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Sample records for active patients younger

  1. Biceps Tenotomy Versus Tenodesis in Active Patients Younger Than 55 Years

    Science.gov (United States)

    Friedman, Jamie L.; FitzPatrick, Jennifer L.; Rylander, Lucas S.; Bennett, Christine; Vidal, Armando F.; McCarty, Eric C.

    2015-01-01

    Background: Proximal biceps pathology is a significant factor in shoulder pain. Surgical treatment options include biceps tenotomy and subpectoral biceps tenodesis. Tenotomy is a simple procedure, but it may produce visible deformity, subjective cramping, or loss of supination strength. Tenodesis is a comparatively technical procedure involving a longer recovery, but it has been hypothesized to achieve better outcomes in younger active patients (Popeye” deformity, compared with 18.2% (4/22) of tenodesis patients. Strength prior to fatiguing exercise was similar between tenodesis and tenotomy for FS (6.9 vs 7.3 lbs; P < .05), EF in neutral (35.4 vs 35.4 lbs), and EF in supination (33.8 vs 34.2 lbs). Strength was not significantly different between groups for isometric strength and endurance measures. Subjective functional outcome measured by the DASH, ASES, and VAS scores were similar between groups. Frequency of complaints of cramping was higher in the tenotomy group (4/20 vs 1/22), and complaints of pain were higher in the tenodesis group (11/22 vs 5/20). Conclusion: Despite increased demands and activity placed on biceps function in a younger population, this study showed no differences in functional and subjective outcome measurements. The choice between biceps tenotomy and tenodesis for pathology of the proximal biceps tendon can continue to be based on surgeon and patient preference. PMID:26535382

  2. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  3. Lung cancer in younger patients

    DEFF Research Database (Denmark)

    Abbasowa, Leda; Madsen, Poul Henning

    2016-01-01

    INTRODUCTION: Lung cancer remains a leading cause of cancer-related death. The incidence increases with age and the occurrence in young patients is relatively low. The clinicopathological features of lung cancer in younger patients have not been fully explored previously. METHODS: To assess the age...... differences in the clinical characteristics of lung cancer, we conducted a retrospective analysis comparing young patients ≤ 65 years of age with an elderly group > 65 years of age. Among 1,232 patients evaluated due to suspicion of lung cancer in our fast-track setting from January-December 2013, 312 newly...... diagnosed lung cancer patients were included. RESULTS: Patients ≤ 65 years had a significantly higher representation of females (p = 0.0021), more frequent familial cancer aggregation (p = 0.028) and a lower incidence of squamous cell carcinoma (p = 0.0133). When excluding pure carcinoid tumours...

  4. Intrinsic Brain Activity of Cognitively Normal Older Persons Resembles More That of Patients Both with and at Risk for Alzheimer's Disease Than That of Healthy Younger Persons

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    Pasquini, Lorenzo; Tonch, Annika; Plant, Claudia; Zherdin, Andrew; Ortner, Marion; Kurz, Alexander; Förstl, Hans; Zimmer, Claus; Grimmer, Timo; Wohlschäger, Afra; Riedl, Valentin

    2014-01-01

    Abstract In Alzheimer's disease (AD), recent findings suggest that amyloid-β (Aβ)-pathology might start 20–30 years before first cognitive symptoms arise. To account for age as most relevant risk factor for sporadic AD, it has been hypothesized that lifespan intrinsic (i.e., ongoing) activity of hetero-modal brain areas with highest levels of functional connectivity triggers Aβ-pathology. This model induces the simple question whether in older persons without any cognitive symptoms intrinsic activity of hetero-modal areas is more similar to that of symptomatic patients with AD or to that of younger healthy persons. We hypothesize that due to advanced age and therefore potential impact of pre-clinical AD, intrinsic activity of older persons resembles more that of patients than that of younger controls. We tested this hypothesis in younger (ca. 25 years) and older healthy persons (ca. 70 years) and patients with mild cognitive impairment and AD-dementia (ca. 70 years) by the use of resting-state functional magnetic resonance imaging, distinct measures of intrinsic brain activity, and different hierarchical clustering approaches. Independently of applied methods and involved areas, healthy older persons' intrinsic brain activity was consistently more alike that of patients than that of younger controls. Our result provides evidence for larger similarity in intrinsic brain activity between healthy older persons and patients with or at-risk for AD than between older and younger ones, suggesting a significant proportion of pre-clinical AD cases in the group of cognitively normal older people. The observed link of aging and AD with intrinsic brain activity supports the view that lifespan intrinsic activity may contribute critically to the pathogenesis of AD. PMID:24689864

  5. Treatment of younger patients with chronic lymphocytic leukemia.

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    Ferrajoli, Alessandra

    2010-01-01

    Younger patients (defined as patients younger than 50-55 years of age) represent a small group of newly diagnosed patients with chronic lymphocytic leukemia, accounting only for 10% to 20% of newly diagnosed cases. However, once these patients become symptomatic and require treatment, their life expectancy is significantly reduced. Therapeutic approaches for younger patients should be directed at improving survival by achieving a complete remission and, where possible, eradicating minimal residual disease. Chemoimmunotherapy combinations carry the highest response rates and are commonly offered to younger patients. Additional strategies that should be considered for younger patients include early referral for stem-cell transplantation and clinical trials of consolidation therapy to eliminate minimal residual disease.

  6. [Choice of hip prosthesis in patients younger than 50 years

    NARCIS (Netherlands)

    Schreurs, B.W.; Busch, V.J.; Veth, R.P.H.

    2007-01-01

    There is no agreement about the most ideal type of hip prosthesis to be used in patients younger than 50 years. The most commonly used hip prostheses in patients younger than 50 years are uncemented or resurfacing prostheses and to a lesser extent cemented prostheses. A good result of a hip prosthes

  7. Is Chemo Overused in Younger Colon Cancer Patients?

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    ... fullstory_163245.html Is Chemo Overused in Younger Colon Cancer Patients? Study found the treatment often wasn't ... 25, 2017 (HealthDay News) -- Young and middle-aged colon cancer patients may be getting chemotherapy more often than ...

  8. Clinical Analysis of Lung Cancer Patients Younger Than 30 Years

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    Guangjie HOU

    2011-05-01

    Full Text Available Background and objective It is common recognized that young patients of lung cancer have poor prognosis due to relatively higher malignancy and more invasive growth. In the past most studies on young patients of lung cancer selected patients younger than 40 or 45 years old, and there were few clinical materials for younger patients under 30 years. This study retrospectively described the the disease history, stage, treatment and pathology features of lung cancer patients younger than 30 years and aimed to provide references for these patients. Methods Those patients younger than 30 years, once admitted in the General Hospital of the People's Liberation Army for lung cancer from 1993 to date, were sought in medical record system, and 53 patients were found in total. In this group, there were 34 non-small cell lung cancer (NSCLC patients and 19 small cell lung cacer (SCLC patients. The male/female ratio was 1.5:1. In the NSCLC patients, there were 27 adenocarcinomas, 6 squamous carcinomas and 1 adenosquamous carcinoma, with no large cell carcinoma involved. In these patients, 12 patients received operations while 38 patients got chemo- and/or radiotherapy and 3 quited any treatment. Results There was no death in hospital, however, in the 12 patients who got operation, only 8 patients got complete resection while 4 patients got palliative resection. Conclusion Lung cancer patients younger than 30 years had a high fraction of adenocarcinoma and small cell type pathologically and most of them were in late stage when presenting with symptoms in hospital and would have a dismal prognosis. The routine health examination and early diagnosis should be emphasized to improve the prognosis of these patients.

  9. Allograft Anterior Cruciate Ligament Reconstruction in Patients Younger than 25 Years.

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    Carter, Thomas R; Rabago, Michael T

    2016-05-01

    Purpose The purpose of this study was to evaluate the outcomes for patients younger than 25 years who had anterior cruciate ligament (ACL) reconstructions with allograft tissue. Methods A total of 52 ACL reconstructions performed with fresh-frozen, nonirradiated tibialis or Achilles allografts in active patients younger than 25 years. Outcome evaluations included the International Knee Documentation Committee (IKDC) objective and subjective forms, KT-1000 arthrometry and Lysholm. Results Forty-two patients were available for follow-up at an average follow-up of 65 months (range, 33-99 months). The average age at surgery was 17 years and 7 months (range, 11 years 10 months-24 years 8 months). Objective and subjective data were obtained from 37 patients with 1 requiring revision, and 5 patients had only subjective data. IKDC objective results were 29-A and 5-B. KT-1000 differences were 0 mm for 4 patients, 1 mm for 23, 2 mm for 8, 3 mm for 1, and > 5 mm for 1 patient. The average IKDC subjective score was 90.2 ± 15.0 and average Lysholm score was 90.0 ± 11. Conclusion The result of our study found that using nonirradiated Achilles or tibialis tendon allografts for ACL reconstructions in active patients younger than 25 years can achieve good outcomes, with a low rate of failure.

  10. Prognostic differences of World Health Organization - assessed mitotic activity index and mitotic impression by quick scanning in invasive ductal breast cancer patients younger than 55 years

    NARCIS (Netherlands)

    Skaland, Ivar; van Diest, Paul J.; Janssen, Emiel A. M.; Gudlaugsson, Einar; Baak, Jan P. A.

    2008-01-01

    The proliferation marker mitotic activity index is the strongest prognostic indicator in lymph node-negative breast cancer. The World Health Organization (WHO) 2003-defined procedure for determining WHO-mitotic activity index is often replaced by a quick scan mitotic impression. We evaluated the pro

  11. North Atlantic Storm Activity During the Younger Dryas

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    Toomey, M.

    2015-12-01

    The risks posed to cities along the Eastern Seaboard by a potential intensification of tropical cyclone activity over the coming decades remain poorly constrained, in part, due to a lack of available storm proxy records that extend beyond the relatively stable climates of the late Holocene. Previous work in the Bahamas shows that coarse-grained, high-energy event layers in carbonate bank margin sediments: (1) closely track recent historic hurricane events and (2) that the sensitivity of this proxy may be less affected by the deglacial changes in sea level that have limited our ability to reconstruct past hurricane activity using overwash records from back-barrier beach settings. Here we present a record of storm triggered turbidite deposition from a suite of well dated (e.g. Lynch-Stieglitz et al., 2011, Paleoceanography) jumbo piston cores taken offbank (300-500 mbsl) the Dry Tortugas, Florida, that spans abrupt transitions in North Atlantic sea surface temperature and thermohaline circulation during the Younger Dryas (12.9 - 11.5 kyr BP). This record, along with General Circulation Model output (TraCE: NCAR-CGD), indicates strong hurricane activity may have occurred along Southeastern US coasts through this interval despite considerably colder North Atlantic SSTs.

  12. Changes in cognitive function after carotid endarterectomy in older patients: comparison with younger patients.

    Science.gov (United States)

    Takahashi, Yoshihiro; Ogasawara, Kuniaki; Matsumoto, Yuuki; Kobayashi, Masakazu; Yoshida, Kenji; Kubo, Yoshitaka; Beppu, Takaaki; Murakami, Toshiyuki; Nanba, Takamasa; Ogawa, Akira

    2013-01-01

    Objective and subjective assessments of changes in cognition after carotid endarterectomy (CEA) were compared between older patients (≥76 years old) and younger patients (cognitive assessment by a neurosurgeon and the patient's next of kin, and neuropsychological testing (five parameters) before and after surgery. Of 37 older patients studied, 4 (11%), 28 (75%), and 5 (14%) patients were defined as having subjectively improved, unchanged, and impaired cognition, respectively, following surgery. Differences in test scores (postoperative test score - preoperative test score: Δ score) in all neuropsychological tests were significantly lower in the older patients than in the 213 younger patients. The Δ score was able to statistically differentiate older patients with subjectively improved, unchanged, and impaired cognition after surgery. Receiver operating characteristic analysis showed that the Δ score cut-off point for detecting subjective improvement (upper cut-off point) and impairment (lower cut-off point) in cognition after surgery in older patients was identical to the mean or the mean +0.5 standard deviation (SD) and the mean -1.5 SD or the mean -1 SD, respectively, of the control value obtained from normal subjects. The upper and lower cut-off points were lower and higher, respectively, than those in younger patients. In conclusion, although neuropsychological test scores reflect the subjective assessment of postoperative change in cognition in older patients, the optimal cut-off points for the test scores to detect subjective improvement and impairment in cognition after CEA are different in older patients compared with younger patients.

  13. Future patient demand for shoulder arthroplasty by younger patients: national projections.

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    Padegimas, Eric M; Maltenfort, Mitchell; Lazarus, Mark D; Ramsey, Matthew L; Williams, Gerald R; Namdari, Surena

    2015-06-01

    The outcomes of shoulder arthroplasties in younger patients (55 years or younger) are not as reliable compared with those of the general population. Greater risk of revision and higher complication rates in younger patients present direct costs to the healthcare system and indirect costs to the patient in terms of quality of life. Previous studies have suggested an increased demand for shoulder arthroplasties overall, but to our knowledge, the demand in younger patients has not been explored. We asked: (1) What was the demand for shoulder arthroplasties between 2002 and 2011 in the United States for all patients and a specific subpopulation of patients who were 55 years old or younger? (2) How is the demand for shoulder arthroplasties in younger patients projected to change through 2030? (3) How is procedural demand projected to change in younger patients through 2030, and specifically, what can we anticipate in terms of hemiarthroplasty volume compared with that of total shoulder arthroplasty? We used the National Inpatient Sample database to identify primary shoulder arthroplasties performed between 2002 and 2011. A Poisson regression model was developed using the National Inpatient Sample data and United States Census Bureau projections on future population changes to predict estimated national demand for total shoulder arthroplasties and hemiarthroplasties in all patients and in the subpopulation 55 years old or younger. This model was projected until 2030, with associated 95% CIs. We then specifically analyzed the projected demand of hemiarthroplasties and compared this with demand for all arthroplasty procedures in the younger patient population. Demand for shoulder arthroplasties in patients 55 years or younger is increasing at a rate of 8.2% per year (95% CI, 7.06%-9.35%), compared with a growth rate of 12.1% (95% CI, 8.35%-16.02%) per year for patients older than 55 years. In 2002, 15.9% (3587 of 22,617 captured in the National Inpatient Sample) of

  14. Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Veen, D.C. van der; Kapur, N.; Hunt, I.; Williams, A.; Pachana, N.A.

    2015-01-01

    BACKGROUND: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. METHOD: A

  15. Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients

    NARCIS (Netherlands)

    Oude Voshaar, R. C.; van der Veen, D.C.; Kapur, N.; Hunt, I.; Williams, A.; Pachana, N. A.

    Background: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. Method: A

  16. Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Veen, D.C. van der; Kapur, N.; Hunt, I.; Williams, A.; Pachana, N.A.

    2015-01-01

    BACKGROUND: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. METHOD: A 15-y

  17. Suicide in patients suffering from late-life anxiety disorders; a comparison with younger patients

    NARCIS (Netherlands)

    Oude Voshaar, R. C.; van der Veen, D.C.; Kapur, N.; Hunt, I.; Williams, A.; Pachana, N. A.

    2015-01-01

    Background: Anxiety disorders are assumed to increase suicide risk, although confounding by comorbid psychiatric disorders may be one explanation. This study describes the characteristics of older patients with an anxiety disorder who died by suicide in comparison to younger patients. Method: A 15-y

  18. Hypocaloric, high-protein nutrition therapy in older vs younger critically ill patients with obesity.

    Science.gov (United States)

    Dickerson, Roland N; Medling, Theresa L; Smith, Ashley C; Maish, George O; Croce, Martin A; Minard, Gayle; Brown, Rex O

    2013-01-01

    Older patients require more protein than younger patients to achieve anabolism, but age-associated renal dysfunction may limit the amount of protein that can be safely provided. This study examined whether older, critically ill trauma patients with obesity can safely achieve nitrogen equilibrium and have positive clinical outcomes similar to younger obese patients during hypocaloric, high-protein nutrition therapy. Adult patients with traumatic injury and obesity (body mass index [BMI] >30 kg/m(2)), admitted to the Presley Trauma Center from January 2009 to April 2011, were evaluated. Patients were targeted to receive hypocaloric, high-protein nutrition therapy (2 g/kg IBW/d of protein) for >10 days. Patients were stratified as older (≥60 years) or younger (18-59 years). Seventy-four patients (33 older, 41 younger) were studied. Older and younger patients were similar in BMI and injury severity. When given isonitrogenous regimens (2.3 ± 0.2 g/kg IBW/d), nitrogen balance was similar between older and younger patients (-3.2 ± 5.7 g/d vs -4.9 ± 9.0 g/d; P = .363). Older patients experienced a greater mean serum urea nitrogen concentration than younger patients (30 ± 14 mg/dL vs 20 ± 9 mg/dL; P = .001) during nutrition therapy. Clinical outcomes were not different between groups. Older critically ill trauma patients exhibited an equivalent net protein response as younger patients during hypocaloric, high-protein nutrition therapy. Older patients are at greater risk for developing azotemia. Close monitoring is warranted.

  19. Outcome and Risk Factors Presented in Old Patients Above 80 Years of Age Versus Younger Patients After Ischemic Stroke

    DEFF Research Database (Denmark)

    Bentsen, Line; Christensen, Louisa; Christensen, Anders

    2014-01-01

    . METHODS: The analysis was based on consecutive patients admitted within 6 hours after stroke onset and discharged with ischemic stroke, surviving at least 3 months after ictus. To prevent bias, the analysis was based on a registry from before implementation of tissue plasminogen activator treatment; all...... of age or older presented with significantly more severe strokes than younger patients, median Scandinavian Stroke Scale score 39 vs 42 (P = .003). Median mRS score before stroke was significantly higher in patients aged 80 years or older (P ictus (P...

  20. Educating for Political Activity: A Younger Generational Response

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    Mac an Ghaill, Mairtin

    2010-01-01

    This paper is a response to Professor Chitty's "Educational Review" Guest Lecture article, "Educating for political activity". I address the three sections of his paper: a global and national-based politics of war, corporate manipulation and parliamentary scandals. This provides a basis to draw upon empirical material from a…

  1. Emotion in younger and older adults: retrospective and prospective associations with sleep and physical activity.

    Science.gov (United States)

    Ready, Rebecca E; Marquez, David X; Akerstedt, Anna

    2009-01-01

    Older adults may have superior emotion regulation skills than younger adults and the authors suggest that as emotion regulation capacities increase with age, emotions may be less swayed by external events or even by internal traits. The current retrospective and prospective study further tested this hypothesis by determining if the emotions of younger adults were more reactive to two behaviors (i.e., physical activity, sleep) than for older adults. Results supported predictions. Specifically, retrospective self-reports and prospective diary data about physical activity and sleep exhibited stronger associations with emotion for younger than older persons. Implications for emotional well-being across the life span are discussed.

  2. Discharge home after acute stroke : Differences between older and younger patients

    NARCIS (Netherlands)

    Dutrieux, Roy D.; Van Eijk, Monica; Van Mierlo, Marloes L.; Van Heugten, Caroline M.; Visser-Meily, Johanna M A; Achterberg, Wilco P.

    2016-01-01

    Objective: To identify determinants for discharge destination of older (≥ 70 years) and younger (<70 years) acute stroke patients. Design: Multicentre prospective cohort. Patients: A total of 395 patients, within 7 days of clinically evaluated stroke, were included from 6 hospital stroke units. Meth

  3. Higher cumulative revision rate of knee arthroplasties in younger patients with osteoarthritis.

    Science.gov (United States)

    Harrysson, Ola L A; Robertsson, Otto; Nayfeh, Jamal F

    2004-04-01

    This study was designed to test the hypothesis that younger patients treated for osteoarthritis and similar conditions using total knee arthroplasty and unicompartmental knee arthroplasty have a lower implant survival rate when compared with older patients. Previous studies have been done on a small number of patients and only included the younger patients. In many cases patients treated for rheumatoid arthritis have been included in the studies and exceptional survival rates have been reported. The current study compared the cumulative revision rate of the components in 33,251 patients older than 60 years and 2606 patients younger than 60 years treated with total knee arthroplasty or unicompartmental knee arthroplasty for osteoarthritis or similar conditions. Cox regression was used to compare the risk for revision between the two age groups and between gender and the effect of year of operation. The results showed a higher cumulative revision rate for the group of younger patients in all statistical analyses and the risk ratio for revision was significantly lower for the group of older patients. The risk for revision decreased for both groups when considering the year of surgery. This is probably attributable to better implant components and surgical techniques.

  4. Gap in the Intensity of End-of-Life Care between Younger and Older Taiwanese Adult Cancer Patients may not Reflect Younger Patients’ Preferences

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    Siew-Tzuh Tang

    2015-09-01

    Conclusions: Except for EOL-care goals, ICU care, hospice care, and place of death, preferences for specific aggressive life-sustaining treatments did not differ by age group of Taiwanese terminally ill cancer patients. We speculate that the age-related gap in intensity of EOL care among Taiwanese cancer decedents (younger cancer decedents received more life-sustaining treatments, i.e., ICU care, CPR, and intubation with mechanical ventilation support in the last month of life may not reflect the preferences of younger patients.

  5. Comparison of outcome after patent foramen ovale closure in older versus younger patients.

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    Luermans, Justin G; Budts, Werner; Ten Berg, Jurriën M; Plokker, Herbert W; Suttorp, Maarten J; Post, Martijn C

    2011-06-01

    Percutaneous patent foramen ovale (PFO) closure seems to be effective for secondary prevention of cryptogenic stroke in patients younger than 55 years of age. The efficacy in older patients remains uncertain. We compared the efficacy of PFO closure between patients younger and older than 55 years. All 335 patients (mean age 50.2 ± 12.6 years; 205 men) with cryptogenic thromboembolism who underwent PFO closure in our centres between 1998 and 2008 were included. Mean follow-up period was 4.2 ± 1.9 years in the elderly (n=120) and 3.8 ± 2.4 years in the younger patients (n=215) (p=0.15). Prevalence of hypertension, diabetes, hyperlipidaemia and coronary and peripheral artery disease was higher in the elderly (p55 years was an independent predictor of recurrent stroke or TIA (HR 3.2, p=0.03). Percutaneous PFO closure appears to be effective for secondary prevention of cryptogenic stroke in younger patients but seems to be related with less beneficial outcome in elderly. Randomised controlled trials are needed to confirm our findings.

  6. Comparison between surgical outcomes of colorectal cancer in younger and elderly patients

    Institute of Scientific and Technical Information of China (English)

    Longxue Jin; Katsutoshi Kaneko; Norio Inoue; Naoki Sato; Susumu Matsumoto; Hitoshi Kanno; Yuko Hashimoto; Kazuhiro Tasaki; Kinya Sato; Shun Sato

    2011-01-01

    AIM: To compare the outcome of surgical treatment of colorectal adenocarcinoma in elderly and younger patients. METHODS: The outcomes of 122 patients with colorectal adenocarcinoma who underwent surgical treatment between January 2004 and June 2009 were analyzed. The clinicopathological and blood biochemistry data of the younger group (< 75 years) and the elderly group (≥ 75 years) were compared. RESULTS: There were no significant differences between the two groups in operation time, intraoperative blood loss, hospital stay, time to resumption of oral intake, or morbidity. The elderly group had a significantly higher rate of hypertension and cardiovascular disease. levels were significantly lower in the elderly than in the younger group. The serum carcinoembryonic antigen level was lower in the elderly than in the younger group, and there was a significant decreasing trend after the operation in the elderly group. CONCLUSION: The short-term outcomes of surgical treatment in elderly patients with colorectal adenocarcinoma were acceptable. Surgical treatment in elderly patients was considered a selectively effective approach.

  7. Autologous transplantation and management of younger patients with mantle cell lymphoma

    DEFF Research Database (Denmark)

    Geisler, Christian H

    2012-01-01

    and molecular remission in younger patients with MCL, is now within reach, based on an integrated approach of intensive AraC containing immunochemotherapy with or without subsequent ASCT, and post-treatment maintenance with rituximab or lenalidomide are now being investigated. Such an integrated approach might...

  8. Characteristic muscle activity patterns during gait initiation in the healthy younger and older adults.

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    Khanmohammadi, Roya; Talebian, Saeed; Hadian, Mohammad Reza; Olyaei, Gholamreza; Bagheri, Hossein

    2016-01-01

    It is thought that gait initiation (GI) might be an optimal task for identifying postural control deficiencies. Thus, the aim of this study was to clarify the strategies adopted by older subjects during this task. 16 healthy younger and 15 healthy older adults participated in the study. Subjects were instructed to begin forward stepping with their dominant limb in response to an auditory stimulus. The mean muscle activity, co-contraction index, and intra-subject coefficients of variation (intra-subject CVs) of dominant limb muscles in different phases of GI were measured. The level of association between the co-contraction index and intra-subject CV of muscles was also explored. This study showed that in the anticipatory phase, the younger group had larger amplitudes and more intra-subject CVs than older the group, particularly for the tibialis anterior muscle. However, the co-contraction index was greater in older subjects relative to younger subjects. During the weight transition phase, tibialis anterior, semitendinosus and vastus lateralis muscles of older adults had a lower amplitude as compared to younger adults. However, during the locomotor phase, the activity of tibialis anterior was greater in comparison to younger adults. Also, during this phase, similar to the anticipatory phase, the co-contraction index between tibialis anterior and gastrocnemius muscles was greater in older subjects relative to younger subjects. Additionally, the larger co-contraction index of some muscles was associated with smaller intra-subject CV. These findings suggest that muscle behaviors are altered with aging and older adults employ different strategies in the different phases of GI as compared to younger adults.

  9. Clinical features of heart failure hospitalization in younger and elderly patients in Taiwan.

    Science.gov (United States)

    Tseng, Chin-Hsiao

    2011-06-01

      This study compared the comorbidities, drugs, expenses and in-hospital mortality between younger and elderly patients hospitalized with heart failure. A random sample of 1,000.000 insurants of the National Health Insurance program of Taiwan in 2005 was used. Comparisons were made between younger (20-64years) and elderly (≥65years) patients. Heart failure hospitalization was identified in 2692 patients. Ageing, female sex, diabetes, hypertension, chronic obstructive pulmonary disease, nephropathy, infection and ischaemic heart disease were significantly associated with heart failure hospitalization. The incidence was 88 and 2181 per 100,000 population, in younger and elderly people, respectively. The most common comorbidity in the elderly was hypertension (38·3%), followed by infection (32·0%) and ischaemic heart disease (31·9%). In younger patients, hypertension (41·3%), diabetes (35·5%) and ischaemic heart disease (29·8%) were the most common comorbidity. Diuretics were the most common drugs for both the younger (74·4%) and the elderly (76·9%) patients, followed by angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers and aspirin. The length of stay was longer (17·1 vs. 11·0days, Pexpense higher (105,290·5 vs. 85,473·6 New Taiwan Dollars, Phospital mortality higher (4·2% vs. 2·7%, P=0·0823) in the elderly. Length of stay, nephropathy, infection, ischaemic heart disease and peripheral arterial disease were associated with expenses. In-hospital mortality was associated with age, length of stay, cancer, infection and peripheral arterial disease. The elderly have a 25-fold higher risk of heart failure hospitalization, longer length of in-hospital stay, higher total medical expense and higher in-hospital mortality. © 2010 The Author. European Journal of Clinical Investigation © 2010 Stichting European Society for Clinical Investigation Journal Foundation.

  10. Return to Sport in the Younger Patient With Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Webster, Kate E.; Feller, Julian A.; Whitehead, Timothy S.; Myer, Gregory D.; Merory, Peter B.

    2017-01-01

    Background: Although anterior cruciate ligament (ACL) reconstruction is generally regarded as a successful procedure, only 65% of patients return to their preinjury sport. While return-to-sport rates are likely higher in younger patients, there is a paucity of data that focus on the younger patient and their return-to-sport experience after ACL reconstruction. Purpose: To investigate a range of return-to-sport outcomes in younger athletes who had undergone ACL reconstruction surgery. Study Design: Case series; Level of evidence, 4. Methods: A group of 140 young patients (sport participation at a mean follow-up of 5 years (range, 3-7 years). Results: Overall, 76% (95% CI, 69%-83%) of the young patient group returned to the same preinjury sport. Return rates were higher for males than females (81% vs 71%, respectively; P > .05). Of those who returned to their sport, 65% reported that they could perform as well as before the ACL injury and 66% were still currently participating in their respective sport. Young athletes who never returned to sport cited fear of a new injury (37%) or study/work commitments (30%) as the primary reasons for dropout. For those who had successfully returned to their preinjury sport but subsequently stopped participating, the most common reason cited for stopping was study/work commitments (53%). At a mean 5-year follow-up, 48% of female patients were still participating in level I (jumping, hard pivoting) sports, as were 54% of males. Conclusion: A high percentage of younger patients return to their preinjury sport after ACL reconstruction surgery. For patients in this cohort who had not sustained a second ACL injury, the majority continue to participate and are satisfied with their performance. PMID:28473996

  11. Hormone therapy affects plasma measures of factor VII-activating protease in younger postmenopausal women

    DEFF Research Database (Denmark)

    Mathiasen, Jørn Sidelmann; Skouby, S.O.; Vitzthum, F.;

    2010-01-01

    Objectives Current reviews indicate that hormone therapy (HT) has a protective role in coronary heart disease (CHD) in younger postmenopausal women, whereas HT contributes to CHD in older women Factor VII-activating protease (FSAP) is a serine protease that accumulates in unstable atherosclerotic...

  12. The issues of the intellectual and cognitive activity stimulation of younger pupils

    Directory of Open Access Journals (Sweden)

    Repko I.P.

    2012-02-01

    Full Text Available Some means of stimulating the intellectual and cognitive activity of younger pupils are considered: the creation of favourable educational environment (organization of the pedagogically rational dialogue with the children; using the ways of intellectual and emotional stimulating of the pupils, the use of active teaching methods and form (methods of empathy and figurative vision, didactical games, discussions, conducting of the non standard lessons est., personality-oriented evaluation of the study-cognitive activity of pupils.

  13. Are Short-term Outcomes of Hip Arthroscopy in Patients 55 Years and Older Inferior to Those in Younger Patients?

    Science.gov (United States)

    Bryan, Andrew J; Krych, Aaron J; Pareek, Ayoosh; Reardon, Patrick J; Berardelli, Rebecca; Levy, Bruce A

    2016-10-01

    Hip arthroscopy for young patients with femoroacetabular impingement (FAI) has been successful, but the efficacy of hip arthroscopy in older patients is not clearly defined. To evaluate the clinical outcomes of patients 55 years and older who are undergoing hip arthroscopy and to compare outcomes with those of patients younger than 55 years. Cohort study; Level of evidence, 3. A total of 201 (63 male, 138 female) patients undergoing primary hip arthroscopy for FAI without radiographic arthritis (Tönnis grade 55-year and ≥55-year groups. Patients were evaluated preoperatively and 1 and 2 years postoperatively using the modified Harris Hip Score (mHHS) and Hip Outcome Score (HOS: functional scores, as well as Activities of Daily Living [ADL] and Sport subscales). A Wilcoxon signed rank sum test was used to evaluate the differences in outcome scores between the cohorts at each interval. The 55-year group included 174 patients (mean age, 37 ± 12 years), and the ≥55-year group included 27 patients (mean age, 61 ± 5 years). The minimum follow-up time was 2 years in each group. Preoperative Tönnis grades and mHHS scores (59 vs 59; P = .75) were similar between groups. The ≥55-year cohort underwent labral debridement more frequently (78% vs 36%; P =.02) and were more likely to have full-thickness cartilage defects (22% vs 4%; P = .04). Despite this, the mHHS in both groups improved significantly from baseline, without significant differences at 1 year (86 [≥55 years] vs 81 [55 years]; P = .53) or 2 years (73.88 [≥55 years] vs 79.54 [55 years]; P = .06). However, at a minimum 2-year follow-up, patients 55 years had significant improvements over patients ≥55 years in the HOS subscales for ADL score (85.6 vs 75.2; P = .03), ADL rating (80.1 vs 70.0; P = .004), Sport score (70.2 vs 55.6; P = .04), and Sport rating (70.2 vs 58.0; P = .04). Although younger patients had superior HOS outcomes reported at 2 years compared with older patients after hip arthroscopy

  14. Distinctive Risk Factors and Phenotype of Younger Patients With Resistant Hypertension: Age Is Relevant.

    Science.gov (United States)

    Ghazi, Lama; Oparil, Suzanne; Calhoun, David A; Lin, Chee Paul; Dudenbostel, Tanja

    2017-05-01

    Resistant hypertension, defined as blood pressure >140/90 mm Hg despite using ≥3 antihypertensive medications, is a well-recognized clinical entity. Patients with resistant hypertension are at an increased risk of cardiovascular disease compared with those with more easily controlled hypertension. Coronary heart disease mortality rates of younger adults are stagnating or on the rise. The purpose of our study was to characterize the phenotype and risk factors of younger patients with resistant hypertension, given the dearth of data on cardiovascular risk profile in this cohort. We conducted a cross-sectional analysis with predefined age groups of a large, ethnically diverse cohort of 2170 patients referred to the Hypertension Clinic at the University of Alabama at Birmingham. Patients (n=2068) met the inclusion criteria and were classified by age groups, that is, ≤40 years (12.7% of total cohort), 41 to 55 years (32.1%), 56 to 70 years (36.1%), and ≥71 years (19.1%). Patients aged ≤40 years compared with those aged ≥71 years had significantly earlier onset of hypertension (24.7±7.4 versus 55.0±14.1 years; Phypertension, younger individuals have a distinct phenotype characterized by overlapping risk factors and comorbidities, including obesity, high aldosterone, and high dietary sodium intake compared with elderly. © 2017 American Heart Association, Inc.

  15. Differences in dual-task performance and prefrontal cortex activation between younger and older adults

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    Ohsugi Hironori

    2013-01-01

    Full Text Available Abstract Background The purpose of this study was to examine task-related changes in prefrontal cortex (PFC activity during a dual-task in both healthy young and older adults and compare patterns of activation between the age groups. We also sought to determine whether brain activation during a dual-task relates to executive/attentional function and how measured factors associated with both of these functions vary between older and younger adults. Results Thirty-five healthy volunteers (20 young and 15 elderly participated in this study. Near-infrared spectroscopy (NIRS was employed to measure PFC activation during a single-task (performing calculations or stepping and dual-task (performing both single-tasks at once. Cognitive function was assessed in the older patients with the Trail-making test part B (TMT-B. Major outcomes were task performance, brain activation during task (oxygenated haemoglobin: Oxy-Hb measured by NIRS, and TMT-B score. Mixed ANOVAs were used to compare task factors and age groups in task performance. Mixed ANOVAs also compared task factors, age group and time factors in task-induced changes in measured Oxy-Hb. Among the older participants, correlations between the TMT-B score and Oxy-Hb values measured in each single-task and in the dual-task were examined using a Pearson correlation coefficient. Oxy-Hb values were significantly increased in both the calculation task and the dual-task within patients in both age groups. However, the Oxy-Hb values associated with there were higher in the older group during the post-task period for the dual-task. Also, there were significant negative correlations between both task-performance accuracy and Oxy-Hb values during the dual-task and participant TMT-B scores. Conclusions Older adults demonstrated age-specific PFC activation in response to dual-task challenge. There was also a significant negative correlation between PFC activation during dual-task and executive

  16. Histopathological correlation of oral squamous cell carcinoma among younger and older patients

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    Syed Mukith Ur Rahaman

    2014-01-01

    Full Text Available Background: Oral Squamous Cell Carcinoma (OSCC is commonly noted in elder men, when occurring in younger individuals, its aggression and prognosis is questioned due to biased data in literature. Traditionally, various histopathological grading systems have been used for assessing aggression and prognosis of OSCC. However, multifactorial grading of Anneroth et al., is considered effective. Materials and Methods: In this retro-prospective study, files of 75 OSCC patients were retrieved from Oral Pathology Department; among this 50 patients were >40 years and 25 patients were ≤40 years of age. Archival formalin fixed paraffin embedded tissue blocks of these patients were used to prepare hematoxylin and eosin (H and E stained sections for grading OSCC based on Broder′s and Anneroth et al., criteria. Further, recurrence of OSCC among study subjects within 5 years of treatment was evaluated. Chi-square test was used to compare the disease in patients who were >40 years with ≤40 years. Results: Comparison according to Broder′s classification didn′t show any relevant variation. Three of the six parameters and overall grading according to Anneroth et al., criteria showed statistically higher grades of OSCC in the younger age-group; however, there was no significant difference in 5-year recurrence rate. Interpretation and Conclusion: Results of the study are suggestive of aggressive OSCC among young patients when compared to older. Conversely, this aggression didn′t affect the recurrence in younger patients. Further studies on genetics, diet and demographics of patients below 40 years of age affected by OSCC will be of greater value.

  17. Hospital-Acquired Infections in Elderly Versus Younger Patients in an Acute Care Hospital

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    Solis-Hernandez

    2015-11-01

    Full Text Available Background A growing number of elderly patients are hospitalized for various causes and age has been described inconsistently as a risk factor for acquiring nosocomial infections with a subsequent higher mortality rate compared to younger patients. Objectives To describe the incidence, type, and microbiological characteristics of nosocomial infections in elderly and non-elderly patients. Patients and Methods Retrospective analysis of all hospital-acquired infections (HAIs in an academic community hospital. Patients were stratified into two groups: non-elderly (18 - 64 years and elderly (> 65 years. Results A total of 18469 patients were included (108555 hospital days in this study. About 79.6% of HAI were infected non-elderly and 20.3% elderly (P 0.05. Hospital mortality increased with every HAI diagnosed per patient. Conclusions The study showed that HAIs were more frequent in elderly population predominately with respect to VAP and infections by Gram-negative pathogens. Overall mortally was greater in the elderly group although the odds ratio for death was higher in younger patients and increased with every HAI diagnosed.

  18. Acute diverticulitis in younger patients: Any rationale for a different approach?

    Institute of Scientific and Technical Information of China (English)

    Gil R Faria; Ana B Almeida; Herculano Moreira; Jo(a)o Pinto-de-Sousa; Pedro Correia-da-Silva; Amadeu P Pimenta

    2011-01-01

    AIM: To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently.METHODS: This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1, 2004 and December 31, 2007. Diverticulitis was stratified according to the Hinchey classification.Patients were divided into 2 populations: group A ≤50 years (n = 31); group B > 50 years (n = 126). Mean patient follow-up was 15 mo.RESULTS: The median age was 60 years. A significantly higher proportion of patients in group B presented with complicated diverticulitis (36.5% vs 12.9%,P = 0.01). Recurrence was more frequent in group A (25.8% vs 11.1%, P = 0.03) and the mean time-torecurrence was shorter (12 mo vs 28 mo, P = 0.26).The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stage Ⅰ and none of the patients required emergency surgery. In multivariate analysis, only age (P = 0.024) was identified as an independent prognostic factor for recurrence.CONCLUSION: Based on the results of this study, we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.

  19. Diabetes Mellitus and Younger Age Are Risk Factors for Hyperphosphatemia in Peritoneal Dialysis Patients

    Science.gov (United States)

    Imtiaz, Rameez; Hawken, Steven; McCormick, Brendan B.; Leung, Simon; Hiremath, Swapnil; Zimmerman, Deborah L.

    2017-01-01

    Hyperphosphatemia has been associated with adverse outcomes in patients with end stage kidney disease (ESKD). The purpose of this study was to determine risk factors for hyperphosphatemia in ESKD patients treated with peritoneal dialysis (PD). This information will be used to develop a patient specific phosphate binder application to facilitate patient self-management of serum phosphate. Adult PD patients documented their food, beverage, and phosphate binder intake for three days using a dietitian developed food journal. Phosphate content of meals was calculated using the ESHA Food Processor SQL Software (ESHA Research, Salem, UT, USA). Clinic biochemistry tests and an adequacy assessment (Baxter Adequest program) were done. Univariate logistic regression was used to determine predictors of serum phosphate >1.78 mmol/L. A multivariable logistic regression model was then fit including those variables that achieved a significance level of p 1.78 mmol/L). In univariate analysis, the variables associated with an increased risk of hyperphosphatemia with a p-value carbonate (0.08), higher parathyroid serum concentration (0.08), lower phosphate intake (0.03), lower measured glomerular filtration rate (0.15), higher phosphate excretion (0.11), and a higher body mass index (0.15). After multivariable logistic regression analysis, younger age (odds ratio (OR) 0.023 per decade, 95% confidence interval (CI) 0.00065 to 0.455; p = 0.012), presence of diabetes (OR 11.40, 95 CI 2.82 to 61.55; p = 0.0003), and measured GFR (OR 0.052 per mL/min decrease; 95% CI 0.0025 to 0.66) were associated with hyperphosphatemia. Our results support that younger age and diabetes mellitus are significant risk factors for hyperphosphatemia. These findings warrant further investigation to determine the potential mechanisms that predispose younger patients and those with DM to hyperphosphatemia. PMID:28218647

  20. Diabetes Mellitus and Younger Age Are Risk Factors for Hyperphosphatemia in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Imtiaz, Rameez; Hawken, Steven; McCormick, Brendan B; Leung, Simon; Hiremath, Swapnil; Zimmerman, Deborah L

    2017-02-17

    Hyperphosphatemia has been associated with adverse outcomes in patients with end stage kidney disease (ESKD). The purpose of this study was to determine risk factors for hyperphosphatemia in ESKD patients treated with peritoneal dialysis (PD). This information will be used to develop a patient specific phosphate binder application to facilitate patient self-management of serum phosphate. Adult PD patients documented their food, beverage, and phosphate binder intake for three days using a dietitian developed food journal. Phosphate content of meals was calculated using the ESHA Food Processor SQL Software (ESHA Research, Salem, UT, USA). Clinic biochemistry tests and an adequacy assessment (Baxter Adequest program) were done. Univariate logistic regression was used to determine predictors of serum phosphate >1.78 mmol/L. A multivariable logistic regression model was then fit including those variables that achieved a significance level of p diabetes mellitus (DM) and 33% had hyperphosphatemia (PO₄ > 1.78 mmol/L). In univariate analysis, the variables associated with an increased risk of hyperphosphatemia with a p-value diabetes (OR 11.40, 95 CI 2.82 to 61.55; p = 0.0003), and measured GFR (OR 0.052 per mL/min decrease; 95% CI 0.0025 to 0.66) were associated with hyperphosphatemia. Our results support that younger age and diabetes mellitus are significant risk factors for hyperphosphatemia. These findings warrant further investigation to determine the potential mechanisms that predispose younger patients and those with DM to hyperphosphatemia.

  1. Lower extremity venous thrombosis in patients younger than 50 years of age

    Directory of Open Access Journals (Sweden)

    Kreidy R

    2012-03-01

    Full Text Available Raghid Kreidy1, Pascale Salameh2, Mirna Waked31Department of Vascular Surgery, Saint George Hospital, University Medical Center, University of Balamand, 2Laboratory of Clinical and Epidemiological Research, Faculty of Pharmacy, Lebanese University, 3Department of Pulmonary Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Lower extremity deep venous thrombosis in the young adult is uncommon and has not been well studied in the literature. The aim of this study is to define risk factors for deep venous thrombosis among patients younger than 50 years of age, to compare them with a control group, and to suggest recommendations for the management and treatment of venous thrombosis in this particular group of patients.Methods: From January 2003 to January 2011, 66 consecutive Lebanese patients (29 males and 37 females younger than 50 years, diagnosed in an academic tertiary-care center with lower extremity deep venous thrombosis by color flow duplex scan, were retrospectively reviewed. Their age varied between 21 and 50 years (mean 38.7 years. The control group included 217 patients (86 males and 131 females older than 50 years (range: 50–96 years; mean 72.9 years.Results: The most commonly reported risk factors in the younger age group were inherited thrombophilia (46.9% compared with 13.8% in the control group; P < 0.001, pregnancy (18.2% compared with 0.5%; P < 0.001, treatment with estrogen drugs (13.6% compared with 2.3%; P = 0.001, and family history of venous thromboembolism (9.1% compared with 3.8%; P = 0.084.Conclusion: Inherited thrombophilia is the most commonly observed risk factor among patients younger than 50 years, with a prevalence of three times more than the control group. Young adults should be screened for thrombophilia even in the presence of transient acquired risk factors. Pregnancy and treatment with estrogen drugs essentially when associated with inherited thrombophilia

  2. Pial synangiosis in patients with moyamoya younger than 2 years of age.

    Science.gov (United States)

    Jackson, Eric M; Lin, Ning; Manjila, Sunil; Scott, R Michael; Smith, Edward R

    2014-04-01

    Object Patients with moyamoya who are younger than 2 years of age represent a therapeutic challenge because of their frequent neurological instability and concomitant anesthetic risks. The authors report their experience with pial synangiosis revascularization in this population. Methods The authors reviewed the clinical and radiographic records of all patients with moyamoya in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results During a 12-year period (1994-2005), 34 procedures (bilateral in 15 patients, unilateral in 4) were performed in 19 patients younger than 2 years (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or transient ischemic attack. The average age of the 19 patients at first surgery was 1.4 years (range 6 months-1.9 years). Unanticipated staged operations occurred in 3 patients, due to persistent electroencephalographic changes during the initial surgery in 2 cases and due to brain swelling during the procedure requiring ventriculostomy in the other. There were 2 perioperative strokes; both patients had postoperative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14 years). Long term, at follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures performed years later for frontal lobe ischemia (2), late infarction (1), and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre- and postoperative angiography demonstrated progression of disease. Conclusions Despite the challenges inherent to this population, the majority of children with moyamoya under the age of 2 years have a good long-term prognosis. The data from this study support the use of pial

  3. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

    DEFF Research Database (Denmark)

    Klit, Jakob

    2014-01-01

    BACKGROUND: Knee and hip OA is the clinical and pathological outcome of a functional and structural failure of the joint, resulting in pain and physical dysfunction. Despite the similarity in clinical presentation the pathogenesis seems to differ. Where knee OA is associated with obesity and trauma...... bilateral THA, and 44 HR. The study groups received a paper-format questionnaire within one month before surgery and at three, six, and 12 months postoperatively. RESULTS: Study I showed a high willingness to undergo PAO again with the experience and knowledge they have today and improvements were seen...... in younger patients cannot be expected to change the patient's relation to work or annual income. Patients stay sexually active after THA, and female patients experiences positive changes. CONCLUSION: Based on the findings in this thesis PAO patients are satisfied with the outcome at medium to long...

  4. Supplementary home biofeedback improves quality of life in younger patients with fecal incontinence.

    Science.gov (United States)

    Bartlett, Lynne; Sloots, Kathryn; Nowak, Madeleine; Ho, Yik-Hong

    2015-01-01

    Biofeedback is a scarce, resource-intensive clinical therapy. It is used to treat patients with bowel problems, including fecal incontinence (FI), who fail to respond to simple dietary advice, medication, or pelvic floor exercises. Populations are aging and younger cohorts use technology in managing their health, affording FI self-management opportunities. Does supplementary home-based biofeedback improve FI and quality of life (QOL)? Seventy-five incontinent participants (12 male), mean age 61.1 years, consented to participate. Thirty-nine patients (5 male) were randomized to the standard biofeedback protocol plus daily home use of a Peritron perineometer (intervention) and 36 patients (7 male) to the standard biofeedback protocol (control). On completion of the study each perineometer exercise session was rated for technique by 2 raters, blinded to the patient and order of sessions. With the exception of Fecal Incontinence Quality of Life Scale lifestyle improvement (intervention--9.1% vs. controls--0.3%, P=0.026) and embarrassment improvement (intervention--50.0% vs. controls--18.3%, P=0.026), supplementary home biofeedback did not result in greater clinical improvement for the intervention group as a whole. However, on stratification around the mean age, continence and QOL of younger people in the intervention group were significantly better than those of their control counterparts. Graphed perineometer sessions demonstrated high compliance and improvement in exercise technique. Perineometers provided reassurance, motivation, and an exercise reminder ensuring that confidence was achieved quickly. Home biofeedback was acceptable and well tolerated by all users. Younger participants significantly benefited from using this technology.

  5. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

    DEFF Research Database (Denmark)

    Klit, Jakob

    2013-01-01

    in younger PAO, TKA, and THA patients our aims were, to explore patient satisfaction, fulfillment of expectations, symptoms of depression, the effect on socioeconomic status, and abilities in sex-life in younger PAO, TKA, and THA patients using PROMs. These alternative endpoints were collected in addition...... to traditional measures of function and HRQoL. Our aims were: 1. To investigate the consequences of TKA, and THA treatment in younger patients in regard to patient satisfaction, expectations, symptoms of depression, socioeconomic effects, and abilities in sex-life. To generate important new information......, important to both patients and surgeons during the decision making process prior to TKA and THA surgery. 2. To create a database that can follow this well-defined high-demanding younger patient group over years, and reveal complications and revision rates due to a higher wear in this group. To support...

  6. Mortality, Recurrence, and Dependency Rates Are Higher after Acute Ischemic Stroke in Elderly Patients with Diabetes Compared to Younger Patients.

    Science.gov (United States)

    Long, Xue; Lou, Yongzhong; Gu, Hongfei; Guo, Xiaofei; Wang, Tao; Zhu, Yanxia; Zhao, Wenjuan; Ning, Xianjia; Li, Bin; Wang, Jinghua; An, Zhongping

    2016-01-01

    Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64-2.89) and 3.10 (2.35-4.08), respectively, for mortality, all P dependency, all P dependency after stroke.

  7. Clinical results of the Metha short hip stem: a perspective for younger patients?

    Directory of Open Access Journals (Sweden)

    Fritz Thorey

    2013-11-01

    Full Text Available In recent years, various uncemented proximal metaphyseal hip stems were introduced for younger patients as a bone preserving strategy. Initial osteodensitometric analyses of the surrounding bone of short stems indicate an increase of bone mass with secondary bone ingrowth fixation as a predictor of long-term survival of these types of implants. We report the outcome of 151 modular Metha short hip stem implants in 148 patients between March 2005 and October 2007. The mean follow-up was 5.8±0.7 years and the mean age of the patients was 55.7±9.8 years. Along with demographic data and co-morbidities, the Harris Hip Score (HHS, the Hip dysfunction and Osteoarthritis Outcome Score (HOOS, and also the results of a patient-administered questionnaire were recorded pre-operatively and at follow-up. The mean HHS increased from 46±17 pre-operatively to 90±5 the HOOS improved from 55±16 pre-operatively to 89±10 at the final follow-up. A total of three patients have been revised, two for subsidence with femoral revision and one for infection without femoral revision (Kaplan Meier survival estimate 98%. The radiological findings showed no radiolucent lines in any of the patients. The modular Metha short hip stem was implanted in younger patients, who reported an overall high level of satisfaction. The clinical and radiographic results give support to the principle of using short stems with metaphyseal anchorage. However, long-term results are necessary to confirm the success of this concept in the years to come.

  8. Early reconstruction should be considered in younger patients with symptomatic mucoid degeneration of the anterior cruciate ligament

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    Masashi Kusano

    2015-07-01

    Conclusion: Considering the rupture of residual ACL fibres after partial resection and the inevitability of total ACL resection due to degeneration of the entire ligament, ACL reconstruction should be considered in younger patients with symptomatic mucoid degeneration of the ACL.

  9. A Modified Integrated Genetic Model for Risk Prediction in Younger Patients with Acute Myeloid Leukemia.

    Directory of Open Access Journals (Sweden)

    Caroline E Sloan

    = 0.919.The IGP model was not completely validated in our cohort. However, mutations in six out of the nine genes can be used to characterize survival (NPMI, IDH1, IDH2, FLT3-ITD, TET2, DNMT3A and allow for more robust prognostication in the patients who are re-categorized by the IGP model. These mutations should be incorporated into clinical testing for younger patients outside of clinical trials, in order to guide therapy.

  10. Seroprevalence of Hepatitis a in Hemodialysis Patient Candidate for Kidney Transplant Younger Than Forty Years

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    Sara Abolghasemi

    2017-04-01

    Full Text Available Background: Hepatitis A is a common infection during childhood, especially in developing countries. It can cause severe complications in immunocompromised patients. Due to the increasing number of kidney transplants in the country and epidemiologic shift of HAV which was observed in previous studies, we're going to evaluate the seroprevalence of hepatitis A in hemodialysis patients less than forty years serving kidney transplant candidates to follow vaccination policy for them.Materials and Methods: In a cross sectional study during 2014-2015 hepatitis A antibody levels in hemodialysis patients less than forty years in kidney transplant candidates examined in 12 hospitals in Tehran, Iran. Their serums were tested for anti HAV IgM and IgG by ELISA kits.Results: Hepatitis A virus antibody was positive in 66 (72.5% of 91 patients. The prevalence of HAV was 0% at the range of younger than 20 and 45% in under 25 years age group. This significantly increased prevalence by increasing the age, and there was according to epidemiological shifts which were shown in other studies.Conclusion: Due to the availability of vaccine and hepatitis severe complications in immunocompromised individuals, as well as a low prevalence of positive serology in individuals under 25 years, it seems the check of antibodies in patients undergoing kidney transplantation and vaccination in seronegative persons is a logical.

  11. The Rising Incidence of Younger Patients With Colorectal Cancer: Questions About Screening, Biology, and Treatment.

    Science.gov (United States)

    Connell, Louise C; Mota, José Mauricio; Braghiroli, Maria Ignez; Hoff, Paulo M

    2017-04-01

    Colorectal cancer (CRC) is the third leading cancer diagnosed globally and an important cause of cancer-related mortality. Of interest, while we have witnessed a declining incidence trend over the past few decades in the older population, incidence rates for adolescents and young adults have been increasing steadily. Several factors may well explain this apparent epidemic in the young, namely a lack of routine screening and emerging lifestyle issues such as obesity, lack of exercise, and dietary factors. It is known that both environmental and genetic factors can increase the likelihood of developing CRC. Although inherited susceptibility is associated with the most striking increases in risk, and must always be considered in a young patient with CRC, the majority of CRCs are in fact sporadic rather than familial. Early-onset CRC is a truly heterogeneous disease, with mounting evidence to suggest that this patient population has a distinctive molecular profile, very different to late-onset CRC cases. Currently, both younger and older patients with CRC are treated in essentially the same manner, but with a better understanding of the molecular mechanisms underlying CRC in the young, we will have the opportunity to specifically tailor screening and clinical management strategies in this unique patient population in an effort to improve outcomes. The aim of this review is to outline our current knowledge of the distinguishing features of early-onset CRC, the ongoing research efforts, and the evolving evidence in this field.

  12. Changes in Female Support Network Systems and Adaptation after Breast Cancer Diagnosis: Differences between Older and Younger Patients

    Science.gov (United States)

    Ashida, Sato; Palmquist, Aunchalee E. L.; Basen-Engquist, Karen; Singletary, S. Eva; Koehly, Laura M.

    2009-01-01

    Purpose: This study evaluates the changes in social networks of older and younger breast cancer patients over a 6-month period following their first diagnosis and how such modifications are associated with changes in the patients' mood state. Design and Methods: Newly diagnosed breast cancer patients were interviewed shortly after their diagnosis…

  13. Differences in Predictive Factors for Sustained Clinical Remission with Abatacept Between Younger and Elderly Patients with Biologic-naive Rheumatoid Arthritis: Results from the ABROAD Study.

    Science.gov (United States)

    Sekiguchi, Masahiro; Fujii, Takao; Matsui, Kiyoshi; Murakami, Kosaku; Morita, Satoshi; Ohmura, Koichiro; Kawahito, Yutaka; Nishimoto, Norihiro; Mimori, Tsuneyo; Sano, Hajime

    2016-11-01

    To differentiate predictive factors for sustained clinical remission between elderly and younger patients with rheumatoid arthritis (RA) receiving abatacept (ABA) as an initial biological disease-modifying antirheumatic drug. The study involved 277 biologic-naive patients with RA with high or moderate disease activity, who were treated with intravenous ABA and evaluated for 48 weeks in 43 Japanese hospitals and rheumatology clinics (the ABatacept Research Outcomes as a First-line Biological Agent in the Real WorlD study: UMIN000004651). Predictive factors associated with sustained clinical remission defined by the 28-joint Disease Activity Score with C-reactive protein (DAS28-CRP) during the 24-48-week or 36-48-week periods were determined in elderly (≥ 65 yrs, n = 148) and younger patient groups (< 65 yrs, n = 129) using logistic regression analysis. Clinical remission was achieved at 24 and 48 weeks in 35.1% and 36.5% of patients in the elderly group and 34.9% and 43.4% in the younger group, respectively. In elderly patients, anticitrullinated protein antibody (ACPA) positivity and a lower DAS28-CRP score were significantly associated with sustained clinical remission; however, a lower Health Assessment Questionnaire-Disability Index (HAQ-DI) score was not related to sustained clinical remission. In younger patients, lower DAS28-CRP and HAQ-DI scores were predictive factors for sustained clinical remission, whereas ACPA positivity was not a useful predictive factor for sustained clinical remission. Although the effectiveness of ABA in biologic-naive patients with RA was equally recognized in elderly and younger patients, the baseline clinical characteristics associated with sustained clinical remission were substantially different.

  14. Forefoot Surgery in Elderly Compared With Younger Patient Populations: Complications and Type of Procedure.

    Science.gov (United States)

    Vermersch, Thibault; Fessy, Michel Henri; Besse, Jean-Luc

    2015-01-01

    In forefoot surgery, the presenting complaints and expected benefits differ between elderly and younger patients. The present study mapped forefoot procedures recommended to elderly patients compared with those recommended to the general population and assessed the complications according to age group and comorbidity. Consecutive patients were included in a single-center, continuous, retrospective case-control study. Three age groups were defined: <65 years, 65 to 74 years, and ≥ 75 years. All patients, regardless of age, underwent the same procedure; elderly-specific techniques such as the Keller procedure were not used. A total of 321 patients were included, with a mean age of 60.6 (range 16 to 86) years. A similar procedure was used in all 3 groups, but at differing frequencies, with arthrodesis and minor procedures increasing with increasing patient age. In all 3 groups, in the population as a whole, the incidence of delayed healing, deep infection, and nonunion was 9%, 1%, and 2%, respectively. These complications were independent of age group. In the <65-year-old group, just as in the study population as a whole, arthrodesis associated with resection arthroplasty resulted in greater rates of delayed healing and deep infection. The complications rates were equivalent among the 3 age groups. Major surgical procedures should be avoided in elderly patients, if possible. However, no particular procedure is contraindicated in the elderly, although the method of fixation must be robust owing to the frequency of osteoporosis. A first step would be to achieve consensus on the age threshold for "elderliness."

  15. Radio(chemotherapy in elderly patients with oesophageal cancer : a feasible treatment with an outcome consistent with younger patients.

    Directory of Open Access Journals (Sweden)

    Philippe eRochigneux

    2014-05-01

    Full Text Available Background : Although the prevalence of oesophageal cancer increases in elderly patients, its clinical history and outcome after treatment remain poorly described.Methods : Between January 2001 and December 2011, 58 patients (pts older than 75 years-old received 3D conformal radiotherapy (mean dose 51 Gy in two French cancer centres. 47/58 (82% pts received concomitant chemotherapy (with CDDP and/or FU regimens and 8 pts underwent surgery after primary radiochemotherapy (RCT.Results : Median age was 77.9 years and the performance status was 0 or 1 in 89%. Tumours were mainly adenocarcinoma of lower oesophagus or gastroesophageal junction (n=51, 89%, T3T4 (n=54, 95% and N1 (n=44, 77%. The mean follow-up was 21.9 months. In the overall population, the median progression free survival was 9.6 months and median overall survival (OS was 14.5 months. Using univariate analysis, OS was significantly influenced by age (p=0.048, PS (pConclusion : RCT in elderly patients is a feasible treatment and its outcome is close to younger patient’s outcome published in the literature. Surgical resection, after comprehensive geriatric assessment, should be recommended as the standard treatment for adenocarcinoma of lower oesophagus or gastroesophageal junction in elderly patients with good performance status and low comorbidity profile, as it is in younger patients.

  16. Assessing Compliance With Mercaptopurine Treatment in Younger Patients With Acute Lymphoblastic Leukemia in First Remission | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies compliance to a mercaptopurine treatment intervention compared to standard of care in younger patients with acute lymphoblastic leukemia in remission. Assessing ways to help patients who have acute lymphoblastic leukemia to take their medications as prescribed may help them in taking their medications more consistently and may improve treatment outcomes. |

  17. Cognitive-behavioral therapy for panic disorder with agoraphobia in older people : a comparison with younger patients

    NARCIS (Netherlands)

    Hendriks, Gert-Jan; Kampman, Mirjam; Keijsers, Ger P. J.; Hoogduin, Cees A. L.; Oude Voshaar, Richard C.

    2014-01-01

    BACKGROUND: Older adults with panic disorder and agoraphobia (PDA) are underdiagnosed and undertreated, while studies of cognitive-behavioral therapy (CBT) are lacking. This study compares the effectiveness of CBT for PDA in younger and older adults. METHODS: A total of 172 patients with PDA (DSM-IV

  18. Comparison of Provision of Stroke Care in Younger and Older Patients: Findings from the South London Stroke Register

    Science.gov (United States)

    Crichton, Siobhan L.; Wolfe, Charles D. A.; Rudd, Anthony G.; McKevitt, Christopher

    2012-01-01

    Background. Evidence-based stroke care should be available to all patients. However, evidence exists of inequalities according to age. This study compared access to care for younger adults to that for over 65s. Methods. Using population-based data from 4229 patients with first-ever stroke between 1995 and 2010, associations between age and 21 care indicators were investigated using multivariable logistic regression. Results. Age was not associated with stroke unit admission for ischaemic stroke (P = 0.666). Younger PICH patients were least likely to be admitted to stroke units (P = 0.001), instead treated on neurosurgical or ICU wards. Younger age was also associated with admission to neurosurgery or ICU after SAH (P = 0.006), increased occupational or physiotherapy at 1 year (P = 0.043), and contact with a GP 3 months after stroke (P < 0.001). Conclusion. Younger patients have equal or greater access to evidence-based care. However, there is a need to ensure that services meet the needs of this group. PMID:22593833

  19. Comparison of Provision of Stroke Care in Younger and Older Patients: Findings from the South London Stroke Register

    Directory of Open Access Journals (Sweden)

    Siobhan L. Crichton

    2012-01-01

    Full Text Available Background. Evidence-based stroke care should be available to all patients. However, evidence exists of inequalities according to age. This study compared access to care for younger adults to that for over 65s. Methods. Using population-based data from 4229 patients with first-ever stroke between 1995 and 2010, associations between age and 21 care indicators were investigated using multivariable logistic regression. Results. Age was not associated with stroke unit admission for ischaemic stroke (P=0.666. Younger PICH patients were least likely to be admitted to stroke units (P=0.001, instead treated on neurosurgical or ICU wards. Younger age was also associated with admission to neurosurgery or ICU after SAH (P=0.006, increased occupational or physiotherapy at 1 year (P=0.043, and contact with a GP 3 months after stroke (P<0.001. Conclusion. Younger patients have equal or greater access to evidence-based care. However, there is a need to ensure that services meet the needs of this group.

  20. Physical activity across the life-span: Does feeling physically younger help you to plan physical activities?

    Science.gov (United States)

    Wienert, Julian; Gellert, Paul; Lippke, Sonia

    2017-03-01

    We tested whether the relationship between subjective physical age and physical activity is mediated by planning. Participants came from a broad age range (25-78 years, M = 39.57, standard deviation = 10.75) and reported relatively good health ( M = 3.36, standard deviation = 0.90). The model supported the suggested mediation ( β = -.01, standard error = .01, p = .042). Feeling physically younger is associated with higher planning to adopt higher levels of physical activity and more planning is associated with more subsequent physical activity. Results open avenues for interventions that help people to become more active by focusing on subjective age. One way to do so might be tailoring approaches for interventions.

  1. Comparison of the Risk Factor Profile, Stroke Subtypes, and Outcomes Between Stroke Patients Aged 65 Years or Younger and Elderly Stroke Patients: A Hospital-based Study

    Directory of Open Access Journals (Sweden)

    Yi-Min Chen

    2013-12-01

    Conclusion: We conclude that, apart from risk factors and stroke subtypes, the functional outcomes observed in the two groups differed. Early identification of these differences with good management may help to improve the clinical outcomes in younger stroke patients.

  2. Comparison of Patient-Reported Outcome from Neck-Preserving, Short-Stem Arthroplasty and Resurfacing Arthroplasty in Younger Osteoarthritis Patients

    Directory of Open Access Journals (Sweden)

    Marius Dettmer

    2015-01-01

    Full Text Available Hip resurfacing has been considered a good treatment option for younger, active osteoarthritis patients. However, there are several identified issues concerning risk for neck fractures and issues related to current metal-on-metal implant designs. Neck-preserving short-stem implants have been discussed as a potential alternative, but it is yet unclear which method is better suited for younger adults. We compared hip disability and osteoarthritis outcome scores (HOOS from a young group of patients (n=52, age 48.9 ± 6.1 years who had received hip resurfacing (HR with a cohort of patients (n=73, age 48.2 ± 6.6 years who had received neck-preserving, short-stem implant total hip arthroplasty (THA. Additionally, durations for both types of surgery were compared. HOOS improved significantly preoperatively to last followup (>1 year in both groups (p<0.0001, η2=0.69; there were no group effects or interactions. Surgery duration was significantly longer for resurfacing (104.4 min ± 17.8 than MiniHip surgery (62.5 min ± 14.8, U=85.0, p<0.0001, η2=0.56. The neck-preserving short-stem approach may be preferable to resurfacing due to the less challenging surgery, similar outcome, and controversy regarding resurfacing implant designs.

  3. Reduced solar activity as a trigger for the start of the Younger Dryas?

    NARCIS (Netherlands)

    Renssen, H; van Geel, B; van der Plicht, J; Magny, M

    2000-01-01

    It is generally assumed that changes in ocean circulation forced the abrupt climate changes during the Late Pleistocene, including the Younger Dryas event. Recently, however, it was proposed that variations in solar irradiance could have played a much more prominent role in forcing Pleistocene clima

  4. Relationship of blood pressure, behavioral mood state, and physical activity following caffeine ingestion in younger and older women.

    Science.gov (United States)

    Arciero, Paul J; Ormsbee, Michael J

    2009-08-01

    The purpose of this study was to examine the age-related differences in blood pressure, heart rate, and behavioral mood state after caffeine ingestion in younger and older women. Using a placebo-controlled, double-blind design, 10 younger (Y; 18-22 years) and 10 older (O; 50-67 years) healthy women who were moderate consumers of caffeine (self-reported mean intake: Y, 139 +/- 152 mg.day-1; O, 204 +/- 101 mg.day-1) were investigated. All volunteers were characterized for fasting plasma glucose, insulin, free-fatty acids and caffeine levels, body composition, cardiovascular fitness, physical activity, and energy intake. Before and after placebo and caffeine ingestion (5 mg.kg-1 fat-free mass; approximately 208-270 mg) test days, the following variables were measured in all subjects: plasma caffeine levels, heart rate, blood pressure, and behavioral mood state. Results showed that, following caffeine ingestion: (i) both systolic and diastolic blood pressure (SBP and DBP, respectively) increased significantly (p older women (SBP, 128.4 +/- 14.2 vs. 132.1 +/- 13.0 mm Hg (3%); DBP, 80.2 +/- 6.9 vs. 83.4 +/- 7.5 mm Hg (4%), whereas only DBP increased in the younger women (67.1 +/- 4.7 vs. 69.9 +/- 5.4 mm Hg (4.2%); p older women. Self-reported level of physical activity was inversely related to change in DBP following caffeine ingestion in younger women. In conclusion, blood pressure response is augmented and subjective feelings of behavioral mood state are attenuated to a greater degree in older than in younger women following acute caffeine ingestion. Less physically active younger women are more vulnerable to the pressor response to caffeine than more active younger women. It should be noted that these findings are limited to moderate consumers of caffeine who abstained for 48 h prior to testing, and who ingested caffeine in pill form (approximately 240 mg).

  5. Cannabis use patterns and motives: A comparison of younger, middle-aged, and older medical cannabis dispensary patients.

    Science.gov (United States)

    Haug, Nancy A; Padula, Claudia B; Sottile, James E; Vandrey, Ryan; Heinz, Adrienne J; Bonn-Miller, Marcel O

    2017-09-01

    Medical cannabis is increasingly being used for a variety of health conditions as more states implement legislation permitting medical use of cannabis. Little is known about medical cannabis use patterns and motives among adults across the lifespan. The present study examined data collected at a medical cannabis dispensary in San Francisco, California. Participants included 217 medical cannabis patients who were grouped into age-defined cohorts (younger: 18-30, middle-aged: 31-50, and older: 51-72). The age groups were compared on several measures of cannabis use, motives and medical conditions using one-way ANOVAs, chi-square tests and linear regression analyses. All three age groups had similar frequency of cannabis use over the past month; however, the quantity of cannabis used and rates of problematic cannabis use were higher among younger users relative to middle-aged and older adults. The association between age and problematic cannabis use was moderated by age of regular use initiation such that earlier age of regular cannabis use onset was associated with more problematic use in the younger users, but not among older users. Middle-aged adults were more likely to report using medical cannabis for insomnia, while older adults were more likely to use medical cannabis for chronic medical problems such as cancer, glaucoma and HIV/AIDS. Younger participants reported cannabis use when bored at a greater rate than middle-aged and older adults. Findings suggest that there is an age-related risk for problematic cannabis use among medical cannabis users, such that younger users should be monitored for cannabis use patterns that may lead to deleterious consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Cannabis Use Patterns and Motives: A Comparison of Younger, Middle-Aged, and Older Medical Cannabis Dispensary Patients

    Science.gov (United States)

    Haug, Nancy A.; Padula, Claudia B.; Sottile, James E.; Vandrey, Ryan; Heinz, Adrienne J.; Bonn-Miller, Marcel O.

