxicity for plants is widely reported. A relevant phytostabilisation solution must limit metal transfer through the food chain. Therefore, this study aimed at evaluating the long-term efficiency of aided phytostabilisation on former agricultural soils highly contaminated by cadmium, lead, and zinc. The influence of afforestation and fly ash amendments on reducing metal phytoavailability was investigated as were their effects on plant development. Before being planted with a tree mix, the site was divided into three plots: a reference plot with no amendment, a plot amended with silico-aluminous fly ash and one with sulfo-calcic fly ash. Unlike Salix alba and Quercus robur, Alnus glutinosa, Acer pseudoplatanus and Robinia pseudoacacia grew well on the site and accumulated, overall, quite low concentrations of metals in their leaves and young twigs. This suggests that these three species have an excluder phenotype for Cd, Zn and Pb. After 8 years, metal availability to A. glutinosa, A. pseudoplatanus and R. pseudoacacia, and translocation to their above-ground parts, strongly decreased in fly ash-amended soils. Such decreases fit well together with the depletion of CaCl{sub 2}-extractable metals in amended soils. Although both fly ashes were effective to decrease Cd, Pb and Zn concentrations in above-ground parts of trees, the sulfo-calcic ash was more efficient.

  19. Executive functions in 5- to 8-year olds: Developmental changes and relationship to academic achievement

    OpenAIRE

    Röthlisberger, Marianne; Neuenschwander, Regula; Cimeli, Patrizia; Roebers, Claudia M.

    2013-01-01

    Pronounced improvements in executive functions (EF) during preschool years have been documented in cross-sectional studies. However, longitudinal evidence on EF development during the transition to school and predictive associations between early EF and later school achievement are still scarce. This study examined developmental changes in EF across three time-points, the predictive value of EF for mathematical, reading and spelling skills and explored children's specific academic attainment ...

  20. Reversal of dental fluorosis: A clinical study.

    Science.gov (United States)

    Mehta, Dhaval N; Shah, Jigna

    2013-01-01

    This study was conducted to evaluate the clinical reversal of dental fluorosis with various combinations of calcium, vitamin D3, and ascorbic acid, along with changes in levels of certain biochemical parameters concerned with dental fluorosis. The role of fluoride level of drinking water in the etiology of dental fluorosis and the prevalence of dental fluorosis in both dentitions and teeth were also assessed. A total number of 50 patients with clinical features of dental fluorosis without trauma and any adverse habits were selected. Of these, in 30 co-operative patients, estimation of water fluoride level and pretreatment and post-treatment serum and urine fluoride levels were done with ion selective electrode method. The selected 30 patients were divided into three groups, that is, group A, group B, and group C, and were given various combinations of medications like calcium with vitamin D3 supplements, ascorbic acid with vitamin D3 supplements, and chlorhexidine mouthwash (placebo) for three months, respectively. These 30 patients were assessed for any change in the clinical grading of dental fluorosis. No change in clinical grading of dental fluorosis was noted. Considerable reduction in serum and urine fluoride levels was noted in both group A and group B patients. Dental fluorosis was noted in permanent teeth more commonly than deciduous teeth, and permanent maxillary central incisors had the highest prevalence rate. This study comprises only 30 patients with three months of follow-up. So, this sample of patients and duration of follow-up period are conclusive to observe changes in biochemical parameters but not sufficient to observe changes in clinical grading.

  1. Playful Fostering of 6- to 8-Year-Old Students' Inductive Reasoning

    Science.gov (United States)

    Molnar, Gyongyver

    2011-01-01

    This paper focuses on a training program in inductive reasoning for first-grade students and presents the direct results as well as the longitudinal effects of the evaluation study. The training is based on Klauer's theory of inductive reasoning and on his "Cognitive training for children" concept (Klauer, 1989a). The training program consists of…

  2. Asthma at 8 years of age in children born by caesarean section

    NARCIS (Netherlands)

    Roduit, C.; Scholtens, S.; de Jongste, J.C.; Wijga, A.H.; Gerritsen, J.; Postma, D.S.; Brunekreef, B.; Hoekstra, M.O.; Aalberse, R.; Smit, H.A.

    2009-01-01

    Background: Caesarean section might be a risk factor for asthma because of delayed microbial colonisation, but the association remains controversial. A study was undertaken to investigate prospectively whether children born by caesarean section are more at risk of having asthma in childhood and sens

  3. Asthma at 8 years of age in children born by caesarean section.

    NARCIS (Netherlands)

    Roduit, C.; Scholtens, S.; de Jongste, J.C.; Wijga, A.H.; Gerritsen, J.; Postma, D.S.; Brunekreef, B.; Hoekstra, M.O.; Aalberse, R.C.; Smit, H.A.

    2009-01-01

    BACKGROUND: Caesarean section might be a risk factor for asthma because of delayed microbial colonisation, but the association remains controversial. A study was undertaken to investigate prospectively whether children born by caesarean section are more at risk of having asthma in childhood and sens

  4. Content analysis of 4 to 8 year-old children's dream reports.

    Science.gov (United States)

    Sándor, Piroska; Szakadát, Sára; Kertész, Katinka; Bódizs, Róbert

    2015-01-01

    The role of dreaming in childhood and in adulthood are still equally enigmatic fields yet to be fully explored. However, while there is a consensus at least about the typical content and formal characteristics of adult dream reports, these features are still a matter of debate in the case of young children. Longitudinal developmental laboratory studies concluded that preschoolers' dreams usually depict static images about mostly animals and body states of the dreamer but they basically lack the active representation of the self, human characters, social interactions, dream emotions and motion imagery. Due to methodological arguments these results became the reference points in the literature of developmental dream research, in spite of the significantly different results of numerous recent and relevant studies using extra-laboratory settings. This study aims to establish a methodologically well-controlled and valid way to collect children's dreams for a representative period of time in a familiar home setting to serve as a comparison to the laboratory method. Pre trained parents acted as interviewers in the course of a 6 week-period of dream collection upon morning awakenings. Our results suggest that even preschoolers are likely to represent their own self in an active role (70%) in their mostly kinematic (82%) dream narratives. Their dream reports contain more human, than animal characters (70 and 7% of all dream characters respectively), and social interactions, self-initiated actions, and emotions are usual part of these dreams. These results are rather similar to those of recent extra-laboratory studies, suggesting that methodological issues may strongly interfere with research outcomes especially in the case of preschoolers' dream narratives. We suggest that nighttime awakenings in the laboratory setting could be crucial in understanding the contradictory results of dream studies in case of young children.

  5. Content analysis of 4 to 8 year-old children’s dream reports

    Directory of Open Access Journals (Sweden)

    Piroska eSándor

    2015-04-01

    Full Text Available The role of dreaming in childhood and in adulthood are still equally enigmatic fields yet to be explored. However while there is a consensus at least about the typical content and formal characteristics of adult dream reports, these features are still a matter of debate in case of young children. Longitudinal developmental laboratory studies concluded that preschoolers’ dreams usually depict static images about mostly animals and body states of the dreamer but they basically lack the active representation of the self, human characters, social interactions, dream emotions and motion imagery. Due to methodological arguments these results became the reference points in the literature of developmental dream research, in spite of the significantly different results of some more recent studies using extra-laboratory settings. This study aims to establish a methodologically well-controlled and valid way to collect children’s dreams for a representative period of time in a familiar home setting to serve as a comparison to the laboratory method. Pre trained parents acted as interviewers in the course of a 6 week-period of dream collection upon morning awakenings. Our results suggest that even preschoolers are likely to represent their own self in an active role (70% in their mostly kinematic (82% dream narratives. Their dream reports contain more human, than animal characters (70% and 7% of all dream characters respectively, and that social interactions, self-initiated actions and emotions are usual part of these dreams. These results are rather similar to those of recent extra-laboratory studies, suggesting that methodological issues may strongly interfere with research outcomes especially in the case of preschoolers’ dream narratives. We suggest that nighttime awakenings in the laboratory setting could be crucial in understanding the contradictory results of dream studies in case of young children.

  6. Nail disorders in children, a clinical study

    Directory of Open Access Journals (Sweden)

    Ayşe Akbaş

    2016-04-01

    Full Text Available Introduction: Aims of the study to investigate the frequency and the nature ofnail disorders in children significant clinical data is available. Nail disorders although common in children in some parts of our country. This study was carried out to document the clinical and demographic pattern of nail disorders in a dermatology outpatient clinic of a pediatric hospital in Ankara, Turkey. Material and Methods: All consecutive patients a total of 3000 children from age 0-16 were admitted to dermatology outpatient clinic of Ankara Pediatric Hematology and Oncology Education and Research Hospital during January 2011 to December 2011 were studied and retrospectively evaluated for age, gender, drug use, diseases, systemic or genetic disorders and demographic features. Diagnostic evaluation results were noted and patients were categorized for demographic features and diagnosis. Results: These 133 patients (M: F 58:75, %44 vs 56, respectively were under 16 years of age and have 17 different dermatological disorders related with nail symptoms. Fifty three of (39,8% these patient were under 2 years of age, 31 (23.3% were between 3-5 years, 30 (22.5% were between 6-11 years old, 19 of 133 (14%, 2 were between 11-16 years of age. Through all of ages and independent of gender the most etiologies of nail disorders were, onychomadesis, paronychia, onycholysis, onychomycosis and systemic nail presentation of systemic dermatosis. Conclusion: Nail disorders are different in children than in adults. In our study, the first 5 years of age was found in 53% of nail disorders. Nail disorders are uncommon but may be seen as a part of a systemic disease and may be associated with cosmetic and psychologic problem.

  7. Clinical and histopathological study of palmoplantar keratoderma

    Directory of Open Access Journals (Sweden)

    Mahajan P

    1994-01-01

    Full Text Available Study of palmo-plantar keratoderma in eighty-two cases showed that twenty different diseases, both hereditary and acquired were responsible for palmoplantar keratoderma. Maximum number of cases were of hereditary variety of palmoplantar keratoderma (Unna-Thost syndrome (28.05%. Whereas psoriasis was the leading cause among the acquired conditions (17.07%. Two histopathological types of Unna-Thost syndrome and their correlation with clinical features are reported.

  8. Learning from 8 years of regional cyanobacteria observation in Brittany in view of sanitary survey improvement.

    Science.gov (United States)

    Pitois, Frédéric; Thomas, Olivier; Thoraval, Isabelle; Baurès, Estelle

    2014-01-01

    Cyanobacteria and cyanotoxins have been more and more studied during the last decades with regard to environment and health issues. More recently the consequences of climate change reinforced the need for research in view of a better management of cyanobacteria blooms. In this context the exploitation of the water quality survey of 26 recreational lakes in Brittany (north western France) between 2004 and 2011 is reported in this paper in order to encompass spatial and interannual patterns of cyanobacteria development at a regional scale. Starting from weekly data principally acquired during summertime, the links between cyanobacteria cell densities, toxin occurrences and interannual meteorological factors can give insights on the potential evolution of cyanobacterial crisis in the future. This study is part of a project aiming at a better understanding of potentially toxic cyanobacteria crisis occurrences in recreational waters, in order to improve predictive monitoring routines.

  9. Content analysis of 4 to 8 year-old children's dream reports

    OpenAIRE

    Sándor, Piroska; Szakadát, Sára; Kertész, Katinka; Bódizs, Róbert

    2015-01-01

    The role of dreaming in childhood and in adulthood are still equally enigmatic fields yet to be fully explored. However, while there is a consensus at least about the typical content and formal characteristics of adult dream reports, these features are still a matter of debate in the case of young children. Longitudinal developmental laboratory studies concluded that preschoolers' dreams usually depict static images about mostly animals and body states of the dreamer but they basically lack t...

  10. Content analysis of 4 to 8 year-old children’s dream reports

    OpenAIRE

    Piroska eSándor; Sára eSzakadát; Katinka eKertész; Róbert eBódizs

    2015-01-01

    The role of dreaming in childhood and in adulthood are still equally enigmatic fields yet to be explored. However while there is a consensus at least about the typical content and formal characteristics of adult dream reports, these features are still a matter of debate in case of young children. Longitudinal developmental laboratory studies concluded that preschoolers’ dreams usually depict static images about mostly animals and body states of the dreamer but they basically lack the active r...

  11. Clinical and Statistical Study on Canine Impaction

    Directory of Open Access Journals (Sweden)

    Adina-Simona Coșarcă

    2013-08-01

    Full Text Available Aim: The aim of this study was to perform a clinical and statistical research on permanent impacted canine patients among those with dental impaction referred to and treated at the Oral and Maxillo-Facial Surgery Clinic of Tîrgu Mureș, over a four years period (2009-2012. Materials and methods: The study included 858 patients having dental impaction, and upon clinical records, different parameters, like frequency, gender, age, quadrant involvement, patient residence, associated complications, referring specialist and type of treatment, related to canine impaction, were assessed. Results: The study revealed: about 10% frequency of canine impaction among dental impactions; more frequent in women, in the first quadrant (tooth 13; most cases diagnosed between the age of 10-19 years; patients under 20 were referred by an orthodontist, those over 20 by a dentist; surgical exposure was more often performed than odontectomy. Conclusions: Canine impaction is the second-most frequent dental impaction in dental arch after third molars; it occurs especially in women. Due to its important role, canine recovery within dental arch is a goal to be achieved, whenever possible. Therefore, diagnose and treatment of canine impaction requires an interdisciplinary approach (surgical and orthodontic

  12. Knowledge, Attitudes, and Environment Oriented Behaviors for 7-8 Year Old Children

    Directory of Open Access Journals (Sweden)

    Valeria LAZA

    2009-12-01

    Full Text Available The theme of the risk, as a public problem, is rarely debated in Romania. In the world, the research related to the risk perception, especially the environment risk, started 59 years ago, on the grounds of the nuclear danger. The environment-risk perception at children depends on the prior perceptions acting as decoding filters, nonetheless it can be influenced by the targeted environment oriented education, correcting the false perceptions and aiding the children to form a set of perennial values and to digest healthy behaviours. The work presents the results of the study made on 446 pupils in the primary classes, in three schools from Cluj-Napoca, Romania, with the purpose to encourage environmental friendly behaviours by combining previous strategies (modifying the attitudes and the values towards the environment with the consecutive strategies (of recompense for the pro-environment behaviours. The study demonstrates the role and the importance both of the school, and the parents’ level of instruction, in building and consolidating the environment consciousness at children.

  13. Physical activity and fitness in 8-year-old overweight and normal weight children and their parents

    Science.gov (United States)

    Karppanen, Anna-Kaisa; Ahonen, Sanna-Mari; Tammelin, Tuija; Vanhala, Marja; Korpelainen, Raija

    2012-01-01

    Objectives To compare the physical fitness and physical activity of 8-year-old overweight children (n =53) to normal weight children (n=65), and to determine whether a significant relationship exists between physical activity of parents and their children. Study design A cross-sectional study. Methods A total of 119 children from Northern Finland were recruited for the study. Waist circumference, height, weight and BMI were measured. Physical activity of the children and their parents was determined with self-administered 7-day recall questionnaires (PAQ-C). Physical fitness of the children was evaluated with 7 items of the EUROFIT-test battery (flamingo balance test, plate tapping, sit-and-reach test, sit-ups, bent arm hang and 10×5 shuttle run). Aerobic capacity of the children was tested with 6-minute walking test. Results Overweigh was related to impaired performance in tests requiring muscle endurance, balance, explosive power of lower extremities, upper body strength and endurance, speed and agility in both genders and aerobic capacity in boys. Physical activity levels of overweight boys (2.41 SD 0.72) were lower than their lean counterparts (2.91 SD 0.64, p=0.004); no such difference was observed in girls (2.53 SD 0.64 vs. 2.59 SD 0.68, p=0.741). Physical activity was significantly associated with better performance in several physical fitness tests in boys, but not in girls. Mothers’ physical activity was associated with children's physical activity (r=0.363, pchildren (r=0.019, p=0.864). Conclusion This study shows an inverse relationship between excess bodyweight and physical fitness in children. Mother-child relationship of physical activity appeared to be stronger than father-child relationship. Improving physical fitness in children through physical activity might require interventions that are responsive to the ability and needs of overweight children and their families and focus on helping parents and children to be physically active together

  14. Physical activity and fitness in 8-year-old overweight and normal weight children and their parents

    Directory of Open Access Journals (Sweden)

    Anna-Kaisa Karppanen

    2012-03-01

    Full Text Available Objectives: To compare the physical fitness and physical activity of 8-year-old overweight children (n = 53 to normal weight children (n = 65, and to determine whether a significant relationship exists between physical activity of parents and their children. Study design: A cross-sectional study. Methods: A total of 119 children from Northern Finland were recruited for the study. Waist circumference, height, weight and BMI were measured. Physical activity of the children and their parents was determined with self-administered 7-day recall questionnaires (PAQ-C. Physical fitness of the children was evaluated with 7 items of the EUROFIT-test battery (flamingo balance test, plate tapping, sit-and-reach test, sit-ups, bent arm hang and 10×5 shuttle run. Aerobic capacity of the children was tested with 6-minute walking test. Results: Overweigh was related to impaired performance in tests requiring muscle endurance, balance, explosive power of lower extremities, upper body strength and endurance, speed and agility in both genders and aerobic capacity in boys. Physical activity levels of overweight boys (2.41 SD 0.72 were lower than their lean counterparts (2.91 SD 0.64, p = 0.004; no such difference was observed in girls (2.53 SD 0.64 vs. 2.59 SD 0.68, p = 0.741. Physical activity was significantly associated with better performance in several physical fitness tests in boys, but not in girls. Mothers’ physical activity was associated with children's physical activity (r = 0.363, p < 0.001, but no such association was found between fathers and children (r = 0.019, p = 0.864. Conclusion: This study shows an inverse relationship between excess bodyweight and physical fitness in children. Mother-child relationship of physical activity appeared to be stronger than father-child relationship. Improving physical fitness in children through physical activity might require interventions that are responsive to the ability and needs of overweight children and

  15. Vertebral augmentation by kyphoplasty and vertebroplasty: 8 years experience outcomes and complications

    Science.gov (United States)

    Yaltirik, Kaan; Ashour, Ahmed M; Reis, Conner R; Özdoğan, Selçuk; Atalay, Başar

    2016-01-01

    Background and Context: Minimally invasive percutaneous vertebral augmentation techniques; vertebroplasty, and kyphoplasty have been treatment choices for vertebral compression fractures (VCFs). The purpose of this study is to evaluate the outcomes of the patients who underwent vertebroplasty or kyphoplasty regarding complications, correction of vertebral body height, kyphosis angle and pain relief assessment using visual analog score (VAS) for pain. Materials and Methods: A retrospective review of the hospital records for 100 consecutive patients treated with kyphoplasty or vertebroplasty in our department database. Patients with osteoporotic compression fractures, traumatic compressions, and osteolytic vertebral lesions, including metastases, hemangiomas, and multiple myeloma, were included in the study. Preoperative and postoperative VAS pain scores, percentages of vertebral compression and kyphotic angles were measured and compared as well as demographic characteristics and postoperative complications. Mobilization and length of stay (LOS) were recorded. Results: One hundred patients were treated by 110 procedures. 64 patients were operated on due to osteoporosis (72 procedures). Twelve patients were operated on because of metastasis (13 procedures), 8 patients were operated on because of multiple myeloma (9 procedures). Five patients had two surgeries, 1 patient had 3 surgeries, and 1 patient had 5 surgeries. The mean preoperative VAS was 74.05 ± 9.8. In total, 175 levels were treated, 46 levels by kyphoplasty and 129 by vertebroplasty. The mean postoperative VAS was 20.94 ± 11.8. Most of the patients were mobilized in the same day they of surgery. Mean LOS was 1.83 days. Six patients had nonsymptomatic leakage of polymethlymethacrylate, and patient had epidural hematoma, which was operated on performing hemi-laminectomy. Conclusions: Percutaneous vertebroplasty and balloon kyphoplasty are both effective and safe minimally invasive procedures for the

  16. Pathways to Sustainability: 8-Year Follow-Up From the PROSPER Project.

    Science.gov (United States)

    Welsh, Janet A; Chilenski, Sarah M; Johnson, Lesley; Greenberg, Mark T; Spoth, Richard L

    2016-06-01

    The large-scale dissemination of evidence-based practices (EBPs) is often hindered by problems with sustaining initiatives past a period of initial grant funding. Communities often have difficulty generating resources needed to sustain and grow their initiatives, resulting in limited public health impact. The PROSPER project, initiated in 2001, provided community coalitions with intensive technical assistance around marketing, communications, and revenue generating strategies. Past reports from PROSPER have indicated that these coalitions were successful with sustaining their programming, and that sustainability could be predicted by early aspects of team functioning and leadership. The current study examines financial sustainability 8 years following the discontinuation of grant funding, with an emphasis on sources of revenue and the relationships between revenue generation, team functioning, and EBP participation. This study used four waves of data related to resource generation collected between 2004 and 2010 by PROSPER teams in Iowa and Pennsylvania. Teams reported annually on the amount and sources of funding procured, as well as annual reports of team functioning and leadership and annual reports of EBP participation by youth and parents. Data revealed that teams' overall revenue generation increased over time. There was significant variation in success with revenue generation at both the community level and across the two states. Teams accessed a variety of sources. Cash revenue generation was positively and predictively associated with EBP participation, but relationships with team functioning and leadership ratings varied significantly by state. State level differences in in-kind support were also apparent. The results indicated that there are different pathways to sustainability, and that no one method works for all teams. The presence of state level infrastructures available to support prevention appeared to account for significant differences in

  17. Safety and efficacy of adjunctive lacosamide among patients with partial-onset seizures in a long-term open-label extension trial of up to 8 years.

    Science.gov (United States)

    Rosenfeld, William; Fountain, Nathan B; Kaubrys, Gintaras; Ben-Menachem, Elinor; McShea, Cindy; Isojarvi, Jouko; Doty, Pamela

    2014-12-01

    Long-term (up to 8 years of exposure) safety and efficacy of the antiepileptic drug lacosamide was evaluated in this open-label extension trial (SP615 [ClinicalTrials.gov identifier: NCT00552305]). Patients were enrolled following participation in a double-blind trial or one of two open-label trials of adjunctive lacosamide for partial-onset seizures. Dosage adjustments of lacosamide (100-800 mg/day) and/or concomitant antiepileptic drugs were allowed to optimize tolerability and seizure reduction. Of the 370 enrolled patients, 77%, 51%, and 39% had >1, >3, or >5 years of lacosamide exposure, respectively. Median lacosamide modal dose was 400mg/day. Common treatment-emergent adverse events (TEAEs) were dizziness (39.7%), headache (20.8%), nausea (17.3%), diplopia (17.0%), fatigue (16.5%), upper respiratory tract infection (16.5%), nasopharyngitis (16.2%), and contusion (15.4%). Dizziness (2.2%) was the only TEAE that led to discontinuation in >2% of patients. Ranges for median percent reductions in seizure frequency were 47-65%, and those for ≥ 50% responder rates were 49-63% for 1-, 3-, and 5-year completer cohorts. Exposure to lacosamide for up to 8 years was generally well tolerated, with a safety profile similar to previous double-blind trials, and efficacy was maintained.

  18. Clinical, biochemical & cytomorphologic study on Hashimoto's thyroiditis

    Science.gov (United States)

    Thomas, Tina; Sreedharan, Suja; Khadilkar, Urmila N.; Deviprasad, D; Kamath, M. Panduranga; Bhojwani, Kiran M.; Alva, Arathi

    2014-01-01

    Background & objectives: Despite, the extensive salt iodization programmes implemented in India, the prevalence of goiter has not reduced much in our country. The most frequent cause of hypothyroidism and goiter in iodine sufficient areas is Hashimoto's thyroiditis (HT). This study records the clinical presentation, biochemical status, ultrasonographic picture and cytological appearance of this disease in a coastal endemic zone for goiter. Methods: Case records of patients with cytological diagnosis of HT were studied in detail, with reference to their symptoms, presence of goiter, thyroid function status, antibody levels and ultrasound picture. Detailed cytological study was conducted in selected patients. Results: A total of 144 patients with cytological proven HT/lymphocytic thyroiditis were studied. Ninety per cent of the patients were females and most of them presented within five years of onset of symptoms. Sixty eight per cent patients had diffuse goiter, 69 per cent were clinically euthyroid and 46 per cent were biochemically mildly hypothyroid. Antibody levels were elevated in 92.3 per cent cases. In majority of patients the sonographic picture showed heterogeneous echotexture with increased vascularity. Cytological changes were characteristic. Interpretation & conclusions: Our study showed predominance of females in the study population in 21-40 yr age group with diffuse goiter. We suggest that in an endemic zone for goiter, all women of the child bearing age should be screened for HT. PMID:25758571

  19. Clinical study on osteoradionecrosis of the jaws

    Energy Technology Data Exchange (ETDEWEB)

    Okano, Atsuo; Kato, Joji

    1988-07-01

    In the present study osteoradionecrosis which had developed after radiotherapy for malignant tumor was studied clinically and therapeutically and the following results were obtained. 1. The subjects were 28 patients with squamous cell carcinoma and 2 patients with adenoid cystic carcinoma aged 38 to 72. The ratio of male: female was 3.3 : 1. The time of manifestation was 1 month-14 years after irradiation. The main symptoms were pain and exposed bone mainly in the region of mandibular molar tooth. 2. Osteoradionecrosis was observed in 10 cases supposed to be induced by tooth extraction but also in 5 edentulous cases. 3. When the osteoradionecrosis cases were classified into limited area type and wide range type on the basis of clinical findings. X-ray of the jaws showed the presence of bone resorption and induration together in many wide range type cases. 4. Scintigram of bone showed widespread accumulation of radiation even in clinically limited area type, and the picture of some loss of bone and the intensity of the accumulation were considered to be extremely useful as an index in making therapeutical plans and decisions on the prognosis of tumor of the jaws. 5. As the method of treatment, sequestrectomy was performed in 14 of 19 cases of the limited area type and 4 of 11 cases of the wide range type and excision of the jaws in 4 cases. 6. Hyperbaric oxygen therapy was carried out in 3 cases and had good effect. (J.P.N.).

  20. CLINICAL STATISTICAL STUDIES ON HEMATURIA IN OUTPATIENTS

    OpenAIRE

    青木, 正治; 熊本, 悦明

    1982-01-01

    Clinical statistical studies on hematuria were performed in outpatients who were seen at our Department, during the 7-year period from 1974 through 1980. Of the 11,574 outpatients studied, the total number of outpatients with hematuria 1,705; macroscopic hematuria was found in 446 cases (3.9%) and microscopic hematuria was in 1,259 cases (10.9%). The most frequent cause of macroscopic hematuria was malignant urinary tumors and that of microscopic hematuria was urinary tract infections. Macros...

  1. Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study

    DEFF Research Database (Denmark)

    Haaverstad, Rune; Vitale, Nicola; Karevold, Asbjørn

    2006-01-01

    OBJECTIVE: The aim of this report is the prospective, multicentre evaluation of clinical results and haemodynamic performance of the Medtronic Advantage aortic valve prosthesis. METHODS: From April 2001 to June 2003, 166 patients (male:female 125:41; mean (SD) age 61.8 (11.8) years) received...... echocardiography. CONCLUSIONS: Haemodynamic performance and early clinical results of Medtronic advantage in the aortic position were satisfactory and comparable with those of other bileaflet valves in current clinical use....

  2. Assessment of the global intelligence and selective cognitive capacities in preterm 8-year-old children.

    Science.gov (United States)

    Begega, Azucena; Méndez López, Magdalena; de Iscar, María Jesús; Cuesta-Izquierdo, Marcelino; Solís, Gonzalo; Fernández-Colomer, Belén; Álvarez, Luis; Méndez, Marta; Arias, Jorge L

    2010-11-01

    The aim of this study was to assess various cognitive abilities such as attention, IQ, reasoning, and memory related to academic achievement in 8- and 9-year-old preterm children. A total of 141 children were assessed. The preterm group (=37 weeks) comprised 63 children and was compared to 78 full-term children. Attention was evaluated using the d2 Selective Attention test, and the IQ by the L-M form of the Stanford-Binet Intelligence Scale, establishing a profile of abilities: perception, memory, comprehension, reasoning, and verbal fluency. Significant differences in IQ were found between the preterm and full-term children. Of the cognitive abilities assessed, the only significant differences were found in verbal fluency, with preterm boys showing lower verbal fluency scores than full-term children. In conclusion, all preterm groups have attention ability similar to that of full-term children. However, preterm children obtain lower scores in intelligence measures. In addition, preterm boys have verbal fluency difficulties. Taking into account the increase in preterm births, suitable intervention programs must be planned to attend the difficulties found.

