Sample records for active patients younger

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

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


    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

    Abbasowa, Leda; Madsen, Poul Henning


    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. Treatment of younger patients with chronic lymphocytic leukemia.

    Ferrajoli, Alessandra


    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.

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

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


    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

  5. Is Chemo Overused in Younger Colon Cancer Patients?

    ... 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 ...

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

    Guangjie HOU


    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.

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

    Carter, Thomas R; Rabago, Michael T


    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.

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

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


    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.

  9. North Atlantic Storm Activity During the Younger Dryas

    Toomey, M.


    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.

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

    Oude Voshaar, R.C.; Veen, D.C. van der; 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 15-y

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

    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 15-y

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

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


    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

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

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


    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.

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

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


    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.

  15. Educating for Political Activity: A Younger Generational Response

    Mac an Ghaill, Mairtin


    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…

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

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


    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.

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

    Geisler, Christian H


    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...

  18. Younger Age Is an Independent Predictor for Poor Survival in Patients with Signet Ring Prostate Carcinoma

    Jue Wang


    Full Text Available Objective. The aim of this study was to examine the epidemiology, natural history, treatment pattern, and predictors of long-term survival of signet ring prostate carcinoma (SRPC patients based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER database. Methods & Results. Between 1980 and 2004, a total of 93 patients with pathologically confirmed SRPC were identified. The mean age was 70±11 years old. 82.8% of the patients had poorly or undifferentiated histology grade. 13.9% patients presented with metastatic disease. The 1-, 3-, and 5-year cancer-specific survival rates were 94.6%, 89.6%, and 83.8%, respectively. Using multivariate Cox proportional hazard model, younger age (40–50 versus age >70 yrs, =.01, advanced tumor stage (distant versus local/regional, =.02, and earlier diagnosis year (before 1995 versus after 1995, =.01 were predictors of worse cancer specific survival. Conclusions. Despite more aggressive cancer therapy, younger SRPC patients had a worse cancer specific survival. This information could be useful when counseling these patients and emphasizes the need for new strategies and molecular-based therapeutic approaches for younger patients with SRPC.

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

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


    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.

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



    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.

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

    Syed Mukith Ur Rahaman


    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.

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

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


    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...

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

    Repko I.P.


    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.

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

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


    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.

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

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


    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

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

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


    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

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

    Kreidy R


    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

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

    Ohsugi Hironori


    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

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

    Klit, Jakob


    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...

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

    Klit, Jakob


    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...

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

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


    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.

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

    Fritz Thorey


    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.

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

    Masashi Kusano


    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.

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

    Klit, Jakob; Jacobsen, Steffen; Rosenlund, Signe


    In this prospective multicenter study we included subjects younger than 60 years of age and scheduled for primary total knee arthroplasty (TKA). The study assessed patients’ overall satisfaction, fulfillment of pre-operative expectations, the effect on socioeconomic parameters, and quality...... 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...

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

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


    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…

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

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


    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."

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

    Philippe eRochigneux


    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.

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

    Siobhan L. Crichton


    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.

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

    Marius Dettmer


    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.

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

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


    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

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

    Arciero, Paul J; Ormsbee, Michael J


    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; O, 204 +/- 101 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 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).

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

    Ritu eSikka


    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.

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

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


    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.

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

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


    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.

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

    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.

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

    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


    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.

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

    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.

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

    Kåreholt Ingemar


    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.

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

    Akbari Mohammad


    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.

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

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


    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.

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

    Asgar Elmi


    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

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

    Bogdanos Dimitrios P


    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.

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

    Johan Denollet


    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.

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

    Ben Huang


    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.

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

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


    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


    Ksenia Pavlovna Zaytseva


    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.

  17. 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

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


    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....

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

    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)


    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

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

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


    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…

  20. 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

    侯广杰; 张连斌; 初向阳; 王继云


    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

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

    Vukomanović Aleksandra


    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.

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

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


    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.

  3. 8-year trends in physical activity, nutrition, TV viewing time, smoking, alcohol and BMI: A comparison of younger and older Queensland adults

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


    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

  4. 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.

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


    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.

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

    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.