    2017-01-01

    Introduction Medical cannabis is increasingly being used for a variety of health conditions as more states implement legislation permitting medical use of cannabis. Little is known about medical cannabis use patterns and motives among adults across the lifespan. Methods The present study examined data collected at a medical cannabis dispensary in San Francisco, California. Participants included 217 medical cannabis patients who were grouped into age-defined cohorts (younger: 18–30, middle-aged: 31–50, and older: 51–72). The age groups were compared on several measures of cannabis use, motives and medical conditions using one-way ANOVAs, chi-square tests and linear regression analyses. Results All three age groups had similar frequency of cannabis use over the past month; however, the quantity of cannabis used and rates of problematic cannabis use were higher among younger users relative to middle-aged and older adults. The association between age and problematic cannabis use was moderated by age of regular use initiation such that earlier age of regular cannabis use onset was associated with more problematic use in the younger users, but not among older users. Middle-aged adults were more likely to report using medical cannabis for insomnia, while older adults were more likely to use medical cannabis for chronic medical problems such as cancer, glaucoma and HIV/AIDS. Younger participants reported cannabis use when bored at a greater rate than middle-aged and older adults. Conclusions Findings suggest that there is an age-related risk for problematic cannabis use among medical cannabis users, such that younger users should be monitored for cannabis use patterns that may lead to deleterious consequences. PMID:28340421

  7. An fMRI comparison of neural activity associated with recognition of familiar melodies in younger and older adults

    Directory of Open Access Journals (Sweden)

    Ritu eSikka

    2015-10-01

    Full Text Available Several studies of semantic memory in non-musical domains involving recognition of items from long-term memory have shown an age-related shift from the medial temporal lobe structures to the frontal lobe. However, the effects of aging on musical semantic memory remain unexamined. We compared activation associated with recognition of familiar melodies in younger and older adults. Recognition follows successful retrieval from the musical lexicon that comprises a lifetime of learned musical phrases. We used the sparse-sampling technique in fMRI to determine the neural correlates of melody recognition by comparing activation when listening to familiar versus unfamiliar melodies, and to identify age differences. Recognition-related cortical activation was detected in the right superior temporal, bilateral inferior and superior frontal, left middle orbitofrontal, bilateral precentral, and left supramarginal gyri. Region-of-interest analysis showed greater activation for younger adults in the left superior temporal gyrus and for older adults in the left superior frontal, left angular, and bilateral superior parietal regions. Our study provides powerful evidence for these musical memory networks due to a large sample (N = 40 that includes older adults. This study is the first to investigate the neural basis of melody recognition in older adults and to compare the findings to younger adults.

  8. A pilot study assessing social support among cancer patients enrolled on clinical trials: a comparison of younger versus older adults

    Directory of Open Access Journals (Sweden)

    Paul J Novotny

    2010-05-01

    Full Text Available Paul J Novotny1, Denise J Smith1, Lorna Guse2, Teresa A Rummans3, Lynn Hartmann4, Steven Alberts4, Richard Goldberg5, David Gregory6, Mary Johnson7, Jeff A Sloan11Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 2Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada; 3Psychiatry, Mayo Clinic, Rochester, MN, USA; 4Medical Oncology, Mayo Clinic, Rochester, MN, USA; 5Oncology Services, University of North Carolina, Chapel Hill, NC, USA; 6Faculty of Health Sciences Nursing, University of Lethbridge, Lethbridge, Alberta, Canada; 7Chaplain Services, Mayo Clinic, Rochester, MN, USAPurpose: This study tested the logistical feasibility of obtaining data on social support systems from cancer patients enrolled on clinical trials and compared the social support of older adults (age ≥65 and younger adults (<50 years of age with cancer.Methods: Patients had to be eligible for a phase II or phase III oncology clinical trial and enter the study prior to treatment. Patients filled out the Lubben Social Network Scale (LSNS at baseline. The Symptom Distress Scale (SDS and single-item overall quality of life (QOL Uniscale were assessed at baseline and weekly for 4 weeks.Results: There was no significant difference in overall mean Lubben social support levels by age. Older patients had more relatives they felt close to (85% versus 53% with 5 or more relatives, P = 0.02, heard from more friends monthly (84% versus 53% with 3 or more friends, P = 0.02, less overall symptom distress (P = 0.03, less insomnia (P = 0.003, better concentration (P = 0.005, better outlook (P = 0.01, and less depression (P = 0.005 than younger patients.Conclusions: Younger subjects reported worse symptoms, a smaller social support network, and fewer close friends and relatives than older subjects. Having someone to discuss decisions and seeing friends or relatives often was associated with longer survival. Keywords: social support, Lubben scale, QOL, elderly

  9. Elderly patients have similar short term outcomes and five-year survival compared to younger patients after pancreaticoduodenectomy.

    Science.gov (United States)

    Shamali, Awad; De'Ath, Henry D; Jaber, Bashar; Abuawad, Mahmoud; Barbaro, Salvatore; Hamaday, Zaed; Abu Hilal, Mohammad

    2017-09-01

    Outcomes following pancreaticoduodenectomy (PD) in elderly patients in the United Kingdom (UK) remain uncertain. This study aimed to analyse peri-operative outcomes in the elderly, and investigate the impact of age on five-year survival following PD in a UK tertiary centre. All patients who underwent PD in a single Hepatobiliary and Pancreatic unit in the UK between January 2007 to December 2015 were analysed from a prospectively collected database. Individuals were divided into two groups (Group A years and Group B ≥ 75 years "elderly") and outcomes compared. Five hundred and twenty-four patients were included (Group A n = 422, Group B n = 102). Post-operative cardiac events and peri-operative mortality were higher in the elderly (10.8 vs 3.6%, p = 0.008 and 5.9 vs 1.9%, 0.037, respectively). Multivariate analysis revealed only ASA score (OR 0.279, 95% CI 0.063-1.130), post-pancreatectomy haemorrhage (OR 0.055, 95% CI 0.006-0.518) and pulmonary embolism (OR 0.03, 95% CI 0.00-0.148) as independent risk factors for peri-operative mortality. Age was not (OR 0.978, 95% CI 0.911-1.049). Median survival was 22 months in Group A and 19 months in Group B (p = 0.165). Predictors of five-year survival included vascular resection (OR 0.171, 95% CI 0.053-0.549), positive margin (OR 0.256, 95% CI 0.102-0.641), lympho-vascular invasion (OR 0.392, 95% CI 0.160-0.958) and lymph node ratio (OR 67.381, 95% CI 3.301-1375.586), but not age (OR 1.012, 95% CI 0.972-1.054). Older patients have similar peri-operative outcomes and five-year survival compared to younger counterparts after PD in a UK tertiary centre, and should be considered for surgical resection of pancreatic and periampullary cancers. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Computed tomography-guided percutaneous radiofrequency thermocoagulation for primary trigeminal neuralgia in older and younger patients

    Institute of Scientific and Technical Information of China (English)

    Guanghui Lai; Jiaxiang Ni; Baishan Wu; Mingwei He; Liqiang Yang; Jianning Yue; Yuna Guo

    2011-01-01

    We evaluated the immediate and long-term clinical efficacy of computed tomography (CT)-guided radiofrequency thermocoagulation for primary trigeminal neuralgia (RTPTN) in 852 patients includ-ing 502 patients aged ≥ 60 years and 350 patients aged < 60 years. After discharge, the incidence of complications was 1.0% and 0.9% in patients aged ≥ 60 years and patients aged < 60 years, respectively. Over 3-year follow-up after CT-guided RTPTN, 96.8% of the patients aged ≥ 60 years and 98.6% of the patients aged < 60 years were completely pain-free, and there was no significant difference between these two age brackets. In addition, there were no significant differences in quality of life scores and numbness scores between these two age brackets. These findings suggest that CT-guided RTPTN is a safe and effective method and is recommended for older and poor-risk patients.

  11. Diagnosis of colon cancer differs in younger versus older patients despite similar complaints.

    Science.gov (United States)

    Ben-Ishay, Offir; Brauner, Eran; Peled, Zvi; Othman, Amira; Person, Benjamin; Kluger, Yoram

    2013-06-01

    Colon cancer is common, affecting mostly older people. Since age is a risk factor, young patients might not be given the same attention as older ones regarding symptoms that could imply the presence of colon cancer. To investigate whether young patients, i.e., under age 50, complain of symptoms for longer than older patients until the diagnosis of colon cancer is established. In this retrospective cohort study, patients were divided into two groups: or = 50 (group 2). All had undergone surgery for left or right-colon cancer during the 10 year period of the study from January 2000 through December 2009 at one medical center. Rectal and sigmoid cancers were excluded. Data collected included age, geander, quantity and quality of complaints, duration of complaints, in-hospital versus community diagnosis, pathological staging, the side of colon involved, and overall mortality. The primary outcome was the quality and duration of complaints. Secondary outcomes were the pathological stage at presentation and the mortality rate. The study group comprised 236 patients: 31 (13.1%) were or = 50. No significant difference was found in the quantity and quality of complaints between the two groups. Patients in group 1 (colon cancer later, at a more advanced stage. Alertness to patients' complaints, together with evaluation regardless of age but according to symptoms and clinical presentation are crucial. Large-scale population-based studies are needed to confirm this trend.

  12. Cementless acetabular fixation in patients 50 years and younger at 10 to 18 years of follow-up.

    Science.gov (United States)

    Teusink, Matthew J; Callaghan, John J; Warth, Lucian C; Goetz, Devon D; Pedersen, Douglas R; Johnston, Richard C

    2012-08-01

    The purpose of the study was to evaluate the 10- to 18-year follow-up of cementless acetabular fixation in patients 50 years and younger. We retrospectively reviewed a consecutive group of 118 patients (144 hips) in whom primary total hip arthroplasty had been performed by 2 surgeons using a cementless acetabular component. Two (1.4%) cementless acetabular components were revised because of aseptic loosening. Twenty-four hips (16.7%) were revised for any mechanical failure of the acetabular component mostly related to acetabular liner wear and osteolysis. The average linear wear rate was 0.19 mm per year, which was higher than our previous reports with cemented acetabular fixation. The fiber mesh ingrowth surface of the cementless acetabular component in this study was superior to cemented acetabular components in terms of fixation. However, the high rates of wear and osteolysis have led to poor overall acetabular component construct survivorship.

  13. Greater Resting Lumbar Extensor Myofascial Stiffness in Younger Ankylosing Spondylitis Patients Than Age-Comparable Healthy Volunteers Quantified by Myotonometry.

    Science.gov (United States)

    Andonian, Brian J; Masi, Alfonse T; Aldag, Jean C; Barry, Alexander J; Coates, Brandon A; Emrich, Katherine; Henderson, Jacqueline; Kelly, Joseph; Nair, Kalyani

    2015-11-01

    To quantify resting lumbar erector myofascial stiffness in younger patients with ankylosing spondylitis (AS) and age-comparable healthy control subjects using a handheld mechanical impulse-based myotonometric device. A case-control study of 24 patients with AS and 24 age-comparable healthy control subjects. University physical therapy department. Patients with AS (men: n=19; women: n=5; total: N=24) and healthy volunteers (men: n=19; women: n=5; total: N=24) without low back pain (age range, 18-46y). Not applicable. Lumbar myofascial stiffness. At the initial measurements, median stiffness (Nm) of the averaged right- and left-sided values was greater (P=.021) in 24 patients with AS than 24 control subjects (268.9 vs 238.9, respectively). Repeated measurements after a 10-minute prone resting period were also greater (P=.007) in patients with AS than control subjects (281.0 vs 241.4, respectively). The 48 averaged right- and left-sided values from baseline and 10-minute measurements were compared in each subject group. The patients with AS more frequently (P=.012) had stiffness values >250 Nm (35 [72.9%] vs 22 [45.8%] in control subjects). Lumbar myofascial stiffness was greater in 24 patients with AS than in the control subjects. A hypothesized biomechanical concept of increased resting lumbar myofascial stiffness in AS may be supported by this preliminary controlled study. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Total Knee Arthroplasty in Younger Patients Evaluated by Alternative Outcome Measures

    DEFF Research Database (Denmark)

    Klit, Jakob; Jacobsen, Steffen; Rosenlund, Signe

    2014-01-01

    of sexual life. Questionnaires including Oxford Knee Score (OKS) and SF-36 were evaluated preoperatively and three, six, and twelve months postoperatively. OKS and SF-36 showed significant improvements. However, patient satisfaction and fulfillment of personal expectations did not reflect these scores....... Overall, TKA did not affect the patients’ socioeconomic status, and overall, patients did not experience impairment of sexual life, but decreased frequency and negative affection of sexual practice should be anticipated. Alternative outcome measurements of TKA surgery not focusing on implants and surgical...... techniques shed new light on important consequences of replacement surgery....

  15. Income and education as predictors of return to working life among younger stroke patients

    Directory of Open Access Journals (Sweden)

    Kåreholt Ingemar

    2011-09-01

    Full Text Available Abstract Background Socioeconomic conditions are not only related to poor health outcomes, they also contribute to the chances of recovery from stroke. This study examines whether income and education were predictors of return to work after a first stroke among persons aged 40-59. Methods All first-stroke survivors aged 40-59 who were discharged from a hospital in 1996-2000 and who had received income from work during the year prior to the stroke were sampled from the Swedish national register of in-patient care (n = 7,081. Income and education variables were included in hazard regressions, modelling the probability of returning to work from one to four years after discharge. Adjustments for age, sex, stroke subtype, and length of in-patient care were included in the models. Results Both higher income and higher education were associated with higher probability of returning to work. While the association between education and return to work was attenuated by income, individuals with university education were 13 percent more likely to return than those who had completed only compulsory education, and individuals in the highest income quartile were about twice as likely to return as those in the lowest. The association between socioeconomic position and return to work was similar for different stroke subtypes. Income differences between men and women also accounted for women's lower probability of returning to work. Conclusions The study demonstrates that education and income were independent predictors of returning to work among stroke patients during the first post-stroke years. Taking the relative risk of return to work among those in the higher socioeconomic positions as the benchmark, there may be considerable room for improvement among patients in lower socioeconomic strata.

  16. Nonapnea Sleep Disorders in Patients Younger than 65 Years Are Significantly Associated with CKD: A Nationwide Population-Based Study.

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    Hugo You-Hsien Lin

    Full Text Available Nonapnea sleep disorders (NASD and sleep-related problems are associated with poor health outcomes. However, the association between NASD and the development and prognosis of chronic kidney disease (CKD has not been investigated thoroughly. We explored the association between CKD and NASD in Taiwan.We conducted a population-based study using the Taiwan National Health Insurance database with1,000,000 representative data for the period from January 1, 2000 to December 31, 2009. We investigated the incidence and risk of CKD in 7,006 newly diagnosed NASD cases compared with 21,018 people without NASD matched according to age, sex, index year, urbanization, region, and monthly income at a 1:3 ratio.The subsequent risk of CKD was 1.48-foldhigher in the NASD cohort than in the control cohort (95% confidence interval [CI] = 1.26-1.73, p< 0.001. Men, older age, type 2 diabetes mellitus, and gout were significant factors associated with the increased risk of CKD (p< 0.001. Among different types of NASDs, patients with insomnia had a 52% increased risk of developing CKD (95%CI = 1.23-1.84; P<0.01, whereas patients with sleep disturbance had a 49%increased risk of subsequent CKD (95% CI = 1.19-1.87; P<0.001. Younger women (aged < 65 years were at a high risk of CKD with NASD (adjusted hazard ratio, [HR] = 1.81; 95% CI = 1.35-2.40, p< 0.001.In this nationwide population-based cohort study, patients with NASD, particularly men of all ages and women aged younger than 65 years, were at high risk of CKD.

  17. Hereditary risk factors for the development of gastric cancer in younger patients

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    Akbari Mohammad

    2004-10-01

    Full Text Available Abstract Background It is believed that the development of gastric cancer (GC before the age of 50 has a hereditary basis. Blood group A and history of gastric cancer in first-degree relatives have been shown to be risk factors for GC. Methods In this case-control study, we enrolled patients with GC who were diagnosed before the age of 50. Patients who were diagnosed as having GC were selected. A total of 534 cases were found; of these, 44 diagnosed before the age of 50 were included in the case group. For the control group, 22 males and 22 females were randomly selected from the remaining subjects, who had diagnoses of GC after the age of 50. All the surviving patients and family members of the dead patients were interviewed about the history of cancer in the family and the age at which other family members developed cancer. The blood group of each subject was also obtained. Results forty-four cases under 50 years old (mean age: 36.2 years and forty-four controls (mean age: 67.1 years were enrolled in the study. At the time of the study, 59.1% of the study group and 50% of the control group were alive (P value = NS. In the study group, 68.1%, 13.6%, 13.6% and 4.5% had blood groups O, A, B and AB, respectively. In the control group the corresponding figures were 27.7%, 63.6%, 6.8% and 4.5%. First or second-degree relatives with cancer, including gastric (the most frequent, breast, lung, gynecological and hematological malignancies, were noted in 54.5% of the cases and 11.4% of the controls (p Conclusions It seems that the development of GC before the age of 50 is likely to be accompanied by familial susceptibility. Interestingly, our study showed a significant correlation between blood group O and the development of gastric cancer under the age of 50.

  18. Elderly Peritoneal Dialysis Compared with Elderly Hemodialysis Patients and Younger Peritoneal Dialysis Patients: Competing Risk Analysis of a Korean Prospective Cohort Study.

    Science.gov (United States)

    Kim, Hyunsuk; An, Jung Nam; Kim, Dong Ki; Kim, Myoung-Hee; Kim, Ho; Kim, Yong-Lim; Park, Ki Soo; Oh, Yun Kyu; Lim, Chun Soo; Kim, Yon Su; Lee, Jung Pyo

    2015-01-01

    The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50~64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (Pelderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients.

  19. Elderly Peritoneal Dialysis Compared with Elderly Hemodialysis Patients and Younger Peritoneal Dialysis Patients: Competing Risk Analysis of a Korean Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Hyunsuk Kim

    Full Text Available The outcomes of peritoneal dialysis (PD in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830, patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI scores of elderly PD patients (≥65 years, n = 95 were compared with those of PD patients aged ≤49 years (n = 205 and 50~64 years (n = 192; and elderly hemodialysis (HD patients (n = 315. The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001. However, the technical survival rate was similar (P = 0.097. Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987. Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003. Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients.

  20. TP53 mutations identify younger mantle cell lymphoma patients who do not benefit from intensive chemoimmunotherapy

    DEFF Research Database (Denmark)

    Eskelund, Christian W; Dahl, Christina; Hansen, Jakob W

    2017-01-01

    Despite recent advances in lymphoma treatment, mantle cell lymphoma (MCL) remains incurable and we are still unable to identify patients who will not benefit from the current standard-of-care. Here, we explore the prognostic value of recurrent genetic aberrations in diagnostic bone marrow (BM...... to relapse. TP53-mutated cases had a dismal outcome with a median OS of 1.8 years and 50% relapsed at 1.0 years (compared to not reached (NR) and 12.7 years, respectively, for TP53-unmutated cases, p30%, blastoid morphology, MIPI high......-risk and inferior responses to both induction- and high-dose chemotherapy. In conclusion, we show that TP53 mutations identify a phenotypically distinct and highly aggressive form of MCL with poor or no response to regimens including cytarabine, rituximab and autologous stem-cell transplant (ASCT). We suggest...

  1. Allograft anterior cruciate ligament reconstruction in patients younger than 30 years: a matched-pair comparison of bone-patellar tendon-bone and tibialis anterior.

    Science.gov (United States)

    O'Brien, Daniel F; Kraeutler, Matthew J; Koyonos, Loukas; Flato, Russell R; Ciccotti, Michael G; Cohen, Steven B

    2014-03-01

    We conducted a study to compare patient-reported outcomes and graft-rupture rates of bone-patellar tendon-bone (BPTB) and tibialis anterior (TA) allograft primary anterior cruciate ligament (ACL) reconstruction in patients younger than 30 years. Patients were retrospectively identified as having undergone ACL reconstruction with either a BPTB (n = 20) or a TA (n = 20) allograft. Each patient in the BPTB group was matched to a patient in the TA group based on sex, age at time of surgery, height, weight, and preoperative activity level. The Lysholm Knee Scoring Scale and the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form were administered at a minimum of 1 year after surgery. Mean Lysholm scores were 92.9 (BPTB) and 93.0 (TA), and mean IKDC scores were 92.6 (BPTB) and 90.3 (TA). The differences were not statistically significant. Overall graft-rupture rates for the study period were 4.7% (BPTB) and 1.9% (TA) (P = .18). There was no statistically significant difference in patient-rated outcomes and graft-rupture rates between BPTB and TA allografts for ACL reconstruction at a minimum of 1 year after surgery. Future research efforts should focus on mid- and long-term follow-up and objective outcomes.

  2. Pancreatic-specific autoantibodies to glycoprotein 2 mirror disease location and behaviour in younger patients with Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Bogdanos Dimitrios P

    2012-08-01

    Full Text Available Abstract Background Glycoprotein 2 (GP2 was discovered as the major autoantigen of Crohn’s disease (CD-specific pancreatic autoantibodies (PAB. We investigated anti-GP2 IgA and IgG antibodies as novel serological parameters in CD and assessed their association with distinct disease phenotypes. Methods Anti-GP2 and anti-Saccharomyces cerevisiae (ASCA IgA and IgG were detected by ELISA employing recombinant human GP2 and phosphopeptidomannan, respectively and PAB by indirect immunofluorescence (IIF in 271 sera, 169 with CD and 102 with ulcerative colitis (UC. As healthy controls 160 adult blood donors and 65 children were included. Results Anti-GP2 IgG and/or IgA were more prevalent in CD (51/169, 30.2% than in UC (9/102, 8.9% patients and in controls (9/225, 4% (p  Conclusions Anti-GP2 IgG and IgA, constituting novel CD specific autoantibodies, appear to be associated with distinct disease phenotypes identifying patients at a younger age, with ileocolonic location, and stricturing behaviour with perianal disease.

  3. DEXAMETHASONE IMPLANT FOR MACULAR EDEMA SECONDARY TO CENTRAL RETINAL VEIN OCCLUSION IN PATIENTS YOUNGER THAN 50 YEARS.

    Science.gov (United States)

    Battaglia Parodi, Maurizio; Iacono, Pierluigi; Sacconi, Riccardo; Parravano, Mariacristina; Varano, Monica; Bandello, Francesco

    2015-07-01

    To evaluate the effects of dexamethasone implant for macular edema secondary to central retinal vein occlusion in patients younger than 50 years. Patients with no previous treatment, macular edema with central foveal thickness >250 μm and best-corrected visual acuity between 1.30 LogMAR and 0.30 LogMAR were prospectively recruited for a 12-month follow-up study. After baseline dexamethasone implant, re-treatment was performed starting from the fourth month if a best-corrected visual acuity deterioration with central foveal thickness >250 μm occurred after an initial improvement. The primary outcome was the change in the best-corrected visual acuity. Secondary outcomes included the proportion of eyes gaining at least 3 Early Treatment Diabetic Retinopathy Study lines, the change in the central foveal thickness, and the number of treatments. Mean best-corrected visual acuity changed significantly from 0.60 ± 0.38 LogMAR at baseline to 0.43 ± 0.48 at the 12-month examination (P = 0.03). Eight of 16 eyes (50%) gained 3 Early Treatment Diabetic Retinopathy Study lines. Mean central foveal thickness improved significantly from 705 ± 202 μm at baseline to 408 ± 196 μm at 12-month visit (P central retinal vein occlusion.

  4. Comparison of Outcome of Femoral Shaft Fracture Fixation with Intramedullary Nail in Elderly Patient and Patients Younger than 60 Years Old

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    Asgar Elmi

    2014-06-01

    Full Text Available Background:   Although intramedullary nailing (IMN is an established and accepted operative treatment for femoral shaft fracture in patients younger than 60, there is a lack of data on the results of this treatment on those over 60. The purpose of this study was to determine if the outcome of IMN for femoral shaft fracture in elderly patients is also acceptable. Particular challenges in this group of patients included osteopenia and other associated multiple medical problems frequently observed. Methods: The outcome of 84 patients who had IMN for femoral shaft fracture was reviewed and the results were compared between two groups of patients (younger than 60 and over 60 year old patients. Complications and mortality was analyzed for each group, and then compared between the two groups by testing the null hypothesis that the outcome of treatment in the two groups are similar (P>0.05. Results: The mean duration of follow up was 57.3 months (range: 10-94 months. Incidence of malunion, nonunion, infection, DVT, and dependence on walker/crutch in the groups were similar and differences were not significant (P>0.05. However, incidence of mortality (P

  5. Age-Related Differences in the Effect of Psychological Distress on Mortality: Type D Personality in Younger versus Older Patients with Cardiac Arrhythmias

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    Johan Denollet

    2013-01-01

    Full Text Available Background. Mixed findings in biobehavioral research on heart disease may partly be attributed to age-related differences in the prognostic value of psychological distress. This study sought to test the hypothesis that Type D (distressed personality contributes to an increased mortality risk following implantable cardioverter defibrillator (ICD treatment in younger patients but not in older patients. Methods. The Type D Scale (DS14 was used to assess general psychological distress in 455 younger (≤70 y,. Cardiac resynchronization therapy (CRT, but not Type D personality, was associated with increased mortality in older patients. Among younger patients, however, Type D personality was associated with an adjusted hazard ratio = 1.91 (95% CI 1.09–3.34 and 2.26 (95% CI 1.16–4.41 for all-cause and cardiac mortality; other predictors were increasing age, CRT, appropriate shocks, ACE-inhibitors, and smoking. Conclusion. Type D personality was independently associated with all-cause and cardiac mortality in younger ICD patients but not in older patients. Cardiovascular research needs to further explore age-related differences in psychosocial risk.

  6. Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score.

    Science.gov (United States)

    Li, Dana; Troelsen, A; Ingelsrud, L; Husted, H; Gromov, K

    2017-02-16

    The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this study was to identify possible factors that may explain the variance of pre-operative FJS levels and evaluate the relationship between pre-operative FJS and pre-operative Oxford Knee Score (OKS). Four-hundred and six individual knees undergoing primary TKA between 2014 and 2016 were included in the study. Age, gender, body mass index (BMI), pre-operative FJS and pre-operative OKS were obtained maximum 2 weeks prior to surgery. Kellgren-Lawrence (K-L) grade, alignment and joint space width (JSW) were evaluated on pre-operative radiographs. Mean FJS was 21.1 ± 15.6. Females, younger patients and patients with high BMI had significantly the worst pre-operative FJS (p < 0.005). Females scored 6.5 FJS points lower than males. A 0.2-point increase in FJS for every added year indicated improvement in knee awareness with age. A 0.4-point decrease in FJS points for every added BMI point indicated worse knee awareness with higher BMI. There was a strong positive correlation between pre-operative FJS and pre-operative OKS according to the Spearman's rank order test (p < 0.005). Females, younger patients and patients with high BMI had significantly the worst pre-operative joint awareness. FJS had a strong positive correlation to OKS in pre-operative patients for primary TKA. This information can be used for improved patient selection; clinically continuous low FJS despite weight loss and/or the passing of time may be indication for TKA. Prospective cohort study, Level II.

  7. Younger Age Is Associated with Poorer Survival in Patients with Signet-Ring Cell Carcinoma of the Colon without Distant Metastasis

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    Ben Huang

    2016-01-01

    Full Text Available Background. In general, younger age is associated with better survival in patients with colon cancer. In this study, we aim to analyze the impact of age on cancer-specific survival (CSS in patients with signet-ring cell carcinoma (SRCC of the colon, a particularly aggressive type of colon cancer. Methods. Information on patients with SRCC of the colon with no distant metastasis was extracted from the US Surveillance, Epidemiology, and End Results (SEER database. An X-tile plot was used to determine the optimal cutoff age at diagnosis. Results. A total of 776 patients were included in data analysis. The X-tile program revealed an optimal cutoff at 35 years of age. A higher percentage of stage III disease and a higher percentage of N2 disease were observed in patients ≤ 35 years of age. The multivariate Cox proportional model demonstrated that patients ≤ 35 years of age were more likely to have a poorer survival outcome compared with patients aged >35 years (HR 1.411, 95% CI 1.032–1.929, and P=0.031. Conclusion. In contrast to the association of younger age with better survival in colon cancer patients, younger age (≤35 years is associated with poorer survival outcome in patients with SRCC of the colon without distant metastasis.

  8. Fourth-generation ceramic-on-ceramic total hip arthroplasty in patients of 55 years or younger: short-term results and complications analysis

    Institute of Scientific and Technical Information of China (English)

    Wang Weiguo; Guo Wanshou; Yue Debo; Shi Zhencai; Zhang Nianfei; Liu Zhaohui; Sun Wei

    2014-01-01

    Background The incidence of total hip replacement in the younger and more active patients is ever increasing.The ceramic-on-ceramic (COC) bearing was developed to reduce wear debris-induced osteolysis and loosening and to improve the longevity of hip arthroplasties.Few studies have reported the clinical results and complications of the new zirconia-toughened ceramic total hip arthroplasty (THA).Methods A consecutive series of 132 young patients (177 hips) that underwent primary cementless THAs between January 2010 and December 2012 were included in this study.These arthroplasties all had fourth-generation COC bearings performed through a posterolateral approach.The average age was (41.8±8.3) years (ranging from 22 to 55 years),and the mean follow-up period was (24.5±9.4) months (ranging from 12 to 47 months).The results were evaluated both clinically and radiographically.Harris hip score (HHS) was determined before surgery and at the time of each follow-up.Presence of postoperative groin or thigh pain and squeaking were recorded.Other complications such as dislocations,periprosthetic fractures,and ceramic components fractures were diagnosed and treated in emergency.Results The average HHSs improved from preoperative 60.3±10.7 (ranging from 29 to 76) to 91.0±5.1 (ranging from 74 to 100) at the final follow-up (t=-45.064,P <0.05),and 97.7% of cases were scored as excellent and good results.At the last follow-up,incidental inguinal pain was found in three hips (1.7%) and thigh pain in 11 hips (6.2%).Radiographs showed a high rate of new bone formation around the acetabular and stem components.No obvious osteolysis or prosthesis loosening was detected.Complications occurred in six hips (3.4%):posterior dislocation in two hips (1.1%),periprosthetic femoral fracture in one hip (0.6%),asymptomatic squeaking in two hips (1.1%),and ceramic liner fracture in one hip (0.6%).Conclusions The fourth-generation COC THA showed excellent clinical results in

  9. Fourth-generation ceramic-on-ceramic total hip arthroplasty in patients of 55 years or younger: short-term results and complications analysis.

    Science.gov (United States)

    Wang, Weiguo; Guo, Wanshou; Yue, Debo; Shi, Zhencai; Zhang, Nianfei; Liu, Zhaohui; Sun, Wei; Wang, Bailiang; Li, Zirong

    2014-01-01

    The incidence of total hip replacement in the younger and more active patients is ever increasing. The ceramic-on-ceramic (COC) bearing was developed to reduce wear debris-induced osteolysis and loosening and to improve the longevity of hip arthroplasties. Few studies have reported the clinical results and complications of the new zirconia-toughened ceramic total hip arthroplasty (THA). A consecutive series of 132 young patients (177 hips) that underwent primary cementless THAs between January 2010 and December 2012 were included in this study. These arthroplasties all had fourth-generation COC bearings performed through a posterolateral approach. The average age was (41.8 ± 8.3) years (ranging from 22 to 55 years), and the mean follow-up period was (24.5 ± 9.4) months (ranging from 12 to 47 months). The results were evaluated both clinically and radiographically. Harris hip score (HHS) was determined before surgery and at the time of each follow-up. Presence of postoperative groin or thigh pain and squeaking were recorded. Other complications such as dislocations, periprosthetic fractures, and ceramic components fractures were diagnosed and treated in emergency. The average HHSs improved from preoperative 60.3 ± 10.7 (ranging from 29 to 76) to 91.0 ± 5.1 (ranging from 74 to 100) at the final follow-up (t = 45.064, P acetabular and stem components. No obvious osteolysis or prosthesis loosening was detected. Complications occurred in six hips (3.4%): posterior dislocation in two hips (1.1%), periprosthetic femoral fracture in one hip (0.6%), asymptomatic squeaking in two hips (1.1%), and ceramic liner fracture in one hip (0.6%). The fourth-generation COC THA showed excellent clinical results in younger active patients with no osteolysis-related prosthesis failure at a short-term follow-up study. Surgeons should still be aware of the potential risks of complications such as dislocation, periprosthetic fracture, squeaking, and ceramic components fracture.

  10. FORMATION OF COMMUNICATIVE ABILITIES OF YOUNGER SCHOOL STUDENTS IN TEACHING AND EDUCATIONAL ACTIVITY IN THE CONDITIONS OF CONTINUITY OF FGOS OF HOO AND FGOS TO

    Directory of Open Access Journals (Sweden)

    Ksenia Pavlovna Zaytseva

    2015-12-01

    Full Text Available In this work we will consider features of formation of communicative abilities of younger school students as a basis of their social adaptation. For this purpose we will reveal features of the teaching and educational activity of younger school students creating conditions for formation of their communicative abilities and we will show as the communicative abilities formed in teaching and educational activity can be directed on training of younger school students for social adaptation.Purpose. In the Federal state educational standard of the general education (FGOS of the second generation transition from minimizatsionny approach in education is designated. Communicative abilities are a basis not only productive inclusion of pupils in interpersonal relationship with contemporaries and adults in educational activity, socially important for them, but also basis for an exit in system of broader social relationship with people and the world in general.Methodology. The basis of research is formed by the empirical – studying and the analysis of literature, normative documents and textbooks for elementary school; supervision, poll (oral and written.Results. Results of work consists preparation of methodical ensuring process of formation of communicative abilities of younger school students in teaching and educational activity as bases of their social adaptation: Socialization programs.Practical implications. Results of research can be used by elementary school teachers in teaching and educational activity, and also students when writing theses and carrying out experiment.

  11. High Satisfaction and Return to Sports After Total Shoulder Arthroplasty in Patients Aged 55 Years and Younger.

    Science.gov (United States)

    Garcia, Grant H; Liu, Joseph N; Sinatro, Alec; Wu, Hao-Hua; Dines, Joshua S; Warren, Russell F; Dines, David M; Gulotta, Lawrence V

    2017-06-01

    Young, active candidates for total shoulder arthroplasty (TSA) are a unique group of patients. Not only do they demand longevity and improved function, but they also desire a return to physical activities. To determine the rate of return to sports in patients aged ≤55 years undergoing TSA. Case series; Level of evidence, 4. This was a retrospective review of consecutive patients who underwent anatomic TSA at a single institution. Exclusion criteria included age at the time of surgery >55 years and 55 years). The average VAS score improved from 5.6 to 0.9 ( P 55/57) restarted at least 1 sport at an average of 6.7 months. Direct rates of return were as follows: fitness sports (97.2%), golf (93.3%), singles tennis (87.5%), swimming (77.7%), basketball (75.0%), and flag football (66.7%). Patients in 47 shoulders (82.4%) returned to a similar or higher level of sports; 90.3% returned to high-demand sports, and 83.8% returned to high upper extremity sports. There was no significant difference in rates of return to sports by body mass index, sex, age, preoperative diagnosis, revision status, and dominant extremity. In patients aged ≤55 years undergoing TSA, there was a 96.4% rate of return to ≥1 previous sports at an average of 6.7 months. Furthermore, at an average follow-up of 61.0 months, no patients needed revision of their glenoid component, despite an 83.8% rate of return to high upper extremity sports. While caution should still be advised in young, active patients undergoing TSA, these results demonstrate a high satisfaction rate and improved ability to return to most sports after surgery.

  12. Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain.

    Science.gov (United States)

    Lindau, Stacy Tessler; Abramsohn, Emily; Bueno, Hector; D'Onofrio, Gail; Lichtman, Judith H; Lorenze, Nancy P; Sanghani, Rupa Mehta; Spatz, Erica S; Spertus, John A; Strait, Kelly M; Wroblewski, Kristen; Zhou, Shengfan; Krumholz, Harlan M

    2016-10-01

    Most younger adults who experience an acute myocardial infarction (AMI) are sexually active before the AMI, but little is known about sexual activity or sexual function after the event. To describe patterns of sexual activity and function and identify indicators of the probability of loss of sexual activity in the year after AMI. Data from the prospective, multicenter, longitudinal Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study (conducted from August 21, 2008, to January 5, 2012) were assessed at baseline, 1 month, and 1 year. Participants were from US (n = 103) and Spanish (n = 24) hospitals and completed baseline and all follow-up interviews. Data analysis for the present study was conducted from October 15, 2014, to June 6, 2016. Characteristics associated with loss of sexual activity were assessed using multinomial logistic regression analyses. Loss of sexual activity after AMI. Of the 2802 patients included in the analysis, 1889 were women (67.4%); median (25th-75th percentile) age was 49 (44-52) years (range, 18-55 years). At all time points, 637 (40.4%) of women and 437 (54.9%) of men were sexually active. Among people who were active at baseline, men were more likely than women to have resumed sexual activity by 1 month (448 [63.9%] vs 661 [54.5%]; P year (662 [94.4%] vs 1107 [91.3%]; P = .01) after AMI. Among people who were sexually active before and after AMI, women were less likely than men to report no sexual function problems in the year after the event (466 [40.3%] vs 382 [54.8%]; P year after the AMI. At 1 year, the most prevalent sexual problems were lack of interest (487 [39.6%]) and trouble lubricating (273 [22.3%]) among women and erectile difficulties (156 [21.7%]) and lack of interest (137 [18.8%]) among men. Those who had not communicated with a physician about sex in the first month after AMI were more likely to delay resuming sex (adjusted odds ratio [AOR], 1.51; 95% CI, 1.11-2.05; P = .008

  13. Age-related differences in brain electrical activity during extended continuous face recognition in younger children, older children and adults

    NARCIS (Netherlands)

    J.W. van Strien (Jan); J.C. Glimmerveen (Johanna C.); I.H.A. Franken (Ingmar); V.E. Martens (Vanessa E.G.); E.A. de Bruin (Eveline)

    2011-01-01

    textabstractTo examine the development of recognition memory in primary-school children, 36 healthy younger children (8-9years old) and 36 healthy older children (11-12years old) participated in an ERP study with an extended continuous face recognition task (Study 1). Each face of a series of 30 fac

  14. Age-Related Differences in Brain Electrical Activity during Extended Continuous Face Recognition in Younger Children, Older Children and Adults

    Science.gov (United States)

    Van Strien, Jan W.; Glimmerveen, Johanna C.; Franken, Ingmar H. A.; Martens, Vanessa E. G.; de Bruin, Eveline A.

    2011-01-01

    To examine the development of recognition memory in primary-school children, 36 healthy younger children (8-9 years old) and 36 healthy older children (11-12 years old) participated in an ERP study with an extended continuous face recognition task (Study 1). Each face of a series of 30 faces was shown randomly six times interspersed with…

  15. THE STUDY OF SELF-ATTITUDE OF YOUNGER ADOLESCENTS WITH CHRONIC DISEASES (CASE STUDY OF PATIENTS WITH CHRONIC GLOMERULONEPHRITIS

    Directory of Open Access Journals (Sweden)

    T. V. Sviridova

    2013-01-01

    Full Text Available In order to study self-attitude of younger adolescents with chronic diseases, we examined 86 children with chronic glomerulonephritis and 78 conditionally healthy peers. The average disease duration was 3.5 years. The authors revealed that the level of integral self-attitude, its components (self-esteem, autogenic sympathy, self-interest, expected positive attitude and sets on internal actions towards one’s ego (self-confidence, attitude of other people, self-acceptance, self-interest of younger adolescents with chronic diseases is significantly lower than in healthy peers. Special social situation arising in connection with the disease leads to distorted development of the personality. The adolescent’s personality becomes even more vulnerable to stressful situations, social and psychological deadaptation.

  16. Patterns of structural head injury in children younger than 3 years: a ten-year review of 519 patients.

    Science.gov (United States)

    John, Simon Mathew; Kelly, Patrick; Vincent, Andrea

    2013-01-01

    Abusive head injury is a major contributor to morbidity and mortality in infants and toddlers, but data comparing patterns of injury in corroborated accidental trauma and confessed child abuse are scarce. This is a retrospective review of head injuries with abnormal neuroimaging in children younger than 3 years during a 10-year period in Auckland, New Zealand. Histories were assumed to be true. Results were analyzed for incongruity then compared with data on confessed abuse and corroborated accidental injury. Five hundred nineteen cases were analyzed. Most cases were congruent with the history, and their pattern was consistent with the literature on accidental head trauma in childhood. However, a spike of subdural hemorrhage was seen in the first 6 months of life, explained neither by mechanism nor by published data on birth trauma. The age distribution of retinal hemorrhage was also inconsistent with published data on birth trauma. In infants younger than 6 months, retinal and subdural hemorrhages were associated with the absence of a history of trauma. In older children (6 months-3 years), subdural hemorrhage was more common after minor falls (2 m, 20%) (p = 0.002). We conclude that when a young child (particularly an infant younger than 6 months) presents with traumatic intracranial pathology and either no history of trauma or a history of a minor fall, it must be seriously considered that the history is false. Epidemiologic study, level III.

  17. Age-related differences in brain electrical activity during extended continuous face recognition in younger children, older children and adults.

    Science.gov (United States)

    Van Strien, Jan W; Glimmerveen, Johanna C; Franken, Ingmar H A; Martens, Vanessa E G; de Bruin, Eveline A

    2011-09-01

    To examine the development of recognition memory in primary-school children, 36 healthy younger children (8-9 years old) and 36 healthy older children (11-12 years old) participated in an ERP study with an extended continuous face recognition task (Study 1). Each face of a series of 30 faces was shown randomly six times interspersed with distracter faces. The children were required to make old vs. new decisions. Older children responded faster than younger children, but younger children exhibited a steeper decrease in latencies across the five repetitions. Older children exhibited better accuracy for new faces, but there were no age differences in recognition accuracy for repeated faces. For the N2, N400 and late positive complex (LPC), we analyzed the old/new effects (repetition 1 vs. new presentation) and the extended repetition effects (repetitions 1 through 5). Compared to older children, younger children exhibited larger frontocentral N2 and N400 old/new effects. For extended face repetitions, negativity of the N2 and N400 decreased in a linear fashion in both age groups. For the LPC, an ERP component thought to reflect recollection, no significant old/new or extended repetition effects were found. Employing the same face recognition paradigm in 20 adults (Study 2), we found a significant N400 old/new effect at lateral frontal sites and a significant LPC repetition effect at parietal sites, with LPC amplitudes increasing linearly with the number of repetitions. This study clearly demonstrates differential developmental courses for the N400 and LPC pertaining to recognition memory for faces. It is concluded that face recognition in children is mediated by early and probably more automatic than conscious recognition processes. In adults, the LPC extended repetition effect indicates that adult face recognition memory is related to a conscious and graded recollection process rather than to an automatic recognition process.

  18. Association between fixation technique and revision risk in total hip arthroplasty patients younger than 55 years of age. Results from the Nordic Arthroplasty Register Association

    DEFF Research Database (Denmark)

    Pedersen, A B; Mehnert, F; Havelin, L I;

    2014-01-01

    to Norway, Sweden and Finland. Conclusions: Uncemented implants perform better in relation to long-term risk of aseptic loosening, whereas both uncemented and hybrid rather than cemented implants in patients younger than 55 years had more short-term revisions because problems due to dislocation......, periprosthetic fracture and infection has not yet been completely solved. The vast majority of cup-stem combinations were used in very few operations. (C) 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved....

  19. Clinical Analysis of Lung Cancer Patients Younger Than 30 Years%小于30岁低龄肺癌患者的临床分析

    Institute of Scientific and Technical Information of China (English)

    侯广杰; 张连斌; 初向阳; 王继云

    2011-01-01

    Background and objective It is common recognized that young patients of lung cancer have poor prognosis due to relatively higher malignancy and more invasive growth.In the past most studies on young patients of lung cancer selected patients younger than 40 or 45 years old, and there were few clinical materials for younger patients under 30 years.This study retrospectively described the the disease history, stage, treatment and pathology features of lung cancer patients younger than 30 years and aimed to provide references for these patients.Methods Those patients younger than 30 years, once admitted in the General Hospital of the People's Liberation Army for lung cancer from 1993 to date, were sought in medical record system, and 53 patients were found in total In this group, there were 34 non-small cell lung cancer (NSCLC) patients and 19 small cell lung cacer (SCLC) patients.The male/female ratio was 1.5:1.In the NSCLC patients, there were 27 adenocarcinomas, 6 squamous carcinomas and 1 adenosquamous carcinoma, with no large cell carcinoma involved.In these patients,12 patients received operations while 38 patients got chemo- and/or radiotherapy and 3 quited any treatment.Results There was no death in hospital, however, in the 12 patients who got operation, only 8 patients got complete resection while 4 patients got palliative resection.Conclusion Lung cancer patients younger than 30 years had a high fraction of adenocarcinoma and small cell type pathologically and most of them were in late stage when presenting with symptoms in hospital and would have a dismal prognosis.The routine health examination and early diagnosis should be emphasized to improve the prognosis of these patients.%背景与目的青年肺癌患者肿瘤恶性程度高,侵袭性强,预后差,已成为多数共识.既往对青年肺癌患者的研究多以40岁或45岁为界,而<30岁的低龄肺癌患者临床资料少见报道.本文回顾分析了解放军总医院从1993年至今17

  20. The effects of short-term preoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Vukomanović Aleksandra

    2008-01-01

    third day after the operation the study group was significantly more independent than the control one while performing any basic activities (changing position in bed from supine to side lying, from supine to sitting on the edge of the bed, from sitting to standing, from standing to lying in the bad, standing, walking, using toilet and chair. At discharge the patients from the control group still needed the therapist help for walking up and down stairs (3±1.26, while the patients from the study group performed there activities independently (4.85±0.37 (p ≤ 0.000. Endurance while walking was significantly better in the study group than in the control one. The length of hospital stay after the operation was similar for both groups, but the patients from the study group needed significantly less classes with the therapist (5.2±2.35 vs 6.85±1.14, p ≤ 0.02 during hospital stay. Conclusion. The short-term preoperative program of education with the elements of physical therapy accelerated early functional recovery of patients (younger than 70 immediately after THA and we recommend it for routine use.

  1. 8-year trends in physical activity, nutrition, TV viewing time, smoking, alcohol and BMI: A comparison of younger and older Queensland adults

    Science.gov (United States)

    Duncan, Mitch J.; Schoeppe, Stephanie; Rebar, Amanda L.; Vandelanotte, Corneel

    2017-01-01

    Lifestyle behaviours significantly contribute to high levels of chronic disease in older adults. The aims of the study were to compare the prevalence and the prevalence trends of health behaviours (physical activity, fruit and vegetable consumption, fast food consumption, TV viewing, smoking and alcohol consumption), BMI and a summary health behaviour indicator score in older (65+ years) versus younger adults (18–65 years). The self-report outcomes were assessed through the Queensland Social Survey annually between 2007–2014 (n = 12,552). Regression analyses were conducted to compare the proportion of older versus younger adults engaging in health behaviours and of healthy weight in all years combined and examine trends in the proportion of younger and older adults engaging in health behaviours and of healthy weight over time. Older adults were more likely to meet recommended intakes of fruit and vegetable (OR = 1.43, 95%CI = 1.23–1.67), not consume fast food (OR = 2.54, 95%CI = 2.25–2.86) and be non-smokers (OR = 3.02, 95%CI = 2.53–3.60) in comparison to younger adults. Conversely, older adults were less likely to meet the physical activity recommendations (OR = 0.86, 95%CI = 0.78–0.95) and watch less than 14 hours of TV per week (OR = 0.65, 95%CI = 0.58–0.74). Overall, older adults were more likely to report engaging in 3, or at least 4 out of 5 healthy behaviours. The proportion of both older and younger adults meeting the physical activity recommendations (OR = 0.97, 95%CI = 0.95–0.98 and OR = 0.94, 95%CI = 0.91–0.97 respectively), watching less than 14 hours of TV per week (OR = 0.96, 95%CI = 0.94–0.99 and OR = 0.94, 95%CI = 0.90–0.99 respectively) and who were a healthy weight (OR = 0.95, 95%CI = 0.92–0.99 and OR = 0.96, 95%CI = 0.94–0.98 respectively) decreased over time. The proportion of older adults meeting the fruit and vegetable recommendations (OR = 0.90, 95%CI = 0.84–0.96) and not consuming fast food (OR = 0.94, 95%CI = 0

  2. The effects of divided attention on encoding- and retrieval-related brain activity: A PET study of younger and older adults.

    Science.gov (United States)

    Anderson, N D; Iidaka, T; Cabeza, R; Kapur, S; McIntosh, A R; Craik, F I

    2000-09-01

    Divided attention (DA) disrupts episodic encoding, but has little effect on episodic retrieval. Furthermore, normal aging is associated with episodic memory impairments, and when young adults are made to encode information under DA conditions, their memory performance is reduced and resembles that of old adults working under full attention (FA) conditions. Together, these results suggest a common neurocognitive mechanism by which aging and DA during encoding disrupt memory performance. In the current study, we used PET to investigate younger and older adults' brain activity during encoding and retrieval under FA and DA conditions. In FA conditions, the old adults showed reduced activity in prefrontal regions that younger adults activated preferentially during encoding or retrieval, as well as increased activity in prefrontal regions young adults did not activate. These results indicate that prefrontal functional specificity of episodic memory is reduced by aging. During encoding, DA reduced memory performance, and reduced brain activity in left-prefrontal and medial-temporal lobe regions for both age groups, indicating that DA during encoding interferes with encoding processes that lead to better memory performance. During retrieval, memory performance and retrieval-related brain activity were relatively immune to DA for both age groups, suggesting that DA during retrieval does not interfere with the brain systems necessary for successful retrieval. Finally, left inferior prefrontal activity was reduced similarly by aging and by DA during encoding, suggesting that the behavioral correspondence between these effects is the result of a reduced ability to engage in elaborate encoding operations.

  3. Elderly multiple myeloma patients experience less deterioration in health-related quality of life than younger patients compared to a normative population: a study from the population-based PROFILES registry.

    Science.gov (United States)

    van der Poel, M W M; Oerlemans, S; Schouten, H C; van de Poll-Franse, L V

    2015-04-01

    The objectives of this study were to compare health-related quality of life (HRQOL) between multiple myeloma (MM) patients aged ≤65 and >65 years and to compare this with a normative population. Factors associated with HRQOL were identified. The population-based Eindhoven Cancer Registry was used to select MM patients diagnosed from 1999 to 2010. Patients (n = 289) were invited to complete the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire Multiple Myeloma Module 20 (QLQ-MY20), and 212 patients responded (73 %). Data from the normative population (n = 568) were used for comparison. MM patients >65 years scored better on emotional functioning (p 65 years scored worse on social, physical, and role functioning and on global health/QOL, fatigue, pain, and dyspnea (p < 0.01). Younger patients had worse HRQOL compared to the normative population than elderly patients. Patients with comorbidities reported lower QOL. The longer the time since diagnosis, the better the physical functioning. No major differences in HRQOL were found between younger and older MM patients. Compared to that of the normative population, HRQOL in younger patients was worse than that in older patients. The number of comorbidities and time since diagnosis were associated with HRQOL. MM patients reported that a high symptom burden and therapy should, besides prolonging survival, be aimed at improving HRQOL.

  4. Diagnostic Accuracy of NT-ProBNP for Heart Failure with Sepsis in Patients Younger than 18 Years.

    Directory of Open Access Journals (Sweden)

    Chun-Wang Lin

    Full Text Available This clinical study investigated plasma NT-proBNP levels as a potential predictor of heart failure in pediatric patients with sepsis. Plasma NT-ProBNP levels of 211 pediatric patients with sepsis and 126 healthy children were measured. Patients were stratified as with heart failure (HF or without heart failure (non-HF. Patients were graded as having sepsis, severe sepsis, or septic shock. The optimal cut-off values of plasma NT-ProBNP for heart failure were determined by analyzing the receiver operating characteristic (ROC. In the HF, non-HF and control groups, the median plasma NT-proBNP levels were 3640, 656, and 226 ng/L, respectively. For all patients with sepsis, the optimal diagnostic cut-off value was 1268 ng/L for differentiating heart failure. In the severe sepsis patients and septic shock patients, the optimal diagnostic cut-off values were 1368 ng/L and 1525 ng/L, respectively. This report is the first one to reveal that NT-proBNP may predict heart failure in children with sepsis. It provides an important clinical reference for the diagnosis of heart failure in pediatric patients with sepsis, and enables monitoring septic children for cardiac involvement.

  5. Benefits and Adverse Events in Younger Versus Older Patients Receiving Neoadjuvant Chemotherapy for Osteosarcoma : Findings From a Meta-Analysis

    NARCIS (Netherlands)

    Collins, Marnie; Wilhelm, Miriam; Conyers, Rachel; Herschtal, Alan; Whelan, Jeremy; Bielack, Stefan; Kager, Leo; Kuehne, Thomas; Sydes, Matthew; Gelderblom, Hans; Ferrari, Stefano; Picci, Piero; Smeland, Sigbjorn; Eriksson, Mikael; Petrilli, Antonio Sergio; Bleyer, Archie; Thomas, David M.

    2013-01-01

    Purpose The LIVESTRONG Young Adult Alliance has conducted a meta-analysis of individual patient data from prospective neoadjuvant chemotherapy osteosarcoma studies and registries to examine the relationships of sex, age, and toxicity on survival. Patients and Methods Suitable data sets were identifi

  6. Congenital scoliosis treated with posterior vertebral column resection in patients younger than 18 years: longer than 10-year follow-up.

    Science.gov (United States)

    Chang, Dong-Gune; Yang, Jae Hyuk; Lee, Jung-Hee; Kim, Jin-Hyok; Suh, Seung-Woo; Ha, Kee-Yong; Suk, Se-Il

    2016-08-01

    OBJECTIVE There have been no reports on the long-term radiographic outcomes of posterior vertebral column resection (PVCR) in patients with congenital scoliosis. The purpose of this study was to evaluate the surgical outcomes and complications after PVCR and its long-term effects on correcting this deformity in children with congenital scoliosis. METHODS The authors retrospectively analyzed the medical records of 45 patients with congenital scoliosis who were younger than 18 years at the time of surgery and who underwent PVCR and fusion with pedicle screw fixation (PSF). The mean age of the patients at the time of surgery was 11.3 years (range 2.4-18.0 years), and the mean length of follow-up was 12.8 years (range 10.1-18.2 years). RESULTS The mean Cobb angle of the main curve was 46.5° before PVCR, 13.7° immediately after PVCR, and 17.6° at the last follow-up. For the compensatory cranial curve, PVCR corrected the preoperative Cobb angle of 21.2° to 9.1° postoperatively and maintained it at 10.9° at the last follow-up. For the compensatory caudal curve, the preoperative Cobb angle of 23.8° improved to 7.7° postoperatively and was 9.8° at the last follow-up. The authors noted 22 complications, and the overall incidence of complications was 48.9%. CONCLUSIONS Posterior vertebral column resection is an effective procedure for managing congenital scoliosis in patients younger than 18 years. Use of PVCR and fusion with PSF for congenital scoliosis achieved rigid fixation and satisfactory deformity correction that was maintained over the long term. However, the authors note that PVCR is a technically demanding procedure and entails risks for major complications and excessive blood loss.

  7. Rib overgrowth may be a contributing factor for pectus excavatum: Evaluation of prepubertal patients younger than 10years old.

    Science.gov (United States)

    Park, Chul Hwan; Kim, Tae Hoon; Haam, Seok Jin; Lee, Sungsoo

    2015-11-01

    We compared the costal cartilage and rib length between prepubertal patients with symmetric pectus excavatum and age- and sex-matched controls without anterior chest wall depression to evaluate if rib overgrowth is a contributing factor for pectus excavatum The sample included 18 prepubertal patients ribs and costal cartilage were measured using three-dimensional volume-rendered computed tomography and curved multiplanar reformatting techniques. The rib and costal cartilage lengths, total combined rib and costal cartilage length, and costal index ([length of cartilage/length of rib]×100 [%]) at the fourth to sixth levels were compared between the groups. The rib lengths in the patient group were significantly longer than in the control group for the 6th right rib and 4th, 5th, and 6th left ribs. The costal cartilage lengths and costal indices were not different between two groups. In patients with symmetric pectus excavatum aged ribs were longer than those of controls, suggesting that abnormal rib overgrowth may be a contributing factor responsible for pectus excavatum rather than cartilage overgrowth. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Comparison of conventional risk factors, clinical and angiographic profile between younger and older coronary heart disease patients

    Directory of Open Access Journals (Sweden)

    Gajanan D. Khadkikar

    2016-02-01

    Conclusions: Young patients with Coronary heart disease had different risk profile and less extensive coronary artery disease as compared to older counterparts. Emphasis should be given on diagnosis and management of major modifiable risk factors. [Int J Res Med Sci 2016; 4(2.000: 567-570

  9. Prevalence and awareness of sacroiliac joint alterations on lumbar spine CT in low back pain patients younger than 40 years.

    Science.gov (United States)

    Klang, Eyal; Lidar, Merav; Lidar, Zvi; Aharoni, Dvora; Eshed, Iris

    2017-04-01

    Background Computed tomography (CT) examinations of the lumbar spine are commonly performed in patients aged ≤40 years due to low back pain (LBP). Purpose To investigate the prevalence and awareness of radiologists for the presence of structural post-inflammatory/other sacroiliac joint (SIJ) alterations on lumbar spine CTs of young patients with LBP. Material and Methods A total of 484 lumbar spine CT examinations (272 men, 212 women; average age, 31 years; age range, 18-40 years) of patients with LBP in which the entire SIJs were visualized were retrospectively reviewed. SIJs were scored (consensus) by two senior radiologists (study reading) for the presence of post-inflammatory structural SIJ findings or other SIJs alterations. The original reports were compared to the study reading. Fifty CT examinations were re-evaluated for reliability assessment (intra-class correlation coefficient [ICC]). Results A total of 150 (31%) abnormal SIJ examinations were registered (ICC: r = 0.7-0.8; P < 0.0001): suspected sacroiliitis = 50 (10.2%); definite sacroiliitis = 16 (3.3%); osteitis-condensans-ilii = 38 (7.8%); diffuse idiopathic skeletal hyperostosis = 24 (5%); degenerative changes = 22 (4.5%); accessory SIJ = 22 (4.5%); and tumor = 1. The SIJs were referenced 39 times (8.0%) in the original readings: pathological findings (n = 15); and normal SIJ (n = 24). Total diagnostic accuracy for these reports only and for the entire readings were 49% and 69%, respectively, and 13% and 1.3%, respectively, for the pathological findings. Conclusion Sacroiliitis and other SIJ alterations are prevalent in young individuals with LBP, albeit, the majority of these alterations are not recognized nor reported by senior radiologists thus may delay efficacious treatment.

  10. Sentinel lymph node biopsy is unsuitable for routine practice in younger female patients with unilateral low-risk papillary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Zhou ShuMei

    2011-09-01

    Full Text Available Abstract Background Sentinel lymph node (SLN biopsy has been used to assess patients with papillary thyroid carcinoma (PTC. To achieve its full potential the rate of SLN identification must be as close to 100 percent as possible. In the present study we compared the combination of preoperative lymphoscintigraphy scanning by sulfur colloid labeled with 99 m Technetium, gamma-probe guided surgery, and methylene blue with methylene blue, alone, for sentinel node identification in younger women with unilateral low-risk PTC. Methods From January 2004 to January 2007, 90 female patients, ages 23 to 44 (mean = 35, with unilateral low-risk PTC (T1-2N0M0 were prospectively studied. Mean tumor size was 1.3 cm (range, 0.8-3.7 cm. All patients underwent unilateral modified neck dissection. Prior to surgery, patients had, by random assignment, identification and biopsy of SLNs by methylene blue, alone (Group 1, or by sulfur colloid labeled with 99 m Technetium, gamma-probe guided surgery and methylene blue (Group 2. Results In the methylene blue group, SLNs were identified in 39 of 45 patients (86.7%. Of the 39 patients, 28 (71.8% had positive cervical lymph nodes (pN+, and 21 patients (53.8% had pSLN+. In 7 of the 28 pN+ patients (25%, metastases were also detected in non-SLN, thus giving a false-negative rate (FNR of 38.9% (7/18, a negative predictive value (NPV of 61.1% (11/18, and an accuracy of 82.1% (32/39. In the combined technique group, the identification rate (IR of SLN was 100% (45/45. Of the 45 patients, 27 (60.0% had pN+, 24 (53.3% had pSLN+. There was a FNR of 14.3% (3/21, a NPV of 85.7% (18/21, and an accuracy of 93.3% (42/45. The combined techniques group was significantly superior to the methylene blue group in IR (p = 0.035. There were no significant differences between two groups in sensitivity, specificity, NPV, or accuracy. Location of pN+ (55 patients in 84 patients was: level I and V, no patients; level II, 1 patient (1.2%; level III

  11. Depression and gender differences among younger immigrant patients on sick leave due to chronic back pain: a primary care study.

    Science.gov (United States)

    Taloyan, Marina; Löfvander, Monica

    2014-01-01

    Mental ill-health and pain are major causes for disability compensation in female adults in Sweden. Aims The aims of this study were to (1) analyse gender differences in the prevalence of depression among immigrant patients with chronic back pain and (2) explore whether factors such as age, marital status, educational level, religious faith, number of children and number of diagnosed pain sites could explain these differences. The study sample consisted of 245 sick-listed primary care patients in consecutive order aged 18 through 45 years with a median duration of sick leave of 10 months for back pain and participating in a rehabilitation programme. Explanatory variables included physicians' diagnosed pain sites, age, marital status, education, number of children and religious affiliation. Predictive factors for depression were analysed using logistic regression. The women differed significantly from the men in three aspects: they were less educated, had more children and had more multiple pain sites, that is, 68% versus 45%. In the age-adjusted model, women were twice as likely to have depression (odds ratio (OR) 2.1). Regardless the gender, those with intermediate education of 9-11 years had the lowest odds of outcome compared with those with education. Finally, after adjusting for all explanatory variables, the ORs of depression for women decreased to a non-significant level (OR 1.8; 95% confidence interval (CI) 0.94-3.43). Furthermore, regardless of the gender, those with multiple pain sites had twice higher odds (OR 2.04; 95% CI 1.11-3.74) of depression than those with fewer pain sites. Gender differences in odds of depression in our study could be explained by a higher prevalence of diagnosed multiple pain sites in women. This calls for tailor-made treatments that focus on the pain relief needs of immigrant women with low education and chronic back pain.

  12. Effects of rapid aging and lower participation rate among younger adults on the short-term trend of physical activity in the National Health and Nutrition Survey, Japan.

    Science.gov (United States)

    Nishi, Nobuo; Yoshizawa, Takeshi; Okuda, Nagako

    2017-01-06

    The National Health and Nutrition Survey, Japan, has annually monitored two indicators of physical activity in adults. They are contrasting in the association with age; the prevalence of exercise habit is lower and step counts are higher among younger participants. The present study aimed to examine the effects of rapid aging of the Japanese population and the lower participation rate among younger adults on the short-term trend of two indicators of physical activity using tabulated data. The prevalence of exercise habit and step counts by age groups (≥20 years) from 2003 to 2010 were estimated using tabulated data from the National Health and Nutrition Survey by calculating sex-specific means weighted by age-specific Japanese population data for each year (population-weighted estimates) and for a fixed year (2005; age-standardized estimates). Linear regression analyses were used to test the statistical significance of their trends. Statistically significant increasing trends in the prevalence of exercise habit were observed for the crude means (P = 0.029), the population-weighted estimates (P = 0.007) and the age-standardized estimates (P = 0.016) only in men. Statistically significant decreasing trends in the step counts were observed for the crude means (P = 0.006 in men and P = 0.033 in women) and the population-weighted estimates (P = 0.008 in men and P = 0.049 in women) both in men and women, but for the age-standardized estimates (P = 0.039) only in men. The effects of rapid aging of the Japanese population and the lower participation rate among younger adults on the short-term trend are not small, and age-standardization is necessary to observe even the short-term trend of physical activity data. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  13. Clinicopathological characteristics of younger colorectal cancer patients%青年结直肠癌临床病理特征分析

    Institute of Scientific and Technical Information of China (English)

    陈美如; 张丽贤; 田志颖; 王丽华

    2016-01-01

    目的:探讨青年结直肠癌发病模式及临床特点,为临床早期诊断和制定筛查方案提供一定的理论依据。方法回顾性分析衡水市哈励逊国际和平医院2001~2015年113例青年结直肠癌住院患者,就其性别、年龄以及临床表现、实验室检查、病理特征等进行分析比较,总结青年结直肠癌患者的临床特点和病理特征。结果青年结直肠癌患者发病率低(7.85%),男性多于女性(1.26:1);发病年龄在30~40岁居多(73.45%),主要临床表现是排便习惯改变(69.03%)、便血(61.95%)、大便性状改变(59.29%)和腹痛(47.79%);腹部查体及直肠指诊检查多有阳性发现(57.52%),便潜血常呈阳性(58.41%),贫血也不少见(47.79%),而CEA升高的患者较少(20.35%);肿瘤部位以乙状结肠及直肠癌为主(61.06%),组织学以低分化腺癌、粘液腺癌、印戒细胞癌常见(50.44%),65.49%已侵及浆膜层,61.06%已发生淋巴结转移。结论青年结直肠癌临床表现缺乏特异性,重视腹部查体、直肠指检、便潜血、血红蛋白、肿瘤标志物化验,及时行肠镜检查,做到早诊断、早治疗,提高生存率。%Objective To investigate the patterns and clinicopathological characteristics of younger colorectal cancer patients , than offer a theoretic basis to early clinial diagnosis and enact screening program .Methods Retrospective analysis 113 cases of younger colorectal cancer patients in Harrison International Peace Hospital from January 2001 to December 2015 .Analysis and comparison the gender ,age ,clinical manifestation ,laboratory examination and pathologital feature ,and summary the clinicopatho‐logical characteristics of younger colorectal cancer patients .Results The younger colorectal cancer patients have low incidence (7 . 85% ) ,the male cases were more than the

  14. All-trans retinoic acid as adjunct to intensive treatment in younger adult patients with acute myeloid leukemia: results of the randomized AMLSG 07-04 study.

    Science.gov (United States)

    Schlenk, Richard F; Lübbert, Michael; Benner, Axel; Lamparter, Alexander; Krauter, Jürgen; Herr, Wolfgang; Martin, Hans; Salih, Helmut R; Kündgen, Andrea; Horst, Heinz-A; Brossart, Peter; Götze, Katharina; Nachbaur, David; Wattad, Mohammed; Köhne, Claus-Henning; Fiedler, Walter; Bentz, Martin; Wulf, Gerald; Held, Gerhard; Hertenstein, Bernd; Salwender, Hans; Gaidzik, Verena I; Schlegelberger, Brigitte; Weber, Daniela; Döhner, Konstanze; Ganser, Arnold; Döhner, Hartmut

    2016-12-01

    The aim of this clinical trial was to evaluate the impact of all-trans retinoic acid (ATRA) in combination with chemotherapy and to assess the NPM1 status as biomarker for ATRA therapy in younger adult patients (18-60 years) with acute myeloid leukemia (AML). Patients were randomized for intensive chemotherapy with or without open-label ATRA (45 mg/m(2), days 6-8; 15 mg/m(2), days 9-21). Two cycles of induction therapy were followed by risk-adapted consolidation with high-dose cytarabine or allogeneic hematopoietic cell transplantation. Due to the open label character of the study, analysis was performed on an intention-to-treat (ITT) and a per-protocol (PP) basis. One thousand one hundred patients were randomized (556, STANDARD; 544, ATRA) with 38 patients treated vice versa. Median follow-up for survival was 5.2 years. ITT analyses revealed no difference between ATRA and STANDARD for the total cohort and for the subset of NPM1-mutated AML with respect to event-free (EFS; p = 0.93, p = 0.17) and overall survival (OS; p = 0.24 and p = 0.32, respectively). Pre-specified PP analyses revealed better EFS in NPM1-mutated AML (p = 0.05) and better OS in the total cohort (p = 0.03). Explorative subgroup analyses on an ITT basis revealed better OS (p = 0.05) in ATRA for genetic low-risk patients according to ELN recommendations. The clinical trial is registered at clinicaltrialsregister.eu (EudraCT Number: 2004-004321-95).