  3. Associations between indoor environmental factors and parental-reported autistic spectrum disorders in children 6-8 years of age.

    Science.gov (United States)

    Larsson, Malin; Weiss, Bernard; Janson, Staffan; Sundell, Jan; Bornehag, Carl-Gustav

    2009-09-01

    Potential contributions of environmental chemicals and conditions to the etiology of Autism Spectrum Disorders are the subject of considerable current research and speculation. The present paper describes the results of a study undertaken as part of a larger project devoted to the connection between properties of the indoor environment and asthma and allergy in young Swedish children. The larger project, The Dampness in Buildings and Health (DBH) Study, began in the year 2000 with a questionnaire distributed to parents of all children 1-6 years of age in one Swedish county (DBH-I). A second, follow-up questionnaire (DBH-III) was distributed in 2005. The original survey collected information about the child, the family situation, practices such as smoking, allergic symptoms, type of residence, moisture-related problems, and type of flooring material, which included polyvinyl chloride (PVC). The 2005 survey, based on the same children, now 6-8 years of age, also asked if, during the intervening period, the child had been diagnosed with Autism, Asperger's syndrome, or Tourette's syndrome. From a total of 4779 eligible children, 72 (60 boys, 12 girls) were identified with parentally reported autism spectrum disorder. A random sample of 10 such families confirmed that the diagnoses had been made by medical professionals, in accordance with the Swedish system for monitoring children's health. An analysis of the associations between indoor environmental variables in 2000 as well as other background factors and the ASD diagnosis indicated five statistically significant variables: (1) maternal smoking; (2) male sex; (3) economic problems in the family; (4) condensation on windows, a proxy for low ventilation rate in the home; (5) PVC flooring, especially in the parents' bedroom. In addition, airway symptoms of wheezing and physician-diagnosed asthma in the baseline investigation (2000) were associated with ASD 5 years later. Results from the second phase of the DBH-study

  4. Kleine-Levin Syndrome in an 8-Year-Old Girl with Autistic Disorder: Does Autism Account a Primary or Secondary Cause?

    Science.gov (United States)

    Hakim Shoushtari, Mitra; Ghalebandi, Mirfarhad; Tavasoli, Azita; Pourshams, Maryam

    2015-01-01

    Objective Kleine-Levin syndrome (KLS) is a rare disorder with an unknown etiology. Autism spectrum disorder is characterized by various degrees of impairment in social communication, repetitive behavior and restricted interests. Only four patients of KLS with autistic spectrum disorder (ASD) have been reported so far. This report presents an 8-year-old girl with history of autistic disorder and epilepsy that superimposed KLS. Because of the rarity of KLS and related studies did not address whether autism accounts for a primary or secondary cause, the area required attention further studies.

  5. Clinical Study on Ocular Trauma in Children

    Institute of Scientific and Technical Information of China (English)

    Zicai Huang; Hongni Li; Yixia Huang; Zhongxia Zhou

    2002-01-01

    Purpose: To investigate the clinical characteristics of ocular trauma in children and put forward the major treatment and prevention of ocular trauma in children.Methods: To analyze the clinical data by 77 eyes in 77 cases of ocular trauma in children from April 1999 to February 2002. Results: The male and female were in the ratio of 2.21: 1. Right eye ocular traumas were more than left ones. Ocular penetrating trauma was 83.12% and blunt trauma 12.99%. 41 cases (53.25%) were injured by themselves while 33 cases by others. 90.91% patients came from the countryside.Conclusion: The rate of blindness of children with ocular trauma could be reduced by prompt treatment. The study indicated that ocular trauma preventive publicity should be faced in the countryside in order to improve the understanding of the severity of ocular trauma and treat it as a social problem.

  6. Robust diffusion imaging framework for clinical studies

    CERN Document Server

    Maximov, Ivan I; Neuner, Irene; Shah, N Jon

    2015-01-01

    Clinical diffusion imaging requires short acquisition times and good image quality to permit its use in various medical applications. In turn, these demands require the development of a robust and efficient post-processing framework in order to guarantee useful and reliable results. However, multiple artefacts abound in in vivo measurements; from either subject such as cardiac pulsation, bulk head motion, respiratory motion and involuntary tics and tremor, or imaging hardware related problems, such as table vibrations, etc. These artefacts can severely degrade the resulting images and render diffusion analysis difficult or impossible. In order to overcome these problems, we developed a robust and efficient framework enabling the use of initially corrupted images from a clinical study. At the heart of this framework is an improved least trimmed squares diffusion tensor estimation algorithm that works well with severely degraded datasets with low signal-to-noise ratio. This approach has been compared with other...

  7. Cryogenic Thermophysical Studies for Clinical Medicine

    Institute of Scientific and Technical Information of China (English)

    华泽钊

    2002-01-01

    Cryogenic technology has been widely used in clinical medicine and in pharmaceutics, so thermophysical studies are extremely important to solve problems during freezing and thawing. This paper reports some recent research in clinical medicine, including cryo-injury, cryosurgery, and cryopreservation of some important cells and tissues. Microscopic images of the freezing process with a cryomicroscope system show that the dendritic ice growth is affected by the solution concentration, the cooling rate, and the number of embryos. An enthalpy method is used for the freeze-thaw analysis of the cryosurgery with a program developed to predict the temperature profile and the interface motion, which compares well with experimental results. A very rapid cooling technique is developed by quenching the samples into subcooled liquid nitrogen for vitrification of cells and tissues. An analytical method developed to prevent the fracture of arteries during freezing has been verified by the electronic microscopic investigation.

  8. Changes in dental caries and oral hygiene among 7-8 year-old schoolchildren in different regions of Lithuania 1983-2009.

    Science.gov (United States)

    Matulaitiene, Zivilė Kristina; Zemaitiene, Migle; Zemgulyte, Sandra; Milciuviene, Simona

    2012-01-01

    The objectives of this study were to evaluate and compare the changes of the dental caries prevalence and severity of 7 to 8 year old schoolchildren in six Lithuanian regions over the past 26 years (1983-2009) and to propose recommendations based on the results of the study. The study is based on the analysis of data, containing 576 cases of children examined in 1983 and comparison with data containing 531 cases added in 2009. The studies were conducted in the same six regions of Lithuania among the children from 7 to 8 years of age. For the study of children the WHO oral assessment methodology was used (WHO Basic methods 1997). Severity of dental caries was described by df-t and DMF-T index. The average of individual df-t and DMF-T indices was calculated for all subjects and sorted by gender. Oral hygiene status was evaluated by applying the simplified Green-Vermilion index-OHI-S (1964) The prevalence of primary dental caries among the children 7 to 8 years of age was 92.4% in 1983 and 88.7% (p=0.43) in 2009. The prevalence of permanent dental caries decreased from 49.6% in 1983 to 29.7% (pindex decreased from 1.1±1.7 in 1983 to 0.5±1.0 in 2009 (pOHI-S index was not significantly different during 1983-2009. In the period of last 26 years a tendency towards the decrease in the prevalence and severity of dental caries was observed. That could be related to the frequent using of the toothpastes with fluoride, as well as implementation of the caries prevention program with sealants among the children of that age. The poor oral hygiene and comparatively high caries prevalence in schoolchildren show that it is still necessary to improve preventive measures in Lithuania.

  9. Use of Antibiotics in Pediatrics: 8-Years Survey in Italian Hospitals.

    Science.gov (United States)

    Buccellato, Elena; Melis, Mauro; Biagi, Chiara; Donati, Monia; Motola, Domenico; Vaccheri, Alberto

    2015-01-01

    To evaluate antibiotic consumption in the pediatric wards of Emilia-Romagna Region, from 2004 to 2011, with a focus on the antibiotics reserved to the most serious infections, and to analyse the ADRs reported for antibiotics by the pediatric wards of Emilia-Romagna hospitals. Reference population was represented by all the patients (0-14 years old) admitted to the pediatric wards of all the hospitals of Emilia-Romagna Region. Drug consumption was expressed as number of DDDs per 100 Bed-Days (BD) and data were analysed by active substance, by therapeutic subgroups or by ward type. The time trends of antibiotic consumption were statistically analysed by linear regression. All the suspected ADR reports associated with antibiotics, reported between January 2004 and December 2011 were drawn by the Italian Spontaneous Reporting Database. Overall antibiotic consumption showed only a slight increase (p = 0.224). Among the pediatric wards, pediatric surgery showed the highest increase from 2004 to 2011 (p = 0.011). Penicillins and β-lactamase inhibitors was the first therapeutic group with a statistically significant increase over years (p = 0.038), whereas penicillins with extended spectrum presented a statistically significant reduction (p = 0.008). Moreover, only 5 drugs out of the 8 antibiotics reserved to the most serious infections were used. Pharmacovigilance data showed 27 spontaneous ADR reports associated to ATC J01 drugs. Amoxicillin/clavulanic acid had the highest number of ADR reports (n = 7). The steadily increasing consumption in penicillins and β-lactamase inhibitors, in association with a considerable decrease of plain penicillins, raises a serious concern. Pharmacovigilance reports seem to suggest a safe use of antibiotics in the hospital setting of Emilia-Romagna. Further studies to investigate the reason for prescribing antibiotics in children inpatients are needed.

  10. MR imaging of deferoxamine-induced bone dysplasia in an 8-year-old female with thalassemia major

    Energy Technology Data Exchange (ETDEWEB)

    Miller, T.T. (Dept. of Radiology and Nuclear Medicine, Hospital for Special Surgery, New York, NY (United States)); Caldwell, G. (Dept. of Orthopedic Surgery, Hospital for Special Surgery, New York, NY (United States)); Kaye, J.J. (Dept. of Radiology and Nuclear Medicine, Hospital for Special Surgery, New York, NY (United States)); Arkin, S. (Dept. of Pediatrics, Mount Sinai Medical Center, New York, NY (United States)); Burke, S. (Dept. of Orthopedic Surgery, Hospital for Special Surgery, New York, NY (United States)); Brill, P.W. (Dept. of Radiolgy, New York Hospital, Cornell Univ. Medical Center, New York, NY (United States))

    1993-11-01

    Bone changes in thalassemic patients receiving deferoxamine therapy for iron chelation include metaphyseal and growth plate irregularities. We present a case of an 8-year-old female with thalassemia major, who had magnetic resonance imaging after plain radiographs had shown metaphyseal changes in the distal femur. The signal characteristics of these abnormalities were consistent with hyaline cartilage; the surrounding marrow showed no evidence of iron overrload. (orig.)

  11. Hereditary hemorrhagic telangiectasia: a rare cause of long-lasting abdominal distension in an 8-year-old boy

    Institute of Scientific and Technical Information of China (English)

    陈雷铃; 郎诗明; 胡廷泽; 钟麟; 李俊杰

    2002-01-01

    @@ Abdominal distension is a common complaint encountered in pediatric surgery. In most cases, Hirschsprung's disease is the most common cause associated with abdominal distension in older children. Hereditary hemorrhagic telangiectasia is a rare disease which commonly presents with hemorrhage and anemia. We treated an 8-year-old boy with long lasting intractable abdominal distension associated with hereditary hemorrhagic telangiectasia. Clinicopathologic features of this rare entity are discussed with emphasis on its pathogenesis and diagnosis.

  12. Non-inferiority of minimally invasive oesophagectomy: an 8-year retrospective case series.

    Science.gov (United States)

    Findlay, L; Yao, C; Bennett, D H; Byrom, R; Davies, N

    2017-01-11

    The trend towards laparoscopic surgery seen in other specialties has not occurred at the same pace in oesophagectomy. This stems from concerns regarding compromised oncological clearance, and complications associated with gastric tube necrosis and anastomotic failure. We present our experience of minimally invasive oesophagectomy (MIO) compared to open and hybrid surgery. We aim to ascertain non-inferiority of MIO by evaluating impact on survival, oncological clearance by resection margin and lymph node harvest and post-operative complications. Data were sourced retrospectively 2008-2015. Three approaches were studied. MIO (3-stage Mckeown), hybrid (2-stage Ivor Lewis, laparoscopy, thoracotomy) and open (2-stage Ivor Lewis). Five-year survival was 54.2%. Surgical approach had no significant impact on survival at any stage of disease (Stage 0/I p = 0.98; stage II p = 0.2; stage III p = 0.76). There was no statistically significant difference in oncological clearance by resection margins between procedures when compared by disease stage (p = 0.49). A higher number of nodes were harvested in hybrid [median 27.5 (6-65)] and open surgeries [median 26 (4-54)] than in MIO [median 20 (7-44)] (p > 0.01). Numbers of nodes resected did not impact risk of recurrence [recurrence, median 25 (6-54), no recurrence, 26 (4-65)] (p = 0.25). Anastomotic strictures (22.4%) and potential leaks (17.9%) were more common in MIO (strictures p > 0.01, leaks p = 0.08), although associated morbidity was lower. Respiratory complications were less common in MIO (2.9%) versus hybrid (13.3%) (p = 0.02). Wound infection and chyle leak were also lower (wound 1.5% MIO 3.5% open, p = 0.6; chyle leak 1.5% MIO, 6.7% hybrid, p = 0.2). Our results show no negative impact of MIO on survival or oncological clearance. Respiratory and wound complications are lower in MIO, but rates of anastomotic strictures and potential anastomotic leaks are increased. This may be due to the longer

  13. [Depression and dementia: perspectives from clinical studies].

    Science.gov (United States)

    Nozaki, Shoko; Yoshimura, Kimio; Mimura, Masaru

    2012-12-01

    In this review, we present an overview of clinical studies that addressed the relationship between depression and dementia or cognitive decline. Cross-sectional studies and meta-analyses have repeatedly shown an association between late-life depression (LLD) and dementia, particularly Alzheimer's disease (AD) and vascular dementia; however, the findings of cohort studies have been inconsistent. Furthermore, studies on the association between depression with a younger age of onset and dementia have yielded inconsistent results. Regarding cognitive decline associated with LLD, several studies have reported an association between LLD and mild cognitive impairment, suggesting that depression itself can cause persistent cognitive impairment. Other studies have compared the cognitive profile between LLD and depression with a younger age of onset, but their results have been inconclusive, especially regarding the association between memory impairment and the age of onset of depression. LLD is associated with vascular change and white matter degeneration of the brain, as shown by magnetic resonance imaging (MRI). Recently, several studies reported an association between gray matter change and LLD. Studies currently in progress employ functional brain imaging methods such as single-photon emission computed tomography, functional MRI, and positron emission tomography. Clinically, it is important to understand how subtypes of depression can be defined in terms of risk of developing dementia, and to devise effective treatments. One paper explored the possibility of detecting depression associated with AD by measuring the blood Aβ40/Aβ42 levels, and other studies have suggested that symptoms of apathy and loss of interest are associated with conversion of depression to AD. Unfortunately, current antidepressants may have limited efficacy on depression with dementia; therefore, further investigation for devising methods of predicting conversion of depression to dementia and

  14. Planning a study abroad clinical experience.

    Science.gov (United States)

    Wright, Dolores J

    2010-05-01

    Not only is globalization expanding areas of human activity, it is also influencing the variety of educational offerings in universities. Therefore, globalization must be considered by nurse educators as they reevaluate ways of preparing nursing students to meet the health care needs of populations they currently serve and will care for in the future. Study abroad programs have been encouraged to be part of the college experience in the United States for more than 30 years; however, these programs have been relatively lacking in nursing education. Most of the study abroad programs described in the nursing literature are research-based or first-person accounts of an experience and provide little information about planning a study abroad program. This article describes a study abroad learning experience for senior nursing students and discusses the issues such as student selection, student safety, and available clinical experiences that need to be considered before undertaking such an endeavor.

  15. A clinical and investigational study of donovanosis

    Directory of Open Access Journals (Sweden)

    Veeranna S

    2003-03-01

    Full Text Available A clinical and investigational study of 25 cases of Donovanosis was undertaken. The incidence was found to be 1.53% of all STD cases and 2.9% of GUD. M:F ratio was 2.12:1. Incidence was more in unmarried people. Fleshy exuberant type was seen in 88% of cases. Two patients (8% had extragenital ulcers. Donovan bodies were found in 88%. Pseudo elephantiasis was seen in 8 patients. Biopsy was done in 8 cases and showed ocanthosis, plasma cell infiltration and pseudo epitheliomatous hyperplasia. One patient developed squamous cell carcinoma of vulva.

  16. Angular cheilitis: a clinical and microbial study.

    Science.gov (United States)

    Ohman, S C; Dahlén, G; Möller, A; Ohman, A

    1986-04-01

    The purpose of this prospective study was to re-examine the relative importance of various factors in the pathogenesis of angular cheilitis. Sixty-four patients with cheilitis were examined clinically and microbiologically. In addition, a subsample of 23 patients was examined for serum iron and transferrin. The clinical appearance of the lip lesions fell into 4 categories. A ground rhagad at the corner of the mouth involving adjacent skin, was the most frequent type among dentate patients, whereas among denture wearers a deep lesion following the labial marginal sulcus was frequently observed. Dentate patients and denture wearers with cheilitis often had atopic constitution or cutaneous diseases. Pathogenic microorganisms were cultured from the lesions in all 64 patients; Staphylococcus aureus in 40 patients and Candida albicans in 45. The results of this study indicate a correlation between angular cheilitis and pathogenic microorganisms. Furthermore, among dentate patients, a correlation exists between cutaneous discomfort and angular cheilitis. Other etiological factors suggested for this disorder were found to be of subordinate importance.

  17. Evidence-based review of clinical studies on pulpotomy.

    Science.gov (United States)

    2009-08-01

    Although pulpotomy procedures have a long history of clinical application, comparatively few dental clinical trials have evaluated this treatment approach. In this section, we provide an analysis of recent clinical studies evaluating pulpotomy procedures in dental patients.

  18. Korean Clinic Based Outcome Measure Studies

    Directory of Open Access Journals (Sweden)

    Jongbae Park

    2003-02-01

    Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

  19. A CLINICAL STUDY ON BLUNT INJURY ABDOMEN

    Directory of Open Access Journals (Sweden)

    G. Kishore Babu

    2016-10-01

    Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

  20. The clinical studies to developing BV Partner

    Directory of Open Access Journals (Sweden)

    Kwon Gi-Rok

    2001-12-01

    Full Text Available Objective: This study was performed to examine the Herbal Acupuncture decrease the side effect of Bee Venom. Methods: We treated Bee Venom and various Herbal Acupuncture mixed Bee Venom using double blind test to 70th health youth, and checked pain, edema size, CBC, Serum biochemistry and Thermography. Results:1. Herbal Acupuncture made by Morus bombycis Koidzumi showed good results to decrease the side effect of Bee Venom than any other Herbal Acupuncture. 2. We examined CBC, ESR and Serum biochemistry before and after treated. Special change was not showed. 3. We observed the pain and edema after treated Bee Venom and Morus bombycis Koidzumi Herbal Acupuncture mixed Bee Venom. We knew that Morus bombycis Koidzumi Herbal Acupuncture was decrease the pain and edema due to Bee Venom. 4. According to these clinical studies, Morus bombycis Koidzumi Herbal Acupuncture has a possibility to be a good partner of Bee Venom.

  1. Clinical studies on mercury poisoning in cattle

    Energy Technology Data Exchange (ETDEWEB)

    Sonoda, M.; Nakamura, R.; Too, K.; Matsuhashi, A.; Ishimoto, H.; Sasaki, R.; Ishida, K.; Takahashi, M.

    1956-01-01

    A sporadic outbreak of an unknown disease occurred among dairy cattle, from early February to late May 1955, in Japan. The characteristic symptoms of this disease were dyspnea and depilation; out of 29 cases, 8 died while 2 were slaughtered. Clinical studies have disclosed that the symptoms were similar to those found in cases of mercury poisoning as described by others. So the animals' feed was suspected of being the cause of the sickness. It was confirmed that the incident was due to poisoning resulting from ingestion of linseed meal treated with a mercurial fungicide. From the results of the testing anamnesis, it was found that 171 cattle were fed with the meal and 29 cases were affected. In veiw of the wide use of mercurial preparations for treating seed grains against fungi infection, a further experimental study was made on the effects of the feed and fungicide upon calves.

  2. A CLINICAL STUDY ON SLIDING INGUINAL HERNIAS

    Directory of Open Access Journals (Sweden)

    Sobha Rani

    2015-09-01

    Full Text Available INTRODUCTION: A sliding hernia is a type of hernia in which posterior wall of the sac is not only formed by the parietal peritoneum, but also by sigmoid colon with its mesentery on its left side; caecum on right side and often with portion of bladder in both sides. During surgery care is taken not t o separate the content from the sac as the posterior wall of the sac is formed by the sliding component itself and attempts to dissect it from wall results in vascular injury to the structure and end in ischemic insult of the sliding component. Thus slidin g hernia is important for the special surgical technique and care during intraoperative period which decreases the morbidity. AIMS AND OBJECTIVE S : To study the incidence of sliding hernia in S.V.R.R.G. General Hospital Tirupati . To know the presentation, o rgan involved in the sliding, post - operative complications in the management of sliding hernias. METHODOLOGY : STUDY DESIGN: Prospective Clinical Study , STUDY AREA: Sri Venka teswara Medical College Tirupat i . SOURCE OF DATA: This study is an observational study in which 600 patients with hernia were studied and 40 patients with sliding component during intra operative period were studied in a period of 12 months. S AMPLE SIZE: 40 patients fulfilling the inclusion criteria . METHOD OF COLLECTION OF DATA: Detai led history taking , Complete clinical examination , Appropriate Investigations Blood & Urine Examination, USG , Surgery is performed & Operative findings were recorded. INCLUSION CRITERIA: Patients more than 13 years, with inguinal hernia giving written inform ed consent. EXCLUSION C RITERIA: Patients less than 13 yrs. Patients with comorbid conditions like heart diseases, liver and renal diseases. SOFTWARE: Statistical software mainly SPSS 11.0 and Systat 8.00 was used for the analysis of the data and Microsoft word and excel have been used to generate graphs tables etc. CONCLUSION: In the observational study done on 40 ca ses of

  3. Sudden onset vision loss in an 8-year-old female with McCune-Albright syndrome.

    Science.gov (United States)

    Kim, David; Wysong, Ashley; Lai, Jennifer; Alcorn, Deborah M; Benjamin, Latanya T

    2014-01-01

    We describe a case of an 8-year-old girl with large irregular café au lait macules on the right cheek and right lower extremity presenting with sudden onset vision loss and found to have polyostotic fibrous dysplasia on imaging. The classic triad of McCune-Albright syndrome is discussed along with the importance of recognition in patients with partial presentation. This case also highlights a rare and potentially devastating neurologic complication of McCune-Albright syndrome, as well as the need for early diagnosis and continual surveillance in these patients.

  4. Basaloid squamous carcinoma of skin associated with xeroderma pigmentosum in an 8-year-old child: A rare entity

    Directory of Open Access Journals (Sweden)

    Tashnin Rahman

    2014-01-01

    Full Text Available Xeroderma pigmentosum (XP is a rare autosomal recessive genodermatosis associated with hypersensitivity to ultraviolet (UV light, due to defects in deoxyribonucleic acid (DNA repair. Basaloid squamous cell carcinoma is a rare aggressive variant of squamous cell carcinoma. Patients with XP are at increased risk of developing cutaneous malignancy and are commonly associated with squamous carcinoma. We report an extremely rare case of 8-year-old child with XP along with basaloidsquamous carcinoma of skin; and review of literature related to it.

  5. [Purine metabolism in ankylosing spondylitis: clinical study].

    Science.gov (United States)

    Jiménez Balderas, F J; Robles, E J; Juan, L; Badui, E; Arellano, H; Espinosa Said, L; Mintz Spiro, G

    1989-01-01

    We undertook a prospective study of 23 male patients with Ankylosing Spondylitis (AS) (New York Criteria), 18 HLA-B27 positive and 5 HLA-B27 negative, five of them had hyperuricemia. The following data of evolution were taken into consideration: age at onset of disease, time course of the disease, presence of urolithiasis, heart disease, flares of uveitis. Clinical activity and degree of disability were evaluated every one to 3 months; on each visit, every patient had determinations of serum and urinary uric acid levels, serum and phosphorus, erythrocyte sedimentation rate (ESR), serum protein electrophoresis, as well as X-ray films of the vertebral spine and pelvis. Three groups of patients were detected, all of them with equal age at onset, duration of disease, frequency of B27, peripheral arthritis, and leukocytosis. One group had hyperuricemia (5 of 23 patients, 80% of them HLA-B27 positive) and a lesser degree of clinical activity of the disease (p less than .001, a higher frequency of uveitis (40%, lower levels of serum gammaglobulins (p less than 0.05) and ESR (p less than 0.05), a lesser degree of ankylosis of the spine, and a better functional prognosis than the other groups. Another group (8 of 23 patients, 75% of them were HLA-B27 positive) had normouricemia and hyperuricosuria, and showed a higher frequency of fever (50%), an abnormal urinalysis, and urolithiasis (25%).

  6. Controlled outcome studies of child clinical hypnosis.

    Science.gov (United States)

    Adinolfi, Barbara; Gava, Nicoletta

    2013-09-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.

  7. Evidence Based Studies in Clinical Transfusion Medicine

    NARCIS (Netherlands)

    A.J.G. Jansen (Gerard)

    2007-01-01

    textabstractAfter the introduction of blood component therapy in the 1960s, more and more attention is given to clinical transfusion medicine. Although blood transfusion is an important treatment in different clinical settings, there are still lack of much randomized clinical trials. Nowadays bloo

  8. Evidence Based Studies in Clinical Transfusion Medicine

    NARCIS (Netherlands)

    A.J.G. Jansen (Gerard)

    2007-01-01

    textabstractAfter the introduction of blood component therapy in the 1960s, more and more attention is given to clinical transfusion medicine. Although blood transfusion is an important treatment in different clinical settings, there are still lack of much randomized clinical trials. Nowadays

  9. [Lymphocytic duodenosis: etiological study and clinical presentations].

    Science.gov (United States)

    Santolaria, Santos; Dominguez, Manuel; Alcedo, Javier; Abascal, Manuel; García-Prats, M Dolores; Marigil, Miguel; Vera, Jesus; Ferrer, Margarita; Montoro, Miguel

    2013-11-01

    Lymphocytic duodenosis (LD) is a characteristic lesion in the initial phases of celiac disease (CD) but can be associated with many other entities. The aim of this study was to evaluate the prevalence of distinct causes of LD and possible differences in clinical presentation according to etiology. A retrospective study was performed that included 194 patients diagnosed with LD (more than 25 intraepithelial lymphocytes per 100 epithelial cells). A preestablished strategy to evaluate the cause of the disease was followed that included celiac serology (antitransglutaminase antibodies), HLA-DQ2/DQ8 genotypes, diagnosis of Helicobacter pylori and small intestinal bacterial overgrowth (SIBO). Diagnosis of CD was established on the basis of clinical and histological response to a gluten-free diet in patients with positive serology or compatible findings on HLA-DQ2 (at least one of the alleles) or -DQ8 (both alleles) study. The most frequent cause of LD was CD (39%), followed by SBBO (22%), H.pylori (14%), CD and SIBO (12%), and other causes (13%). Most of the patients (83%) had a compatible HLA-DQ2 or -DQ8 genotype. In these patients, the most frequent diagnosis was CD (46%), while in the absence of HLA-DQ2/DQ8, the most frequent diagnoses were SIBO (44%) and H. pylori (22%). CD was the most frequent diagnosis in patients referred for dyspepsia, diarrhea and anemia, while H. pylori was the most frequent diagnosis in patients with abdominal pain. The most common causes of LD in our environment are CD, followed by SIBO and H. pylori infection. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  10. Clinical studies of IGFBP-2 by radioimmunoassay

    DEFF Research Database (Denmark)

    Blum, W F; Horn, N; Kratzsch, J

    1993-01-01

    A specific radioimmunoassay for human IGFBP-2 was developed using a polyclonal antiserum directed against a partial sequence (hIGFBP-2(176-190)). The tracer was prepared by radioiodination of a [Tyr]o-hIGFBP-2(176-190) derivative. The assay was used to study IGFBP-2 levels in numerous clinical...... and experimental situations. There was little circadian fluctuations of serum level which showed a marked age-dependence with high levels at birth and senescence and low levels during puberty. Decreased IGFBP-2 levels were present in untreated insulin-dependent diabetes mellitus (IDDM), in acromegaly and during...... dexamethasone suppression test. GH deficiency, fasting, IGF-I administration to patients with GH receptor deficiency, hepatic failure and insulinomas caused a moderate increase of serum IGFBP-2. Markedly elevated levels were found in chronic renal failure, non-islet cell tumour induced hypoglycemia...