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

    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.


    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

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

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


    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.

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

    Gajanan D. Khadkikar


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

    Zhou ShuMei


    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

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

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


    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.

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

    陈美如; 张丽贤; 田志颖; 王丽华


    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

  12. 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.

    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


    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 (EudraCT Number: 2004-004321-95).

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

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


    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....

  14. 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.

    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


    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.

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

    Beisecker, Analee E.; And Others


    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…

  16. 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?

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


    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...

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

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


    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.

  18. Exposed: younger mothers and breastfeeding.

    Noble-Carr, Debbie; Bell, Catherine


    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.

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

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


    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.

  20. 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.

    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


    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 as #NCT00006363.

  1. 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.

    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


    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.

  2. Clinical presentation of urolithiasis in older and younger population

    Murat Dursun


    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.

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

    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


    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.

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

    Samed Ordu


    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

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

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


    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.)

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

    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)


    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

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

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


    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....

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

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


    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...

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

    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.


    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

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

    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.


    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

  11. 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.

    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.

  12. 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

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


    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

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

    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


    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.

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

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


    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.

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

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


    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.

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

    Đorđević Vladimir V.


    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

  17. Older Siblings Influence Younger Siblings' Motor Development

    Berger, Sarah E.; Nuzzo, Katie


    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…

  18. Coagulation factor VIII activity in diabetic patients

    Nermina Babić


    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.

  19. 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

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


    ,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.




    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

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

    Ennis Marguerite


    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

  2. Physical Activity in Hospitalised Stroke Patients

    Tanya West


    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.

  3. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    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: [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)


    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

  4. On Younger Stakeholders and Decommissioning of Nuclear Facilities

    Tyszkiewicz, Bogumila; Labor, Bea


    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

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

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


    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

  6. Nutrition and Physical Activity in CKD patients

    Adamasco Cupisti


    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.

  7. The atmosphere during the younger dryas.

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


    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.

  8. T cell activation in APECED patients

    Mannerström, Helga


    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...

  9. 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

    蔡煦; 沈卫峰; 龚兰生


    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

  10. Physical activity in patients with anorexia nervosa.

    Achamrah, Najate; Coëffier, Moïse; Déchelotte, Pierre


    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.

  11. Design for learning: deconstructing virtual patient activities.

    Ellaway, Rachel H; Davies, David


    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'.

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

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


    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

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

    Martin Salö


    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.

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

    Rodbell, D T


    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.

  15. 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

    任维果; 边家盛; 夏宝山; 宋海峰; 吴石; 许真俊; 章建胜


    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

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

    Peter Jirak


    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.

  17. Meltwater routing and the Younger Dryas.

    Condron, Alan; Winsor, Peter


    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.

  18. 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

    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


    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

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

    Silvia Maria Velasques de Oliveira


    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.

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

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


    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.

  1. On Younger Stakeholders and Decommissioning of Nuclear Facilities

    Tyszkiewicz, Bogumila; Labor, Bea


    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. 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

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


    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

  3. 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

    罗凤; 唐秀英; 吴凯南; 石果; 金鹏娟


    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 .

  4. Analysis of the Younger Dryas Impact Layer

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


    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

  5. 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

    李晓林; 王嘉玮; 刘传信


    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.

  6. 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.

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


    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.

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

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


    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.

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

    Todaro, A


    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.

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

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


    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

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

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


    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…

  11. Habitual fat intake predicts memory function in younger women

    Edward Leigh eGibson


    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

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

    Moore, DeWayne; And Others


    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)

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

    Bialystok, Ellen; Craik, Fergus; Luk, Gigi


    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…

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

    Leininger, Lindsey Jeanne; Burns, Marguerite E


    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.

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

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


    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.


    Yulia V. KURBATOVA


    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. 

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

    ... page: 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 ...

  18. Obesity and sexual dysfunction in younger Danish men

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


    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...

  19. CDC Vital Signs: Preventing Pregnancies in Younger Teens

    ... AIDS Motor Vehicle Safety Obesity Prescription Drug Overdoses Teen Pregnancy Tobacco Other Digital Media Tools About Vital Signs ... Report (MMWR) CDC Feature - Breaking the Cycle of Teen Pregnancy Vital Signs – Preventing Pregnancy in Younger Teens [ ...