  15. [Factors impacting the growth and nutritional status of cystic fibrosis patients younger than 10 years of age who did not undergo neonatal screening].

    Science.gov (United States)

    Hortencio, Taís Daiene Russo; Nogueira, Roberto José Negrão; Marson, Fernando Augusto de Lima; Hessel, Gabriel; Ribeiro, José Dirceu; Ribeiro, Antônio Fernando

    2015-01-01

    The aim of this study was to evaluate by clinical and laboratory parameters how cystic fibrosis (CF) affects growth and nutritional status of children who were undergoing CF treatment but did not receive newborn screening. A historical cohort study of 52 CF patients younger than 10 years of age were followed in a reference center in Campinas, Southeast Brazil. Anthropometric measurements were abstracted from medical records until March/2010, when neonatal screening program was implemented. Between September/2009 and March/2010, parental height of the 52 CF patients were also measured. Regarding nutritional status, four patients had Z-scores ≤ -2 for height/age (H/A) and body mass index/age (BMI/A). The following variables were associated with improved H/A ratio: fewer hospitalizations, longer time from first appointment to diagnosis, longer time from birth to diagnosis and later onset of respiratory disease. Forced vital capacity [FVC(%)], forced expiratory flow between 25-75% of FVC [FEF25-75(%)], forced expiratory volume in the first second [FEV1(%)], gestational age, birth weight and early respiratory symptoms were associated with IMC/A. Greater number of hospitalizations, diagnosis delay and early onset of respiratory disease had a negative impact on growth. Lower spirometric values, lower gestational age, lower birth weight, and early onset of respiratory symptoms had negative impact on nutritional status. Malnutrition was observed in 7.7% of cases, but 23% of children had nutritional risk. Copyright © 2014 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  16. A nationwide, retrospective analysis of symptoms, comorbidities, medical care and autopsy findings in cases of fatal pulmonary embolism in younger patients

    DEFF Research Database (Denmark)

    Haunsø, S; Theilade, J; Winkel, B G

    2010-01-01

    Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings.......Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings....

  17. Comparison of hospital mortality during ST-segment elevation myocardial infarction in the era of reperfusion therapy in women versus men and in older versus younger patients.

    Science.gov (United States)

    Juliard, Jean-Michel; Golmard, Jean Louis; Himbert, Dominique; Feldman, Laurent J; Delorme, Laurent; Ducrocq, Gregory; Descoutures, Fleur; Sorbets, Emmanuel; Garbarz, Eric; Boudvillain, Olivier; Aubry, Pierre; Vahanian, Alec; Steg, Philippe Gabriel

    2013-06-15

    There is intense interest in examining hospital mortality in relation to gender in ST-segment elevation myocardial infarction. The aim of the present study was to determine whether gender influences outcomes in men and women treated with the same patency-oriented reperfusion strategy. The influence of gender on hospital mortality was tested using multivariate analysis and local regression. The influence of age was tested as a continuous and as a categorical variable. In the overall population of 2,600 consecutive patients, gender was not correlated with hospital mortality except in the subgroup of women aged ≥65 years. The risk for death increased linearly in logit scale for men. Up to the age of 65 years, the risk also increased linearly in women but thereafter increased faster than in men. Testing age as a categorical variable, hospital mortality was higher in women than in men aged ≥75 years but was similar between the genders in the younger age categories. In conclusion, despite following an equal patency-oriented management strategy in men and women with ST-segment elevation myocardial infarctions, the risk for hospital death increased linearly with age but with an interaction between age and gender such that older women had an independent increase in hospital mortality. Longer time to presentation and worse baseline characteristics probably contributed to determine a high-risk subset but reinforce the need to apply, as recommended in the international guidelines in the management of patients with ST-segment elevation myocardial infarctions, the same strategy of acute reperfusion in men and women.

  18. Attitudes of Oncologists, Oncology Nurses, and Patients from a Women's Clinic Regarding Medical Decision Making for Older and Younger Breast Cancer Patients.

    Science.gov (United States)

    Beisecker, Analee E.; And Others

    1994-01-01

    Administered Beisecker Locus of Authority in Decision Making: Breast Cancer survey to 67 oncologists, 94 oncology nurses, and 288 patients from women's clinic. All groups believed that physicians should have dominant role in decision making. Nurses felt that patients should have more input than patients or physicians felt they should. Physicians…

  19. Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score

    DEFF Research Database (Denmark)

    Li, Dana; Troelsen, A; Ingelsrud, L

    2017-01-01

    PURPOSE: The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this s......PURPOSE: The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim...

  20. Outcome and survival of patients aged 75 years and older compared to younger patients after ruptured abdominal aortic aneurysm repair: do the results justify the effort?

    DEFF Research Database (Denmark)

    Shahidi, S; Schroeder, T Veith; Carstensen, M.

    2009-01-01

    on prospectively registered data. The protocol was an "all-comers" policy. Seventy-two patients, who were operated on for RAAA in our department from January 1, 2005, to December 30, 2005, are included in this study. The follow-up time of survivors was 1 year. We defined 75-year-old patients as elderly because...... the only significant (p believe that treatment for RAAA can be justified in elderly patients. In our experience, surgical open repair has been life-saving in 33% of patients aged 75 years and older, at a relatively low price for each...

  1. Survival of multiple myeloma patients in the era of novel therapies confirms the improvement in patients younger than 75 years: a population-based analysis.

    Science.gov (United States)

    Pozzi, Samantha; Marcheselli, Luigi; Bari, Alessia; Liardo, Eliana V; Marcheselli, Raffaella; Luminari, Stefano; Quaresima, Micol; Cirilli, Claudia; Ferri, Paola; Federico, Massimo; Sacchi, Stefano

    2013-10-01

    Novel treatments for multiple myeloma (MM) have shown promising results in clinical trials, but the advantage in unselected patients is still unclear. In order to evaluate whether novel therapies impact survival of MM patients, we performed a population-based analysis on data collected by the Modena Cancer Registry from 1989 to 2009. The analysis evaluated 1206 newly diagnosed MM patients collected in the years 1988-96 (conventional therapy), 1997-05 (high dose melphalan and autologous transplant), and 2006-09 (novel agents era). Both relative survival (RS) and overall survival (OS) improved over the years, but not equally in the three groups. For patients aged survival of MM patients aged survival. Despite the limits of this study, these data refer to an unselected population, giving a picture of every day clinical practice.

  2. Factores de riesgo de las infecciones respiratorias agudas en pacientes menores de un año Risk factors of acute respiratory infections in patient younger one year

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    Adealvys Corcho Quintero

    2010-12-01

    Full Text Available El comportamiento de las infecciones respiratorias agudas es similar en los países desarrollados y en los subdesarrollados. Constituyen la primera causa de muerte por enfermedad infecciosa en los países desarrollados, y en Cuba se ubica entre las 10 primeras causas de muerte. Bajo un diseño de estudio de corte transversal, se detallan en este artículo los factores de riesgo asociados a estas infecciones en los pacientes menores de un año del Consejo Popular No. 2, perteneciente al Policlínico "Flores Betancourt", en Caimito, durante el año 2007. De los 67 niños estudiados fueron 54 los que enfermaron. Las infecciones respiratorias agudas altas no complicadas, fueron la forma de presentación más frecuente. Los factores que predominaron en los pacientes expuestos fueron: la lactancia mixta y artificial, la contaminación ambiental, la inmunización regular y/o deficiente, el bajo peso al nacer, la asistencia a instituciones infantiles, las edades maternas de 20 a 24 años de edad, y el nivel escolar materno de preuniversitario concluido.The behavior of acute respiratory infections is similar in developed countries and in those underdeveloped being the first cause of death from infectious disease in the developed ones and in Cuba it is place among the 10 first causes of death. In present cross-sectional study design are detailed the risk factors associated with these infections in patients younger one year from the No. 2 Popular Council from the "Flores Betancourt" Polyclinic in Caimito municipality over 2007. From the study children 54 become ill. The non-complicated high acute respiratory infections were the more frequent. The factors prevailing in exposed patients were: mixed and artificial breastfeeding, the environmental contamination, the regular and/or poor immunization, the low birth weight, attendance to children institutions, mother aged 20 to 24 and the mother pre-university level concluded.

  3. Exposed: younger mothers and breastfeeding.

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    Noble-Carr, Debbie; Bell, Catherine

    2012-11-01

    This qualitative study, conducted by volunteers from the Australian Capital Territory/Southern New South Wales (ACT/SNSW) Branch of the Australian Breastfeeding Association (ABA), explored the breastfeeding experiences of younger mothers (under the age of 26 years) in the ACT by conducting three focus groups. The study aimed to gain an understanding of how, when and where younger mothers want and need to receive breastfeeding information and support. Younger mothers provided important insights into their breastfeeding experiences, which were often characterised by judgement from health professionals and the wider public. A number of key issues were identified including: breastfeeding is far from a cultural norm in our society and as such the risks of artificial baby milk are not clearly understood by many younger mothers; younger mothers are strongly influenced by their partners, mothers and peers and they rely upon them for breastfeeding information and support. Younger mothers indicated that a number of improvements could be made to the way that breastfeeding information and support is currently provided within the ACT. The findings indicated that younger mothers (and their significant others) would benefit from receiving clear, concise and consistent breastfeeding information early on in their pregnancy, that is positive in tone, not necessarily 'young mum' specific and consistent with a 'less is more' approach. Younger mothers indicated that after the birth of their baby this breastfeeding information needs to be complemented by readily accessible, seamless, respectful support for as long as they need to establish breastfeeding and overcome any breastfeeding challenges. The focus group findings were largely consistent with the existing literature available on younger mothers and breastfeeding and provide valuable insights to all stakeholders responsible for providing breastfeeding information and support to younger mothers.

  4. Mid- to long-term outcome comparison of the Medtronic Hancock II and bi-leaflet mechanical aortic valve replacement in patients younger than 60 years of age: a propensity-matched analysis.

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    Wang, Yin; Chen, Si; Shi, Jiawei; Li, Geng; Dong, Nianguo

    2016-03-01

    This study aims to compare mid-long-term clinical outcomes between patients younger than 60 years of age undergoing bioprosthetic and mechanical aortic valve replacement. From January 2002 to December 2009, patients younger than 60 years of age who received Medtronic Hancock II porcine bioprostheses were selected and compared with those who received mechanical bi-leaflet valves in the aortic position. A stepwise logistic regression propensity score identified a subset of 112 evenly matched patient-pairs. Mid-long-term outcomes of survival, valve-related reoperations, thromboembolic events and bleeding events were assessed. The follow-up was only 95.1% complete. Fourteen measurable variables were statistically similar for the matched cohort. Postoperative in-hospital mortality was 3.6% (bioprosthetic valves) and 2.7% (mechanical valves) (P = 0.700). Survival at 5 and 10 years was 96.3 and 88.7% for patients receiving bioprosthetic valve replacement versus 96.3 and 87.9% for patients receiving mechanical valve replacement (P = 0.860), respectively. At 5 and 10 years after operations, freedom from valve-related reoperation was 97.2 and 94.8% for patients receiving mechanical valve replacement, and 96.3 and 90.2% for patients receiving bioprosthetic valve replacement (P = 0.296), respectively. There was no difference between freedom from thromboembolic events (P = 0.528) and bleeding events (P = 0.128) between the matched groups during the postoperative 10 years. In patients younger than 60 years of age undergoing aortic valve replacement, mid-long-term survival rate was similar for patients receiving bioprosthetic versus mechanical valve replacement. Bioprosthetic valves were associated with a trend for a lower risk of anticoagulation treatment and did not have significantly greater likelihood of a reoperation. These findings suggest that a bioprosthetic valve may be a reasonable choice for AVR in patients younger than 60 years of age. © The Author 2015. Published by

  5. Hip and Knee Osteoarthritis Affects Younger People, Too.

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    Ackerman, Ilana N; Kemp, Joanne L; Crossley, Kay M; Culvenor, Adam G; Hinman, Rana S

    2017-02-01

    Synopsis Although osteoarthritis (OA) has traditionally been considered a disease of older age, hip and knee OA can and does affect younger adults, with a profound impact on psychosocial well-being and work capacity. Obesity and a history of traumatic knee injury (eg, anterior cruciate ligament rupture and/or meniscal tear) are key risk factors for the accelerated development of knee OA, while structural hip deformities (including those contributing to femoroacetabular impingement syndrome) are strong predictors of early-onset hip OA. In view of these associations, rising rates of obesity and sports injuries are concerning, and may signal a future surge in OA incidence among younger people. Assessment of hip and knee OA in younger people should focus on a patient-centered history, comprehensive physical examination, performance-based measures, and patient-reported outcome measures to enable monitoring of symptoms and function over time. Referral for imaging should be reserved for people presenting with atypical signs or symptoms that may indicate diagnoses other than OA. Nonpharmacological approaches are core strategies for the management of hip and knee OA in younger people, and these include appropriate disease-related education, activity modification (including for work-related tasks), physical therapist- prescribed exercise programs to address identified physical impairments, and weight control or weight loss. High-quality evidence has shown no benefit of arthroscopy for knee OA, and there are no published clinical trials to support the use of hip arthroscopy for OA. Referral for joint-conserving or joint replacement surgery should be considered when nonpharmacological and pharmacological management strategies are no longer effective. J Orthop Sports Phys Ther 2017;47(2):67-79. doi:10.2519/jospt.2017.7286.

  6. High-dose cytarabine in induction treatment improves the outcome of adult patients younger than age 46 years with acute myeloid leukemia: results of the EORTC-GIMEMA AML-12 trial.

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    Willemze, Roelof; Suciu, Stefan; Meloni, Giovanna; Labar, Boris; Marie, Jean-Pierre; Halkes, Constantijn J M; Muus, Petra; Mistrik, Martin; Amadori, Sergio; Specchia, Giorgina; Fabbiano, Francesco; Nobile, Francesco; Sborgia, Marco; Camera, Andrea; Selleslag, Dominik L D; Lefrère, Francois; Magro, Domenico; Sica, Simona; Cantore, Nicola; Beksac, Meral; Berneman, Zwi; Thomas, Xavier; Melillo, Lorella; Guimaraes, Jose E; Leoni, Pietro; Luppi, Mario; Mitra, Maria E; Bron, Dominique; Fillet, Georges; Marijt, Erik W A; Venditti, Adriano; Hagemeijer, Anne; Mancini, Marco; Jansen, Joop; Cilloni, Daniela; Meert, Liv; Fazi, Paola; Vignetti, Marco; Trisolini, Silvia M; Mandelli, Franco; de Witte, Theo

    2014-01-20

    Cytarabine plays a pivotal role in the treatment of patients with acute myeloid leukemia (AML). Most centers use 7 to 10 days of cytarabine at a daily dose of 100 to 200 mg/m(2) for remission induction. Consensus has not been reached on the benefit of higher dosages of cytarabine. The European Organisation for Research and Treatment of Cancer (EORTC) and Gruppo Italiano Malattie Ematologiche dell' Adulto (GIMEMA) Leukemia Groups conducted a randomized trial (AML-12; Combination Chemotherapy, Stem Cell Transplant and Interleukin-2 in Treating Patients With Acute Myeloid Leukemia) in 1,942 newly diagnosed patients with AML, age 15 to 60 years, comparing remission induction treatment containing daunorubicin, etoposide, and either standard-dose (SD) cytarabine (100 mg/m(2) per day by continuous infusion for 10 days) or high-dose (HD) cytarabine (3,000 mg/m(2) every 12 hours by 3-hour infusion on days 1, 3, 5, and 7). Patients in complete remission (CR) received a single consolidation cycle containing daunorubicin and intermediate-dose cytarabine (500 mg/m(2) every 12 hours for 6 days). Subsequently, a stem-cell transplantation was planned. The primary end point was survival. At a median follow-up of 6 years, overall survival was 38.7% for patients randomly assigned to SD cytarabine and 42.5% for those randomly assigned to HD cytarabine (log-rank test P = .06; multivariable analysis P = .009). For patients younger than age 46 years, survival was 43.3% and 51.9%, respectively (P = .009; multivariable analysis P = .003), and for patients age 46 to 60 years, survival was 33.9% and 32.9%, respectively (P = .91). CR rates were 72.0% and 78.7%, respectively (P < .001) and were 75.6% and 82.4% for patients younger than age 46 years (P = .01) and 68.3% and 74.8% for patients age 46 years and older (P = .03). Patients of all ages with very-bad-risk cytogenetic abnormalities and/or FLT3-ITD (internal tandem duplication) mutation, or with secondary AML benefitted from HD

  7. P-glycoprotein inhibition using valspodar (PSC-833) does not improve outcomes for patients younger than age 60 years with newly diagnosed acute myeloid leukemia: Cancer and Leukemia Group B study 19808.

    Science.gov (United States)

    Kolitz, Jonathan E; George, Stephen L; Marcucci, Guido; Vij, Ravi; Powell, Bayard L; Allen, Steven L; DeAngelo, Daniel J; Shea, Thomas C; Stock, Wendy; Baer, Maria R; Hars, Vera; Maharry, Kati; Hoke, Eva; Vardiman, James W; Bloomfield, Clara D; Larson, Richard A

    2010-09-01

    Cancer and Leukemia Group B 19808 (CALGB 19808) is the only randomized trial of a second-generation P-glycoprotein (Pgp) modulator in untreated patients with acute myeloid leukemia (AML) younger than age 60 years. We randomly assigned 302 patients to receive induction chemotherapy regimens consisting of cytosine arabinoside (Ara-C; A), daunorubicin (D), and etoposide (E), without (ADE) or with (ADEP) PSC-833 (P). The incidence of complete remission was 75% with both regimens. Reversible grade 3 and 4 liver and mucosal toxicities were significantly more common with ADEP. Therapy-related mortality was 7% and did not differ by induction arm. Excess cardiotoxicity was not seen with high doses of D in ADE. The median disease-free survival was 1.34 years in the ADE arm and 1.09 years in the ADEP arm (P = .74, log-rank test); the median overall survival was 1.86 years in the ADE arm and 1.69 years in the ADEP arm (P = .82). There was no evidence of a treatment difference within any identifiable patient subgroup. Inhibition of Pgp-mediated drug efflux by PSC-833 did not improve clinical outcomes in younger patients with untreated AML. This trial was registered at www.clinicaltrials.gov as #NCT00006363.

  8. Development of a modified prognostic index of patients with aggressive adult T-cell leukemia-lymphoma aged 70 years or younger: a possible risk-adapted management strategies including allogeneic transplantation.

    Science.gov (United States)

    Fuji, Shigeo; Yamaguchi, Takuhiro; Inoue, Yoshitaka; Utsunomiya, Atae; Moriuchi, Yukiyoshi; Uchimaru, Kaoru; Owatari, Satsuki; Miyagi, Takashi; Taguchi, Jun; Choi, Ilseung; Otsuka, Eiichi; Nakachi, Sawako; Yamamoto, Hisashi; Kurosawa, Saiko; Tobinai, Kensei; Fukuda, Takahiro

    2017-03-24

    Adult T-cell leukemia-lymphoma is a distinct type of peripheral T-cell lymphoma caused by human T-cell lymphotropic virus type I. Although allogeneic stem cell transplantation after chemotherapy is a recommended treatment option for patients with aggressive adult T-cell leukemia-lymphoma, there is no consensus about indications for allogeneic stem cell transplantation because there is no established risk stratification system for transplant eligible patients. We conducted a nationwide survey of patients with aggressive adult T-cell leukemia-lymphoma to construct a new large database that includes 1,792 patients aged 70 years or younger with aggressive adult T-cell leukemia-lymphoma who were diagnosed between 2000 and 2013 and received intensive first-line chemotherapy. We randomly divided patients into two groups (training and validation sets). Acute type, poor performance status, high soluble interleukin-2 receptor level (> 5,000 U/mL), high adjusted calcium level (≥ 12 mg/dL), and high C-reactive protein level (≥ 2.5 mg/dL) were independent adverse prognostic factors using the training set. We used these five variables to divide patients into three risk groups. In the validation set, medial overall survival was 626 days, 322 days, and 197 days for the low-, intermediate-, and high-risk groups, respectively. In the intermediate- and high-risk groups, transplanted recipients had significantly better overall survival than non-transplanted patients. We developed a new promising risk stratification system to identify patients aged 70 years or younger with aggressive adult T-cell leukemia-lymphoma who may benefit from upfront allogeneic stem cell transplantation. Prospective studies are warranted to confirm the benefit of this treatment strategy.

  9. Clinical presentation of urolithiasis in older and younger population

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    Murat Dursun

    2014-12-01

    Full Text Available Aim of the study: We compared stone size, localization, complaint at the time of applying, comorbidity, treatment and complications between older (60 years of age and older and younger patients with urolithiasis (59 years of age and younger. Materials and Methods: We retrospectively reviewed the records of 950 consecutive patients who presented to our clinic and underwent surgery for urolithiasis from January 2007 to March 2012. The patients were divided into two groups: patients ≥ 60 years an patients < 60 years. Results: There were 174 men and 61 women in elderly group, 528 men and 187 women in younger group. Ureteral stones were found more often in the younger group compared to elderly patients (p < 0.05. Conversely, bladder stone was more frequent in the elderly group. In the elderly group comorbidities are more frequent (diabetes mellitus, hypertension, ischemic heart disease, congestive heart disease, osteoarthritis and chronic obstructive lung. Patients ≥ 60 years significantly had larger kidney and bladder stones compared the younger, but ureteral stone sizes were not statistically different between the two groups. Older patients had a higher postoperative complication rate than younger patients (16% versus 3%, p < 0.05 although postoperative complications (e.g. urinary retention, cardiac dysrythmia, fever, constipation were not serious and resolved with medical treatment. The average length of stay in hospital was longer in the elderly group, but the difference was not statistically significant. Conclusions: Elderly patients with urolithiasis usually have larger and more complex stone disease, more comorbidities and atypical presentation.

  10. Radiolabeled anti-CD45 antibody with reduced-intensity conditioning and allogeneic transplantation for younger patients with advanced acute myeloid leukemia or myelodysplastic syndrome.

    Science.gov (United States)

    Mawad, Raya; Gooley, Ted A; Rajendran, Joseph G; Fisher, Darrell R; Gopal, Ajay K; Shields, Andrew T; Sandmaier, Brenda M; Sorror, Mohamed L; Deeg, Hans Joachim; Storb, Rainer; Green, Damian J; Maloney, David G; Appelbaum, Frederick R; Press, Oliver W; Pagel, John M

    2014-09-01

    We treated patients under age 50 years with iodine-131 ((131)I)-anti-CD45 antibody combined with fludarabine and 2 Gy total body irradiation to create an improved hematopoietic cell transplantation (HCT) strategy for advanced acute myeloid leukemia or high-risk myelodysplastic syndrome patients. Fifteen patients received 332 to 1561 mCi of (131)I, delivering an average of 27 Gy to bone marrow, 84 Gy to spleen, and 21 Gy to liver. Although a maximum dose of 28 Gy was delivered to the liver, no dose-limiting toxicity was observed. Marrow doses were arbitrarily capped at 43 Gy to avoid radiation-induced stromal damage; however, no graft failure or evidence of stromal damage was observed. Twelve patients (80%) developed grade II graft-versus-host disease (GVHD), 1 patient developed grade III GVHD, and no patients developed grade IV GVHD during the first 100 days after HCT. Of the 12 patients with chronic GVHD data, 10 developed chronic GVHD, generally involving the skin and mouth. Six patients (40%) are surviving after a median of 5.0 years (range, 4.2 to 8.3 years). The estimated survival at 1 year was 73% among the 15 treated patients. Eight patients relapsed, 7 of whom subsequently died. The median time to relapse among these 8 patients was 54 days (range, 26 to 1364 days). No cases of nonrelapse mortality were observed in the first year after transplantation. However, 2 patients died in remission from complications of chronic GVHD and cardiomyopathy, at 18 months and 14 months after transplantation, respectively. This study suggests that patients may tolerate myeloablative doses >28 Gy delivered to the liver using (131)I-anti-CD45 antibody in addition to standard reduced-intensity conditioning. Moreover, the arbitrary limit of 43 Gy to the marrow may be unnecessarily conservative, and continued escalation of targeted radioimmunotherapy doses may be feasible to further reduce relapse.

  11. The Relationship of Anterior Cruciate Ligament Lesions and Osteochondral Lesions with Meniscal Tears in Patients Younger than Fifty Years of Age

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    Samed Ordu

    2014-09-01

    Full Text Available Aim: The purpose of this study was to determine the incidence of anterior cruciate ligament (ACL lesions and osteochondral lesions according to type and localization of the meniscal tear and age, gender in patients who have been arthroscopicaly treated, besides, to make the coexisting lesions more predictable in these patients. Methods: We retrospectively investigated 352 patients under 50 years of age who underwent surgery for a meniscal tear between 2008 and 2012. We scanned the surgical operation notes, preoperative questionnaires and the magnetic resonance imaging findings. We recorded patients who had ACL lesions, such as elongation, partial rupture and total rupture. Osteochondral lesions were classified according to the Outerbridge classification from grade 1 to grade 4. Results: Chondral lesions were present in 77.4% of patients with degenerative meniscal tears and in 63% of patients with radial meniscal tears. One the other hand, osteochondral lesions were observed in only 33.9% of patients with other types of meniscal tears. 46.6% of ACL lesions accompanied by meniscal tears with longitudinal pattern, such as longitudinal tears, bucket handle tears and root tears. For the other types of meniscal tears, this percentage was 20.7. When we excluded degenerative type meniscal tears, the mean age of the patients with radial tears was 40.86±9.03 years and the mean age of the patients with other types of tear was 35.44±9.44 years. The difference was statistically significant. Conclusion: We found close relationship between osteoarthritic chondral lesions and radial tears in the root of the posterior horn of the medial meniscus. On the other side, longitudinal tears were related with ACL lesions. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 177-80

  12. Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

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    Braak, Bert P.M. ter; Vincken, Patrice W.J.; Erkel, Arian R. van; Bloem, Johan L. [Leiden University Medical Center, Department of Radiology, P.O. Box 9600, Leiden (Netherlands); Bloem, Rolf M. [Leiden University Medical Center, Department of Orthopaedic Surgery, Leiden (Netherlands); Napoleon, L.J.; Coene, M.N. [HAGA Hospital, Department of Orthopaedic Surgery, The Hague (Netherlands); Luijt, Peter A. van [Leiden University Medical Center, Department of Traumatology, Leiden (Netherlands); Lange, Sam de [Medical Center Haaglanden, Department of Orthopaedic Surgery, The Hague (Netherlands); Department of Orthopaedic Surgery, Delft (Netherlands)

    2007-12-15

    The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks' duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs. Radiographs should not be obtained routinely when MRI is

  13. Subchondral insufficiency fracture of the femoral head in younger adults

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    Yamamoto, Takuaki; Nakashima, Yasuharu; Shuto, Toshihide; Jingushi, Seiya; Iwamoto, Yukihide [Graduate School of Medical Sciences, Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan)

    2007-06-15

    We report two cases of subchondral insufficiency fracture of the femoral head observed in younger adults without any history of overexertion. In both cases, MRI revealed an irregular, discontinuous low-intensity band on the T1-weighted images. Both patients were treated operatively, and histological examination confirmed the diagnosis of subchondral fracture. A diagnosis of subchondral insufficiency fracture needs to be put in as one of the diagnoses in younger patients with a hip pain. (orig.)

  14. The follow-up of patients of sixty-five years of age and younger with acute ischemic stroke and transient ischemic attacks, and elevated D-dimer levels in plasma

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    Magnus Vrethem

    2009-09-01

    Full Text Available D-dimer levels in plasma, a degradation product of fibrin, have been shown to correlate with the severity of ischemic stroke. In order to investigate the outcome of patients with elevated D-dimer we have carried out a follow-up study of patients of 65 years of age and younger with acute ischemic stroke or transient ischemic attacks (TIA admitted to our stroke unit from 1991 to 1992. Twenty-two of the 57 patients had elevated D-dimer levels in the plasma. High levels were associated with cardioembolic stroke. On follow-up after a mean of 12 years, 15 patients had died and six patients had suffered another stroke or TIA (three of whom were dead. Ten patients had suffered other cardiovascular events and seven of them were dead. We concluded that high levels of D-dimer in acute ischemic stroke patients on admission were associated with cardioembolic stroke and might have prognostic value for the development of further cardio- or cerebrovascular events. Advanced age was found to be an independent risk factor.

  15. Predictors of Chemotherapy-Induced Toxicity and Treatment Outcomes in Elderly Versus Younger Patients With Metastatic Castration-Resistant Prostate Cancer

    DEFF Research Database (Denmark)

    Kongsted, Per; Svane, Inge Marie; Lindberg, Henriette

    2016-01-01

    BACKGROUND: In the present study, we examined possible predictors of chemotherapy-induced toxicity, treatment outcomes, and the consequences of dose reductions in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving standard docetaxel. PATIENTS AND METHODS: Medical...... records from 421 consecutive patients treated with first-line docetaxel (75 mg/m(2) every 3 weeks) and low-dose prednisolone from 2007 to 2013 at Herlev University Hospital were reviewed. Common Terminology Criteria for Adverse Events, version 4.0, and the Prostate Cancer Working Group 2 guidelines were...... (hazard ratio [HR], 1.00), baseline hemoglobin levels (HR, 0.85), Eastern Cooperative Oncology Group performance status > 0 to 1 (HR, 1.44), lactate dehydrogenase greater than the upper limit of normal (HR, 1.64), and prostate-specific antigen levels (HR, 1.00) were predictors of OS. CONCLUSIONS: OS...

  16. Good performance of a titanium femoral component in cementless hip arthroplasty in younger patients: 97 arthroplasties followed for 5-11 years

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Jensen, Frank Krieger; Poulsen, Klaus

    2003-01-01

    We performed 97 uncemented primary total hip arthroplasties in 80 patients having an average age of 50 years. The femoral implant was a titanium stem with a proximal circumferential plasma spray-coating. Three different acetabular components were used: a threaded and partly porous-coated design...... osteolysis associated with a deep infection, but no signs of proximal loosening. 3 femora had areas of minor proximal osteolysis. 16 acetabular components (14 threaded) had been revised in 13 patients. The average Harris hip score was 91 points at the latest follow-up. We conclude that the uncemented...... titanium femoral component with a circumferential porous coating performed well in these patients, most of whom were young. As reported previously, aseptic loosening of threaded acetabular components was common....

  17. Good performance of a titanium femoral component in cementless hip arthroplasty in younger patients: 97 arthroplasties followed for 5-11 years

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Jensen, Frank Krieger; Poulsen, Klaus

    2003-01-01

    We performed 97 uncemented primary total hip arthroplasties in 80 patients having an average age of 50 years. The femoral implant was a titanium stem with a proximal circumferential plasma spray-coating. Three different acetabular components were used: a threaded and partly porous-coated design...... osteolysis associated with a deep infection, but no signs of proximal loosening. 3 femora had areas of minor proximal osteolysis. 16 acetabular components (14 threaded) had been revised in 13 patients. The average Harris hip score was 91 points at the latest follow-up. We conclude that the uncemented...... titanium femoral component with a circumferential porous coating performed well in these patients, most of whom were young. As reported previously, aseptic loosening of threaded acetabular components was common....

  18. Congenital hip dysplasia treated by total hip arthroplasty using cementless tapered stem in patients younger than 50 years old: results after 12-years follow-up.

    Science.gov (United States)

    Faldini, Cesare; Miscione, Maria Teresa; Chehrassan, Mohammadreza; Acri, Francesco; Pungetti, Camilla; d'Amato, Michele; Luciani, Deianira; Giannini, Sandro

    2011-12-01

    Congenital hip dysplasia may lead to severe acetabular and femoral abnormalities that can make total hip arthroplasty a challenging procedure. We assessed a series of patients affected by developmental hip dysplasia treated with total hip arthroplasty using cementless tapered stem and here we report the outcomes at long-term follow-up. Twenty-eight patients (24 women and 4 men) aged between 44 and 50 years (mean 47 years) were observed. Clinical evaluation was rated with the Harris Hip Score. Radiographic evaluation consisted in standard anteroposterior and axial view radiographs of the hip. According to Crowe's classification, 16 hips presented dysplasia grade 1, 14 grade 2, and 4 grade 3. All patients were treated with total hip arthroplasty using a cementless tapered stem (Wagner Cone Prosthesis). Six patients were operated bilaterally, with a totally of 34 hips operated. After surgery, the patients were clinically and radiographically checked at 3, 6, and 12 months and yearly thereafter until an average follow-up of 12 years (range 10-14 years). Average Harris Hip Score was 56 ± 9 (range 45-69) preoperatively, 90 ± 9 (range 81-100) 12 months after surgery, and 91 ± 8 (range 83-100) at last follow-up. Radiographic evaluation demonstrated excellent osteointegration of the implants. Signs of bone resorption were present in 6 hips, nevertheless no evidence of loosening was observed and none of the implants has been revised. Even in dysplasic femur, the tapered stem allowed adequate stability and orientation of the implant. We consider tapered stem a suitable option for total hip arthroplasty in developmental hip dysplasia, also in case of young patients, thanks to the favourable long-term results.

  19. Impact of cardiovascular risk factors on progression of arteriosclerosis in younger patients: evaluation by carotid duplex ultrasonography and cardio-ankle vascular index(CAVI).

    Science.gov (United States)

    Suzuki, Jun; Kurosu, Takumi; Kon, Tokuo; Tomaru, Takanobu

    2014-01-01

    To evaluate progression of arteriosclerosis using cardio-ankle vascular index(CAVI) and carotid duplex ultrasonography(DUS) in young and adolescent patients considered to be at risk of cardiovascular disease. We evaluated the progression of arteriosclerosis using CAVI and carotid DUS in 240 young and adolescent patients. Dyslipidemia(DL), hypertension(HT), and diabetes mellitus(DM) were major cardiovascular risk factors. Patients were divided to 4 groups according to number of risk factors. In terms of risk factors, CAVI and CAVI difference(CAVI-D) were elevated only in the HT group(p=0.0290, p=0.0243 vs. no risk respectively). CAVI-D was positively associated with diastolic blood pressure(DBP). Mean IMT was positively associated with LDL-C or systolic blood pressure, and negatively with HDL-C. Plaque score was associated with LDL-C or DBP. In patients with the 3 risk factors, CAVI, CAVI-D and mean intima-media thickness(IMT) were significantly higher than in those without risk(p=0.0009, p=0.0042 and p=0.0151 respectively), and CAVI and CAVID were higher than in those with 1 risk(p=0.0204 and p=0.0231). Carotid plaque develops from around 30 years of age in Japan. Despite numbers of risk factors, there were no differences in CAVI, CAVI-D, mean IMT or plaque score between smoker and non-smoker groups. In conclusion, an increase in the number of risk factors also results in progression of arteriosclerosis in young and adolescent patients. HT was the most important risk factor for arteriosclerosis in these patients.

  20. Younger age and female sex predict a better therapeutic response in HBeAg-positive chronic hepatitis B patients to entecavir therapy

    Directory of Open Access Journals (Sweden)

    Wei-Chih Su

    2014-12-01

    Conclusion: Two-year entecavir therapy has good biochemical and virologic responses; however, the rate of HBeAg loss is modest in HBeAg-positive CHB patients. A young age (i.e., ≤35 years and female sex were also associated with a better serologic response.

  1. Clinical and biological impact of TET2 mutations and expression in younger adult AML patients treated within the EORTC/GIMEMA AML-12 clinical trial

    NARCIS (Netherlands)

    Aslanyan, M.G.; Kroeze, L.; Langemeijer, S.M.C.; Koorenhof-Scheele, T.N.; Massop, M.; Hoogen, P. van; Linders, E.H.P.; Locht, L.T.F. van de; Tonnissen, E.; Heijden, A. van der; Silva-Coelho, P.; Cilloni, D.; Saglio, G.; Marie, J.P.; Tang, R.; Labar, B.; Amadori, S.; Muus, P.; Willemze, R.; Marijt, E.W.; Witte, T.J. de; Reijden, B.A. van der; Suciu, S.; Jansen, J.H.

    2014-01-01

    We assessed the prognostic impact of TET2 mutations and mRNA expression in a prospective cohort of 357 adult AML patients < 60 years of age enrolled in the European Organization For Research and Treatment of Cancer (EORTC)/Gruppo Italiano Malattie Ematologiche dell' Adulto (GIMEMA) AML-12 06991 c

  2. Disease characteristics, treatment patterns, and outcomes of follicular lymphoma in patients 40 years of age and younger: an analysis from the National Lymphocare Study†

    Science.gov (United States)

    Casulo, C.; Day, B.; Dawson, K. L.; Zhou, X.; Flowers, C. R.; Farber, C. M.; Hainsworth, J. D.; Cerhan, J. R.; Link, B. K.; Zelenetz, A. D.; Friedberg, J. W.

    2015-01-01

    Background Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma, with median age at diagnosis in the seventh decade. FL in young adults (YAs), defined as diagnosis at ≤40 years, is uncommon. No standard approaches exist guiding the treatment of YA FL, and little is known about their disease characteristics and outcomes. To gain further insights into YA FL, we analyzed the National LymphoCare Study (NLCS) to describe characteristics, initial treatments, and outcomes in this population versus patients aged >40 years. Patients and methods Using the NLCS database, we stratified FL patients by age: 18–40 (YA), 41–60, 61–70, 71–80, and >80 years. Survival probability was estimated using Kaplan–Meier methodology. We examined associations between age and survival using hazard ratios and 95% confidence intervals (CIs) from multivariable Cox models. Results Of 2652 eligible FL patients in the NLCS, 164 (6%) were YAs. Of YA patients, 69% had advanced disease, 80% had low-grade histology, and 50% had good-risk disease according to the Follicular Lymphoma International Prognostic Index (FLIPI). Nineteen percent underwent observation, 12% received rituximab monotherapy, and 46% received chemoimmunotherapy [in 59% of these: R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone)]. With a median follow-up of 8 years, overall survival (OS) at 2, 5, and 8 years was 98% (95% CI 93–99), 94% (95% CI 89–97), and 90% (95% CI 83–94), respectively. Median progression-free survival (PFS) was 7.3 years (95% CI 5.6–not reached). Conclusions In one of the largest cohorts of YA FL patients treated in the rituximab era, disease characteristics and outcomes were similar to patients aged 41–60 years, with favorable OS and PFS in YAs. Longer-term outcomes and YA-specific survivorship concerns should be considered when defining management. These data may not support the need for more aggressive therapies in YA FL. Clinical trial

  3. [Fatal aorto-esophageal fistula due to accidental ingestion of button battery. Algorithm for management of disk-battery ingestion in patients younger than 6 years old].

    Science.gov (United States)

    Nisse, Patrick; Lampin, Marie Emilie; Aubry, Estelle; Cixou, Emmanuel; Mathieu-Nolf, Monique

    2016-10-01

    The ingestion of disc battery is a common problem in children and current treatment may be sometime inadequate. Ingested button batteries have the potential to cause significant morbidity and mortality. Ingestion of button batteries has been seen with increasing frequency over the last decade, particularly for children aged younger than 6 years. If most cases of disc battery ingestion run uneventful courses, however, harmful outcomes are more common with ingestion of lithium batteries (3V) with a diameter greater than or equal to 16 mm. These young children have to benefit from a chest radiograph within 2hours which follow the ingestion. If the battery impacts in the esophagus, emergency endoscopic management is necessary. We report the case of one young child died followed an unknown lithium disk-battery ingestion complicated with an aorto-œsophageal fistula. We propose a protocol of specific coverage for patients aged younger than 6 years old. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Clinical and biological impact of TET2 mutations and expression in younger adult AML patients treated within the EORTC/GIMEMA AML-12 clinical trial.

    Science.gov (United States)

    Aslanyan, Mariam G; Kroeze, Leonie I; Langemeijer, Saskia M C; Koorenhof-Scheele, Theresia N; Massop, Marion; van Hoogen, Patricia; Stevens-Linders, Ellen; van de Locht, Louis T; Tönnissen, Evelyn; van der Heijden, Adrian; da Silva-Coelho, Pedro; Cilloni, Daniela; Saglio, Giuseppe; Marie, Jean-Pierre; Tang, Ruoping; Labar, Boris; Amadori, Sergio; Muus, Petra; Willemze, Roel; Marijt, Erik W A; de Witte, Theo; van der Reijden, Bert A; Suciu, Stefan; Jansen, Joop H

    2014-08-01

    We assessed the prognostic impact of TET2 mutations and mRNA expression in a prospective cohort of 357 adult AML patients Adulto (GIMEMA) AML-12 06991 clinical trial. In addition the co-occurrence with other genetic defects and the functional consequences of TET2 mutations were investigated. TET2 mutations occurred in 7.6 % of the patients and were an independent marker of poor prognosis (p = 0.024). TET2 and IDH1/2 mutations strongly associated with aberrations in the DNA methyltransferase DNMT3A. Functional studies confirmed previous work that neither nonsense truncations, nor missense TET2 mutations, induced 5-hydroxymethylcytosine formation. In addition, we now show that mutant TET2 forms did not act in a dominant negative manner when co-expressed with the wild-type protein. Finally, as loss-of-function TET2 mutations predicted poor outcome, we questioned whether low TET2 mRNA expression in cases of AML without TET2 mutations would affect overall survival. Notably, also AML patients with low TET2 mRNA expression levels showed inferior overall survival.

  5. Non-contrast-enhanced whole-body magnetic resonance imaging in the general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects.

    Directory of Open Access Journals (Sweden)

    Andrzej Cieszanowski

    Full Text Available PURPOSE: To assess and compare the incidence of abnormal findings detected during non-contrast-enhanced whole-body magnetic resonance imaging (WB-MRI in the general population in two age groups: (1 50 years old and younger; and (2 over 50 years old. MATERIALS AND METHODS: The analysis included 666 non-contrast-enhanced WB-MRIs performed on a 1.5-T scanner between December 2009 and June 2013 in a private hospital in 451 patients 50 years old and younger and 215 patients over 50 years old. The following images were obtained: T2-STIR (whole body-coronal plane, T2-STIR (whole spine-sagittal, T2-TSE with fat-saturation (neck and trunk-axial, T2-FLAIR (head-axial, 3D T1-GRE (thorax-coronal, axial, T2-TSE (abdomen-axial, chemical shift (abdomen-axial. Detected abnormalities were classified as: insignificant (type I, potentially significant, requiring medical attention (type II, significant, requiring treatment (type III. RESULTS: There were 3375 incidental findings depicted in 659 (98.9% subjects: 2997 type I lesions (88.8%, 363 type II lesions (10.8% and 15 type III lesions (0.4%, including malignant or possibly malignant lesions in seven subjects. The most differences in the prevalence of abnormalities on WB-MRI between patients 50 years old and younger and over 50 years old concerned: brain infarction (22.2%, 45.0% respectively, thyroid cysts/nodules (8.7%, 18.8%, pulmonary nodules (5.0%, 16.2%, significant degenerative disease of the spine (23.3%, 44.5%, extra-spinal degenerative disease (22.4%, 61.1%, hepatic steatosis (15.8%, 24.9%, liver cysts/hemangiomas (24%, 34.5%, renal cysts (16.9%, 40.6%, prostate enlargement (5.1% of males, 34.2% of males, uterine fibroids (16.3% of females, 37.9% of females. CONCLUSIONS: Incidental findings were detected in almost all of the subjects. WB-MRI demonstrated that the prevalence of the vast majority of abnormalities increases with age.

  6. Non-Contrast-Enhanced Whole-Body Magnetic Resonance Imaging in the General Population: The Incidence of Abnormal Findings in Patients 50 Years Old and Younger Compared to Older Subjects

    Science.gov (United States)

    Cieszanowski, Andrzej; Maj, Edyta; Kulisiewicz, Piotr; Grudzinski, Ireneusz P.; Jakoniuk-Glodala, Karolina; Chlipala-Nitek, Irena; Kaczynski, Bartosz; Rowinski, Olgierd

    2014-01-01

    Purpose To assess and compare the incidence of abnormal findings detected during non-contrast-enhanced whole-body magnetic resonance imaging (WB-MRI) in the general population in two age groups: (1) 50 years old and younger; and (2) over 50 years old. Materials and Methods The analysis included 666 non-contrast-enhanced WB-MRIs performed on a 1.5-T scanner between December 2009 and June 2013 in a private hospital in 451 patients 50 years old and younger and 215 patients over 50 years old. The following images were obtained: T2-STIR (whole body-coronal plane), T2-STIR (whole spine-sagittal), T2-TSE with fat-saturation (neck and trunk-axial), T2-FLAIR (head-axial), 3D T1-GRE (thorax-coronal, axial), T2-TSE (abdomen-axial), chemical shift (abdomen-axial). Detected abnormalities were classified as: insignificant (type I), potentially significant, requiring medical attention (type II), significant, requiring treatment (type III). Results There were 3375 incidental findings depicted in 659 (98.9%) subjects: 2997 type I lesions (88.8%), 363 type II lesions (10.8%) and 15 type III lesions (0.4%), including malignant or possibly malignant lesions in seven subjects. The most differences in the prevalence of abnormalities on WB-MRI between patients 50 years old and younger and over 50 years old concerned: brain infarction (22.2%, 45.0% respectively), thyroid cysts/nodules (8.7%, 18.8%), pulmonary nodules (5.0%, 16.2%), significant degenerative disease of the spine (23.3%, 44.5%), extra-spinal degenerative disease (22.4%, 61.1%), hepatic steatosis (15.8%, 24.9%), liver cysts/hemangiomas (24%, 34.5%), renal cysts (16.9%, 40.6%), prostate enlargement (5.1% of males, 34.2% of males), uterine fibroids (16.3% of females, 37.9% of females). Conclusions Incidental findings were detected in almost all of the subjects. WB-MRI demonstrated that the prevalence of the vast majority of abnormalities increases with age. PMID:25259581

  7. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P

    2007-01-01

    Arthroplasty Registry (DHR), we identified patients less than 70 years old who had undergone uncemented primary THA during 1997-2005. 4,125 HA-coated and 7,737 non-HA-coated cups and 3,158 HA-coated and 4,749 non-HA-coated stems were available for analysis. The mean follow-up time was 3.4 years for cups and 3.......61-1.1) for HA-coated cups and stems, respectively. INTERPRETATION: In this medium-term follow-up study, the use of HA-coated implants was not associated with any clearly reduced overall risk of revision compared to non-HA-coated implants.......BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip...

  8. Differences in reasons for smoking between younger and older smokers.

    Science.gov (United States)

    Oei, T P; Tilley, D; Gow, K

    1991-01-01

    The reasons why older people smoke have not been examined in the literature. This paper attempted to examine the differences in motivation and maintenance factors of elderly and young smokers using the Horn-Waingrow Why do you smoke questionnaire. One hundred and thirteen clinical patients and 112 non-patient controls were used in this study. The clinical group was divided into an elderly group (n = 58) and a younger group (n = 55). The results of a discriminant analysis showed that patients significantly differed from non-patients on 'automatic habit and stimulation', and 'crutch/tension reduction' factors. Elderly patients were found to be significantly differentiated from both younger patients and the control group on the 'pleasurable relaxation' factor. These findings offer support for the US Surgeon Generals' report that elderly smokers do have different motivating factors for their smoking behaviours from younger smokers.

  9. The Influence of Health Literacy and Patient Activation on Patient Information Seeking and Sharing.

    Science.gov (United States)

    Ledford, Christy J W; Cafferty, Lauren A; Russell, Travis C

    2015-01-01

    This study provided an assessment of how patients looked for information to prepare for a clinical appointment and whether they shared those findings with their provider. A cross-sectional survey allowed insight into patient attitudes, motivations, and behavior in clinical real time. At two hospital-based clinics, 243 patients completed surveys before and after clinical appointments. Younger patients with higher communicative and critical health literacy prepared for clinical appointments with information searches. The predicted association of health literacy and patient activation with information sharing was not supported. This study shows that patients with higher patient activation perceived that their providers responded more positively to patient-obtained medical information. The role of critical health literacy may show that individuals choosing to seek information are considering not just their ability to conduct the search but also their ability to synthesize and critically analyze the results of the information search. An implication for providers is to become skilled in directly asking or passively surveying what outside information sources the patient has engaged with, no matter if the patient does or does not introduce the information.

  10. [Rheumatic cardiopathy in children younger than 6 years of age].

    Science.gov (United States)

    Vázquez-Antona, C; Calderón-Colmenero, J; Attié, F; Zabal, C; Buendía-Hernández, A; Díaz-Medina, L H; Bialkowski, J; García Arenal, F

    1991-01-01

    Most of the published papers on Rheumatic Fever (RF) have not included the younger population. We selected 211 cases of children with RF younger than 6 years of age from 9,471 clinical files from 1944 to 1982. These were followed retrospectively to identify the presence of rheumatic activity, subsequent attacks and penicillin profilaxis. From de 211 cases, 209 had carditis; 57% of them were girls and 43% boys. There were no previous infections of the upper respiratory tract in 36% of the patients. The number of cases with RF increased abruptly after 3 years of age and continued increasing until 5 years of age when 70.5% of the population had there first clinically recognized attack. Lesions were present in the mitral valve in 80% of the cases, in the aortic valve in 12%, in the tricuspid in 5% and in the pulmonary valve in 3%. The death rate during the first attack was 20% being refractory heart failure the main cause of death. Thirteen cases suffered rheumatic pneumonia, 9 of whom died (69.2%). 1) The incidence of acute rheumatic fever in children under 6 years of age has decreased with time. 2) The death rate as well as the valvular damage decreased with the parents cooperation with the treatment. 3) The changes in the clinical picture and the severity of valve sequelea may be due to penicillin profilaxis and the better understanding of the disease.

  11. Older Siblings Influence Younger Siblings' Motor Development

    Science.gov (United States)

    Berger, Sarah E.; Nuzzo, Katie

    2008-01-01

    Evidence exists for two competing theories about the effects of having an older sibling on development. Previous research has found that having an older sibling has both advantages and disadvantages for younger siblings' development. This study examined whether and how older siblings influenced the onset of their own younger siblings' motor…

  12. Age-related changes of superoxide dismutase activity in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Đorđević Vladimir V.

    2017-01-01

    Full Text Available Background/Aim: Superoxide dismutase (SOD is the critical enzyme in the detoxification of superoxide radicals because those are the first species produced in the majority of biological free radical producing reactions. Inconsistent data are present about SOD activity in patients with schizophrenia. Numerous studies have shown that SOD has been elevated in chronic schizophrenic patients. However, decreased SOD activity was found in neuroleptic naïve, first episode schizophrenic patients, in chronic-medicated patients and in chronic-unmedicated patients. The aim of this study was to examine which of the following factors including age, gender, the onset of the disease, the duration, the number of episodes, heredity, psychopathologic symptoms and drug treatment could affect erythrocyte SOD activity in patients with schizophrenia. Methods: This study included 68 consecutive patients with schizophrenia (29 males and 39 females ranging in age from 18 to 61 years, divided into two age groups (34 years. SOD activity was measured in erythrocyte hemolyzates by Ransod commercially available test. Results: In the group of patients younger than 34 years SOD levels were significantly higher (1381±273 U/gHb, p=0.038 compared to the levels of the older group (1231±206 U/gHb. Gender and heredity did not induce any significant difference in SOD activity between younger and older subgroups. A significant difference in enzyme activity was found between the younger and older subgroups having the onset of the disease after 24 years of age (1408±217 U/gHb vs. 1252±213 U/gHb, p=0.031. The patients of the younger group who had more than one psychotic episode had significantly higher SOD activity (1492±298 U/gHb; p=0.009 than those who had only one episode (1256±177 U/gHb, as well as than the older subgroup with more than one episode (1253±231 U/gHb; p=0.014. Although the duration of the disease did not induce any significant difference in enzyme activity between

  13. How active are young cardiac device patients? Objective assessment of activity in children with cardiac devices.

    Science.gov (United States)

    de la Uz, Caridad M; Burch, Ashley E; Gunderson, Bruce; Koehler, Jodi; Sears, Samuel F

    2017-09-12

    The daily activity of pediatric patients with implantable cardiac devices provides behavioral evidence of functional outcomes. Modern devices provide continuous accelerometer data that is sensitive to movement, but normative values have not been published for pediatric activity rates. This study provides the first normative accelerometer data on activity rates in a large sample of pediatric cardiac device patients. Patients were between 3 and 18 years old, (N = 1,905) and implanted with a cardiac device from a single device company, and enrolled in remote monitoring. The median age at implant was 14 years (IQR = 12-16); 61.3% were male. Data for 4 weeks was extracted from a company database at 53 weeks post-implant and an average of daily activity was calculated. Daily average activity for all patients was 5.4 hours (SD = 2.0). In a multivariate analysis, increased level of activity was associated with: being male, having a pacemaker vs implantable cardioverter defibrillator, epicardial device location, rate response turned off, having experienced a shock, and younger age. These results provide the first baseline data of physical activity in children with implanted cardiac devices and provide a clinical guide to physical activity assessment in this population. Further, our data suggest physical activity in children with implantable cardiac devices may differ based on demographic variables, device type, device location, indication for implantation, and history of ICD shock. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Coagulation factor VIII activity in diabetic patients

    Directory of Open Access Journals (Sweden)

    Nermina Babić

    2011-02-01

    Full Text Available Aim To examine coagulation factor VIII activity in plasma, as a risk factor for thrombosis, in the patients with diabetes mellitus (DM. Also, to assess its relationship with ibrinogen and fasting blood glucose concentrations and with body mass index. Methods The plasma coagulation factor VIII activity, plasma levels of ibrinogen and blood glucose concentrations were measured in 30 patients with DM type 1, 30 patients with DM type 2 and in 30 healthy subjects. Body weight and body height were also measured and BMI was calculated.Results The plasma factor VIII activity in patients with DM type 1 and patients with DM type 2 was signiicantly higher than the values measured in healthy subjects. There was no signiicant difference in the factor VIII activity between patients with DM type 1 and type 2. The concentrations of ibrinogen and blood glucose in both groups of patients were signiicantly higher than in the group of healthy subjects. Patients with DM type 2 had a signiicantly higher BMI compared to healthy subjects, as well as compared to patients with DM type 1. There was a signiicant positive correlation between plasma factor VIII activity and plasma level of ibrinogen and a signiicant negative correlation between factor VIII activity and BMI in patients with DM type 2. Conclusion Diabetic patients have the elevated plasma coagulation factor VIII activity and increased ibrinogen concentration thus an increased risk of thrombosis and vascular diseases.

  15. Developing services for younger people with dementia.

    Science.gov (United States)

    Jubb, Dennis; Pollard, Nick; Chaston, Denise

    The services available for younger people with dementia (typically between 45 and 65 years of age) are underdeveloped. This article describes how one trust has addressed the problem through a 'coffee shop' project. This drop-in facility allows younger people with dementia and their carers to meet informally, support each other and access a range of services, such as counselling, medical information, help with benefits and legal advice.

  16. 55岁以内患者前列腺穿刺临床病理特征分析%Prostate biopsy results and clinicopathological characteristics of the 55 years or younger patients

    Institute of Scientific and Technical Information of China (English)

    宋刚; 方冬; 纪光杰; 虞巍; 赵承琳; 李学松; 山刚志; 李淑清; 何群

    2016-01-01

    ,with the median age of 51 years old and median prostate-specific antigen of 8.62 μg/L Among them 71 patients (86.6%) underwent pre-biopsy magnetic resonance imaging test,with 25 positive (35.2%),18 suspicious (25.4%) and 28 negative results (39.4%).Pathology confirmed prostate cancer in 26 patients (31.7%),including 23 (28.0%) high-grade prostate cancer.Higher prostate-specific antigen,positive ultrasonography and positive magnetic resonance imaging were risk factors for prostate cancer and high-grade prostate cancer.For patients with prostate-specific antigen between 4 and 10 μg/L,15.0% were diagnosed with prostate cancer,and positive ultrasound and magnetic resonance imaging were predictive for biopsy results.Conclusions The positive rate of prostate biopsy in men younger than 55 years old is 31.7%,and the risk for prostate cancer of this cohort of patients shouldn't be neglected.Prostate-specific antigen value,ultrasonography and magnetic resonance imaging could help predict biopsy results.

  17. GASTROINTESTINAL MALIGNANCIES: GETTING A DECADE YOUNGER?

    Directory of Open Access Journals (Sweden)

    Sushmitha

    2014-06-01

    Full Text Available INTRODUCTION: Gastrointestinal malignancies are one of the most common malignancies encountered frequently, with rising incidence in young age due to the changing lifestyle and food habits in India. Oesophagus, stomach and colonic cancers are the commonly affected regions of the GI tract. These malignancies is known to occur in older age of fifth decade onwards. This is a study intended to highlight the rising incidence of such malignancies in the younger age in second to third decade as observed in and around Mangalore. Upper gastrointestinal malignancies are common in oesophagus and stomach, whereas lower gastrointestinal malignancies occur more commonly seen in colon. Colorectal cancer (CRC is one of the most common of all familial malignancies with peak incidence in 60 to 70 years of age, 90% of cases occur in people aged 50 or older.Risk factors include a genetic predisposition, diet and lifestyle changes in the current era. Inheritance plays a role in the pathogenesis of upto a third of CRC cases. AIMS AND OBJECTIVE: To study the prevalence of gastrointestinal malignancies in patients less than fifty years and the association of positive family history and polyps with colorectal carcinomas. MATERIAL AND METHODS: This is a retrospective study of 128 cases of gastrointestinal malignancies from June 2010 to May 2012 received in and around Mangalore. The study includes endoscopic biopsies, colonoscopic biopsies partial and total colectomy specimens with growth seen anywhere from oesophagus to rectum. Representative sections are taken, processed routinely and stained with H & E. The pathological findings are then correlated with clinical data like age and sex distribution, site, family history and presence of other malignancies. RESULTS: In this study gastrointestinal malignancies were studied as upper and lower gastrointestinal lesions. Upper gastrointestinal (GI lesions were those in oesophagus, stomach, and duodenum. A total of 128 cases

  18. Navigating stroke care: the experiences of younger stroke survivors.

    Science.gov (United States)

    Sadler, Euan; Daniel, Katie; Wolfe, Charles D A; McKevitt, Christopher

    2014-01-01

    Although stroke is associated with ageing, a significant proportion of strokes occur in younger people. Younger stroke survivors have experienced care available as inappropriate to their needs. However, insufficient attention has been paid to how the social context shapes their experiences of care. We investigated this question with younger stroke survivors in Greater London, UK. We conducted in-depth interviews with individuals aged between 24 and 62 years. Interviews were analysed thematically, with interpretation informed by Bourdieu's concepts of field, capital and habitus. In the acute care setting it was implicit for participants that expertise and guidance was to be prioritised and largely this was reported as what was received. Individuals' cultural capital shaped expectations to access information, but health care professionals' symbolic capital meant they controlled its provision. After discharge, professional guidance was still looked for, but many felt it was limited or unavailable. It was here that participants' social, cultural and economic capital became more important in experiences of care. The field of stroke shaped younger stroke survivors' experiences of care. Navigating stroke care was contingent on accessing different forms of capital. Differences in access to these resources influenced longer term adjustment after stroke. Stroke care can be conceptualised as a temporal field of social activity and relationships which shapes variations in experiences of care among younger stroke survivors, and differences in expectations of support at different time points after stroke. On entering the field of stroke participants reported needing health care professional guidance and expertise to manage the acute event, yet difficulties accessing information in hospital limited the agency of some individuals wanting to take an active role in their recovery. After discharge from hospital variations in experiences of care among participants were more evident

  19. Activities Patients and Nurses Undertake to Promote Patient Participation.

    Science.gov (United States)

    Tobiano, Georgia; Marshall, Andrea; Bucknall, Tracey; Chaboyer, Wendy

    2016-07-01

    To describe and understand activities patients and nurses undertake to enact patient participation in nursing care. This observational study was conducted on two medical units at a public hospital in Australia. Twenty-eight nurse-patient dyads were observed for at least 4 hr. Data were collected from November 2013 to February 2014. Field notes were collected and were analyzed both inductively and deductively. Nurse-patient interactions promoted patient participation through dialogue and knowledge sharing. Less evident was patient involvement in planning or self-care. Nurses exerted control over patient care, which influenced the extent of patient participation. Patient participation appears to be difficult to enact. Nurses' controlling approach, influenced by organizational issues, was in conflict with a patient-centered approach to care. Nurse-patient communication is one aspect of patient-centered care enacted more frequently. Nurses may benefit from strategies at the individual and organizational level to enhance their patient-centered practices. Fostering nurses' communication may enhance patient-centered practices in hospitals. © 2016 Sigma Theta Tau International.

  20. Physical Activity in Hospitalised Stroke Patients

    Directory of Open Access Journals (Sweden)

    Tanya West

    2012-01-01

    Full Text Available The aim of this paper was to examine the amount and type of physical activity engaged in by people hospitalised after stroke. Method. We systematically reviewed the literature for observational studies describing the physical activity of stroke patients. Results. Behavioural mapping, video recording and therapist report are used to monitor activity levels in hospitalised stroke patients in the 24 included studies. Most of the patient day is spent inactive (median 48.1%, IQR 39.6%–69.3%, alone (median 53.7%, IQR 44.2%–60.6% and in their bedroom (median 56.5%, IQR 45.2%–72.5%. Approximately one hour per day is spent in physiotherapy (median 63.2 minutes, IQR 36.0–79.5 and occupational therapy (median 57.0 minutes, IQR 25.1–58.5. Even in formal therapy sessions limited time is spent in moderate to high level physical activity. Low levels of physical activity appear more common in patients within 14 days post-stroke and those admitted to conventional care. Conclusions. Physical activity levels are low in hospitalised stroke patients. Improving the description and classification of post stroke physical activity would enhance our ability to pool data across observational studies. The importance of increasing activity levels and the effectiveness of interventions to increase physical activity after stroke need to be tested further.

  1. On Younger Stakeholders and Decommissioning of Nuclear Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Tyszkiewicz, Bogumila; Labor, Bea

    2009-08-15

    In modern democratic countries, information sharing and effective and open communication concerning dismantling and decommissioning of of nuclear facilities as well as the management of nuclear waste are essential for the task to build the confidence required for any further development of nuclear energy. At the same time, it is often perceived that all decision making processes about nuclear energy policies are probably increasingly influenced by public opinion. Nuclear and radiation safety Authorities have a clear role in this regard to provide unbiased information on any health and safety related issues. In order to meet this need, it is necessary for Authorities and others to understand the values and opinions of the citizens, and especially the younger ones. They hold the key to the future at the same time as their perspective on these issues is the least understood. The need of greater public participation in decision making is becoming increasingly recognised the scientific as well as the political community. Many activities are carried out in order to stimulate to higher levels of public involvement in decision making in this active research area. Younger citizens is a stakeholder group that is often excluded in decision- making processes. The existence of large gaps between the involvement of older and younger stakeholders in decision making processes needs to be addressed, since such imbalances might otherwise lead to unequal opportunities between generations and limit the future consumption level of the coming generations. Another demanding task for the present generation is to assure that appropriate financial resources are injected into the Swedish Nuclear Waste Fund. It will thereby be possible for coming generations to undertake efficient measures in the decommissioning and dismantling of older nuclear facilities. To undertake such measures in line with the environmental and health codex is essential. An appropriate balance in this regard must be

  2. [Physical activity and management of obese patients].

    Science.gov (United States)

    Oppert, J M; Balarac, N

    2001-09-01

    Physical activity is recognized as an integral part of obesity treatment, in association with other therapeutic means. A major benefit of physical activity is the association with better long-term maintenance of weight loss. Physical activity has also positive psychological effects and increases quality of life. An evaluation of the usual level of physical activity and inactivity is needed for each patient. Physical activity counselling should be individualized and graded, in a perspective of individual progression. In subjects with massive obesity, remobilization based on physiotherapy techniques is the first step. All patients should be given simple advice to decrease sedentary behavior: use the stairs instead of the escalators, limit the time spent seated, etc. In general, current physical activity recommendations for the general population fit well with a majority of obese patients, i.e. a minimum of 30 minutes/day of moderate intensity physical activity (brisk walking or equivalent) on most, and preferably all, days of the week. Physical activities of higher intensities (endurance training programme) can be proposed on an individual basis. The type of physical activity required for long-term weight maintenance, and the question of adherence to physical activity recommendations in obese patients should be further investigated.

  3. Preferences for active and aggressive intervention among patients with advanced cancer

    Directory of Open Access Journals (Sweden)

    Ennis Marguerite

    2010-10-01

    Full Text Available Abstract Background Intrinsic to "Patient-Centered Care" is being respectful and responsive to individual patient preferences, expressed needs, and personal values. Establishing a patient's preferences for active and aggressive intervention is imperative and foundational to the development of advance care planning. With the increasing awareness and acceptance of palliative philosophies of care, patients with advanced cancer are increasingly transitioning from active and aggressive medical management (AAMM to conservative palliative management (CPM. Methods A cross-sectional study based on a prospective and sequential case series of patients referred to a regional palliative medicine consultative program was assembled between May 1, 2005 and June 30, 2006. Patients and/or their substitute decision makers (SDM completed a questionnaire, at baseline, that assessed their preferences for AAMM en route to their eventual deaths. Seven common interventions constituting AAMM were surveyed: cardiopulmonary resuscitation (CPR & mechanical ventilation (MV, chemotherapy, antibiotics, anticoagulants, blood transfusions, feeding tubes, and artificial hydration. Multivariable analyses were conducted on the seven interventions individually as well as on the composite score that summed preferences for the seven interventions. Results 380 patients with advanced cancer agreed to participate in the study. A trend to desire a mostly conservative palliative approach was noted as 42% of patients desired one or fewer interventions. At baseline, most patients and their SDM's were relatively secure about decisions pertaining to the seven interventions as the rates of being "undecided" ranged from a high of 23.4% for chemotherapy to a low of 3.9% for feeding tubes. Multivariable modeling showed that more AAMM was preferred by younger patients (P Conclusions Although the majority of patients with advanced cancer in this study expressed preferences for CPM, younger age

  4. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  5. Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Wiggins, Amelia J.; Grandhi, Ravi K.; Schneider, Daniel K.; Stanfield, Denver; Webster, Kate E.; Myer, Gregory D.

    2017-01-01

    Background Injury to the ipsilateral graft used for reconstruction of the anterior cruciate ligament (ACL) or a new injury to the contralateral ACL are disastrous outcomes after successful ACL reconstruction (ACLR), rehabilitation, and return to activity. Studies reporting ACL reinjury rates in younger active populations are emerging in the literature, but these data have not yet been comprehensively synthesized. Purpose To provide a current review of the literature to evaluate age and activity level as the primary risk factors in reinjury after ACLR. Study Design Systematic review and meta-analysis. Methods A systematic review of the literature was conducted via searches in PubMed (1966 to July 2015) and EBSCO host (CINAHL, Medline, SPORTDiscus [1987 to July 2015]). After the search and consultation with experts and rating of study quality, 19 articles met inclusion for review and aggregation. Population demographic data and total reinjury (ipsilateral and contralateral) rate data were recorded from each individual study and combined using random-effects meta-analyses. Separate meta-analyses were conducted for the total population data as well as the following subsets: young age, return to sport, and young age + return to sport. Results Overall, the total second ACL reinjury rate was 15%, with an ipsilateral reinjury rate of 7% and contralateral injury rate of 8%. The secondary ACL injury rate (ipsilateral + contralateral) for patients younger than 25 years was 21%. The secondary ACL injury rate for athletes who return to a sport was also 20%. Combining these risk factors, athletes younger than 25 years who return to sport have a secondary ACL injury rate of 23%. Conclusion This systematic review and meta-analysis demonstrates that younger age and a return to high level of activity are salient factors associated with secondary ACL injury. These combined data indicate that nearly 1 in 4 young athletic patients who sustain an ACL injury and return to high-risk sport

  6. Cost-utility of metal-on-metal hip resurfacing compared to conventional total hip replacement in young active patients with osteoarthritis

    NARCIS (Netherlands)

    Heintzbergen, S.; Kulin, N.A.; IJzerman, M.J.; Steuten, L.M.G.; Werle, J.; Khong, H.; Marshall, D.A.

    2013-01-01

    Background: Metal-on-metal hip resurfacing arthroplasty (MoM HRA) has emerged as an alternative to total hip arthroplasty (THA) for younger active patients with osteoarthritis (OA). Birmingham hip resurfacing is the most common MoM HRA in Alberta, and is therefore compared with conventional THA. Obj

  7. Nutrition and Physical Activity in CKD patients

    Directory of Open Access Journals (Sweden)

    Adamasco Cupisti

    2014-07-01

    Full Text Available Chronic kidney disease (CKD patients are at risk for protein-energy wasting, abnormal body composition and impaired physical capacity. These complications lead to increased risk of hospitalization, morbidity and mortality.In CKD patient as well as in healthy people, there is a close association between nutrition and physical activity. Namely, inadequate nutrient (energy intake impairs physical performance thus favoring a sedentary lifestyle: this further contributes to loss of muscle strength and mass, which limit the quality of life and rehabilitation of CKD patients. In CKD as well as in end-stage-renal-disease patients, regular physical activity coupled with adequate energy and protein intake counteracts protein-energy wasting and related comorbidity and mortality. In summary, exercise training can positively influence nutritional status and the perception of well-being of CKD patients and may facilitate the anabolic effects of nutritional interventions.