  11. A CLINICAL STUDY OF OCULAR TRAUMA

    Directory of Open Access Journals (Sweden)

    Bharat Kumar

    2015-12-01

    Full Text Available AIM This study is designed to enumerate various causes of ocular trauma, clinical spectrum of presentation and to evaluate the visual outcome after appropriate management. MATERIALS AND METHODS A prospective study was conducted on total of 136 patients from the places in and around Kakinada, East Godavari District of Andhra Pradesh, India. A detailed work up of all patients including slit lamp biomicroscopy, direct, indirect ophthalmoscopy and ultra sonography B scan was done. RESULTS Observations from the study were analyzed, discussed and compared with the existing studies in the literature. Mean age group of patients belong to young adults between 20-30 years (57.9%, males (81% affected more than females. Illiterates, Agricultural labourers, Industrial workers affected more. Road Traffic Accidents (25.73%, industrial injuries (22.05% and agricultural hazards (19.11% being the major cause of unilateral eye injury. Closed globe injuries (80.88% more common than Open globe injuries (19.12. CONCLUTIONS Ophthalmic injuries due to innumerable causes results in various types of ocular trauma, leading to untold misery, visual impairment and economic burden to the family, society and country as a whole. Health education regarding use of preventive measures, seeking early treatment and appropriate rehabilitation are very much recommended to reduce the burden of morbidity due to ocular trauma.

  12. Mesiodens: a clinical and radiographic study.

    Science.gov (United States)

    Kim, Su-Gwan; Lee, Sang-Ho

    2003-01-01

    The term 'mesiodens' refers to a supernumerary tooth present in the midline of the maxilla between the two central incisors. This study seeks to investigate the characteristics of mesiodens among children in Korea. The study population consisted of 40 children whose ages ranged from 4 to-26-years. The characteristics of mesiodens were obtained from radiographs and clinical examination results, and were confirmed by surgical intervention. Results showed that males were affected approximately 4 times as frequendy as females. Twenty-five percent of the patients had more than 1 supernumerary tooth. About 66% of the mesiodens were conical in shape and about 52% of the mesiodens were in the upward position. The age and sex distribution, number of mesiodens per patient, shape, direction, size, and effect on permanent maxillary incisors are also presented in this study. The incidence of mesiodens has been estimated at 0.15% to 1% of the population. It occurs more frequently in boys than in girls, with the ratio being approximately 2:1. In this study, a male:female ratio of 4:1 for the prevalence for mesiodens was found. Ten (25%) out of the 40 patients had 2 mesiodens.

  13. Facial growth and oral function in a case of juvenile rheumatoid arthritis during an 8-year period

    DEFF Research Database (Denmark)

    Kreiborg, S; Bakke, M; Kirkeby, S

    1990-01-01

    casts, and roentgencephalometry, and oral function was assessed clinically by electromyography, kinesiography, and bite force. In addition, histological and histochemical analysis was performed on biopsy material from her masseter muscle obtained at the time of surgery. The study showed a clear...... on these observations it is suggested that the conventional treatment strategy with postponement of orthodontic or orthognathic surgical treatment until cessation of growth is abandoned and that early treatment should be undertaken to maintain occlusal stability throughout the growth period....

  14. Spinal cord involvement in chronic inflammatory demyelinating polyradiculoneuropathy: a clinical and MRI study.

    Science.gov (United States)

    Ioannidis, Panagiotis; Parissis, Dimitris; Karapanayiotides, Theodoros; Maiovis, Pantelis; Karacostas, Dimitris; Grigoriadis, Nikolaos

    2015-06-01

    Concomitant central nervous system (CNS) involvement in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is rare. Although the spinal nerve roots may present MRI abnormalities in CIDP, hitherto, the spinal cord has been investigated in a single study. We retrospectively investigated clinically and with MRI a cohort of patients with definite CIDP diagnosis (EFNS/PNS criteria) for evidence of brain and spinal cord involvement, who were initially admitted in our department during the last 4 years. Among 12 patients with CIDP (men: 8, mean age: 59.3 years, mean disease duration: 3.8 years), nine patients had their MRI scan during a clinical relapse and three during remission. Brain MRI did not document typical multiple sclerosis lesions in any patient. We did not identify any MRI abnormalities in ten patients without clinical evidence of spinal cord involvement. Conversely, MRI disclosed extensive lesions of the thoracic cord in two patients with an overt spinal cord syndrome, whom we describe. This represents the biggest MRI study of CIDP patients who have been investigated for spinal cord involvement. Our data support earlier observations that a minority of CIDP patients may additionally develop CNS involvement of variable degree.

  15. [A 8-year-forgotten ureteral stent after kidney transplantation: treatment and long-term follow-up].

    Science.gov (United States)

    Lasaponara, Fedele; Dalmasso, Ettore; Santià, Silvia; Sedigh, Omidreza; Bosio, Andrea; Pasquale, Giovanni; Segoloni, Giuseppe P; Fontana, Dario

    2013-01-01

    Forgotten indwelling ureteral stents can cause significant urological complications. Only few cases are reported after kidney transplantation. We present a case of a 39-year-old woman, transplanted in 1993 and referred to our Transplant Center 8 years later, because of a serious urinary tract infection with renal function impairment. Abdominal CT scan showed pyelonephritis and hydronephrosis in the transplanted kidney and the presence of a calcific ureteral stent, which had been forgotten in situ for 8 years. The stent was removed, but it was impossible to replace it with a new stent both retrogradely and anterogradely, because of a tight obstruction of the mid ureter. So a uretero-ureteral anastomosis with up urinary tract was performed. No intra- or post-operative complications occurred. At 9 years' follow-up, the patient shows an optimal renal function, with no urinary tract infection. A forgotten ureteral stent in a transplanted kidney can cause a lot of complications and can lead to graft loss. The prosthesis may cause an irreversible ureteral damage, so, as in our experience, forgetting a ureteral stent can result in a complex surgery.

  16. A CLINICAL STUDY ON ILEAL PERFORATION

    Directory of Open Access Journals (Sweden)

    Kishore Babu

    2016-03-01

    Full Text Available INTRODUCTION Ileal perforation is a common problem seen in tropical countries, the commonest cause being typhoid fever. In western countries the causes are malignancy, trauma and mechanical aetiology, in the order of frequency.1,2,3 Over the years a definite changing trend has been observed in ileal perforations both in terms of causes, treatment and prognosis. Better antibiotics, aggressive surgery and the elimination of conservative treatment, better preoperative and postoperative care have all significantly contributed to the improvement in patient outcome.4,5 But still cases of ileal perforation cause a significant morbidity and mortality that persists despite the significant changes in health care over the years. AIMS AND OBJECTIVES To study the aetiology, presentation, management outcome and the factors influencing prognosis and outcome in ileal perforations. MATERIAL & METHODS Study Setting S. V. Medical College, Department of General Surgery, Tirupati. Study Period Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2012 to October 2015. Inclusion Criteria Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have ileal perforation in the intra operative period are selected. Exclusion Criteria Patients with peritonitis due to other causes like gastric, duodenum or large bowel perforation are excluded. Study Method The present study is a prospective study done on 28 patients of ileal perforation due to typhoid complication, nonspecific and traumatic perforations. History, clinical examination, investigations, operative findings, post-operative complications were recorded. In patients with non-traumatic perforations Widal test was done. CONCLUSION Typhoid fever and traumatic aetiology are the most common cause of Ileal perforation, followed by TB. Patients are more of male gender and are in reproductive age group. Widal

  17. Parastomal hernias -- clinical study of therapeutic strategies.

    Science.gov (United States)

    Târcoveanu, E; Vasilescu, A; Cotea, E; Vlad, N; Palaghia, M; Dănilă, N; Variu, M

    2014-01-01

    Parastomal hernias are parietal defects adjacent to the stomasite, after ileostomy and colostomy. Their incidence is variable and they are generally underestimated. Between 2001 and 2010 at the First Surgical Clinic Iasi, we treated 861 incisional hernias, of which there were 31 parastomal hernias in 26 patients (3%), 5 of which were recurrent parastomal hernias. Parastomal hernias have been explored clinically, through imaging and intraoperatively.Because our experience and literature review have demonstrated that a mesh repair is a safe procedure in the treatment of parastomal hernia, in 2010 we initiated a prospective randomized trial on the use of prophylactic polypropylene mesh at the time of stoma formation to reduce the risk of parastomal hernia. We enrolled in the study 20 patients with mesh implanted at the primary operation and 22 patients without mesh. The inclusion criteria were: patients with low rectal cancer, stage II-III, irradiated, obese, with a history of hernias, patients who do physical work. Most parastomal hernias were asymptomatic; only six cases with parastomal hernias required emergency surgical treatment. We performed local tissue repair in 16 cases (4 cases with recurrent parastomal hernia, stoma relocation in one case), sublay mesh repair in 15 cases (one case with recurrent parastomal hernia; stoma relocation in 5 cases). Postoperative morbidity registered included 4 wound infections (one case after mesh repair which required surgical reintervention) and stoma necrosis in one case with strangulation parastomal hernia with severe postoperative evolution and death. After local tissue repair recurrences were seen in 6 cases, after mesh repair we registered recurrence only in one case and no relapse after the relocation of the stoma. The patients with prophylactic mesh at the time of stoma formation to reduce the risk of parastomal hernia were followed for a median of 20 months(range 12 to 28 months) by clinical examination and ultrasound

  18. Statistical Issues in TBI Clinical Studies

    Directory of Open Access Journals (Sweden)

    Paul eRapp

    2013-11-01

    Full Text Available The identification and longitudinal assessment of traumatic brain injury presents several challenges. Because these injuries can have subtle effects, efforts to find quantitative physiological measures that can be used to characterize traumatic brain injury are receiving increased attention. The results of this research must be considered with care. Six reasons for cautious assessment are outlined in this paper. None of the issues raised here are new. They are standard elements in the technical literature that describes the mathematical analysis of clinical data. The purpose of this paper is to draw attention to these issues because they need to be considered when clinicians evaluate the usefulness of this research. In some instances these points are demonstrated by simulation studies of diagnostic processes. We take as an additional objective the explicit presentation of the mathematical methods used to reach these conclusions. This material is in the appendices. The following points are made:1. A statistically significant separation of a clinical population from a control population does not ensure a successful diagnostic procedure.2. Adding more variables to a diagnostic discrimination can, in some instances, actually reduce classification accuracy.3. A high sensitivity and specificity in a TBI versus control population classification does not ensure diagnostic successes when the method is applied in a more general neuropsychiatric population. 4. Evaluation of treatment effectiveness must recognize that high variability is a pronounced characteristic of an injured central nervous system and that results can be confounded by either disease progression or spontaneous recovery. A large pre-treatment versus post-treatment effect size does not, of itself, establish a successful treatment.5. A procedure for discriminating between treatment responders and nonresponders requires, minimally, a two phase investigation. This procedure must include a

  19. An 8-year evaluation of sintered ceramic and glass ceramic inlays processed by the Cerec CAD/CAM system

    DEFF Research Database (Denmark)

    Pallesen, U.; Dijken van, J.W.V.

    2000-01-01

    The purpose of this study was to evaluate Cerec CAD/CAM inlays processed of two industrially made machinable ceramics during an 8-yr follow-up period. Each of 16 patients received two similar ceramic inlays. Half the number of the inlays were made of a feldspathic (Vita Mark II) and the other...... of a glass ceramic (Dicor MGC) block. The inlays were luted with a dual resin composite and evaluated clinically using modified USPHS criteria at baseline, 8 months, 2, 3, 5, 6 and 8 yr, and indirectly using models. At baseline, 84% of the inlays were estimated as optimal and 16% as acceptable. Postoperative...... sensitivity was reported by one patient for 8 months. Of the 32 inlays evaluated during the 8 yr, 3 failed due to fracture of the material. No secondary caries was found adjacent to the inlays. No significant differences in the clinical performance were found between inlays made of the two ceramics. It can...

  20. CLINICAL STUDY OF EARLY BREAST CARCINOMA

    Directory of Open Access Journals (Sweden)

    Kiran Kumar

    2016-01-01

    Full Text Available Carcinoma of the breast is one of the commonest cancers occurring in female and accounts for 1/3rd of all the malignant diseases occurring in them. It is mainly a disease of the developed countries and accounts for 1,00,000 deaths annually. Breast carcinoma is classified as Early breast cancer, Locally advanced breast cancer and Metastatic breast cancer. By definition early stage breast cancer constitutes breast tumors of clinical stages I, IIa and T2N1M0. Early breast cancer is the one diagnosed by mammography. Women when approaches at this stage, they can go for breast conservation surgery. Not all women are candidates for this approach, and some require mastectomy as part of their treatment. AIM To observe the incidence of early breast carcinoma with particular reference to the time taken by the patients to seek medical advice after the symptoms have developed i.e. the average time taken by the patients to seek medical advice, their appropriate management and prognosis. MATERIALS AND METHODS This prospective study was conducted over a period of 2 years from Oct-2012 to Oct-2014 in 30 female patients aged between 25-65 years who were presented with lump in breast of size ≤5cms with or without pain, with or without lymph nodes to the outpatient department. All the patients were thoroughly asked about history, examined clinically, investigated, staged and managed by surgery either Breast Conservation Surgery or Modified Radical Mastectomy. Postoperative complications were recorded and followed up regularly. RESULTS The incidence of early breast cancer in this study was 0.98% with peak age incidence between 40-60 years and duration of symptoms <6 months in 18 patients. Breast Conservation Surgery + axillary dissection + Radiotherapy was done in 23%. Prognosis was good in these patients with no local recurrence and death. CONCLUSION The prognosis of early stage breast carcinoma patients in this study was good. To have long term tumor free and

  1. Bioavailability studies and the clinical pharmacologist: correlation of drug distribution with clinical effects.

    Science.gov (United States)

    Ogilvie, R I

    1975-06-01

    Bioavailability studies can be interpreted only when clinical information is available which correlates drug distribution with both efficacious and toxic clinical effects. The clinical pharmacologist should be instrumental in the development of safe and effective drug therapy by the systematic application of well designed clinical trials, the clear definition of therapeutically desirable clinical responses, and the development and application of improved techniques of measuring these effects.

  2. Periodontal conditions in vegetarians: a clinical study.

    Science.gov (United States)

    Staufenbiel, I; Weinspach, K; Förster, G; Geurtsen, W; Günay, H

    2013-08-01

    Investigations about possible correlations between vegetarian diet and periodontal conditions are rare and characterized by small case numbers. The aim of this clinical study was to investigate the influence of a vegetarian diet on periodontal parameters with an appropriate sample size. A total of 200 patients, 100 vegetarians and 100 non-vegetarians, were included in the study. All patients were examined including a full mouth assessment of the periodontal and dental conditions. In addition, a questionnaire was handed out to ask for patients' oral hygiene habits and level of education. For statistical analysis the Mann-Whitney Test (χ(2) for analysis of the questionnaire) was applied (level of significance: Pvegetarians versus 41.72 years non-vegetarians). Vegetarians had significantly lower probing pocket depths (P=0.039), bleeding on probing (P=0.001), periodontal screening index (P=0.012), a better hygiene index (Pvegetarians. Furthermore, vegetarians had a higher level of education (PVegetarians revealed better periodontal conditions (less inflammation signs, less periodontal damage and a better dental home care). However, it should be considered that vegetarians are not only avoiding meat in their nutrition but are also characterized by an overall healthier life style.

  3. CLINICAL STUDY OF HEART DISEASE COMPLICATING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Richa

    2014-07-01

    Full Text Available Introduction-Heart disease complicating pregnancy is considered as a high risk situation. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. AIM: To determine maternal and fetal outcome in women with heart disease complicating pregnancy, To emphasize on proper protocol for managing pregnancy complicated by heart disease, To correlate the time of booking & NYHA grading with maternal & fetal outcome. Risk of adverse outcome is more in rural population as compared to its urban counterpart. METHOD: A prospective clinical study of 25 cases of pregnancy complicated by heart disease, reporting to tertiary care hospital for delivery, was carried out to find out the incidence and maternal and fetal outcome. RESULTS: The incidence of heart disease in pregnancy in the present study was 0.6%. Most of the women (91% belonged to low socioeconomic class in the rural population. Rheumatic heart lesions constituted 77% of the cases. Mitral stenosis was the commonest lesion in 40% of cases. Ten (40% women delivered spontaneously vaginally at term. Cesarean section was performed in 14 cases (56%. There were 5 maternal deaths. There were no perinatal deaths. CONCLUSION: Early diagnosis of heart disease, regular antenatal check-up, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease

  4. CLINICAL STUDY OF FISTULA IN ANO

    Directory of Open Access Journals (Sweden)

    Sushma Ramteke

    2017-02-01

    Full Text Available BACKGROUND Fistula in ano is one of the common problem faced in today’s world. Fistula in ano is track lined by granulation tissue that connect deeply in the anal canal or rectum and superficially on the skin around the anus. It usually results from cryptoglandular infection causing abscess, which burst spontaneously or was drained inadequately. The study is conducted to find most common aetiological factor and to evaluate various surgical technique and their outcome. The aim of the study is to- 1. Study the incidence of various aetiologies of fistula in ano. 2. Study the clinical presentation of fistula in ano. 3. Evaluate different modalities of surgical approach and their outcome. MATERIALS AND METHODS This prospective study was conducted at Late Lakhiram Agrawal Memorial Government Medical College, Raigarh, during the study period of July 2015 to July 2016. All the 50 cases were included in this study who were above 15 year of age diagnosed with fistula in ano on the basis of clinical examination who underwent surgical procedure. RESULTS In present study of 50 cases, 60% of cases were in the age group of 31-50 years. Male:female ratio was 9:1. 80% of cases belong to low socioeconomic status. The most common mode of presentation was discharging sinus in 96% of cases. 70% of patient had past history of burst abscess or surgical drainage of abscess. 90% of cases have single external opening. 80% of cases had posterior external opening. Most of the fistula are of low anal type, which was 92% and rest of the patient had an internal opening situated above the anorectal ring. The most common surgical approach done was fistulectomy. Only fistulectomy was done in 80% of patients. Fistulectomy with sphincterectomy was done in two patients. These two patients had associated anal fissure. Fistulectomy with seton placement was done in two patients of high level of fistula type. Fistulotomy was done in four patients (8%, these were of low fistula type

  5. A CLINICAL STUDY ON GASTRIC OUTLET OBSTRUCTION

    Directory of Open Access Journals (Sweden)

    Latchu

    2015-11-01

    Full Text Available INTRODUCTION Gastric outlet obstruction (GOO is obstruction in the first part of duodenum secondary to cicatrised duodenal ulcer or proximally where the diagnosis of carcinoma is most probable. GOO can be a diagnostic and treatment dilemma. Once a mechanical obstruction is confirmed, differentiate between benign and malignant processes. Cicatrized duodenal ulcer was the most common cause of GOO. But with increased awareness, change in the dietary habits and availability of H2 receptor blockers and Proton Pump Inhibitors and H pylori kits all have resulted in decreased incidence of patients requiring surgery and also the complications like pyloric stenosis have reduced. At the same time the incidence of antral carcinoma of stomach producing GOO has comparatively increased, which may be due to increased early diagnosis of the condition with the help of flexible fibro optic endoscope. AIMS & OBJECTIVES To study and identify the cause of cases of GOO with respect to benign peptic ulcer and malignancy of stomach. MATERIALS AND METHODS An observational study comparing of 30 cases of GOO. An elaborate study of the cases with regard to history, clinical features, routine and special investigation, pre operative treatment, operative findings, post operative management and complications in the post operative period is done. Apart from routine surgical profile special investigations like serum electrolytes, barium meal study, Upper GI Endoscopy and ultrasound abdomen and pelvis will be carried. For peptic ulcer disease truncal vagotomy with posterior gastrojejunostomy was done and for carcinoma partial gastrectomy with Billroth II reconstruction or anterior GJ or palliative resection with anterior GJ were done. INCLUSION CRITERIA 1. Peptic ulcer disease 2. Carcinoma pyloric antrum, 3. Benign neoplasm of stomach. EXCLUSION CRITERIA 1. Carcinoma stomach with liver metastasis, ascites, peritoneal implantation, 2. Gastro duodenal tuberculosis. ETHICAL ISSUES

  6. Calcium-Enriched Mixture Pulpotomy of Primary Molar Teeth with Irreversible Pulpitis. A Clinical Study

    Science.gov (United States)

    Memarpour, Mahtab; Fijan, Soleiman; Asgary, Saeed; Keikhaee, Marzieh

    2016-01-01

    Objectives: To evaluate the outcome of vital pulp therapy in primary teeth with irreversible pulpitis by using calcium-enriched mixture (CEM) cement according to clinical and radiographic assessment. Participants and Methods: Fifty primary molar teeth with irreversible pulpitis in 50 children aged 6-8 years underwent pulpotomy using CEM cement as the dressing material. Following pulpotomy, pain intensity was evaluated by use of a visual analog scale at 1 and 7 days from the treatment and in clinical appointments at 3, 6 and 12 months after baseline. Radiographic evaluation was performed at 6 and 12 months. Data were analyzed using the McNemar test. Results: A total of 42 children (mean age 7.26 ± 0.82 year) completed the study. After one day treatment 56 % of children reported complete relief of pain and after 7 days 62% reported the same. However, two children complained of increased pain 1 day after treatment. None of the children reported pain in the subsequent appointments. One child complained of tenderness in percussion after 6 months. Pulp canal obliteration was the most common change in the radiographic assessment. There was no significant difference between clinical (92.8%) and radiographic (90.4%) success (p=0.990). Conclusion: Pulpotomy using CEM cement could present a successful treatment in primary molar teeth with irreversible pulpitis. PMID:27326265

  7. FETAL ECHOCARDIOGRAPHY: A STUDY OF CLINICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Rajanish

    2014-01-01

    Full Text Available BACKGROUND : S tructural abnormalities of the heart and great vessels are fairly common congenital lab normalities with the incidenceof8 in 1000 live births. With the advent of real time scanners fetal cardia can atomy can be analyze d echocardiographically. The earlier diagnosis will make an impact on clinical management of fetus with congenital heart disease. It helps intimely triage and optimal management of specific congenital heart disease either structural , functional orarrhythmia . OBJECTIVES : This study was conducted to note the spectrum of congenital heart diseases detected on fetal echo in pregnant mothers referred with high risk for CHD sand to assess the outcome of prenatally detected congenital heart diseases. MATERIAL S AND METHODS : T he study is aprospective descriptive study conducted in a tertiary care pediatric hospital in Mumbai over period of one year . P regnant mothers were referred for fetal echo , where pregnancy was considered as high risk for CHDs due to maternal , fetalfactorsorabnormallevel 1 scan.Fetal echowas performed by a trained pediatric cardiologistat 18 to 20 week of gestation using HP sonos 2000 echocardiographicmachinewith3/3.5 Hz transducer. Cardiac lesionsandoutcome of pregnancy was noted by postnatal follow - up of patients. RESULTS : A total of 170 patients underwent fetal echo , 13 patients have not delivered and 48 were lost to follow - up. Fetal echo was normal in 130(76.4% and abnormalities were detected in 40(23.5%.Structural anomalies were seen in 24(14.1% , arrhythmia in 5(2.9% and functional abnormalities in 11(6.4%.On outcome analysis84 (77.1% arealive , IUD /terminationof pregnancyoccurred in 18(16.5% , neonatal death in 6 (5.5% , infant death in 1 (0.9%. CONCLUSIONS : All ranges of CHDs can be diagnosed by fetal echocardiography . O utcome of prenatally detected complex congenital heart disease is poor ; nonetheless earlier detection provides a n opportunity for early interventions and

  8. CLINICAL STUDY AND MANAGEMENT OF CHOLEDOCHOLITHIASIS

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-10-01

    Full Text Available BACKGROUND AND OBJECTIVES: Choledocholithiasis complicates the working and management of cholelithiasis necessitating additional diagnostic procedures, increasing morbidity and mortality. CBD stone generally remain asymptomatic but when symptoms start appearing, cause a lot of suffering. There are various treatment modalities available presently. The objective of our study was to study the incidence, various modes of clinical presentations and different modalities of treatment in common bile duct stones. MATERIALS AND METHODS: 35 Patients were prospectively studied from July 2012 to June 2014 as in-patients in Victoria Hospital. RESULTS: CBD stones occurred predominantly in elderly females and presented from subclinical jaundice to complications in the form of biliary pancreatitis and cholangitis. USG abdomen with LFT was able to diagnose majority of the CBD stones preoperatively. Per operative cholangiogram was used selectively in case USG was inconclusive, ERCP was used in patients presenting with severe obstructive jaundice, pancreatitis, cholangitis, minimal CBD ductal dilation. Open exploration was the main focus with a wide variety of procedures performed according to specific indications. CONCLUSION: CBD was more common in elderly female patients probably due to neglected gall bladder stones. CBD stones can occur from occult asymptomatic stones only with altered LFT to symptomatic presentation in the form of cholangitis, pancreatitis. USG abdomen was inexpensive and easily available imaging modality to diagnose CBD stones with per operative cholangiogram being needed in minority of the cases. While ERCP was good in treating complications of CBD stones and early stages of the disease; the more advanced stage of the disease with gross CBD ductal dilation and multiple stones open CBD exploration were more productive.

  9. Comparing the Effectiveness of a Clinical Registry and a Clinical Data Warehouse for Supporting Clinical Trial Recruitment: A Case Study

    Science.gov (United States)

    Weng, Chunhua; Bigger, J Thomas; Busacca, Linda; Wilcox, Adam; Getaneh, Asqual

    2010-01-01

    This paper reports a case study comparing the relative efficiency of using a Diabetes Registry or a Clinical Data Warehouse to recruit participants for a diabetes clinical trial, TECOS. The Clinical Data Warehouse generated higher positive predictive accuracy (31% vs. 6.6%) and higher participant recruitment than the Registry (30 vs. 14 participants) in a shorter time period (59 vs. 74 working days). We identify important factors that increase clinical trial recruitment efficiency and lower cost. PMID:21347102

  10. Comparing the effectiveness of a clinical registry and a clinical data warehouse for supporting clinical trial recruitment: a case study.

    Science.gov (United States)

    Weng, Chunhua; Bigger, J Thomas; Busacca, Linda; Wilcox, Adam; Getaneh, Asqual

    2010-11-13

    This paper reports a case study comparing the relative efficiency of using a Diabetes Registry or a Clinical Data Warehouse to recruit participants for a diabetes clinical trial, TECOS. The Clinical Data Warehouse generated higher positive predictive accuracy (31% vs. 6.6%) and higher participant recruitment than the Registry (30 vs. 14 participants) in a shorter time period (59 vs. 74 working days). We identify important factors that increase clinical trial recruitment efficiency and lower cost.