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

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


    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…

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

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


    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

    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.


    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

    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


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

    Shah, Shawn L; Siegel, Corey A


    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.

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

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


    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.

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

    Shafquat Azam


    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

  7. Effects of an Individualized Activity Program on Elderly Patients

    Salter, Carlota de Lerma; Salter, Charles A.


    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…

  8. Promoting physical activity in patients with rheumatoid arthritis

    Berg, Machteld Heleen van den


    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

  9. Backward compatibility effects in younger and older adults.

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


    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.

  10. Younger Dryas glaciers in the High Atlas, Morocco

    Hughes, Philip; Fink, David


    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.

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

    Kedage Vivekananda


    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.

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

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


    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

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

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


    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...

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

    Tanji, Jeffrey L.; Batt, Mark E.


    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…

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

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


    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.

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

    Maliy D.V.


    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


    应作霖; 孙建方; 刘珊


    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.

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

    Katarzyna Pawlak-Osińska


    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.

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

    Ellaway, Rachel H


    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.

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

    Woodard LD


    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

  1. Media use by children younger than 2 years.

    Brown, Ari


    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.

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

    Beck, Vanessa; Quinn, Martin


    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…

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

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


    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…

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

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


    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

  5. Physical Activity in Hemodialysis Patients Measured by Triaxial Accelerometer

    Edimar Pedrosa Gomes


    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.

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

    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


    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.

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

    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


    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.

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

    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


    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.

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

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


    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.

  10. Physical Activity in Patients Treated With Peritoneal Dialysis

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


    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

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

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


    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.

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

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


    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...

  13. Ongoing contact activation in patients with hereditary angioedema.

    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.

  14. Oxidative stress level and tyrosinase activity in vitiligo patients

    Eskandani M


    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.

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

    Nurhan Sarioglu


    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.

  16. Rapid Response Team Activations in Pediatric Surgical Patients.

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


    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

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

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


    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.

  18. Active surveillance strategy for patients with localised prostate cancer

    Thomsen, Frederik Birkebæk


    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...

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

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


    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 acceleromet

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

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


    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.

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

    Ping Wu


    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.

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

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


    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.

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

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


    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.

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

    Tatiana Lorincová


    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...

  5. Are Younger or Older Cohorts Hurt the Most?

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


    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 ...

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

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


    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

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

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


    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.

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

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


    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.

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

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


    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

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

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


    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...

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

    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.

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

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

    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.

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

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


    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.

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

    Tijssen, MAJ; Marsden, JF; Brown, P


    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

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

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


    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.

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

    Li SUN


    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

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

    Larrilyn Yelton


    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.

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

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


    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.

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

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


    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.

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

    Signy Bendiksen


    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.

  2. Barriers associated with reduced physical activity in COPD patients

    Priscila Batista Amorim


    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.


    B. Ya. Alekseev


    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.

  4. Asymmetric pallidal neuronal activity in patients with cervical dystonia

    Christian KE eMoll


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

    Berkay Cataloglu


    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

  6. Recognising lifestyle activities of diabetic patients with a smartphone

    Mitja Luštrek


    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.

  7. Studies on Activity of NK Cells in Preeclampsia Patients

    张展; 龚非力; 贾莉婷; 常彩红; 侯磊; 杨如镜; 郑芳


    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.

    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


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

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


    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.

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

    Crain, E F; Gershel, J C


    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.

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

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


    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.

  12. Maintenance of physical activity in patients with rheumaoid arthritis

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


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

    Painter, Patricia; Marcus, Robin L


    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.

  14. Physical activity maintenance in patients with rheumatoid arthritis

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


    were analysed using systematic text condensation, inspired by Giorgi's descriptive phenomenological methodology. RESULTS: The analysis revealed three categories: (1) knowing and enjoying the body; (2) responsibility and challenges; (3) autonomy and social belonging. On the basis of these categories...... with non-arthritis populations. CONCLUSION: This study demonstrates that physical activity in patients with rheumatoid arthritis may be understood as a resource to resist disability and to feel and stay healthy while creating and sustaining meaningfulness in life....