  8. COMPARISON OF CLINICAL ACTIVITY OF PIMECROLIMUS IN PEDIATRIC PATIENTS WITH MILD AND MODERATE ATOPIC DERMATITIS

    Directory of Open Access Journals (Sweden)

    E.V. Deeva

    2008-01-01

    Full Text Available Atopic dermatitis (ad is prevalent disease in younger children. Calcium inhibitor pimecrolimus (elidel, cream 1% is the latest anti-inflammatory drug offered for management of ad. The activity of pimecrolimus was evaluated in open, prospective, randomized, comparison trial, on 60 children (age from 3 months to 7 years with mild and moderate ad. Pimecrolimus was more effective in management of mild ad on the assumption of regular use of drug (TIS < 17, and topical corticosteroids were effective in patients with moderate ad.Key words: children, atopic dermatitis, pimecrolimus, topical corticosteroids, management.

  9. Comparison of outcomes after vaginal reconstruction surgery between elderly and younger women

    Directory of Open Access Journals (Sweden)

    Yiap Loong Tan

    2014-09-01

    Conclusion: This study showed that adequately optimized older patients undergoing pelvic organ prolapse surgery experienced the same anatomical outcomes, comparable improved quality of life, morbidity, and mortality as their counterparts of younger age.

  10. The atmosphere during the younger dryas.

    Science.gov (United States)

    Mayewski, P A; Meeker, L D; Whitlow, S; Twickler, M S; Morrison, M C; Alley, R B; Bloomfield, P; Taylor, K

    1993-07-09

    One of the most dramatic climate change events observed in marine and ice core records is the Younger Dryas, a return to near-glacial conditions that punctuated the last deglaciation. High-resolution, continuous glaciochemical records, newly retrieved from central Greenland, record the chemical composition of the arctic atmosphere at this time. This record shows that both the onset and the termination of the Younger Dryas occurred within 10 to 20 years and that massive, frequent, and short-term (decadal or less) changes in atmospheric composition occurred throughout this event. Changes in atmospheric composition are attributable to changes in the size of the polar atmospheric cell and resultant changes in source regions and to the growth and decay of continental biogenic source regions.

  11. T cell activation in APECED patients

    OpenAIRE

    Mannerström, Helga

    2013-01-01

    Autoimmune polyendocrinopathy-candidasis-ectodermal dystrophy, APECED, is a rare monogenic autoimmune disease in humans, which is caused by loss-of-function mutation in Autoimmune Regulator gene, AIRE. Previous results have shown impairments in the circulating T cells of the APECED patients. In this study we wanted to look closer on the disturbance in the T cell receptor development of APECED patients. By studying the TCR-mediated responsiveness of CD3 stimulation and comparing the activation...

  12. Physical activity in patients with anorexia nervosa.

    Science.gov (United States)

    Achamrah, Najate; Coëffier, Moïse; Déchelotte, Pierre

    2016-05-01

    Anorexia nervosa (AN) is often associated with physical hyperactivity. Recent studies have established links between anorexia and hyperactivity, suggesting the existence of commonalities in neural pathways. How physical activity should be managed during the clinical care of patients with anorexia remains controversial. This review first focuses on the implication of hyperactivity in the pathophysiology of AN. Hyperactivity during refeeding of patients with AN has been associated with increased energy needs to achieve weight gain, poorer clinical outcome, longer hospitalization, and increased psychiatric comorbidity. This typically leads to the prescription of bed rest. However, current knowledge suggests that preserving some kind of physical activity during refeeding of patients with AN should be safe and beneficial for the restoration of body composition, the preservation of bone mineral density, and the management of mood and anxiety. In the absence of standardized guidelines, it is suggested here that physical activity during refeeding of patients with AN should be personalized according to the physical and mental status of each patient. More research is needed to assess whether programmed physical activity may be a beneficial part of the treatment of AN.

  13. Design for learning: deconstructing virtual patient activities.

    Science.gov (United States)

    Ellaway, Rachel H; Davies, David

    2011-01-01

    Digital technologies are used in almost every aspect of contemporary health professional education (HPE) but our understanding of their true potential as instructional tools rather than administrative tools has not significantly advanced in the last decade. One notable exception to this has been the rise of the 'virtual patient' as an educational intervention in HPE. This article attempts to deconstruct the virtual patient concept by developing a model of virtual patients as artifacts with intrinsic encoded properties and emergent constructed properties that build on the core concept of 'activity'.

  14. 卡托普利早期和长期治疗对老年急性心肌梗死患者生存率的影响%Comparison of the effects of early and long-term captopril treatment on the elderly and younger patients after acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    蔡煦; 沈卫峰; 龚兰生

    2001-01-01

    Objective To compare the effects of early and long-term treatment with captopril on clinical outcome between elder patients (65-75 years old) and younger patients (< 64 years old) suffering from acute myocardial infarction (AMI).  Methods In a randomized trial, 822 patients with a first AMI were treated with captopril at initial dosage of 6.25 mg and adjusted to 25 mg t.i.d according to blood pressure (209 younger patients, 269 elder patients) and conventional treatment (131 younger patients, 213 elder patients). Survival rate of the four groups was calculated with Kaplan-Meier method.  Results The survival of treatment group was correlated significantly with age during hospitalization (P=0.0002). Eight patients in younger treatment group and 10 patients in younger control group (3.83% vs 7.63%, P>0.05), 25 patients in elder treatment group and 52 patients in elder control group (9.29% vs 24.41%, relative risk = 0.37, 95% CI 0.29-0.48, P<0.0001) were died. During follow-up period, the survival was however not related to the age (P>0.05), and both the elder and younger patients had better survival (all P<0.01 ) and lower cardiac events (all P<0.01) during captopril treatment.  Conclusions  Captopril exerts less effect on the younger patients but more effect on the elder patients during hospitalization after AMI. Long-term captopril had no difference between the youngers and the elders in prognosis.%目的 比较早期和长期卡托普利治疗对≥65岁和<65岁急性心肌梗死(心梗)患者生存率的影响。 方法 根据是否早期及长期卡托普利治疗,将822例首次心梗72 h内入院患者分为<65岁卡托普利组209例、≥65岁卡托普利组269例,<65岁对照组131例、≥65岁对照组213例。  结果 住院期(1~42 d)<65岁卡托普利组死亡8例(3.83%),<65岁对照组死亡10例(7.63%),差异无显著性(P>0.05);≥65岁卡托普利组死亡25例(9.29%),≥65

  15. Electrodermal activity in patients with persistent insomnia.

    Science.gov (United States)

    Broman; Hetta

    1994-09-01

    In order to evaluate daytime arousal in patients with persistent insomnia, electrodermal activity (EDA) was measured in a habituation paradigm (21 tones, 80 dB, 1 s) in forty patients with persistent insomnia and in twenty normal subjects. Results showed that the patients had higher EDA than the controls implying a higher arousal level in the patients. Among the patients the distribution of trials to a habituation criterion was bimodal and patients were separated into habituators (n = 24) and non-habituators (n = 16). Non-habituators had significantly higher EDA than habituators and they also had a shorter nocturnal sleep time. Thus, daytime arousal was, significantly related to nocturnal sleep in the patients. Both patients with Psychophysiological Insomnia and Insomnia Associated with Psychiatric Disorders had higher EDA than the controls, and EDA was also significantly related to sleep in both groups. Results lend further support for the notion of an excessive daytime arousal, which may serve as a common predisposing factor in the initiation or maintenance of persistent insomnia.

  16. PALEOCLIMATE: The Younger Dryas: Cold, Cold Everywhere?

    Science.gov (United States)

    Rodbell, D T

    2000-10-13

    The transition from the last ice age to the current warm period was interupted by a ~1000-year return to glacial conditions. Most of the evidence for this Younger Dryas (YD) event comes from in and around the North Atlantic, and the geographical extent of the event remains uncertain. In his Perspective, Rodbell reviews the evidence for and against a YD event in the Southern Hemisphere and highlights the study by Bennett et al., who have found no evidence for a YD event in four lake records from southern Chile.

  17. Optimizing Physical Activity Among Older Adults Post Trauma: Overcoming System and Patient Challenges

    Science.gov (United States)

    Resnick, Barbara; Galik, Elizabeth; Wells PT, Chris L.; Boltz, Marie; Holtzman, Lauren

    2015-01-01

    By 2050 it is anticipated that close to half (40%) of all trauma patients will be over the age of 65. Recovery post trauma for these individuals is more complicated than among younger individuals. Specifically there is an increased risk for: (1) functional decline; (2) higher mortality rates; (3) longer length of stay; (4) greater resource consumption; (5) nursing home placement; (6) adverse events such as infections, pressure ulcers and falls; and (7) rehospitalization post discharge. Early mobilization has been shown to improve outcomes. Unfortunately, there are many challenges to early mobilization. The Function Focused Care Intervention was developed to overcome these challenges. The purpose of this paper was to describe the initial recruitment of the first 25 participants and delineate the challenges and successes associated with implementation of this intervention. Overall the intervention was implemented as intended and recruitment rates were consistent with other studies. Most patients were female, white and on average 79 years of age. Optimizing physical activity of patients was a low priority for the nurses with patient safety taking precedence. Patients spent most of the time in bed. Age, depression and tethering were the only factors that were associated with physical activity and functional outcomes of patients. Ongoing work is needed to keep patients physically active in the immediate post trauma recovery period. PMID:26547682

  18. Meltwater routing and the Younger Dryas.

    Science.gov (United States)

    Condron, Alan; Winsor, Peter

    2012-12-04

    The Younger Dryas--the last major cold episode on Earth--is generally considered to have been triggered by a meltwater flood into the North Atlantic. The prevailing hypothesis, proposed by Broecker et al. [1989 Nature 341:318-321] more than two decades ago, suggests that an abrupt rerouting of Lake Agassiz overflow through the Great Lakes and St. Lawrence Valley inhibited deep water formation in the subpolar North Atlantic and weakened the strength of the Atlantic Meridional Overturning Circulation (AMOC). More recently, Tarasov and Peltier [2005 Nature 435:662-665] showed that meltwater could have discharged into the Arctic Ocean via the Mackenzie Valley ~4,000 km northwest of the St. Lawrence outlet. Here we use a sophisticated, high-resolution, ocean sea-ice model to study the delivery of meltwater from the two drainage outlets to the deep water formation regions in the North Atlantic. Unlike the hypothesis of Broecker et al., freshwater from the St. Lawrence Valley advects into the subtropical gyre ~3,000 km south of the North Atlantic deep water formation regions and weakens the AMOC by 30%. We conclude that meltwater discharge from the Arctic, rather than the St. Lawrence Valley, was more likely to have triggered the Younger Dryas cooling.

  19. Appendicitis in Children: Evaluation of the Pediatric Appendicitis Score in Younger and Older Children

    Directory of Open Access Journals (Sweden)

    Martin Salö

    2014-01-01

    Full Text Available Background. This study aimed to evaluate Pediatric Appendicitis Score (PAS, diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis. Method. 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years (n=102 and <4 years (n=20. Results. The mean PAS was lower among the younger compared with the older patients (5.3 and 6.6, resp.; P=0.005, despite the fact that younger children had more severe appendicitis (75.0% and 33.3%, resp.; P=0.001. PAS had low sensitivity in both groups, with a significantly lower sensitivity among the younger patients. Parent and doctor delay were confirmed in children <4 years of age with appendicitis. PAS did not aid in patients with doctor delay. Parameters in patient history, symptoms, and abdominal examination were more diffuse in younger children. Conclusion. PAS should be used with caution when examining children younger than 4 years of age. Diffuse symptoms in younger children with acute appendicitis lead to delay and to later diagnosis and more complicated appendicitis.

  20. High-Dose Cytarabine in Induction Treatment Improves the Outcome of Adult Patients Younger Than Age 46 Years With Acute Myeloid Leukemia: Results of the EORTC-GIMEMA AML-12 Trial

    NARCIS (Netherlands)

    Willemze, R.; Suciu, S.; Meloni, G.; Labar, B.; Marie, J.P.; Halkes, C.J.; Muus, P.; Mistrik, M.; Amadori, S.; Specchia, G.; Fabbiano, F.; Nobile, F.; Sborgia, M.; Camera, A.; Selleslag, D.L.; Lefrere, F., Sr.; Magro, D.; Sica, S.; Cantore, N.; Beksac, M.; Berneman, Z.; Thomas, X.; Melillo, L.; Guimaraes, J.E.; Leoni, P.; Luppi, M.; Mitra, M.E.; Bron, D.; Fillet, G.; Marijt, E.W.; Venditti, A.; Hagemeijer, A.; Mancini, M.; Jansen, J.H.; Cilloni, D.; Meert, L.; Fazi, P.; Vignetti, M.; Trisolini, S.M.; Mandelli, F.; Witte, T.J. de

    2014-01-01

    PURPOSE: Cytarabine plays a pivotal role in the treatment of patients with acute myeloid leukemia (AML). Most centers use 7 to 10 days of cytarabine at a daily dose of 100 to 200 mg/m(2) for remission induction. Consensus has not been reached on the benefit of higher dosages of cytarabine. PATIENTS

  1. 饮食习惯与青年人膀胱移行细胞癌关系的病例对照研究%A case-control study of the relation of eating habit and transitional cell carcinoma of the bladder in patients 40 years old or younger

    Institute of Scientific and Technical Information of China (English)

    任维果; 边家盛; 夏宝山; 宋海峰; 吴石; 许真俊; 章建胜

    2011-01-01

    Objective:To investigate the relation of eating habit and patients with carcinoma of the bladder with 40 years old or younger. Methods: A case - control study was deployed. From January 1995 to August 2006,82 patients with age less than 40 with transitional cell carcinoma of the bladder treated at Shandong Provincial Hospital, Shandong Tumor Hospital and The Central Hospital of Feicheng Mining Group Company were selected as the case group( EG ), and another 82 young adult without bladder cancer as control group( CG ). X test was used for monovariate factor analysis while non - conditional logistic regression for multivariate analysis. Results: Non - conditional logistic regression for multivariate analysis displayed that the bladder cancer in patients younger than 40 was associated with the following factors: Irregular food and drink ( OR = 6. 117,95%CI:1. 079 -34.685 )milchigs intake( OR =0. 031,95% CI: 0. 002 - 0. 544 ). While monovariate analysis displayed that the bladder cancer in patients younger than 40 was associated with the following factors: regular food and drink, milk product intake, vegetable consumption, dietary soy. Conclusion: The bladder cancer in patients younger than 40 was associated with eating habit, regular food and drink, ordinarily intake milk products and vegetable, much water intake and less dietary soy may be the possible protective factors for patients younger than 40 of bladder cancer.%目的:探讨饮食习惯与青年人膀胱移行细胞癌的关系.方法:采用以人群为基础的1∶1病例对照研究,病例组为1995年1月1日至2006年8月31日山东省省立医院、山东省肿瘤医院、山东肥城矿业中心医院三家医院收治的40岁以下膀胱移行细胞癌患者,对照组为无膀胱癌的40岁以下青年人.病例组与对照组各82例.单因素分析采用χ2检验,多因素分析采用非条件Logistic回归分析.结果:多因素非条件Logistic 回归分析显示40岁以下膀胱癌患者与下列

  2. Activities, procedures and doses in pediatric patients due to radiopharmaceuticals

    Directory of Open Access Journals (Sweden)

    Silvia Maria Velasques de Oliveira

    2008-12-01

    Full Text Available An investigation performed between 2003 and 2005 in sixteen selected public and private institutions in Northeast, Southeast and South geographical regions of Brazil evaluated average organ doses and effective doses in 2,411 pediatric patients due to diagnostic procedures with radiopharmaceuticals. For 1 year, effective doses were greater than literature. For 5 years, differences were noticed between present work and literature for bone scintigraphy, thyroid scintigraphy and 67Ga citrate scintigraphy. These differences may be attributed to the uncertainties in internal dose calculations. High absorved doses in bone surfaces of children due to 67Ga citrate and bone scintigraphy should be evaluated accordingly. Current protocols used recommend standardized mean activities per mean weight for all ages. However, it was observed that the activities were not standardized and were higher for children with younger ages. Future studies are needed for optimising activities of radiopharmaceuticals to these patients in the country.Foi realizado no Brasil, no período 2003-2005, um estudo sobre doses absorvidas em órgãos e doses efetivas devido ao uso de radiofármacos em pacientes pediátricos. Foram estudadas 2.411 crianças e adolescentes menores de 18 anos. Foi observado que as atividades usadas não foram padronizadas, sendo maiores para crianças de menor idade, podendo ser otimizadas conforme apropriado. Para 1 ano, as doses efetivas foram maiores do que as publicadas na literatura e para 5 anos, foram observadas diferenças para cintilografias ósseas, cintilografias da tireóide, e pesquisas de corpo inteiro com citrato de 67G. Deve ser avaliado se doses absorvidas em órgãos, especialmente para superfície óssea devido a cintilografias ósseas com 99mTc MDP e pesquisa de corpo inteiro com citrato de 67Ga podem acarretar risco radiológico adicional aos pacientes, considerando-se as peculiaridades de seu estado clínico.

  3. Deaths from Colon Cancer Up Among Younger White Americans

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_167665.html Deaths From Colon Cancer Up Among Younger White Americans Uptick has researchers ... 8, 2017 TUESDAY, Aug. 8, 2017 (HealthDay News) -- Colon cancer is claiming the lives of more younger, white ...

  4. Feasibility of Home-Use Animal-Assisted Activities in Patients With Implanted Cardiac Electronic Devices

    Directory of Open Access Journals (Sweden)

    Peter Jirak

    2016-02-01

    Full Text Available Animal-assisted activities (AAAs are mainly carried out in institutions. The aim of this prospective pilot study was to assess the willingness of patients with cardiac implanted electronic devices (IEDs to participate in AAA. The sample included 75 ambulatory patients (18 females, M age = 69 years, who attended an outpatient clinic for control of antibradycardic pacemakers (n = 15 or implanted cardioverter defibrillators (n = 60. Twenty-three percent were current and 48% were previous pet-owners. Current pet-owners were younger than non-pet-owners (63.5 vs. 72.0 years, p = .0003. Twelve patients (16% showed interest in AAA visits. However, only two patients agreed to an AAA visit. Both patients were visited once, but declined further visits. Hence, AAA sessions at home were poorly accepted, mainly because the patients considered themselves too busy or healthy, or due to a general disinterest in AAA. Potential health benefits associated with AAA may not be feasible to investigate during home visits of AAA-teams in patients with IEDs who are healthy enough to leave their homes. For further studies concerning AAA in patients with cardiovascular diseases, we suggest focusing on institutions like rehabilitation centers or day care centers and on more severely sick, homebound patients.

  5. On Younger Stakeholders and Decommissioning of Nuclear Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Tyszkiewicz, Bogumila; Labor, Bea

    2009-08-15

    In modern democratic countries, information sharing and effective and open communication concerning dismantling and decommissioning of of nuclear facilities as well as the management of nuclear waste are essential for the task to build the confidence required for any further development of nuclear energy. At the same time, it is often perceived that all decision making processes about nuclear energy policies are probably increasingly influenced by public opinion. Nuclear and radiation safety Authorities have a clear role in this regard to provide unbiased information on any health and safety related issues. In order to meet this need, it is necessary for Authorities and others to understand the values and opinions of the citizens, and especially the younger ones. They hold the key to the future at the same time as their perspective on these issues is the least understood. The need of greater public participation in decision making is becoming increasingly recognised the scientific as well as the political community. Many activities are carried out in order to stimulate to higher levels of public involvement in decision making in this active research area. Younger citizens is a stakeholder group that is often excluded in decision- making processes. The existence of large gaps between the involvement of older and younger stakeholders in decision making processes needs to be addressed, since such imbalances might otherwise lead to unequal opportunities between generations and limit the future consumption level of the coming generations. Another demanding task for the present generation is to assure that appropriate financial resources are injected into the Swedish Nuclear Waste Fund. It will thereby be possible for coming generations to undertake efficient measures in the decommissioning and dismantling of older nuclear facilities. To undertake such measures in line with the environmental and health codex is essential. An appropriate balance in this regard must be

  6. Risk factors for loss to follow-up during active surveillance of patients with Stage I seminoma.

    Science.gov (United States)

    Endo, Tsuyoshi; Kawai, Koji; Kamba, Tomomi; Inai, Hiromu; Uchida, Kazunori; Miyazaki, Jun; Kamoto, Toshiyuki; Ogawa, Osamu; Nishiyama, Hiroyuki

    2014-04-01

    To elucidate the patterns and risk factors for loss to follow-up during active surveillance for Stage I seminoma. A total of 425 cases with Stage I seminoma underwent radical orchiectomy from 1985 to 2006 at 25 Japanese institutions, including 22 community hospitals and 3 university hospitals. The post-orchiectomy management selected was active surveillance for 186 patients, adjuvant radiotherapy for 182 patients and chemotherapy for 57 patients. The Kaplan-Meier method was used to estimate the recurrence-free survival and loss to follow-up rate. The risk factors for loss to follow-up were examined using Cox's proportional hazards model with multiple variables. The 2-, 5- and 10-year loss to follow-up rates in the active surveillance group were 14.2, 37.8 and 71.3%, respectively, which were not significantly different in comparison with those in the active surveillance and adjuvant radiotherapy or chemotherapy groups. With regard to the active surveillance group, the multivariate analysis demonstrated that patients younger than 36 years at diagnosis, patients diagnosed since 2000 and patients treated at hospitals that enrolled more than 10 cases had a significant risk for loss to follow-up. No significant correlation between the loss to follow-up rate and pathological risk factors such as tumor size (≤4 versus >4 cm) and rete testis invasion (presence versus absence) was shown. The loss to follow-up rates beyond 5 years were unsatisfactorily high during active surveillance. Further approaches to improve the quality of active surveillance are needed, especially for high-risk patients such as those of younger age.

  7. Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Cataldo Janine K

    2013-01-01

    Full Text Available Abstract Background Mortality rates for cancer are decreasing in patients under 60 and increasing in those over 60 years of age. The reasons for these differences in mortality rates remain poorly understood. One explanation may be that older patients received substandard treatment because of concerns about adverse effects. Given the paucity of research on the multiple dimensions of the symptom experience in older oncology patients, the purpose of this study was to evaluate for differences in ratings of symptom occurrence, severity, frequency, and distress between younger ( Methods Data from two studies in the United States and one study in Australia were combined to conduct this analysis. All three studies used the MSAS to evaluate the occurrence, severity, frequency, and distress of 32 symptoms. Results Data from 593 oncology outpatients receiving active treatment for their cancer (i.e., 44.4% were  Conclusions This study is the first to evaluate for differences in multiple dimensions of symptom experience in older oncology patients. For almost 50% of the MSAS symptoms, older patients reported significantly lower occurrence rates. While fewer age-related differences were found in ratings of symptom severity, frequency, and distress, a similar pattern was found across all three dimensions. Future research needs to focus on a detailed evaluation of patient and clinical characteristics (i.e., type and dose of treatment that explain the differences in symptom experience identified in this study.

  8. Short-term and long-term results of speech improvement after surgery for velopharyngeal insufficiency with pharyngeal flaps in patients younger and older than 6 years old : 10-year experience

    NARCIS (Netherlands)

    Meek, MF; Coert, JH; Hofer, SOP; Goorhuis-Brouwer, SM; Nicolai, JPA

    2003-01-01

    Velopharyngeal insufficiency (VPI) is a well-known cause for hypernasality. To overcome this problem, the authors use a static surgical technique: a cranially or caudally based flap. In 93 patients, the results of this technique on speech (hypernasality, nasal air escape, articulation) and velophary

  9. Study the related factors of sexual disorder after chemotherapy in Younger patients with breast cancer%中青年乳腺癌患者化疗前后性功能状况调查及原因分析

    Institute of Scientific and Technical Information of China (English)

    罗凤; 唐秀英; 吴凯南; 石果; 金鹏娟

    2013-01-01

    目的:探讨乳腺癌患者化疗后性功能状况,分析其原因,探讨应对措施和策略。方法:在患者自愿、主动配合的情况下,对80例乳腺癌患者在化疗前后应用《乳腺癌性功能调查问卷》进行调查,行统计学分析,对其性功能状况进行评估,并进行原因分析。结果:在接受调查的患者中,所有被调查者均认为患病后有不同程度的性功能障碍,并认为与疾病和治疗有关,还有药物、配偶态度和形体改变等因素可能对性功能有影响。结论:化疗对乳腺癌患者性功能有明显影响,针对患者认为的可能影响因素,需要进行一些相对应的干预措施。%Objective :To investigate the functional status of breast cancer patients after chemotherapy ,and its analysis of the reasons to explore nursing response measures .Method :In the case of patients with voluntary initiative with the situation ,the application of the 80cases of breast cancer patients before and after chemotherapy of breast cancer sexual function questionnaire survey were analyzed statistically to evaluate their sexual function ,and according to the patient survey carried out analysis of the reasons .Results :In the patients surveyed ,all respondents have varying degrees of sexual dysfunction after illness .Conclusion :The chemotherapy of breast cancer patients with sexual function obviously ,for patients that may affect the factors ,the need for relative measures of care .

  10. Analysis of the Younger Dryas Impact Layer

    Energy Technology Data Exchange (ETDEWEB)

    Firestone, Richard B.; West, Allen; Revay, Zsolt; Hagstrum, Jonathon T,; Belgya, Thomas; Hee, Shane S. Que; Smith, Alan R.

    2010-02-27

    We have uncovered a thin layer of magnetic grains and microspherules, carbon spherules, and glass-like carbon at nine sites across North America, a site in Belgium, and throughout the rims of 16 Carolina Bays. It is consistent with the ejecta layer from an impact event and has been dated to 12.9 ka BP coinciding with the onset of Younger Dryas (YD) cooling and widespread megafaunal extinctions in North America. At many locations the impact layer is directly below a black mat marking the sudden disappearance of the megafauna and Clovis people. The distribution pattern of the Younger Dryas boundary (YDB) ejecta layer is consistent with an impact near the Great Lakes that deposited terrestrial-like ejecta near the impact site and unusual, titanium-rich projectile-like ejecta further away. High water content associated with the ejecta, up to 28 at. percent hydrogen (H), suggests the impact occurred over the Laurentide Ice Sheet. YDB microspherules and magnetic grains are highly enriched in TiO{sub 2}. Magnetic grains from several sites are enriched in iridium (Ir), up to 117 ppb. The TiO{sub 2}/FeO, K/Th, TiO{sub 2}/Zr, Al{sub 2}O{sub 3}/FeO+MgO, CaO/Al{sub 2}O{sub 3}, REE/ chondrite, FeO/MnO ratios and SiO{sub 2}, Na{sub 2}O, K{sub 2}O, Cr{sub 2}O{sub 3}, Ni, Co, U, Th and other trace element abundances are inconsistent with all terrestrial and extraterrestrial (ET) sources except for KREEP, a lunar igneous rock rich in potassium (K), rare-earth elements (REE), phosphorus (P), and other incompatible elements including U and Th. Normal Fe, Ti, and {sup 238}U/{sup 235}U isotopic abundances were found in the magnetic grains, but {sup 234}U was enriched over equilibrium values by 50 percent in Murray Springs and by 130 percent in Belgium. 40K abundance is enriched by up to 100 percent in YDB sediments and Clovis chert artifacts. Highly vesicular carbon spherules containing nanodiamonds, glass-like carbon, charcoal and soot found in large quantities in the YDB layer are

  11. Reflux esophagitis and hiatal hernia as concomitant abnormality in patients presenting with active duodenal or gastric ulcer: cross-sectional endoscopic study in consecutive patients.

    Science.gov (United States)

    Loffeld, R J.L.F.; van der Putten, A B.M.M.

    2002-05-01

    BACKGROUND: Follow-up studies have shown that patients with ulcer disease are at risk of developing reflux esophagitis (RE) after successful eradication of Heliobacter pylori. It is still not clear whether this is induced by eradication of H. pylori or whether RE is already present at the time the ulcer is diagnosed. A cross-sectional study was done in consecutive patients suffering from active ulcer disease in order to assess coincidental RE. METHODS: Patients with an active duodenal or gastric ulcer were included in the study. Concomitant RE and the presence of hiatal hernia (HH) were scored. Biopsy specimens were taken for detection of H. pylori. RESULTS: In 375 patients (77%), an active duodenal ulcer was the only abnormality. In 43 patients (8.8%), duodenal ulcer and concomitant RE were present and 69 patients (14.2%) had a duodenal ulcer with concomitant HH. Patients with a duodenal ulcer were significantly younger than patients with concomitant RE or HH. From 374 patients (76.8%) with a duodenal ulcer, biopsy specimens were available for the detection of H. pylori. The majority of duodenal ulcer patients were H. pylori-positive. H. pylori was significantly more often present in patients with an active duodenal ulcer than it was in duodenal ulcer patients suffering from concomitant RE (P=0.04). In 218 patients (76%), a gastric ulcer was the only abnormality. Fifteen patients (5.2%) also had RE and 54 patients (18.8%) had a concomitant HH. There was no difference in H. pylori status in these three groups of patients. CONCLUSIONS: Given the low prevalence of concomitant RE, it is concluded that this condition is likely to occur in a large percentage of patients suffering from H. pylori-positive ulcer disease after successful eradication therapy.

  12. STATE NUTRITION THE YOUNGER ELEMENTARY SCHOOLCHILDREN

    Directory of Open Access Journals (Sweden)

    Jelica Stojanović

    2010-09-01

    Full Text Available The obesty is a state characterized by pathological accumulation of fat tissue in the body, and nutritional disorders are associated with the high risk of numerous health problems since earliest childhood. The obesty has been increasing and it has now reached the proportion of an epidemic with the tendency of growth in the number of fat people. Such a negative trend directly influences the reduction of the functional and motorical abilities of the entire population. The research purpose to examine state nutrition the younger elementary schoolchildren and to see if there are deviations between the age groups. In the reasearching were included 313 tested divaidedin four groups. All tested were a regular pupils of the first and second grade of elementary school. In the resarching there were include the bouth the poles of pupils and the conditiones for testing were optimal. On the basis of anthropometric measurement of the body weight and height, body mass index (BMI values were calculated. And if is index of body mass is possible to find a lot of critrcizm, where is the most important that is not support constructive specific of the one man, but it gave information with results is possible standardation and clasification. The differences have been established through multivariant analysis of MANOVA variance, single variant univariant analysis of ANOVA variance and Discriminative analyses.

  13. Surgical results and prognosis of esophageal cancer in patients younger than forty years old%40岁以下青年食管癌患者手术治疗及预后分析

    Institute of Scientific and Technical Information of China (English)

    李晓林; 王嘉玮; 刘传信

    2013-01-01

    Objective:To investigate the clinical features and prognosis of surgical treatment for esophageal cancer in young patients. Methods: We retrospectively reviewed the clinicopathological records and documented the surgical treatment outcomes and prognostic factors of 72 esophageal cancer patients aged less than 40 years in our hospital from June 2004 to June 2009. Results: Fifty - nine patients underwent radical surgery,and 13 had palliative surgery. The 3 - year survival rate was 44.4% and the 5 - year survival rate was 29.2%. Univariate log - rank test results indicated that 3 — year and 5 — year survival rates were closely correlated with the surgical procedures, new adjuvant chemotherapy and the pTNM stage ( P < 0.05 ) . Conclusion: The adolescents who undergo esophageal surgeries often had a late pTNM stage and a low rate of radical operation. The prognosis can be improved by new adjuvant chemotherapy in Ⅲ stage, completely lymph node dissection and standardized postoperative anticancer therapy.%目的:探讨青年食管癌患者手术治疗效果及影响预后的因素.方法:回顾性分析2004年6月-2009年6月经手术治疗72例40岁以下青年食管癌患者的临床资料.结果:总的3、5年生存率分别为44.4%和29.2%.肿瘤TNM分期、淋巴结转移状况、病变长度、手术性质、术前新辅助化疗及术后放化疗是影响预后的主要因素.结论:40岁以下青年食管癌患者临床分期较晚,根治性手术切除率较低,应加强早诊早治意识.Ⅲ期应施行术前新辅助化疗,术中注意淋巴结清扫,病变范围长的食管中段癌尽量选择右胸路径,术后施行规则放化疗,可改善患者预后.

  14. Prognostic significance of FLT3 internal tandem duplication, nucleophosmin 1, and CEBPA gene mutations for acute myeloid leukemia patients with normal karyotype and younger than 60 years: a systematic review and meta-analysis.

    Science.gov (United States)

    Port, M; Böttcher, M; Thol, F; Ganser, A; Schlenk, R; Wasem, J; Neumann, A; Pouryamout, L

    2014-08-01

    Diagnosis and classification of acute myeloid leukemia (AML) are based on morphology and genetics. An increasing number of gene mutations have been found, and some are used for risk classification in AML patients with normal karyotype (cytogenetically normal (CN)-AML). In this systematic review and meta-analysis, we examined three frequent mutations in CN-AML: mutations of fms-related tyrosine kinase 3 (FLT3-ITD), mutated nucleophosmin (NPM1), and mutations of the CCAAT enhancer-binding protein alpha (CEBPA) gene. A systematic literature search of publications listed in the electronic databases (Embase, Pubmed, Healthstar, BIOSIS, ISI Web of Knowledge and Cochrane) from 2000 up to March 2012 was performed (Fig. 1). Nineteen studies were included and qualitatively analyzed. Two to four studies entered the quantitative meta-analysis incorporating 1,378 to 1,942 patients with CN-AML. Meta-analysis for overall survival (OS) and relapse-free survival (RFS) showed FLT3-ITD to predict an unfavorable prognosis, with hazard ratios (HR) of 1.86 and 1.75, respectively. In contrast, meta-analysis of the impact of NPM1 and CEBPA mutations on OS yielded an HR of 0.56 for each mutation, while analysis of impact on RFS produced HRs of 0.37 and 0.42, respectively. This systematic review and meta-analysis aimed to evaluate the prognostic value of mutations in the NPM1, CEBPA, and FLT3 genes. FLT3-ITD was associated with worse prognosis, whereas mutations in NPM1 and CEBPA genes were associated with a favorable prognosis.

  15. Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Wiggins, Amelia J; Grandhi, Ravi K; Schneider, Daniel K; Stanfield, Denver; Webster, Kate E; Myer, Gregory D

    2016-07-01

    Injury to the ipsilateral graft used for reconstruction of the anterior cruciate ligament (ACL) or a new injury to the contralateral ACL are disastrous outcomes after successful ACL reconstruction (ACLR), rehabilitation, and return to activity. Studies reporting ACL reinjury rates in younger active populations are emerging in the literature, but these data have not yet been comprehensively synthesized. To provide a current review of the literature to evaluate age and activity level as the primary risk factors in reinjury after ACLR. Systematic review and meta-analysis. A systematic review of the literature was conducted via searches in PubMed (1966 to July 2015) and EBSCO host (CINAHL, Medline, SPORTDiscus [1987 to July 2015]). After the search and consultation with experts and rating of study quality, 19 articles met inclusion for review and aggregation. Population demographic data and total reinjury (ipsilateral and contralateral) rate data were recorded from each individual study and combined using random-effects meta-analyses. Separate meta-analyses were conducted for the total population data as well as the following subsets: young age, return to sport, and young age + return to sport. Overall, the total second ACL reinjury rate was 15%, with an ipsilateral reinjury rate of 7% and contralateral injury rate of 8%. The secondary ACL injury rate (ipsilateral + contralateral) for patients younger than 25 years was 21%. The secondary ACL injury rate for athletes who return to a sport was also 20%. Combining these risk factors, athletes younger than 25 years who return to sport have a secondary ACL injury rate of 23%. This systematic review and meta-analysis demonstrates that younger age and a return to high level of activity are salient factors associated with secondary ACL injury. These combined data indicate that nearly 1 in 4 young athletic patients who sustain an ACL injury and return to high-risk sport will go on to sustain another ACL injury at some point in

  16. [Physical activities and sports in asthmatic patients].

    Science.gov (United States)

    Todaro, A

    1983-05-31

    Asthma patients are too often advised to refrain from sport. Enforced sedentariness, especially in children, leads to muscle hypotonia, reduced mechanical efficiency, paramorphisms, and adverse psychological consequences. Not all asthmatics develop airway spasm as a result of exercise. On the other hand, there are subjects whose bronchial hyper-reactivity is stimulated solely by muscular effort. The pathogenesis of exercise-induced bronchospasm is not fully understood. In any event, numerous studies have demonstrated the beneficial and even therapeutic effect of physical exercise and sport in cases of asthma. Provided they are practised with judgment and in accordance with a suitable programme, swimming, activities of an alternating aerobic and anaerobic type, cross-country skiing, gymnastics, and fencing are primarily indicated. Some asthmatics have also won Olympic medals. In the light of the studies carried out so far, it is strongly suggested that asthmatics be encouraged to take up sport suitable to their psychophysical characteristics, and not kept wrapped up in cotton wool.

  17. Correlates of knee bone marrow lesions in younger adults.

    Science.gov (United States)

    Antony, Benny; Venn, Alison; Cicuttini, Flavia; March, Lyn; Blizzard, Leigh; Dwyer, Terence; Halliday, Andrew; Cross, Marita; Jones, Graeme; Ding, Changhai

    2016-01-26

    Subchondral bone marrow lesions (BMLs) play a key role in the pathogenesis of osteoarthritis (OA) and are associated with pain and structural progression in knee OA. However, little is known about clinical significance and determinants of BMLs of the knee joint in younger adults. We aimed to describe the prevalence and environmental (physical activity), structural (cartilage defects, meniscal lesions) and clinical (pain, stiffness, physical dysfunction) correlates of BMLs in younger adults and to determine whether cholesterol levels measured 5 years prior were associated with current BMLs in young adults. Subjects broadly representative of the Australian young adult population (n = 328, aged 31-41 years, female 48.7 %) underwent T1- and proton density-weighted fat-suppressed magnetic resonance imaging (MRI) in their dominant knee. BMLs, cartilage defects, meniscal lesions and cartilage volume were measured. Knee pain was assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and physical activity was measured by the International Physical Activity Questionnaire (IPAQ). Cholesterol levels including high-density lipoprotein (HDL) were assessed 5 years prior to MRI. The overall prevalence of BML was 17 % (grade 1: 10.7 %, grade 2: 4.3 %, grade 3: 1.8 %). BML was positively associated with increasing age and previous knee injury but not body mass index. Moderate physical activity (prevalence ratio (PR):0.93, 95 % CI: 0.87, 0.99) and HDL cholesterol (PR:0.36, 95 % CI: 0.15, 0.87) were negatively associated with BML, while vigorous activity (PR:1.02, 95 % CI: 1.01, 1.03) was positively associated with medial tibiofemoral BMLs. BMLs were associated with more severe total WOMAC knee pain (>5 vs ≤5, PR:1.05, 95 % CI: 1.02, 1.09) and WOMAC dysfunction (PR:1.75, 95 % CI: 1.07, 2.89), total knee cartilage defects (PR:2.65, 95 % CI: 1.47, 4.80) and total meniscal lesion score (PR:1.92, 95 % CI: 1.13, 3.28). BMLs in young adults are

  18. Strategies for continuing professional development among younger, middle-aged, and older nurses: a biographical approach.

    Science.gov (United States)

    Pool, Inge A; Poell, Rob F; Berings, Marjolein G M C; ten Cate, Olle

    2015-05-01

    A nursing career can last for more than 40 years, during which continuing professional development is essential. Nurses participate in a variety of learning activities that correspond with their developmental motives. Lifespan psychology shows that work-related motives change with age, leading to the expectation that motives for continuing professional development also change. Nevertheless, little is known about nurses' continuing professional development strategies in different age groups. To explore continuing professional development strategies among younger, middle-aged, and older nurses. A qualitative study using semi-structured interviews, from a biographical perspective. Data were analysed using a vertical process aimed at creating individual learning biographies, and a horizontal process directed at discovering differences and similarities between age groups. Twenty-one nurses in three age groups from general and academic hospitals in the Netherlands. In all age groups, daily work was an important trigger for professional development on the ward. Performing extra or new tasks appeared to be an additional trigger for undertaking learning activities external to the ward. Learning experiences in nurses' private lives also contributed to their continuing professional development. Besides these similarities, the data revealed differences in career stages and private lives, which appeared to be related to differences in continuing professional development strategy; 'gaining experience and building a career' held particularly true among younger nurses, 'work-life balance' and 'keeping work interesting and varied' to middle-aged nurses, and 'consistency at work' to older nurses. Professional development strategies can aim at performing daily patient care, extra tasks and other roles. Age differences in these strategies appear to relate to tenure, perspectives on the future, and situations at home. These insights could help hospitals to orientate continuing

  19. Genotypic characterization and historical perspective of Mycobacterium tuberculosis among older and younger Finns, 2008-2011.

    Science.gov (United States)

    Smit, P W; Haanperä, M; Rantala, P; Couvin, D; Lyytikäinen, O; Rastogi, N; Ruutu, P; Soini, H

    2014-11-01

    The Mycobacterium tuberculosis genotypes obtained from elderly Finns were assessed and compared with those obtained from younger Finns to comprehend the epidemiology of tuberculosis (TB) in Finland. From 2008 to 2011, a total of 1021 M. tuberculosis isolates were characterized by spoligotyping and 15-locus mycobacterial interspersed repetitive units-variable number tandem repeat typing. In total, 733 Finnish-born cases were included in the study, of which 466 (64%) were born before 1945 (older Finns). Of these, 63 (14%) shared an M. tuberculosis genotype with foreign-born or younger Finnish cases (born after 1945), and 59 (13%) shared a genotype with older Finnish cases. Eighty-five per cent had a unique genotypic profile while 70% belonged to T or Haarlem families, suggesting that ongoing transmission is infrequent among young and elderly Finns. Simultaneous reactivation of TB among older Finns was the most likely cause for clustering. As most isolates belonged to Haarlem or T, Finland was most likely affected by a similar TB epidemic at the beginning of the twentieth century as that seen in Sweden and Norway. Younger Finns were significantly more likely to be clustered (56% versus 27%, ptuberculosis isolates from elderly Finns were associated with dominant lineages of the early twentieth century and differed from the heterogeneous lineages found among younger TB patients. Additionally, younger TB patients were more likely to transmit TB than elderly Finns.

  20. Rectus Femoris Echo Intensity Correlates with Muscle Strength, but Not Endurance, in Younger and Older Men.

    Science.gov (United States)

    Mota, Jacob A; Stock, Matt S

    2017-08-01

    We examined correlations between echo intensity and muscle strength and endurance. Rectus femoris echo intensity, maximal voluntary contraction (MVC) force and time to task failure during a 50% MVC task were determined for 12 younger (mean age = 25 y) and 13 older (mean age = 74 y) men. Bivariate correlations between echo intensity and normalized MVC force were similar for younger and older men, but was only statistically significant for the latter (younger r = -0.559, p = 0.059; older r = -0.580, p = 0.038). When all patients were combined, the correlation was significant (r = -0.733, p correlations were not observed for time to task failure (younger r = -0.382, p = 0.221; older r = -0.347, p = 0.246; all patients r = -0.229, p = 0.270). Rectus femoris echo intensity is associated with muscle strength, but not endurance, in younger and older men. Copyright © 2017 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  1. Atlantic Warm Pool Trigger for the Younger Dryas Climate Event

    Science.gov (United States)

    Abdul, N. A.; Mortlock, R. A.; Wright, J. D.; Fairbanks, R. G.; Teneva, L. T.

    2011-12-01

    There is growing evidence that variability in the size and heat content of the tropical Atlantic Warm Pool impacts circum-North Atlantic climate via the Atlantic Multi-decadal Oscillation mode (Wang et al., 2008). The Atlantic Warm Pool spans the Gulf of Mexico, Caribbean Sea and the western tropical North Atlantic. Barbados is located near the center of the tropical Atlantic Warm Pool and coupled ocean models suggest that Barbados remains near the center of the tropical Atlantic Warm Pool under varying wind stress simulations. Measurements of the oxygen isotope paleothermometer in Acropora palmata coral species recovered from cores offshore Barbados, show a 3oC monotonic decrease in sea surface temperature from 13106 ± 83 to 12744 ± 61 years before present (errors given as 2 sigma). This interval corresponds to a sea level rise from 71.4 meters to 67.1 meters below present levels at Barbados. The 3oC temperature decrease is captured in eight A. palmata specimens that are in stratigraphic sequence, 230Th/234U dated, and analyzed for oxygen isotopes. All measurements are replicated. We are confident that this is the warm pool equivalent of the Younger Dryas climate event. The initiation of this temperature drop in the Atlantic Warm Pool predates the Younger Dryas start in Greenland ice cores, reported to start at 12896 ± 138 years (relative to AD 2000) (Rasmussen et al., 2006), while few other Younger Dryas climate records are dated with similar accuracy to make the comparison. Rasmussen, S.O., Andersen, K.K., Svensson, A.M., Steffensen, J.P., Vinther, B.M., Clausen, H.B., Siggaard-Andersen, M.L., Johnsen, S.J., Larsen, L.B., Dahl-Jensen, D., Bigler, M., Röthlisberger, R., Fischer, H., Goto-Azuma, K., Hansson, M.E., and Ruth, U., 2006, A new Greenland ice core chronology for the last glacial termination: J. Geophys. Res., v. 111, p. D06102. Wang, C., Lee, S.-K., and Enfield, D.B., 2008, Atlantic Warm Pool acting as a link between Atlantic Multidecadal

  2. First Younger Dryas moraines in Greenland

    Science.gov (United States)

    Funder, Svend; Larsen, Nicolaj K.; Linge, Henriette; Möller, Per; Schomacker, Anders; Fabel, Derek; Kjær, Kurt H.; Xu, Sheng

    2016-04-01

    Over the Greenland ice sheet the Younger Dryas (YD) cold climate oscillation (12.9-11.7 kaBP) began with up to 10°C drop in temperatures and ended with up to 12°C abrupt warming. In the light of the present warming and melting of the ice sheet, and its importance for future climate change, the ice sheet's response to these dramatic changes in the past is of great interest. However, even though much effort has gone into charting YD ice margin behaviour around Greenland in recent years, no clear-cut signal of response to the oscillation has been uncovered. Here we show evidence to suggest that three major outlets from a local ice cap at Greenland's north coast advanced and retreated synchronously during YD. The evidence comprises OSL (optically stimulated luminescence) dates from a marine transgression of the coastal valleys that preceded the advance, and exposure ages from boulders on the moraines, formed by glaciers that overrode the marine sediment. The OSL ages suggest a maximum age of 12.4 ±0.6 kaBP for the marine incursion, and 10 exposure ages on boulders from the three moraines provide an average minimum age of 12.5 ±0.7 kaBP for the moraines, implying that the moraines were formed within the interval 11.8-13.0 kaBP. Elsewhere in Greenland evidence for readvance has been recorded in two areas. Most notably, in the East Greenland fjord zone outlet glaciers over a stretch of 800 km coast advanced through the fjords. In Scoresby Sund, where the moraines form a wide belt, an extensive 14C and exposure dating programme has shown that the readvance here probably culminated before YD, while cessation of moraine formation and rapid retreat from the moraine belt did not commence until c. 11.5 kaBP, but no moraines have so far been dated to YD. Readvance is also seen in Disko Bugt, the largest ice sheet outlet in West Greenland. However, here the advance and retreat of the ice stream took place in mid YD times, and lasted only a few hundred years, while YD in

  3. Habitual fat intake predicts memory function in younger women

    Directory of Open Access Journals (Sweden)

    Edward Leigh eGibson

    2013-12-01

    Full Text Available High intakes of fat have been linked to greater cognitive decline in old age, but such associations may already occur in younger adults. We tested memory and learning in 38 women (25-45 years old, recruited for a larger observational study in women with polycystic ovary syndrome. These women varied in health status, though not significantly between cases (n=23 and controls (n=15. Performance on tests sensitive to medial temporal lobe function (CANTABeclipse, Cambridge Cognition Ltd., i.e. verbal memory, visuo-spatial learning and delayed pattern matching, were compared with intakes of macronutrients from 7-day diet diaries and physiological indices of metabolic syndrome. Partial correlations were adjusted for age, activity and verbal IQ (National Adult Reading Test. Greater intakes of saturated and trans fats, and higher saturated to unsaturated fat ratio (Sat:UFA, were associated with more errors on the visuo-spatial task and with poorer word recall and recognition. Unexpectedly, higher UFA intake predicted poorer performance on the word recall and recognition measures. Fasting insulin was positively correlated with poorer word recognition only, whereas higher blood total cholesterol was associated only with visuo-spatial learning errors. None of these variables predicted performance on a delayed pattern matching test. The significant nutrient-cognition relationships were tested for mediation by total energy intake: saturated and trans fat intakes, and Sat:UFA, remained significant predictors specifically of visuo-spatial learning errors, whereas total fat and UFA intakes now predicted only poorer word recall. Examination of associations separately for mono- (MUFA and polyunsaturated fats suggested that only MUFA intake was predictive of poorer word recall. Saturated and trans fats, and fasting insulin, may already be associated with cognitive deficits in younger women. The findings need extending but may have important implications for public

  4. Evaluation of a workplace engagement project for people with younger onset dementia.

    Science.gov (United States)

    Robertson, Jacinta; Evans, David

    2015-08-01

    In 2011, a workplace project was established to provide a small group of people who had younger onset dementia with the opportunity to return to the workplace. The project sought to explore the feasibility and safety of engaging these younger people in workplace activities if an appropriate framework of support was provided. Opportunities to engage in meaningful activities are quite limited for younger people with dementia because services are targeted at an older client population. A qualitative exploratory approach was used for the project evaluation. Participants were people who were 65 years or younger and had a diagnosis of dementia. They attended a large metropolitan hardware store one day per week and worked beside a store employee for a four hour work shift. Evaluation of the project included observation of participant's engagement in the workplace, adverse events and a qualitative analysis that used participant-nominated good project outcomes. Nine people with a mean age of 58·8 years participated in the project. Six of these participants have been engaged at the workplace for more than two years. All participants were able to gain the skills needed to complete their respective work duties. Participants initially assisted with simple work tasks, but over time, they were able to expand their range of duties to include more complex activities such as customer sales. Participants achieved their nominated good outcomes of improved well-being, engaging in worthwhile activities, contributing to society and socialisation. The evaluation has shown that this workplace programme is a viable model of engagement for younger people with dementia. This evaluation offers a practical demonstration that it is feasible and safe to provide opportunities for younger people with dementia to engage in meaningful activities in the community if appropriate support is provided. © 2015 John Wiley & Sons Ltd.

  5. Cognitive Control and Lexical Access in Younger and Older Bilinguals

    Science.gov (United States)

    Bialystok, Ellen; Craik, Fergus; Luk, Gigi

    2008-01-01

    Ninety-six participants, who were younger (20 years) or older (68 years) adults and either monolingual or bilingual, completed tasks assessing working memory, lexical retrieval, and executive control. Younger participants performed most of the tasks better than older participants, confirming the effect of aging on these processes. The effect of…

  6. Metacomprehension and Comprehension Performance in Younger and Older Adults.

    Science.gov (United States)

    Moore, DeWayne; And Others

    1997-01-01

    The Metacomprehension Scale was completed by 30 younger and 30 older adults. Younger adults reported greater use of strategies to resolve comprehension failures and valued good comprehension more. The regulation dimension of metacomprehension was a reliable predictor of comprehension performance. (SK)

  7. National evaluation of the effectiveness of cognitive behavioral therapy for insomnia among older versus younger veterans.

    Science.gov (United States)

    Karlin, Bradley E; Trockel, Mickey; Spira, Adam P; Taylor, C Barr; Manber, Rachel

    2015-03-01

    Limited research has examined the effects of cognitive behavioral therapy for insomnia (CBT-I) among older adults (age >65 years) receiving treatment in real-world clinical settings and even less has examined effects on outcomes beyond reducing insomnia, such as improved quality of life. The current article examines and compares outcomes of older versus younger (age 18-64 years) veterans receiving CBT-I nationally in nonsleep specialty settings. Patient outcomes were assessed using the Insomnia Severity Index, Beck Depression Inventory-II, and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised. A total of 536 younger veterans and 121 older veterans received CBT-I; 77% of older and 64% of younger patients completed all sessions or finished early due to symptom relief. Mean insomnia scores declined from 19.5 to 9.7 in the older group and from 20.9 to 11.1 in the younger group. Within-group effect sizes were d = 2.3 and 2.2 for older and younger groups, respectively. CBT-I also yielded significant improvements in depression and quality of life for both age groups. High and increasing levels of therapeutic alliance were observed for both age groups. Older (and younger) patients receiving CBT-I from nonsleep specialists experienced large reductions in insomnia and improvements in depression and quality of life. Effects were similar for both age groups, and the rate of dropout was lower among older adults. The results provide strong support for the effectiveness and acceptability of CBT-I for older adults receiving care in routine treatment settings. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Employment Status and Perceived Health Status in Younger and Older People with Multiple Sclerosis

    Science.gov (United States)

    Krokavcova, Martina; Nagyova, Iveta; Rosenberger, Jaroslav; Gavelova, Miriam; Middel, Berrie; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2012-01-01

    This study explores how employment is associated with perceived physical and mental health status in people with multiple sclerosis (MS) adjusted for sociodemographic and clinical variables stratified by age. The sample consisted of 184 MS patients divided into a younger (less than 45 years) and an older (greater than or equal to 45 years) age…

  9. Parkin gene mutations in younger onset Parkinson's disease

    Institute of Scientific and Technical Information of China (English)

    Piu Chan; Hua Bai; Rong Chen; J Willian Langston

    2000-01-01

    Objective': To screen for exonic and point mutations in the Parkin gene in both Chinese and American Caucasian younger onset Parkinson's disease (YOPD) patients.Background: Recently, the Autosomal recessive juvenile parkinsonism (ARJP) gene was first mapped to chromosome 6q25.2-27 and was late cloned and designated as Parkin. A wide variety of mutations, including homozygous exonic deletions and point mutations,have been found in at least more than 50 ARJP families of Japanese, European and Jewish origins. However, the distribution of Parkin gene mutations is not known in the Chinese and American Caucasians, It is also not clear how frequent the Parkin gene mutations occur in YOPD patients. Method and Material: Twenty-one Chinese subjects were selected from 121 Chinese PD inpatients who were admitted to the Xuanwu Hospital in Beijing between August of 1998 and April of 1999 and had an onset before age 51. Thirty-eight American subjects were PD patients with an onset before age 41 from the Tissue Bank of the Parkinson′s Institute at California. Homozygous exonic deletion and point mutations in all 12 exons of the Parkin gene were screened using PCR, SSCP and direct sequencing methods. Mutations identified by sequencing were further confirmed by restriction enzyme digestion. Results: Five different types of homozygous deletion mutations (exons 1, 4, 6, 7 and 12) were found in 7 out of 21 Chinese cases but none of the 37 American Caucasian patients in all 12 exons of Parkin gene. One novel and four polymorphic mutationswere found in the American Caucasian YOPD cases.Conclusion: our results suggest that homozygous exonic deletions in the Parkin gene may account for a significant amount of YOPD in the Chinese but not in the American Caucasian YOPD.

  10. Why are low-income teens more likely to lack health insurance than their younger peers?

    Science.gov (United States)

    Leininger, Lindsey Jeanne; Burns, Marguerite E

    2011-01-01

    Low-income teenagers are more likely to lack health insurance than younger children. Using data from the 2006, 2007, and 2008 rounds of the National Health Interview Survey, we examine whether differences between teens and younger children in socioeconomic factors, public health insurance eligibility, and observable family characteristics explain this apparent age-related coverage gap. Somewhat surprisingly, they do not. We find a highly robust age-coverage gradient among poor and near-poor children. Our results suggest the need to examine teen-specific insurance enrollment dynamics, particularly in families with no younger siblings, to optimize the effect of the newly enacted Patient Protection and Affordable Care Act on teens' insurance coverage.

  11. How do COPD patients distribute their daily activities?

    NARCIS (Netherlands)

    Tabak, Monique; Vollenbroek-Hutten, Miriam Marie Rosé; van der Valk, P.; van der Palen, Jacobus Adrianus Maria; Tönis, Thijs; Hermens, Hermanus J.

    2011-01-01

    Better insight in daily activity behaviour of COPD patients is needed as a first step to enable a tailoring of their treatment. The objective of this study was to measure the daily activity of COPD patients and to compare the daily activity distribution with asymptomatic controls, using triaxial acc

  12. Analysis of disease activity and response to treatment in a large Spanish cohort of patients with systemic lupus erythematosus.

    Science.gov (United States)

    Pego-Reigosa, J M; Rúa-Figueroa, Í; López-Longo, F J; Galindo-Izquierdo, M; Calvo-Alén, J; Olivé-Marqués, A; del Campo, V; García-Yébenes, M J; Loza-Santamaría, E; Blanco, R; Melero-González, R; Vela-Casasempere, P; Otón-Sánchez, T; Tomero-Muriel, E; Uriarte-Isacelaya, E; Fito-Manteca, M C; Freire-González, M; Narváez, J; Fernández-Nebro, A; Zea-Mendoza, A; Rosas, J; Carlos Rosas, J

    2015-06-01

    The objectives of this paper are to study the impact of disease activity in a large cohort of patients with systemic lupus erythematosus (SLE) and estimate the rate of response to therapies. We conducted a nationwide, retrospective, multicenter, cross-sectional cohort study of 3658 SLE patients. Data on demographics, disease characteristics: activity (SELENA-SLEDAI), damage, severity, hospitalizations and therapies were collected. Factors associated with refractory disease were identified by logistic regression. A total of 3658 patients (90% female; median SLE duration (interquartile range): 10.4 years (5.3-17.1)) were included. At the time of their last evaluation, 14.7% of the patients had moderate-severe SLE (SELENA-SLEDAI score ≥6). There were 1954 (53.4%) patients who were hospitalized for activity at least once over the course of the disease. At some stage, 84.6% and 78.8% of the patients received glucocorticoids and antimalarials, respectively, and 51.3% of the patients received at least one immunosuppressant. Owing to either toxicity or ineffectiveness, cyclophosphamide was withdrawn in 21.5% of the cases, mycophenolate mofetil in 24.9%, azathioprine in 40.2% and methotrexate in 46.8%. At some stage, 7.3% of the patients received at least one biologic. A total of 898 (24.5%) patients had refractory SLE at some stage. Renal, neuropsychiatric, vasculitic, hematological and musculoskeletal involvement, a younger age at diagnosis and male gender were associated with refractory disease. A significant percentage of patients have moderately-to-severely active SLE at some stage. Disease activity has a big impact in terms of need for treatment and cause of hospitalization. The effectiveness of the standard therapies for reducing disease activity is clearly insufficient. Some clinical features are associated with refractory SLE. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. GENDER ORIENTATION FORMATION FEATURES OF YOUNGER PUPILS IN THE EDUCATIONAL PROCESS

    Directory of Open Access Journals (Sweden)

    Yulia V. KURBATOVA

    2015-01-01

    Full Text Available In the modern Russian society modernization of education, accompanied by a rethinking, re-evaluating and adopting new values and orientations. Significant changes have affected and General education, in which the system-activity approach is crucial. The subject of study in this paper is the development of gender orientations of younger students in the educational process. In the process of research used complex methods of research: analysis of scientific literature on the research problem, theoretical analysis and synthesis of interview and participant observation. Scientific novelty consists in the fact that the essence of gender identity and the features of its formation in primary school; the pedagogical potential of management of development of gender orientations of younger students in the educational process. Conducted scientific study of the problem of formation of a gender orientations of younger students in the educational process due to the value of a healthy gender identity to the full development of the person. An empirical study of gender identity younger students showed the existence of problems of formation of a gender orientations in the educational process. Most younger students recorded a rigid gender identity. 

  14. [Matthias Flacius Illyricus, the younger, professor philosophiae et logicae aristotelis and professor of the practical medicine].

    Science.gov (United States)

    Mohorović, Lucijan

    2012-01-01

    The aim of this paper is to offer some new information on the life and work of Matthias Flacius Illiricus the Younger, especially concerning his activity as a medical doctor and university professor. According to our present knowledge, he published 17 of his writings during his lifetime. Matthias Flacius the Younger was born on September 12, 1547 in Braunschweig. His mother Elisabeth had 11 more children with Matthias Flacius the Elder.When Flacius the Younger was 15 (in 1562), his father sent him to Strassburg to study philosophy. According to some scholars (Waltraut Wienke, 2001), Flacius the Younger arrived to Rostock in August 1572 and was granted the title of magister philosophiae on April 1, 1574. According to the sources, that very year he was enrolled at the Faculty of Medicine in Rostock. On April 27, 1579 he was mentioned as lecturing at the Faculty of Philosophy, where he became Philosophiae & Logicae Aristotelis doctor in 1580. It is interesting that only a year later on September 23, 1581, when he was 33 years old, he became Doctor Medicinae by defending a dissertation entitled "De cattarrho; ward darauf zum Dr Med prom". In 1592 he exchanged his position at the Philosophy Chair in Rostock for the medical one, becoming a professor of Practical Medicine. Matthias Flacius the Younger died on April 27, 1593, when he was 46 years old.

  15. Pediatric patients: criteria for radiopharmaceuticals activities in diagnostic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Felipe Simas dos; Oliveira, Silvia M. Velasques de, E-mail: simas@ird.gov.b, E-mail: silvia@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2009-07-01

    Recent studies recommend new criteria to determine radiopharmaceuticals activities per diagnostic procedures for children and teenagers. In USA, the criteria are: minimum and maximum activity and activity per body weight. The minimum activity is necessary for assuring the quality image due to the minimum requested statistical counting. The reduction of maximum activities minimizes the probability of detriment of radiation. In the European Union (EU), the Pediatric Dosage Card (PDC) proposes combined parameters: category of radiopharmaceutical, patient body weight and minimum activity per procedure. The PDC classifies the radiopharmaceuticals according to their biodistribution in the most sensitive organs. In Brazil, an investigation evaluated radiopharmaceuticals activities administered to 2,411 pediatric patients in sixteen institutions. The Brazilian mean activities per body weight, minimum and maximum activities used per institutions were compared with similar parameters surveyed in thirteen American hospitals. It was also used the PDC model to calculate the minimum activities per radiopharmaceuticals using recorded Brazilian patients corporal masses. The wider differences between Brazilian and USA installations were noticed for minimum activities by as much as a factor of 2 and 8. For {sup 67}Ga Citrate, the ranges of activities per patient corporal mass were by as much as a factor of 2 and 9 than activities used in USA. The range of maximum activities presented fewer differences, varying between 0.5 and 2 times for the radiopharmaceuticals studied. The present work needs the collaboration of the professional staff for discussion of the results, to promote regional surveys and to optimize pediatric patient protocols (author)

  16. CDC Vital Signs: Preventing Pregnancies in Younger Teens

    Science.gov (United States)

    ... younger teens made a reproductive health visit for birth control services in the past year. Doctors and nurses could use this opportunity to discuss advantages and disadvantages of different contraceptive methods and the ...

  17. Obesity and sexual dysfunction in younger Danish men

    DEFF Research Database (Denmark)

    Andersen, Ingelise; Heitman, B. L.; Wagner, Gorm

    2008-01-01

    INTRODUCTION: Proportion of populations that are overweight and obese are on the rise and generally affecting more than 50% of the adult Western male population. It is, therefore, of interest to look at possible associations between obesity and sexual function in a homogeneous population. AIM......: To examine a possible association between sexual disorders (erectile dysfunction, ejaculatory disorders, and sexual desire disorders) and obesity among younger men born and living in Denmark. METHODS: A community-based cross-sectional study of sexual health among Danish younger men. Questionnaires were...... the younger obese nonsmokers than obese smokers. Premature ejaculation, retarded ejaculation, and sexual desire disorders were all unrelated to overweight or obesity. CONCLUSION: Obesity (BMI > or = 30 kg/m(2)) seems associated with ED among younger men aged 20-45 years. Health programs directed toward...

  18. Stress May Take Greatest Toll on Younger Women's Hearts

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160597.html Stress May Take Greatest Toll on Younger Women's Hearts: ... 24, 2016 WEDNESDAY, Aug. 24, 2016 (HealthDay News) -- Stress may be especially hard on the hearts of ...

  19. High disease activity is related to low levels of physical activity in patients with ankylosing spondylitis.

    Science.gov (United States)

    Fongen, Camilla; Halvorsen, Silje; Dagfinrud, Hanne

    2013-12-01

    This study aims to compare physical activity (PA) level and exercise habits in patients with ankylosing spondylitis (AS) who have high disease activity with those who have low disease activity and, further, to compare both groups with population controls. Cross-sectional study design was used. The participants include 149 patients (mean age 49.3 (SD 11.1), 61% men, 54% high disease activity) and 133 controls (mean age 52.7 (SD11.3), 58% men). PA was reported with the International PA Questionnaire-Long and results were presented as weekly energy expenditure (metabolic equivalent, MET) in different intensities, domains, and proportion reaching health enhancing physical activity (HEPA). Types of PA were registered in a structured interview. The AS Disease Activity Score was used to assess patients' disease activity. Patients with high disease activity reported significantly lower total weekly energy expenditure (MET) than patients with low disease activity and controls (p = 0.02, p = 0.01, respectively) and lower amounts of walking (p < 0.01, p = 0.02, respectively) and vigorous activity (p = 0.06, p = 0.06, respectively). Only 41% of the patients with high disease activity reached HEPA compared to 61% of the patients with low disease activity (p = 0.02). Patients in general participated less in leisure PA performed outdoor and with higher intensities (MET ≥ 6) than controls.AS patients with high disease activity had lower weekly energy expenditure in PA than patients with low disease activity and controls, and were less likely to reach HEPA than patients with low disease activity. For optimal management, health professionals should focus on physical activity in their consultations with AS patients, especially those with high disease activity.

  20. Assessment of effects of differences in trunk posture during Fowler’s position on hemodynamics and cardiovascular regulation in older and younger subjects

    Directory of Open Access Journals (Sweden)

    Kubota S

    2017-03-01

    Full Text Available Satoshi Kubota,1 Yutaka Endo,1 Mitsue Kubota,1 Tomohiko Shigemasa2 1School of Nursing and Rehabilitation Sciences at Odawara, International University of Health and Welfare, Odawara, Kanagawa, Japan; 2Department of Cardiology, International University of Health and Welfare Atami Hospital, Atami, Shizuoka, Japan Background: Downward shifts in blood volume with changing position generally cause tachycardic responses. Age-related decreases in vagal nerve activity could contribute to orthostatic hypotension in older individuals. Fowler’s position is a reclined position with the back between 30° and 60°, used to facilitate breathing, eating, and other routine daily activities in frail and elderly patients. Objective: This study examined whether stroke volume (SV was higher and heart rate (HR lower in Fowler’s position with an upright upper trunk than in Fowler’s position with the whole trunk upright in both older and younger subjects, based on the assumption that lower HR would result from reduced sympathetic activation in older individuals. Methods: We assessed hemodynamics and HR variability from electrocardiography, noninvasive arterial pressure and impedance cardiography in 11 younger male subjects (age range, 20–22 years and 11 older male subjects (age range, 64–79 years, using three positions: supine, or Fowler’s positions with either 30° of lower trunk inclination and 60° of upper trunk inclination (UT60 or 60° of whole trunk inclination (WT60. Comparisons were then made between age groups and between positions. Results: Reductions in SV and tachycardic response were smaller with UT60 than with WT60, in both younger and older subjects. In addition, reduced tachycardic response with upright upper trunk appeared attributable to decreased vagal withdrawal in younger subjects and to reduced sympathetic activation in older subjects. Conclusion: Our findings indicate that an upright upper trunk during Fowler’s position allowed

  1. Patients' motives for participating in active post-marketing surveillance

    NARCIS (Netherlands)

    Harmark, Linda; Lie-Kwie, Miguel; Berm, Lisette; de Gier, Han; van Grootheest, Kees

    2013-01-01

    Purpose Web-based intensive monitoring is a method to actively collect information about adverse drug reactions (ADRs) using patients as a source of information. To date, little is known about patients' motivation to participate in this kind of active post-marketing surveillance (PMS). Increased ins

  2. Daily Physical Activity in Stable Heart Failure Patients

    NARCIS (Netherlands)

    Dontje, Manon L.; van der Wal, M.H.L.; Stolk, Ronald P.; Brugemann, Johan; Jaarsma, Tiny; Wijtvliet, Petra E. P. J.; van der Schans, Cees P.; de Greef, Mathieu H. G.