  11. Recurrent unicystic mural type ameloblastoma in a 9-year-old boy, 8 years follow-up

    Directory of Open Access Journals (Sweden)

    Burcu Sengüven

    2013-01-01

    Full Text Available Unicystic ameloblastoma is not a rare odontogenic tumor in the pediatric population. A significant care should be given to unicystic ameloblastoma if it has mural invasions due to its local aggressiveness, high recurrence rates and radical management options as in conventional ameloblastoma. Fine needle aspiration (FNA cytology is a rapid, non-traumatic diagnostic method that provides a required attention prior to surgery. We present an excisionsl biopsy proved FNA diagnosed mural type unicystic ameloblastoma in a 9-year-old child recurred as a solid ameloblastoma after 8 years. When distinctive features of ameloblastoma are known, an accurate diagnosis can be made by FNA cytology, in combination with clinicoradiological findings. This method gives benefit to the patients especially the younger ones both for the pre-operative surgical planning and the post-operative follow-up.

  12. Anterior Nutcracker syndrome as a rare cause of hematuria in an 8 year old boy: A case report

    Directory of Open Access Journals (Sweden)

    Prashant S Patil

    2016-09-01

    Full Text Available Nutcracker syndrome is caused by a compression of the left renal vein between the aorta and the superior mesenteric artery. It results in left renal venous hypertension, and the subsequent development of venous varicosities of the renal pelvis, ureter, and gonadal vein. We report a rare case in an 8-year-old boy who presented with a history of intermittent episodes of hematuria leading to anemia and left flank pain. Ultrasound examination of abdomen revealed bulky left kidney and features of subacute medical renal disease. Computed tomography of abdomen showed compressed left renal vein between aorta and superior mesenteric artery. Authors report the successful operative management of this rare syndrome in a pediatric patient.

  13. Aspects of activities and participation of 7-8 year-old children with an obstetric brachial plexus injury.

    Science.gov (United States)

    Spaargaren, Els; Ahmed, Jasmyn; van Ouwerkerk, Willem J R; de Groot, Vincent; Beckerman, Heleen

    2011-07-01

    Children with an obstetric brachial plexus injury (OBPI) can experience problems in the performance of meaningful activities such as writing, bimanual activities, and participation in sports and leisure activities. To quantify the everyday functioning and participation of 7-8 year-old children with an OBPI, with special emphasis on writing, and to investigate associated characteristics. Parents of children with an OBPI were sent a self-report questionnaire regarding the school performance, writing abilities, bimanual hand use, and participation in sports and leisure activities of their child, assessed with the Vineland Adaptive Behavior Scales (VABS sub-scale writing), the ABILHAND-kids, and the Children's Assessment of Participation and Enjoyment (CAPE). Furthermore, questions were asked about socio-demographic variables, medical history, pain, and the use of assistive devices. Fifty three questionnaires were filled in (response 61%). According to the parents, 66% of their children were almost completely recovered, and 58% had a near normal arm function. Most of the children preferred to use their non-involved hand. More than 45% of the children complained about pain, and 39.6% had difficulties with writing, which resulted in a mean developmental delay of 8 months on the VABS sub-scale. Children with writing problems significantly more often had neurosurgery, were living with a single parent, more often received assistance at school, and had a significantly lower ABILHAND-kids score, compared to children with no writing problems. Large percentages of 7-8 year-old children with an OBPI experience difficulties with writing and have musculoskeletal pain. Restrictions in participation were less pronounced. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  14. Primary pontine hemorrhage. A clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Jun; Kagimoto, Hiroshi; Maeda, Masanobu; Soda, Takao [Shimane Prefectural Central Hospital, Izumo (Japan)

    2002-07-01

    We studied the relationship between outcome and clinical symptoms or CT findings of 34 cases with primary pontine hemorrhage diagnosed by CT scan from April 1994 to March 1999. This series comprised 19 males and 15 females ranging in age from 45 to 89 years with a mean of 67.1 years. According to their outcome at discharge, the cases were divided into 6 groups. Sixteen cases died within 2 weeks after onset (group AD), 4 cases died with complication in the chronic phase (group D), 3 cases were severely disabled to bed-ridden state (group C), 2 cases recovered to a daily life with wheelchair (group B), 4 cases recovered to a daily life with partial assistance (group A), and 5 cases showed a full recovery (group J). The factors significantly correlated with bed outcome are as follows: young age, consciousness disturbance, respiratory disturbance, tachycardia over 90 beats per minute, hyperthermia over 39 deg C, abnormal pupils, loss of oculocephalic reflex, tetraplegia, decerebrate rigidity, bilateral extension or over 30 mm transverse diameter of the hematoma. (author)

  15. Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study.

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A.H.; Brunekreef, B.; Kerkhof, M. van de; Hoekstra, M.O.; Gerritsen, J.; Aalberse, R.; Jongste, J.C. de; Smit, H.A.

    2009-01-01

    BACKGROUND: It is unclear how the association between breast feeding and asthma develops with age of the child and how this association over time is influenced by maternal or paternal allergy. These factors--the age of the child and maternal or paternal allergy--might partly explain the conflicting

  16. Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study

    NARCIS (Netherlands)

    Scholtens, S.; Wijga, A. H.; Brunekreef, B.; Kerkhof, M.; Hoekstra, M. O.; Gerritsen, J.; Aalberse, R.; de Jongste, J. C.; Smit, H. A.

    2009-01-01

    Background: It is unclear how the association between breast feeding and asthma develops with age of the child and how this association over time is influenced by maternal or paternal allergy. These factors-the age of the child and maternal or paternal allergy-might partly explain the conflicting re

  17. Emergence of Pseudomonas aeruginosa with KPC-type carbapenemase in a teaching hospital: an 8-year study.

    Science.gov (United States)

    García Ramírez, Dolores; Nicola, Federico; Zarate, Soledad; Relloso, Silvia; Smayevsky, Jorgelina; Arduino, Sonia

    2013-10-01

    An outbreak of Klebsiella pneumoniae carbapenamase (KPC)-producing K. pneumoniae occurred at our institution. Multiresistant Pseudomonas aeruginosa could have acquired this transmissible resistance mechanism, going unnoticed because its phenotypic detection in this species is difficult. We compared P. aeruginosa isolates obtained before and after the KPC-producing K. pneumoniae outbreak. No bla(KPC) genes were detected in the isolates obtained before the outbreak, whereas 33/76 (43%) of the isolates obtained after the outbreak harboured the bla(KPC) gene. P. aeruginosa may thus become a reservoir of this transmissible resistance mechanism. It is very important to understand the epidemiology of these multiresistant isolates, in order to achieve early implementation of adequate control measures to contain and reduce their dissemination in the hospital environment.

  18. CLINICAL STUDY OF FISTULA IN ANO

    Directory of Open Access Journals (Sweden)

    Raj

    2015-10-01

    Full Text Available Fistula in Ano is a benign treatable lesion of the rectum and the anal canal. Cryptoglandular infection accounts for about 90% of these cases. Majority of the infections are Acute and a minority contributed by chronic low grade infection hence pointing to varying etiologies. The pathogenesis has been attributed to the bursting open of an acute or inadequately treated Anorectal abscess into the peri anal skin. Diagnosis of the condition can be made easily with a good source of light, a proctoscope and a meticulous digital examination. Establishing a cure in this condition is difficult owing to two reasons. Firstly, the site of the infection makes the patient reluctant to subject themselves to examination. Secondly, a significant percent of these diseases persist or recur when appropriate surgery is not done or when the post op care is inadequate. Mostly it affects the young and the middle age group thus affecting productive man hours and quality of life. MATERIALS AND METHODS: All cases of clinically diagnosed Fistulae-in-ano above the age of 12 years, admitted in various surgical units in K.R. Hospital (attached to Government Medical College, Mysore during the study period December 1, 2008 to May 31, 2010. REUSLTS: Age Incidence, Sex Incidence, Socio Economic Status, Modes of Presentation, No. of External Openings, Situation of External Openings, Level of Fistulae, Type of surgical treatment, Associated with Fissure in Ano, Postoperative complication and Results were studied. CONCLUSION: Commonest age of presentation in our series is 30-40 years – 40%. Males are more commonly affected. Ratio Male: Female::3:1, Disease is more commonly seen in people with lower socio economic status group. 80% High socio economic class 20%. Discharging sinus is the commonest mode of presentation 72% and pain 72% and 84% pass history of perianal abscess was the presenting symptoms.

  19. Nail alterations during pregnancy: a clinical study.

    Science.gov (United States)

    Erpolat, Seval; Eser, Ayla; Kaygusuz, Ikbal; Balci, Hatice; Kosus, Aydin; Kosus, Nermin

    2016-10-01

    During pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18-40-year-old pregnant women in gestation weeks 16-40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro-Wilk and chi-squared tests were used to make categorical comparisons. A P-value of nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14-28 weeks (16.3%) and 29-42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29-42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women.

  20. Clinical studies on inferior right hepatic veins

    Institute of Scientific and Technical Information of China (English)

    Xue Xing; Hong Li; Wei-Guo Liu

    2007-01-01

    BACKGROUND:Many small veins are called accessory, short hepatic veins in addition to the right, middle and left hepatic veins. The size of these veins varied from a pinhole to 1 cm; the size of inferior right hepatic veins (IRHVs) is thicker than that of short hepatic veins or more than 1 cm occasionally. Adults have a higher incidence rate of the IRHV. DATA SOURCES:A literature search of the PubMed database was conducted and research articles were reviewed. RESULTS:The size of IRHVs is related to the size of the right hepatic vein, i.e. the larger the diameter of the right hepatic vein, the smaller the diameter of the IRHVs, and vice versa. The IRHVs are divided into superior, medial and inferior groups, separately named the superior, medial and inferior right hepatic veins according to the position of the IRHV entering the inferior vena cava. The superior right hepatic vein mainly drains the superior part of segmentⅦ, and the medial right hepatic vein drains the middle part of segmentⅦ. A thicker IRHV mainly drains segmentⅥ and the inferior part of segmentⅦ and a thinner IRHV drains the inferior part of segmentⅤ. CONCLUSIONS:The clinical signiifcance of these studies on IRHVs is varied: (1) Hepatic caudate lobe resection could be introduced after study on the veins of that lobe. (2) It is very important to identify the draining region of the IRHV for guiding hepatic segmentectomy. The postero-inferior area of the right lobe can be preserved along with the hypertrophic IRHV even if the entire main right hepatic vein is resected during segmentectomy ofⅦ andⅧwith right hepatic vein resection for patients with primary liver cancer. (3) The ligation of the major hepatic vein for the treatment of juxtahepatic vein injury is recommended because of severe hemorrhagic shock and dififculty in

  1. A longitudinal study of empathy in pre-clinical and clinical medical students and clinical supervisors.

    Science.gov (United States)

    Mahoney, Sarah; Sladek, Ruth M; Neild, Tim

    2016-10-18

    Although appropriate empathy in health professionals is essential, a loss of empathy can occur during medical education. The structure of clinical learning may be one factor that is implicated in a loss of empathy. This study examines student and doctor empathy, and possible associations between empathy and the structure of clinical learning. There were three groups of participants: medical students (n = 281), who completed a longitudinal survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the beginning and end of the 2013 academic year; private doctors (medical practitioners) in South Australia (n = 78) who completed a survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the end of the students' academic year; and doctors (medical practitioners) from public teaching hospitals (n = 72) in southern Adelaide, South Australia who completed a survey consisting of the Jefferson Scale of Empathy at the end of the students' academic year . Year one students' empathy scores at the end of the year (102.8 ± 17.7) were significantly lower than at the start of the year (112.3 ± 9.6) p empathy scores by year groups or across the two time points. Empathy scores were almost identical for private and hospital clinicians and higher than average scores for students. Free-text comments highlighted the importance students and doctors place on empathy. Students described issues that adversely affected their empathy, including specific incidents, systemic issues, and course structure, but also described some positive role models. Doctors' comments focused on the importance of empathy but qualified its meaning in the therapeutic setting. Medical students and practitioners alike ascribe importance to empathy in clinical practice, yet its developmental course remains poorly understood with possible decrement across the course of medical education. A more sophisticated understanding of empathy

  2. What is a clinical decision analysis study?

    Directory of Open Access Journals (Sweden)

    Aleem Ilyas

    2008-01-01

    Full Text Available Decision making in clinical practice often involves the need to make complex and intricate decisions with important long-term consequences. Decision analysis is a tool that allows users to apply evidence-based medicine to make informed and objective clinical decisions when faced with complex situations. A Decision Tree, together with literature-derived probabilities and defined outcome values, is used to model a given problem and help determine the best course of action. Sensitivity analysis allows an exploration of important variables on final clinical outcomes. A decision-maker can thereafter establish a preferred method of treatment and explore variables which influence the final outcome. The present paper is intended to give an overview of decision analysis and its application in clinical decision making.

  3. An 8-year evaluation of nasal and paranasal sinuses malignant neoplasms in Tehran University of Medical Sciences hospitals

    Directory of Open Access Journals (Sweden)

    Mohsen Naraghi

    2009-07-01

    Full Text Available Introduction: Nasal and paranasal sinuses malignant neoplasms are usually diagnosed in advanced stages because of non-specific and benign symptoms. In this study we evaluated the symptoms, pathology and treatment of paranasal sinuses malignancies in patients admitted to Tehran University of Medical Sciences affiliated hospitals. Material and Methods: In this descriptive study, medical files of patients diagnosed with paranasal sinus malignancies and admitted to Imam Khomeini and Amir Aalam hospitals between 2000-2007 were evaluated. Results: Of 75 patients, 47 were male and 28 were female. The mean age was 55±14.1 years. The most common sinus involvement was seen in Maxillary sinuses (86.7% and 18 patients had concurrent involvement of other sinuses. The most common pathology was squamous cell carcinoma (40% and the most common clinical symptom was nasal obstruction (%28. Distant metastasis was found in 46 patients and 42 patients presented with eye involvement Eleven patients underwent endoscopic resection. Conclusion: The presence of eye involvement and distant metastasis in a large number of the patients showed that diagnosis of paranasal cancers is delayed because of their nonspecific symptoms. Therefore further education of clinical manifestations of paranasal sinus cancers is emphasized. 

  4. A CLINICAL STUDY OF STROKE IN YOUNG

    Directory of Open Access Journals (Sweden)

    Kumbha Thulasi Ram

    2015-02-01

    Full Text Available NTRIDUCTION : Stroke is one of the important causes of morbidity and mortality all over the world. Incidence of stroke steadily increases with age. Experts are concerned of the emerging stroke epidemic in India. Stroke affecting the young has potentially devastating consequence son the individual and his family. Certain risk factors are unique to the young. I t needs more studies for identification and modification of risk factors. The study aims to evaluate clinical features, risk factors, etiology and mortality of stroke in young patients. METHODS : 74 young patients satisfying the inclusion criteria were included in this study. A detailed history was taken from young stroke patients, systemic examination and required investigations were done. Data was collected in standardized proforma and analysed. RESULTS: Stroke in young accounts for 7.95% of stroke cases of all age groups. The mean age of the patients was 34.66 ± 7.48 years. Among 74 patients, 47(63.51% were male and 27(36.49% were female. Seizures, decreased consciousness, speech involvement and motor deficit were observed in 33.78%, 44.59%, 22.97% and 100% of cases respectively. 82.43% patients had ischemic and 17.57% patients had hemorrhagic stroke. Among ischemic stroke, large artery atherosclerosis was 16.21%, tuberculous meningoencephalitis with vasculitis was 16.21%, lacunar stroke was 10.81%, CVT was 10.81% and cardio embolic stroke was 6.76%. Smoking (59.45%, alcoholism (58.10%, hypertension (43.24%, coronary artery disease (8.10%, diabetes mellitus (10.81%, elevated total cholesterol (25.67%, elevated low density lipo proteins (22.97%, elevated triglycerides (27.02% and low HDL (22.97% were important risk factors. Carotid doppler was abnormal in 9.45% of patients. 6.76% patients had mitral stenosis in echocardiogram. Low protein C and protein S were found in 1.35% of patients. Eight (10.81% patients died during the hospital stay. INTERPRETATION AND CONCLUSIONS: The major risk

  5. Body mass index and dental caries in children aged 5 to 8 years attending a dental paediatric referral practice in the Netherlands.

    Science.gov (United States)

    de Jong-Lenters, Maddelon; van Dommelen, Paula; Schuller, Annemarie A; Verrips, Erik H W

    2015-12-01

    Obesity and dental caries are widely-recognised problems that affect general health. The prevention of both dental caries and obesity have proven very difficult: children and their parents may need professional support to achieve behaviour change. To find out whether both dental caries and overweight in childhood can be targeted using a common risk factor approach, it is necessary to establish whether the two diseases are indeed linked. The aim of the present study was therefore to use anthropometric data obtained professionally to investigate the association between Body Mass Index and dental caries experience in children aged 5-8 years receiving treatment in a referral centre for paediatric dental care in the Netherlands. Children's dmft and dmfs scores were calculated using dental records and sociodemographic data were also extracted from these records. Dentists were trained to measure standing height and weight in a standardised way. Body Mass Index was calculated by dividing kilograms by height squared (kg/m(2)). Extended International (International Obesity Task Force) body mass index cut-offs were used to define 'no overweight' and 'overweight' (with the latter category including obesity). No statistically significant differences were found between the mean dmft or dmfs scores of the two groups (overweight and non-overweight), even after correction for the effect of the potential confounders sex, socio-economic status and ethnicity. The percentage of caries-active children in the non-overweight group was almost the same as in the overweight group. No statistically significant differences were found. We hypothesised to find a positive association between body mass index and dental caries experience in children aged 5-8 years attending our practice. However, this study did not find a relationship of this kind. A common risk factor approach for the prevention of caries and overweight is therefore not supported by our study.

  6. [Changing surgical therapy because of clinical studies?].

    Science.gov (United States)

    Schwenk, W; Haase, O; Müller, J M

    2002-04-01

    The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

  7. Using Clinical Gait Case Studies to Enhance Learning in Biomechanics

    Science.gov (United States)

    Chester, Victoria

    2011-01-01

    Clinical case studies facilitate the development of clinical reasoning strategies through knowledge and integration of the basic sciences. Case studies have been shown to be more effective in developing problem-solving abilities than the traditional lecture format. To enhance the learning experiences of students in biomechanics, clinical case…

  8. [Clinical studies of pediatric malabsorption syndromes].

    Science.gov (United States)

    Hosoyamada, Takashi

    2006-11-01

    Multiple cases with various types of pediatric malabsorption syndromes were evaluated. The clinical manifestations, laboratory findings, pathophysiology, and histopathological descriptions of each patient were analyzed in an effort to clear the pathogenesis of the malabsorption syndromes and the treatments were undertaken. The cases studied, included one patient with cystic fibrosis, two with lactose intolerance with lactosuria (Durand type), one with primary intestinal lymphangiectasia, two with familial hypobetalipoproteinemia, one with Hartnup disease, one with congenital chroride diarrhea, one with acrodermatitis enteropathica, one with intestinal nodular lymphoid hyperplasia (NLH), five with intractable diarrhea of early infancy and four with glycogenosis type Ia. Each case description and outcome is described below: 1. A 15-year-old Japanese boy with cystic fibrosis presented with severe symptoms, including pancreatic insufficiency, bronchiectasis, pneumothorax and hemoptysis. His prognosis was poor. Analysis of the CFTR genes of this patient revealed a homozygous large deletion from intron 16 to 17b. 2. In the sibling case of Durand type lactose intolerance, the subjects'disaccaridase activity of the small bowel, including lactase, were within normal limits. The results of per oral and per intraduodenal lactose tolerance tests confirmed lactosuria in both. These observations suggested, not only an abnormal gastric condition, but also duodenal and intestinal mucosal abnormal permeability of lactose. 3. In the case of primary intestinal lymphangiectasia, the subject had a lymphedematous right arm and hand, a grossly coarsened mucosal pattern of the upper gastrointestinal tract (identified via radiologic examination) and the presence of lymphangiectasia (confirmed via duodenal mucosal biopsy). The major laboratory findings were hypoalbuminemia, decreased immunoglobulin levels and lymphopenia resulting from loss of lymph fluid and protein into the gastro

  9. Perception of Nonnative-accented Sentences by 5- to 8-Year-olds and Adults: The Role of Phonological Processing Skills.

    Science.gov (United States)

    Bent, Tessa; Atagi, Eriko

    2017-03-01

    To acquire language and successfully communicate in multicultural and multilingual societies, children must learn to understand speakers with various accents and dialects. This study investigated adults' and 5- to 8-year-old children's perception of native- and nonnative-accented English sentences in noise. Participants' phonological memory and phonological awareness were assessed to investigate factors associated with individual differences in word recognition. Although both adults and children performed less accurately with nonnative talkers than native talkers, children showed greater performance decrements. Further, phonological memory was more closely tied to perception of native talkers whereas phonological awareness was more closely related to perception of nonnative talkers. These results suggest that the ability to recognize words produced in unfamiliar accents continues to develop beyond the early school-age years. Additionally, the linguistic skills most related to word recognition in adverse listening conditions may differ depending on the source of the challenge (i.e., noise, talker, or a combination).

  10. Information transfer across the scales of climate variability: The effect of the 7-8 year cycle on the annual and interannual scales

    Science.gov (United States)

    Palus, Milan; Jajcay, Nikola; Hlinka, Jaroslav; Kravtsov, Sergey; Tsonis, Anastasios

    2016-04-01

    Complexity of the climate system stems not only from the fact that it is variable over a huge range of spatial and temporal scales, but also from the nonlinear character of the climate system that leads to interactions of dynamics across scales. The dynamical processes on large time scales influence variability on shorter time scales. This nonlinear phenomenon of cross-scale causal interactions can be observed due to the recently introduced methodology [1] which starts with a wavelet decomposition of a multi-scale signal into quasi-oscillatory modes of a limited bandwidth, described using their instantaneous phases and amplitudes. Then their statistical associations are tested in order to search for interactions across time scales. An information-theoretic formulation of the generalized, nonlinear Granger causality [2] uncovers causal influence and information transfer from large-scale modes of climate variability with characteristic time scales from years to almost a decade to regional temperature variability on short time scales. In analyses of air temperature records from various European locations, a quasioscillatory phenomenon with the period around 7-8 years has been identified as the factor influencing variability of surface air temperature (SAT) on shorter time scales. Its influence on the amplitude of the SAT annual cycle was estimated in the range 0.7-1.4 °C and the effect on the overall variability of the SAT anomalies (SATA) leads to the changes 1.5-1.7 °C in the annual SATA means. The strongest effect of the 7-8 year cycle was observed in the winter SATA means where it reaches 4-5 °C in central European station and reanalysis data [3]. This study is supported by the Ministry of Education, Youth and Sports of the Czech Republic within the Program KONTAKT II, Project No. LH14001. [1] M. Palus, Phys. Rev. Lett. 112 078702 (2014) [2] M. Palus, M. Vejmelka, Phys. Rev. E 75, 056211 (2007) [3] N. Jajcay, J. Hlinka, S. Kravtsov, A. A. Tsonis, M. Palus, Time

  11. Establishing a multicenter longitudinal clinical cohort Study in ...

    African Journals Online (AJOL)

    ... clinical cohort Study in Ethiopia: Advanced Clinical Monitoring of Antiretroviral Treatment Project. ... Ethiopian Journal of Health Sciences ... Using similar recruitment procedures, a total of 120 children were enrolled in each of retrospective ...

  12. A CLINICAL AND MICROBIAL STUDY OF OTOMYCOSIS: AN ORIGINAL STUDY

    Directory of Open Access Journals (Sweden)

    Prakash

    2015-09-01

    Full Text Available Otomycosis or “Otitis externa myotica” refers to a fungal or yeast infection of the external auditory meatus. Fungi can be isolated in up to 40 percent of all cases of external otitis, especially “Aspergillus niger and Candida albicans”. It has a worldwide distribution with higher prev alence in the hot, humid and dusty climate of the tropical and subtropical regions and sometimes in association with immunosuppression and poor hygienic conditions. The purpose of this study is to analyse the etiology, clinical manifestations, microbial pa ttern of otomycosis and treatment.

  13. Incidence of Vertebral Fractures in Women with Systemic Lupus Erythematosus After 8 Years of Follow-Up.

    Science.gov (United States)

    García-Carrasco, Mario; Mendoza-Pinto, Claudia; León-Vázquez, María de la Luz; Méndez-Martínez, Socorro; Etchegaray-Morales, Ivet; Montiel-Jarquín, Álvaro; Enriquez-Guerra, Miguel Angel; Muñóz-Guarneros, Margarita; Gálvez-Romero, José Luis; Soto-Santillán, Pamela; Cervera, Ricard

    2017-09-01

    The aim of this study was to evaluate possible associations between potential risk factors and the occurrence of established vertebral fractures (VF) in Mexican patients with systemic lupus erythematosus (SLE). Consecutive patients with SLE were enrolled in a prospective, observational study from 2006 to 2015. Information on potential risk factors, including demographics, clinical data, and bone mineral density (BMD) at the lumbar spine and hip on dual-energy X-ray absorptiometry was collected at baseline and follow-up. Semiquantitative analysis was used to determine incident VF on lateral thoracic and lumbar radiographs, defined as any vertebral body graded normal at baseline and at least mildly deformed (20-25% reduction or more in any vertebral height) during follow-up. Differences in baseline characteristics were assessed in patients with and without new radiographic VF. Of 110 SLE patients included, with a median follow-up of 8 (IQR 8-9) years, 22 (20%) had radiographic VF at baseline; 35 (32%) patients had a new VF. The annual incidence rate of new morphometric VF was 3.5 (95% CI 2.4-4.91) per 100 patient/years. Most fractures were mild or moderate and biconcave shaped. Incident VF were significantly associated with baseline BMD at the total hip and longer disease duration. Cumulative glucocorticoid dose, postmenopausal status, and previous prevalent VF were not associated with VF. In this SLE cohort in daily clinical practice, new VF were frequently present in SLE patients, especially those with longer disease duration and low-hip BMD.

  14. Dental emergencies in a university pediatric dentistry clinic: a retrospective study

    Directory of Open Access Journals (Sweden)

    Ayah Qassem Shqair

    2012-02-01

    Full Text Available A significant number of children visit a dentist for the first time due to emergency situations. However, little is known regarding the prevalence, etiology, and treatment provided for children at emergency dental visits. This study aimed to evaluate the profile of children attending a dental school emergency clinic, the reasons for seeking dental care, and the treatment provided. Records of 270 patients who attended an emergency clinic during 2010 were analyzed, and 253 were selected. Demographic, diagnostic, and procedural information was collected. The mean child age was 7.8 years. For 208 children (82%, pain was the main reason for the emergency visit. Nearly 79% of the visits were due to caries, and the most frequently required treatment was endodontic intervention (31.22%. Of the decayed teeth, 61.70% were primary posterior teeth and 31.9% permanent posterior teeth. Pain caused by dental decay was the most frequent chief complaint. A large number of children were brought to the dentist with complaints that had started long before, for which over-the-counter medications had been used.

  15. Comparing treatment fidelity between study arms of a randomized controlled clinical trial for stroke family caregivers.

    Science.gov (United States)

    McLennon, Susan M; Hancock, Rebecca D; Redelman, Kathleen; Scarton, Lisa J; Riley, Elizabeth; Sweeney, Bobbie; Habermann, Barbara; Jessup, Nenette M; Bakas, Tamilyn

    2016-05-01

    To compare treatment fidelity among treatment arms in the Telephone Assessment and Skill-Building Kit study for stroke caregivers (TASK II) with respect to: 1) protocol adherence; 2) intervention dosage and 3) nurse intervener perspectives. A randomized controlled clinical trial design. Urban, community, midwestern United States. A total of 254 stroke caregivers (mean ±SD age, 54.4 ±11.8 years), 55 (22.0%) males and 199 (78.4%) females) randomized to the TASK II intervention (n=123) or an Information, Support, and Referral comparison group (n=131). TASK II participants received the TASK II Resource Guide; Information, Support, and Referral participants received a standard caregiver brochure. At approximately 8 weeks after discharge, both groups received 8 weekly calls from a nurse, with a booster call 4 weeks later. Protocol adherence was evaluated with the TASK II Checklist for Monitoring Adherence. Intervention dosage was measured by the number of minutes caregivers spent reading materials and talking with the nurse. Nurse intervener perspectives were obtained through focus groups. Protocol adherence was 80% for the TASK II and 92% for the Information, Support, and Referral. As expected, intervention dosage differed between TASK II and Information, Support, and Referral with respect to caregiver time spent reading materials (t=-6.49; Pstroke caregiver intervention trial (NIH R01NR010388; ClinicalTrials.govNCT01275495). © The Author(s) 2015.