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

    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.

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

    Afrashtehfar, Kelvin I; Schimmel, Martin


    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

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

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


    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

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

    Egsmose, Emilie Lund; Madsen, Ole Rintek


    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...

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

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


    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

  20. Spontaneous neutrophil activation in HTLV-1 infected patients

    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. Physical activity in patients with type 2 diabetes and hypertension – insights into motivations and barriers from the MOBILE study

    Duclos M


    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

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

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


    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

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

    Tatiana Lorincová


    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

  4. Kids 14 and Younger Only Need 2 HPV Vaccine Shots: CDC

    ... 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. ...

  5. Professional and social activity of patients after heart transplant

    Urszula Marcinkowska


    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

  6. Measuring patient activation in the Netherlands: translation and validation of the American short form Patient Activation Measure (PAM13

    Rademakers Jany


    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.

  7. Gene expression analysis of glioblastomas identifies the major molecular basis for the prognostic benefit of younger age

    Farooqi Haumith K


    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. How do older netcitizens compare with their younger counterparts?

    Bucur, A; Renold, C; Henke, M


    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.

  9. Warm summers during Younger Dryas cold reversal over Eurasia

    Schenk, Frederik; Muschitiello, Francesco; Heikkilä, Miaja; Väliranta, Minna; Tarasov, Lev; Brandefelt, Jenny; Johansson, Arne; Näslund, Jens-Ove; Wohlfarth, Barbara


    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.

  10. Otitis media with effusion in children younger than 1 year

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael


    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

  11. Otitis media with effusion in children younger than 1 year

    Renata Cantisani Di Francesco


    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.

  12. Characteristics of treatment naive chronic hepatitis B in Bangladesh: Younger populations are more affected; HBeAg-negatives are more advanced

    Alam Shahinul


    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.

  13. Immunization Uptake in Younger Siblings of Children with Autism Spectrum Disorder

    Kuwaik, Ghassan Abu; Roberts, Wendy; Zwaigenbaum, Lonnie; Bryson, Susan; Smith, Isabel M.; Szatmari, Peter; Modi, Bonnie M.; Tanel, Nadia; Brian, Jessica


    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…




    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.

  15. Serum amylase activity and renal amylase activity clearance in patients with severely impaired renal function and in patients treated with renal allotransplantation.

    Pedersen, E B; Brock, A; Kornerup, H J


    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.

  16. [Gallbladder motor activity in patients with virus hepatitis B].

    Mamos, Arkadiusz; Wichan, Paweł; Chojnacki, Jan; Grzegorczyk, Krzysztof


    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.

  17. Spatial-sequential working memory in younger and older adults: age predicts backward recall performance within both age groups

    Louise A. Brown


    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

  18. Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups

    Brown, Louise A.


    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

  19. Serum arylesterase and paraoxonase activity in patients with chronic hepatitis

    Suleyman Sirri Kilic; Suleyman Aydin; Nermin Kilic; Fazilet Erman; Suna Aydin; (I)lhami Celik


    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.

  20. The role of play in pre-school and younger school age children

    Kopas-Vukašinović Emina


    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.

  1. The presence of primary circulating prostate cells is associated with upgrading and upstaging in patients eligible for active surveillance

    Murray, Nigel P; Reyes, Eduardo; Fuentealba, Cynthia; Aedo, Socrates; Jacob, Omar


    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

  2. Abrupt release of terrigenous organic carbon to the Laptev Sea at termination of the Younger Dryas

    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.


    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.

  3. Does roflumilast induce phagocytic activity in COPD patients?

    Ghosh B


    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.

  4. Dynamic hyperinflation during activities of daily living in COPD patients.

    Silva, Cláudia S; Nogueira, Fabiana R; Porto, Elias F; Gazzotti, Mariana R; Nascimento, Oliver A; Camelier, Aquiles; Jardim, José R


    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.

  5. [Spontaneous activity of cutaneous nociceptors in patients with painful polyneuropathy. Report of three patients].