    2014-01-01

    Background: Physical activity is the only nonpharmacological therapy that is proven to be effective in heart failure (HF) patients in reducing morbidity. To date, little is known about the levels of daily physical activity in HF patients and about related factors. Objective: The objectives of this s

  3. Daily physical activity in stable heart failure patients

    NARCIS (Netherlands)

    Dontje, Manon L.; Wal, M.H. van der; Stolk, R.P.; Brügemann, J.; Jaarsma, J.; Wijtvliet, P.E.; Schans, Cees van der; Greef, M.H. de

    2013-01-01

    BACKGROUND:: Physical activity is the only nonpharmacological therapy that is proven to be effective in heart failure (HF) patients in reducing morbidity. To date, little is known about the levels of daily physical activity in HF patients and about related factors. OBJECTIVE:: The objectives of this

  4. Exploring Patient Activation in the Clinic: Measurement from Three Perspectives

    Science.gov (United States)

    Ledford, Christy J. W.; Ledford, Christopher C.; Childress, Marc A.

    2013-01-01

    Objective. To further conceptualize and operationalize patient activation (PA), using measures from patient, physician, and researcher perspectives. Data Source/Study Setting. Multimethod observation in 2010 within a family medicine clinic. Study Design. Part of an intervention with 130 patients with type 2 diabetes, this observational study…

  5. Sleep-related electrodermal activity patterns in impotent patients.

    Science.gov (United States)

    Ware, J C; Karacan, I; Salis, P J; Thornby, J; Hirshkowitz, M

    1984-01-01

    The etiology of erectile failure is not always clear despite the fact that recordings of nocturnal penile tumescence (NPT) are used to detect patients with a significant organic component to their complaint. We recorded electrodermal activity in addition to NPT in 60 impotent patients. Normally more electrodermal activity occurs in stage 2 than in stage REM sleep. Despite a similar total amount of electrodermal activity, organically impotent patients tended to have less electrodermal activity in stage 2 and more in stage REM sleep than those with normal NPT. This difference was due to a subgroup of 15 organically impotent patients with less electrodermal activity in stage 2 than in stage REM sleep. Because of this difference in the pattern of electrodermal activity in relation to sleep stages, the results suggest a central nervous system change is related to impaired erectile capability and abnormal NPT in these cases.

  6. Adenosine Deaminase Activities in Hyperlipidaemic Patients ...

    African Journals Online (AJOL)

    Journal of Health and Visual Sciences ... Abstract. Adenosine Deaminase Activities, markers of cellular-mediated immunity ... were statistically significantly higher (P<0.001) in the test groups than in the control groups (10.7+3iu/1) respectively.

  7. Managing hypercholesterolemia and preventing cardiovascular events in elderly and younger Chinese adults: focus on rosuvastatin

    Directory of Open Access Journals (Sweden)

    Wang Z

    2013-12-01

    Full Text Available Zhen Wang, Junbo GeDepartment of Cardiology, Zhongshan Hospital, Shanghai, People's Republic of ChinaAbstract: Coronary heart disease (CHD is the leading cause of death worldwide. The efficacy and safety of statins in primary and secondary prevention of CHD is confirmed in several large studies, and rosuvastatin is the latest statin on market. We review the published literature on rosuvastatin in Chinese people. The pharmacokinetics of rosuvastatin in Chinese is somewhat different from that in Caucasians, but this does not influence the linear relationship between dosage and efficacy and with no drug accumulation. Rosuvastatin 5–20 mg/day is effective and safe in decreasing low-density lipoprotein cholesterol in both younger and elderly patients with hypercholesterolemia, even in very elderly patients. Rosuvastatin also shows anti-inflammatory and antiatherosclerosis features, such as reducing carotid intima-media thickness and plaque area. Rosuvastatin can also improve the prognosis of Chinese CHD patients, such as in the case of acute myocardial infarction. Its adverse-event rate is low and comparable to other statins. In conclusion, rosuvastatin is effective and safe for younger or elderly Chinese patients.Keywords: rosuvastatin, Chinese, younger, elderly

  8. Prognostic quality of activating TERT promoter mutations in glioblastoma: interaction with the rs2853669 polymorphism and patient age at diagnosis.

    Science.gov (United States)

    Spiegl-Kreinecker, Sabine; Lötsch, Daniela; Ghanim, Bahil; Pirker, Christine; Mohr, Thomas; Laaber, Magdalena; Weis, Serge; Olschowski, Alfred; Webersinke, Gerald; Pichler, Josef; Berger, Walter

    2015-09-01

    Expression of the telomerase reverse transcriptase (TERT) might be altered by activating mutations of the rs2853669 polymorphism within the promoter region. Here we investigate the impact of these genomic alterations on telomerase activation and dissect their prognostic potential in glioblastoma (GBM). The respective TERT promoter region was sequenced in 126 GBM tissues and compared with clinical parameters and glioma biomarkers MGMT promoter methylation and IDH1 mutation. TERT mRNA expression, telomerase activity, and telomere lengths were determined by reverse transcriptase PCR, TRAP assay, and real-time PCR, respectively. Seventy-three percent of GBM patients harbored TERT promoter mutations associated with enhanced telomerase activity and TERT mRNA expression but reduced telomere lengths (P < .001 for all). Patients with mutated tumors exhibited significantly shorter overall survival in the entire cohort (11.5 vs 23.1 months; P < .0001) and in the primary GBM patient subgroup lacking IDH1 mutations (n = 120; P = .0084). This prognostic impact was confined to younger patients (aged <65 years), while the negative prognostic power of enhanced age at diagnosis was limited to those patients lacking TERT promoter mutations. Presence of the common single nucleotide polymorphism rs2853669, disrupting an endogenous Ets2 transcription factor-binding site, was associated with improved survival exclusively in patients with a wild-type TERT promoter. On the contrary, the shortest mean overall survival was detected in those patients harboring both an activating TERT promoter mutation and homozygous rs2853669 alleles. In summary, TERT promoter mutations are powerful prognosticators for worse course of disease in human GBM patients but their prognostic value is influenced by the rs2853669 polymorphism and age at diagnosis. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e

  9. Increasing Patient Activation Could Improve Outcomes for Patients with Inflammatory Bowel Disease.

    Science.gov (United States)

    Shah, Shawn L; Siegel, Corey A

    2015-12-01

    Inflammatory bowel disease (IBD) is a complex disease process that often requires the integration of skills from various health care providers to adequately meet the needs of patients with IBD. The medical and surgical treatment options for IBD have become more complicated and are frequently a source of angst for both the patient and provider. However, it has become more important than ever to engage patients in navigating the treatment algorithm. Although novel in the IBD world, the concept of patients' becoming more active and effective managers of their care has been well studied in other disease processes such as diabetes mellitus and mental illness. This idea of patient activation refers to a patient understanding his or her role in the care process and having the skill sets and self-reliance necessary to manage his or her own health care. Over the past decade, evidence supporting the role of patient activation in chronic illness has grown, revealing improved health outcomes, enhanced patient experiences, and lower overall costs. Patient activation can be measured, and interventions have been shown to improve levels of activation over time and influence outcomes. A focus on patient activation is very appropriate for patients with IBD because this may potentially serve as a tool for IBD providers to not only improve patient outcomes and experience but also reduce health care costs.

  10. Effects of an Individualized Activity Program on Elderly Patients

    Science.gov (United States)

    Salter, Carlota de Lerma; Salter, Charles A.

    1975-01-01

    A combined program of Reality Orientation, Activities of Daily Living, and Recreational Activities, together with environmental stimulation, was applied on an individualized basis to 21 elderly patients suffering from both psychological disorders and long-term physical illness. The motivation to participate in the available activities increased…

  11. Promoting physical activity in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Berg, Machteld Heleen van den

    2007-01-01

    The aim of the thesis was to study: 1. The engagement of patients with RA in various forms of physical activity and their preferences regarding the delivery of physical activity interventions; 2. The evidence regarding the effectiveness of physical activity interventions delivered by means of the

  12. Promoting physical activity in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Berg, Machteld Heleen van den

    2007-01-01

    The aim of the thesis was to study: 1. The engagement of patients with RA in various forms of physical activity and their preferences regarding the delivery of physical activity interventions; 2. The evidence regarding the effectiveness of physical activity interventions delivered by means of the I

  13. Promoting physical activity in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Berg, Machteld Heleen van den

    2007-01-01

    The aim of the thesis was to study: 1. The engagement of patients with RA in various forms of physical activity and their preferences regarding the delivery of physical activity interventions; 2. The evidence regarding the effectiveness of physical activity interventions delivered by means of the I

  14. Younger Dryas glaciers in the High Atlas, Morocco

    Science.gov (United States)

    Hughes, Philip; Fink, David

    2016-04-01

    Twelve cirque glaciers formed during the Younger Dryas on the mountains of Aksoual (3912 m a.s.l.) and Adrar el Hajj (3129 m a.s.l.) in the Marrakesh High Atlas. Moraines in two separate cirques on these mountains have been dated using 10Be and 36Cl exposure dating. In both cirques the age scatter is relatively small (13.8-10.1 ka) and all ages overlap within error with the Younger Dryas (12.9-11.7 ka). The glaciers were small and covered ELAs) ranging from 2470 and 3560 m. This large range is attributed to local topoclimatic factors with the lowest glacier (confirmed as Younger Dryas in age by 3 exposure ages) occupying a very steep cirque floor where a combination of steep glacier gradient and a large potential avalanche catchment enabled its low-lying position. This indicates that caution should be taken when using single glacier sites for reconstructing regional palaeoclimate, especially those formed in steep catchments that have strong topoclimatic controls. The average ELA of the twelve Younger Dryas glaciers was c. 3109 m a.s.l. (St Dev = 325 m) and this represents an ELA depression of > 1000 m from the modern theoretical regional ELA. Under precipitation values similar to today this would require a mean annual temperature depression of 9°C. Moreover, the glacier-climate modelling indicates that it is very unlikely that climate was drier than today during the Younger Dryas in the Marrakesh High Atlas.

  15. Backward compatibility effects in younger and older adults.

    Science.gov (United States)

    Hartley, Alan A; Maquestiaux, François; Festini, Sara B; Frazier, Kathryn; Krimmer, Patricia J

    2016-07-01

    In many dual-task situations, responses to the second of two tasks are slowed when the time between tasks is short. The response-selection bottleneck model of dual-task performance accounts for this phenomenon by assuming that central processing of the second task is blocked by a bottleneck until central processing of Task 1 is complete. This assumption could be called into question if it could be demonstrated that the response to Task 2 affected the central processing of Task 1, a backward response compatibility effect. Such effects are well-established in younger adults. Backward compatibility effects in older (as well as younger) adults were explored in two experiments. The first experiment found clear backward response compatibility effects for younger adults but no evidence of them for older adults. The second experiment explored backward stimulus compatibility and found similar effects in both younger and older adults. Evidence possibly consistent with some pre-bottleneck processing of Task 2 central stages also was found in the second experiment in both age groups. For younger adults, the results provide further evidence falsifying the claim of an immutable response selection bottleneck. For older adults, the evidence suggested that Task 2 affects Task 1 when there is stimulus compatibility but not when there is response compatibility.

  16. Pacemaker patients' perception of unsafe activities: a survey

    Directory of Open Access Journals (Sweden)

    Shafquat Azam

    2008-11-01

    Full Text Available Abstract Background Cardiac pacing is a recognized and widely used treatment for patients presenting with bradycardia. Physicians expect patients to return to normal activities almost immediately post implantation. However, patients themselves may perceive interference to pacemaker function by various routine activities and devices, and hence continue to lead restricted, disabled lives. The aim of this study is to determine if routine activities are perceived by pacemaker patients to interfere with their device function. Methods A descriptive cross sectional survey was carried out on consecutive patients at the pacemaker clinic at a public hospital in Karachi, Pakistan. A 47-question tool was developed and tested. Patients' perceptions of safety of performing various routine activities, along with socio-demographic data were recorded. Results The final sample included 93 adult patients (45% males. 41% were illiterate. 77.4% recalled receiving counselling at implantation, predominantly from the implanting physician and house staff. A considerable proportion of patients considered many routine activities unsafe including driving automobiles (28%, passing through metal detectors (31%, bending over (37%, and sleeping on the side of the pacemaker (30%. Also considered unsafe were operation of household appliances- TV/VCR (television/video cassette recorders (53%, irons (55% and electrical wall switches (56%. For nearly all variables neither literacy nor history of counselling improved incorrect perceptions. Conclusion This study shows that our pacemaker patients perceive many routine activities as unsafe, potentially leading to disabling life style modifications. The tremendous investment in pacemaker technology to improve patient performance is not going to pay dividends if patients continue to remain disabled due to incorrect perceptions. Further studies are required to determine the reasons for these misperceptions, and to determine if these

  17. Screw fixation for atlantoaxial dislocation related to Down syndrome in children younger than 5 years.

    Science.gov (United States)

    Ito, Kenyu; Imagama, Shiro; Ito, Zenya; Ando, Kei; Kobayashi, Kazuyoshi; Hida, Tetsuro; Ishikawa, Yoshimoto; Ishiguro, Naoki

    2017-01-01

    The aim of this study was to present cases of upper cervical fixation in Down syndrome patients younger than 5 years. In two cases, C1 lateral mass screws were installed. However, owing to the irreducible atlantoaxial dislocation, the screw backed out and fractured. Therefore, O-C2 fusion was performed. Furthermore, C2 bilateral lamina screws were added to the C2 pedicle screw for reinforcement. C1-C2 fusion is an option for Down syndrome patients younger than 5 years with atlantoaxial dislocation, when the dislocation is reducible. If the dislocation is irreducible, or the implant cannot be firmly secured, the fixation range should be expanded to O-C2 or below.

  18. Physical activity maintenance in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Loeppenthin, K; Esbensen, Bente Appel; Østergaard, Mikkel

    2014-01-01

    OBJECTIVE: To describe the experience of physical activity maintenance in patients with rheumatoid arthritis. DESIGN: A qualitative salutogenic-oriented interview study. SETTING: A rheumatology outpatient clinic. SUBJECTS: A purposive sample of 16 physically active patients (mean age 50, range 37......-67) diagnosed with rheumatoid arthritis on average 21 years previously (range 4-46 years). METHODS: In-depth interviews were conducted using a semi-structured interview guide to illuminate how the phenomenon 'physical activity maintenance' was experienced by patients with rheumatoid arthritis. The interviews...

  19. Activity recognition in patients with lower limb impairments: do we need training data from each patient?

    Science.gov (United States)

    Lonini, Luca; Gupta, Aakash; Kording, Konrad; Jayaraman, Arun

    2016-08-01

    Machine learning allows detecting specific physical activities using data from wearable sensors. Such a quantification of patient mobility over time promises to accurately inform clinical decisions for physical rehabilitation. There are two strategies of setting up the machine learning problem: detect one patient's activities using data from the same patient (personal model) or detect their activities using data from other patients (global model), and we currently do not know if personal models are necessary. Here we consider the problem of detecting physical activities from a waist-worn accelerometer in patients who use a knee-ankle-foot orthosis (KAFO) to walk. We show that while a model based on healthy subjects has low accuracy, the global model performs as well as the personal model. This is encouraging because it suggests that condition-specific activity recognition algorithms are sufficient and that no data from individual patients is necessary.

  20. Serum paraoxonase 1 activity status in patients with liver disorders

    Directory of Open Access Journals (Sweden)

    Kedage Vivekananda

    2010-01-01

    Full Text Available Background/Aim: Paraoxonase 1 (PON1 is an esterase, exclusively synthesized by liver. The present study has two objectives: to determine the PON1 activity status in various disorders associated with hepatocellular damage and to correlate the changes of PON1 activity with the standard liver function and fasting lipid profile tests in these disorders. Patients and Methods: The study groups consisted of 95 patients with liver diseases including acute viral hepatitis (14, cirrhosis with portal hypertension (33, leptospirosis (14, sepsis and multi organ failure (15, left ventricular failure (9, and falciparum malaria (10; and 53 healthy controls. Serum PON1 activity was measured manually using spectrophotometer. Liver function test parameters and fasting lipid profile were performed in clinical chemistry auto analyzer (Hitachi 912. Results: The serum PON1 activity in patients with acute viral hepatitis and sepsis decreased significantly ( P < 0.001 and moderately in falciparum malaria ( P < 0.05. However, in patients with cirrhosis, leptospirosis and left ventricular patients, its activity did not change significantly. On applying Pearson correlation, serum PON1 activity correlated positively with high-density lipoprotein-cholesterol (HDL-C in patients with sepsis (r=0.633, P < 0.05, left ventricular failure patients (r=0.814, P < 0.05 and negatively with acute viral hepatitis patients (r=- 0.528, P < 0.05. Conclusion: PON1 activity has decreased significantly in acute viral hepatitis, sepsis with multi organ failure and falciparum malaria patients. Determination of PON1 activity may serve as a useful additional test in assessing these conditions.

  1. Body Image in Younger Breast Cancer Survivors: A Systematic Review

    Science.gov (United States)

    Paterson, Carly; Lengacher, Cecile A.; Donovan, Kristine A.; Kip, Kevin E.; Tofthagen, Cindy S.

    2015-01-01

    Background Body image is a complex issue with the potential to impact many aspects of cancer survivorship, particularly for the younger breast cancer survivor. Objective The purpose of this review is to synthesize the current state of the science for body image in younger women with breast cancer. Intervention/Methods Combinations of the terms “body image,” “sexuality intervention,” “women,” “younger women,” and “breast cancer” were searched in the PubMed, PsycInfo, CINAHL, Web of Knowledge and Science Direct databases through January 2014. Inclusion criteria for this review were: 1) original research; 2) published in English from the year 2000 forward; 3) measuring body image as an outcome variable; and 4) results included reporting of age-related outcomes. Results Thirty-six articles met the inclusion criteria. The majority of studies were cross-sectional, with extensive variation in body image assessment tools. Age and treatment type had a significant impact on body image, and poorer body image was related to physical and psychological distress, sex and intimacy, and the partnered relationship among younger women. Only one intervention study found a significant improvement in body image post-intervention. Conclusions Findings suggest body image is a complex post-treatment concern for breast cancer survivors, particularly younger women. The findings of this review are limited by the high level of variation in the methods for assessing body image. Implications for Practice Further research of interventions to address body image concerns following treatment for breast cancer is warranted. Improvement of body image may improve the quality of life of younger breast cancer survivors. PMID:25881807

  2. Lower paraoxonase 1 activity in Tunisian bipolar I patients

    Directory of Open Access Journals (Sweden)

    Araoud Manel

    2010-10-01

    Full Text Available Abstract Background The purpose of this study was to investigate the variations of paraoxonase activity and lipid profile in bipolar I patients, and the association of this activity with the sociodemographic, clinical and therapeutic characteristics of this population. Patients and methods Our study included 66 patients with bipolar I disorder and 64 controls aged 37.9 ± 12.6 and 36.3 ± 18.2 years, respectively. Paraoxonase activity was determined by kinetic methods; high-density lipoprotein cholesterol (c-HDL, low-density lipoprotein cholesterol (c-LDL, triglycerides and total cholesterol were determined by enzymatic methods; apolipoprotein (ApoA1, ApoB and lipoprotein (a (Lp(a were determined by immunoturbidimetry using Konelab 30 equipment (Thermo Scientific. Results Compared with controls, patients had a significantly lower paraoxonase activity and ApoA1 level, and significantly higher total cholesterol, c-LDL and Lp(a level and ApoB/ApoA1 ratio. Furthermore, paraoxonase activity was significantly correlated with c-HDL values (r = 0.5612; P Conclusions Bipolar patients had a significant decrease in paraoxonase activity and perturbations in their lipid profile that contribute to increased risk of cardiovascular diseases. Decrease in this activity was significantly associated with treatment with lithium but not with sociodemographic and clinical characteristics. Therefore, such patients require specific care, particularly with regard to their lipid profile.

  3. Prognostic and biologic significance of long non-coding RNA profiling in younger adults with cytogenetically normal acute myeloid leukemia.

    Science.gov (United States)

    Papaioannou, Dimitrios; Nicolet, Deedra; Volinia, Stefano; Mrózek, Krzysztof; Yan, Pearlly; Bundschuh, Ralf; Carroll, Andrew J; Kohlschmidt, Jessica; Blum, William; Powell, Bayard L; Uy, Geoffrey L; Kolitz, Jonathan E; Wang, Eunice S; Eisfeld, Ann-Kathrin; Orwick, Shelley J; Lucas, David M; Caligiuri, Michael A; Stone, Richard M; Byrd, John C; Garzon, Ramiro; Bloomfield, Clara D

    2017-08-01

    Long non-coding ribonucleic acids (RNAs) are a novel class of RNA molecules, which are increasingly recognized as important molecular players in solid and hematologic malignancies. Herein we investigated whether long non-coding RNA expression is associated with clinical and molecular features, as well as outcome of younger adults (aged <60 years) with de novo cytogenetically normal acute myeloid leukemia. Whole transcriptome profiling was performed in a training (n=263) and a validation set (n=114). Using the training set, we identified 24 long non-coding RNAs associated with event-free survival. Linear combination of the weighted expression values of these transcripts yielded a prognostic score. In the validation set, patients with high scores had shorter disease-free (P<0.001), overall (P=0.002) and event-free survival (P<0.001) than patients with low scores. In multivariable analyses, long non-coding RNA score status was an independent prognostic marker for disease-free (P=0.01) and event-free survival (P=0.002), and showed a trend for overall survival (P=0.06). Among multiple molecular alterations tested, which are prognostic in cytogenetically normal acute myeloid leukemia, only double CEBPA mutations, NPM1 mutations and FLT3-ITD associated with distinct long non-coding RNA signatures. Correlation of the long non-coding RNA scores with messenger RNA and microRNA expression identified enrichment of genes involved in lymphocyte/leukocyte activation, inflammation and apoptosis in patients with high scores. We conclude that long non-coding RNA profiling provides meaningful prognostic information in younger adults with cytogenetically normal acute myeloid leukemia. In addition, expression of prognostic long non-coding RNAs associates with oncogenic molecular pathways in this disease. clinicaltrials.gov Identifier: 00048958 (CALGB-8461), 00899223 (CALGB-9665), and 00900224 (CALGB-20202). Copyright© 2017 Ferrata Storti Foundation.

  4. Antibiotic activity and concentrations in clinical samples from patients with chronic bacterial prostatitis.

    Science.gov (United States)

    Heras-Cañas, V; Gutiérrez-Soto, B; Almonte-Fernández, H; Lara-Oya, A; Navarro-Marí, J M; Garrido-Frenich, A; Vázquez-Alonso, F; Gutiérrez-Fernández, J

    2017-06-19

    Chronic bacterial prostatitis (CBP) is the most common urological disease in patients younger than 50 years, whose long-standing symptoms could be related to an inappropriate therapeutic regimen. The objective was to analyse the sensitivity of microorganisms isolated from patients with CBP and measure the weekly antibiotic concentrations in serum, semen and urine. For the antibiotic sensitivity study, 60 clinical isolates were included between January 2013 and December 2014 from semen samples from patients with microbiologically confirmed CBP. Broth microdilution was performed on the samples. For the antibiotic concentration study from January to May 2014, urine, blood and semen samples were collected weekly, over 4 weeks of treatment from 8 patients with positive cultures for CBP. The concentrations were measured using ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). The antibiotics fosfomycin and nitrofurantoin had the highest activity (95.2% in both cases). The mean antibiotic concentrations in semen during the 4 weeks studied were as follows: 1.68mg/L, 8.30mg/L, 2.61mg/L, 0.33mg/L and 2.90mg/L, respectively, for patients 1 to 5, who were treated with levofloxacin; 1.625mg/L for patient 6, who was treated with ciprofloxacin; 2.67mg/L for patient 7, who was treated with ampicillin; and 1.05mg/L for patient 8, who was treated with doxycycline. Higher concentrations were obtained in the urine samples than in serum and semen, the latter 2 of which were comparable. Fosfomycin is proposed as the primary alternative to the empiric treatment of CBP due to its high in vitro activity. The antibiotic concentration in semen was higher than the minimal inhibitory concentration against the aetiological agent, although microbiological negativisation was not always correlated with a favourable clinical outcome. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Serum paraoxonase 1 activity status in patients with liver disorders

    OpenAIRE

    Kedage Vivekananda; Muttigi Manjunatha; Shetty Mahesh; Suvarna Renuka; Rao Soumya; Joshi Chitralekha; Prakash Mungli

    2010-01-01

    Background/Aim: Paraoxonase 1 (PON1) is an esterase, exclusively synthesized by liver. The present study has two objectives: to determine the PON1 activity status in various disorders associated with hepatocellular damage and to correlate the changes of PON1 activity with the standard liver function and fasting lipid profile tests in these disorders. Patients and Methods: The study groups consisted of 95 patients with liver diseases including acute viral hepatitis (14), cirrhosis with port...

  6. DETECTION OF TELOMERASE ACTIVITY IN PATIENTS WITH MYCOSIS FUNGOIDES

    Institute of Scientific and Technical Information of China (English)

    应作霖; 孙建方; 刘珊

    2003-01-01

    Objectives. To detect telomerase activity in patients with mycosis fungoides (MF) and to study therole of telomerase in the tumorigenesis of MF.Methods. The technique of PCR-ELISA was employed to detect telomerase activity in 35 patientswith various stages of MF.Results. 92.3% tumor stage of MF, 78.6% plaque stage of MF and 75.0% patch stage of MF hadpositive telomerase activity. The control samples had no telomerase activity. Telomerase activity in tumorstage of MF was significantly higher than that in plaque stage, while the latter was higher than that inpatch stage. Telomerase activity was correlated with the stage of MF.Conclusion. High level of telomerase activity frequently occurred in patients with MF, suggestingthat telomerase might play an important role in the tumorigenesis of MF and is a useful marker for thediagnosis of MF possibly.

  7. Management of Hypertension: Adapting New Guidelines for Active Patients.

    Science.gov (United States)

    Tanji, Jeffrey L.; Batt, Mark E.

    1995-01-01

    Discusses recent guidelines on hypertension from the National Heart, Lung, and Blood Institute and details the latest management protocols for patients with high blood pressure. The article helps physicians interpret the guidelines for treating active patients, highlighting diagnosis, step care revision, pharmacology, and sports participation…

  8. Serum paraoxonase activity and protein thiols in patients with hyperlipidemia

    Institute of Scientific and Technical Information of China (English)

    Mungli Prakash; Jeevan K Shetty; Sudeshna Tripathy; Pannuri Vikram; Manish Verma

    2009-01-01

    Objective: In the present study we evaluated the paraoxonase activity and protein thiols level in south Indian population with newly diagnosed hyperlipidemia. Methods: The study was conducted on 55 newly diagnosed hyperlipidemic pa-tients and 57 healthy controls. Serum paraoxonase activity and protein thiols were estimated by spectrophotometeric method and lipid profile by enzymatic kinetic assay method. Results: Serum paraoxonase activity, protein thiols and high density lipoprotein levels were low and total cholesterol, triglycerides and low density lipoprutein levels were high in patients with hyperlipidemia compared to healthy controls ( P < 0.01 ). Serum paranxonase activity correlated positively with protein thiols and high density lipoprotein (P<0.01). Conclusion: Decreased paraoxonase activity and protein thiols were found in patients with hyperlipi-demia. This may indicate the susceptibility of this population to accelerated atherogenesis and protein oxidation.

  9. Virtual patients as activities: exploring the research implications of an activity theoretical stance.

    Science.gov (United States)

    Ellaway, Rachel H

    2014-09-01

    Virtual patients are computer-based simulators of patient encounters for the purposes of instruction, practice, and assessment. Although virtual patients have been around for some time they have yet to become part of mainstream medical education. A major reason for this would seem to be a lack of clarity as to what educational value virtual patients actually have. This paper argues that virtual patients should be seen as activities rather than artifacts and that activity theory can be used to generate different ways to frame scholarship in and around virtual patients. Drawing on the work of Leont'ev and Engeström this paper describes a range of perspectives based on the operations, actions, and objectives in and around virtual patients; the use of virtual patients to mediate activities; and the sociocultural context and the participants in virtual patient activities. This approach allows us to move beyond the 'does or does not work' discourse of much of the existing scholarship around virtual patients and, to an extent, around educational technologies as a whole. Activity perspectives, and activity theory in particular, offer new horizons for research and evaluation that address many of the limitations of intervention-based paradigms of inquiry.

  10. Cortical activity in tinnitus patients and its modification by phonostimulation

    Directory of Open Access Journals (Sweden)

    Katarzyna Pawlak-Osińska

    2013-04-01

    Full Text Available OBJECTIVE: The goal of this study was to observe spontaneous cortical activity and cortical activity modulated by tinnitus-matched sound in tinnitus patients and healthy subjects with no otoneurologic symptoms. METHOD: Data were prospectively collected from 50 tinnitus patients and 25 healthy subjects. Cortical activity was recorded in all subjects with eyes closed and open and during photostimulation, hyperventilation and acoustic stimulation using 19-channel quantitative electroencephalography. The sound applied in the tinnitus patients was individually matched with the ability to mask or equal the tinnitus. The maximal and mean amplitude of the delta, theta, alpha and beta waves and the type and amount of the pathologic EEG patterns were noted during each recording. Differences in cortical localization and the influence of sound stimuli on spontaneous cortical activity were evaluated between the groups. RESULTS: The tinnitus group exhibited decreased delta activity and increased alpha and beta activity. Hyperventilation increased the intensity of the differences. The tinnitus patients had more sharp-slow waves and increased slow wave amplitude. Sound stimuli modified the EEG recordings; the delta and beta wave amplitudes were increased, whereas the alpha-1 wave amplitude was decreased. Acoustic stimulation only slightly affected the temporal region. CONCLUSION: Cortical activity in the tinnitus patients clearly differed from that in healthy subjects, i.e., tinnitus is not a “phantom” sign. The changes in cortical activity included decreased delta wave amplitudes, increased alpha-1, beta-1 and beta-h wave amplitudes and pathologic patterns. Cortical activity modifications occurred predominantly in the temporal region. Acoustic stimulation affected spontaneous cortical activity only in tinnitus patients, and although the applied sound was individually matched, the pathologic changes were only slightly improved.

  11. The correlation between a passion for computer games and the school performance of younger schoolchildren.

    Directory of Open Access Journals (Sweden)

    Maliy D.V.

    2015-07-01

    Full Text Available Today computer games occupy a significant place in children’s lives and fundamentally affect the process of the formation and development of their personalities. A number of present-day researchers assert that computer games have a developmental effect on players. Others share the point of view that computer games have negative effects on the cognitive and emotional spheres of a child and claim that children with low self-esteem who neglect their schoolwork and have difficulties in communication are particularly passionate about computer games. This article reviews theoretical and experimental pedagogical and psychological studies of the nature of the correlation between a passion for computer games and the school performance of younger schoolchildren. Our analysis of foreign and Russian psychology studies regarding the problem of playing activities mediated by information and computer technologies allowed us to single out the main criteria for children’s passion for computer games and school performance. This article presents the results of a pilot study of the nature of the correlation between a passion for computer games and the school performance of younger schoolchildren. The research involved 32 pupils (12 girls and 20 boys aged 10-11 years in the 4th grade. The general hypothesis was that there are divergent correlations between the passion of younger schoolchildren for computer games and their school performance. A questionnaire survey administered to the pupils allowed us to obtain information about the amount of time they devoted to computer games, their preferences for computer-game genres, and the extent of their passion for games. To determine the level of school performance we analyzed class registers. To establish the correlation between a passion for computer games and the school performance of younger schoolchildren, as well as to determine the effect of a passion for computer games on the personal qualities of the children

  12. Media use by children younger than 2 years.

    Science.gov (United States)

    Brown, Ari

    2011-11-01

    In 1999, the American Academy of Pediatrics (AAP) issued a policy statement addressing media use in children. The purpose of that statement was to educate parents about the effects that media--both the amount and the content--may have on children. In one part of that statement, the AAP recommended that "pediatricians should urge parents to avoid television viewing for children under the age of two years." The wording of the policy specifically discouraged media use in this age group, although it is frequently misquoted by media outlets as no media exposure in this age group. The AAP believed that there were significantly more potential negative effects of media than positive ones for this age group and, thus, advised families to thoughtfully consider media use for infants. This policy statement reaffirms the 1999 statement with respect to media use in infants and children younger than 2 years and provides updated research findings to support it. This statement addresses (1) the lack of evidence supporting educational or developmental benefits for media use by children younger than 2 years, (2) the potential adverse health and developmental effects of media use by children younger than 2 years, and (3) adverse effects of parental media use (background media) on children younger than 2 years.

  13. Older and Younger Workers: The Equalling Effects of Health

    Science.gov (United States)

    Beck, Vanessa; Quinn, Martin

    2012-01-01

    Purpose: The purpose of this paper is to consider the statistical evidence on the effects that ill health has on labour market participation and opportunities for younger and older workers in the East Midlands (UK). Design/methodology/approach: A statistical analysis of Labour Force Survey data was undertaken to demonstrate that health issues…

  14. Memory Dynamics and Decision Making in Younger and Older Adults

    Science.gov (United States)

    Lechuga, M. Teresa; Gomez-Ariza, Carlos J.; Iglesias-Parro, Sergio; Pelegrina, Santiago

    2012-01-01

    The main aim of this research was to study whether memory dynamics influence older people's choices to the same extent as younger's ones. To do so, we adapted the retrieval-practice paradigm to produce variations in memory accessibility of information on which decisions were made later. Based on previous results, we expected to observe…

  15. Interaction between functional health literacy, patient activation, and glycemic control

    Directory of Open Access Journals (Sweden)

    Woodard LD

    2014-07-01

    Full Text Available LeChauncy D Woodard, Cassie R Landrum, Amber B Amspoker, David Ramsey, Aanand D Naik Veterans Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Background: Functional health literacy (FHL and patient activation can impact diabetes control through enhanced diabetes self-management. Less is known about the combined effect of these characteristics on diabetes outcomes. Using brief, validated measures, we examined the interaction between FHL and patient activation in predicting glycosylated hemoglobin (HbA1c control among a cohort of multimorbid diabetic patients.Methods: We administered a survey via mail to 387 diabetic patients with coexisting ­hypertension and ischemic heart disease who received outpatient care at one regional VA medical center between November 2010 and December 2010. We identified patients with the study conditions using the International Classification of Diseases-Ninth Revision-Clinical ­Modification (ICD-9-CM diagnoses codes and Current Procedure Terminology (CPT ­procedures codes. Surveys were returned by 195 (50.4% patients. We determined patient activation levels based on participant responses to the 13-item Patient Activation Measure and FHL levels using the single-item screening question, “How confident are you filling out medical forms by yourself?” We reviewed patient medical records to assess glycemic control. We used multiple logistic regression to examine whether activation and FHL were individually or jointly related to HbA1c control.Results: Neither patient activation nor FHL was independently related to glycemic control in the unadjusted main effects model; however, the interaction between the two was significantly associated with glycemic control (odds ratio 1.05 [95% confidence

  16. Compensatory muscle activation in patients with glenohumeral cuff tears

    NARCIS (Netherlands)

    Steenbrink, Franciscus

    2010-01-01

    Patients suffering tendon tears in the glenohumeral cuff muscles show activation of muscles which pull the arm downwards during arm elevation tasks. This so-called co-activation deviates from healthy controls and is triggered by pain. Goal of this thesis was to demonstrate that deviating muscle

  17. Drive for activity in patients with anorexia nervosa

    NARCIS (Netherlands)

    Sternheim, Lot; Danner, Unna; Adan, Roger; van Elburg, Annemarie

    2014-01-01

    OBJECTIVE: Hyperactivity and elevated physical activity are both considered symptom characteristics of anorexia nervosa (AN). It has been suggested that a drive for activity (DFA) may underlie these expressions, yet research into DFA in AN remains scant. This study investigated DFA levels in patient

  18. A qualitative study of younger men's experience of heart attack (myocardial infarction).

    Science.gov (United States)

    Merritt, Christopher J; de Zoysa, Nicole; Hutton, Jane M

    2017-09-01

    The effects of heart attack, or myocardial infarction (MI), across psychosocial domains may be particularly acute in younger adults, for whom serious health events are non-normative. MI morbidity is declining in Western countries, but in England MI numbers have plateaued for the under-45 cohort, where approximately 90% of patients are male. Qualitative research on younger adults' experience of MI is limited, and no study has sampled exclusively under-45s. This study aimed to understand how a sample of men under 45 adjusted to and made sense of MI. Qualitative research design based on semi-structured in-depth interviews. Ten men aged under 45 who had experienced MI in the past 3-6 months were purposively recruited and interviewed. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis. Seven superordinate themes were identified. This article focuses in depth on the three most original themes: (1) 'I'm less of a man', which described experiences of losing 'maleness' (strength, independence, ability to provide) post-MI; (2) 'Shortened horizons', which covered participants' sense of foreshortened future and consequent reprioritization; and (3) 'Life loses its colour', describing the loss of pleasure from lifestyle-related changes. Themes broadly overlapped with the qualitative literature on younger adult MI. However, some themes (e.g., loss of 'maleness' post-MI, and ambivalence towards MI risk factors) appeared unique to this study. Themes were also discussed in relation to risk factors for anxiety and depression and how this might inform clinical care for a younger, male population. Statement of contribution What is already known on this subject? Myocardial infarction (MI) morbidity is not declining in England for under-45s. Adjustment to MI is particularly challenging for younger adults, perhaps because it is non-normative. However, little is known about the experience of MI in younger adults. What does this study add? This

  19. Glacier retreat in New Zealand during the Younger Dryas stadial.

    Science.gov (United States)

    Kaplan, Michael R; Schaefer, Joerg M; Denton, George H; Barrell, David J A; Chinn, Trevor J H; Putnam, Aaron E; Andersen, Bjørn G; Finkel, Robert C; Schwartz, Roseanne; Doughty, Alice M

    2010-09-09

    Millennial-scale cold reversals in the high latitudes of both hemispheres interrupted the last transition from full glacial to interglacial climate conditions. The presence of the Younger Dryas stadial (approximately 12.9 to approximately 11.7 kyr ago) is established throughout much of the Northern Hemisphere, but the global timing, nature and extent of the event are not well established. Evidence in mid to low latitudes of the Southern Hemisphere, in particular, has remained perplexing. The debate has in part focused on the behaviour of mountain glaciers in New Zealand, where previous research has found equivocal evidence for the precise timing of increased or reduced ice extent. The interhemispheric behaviour of the climate system during the Younger Dryas thus remains an open question, fundamentally limiting our ability to formulate realistic models of global climate dynamics for this time period. Here we show that New Zealand's glaciers retreated after approximately 13 kyr bp, at the onset of the Younger Dryas, and in general over the subsequent approximately 1.5-kyr period. Our evidence is based on detailed landform mapping, a high-precision (10)Be chronology and reconstruction of former ice extents and snow lines from well-preserved cirque moraines. Our late-glacial glacier chronology matches climatic trends in Antarctica, Southern Ocean behaviour and variations in atmospheric CO(2). The evidence points to a distinct warming of the southern mid-latitude atmosphere during the Younger Dryas and a close coupling between New Zealand's cryosphere and southern high-latitude climate. These findings support the hypothesis that extensive winter sea ice and curtailed meridional ocean overturning in the North Atlantic led to a strong interhemispheric thermal gradient during late-glacial times, in turn leading to increased upwelling and CO(2) release from the Southern Ocean, thereby triggering Southern Hemisphere warming during the northern Younger Dryas.

  20. Active acute leukaemia: should transplant be offered to all patients?

    Science.gov (United States)

    Avni, Batia; Shapira, Michael Y; Resnick, Igor B; Stepensky, Polina; Or, Reuven; Grisariu, Sigal

    2016-06-24

    The probability of achieving long term remission for patients with refractory acute leukaemia is very low. Allogeneic stem cell transplantation (SCT) is offered to these patients in order to improve their dismal outcome. We retrospectively analyzed 361 acute leukaemia patients, who underwent allogeneic SCT in the Hadassah's bone marrow transplantation department between the years 2005 and 2012 and identified 84 patients with active leukaemia at transplantation. Median age was 34 years. Sixty four patients were diagnosed with acute myeloid leukaemia (AML), 18 patients with acute lymphoblastic leukaemia and two with biphenotypic leukaemia. The majority of patients were diagnosed with de-novo AML and transplanted at relapse. In the surviving patients, median follow up was 15 months. One year OS was 20%. At time of last follow up, 13 patients were alive (15.5%): ten patients with AML and two patients with acute lymphoblastic leukaemia. In the univariate analysis, factors associated with significantly better overall survival were as follows: matched unrelated donor (p = 0.006), matched donor (p = 0.014) and occurrence of acute graft-versus-host disease (aGVHD) (p = 0.019). Karnofsky performance score at SCT and occurrence of cGVHD were found to be borderline significant. Only matched unrelated donor and aGVHD were found to affect overall survival significantly in the multivariate analysis. Other than performance score at SCT, none of the pretransplant patients' characteristics were found to influence survival. In conclusion, as none of the pretransplant characteristics were found to influence the ability to select the patients that will benefit from HSC transplantation, this work supports offering HSCT to all active leukaemia eligible patients with reasonable performance status. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Effectiveness of acceptance and commitment therapy for depression: comparison among older and younger veterans.

    Science.gov (United States)

    Karlin, Bradley E; Walser, Robyn D; Yesavage, Jerome; Zhang, Aimee; Trockel, Mickey; Taylor, C Barr

    2013-01-01

    Limited data exist on outcomes of older adults receiving psychotherapy for depression in real-world settings. Acceptance and Commitment Therapy for depression (ACT-D) offers potential utility for older individuals who may experience issues of loss, reduced control, and other life changes. The present article examines and compares outcomes of older and younger Veterans receiving ACT-D nationally in the U.S. Department of Veterans Affairs health care system. Patient outcomes were assessed using the Beck Depression Inventory-Second Edition and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised. Six hundred fifty-five Veterans aged 18-64 and 76 Veterans aged 65+ received ACT-D. Seventy-eight percent of older and 67% of younger patients completed all sessions or finished early. Mean depression scores declined from 28.4 (SD = 11.4) to 17.5 (SD = 12.0) in the older group and 30.3 (SD = 10.6) to 19.1 (SD = 14.3) in the younger group. Within-group effect sizes were d = .95 and d = 1.06 for the two age groups, respectively. Quality of life and therapeutic alliance also increased during treatment. The findings suggest that ACT-D is an effective and acceptable treatment for older Veterans treated in routine clinical settings, including those with high levels of depression.

  2. Physical Activity in Hemodialysis Patients Measured by Triaxial Accelerometer

    Directory of Open Access Journals (Sweden)

    Edimar Pedrosa Gomes

    2015-01-01

    Full Text Available Different factors can contribute to a sedentary lifestyle among hemodialysis (HD patients, including the period they spend on dialysis. The aim of this study was to evaluate characteristics of physical activities in daily life in this population by using an accurate triaxial accelerometer and to correlate these characteristics with physiological variables. Nineteen HD patients were evaluated using the DynaPort accelerometer and compared to nineteen control individuals, regarding the time spent in different activities and positions of daily life and the number of steps taken. HD patients were more sedentary than control individuals, spending less time walking or standing and spending more time lying down. The sedentary behavior was more pronounced on dialysis days. According to the number of steps taken per day, 47.4% of hemodialysis patients were classified as sedentary against 10.5% in control group. Hemoglobin level, lower extremity muscle strength, and physical functioning of SF-36 questionnaire correlated significantly with the walking time and active time. Looking accurately at the patterns of activity in daily life, HDs patients are more sedentary, especially on dialysis days. These patients should be motivated to enhance the physical activity.

  3. Inflammatory bowel diseases activity in patients undergoing pelvic radiation therapy

    Science.gov (United States)

    Seisen, Thomas; Klotz, Caroline; Mazeron, Renaud; Maroun, Pierre; Petit, Claire; Deutsch, Eric; Bossi, Alberto; Haie-Meder, Christine; Chargari, Cyrus; Blanchard, Pierre

    2017-01-01

    Background Few studies with contradictory results have been published on the safety of pelvic radiation therapy (RT) in patients with inflammatory bowel disease (IBD). Methods From 1989 to 2015, a single center retrospective analysis was performed including all IBD patients who received pelvic external beam radiation therapy (EBRT) or brachytherapy (BT) for a pelvic malignancy. Treatment characteristics, IBD activity and gastrointestinal (GI) toxicity were examined. Results Overall, 28 patients with Crohn’s disease (CD) (n=13) or ulcerative colitis (n=15) were included in the present study. Median follow-up time after irradiation was 5.9 years. Regarding IBD activity, only one and two patients experienced a severe episode within and after 6 months of follow-up, respectively. Grade 3/4 acute GI toxicity occurred in 3 (11%) patients, whereas one (3.6%) patient experienced late grade 3/4 GI toxicity. Only patients with rectal IBD location (P=0.016) or low body mass index (BMI) (P=0.012) experienced more severe IBD activity within or after 6 months following RT, respectively. Conclusions We report an acceptable tolerance of RT in IBD patients with pelvic malignancies. Specifically, a low risk of uncontrolled flare-up was observed. PMID:28280621

  4. Development of the Patient Activation Measure for mental health.

    Science.gov (United States)

    Green, Carla A; Perrin, Nancy A; Polen, Michael R; Leo, Michael C; Hibbard, Judith H; Tusler, Martin

    2010-07-01

    Our objective was to adapt the physical health Patient Activation Measure (PAM) for use among people with mental health conditions (PAM-MH). Data came from three studies among people with chronic mental health conditions and were combined in Rasch analyses. The PAM-MH's psychometric properties equal those of the original 13-item PAM. Test-retest reliability and concurrent validity were good, and the PAM-MH showed sensitivity to change. The PAM-MH appears to be a reliable and valid measure of patient activation among individuals with mental health problems. It appears to have potential for use in assessing change in activation.

  5. Prognostic value of serum angiogenic activity in colorectal cancer patients.

    Science.gov (United States)

    Gonzalez, Francisco-Jesus; Quesada, Ana-Rodriguez; Sevilla, Isabel; Baca, Juan-Javier; Medina, Miguel-Angel; Amores, Jose; Diaz, Juan Miguel; Rius-Diaz, Francisca; Marques, Eduardo; Alba, Emilio

    2007-01-01

    Angiogenesis, resulting from an imbalance between angiogenic activator factors and inhibitors, is required for tumour growth and metastasis. The determination of the circulating concentration of all angiogenic factors (activators and inhibitors) is not feasible at present. We have evaluated diagnostic and prognostic values of the measurement of serum angiogenic activity in colorectal carcinoma (CRC) patients. Serum proliferative activity (PA) on human umbilical vein endothelial cells (HUVEC) in vitro, and serum vascular endothelial growth factor (VEGF) levels were determined by ELISA in 53 patients with primary CRC, 16 subjects with non-neoplastic gastrointestinal disease (SC) and 34 healthy individuals. Data were compared with clinical outcome of the patients. Although serum from CRC patients significantly increased the PA of HUVEC, compared to culture control (HUVEC in medium + 10% foetal bovine serum (FBS); P < 0.001); our results indicate that serum PA in CRC patients was similar to that of SC or healthy individuals. There was no correlation between serum PA and circulating VEGF concentrations. Surgery produced a decrease of PA at 8 hrs after tumour resection in CRC patients compared to pre-surgery values (186 +/- 47 versus 213 +/- 41, P < 0.001). However, an increase in serum VEGF values was observed after surgery (280 [176-450] versus 251 [160-357] pg/ml, P = 0.004). Patients with lower PA values after surgery showed a worse outcome that those with higher PA values. Therefore, this study does not support a diagnostic value for serum angiogenic activity measured by proliferative activity on HUVEC but suggests it could have a prognostic value in CRC patients.

  6. Maintenance of physical activity in patients with rheumaoid arthritis

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Østergaard, Mikkel

    2012-01-01

    . The analysis was discussed within a multidisciplinary team of qualitative researchers. Results: The analysis revealed tree dimensions of PA maintenance: (1) A bodily dimension: physical sensations of vitality, sparkling energy and liberation in movement; (2) a mental component: referring to experiences of self......Background: Several exercise trials indicate that physical activity (PA) may improve physical function and quality of life, and reduce pain in patients with rheumatoid arthritis (RA) 1, 2. Few of these studies have included physical activity maintenance. Thus, it is still unknown how and why some...... patients with RA are able to maintain physical active. Objectives: The aim of this study was to describe the experience of physical activity maintenance in patients with RA. Methods: A qualitative salutogenetic-oriented study was conducted based on individual semi-structured interviews. Interviewee...

  7. Maintenance of physical activity in patients with rheumaoid arthritis

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Østergaard, Mikkel

    2012-01-01

    Background: Several exercise trials indicate that physical activity (PA) may improve physical function and quality of life, and reduce pain in patients with rheumatoid arthritis (RA) 1, 2. Few of these studies have included physical activity maintenance. Thus, it is still unknown how and why some...... patients with RA are able to maintain physical active. Objectives: The aim of this study was to describe the experience of physical activity maintenance in patients with RA. Methods: A qualitative salutogenetic-oriented study was conducted based on individual semi-structured interviews. Interviewee....... The analysis was discussed within a multidisciplinary team of qualitative researchers. Results: The analysis revealed tree dimensions of PA maintenance: (1) A bodily dimension: physical sensations of vitality, sparkling energy and liberation in movement; (2) a mental component: referring to experiences of self...

  8. Physical Activity in Patients Treated With Peritoneal Dialysis

    Science.gov (United States)

    Thangarasa, Tharshika; Imtiaz, Rameez; Hiremath, Swapnil; Zimmerman, Deborah

    2017-01-01

    Background: Patients with chronic diseases are known to benefit from exercise. Despite a lack of compelling evidence, patients with end-stage kidney disease treated with peritoneal dialysis are often discouraged from participating in exercise programs that include resistance training due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for these patients remain unclear. The purpose of this study is to more completely define the risks and benefits of physical activity in the end-stage kidney disease population treated with peritoneal dialysis. Methods/design: We will conduct a systematic review examining the effects of physical activity on end-stage kidney disease patients treated with peritoneal dialysis. For the purposes of this review, exercise will be considered a purposive subcategory of physical activity. The primary objective is to determine if physical activity in this patient population is associated with improvements in mental health, physical functioning, fatigue and quality of life and if there is an increase in adverse outcomes. With the help of a skilled librarian, we will search MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials for randomized trials and observational studies. We will include adult end-stage kidney disease patients treated with peritoneal dialysis that have participated in an exercise training program or had their level of physical activity assessed directly or by self-report. The study must include an assessment of the association between physical activity and one of our primary or secondary outcomes measures. We will report study quality using the Cochrane Risk of Bias Assessment Tool for randomized controlled trials and the Newcastle–Ottawa Scale for observational studies. Quality across studies will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The

  9. Lifestyle, cardiovascular drugs and risk factors in younger and elder adults: The PEP family heart study

    Directory of Open Access Journals (Sweden)

    Peter Schwandt

    2010-01-01

    Full Text Available Objectives: This study aimed to compare cardiovascular disease (CVD risk factors, lifestyle habits and pharmacological treatment in two groups of elder adults with 20 years difference in their mean age. Methods: This study comprised 590 women including two groups with mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of two groups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data on physical examination, fasting blood analyses, 7-day dietary re-cords, physical activity, smoking and actual medication use were recorded. Results: Compared with younger individuals, seniors had a more adverse risk factor profile in terms of abdominal obesity, over-weight, hyperglycemia, hypertension, dyslipoproteinemia without differences in HDL-C. But this is not reflected by lifestyle behav-ior. Less than 2% of the elderly and 17% of the younger adults were current smoker. Furthermore, the pattern of physical activ-ity was different in terms of more continuous sports in seniors contrasting with extremes between no sports and more than twice a week in the younger group. Seniors consumed significantly less carbohydrates including more monosaccharide and less polysaccharides, more alcohol and water. The intake of fat and protein was higher in elder women than in all other groups. One third of seniors took antihypertensive medications and 12% used lipid modifying drugs. Conclusions: Different levels of prevention against CVDs and their risk factors shall be considered for various age groups of population. The findings of this study emphasize on the necessity of preventive measures against smoking and physical inactivity in younger adults and dietary habits in seniors.

  10. Accelerometer Quantification of Physical Activity and Activity Patterns in Patients with Ankylosing Spondylitis and Population Controls

    NARCIS (Netherlands)

    van Genderen, Simon; Boonen, Annelies; van der Heijde, Desiree; Heuft, Liesbeth; Luime, Jolanda; Spoorenberg, Anneke; Arends, Suzanne; Landewe, Robert; Plasqui, Guy

    2015-01-01

    Objective. To compare the total amount of physical activity (TPA) and time spent in various activity intensities of patients with ankylosing spondylitis (AS) and population controls, and to explore factors related to physical activity (PA). Methods. Subjects were asked to wear a triaxial

  11. Improving activity and engagement for patients with dementia.

    Science.gov (United States)

    Bray, Jennifer; Evans, Simon; Bruce, Mary; Carter, Christine; Brooker, Dawn; Milosevic, Sarah; Thompson, Rachel; Hutt, Louise

    2015-10-01

    This is the second in a short series that presents case study examples of the positive work achieved by trusts that participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. Staff often think that there is insufficient time to get to know patients and carers, especially with large and challenging workloads. Combined with a lack of activities and stimulation for patients with dementia in hospital, this can result in poor engagement and a disconnect between staff and patients. To improve these relationships and give staff more time with patients, Cambridge University Hospitals NHS Foundation Trust has introduced bay nursing for patients with dementia, where one nurse is responsible for monitoring a bay alongside a healthcare assistant for an entire shift. Part of Betsi Cadwaladr University Health Board, Glan Clwyd Hospital in north Wales has focused on improving stimulation by creating an activity room with a specially trained activity worker, providing a relaxed and friendly setting where patients with dementia can take part in a range of activities and have lunch together.

  12. Targeting physical activity promotion in general practice: Characteristics of inactive patients and willingness to change

    Directory of Open Access Journals (Sweden)

    Sánchez-Pinilla Ricardo

    2008-05-01

    Full Text Available Abstract Background Counselling in routine general practice to promote physical activity (PA is advocated, but inadequate evidence is available to support this intervention, and its sustainable implementation over time is difficult. Objectives To describe the characteristics of physically inactive adults visiting GPs and the factors associated with their willingness to change PA. Methods A cross-sectional analysis of 4317 Spanish people aged 20–80 years, selected by systematic sampling among those attending 56 public primary health care practices identified as inactive by their GPs in 2003. PA (7-day PAR, PA stage of change, health-related quality of life (SF-36, cardiovascular risk factors, and social and demographic characteristics were measured. Multivariate mixed effects ordinal logistic models were adjusted to identify factors associated with motivational readiness to change. Results At least 70% (95% CI: 67.6% to 72.8% of patients assessed by GPs did not achieve minimal PA recommendations. In addition, 85% (95% CI: 83% to 86.3% had at least an additional cardiovascular risk factor. Only 30% (95% CI: 25.8% to 33.5% were prepared for or attempting a change. A younger age; retirement or work at home; higher education and social class levels; obesity; and hypertension were associated with a higher motivational readiness to change (p Conclusion The overburden that would result from counselling such a high proportion of inactive primary care patients justifies a targeted strategy for PA promotion in family practice. Selection of a target population based on readiness to change, the combination of risk factors and socio-demographic characteristics of patients is suggested in order to prioritise promotion efforts.

  13. Failure of highly active antiretroviral therapy in reconstituting immune response to Clostridium tetani vaccine in aged AIDS patients.

    Science.gov (United States)

    Andrade, Regis M; Andrade, Arnaldo F B; Lazaro, Marta A; Vieira, Morgana M M; Barros, Priscila O; Borner, Alice R S; Silva-Filho, Renato G; Santos, Juliana O; Brindeiro, Rodrigo M; Tanuri, Amilcar; Bento, Cleonice A M

    2010-05-01

    The purpose of this study was to evaluate the impact of age on tetanus-specific immune response in successfully highly active antiretroviral therapy-treated AIDS patients, using healthy age-matched individuals as controls. Whole Peripheral blood mononuclear cells or CD8(+) cell-depleted peripheral blood mononuclear cells from previously tetanus toxoid (TT)-immunized individuals were activated with TT plus IL-2, and cell proliferation, cytokine production, and in vitro HIV-1 replication were measured. The in vivo magnitude of the humoral immune response was also assessed by antibody measurements. Our results showed that, compared with other groups, both in vitro TT-specific lymphoproliferation and serum antibody concentration were lower in older AIDS patients. Although the IL-1beta and tumour necrosis factor alpha (TNF-alpha) production were higher in cultures from aged HIV-1-infected patients, a dramatic damage on the interferon gamma (IFN-gamma) release was observed, when compared with younger patients. CD8(+) T lymphocytes depletion reduced IL-1beta and TNF-alpha release in the older groups, however, it did not significantly alter their IFN-gamma production. Furthermore, the neutralization of endogenous IL-10 did not change the IFN-gamma deficiency in older AIDS patients. Finally, the lower cellular immune response in this patient group was not related to in vitro HIV-1 replication. The results suggest that successfully highly active antiretroviral therapy-treated aged AIDS patients do not reconstitute the immune response to TT, making them probably more susceptible to tetanus even after vaccination.

  14. Viral hepatitis prevalence in patients with active and latent tuberculosis

    Science.gov (United States)

    Nooredinvand, Hesam Ahmadi; Connell, David W; Asgheddi, Mahmoud; Abdullah, Mohammed; O’Donoghue, Marie; Campbell, Louise; Wickremasinghe, Melissa I; Lalvani, Ajit; Kon, Onn Min; Khan, Shahid A

    2015-01-01

    AIM: To assess the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and association with drug induced liver injury (DILI) in patients undergoing anti-tuberculosis (TB) therapy. METHODS: Four hundred and twenty nine patients with newly diagnosed TB - either active disease or latent infection - who were due to commence anti-TB therapy between September 2008 and May 2011 were included. These patients were prospectively tested for serological markers of HBV, HCV and human immunodeficiency virus (HIV) infections - hepatitis B core antigen (HBcAg), hepatitis B surface antigen (HBsAg), hepatitis B e antigen, IgG and IgM antibody to HBcAg (anti-HBc), HCV IgG antibody and HIV antibody using a combination of enzyme-linked immunosorbent assay, Western blot assay and polymerase chain reaction techniques. Patients were reviewed at least monthly during the TB treatment initiation phase. Liver function tests were measured prior to commencement of anti-TB therapy and 2-4 wk later. Liver function tests were also performed at any time the patient had significant nausea, vomiting, rash, or felt non-specifically unwell. Fisher’s exact test was used to measure significance in comparisons of proportions between groups. A P value of less than 0.05 was considered statistically significant. RESULTS: Of the 429 patients, 270 (62.9%) had active TB disease and 159 (37.1%) had latent TB infection. 61 (14.2%) patients had isolated anti-HBc positivity, 11 (2.6%) were also HBsAg positive and 7 (1.6%) were HCV-antibody positive. 16/270 patients with active TB disease compared to 2/159 patients with latent TB infection had markers of chronic viral hepatitis (HBsAg or HCV antibody positive; P = 0.023). Similarly the proportion of HBsAg positive patients were significantly greater in the active vs latent TB infection group (10/43 vs 1/29, P = 0.04). The prevalence of chronic HBV or HCV was significantly higher than the estimated United Kingdom prevalence of 0.3% for each

  15. Translating primary care practice climate into patient activation: the role of patient trust in physician.

    Science.gov (United States)

    Becker, Edmund R; Roblin, Douglas W

    2008-08-01

    Little is known about processes by which proactive primary care teams might activate their patients. We examine the role of trust in patient-physician relationships for translating practice teamwork into patient activation. Data were collected by surveys of adult enrollees and primary care teams of a group-model managed care organization in metropolitan Atlanta. Enrollees who were 25-59 years of age were randomly sampled from 3 condition cohorts (diabetes, elevated lipids but no coronary artery disease history, and low risk). A total of 2224 responded to a mixed mode survey in 2005 (42% response rate). Ninety-seven practitioners and 187 support staff of 16 primary care teams responded to a practice climate survey in 2004 (85% response rate). Practice climate is a multidimensional concept measuring support and collaboration with a team. Linear models of patients nested within their primary care teams were estimated for patient trust in physician as a function of practice climate and for activation as a function of trust, adjusted for other respondent characteristics. We found significant, positive associations between practice climate and patient trust in their primary care physicians and between patient trust and activation in their health. Our study shows 1 process by which practice climate translates into patient activation. Supportive interactions among practitioners and staff within primary care teams facilitate trust-building interactions between practitioners and patients. Supportive, trustworthy interactions, in turn, help to ameliorate the inherent imbalance in power between patients and physicians, contributing to patients who take a more active role in their health.

  16. Ongoing contact activation in patients with hereditary angioedema.

    Directory of Open Access Journals (Sweden)

    Joke Konings

    Full Text Available Hereditary angioedema (HAE is predominantly caused by a deficiency in C1 esterase inhibitor (C1INH (HAE-C1INH. C1INH inhibits activated factor XII (FXIIa, activated factor XI (FXIa, and kallikrein. In HAE-C1INH patients the thrombotic risk is not increased even though activation of the contact system is poorly regulated. Therefore, we hypothesized that contact activation preferentially leads to kallikrein formation and less to activation of the coagulation cascade in HAE-C1INH patients. We measured the levels of C1INH in complex with activated contact factors in plasma samples of HAE-C1INH patients (N=30, 17 during remission and 13 during acute attack and healthy controls (N=10. We did not detect differences in enzyme-inhibitor complexes between samples of controls, patients during remission and patients during an acute attack. Reconstitution with C1INH did not change this result. Next, we determined the potential to form enzyme-inhibitory complexes after complete in vitro activation of the plasma samples with a FXII trigger. In all samples, enzyme-C1INH levels increased after activation even in patients during an acute attack. However, the levels of FXIIa-C1INH, FXIa-C1INH and kallikrein-C1INH were at least 52% lower in samples taken during remission and 70% lower in samples taken during attack compared to samples from controls (p<0.05. Addition of C1INH after activation led to an increase in levels of FXIIa-C1INH and FXIa-C1INH (p<0.05, which were still lower than in controls (p<0.05, while the levels of kallikrein-C1INH did not change. These results are consistent with constitutive activation and attenuated depletion of the contact system and show that the ongoing activation of the contact system, which is present in HAE-C1INH patients both during remission and during acute attacks, is not associated with preferential generation of kallikrein over FXIa.

  17. Keeping it steady: older adults perform more consistently on cognitive tasks than younger adults.

    Science.gov (United States)

    Schmiedek, Florian; Lövdén, Martin; Lindenberger, Ulman

    2013-09-01

    People often attribute poor performance to having bad days. Given that cognitive aging leads to lower average levels of performance and more moment-to-moment variability, one might expect that older adults should show greater day-to-day variability and be more likely to experience bad days than younger adults. However, both researchers and ordinary people typically sample only one performance per day for a given activity. Hence, the empirical basis for concluding that cognitive performance does substantially vary from day to day is inadequate. On the basis of data from 101 younger and 103 older adults who completed nine cognitive tasks in 100 daily sessions, we show that the contributions of systematic day-to-day variability to overall observed variability are reliable but small. Thus, the impression of good versus bad days is largely due to performance fluctuations at faster timescales. Despite having lower average levels of performance, older adults showed more consistent levels of performance across days.

  18. Paraoxonase 1 phenotype and paraoxonase activity in asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Nurhan Sarioglu

    2015-02-01

    Full Text Available Oxidative stress is involved in the pathogenesis of asthma. Paraoxonase 1 (PON1 and arylesterase are esterase enzymes displaying antioxidant characteristics. PON1 activity varies widely among individuals and ethnic groups, partly related to polymorphisms. The aim of this study was to determine the activities of PON1 and arylesterase including the phenotype distribution of PON1 in asthmatic patients and healthy subjects. Forty-nine asthmatic patients and 41 healthy people were included in this study. Serum PON1 and arylesterase activities were determined by spectrophotometric assays, as well as the lipid profiles. The PON1 ratio (salt stimulated paraoxonase/arylesterase was trimodally distributed and this ratio was used to determine the individual phenotypes of all subjects. The PON1 activity in the asthmatic patients was significantly lower (p=0.024 when compared to the healthy control group, however no significant difference in the activity of arylesterase was observed between the two groups. The prevalence of the PON1 phenotypes in the asthmatic population were 26.5%, 16.3% and 57.2 % for QQ, QR and RR, respectively. PON1 activity was significantly lower in asthmatic patients; in addition, the results of this investigation indicated that PON1 RR phenotype may be an important risk factor in asthma disease.

  19. Oxidative stress level and tyrosinase activity in vitiligo patients

    Directory of Open Access Journals (Sweden)

    Eskandani M

    2010-01-01

    Full Text Available Background: Vitiligo is an acquired pigmentary disorder of the skin. Genetic factors, oxidative stress, autoimmunity, and neurochemical agents might be contributing factors for the development of the disease. Aims: To evaluate the oxidative stress level and tyrosinase activity in vitiligo patients and to compare them with healthy volunteers. Materials and Methods: We used Comet assay to evaluate DNA strand breaks in peripheral blood cells of active vitiligo patients. We then extracted total protein from lesional and nonlesional skin of ten selected patients. Tyrosinase activity was found to play a crucial role in melanogenesis. Results: The basal level of systemic oxidative DNA strand breaks in leukocytes increased in vitiligo patients compared to healthy participants. We observed that tyrosinase activity in lesional skin was lower than in nonlesional skin. Conclusion: Our finding suggests that increased levels of oxidative stress might impact tyrosinase activity and eumelanin synthesis via anabolism pathway of melanin synthesis. In sum, we observed a negative correlation between levels of systemic oxidative stress and of tyrosinase activity.

  20. Physical activity in patients with axial spondyloarthritis: a cross-sectional study of 203 patients.

    Science.gov (United States)

    Fabre, Stéphanie; Molto, Anna; Dadoun, Sabrina; Rein, Christopher; Hudry, Christophe; Kreis, Sarah; Fautrel, Bruno; Pertuiset, Edouard; Gossec, Laure

    2016-12-01

    Physical activity is recommended in axial spondyloarthritis (axSpA) but may be insufficiently performed. The objective of this study was to assess physical activity in axial spondyloarthritis and to explore its explanatory factors. This was a cross-sectional study of patients with definite axSpA. The level of physical activity (International Physical Activity Questionnaire-Long form, IPAQ-L), type of aerobic exercise and the Exercise Benefits and Barriers Score were collected. Multivariate logistic regression analyses were performed to explain levels of exercise at least as recommended by the World Health Organization. In all, 203 patients were included: mean age 46.0 ± 11.6 years, 108 (53.2 %) males, mean Bath Ankylosing Spondylitis Activity Index (0-100) 37.8 ± 19.9; 137 (68.8 %) were treated with TNF-inhibitors. In all, 111 patients (54.7 %) were exercising at least as recommended; 96 (47.2 %) were in the 'high physical activity' category. Aerobic exercise >30 min was performed at least once a week by 61 (30.0 %) patients; the most frequent activities were energetic walking (31.0 %) and swimming (21.2 %). Main perceived benefits of exercising were improving physical fitness and functioning of the cardiovascular system, and the main barrier was physical exertion. Patients with paid employment had lower levels of physical activity whereas other demographic variables, disease activity/severity or TNF-inhibitor treatment were not predictive. One half of these patients performed enough physical activity according to the recommendations, similarly to the French population. Levels of physical activity did not appear to be explained by disease-related variables. Physical activity should be encouraged in axSpA.

  1. Older (but not younger) siblings facilitate false belief understanding.

    Science.gov (United States)

    Ruffman, T; Perner, J; Naito, M; Parkin, L; Clements, W A

    1998-01-01

    Results from 4 experiments and an analysis in which all data from 444 English and Japanese children are pooled show (a) a linear increase in understanding false belief with the number of older siblings, (b) no such effect for children younger than 3 years 2 months, (c) no helpful effect of younger siblings at any age (despite the large sample), (d) no effect of siblings' gender, and (e) no helpful effect of siblings on a task measuring children's understanding of how they know something. Discussion involves speculation about how older siblings may assist children (e.g., through pretend play and mental state language) and how different aspects of a theory of mind may develop through different means.

  2. Younger Dryas interval and outflow from the Laurentide ice sheet

    Science.gov (United States)

    Moore, T.C.; Walker, J.C.G.; Rea, David K.; Lewis, C.F.M.; Shane, L.C.K.; Smith, A.J.

    2000-01-01

    A boxmodel of the Great Lakes is used to estimate meltwater flow into the North Atlantic between 8000 and 14,000 calendar years B.P. Controls on the model include the oxygen isotopic composition of meltwaters and lake waters as measured in the shells of ostracodes. Outflow rates are highest when oxygen isotopic values of the lake waters are most negative, denoting a maximum glacial meltwater component. Flow rates reach maximum values before the onset of the Younger Dryas and after it ends. These maxima appear to be correlative with the major meltwater pulses MWP 1A and 1B. Although the resumption of North Atlantic Deep Water formation may be tied to the reduction in ice sheet melting, neither the onset nor the end of the Younger Dryas, as recorded in the Greenland Ice Sheet Project (GISP2) records, appear tied to maxima in meltwater outflow from the Laurentide ice sheet. Copyright 2000 by the American Geophysical Union.