  16. Response to hepatitis A and B vaccination in patients with chronic hepatitis C: 8-year follow-up.

    Science.gov (United States)

    Kalyoncu, Derya; Urganci, Nafiye

    2012-08-01

    In patients with chronic hepatitis C (CHC), superinfection with hepatitis A (HAV) or B (HAB) viruses is associated with increased morbidity and mortality. The seroconversion rate of these patients following vaccination is considered to be lower than in healthy subjects. To evaluate the response to HAV and HBV vaccination in children with CHC. Thirty patients with CHC aged from 7.3 to 18 years were compared with 50 healthy age-, gender- and body-mass-index-matched controls. Post-vaccination serological evaluation was performed 1 month after the last dose of primary vaccination, 1 month after the booster dose and once a year during follow-up. Twenty-two patients received hepatitis A vaccine and response rate was 95.4%. Thirty patients received hepatitis B vaccine and 80% responded (hepatitis Bs titres ≥10 mIU/ml). Thirty-five controls received hepatitis A vaccine and protective anti-HAV antibodies developed in all. All of the controls were vaccinated against hepatitis B virus and 90% responded. After the whole vaccination series, overall seroprotection rates were 86% in patients and 96% in controls. No significant reduction in antibody response was observed in patients or controls during 8-years follow-up. The rate of seroconversion to the HBV vaccine is lower in patients with CHC than in healthy controls but response to HAV is adequate.

  17. Short-Term Memory Performance in 7- and 8-Year-Old Children: The Relationship Between Phonological and Pitch Processing.

    Science.gov (United States)

    Flagge, Ashley Gaal; Estis, Julie M; Moore, Robert E

    2016-10-01

    The relationship between short-term memory for phonology and pitch was explored by examining accuracy scores for typically developing children for 5 experimental tasks: immediate nonword repetition (NWR), nonword repetition with an 8-s silent interference (NWRS), pitch discrimination (PD), pitch discrimination with an 8-s silent interference (PDS), and pitch matching (PM). Thirty-six 7- and 8-year-old children (21 girls, 15 boys) with normal hearing, language, and cognition were asked to listen to and repeat nonsense words (NWR, NWRS), make a same versus different decision between 2 tones (PD, PDS), and listen to and then vocally reproduce a tone (PM). Results showed no significant correlations between tasks of phonological memory and tests of pitch memory, that participants scored significantly better on nonword repetition tasks than PD and PM tasks, and that participants performed significantly better on tasks with no silent interference. These findings suggest that, for typically developing children, pitch may be stored and rehearsed in a separate location than phonological information. Because of fundamental task differences, further research is needed to corroborate these data and determine the presence of developmental effects and neuroanatomical locations where a potential language/music overlap is occurring in children.

  18. Calcium-Enriched Mixture Pulpotomy of Primary Molar Teeth with Irreversible Pulpitis. A Clinical Study

    OpenAIRE

    2016-01-01

    Objectives: To evaluate the outcome of vital pulp therapy in primary teeth with irreversible pulpitis by using calcium-enriched mixture (CEM) cement according to clinical and radiographic assessment. Participants and Methods: Fifty primary molar teeth with irreversible pulpitis in 50 children aged 6-8 years underwent pulpotomy using CEM cement as the dressing material. Following pulpotomy, pain intensity was evaluated by use of a visual analog scale at 1 and 7 days from the treatment and in c...

  19. Cryptogenic Polyneuropathy : Clinical, Environmental, And Genetic Studies

    OpenAIRE

    Lindh, Jonas

    2011-01-01

    Objectives: The purpose of this medical thesis was to describe the clinical and neurophysiological features and to evaluate the health related quality of life (HR-QoL) in patients with cryptogenic polyneuropathy. We also wanted to investigate different occupational, and leisure time exposures as determinants for cryptogenic polyneuropathy, and to analyze whether polymorphisms for the null alleles of Glutathione S-Transferase Mu-1 (GSTM1), and Theta-1 (GSTT1), and a low activity genetic variat...

  20. [Organizational ethics: a study in ophthalmologic clinics].

    Science.gov (United States)

    Sanches, Maria Aparecida; Scarpi, Marinho Jorge

    2005-01-01

    Research on the field of organizational ethics to investigate to which extent ophthalmologic clinics, inserted in the competitive atmosphere, in the condition of organizations in search of survival, subordinate ethics to competitiveness in the managerial praxis, that is, in the administrative sphere. Kohlberg is taken as theoretical reference, approaching the theme of ethical subordination to competitiveness. The instrument to evaluate moral behaviors of organizations, elaborated by Licht, is applied. The quantitative method is used, adopting analytic instruments, such as Q of Yule and non parametric tests, when dealing with the data of 41 ophthalmologic clinics. The results of the research seem to indicate that administrators of ophthalmologic clinics of greater performance subordinate ethical principles to competitiveness, seeking to assure the survival of the company and, when confronted with the instrument to evaluate their moral behavior, proposed by Kohlberg, have a significantly smaller presence in the postconventional stage than administrators of ophthalmologic clinics with a smaller performance. One may affirm, according to non parametric tests, at the level of significance of 0.05, that the levels of moral development of the two groups differ significantly. The obtained results are according to the literature, especially concerning the "paradox of the ethical subordination and competitiveness". They also suggest that the warrant of the survival of the company tends to reduce the perception of the groups in power regarding the problems that happen in the community, and that a reduction of the ethical values subordinated to competition occurs, and such reduction provokes growing feelings of economical disputes in the social sphere.

  1. Celiac Patients: A Randomized, Controlled Clinical Study

    Directory of Open Access Journals (Sweden)

    Giuseppe Mazzarella

    2012-01-01

    Full Text Available A lifelong gluten-free diet (GFD is mandatory for celiac disease (CD but has poor compliance, justifying novel strategies. We found that wheat flour transamidation inhibited IFN-γ secretion by intestinal T cells from CD patients. Herein, the primary endpoint was to evaluate the ability of transamidated gluten to maintain GFD CD patients in clinical remission. Secondary endpoints were efficacy in prevention of the inflammatory response and safety at the kidney level, where reaction products are metabolized. In a randomized single blinded, controlled 90-day trial, 47 GFD CD patients received 3.7 g/day of gluten from nontransamidated (12 or transamidated (35 flour. On day 15, 75% and 37% of patients in the control and experimental groups, respectively, showed clinical relapse (=0.04 whereas intestinal permeability was mainly altered in the control group (50% versus 20%, =0.06. On day 90, 0 controls and 14 patients in the experimental group completed the challenge with no variation of antitransglutaminase IgA (=0.63, Marsh-Oberhuber grading (=0.08, or intestinal IFN-γ mRNA (>0.05. Creatinine clearance did not vary after 90 days of treatment (=0.46. In conclusion, transamidated gluten reduced the number of clinical relapses in challenged patients with no changes of baseline values for serological/mucosal CD markers and an unaltered kidney function.

  2. CLINICAL AND INVESTIGATIONAL STUDY OF DIABETIC KETOACIDOSIS

    Directory of Open Access Journals (Sweden)

    Narasimham

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: To compare the clinical features and biochemical profile in DKA. To assess the response in the patients with standard treatment of DKA. Clinical descriptions of polyuric states resembling diabetes mellitus have been described in the Ebers papyrus of Egypt in 15th century BC . 1,2 A yurvedic literature from the times of Charaka and Sushrutha, the ancient Indian physicians identified two forms of “MadhuMeha” ( H oneyed Urine in 400 BC . 3 John Rolo of England in 1797 was one of 1st who coined the term diabetes mellitus. William Prout of E ngland described diabetic coma during 1810 – 20. In 1886, Dreschfeld8 described DKA and HHNS (Hyper osmolar Hyperglycemic Non - ketotic Syndrome. In 1922 Banting , Best, Collip and Macleod isolated and clinically used insulin and later won Nobel prize for that memorable invention. SETTING: Inpatients of king George Hospital attached to Andhra Medical College, Visakhapatnam . METHODS: Diagnosis of diabetic ketoacidosis was made according to the inclusion criteria. Hyperglycemia >250 mg/dl, acidosis with blood pH <7.3, serum bicarbonate <15 mEq/l, urine positive for ketones. RESULTS: Of the 100 patients admitted for diabetic ketoacidosis; 84 had type 2 diabetes (84% and 16(16% were type I diabetes. Average age at the time of presentation was 42.9±12.9 years. Th e commonest precipitating factor was infection (56% followed by other factors (28% and irregular treatment (16%. The most common clinical features at the time of presentation were vomiting, abdominal pain, acidotic breathing and dehydration. The values for RBS, HCO3, and pH were 355.3±69.1, 14.9±3.4 and 7.2±0.1 respectively. INTERPRETATION AND CONCLUSION: Most common precipitating factors are infection and omission of insulin or irregular treatment. Most common clinical features at the time of presentati on are vomiting, abdominal pain, dehydration, acidotic breathing and tachycardia. Mortality rate in diabetic

  3. Efficacy of a probiotic and chlorhexidine mouth rinses: A short-term clinical study

    Directory of Open Access Journals (Sweden)

    Harini P

    2010-09-01

    Full Text Available Introduction: Probiotic technology represents a breakthrough approach to maintaining oral health by utilizing natural beneficial bacteria commonly found in healthy mouths to provide a natural defense against those bacteria thought to be harmful to teeth and gums. However, data are still sparse on the probiotic action in the oral cavity. The review article on probiotics in children published by Twetman and Stecksen- Blicks in 2008 showed only one study of dental interest on probiotics in children. Aim and Objectives: The present study evaluated clinically the efficacy of a probiotic and chlorhexidine mouth rinses on plaque and gingival accumulation in children. The trial design is a double-blind parallel group, 14 days comparative study between a probiotic mouth rinse and a chlorhexidine mouth rinse, which included 45 healthy children in the age group of 6-8 years. Results: The Probiotic and Chlorhexidine groups had less plaque accumulations compared with the Control group at the end of 14 years (P < 0.001 and P < 0.001, respectively. But, unlike the plaque score, there was a significant difference in the Gingival Index between the Probiotic and the Chlorhexidine groups (P = 0.009, Probiotic group being better than the Chlorhexidine group (mean = 0.2300 and 0.6805, respectively. Conclusion: The Probiotic mouth rinse was found effective in reducing plaque accumulation and gingival inflammation. Therefore, probiotic mouth rinse obviously has a potential therapeutic value and further long-term study is recommended to determine its efficacy.

  4. New graduate nurses' clinical competence, clinical stress, and intention to leave: a longitudinal study in Taiwan.

    Science.gov (United States)

    Cheng, Ching-Yu; Tsai, Hsiu-Min; Chang, Chia-Hao; Liou, Shwu-Ru

    2014-01-01

    This longitudinal research study aimed to develop a pregraduation clinical training program for nursing students before graduation and evaluate its effect on students' self-perceived clinical competence, clinical stress, and intention to leave current job. A sample of 198 students returned the questionnaires before and after the program. They were followed up at 3, 6, and 12 months after graduation. Results showed that posttest clinical competence was significantly higher than pretest competence, positively related to clinical competence at 3 and 12 months, and negatively related to clinical stress at 3 months. The clinical competence at 3 months was positively related to clinical competence at 6 and 12 months, and clinical competence at 6 months was related to intention to leave at 12 months. Intention to leave at 6 months was positively related to intention to leave at 3 and 12 months. Clinical stress at 3 months was positively related to clinical stress at 6 and 12 months, but not related to intention to leave at any time points. The training program improved students' clinical competence. The stressful time that was correlated with new graduate nurses' intention to leave their job was between the sixth and twelfth months after employment.

  5. Two cycles of adjuvant carboplatin in stage I seminoma: 8-year experience by the Hellenic Cooperative Oncology Group (HECOG).

    Science.gov (United States)

    Koutsoukos, Konstantinos; Tzannis, Kimon; Christodoulou, Christos; Karavasilis, Vasilios; Bakoyiannis, Charalambos; Makatsoris, Thomas; Papandreou, C N; Pectasides, Dimitrios; Dimopoulos, Meletios A; Bamias, Aristotelis

    2016-06-01

    Following the establishment of adjuvant carboplatin in stage I testicular seminoma as a standard, we adopted this treatment for all stage I seminoma patients. We report our 8-year experience and compare these results with our previous adjuvant etoposide/cisplatin (EP) strategy. Patients with stage I seminoma, treated with adjuvant carboplatin and with a minimum follow-up of 1 year, were included. Two cycles of carboplatin [area under the curve (AUC) 6] were administered. A total of 138 patients with median age of 34 years, treated from September 2003 to December 2011, were selected. There were 5 relapses [5-year relapse-free rate (RFR) 96.8 % (95 % confidence interval 91.6-98.8)]: 3 relapses at retroperitoneal lymph nodes, 1 relapse at the adrenal gland, and 1 isolated brain metastasis. Four patients with relapse were cured with salvage chemotherapy. All patients with relapse had tumor diameter ≥4 cm and/or age ≤34 years. Patients with at least 1 of the above risk factors (n = 111) had a significantly higher relapse rate compared with a similar population (n = 64) treated with 2 cycles of adjuvant EP: 5-year RFR was 95 % (SE 2 %) versus 100 % (SE 0 %), (p = 0.067). Age and tumor diameter were associated with relapse in stage I seminoma treated with adjuvant carboplatin. Although adjuvant carboplatin in patients with age ≤34 and/or tumor diameter ≥4 cm is associated with higher relapse rates than EP, the prognosis of these patients is excellent, and therefore, the use of less toxic treatment is justified.

  6. [Limitations and pitfalls of clinical studies in oncology].

    Science.gov (United States)

    Cerny, Thomas

    2008-01-01

    Nowadays results of clinical studies in oncology are often first found and commented in the news media because of their high relevance to the pharmaceutical market. The limits and pitfalls of clinical studies are manifold and not always appreciated even by specialists as well as journalists and politicians. The planning of a study is a most crucial phase, and most deficits are due to inappropriate design and conduct of a study. Adequate and skilful interpretation of a study is often hampered by many known but mostly overlooked variable pitfalls. Today there is an overrepresentation of pharmaceutically sponsored studies and a painful lack of well-designed academic studies with really meaningful endpoints for patient care. This paper touches several important aspects of today's shortcomings of clinical studies in oncology and highlights the importance of strengthening the academic clinical research. Evidence-based medicine needs to be more clinically relevant, and therefore we need well-designed, and critically interpreted studies in the future.

  7. A prospective clinical study of polycarboxylate cement in periapical surgery

    National Research Council Canada - National Science Library

    Peñarrocha-Diago, M-A; Ortega-Sánchez, B; García-Mira, B; Maestre-Ferrín, L; Peñarrocha-Oltra, D; Gay-Escoda, C

    .... A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material...

  8. CLINICAL STUDY OF POSTOPERATIVE WOUND INFECTION

    OpenAIRE

    Sudheer Darbha; Giddaluru Srihari

    2016-01-01

    BACKGROUND The aim of the study is to study the most common organisms encountered and their sensitivity and resistance to antibiotics in postoperative wound infection and to study relation of emergency and elective surgery to postoperative wound infection and to study efficacy of different modes of preoperative preparation on postoperative wound infection and to study distribution of postoperative wound infection among different surgeries based on bacterial contamination such a...

  9. Oral mucocele: A clinical and histopathological study

    Science.gov (United States)

    More, Chandramani B; Bhavsar, Khushbu; Varma, Saurabh; Tailor, Mansi

    2014-01-01

    Background: Oral mucocele is the most common benign minor (accessory) salivary gland lesion, caused due to mechanical trauma to the excretory duct of the gland. Clinically they are characterized by single or multiple, soft, fluctuant nodule, ranging from the normal color of the oral mucosa to deep blue. It affects at any age and is equally present in both sexes with highest incidence in second decade of life. They are classified as extravasation or retention type. Objectives: To analyze the data between 2010 and 2011 of, clinically and histopathologically diagnosed 58 oral mucoceles for age, gender, type, site, color, cause, symptoms and dimension. Results: Oral mucoceles were highly prevalent in the age group of 15-24 years, were seen in 51.72% of males and 48.28% of females, with a ratio of 1.07:1. The extravasation type (84.48%) was more common than the retention type (15.52%). The most common affected site was lower lip (36.20%) followed by ventral surface of the tongue (25.86%). The lowest frequency was observed in floor of mouth, upper lip and palate. The maximum numbers of mucoceles were asymptomatic (58.62%), and the color of the overlying mucosa had color of adjacent normal mucosa (48.28%). It was also observed that most of the mucoceles had diameter ranging from 5 to 14 mm. The causative factors of the lesion were lip biting (22.41%), trauma (5.18%) and numerous lesions (72.41%). Conclusion: Oral Mucoceles are frequently seen in an oral medicine service, mainly affecting young people and lower lip, measuring around 5 to 14 mm and the extravasation type being the most common. PMID:25364184

  10. Prospective Clinical Study of Precision Oncology in Solid Tumors.

    Science.gov (United States)

    Sohal, Davendra P S; Rini, Brian I; Khorana, Alok A; Dreicer, Robert; Abraham, Jame; Procop, Gary W; Saunthararajah, Yogen; Pennell, Nathan A; Stevenson, James P; Pelley, Robert; Estfan, Bassam; Shepard, Dale; Funchain, Pauline; Elson, Paul; Adelstein, David J; Bolwell, Brian J

    2016-03-01

    Systematic studies evaluating clinical benefit of tumor genomic profiling are lacking. We conducted a prospective study in 250 patients with select solid tumors at the Cleveland Clinic. Eligibility required histopathologic diagnosis, age of 18 years or older, Eastern Cooperative Oncology Group performance status 0-2, and written informed consent. Tumors were sequenced using FoundationOne (Cambridge, MA). Results were reviewed at the Cleveland Clinic Genomics Tumor Board. Outcomes included feasibility and clinical impact. Colorectal (25%), breast (18%), lung (13%), and pancreatobiliary (13%) cancers were the most common diagnoses. Median time from consent to result was 25 days (range = 3-140). Of 223 evaluable samples, 49% (n = 109) of patients were recommended a specific therapy, but only 11% (n = 24) received such therapy: 12 on clinical trials, nine off-label, three on-label. Lack of clinical trial access (n = 49) and clinical deterioration (n = 29) were the most common reasons for nonrecommendation/nonreceipt of genomics-driven therapy.

  11. A clinical and radiological study of peroneal tendon pathology.

    Science.gov (United States)

    Giza, Eric; Mak, Walter; Wong, Stephanie E; Roper, Glade; Campanelli, Valentina; Hunter, John C

    2013-12-01

    The proportion of patients with clinical findings referable to peroneal pathology and magnetic resonance imaging (MRI)-diagnosed peroneal tendon pathology is unknown. Previous studies have correlated surgical findings with clinical data and preoperative MRI, but there are no published studies that reference clinical examination findings to imaging findings. To determine the relationship between peroneal tendon pathology as diagnosed by MRI and clinical findings of peroneal tendon pathology. Fifty-six patients who had both MRI evidence of peroneal tendon pathology and an associated clinical examination of the ankle were evaluated over a 3-year period at a tertiary care institution. Clinical examination criteria included lateral ankle tenderness, dislocation/snapping, and lateral ankle pain. A board-certified, fellowship-trained musculoskeletal radiologist confirmed the presence of MRI findings consistent with peroneal tendon pathology. Of the 56 patients with positive findings on MRI, 27 patients had an associated positive clinical exam and 29 patients had a negative clinical exam. The positive predictive value of MRI for peroneal tendon tears with positive clinical findings was 48% (95% confidence interval = 35% to 61%). Patients with MRI findings of peroneal tendon pathology should undergo careful clinical examination, as the positive predictive value of MRI for peroneal tendon pathology with actual clinical findings is low. This study demonstrates that peroneal tendon tears are often incidental findings on MRI.

  12. Enzootic bovine leukosis: report of eradication and surveillance measures in Italy over an 8-year period (2005-2012).

    Science.gov (United States)

    Maresca, C; Costarelli, S; Dettori, A; Felici, A; Iscaro, C; Feliziani, F

    2015-05-01

    Bovine leukaemia virus (BLV) is associated with enzootic bovine leukosis (EBL). BLV causes malignant lymphoma and lymphosarcoma; however, most BLV infections remain clinically silent in an aleukaemic state. EBL is a notifiable disease, and official control measures include screening or monitoring, precautions at borders, control of movement inside the country, and stamping out. The objective of this study was to evaluate EBL eradication and surveillance measures in Italy from 2005 to 2012. One-hundred twenty-three outbreaks were recorded (1 January 2006 to 31 December 2012) in the National Veterinary Information System (SIMAN) on 7 November 2013. Of these, 101 had occurred in southern Italy. An outbreak usually lasted for a few days, but sometimes lasted for weeks. Some areas were subjected to normal eradication measures, whereas others were subjected to additional eradication measures as a consequence of persisting EBL outbreaks. During the study period, we noted an overall annual decrease from 0.21% in 2005 to 0.08% in 2012 in the herd prevalence rate, from 0.06% in 2005 to 0.04% in 2012 in the herd incidence rate, and from 0.027% in 2005 to 0.015% in 2012 in the animal prevalence rate. Regions officially recognised as EBL-free areas were found to have their own surveillance plans. Differences in their surveillance plans include the type of sample (serum, milk, or both), age at which the animals must be tested (12 or 24 months), and test frequency of herds (annually or every 2, 3, 4, 5, or 6 years). The eradication programme for EBL is difficult to implement in some Italian areas because of several factors such as incomplete herd registry, geographical location and socio-economic conditions of the region.

  13. Methodological Aspects in Studies Based on Clinical Routine Data.

    Science.gov (United States)

    Kennes, Lieven Nils

    2017-09-12

    Randomized controlled clinical trials are regarded as the gold standard for comparing different clinical interventions, but generally their conduct is operationally cumbersome, time-consuming, and expensive. Studies and investigations based on clinical routine data on the contrary utilize existing data acquired under real-life conditions and are increasingly popular among practitioners. In this paper, methodological aspects of studies based on clinical routine data are discussed. Important limitations and considerations as well as unique strengths of these types of studies are indicated and exemplarily demonstrated in a recent real-case study based on clinical routine data. In addition two simulation studies reveal the impact of bias in studies based on clinical routine data on the type I error rate and false decision rate in favor of the inferior intervention. It is concluded that correctly analyzing clinical routine data yields a valuable addition to clinical research; however, as a result of a lack of statistical foundation, internal validity, and comparability, generalizing results and inferring properties derived from clinical routine data to all patients of interest has to be considered with extreme caution. Grünenthal GmbH.

  14. Oral mucocele: A clinical and histopathological study

    Directory of Open Access Journals (Sweden)

    Chandramani B More

    2014-01-01

    Objectives: To analyze the data between 2010 and 2011 of, clinically and histopathologically diagnosed 58 oral mucoceles for age, gender, type, site, color, cause, symptoms and dimension. Results: Oral mucoceles were highly prevalent in the age group of 15-24 years, were seen in 51.72% of males and 48.28% of females, with a ratio of 1.07:1. The extravasation type (84.48% was more common than the retention type (15.52%. The most common affected site was lower lip (36.20% followed by ventral surface of the tongue (25.86%. The lowest frequency was observed in floor of mouth, upper lip and palate. The maximum numbers of mucoceles were asymptomatic (58.62%, and the color of the overlying mucosa had color of adjacent normal mucosa (48.28%. It was also observed that most of the mucoceles had diameter ranging from 5 to 14 mm. The causative factors of the lesion were lip biting (22.41%, trauma (5.18% and numerous lesions (72.41%. Conclusion: Oral Mucoceles are frequently seen in an oral medicine service, mainly affecting young people and lower lip, measuring around 5 to 14 mm and the extravasation type being the most common.

  15. [Surgical clinical studies and their practical realization].

    Science.gov (United States)

    Uhl, W; Wente, M N; Büchler, M W

    2000-06-01

    The employment of the optimal therapeutic option according to the best current knowledge is called evidence-based medicine (EBM). Moreover, considering the cost explosion in public health systems, EBM should contribute towards economical and targeted use of the restricted resources and towards quality assurance in medicine. Obviously, this is applicable to the operative specialties and can be termed as evidence-based surgery. Surgeons have to do their "homework" about this subject and to perform randomized controlled trials (the gold standard with the greatest evidence) on a large scale, in order to come up to this expectation in future. Evidence-based therapy is essential for the preservation and especially for the further development and evolution of high-quality surgery with, at the same time, quality assurance in the new millenium. This article presents the definition of EBM and its implication in the operative fields. Fundamental principles for the practical conduct of clinical randomized controlled trials are defined and the specific problems in surgery are discussed.

  16. Corticosteroid myopathy: a clinical and pathological study.

    Science.gov (United States)

    Khaleeli, A A; Edwards, R H; Gohil, K; McPhail, G; Rennie, M J; Round, J; Ross, E J

    1983-02-01

    In six patients with Cushing's syndrome and three with steroid myopathy, the clinical, functional, biochemical and structural characteristics of myopathy are described. Proximal muscle weakness occurred in all the patients, preferentially affected the lower limbs and was accompanied by muscle wasting in all but one patient. Force measurements confirmed quadriceps weakness in every patient. Vastus lateralis muscle biopsies showed light microscopic abnormalities in two of three patients with steroid myopathy and one of five patients with Cushing's syndrome. Type II fibre atrophy was the commonest abnormality. Reduced type II mean fibre areas occurred in all the patients with steroid myopathy and were common in Cushing's syndrome patients. Type I mean fibre areas were also reduced in two of the former group and one of the latter group and two further patients in this group had areas at the lower end of the normal range. Abnormalities in electron microscopy, mitochondrial function tests and chemical content of skeletal muscle were frequent and are described and discussed. A plasma creatine kinase activity (CK) at the lower end of the normal range, a myopathic electromyogram (EMG) and a raised 24-h urinary 3-methylhistidine/creatinine ratio on a creatine free diet were other characteristic findings in both groups of patients.

  17. Clinical Study on Treatment of Infantile Rotaviral

    Institute of Scientific and Technical Information of China (English)

    魏连波; 李智军; 陈宝田; 栾图; 高云飞; 李吉来; 孙升云

    2001-01-01

    Objective: To observe the clinical effect of guava leaf (GL) in treating infantile rotaviral enteritis.Methods: Sixty-two patients of rotaviral enteritis were randomly divided into the treated group treated with GL and the control group treated with Gegen Qinlian Decoction. The time for ceasing diarrhea, content of Na+ in blood, content of Na+ and glucose in stool, and the rate of negative conversion of human rotavirus antigen (HRVA) were observed.Results: The 3-day recovery rate in the treated group (87.1%) was significantly higher than that in the control group (58.1%, P<0.05). The time of ceasing diarrhea in the treated group (25.1±9.5 hrs) was significantly shorter than that in the control group (38.7±15.2 hrs, P<0.01). Moreover, content of Na+ and glucose in stool were reduced obviously in the treated group but not in the control group; and negative conversion rate of HRVA in the former group also got better than that in the latter group (87.1% vs 58.1%, P<0.05). Consequently, the effect of GL was superior to that of the control significantly.Conclusion: GL has good curative effect on infantile rotaviral enteritis.