    Campero, Mario; Campero, Sebastián


    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.

  6. Younger and Older Users’ Recognition of Virtual Agent Facial Expressions

    Beer, Jenay M.; Smarr, Cory-Ann; Fisk, Arthur D.; Rogers, Wendy A.


    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

  7. Therapeutic options for patients returning to sexual activity.

    Nusbaum, Margaret R H


    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.

  8. Increased Incidence of Interatrial Block in Younger Adults with Cryptogenic Stroke and Patent Foramen Ovale

    P.E. Cotter


    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.

  9. Differences in physical functioning between relatively active and passive patients with Chronic Fatigue Syndrome.

    Vos-Vromans, D.C.; Huijnen, I.P.; Koke, A.J.; Seelen, H.A.; Knottnerus, J.A.; Smeets, R.J.P.


    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

  10. 78 FR 53195 - Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request


    ... 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...

  11. Exercise holds immediate benefits for affect and cognition in younger and older adults.

    Hogan, Candice L; Mata, Jutta; Carstensen, Laura L


    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.

  12. The Difference between Right and Wrong: Accuracy of Older and Younger Adults’ Story Recall

    Danielle K. Davis


    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.

  13. "Feeling younger, walking faster": subjective age and walking speed in older adults.

    Stephan, Yannick; Sutin, Angelina R; Terracciano, Antonio


    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.

  14. Hiding its age: the case for a younger bulge

    Haywood, M; Snaith, O; Calamida, A


    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. ...

  15. The Younger Dryas in the West Pacific marginal seas

    汪品先; 卞云华; 李保华; 黄奇瑜


    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.

  16. 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

    Sachsse Jan


    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

  17. Complement factor B activation in patients with preeclampsia.

    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


    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.

  18. Global strategy for the diagnosis and management of asthma in children 5 years and younger.

    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


    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

  19. DANBIO-powerful research database and electronic patient record

    Hetland, Merete Lund


    with RA patients, who were on conventional treatment with DMARDs, the patients who started biological treatment were younger, had longer disease duration, higher disease activity, tried more DMARDs and received more prednisolone. Also, more patients on biological therapy were seropositive and had erosive...... disease. However, the current levels of disease activities and the fraction of patients who had gone into remission in the two groups of patients were very similar. This indicates that clinicians have a common treatment goal for RA patients regardless of treatment. In conclusion, DANBIO serves...... as an electronic patient 'chronicle' in routine care, and at the same time provides a powerful research database....

  20. Relationship between balance and physical activity measured by an activity monitor in elderly COPD patients

    Iwakura, Masahiro; Okura, Kazuki; Shibata, Kazuyuki; Kawagoshi, Atsuyoshi; Sugawara, Keiyu; Takahashi, Hitomi; Shioya, Takanobu


    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

  1. A report of two cases of splenectomy in children younger than two years old with hereditary spherocytosis

    Sheng Jin


    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.

  2. Penfigoide bolhoso no adulto mais jovem: relato de três casos Bullous pemphigoid in younger adults: three case reports

    Roberta Richter Zanella


    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.

  3. Heinrich 0 at the Younger Dryas Termination Offshore Newfoundland

    Pearce, C.; Andrews, J. T.; Jennings, A. E.; Bouloubassi, I.; Seidenkrantz, M. S.; Kuijpers, A.; Hillaire-Marcel, C.


    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.

  4. Factors associated with younger adolescents' exposure to online alcohol advertising.

    D'Amico, Elizabeth J; Martino, Steven C; Collins, Rebecca L; Shadel, William G; Tolpadi, Anagha; Kovalchik, Stephanie; Becker, Kirsten M


    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

  5. Thyroid axis activity and suicidal behavior in depressed patients.

    Duval, Fabrice; Mokrani, Marie-Claude; Lopera, Felix Gonzalez; Diep, Thanh Son; Rabia, Hassen; Fattah, Saïd


    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.

  6. The ironic effect of guessing: increased false memory for mediated lists in younger and older adults.

    Coane, Jennifer H; Huff, Mark J; Hutchison, Keith A


    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

    Cox Victoria C


    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. Younger age as a prognostic indicator in breast cancer: A cohort study

    Kheirelseid, Elrasheid A.H.