  3. Active surveillance strategy for patients with localised prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebæk

    2014-01-01

    BACKGROUND: Active surveillance - an initial observational strategy - offers a tailored management of patients with localised prostate cancer. The aim of the strategy is to appoint patients with potentially lethal prostate cancer to curatively intended treatment, while patients with slowly evolving...... resulted in a significant risk of being misclassified according to the definition of progression. The interobserver agreement of biopsy histopathology between expert uropathologist was substantial. Still, the pathologists' disagreement would have resulted in different treatment recommendations in up to 10...... with defined final histopathological findings at radical prostatectomy that was perceived as unacceptable for a continued observational strategy. CONCLUSION: The thesis has demonstrated that active surveillance is feasible and reduces the number of patients undergoing curative intended treatment. However...

  4. Training of selective attention in work-active stroke patients.

    Science.gov (United States)

    Starovasnik Žagavec, Barbara; Mlinarič Lešnik, Vesna; Goljar, Nika

    2015-12-01

    The aim was to examine the effects of computer-based cognitive rehabilitation of attention in work-active patients after stroke. The study included 11 patients treated as inpatients at the University Rehabilitation Institute, Republic of Slovenia, who were included in intensive selective attention training four times a week for 3 months. Each patient was assessed at the initial and the final rehabilitation stage with the TAP system (Test of Attentional Performance), alertness, and divided attention tasks. The results indicate a moderate to strong increase in performance on the divided attention test and a mild effect on the alertness test. Early cognitive rehabilitation of the attentional system can contribute toward recovery of divided attention in work-active patients after stroke.

  5. Functional activity in patients after total hip replacement.

    Science.gov (United States)

    Pogorzała, Adam M; Stryła, Wanda; Nowakowski, Andrzej

    2012-11-08

    Osteoarthritis of hip joints is one of the most common diseases limiting social functioning of patients. Pain and mobility disorders are major problems associated with the disease. The goal of the study was to compare the efficacy of surgical treatment in a selected group of patients using a modified Harris Hip Score questionnaire including questions regarding the pain, the type of gait disorders and the functional activity. Surgical treatment helped to reduce the pain and improve the gait quality and parameters as well as functional activities associated with putting on socks and shoes, climbing stairs, sitting and using public transportation. Following conclusions were drawn after the study: Surgical treatment leads to significant reduction in hip pain. Mobility improvement was observed in most analyzed patients in early post-operative period as a consequence of hip contracture and pain being eliminated. The walking speed and distance improved significantly during the first 3 months after the surgery. All patients were satisfied with the treatment.

  6. Lifestyle, Cardiovascular Drugs and Risk Factors in Younger and Elder Adults: The PEP Family Heart Study.

    Science.gov (United States)

    Schwandt, Peter; Liepold, Evelyn; Bertsch, Thomas; Haas, Gerda-Maria

    2010-01-01

    This study aimed to compare cardiovascular disease (CVD) risk factors, lifestyle habits and pharmacological treatment in two groups of elder adults with 20 years difference in their mean age. This study comprised 590 women including two groups with mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of two groups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data on physical examination, fasting blood analyses, 7-day dietary records, physical activity, smoking and actual medication use were recorded. Compared with younger individuals, seniors had a more adverse risk factor profile in terms of abdominal obesity, overweight, hyperglycemia, hypertension, dyslipoproteinemia without differences in HDL-C. But this is not reflected by lifestyle behavior. Less than 2% of the elderly and 17% of the younger adults were current smoker. Furthermore, the pattern of physical activity was different in terms of more continuous sports in seniors contrasting with extremes between no sports and more than twice a week in the younger group. Seniors consumed significantly less carbohydrates including more monosaccharide and less polysaccharides, more alcohol and water. The intake of fat and protein was higher in elder women than in all other groups. One third of seniors took antihypertensive medications and 12% used lipid modifying drugs. Different levels of prevention against CVDs and their risk factors shall be considered for various age groups of population. The findings of this study emphasize on the necessity of preventive measures against smoking and physical inactivity in younger adults and dietary habits in seniors.

  7. Comparing lexically guided perceptual learning in younger and older listeners.

    Science.gov (United States)

    Scharenborg, Odette; Janse, Esther

    2013-04-01

    Numerous studies have shown that younger adults engage in lexically guided perceptual learning in speech perception. Here, we investigated whether older listeners are also able to retune their phonetic category boundaries. More specifically, in this research we tried to answer two questions. First, do older adults show perceptual-learning effects of similar size to those of younger adults? Second, do differences in lexical behavior predict the strength of the perceptual-learning effect? An age group comparison revealed that older listeners do engage in lexically guided perceptual learning, but there were two age-related differences: Younger listeners had a stronger learning effect right after exposure than did older listeners, but the effect was more stable for older than for younger listeners. Moreover, a clear link was shown to exist between individuals' lexical-decision performance during exposure and the magnitude of their perceptual-learning effects. A subsequent analysis on the results of the older participants revealed that, even within the older participant group, with increasing age the perceptual retuning effect became smaller but also more stable, mirroring the age group comparison results. These results could not be explained by differences in hearing loss. The age effect may be accounted for by decreased flexibility in the adjustment of phoneme categories or by age-related changes in the dynamics of spoken-word recognition, with older adults being more affected by competition from similar-sounding lexical competitors, resulting in less lexical guidance for perceptual retuning. In conclusion, our results clearly show that the speech perception system remains flexible over the life span.

  8. Are Younger or Older Cohorts Hurt the Most?

    OpenAIRE

    Raymundo M. Campos-Vazquez; Luis F. Lopez-Calva; Lustig, Nora

    2016-01-01

    Wage inequality has declined in Mexico since 2000. Using data from Mexican labor surveys for the period between 2000 and 2014, this paper investigates whether the decline was driven by wages declining more sharply for younger or older workers. The analysis finds that the wages of older workers declined and the decline was more pronounced in the older cohort. This would seem to support the ...

  9. Rapid Response Team Activations in Pediatric Surgical Patients.

    Science.gov (United States)

    Acker, Shannon N; Wathen, Beth; Roosevelt, Genie E; Hill, Lauren R S; Schubert, Anna; Reese, Jenny; Bensard, Denis D; Kulungowski, Ann M

    2017-02-01

    Introduction The rapid response team (RRT) is a multidisciplinary team who evaluates hospitalized patients for concerns of nonemergent clinical deterioration. RRT evaluations are mandatory for children whose Pediatric Early Warning System (PEWS) score (assessment of child's behavior, cardiovascular and respiratory status) is ≥4. We aimed to determine if there were differences in characteristics of RRT calls between children who were admitted primarily to either medical or surgical services. We hypothesized that RRT activations would be called for less severely ill children with lower PEWS score on surgical services compared with children admitted to a medical service. Materials and Methods We performed a retrospective review of all children with RRT activations between January 2008 and April 2015 at a tertiary care pediatric hospital. We evaluated the characteristics of RRT calls and made comparisons between RRT calls made for children admitted primarily to medical or surgical services. Results A total of 2,991 RRT activations were called, and 324 (11%) involved surgical patients. Surgical patients were older than medical patients (median: 7 vs. 4 years; p < 0.001). RRT evaluations were called for lower PEWS score in surgical patients compared with medical (median: 3 vs. 4, p < 0.001). Surgical patients were more likely to remain on the inpatient ward following the RRT (51 vs. 39%, p < 0.001) and were less likely to require an advanced airway than medical patients (0.9 vs. 2.1%; p = 0.412). RRT evaluations did not differ between day and night shifts (52% day vs. 48% night; p = 0.17). All surgical patients and all but one medical patient survived the event; surgical patients were more likely to survive to hospital discharge (97 vs. 91%, p < 0.001) Conclusions RRT activations are rare events among pediatric surgical patients. When compared with medical patients, RRT evaluation is requested for surgical patients with a lower PEWS

  10. Efficacy of natalizumab in multiple sclerosis patients with high disease activity: a Danish nationwide study

    DEFF Research Database (Denmark)

    Oturai, A.B.; Koch-Henriksen, N.; Petersen, T.;

    2009-01-01

    INTRODUCTION: Previous studies of natalizumab (Tysabri) in relapsing multiple sclerosis (MS) patients have included patients with moderate disease activity. We studied a patient population with high disease activity. PATIENTS AND METHODS: We analyzed data from 234 consecutive, natalizumab-treated...

  11. Physical Activity in Bariatric Surgery Patients: Does Temperament Matter?

    Science.gov (United States)

    Gruner-Labitzke, Kerstin; Claes, Laurence; Bartsch, Merle; Schulze, Mareike; Langenberg, Svenja; Köhler, Hinrich; Marschollek, Michael; de Zwaan, Martina; Müller, Astrid

    2017-07-01

    Our aim was to investigate if physical activity (PA) in bariatric surgery patients is related to temperament. Preoperative (n = 70) and post-operative (n = 73) patients were categorized as being physically 'active' versus 'inactive' on the basis of objective PA monitoring. Assessment included the behavioural inhibition system (BIS)/behavioural activation system (BAS) scales, the effortful control (EC) subscale of the Adult Temperament Questionnaire-Short Form, a numeric pain rating scale and measures for depressive and eating disorder symptoms. 'Active' did not differ from 'inactive' patients with regard to temperament (BIS, BAS, and EC). Regressions with PA grouping as dependent variable (adjusted for age, gender, body mass index (BMI), depressive or eating disorder symptoms, or pain intensity) indicated an association between lower BMI and more PA in the preoperative and the post-operative group. In the post-operative group, in addition to lower BMI, also lower age and higher BIS reactivity contributed to more PA. Furthermore, there was a significant interaction between BMI and BIS suggesting that low BMI was only associated with more PA in post-operative patients with high BIS. The results indicate that temperament per se does not contribute to the level of PA in bariatric surgery patients. However, in post-operative patients, lower BMI was associated with a higher likelihood of being physically active particularly in patients with anxious temperament. These preliminary findings need further investigation within longitudinal studies. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  12. Stress modulates reinforcement learning in younger and older adults.

    Science.gov (United States)

    Lighthall, Nichole R; Gorlick, Marissa A; Schoeke, Andrej; Frank, Michael J; Mather, Mara

    2013-03-01

    Animal research and human neuroimaging studies indicate that stress increases dopamine levels in brain regions involved in reward processing, and stress also appears to increase the attractiveness of addictive drugs. The current study tested the hypothesis that stress increases reward salience, leading to more effective learning about positive than negative outcomes in a probabilistic selection task. Changes to dopamine pathways with age raise the question of whether stress effects on incentive-based learning differ by age. Thus, the present study also examined whether effects of stress on reinforcement learning differed for younger (age 18-34) and older participants (age 65-85). Cold pressor stress was administered to half of the participants in each age group, and salivary cortisol levels were used to confirm biophysiological response to cold stress. After the manipulation, participants completed a probabilistic learning task involving positive and negative feedback. In both younger and older adults, stress enhanced learning about cues that predicted positive outcomes. In addition, during the initial learning phase, stress diminished sensitivity to recent feedback across age groups. These results indicate that stress affects reinforcement learning in both younger and older adults and suggests that stress exerts different effects on specific components of reinforcement learning depending on their neural underpinnings.

  13. Arctic freshwater forcing of the Younger Dryas cold reversal.

    Science.gov (United States)

    Tarasov, Lev; Peltier, W R

    2005-06-02

    The last deglaciation was abruptly interrupted by a millennial-scale reversal to glacial conditions, the Younger Dryas cold event. This cold interval has been connected to a decrease in the rate of North Atlantic Deep Water formation and to a resulting weakening of the meridional overturning circulation owing to surface water freshening. In contrast, an earlier input of fresh water (meltwater pulse 1a), whose origin is disputed, apparently did not lead to a reduction of the meridional overturning circulation. Here we analyse an ensemble of simulations of the drainage chronology of the North American ice sheet in order to identify the geographical release points of freshwater forcing during deglaciation. According to the simulations with our calibrated glacial systems model, the North American ice sheet contributed about half the fresh water of meltwater pulse 1a. During the onset of the Younger Dryas, we find that the largest combined meltwater/iceberg discharge was directed into the Arctic Ocean. Given that the only drainage outlet from the Arctic Ocean was via the Fram Strait into the Greenland-Iceland-Norwegian seas, where North Atlantic Deep Water is formed today, we hypothesize that it was this Arctic freshwater flux that triggered the Younger Dryas cold reversal.

  14. Serum paraoxonase 1 activity in patients with iron deficiency anemia

    Science.gov (United States)

    Gedikbasi, Asuman; Akalin, Nilgul; Gunaldi, Meral; Yilmaz, Deniz; Mert, Meral; Harmankaya, Ozlem; Soylu, Aliye; Karakaya, Pinar; Kumbasar, Abdulbaki

    2016-01-01

    Introduction In this study we aimed to detect paraoxonase 1 (PON-1) activity in iron deficiency anemia (IDA) and to compare it with healthy controls by observing the change after iron therapy. Material and methods In this study, 50 adult patients with IDA and 40 healthy subjects were enrolled. All patients were analyzed at the beginning and after treatment according to laboratory assessments. Results Mean paraoxonase and arylesterase activities in the iron deficiency anemia group were significantly lower than mean activities of the control group (102.4 ±19.2 U/l and 163.3 ±13.68 U/l, respectively and 157.3 ±26.4 U/l and 256.1 ±24.6 U/l, respectively; p = 0.0001 for both). Paraoxonase and arylesterase activities significantly increased after treatment for IDA (143.2 ±13.9 and 197.6 ±27.9 U/l, respectively, p = 0.0001). Mean activities after treatment with iron were significantly lower than mean activities in the control group (p = 0.002; p = 0.0001 respectively). Conclusions Paraoxonase and arylesterase activities in patients with IDA significantly increased after treatment with iron therapy. In adults IDA may also be one of the factors associated with increased risk of atherosclerosis. PMID:27478448

  15. Approach to the active patient with chronic anterior knee pain.

    Science.gov (United States)

    Atanda, Alfred; Ruiz, Devin; Dodson, Christopher C; Frederick, Robert W

    2012-02-01

    The diagnosis and management of chronic anterior knee pain in the active individual can be frustrating for both the patient and physician. Pain may be a result of a single traumatic event or, more commonly, repetitive overuse. "Anterior knee pain," "patellofemoral pain syndrome," and "chondromalacia" are terms that are often used interchangeably to describe multiple conditions that occur in the same anatomic region but that can have significantly different etiologies. Potential pain sources include connective or soft tissue irritation, intra-articular cartilage damage, mechanical irritation, nerve-mediated abnormalities, systemic conditions, or psychosocial issues. Patients with anterior knee pain often report pain during weightbearing activities that involve significant knee flexion, such as squatting, running, jumping, and walking up stairs. A detailed history and thorough physical examination can improve the differential diagnosis. Plain radiographs (anteroposterior, anteroposterior flexion, lateral, and axial views) can be ordered in severe or recalcitrant cases. Treatment is typically nonoperative and includes activity modification, nonsteroidal anti-inflammatory drugs, supervised physical therapy, orthotics, and footwear adjustment. Patients should be informed that it may take several months for symptoms to resolve. It is important for patients to be aware of and avoid aggravating activities that can cause symptom recurrence. Patients who are unresponsive to conservative treatment, or those who have an underlying systemic condition, should be referred to an orthopedic surgeon or an appropriate medical specialist.

  16. Changes of resting cerebral activities in subacute ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Ping Wu

    2015-01-01

    Full Text Available This study aimed to detect the difference in resting cerebral activities between ischemic stroke patients and healthy participants, define the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efficacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunction and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks and 15 age-matched healthy participants. A resting-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental findings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely potential targets for the neural regeneration of subacute ischemic stroke patients.

  17. Changes of resting cerebral activities in subacute ischemic stroke patients

    Institute of Scientific and Technical Information of China (English)

    Ping Wu; Fang Zeng; Yong-xin Li; Bai-li Yu; Li-hua Qiu; Wei Qin; Ji Li; Yu-mei Zhou; Fan-rong Liang

    2015-01-01

    This study aimed to detect the difference in resting cerebral activities between ischemic stroke pa-tients and healthy participants, deifne the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efifcacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunc-tion and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks) and 15 age-matched healthy participants. A rest-ing-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental ifndings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely po-tential targets for the neural regeneration of subacute ischemic stroke patients.

  18. Active rehabilitation in a pediatric extracorporeal membrane oxygenation patient.

    Science.gov (United States)

    Zebuhr, Carleen; Sinha, Amit; Skillman, Heather; Buckvold, Shannon

    2014-05-01

    Decreased intensive care unit (ICU) mortality has led to an increase in ICU morbidity. ICU-induced immobilization plays a major role in this morbidity. Recently, ICU mobility has been shown to be safe and effective in adolescent and adult patients. We report the successful rehabilitation of an 8-year-old boy with severe acute respiratory distress syndrome on extracorporeal membrane oxygenation. A child who is critically ill may safely perform active rehabilitation while on venovenous extracorporeal membrane oxygenation. The gains achieved through active rehabilitation and optimal nutrition can facilitate recovery from severe acute respiratory distress syndrome in select pediatric patients on extracorporeal membrane oxygenation.

  19. Increased activity of the mannan-binding lectin complement activation pathway in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Ytting, H; Jensenius, J C; Christensen, Ib Jarle

    2004-01-01

    BACKGROUND: Postoperative bacterial infectious complications are frequent in patients with colorectal cancer (CRC), with subsequent increased recurrence rates and poor prognosis. Deficiency of the mannan-binding lectin (MBL) complement activation pathway may cause increased risk of infection...... with colorectal cancer compared with healthy persons. However, similar frequencies of MBL pathway deficiency are observed in patients and healthy persons....... in certain patient groups. It is hypothesized that a deficient MBL pathway might be more frequent among patients with CRC than in healthy individuals. The MBL pathway was therefore evaluated in serum obtained preoperatively from 193 patients with primary CRC and in serum from 150 healthy volunteers. METHODS...

  20. Reduced Arylsulfatase B Activity in Leukocytes from Cystic Fibrosis Patients

    Science.gov (United States)

    Sharma, Girish; Burke, Jenifer; Bhattacharyya, Sumit; Sharma, Neha; Katyal, Shivani; Park, R. Lucy; Tobacman, Joanne

    2013-01-01

    Summary The enzyme Arylsulfatase B (ARSB; N-acetylgalactosamine-4-sulfatase) removes 4-sulfate groups from chondroitin-4-sulfate and dermatan sulfate and is required for the degradation of these sulfated glycosaminoglycans (GAGs). Since these GAGs accumulate in patients with Cystic Fibrosis (CF), we investigated the activity of ARSB in leukocytes of patients with CF, to consider if reduced activity of ARSB might contribute to the pathophysiology of CF. Previous cell-based experiments had demonstrated that when the deficiency of the cystic fibrosis transmembrane regulator (CFTR) was corrected in bronchial epithelial cells, the ARSB activity increased significantly. De-identified, citrated blood samples were collected from 16 children with cystic fibrosis and 31 control subjects, seen in the Pediatric Clinic at Rush University Medical Center. Polymorphonuclear (PMN) and mononuclear cell (MC) populations were separated by density gradient, and blinded determinations of ARSB activity were performed using the exogenous substrate 4-methylumbilliferyl sulfate. Interleukin-6 was measured in the plasma samples by ELISA. ARSB activity was significantly less in the PMN and MC from the CF patients than controls (p<0.0001, unpaired t-test, two-tailed). Interleukin-6 levels in plasma were significantly greater in the CF population (p<0.001). Mean age, age range, and male:female ratio of CF patients and controls were similar, and no association of ARSB activity with age, gender, or CFTR genotype was evident. Since recombinant human ARSB is used successfully for replacement therapy in Mucopolysaccharidosis VI, it may be useful to restore ARSB activity to normal levels and increase degradation of sulfated GAGs in CF patients. PMID:22550062

  1. NLRP3 inflammasome activation in dialyzed chronic kidney disease patients.

    Directory of Open Access Journals (Sweden)

    Simona Granata

    Full Text Available To assess whether NLR pyrin domain-containing protein 3 (NLRP3 inflammasome, a multiprotein complex that mediates the activation of caspase-1 (CASP-1 and pro-inflammatory cytokines IL-18 and IL-1β, could be involved in the chronic inflammatory state observed in chronic kidney disease patients undergoing hemodialysis treatment (CKD-HD, we employed several biomolecular techniques including RT-PCR, western blot, FACS analysis, confocal microscopy and microarray. Interestingly, peripheral blood mononuclear cells from 15 CKD-HD patients showed higher mRNA levels of NLRP3, CASP-1, ASC, IL-1β, IL-18 and P2X7 receptor compared to 15 healthy subjects. Western blotting analysis confirmed the above results. In particular, active forms of CASP-1, IL1-β and IL-18 resulted significantly up-regulated in CKD-HD versus controls. Additionally, elevated mitochondrial ROS level, colocalization of NLRP3/ASC/mitochondria in peripheral blood mononuclear cells from CKD-HD patients and down-regulation of CASP-1, IL1-β and IL-18 protein levels in immune-cells of CKD-HD patients stimulated with LPS/ATP in presence of mitoTEMPO, inhibitor of mitochondrial ROS production, suggested a possible role of this organelle in the aforementioned CKD-associated inflammasome activation. Then, microarray analysis confirmed, in an independent microarray study cohort, that NLRP3 and CASP-1, along with other inflammasome-related genes, were up-regulated in 17 CKD-HD patients and they were able to clearly discriminate these patients from 5 healthy subjects. All together these data showed, for the first time, that NLRP3 inflammasome was activated in uremic patients undergoing dialysis treatment and they suggested that this unphysiological condition could be possibly induced by mitochondrial dysfunction.

  2. Coagulation activation and microparticle-associated coagulant activity in cancer patients: An exploratory prospective study

    NARCIS (Netherlands)

    van Doormaal, Frederiek F.; Kleinjan, Ankie; Berckmans, René J.; Mackman, Nigel; Manly, David; Kamphuisen, Pieter W.; Richel, Dick J.; Büller, Harry R.; Sturk, Auguste; Nieuwland, Rienk

    2012-01-01

    Cancer increases the risk of venous thromboembolism (VTE). Here, we investigated the contribution of microparticle (MP)-dependent procoagulant activity to the prothrombotic state in these patients. In 43 cancer patients without VTE at study entry and 22 healthy volunteers, markers of in vivo and

  3. Action prediction in younger versus older adults: neural correlates of motor familiarity.

    Directory of Open Access Journals (Sweden)

    Nadine Diersch

    Full Text Available Generating predictions during action observation is essential for efficient navigation through our social environment. With age, the sensitivity in action prediction declines. In younger adults, the action observation network (AON, consisting of premotor, parietal and occipitotemporal cortices, has been implicated in transforming executed and observed actions into a common code. Much less is known about age-related changes in the neural representation of observed actions. Using fMRI, the present study measured brain activity in younger and older adults during the prediction of temporarily occluded actions (figure skating elements and simple movement exercises. All participants were highly familiar with the movement exercises whereas only some participants were experienced figure skaters. With respect to the AON, the results confirm that this network was preferentially engaged for the more familiar movement exercises. Compared to younger adults, older adults recruited visual regions to perform the task and, additionally, the hippocampus and caudate when the observed actions were familiar to them. Thus, instead of effectively exploiting the sensorimotor matching properties of the AON, older adults seemed to rely predominantly on the visual dynamics of the observed actions to perform the task. Our data further suggest that the caudate played an important role during the prediction of the less familiar figure skating elements in better-performing groups. Together, these findings show that action prediction engages a distributed network in the brain, which is modulated by the content of the observed actions and the age and experience of the observer.

  4. An fMRI investigation on simple multiplication in younger and older adults

    Directory of Open Access Journals (Sweden)

    Li SUN

    2014-03-01

    Full Text Available Objective To investigate the cortical activation patterns and their correlation with behavioristics during simple multiplication in Chinese younger and older adults. Methods Functional magnetic resonance imaging (fMRI was performed as healthy younger and older participants resolving arithmetic and control problems. Results Totally 39 right-handed healthy adults were recruited in this study, including 19 (11 females, 8 males younger and 20 (12 females, 8 males older subjects. Age (P = 0.000 was significantly different between 2 groups, and no significant difference was observed in years of education (P = 0.125 and IQ scores (P = 0.921. The accuracy for simple multiplication (P = 0.880 and control task (P = 0.142 were not significantly different between 2 groups, however differences were observed in reaction time for experimental (P = 0.005 and control (P = 0.000 tasks. In younger group, activation in right hemisphere included inferior parietal lobule with an extending to the intraparietal sulcus and superior/middle temporal gyrus, precentral gyrus, premotor cortex and prefrontal cortex. Activation of supramarginal gyrus, angular gyrus, temporal lobe was found in the left. And activation in medial cingulate gyrus, precuneus, parahippocampal gyrus, uncus, and supplementary motor area (SMA was also observed. In older group, supramarginal gyrus, inferior parietal lobule, precentral gyrus, premotor cortex and prefrontal cortex were activated in the right hemisphere. Left angular gyrus, supramarginal gyrus, precentral gyrus, premotor cortex, insula and prefrontal cortex were also activated, as well as cingulate gyrus, paracentral lobule and prefrontal cortex in the medial part. The conjunction analysis of the fMRI data revealed in a distributed network consisting of inferior parietal area, precuneus, precentral/postcentral gyrus and prefrontal lobe, as well as some subcortical areas. Conclusions The major components of the network subserving simple

  5. Demoralization, Patient Activation, and the Outcome of Spine Surgery

    Directory of Open Access Journals (Sweden)

    Andrew R Block

    2016-01-01

    Full Text Available It is now well established that psychosocial factors can adversely impact the outcome of spine surgery. This article discusses in detail one such recently-identified “risk” factor: demoralization. Several studies conducted by the author indicate that demoralization, an emotional construct distinct from depression, is associated with poorer pain reduction, less functional improvement and decreased satisfaction among spine surgery patients. However, there are indications that the adverse impact of risk factors such as demoralization can be mitigated by psychosocial “maximizing” factors—characteristics that propel the patient towards positive surgical results. One of these maximizing factors, patient activation, is discussed in depth. The patient activation measure (PAM, an inventory assessing the extent to which patients are active and engaged in their health care, is associated not only with improved spine surgery results, but with better outcomes across a broad range of medical conditions. Other maximizing factors are discussed in this article. The author concludes that the past research focus on psychosocial risk factors has limited the value of presurgical psychological screening, and that future research, as well as clinical assessment, should recognize that the importance of evaluating patients’ strengths as well as their vulnerabilities.

  6. Low leucocyte myeloperoxidase activity in patients with multiple sclerosis

    NARCIS (Netherlands)

    Ramsaransing, G; Teelken, A; Prokopenko, VM; Arutjunyan, AV; De Keyser, J

    2003-01-01

    The gene for myeloperoxidase (MPO) has been implicated in multiple sclerosis (MS). By measuring H2O2 dependent oxidation of 3,3'5,5'-tetramethylbenzidine with spectrophotometry the authors investigated MPO activity in peripheral blood leucocytes from 42 patients with MS (12 with secondary progressiv

  7. Gastric myoelectrical and antroduodenal motor activity in patients with achalasia.

    Science.gov (United States)

    Verhagen, M A; Samsom, M; Smout, A J

    1998-06-01

    Achalasia is a primary motor disorder of the oesophagus, in which the myenteric plexus is involved. However, abnormalities in other parts of the digestive tract have also been described in achalasia. Whether gastric myoelectrical and duodenal motor activity in these patients is also affected is unknown. Therefore, interdigestive and postprandial gastric myoelectrical and antroduodenal motor activity were studied in 11 patients with achalasia, using electrogastrography (EGG) and stationary antroduodenal manometry. Electrogastrographically, no differences were found in the gastric frequency, incidence of dysrhythmias and postprandial/fasting power ratio. In the interdigestive state a lower propagation velocity of phase III episodes was found in the achalasia patients, but other parameters were unaltered. Postprandially, no differences were found in the number of pressure waves, in the amplitude of pressure waves or in antroduodenal coordination. We conclude that gastric myoelectrical activity and antral motor activity in patients with achalasia is normal, suggesting an intact extrinsic and intrinsic neural innervation of the distal stomach. Although postprandial duodenal motility is normal, a lower propagation velocity of phase III suggests involvement of the small intestine in achalasia.

  8. Frequency analysis of EMG activity in patients with idiopathic torticollis

    NARCIS (Netherlands)

    Tijssen, MAJ; Marsden, JF; Brown, P

    2000-01-01

    The pathophysiology of idiopathic dystonic torticollis is unclear and there is no simple test that confirms the diagnosis and excludes a psychogenic or voluntary torticollis in individual patients. We recorded EMG activity in the sternocleidomastoid (SCM) and splenius capitis (SPL) muscles of eight

  9. Telomere shortening and telomerase activity in ischaemic cardiomyopathy patients

    DEFF Research Database (Denmark)

    Sawhney, V; Campbell, N G; Brouilette, S W

    2016-01-01

    difference in the age and sex adjusted mean telomere length analysed by qPCR between the groups (p=0.88). In contrast, the load-of-short telomeres assessed by Universal-STELA method and telomerase activity by TRAP assay were both higher in patients who had appropriate ICD therapy and were significantly...

  10. Chios mastic treatment of patients with active Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Andriana C Kaliora; Maria G Stathopoulou; John K Triantafillidis; George VZ Dedoussis; Nikolaos K Andrikopoulos

    2007-01-01

    AIM: To evaluate the effectiveness of mastic administration on the clinical course and plasma inflammatory mediators of patients with active Crohn's disease (CD).METHODS: This pilot study was conducted in patients with established mild to moderately active CD, attending the outpatient clinics of the hospital, and in healthy controls. Ten patients and 8 controls were recruited for a 4-wk treatment with mastic caps (6 caps/d, 0.37 g/cap).All patients successfully completed the protocol. CD Activity Index (CDAI), Nutritional Risk Index (NRI), C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemotactic protein-1 (MCP-1), and total antioxidant potential (TAP) were evaluated in the plasma at baseline and at the end of the treatment period. Results were expressed as mean values + SE and P < 0.05 was considered to indicate statistical significance.RESULTS: Patients exhibited significant reduction of CDAI (222.9 ± 18.7 vs 136.3 ± 12.3, P = 0.05) as compared to pretreament values. Plasma IL-6 was significantly decreased (21.2 ± 9.3 pg/mL vs 7.2 ± 2.8 pg/mL,P = 0.027), and so did CRP (40.3 ± 13.1 mg/mL vs 19.7± 5.5, P = 0.028). TAP was significantly increased (0.15± 0.09 vs 0.57 ± 0.15 mmol/L uric acid, P = 0.036). No patient or control exhibited any kind of side effects.CONCLUSION: The results suggest that mastic significantly decreased the activity index and the plasma levels of IL-6 and CRP in patients with mildly to moderately active CD. Further double-blind, placebo-controlled studies in a larger number of patients are required to clarify the role of this natural product in the treatment of patients with CD.

  11. Influences and Barriers on Physical Activity in Pediatric Oncology Patients

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    Larrilyn Yelton

    2016-12-01

    Full Text Available Objectives: To determine the influence of family, peers, school, and physicians on exercise in pediatric oncology patients and evaluate the barriers to physical activity levels in this population. Methods: A search of PubMed and Google Scholar resulted in 12 related articles. The articles were assessed for the influence of school systems, family, peers, self-efficacy, and physicians on exercise. Additionally barriers and interventions to physical activity were also assessed. Limitations and research methodologies of each article were also evaluated. Results: Many school systems were unsure of expectations in regards to physical activity for their returning students with cancer. Most schools acknowledged willingness to increase exercise for these students; however, there is a communication gap between the medical field and the school system on what expectations should be. Family is associated with increased physical activity levels and healthier diets in this population with children preferring mothers as exercise partners more than fathers. While physician interventions have been shown to positively impact physical activity, it has been reported that physicians are not engaging in exercise counseling with their patients. Conclusion: Several issues and barriers related to physical activity in pediatric oncology population were identified. Studies have demonstrated it is feasible to increase physical activity and self-efficacy in this population. Further research is needed to better understand and quantify these issues as well as further test the interventions that have been suggested in this review and have been successful in other pediatric populations.

  12. Biological characteristics and clinical outcome of triple negative primary breast cancer in older women - comparison with their younger counterparts.

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    Binafsha M Syed

    Full Text Available Triple negative (ER, PgR and HER2 negative breast cancers (TNBCs are often considered as a poor prognostic phenotype. There is dearth of evidence showing the prevalence and biological behaviour of TNBCs in older women. This study aimed to analyse their biological characteristics in comparison with a well characterised younger series from a single centre with long term clinical follow-up. Over 37 years (1973-2010, 1,758 older (≥70 years women with early operable (<5 cm primary breast cancer were managed in a dedicated clinic and have complete clinical information available. Of these 813 patients underwent primary surgery and 575 had good quality tumour samples available for tissue microarray analysis using indirect immunohistochemistry. A total of 127 patients (22.1% had TNBCs and full biological analysis of 15 biomarkers was performed. The results were compared with those of their younger (<70 years counterparts 342 (18.9% from a previously characterised, consecutive series of primary breast cancer treated in the same unit (1986-1998. The 127 older patients with TNBCs showed lower rates of Ki67 and CK 7/8 positivity and high rates of bcl2 and CK18 positivity when compared with their younger counterparts (p<0.05. There was no significant difference in the long term clinical outcome between the two age groups, despite the fact that 47% of the younger patients had adjuvant chemotherapy, while none in the older cohort received such treatment. EGFR, axillary stage and pathological size showed prognostic significance in older women with TNBCs on univariate analysis. Despite not having received adjuvant chemotherapy, the older series had clinical outcome similar to the younger patients almost half of whom had chemotherapy. This appears to be related to other biomarkers (in addition to ER/PgR/HER2 eg Ki67, bcl2 and cytokeratins which have different expression patterns influencing prognosis.

  13. Correlation of BAT activity with thyroid metabolic activity in patients with fibromyalgia

    Science.gov (United States)

    Costa, A. P. C.; Maia, J. M.; Brioschi, M. L.; Machado, J. E. M. M.

    2017-03-01

    The objective of this research is to correlate the brown fat activity (BAT) with the metabolic activity of thyroid in patients with fibromyalgia syndrome (FS). For the development of the research, it was select a database containing 132 patients of a thermography clinic, male and female, with age over 18 years old; where the images selected were anteroposterior orthostasis top and anteroposterior in cervical extension. In the program Flir Report, it was possible to demarcate the region of the left and right interscapular and thyroid of each patient by getting the respective temperatures, in addition to view the hyper-radiation ("signal of mantle") in the interscapular. Temperature was organized in table format, and statistical analysis was performed in the program Microcal Origin 6.0. As conclusion, it was found that the greater the metabolic activity of thyroid in patients with fibromyalgia, the greater will be the metabolic rate of brown fat (BAT).

  14. Metabolic Syndrome and Physical Activity in Hemodialysis Patients

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    derya atik

    2014-06-01

    Full Text Available Purpose: This descriptive study was carried out to reveal the level of physical activity in patients who receive hemodialysis due to chronic kidney failure and to identify its relationship with the prevalence of metabolic syndrome (MetS. Material and method: The study was conducted with 55 patients at the hemodialysis units of Alanya State Hospital and Private Alanya Anadolu Hospital between 10 and 30 June 2013. The study data were collected using the National Cholesterol Education Program, the Adult Treatment Panel III (NCEP-ATP III, a data collection form containing Metabolic Syndrome Diagnosis Criteria, and the International Physical Activity Questionnaire (IPAQ. The data were analyzed using arithmetic mean +/- standard deviation (SD, number and percentage distributions, independent sample t test, crosstabs, One Way Anova, and Pearson and #8217;s Correlation Analysis. Conclusion and suggestions: It was found that 41.8% of the patients were between 50 and 65 years of age, the majority of them were male (58.2%, hemodialysis had been administered to 69.1% of them for at least 36 months, and 50.9% of them met three and more of the MetS criteria. There was no statistically significant relationship between MetS and physical activity levels, but the length of physical activity was longer in those who did not meet the MetS diagnosis criteria (p>0.05. An increase in sedentary time raised the MetS criteria (p<0.05. Conclusion: Nearly 1/2 of the patients were at risk of MetS. Physical activity level being statistically ineffective on MetS can be associated with low physical activity level and longer sedentary time. It can be said that being completely sedentary increases BMI and therefore MetS. The study can be repeated on different samples and the results can be compared. [J Contemp Med 2014; 4(2.000: 69-75

  15. Human Endogenous Retrovirus W Activity in Cartilage of Osteoarthritis Patients

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    Signy Bendiksen

    2014-01-01

    Full Text Available The etiology of viruses in osteoarthritis remains controversial because the prevalence of viral nucleic acid sequences in peripheral blood or synovial fluid from osteoarthritis patients and that in healthy control subjects are similar. Until now the presence of virus has not been analyzed in cartilage. We screened cartilage and chondrocytes from advanced and non-/early osteoarthritis patients for parvovirus B19, herpes simplex virus-1, Epstein Barr virus, cytomegalovirus, human herpes virus-6, hepatitis C virus, and human endogenous retroviruses transcripts. Endogenous retroviruses transcripts, but none of the other viruses, were detected in 15 out the 17 patients. Sequencing identified the virus as HERV-WE1 and E2. HERV-W activity was confirmed by high expression levels of syncytin, dsRNA, virus budding, and the presence of virus-like particles in all advanced osteoarthritis cartilages examined. Low levels of HERV-WE1, but not E2 envelope RNA, were observed in 3 out of 8 non-/early osteoarthritis patients, while only 3 out of 7 chondrocytes cultures displayed low levels of syncytin, and just one was positive for virus-like particles. This study demonstrates for the first time activation of HERV-W in cartilage of osteoarthritis patients; however, a causative role for HERV-W in development or deterioration of the disease remains to be proven.

  16. Barriers associated with reduced physical activity in COPD patients

    Directory of Open Access Journals (Sweden)

    Priscila Batista Amorim

    2014-10-01

    Full Text Available OBJECTIVE: To evaluate the ability of COPD patients to perform activities of daily living (ADL; to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT, and an ADL limitation score. METHODS: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. RESULTS: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001, as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001. The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. CONCLUSIONS: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

  17. Coping with chronic pain among younger, middle-aged, and older adults living with neurological injury and disease.

    Science.gov (United States)

    Molton, Ivan; Jensen, Mark P; Ehde, Dawn M; Carter, Gregory T; Kraft, George; Cardemas, Diana D

    2008-01-01

    Objective. This article compares use of pain coping strategies among older, middle-aged, and younger adults living with chronic pain and seeks to determine whether the relationship between pain severity and coping is moderated by age. Method. Participants were 464 adults reporting chronic pain secondary to multiple sclerosis, spinal cord injury, or neuromuscular disease. Participants completed a survey including measures of pain severity and the Chronic Pain Coping Inventory. Results. After controlling for clinical and demographic variables, older adults (older than 60) reported a wider range of frequently used strategies and significantly more frequent engagement in activity pacing, seeking social support, and use of coping self-statements than did younger or middle-aged adults. Moderation analyses suggest that, for younger adults, efforts at coping generally increased with greater pain severity, whereas this relationship did not exist for older adults. Discussion. These data suggest differences in the quantity and quality of pain coping among age groups.

  18. Recognising lifestyle activities of diabetic patients with a smartphone

    Directory of Open Access Journals (Sweden)

    Mitja Luštrek

    2015-11-01

    Full Text Available Diabetes is both heavily affected by the patients’ lifestyle, and it affects their lifestyle. Most diabetic patients can manage the disease without technological assistance, so we should not burden them with technology unnecessarily, but lifestylemonitoring technology can still be beneficial both for patients and their physicians. Because of that we developed an approach to lifestyle monitoring that uses the smartphone, which most patients already have. The approach consists of three steps. First, a number of features are extracted from the data acquired by smartphone sensors, such as the user’s location from GPS coordinates and visible wi-fi access points, and the physical activity from accelerometer data. Second, several classifiers trained by machine learning are used to recognise the user’s activity, such as work, exercise or eating. And third, these activities are refined by symbolic reasoning encoded in Event Calculus. The approach was trained and tested on five people who recorded their activities for two weeks each. Its classification accuracy was 0.88.

  19. Decreased Heme Oxygenase Activity in Patients with Alzheimer's Disease

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    Berkay Cataloglu

    2013-04-01

    Full Text Available Alzheimer's disease is a neurodegenerative disorder characterized with progressive im-pairment of cognitive functions. Heme oxygenase is an enzyme that degrades the heme molecule resulting in equimolar amounts of the carbon monoxide, ferrous iron, and bili-verdin. Up to now, heme oxygenase activity and its metabolic effects in Alzheimer's dis-ease have been investigated in so many studies; most of them were performed in post-mortem brain tissues of Alzheimer's disease patients or in animal models. Therefore, we aimed to investigate heme oxygenase activity in leukocytes of Alzheimer's disease pa-tients as a peripheral sample. Mean heme oxygenase activity was significantly lower in patients with Alzheimer's disease (0.53 +/- 0.32 nmol/h/mg protein compared to control sucjects (1.19 +/- 0.84 nmol/h/mg protein (p= 0.001. We think that reduction in leukocyte heme oxygenase activity may limit disease progression through preserving peripheral mitochondrial function by reducing the formation of free iron and carbon monoxide. [Dis Mol Med 2013; 1(2.000: 31-34

  20. ACTIVE OBSERVATION TACTICS IN PATIENTS WITH KIDNEY NEOPLASMS

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    B. Ya. Alekseev

    2012-01-01

    Full Text Available As of now, about 40-60% of the first detected kidney tumors are accidentally diagnosed. These are most often asymptomatic small kidney tumors (SKT without distant metastases; 15–20% of them are benign. A number of studies have revealed that kidney malignant tumors grow slowly and spread extremely rarely, as evidenced by a histological study. These and other data formed the basis for the active observation tactic that became possible and acceptable in well-selected patients, in elderly patients with SKT and severe comorbidity in particular.

  1. Learning to recognize younger faces at an older age.

    Science.gov (United States)

    Obermeyer, Sven; Kubik, Veit; Schaich, Andreas; Kolling, Thorsten; Knopf, Monika

    2017-04-01

    Processing of horizontal face cues has been shown to be an important element in face recognition of adults aged up to 30 years. In contrast, horizontally aligned facial features do not appear to contribute to older adults' (60-75 years) recognition in a similar way. To this end, we investigated potential learning effects on the ability to recognize faces based on horizontal features. Previous research suggests face recognition based on all face information experiences an accelerated decline after the age of 70. However, recognition based only on horizontal face information has not yet been studied in old age (75+ years of age). Thus, we investigated whether older adults (aged up to as well as starting at 75 years) can learn to recognize faces based on horizontal face cues alone. One younger and two older adult groups (20-30, 60-75, and 75+ years) were familiarized with a high and a low amount of previously unfamiliar faces-some containing all face cues and others containing only horizontal face cues (reduced information). Subsequently, all groups received a recognition test. Repeated learning increased natural face recognition for all three age groups when all face cues were available. However, increases in face recognition were only observed for younger adults when horizontal face cued were only available. The importance of horizontally aligned spatial frequencies for recognizing human faces is lessened before the age of 60 (and plateaus thereon), whereas recognition of stimuli containing all face cues is still capable of improvement.

  2. Leg Strength Comparison between Younger and Middle-age Adults.

    Science.gov (United States)

    Kim, Sukwon; Lockhart, Thurmon; Nam, Chang S

    2010-05-01

    Although a risk of occupational musculoskeletal diseases has been identified with age-related strength degradation, strength measures from working group are somewhat sparse. This is especially true for the lower extremity strength measures in dynamic conditions (i.e., isokinetic). The objective of this study was to quantify the lower extremity muscle strength characteristics of three age groups (young, middle, and the elderly). Total of 42 subjects participated in the study: 14 subjects for each age group. A commercial dynamometer was used to evaluate isokinetic and isometric strength at ankle and knee joints. 2 × 2 (Age group (younger, middle-age, and older adult groups) × Gender (male and female)) between-subject design and Post-hoc analysis were performed to evaluate strength differences among three age groups. Post-hoc analysis indicated that, overall, middle-age workers' leg strengths (i.e. ankle and knee muscles) were significantly different from younger adults while middle-age workers' leg strengths were virtually identical to older adults' leg strengths. These results suggested that, overall, 14 middle-age workers in the present study could be at a higher risk of musculoskeletal injuries. Future studies looking at the likelihood of musculoskeletal injuries at different work places and from different working postures at various age levels should be required to validate the current findings. The future study would be a valuable asset in finding intervention strategies such that middle-age workers could stay healthier longer.

  3. Septic Arthritis in Infants Younger Than 3 Months: A Retrospective Review.

    Science.gov (United States)

    Bono, Kenneth T; Samora, Julie Balch; Klingele, Kevin E

    2015-09-01

    Septic arthritis in infants is rare and can be difficult to diagnose. This study reviewed a series of patients younger than 3 months to identify factors that may assist in early diagnosis and treatment. A query of records at a large Midwestern pediatric hospital (1994-2010) was performed to identify all patients younger than 3 months at the time of diagnosis. Analysis included birth history, joint involvement, physical examination findings, laboratory results, imaging results, method of treatment, and outcome. In 14 cases (11 boys, 3 girls; mean age at diagnosis, 42.2 days), complete records were available for review. Involved joints included the knee, hip, and shoulder. The most common findings on physical examination were decreased range of motion (100%), tenderness (100%), and swelling (71.4%). Mean temperature was 38.5°C. Mean white blood cell count was 18.5 K/µL, mean erythrocyte sedimentation rate was 48.9 mm/h, and mean C-reactive protein level was 6.1 mg/dL. More than half (57.1%) of joint aspirates grew positive cultures, and 41.7% of blood cultures had positive results. Causative organisms were group B streptococcus, methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Salmonella enterica, and Candida albicans. The most common physical examination findings in infants younger than 3 months with septic arthritis include tenderness, decreased range of motion, and swelling. White blood cell count, C-reactive protein level, and erythrocyte sedimentation rate are likely to be elevated, but these findings should be used in combination with findings on physical examination and radiographic studies to aid in diagnosis.

  4. Asymmetric pallidal neuronal activity in patients with cervical dystonia

    Directory of Open Access Journals (Sweden)

    Christian KE eMoll

    2014-02-01

    Full Text Available The origin of asymmetric clinical manifestation of symptoms in patients suffering from cervical dystonia (CD is hitherto poorly understood. Dysregulated neuronal activity in the basal ganglia has been suggested to have a role in the pathophysiology of CD. Here, we re-assessed the question to what extent relative changes occur in the direct versus indirect basal ganglia pathway in CD, whether these circuit changes are lateralized, and how these alterations relate to CD symptoms. To this end, we recorded ongoing single cell and local field potential (LFP activity from the external (GPe and internal pallidal segment (GPi of thirteen CD patients undergoing microelectrode-guided stereotactic surgery for deep brain stimulation in the GPi. We compared pallidal recordings from CD patients operated under local anaesthesia (LA with those obtained in CD patients operated under general anaesthesia (GA. In awake patients, mean GPe discharge rate (52 Hz was lower than that of GPi (72 Hz. Mean GPi discharge ipsilateral to the side of head turning was higher than contralateral and correlated with torticollis symptom severity. Lateralized differences were absent at the level of the GPe and in recordings from patients operated under GA. Furthermore, in the GPi of CD patients there was a subpopulation of theta-oscillatory cells with unique bursting characteristics. Power and coherence of GPe- and GPi-LFPs were dominated by a theta peak and also exhibited band-specific interhemispheric differences. Strong cross-frequency coupling of low-gamma amplitude to theta phase was a feature of pallidal LFPs recorded under LA, but not GA. These results indicate that CD is associated with an asymmetric pallidal outflow. Based on the finding of symmetric neuronal discharges in the GPe, we propose that an imbalanced interhemispheric direct pathway gain may be involved in CD pathophysiology.

  5. Platelet activation indices and apolipoproteins in hypertensive patients.

    Science.gov (United States)

    Catalano, M; Belletti, S; Russo, U; Aronica, A; Carzaniga, G; Seregni, R; Libretti, A

    1988-10-01

    We have studied the platelet activation indices beta-thromboglobulin (beta-TG and platelet factor 4(PF4), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL) and apolipoprotein (A1, A2, B, C2, C3, E) profiles of 22 untreated essential hypertensive subjects (WHO stages 1 and 2) and 22 controls, to see if there might be some causal relationship between lipoprotein abnormalities and greater platelet activation. The results showed the patients had both greater platelet activation than the controls, as demonstrated by higher plasma beta-TG levels (P less than 0.01) and lower apolipoprotein A2 levels (P less than 0.05). However there were no significant correlations between the platelet activation indices and the plasma levels of apolipoproteins, lipoproteins or lipids in either group.

  6. Ketamine Patient Controlled Analgesia for Acute Pain in Trauma Patients: A Randomized, Active Comparator Controlled, Blinded, Pilot Trial

    Science.gov (United States)

    2017-01-11

    AFRL-SA-WP-SR-2017-0003 Ketamine Patient-Controlled Analgesia for Acute Pain in Trauma Patients: A Randomized, Active Comparator...June 2013 – December 2016 4. TITLE AND SUBTITLE Ketamine Patient-Controlled Analgesia for Acute Pain in Trauma Patients: A Randomized, Active...in trauma patients while reducing opioid consumption in the traumatically injured patient. The objective of this study was to compare differences in

  7. Studies on Activity of NK Cells in Preeclampsia Patients

    Institute of Scientific and Technical Information of China (English)

    张展; 龚非力; 贾莉婷; 常彩红; 侯磊; 杨如镜; 郑芳

    2004-01-01

    The activity of the NK cells in patients with preeclampsia was studied to investigate the pathogenesis of preeclampsia. By using MTT and 51Cr releasing technique, the proliferation and killing ability of the NK cells in maternal and umbilical blood from preeclampsia patients (n= 18)and normal third trimester pregnant women (n= 18) were detected. The NK-92 cell line was as the positive control. The results showed that the NK cell counts of umbilical blood in preeclampsia patients and normal third trimester pregnant women were significantly greater than those of maternal blood (both P<0.05). Compared with that in normal third trimester pregnant women, the proliferative ability of the NK cells in preeclampsia patients was apparently increased (P<0.05). Compared with that in maternal blood, the proliferative ability of the NK cells in umbilical blood from both preeclampsia patients and normal third trimester pregnant women was dramatically increased.The killing ability of the NK cells in preeclampsia patients was significantly higher than that in normal third trimester pregnant women (P <0.05). It was suggested that both number and function of the NK cells in preeclampsia women were increased, and that in umbilical blood was greater than that in maternal blood, speculating that the function of the NK cells may affect the maintenance of the maternal and fetal immune tolerance during pregnancy.

  8. Basophil activation test with food additives in chronic urticaria patients.

    Science.gov (United States)

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the tested food additives. One patient responded to monosodium glutamate, showing 18.7% of CD203c-positive basophils. Another patient showed a positive BAT result to sodium benzoate. Both patients had clinical correlations with the agents, which were partly determined by elimination diets. The present study suggested that at least a small proportion of patients with CU had symptoms associated with food additives. The results may suggest the potential utility of the BAT to identity the role of food additives in CU.

  9. FEATURES OF INTERCONNECTION OF SELF-ESTEEM AND ANXIETY IN THE YOUNGER SCHOOL AGE

    OpenAIRE

    Калюжна, Євгенія; Шевергіна, Марія

    2015-01-01

     The article is devoted the phenomenology of anxiety and self-esteem of personality and the nature their interconnection in the younger school age. Is emphasized that self-esteem and anxiety are complex personal formations, which belong to basic personality traits. The importance of self-esteem as a component of core of personality and the important regulator of social activity. Substantiated the thesis that self-esteem is the result of comparing the person’s qualities with social relevant st...

  10. Social and pedagogical aspects of religious literacy among the younger generation

    Directory of Open Access Journals (Sweden)

    Efimov Vladimir Fedorovich

    2015-07-01

    Full Text Available The article reveals the problem of the education of youth in religious issues through the activities of the Church and secular educational institutions. The author shows the absolute failure of the efforts of the state and the Church in this direction that causes damage to the moral education of the younger generation. The author enlightens the originality, specificity, criticism of the interaction between the Church and the intelligentsia, and also the organizational ways of formation of the religious literacy among the population of Russia.

  11. Assessing physical function and physical activity in patients with CKD.

    Science.gov (United States)

    Painter, Patricia; Marcus, Robin L

    2013-05-01

    Patients with CKD are characterized by low levels of physical functioning, which, along with low physical activity, predict poor outcomes in those treated with dialysis. The hallmark of clinical care in geriatric practice and geriatric research is the orientation to and assessment of physical function and functional limitations. Although there is increasing interest in physical function and physical activity in patients with CKD, the nephrology field has not focused on this aspect of care. This paper provides an in-depth review of the measurement of physical function and physical activity. It focuses on physiologic impairments and physical performance limitations (impaired mobility and functional limitations). The review is based on established frameworks of physical impairment and functional limitations that have guided research in physical function in the aging population. Definitions and measures for physiologic impairments, physical performance limitations, self-reported function, and physical activity are presented. On the basis of the information presented, recommendations for incorporating routine assessment of physical function and encouragement for physical activity in clinical care are provided.

  12. Maintenance of physical activity in patients with rheumaoid arthritis

    DEFF Research Database (Denmark)

    Løppenthin, Katrine; Esbensen, Bente Appel; Østergaard, Mikkel

    2012-01-01

    Background: Several exercise trials indicate that physical activity (PA) may improve physical function and quality of life, and reduce pain in patients with rheumatoid arthritis (RA) 1, 2. Few of these studies have included physical activity maintenance. Thus, it is still unknown how and why some....... The analysis was discussed within a multidisciplinary team of qualitative researchers. Results: The analysis revealed tree dimensions of PA maintenance: (1) A bodily dimension: physical sensations of vitality, sparkling energy and liberation in movement; (2) a mental component: referring to experiences of self......, described experiences of bodily well-being and liberation from illness provided and secured through PA maintenance. The understanding of regular PA as a resistance resource is essential to development future health promoting interventions aimed to encourage PA maintenance in patients with RA....

  13. Increased activity of the mannan-binding lectin complement activation pathway in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Ytting, H; Jensenius, Jens Christian; Christensen, I J

    2004-01-01

    in the colon or rectum, and disease stages according to Dukes' classification. No statistical difference (P=0.20) in frequency of MBL deficiency was found between the patients (20%) and the donors (27%). CONCLUSIONS: Overall, the MBL complement activation pathway is significantly increased in patients......BACKGROUND: Postoperative bacterial infectious complications are frequent in patients with colorectal cancer (CRC), with subsequent increased recurrence rates and poor prognosis. Deficiency of the mannan-binding lectin (MBL) complement activation pathway may cause increased risk of infection......: Serum MBL concentrations and MBL/MASP activity were determined using immunofluorometric assays. The levels are presented as the median, inter-quartile range and range. RESULTS: Serum MBL levels were significantly (P

  14. Muscular activity may improve in edentulous patients after implant treatment.

    Science.gov (United States)

    Afrashtehfar, Kelvin I; Schimmel, Martin

    2016-12-01

    Data sourcesMedline via Pubmed and the Cochrane Library were searched from January 1980 to September 2013. This was complemented by a manual search of the magazines Deutsche Zahnaerztliche Zeitung, Quintessenz, Zeitschrift für Zahnärztliche Implantologie, Schweizerische Monatszeitschrift and Implantologie. Additionally, the list of reference s of all selected full-text articles and related reviews were further scrutinised for potential included studies in English or German.Study selectionThree review authors independently searched for clinical trials that assessed the muscular activity in the intervention groups: edentulous patients treated with implant-overdentures (IODs) and implant-supported fixed dental prostheses (ISFDPs) and the comparison groups: dentates and edentulous patients treated with mucosa-borne complete removable dental prostheses (CRDPs).Data extraction and synthesisThe primary outcome was the muscular activity (measured by electromyography [EMG]) in masseter or temporalis muscle of the participants during clenching and chewing. The data extraction of each included study consisted of author, year, age range, treatment, number of participants, number of implants inserted, arch treated, opposite jaw, kind and side of the muscles that were measured. EMG gain or loss (unit measured: volt) was considered by using the effect size. For the meta-analyses only the studies that included masseter muscle measured separately from temporalis were considered. Concerning the side of measurement (right and left side measured together or right and left side measured separately), only the dominant type in each category was included.ResultsSixteen articles, out of the initial 646 retrieved abstracts, were analysed. The muscular activity of edentulous subjects increased after implant support therapy during clenching (effect size [ES]: 2.18 [95% confidence interval [CI]: 1.14, 3.23]) and during chewing (ES: 1.45 [95 % CI: 1.21, 1.69]). In addition, the pooled EMG

  15. Individual differences in cognitive functioning predict effectiveness of a heads-up lane departure warning for younger and older drivers.

    Science.gov (United States)

    Aksan, Nazan; Sager, Lauren; Hacker, Sarah; Lester, Benjamin; Dawson, Jeffrey; Rizzo, Matthew; Ebe, Kazutoshi; Foley, James

    2017-02-01

    The effectiveness of an idealized lane departure warning (LDW) was evaluated in an interactive fixed base driving simulator. Thirty-eight older (mean age=77years) and 40 younger drivers (mean age=35years) took four different drives/routes similar in road culture composition and hazards encountered with and without LDW. The four drives were administered over visits separated approximately by two weeks to examine changes in long-term effectiveness of LDW. Performance metrics were number of LDW activations and average correction time to each LDW. LDW reduced correction time to re-center the vehicle by 1.34s on average (95% CI=1.12-1.57s) but did not reduce the number of times the drivers drifted enough in their lanes to activate the system (LDW activations). The magnitude of reductions in average correction RT was similar for older and younger drivers and did not change with repeated exposures across visits. The contribution of individual differences in basic visual and motor function, as well as cognitive function to safety gains from LDW was also examined. Cognitive speed of processing predicted lane keeping performance for older and younger drivers. Differences in memory, visuospatial construction, and executive function tended to predict performance differences among older but not younger drivers. Cognitive functioning did not predict changes in the magnitude of safety benefits from LDW over time. Implications are discussed with respect to real-world safety systems.

  16. Evaluation of voice disorders in patients with active laryngeal tuberculosis.

    Directory of Open Access Journals (Sweden)

    Marcia Mendonça Lucena

    Full Text Available Laryngeal tuberculosis (LTB is the most frequent larynx granulomatous disease. In general there is lung involvement, but in an important proportion of cases you can find LTB without pulmonary disease. The lesions observed in LTB, such as ulceration and fibrosis, can interfere in the process of voice production. The involvement of the mucous lining of the vocal folds can change their flexibility and, consequently, change voice quality, and the main symptom is dysphonia present in almost 90% of cases.To describe the anatomical characteristics and voice quality in LTB patients.A descriptive cross-sectional study was conducted with 24 patients.The most frequently affected sites were vocal folds in 87.5% patients, vestibular folds in 66.7%, epiglottis in 41.7%, arytenoid in 50%, aryepiglottic folds in 33.3%, and interarytenoid region in 33.3% patients. We found 95.8% cases of dysphonia. The voice acoustic analysis showed 58.3% cases of Jitter alterations, 83.3% of Shimmer and 70.8% of GNE.Voice disorders found in active laryngeal tuberculosis are similar to those reported after clinical healing of the disease, suggesting that sequelae and vocal adjustments may install during the active phase of the disease, negatively impacting the process of vocal quality reestablishment.

  17. Urinary tract infections in febrile infants younger than 8 weeks of age.

    Science.gov (United States)

    Crain, E F; Gershel, J C

    1990-09-01

    In this prospective study of 442 infants younger than 8 weeks of age who attended a pediatric emergency department with temperature greater than or equal to 100.6 degrees F (38.1 degrees C), urinary tract infections (UTIs) were found in 33 patients (7.5%), 2 of whom were bacteremic. Clinical and laboratory data were not helpful for identifying UTIs. Of the 33 patients with UTIs, 32 had urinalyses recorded; 16 were suggestive of a UTI (more than five white blood cells per high-power field or any bacteria present). Of the 16 infants with apparently normal urinalysis results, three had an emergency department diagnosis suggesting an alternative bacterial focus of infection. If the physician had decided on the basis of apparently normal urinalysis results to forgo obtaining a urine culture, more than half of the UTIs would have been missed. Bag-collected specimens were significantly more likely to yield indeterminate urine culture results than either catheter or suprapubic specimens. In addition, uncircumcised males were significantly more likely to have a UTI than circumcised boys. These results suggest that a suprapubic or catheter-obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants younger than 8 weeks of age, regardless of the urinalysis findings or another focus of presumed bacterial infection.

  18. Glacier-derived climate for the Younger Dryas in Europe

    Science.gov (United States)

    Pellitero, Ramon; Rea, Brice R.; Spagnolo, Matteo; Hughes, Philip; Braithwaite, Roger; Renssen, Hans; Ivy-Ochs, Susan; Ribolini, Adriano; Bakke, Jostein; Lukas, Sven

    2016-04-01

    We have reconstructed and calculated the glacier equilibrium line altitudes (ELA) for 120 Younger Dryas palaeoglaciers from Morocco in the south to Svalbard in the north and from Ireland in the west to Turkey in the east. The chronology of these landform were checked and, when derived from cosmogenic dates, these were recalculated based on newer production rates. Frontal moraines/limits for the palaeoglaciers were used to reconstruct palaeoglacier extent by using a GIS tool which implements a discretised solution for the assumption of perfect-plasticity ice rheology for a single flowline and extents this out to a 3D ice surface. From the resulting equilibrium profile, palaeoglaciers palaeo-ELAs were calculated using another GIS tool. Where several glaciers were reconstructed in a region, a single ELA value was generated following the methodology of Osmaston (2005). In order to utilise these ELAs for quantitative palaeo-precipitation reconstructions an independent regional temperature analysis was undertaken. A database of 121 sites was compiled where the temperature was determined from palaeoproxies other than glaciers (e.g. pollen, diatoms, choleoptera, chironimids…) in both terrestrial and offshore environments. These proxy data provides estimates of average annual, summer and winter temperatures. These data were merged and interpolated to generate maps of average temperature for the warmest and coldest months and annual average temperature. From these maps the temperature at the ELA was obtained using a lapse rate of 0.65°C/100m. Using the ELA temperature range and summer maximum in a degree-day model allows determination of the potential melt which can be taken as equivalent to precipitation given the assumption a glacier is in equilibrium with climate. Results show that during the coldest part of the Younger Dryas precipitation was high in the British Isles, the NW of the Iberian Peninsula and the Vosges. There is a general trend for declining precipitation

  19. Attachment and Aggressive Manifestations in Younger Adulthood - "Preliminary Findings"

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    Tatiana Lorincová

    2014-07-01

    Full Text Available The main topic of the contribution was comparison between retrospective attachment (emocional warmth and rejection and aggressive manifestations (physical aggressivness, verbal aggressivness, anger and hostility among younger adulthood. Bowlby's theory of attachment was that once a core attachment style develops in an infant, it will influence and shape the nature of all intimate relations for the individual moving forward throughout the infant's life cycle. Authors Mikulincer and Shaver (2011 explain how these primary attachment experiences would affect future emotional, cognitive and behavioral processes. Secure adolescents, in comparison to insecure ones are perceived as being less aggressive. Research has pointed out that secure parental attachment promotes adaptive psychological functioning. The direct relationship between attachment security and aggressive/delinquent behaviour is in line with prior evidence that secure adolescents rate higher in terms of emotional and social adjustment, enjoy more positive relationships with their family and peers, and are less likely to engage in externalizing problems, such as antisocial and aggressive behaviours. On the other hand, insecure attachment is connected with aggressive and externalizing behaviour. Hypotheses were formulated on the base of theoretical background and our assumption was, that younger adults with emocional warmth attachment will have lower level of aggressive manifestations (physical aggression, verbal aggression, anger and hostility than younger adults with rejectional attachment. We used two standardized questionnaires for data collection, s.E.M.B.U. Questionnaire, which measured retrospective attachment (emocional warmth and rejection and Questionnaire of Aggressivness, which measured aggressive manifestations. We used statistical analysis and we found statistically significant differencies, which are preliminary findings from broader research, between emocional warmth

  20. Spontaneous neutrophil activation in HTLV-1 infected patients

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    Jaqueline B. Guerreiro

    Full Text Available Human T cell lymphotropic Virus type-1 (HTLV-1 induces lymphocyte activation and proliferation, but little is known about the innate immune response due to HTLV-1 infection. We evaluated the percentage of neutrophils that metabolize Nitroblue tetrazolium (NBT to formazan in HTLV-1 infected subjects and the association between neutrophil activation and IFN-gamma and TNF-alpha levels. Blood was collected from 35 HTLV-1 carriers, from 8 patients with HAM/TSP (HTLV-1- associated myelopathy; 22 healthy individuals were evaluated for spontaneous and lipopolysaccharide (LPS-stimulated neutrophil activity (reduction of NBT to formazan. The production of IFN-gamma and TNF-alpha by unstimulated mononuclear cells was determined by ELISA. Spontaneous NBT levels, as well as spontaneous IFN-gamma and TNF-alpha production, were significantly higher (p<0.001 in HTLV-1 infected subjects than in healthy individuals. A trend towards a positive correlation was noted, with increasing percentage of NBT positive neutrophils and levels of IFN-gamma. The high IFN-gamma producing HTLV-1 patient group had significantly greater NBT than healthy controls, 43±24% and 17±4.8% respectively (p< 0.001, while no significant difference was observed between healthy controls and the low IFN-gamma-producing HTLV-1 patient group (30±20%. Spontaneous neutrophil activation is another marker of immune perturbation resulting from HTLV-1 infection. In vivo activation of neutrophils observed in HTLV-1 infected subjects is likely to be the same process that causes spontaneous IFN-gamma production, or it may partially result from direct IFN-gamma stimulation.

  1. Spontaneous neutrophil activation in HTLV-1 infected patients

    Directory of Open Access Journals (Sweden)

    Jaqueline B. Guerreiro

    2005-12-01

    Full Text Available Human T cell lymphotropic Virus type-1 (HTLV-1 induces lymphocyte activation and proliferation, but little is known about the innate immune response due to HTLV-1 infection. We evaluated the percentage of neutrophils that metabolize Nitroblue tetrazolium (NBT to formazan in HTLV-1 infected subjects and the association between neutrophil activation and IFN-gamma and TNF-alpha levels. Blood was collected from 35 HTLV-1 carriers, from 8 patients with HAM/TSP (HTLV-1- associated myelopathy; 22 healthy individuals were evaluated for spontaneous and lipopolysaccharide (LPS-stimulated neutrophil activity (reduction of NBT to formazan. The production of IFN-gamma and TNF-alpha by unstimulated mononuclear cells was determined by ELISA. Spontaneous NBT levels, as well as spontaneous IFN-gamma and TNF-alpha production, were significantly higher (p<0.001 in HTLV-1 infected subjects than in healthy individuals. A trend towards a positive correlation was noted, with increasing percentage of NBT positive neutrophils and levels of IFN-gamma. The high IFN-gamma producing HTLV-1 patient group had significantly greater NBT than healthy controls, 43±24% and 17±4.8% respectively (p< 0.001, while no significant difference was observed between healthy controls and the low IFN-gamma-producing HTLV-1 patient group (30±20%. Spontaneous neutrophil activation is another marker of immune perturbation resulting from HTLV-1 infection. In vivo activation of neutrophils observed in HTLV-1 infected subjects is likely to be the same process that causes spontaneous IFN-gamma production, or it may partially result from direct IFN-gamma stimulation.

  2. Mountain glacier evolution in the Iberian Peninsula during the Younger Dryas

    Science.gov (United States)

    García-Ruiz, J. M.; Palacios, D.; González-Sampériz, P.; de Andrés, N.; Moreno, A.; Valero-Garcés, B.; Gómez-Villar, A.