  18. Impact of changes in metabolic control on progression to photocoagulation for clinically significant macular oedema:a 20 year study of type 1 diabetes

    DEFF Research Database (Denmark)

    Sander, B.; Larsen, M.; Andersen, Elisabeth Wreford;

    2013-01-01

    Center from 1988 to 2008, using the endpoint referral to first photocoagulation treatment for clinically significant diabetic macular oedema. The analysis included 1,878 patients (median observation, 8 years). Changes were defined as the inter-visit change; in the case of an event the last event...... model. A recent decrease of ≥0.5 percentage points or an increase in HbA1c of >0.5 percentage points per 6 months was associated with HRs of 3.04 and 1.28, respectively, compared with lesser changes in HbA1c. Conclusions/interpretation In this study, large recent...

  19. Clinical Study of Tuina for Stiff Neck

    Institute of Scientific and Technical Information of China (English)

    吴耀持; 张峻峰; 汪崇淼; 王健雄; 张沈煜

    2009-01-01

    Objective: To observe the clinical effect of Tuina for stiffneck. Methods: All of 216 cases with stiff neck were randomly allocated into a tuina group (110 cases) and a control group (106 cases). The patients in the tuina group were treated with "Three Parts, Four Points,Five Manipulation" tuina therapy, while those in the control group were treated with pucturing Wailaogong (Ex-UE 8), Houxi (SI 3), Jianjing (GB 21) and Ashi points in the affected side,Once a day, and 3 times constitute one treatment course. The effect was observed after 2-course treatments. Result: The effective rate in the tuina group and the control group was 93.64% and 83.02%, respectively, and there was statistical difference between the two groups (P < 0.05).Conclusion: The tuina therapy of "Three Parts, Four Points, Five Manipulations" is better than simple acupuncture therapy in treating stiff neck.%目的:观察推拿治疗落枕的临床疗效.方法:将216例落枕患者随机分为推拿组110例和对照组106例,推拿组用"三部四穴五法"推拿法治疗,对照组针刺患侧外劳宫、后溪、肩井和阿是穴.每日1次,3次为1个疗程;治疗2个疗程后观察疗效. 结果:推拿组有效率为93.64%,对照组为83.02%,两者比较有统计学意义(P<0.05)结论:"三部四穴五法"推拿法治疗落枕明显优于单纯针刺疗法.

  20. Towards achieving semantic interoperability of clinical study data with FHIR.

    Science.gov (United States)

    Leroux, Hugo; Metke-Jimenez, Alejandro; Lawley, Michael J

    2017-09-19

    Observational clinical studies play a pivotal role in advancing medical knowledge and patient healthcare. To lessen the prohibitive costs of conducting these studies and support evidence-based medicine, results emanating from these studies need to be shared and compared to one another. Current approaches for clinical study management have limitations that prohibit the effective sharing of clinical research data. The objective of this paper is to present a proposal for a clinical study architecture to not only facilitate the communication of clinical study data but also its context so that the data that is being communicated can be unambiguously understood at the receiving end. Our approach is two-fold. First we outline our methodology to map clinical data from Clinical Data Interchange Standards Consortium Operational Data Model (ODM) to the Fast Healthcare Interoperable Resource (FHIR) and outline the strengths and weaknesses of this approach. Next, we propose two FHIR-based models, to capture the metadata and data from the clinical study, that not only facilitate the syntactic but also semantic interoperability of clinical study data. This work shows that our proposed FHIR resources provide a good fit to semantically enrich the ODM data. By exploiting the rich information model in FHIR, we can organise clinical data in a manner that preserves its organisation but captures its context. Our implementations demonstrate that FHIR can natively manage clinical data. Furthermore, by providing links at several levels, it improves the traversal and querying of the data. The intended benefits of this approach is more efficient and effective data exchange that ultimately will allow clinicians to switch their focus back to decision-making and evidence-based medicines.

  1. Inter-annual variability in flowering of orchids: lessons learned from 8 years of monitoring in a Mediterranean region of France

    Directory of Open Access Journals (Sweden)

    Hélène Vogt-Schilb

    2013-12-01

    Full Text Available It is important to evaluate the loss of biodiversity caused by global changes. In the case of orchids, it is still unclear how long the monitoring duration should be chosen in order to achieve a good compromise between the reliability of the orchid dynamics recorded and sampling duration (e.g. years of monitoring. This study aims to propose a method of monitoring orchids. Using a large database, we investigated the inter-annual variability in flowering of orchids in a French Mediterranean region. The database includes an 8-year-long study (2006–2013 of 47 species at 26 locations in three different types of habitats. The number of individual plants that flowered per species varied significantly between years, but not the number of species. Depending on habitat, two to four years were needed to observe the total number of species per location. Therefore, in Mediterranean regions a one-year-study seems to be insufficient to produce reliable results.

  2. Socio-Economic and Environmental Factors Associated with Overweight and Obesity in Children Aged 6–8 Years Living in Five Italian Cities (the MAPEC_LIFE Cohort)

    Science.gov (United States)

    Grassi, Tiziana; De Donno, Antonella; Bagordo, Francesco; Serio, Francesca; Piscitelli, Prisco; Ceretti, Elisabetta; Zani, Claudia; Viola, Gaia C. V.; Villarini, Milena; Moretti, Massimo; Levorato, Sara; Carducci, Annalaura; Verani, Marco; Donzelli, Gabriele; Bonetta, Sara; Bonetta, Silvia; Carraro, Elisabetta; Bonizzoni, Silvia; Bonetti, Alberto; Gelatti, Umberto

    2016-01-01

    The prevalence of obesity among Italian children has reached such alarming levels as to require detailed studies of the causes of the phenomenon. A cross-sectional study was carried out in order to assess the weight status of 1164 Italian children aged 6–8 years (the Monitoring Air Pollution Effects on Children for Supporting Public Health Policy (MAPEC_LIFE) cohort) and to identify any associations between selected socio-economic and environmental factors and overweight/obesity. The data were obtained by means of a questionnaire given to parents, and any associations were examined by binomial logistic regression analyses. Overweight was found to be positively associated with male gender, parents of non-Italian origin, and parents who smoke, and negatively associated with the parents’ level of education and employment. In addition, the frequency of overweight varied in relation to the geographical area of residence, with a greater prevalence of overweight children in the cities of central-southern Italy. This study highlights the need to implement appropriate obesity prevention programs in Italy, which should include educational measures concerning lifestyle for parents from the earliest stages of their child’s life. PMID:27727193

  3. Socio-Economic and Environmental Factors Associated with Overweight and Obesity in Children Aged 6-8 Years Living in Five Italian Cities (the MAPEC_LIFE Cohort).

    Science.gov (United States)

    Grassi, Tiziana; De Donno, Antonella; Bagordo, Francesco; Serio, Francesca; Piscitelli, Prisco; Ceretti, Elisabetta; Zani, Claudia; Viola, Gaia C V; Villarini, Milena; Moretti, Massimo; Levorato, Sara; Carducci, Annalaura; Verani, Marco; Donzelli, Gabriele; Bonetta, Sara; Bonetta, Silvia; Carraro, Elisabetta; Bonizzoni, Silvia; Bonetti, Alberto; Gelatti, Umberto

    2016-10-11

    The prevalence of obesity among Italian children has reached such alarming levels as to require detailed studies of the causes of the phenomenon. A cross-sectional study was carried out in order to assess the weight status of 1164 Italian children aged 6-8 years (the Monitoring Air Pollution Effects on Children for Supporting Public Health Policy (MAPEC_LIFE) cohort) and to identify any associations between selected socio-economic and environmental factors and overweight/obesity. The data were obtained by means of a questionnaire given to parents, and any associations were examined by binomial logistic regression analyses. Overweight was found to be positively associated with male gender, parents of non-Italian origin, and parents who smoke, and negatively associated with the parents' level of education and employment. In addition, the frequency of overweight varied in relation to the geographical area of residence, with a greater prevalence of overweight children in the cities of central-southern Italy. This study highlights the need to implement appropriate obesity prevention programs in Italy, which should include educational measures concerning lifestyle for parents from the earliest stages of their child's life.

  4. Socio-Economic and Environmental Factors Associated with Overweight and Obesity in Children Aged 6–8 Years Living in Five Italian Cities (the MAPEC_LIFE Cohort

    Directory of Open Access Journals (Sweden)

    Tiziana Grassi

    2016-10-01

    Full Text Available The prevalence of obesity among Italian children has reached such alarming levels as to require detailed studies of the causes of the phenomenon. A cross-sectional study was carried out in order to assess the weight status of 1164 Italian children aged 6–8 years (the Monitoring Air Pollution Effects on Children for Supporting Public Health Policy (MAPEC_LIFE cohort and to identify any associations between selected socio-economic and environmental factors and overweight/obesity. The data were obtained by means of a questionnaire given to parents, and any associations were examined by binomial logistic regression analyses. Overweight was found to be positively associated with male gender, parents of non-Italian origin, and parents who smoke, and negatively associated with the parents’ level of education and employment. In addition, the frequency of overweight varied in relation to the geographical area of residence, with a greater prevalence of overweight children in the cities of central-southern Italy. This study highlights the need to implement appropriate obesity prevention programs in Italy, which should include educational measures concerning lifestyle for parents from the earliest stages of their child’s life.

  5. Ant exclusion in citrus over an 8-year period reveals a pervasive yet changing effect of ants on a Mediterranean spider assemblage.

    Science.gov (United States)

    Mestre, L; Piñol, J; Barrientos, J A; Espadaler, X

    2013-09-01

    Ants and spiders are ubiquitous generalist predators that exert top-down control on herbivore populations. Research shows that intraguild interactions between ants and spiders can negatively affect spider populations, but there is a lack of long-term research documenting the strength of such interactions and the potentially different effects of ants on the diverse array of species in a spider assemblage. Similarly, the suitability of family-level surrogates for finding patterns revealed by species-level data (taxonomic sufficiency) has almost never been tested in spider assemblages. We present a long-term study in which we tested the impact of ants on the spider assemblage of a Mediterranean citrus grove by performing sequential 1-year experimental exclusions on tree canopies for 8 years. We found that ants had a widespread influence on the spider assemblage, although the effect was only evident in the last 5 years of the study. During those years, ants negatively affected many spiders, and effects were especially strong for sedentary spiders. Analyses at the family level also detected assemblage differences between treatments, but they concealed the different responses to ant exclusion shown by some related spider species. Our findings show that the effects of experimental manipulations in ecology can vary greatly over time and highlight the need for long-term studies to document species interactions.

  6. CLINICAL STUDY OF ACUTE POISONING: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Praveen

    2014-11-01

    Full Text Available : OBJECTIVES: To determine the common agents, clinical features and outcomes of acute poisoning. MATERIALS AND METHODS: A retrospective study of patients of acute poisoning of more than 14 years age admitted through emergency with a history of intentional, self-inflicted and suicidal poisoning in SRMS-IMS from Jan 2010 to Dec 2012. RESULTS: A total of 58 cases were included with a common age of affection 16 to 25 years and male to female ratio 1.63: 1. Poisoning cases occur throughout the year with maximum prevalence in May and minimum in June. Organophosphorus was the most common poison followed by aluminium phosphide. Vomiting was the most common symptoms followed by altered sensorium. 70.68% patients were discharged, 20.68% expired and 8.62% left against medical advice. Aluminium phosphide was the most common toxin consumed by dead patients. CONCLUSION: Acute poisoning is commonly affecting young population and is caused by variety of toxin. High mortality is associated with aluminum phosphide.

  7. CLINICAL AND EPIDEMIOLOGICAL STUDIES ON VASECTOMY

    Institute of Scientific and Technical Information of China (English)

    TANGGuang-Hua

    1989-01-01

    In order to ascertain whether vasectomy presented any increased risk of diseases or long-term sequelae, we conducted from 1981 to 82 a large scale cross sectional prevalence study on coronary heart disease, hypertension and other diseases following

  8. Alopecia areata and autoimmunity: A clinical study

    Directory of Open Access Journals (Sweden)

    Thomas Emy

    2008-01-01

    Full Text Available Alopecia areata (AA frequently occur in association with other autoimmune diseases such as thyroid disorders, anemias and other skin disorders with autoimmune etiology. Despite numerous studies related to individual disease associations in alopecia areata, there is paucity of literature regarding comprehensive studies on concomitant cutaneous and systemic diseases. The present study has been designed to determine if there is a significant association between alopecia areata and other autoimmune diseases. This study covers 71 patients with the diagnosis of alopecia areata as the case group and 71 patients with no evidence of alopecia areata as the control group. Among the cutaneous diseases associated with AA, atopic dermatitis (AD showed maximum frequency with an O/E ratio of 2.5, which indicates that it is two to three times more common in patients with alopecia areata. In our study, thyroid disorders showed the highest frequency with on O/E ratio of 3.2 and a P value of 0.01, which is statistically highly significant. Among the thyroid disorders, hypothyroidism was the most frequent association (14.1% in our study. Since systemic involvement is not infrequent in patients with alopecia areata, it is imperative to screen these patients for associated disorders, particularly atopy, thyroid diseases, anemias and other autoimmune disorders, especially if alopecia areata is chronic, recurrent and extensive.

  9. Competence of novice nurses: role of clinical work during studying.

    Science.gov (United States)

    Manoochehri, H; Imani, E; Atashzadeh-Shoorideh, F; Alavi-Majd, A

    2015-01-01

    Aim: Clinical competence is to carry out the tasks with excellent results in a different of adjustments. According to various studies, one of the factors influencing clinical competence is work experience. This experience affects the integrity of students' learning experience and their practical skills. Many nursing students practice clinical work during their full-time studying. The aim of this qualitative research was to clarify the role of clinical work during studying in novice nurses' clinical competence. Methods: This qualitative content analysis performed with the conventional approach. All teaching hospitals of Hormozgan University of Medical Sciences selected as the research environment. To collect data, deep and semi-structured interviews, presence in the scene and manuscripts used. To provide feedback for the next release and the capacity of the data, interviews were transcribed verbatim immediately. Results: 45 newly-graduated nurses and head nurses between 23 and 40 with 1 to 18 years of experience participated in the study. After coding all interviews, 1250 original codes were derived. The themes extracted included: task rearing, personality rearing, knowledge rearing, and profession rearing roles of clinical work during studying. Conclusion: Working during studying can affect performance, personality, knowledge, and professional perspectives of novice nurses. Given the differences that may exist in clinical competencies of novice nurses with and without clinical work experience, it is important to pay more attention to this issue and emphasize on their learning in this period.

  10. Towards Data Value-Level Metadata for Clinical Studies.

    Science.gov (United States)

    Zozus, Meredith Nahm; Bonner, Joseph

    2017-01-01

    While several standards for metadata describing clinical studies exist, comprehensive metadata to support traceability of data from clinical studies has not been articulated. We examine uses of metadata in clinical studies. We examine and enumerate seven sources of data value-level metadata in clinical studies inclusive of research designs across the spectrum of the National Institutes of Health definition of clinical research. The sources of metadata inform categorization in terms of metadata describing the origin of a data value, the definition of a data value, and operations to which the data value was subjected. The latter is further categorized into information about changes to a data value, movement of a data value, retrieval of a data value, and data quality checks, constraints or assessments to which the data value was subjected. The implications of tracking and managing data value-level metadata are explored.

  11. Incisional Hernia: An Experimental and Clinical Study

    NARCIS (Netherlands)

    M. van 't Riet (Martijne)

    2004-01-01

    markdownabstract__Abstract__ Incisional hernia is one of the most common long-term complications of abdominal surgery. In prospective studies with sufficient follow-up, incidences of incisional hernia after laparotomy up to 20% are reported. Incisional hernia can be defined as an internal abdominal

  12. Prevalence of Cerebral Palsy among 8-Year-Old Children in 2010 and Preliminary Evidence of Trends in Its Relationship to Low Birthweight

    Science.gov (United States)

    Durkin, Maureen S.; Benedict, Ruth E.; Christensen, Deborah; Dubois, Lindsay A.; Fitzgerald, Robert T.; Kirby, Russell S.; Maenner, Matthew J.; Van Naarden Braun, Kim; Wingate, Martha S.; Yeargin-Allsopp, Marshalyn

    2017-01-01

    Background The public health objective for cerebral palsy (CP) in the United States is to reduce the percentage of children with CP who were born low birthweight (LBW, public health objective. Methods Data on children with CP at age 8 years were ascertained by the Autism and Developmental Disabilities Monitoring (ADDM) Network, a population-based surveillance system that monitored CP in four areas of the United States. Results CP prevalence in 2010 was 2.9 per 1000 [95% confidence interval (CI) 2.6, 3.2], down from 3.5 (95% CI 3.2, 3.9) in the same surveillance area in 2006. Among CP cases with no documented postneonatal aetiology, 49.1% (95% CI 42.9, 55.2) were born LBW in 2010 compared with 54.3% (95% CI 48.4, 60.1) in 2006. In 2010, 28.1% (95% CI 22.9, 30.4) were born very low birthweight (VLBW, relative risks for associations between CP and both LBW and VLBW also declined, though not significantly, during the study period. Conclusions Declines in the associations between CP and LBW categories may have contributed to declines during the study period in both the prevalence of CP and the percentage of children with CP who were born LBW or VLBW. Ongoing monitoring of these trends is warranted. PMID:27215680

  13. Comparative effect of thymus vulgaris and ibuprofen on primary dysmenorrhea: A triple-blind clinical study.

    Science.gov (United States)

    Salmalian, Hajar; Saghebi, Roshanak; Moghadamnia, Ali Akbar; Bijani, Ali; Faramarzi, Mahbobeh; Nasiri Amiri, Fatemeh; Bakouei, Fatemeh; Behmanesh, Fereshte; Bekhradi, Reza

    2014-01-01

    Dysmenorrhea is one of the most common medical problems in gynecology causing several problems in the personal and social life of women. This study was conducted to compare the effect of thymus vulgaris and ibuprofen on the treatment of primary dysmenorrhea Methods: This clinical study was conducted on 84 students of Babol University of Medical Sciences with primary dysmenorrhea. The students were randomly assigned to three groups receiving thymus vulgaris, ibuprofen and placebo. In all three groups, with the beginning of pain, 200 mg capsules and 25 drops of essential oil were given every 6 hours for two consecutive cycles. Pain intensity used the visual scale before and one hour after each dose for 48 hour after starting medication. The data were collected and analyzed. This study was registered in the Iranian Registry of Clinical Trial (www.irct.ir) with registration number ID: IRCT201101245683N1 RESULTS: The mean age of participants was 20.5±1.8 years. Both thymus vulgaris and ibuprofen were effective to reduce the pain severity of dysmenorrhea. Before treatment, the mean pain intensity in thymus vulgaris, ibuprofen and placebo groups were 6.57±2.02, 5.30±2.23 and 6.18±1.78, respectively and after treatment decreased to 1.21±1.06, 1.48±1.62 and 3.54±2.26, respectively. Reduction of pain severity was not statistically significant between the two medications, however it was significant for each drug compared with placebo (pthymus vulgaris as well as ibuprofen can be effective in reducing the severity of pain and spasm in primary dysmenorrhea.

  14. Melanocytic nevi in children: A clinical study

    Directory of Open Access Journals (Sweden)

    Senthilkumar M

    2006-01-01

    Full Text Available BACKGROUND: Melanocytic nevi show different presentations in children which have not much studied in India. PURPOSES: To document the incidence and pattern of melanocytic nevi in children. METHODS: A total of 4,256 paediatric cases attending the dermatology OPD, JIPMER during the study period from August 2002 to August 2004 were screened for melanocytic nevi. FINDINGS: Out of these, 41 (0.96% cases were found to have melanocytic nevi. The mean age of these cases was 1.4 years (range of 3 days to 14 years. Fourteen (34.1% of them were males and 27 (65.9% were females with male to female ratio of 1:1.9. Majority of these cases (32 cases, 78% were in the age group of 0-1 year. Thirty-seven (90.2% cases had single lesion and 4 (9.8% cases had multiple lesions. The size of the nevi varied from 1.5 cm to 20 cm in 40 (97.6% cases and more than 20 cm in 1 (2.4% case. The most common site of involvement was the back (32 cases, 78% followed by head and neck (6 cases, 14.6%. Out of the total of 41 cases, 30 (73.2% were Mongolian spots, 8 (19.5% were congenital melanocytic nevi, one case (2.4% each had giant congenital melanocytic nevus, nevus spilus and nevus of Ota. Four cases had other associated cutaneous disorders. These included ashleaf macules in 2 cases, epidermolysis bullosa simplex in 1 case and a solitary case had both cafι-au-lait macule and mixed hemangioma. The systemic associations included seizures (suspected neurocutaneous melanosis in a solitary case of congenital melanocytic nevi. CONCLUSIONS: The spectrum of melanocytic nevi seen in children in this study partially differs from this of abroad studies. LIMITATION: Unicentre hospital-based study which cannot be generalized.

  15. Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study

    Science.gov (United States)

    Calle Rubio, Myriam; Alcázar Navarrete, Bernardino; Soriano, Joan B; Soler-Cataluña, Juan J; Rodríguez González-Moro, José Miguel; Fuentes Ferrer, Manuel E; López-Campos, José Luis

    2017-01-01

    Background Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate the clinical interventions and the degree of adherence to recommendations in outpatients of current COPD clinical practice guidelines. Methodology This is an observational study with prospective recruitment (May 2014–May 2015) of patients with a COPD diagnosis as seen in outpatient respiratory clinics. The information collected was historical in nature as for the clinical data of the last and previous consultations, and the information concerning hospital resources was concurrent. Results A total of 17,893 clinical records of COPD patients in outpatient respiratory clinics from 59 Spanish hospitals were evaluated. Of the 5,726 patients selected, 4,508 (78.7%) were eligible. Overall, 12.1% of COPD patients did not fulfill a diagnostic spirometry criteria. Considerable variability existed in the available resources and work organization of the hospitals, although the majority were university hospitals with respiratory inpatient units. There was insufficient implementation of clinical guidelines in preventive and educational matters. In contrast, quantitative evaluation of dyspnea grade (81.9%) and exacerbation history (70.9%) were more frequently performed. Only 12.4% had COPD severity calculated according to the Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) index. Phenotype characteristics according to Spanish National Guideline for COPD were determined in 46.3% of the audited patients, and the risk evaluation according to Global initiative for chronic Obstructive Lung Disease was estimated only in 21.9%. Conclusion The EPOCONSUL study reports the current situation of medical care for COPD patients in outpatient clinics in Spain, revealing

  16. CLINICAL STUDY OF PENETRATING INJURIES OF ABDOMEN

    OpenAIRE

    Raghu; Santhosh Babu; Devender

    2016-01-01

    Penetrating trauma forms an important component of surgical emergencies. The importance of this category becomes further apparent when one realises that most of such trauma victims are essentially healthy people and in the prime of their life. Over the past century, great advances were made in the management of such wounds. The operative management replaced the expectant therapy and reduced mortality rates. So this study is being done to evaluate the various indications for early ...

  17. Clinical study of patient with Ankylosing Spondylitis

    OpenAIRE

    Lee Jae-Min; Hong Kwon-eui

    2006-01-01

    Object : This study is designed in order to evaluate oriental medical treatment of ankylosing spondylitis. Methods : The authors observed patient by ROM & VAS for operated acupuncture treatment, herbal medicine treatment and physiotherapy Conclusion : 1. Ankylosing spondylitis patient of this case is caused by taiyang channel warm-heat evi. 2. Ankylosing spondylitis patient by taiyang channel warm-heat evi is evaluated by acupuncture treatment. ; SP3, S36, LIll, LI4, S40. 3. A...

  18. Clinical study of histologically proven conjunctival cysts

    Science.gov (United States)

    Thatte, Shreya; Jain, Jagriti; Kinger, Mallika; Palod, Sapan; Wadhva, Jatin; Vishnoi, Avijit

    2014-01-01

    Purpose This is a clinco-histopathological study of different varieties of conjunctival cysts where modification of surgical technique was done as per requirement for intact removal of cysts to minimise recurrence rate. Materials and methods Retrospective study of 40 cases of conjunctival cysts. A thorough ocular examination and basic haematological work up was done for all patients. B-scan USG and MRI was done wherever required to see the posterior extent. All patients underwent surgical excision of cyst followed by histo-pathological examination. Results The various types of conjunctival cysts found in our study were primary inclusion cyst 12 (30%), secondary inclusion cyst 6 (15%), pterygium with cysts 15 (37.5%), parasitic cyst 4 (10%), lymphatic cyst 2 (5%), and orbital cyst with rudimentary eye 1 (2.5%). The common symptoms noted were progressive increase in size of cyst (39.45%), cosmetic disfigurement (26.23%), foreign body sensations (27.86%), proptosis (1.6%), ocular motility restrictions (3.2%) and decreased visual acuity (1.6%). The patients were followed till one year after surgical excision for any recurrence and complications and no recurrence was seen. Conclusion Careful and intact removal of conjunctival cyst is important to prevent recurrence. Minor modifications in surgical technique according to the size, site and nature of cyst help in intact removal and prevent recurrence. PMID:25892928

  19. CLINICAL STUDY OF LABOUR IN TWIN PREGNANCY

    Directory of Open Access Journals (Sweden)

    Amudha

    2015-07-01

    Full Text Available OBJECTIVES: The objective of the present study is to analyse the incidence of preterm labour, intrapartum complications, incidence of operative delivery both vaginal and cesarean and indications for such interventions. METHODOLOGY: A total of 150 cases of twin pregnancy were analyzed between the period of September 2012 to February 2014. These cases were stud ied with respect to period of gestation at the onset of labour, fetal presentations at the onset of labour, route and mode of delivery, indications in cases of cesarean delivery, intrapartum complications and delivery interval between twins. OBSERVATIONS A ND RESULTS: In the present study there was increased incidence of preterm labour (52.6%, fetal malpresentations (43.3%, operative vaginal delivery (29.5%, cesarean delivery (17.3%. CONCLUSION: In this study it is observed that above mentioned labour ev ents and complications double up in the event of a twin pregnancy. Regular antenatal visits, planned delivery and anticipation and identification of complications will help for better pregnancy outcome.

  20. Clinical study of nail changes in vitiligo.

    Science.gov (United States)

    Anbar, Tag; Hay, Rania Abdel; Abdel-Rahman, Amal T; Moftah, Noha H; Al-Khayyat, Mohamed A

    2013-03-01

    Both vitiligo and alopecia areata (AA) are associated together, associated with other autoimmune diseases, and autoimmunity is one of the important theories in their etiology. Nail changes are a known association with AA, thus we hypothesized that nail changes can be found in vitiligo patients. On revising the literature, only two types of nail changes were described in association with vitiligo. Our aim was to study the frequency and types of nail changes among vitiligo patients in comparison with normal healthy volunteers. This multi-centric study was carried on 91 patients with vitiligo, as well as 91 normal healthy control subjects who were age- and sex-matched. Nails were examined for changes in nail plates as regards striations, texture, curvature, dystrophy, and pigmentation. The presence or absence of the thumb lunula was also reported. Nail changes were observed in 62 patients (68.1%) and 46 (50.5%) control subjects with a statistically significant difference (P = 0.016). Longitudinal ridging and absent lunula were significantly higher in patients than in the controls (P = 0.001 and 0.037, respectively). Other reported nail abnormalities in the current study included punctate leukonychia, pitting, flag sign, and Terry's nails. Awareness of this association will widen the clinician's perspective to carefully examine the nail changes in vitiligo patients and conversely examine patients with nail changes for vitiligo.

  1. Review of clinical studies on clobazam.

    Science.gov (United States)

    Koeppen, D

    1979-01-01

    1 Clobazam was compared with placebo and diazepam in 45 double-blind studies. 2 Clobazam dosage ranged from 5 mg daily (paediatric patients) to 120 mg daily (psychiatric in-patients). Usual daily dosage in out-patient therapy ranged from 20-30 mg clobazam. 3 Treatment duration varied from a few days up to 3.5 years. The usual duration of treatment was 2-4 weeks. 4 Clobazam was shown to be an efficacious and well tolerated anxiolytic agent in various neurotic and psychosomatic disorders. 5 Dosages showing distinct anxiolytic effects in out-patient therapy did not impair psychomotor performance.

  2. Clinical study of patient with Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Lee Jae-Min

    2006-06-01

    Full Text Available Object : This study is designed in order to evaluate oriental medical treatment of ankylosing spondylitis. Methods : The authors observed patient by ROM & VAS for operated acupuncture treatment, herbal medicine treatment and physiotherapy Conclusion : 1. Ankylosing spondylitis patient of this case is caused by taiyang channel warm-heat evi. 2. Ankylosing spondylitis patient by taiyang channel warm-heat evi is evaluated by acupuncture treatment. ; SP3, S36, LIll, LI4, S40. 3. Ankylosing spondylitis patient by taiyang channel warm-heat evi is evaluated by Hervbal medication. ; Gamikangwhalsungsub-Tang.

  3. Clinical cosmobiology: The Lithuanian study 1990 1992

    Science.gov (United States)

    Stoupel, Eliyahu; Petrauskiene, Jadviga; Kalediene, Ramune; Abramson, Evgeny; Sulkes, Jacqueline

    1995-12-01

    The numbers of deaths from ischaemic heart disease (IHD), stroke (CVA), all accidents except vehicular, vehicular accidents and suicide (overall total, totals for men and women) per month for 36 months (1990 1992) in Lithuania were analysed in relation to: (1) month of the year (1 12); (2) geomagnetic activity; and (3) solar activity. A total of 122227 deaths (64490 men and 57737 women) was studied, and the results compared with those obtained in an earlier study in Israel, differing geographically and climatically from Lithuania. It was shown that the time of year, solar activity, and geomagnetic activity were related to the monthly death distribution, especially regarding death from IHD and suicide. Age and gender differences were apparent in the relationship between death distribution and physical environmental factors. At age >70 years, many of these relationships change. The monthly distribution of deaths from IHD and suicide are adversely correlated with solar activity and with each other. Differences are presumed in serotoninergic effects as caused by environmental influences.

  4. A CLINICAL STUDY OF ABDOMINAL WOUND DEHISCENCE

    Directory of Open Access Journals (Sweden)

    Zahir Hussain

    2016-10-01

    Full Text Available BACKGROUND Abdominal wound dehiscence is a preventable complication, but is still seen. When present, it poses problem in the management of the case, increases the morbidity and mortality of the patient. The present study is a prospective study done from January 2010-May 2016 with an objective to find out the incidence of wound dehiscence, the most common pathologies associated with dehiscence and to find out the statistical significance of the difference risk factors causing wound dehiscence and to evaluate the role of tension sutures in prevention of wound dehiscence. MATERIALS AND METHODS 291 major laparotomies were followed from January 2010-September 2016. There were 21 cases of dehiscence and from the remaining 270 cases, 58 patients were chosen as controls who underwent the same procedure, but without dehiscence. 15 factors were analysed and compared between the dehiscence and control groups. RESULTS The incidence was found to be 7.2%. Peritonitis was the most common pathology. The significant factors were age more than 50, wound infection. Tension suture application has shown to reduce the incidence of wound dehiscence. CONCLUSIONS  Intra-abdominal sepsis (peritonitis increases the incidence of wound dehiscence.  Age >50, Uraemic, Jaundiced, Obesity, Malnutrition increases the incidence of wound dehiscence.  Wound infection was a highly significant factor having 8 times more risk of dehiscence.

  5. Best practices for clinical pathology testing in carcinogenicity studies.

    Science.gov (United States)

    Young, Jamie K; Hall, Robert L; O'Brien, Peter; Strauss, Volker; Vahle, John L

    2011-02-01

    The Society of Toxicologic Pathology (STP) and American Society for Veterinary Clinical Pathology (ASCVP) convened a Clinical Pathology in Carcinogenicity Studies Working Group to recommend best practices for inclusion of clinical pathology testing in carcinogenicity studies. Regulatory guidance documents and literature were reviewed, and veterinary pathologists from North America, Japan, and Europe were surveyed regarding current practices, perceived value, and recommendations for clinical pathology testing in carcinogenicity studies. For two-year rodent carcinogenicity studies, the Working Group recommends that clinical pathology testing be limited to collection of blood smears at scheduled and unscheduled sacrifices to be examined only if indicated to aid in the diagnosis of possible hematopoietic neoplasia following histopathologic evaluation. Additional clinical pathology testing is most appropriately used to address specific issues from prior toxicity studies or known test article-related class effects. Inadequate data were available to make a recommendation concerning clinical pathology testing for alternative six-month carcinogenicity assays using genetically modified mice, although the Working Group suggests that it may be appropriate to use the same approach as for two-year carcinogenicity studies since the study goal is the same.

  6. [Anatomo-clinical study of arterioventricular disorders].

    Science.gov (United States)

    Attié, F; Bassotti, R; Arteaga, M; Kuri, J; Zamora, C

    1976-01-01

    The relationship of the great arteries with their respective ventricles in the three toncoconal morphologies depends on the orientation and rotation of the septum of the trunk and cone. In this work we study a case of crossed great arteries and another of partial distortion of the great arteries and one of transposition of the great arteries, all with arterioventricular concordance. In the anatomic and angiocardiographic examples an analysis is made of the arterioventricular relation in each type of arterial pedicle. We say that arterioventricular concordance exists with crossed great arteries when the pulmonary originated from the anterior infundibulum and its direction of right to left or from left to right in the frontal plane shows the spacial position of the anatomically right ventricle. In the transposition of the great arteries or in the partial distortion of the great arteries with arterioventricular concordance the aorta in the frontal plane shows the spacial position of the anatomically right ventricle. In the first group the aorta originates from the anterior infundibulum while in the second, from the posterior infundibulum. We review the examples of arterioventricular discordance diagnosed by necropsy or by laboratory studies. We study 5 cases; 1 with crossed great arteries, 3 with transposition of great arteries and the last with partial distortion of the great arteries. In the arterioventricular discordances with crossed great arteries in the lateral position, we observe that the pulmonary artery originates from the anterior infudnibulum whereas in the transposition, the aorta emerges from the anterior infundibulum. In the partial distortion of the great arteries the vessels are side by side or the aorta a little bit anterior to the pulmonary which is connected with the anterior infundibulum. In the posteroanterior incidence when there exists an arterioventricular discordance with crossed great arteries, the direction of the pulmonary does not

  7. Regional enteritis and gluten-free diet. A clinical study

    NARCIS (Netherlands)

    Merwe, Christiaan Frederik van der

    1974-01-01

    The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the

  8. Regional enteritis and gluten-free diet. A clinical study

    NARCIS (Netherlands)

    Merwe, Christiaan Frederik van der

    1974-01-01

    The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the treatmen

  9. Clinical rehabilitation of the amputee : A retrospective study

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Groothoff, JW; Eisma, WH

    1996-01-01

    The aim of this study was to determine the rehabilitation outcome of lower limb amputee patients after clinical rehabilitation. Altogether 183 amputee patients admitted for clinical rehabilitation in the years 1987-1991 were reviewed by retrospective analysis of medical record data. Three groups of

  10. Rethinking clinical governance : Healthcare professionals' views: a Delphi study

    NARCIS (Netherlands)

    Veenstra, Gepke L.; Ahaus, Kees; Welker, Gera A.; Heineman, Erik; van der Laan, Maarten J.; Muntinghe, Friso L. H.

    OBJECTIVE: Although the guiding principle of clinical governance states that healthcare professionals are the leading contributors to quality and safety in healthcare, little is known about what healthcare professionals perceive as important for clinical governance. The aim of this study is to

  11. Dutch transmural nurse clinics for chronic patients: a descriptive study.

    NARCIS (Netherlands)

    Temmink, D.; Francke, A.L.; Kerkstra, A.; Huyer Abu-Saad, H.

    2000-01-01

    'Transmural care' can be defined as patient-tailored care provided on the basis of close collaboration and joint responsibility between hospitals and home care organizations. One form of transmural care is transmural nurse clinics for chronically ill. This study describes 62 transmural nurse clinics

  12. Clinical and molecular studies on differentiated thyroid carcinoma management

    NARCIS (Netherlands)

    Abdulrahman Hareedy, Randa Mostafa

    2015-01-01

    This thesis describes clinical and fundamental studies addressing clinical challenges in patients with differentiated thyroid carcinoma (DTC). The diagnosis of DTC is hampered by the fact that although the incidence is low thyroid nodules are prevalent. In this thesis, the diagnostic value of a pote

  13. TRACHEOSTOMY IN CHILDREN: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Shankar

    2015-11-01

    Full Text Available : A trachestomy is a small, surgical opening from the skin to the anterior wall of the trachea, pediatric patients for whom tracheostomy is more hazardous than adults, consideration have different anatomy, medical conditions, and prognoses than adults, even the tracheostomy tubes are different in size, the indications for tracheostomy in children include, bypassing airway obstruction (Laryngo- tracheobronchitis, epiglottitis, providing access for prolong ventilation, and facilitating tracheo-bronchial toilet, to day prime indication for pediatrics tracheostomy is subglottic stenosis. We have reviewed experience with 84 tracheostomies under 13 years of age in our hospital. We are here discussing the common indications and complications, difficulty in decannulation in pediatric patients, in our study the common indication is the foreign body bronchus followed by other conditions.

  14. A clinical study of annular cyclitis

    Directory of Open Access Journals (Sweden)

    Marilita Michael Moschos

    2009-02-01

    Full Text Available Marilita Michael Moschos1, Yan Guex-Crosier2, Ioannis Margetis1, Leonidas Zografos21Department of Ophthalmology, University of Athens, Greece; 2Jules Gonin Eye Hospital, University of Lausanne, SwitzerlandPurpose: To investigate six cases of annular cyclitis.Methods: All patients with impairment of visual acuity underwent complete ophthalmologic examination, color fundus photography, laboratory tests and fluorescein angiography. Indocyanine green (ICG angiography and B-scan ultrasonography were also performed in three cases in order to diagnose the disease.Results: All patients presented a unilateral or bilateral granulomatous uveitis, associated with inflammatory annular cyclitis. They had a shallow anterior chamber, a mildly elevated intraocular pressure (under 25 mm Hg and an annular serous retinal detachment. A resolution was observed after specific therapy associated with systemic prednisolone therapy and antiglaucomatous drops.Conclusion: This is the first description of an observational study of six patients with inflammatory annular cyclitis.Keywords: cyclitis, uveitis, malignant glaucoma

  15. Leigh syndrome: Clinical and paraclinical study

    Directory of Open Access Journals (Sweden)

    "Ashrafi MR

    2002-08-01

    Full Text Available During two years study about mitochondrial disease (Sep 1999-Agu 2001, 15 cases of Leigh syndrome (LS were diagnosed, that consisted of 11 boys and 4 girls aged between 6 to 156 (mean: 40.5 months. Most of the patients (46.7% became symptomatic between 1-5 years of age. Triggering factors were reported in 66.6% of the patients and 40% of them became symptomatic after infections. The most frequent presenting symptoms of the patients were somnolence and lethargy (40%, developmental regression (20% and seizure (13.3%. The most common neurologic findings were developmental regression or arrest (93.3%, seizure (93.3% abnormal tone (86.7% and abnormal movements (53.3%. Blood lactate increased in 93.3% and blood ammonia elevated in 26.7% of the cases. Symmetric striatal necrosis (100% and caudate nucleus involvement (73.3% were the most frequent neuroimaging findings of the patients.

  16. CLINICAL STUDY OF THIAZIDE DIURETIC INDUCED HYPONATREMIA

    Directory of Open Access Journals (Sweden)

    Siddappa

    2015-12-01

    Full Text Available AIMS AND OBJECTIVES The importance of Thiazide-Induced Hyponatremia (TIH is reemerging because thiazide diuretic prescription seems to be increasing after the guidelines recommending thiazides as first-line treatment of essential hypertension have been introduced. Hyponatremia is a common complication comes across with thiazide diuretics. Aim is to determine the prevalence and vulnerability of symptoms from thiazide-induced hyponatremia. MATERIALS AND METHOD Study included 100 patients attending outpatient department/admitted in S. S. Hospital, Davangere fulfilling the inclusion and exclusion criteria. Patients received 6.25mg to 25mg hydrochlorothiazide with or without combination of other anti-hypertensives. Patients were followed up every day with estimation of serum electrolytes after hospitalization. RESULTS Female patients presented with lower serum sodium levels than male counterparts (114±8 versus 117±8 mmol/L, P=0.02, although the frequency of central nervous system manifestation was comparable between both gender groups. The most frequent symptoms were malaise and lethargy (49%, followed by dizzy spells (47% and vomiting (35%. Degree of hyponatremia depend upon presentation predicted the development of confusion and vomiting symptoms. Serum sodium concentration <115 mmol/L was significantly associated with the development of confusion (odds ratio 2.6, 95% confidence interval 1.3 to 5.1, P=0.004. Our results show that symptoms from thiazide-induced hyponatremia primarily reflect osmotic water shift into brain cells rather than extracellular fluid volume depletion. CONCLUSION In our study hyponatremia is common and serious side effect of thiazide diuretics. Timely detection and intervention is very essential and improves the outcomes in patients with thiazide diuretics.

  17. The influence of maternal self-objectification, materialism and parenting style on potentially sexualized 'grown up' behaviours and appearance concerns in 5-8year old girls.

    Science.gov (United States)

    Slater, Amy; Tiggemann, Marika

    2016-08-01

    There is widespread concern about young girls displaying 'grown up' or sexualized behaviours, as well as experiencing body image and appearance concerns that were previously thought to only impact much older girls. The present study examined the influence of three maternal attributes, self-objectification, materialism and parenting style, on sexualized behaviours and appearance concerns in young girls. A sample of 252 Australian mothers of 5-8year old girls reported on the behaviours and appearance concerns observed in their daughters and also completed measures of their own self-objectification, materialism and parenting style. It was found that a significant proportion of young girls were engaging with 'teen' culture, using beauty products and expressing some degree of appearance concern. Maternal self-objectification was related to daughters' engagement in teen culture, use of beauty products and appearance concern. Maternal materialism was related to girls' engagement in teen culture and appearance concern, while an authoritative parenting style was negatively related to girls' use of beauty products. The findings suggest that maternal self-objectification and materialism play a role in the body image and appearance concerns of young girls, and in so doing, identify these maternal attributes as novel potential targets for intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Long-term validity of biological markers of psychopathy and criminal recidivism: follow-up 6-8 years after forensic psychiatric investigation.

    Science.gov (United States)

    Stalenheim, E Gunilla

    2004-01-01

    This study is a follow-up investigation of a forensic psychiatric sub-population 6-8 years after forensic psychiatric evaluation. The aim was to examine the long-term validity of biological markers of psychopathy and antisocial behavior over time. Data on criminal records were obtained at follow-up from the National Council for Crime Prevention. Basic data included findings of psychiatric and psychological assessments, as well as values for serum triiodothyronine (T3) and free thyroxin (FT4), and platelet monoamine oxidase (MAO) activity, all obtained during the forensic psychiatric examination. Criminal recidivists at follow-up had higher serum T3 levels than non-recidivists, and much higher values than normal controls, while their levels of free T4 were lower. The T3 levels in criminal recidivists correlated to psychopathy- and aggression-related personality traits as measured by the Karolinska Scale of Personality. In violent recidivists, a remarkably high correlation was noted between T3 levels and Irritability and Detachment, traits that have previously been linked to the dopaminergic system. Stepwise multiple regression analyses confirmed the relationships of T3 levels and platelet MAO activity with personality traits in criminal recidivists. The predictive validity of biological markers of psychopathy, T3 and platelet MAO, measured during forensic psychiatric investigation, is stable over time. The results indicate chronic alterations of the hypothalamic-pituitary-thyroid axis in this group of subjects.

  19. The development of a test of speech reception disability for use in 5- to 8-year-old children with otitis media with effusion.

    Science.gov (United States)

    Williamson, I; Sheridan, C

    1994-01-01

    The study aims to develop a test of speech reception disability under simulated classroom conditions for use in young (5-8 year old) schoolchildren, to manage children with otitis media with effusion more effectively. A new video test, TADAST (Two Alternative Auditory Disability and Speech Reception Test), has been constructed in stages by extensively modifying the FADAST (Four Alternative) currently used to assess auditory disability in adults. Minimal word pair lists which were easily identifiable in picture form were developed and refined, and then formulated as a two alternative forced choice picture test. The distribution characteristics of the new test were defined in 89 schoolchildren with and without otitis media with effusion (OME) and compared with pure-tone audiometry performed at the same time. The test correlated highly with audiometry in older children. The distribution characteristics revealed a considerable proportion of children with bilateral OME with little functional disability who might otherwise be at risk of surgery. The test appeared to be sensitive to a 'history of OME' effect. Further refinements are needed to develop a final version which could also be used to evaluate hearing disability in 4-year-old children.

  20. Factors associated with the health and cognition of 6-year-old to 8-year-old children in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Ajayi, Oluwakemi R; Matthews, Glenda; Taylor, Myra; Kvalsvig, Jane; Davidson, Leslie L; Kauchali, Shuaib; Mellins, Claude A

    2017-05-01

    To investigate 6-year-old to 8-year-old children's health, nutritional status and cognitive development in a predominantly rural area of KwaZulu-Natal, South Africa. Cohort study of 1383 children investigating the association of demographic variables (area of residence, sex, pre-school education, HIV status, height for age and haemoglobin level) and family variables (socioeconomic status, maternal and paternal level of education), with children's cognitive performance. The latter was measured using the Grover-Counter Scale of Cognitive Development and subtests of the Kaufman Assessment Battery for Children, second edition (KABC-II). General linear models were used to determine the effect of these predictors. Area of residence and height-for-age were the statistically significant factors affecting cognitive test scores, regardless of attending pre-school. Paternal level of education was also significantly associated with the cognitive test scores of the children for all three cognitive test results, whereas HIV status, sex and their socioeconomic status were not. Children with low cognitive scores tended to be stunted (low height-for-age scores), lacked pre-school education and were younger. Area of residence and their parents' educational level also influenced their cognition. © 2017 John Wiley & Sons Ltd.

  1. Higher weight status of only and last-born children. Maternal feeding and child eating behaviors as underlying processes among 4-8 year olds.

    Science.gov (United States)

    Mosli, Rana H; Lumeng, Julie C; Kaciroti, Niko; Peterson, Karen E; Rosenblum, Katherine; Baylin, Ana; Miller, Alison L

    2015-09-01

    Birth order has been associated with childhood obesity. The objective of this cross-sectional study was to examine maternal feeding and child eating behaviors as underlying processes for increased weight status of only children and youngest siblings. Participants included 274 low-income 4-8 year old children and their mothers. The dyads completed a videotaped laboratory mealtime observation. Mothers completed the Caregiver's Feeding Styles Questionnaire and the Children's Eating Behavior Questionnaire. Child weight and height were measured using standardized procedures. Path analysis was used to examine associations of birth order, maternal feeding behavior, child eating behavior, and child overweight/obese status. The association between only child status and greater likelihood of overweight/obesity was fully mediated by higher maternal Verbal Discouragement to eat and lower maternal Praise (all p values < 0.05). The association between youngest sibling status and greater likelihood of overweight/obesity was partially mediated by lower maternal Praise and lower child Food Fussiness (all p values < 0.05). Results provide support for our hypothesis that maternal control and support and child food acceptance are underlying pathways for the association between birth order and weight status. Future findings can help inform family-based programs by guiding family counseling and tailoring of recommendations for family mealtime interactions.

  2. Long-term influences of a preterm birth on movement organization and side specialization in children at 4-8 years of age.

    Science.gov (United States)

    Johansson, Anna-Maria; Domellöf, Erik; Rönnqvist, Louise

    2014-09-01

    This study explored upper-limb and head kinematics during unimanual goal-directed movements in children born preterm (PT) and full-term (FT) aged 4-8 years. Further, functional lateralization was investigated through side-specific kinematics and hand preference observations. Altogether, 141 children were included, divided into three sub-groups based on gestation week at birth (GW). Children born FT (38-41 GW) and moderately PT (33-35 GW) showed faster, smoother, and shorter movement trajectories than children born very PT (V-PT children born FT expressed evident side differences that were characterized by smoother movements with the preferred side. Regarding hand preference, the children born V-PT showed increased rates of non-right-handedness compared with the other groups. Regardless of hand preference, the children born V-PT showed less well organized movements compared with the other groups. These findings suggest that spatio-temporal movement organization and side specialization at pre-/early school-age are affected by a PT birth, and more frequently so for children born before 33 GWs, indicating long-lasting influences on neuromotor development and specialization.

  3. Defining the primary research question in veterinary clinical studies.

    Science.gov (United States)

    Giuffrida, Michelle A

    2016-09-01

    A thoughtful, clearly defined research question should be the foundation of any clinical trial or research study. The research question helps determine key study methods, and defining a specific research question helps avoid problems with inadequate sample size, inappropriate design, or multiple statistical comparisons. Rationales and strategies for formulating research questions and using them to define study protocols are discussed, with a focus on application in clinical trials.

  4. CLINICAL STUDY AND MANAGEMENT OF INCISIONAL HERNIA

    Directory of Open Access Journals (Sweden)

    Jyothirmayi

    2016-05-01

    Full Text Available Incisional hernia follows operations on the anterolateral abdominal wall. It is a diffuse extrusion of peritoneum and abdominal contents through a weak scar due to the failure of the lines of closure of the abdominal wall following laparotomy. The incidence of incisional hernia varies widely in different series published and is at least 10% as shown in longterm follow-up studies. Clarification regarding the type of mesh and its positioning and operative methods of open surgery and laparoscopic repair needs to be addressed. In addition to surgical closure techniques, patient's risk factors also influence surgical outcome following wound closure. RESULTS Age, gender and risk factors such as diabetes, Hypertension, Anaemia, Obesity, COPD and Type of previous incision contribute to the development of primary and recurrent incisional hernia. Although complete prevention of development of incisional hernia is not possible, repair of hernia by replacement of simple suture technique with that of mesh reinforcement has shown better longterm results and patient satisfaction. CONCLUSION For management of incisional hernia, the available evidence has been favourable for good quality long term results with mesh repair techniques.

  5. A clinical study of sudden deafness.

    Science.gov (United States)

    Zhang, Xiaotong; Xu, Xinda; Ma, Weijun; Zhang, Qing; Tong, Busheng; Yu, Hong; Xu, Min; Ren, Tianying; Rosenhall, Ulf; Anniko, Matti; Duan, Maoli

    2015-01-01

    Sudden Sensorineural Hearing Loss (SSHL) was commonly seen in middle aged people. Tinnitus was reported by 87.2% of the patients, and dizziness or vertigo were reported by 48.5%. The most common concomitant disorder of SSHL was hyperlipidemia. A retrospective register study with SSHL was performed in Xi'an, China, from 2000-2009. Of 617 inpatients, the right ear was affected in 267 cases, the left ears in 282 cases, and both ears in 68 cases. The most common age of patients was 41-50 years. There were 20.4% SSHL patients with hypertension, coronary artery disease, or diabetes, and 49.6% patients with hyperlipidemia. Auditory Brainstem Responses (ABR) were performed in 460 patients (504 ears) before treatment, and the ABR threshold of 56.4% ears was > 90 dB. The constituent ratio of patients with an ABR threshold over 90 dB was greater in the vertigo group than the other group. CT and/or MRI scans were available in 277 cases, of which 40 cases (14.4%) were abnormal.

  6. Oral hybrid verrucous carcinoma: a clinical study.

    Science.gov (United States)

    Gokavarapu, Sandhya; Rao S, L M Chandrasekhara; Tantravahi, Uma Sankar; Gundimeda, Sandhya Devi; Rao, T Subramaneshwar; Murthy, Sudha

    2014-12-01

    Hybrid Verrucous Carcinoma is an uncommon tumour wherein Verrucous Carcinoma (VC) is coexisting with conventional Squamous Cell Carcinoma (SCC) within same maternal field. The heterogeneous nature, infrequency of occurrence and the difficulties associated with diagnosis and management of this tumor is discussed through a retrospective study. Patients of primary hybrid VC treated from Jan 2010 to May 2013 at a tertiary institute were analyzed on multivariate cox regression model. During the above mentioned period; 37 patients of hybrid VC were reported; 18(48.6 %) were male and 19(51.3 %) were female. Age ranged between 33 years to 78 years. Median follow up period was 32 months. T stage status and Stage grouping was not statistically significant for mortality (p value: 0.338). In the multivariate cox-regression model, the presence of second primary oral cancer was significantly associated with mortality, adjusted HR; 23.10 (95 % CI: 1.73, 307.65) (p = 0.017). Tumour staging is often unreliable in predicting prognosis of hybrid VC, occurrence of second primary oral cancer and recurrence appears to be significant factors effecting prognosis.

  7. ClinicalTrials.gov, stem cells and 'pay-to-participate' clinical studies.

    Science.gov (United States)

    Turner, Leigh

    2017-07-19

    Numerous US businesses that engage in direct-to-consumer advertising of stem cell interventions that are not US FDA-approved also recruit clients by listing 'pay-to-participate' studies listed on ClinicalTrials.gov . Individuals considering enrolling in such studies and NIH officials responsible for overseeing the database need to be aware that some businesses are using the registry to promote unapproved stem cell interventions that study subjects are charged to receive. Inclusion of such studies in ClinicalTrials.gov reveals that the database needs better screening tools. In particular, screening should evaluate whether studies submitted to the registry have been reviewed and permitted to proceed by the FDA in the case of clinical studies requiring FDA clearance in addition to institutional review board approval.

  8. Clinical pearls: factors affecting reported contraceptive efficacy rates in clinical studies.

    Science.gov (United States)

    Burkman, Ronald T

    2002-01-01

    Current combination oral contraceptives (OCs) are among the most popular, safe, and effective methods of reversible contraception. There are, however, many factors that can affect contraceptive failure rates as reported in clinical trials, including subject characteristics, factors related to study methodology and data analysis, and publication biases. The variability of these factors among clinical trials makes meaningful comparisons of contraceptive efficacy data across studies difficult, if not misleading or erroneous. It is even more difficult to reconcile the differences between clinical trial efficacy rates and everyday use rates; for instance, the National Survey of Family Growth reported that the rate of OC failure is close to 8% in the United States, which is higher than rates reported in clinical trials. Thus, it is important for the clinician to consider the many factors that can influence reporting of contraceptive failure rates in clinical trials and be aware of the limitations in differentiating OCs on the basis of contraceptive efficacy derived from clinical trial data. Furthermore, clinical trial data may not accurately predict contraceptive efficacy in everyday use.

  9. Plasma Matrix Metalloproteinase-9 Levels Predict First-Time Coronary Heart Disease: An 8-Year Follow-Up of a Community-Based Middle Aged Population.

    Directory of Open Access Journals (Sweden)

    Peter Garvin

    Full Text Available The enzyme in matrix metalloproteinase (MMP-9 has been suggested to be an important determinant of plaque degradation. While several studies have shown elevated levels in patients with coronary heart disease, results in prospective population based studies evaluating MMP-9 in relation to first time coronary events have been inconclusive. As of today, there are four published studies which have measured MMP-9 in serum and none using plasma. Measures of MMP-9 in serum have been suggested to have more flaws than measures in plasma.To investigate the independent association between plasma levels of MMP-9 and first-time incidence of coronary events in an 8-year follow-up.428 men and 438 women, aged 45-69 years, free of previous coronary events and stroke at baseline, were followed-up. Adjustments were made for sex, age, socioeconomic position, behavioral and cardiovascular risk factors, chronic disease at baseline, depressive symptoms, interleukin-6 and C-reactive protein.53 events were identified during a risk-time of 6 607 person years. Hazard ratio (HR for MMP-9 after adjustment for all covariates were HR = 1.44 (1.03 to 2.02, p = 0.033. Overall, the effect of adjustments for other cardiovascular risk factors was low.Levels of plasma MMP-9 are independently associated with risk of first-time CHD events, regardless of adjustments. These results are in contrast to previous prospective population-based studies based on MMP-9 in serum. It is essential that more studies look at MMP-9 levels in plasma to further evaluate the association with first coronary events.

  10. Influence of the training loading on the program paralympic junior sport school on the indexes of physical qualities of young tennis players 6-8 years

    Directory of Open Access Journals (Sweden)

    Loboda V.S.