    2016-04-01

    We review the evolution of glaciers in the Iberian Mountains during the Younger Dryas (12.9-11.7 ka, following the chronology of Greenland Stadial 1 - GS1) and compare with available environmental and climate data to investigate glacier dynamics during cold stadial episodes. The best examples of Younger Dryas moraines are found in the Central Pyrenees, involving short ice tongues up to 4 km in length in the highest massifs (above 3000 m a.s.l.) of the southern versant. Small cirque glaciers and rock glaciers formed during the YD occurred in other Pyrenean massifs, in the Cantabrian Range and in the Gredos and Guadarrama sierras (Central Range), as indicated by several rocky, polished thresholds that were ice-free at the beginning of the Holocene. Although some former rock glaciers were re-activated during the Younger Dryas, glacial activity was limited in the southernmost part of the Iberian Peninsula (Sierra Nevada). Most Iberian records show vegetation changes during the YD characterized by a forest decline and an expansion of shrubs (mainly Juniperus) and steppe herbs, although the vegetation response was not homogeneous because of variable resilience among ecosystems. Available records also document a variable lake response in terms of hydrology and productivity, with a decrease in sedimentation rates and organic productivity in most high altitude lakes and increases in salinity and relatively lower lake levels at lower altitudes. The impact of the Younger Dryas on the coastal environment was almost negligible, but it was responsible for a brief cessation in sea level rise. High-resolution analyses of new speleothem records have documented a double structure for the YD with an earlier drier phase followed by a relatively more humid period. The review of geomorphological evidence demonstrates a strong latitudinal control of glacial activity during the YD, with more intense development in the northern than in the southern regions. The increase in humidity during

  3. Interplay between patient global assessment, pain, and fatigue and influence of other clinical disease activity measures in patients with active rheumatoid arthritis

    DEFF Research Database (Denmark)

    Egsmose, Emilie Lund; Madsen, Ole Rintek

    2015-01-01

    analog scales (VAS) in the daily clinic by patients with active rheumatoid arthritis (RA). Associations with other measures of disease activity were also examined. Traditional disease activity data on 221 RA patients with active disease planned to initiate biological treatment were extracted from...

  4. How do older netcitizens compare with their younger counterparts?

    Science.gov (United States)

    Bucur, A; Renold, C; Henke, M

    1999-01-01

    The Internet is modifying the lives of people around the world. Although many talk about the democratization of knowledge and information, differences remain among users as older netcitizens are under-represented and less involved. We use national and representative U.S. data, the Current Population Survey, to show age-based differences. We complement our analysis with web-based data, the Georgia Tech World Wide Web User Surveys, to show Internet characteristics and trends by age for netcitizens. Results show that older users compose a lower share of Internet users than that of the total U.S. population; however, once they join the ranks of avid Internet users, older netcitizens are similar to their younger counterparts.

  5. [Otitis media with effusion in children younger than 1 year].

    Science.gov (United States)

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-06-01

    To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  6. Otitis media with effusion in children younger than 1 year

    Directory of Open Access Journals (Sweden)

    Renata Cantisani Di Francesco

    2016-06-01

    Full Text Available Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position, type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding.

  7. Warm summers during Younger Dryas cold reversal over Eurasia

    Science.gov (United States)

    Schenk, Frederik; Muschitiello, Francesco; Heikkilä, Miaja; Väliranta, Minna; Tarasov, Lev; Brandefelt, Jenny; Johansson, Arne; Näslund, Jens-Ove; Wohlfarth, Barbara

    2016-04-01

    The Younger Dryas cold reversal (GS-1) sticks out as a major stadial interrupting the mid to late deglaciation with a sharp temperature drop of several degrees around the North Atlantic with global teleconnections. The abrupt return to a very cold glacial-like ocean state introduces a strong temperature anomaly to the climate system contrasting the high solar radiation received by northern summers. Here we show that, in contrast to earlier coarse resolution climate simulations of the Younger Dryas, these competing factors result in rather warm summer conditions over Eurasia comparable to the preceding warm period of the late Allerød (GI-1a). Despite up to 10 K colder sea-surface-temperatures in summer, our high resolution simulation with the Community Earth System Model 1 (CESM1.0.5) suggests that the presence of large ice sheets over Scandinavia, Spitsbergen and the Kara Sea significantly modifies atmospheric flow in summer preventing cold westerly winds from the Atlantic to impact the continent. Instead, fluid dynamics around ice sheets deflect winds to the north or south along the coasts supported by divergent flow from ice domes, stratification and increased tendency to high pressure and atmospheric blocking. Consistent with our model simulation, we show that temperature reconstructions derived from an extended compilation of multi-proxy lake records (chironomids, aquatic pollen, macrofossils) suggest warm July conditions of 13-17° C for continental Europe with exception of coastal and high elevation sites. The analysis of simulated growing degree days, season length and first results from paleo lake modelling driven by climate model output suggests that severe winter to spring conditions significantly delay and shorten the vegetation season but do not produce cold summers as previously simulated.

  8. Otitis media with effusion in children younger than 1 year

    Science.gov (United States)

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-01-01

    Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. PMID:26559603

  9. Measuring patient activation in the Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13

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    Rademakers Jany

    2012-07-01

    Full Text Available Abstract Background The American short form Patient Activation Measure (PAM is a 13-item instrument which assesses patient (or consumer self-reported knowledge, skills and confidence for self-management of one’s health or chronic condition. In this study the PAM was translated into a Dutch version; psychometric properties of the Dutch version were established and the instrument was validated in a panel of chronically ill patients. Methods The translation was done according to WHO guidelines. The PAM 13-Dutch was sent to 4178 members of the Dutch National Panel of people with Chronic illness or Disability (NPCD in April 2010 (study A and again to a sub sample of this group (N = 973 in June 2010 (study B. Internal consistency, test-retest reliability and cross-validation with the SBSQ-D (a measure for Health literacy were computed. The Dutch results were compared to similar Danish and American data. Results The psychometric properties of the PAM 13-Dutch were generally good. The level of internal consistency is good (α = 0.88 and item-rest correlations are moderate to strong. The Dutch mean PAM score (61.3 is comparable to the American (61.9 and lower than the Danish (64.2. The test-retest reliability was moderate. The association with Health literacy was weak to moderate. Conclusions The PAM-13 Dutch is a reliable instrument to measure patient activation. More research is needed into the validity of the Patient Activation Measure, especially with respect to a more comprehensive measure of Health literacy.

  10. Opioid Abuse Down in Younger Americans, but Up Among Older Adults

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_167434.html Opioid Abuse Down in Younger Americans, But Up Among ... 2017 WEDNESDAY, July 26, 2017 (HealthDay News) -- While opioid abuse has fallen among younger Americans, the same ...

  11. Kids 14 and Younger Only Need 2 HPV Vaccine Shots: CDC

    Science.gov (United States)

    ... html Kids 14 and Younger Only Need 2 HPV Vaccine Shots: CDC But agency's revised guidelines still recommend ... and younger require only two doses of the HPV vaccine rather than the previously recommended three shots, U.S. ...

  12. Relationship between balance and physical activity measured by an activity monitor in elderly COPD patients.

    Science.gov (United States)

    Iwakura, Masahiro; Okura, Kazuki; Shibata, Kazuyuki; Kawagoshi, Atsuyoshi; Sugawara, Keiyu; Takahashi, Hitomi; Shioya, Takanobu

    2016-01-01

    Little is known regarding the relationship between balance impairments and physical activity in COPD. There has been no study investigating the relationship between balance and objectively measured physical activity. Here we investigated the association between balance and physical activity measured by an activity monitor in elderly COPD patients. Twenty-two outpatients with COPD (mean age, 72±7 years; forced expiratory volume in 1 second, 53%±21% predicted) and 13 age-matched healthy control subjects (mean age, 72±6 years) participated in the study. We assessed all 35 subjects' balance (one-leg standing test [OLST] times, Short Physical Performance Battery total scores, standing balance test scores, 4 m gait speed, and five-times sit-to-stand test [5STST]) and physical activity (daily steps and time spent in moderate-to-vigorous physical activity per day [MV-PA]). Possible confounders were assessed in the COPD group. The between-group differences in balance test scores and physical activity were analyzed. A correlation analysis and multivariate regression analysis were conducted in the COPD group. The COPD patients exhibited significant reductions in OLST times (P=0.033), Short Physical Performance Battery scores (P=0.013), 4 m gait speed (Pbalance test scores. The correlation and multivariate regression analyses revealed significant independent associations between OLST times and daily steps (Pbalance and reductions in physical activity were observed in the COPD group. Deficits in balance are independently associated with physical inactivity.

  13. Low prevalence of Blastocystis sp. in active ulcerative colitis patients.

    Science.gov (United States)

    Rossen, N G; Bart, A; Verhaar, N; van Nood, E; Kootte, R; de Groot, P F; D'Haens, G R; Ponsioen, C Y; van Gool, T

    2015-05-01

    Ulcerative colitis (UC) is thought to originate from a disbalance in the interplay between the gut microbiota and the innate and adaptive immune system. Apart from the bacterial microbiota, there might be other organisms, such as parasites or viruses, that could play a role in the aetiology of UC. The primary objective of this study was to compare the prevalence of Blastocystis sp. in a cohort of patients with active UC and compare that to the prevalence in healthy controls. We studied patients with active UC confirmed by endoscopy included in a randomised prospective trial on the faecal transplantation for UC. A cohort of healthy subjects who served as donors in randomised trials on faecal transplantation were controls. Healthy subjects did not have gastrointestinal symptoms and were extensively screened for infectious diseases by a screenings questionnaire, extensive serologic assessment for viruses and stool analysis. Potential parasitic infections such as Blastocystis were diagnosed with the triple faeces test (TFT). The prevalence of Blastocystis sp. were compared between groups by Chi-square testing. A total of 168 subjects were included, of whom 45 had active UC [median age 39.0 years, interquartile range (IQR) 32.5-49.0, 49 % male] and 123 were healthy subjects (median age 27 years, IQR 22.0-37.0, 54 % male). Blastocystis sp. was present in the faeces of 40/123 (32.5 %) healthy subjects and 6/45 (13.3 %) UC patients (p = 0.014). Infection with Blastocystis is significantly less frequent in UC patients as compared to healthy controls.

  14. Professional and social activity of patients after heart transplant

    Directory of Open Access Journals (Sweden)

    Urszula Marcinkowska

    2015-08-01

    Full Text Available Objectives: The aim of the study is to describe both professional and social activities of patients after heart transplant. Material and Methods: Ninety-five heart transplant patients treated at the Silesian Center for Heart Diseases in Zabrze were surveyed, comprising 29 women (30.5% and 66 men (69.5%. The average age of respondents was 54.3 years old (standard deviation (SD = 15 years; the average period that had elapsed since the heart transplant was 7.1 years (SD = 4 years. We designed a questionnaire as a tool for collecting information from patients. Results: Twenty-five percent of patients worked at the time of completion of the questionnaire. Eighty percent of those patients were working before and after the transplant, 20% – only after transplantation (p < 0.05. A different job position at a new workplace had 47.8% of patients, 34.8% of them had the same job position at the same work place as they had had before, 63.4% of the heart transplant respondents were pensioners. Eighty-two percent of patients had a certificate with a designated degree of disability – among them: 69% had a certificate for a significant degree of disability, 22% – for a moderate degree of disability. Among those surveyed, 52.5% said that their financial situation had not changed whereas 34.5% of those surveyed reported a change for the worse. Thirty-seven percent of respondents reported changes in family relationships. Seventy-seven percent reported that they received help from family members, as compared with 19% who did not. Conclusions: Only 25.3% of the patients treated at the Silesian Centre for Heart Diseases after heart transplant are employed and it is one of the lowest employment rates in this category of patients in Europe. One third of working patients have the same work place as they had before their operation. Heart transplant is a cause of changes in family relationships. Most often family bonds are strengthened but sometimes family members

  15. Influences of patient informed cognitive complaints on activities of daily living in patients with bipolar disorder

    DEFF Research Database (Denmark)

    Träger, Conny; Decker, Lone; Wæhrens, Eva Ejlersen

    2017-01-01

    Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of impaired occupational and psychosocial functioning. However, knowledge of how these deficits impact the patients' ability to perform Activities of Daily Living (ADL), tasks related to self-care and d......Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of impaired occupational and psychosocial functioning. However, knowledge of how these deficits impact the patients' ability to perform Activities of Daily Living (ADL), tasks related to self...... Complaints in Bipolar Disorder Rating Assessment questionnaire (COBRA)) were included. Objective neurocognitive function was evaluated with a short comprehensive cognitive test battery and ADL ability was evaluated with the performance-based Assessment of Motor and Process Skills (AMPS) in the homes...... of the patients. Our findings indicate that low processing speed correlated with decreased ADL ability, and processing speed as measured by the cognitive test battery thus seems to be significantly related to patients' ability to live independently in the community. Overall, adding a performance based test...

  16. Physical activity in patients with type 2 diabetes and hypertension – insights into motivations and barriers from the MOBILE study

    Directory of Open Access Journals (Sweden)

    Duclos M

    2015-06-01

    Full Text Available Martine Duclos,1,2 Sylvie Dejager,3,4 Nicolas Postel-Vinay,5 Sylvie di Nicola,6 Stéphane Quéré,7 Béatrice Fiquet4,5 1Department of Sport Medicine and Functional Explorations, University-Hospital (CHU, G Montpied Hospital; INRA, UNH, CRNH Auvergne, 2Nutrition Department, University of Auvergne, Clermont-Ferrand, Auvergne, 3Department of Endocrinology and Metabolism, La Pitié-Salpétrière Hospital, Paris, 4Clinical and Scientific Affairs, Novartis Pharma SAS, Rueil-Malmaison, 5Department of Hypertension, Georges Pompidou European Hospital, Paris, 6Biostatistics, Inferential, Paris, 7Biostatistics, Novartis Pharma SAS, Rueil-Malmaison, France Background: Although physical activity (PA is key in the management of type 2 diabetes (T2DM and hypertension, it is difficult to implement in practice. Methods: Cross-sectional, observational study. Participating physicians were asked to recruit two active and four inactive patients, screened with the Ricci-Gagnon (RG self-questionnaire (active if score ≥16. Patients subsequently completed the International Physical Activity Questionnaire. The objective was to assess the achievement of individualized glycated hemoglobin and blood pressure goals (<140/90 mmHg in the active vs inactive cohort, to explore the correlates for meeting both targets by multivariate analysis, and to examine the barriers and motivations to engage in PA. Results: About 1,766 patients were analyzed. Active (n=628 vs inactive (n=1,138 patients were more often male, younger, less obese, had shorter durations of diabetes, fewer complications and other health issues, such as osteoarticular disorders (P<0.001 for all. Their diabetes and hypertension control was better and obtained despite a lower treatment burden. The biggest difference in PA between the active vs inactive patients was the percentage who declared engaging in regular leisure-type PA (97.9% vs 9.6%, also reflected in the percentage with vigorous activities in

  17. Serum arylesterase and paraoxonase activity in patients with chronic hepatitis

    Institute of Scientific and Technical Information of China (English)

    Suleyman Sirri Kilic; Suleyman Aydin; Nermin Kilic; Fazilet Erman; Suna Aydin; (I)lhami Celik

    2005-01-01

    AIM: To investigate the relationship between serum paraoxonase (PON1), AST, ALT, GGT, and arylesterase (AE) activity alterations and the degree of liver damage in patients with chronic hepatitis.METHODS: We studied 34 chronic hepatitis patients and 32 control subjects, aged between 35 and 65 years,in the Department of Infection and Clinical Microbiology at the Firat University School of Medicine. Blood samples were collected from subjects between 8:00 and 10:00 a.m. following a 12-h fast. Baseline and salt-stimulated PON1 activities were measured by the hydrolysis of paraoxon. Phenyl acetate was used as the substrate and formed phenol was measured spectrophotometrically at 270 nm after the addition of a 10-fold diluted serum sample in AE activity measurements.RESULTS: The results of this investigation revealed that the levels of AE activity decreased from 132±52 to 94±36 (29%), baseline PON1 activity from 452±112 to 164±67 (64%), salt-stimulated PON1 activity from 746±394 to 294±220 (61%), HDL from 58.4±5.1 to 47.2±5.6(20%), triglyceride from 133±51.2 to 86±34.0 (35%),while a slight increase in the level of LDL (from 163±54.1 to 177.3±56.0; 9%) and significant increases in the levels of AST (from 29±9.3 to 98±44), ALP (from 57.2±13.1 to 91±38.1), ALT (from 27.9±3.32 to 89±19.1), GGT (from 24.3±2.10 to 94±48.2), total bilirubin (from 0.74±0.02 to 1.36±0.06; 84%) and direct bilirubin (from 0.18±0.01 to 0.42±0.04; 133%) were detected.However, the levels of albumin, total protein, cholesterol,and uric acid were almost the same in chronic hepatitis and the control subjects.CONCLUSION: Low PON1 and AE activity may contribute to the increased liver dysfunction in chronic hepatitis patients by reducing the ability of HDL to retard LDL oxidation and might be clinically useful for monitoring the disease of chronic hepatitis.

  18. [Gallbladder motor activity in patients with virus hepatitis B].

    Science.gov (United States)

    Mamos, Arkadiusz; Wichan, Paweł; Chojnacki, Jan; Grzegorczyk, Krzysztof

    2003-12-01

    In acute stage of virus hepatitis B patients often complain of dyspeptic discomfort. They may be a consequence of alimentary tract motor activity disorders including these of gallbladder. Routine ultrasonography in an early phase of virus hepatitis often reveals gallbladder wall thickening what may confirm the above thesis. Thus, a group of 15 patients in an acute phase of virus hepatitis B was subjected to examinations. Gallbladder motor activity was assessed by ultrasonographic method determining its total volume and ejection fraction and volume after test meal stimulus. First examination was performed in the first week since the appearance of yellowing of the walls, successive in 4 and 8 week of the disease. Obtained results were compared to the values obtained in the group of 25 healthy volunteers. It was found out that gallbladder volume was significantly decreased and ejection fraction increased in the acute phase of virus hepatitis B than in the controls. This may speak for gallbladder hyperreactivity in patients in the course of virus hepatitis B. These disorders decreased during two-month observation but even in the 8 week the investigated parameters differed from those found in the control group.

  19. The role of play in pre-school and younger school age children

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    Kopas-Vukašinović Emina

    2006-01-01

    Full Text Available The paper deals with the importance of play for children’s development and learning in institutionalized preschool education, as well as the opportunities it provides concerning the organization of teaching activities with younger school age children. The paper is based on the theoretical framework emphasizing educational character of children’s play, as a specific form of learning. Notwithstanding occasional attempts within pedagogic theory to deny educational values of children’s play and to emphasize instruction as the only form of systematic learning, contemporary pedagogic views consider play an important part of school education. Learning through play at younger school age helps overcome the discontinuity between preschool and school education. Curriculum subject matter can be covered through carefully selected and prepared play activities within the existing system, providing the support, encouragement and guidance by the adults involved, including their proper knowledge of children’ age-related and psycho-physical characteristics. Play facilitates gradual change over from preschool to school developmental stage, free, spontaneous and creative expression and the development of children’s potential.

  20. Immunization Uptake in Younger Siblings of Children with Autism Spectrum Disorder

    Science.gov (United States)

    Kuwaik, Ghassan Abu; Roberts, Wendy; Zwaigenbaum, Lonnie; Bryson, Susan; Smith, Isabel M.; Szatmari, Peter; Modi, Bonnie M.; Tanel, Nadia; Brian, Jessica

    2014-01-01

    Background: Parental concerns persist that immunization increases the risk of autism spectrum disorder, resulting in the potential for reduced uptake by parents of younger siblings of children with autism spectrum disorder ("younger sibs"). Objective: To compare immunization uptake by parents for their younger child relative to their…

  1. CSF ADENOSINE DEAMINASE (ADA ACTIVITY IN PATIENTS WITH MENINGITIS

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    Justin

    2016-05-01

    Full Text Available Meningitis is inflammation of the meninges (pia, arachnoid and dura mater covering the brain and the spinal cord. ADA is an enzyme in the purine salvage pathway which is found in abundance in active T-lymphocytes. Hence, an attempt was made to estimate the CSF ADA level in patients with suspected meningitis and throw light on its use in differentiating the various types of meningitis. AIMS AND OBJECTIVES To estimate the level of CSF adenosine deaminase level in different types of meningitis. To assess its usefulness in differentiating the various types (bacterial, viral and tuberculous of meningitis. MATERIALS AND METHODS The study was conducted at the medical wards of Govt. Rajaji Hospital, Madurai, a prospective analytical study from a period of April 2012 to September 2012. OBSERVATION AND RESULTS Tuberculous meningitis occurred more in the age group of 21–40 years. Bacterial meningitis was seen mainly in patients < 20 years of age. Viral meningitis was seen in all age groups. CSF ADA level was highest in tuberculous meningitis, the mean value being 24.5 U/L. The mean value of ADA in bacterial meningitis was 4.54 U/L and viral meningitis patients had lowest mean ADA value of 2.65 U/L. CONCLUSION In our study, 50 patients with meningitis admitted in Government Rajaji Hospital from April 2012 to September 2012 were evaluated. Meningitis predominantly affected people in the age group of 20-40 years in our study with a male: female ratio of 1.9:1. Cases of tuberculous meningitis constituted 48% of the study group and bacterial and viral meningitis were 26% each. CSF protein values were higher and sugar values lower in patients with tuberculous and bacterial meningitis. CSF cell counts were higher in patients with bacterial meningitis.

  2. Israeli Arabs develop diverticulitis at a younger age and are more likely to require surgery than Jews.

    Science.gov (United States)

    Itai, Ghersin; Slijper, Nadav; Sroka, Gideon; Matter, Ibrahim

    2015-01-01

    Only few studies have examined the impact of racial differences on the age of onset, course and outcomes of diverticulitis. To provide data about the epidemiology of diverticulitis in northern Israel, and to determine whether ethnicity is a predictor of age of onset, complications, and need for surgery. Was conducted a retrospective review of the charts of all patients diagnosed with a first episode of diverticulitis in our hospital between 2005 and 2012. Were found 638 patients with a first episode of acute diverticulitis in the eight year interval. Israeli Arabs developed a first episode of diverticulitis at a younger age compared to Jews (51.2 vs 63.8 years, p<0.01). Arabs living in rural areas developed diverticulitis at a younger age than Arabs living in urban centers (49.4 vs 54.5 years, P=0.03). Jewish and Arabic men developed diverticulitis at younger age compared to their female counterparts (59.9 vs 66.09, p<0.01, and 47.31 vs 56.93, p<0.01, respectively). Arabs were more likely [odds ratio (OR)=1.81 ,95% confidence interval (CI)1.12-2.90, p=0.017] than Jews to require surgical treatment (urgent or elective) for diverticulitis. Israeli Arabs tend to develop diverticulitis at a younger age and are more likely to require surgical treatment for diverticulitis compared to Jews. Arabs living in rural areas develop diverticulitis at a younger age than Arabs living in urban centers. These findings highlight a need to address the root cause for ethnic differences in onset, course and outcome of acute diverticulitis.

  3. Spatial-sequential working memory in younger and older adults: age predicts backward recall performance within both age groups

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    Louise A. Brown

    2016-10-01

    Full Text Available Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18-40 years and older (64-85 years adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale – Third Edition (WMS-III; Wechsler, 1998. Across both age groups, the effects of interference (control, visual, or spatial, and recall type (forward and backward, were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping reliably reducing performance relative to both the control and visual interference (dynamic visual noise conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward. Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age

  4. Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups

    Science.gov (United States)

    Brown, Louise A.

    2016-01-01

    Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18–40 years) and older (64–85 years) adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale – Third Edition (WMS-III; Wechsler, 1998). Across both age groups, the effects of interference (control, visual, or spatial), and recall type (forward and backward), were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping) reliably reducing performance relative to both the control and visual interference (dynamic visual noise) conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward). Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age predicts

  5. Abrupt release of terrigenous organic carbon to the Laptev Sea at termination of the Younger Dryas

    Science.gov (United States)

    Tesi, T.; Muschitiello, F.; Smittenberg, R.; Jakobsson, M.; Vonk, J.; Hill, P.; Dudarev, O.; Semiletov, I. P.; Kirchner, N.; Noormets, R.; Andersson, A.; Gustafsson, O.

    2015-12-01

    Based on analysis of a piston core collected in 2014 from the Lena River paleo delta, now Laptev Sea, we show that rapid and massive organic carbon (OC) deposition took place into the marine system at the termination of the Younger Dryas when the Arctic region experienced a large and extremely fast climate change. The highly laminated strata with absence of bioturbation further confirm the rapid event-driven emplacement of this deposit which was largely dominated by terrigenous OC as indicated by depleted δ13C values and high concentrations of terrestrial fossil biomarkers (lignin phenols and cutin-derived products). Moreover, the hydrogen isotopic composition (δ2H) of HMW n-alkanes indicates that this terrestrially-derived translocated OC was produced in the watershed during a relatively cold period. The OC appears to be a few thousand years old at time of deposition (ca. 4-5000 radiocarbon years; reservoir age corrected), consistent with the radiocarbon age of pre-aged OC currently supplied by the Lena river. Altogether our results indicate that fast climate warming exerts first-order control on large-scale carbon redistribution. Because the Younger Dryas-Preboreal transition occurred within a few decades, we infer that the abrupt and large release of terrigenous OC was essentially driven by rapid changes in the permafrost stability (i.e., thermal collapse/thawing) and increase in precipitation over the Siberian watershed. Interestingly, only surface and sub-surface carbon pools (i.e., active layer) were remobilized while deep and old sources (radiocarbon dead) did not seem to have substantially contributed to the total land-to-ocean flux during the Younger Dryas-Preboreal transition.

  6. Lifestyle, Cardiovascular Drugs and Risk Factors in Younger and Elder Adults: The PEP Family Heart Study

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    Peter Schwandt

    2010-01-01

    Full Text Available Objectives: This study aimed to compare cardiovascular disease(CVD risk factors, lifestyle habits and pharmacological treatmentin two groups of elder adults with 20 years difference in theirmean age.Methods: This study comprised 590 women including two groupswith mean age of 42.4±5.5 vs. 66.5±4.0 years, and 486 men of twogroups with mean age of 44.1±5.6 vs. 63.9±7.0 years. Data onphysical examination, fasting blood analyses, 7-day dietary records,physical activity, smoking and actual medication use wererecorded.Results: Compared with younger individuals, seniors had a moreadverse risk factor profile in terms of abdominal obesity, overweight,hyperglycemia, hypertension, dyslipoproteinemia withoutdifferences in HDL-C. But this is not reflected by lifestyle behavior.Less than 2% of the elderly and 17% of the younger adultswere current smoker. Furthermore, the pattern of physical activitywas different in terms of more continuous sports in seniorscontrasting with extremes between no sports and more than twicea week in the younger group. Seniors consumed significantly lesscarbohydrates including more monosaccharide and less polysaccharides,more alcohol and water. The intake of fat and proteinwas higher in elder women than in all other groups. One third ofseniors took antihypertensive medications and 12% used lipidmodifying drugs.Conclusions: Different levels of prevention against CVDs andtheir risk factors shall be considered for various age groups ofpopulation. The findings of this study emphasize on the necessityof preventive measures against smoking and physical inactivity inyounger adults and dietary habits in seniors.

  7. Gene expression analysis of glioblastomas identifies the major molecular basis for the prognostic benefit of younger age

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    Farooqi Haumith K

    2008-10-01

    Full Text Available Abstract Background Glioblastomas are the most common primary brain tumour in adults. While the prognosis for patients is poor, gene expression profiling has detected signatures that can sub-classify GBMs relative to histopathology and clinical variables. One category of GBM defined by a gene expression signature is termed ProNeural (PN, and has substantially longer patient survival relative to other gene expression-based subtypes of GBMs. Age of onset is a major predictor of the length of patient survival where younger patients survive longer than older patients. The reason for this survival advantage has not been clear. Methods We collected 267 GBM CEL files and normalized them relative to other microarrays of the same Affymetrix platform. 377 probesets on U133A and U133 Plus 2.0 arrays were used in a gene voting strategy with 177 probesets of matching genes on older U95Av2 arrays. Kaplan-Meier curves and Cox proportional hazard analyses were applied in distinguishing survival differences between expression subtypes and age. Results This meta-analysis of published data in addition to new data confirms the existence of four distinct GBM expression-signatures. Further, patients with PN subtype GBMs had longer survival, as expected. However, the age of the patient at diagnosis is not predictive of survival time when controlled for the PN subtype. Conclusion The survival benefit of younger age is nullified when patients are stratified by gene expression group. Thus, the main cause of the age effect in GBMs is the more frequent occurrence of PN GBMs in younger patients relative to older patients.

  8. Does roflumilast induce phagocytic activity in COPD patients?

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    Ghosh B

    2015-09-01

    Full Text Available Baishakhi Ghosh,1,2 Nitin V Vanjare1 1Chest Research Foundation (CRF, Pune, Maharashtra, India; 2Faculty of Health and Biomedical Science (FOHBS, Symbiosis International University, Pune, Maharashtra, IndiaWe read the article by Porpodis et al1 with great interest. In this study, the authors have evaluated the effect of roflumilast on the phagocytic activity of systemic phagocytes in severe and very severe COPD patients by measuring the oxidative burst post-bacterial stimulation. The study group for this study involved 21 severe or very severe COPD patients who were administered roflumilast in addition to other COPD treatments such as long-acting beta-adrenoceptor agonists (LABA + inhaled corticosteroids (ICS + long-acting anti-muscarinic agent (LAMA or ICS + LABA.View original paper by Porpodis and colleagues.

  9. Serum amylase activity and renal amylase activity clearance in patients with severely impaired renal function and in patients treated with renal allotransplantation.

    Science.gov (United States)

    Pedersen, E B; Brock, A; Kornerup, H J

    1976-03-01

    Serum amylase activity was measured in 29 nondialysed patients with severe renal failure, in 24 uraemic patients treated with chronic haemodialysis, and in 29 patients treated with renal allotransplantation. Simultaneous measurement of renal amylase activity clearance (CAm) and creatinine clearance (CCr) was performed in 25 patients with severe renal failure and in 19 transplanted patients. Serum amylase activity was elevated in all three groups. CAm was significantly correlated to CCr both in the group with severe renal failure and in the transplanted group. Unlike in the group of transplanted patients, the ratio CAm/CCr was significantly increased in patients with severe impaired renal function. It is concluded that the elevation of serum amylase activity in patients with impaired renal function is primarily due to decreased glomerular filtration rate. The value of CAm/CCr for diagnosing acute pancreatitis is doubtful in patients with severe renal disease.

  10. Muscle activation patterns in patients with recurrent shoulder instability

    Science.gov (United States)

    Jaggi, Anju; Noorani, Ali; Malone, Alex; Cowan, Joseph; Lambert, Simon; Bayley, Ian

    2012-01-01

    Purpose: The aim of this study is to present muscle patterns observed with the direction of instability in a series of patients presenting with recurrent shoulder instability. Materials and Methods: A retrospective review was carried out on shoulder instability cases referred for fine wire dynamic electromyography (DEMG) studies at a specialist upper limb centre between 1981 and 2003. An experienced consultant clinical neurophysiologist performed dual needle insertion into four muscles (pectoralis major (PM), latissimus dorsi (LD), anterior deltoid (AD) and infraspinatus (IS)) in shoulders that were suspected to have increased or suppressed activation of muscles that could be contributing to the instability. Raw EMG signals were obtained while subjects performed simple uniplanar movements of the shoulder. The presence or absence of muscle activation was noted and compared to clinical diagnosis and direction of instability. Results: A total of 140 (26.6%) shoulders were referred for fine wire EMG, and 131 studies were completed. Of the shoulders tested, 122 shoulders (93%) were identified as having abnormal patterns and nine had normal patterns. PM was found to be more active in 60% of shoulders presenting with anterior instability. LD was found to be more active in 81% of shoulders with anterior instability and 80% with posterior instability. AD was found to be more active in 22% of shoulders with anterior instability and 18% with posterior instability. IS was found to be inappropriately inactive in only 3% of shoulders with anterior instability but in 25% with posterior instability. Clinical assessment identified 93% of cases suspected to have muscle patterning, but the specificity of the clinical assessment was only correct in 11% of cases. Conclusion: The DEMG results suggest that increased activation of LD may play a role in both anterior and posterior shoulder instability; increased activation of PM may play a role in anterior instability. PMID:23493512

  11. Dynamic hyperinflation during activities of daily living in COPD patients.

    Science.gov (United States)

    Silva, Cláudia S; Nogueira, Fabiana R; Porto, Elias F; Gazzotti, Mariana R; Nascimento, Oliver A; Camelier, Aquiles; Jardim, José R

    2015-08-01

    The objective of this study was to investigate whether some activities of daily living (ADLs) usually related to dyspnea sensation in patients with chronic obstructive pulmonary disease (COPD) are associated with dynamic lung hyperinflation (DH) and whether the use of simple energy conservation techniques (ECTs) might reduce this possible hyperinflation. Eighteen patients (mean age: 65.8 ± 9.8 years) with moderate-to-severe COPD performed six ADLs (walking on a treadmill, storing pots, walking 56 meters carrying a 5-kilogram weight, climbing stairs, simulating taking a shower, and putting on shoes) and had their inspiratory capacity (IC) measured before and after each task. The patients were moderately obstructed with forced expiratory volume in 1 second (FEV1): 1.4 ± 0.4 L (50% ± 12.4); FEV1/forced vital capacity: 0.4 ± 8.1; residual volume/total lung capacity: 52.7 ± 10.2, and a reduction in IC was seen after all six activities (p < 0.05): (1) going upstairs, 170 mL; (2) walking 56 meters carrying 5 kilogram weight, 150 mL; (3) walking on a treadmill without and with ECT, respectively, 230 mL and 235 mL; (4) storing pots without and with ECT, respectively, 170 mL and 128 mL; (5) taking a shower without and with ECT, respectively, 172 mL and 118 mL; and (6) putting on shoes without and with ECT, respectively, 210 mL and 78 mL). Patients with moderate to severe COPD develop DH after performing common ADLs involving the upper and lower limbs. Simple ECTs may avoid DH in some of these ADLs.

  12. The presence of primary circulating prostate cells is associated with upgrading and upstaging in patients eligible for active surveillance

    Science.gov (United States)

    Murray, Nigel P; Reyes, Eduardo; Fuentealba, Cynthia; Aedo, Socrates; Jacob, Omar

    2017-01-01

    Active surveillance (AS) is a considered treatment option for men with low or very low-risk prostate cancer. However, on repeat biopsy some 25% were upgraded and recommended for active treatment. We compare the presence or absence of primary circulating prostate cells (CPCs) with the clinical pathological findings after radical prostatectomy in men fulfilling the criteria for active surveillance and the risk of reclassification for active observation (AO). Methods and patients A single centre observational study was done involving 102 men who fulfilled the Epstein criteria for AS and underwent radical prostatectomy as mono-therapy for prostate cancer. The patients were classified according to the presence or absence of CPCs detected immediately before the prostate biopsy. Mononuclear cells were obtained by differential gel centrifugation of 8 mL of venous blood and CPCs identified using immunocytochemistry with anti-PSA and anti-P504S. A positive CPC test was defined as at least 1 PSA (+), P504S (+) cell detected/blood sample. The surgical specimen was analysed for Gleason score and pathological stage. Results A total of 25 out of 102 (24.5%) men were upgraded based on the pathological findings of the surgical specimen. Among which 45 (44%) men were positive for CPCs. They were younger, 63.9 versus 68.1 years (p = 0.0148), had a lower frequency of pT2 or lower disease (64.4% versus 91.2% p <0.001), higher median Gleason scores (6 versus 5 p < 0.001) in both the biopsy and surgical specimens, and a higher frequency of upgrading 44% versus 9% (p < 0.001) Conclusions In men fulfilling the criteria for AS, the presence of primary CPCs suggests a high risk for disease upgrade and therefore these men may not be ideal for observational therapy. Further studies with a larger population are warranted. PMID:28144285

  13. Younger and Older Users’ Recognition of Virtual Agent Facial Expressions

    Science.gov (United States)

    Beer, Jenay M.; Smarr, Cory-Ann; Fisk, Arthur D.; Rogers, Wendy A.

    2015-01-01

    As technology advances, robots and virtual agents will be introduced into the home and healthcare settings to assist individuals, both young and old, with everyday living tasks. Understanding how users recognize an agent’s social cues is therefore imperative, especially in social interactions. Facial expression, in particular, is one of the most common non-verbal cues used to display and communicate emotion in on-screen agents (Cassell, Sullivan, Prevost, & Churchill, 2000). Age is important to consider because age-related differences in emotion recognition of human facial expression have been supported (Ruffman et al., 2008), with older adults showing a deficit for recognition of negative facial expressions. Previous work has shown that younger adults can effectively recognize facial emotions displayed by agents (Bartneck & Reichenbach, 2005; Courgeon et al. 2009; 2011; Breazeal, 2003); however, little research has compared in-depth younger and older adults’ ability to label a virtual agent’s facial emotions, an import consideration because social agents will be required to interact with users of varying ages. If such age-related differences exist for recognition of virtual agent facial expressions, we aim to understand if those age-related differences are influenced by the intensity of the emotion, dynamic formation of emotion (i.e., a neutral expression developing into an expression of emotion through motion), or the type of virtual character differing by human-likeness. Study 1 investigated the relationship between age-related differences, the implication of dynamic formation of emotion, and the role of emotion intensity in emotion recognition of the facial expressions of a virtual agent (iCat). Study 2 examined age-related differences in recognition expressed by three types of virtual characters differing by human-likeness (non-humanoid iCat, synthetic human, and human). Study 2 also investigated the role of configural and featural processing as a

  14. Therapeutic options for patients returning to sexual activity.

    Science.gov (United States)

    Nusbaum, Margaret R H

    2004-03-01

    No head-to-head studies have been conducted with the phosphodiesterase type 5 (PDE5) inhibitors to date. Results of noncomparative studies, however, suggest that tadalafil and vardenafil hydrochloride are at least as effective as sildenafil citrate in improving erections and increasing the number of successful intercourse attempts in men with erectile dysfunction (ED) at all levels of severity. By facilitating a sexual response, PDE5 inhibitors lend naturalness to sexual activity and may permit couples to return to their previous sexual lifestyle. By providing a broader window of opportunity, a longer-acting PDE5 inhibitor such as tadalafil adds to the variety of options currently available in managing ED with PDE5 inhibitors. This option offers increased flexibility by minimizing the need to plan sexual activity; allowing more time for intimacy or romance before sexual intercourse; and reducing the pressure on the patient to perform.

  15. Characteristics of treatment naive chronic hepatitis B in Bangladesh: Younger populations are more affected; HBeAg-negatives are more advanced

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    Alam Shahinul

    2008-01-01

    Full Text Available Background/Aim: Bangladesh is a densely populated country with intermediate endemicity for chronic hepatitis B (CHB. The aim of the present study was to evaluate the biochemical, virological and histological character of CHB patients and to examine the relationship between these indices. Materials and Methods: One thousand and twenty-two patients of CHB fulfilled our inclusion criteria. Inclusion criteria were (1 HBsAg positive for at least 6 months, (2 HBeAg-positive or negative and (3 hepatitis B virus (HBV DNA positive. Patients with detectable antibodies to human immunodeficiency virus (HIV, hepatitis Delta virus (HDV or hepatitis C virus (HCV, with previous antiviral treatment, overt cirrhosis and hepatocellular carcinoma, were excluded. Of these, 191 patients were randomly selected for liver biopsy and were evaluated for analysis. Results: In the 191 patients, male to female ratio was 4.6:1; age distribution was 26.5 ± 8.5 (mean ± standard deviation years. One hundred and seventy-eight (93.2% patients were under 40 years. Sixty-eight (35.6% patients were HBeAg-negative, had less DNA load, and were significantly older, more fibrotic and cirrhotic ( P < 0.001. Correlation was not found between DNA level and histological activity. Histological activity was not correlated with ALT level in HBeAg-positive patients ( P < 0.001. Conclusion: CHB affects the younger population in Bangladesh. HBeAg-positive CHB was associated with more fibrosis and cirrhosis. Serum HBV DNA levels do not correlate with the severity of histological lesions in all patients. Evaluation by liver biopsy remains gold standard for taking decision of treatment.

  16. Body Image in Adult Women: Moving Beyond the Younger Years

    Science.gov (United States)

    Kilpela, Lisa Smith; Becker, Carolyn Black; Wesley, Nicole; Stewart, Tiffany

    2015-01-01

    In spite of copious literature investigating body dissatisfaction and its correlates in adolescents and young adult women, exploration of body image disturbances in adult women remains an underrepresented domain in the literature. Yet, there are many reasons to suspect that body image in adult women both may differ from and possibly be more complex than that of younger women. Adult women face myriad factors influencing body image beyond those delineated in the body image literature on adolescents and young adult women. For instance, aging-related physiological changes shift the female body further away from the thin-young-ideal, which is the societal standard of female beauty. Further, life priorities and psychological factors evolve with age as well. As such, adult women encounter changes that may differentially affect body image across the lifespan. This paper aims to provide an up-to-date review of the current literature on the relationship between body image and associated mental and physical health problems and behaviors in adult women. In addition, we explore factors that may influence body image in adult women. Lastly, we use this review to identify significant gaps in the existing literature with the aim of identifying critical targets for future research. PMID:26052476

  17. The Younger Dryas in the West Pacific marginal seas

    Institute of Scientific and Technical Information of China (English)

    汪品先; 卞云华; 李保华; 黄奇瑜

    1996-01-01

    The occurrence and nature of the Younger Dryas (YD) abrupt climatic event in the West Pacific marginal seas are discussed on the basis of 15 sediment cores. This event has been found in all these cores studied with a high-resolution stratigraphy and proved to be common to the West Pacific region. As shown by the isotopic and micropaleontologic analyses, the YD, dated by C-14 at about 11000 to 10000 a B.P., is a brief event of sea surface cooling in winter season following a fresh-water pulse about 12000 a B.P. The "apparent regression" of the YD recorded in the Changjiang River delta and the Sea of Japan agrees with the interpretation that the YD is a period of slowed sea level rising between two phases of rapid rising. Both the winter surface water cooling and the increasing salinity in the YD imply a strengthening of the winter, but not summer monsoon circulation. This major climatic event in the marginal seas must have had profound impact on the adjacent continent.

  18. Body Image in Adult Women: Moving Beyond the Younger Years.

    Science.gov (United States)

    Kilpela, Lisa Smith; Becker, Carolyn Black; Wesley, Nicole; Stewart, Tiffany

    2015-07-01

    In spite of copious literature investigating body dissatisfaction and its correlates in adolescents and young adult women, exploration of body image disturbances in adult women remains an underrepresented domain in the literature. Yet, there are many reasons to suspect that body image in adult women both may differ from and possibly be more complex than that of younger women. Adult women face myriad factors influencing body image beyond those delineated in the body image literature on adolescents and young adult women. For instance, aging-related physiological changes shift the female body further away from the thin-young-ideal, which is the societal standard of female beauty. Further, life priorities and psychological factors evolve with age as well. As such, adult women encounter changes that may differentially affect body image across the lifespan. This paper aims to provide an up-to-date review of the current literature on the relationship between body image and associated mental and physical health problems and behaviors in adult women. In addition, we explore factors that may influence body image in adult women. Lastly, we use this review to identify significant gaps in the existing literature with the aim of identifying critical targets for future research.

  19. Hiding its age: the case for a younger bulge

    CERN Document Server

    Haywood, M; Snaith, O; Calamida, A

    2016-01-01

    The determination of the age of the bulge has led to two contradictory results. On the one side, the color-magnitude diagrams in different bulge fields seem to indicate a uniformly old ($>$10 Gyr) population. On the other side, individual ages derived from dwarfs observed through microlensing events seem to indicate a large spread, from $\\sim$ 2 to $\\sim$ 13 Gyr. Because the bulge is now recognised as being mainly a boxy peanut-shaped bar, it is suggested that disk stars are one of its main constituents, and therefore also stars with ages significantly younger than 10 Gyr. Other arguments as well point to the fact that the bulge cannot be exclusively old, and in particular cannot be a burst population, as it is usually expected if the bulge was the fossil remnant of a merger phase in the early Galaxy. In the present study, we show that given the range of metallicities observed in the bulge, a uniformly old population would be reflected into a significant spread in color at the turn-off which is not observed. ...

  20. Paleoproductivity during the Younger Dryas off northeastern Luzon, Philippines

    Science.gov (United States)

    Quevedo, J. M. D.; Siringan, F. P.; Villanoy, C.

    2014-12-01

    The influence of the Younger Dryas (YD) event on primary production off the northeast shelf of Luzon, Philippines is examined using sediment cores from two deep sea sites north of the Bicol shelf and with varying relative influence from terrestrial sediment input and the Kuroshio Current. Core A is immediately west of the Kuroshio feeder current and is off the slope while Core B is from a bathymetric high located almost west of Core A. XRF-, CHN- and LOI-derived geochemical proxies are utilized for reconstruction. A decrease in sediment input from ~12.9 to ~11.6 kyr BP corresponding to the YD event is indicated by the proxies, Ti, Al, and Al/Ti, in both cores. This is consistent with the drier climate during this period. Primary productivity indicators in the cores show opposing trends during the YD; Core A shows an increasing trend while Core B shows a decreasing trend. The decreasing trend in Core B can be due to a decrease in terrestrial nutrient input due to a decrease in precipitation. On the other hand, the increasing trend in Core A can be due to a swifter Kuroshio Current caused by a swifter and more southerly NEC bifurcation which in turn is due to a southerly shift of the ITCZ during YD. A swifter Kuroshio would have enhanced upwelling induced by steeper sea surface across the current and by more intense cyclonic gyres due to flow separation where the shelf width suddenly decreases north of the Bicol Shelf.

  1. Dynamic drawing characteristics of preschool and younger school age children

    Directory of Open Access Journals (Sweden)

    Cvetković Andrijana

    2014-01-01

    Full Text Available The main objective of this research is to determine developmental characteristics of dynamic drawings of preschool and younger school age children. The sample consists of 90 typical developed children, aged between 6 and 9. The sample includes 47 (52.2% girls and 43 (47.8% boys from preschool institutions and elementary schools in Pirot and Belgrade. Action representation in dynamic drawings was evaluated using three types of drawings: a man who runs, a man shooting a ball and a man lifting a ball from the floor. We determined that a very small number of the respondents reaches the highest level of graphical representation of figures in motion, and that girl’s achievements are better than boy’s achievements. However, this result is on the border of statistical significance (p=0.052. Also, there is a statistically significant trend of progress to higher levels of action representation (p=0.000 with the increase in chronological age of the respondents.

  2. [Spontaneous activity of cutaneous nociceptors in patients with painful polyneuropathy. Report of three patients].

    Science.gov (United States)

    Campero, Mario; Campero, Sebastián

    2012-11-01

    Painful polyneuropathy may result from selective impairment of small diameter nerve fibers, while tactile and motor functions are preserved. In these patients clinical and electrophysiological assessment is usually unrevealing. We report three patients with a pure painful polyneuropathy. One of them had neurogenic pruritus additionally. Quantitative sensory analysis disclosed a slight warm hypoesthesia (3/3) and paradoxical hot sensation (2/3) in the feet. Intraneural recordings from the peroneal nerve demonstrated abnormal spontaneous activity in 8 of 17 nociceptive afferents. One of them displayed double firing reflecting impulse multiplication. These results support the notion that patients with pain or pruritus with a distal distribution similar to a polyneuropathy, could have small diameter afferent fiber damage, despite normal function of large diameter fibers.

  3. "Feeling younger, walking faster": subjective age and walking speed in older adults.

    Science.gov (United States)

    Stephan, Yannick; Sutin, Angelina R; Terracciano, Antonio

    2015-10-01

    Walking speed is a key vital sign in older people. Given the implications of slower gait speed, a large literature has identified health-related, behavioral, cognitive, and biological factors that moderate age-related decline in mobility. The present study aims to contribute to existing knowledge by examining whether subjective age, how old or young individuals experience themselves to be relative to their chronological age, contributes to walking speed. Participants were drawn from the 2008 and 2012 waves of the Health and Retirement Study (HRS, N = 2970) and the 2011 and 2013 waves of the National Health and Aging Trends Study (NHATS, N = 5423). In both the HRS and the NHATS, linear regression analysis revealed that a younger subjective age was associated with faster walking speed at baseline and with less decline over time, controlling for age, sex, education, and race. These associations were partly accounted for by depressive symptoms, disease burden, physical activity, cognition, body mass index, and smoking. Additional analysis revealed that feeling younger than one's age was associated with a reduced risk of walking slower than the frailty-related threshold of 0.6 m/s at follow-up in the HRS. The present study provides novel and consistent evidence across two large prospective studies for an association between the subjective experience of age and walking speed of older adults. Subjective age may help identify individuals at risk for mobility limitations in old age and may be a target for interventions designed to mitigate functional decline.

  4. The Difference between Right and Wrong: Accuracy of Older and Younger Adults’ Story Recall

    Directory of Open Access Journals (Sweden)

    Danielle K. Davis

    2015-09-01

    Full Text Available Sharing stories is an important social activity in everyday life. This study used fine-grained content analysis to investigate the accuracy of recall of two central story elements: the gist and detail of socially-relevant stories. Younger (M age = 28.06 and older (M age = 75.03 American men and women (N = 63 recalled fictional stories that were coded for (i accuracy of overall gist and specific gist categories and (ii accuracy of overall detail and specific detail categories. Findings showed no age group differences in accuracy of overall gist or detail, but differences emerged for specific categories. Older adults more accurately recalled the gist of when the event occurred whereas younger adults more accurately recalled the gist of why the event occurred. These differences were related to episodic memory ability and education. For accuracy in recalling details, there were some age differences, but gender differences were more robust. Overall, women remembered details of these social stories more accurately than men, particularly time and perceptual details. Women were also more likely to accurately remember the gist of when the event occurred. The discussion focuses on how accurate recall of socially-relevant stories is not clearly age-dependent but is related to person characteristics such as gender and episodic memory ability/education.

  5. Exercise holds immediate benefits for affect and cognition in younger and older adults.

    Science.gov (United States)

    Hogan, Candice L; Mata, Jutta; Carstensen, Laura L

    2013-06-01

    Physical activity is associated with improved affective experience and enhanced cognitive processing. Potential age differences in the degree of benefit, however, are poorly understood because most studies examine either younger or older adults. The present study examined age differences in cognitive performance and affective experience immediately following a single bout of moderate exercise. Participants (144 community members aged 19 to 93) were randomly assigned to one of two experimental conditions: (a) exercise (15 min of moderate intensity stationary cycling) or (b) control (15 min completing ratings of neutral IAPS images). Before and after the manipulation, participants completed tests of working memory and momentary affect experience was measured. Results suggest that exercise is associated with increased levels of high-arousal positive affect (HAP) and decreased levels of low-arousal positive affect (LAP) relative to control condition. Age moderated the effects of exercise on LAP, such that younger age was associated with a drop in reported LAP postexercise, whereas the effects of exercise on HAP were consistent across age. Exercise also led to faster RTs on a working memory task than the control condition across age. Self-reported negative affect was unchanged. Overall, findings suggest that exercise may hold important benefits for both affective experience and cognitive performance regardless of age.

  6. Relationship between balance and physical activity measured by an activity monitor in elderly COPD patients

    Science.gov (United States)

    Iwakura, Masahiro; Okura, Kazuki; Shibata, Kazuyuki; Kawagoshi, Atsuyoshi; Sugawara, Keiyu; Takahashi, Hitomi; Shioya, Takanobu

    2016-01-01

    Background Little is known regarding the relationship between balance impairments and physical activity in COPD. There has been no study investigating the relationship between balance and objectively measured physical activity. Here we investigated the association between balance and physical activity measured by an activity monitor in elderly COPD patients. Materials and methods Twenty-two outpatients with COPD (mean age, 72±7 years; forced expiratory volume in 1 second, 53%±21% predicted) and 13 age-matched healthy control subjects (mean age, 72±6 years) participated in the study. We assessed all 35 subjects’ balance (one-leg standing test [OLST] times, Short Physical Performance Battery total scores, standing balance test scores, 4 m gait speed, and five-times sit-to-stand test [5STST]) and physical activity (daily steps and time spent in moderate-to-vigorous physical activity per day [MV-PA]). Possible confounders were assessed in the COPD group. The between-group differences in balance test scores and physical activity were analyzed. A correlation analysis and multivariate regression analysis were conducted in the COPD group. Results The COPD patients exhibited significant reductions in OLST times (P=0.033), Short Physical Performance Battery scores (P=0.013), 4 m gait speed (P<0.001), five-times sit-to-stand times (P=0.002), daily steps (P=0.003), and MV-PA (P=0.022) compared to the controls; the exception was the standing balance test scores. The correlation and multivariate regression analyses revealed significant independent associations between OLST times and daily steps (P<0.001) and between OLST times and MV-PA (P=0.014) in the COPD group after adjusting for possible confounding factors. Conclusion Impairments in balance and reductions in physical activity were observed in the COPD group. Deficits in balance are independently associated with physical inactivity. PMID:27445470

  7. Patient reported activities after reverse total shoulder arthroplasty in rotator cuff arthropathy patients.

    Science.gov (United States)

    Alcobía-Díaz, B; Lópiz, Y; García-Fernández, C; Rizo de Álvaro, B; Marco, F

    Reverse total shoulder arthroplasty in rotator cuff arthropathy patients, improves anteversion and abduction, but not rotational, outcomes. The main aim of this study is to determine its repercussions on daily life activities in our patients. Between 2009 and 2011 we implanted 210 shoulder arthroplasties, 126 of them were reverse total shoulder arthroplasty in a rotator cuff arthropathy context. About 88% were women, with a mean age at time of surgery of 81 years, 95% were retired. The mean follow up was 53 months. The Constant scale, Visual Analogue Scale, Charlson Comorbidity Index, range of motion were measured for each patient and whether they could manage 40 daily life activities by means of a new questionnaire, classifying them according toshoulder functional demand. Mean normalized by sex and age Constant value was 81.2%. Mean Visual Analogue Scale and Charlson Index were 3.56 and 1.69 respectively. Improvement in anteversion and abduction, not in rotational range of motion. Limitation was found in low and high functional demand activities in 20% and 51% respectively, especially those which involved internal rotation. Reverse total shoulder arthroplasty treatment for RCA in the elderly, achieves adequate pain management and good functional outcomes. Nevertheless, an important risk of DLA limitation must be accepted in those which involve internal rotation or shoulder high functional demand. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. [Hip arthroscopy in males younger than 40 with femoroacetabular impingement: short-term outcomes].

    Science.gov (United States)

    Más Martínez, J; Morales-Santías, M; Bustamante Suarez Suarez de Puga, D; Sanz-Reig, J

    2014-01-01

    Femoroacetabular impingement is probably the most common mechanism that leads to the development of early cartilage and labral damage in the non-dysplastic hip. The objective was to evaluate the outcomes of hip arthroscopy as a treatment for femoroacetabular impingement in patients with high level of function. A prospective study was performed on 41 patients younger than 40 years old undergoing hip arthroscopy for femoroacetabular impingement. Modified Harris Hip Score and HOS and IHOT questionnaires were used for clinical assessment. Radiological evaluation was made for joint space and alpha angle. The mean age of patients was 32.7 years. Labrum injury was detected in 78%, and acetabular cartilage injury in 56% of cases. The average follow-up was 31.3 months. There was a significantly improvement in the mean score in the clinical questionnaires. Radiologically there was no change in the mean joint space, with significantly reduction to normal values of the alpha angle. All patients returned to sports at their pre-injury level of function. Hip arthroscopy resulted in improvement in hip functional outcomes with correction of the underlying osseous deformity and treatment of the associated labral and cartilage pathology, with the return of patients to their pre-injury sports. Further follow-up is essential to confirm the stability of the clinical and radiological outcomes. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  9. Increased Incidence of Interatrial Block in Younger Adults with Cryptogenic Stroke and Patent Foramen Ovale

    Directory of Open Access Journals (Sweden)

    P.E. Cotter

    2011-04-01

    Full Text Available Background: Stroke is often unexplained in younger adults, although it is often associated with a patent foramen ovale (PFO. The reason for the association is not fully explained, and mechanisms other than paradoxical embolism may be involved. Young stroke patients with PFO have more atrial vulnerability than those without PFO. It is plausible that stretching of the interatrial septum may disrupt the interatrial conduction pathways causing interatrial block (IAB. IAB is associated with atrial fibrillation, dysfunctional left atria and stroke. Methods: Electrocardiogram (ECG characteristics of prospectively recruited young patients (≤55 years of age with unexplained stroke (TOAST and A-S-C-O were compared with control data. All stroke cases underwent bubble contrast transthoracic and transoesophageal echography. IAB was defined as a P-wave duration of ≧110 ms. ECG data were converted to electronic format and analysed in a blind manner. Results: Fifty-five patients and 23 datasets were analysed. Patients with unexplained stroke had longer P-wave duration (p = 0.013 and a greater prevalence of IAB (p = 0.02 than healthy controls. Case status was an independent predictor of P-wave duration in a significant multivariate model. There was a significant increase in the proportion of cases with a PFO with IAB compared with cases without PFO and with controls (p = 0.005. Conclusions: Young patients with unexplained stroke, particularly those with PFO, exhibit abnormal atrial electrical characteristics suggesting atrial arrhythmia or atrial dysfunction as a possible mechanism of stroke.

  10. Complement factor B activation in patients with preeclampsia.

    Science.gov (United States)

    Velickovic, Ivan; Dalloul, Mudar; Wong, Karen A; Bakare, Olufunke; Schweis, Franz; Garala, Maya; Alam, Amit; Medranda, Giorgio; Lekovic, Jovana; Shuaib, Waqas; Tedjasukmana, Andreas; Little, Perry; Hanono, Daniel; Wijetilaka, Ruvini; Weedon, Jeremy; Lin, Jun; Toledano, Roulhac d'Arby; Zhang, Ming

    2015-06-01

    Preeclampsia is a leading cause of maternal and fetal morbidity and mortality. Bb, the active fragment of complement factor B (fB), has been reported to be a predictor of preeclampsia. However, conflicting results have been found by some investigators. We hypothesized that the disagreement in findings may be due to the racial/ethnic differences among various study groups, and that fB activation is significant in women of an ethnic minority with preeclampsia. We investigated the maternal and fetal levels of Bb (the activated fB fragment) in pregnant women of an ethnic minority with or without preeclampsia. We enrolled 291 pregnant women (96% of an ethnic minority, including 78% African-American). Thirteen percent of these were diagnosed with preeclampsia. Maternal venous blood was collected from all participants together with fetal umbilical cord blood samples from 154 deliveries in the 291 women. The results were analyzed using the Mann-Whitney U test and multivariate analyses. Maternal Bb levels were significantly higher in the preeclamptic group than in the nonpreeclamptic group. Levels of Bb in fetal cord blood were similar in both groups. Subgroup analyses of African-American patients' results confirmed the study hypothesis that there would be a significant increase in Bb in the maternal blood of the preeclamptic group and no increase in Bb in the fetal cord blood of this group. These results suggest that a maternal immune response through complement fB might play a role in the development of preeclampsia, particularly in African-American patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. 78 FR 53195 - Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request

    Science.gov (United States)

    2013-08-28

    ... AFFAIRS Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request... patient satisfaction with VA's dental services. DATES: Written comments and recommendations on the... refer to ``OMB Control No. 2900-0764 (Dental Patient Satisfaction Survey)'' in any...

  12. Differences in physical functioning between relatively active and passive patients with Chronic Fatigue Syndrome.

    NARCIS (Netherlands)

    Vos-Vromans, D.C.; Huijnen, I.P.; Koke, A.J.; Seelen, H.A.; Knottnerus, J.A.; Smeets, R.J.P.

    2013-01-01

    OBJECTIVE: According to the Cognitive behavioral therapy (CBT) protocol for patients with Chronic Fatigue Syndrome (CFS), therapists are advised to categorize patients in relatively active and passive patients. However, evidence to support the differences in physical functioning between these subgro

  13. Do older adults with chronic low back pain differ from younger adults in regards to baseline characteristics and prognosis?

    Science.gov (United States)

    Manogharan, S; Kongsted, A; Ferreira, M L; Hancock, M J

    2017-05-01

    Low back pain (LBP) in older adults is poorly understood because the vast majority of the LBP research has focused on the working aged population. The aim of this study was to compare older adults consulting with chronic LBP to middle aged and young adults consulting with chronic LBP, in terms of their baseline characteristics, and pain and disability outcomes over 1 year. Data were systematically collected as part of routine care in a secondary care spine clinic. At initial presentation patients answered a self-report questionnaire and underwent a physical examination. Patients older than 65 were classified as older adults and compared to middle aged (45-65 years old) and younger adults (17-44 years old) for 10 baseline characteristics. Pain intensity and disability were collected at 6 and 12 month follow-ups and compared between age groups. A total of 14,479 participants were included in the study. Of these 3087 (21%) patients were older adults, 6071 (42%) were middle aged and 5321 (37%) were young adults. At presentation older adults were statistically different to the middle aged and younger adults for most characteristics measured (e.g. less intense back pain, more leg pain and more depression); however, the differences were small. The change in pain and disability over 12 months did not differ between age groups. This study found small baseline differences in older people with chronic LBP compared to middle aged and younger adults. There were no associations between age groups and the clinical course. Small baseline differences exist in older people with chronic low back pain compared to middle aged and younger adults referred to secondary care for chronic low back pain. Older adults present with slightly less intense low back pain but slightly more intense leg pain. Changes in pain intensity and disability over a 12 month period were similar across all age groups. © 2017 European Pain Federation - EFIC®.

  14. Heinrich 0 at the Younger Dryas Termination Offshore Newfoundland

    Science.gov (United States)

    Pearce, C.; Andrews, J. T.; Jennings, A. E.; Bouloubassi, I.; Seidenkrantz, M. S.; Kuijpers, A.; Hillaire-Marcel, C.

    2014-12-01

    The last deglaciation was marked by intervals of rapid climatic fluctuations accompanied by glacial advances and retreats along the eastern edge of the Laurentide ice sheet. The most severe of these events, the Younger Dryas cold reversal, was accompanied by the major detrital carbonate (DC) event generally referred to as "Heinrich event 0" (H0) in the westernmost and southern Labrador Sea. A detrital carbonate layer was observed in a high resolution marine sediment record from southern Newfoundland and the onset of the event was dated to 11,600 ± 70 cal. yrs. BP (local ΔR = 140 yrs.). A variety of different proxies was applied to investigate the transport mechanisms for deposition of the layer and provenance of the carbonates. Elevated concentrations of dolomite and calcite based on quantitative X-ray diffraction measurements, combined with the presence of several mature petrogenic biomarkers limit the source of the H0 detrital input to Palaeozoic carbonate outcrops in north-eastern Canada. The event is attributed to the rapid ice retreat from the Hudson Strait directly following the warming at the onset of the Holocene. Based on additional proxy data published earlier from the same record, the event succeeded the early Holocene resumption of the Atlantic Meridional Overturning Circulation (AMOC), indicating that the Hudson Strait meltwater event had probably no significant impact on the AMOC. The detrital carbonate layer can be found in other marine sediment records along the Labrador Current pathway, from Hudson Strait to the Grand Banks and the southern Newfoundland slope. By using the onset of deposition of the carbonates as a time-synchronous marker, the DC layer has great potential for improving marine chronologies of late glacial age in the region and evaluating spatial variations in ΔR values.

  15. Factors associated with younger adolescents' exposure to online alcohol advertising.

    Science.gov (United States)

    D'Amico, Elizabeth J; Martino, Steven C; Collins, Rebecca L; Shadel, William G; Tolpadi, Anagha; Kovalchik, Stephanie; Becker, Kirsten M

    2017-03-01

    Little is known about the extent and nature of youth exposure to online alcohol advertising, or factors that may be associated with exposure. The current study recruited middle school students who completed a paper survey and then logged each alcohol advertisement that they encountered over a 2-week period using cell phones as part of an ecological momentary assessment design. We examined the percentage of youth who reported exposure to online alcohol advertising in the past 2 weeks, average weekly rate of exposure, types of online alcohol advertisements youth reported seeing, and factors that increased youths' risk of exposure to online alcohol advertising. Analyses are based on 485 participants (47% female; 25% Hispanic, 25% White, 27% Black; 6% Asian, 16% other). Youth logged exposures to a total of 3,966 (16,018 weighted for underreporting) alcohol advertisements across the monitoring period; 154 (568 weighted) or 3.6% were online ads. Seventeen percent of youth reported seeing any online alcohol ad; the majority of online ads seen were video commercials (44.8%) and banner/side ads (26.6%). Factors associated with greater ad exposure were being older, rebellious, and Black race; greater parental monitoring and more hours spent on social media were associated with less exposure. Findings provide important information about adolescents' exposure to online alcohol advertising and what might contribute to a greater likelihood of exposure. Given that online ad exposure is linked to drinking behavior, prevention programming for younger adolescents should continue to address this issue to help youth make healthy choices regarding alcohol use. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. Global strategy for the diagnosis and management of asthma in children 5 years and younger.

    Science.gov (United States)

    Pedersen, Soren Erik; Hurd, Suzanne S; Lemanske, Robert F; Becker, Allan; Zar, Heather J; Sly, Peter D; Soto-Quiroz, Manuel; Wong, Gary; Bateman, Eric D

    2011-01-01

    Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalisation. During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non-specific. Furthermore, neither airflow limitation nor airway inflammation, the main pathologic hallmarks of the condition, can be assessed routinely in this age group. For this reason, to aid in the diagnosis of asthma in young children, a symptoms-only descriptive approach that includes the definition of various wheezing phenotypes has been recommended. In 1993, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care. Since then, GINA has developed and regularly revised a Global Strategy for Asthma Management and Prevention. Publications based on the Global Strategy for Asthma Management and Prevention have been translated into many different languages to promote international collaboration and dissemination of information. In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in

  17. P04.24MUTATIONS OF THE TERT PROMOTER CORRELATE WITH ENHANCED TELOMERASE ACTIVATION AND PREDICT A WORSE PROGNOSIS IN PRIMARY GLIOBLASTOMA PATIENTS

    Science.gov (United States)

    Spiegl-Kreinecker, S.; Loetsch, D.; Laaber, M.; Pichler, J.; Weis, S.; Ghanim, B.; Webersinke, G.; Olschowski, A.; Berger, W.

    2014-01-01

    The stabilization of telomeres by upregulation of telomerase is compulsive for indefinite proliferation and cell immortalization therefore representing a main feature of malignant solid tumors, including gliomas. However, the mechanisms responsible for cancer-associated telomerase activation are not completely understood. Recently, defined mutations in the TERT promoter were identified in a variety of tumors, most frequent in primary glioblastomas (GBM). Presence of the mutations was associated with increased TERT expression. In the present study GBM derived tumor tissue from 126 patients operated at the Wagner Jauregg Hospital were screened for TERT promoter mutations. Subsequently the collected data were correlated with telomere associated parameters (telomerase activity, TERT mRNA expression, telomere lengths), the glioma biomarkers MGMT promoter methylation and IDH1 mutation as well as clinical parameters including patient survival. Using direct sequencing, the TERT promoter mutations (C228T, C250T) were found in 73% of tumors with predominance of C228T (72% of the mutated cases). Thirty-four (27%) samples contained none of the investigated TERT promoter mutations while mutations at both sites occurred in none of the investigated GBM cases. TERT promoter mutations were accompanied by a significant upregulation of telomerase activity (p = 0.0005) and TERT mRNA expression (p = 0.0004). Accordingly, telomere lengths of TERT promoter mutated tumors were significantly shorter compared to the TERT promoter wild-type subgroup (p = 0.001). Moreover, Kaplan-Meier survival analyses revealed a significantly shorter overall survival for GBM patients harbouring mutant tumors (p < 0.0001). In the multivariate Cox regression analysis TERT promoter mutation was found to have independent prognostic power (p = 0.049) but reached elevated significance in the interaction with age (p = 0.007). Accordingly, the prognostic quality of TERT promoter mutations was confined to the

  18. ANTIMYCOTIC ACTIVITY OF ACTIVATED ZINC PYRITHIONE IN RELATION TO MALASSEZIA IN PATIENTS WITH ATOPIC DERMATITIS

    Directory of Open Access Journals (Sweden)

    E.V. Golysheva

    2010-01-01

    Full Text Available The article illustrates the results of a study whose purpose was to determine the antimycotic action of activated zinc pyrithione (AZP against Malassezia in patients with atopic dermatitis (AD. 30 patients diagnosed with AD and aged 3 to 18 years were studied. A mycological study that aimed to identify Malassezia was done by the scraping method and skin surface collection using a cotton ball on a 1 cm2 area, with further yeast maintenance procedure in a selective environment. The activated zinc pyrithione in the form of cream was applied on children’s skin of the left shoulder and forearm twice a day. Nothing but a moisturizing cream was applied to the skin on the right shoulder and forearm. The samples for mycobiota were taken on both sides three times: before AZP treatment, 1 and 2 weeks after treatment. As a result of treatment, a two-fold reduction in skin colonization with Malassezia just in a week’s time (up to 102–105 КОЕ/cm2. The significant dynamics was observed in the modification of species diversity which got more sparse in skin areas where activated zinc pyrithione cream was applied. The follow-up results confirm that AZP has a moderate antimycotic effect. Key words: atopic dermatitis, treatment, activated zinc pyrithione, antimycotic action, children. (Pediatric Pharmacology. – 2010; 7(6:58-62

  19. Invasive pneumococcal disease in children aged younger than 5 years in India: a surveillance study.

    Science.gov (United States)

    Manoharan, Anand; Manchanda, Vikas; Balasubramanian, Sundaram; Lalwani, Sanjay; Modak, Meera; Bai, Sushama; Vijayan, Ajith; Shet, Anita; Nagaraj, Savitha; Karande, Sunil; Nataraj, Gita; Yewale, Vijay N; Joshi, Shrikrishna A; Iyer, Ranganathan N; Santosham, Mathuram; Kahn, Geoffrey D; Knoll, Maria Deloria

    2017-03-01

    Invasive pneumococcal disease continues to be a major cause of morbidity and mortality among children younger than 5 years of age in India. We aimed to provide nationally representative data for the pattern of disease due to Streptococcus pneumoniae, trends in the serotype of invasive pneumococci, and invasive pneumococci antimicrobial resistance patterns, in India. In this prospective hospital-based and retrospective laboratory-based surveillance study, we prospectively enrolled children aged younger than 5 years with suspected or proven invasive pneumococcal disease from 18 hospitals or institutional centres and retrospectively included laboratory-confirmed pneumococcal isolates from ten sentinel laboratories, together representing 11 states in India. Eligibility criteria were fever higher than 38°C without localising symptoms, clinical presentation of suspected meningitis or pneumonia, and evidence of radiographic pneumonia. We cultured blood and other normally sterile body fluids, reconfirmed and serotyped pneumococcal isolates, and established antimicrobial susceptibility using standard study protocols. Between Jan 1, 2011, and June 30, 2015, we enrolled 4377 patients. Among 361 (8%) patients with culture-proven pneumococcal disease, all clinical data were known for 226 (63%); among these patients, 132 (58%) presented with pneumonia, 78 (35%) presented with meningitis, and 16 (7%) had other clinical conditions. 131 (3%) died overall and 29 (8%) patients with invasive pneumococcal disease died. Serotypes 14 (52 [14%] of 361), 1 (49 [14%]), 5 (37 [10%]), and 19F (33 [9%]) were the most common. Penicillin non-susceptibility occurred in isolates from 29 (8%) patients, co-trimoxazole resistance occurred in 239 (66%), erythromycin resistance occurred in 132 (37%), and chloramphenicol resistance occurred in 33 (9%). We found multidrug resistance in 33 (9%) of 361 patients. The proportion of positive blood cultures, number of isolates, geographical representation

  20. Thyroid axis activity and suicidal behavior in depressed patients.

    Science.gov (United States)

    Duval, Fabrice; Mokrani, Marie-Claude; Lopera, Felix Gonzalez; Diep, Thanh Son; Rabia, Hassen; Fattah, Saïd

    2010-08-01

    The aim of this study was to investigate the relationship between suicidal behavior and hypothalamic-pituitary thyroid (HPT) axis activity in depressed patients. The serum levels of thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were evaluated before and after 0800 and 2300 h thyrotropin-releasing hormone (TRH) challenges, on the same day, in 95 medication-free DSM-IV euthyroid major depressed inpatients and 44 healthy hospitalized controls. Compared to controls: (1) patients with a positive suicide history (PSH; n=53) showed lower basal FT4 (at 0800 h: p<0.005; at 2300 h: p<0.03), but normal FT3 levels, while patients with a negative suicide history (NSH; n=42) showed normal FT4 and FT3 levels; (2) TSH responses to TRH (DeltaTSH) were blunted in NSHs (at 0800 h: p<0.03; at 2300 h: p<0.00001), but not in PSHs; (3) both NSHs and PSHs showed lower DeltaDeltaTSH values (differences between 2300 h-DeltaTSH and 0800 h-DeltaTSH) (p<0.000001 and p<0.003, respectively). Compared to NSHs, basal FT4 levels were reduced in PSHs (at 0800 h: p<0.002; at 2300h: p<0.006). HPT parameters were not significantly different between recent suicide attempters (n=32) and past suicide attempters (n=21). However, compared to controls, recent suicide attempters showed lower 2300 h-DeltaTSH (p<0.04) and DeltaDeltaTSH (p<0.002) values, and lower basal FT4 values (at 0800 h: p<0.006; at 2300 h: p<0.02). Our results, obtained in a large sample of depressed inpatients, indicate that various degrees of HPT axis dysregulation are associated with the history of suicide.

  1. Auditory change detection in schizophrenia: sources of activity, related neuropsychological function and symptoms in patients with a first episode in adolescence, and patients 14 years after an adolescent illness-onset

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    Sachsse Jan

    2006-02-01

    Full Text Available Abstract Background The event-related brain response mismatch negativity (MMN registers changes in auditory stimulation with temporal lobe sources reflecting short-term echoic memory and frontal sources a deviance-induced switch in processing. Impairment, controversially present at the onset of schizophrenia, develops rapidly and can remain independent of clinical improvement. We examined the characteristics of the scalp-recorded MMN and related these to tests of short-term memory and set-shifting. We assessed whether the equivalent dipole sources are affected already at illness-onset in adolescence and how these features differ after a 14-year course following an adolescent onset. The strength, latency, orientation and location of frontal and temporal lobe sources of MMN activity early and late in the course of adolescent-onset schizophrenia are analysed and illustrated. Methods MMN, a measure of auditory change-detection, was elicited by short deviant tones in a 3-tone oddball-presentation and recorded from 32 scalp electrodes. Four dipole sources were placed following hypothesis-led calculations using brain electrical source analysis on brain atlas and MR-images. A short neuropsychological test battery was administered. We compared 28 adolescent patients with a first episode of schizophrenia and 18 patients 14 years after diagnosis in adolescence with two age-matched control groups from the community (n = 22 and 18, respectively. Results MMN peaked earlier in the younger than the older subjects. The amplitude was reduced in patients, especially the younger group, and was here associated with negative symptoms and slow set-shifting. In first-episode patients the temporal lobe sources were more ventral than in controls, while the left cingular and right inferior-mid frontal sources were more caudal. In the older patients the left temporal locus remained ventral (developmental stasis, the right temporal locus extended more antero

  2. A report of two cases of splenectomy in children younger than two years old with hereditary spherocytosis

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    Sheng Jin

    2015-02-01

    Full Text Available Hereditary spherocytosis (HS is a common pediatric hemolytic anemia and one of the most common types of familial hemolytic anemia caused by congenital red blood cell defects. HS often presents clinically as childhood anemia, jaundice, and progressive splenomegaly. It is generally accepted that splenectomy is the most effective treatment for HS, but development of overwhelming infections with symptoms such as chills, high fever, and septicemia may occur because of immune dysfunction after splenectomy. As a result, the generally proposed age for children to undergo splenectomy is after 5 years of age. Splenectomy in younger HS patients is rarely reported. Here, however, we report 2 cases of HS in children younger than 2 years of age (15 months and 18 months who underwent splenectomy; we also report on their follow-up.

  3. Penfigoide bolhoso no adulto mais jovem: relato de três casos Bullous pemphigoid in younger adults: three case reports

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    Roberta Richter Zanella

    2011-04-01

    Full Text Available O penfigoide bolhoso é uma dermatose bolhosa autoimune subepidérmica, mais comumente observada na população idosa (acima dos 70 anos. Autoanticorpos são formados contra antígenos específicos da zona de membrana basal: BP180 e BP230 (proteínas do hemidesmossomo. Apresentamos três casos de penfigoide bolhoso, em adultos com menos de 50 anos de idade, destacan do as peculiaridades clínicas na faixa etária mais jovem.Bullous pemphigoid is an autoimmune subepidermal bullous dermatosis more commonly observed in the elderly (over 70 years old. Autoantibodies are produced for specific antigens of the epidermal basement membrane zone: BP 180 and BP 230 (hemidesmosome proteins. We report three cases of bullous pemphigoid in adults younger than 50 years old, discussing the clinical characteristics of the disease in younger patients.

  4. Do older adults with chronic low back pain differ from younger adults in regards to baseline characteristics and prognosis?

    DEFF Research Database (Denmark)

    Manogharan, S; Kongsted, A; Ferreira, M L

    2017-01-01

    , more leg pain and more depression); however, the differences were small. The change in pain and disability over 12 months did not differ between age groups. CONCLUSIONS: This study found small baseline differences in older people with chronic LBP compared to middle aged and younger adults. There were......BACKGROUND: Low back pain (LBP) in older adults is poorly understood because the vast majority of the LBP research has focused on the working aged population. The aim of this study was to compare older adults consulting with chronic LBP to middle aged and young adults consulting with chronic LBP....... Patients older than 65 were classified as older adults and compared to middle aged (45-65 years old) and younger adults (17-44 years old) for 10 baseline characteristics. Pain intensity and disability were collected at 6 and 12 month follow-ups and compared between age groups. RESULTS: A total of 14...

  5. Relationship between balance and physical activity measured by an activity monitor in elderly COPD patients

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    Iwakura M

    2016-07-01

    Full Text Available Masahiro Iwakura,1,2 Kazuki Okura,2 Kazuyuki Shibata,1,2 Atsuyoshi Kawagoshi,2 Keiyu Sugawara,2 Hitomi Takahashi,2 Takanobu Shioya1 1Department of Rehabilitation, Akita City Hospital, 2Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan Background: Little is known regarding the relationship between balance impairments and physical activity in COPD. There has been no study investigating the relationship between balance and objectively measured physical activity. Here we investigated the association between balance and physical activity measured by an activity monitor in elderly COPD patients. Materials and methods: Twenty-two outpatients with COPD (mean age, 72±7 years; forced expiratory volume in 1 second, 53%±21% predicted and 13 age-matched healthy control subjects (mean age, 72±6 years participated in the study. We assessed all 35 subjects’ balance (one-leg standing test [OLST] times, Short Physical Performance Battery total scores, standing balance test scores, 4 m gait speed, and five-times sit-to-stand test [5STST] and physical activity (daily steps and time spent in moderate-to-vigorous physical activity per day [MV-PA]. Possible confounders were assessed in the COPD group. The between-group differences in balance test scores and physical activity were analyzed. A correlation analysis and multivariate regression analysis were conducted in the COPD group. Results: The COPD patients exhibited significant reductions in OLST times (P=0.033, Short Physical Performance Battery scores (P=0.013, 4 m gait speed (P<0.001, five-times sit-to-stand times (P=0.002, daily steps (P=0.003, and MV-PA (P=0.022 compared to the controls; the exception was the standing balance test scores. The correlation and multivariate regression analyses revealed significant independent associations between OLST times and daily steps (P<0.001 and between OLST times and MV-PA (P=0.014 in the COPD group after adjusting for

  6. The ironic effect of guessing: increased false memory for mediated lists in younger and older adults.

    Science.gov (United States)

    Coane, Jennifer H; Huff, Mark J; Hutchison, Keith A

    2016-01-01

    Younger and older adults studied lists of words directly (e.g., creek, water) or indirectly (e.g., beaver, faucet) related to a nonpresented critical lure (CL; e.g., river). Indirect (i.e., mediated) lists presented items that were only related to CLs through nonpresented mediators (i.e., directly related items). Following study, participants completed a condition-specific task, math, a recall test with or without a warning about the CL, or tried to guess the CL. On a final recognition test, warnings (vs. math and recall without warning) decreased false recognition for direct lists, and guessing increased mediated false recognition (an ironic effect of guessing) in both age groups. The observed age-invariance of the ironic effect of guessing suggests that processes involved in mediated false memory are preserved in aging and confirms the effect is largely due to activation in semantic networks during encoding and to the strengthening of these networks during the interpolated tasks.

  7. Factors influencing quality of life in patients with active tuberculosis

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    Cox Victoria C

    2004-10-01

    Full Text Available Abstract Background With effective treatment strategies, the focus of tuberculosis (TB management has shifted from the prevention of mortality to the avoidance of morbidity. As such, there should be an increased focus on quality of life (QoL experienced by individuals being treated for TB. The objective of our study was to identify areas of QoL that are affected by active TB using focus groups and individual interviews. Methods English, Cantonese, and Punjabi-speaking subjects with active TB who were receiving treatment were eligible for recruitment into the study. Gender-based focus group sessions were conducted for the inner city participants but individual interviews were conducted for those who came to the main TB clinic or were hospitalized. Facilitators used open-ended questions and participants were asked to discuss their experiences of being diagnosed with tuberculosis, what impact it had on their lives, issues around adherence to anti-TB medications and information pertaining to their experience with side effects to these medications. All data were audio-recorded, transcribed verbatim, and analyzed using constant comparative analysis. Results 39 patients with active TB participated. The mean age was 46.2 years (SD 18.4 and 62% were male. Most were Canadian-born being either Caucasian or Aboriginal. Four themes emerged from the focus groups and interviews. The first describes issues related to the diagnosis of tuberculosis and sub-themes were identified as 'symptoms', 'health care provision', and 'emotional impact'. The second theme discusses TB medication factors and the sub-themes identified were 'adverse effects', 'ease of administration', and 'adherence'. The third theme describes social support and functioning issues for the individuals with TB. The fourth theme describes health behavior issues for the individuals with TB and the identified sub-themes were "behavior modification" and "TB knowledge." Conclusion Despite the ability to

  8. Fluid Cognitive Ability is a Resource for Successful Emotion Regulation in Older and Younger Adults

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    Philipp C. Opitz

    2014-06-01

    Full Text Available The Selection, Optimization, and Compensation with Emotion Regulation (SOC-ER framework suggests that (1 emotion regulation (ER strategies require resources and that (2 higher levels of relevant resources may increase ER success. In the current experiment, we tested the specific hypothesis that individual differences in one internal class of resources, namely cognitive ability, would contribute to greater success using cognitive reappraisal (CR, a form of ER in which one reinterprets the meaning of emotion-eliciting situations. To test this hypothesis, 60 participants (30 younger and 30 older adults completed standardized neuropsychological tests that assess fluid and crystallized cognitive ability, as well as a CR task in which participants reinterpreted the meaning of sad pictures in order to alter (increase or decrease their emotions. In a control condition, they viewed the pictures without trying to change how they felt. Throughout the task, we indexed subjective emotional experience (self-reported ratings of emotional intensity, expressive behavior (corrugator muscle activity, and autonomic physiology (heart rate and electrodermal activity as measures of emotional responding. Multilevel models were constructed to explain within-subjects variation in emotional responding as a function of ER contrasts comparing increase or decrease conditions with the view control condition and between-subjects variation as a function of cognitive ability and/or age group (older, younger. As predicted, higher fluid cognitive ability – indexed by perceptual reasoning, processing speed, and working memory – was associated with greater success using reappraisal to alter emotional responding. Reappraisal success did not vary as a function of crystallized cognitive ability or age group. Collectively, our results provide support for a key tenet of the SOC-ER framework that higher levels of relevant resources may confer greater success at emotion regulation.

  9. Short term effects of corticosteroid pulse treatment on disease activity and the wellbeing of patients with active rheumatoid arthritis

    NARCIS (Netherlands)

    Jacobs, JWG; Geenen, R; Evers, AWM; van Jaarsveld, CHM; Kraaimaat, FW; Bijlsma, JWJ

    2001-01-01

    Objective-To investigate the short term effects of corticosteroid pulse treatment (CPT) ability, and psychological wellbeing of patients with active rheumatoid arthritis (RA). Methods-Of 66 consecutive patients with active RA admitted for CPT, erythrocyte sedimentation rate, C reactive protein level

  10. Short term effects of corticosteroid pulse treatment on disease activity and the wellbeing of patients with active rheumatoid arthritis

    NARCIS (Netherlands)

    Jacobs, JWG; Geenen, R; Evers, AWM; van Jaarsveld, CHM; Kraaimaat, FW; Bijlsma, JWJ

    2001-01-01

    Objective-To investigate the short term effects of corticosteroid pulse treatment (CPT) ability, and psychological wellbeing of patients with active rheumatoid arthritis (RA). Methods-Of 66 consecutive patients with active RA admitted for CPT, erythrocyte sedimentation rate, C reactive protein level

  11. Younger age as a prognostic indicator in breast cancer: A cohort study

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    Dooley Cara

    2011-08-01

    Full Text Available Abstract Background The debate continues as to whether younger women who present with breast cancer have a more aggressive form of disease and a worse prognosis. The objectives of this study were to determine the incidence of breast cancer in women under 40 years old and to analyse the clinicopathological characteristics and outcome compared to an older patient cohort. Methods Data was acquired from a review of charts and the prospectively reviewed GUH Department of Surgery database. Included in the study were 276 women diagnosed with breast cancer under the age of forty and 2869 women over forty. For survival analysis each women less than 40 was matched with two women over forty for both disease stage and grade. Results The proportion of women diagnosed with breast cancer under the age of forty in our cohort was 8.8%. In comparison to their older counterparts, those under forty had a higher tumour grade (p = 0.044 and stage (p = 0.046, a lower incidence of lobular tumours (p HER2 over-expression (p = 0.002; there was no statistical difference as regards tumour size (p = 0.477. There was no significant difference in overall survival (OS for both groups; and factors like tumour size (p = 0.026, invasion (p = 0.026 and histological type (p = 0.027, PR (p = 0.031 and HER2 (p = 0.002 status and treatment received were independent predictors of OS Conclusion Breast cancer in younger women has distinct histopathological characteristics; however, this does not result in a reduced survival in this population.

  12. Younger age as a prognostic indicator in breast cancer: A cohort study

    LENUS (Irish Health Repository)

    Kheirelseid, Elrasheid A.H.

    2011-08-28

    Abstract Background The debate continues as to whether younger women who present with breast cancer have a more aggressive form of disease and a worse prognosis. The objectives of this study were to determine the incidence of breast cancer in women under 40 years old and to analyse the clinicopathological characteristics and outcome compared to an older patient cohort. Methods Data was acquired from a review of charts and the prospectively reviewed GUH Department of Surgery database. Included in the study were 276 women diagnosed with breast cancer under the age of forty and 2869 women over forty. For survival analysis each women less than 40 was matched with two women over forty for both disease stage and grade. Results The proportion of women diagnosed with breast cancer under the age of forty in our cohort was 8.8%. In comparison to their older counterparts, those under forty had a higher tumour grade (p = 0.044) and stage (p = 0.046), a lower incidence of lobular tumours (p < 0.001), higher estrogen receptor negativity (p < 0.001) and higher HER2 over-expression (p = 0.002); there was no statistical difference as regards tumour size (p = 0.477). There was no significant difference in overall survival (OS) for both groups; and factors like tumour size (p = 0.026), invasion (p = 0.026) and histological type (p = 0.027), PR (p = 0.031) and HER2 (p = 0.002) status and treatment received were independent predictors of OS Conclusion Breast cancer in younger women has distinct histopathological characteristics; however, this does not result in a reduced survival in this population.

  13. Physical activity: from epidemiological evidence to individualized patient management.

    Science.gov (United States)

    Charansonney, Olivier Luc; Vanhees, Luc; Cohen-Solal, Alain

    2014-01-01

    Physical activity (PA), physical fitness (PF), and even a few sedentary behaviors (SB) are strongly and independently linked to improved survival rate. However, key questions remain: what are the physiological interrelationships between SB, PA, and PF? How should we differently emphasize promoting PA, increasing PF with exercise, and decreasing SB among other prevention measures? What are the interrelationships of both PA and SB levels with drug treatment efficacy? To address these questions we developed an integrated patient-centric model combining physiology with epidemiological evidence to characterize the individual risk attached to PA level, PF, and SB. Epidemiological data were collected by extensive literature review. Nine meta-analyses, 198 cohort studies (3.8 million people), and 13 controlled trials were reviewed. 1. A high level of SB induces chronic stress and increases the risk of both chronic disease and mortality. 2. Vigorous PA increases PF and physiological reserve, thereby improving survival rate. This effect is not mediated by improved traditional risk factors. The risk for most individuals is a mix of high SB, low to mild PA, and low to mild PF. This model can improve the individualized prescription of PA modalities. Furthermore, the benefit of treatments such as statins or beta-blockers can be cancelled out if a decrease in PA or an increase in SB is induced by drug related side effects. To improve patient management both types of therapeutic interventions and dose should be carefully chosen for each individual in order to maintain/increase PA level while decreasing SB. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Lower limb muscle coactivation levels in healthy younger and older adults during functional dual-task gait

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    Camilla Zamfolini Hallal

    2013-09-01

    Full Text Available The purpose of this study was to investigate the influence of daily cognitive task on stiffness of old and young female adults during the gait. The study included 17 physically active younger and 18 older women, with low risk of falls. The volunteers were asked to walk on the treadmill at two different gait conditions: normal gait and functional dual-task gait. The electromyographic signals were collected of the lower limb muscles. The percentage of coactivation for the tibialis anterior/gastrocnemius lateralis and tibialis anterior/soleus were significantly higher in elderly than in younger in the normal gait and dual-task gait. Our results suggest that the elderly have a greater stiffness in the ankle joint during gait normal and daily dual task gait. Thus, we conclude that challenging cognitively situations during the gait may increase the risk of falls in this population.

  15. Linguistic Context Versus Semantic Competition in Word Recognition by Younger and Older Adults With Cochlear Implants.

    Science.gov (United States)

    Amichetti, Nicole M; Atagi, Eriko; Kong, Ying-Yee; Wingfield, Arthur

    2017-07-11

    The increasing numbers of older adults now receiving cochlear implants raises the question of how the novel signal produced by cochlear implants may interact with cognitive aging in the recognition of words heard spoken within a linguistic context. The objective of this study was to pit the facilitative effects of a constraining linguistic context against a potential age-sensitive negative effect of response competition on effectiveness of word recognition. Younger (n = 8; mean age = 22.5 years) and older (n = 8; mean age = 67.5 years) adult implant recipients heard 20 target words as the final words in sentences that manipulated the target word's probability of occurrence within the sentence context. Data from published norms were also used to measure response entropy, calculated as the total number of different responses and the probability distribution of the responses suggested by the sentence context. Sentence-final words were presented to participants using a word-onset gating paradigm, in which a target word was presented with increasing amounts of its onset duration in 50 msec increments until the word was correctly identified. Results showed that for both younger and older adult implant users, the amount of word-onset information needed for correct recognition of sentence-final words was inversely proportional to their likelihood of occurrence within the sentence context, with older adults gaining differential advantage from the contextual constraints offered by a sentence context. On the negative side, older adults' word recognition was differentially hampered by high response entropy, with this effect being driven primarily by the number of competing responses that might also fit the sentence context. Consistent with previous research with normal-hearing younger and older adults, the present results showed older adult implant users' recognition of spoken words to be highly sensitive to linguistic context. This sensitivity, however, also resulted in a

  16. Acute atomoxetine treatment of younger and older children with ADHD: A meta-analysis of tolerability and efficacy

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    Vaughan Brigette S

    2008-09-01

    Full Text Available Abstract Background Atomoxetine is FDA-approved as a treatment of attention-deficit/hyperactivity disorder (ADHD in patients aged 6 years to adult. Among pediatric clinical trials of atomoxetine to date, six with a randomized, double-blind, placebo-controlled design were used in this meta-analysis. The purpose of this article is to describe and compare the treatment response and tolerability of atomoxetine between younger children (6–7 years and older children (8–12 years with ADHD, as reported in these six acute treatment trials. Methods Data from six clinical trials of 6–9 weeks duration were pooled, yielding 280 subjects, ages 6–7 years, and 860 subjects, ages 8–12 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-diagnosed ADHD. Efficacy was analyzed using the ADHD Rating Scale-IV (ADHD-RS, Conners' Parent Rating Scale-revised (CPRS-R:S, and the Clinical Global Impression of ADHD Severity (CGI-ADHD-S. Results Atomoxetine was superior to placebo in both age categories for mean (SD change in ADHD-RS total, total T, and subscale scores; 3 CPRS-R:S subscales; and CGI-ADHD-S from baseline. Although there were no significant treatment differentials between the age groups for these efficacy measures, the age groups themselves, regardless of treatment, were significantly different for ADHD-RS total (younger: ATX = -14.2 [13.8], PBO = -4.6 [10.4]; older: ATX = -15.4 [13.2], PBO = -7.3 [12.0]; p = .001, total T (younger: ATX = -15.2 [14.8], PBO = -4.9 [11.2]; older: ATX = -16.4 [14.6], PBO = -7.9 [13.1]; p = .003, and subscale scores (Inattentive: younger: ATX = -7.2 [7.5], PBO = -2.4 [5.7]; older: ATX = -8.0 [7.4], PBO = -3.9 [6.7]; p = .043; Hyperactive/Impulsive: younger: ATX = -7.0 [7.2], PBO = -2.1 [5.4]; older: ATX = -7.3 [7.0], PBO = -3.4 [6.3]; p Conclusion Atomoxetine is an effective and generally well-tolerated treatment of ADHD in both younger and older children as assessed by three

  17. The platinum group metals in Younger Dryas Horizons are terrestrial

    Science.gov (United States)

    Wu, Y.; Wikes, E.; Kennett, J.; West, A.; Sharma, M.

    2009-12-01

    The Younger Dryas (YD) event, which began 12,900 years ago, was a period of abrupt and rapid cooling in the Northern Hemisphere whose primary cause remains unclear. The prevalent postulated mechanism is a temporary shutdown of the thermohaline circulation following the breakup of an ice dam in North America. Firestone et al. (2007) proposed that the cooling was triggered by multiple cometary airbursts and/or impacts that engendered enormous environmental changes and disrupted the thermohaline circulation. The evidence in support for this hypothesis is a black layer in North America and in Europe marking the YD boundary containing charcoal, soot, carbon spherules and glass-like carbon suggesting extensive and intense forest fires. This layer is also enriched in magnetic grains high in iridium, magnetic microspherules, fullerenes containing extraterrestrial He-3, and nanodiamonds. Whereas the nanodiamonds could be produced in an impact or arrive with the impactor, the cometary burst/impact hypothesis remains highly controversial as the YD horizon lacks important impact markers such as craters, breccias, tektites and shocked minerals. Firestone et al. (2007) contend that bulk of Ir found at the YD boundary is associated with magnetic grains. The key issue is whether this Ir is meteorite derived. We used Ir and Os concentrations and Os isotopes to investigate the provenance of the platinum group metals in the YD horizon. The bulk sediment samples from a number of North American YD sites (Blackwater Draw, Murray Springs, Gainey, Sheriden Cave, and Myrtle Beach) and a site in Europe (Lommel) do not show any traces of meteorite derived Os and Ir. The [Os] = 2 to 45 pg/g in these sediments and the 187Os/188Os ratios are similar to the upper continental crustal values (~1.3), much higher than those in meteorites (0.13). Higher [Os] is observed in Blackwater Draw (= 194 pg/g). However, the Os/Ir ratio in Blackwater Draw is 5 (not 1 as expected for a meteorite) and 187Os/188

  18. Search for Extraterrestrial Osmium at the Allerod - Younger Dryas Boundary

    Science.gov (United States)

    Beets, C.; Sharma, M.; Kasse, K.; Bohncke, S.

    2008-12-01

    Ir and Os are excellent markers of extraterrestrial impact events, due to their high abundance in ET objects (Alvarez et al., 1980 Science; Turekian, 1982 Geol. Bull. Am. Spec. Pap.). Os has the advantage over Ir, in that the 187Os/188Os ratio also greatly differs between meteorites and upper continental crust (UCC). The combination of [Os] and 187Os/188Os analyses would be superior in detecting any ET contribution. Firestone et al (2007 PNAS) attributed a widespread 12.9 ka Ir containing black carbon layer to a potential extraterrestrial impact at the Allerød-Younger Dryas (A-YD) boundary. In order to test this inference, we measured [Os] and 187Os/188Os on a radiocarbon dated A-YD record (13.210 to 12.788 cal years BP) from the Netherlands. This location is close to Lommel, a Belgian site studied by Firestone et al.(2007). The organic-rich sequence was sampled continuously over a 12 cm interval at 2 cm resolution (~70 years). About 10 g samples were freeze-dried, ground and homogenized in a zirconia ball-mill. The samples mixed with 190Os tracer solutions were dissolved in carius tubes and Os extracted in liquid bromine. Os was further purified using micro-distillation. Os isotopes were measured using N-TIMS on Dartmouth Triton. The procedural blank was 7 fg/g Os with an isotopic composition of 0.41±0.01 The Allerød samples have an order of magnitude higher abundance than UCC (200 vs. 30 pg/g), but similar 187Os/188Os ratios, >1.1. The sample at the base of the YD (12.893±75 cal years BP) contains a similar amount of Os, but has a distinctly lower isotopic signature, 0.53±0.002. The high [Os] in the A-YD section possibly reflects enrichment by preferential partitioning into organic matter. The Os isotope composition of 0.53, sandwiched between values >1.1, implies contribution of a significant amount of non-radiogenic Os. Since the pollen spectra show no reworking, the non-radiogenic Os could only have been delivered as a discrete pulse at 12.893 cal yr BP

  19. Subtropical freshwater event at the onset of Younger Dryas

    Science.gov (United States)

    Weinelt, M.; Repschläger, J.; Balmer, S.; Schwab, C.; Andersen, N.; Blanz, T.; Sarnthein, M.

    2012-12-01

    The Younger Dryas (YD) (12.79-11.6 ka BP) cold spell during the last deglaciation is associated with a major breakdown of the Atlantic meridional overturning circulation (AMOC), the details of which are still controversial. Catastrophic events like a bolide impact or a major outflow of meltwater stored in the proglacial Lake Agassiz, which led to the capping of North Atlantic deep water convection sites, have been suggested to trigger the AMOC shutdown. However the geomorphological evidence for such a meltwater flood is not in agreement with the timing of the YD. Also, the YD was postulated to be part of a deglacial sequence of events generally characteristic of glacial terminations involving the displacement of major climatic zones and oceanographic fronts. We present detailed paleoceanographic records from sediment cores MD08-3180/ GEOFAR KF16 (38°N; 31.13°W, 3050 m w.d.) retrieved immediately east of the Mid Atlantic ridge south of the Azores Islands. At present, this site is located at the northern rim of the Azores Current, which delineates the subtropical gyre, recirculating warm waters of the North Atlantic Current. Due to its position at the boundary between temperate North East Atlantic waters and subtropical gyre waters, the site is ideally suited to trace past changes in the alternating influence of both water masses. Parallel stable-oxygen isotope records of surface water dwelling foraminifera Globigerinoides ruber w. (habitat depth 0-25m) and Globigerina bulloides (habitat depth 0-300m) may document the structure of surface waters. Sea Surface Temperatures (SST) were derived from the UK'37 index and from planktonic foraminifera (PF) assemblages using transfer functions. d18Ow-ice and Sea Surface Salinities were estimated using the d18O G.ruber w. record corrected for SST and changes in global ice volume. The d18O records of G.ruber w. and G.bulloides diverge between 13.4 ka and 12.95 ka BP. d18Ow data show a gradual increase in the freshening of

  20. Telemonitoring of Daily Activity and Symptom Behavior in Patients with COPD

    Directory of Open Access Journals (Sweden)

    Monique Tabak

    2012-01-01

    Full Text Available Objectives. This study investigated the activity behavior of patients with COPD in detail compared to asymptomatic controls, and the relationship between subjective and objective activities (awareness, and readiness to change activity behavior. Methods. Thirty-nine patients with COPD (66.0 years; FEV1% predicted: 44.9% and 21 healthy controls (57.0 years participated. Objective daily activity was assessed by accelerometry and expressed as amount of activity in counts per minute (cpm. Patients' baseline subjective activity and stage of change were assessed prior to measurements. Results. Mean daily activity in COPD patients was significantly lower compared to the healthy controls ( cpm versus  cpm, . COPD patients showed a temporary decrease in objective activities in the early afternoon. Objective and subjective activities were significantly moderately related and most patients (55.3% were in the maintenance phase of the stages of change. Conclusions. COPD patients show a distinctive activity decrease in the early afternoon. COPD patients are moderately aware of their daily activity but regard themselves as physically active. Therefore, future telemedicine interventions might consider creating awareness of an active lifestyle and provide feedback that aims to increase and balance activity levels.

  1. Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

    Directory of Open Access Journals (Sweden)

    Mark V Mishra

    Full Text Available OBJECTIVES: Qualitative research aimed at identifying patient acceptance of active surveillance (AS has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs could be utilized to identify unmet public needs regarding AS. METHODS: English-language ICs regarding prostate cancer (PC treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC-(#Negative IC/#Total IC x 100]. RESULTS: A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS. CONCLUSIONS: This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS.

  2. Exploring sibling attitudes towards participation when the younger ...

    African Journals Online (AJOL)

    towards their sibling with a disability and towards their participation in everyday family activities. ... and interactions, major life areas (play and education) and, to a lesser extent .... The mean for play was significantly higher than the mean for.

  3. Informal work and formal plans: Articulating the active role of patients in cancer trajectories

    DEFF Research Database (Denmark)

    Dalsted, R.; Hølge-Hazelton, Bibi; Kousgaard, MB;

    2013-01-01

    Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories...

  4. Informal work and formal plans: Articulating the active role of patients in cancer trajectories

    DEFF Research Database (Denmark)

    Dalsted, R.; Hølge-Hazelton, Bibi; Kousgaard, MB

    2013-01-01

    Formal pathways models outline that patients should receive information in order to experience a coherent journey but do not describe an active role for patients or their relatives. The aim of this is paper is to articulate and discuss the active role of patients during their cancer trajectories...

  5. Motivation, self-regulation and physical activity among patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Knittle, Keegan

    2013-01-01

    Regular participation in moderate-intensity physical activity (PA) is beneficial for patients with rheumatoid arthritis (RA); however, a large proportion of patients with RA are not physically active. In this dissertation, we describe the pilot-testing of an intervention to promote PA among patients

  6. Younger age at onset of sporadic Parkinson’s disease among subjects occupationally exposed to metals and pesticides

    Directory of Open Access Journals (Sweden)

    Ratner Marcia H.

    2014-09-01

    Full Text Available An earlier age at onset of Parkinson’s disease (PD has been reported to be associated with occupational exposures to manganese and hydrocarbon solvents suggesting that exposure to neurotoxic chemicals may hasten the progression of idiopathic PD. In this study the role of occupational exposure to metals and pesticides in the progression of idiopathic PD was assessed by looking at age at disease onset. The effects of heritable genetic risk factors, which may also influence age at onset, was minimized by including only sporadic cases of PD with no family history of the disease (n=58. Independent samples Student t-test revealed that subjects with occupational exposure to metals and/or pesticides (n=36 were significantly (p=0.013 younger than unexposed controls (n=22. These subjects were then divided into three groups [high (n=18, low (n=18, and unexposed (n=22] to ascertain if duration of exposure further influenced age at onset of PD. One-way ANOVA revealed that subjects in the high exposure group were significantly (p=0.0121 younger (mean age: 50.33 years than unexposed subjects (mean age: 60.45 years. Subjects were also stratified by exposure type (metals vs. pesticides. These results suggest that chronic exposure to metals and pesticides is associated with a younger age at onset of PD among patients with no family history of the disease and that duration of exposure is a factor in the magnitude of this effect.

  7. Patient Activation in Type 2 Diabetes: Does It Differ between Men and Women?

    Directory of Open Access Journals (Sweden)

    Steven H. Hendriks

    2016-01-01

    Full Text Available Background. Aim was to investigate whether the degree of patient activation of patients with type 2 diabetes (T2D is different between men and women. Furthermore, we investigated which factors are associated with patient activation in men and women. Methods. This cross-sectional study included 1615 patients with T2D from general practices. Patient activation was measured with the Patient Activation Measure (PAM questionnaire. Multivariate linear regression analyses were used to investigate the association between gender and patient activation. Stratified analyses according to gender were performed to investigate which factors are associated with patient activation. Results. No association between gender and PAM score was found after adjustment for all selected confounders (p=0.094. In men, lower age (p=0.001, a higher WHO-5 score (p<0.001, and a lower BMI (p=0.013 were associated with a higher PAM score. In women, a higher WHO-5 score (p<0.017 and the absence of macrovascular complications (p<0.031 were associated with a higher PAM score. Conclusion. There is no difference in the degree of patient activation of men and women with T2D. Age, well-being, and BMI were found to be associated with patient activation in men, whereas well-being and macrovascular complications were found to be associated with patient activation in women.

  8. The advantage of letrozole over tamoxifen in the BIG 1-98 trial is consistent in younger postmenopausal women and in those with chemotherapy-induced menopause.

    Science.gov (United States)

    Chirgwin, Jacquie; Sun, Zhuoxin; Smith, Ian; Price, Karen N; Thürlimann, Beat; Ejlertsen, Bent; Bonnefoi, Hervé; Regan, Meredith M; Goldhirsch, Aron; Coates, Alan S

    2012-01-01

    Letrozole, an aromatase inhibitor, is ineffective in the presence of ovarian estrogen production. Two subpopulations of apparently postmenopausal women might derive reduced benefit from letrozole due to residual or returning ovarian activity: younger women (who have the potential for residual subclinical ovarian estrogen production), and those with chemotherapy-induced menopause who may experience return of ovarian function. In these situations tamoxifen may be preferable to an aromatase inhibitor. Among 4,922 patients allocated to the monotherapy arms (5 years of letrozole or tamoxifen) in the BIG 1-98 trial we identified two relevant subpopulations: patients with potential residual ovarian function, defined as having natural menopause, treated without adjuvant or neoadjuvant chemotherapy and age ≤ 55 years (n = 641); and those with chemotherapy-induced menopause (n = 105). Neither of the subpopulations examined showed treatment effects differing from the trial population as a whole (interaction P values are 0.23 and 0.62, respectively). Indeed, both among the 641 patients aged ≤ 55 years with natural menopause and no chemotherapy (HR 0.77 [0.51, 1.16]) and among the 105 patients with chemotherapy-induced menopause (HR 0.51 [0.19, 1.39]), the disease-free survival (DFS) point estimate favoring letrozole was marginally more beneficial than in the trial as a whole (HR 0.84 [0.74, 0.95]). Contrary to our initial concern, DFS results for young postmenopausal patients who did not receive chemotherapy and patients with chemotherapy-induced menopause parallel the letrozole benefit seen in the BIG 1-98 population as a whole. These data support the use of letrozole even in such patients.

  9. How might physical activity benefit patients with Parkinson disease?

    NARCIS (Netherlands)

    Speelman, A.D.; Warrenburg, B.P.C. van de; Nimwegen, M.L. van; Petzinger, G.M.; Munneke, M.; Bloem, B.R.

    2011-01-01

    Parkinson disease (PD) is a neurodegenerative disorder characterized by progressive motor and nonmotor impairments. These impairments incline many patients towards a sedentary lifestyle, which has many deleterious consequences. Accumulating evidence suggests that patients with PD might benefit from

  10. How might physical activity benefit patients with Parkinson disease?

    NARCIS (Netherlands)

    Speelman, A.D.; Warrenburg, B.P.C. van de; Nimwegen, M.L. van; Petzinger, G.M.; Munneke, M.; Bloem, B.R.

    2011-01-01

    Parkinson disease (PD) is a neurodegenerative disorder characterized by progressive motor and nonmotor impairments. These impairments incline many patients towards a sedentary lifestyle, which has many deleterious consequences. Accumulating evidence suggests that patients with PD might benefit from

  11. Is satisfaction among orthopaedic trauma patients predicted by depression and activation levels?

    Science.gov (United States)

    Knutsen, Elisa J; Paryavi, Ebrahim; Castillo, Renan C; OʼToole, Robert V

    2015-05-01

    Among orthopaedic trauma patients, little is known regarding the relationship between patient satisfaction and patient levels of depression and "activation" (level of involvement of patient in his or her own care). Our hypothesis was that satisfaction is correlated to levels of depression and activation. Patient questionnaires. Level 1 trauma center. One hundred twenty-four patients with at least one fracture. Patients were evaluated at orthopaedic trauma clinics 6 weeks or longer after injury. Patient Satisfaction Questionnaire (PSQ), Patient Activation Measure, and Patient Health Questionnaire, a screening and evaluation tool for the presence and severity of depression. Spearman correlation coefficients assessed the relationship between activation level and depression severity with PSQ domains. Bivariate and multivariate linear regression models determined independent effects of depression and activation on general satisfaction. Patient satisfaction was moderate to high in general (mean score, 4.17). Spearman correlation coefficients were high for patient activation and all PSQ domains (generally >0.3, P < 0.05). Correlation coefficients were weaker for depression and PSQ domains (rho range, 0.16-0.33). Final multivariate linear regression model indicated improvement in general satisfaction of 0.14 with increasing patient activation. A decrease in general satisfaction of -0.03 was noted with increasing Patient Health Questionnaire depression score. Patient satisfaction is strongly correlated with patient activation but less correlated with the presence of depression. Patient satisfaction after orthopaedic trauma might be improved by encouraging and coaching patients on how to be more involved in their own health care. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  12. Assessing motor imagery ability in younger and older adults by combining measures of vividness, controllability and timing of motor imagery.

    Science.gov (United States)

    Saimpont, Arnaud; Malouin, Francine; Tousignant, Béatrice; Jackson, Philip L

    2015-02-09

    With the population aging, a large number of patients undergoing rehabilitation are older than 60 years. Also, since the use of motor imagery (MI) training in rehabilitation is becoming more popular, it is important to gain a better knowledge about the age-related changes in MI ability. The main goal of this study was to compare MI ability in younger and older adults as well as to propose a new procedure for testing this ability. Thirty healthy young subjects (mean age: 22.9±2.7 years) and 28 healthy elderly subjects (mean age: 72.4±5.5 years) participated in the experiment. They were administered three tests aimed at assessing three dimensions of MI: (1) the kinesthetic and visual imagery questionnaire (KVIQ) to assess MI vividness; (2) a finger-thumb opposition task to assess MI controllability; and (3) a chronometric task to assess the timing of MI. On average, the younger and older groups showed similar results on the KVIQ and the chronometric task, but the younger group was more accurate at the finger-thumb opposition task. Interestingly, there was a large variability in the performance within both groups, emphasizing the importance of considering each person individually regarding MI ability, whatever his age. Finally, we propose two indexes of MI ability to identify the potential of persons to engage in MI training programs. Future studies are needed to confirm the predictive value of these MI indexes and define inclusion/exclusion thresholds for their use as a screening tool in both younger and older adults.

  13. The role of prior knowledge in error correction for younger and older adults.

    Science.gov (United States)

    Sitzman, Danielle M; Rhodes, Matthew G; Tauber, Sarah K; Liceralde, Van Rynald T

    2015-01-01

    Previous work has demonstrated that, when given feedback, younger adults are more likely to correct high-confidence errors compared with low-confidence errors, a finding termed the hypercorrection effect. Research examining the hypercorrection effect in both older and younger adults has demonstrated that the relationship between confidence and error correction was stronger for younger adults compared with older adults. Their results demonstrated that the relationship between confidence and error correction was stronger for younger adults compared with older adults. However, recent work suggests that error correction is largely related to prior knowledge, while confidence may primarily serve as a proxy for prior knowledge. Prior knowledge generally remains stable or increases with age; thus, the current experiment explored how both confidence and prior knowledge contributed to error correction in younger and older adults. Participants answered general knowledge questions, rated how confident they were that their response was correct, received correct answer feedback, and rated their prior knowledge of the correct response. Overall, confidence was related to error correction for younger adults, but this relationship was much smaller for older adults. However, prior knowledge was strongly related to error correction for both younger and older adults. Confidence alone played little unique role in error correction after controlling for the role of prior knowledge. These data demonstrate that prior knowledge largely predicts error correction and suggests that both older and younger adults can use their prior knowledge to effectively correct errors in memory.

  14. Younger Children's (Three to Five Years) Perceptions of Being in a Health-Care Situation

    Science.gov (United States)

    Stålberg, Anna; Sandberg, Anette; Söderbäck, Maja

    2016-01-01

    Younger children are common users of health-care services. Their perspective on a health-care situation and their ways of communication differ from that of adults. There is a shortness of research of younger children's perceptions of health-care situations. The knowledge that exists indicates the importance of involving the child's perspective to…

  15. A Group-Based Program of Emotional Recovery for Younger Women Following Myocardial Infarction

    Science.gov (United States)

    Bowers, Michele J.; Buchanan, Marla J.

    2007-01-01

    Heart disease is the leading cause of illness, disability, and death among women in Canada. Myocardial infarction (MI) accounts for almost half of these deaths yearly. The purpose of this study was to understand younger women's experience of recovery from MI. A purposive sample consisting of six younger women diagnosed with MI participated in …

  16. 'Being young': a qualitative study of younger nurses' experiences in the workplace.

    Science.gov (United States)

    Clendon, J; Walker, L

    2012-12-01

    The overall goal of this study was to obtain a greater understanding of the experiences of nurses aged under 30 in the New Zealand workforce with a view to developing age-appropriate retention strategies. Nurses aged under 30 constitute around 10% of the world's nursing workforce yet little is known about their experiences in the workplace. Poor retention of younger nurses is a cause for concern. The implications of the perceptions and needs of this generation of nurses must be considered in order to ensure effective succession planning. An explorative descriptive design framed within a broad qualitative methodology was utilized to explore experiences of younger nurses in the New Zealand workforce. Data were analysed thematically. Findings are reported under five themes: challenges of nursing, rewards of nursing, being young, coping and addressing generational differences. The study provides new knowledge about the experiences of younger nurses in the workforce and in particular the challenges facing younger Asian nurses. Managers and nurse leaders must address broader workforce issues as well as improving support for younger nurses to help improve younger nurse retention. Strategies designed to extend and challenge younger nurses in the workplace such as professional development and project work will also help, but will only be effective if nurses are given sufficient paid time to undertake this work. Being Asian provides added challenges for younger nurses in New Zealand and further research into the experiences of this subgroup is highly recommended. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

  17. Is psychotherapy for depression equally effective in younger and older adults? A meta-regression analysis.

    NARCIS (Netherlands)

    Cuijpers, P.; Straten, van A.; Smit, H.F.E.; Andersson, G.

    2009-01-01

    Background: It is well established that psychotherapy is effective in the treatment of depression in younger as well as in older adults. Whether these psychotherapies are equally effective in younger and older age groups has not been examined in meta-analytic research. Methods: We conducted a

  18. Regression and Progression Predictors of CIN2 in Women Younger Than 25 Years

    NARCIS (Netherlands)

    Loopik, D.L.; Doucette, S.; Bekkers, R.L.M.; Bentley, J.R.

    2016-01-01

    OBJECTIVE: The purpose of this study was to review the management and outcome of cervical intraepithelial neoplasia 2 (CIN2) in women younger than 25 years. METHODS: A retrospective review was performed, investigating women younger than 25 years at the time of diagnosis with biopsy-proven CIN2

  19. Neurocognitive and Behavioral Outcomes of Younger Siblings of Children with Autism Spectrum Disorder at Age Five

    Science.gov (United States)

    Warren, Zachary E.; Foss-Feig, Jennifer H.; Malesa, Elizabeth E.; Lee, Evon Batey; Taylor, Julie Lounds; Newsom, Cassandra R.; Crittendon, Julie; Stone, Wendy L.

    2012-01-01

    Later-born siblings of children with Autism Spectrum Disorders (ASD) are at increased risk for ASD as well as qualitatively similar traits not meeting clinical cutoffs for the disorder. This study examined age five neurocognitive and behavioral outcomes of 39 younger siblings of children with ASD (Sibs-ASD) and 22 younger siblings of typically…

  20. Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Wouters, Eveline J. M.; van Leeuwen, Ninke; Bossema, Ercolie R.; Kruize, Aike A.; Bootsma, Hendrika; Bijlsma, Johannes W. J.; Geenen, Rinie

    Background Fatigue is a prevalent and debilitating problem in Sjogren's syndrome. It has been suggested that physical activity and cognitions about physical activity can influence fatigue. Objective The aim of this study was to examine fatigue and physical activity levels in patients with Sjogren's

  1. Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjögren's syndrome

    NARCIS (Netherlands)

    Van Leeuwen; MD E.J.M. Wouters; Bossema; Bootsma; Geenen; Kruize; Bijlsma

    2012-01-01

    Background Fatigue is a prevalent and debilitating problem in Sjögren's syndrome. It has been suggested that physical activity and cognitions about physical activity can influence fatigue. Objective The aim of this study was to examine fatigue and physical activity levels in patients with Sjögren's

  2. Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Wouters, Eveline J. M.; van Leeuwen, Ninke; Bossema, Ercolie R.; Kruize, Aike A.; Bootsma, Hendrika; Bijlsma, Johannes W. J.; Geenen, Rinie

    2012-01-01

    Background Fatigue is a prevalent and debilitating problem in Sjogren's syndrome. It has been suggested that physical activity and cognitions about physical activity can influence fatigue. Objective The aim of this study was to examine fatigue and physical activity levels in patients with Sjogren's

  3. Time-related feedback messages for changing activity behaviour of patients with COPD

    NARCIS (Netherlands)

    Tabak, Monique; Akker, op den Harm; Hermens, H.J.

    2013-01-01

    Background: The promotion of physical activity in daily life is an important aspect in the treatment of COPD patients [1]. We developed a telemedicine application – the Activity Coach – that aims to increase activity levels and to balance activities over the day. Activity levels are measured using a

  4. A breast cancer meta-analysis of two expression measures of chromosomal instability reveals a relationship with younger age at diagnosis and high risk histopathological variables

    DEFF Research Database (Denmark)

    Endesfelder, David; McGranahan, Nicholas; Birkbak, Nicolai Juul;

    2011-01-01

    . In a breast cancer meta-analysis of 2423 patients we examine the relationship between clinicopathological parameters and two distinct chromosomal instability gene expression signatures in order to address whether younger age at diagnosis is associated with increased tumour genome instability. We find that CIN......, assessed by the two independently derived CIN expression signatures, is significantly associated with increased tumour size, ER negative or HER2 positive disease, higher tumour grade and younger age at diagnosis in ER negative breast cancer. These data support the hypothesis that chromosomal instability...

  5. Influence of outdoor games on functional condition of the respiratory system at girls of the younger school age

    Directory of Open Access Journals (Sweden)

    Оlena Potapova

    2016-10-01

    Full Text Available Purpose: to study influence of outdoor games on functional condition of the respiratory system of girls of the younger school age in the groups of 6–8 and 9–10 years old. Material & Methods: the problem of functional condition of external breath at girls of the younger school age (in the age groups of 6–8 and 9–10 years old, who were divided into the control group (CG in number of 32persons (CS No. 58 and the experimental (EG in number of 29 persons (OTEC No. 109 of Zaporozhe, is considered. Results: it is defined that the studied girls of both groups at the beginning of the research had mainly below average and average levels of functional condition of the system of external breath. Conclusions: the effective impact of outdoor games on functional condition of the whole organism in general and on the system of external breath, in particular, at girls of the experimental group in comparison with the studied girls of the same age of the control group is proved experimentally. Application of the large number of various outdoor games allowed diversifying the program of training at physical education classes emotionally and physically, than promoted the activation of functions of the whole organism of girls of the younger school age.

  6. The preservation of response inhibition aftereffects in a location-based spatial negative priming task: younger versus older adults.

    Science.gov (United States)

    Buckolz, Eric; Lok, Michael; Kajaste, Ben; Edgar, Cameron; Khan, Michael

    2015-01-01

    Younger (M = 21 years) and older (M = 74 years) adults completed a spatial negative priming (SNP) task where (central) events (i.e., target or distractor) are presented in trial pairs: first the prime and then the probe. Free-choice trials were included (1 location: 2 permissible responses), which allowed us to isolate response inhibition and its consequent inhibitory aftereffects (i.e., current inhibition interferes with later related processing-e.g., SNP). The inhibitory aftereffects associated with the suppression of responses activated by distractor-occupied locations were highly comparable for younger and older adults; including similar SNP effect sizes, a significant tendency to select against former distractor (inhibited) responses (within-hand finger options) on free-choice trials, and latency delays attributable solely to the use of self-selected distractor responses. Aftereffects generated by target-occupied prime trials locations were also the same for both age groups; recently executed target responses were selected for and produced faster responding (within hand). Aftereffects were absent on between-hand free-choice trials and, overall, response selection determinants on free-choice trials matched for older and younger adults.

  7. 75 FR 32539 - Agency Information Collection (Dental Patient Satisfaction Survey) Activities Under OMB Review

    Science.gov (United States)

    2010-06-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Dental Patient Satisfaction Survey) Activities Under OMB Review... Form 10-0503).'' Title: Survey of Healthcare Experiences, Dental Patient Satisfaction Survey, VA...

  8. Serum YKL-40, a potential new marker of disease activity in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Vind, Ida; Johansen, J S; Price, P A

    2003-01-01

    BACKGROUND: YKL-40 is secreted by macrophages and neutrophils and is a growth factor for vascular endothelial cells and fibroblasts. Elevated serum concentrations of YKL-40 are found in patients with diseases characterized by inflammation or ongoing fibrosis. The aim of this study was to seek...... association between serum YKL-40 in patients with ulcerative colitis (UC) and Crohn disease (CD) and clinical disease activity. METHODS: One-hundred-and-sixty-four patients with UC and 173 patients with CD were studied. The Simple Clinical Colitis Activity Index (SCCAI) and the Harvey-Bradshaw (H-B) score...... were used to assess disease activity. Serum YKL-40 (determined by ELISA) was related to C-reactive protein (CRP) and disease activity. RESULTS: In patients with UC, the median serum YKL-40 rose with increasing disease activity, and patients with severe active disease had higher serum YKL-40 (median 59...

  9. Clinical and arthroscopic findings in recreationally active patients

    Directory of Open Access Journals (Sweden)

    Fowler Elizabeth M

    2010-01-01

    Full Text Available Abstract Objective To examine the diagnostic accuracy of standard clinical tests for the shoulder in recreational athletes with activity related pain. Design Cohort study with index test of clinical examination and reference standard of arthroscopy. Setting Sports Medicine clinic in Sheffield, U.K. Participants 101 recreational athletes (82 male, 19 female; mean age 40.8 ± 14.6 years over a six year period. Interventions Bilateral evaluation of movements of the shoulder followed by standardized shoulder tests, formulation of clinical diagnosis and shoulder arthroscopy conducted by the same surgeon. Main Outcome Measurements Sensitivity, specificity, likelihood ratio for a positive test and over-all accuracy of clinical examination was examined retrospectively and compared with arthroscopy. Results Isolated pathology was rare, most patients (72% having more than one injury recorded. O'Brien's clinical test had a mediocre sensitivity (64% and over-all accuracy (54% for diagnosing SLAP lesions. Hawkins test and Jobe's test had the highest but still not impressive over-all accuracy (67% and sensitivity (67% for rotator cuff pathology respectively. External and internal impingement tests showed similar levels of accuracy. When a positive test was observed in one of a combination of shoulder tests used for diagnosing SLAP lesions or rotator cuff disease, sensitivity increased substantially whilst specificity decreased. Conclusions The diagnostic accuracy of isolated standard shoulder tests in recreational athletes was over-all very poor, potentially due to the majority of athletes (71% having concomitant shoulder injuries. Most likely, this means that many of these injuries are missed in general practice and treatment is therefore delayed. Clinical examination of the shoulder should involve a combination of clinical tests in order to identify likely intra articular pathology which may warrant referral to specialist for surgery.

  10. The influence of monetary incentives on context processing in younger and older adults: an event-related potential study.

    Science.gov (United States)

    Schmitt, Hannah; Ferdinand, Nicola K; Kray, Jutta

    2015-06-01

    Recent evidence has indicated that neuronal activity related to reward anticipation benefits subsequent stimulus processing, but the effect of penalties remains largely unknown. Since the dual-mechanisms-of-control theory (DMC; Braver & Barch, Neuroscience and Biobehavioral Reviews, 26, 809-81, 2002) assumes that temporal differences in context updating underlie age differences in cognitive control, in this study we investigated whether motivational cues (signaling the chance to win or the risk to lose money, relative to neutral cues) preceding context information in a modified AX-CPT paradigm influence the temporal stages of context processing in younger and older adults. In the behavioral data, younger adults benefited from gain cues, evident in their enhanced context updating, whereas older adults exhibited slowed responding after motivational cues, irrespective of valence. Event-related potentials (ERPs) revealed that the enhanced processing of motivational cues in the P2 and P3b was mainly age-invariant, whereas age-differential effects were found for the ERP correlates of context processing. Younger adults showed improved context maintenance (i.e., a larger negative-going CNV), as well as increased conflict detection (larger N450) and resolution (indicated by a sustained positivity), whenever incorrect responding would lead to a monetary loss. In contrast, motivationally salient cues benefited context representations (in cue-locked P3b amplitudes), but increased working memory demands during response preparation (via a temporally prolonged P3b) in older adults. In sum, motivational valence and salience effects differentially modulated the temporal stages of context processing in younger and older adults. These results are discussed in terms of the DMC theory, recent findings of emotion regulation in old age, and the relationship between cognitive and affective processing.

  11. Providers, payers, the community, and patients are all obliged to get patient activation and engagement ethically right

    National Research Council Canada - National Science Library

    Danis, Marion; Solomon, Mildred

    2013-01-01

    .... Efforts to promote such patient activation and engagement are ethically justified because they are consonant with the well-established principle of respect for persons and, as the evidence shows...

  12. Intensive care unit admission in patients following rapid response team activation: call factors, patient characteristics and hospital outcomes.

    Science.gov (United States)

    Le Guen, M P; Tobin, A E; Reid, D

    2015-03-01

    Rapid Response Systems (RRSs) have been widely introduced throughout hospital health systems, yet there is limited research on the characteristics and outcomes of patients admitted to an intensive care unit (ICU) following RRS activation. Using database extraction, this study examined the factors associated with ICU admission and patient outcome in patients receiving RRS activation in a tertiary level hospital between 2009 and 2013. Of 3004 RRS activations, 392 resulted in ICU admissions. Call factors associated with ICU admission and increased hospital mortality included tachypnoea (P Medical Emergency Team call triggers breached simultaneously (P admission included young age (P admission and hospital mortality post RRS activation. This information may be useful for risk stratification of deteriorating patients and determination of appropriate escalation.

  13. Effect of action observation therapy on daily activities and motor recovery in stroke patients

    Directory of Open Access Journals (Sweden)

    Mei-Hong Zhu

    2015-09-01

    Conclusion: Action observation therapy significantly improves upper extremity motor function and performance of activities of daily living, and alleviates upper limb spasticity in patients with stroke.

  14. Impact of negative emotion on the neural correlates of long-term recognition in younger and older adults

    Directory of Open Access Journals (Sweden)

    Grégoria eKalpouzos

    2012-09-01

    Full Text Available Some studies have suggested that the memory advantage for negative emotional information over neutral information (negativity effect is reduced in aging. Besides the fact that most findings are based on immediate retrieval, the neural underpinnings of long-term emotional memory in aging have so far not been investigated. To address these issues, we assessed recognition of neutral and negative scenes after one- and 3-week retention intervals in younger and older adults using fMRI. We further used an event-related design in order to disentangle successful, false and true recognition. This study revealed 4 key findings: 1 Increased retention interval induced an increased rate of false recognitions for negative scenes, cancelling out the negativity effect (present for hit rates only on discrimination in both younger and older adults; 2 In younger, but not older, adults, reduced activity of the medial temporal lobe was observed over time for neutral scenes, but not for negative scenes, where stable or increased activity was seen; 3 Engagement of amygdala was observed in older adults after a 3-week delay during successful recognition of negative scenes (hits versus misses in comparison with neutral scenes, which may indicate engagement of automatic processes, but engagement of ventrolateral prefrontal cortex was unrelated to amygdala activity and performance; and 4 After 3 weeks, but not after one week, true recognition of negative scenes was characterized by more activity in left hippocampus and lateral occipito-temporal regions (hits versus false alarms. As these regions are known to be related to consolidation mechanisms, the observed pattern may indicate the presence of delayed consolidation of true memories. Nonetheless, older adults’ low performance in discrimination of negative scenes could reflect the fact that overall, after long delays of retention, they rely more on general information rather than on perceptual detail in making

  15. Impact of negative emotion on the neural correlates of long-term recognition in younger and older adults.

    Science.gov (United States)

    Kalpouzos, Grégoria; Fischer, Håkan; Rieckmann, Anna; Macdonald, Stuart W S; Bäckman, Lars

    2012-01-01

    Some studies have suggested that the memory advantage for negative emotional information over neutral information ("negativity effect") is reduced in aging. Besides the fact that most findings are based on immediate retrieval, the neural underpinnings of long-term emotional memory in aging have so far not been investigated. To address these issues, we assessed recognition of neutral and negative scenes after 1- and 3-week retention intervals in younger and older adults using functional magnetic resonance imaging. We further used an event-related design in order to disentangle successful, false, and true recognition. This study revealed four key findings: (1) increased retention interval induced an increased rate of false recognitions for negative scenes, canceling out the negativity effect (present for hit rates only) on discrimination in both younger and older adults; (2) in younger, but not older, adults, reduced activity of the medial temporal lobe was observed over time for neutral scenes, but not for negative scenes, where stable or increased activity was seen; (3) engagement of amygdala (AMG) was observed in older adults after a 3-week delay during successful recognition of negative scenes (hits vs. misses) in comparison with neutral scenes, which may indicate engagement of automatic processes, but engagement of ventrolateral prefrontal cortex was unrelated to AMG activity and performance; and (4) after 3 weeks, but not after 1 week, true recognition of negative scenes was characterized by more activity in left hippocampus and lateral occipito-temporal regions (hits vs. false alarms). As these regions are known to be related to consolidation mechanisms, the observed pattern may indicate the presence of delayed consolidation of true memories. Nonetheless, older adults' low performance in discrimination of negative scenes could reflect the fact that overall, after long delays of retention, they rely more on general information rather than on perceptual

  16. Urinary heparanase activity in patients with Type 1 and Type 2 diabetes.

    Science.gov (United States)

    Rops, Angelique L W M M; van den Hoven, Mabel J; Veldman, Bart A; Salemink, Simone; Vervoort, Gerald; Elving, Lammy D; Aten, Jan; Wetzels, Jack F; van der Vlag, Johan; Berden, Jo H M

    2012-07-01

    A reduced heparan sulphate (HS) expression in the glomerular basement membrane of patients with overt diabetic nephropathy is associated with an increased glomerular heparanase expression. We investigated the possible association of urinary heparanase activity with the development of proteinuria in patients with Type 1 diabetes (T1D), Type 2 diabetes (T2D), or membranous glomerulopathy (MGP) as non-diabetic disease controls. Heparanase activity, albumin, HS and creatinine were measured in the urine of patients with T1D (n=58) or T2D (n=31), in patients with MGP (n=52) and in healthy controls (n=10). Heparanase messenger RNA (mRNA) expression in leukocytes was determined in a subgroup of patients with T1D (n=19). Urinary heparanase activity was increased in patients with T1D and T2D, which was more prominent in patients with macroalbuminuria, whereas no activity could be detected in healthy controls. Albuminuria levels were associated with increased urinary heparanase activity in diabetic patients (r=0.20; P<0.05) but not in patients with MGP (r=0.11; P=0.43). A lower urinary heparanase activity was observed in diabetic patients treated with inhibitors of the renin-angiotensin-aldosterone system (RAAS), when compared to diabetic patients treated with other anti-hypertensives. Additionally, urinary heparanase activity was associated with age in T1D and MGP. In MGP, heparanase activity and β2-microglobulin excretion correlated. In patients with T1D, no differences in heparanase mRNA expression in leukocytes could be observed. Urinary heparanase activity is increased in diabetic patients with proteinuria. However, whether increased heparanase activity is a cause or consequence of proteinuria requires additional research.

  17. Decreased salivary sulphotransferase activity correlated with inflammation and autoimmunity parameters in Sjogren's syndrome patients

    DEFF Research Database (Denmark)

    Castro, Isabel; Aguilera, Sergio; Brockhausen, Inka

    2012-01-01

    To determine the expression and enzymatic activities of sulphotransferases involved in mucin hyposulphation in labial salivary glands (LSGs) from SS patients and to correlate sulphotransferase activity with clinical parameters such as secretion, inflammation and serology....

  18. The relationship between disease activity and radiologic progression in patients with rheumatoid arthritis: a longitudinal analysis.

    NARCIS (Netherlands)

    Welsing, P.M.J.; Landewe, R.B.; Riel, P.L.C.M. van; Boers, M.; Gestel, A.M. van; Linden, S.G. van der; Swinkels, H.L.; Heijde, D.M.F.M. van der

    2004-01-01

    OBJECTIVE: Radiologic progression in rheumatoid arthritis (RA) is considered the consequence of persistent inflammatory activity. To determine whether a change in disease activity is related to a change in radiologic progression in individual patients, we investigated the longitudinal relationship b

  19. MBM12 A Younger Version of the TW Hydrae Association?

    CERN Document Server

    Wolk, S J; Jayawardhana, R; Hearty, T J; Wolk, Scott J.; Cover, Rebecca T.; Jayawardhana, Ray; Hearty, Thomas J.

    2000-01-01

    We present optical and infrared photometry of stars near the MBM 12 dark cloud. The optical data indicate that there are about 40 candidate pre-main sequence stars in the same area currently occupied by eight bona-fide PMS stars. Analysis of 2MASS data suggests that 60% of PMS candidates have been detected. Some of these show evidence of optically thick disks. Our study of the 2MASS data also reveals a large enhancement of sources within the MBM 12 cloud, indicating that it is still actively forming stars.

  20. Call 4 Concern: patient and relative activated critical care outreach.

    Science.gov (United States)

    Odell, Mandy; Gerber, Karin; Gager, Melanie

    Patients can experience unexpected deterioration in their physiological condition that can lead to critical illness, cardiac arrest, admission to the intensive care unit and death. While ward staff can identify deterioration through monitoring physiological signs, these signs can be missed, interpreted incorrectly or mismanaged. Rapid response systems using early warning scores can fail if staff do not follow protocols or do not notice or manage deterioration adequately. Nurses often notice deterioration intuitively because of their knowledge of individual patients. Patients and their relatives have the greatest knowledge of patients, and can often pick up subtle signs physiological deterioration before this is identified by staff or monitoring systems. However, this ability has been largely overlooked. Call 4 Concern (C4C) is a scheme where patients and relatives can call critical care teams directly if they are concerned about a patient's condition- it is believed to be the first of its kind in the UK. A C4C feasibility project ran for six months, covering patients being transferred from the intensive care unit to general wards. C4C has the potential to prevent clinical deterioration and is valued by patients and relatives. Concerns of ward staff could be managed through project management. As it is relatively new, this field offers further opportunities for research.

  1. Abnormal atrial activation in young patients with lone atrial fibrillation

    DEFF Research Database (Denmark)

    Holmqvist, Fredrik; Olesen, Morten S; Tveit, Arnljot

    2011-01-01

    Aims Patients with a history of atrial fibrillation (AF) have previously been shown to have altered atrial conduction, as seen non-invasively using signal-averaged P-wave analysis. However, little is known about the P-wave morphology in patients in the early phases of AF with structurally normal ...

  2. Serum YKL-40 concentrations in patients with rheumatoid arthritis: relation to disease activity

    DEFF Research Database (Denmark)

    Johansen, J S; Stoltenberg, M; Hansen, M

    1999-01-01

    OBJECTIVE: YKL-40, also called human cartilage glycoprotein-39, is secreted by chondrocytes, synovial cells, macrophages and neutrophils. Studies have shown that YKL-40 is an autoantigen in rheumatoid arthritis (RA). We evaluated whether serum YKL-40 was related to disease activity in patients...... with RA. METHODS: Serum YKL-40 was determined by radioimmunoassay in 156 patients with RA during a 1 yr longitudinal study. RESULTS: Serum YKL-40 was increased in 54% of the patients with clinically active disease. Patients with clinically active disease initially who became inactive after 12 months had...... a significant decrease in serum YKL-40 (-30%, P patients who changed from inactive to active disease had an increase in serum YKL-40. Patients who remained active had unchanged serum YKL-40 during the study. Serum YKL-40 decreased rapidly (-24% after 7 days, P

  3. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity

    Directory of Open Access Journals (Sweden)

    Alexander Tallner

    2015-07-01

    Full Text Available Multiple sclerosis (MS patients, in general, show reduced physical function, physical activity, and quality of life. Positive associations between physical activity and quality of life have been reported. In particular, we were interested in the relation between physical activity and mental health in MS patients without limitation of physical function, since limitations of physical function may influence both physical activity and quality of life. Assessment comprised the Baecke questionnaire on physical activity, the Short Form 36 Health Survey (SF-36, and Beck Depression Inventory (BDI. We ranked our sample according to physical activity into four groups and performed an ANOVA to analyze the relationship between levels of physical activity and health-related quality of life (HRQoL. Then we performed a subgroup analysis and included patients with unlimited walking distance and a score of less than 18 in the BDI. Most active vs. inactive patients were compared for the mental subscales of the SF-36 and depression scores. From 632 patients, 265 met inclusion criteria and hence quartiles were filled with 67 patients each. Active and inactive patients did not differ considerably in physical function. In contrast, mental subscales of the SF-36 were higher in active patients. Remarkable and significant differences were found regarding vitality, general health perception, social functioning and mental health, all in favor of physically active patients. Our study showed that higher physical activity is still associated with higher mental health scores even if limitations of physical function are accounted for. Therefore, we believe that physical activity and exercise have considerable health benefits for MS patients.

  4. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity.

    Science.gov (United States)