    2012-04-01

    Full Text Available Influence of the training loading is considered on the program paralympic junior sport school on the indexes of physical qualities of young tennis players 6-8 years. The aim of experiment was an exposure of dynamics of development of motive internalss of young tennis players during three years (6-8 years under the influence of the training loading on the program of children sport school. In experiment took part the group of initial preparation in an amount 25 children (boys. Research was conducted within the framework of the operative (employments, current (mezocycle and stage (annual planning of training process.

  11. Facilitating case studies in massage therapy clinical education.

    Science.gov (United States)

    Baskwill, Amanda

    2013-01-01

    The integration of evidence into reflective health care practice has been on the rise in recent years and is a phenomenon that has affected all health care professions, including massage therapy. Clinical case studies are a research design that follows one patient or subject, making the studies ideal for use in clinical practice. They are valuable for communicating information from clinical practice to the broader community. Case studies have face validity that may be more valuable to individual practitioners than homogeneous randomized controlled trials, as the practitioner may recognize a complex patient in the case report. At Humber College, Student Massage Therapists (SMTs) create, conduct, and communicate results of a clinical case study prior to graduation. This article describes the process and experience.

  12. A multichannel time-domain brain oximeter for clinical studies

    Science.gov (United States)

    Contini, Davide; Spinelli, Lorenzo; Caffini, Matteo; Cubeddu, Rinaldo; Torricelli, Alessandro

    2009-07-01

    We developed and optimized a multichannel dual-wavelength time-domain brain oximeter for functional studies in the clinical environment. The system, mounted on a 19"-rack, is interfaced with instrumentation for monitoring physiological parameters and for stimuli presentation.

  13. Genome-wide association study of clinical dimensions of schizophrenia

    DEFF Research Database (Denmark)

    Fanous, Ayman H; Zhou, Baiyu; Aggen, Steven H;

    2012-01-01

    Multiple sources of evidence suggest that genetic factors influence variation in clinical features of schizophrenia. The authors present the first genome-wide association study (GWAS) of dimensional symptom scores among individuals with schizophrenia....

  14. Clinical waste incinerators in Cameroon--a case study

    DEFF Research Database (Denmark)

    Mochungong, Peter Ikome Kuwoh; Gulis, Gabriel; Sodemann, Morten

    2012-01-01

    Incinerators are widely used to treat clinical waste in Cameroon's Northwest Region. These incinerators cause public apprehension owing to purported risks to operators, communities and the environment. This article aims to summarize findings from an April 2008 case study....

  15. Chronic urticaria. Clinical and pathogenetic studies in 141 patients

    NARCIS (Netherlands)

    Doeglas, Hendrik Maarten George

    1975-01-01

    This study describes a combined clinical, laboratory and experimental approach of the problems of 141 patients with chronic urticaria, collected over a three-year period in a Dermatology department. ... Zie: Summary

  16. Chronic urticaria. Clinical and pathogenetic studies in 141 patients

    NARCIS (Netherlands)

    Doeglas, Hendrik Maarten George

    1975-01-01

    This study describes a combined clinical, laboratory and experimental approach of the problems of 141 patients with chronic urticaria, collected over a three-year period in a Dermatology department. ... Zie: Summary

  17. Case Study: Caregiver Perception of Pediatric Multidisciplinary Feeding Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Thomas F. Fisher PhD, OT, FAOTA

    2014-01-01

    Full Text Available This study explores the perception of satisfaction of caregivers who attended a feeding clinic at a large pediatric hospital in the midwest. The clinic is designed for a multidisciplinary team to meet with the child and the caregiver. Thirty-five participants were involved in the study. Results indicated that most participants were satisfied with the clinic experience. However, there were areas of care not covered by the members of the feeding team, which indicates a need. It is suggested that this need could be filled by occupational therapists.

  18. Clinical patterns of primary stabbing headache: a single clinic-based prospective study.

    Science.gov (United States)

    Kim, Dong Yeop; Lee, Mi Ji; Choi, Hyun Ah; Choi, Hanna; Chung, Chin-Sang

    2017-12-01

    The clinical features and disease courses of primary stabbing headache (PSH) are diverse. We aimed to identify distinct clinical patterns of PSH. We prospectively screened consecutive first-visit patients who presented with stabbing headache at the Samsung Medical Centre Headache Clinic from June 2015 to March 2016. Demographics, headache characteristics, and disease courses were prospectively evaluated. After discerning factors related to the chronicity at the time of presentation, clinical patterns were identified based on the frequency (daily vs. intermittent), clinical course (remitted or not), and total disease duration (3 months). In the 65 patients with PSH included in this study, monophasic (n = 31), intermittent (n = 17), and chronic daily (n = 12) patterns were identified. The median disease durations were 9 days for monophasic PSH, 9 months for chronic daily PSH, and 2 years for intermittent PSH. The features of monophasic PSH were greater severity, single and side-locked locations, more attacks per day, daily occurrence, and good treatment response. Chronic daily PSH was associated with female predominance, longer-lasting stabs, and multiple or migrating locations on bilateral or alternating sides. The characteristics of intermittent PSH included female predominance and sporadic stabs with less intensity. Our study demonstrated distinct clinical patterns of PSH. In addition to help early recognition of disease, our findings suggest different pathophysiologic mechanisms. Future prospective studies are required to reveal the etiologies of these different PSH patterns and their optimal treatment strategies.

  19. Interdisciplinary Full Mouth Rehabilitation of a Patient with Amelogenesis Imperfecta: A Case Report with 8 Years Follow-up.

    Science.gov (United States)

    Sreedevi, S; Sanjeev, R; Ephraim, Rena; Joseph, Mathai

    2014-01-01

    This case report deals with the interdisciplinary approach of a 28-year-old lady with Amelogenesis imperfecta of the hypoplastic kind. The patient came with a chief illness of worn out teeth, unsatisfactory esthetics and severe sensitivity of teeth. Her family history revealed a related situation in her father's brother and her sister. On clinical assessment, the crowns of all teeth were worn out. The plan of the treatment was to protect as much tooth structure, restore the vertical dimension, and improve esthetics and masticatory function. The treatment procedures involved prosthodontic, endodontic, and periodontic interventions. After recording the vertical height, endodontic treatment and crown lengthening were performed with respect to the lower anteriors. The lost vertical height was regained in stages by insertion of full coverage crowns for all the teeth. The patient's esthetic and functional needs were met with systematic and sequential interdisciplinary treatment approach.

  20. Microneedle delivery: clinical studies and emerging medical applications.

    Science.gov (United States)

    Pettis, Ronald J; Harvey, Alfred J

    2012-03-01

    The concept of microneedle drug delivery was described three decades ago; however, effective clinical demonstration has only occurred within the past 10-15 years. Substantial progress in microneedle design and fabrication including extensive in vitro, ex vivo, and in vivo preclinical evaluation with various drugs, vaccines and other agents has transpired over the last decade. In contrast with this large volume of preclinical data, there are relatively few published microneedle clinical studies. To date, the clinical investigative focus has included testing to reduce dermal barrier properties and enhance transdermal delivery; evaluation of enhanced vaccine antigenicity, including development of the first commercial microneedle product for intradermal influenza vaccination; evaluation of altered microneedle protein pharmacokinetics and pharmacodynamics, especially for insulin; and evaluation of the pain and other perceptions associated with microneedle usage. This review summarizes the various aspects of microneedle clinical evaluation to date and identifies areas requiring further clinical evaluation.

  1. Enhancing Patient Safety Using Clinical Nursing Data: A Pilot Study.

    Science.gov (United States)

    Choi, Jeeyae; Choi, Jeungok E

    2016-01-01

    To enhance patient safety from falls, many hospital information systems have been implemented to collect clinical data from the bedside and have used the information to improve fall prevention care. However, most of them use administrative data not clinical nursing data. This necessitated the development of a web-based Nursing Practice and Research Information Management System (NPRIMS) that processes clinical nursing data to measure nurses' delivery of fall prevention care and its impact on patient outcomes. This pilot study developed computer algorithms based on a falls prevention protocol and programmed the prototype NPRIMS. It successfully measured the performance of nursing care delivered and its impact on patient outcomes using clinical nursing data from the study site. Results of the study revealed that NPRIMS has the potential to pinpoint components of nursing processes that are in need of improvement for preventing patient from falls.

  2. Volar lunate dislocation associated with a Salter-Harris Type III fracture of the distal radial epiphysis in an 8 year-old child.

    Science.gov (United States)

    Sharma, H; Azzopardi, T; Sibinski, M; Wilson, N

    2007-02-01

    Carpal fracture-dislocations in children are extremely rare injuries and are easily missed or misdiagnosed. An 8 year-old boy who presented with a volar lunate dislocation associated with a Salter Harris Type III injury of the distal radial epiphysis is reported. Open reduction without internal fixation followed by plaster immobilisation achieved good short-term results.

  3. Academic Achievement over 8 Years among Children Who Met Modified Criteria for Attention-Deficit/Hyperactivity Disorder at 4-6 Years of Age

    Science.gov (United States)

    Massetti, Greta M.; Lahey, Benjamin B.; Pelham, William E.; Loney, Jan; Ehrhardt, Ashley; Lee, Steve S.; Kipp, Heidi

    2008-01-01

    The predictive validity of symptom criteria for different subtypes of ADHD among children who were impaired in at least one setting in early childhood was examined. Academic achievement was assessed seven times over 8 years in 125 children who met symptom criteria for ADHD at 4-6 years of age and in 130 demographically-matched non-referred…

  4. Realizing Relevance: The Influence of Domain-Specific Information on Generation of New Knowledge through Integration in 4- to 8-Year-Old Children

    Science.gov (United States)

    Bauer, Patricia J.; Larkina, Marina

    2017-01-01

    In accumulating knowledge, direct modes of learning are complemented by productive processes, including self-generation based on integration of separate episodes. Effects of the number of potentially relevant episodes on integration were examined in 4- to 8-year-olds (N = 121; racially/ethnically heterogeneous sample, English speakers, from large…

  5. The Effects of Severe Psychosocial Deprivation and Foster Care Intervention on Cognitive Development at 8 Years of Age: Findings from the Bucharest Early Intervention Project

    Science.gov (United States)

    Fox, Nathan A.; Almas, Alisa N.; Degnan, Kathryn A.; Nelson, Charles A.; Zeanah, Charles H.

    2011-01-01

    Background: Previous reports from the Bucharest Early Intervention Project suggested that children removed from institutions and placed into intervention displayed gains in IQ relative to children randomized to remain in institutional care. Method: The current report presents data from the 8-year follow-up of these children. One hundred and three…

  6. Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: a retrospective analysis of 28,729,765 U.S. deliveries over 8 years.

    Science.gov (United States)

    Partridge, Sarah; Balayla, Jacques; Holcroft, Christina A; Abenhaim, Haim A

    2012-11-01

    To evaluate the association between adequacy of prenatal care utilization and risk of fetal and neonatal mortality and adverse outcomes. We conducted a population-based cohort study using the Center for Disease Control and Prevention's Linked Birth-Infant Death and Fetal Death data on all deliveries in the United States between 1995 and 2002. Inclusion criteria were singleton births ≥22 weeks of gestation with no known congenital malformation. Inadequate prenatal care was defined according to the Adequacy of Prenatal Care Utilization Index, and its effect on fetal and neonatal death was estimated using unconditional logistic regression analysis adjusting for maternal age, race, education, and other confounding variables. During our 8-year study period, 32,206,417 births occurred, 28,729,765 (89.2%) of which met inclusion criteria. Inadequate prenatal care utilization occurred in 11.2% of expectant mothers, more commonly among women ≤20 years, black non-Hispanic and Hispanic women, and those without high school education. Relative to adequate care, inadequate care was associated with increased risk of prematurity 3.75 (3.73 to 3.77), stillbirth 1.94 (1.89 to 1.99), early neonatal dearth 2.03 (1.97 to 2.09), late neonatal death 1.67 (1.59 to 1.76), and infant death 1.79 (1.76 to 1.82). Risk of prematurity, stillbirth, early and late neonatal death, and infant death increased linearly with decreasing care. Given the population effect of this association, public health initiatives should target program expansion to ensure timely and adequate access, particularly for women ≤20 years, Black non-Hispanic and Hispanic women, and those without high school education. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Endogenous Cushing's Syndrome with Precocious Puberty in an 8-Year-Old Boy due to a Large Unilateral Adrenal Adenoma

    Science.gov (United States)

    Hossain, Muhammad Rajib; Alam, Md. Mashiul; Nabi, Junaid; Kibria, Mahzabin

    2013-01-01

    Adrenocortical tumors (ACTs) causing Cushing's syndrome are extremely rare in children and adolescents. Bilateral macronodular adrenocortical disease which is a component of the McCune-Albright syndrome is the most common cause of endogenous Cushing's syndrome. We report the case of a boy with Cushing's syndrome who presented with obesity and growth retardation. The child was hypertensive. The biochemical evaluation revealed that his serum cortisol levels were 25.80 μg/dL, with a concomitant plasma ACTH level of 10.0 pg/mL and nonsuppressed serum cortisol on high-dose dexamethasone suppression test (HDDST) to be 20.38 μg/dL. Computed tomography of the abdomen demonstrated a 8 × 6 × 5 cm left adrenal mass with internal calcifications. Following preoperative stabilization, laparotomy was carried out which revealed a lobulated left adrenal mass with intact capsule weighing 120 grams. Histopathological examination revealed a benign cortical neoplastic lesion, suggestive of adrenal adenoma; composed of large polygonal cells with centrally placed nuclei and prominent nucleoli without capsular and vascular invasion. On the seventh postoperative day, cortisol levels were within normal range indicating biochemical remission of Cushing's syndrome. On followup after three months, the patient showed significant clinical improvement and had lost moderate amount of weight and adrenal imaging was found to be normal. PMID:23533838

  8. Use of computerized tomography for diagnosis and follow-up after endodontic surgery: clinical case report with 8 years of follow-up.

    Science.gov (United States)

    Tanomaru-Filho, Mario; Lima, Regina K P; Nakazone, Paula A; Tanomaru, Juliane M G

    2010-04-01

    Computerized tomography (CT) is a valuable tool for diagnosis and planning in conventional and surgical endodontic therapy. This case report describes the use of CT in the diagnosis of a periapical lesion undetected by periapical radiography in the mandibular molar area. The CT also showed a possible mesial root perforation associated with the lesion. Following CT, surgical planning, periradicular curettage, and sealing of the root perforation were performed. Eight years after surgery, cone beam CT revealed periapical bone repair. Computerized tomography can be an important resource for diagnosis and planning in conventional and surgical endodontic therapy, as well as for evaluation of post-treatment bone repair. Copyright 2010 Mosby, Inc. All rights reserved.

  9. The natural course of nonoperatively treated rotator cuff tears: an 8.8-year follow-up of tear anatomy and clinical outcome in 49 patients.

    Science.gov (United States)

    Moosmayer, Stefan; Gärtner, Anne V; Tariq, Rana

    2017-04-01

    The natural course of nonoperatively treated rotator cuff tears is not fully understood. We explored the long-term development of tear anatomy and assessed functional outcomes. Eighty-nine small to medium-sized full-thickness tears of the rotator cuff, all primarily treated by physiotherapy, were identified retrospectively. Twenty-three tears needed surgical treatment later on, and 17 patients were unable to meet for follow-up. The remaining 49 still unrepaired tears were re-examined after 8.8 (8.2-11.0) years with sonography. Re-examination by magnetic resonance imaging was possible for 37 patients. Shoulder function was assessed with shoulder scores. Primary outcome measures were progression of tear size, muscle atrophy, and fatty degeneration and the Constant score (CS). Mean tear size increased by 8.3 mm in the anterior-posterior plane (P = .001) and by 4.5 mm in the medial-lateral plane (P = .001). Increase of tear size was -5 to +9.9 mm in 33 patients, 10 to 19.9 mm in 8 patients, and ≥20 mm in 8 patients. The CS was 81 points for tear increases Muscle atrophy and fatty degeneration progressed in 18 and 15 of the 37 patients, respectively. In tears with no progression of atrophy, the CS was 82 points compared with 75.5 points in tears with progression (P = .04). Anatomic tear deterioration was found in the majority of patients, but it was often moderate. Large tear size increases and progression of muscle atrophy were correlated to a poorer functional outcome. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. [Latent tetany in child, electrophysiologico-clinical study].

    Science.gov (United States)

    Kurdziel, Katarzyna; Skowronek-Bała, Barbara; Gergont, Aleksandra

    2016-01-01

    Tetany is the abnormal state of increased neuromuscular excitability. It is manifested with muscle cramps and spasms, usually associated with abnormal calcium metabolism. This state can be devided into two main types: tetany with clinical manifestaton (hypocalcemic) and occurred more frequently latent tetany (normocalcemic). In this study was presented the case of a child with electrophysiological and clinical manifestation of latent tetany. We report a case of a female patient who was admitted to the Pediatric Neurology Department in the year 2015. Some clinical, biochemical and neurophysiological results have been analyzed.

  11. Nursing Students' Clinical Experience With Death: A Pilot Study.

    Science.gov (United States)

    Heise, Barbara A; Gilpin, Laura C

    2016-01-01

    Although debriefing in simulation settings is routine in nursing education, debriefing does not routinely take place in clinical settings with nursing students after a patient has died. This pilot study sought to explore nursing students' perceptions of their first experience with the death of a patient. Students reported emotional distress and feelings of inadequacy with regard to communicating with and supporting the family of the dying patient. Only half the students sampled reported debriefing by their clinical instructor or staff. Nurse educators must include debriefing and student support following a patient death in the clinical setting.

  12. Clinical Trial and Research Study Recruiters' Verbal Communication Behaviors.

    Science.gov (United States)

    Morgan, Susan E; Mouton, Ashton; Occa, Aurora; Potter, Jonell

    2016-07-01

    The lack of accrual to research studies and clinical trials is a persistent problem with serious consequences: Advances in medical science depend on the participation of large numbers of people, including members of minority and underserved populations. The current study examines a critical determinant of accrual: the approach of patients by professional recruiters who request participation in research studies and clinical trials. Findings indicate that recruiters use a number of verbal strategies in the communication process, including translating study information (such as simplifying, using examples, and substituting specific difficult or problematic words), using linguistic reframing or metaphors, balancing discussions of research participation risks with benefits, and encouraging potential participants to ask questions. The identification of these verbal strategies can form the basis of new communication protocols that will help medical and nonmedical professionals communicate more clearly and effectively with patients and other potential participants about research studies and clinical trials, which should lead to increased accrual in the future.

  13. Clinical outcome of shoulder muscle transfer for shoulder deformities in obstetric brachial plexus palsy: A study of 150 cases

    Directory of Open Access Journals (Sweden)

    Mukund R Thatte

    2011-01-01

    Full Text Available Background: Residual muscle weakness, cross-innervation (caused by misdirected regenerating axons, and muscular imbalance are the main causes of internal rotation contractures leading to limitation of shoulder joint movement, glenoid dysplasia, and deformity in obstetric brachial plexus palsy. Muscle transfers and release of antagonistic muscles improve range of motion as well as halt or reverse the deterioration in the bony architecture of the shoulder joint. The aim of our study was to evaluate the clinical outcome of shoulder muscle transfer for shoulder abnormalities in obstetric brachial plexus palsy. Materials and Methods: One hundred and fifty patients of obstetric brachial plexus palsy with shoulder deformity underwent shoulder muscle transfer along with anterior shoulder release at our institutions from 1999 to 2007. Shoulder function was assessed both preoperatively and postoperatively using aggregate modified Mallet score and active and passive range of motion. The mean duration of follow-up was 4 years (2.5-8 years. Results: The mean preoperative abduction was 45° ± 7.12, mean passive external rotation was 10° ± 6.79, the mean active external rotation was 0°, and the mean aggregate modified Mallet score was 11.2 ± 1.41. At a mean follow-up of 4 years (2.5-8 years, the mean active abduction was 120° ± 18.01, the mean passive external rotation was 80° ± 10.26, while the mean active external rotation was 45° ± 3.84. The mean aggregate modified Mallet score was 19.2 ± 1.66. Conclusions: This procedure can thus be seen as a very effective tool to treat internal rotation and adduction contractures, achieve functional active abduction and external rotation, as well as possibly prevent glenohumeral dysplasia, though the long-term effects of this procedure may still have to be studied in detail clinico-radiologically to confirm this hypothesis. Level of evidence: Therapeutic level IV

  14. A prospective clinical study of polycarboxylate cement in periapical surgery

    OpenAIRE

    Peñarrocha Diago, María; Ortega Sánchez, Bárbara; García Mira, Berta; Maestre Ferrín, Laura; Peñarrocha Oltra, David; Gay Escoda,Cosme

    2012-01-01

    Objective: To evaluate the clinical efficacy of polycarboxylate cement as retrograde filling material. Design: A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material. Measurements were made of the area and diameter of the lesions pre- and postoperatively, and 6 and 12 months after the operation. The apical resection and retrograde filling areas were also...

  15. Evidenced-based review of clinical studies on periodontics.

    Science.gov (United States)

    2009-08-01

    Periodontal diseases have several implications for the practice of endodontics. First, advanced periodontitis often has direct implications for the long-term prognosis of the case and requires careful evaluation and coordinated treatment of both the periodontic and endodontic diseases. Second, the potential for functional interactions between odontogenic pathoses and marginal periodontitis requires careful collection of clinical observations and monitoring the outcome of various treatments. In this section, we provide an analysis of recent clinical studies in this area.

  16. Primary gout in Shantou: a clinical and epidemiological study

    Institute of Scientific and Technical Information of China (English)

    曾庆馀; 王庆文; 陈韧; 肖征宇; 黄少弼; 许敬才

    2003-01-01

    Objective To evaluate the prevalence of primary gout in the Shantou area, China, and to understand its clinical features. Methods Samples from three surveys of the Chenghai across ten years were studied. Clinical, laboratory and radiology data of 419 cases of primary gout were collected and analyzed. Conclusions The prevalence of primary gout in Shantou area has been increasing in the last ten years. Changes in diet and lifestyle may be responsible for this rapid increase.

  17. Acute radiation proctitis. A clinical, histopathological and histochemical study

    Energy Technology Data Exchange (ETDEWEB)

    Hovdenak, Nils

    2004-07-01

    The aim of the study is: 1) A sequential description of the clinical course of acute radiation proctitis during pelvic RT. 2) A sequential description of the rectal mucosal histopathology during pelvic RT as a possible substrate for clinical toxicity. 3) To assess the mucosal protease activity during RT as a possible explanation of the observed tissue changes. 4) To assess the efficacy of prophylactic sucralfate in acute radiation proctitis a randomised study was initiated and carried out together with a meta-analysis of previously available data. 5) Most studies on clinical acute toxicity in pelvic RT use either the RTOG/EORTC score system or focus on diarrhoea/stool frequency. A more differentiated and sensitive recording was developed and tested to pick up symptoms escaping the commonly used scores. 6) Study the relation between histopathological findings and the clinical picture. 4 papers presenting various studies are included. The titles are: 1) Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy. 2) Clinical significance of increased gelatinolytic activity in the rectal mucosa during external beam radiation therapy of prostate cancer. 3) Profiles and time course of acute radiation toxicity symptoms during conformal radiotherapy for cancer of the prostate. 4) Sucralfate does not ameliorate acute radiation proctitis. Some future prospects are discussed.

  18. APOE genotype and cardio-respiratory fitness interact to determine adiposity in 8-year-old children from the Tasmanian Infant Health Survey.

    Directory of Open Access Journals (Sweden)

    Justine A Ellis

    Full Text Available APOE plays a well established role in lipid metabolism. Animal model evidence suggests APOE may also be associated with adiposity, but this has not been thoroughly investigated in humans. We measured adiposity (BMI, truncal fat mass, waist circumference, physical activity (PA, cardiorespiratory fitness and APOE genotype (E2, E3, E4 in 292 8-year-old children from the Tasmanian Infant Health Survey (TIHS, an Australian population-based prospective birth cohort. Our aims were to examine the association of APOE with child adiposity, and to examine the interplay between this association and other measured factors. We found that APOE was associated with child lipid profiles. APOE was also associated with child adiposity measures. The association was E4 allele-specific, with adiposity lower in the E4-containing group (BMI: Mean difference -0.90 kg/m²; 95% confidence intervals (CI -1.51, -0.28; p = 0.004. The association of APOE4 with lower BMI differed by fitness status (difference in effect p = 0.002, and was more evident among the less fit (mean difference -1.78 kg/m²; 95% CI -2.74, -0.83; p<0.001. Additionally, associations between BMI and lipids were only apparent in those of lower fitness who did not carry APOE4. Similar overall findings were observed when truncal fat mass and waist circumference were used as alternative adiposity measures. APOE4 and cardiorespitatory fitness could interact to influence child adiposity. In studies addressing the genetic determinants of childhood obesity, the context of child fitness should also be taken into account.

  19. Identifying components of advanced-level clinical nutrition practice: a Delphi study.

    Science.gov (United States)

    Brody, Rebecca A; Byham-Gray, Laura; Touger-Decker, Riva; Passannante, Marian R; O'Sullivan Maillet, Julie

    2012-06-01

    The dietetics profession lacks a comprehensive definition of advanced-level practice. Using a three-round Delphi study with mailed surveys, expert consensus on four dimensions of advanced-level practice that define advanced practice registered dietitians (RDs) in clinical nutrition was explored. Purposive sampling identified 117 RDs who met advanced-level practice criteria. In round 1, experts rated the essentiality of statements on a 7-point ordinal scale and generated open-ended practice activity statements regarding the following four dimensions of advanced-level practice: professional knowledge, abilities and skills, approaches to practice, roles and relationships, and practice behaviors. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 was neutral, and 5.0 to 7.0 were nonessential. In rounds 2 and 3, experts re-rated statements not reaching consensus by evaluating their previous responses, group median rating, and comments. Consensus was reached when the interquartile range of responses to a statement was ≤2.0. Eighty-five experts enrolled (72.6%); 76 (89.4%) completed all rounds. In total, 233 statements were rated, with 100% achieving consensus; 211 (90.6%) were essential to advanced practice RD clinical practice. Having a master's degree; completing an advanced practice residency; research coursework; and advanced continuing education were essential, as were having 8 years of experience; clinical nutrition knowledge/expertise; specialization; participation in research activities; and skills in technology and communication. Highly essential approaches to practice were systematic yet adaptable and used critical thinking and intuition and highly essential values encompassed professional growth and service to patients. Roles emphasized patient care and leadership. Essential practice activities within the nutrition care process included provision of complex patient-centered nutrition care using application of advanced knowledge/expertise and

  20. [Clinical stages of patients with Alzheimer disease treated in specialist clinics in Spain. The EACE study].

    Science.gov (United States)

    Alom Poveda, J; Baquero, M; González-Adalid Guerreiro, M

    2013-10-01

    The diagnostic paradigm of Alzheimer disease (AD) is changing; there is a trend toward diagnosing the disease in its early stages, even before the complete syndrome of dementia is apparent. The clinical stage at which AD is usually diagnosed in our area is unknown. Therefore, the purpose of this study is to describe the clinical stages of AD patients at time of diagnosis. Multicentre, observational and cross-sectional study. Patients with probable AD according to NINCDS-ARDRA criteria, attended in specialist clinics in Spain, were included in the study. We recorded the symptom onset to evaluation and symptom onset to diagnosis intervals and clinical status of AD (based on MMSE, NPI questionnaire, and CDR scale). Participants in this study included 437 specialists representing all of Spain's autonomous communities and a total of 1,707 patients, of whom 1,694 were included in the analysis. Mean MMSE score was 17.6±4.8 (95% CI:17.4-17.9). Moderate cognitive impairment (MMSE between 10 and 20) was detected in 64% of the patients, and severe cognitive impairment (MMSE<10) in 6%. The mean interval between symptom onset and the initial primary care visit was 10.9±17.2 months (95% CI:9.9-11.8), and the interval between symptom onset and diagnosis with AD was 28.4±21.3 months. Results from the EACE show that most AD patients in our area have reached a moderate clinical stage by the time they are evaluated in a specialist clinic. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.