    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.

  9. Relationship between balance and physical activity measured by an activity monitor in elderly COPD patients

    Iwakura M


    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

  10. 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.

    Chirgwin, Jacquie; Sun, Zhuoxin; Smith, Ian; Price, Karen N; Thürlimann, Beat; Ejlertsen, Bent; Bonnefoi, Hervé; Regan, Meredith M; Goldhirsch, Aron; Coates, Alan S


    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.

  11. Short term effects of corticosteroid pulse treatment on disease activity and the wellbeing of patients with active rheumatoid arthritis

    Jacobs, JWG; Geenen, R; Evers, AWM; van Jaarsveld, CHM; Kraaimaat, FW; Bijlsma, JWJ


    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

  12. Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

    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.

  13. Telemonitoring of Daily Activity and Symptom Behavior in Patients with COPD

    Monique Tabak


    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.

  14. Younger age at onset of sporadic Parkinson’s disease among subjects occupationally exposed to metals and pesticides

    Ratner Marcia H.


    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.

  15. Motivation, self-regulation and physical activity among patients with rheumatoid arthritis

    Knittle, Keegan


    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

  16. Informal work and formal plans: Articulating the active role of patients in cancer trajectories

    Dalsted, R.; Hølge-Hazelton, Bibi; Kousgaard, MB;


    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...

  17. Patient Activation in Type 2 Diabetes: Does It Differ between Men and Women?

    Steven H. Hendriks


    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.

  18. Assessing motor imagery ability in younger and older adults by combining measures of vividness, controllability and timing of motor imagery.

    Saimpont, Arnaud; Malouin, Francine; Tousignant, Béatrice; Jackson, Philip L


    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.

  19. Subtropical freshwater event at the onset of Younger Dryas

    Weinelt, M.; Repschläger, J.; Balmer, S.; Schwab, C.; Andersen, N.; Blanz, T.; Sarnthein, M.


    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. 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

    Endesfelder, David; McGranahan, Nicholas; Birkbak, Nicolai Juul;


    . 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...

  1. How might physical activity benefit patients with Parkinson disease?

    Speelman, A.D.; Warrenburg, B.P.C. van de; Nimwegen, M.L. van; Petzinger, G.M.; Munneke, M.; Bloem, B.R.


    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

  2. Younger Children's (Three to Five Years) Perceptions of Being in a Health-Care Situation

    Stålberg, Anna; Sandberg, Anette; Söderbäck, Maja


    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…

  3. A Group-Based Program of Emotional Recovery for Younger Women Following Myocardial Infarction

    Bowers, Michele J.; Buchanan, Marla J.


    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 …

  4. The role of prior knowledge in error correction for younger and older adults.

    Sitzman, Danielle M; Rhodes, Matthew G; Tauber, Sarah K; Liceralde, Van Rynald T


    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.

  5. Neurocognitive and Behavioral Outcomes of Younger Siblings of Children with Autism Spectrum Disorder at Age Five

    Warren, Zachary E.; Foss-Feig, Jennifer H.; Malesa, Elizabeth E.; Lee, Evon Batey; Taylor, Julie Lounds; Newsom, Cassandra R.; Crittendon, Julie; Stone, Wendy L.


    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…

  6. 75 FR 32539 - Agency Information Collection (Dental Patient Satisfaction Survey) Activities Under OMB Review


    ... 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...

  7. Influence of outdoor games on functional condition of the respiratory system at girls of the younger school age

    Оlena Potapova


    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.

  8. The preservation of response inhibition aftereffects in a location-based spatial negative priming task: younger versus older adults.

    Buckolz, Eric; Lok, Michael; Kajaste, Ben; Edgar, Cameron; Khan, Michael


    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.

  9. Serum YKL-40, a potential new marker of disease activity in patients with inflammatory bowel disease

    Vind, Ida; Johansen, J S; Price, P A


    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...

  10. Time-related feedback messages for changing activity behaviour of patients with COPD

    Tabak, Monique; Akker, op den Harm; Hermens, H.J.


    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

  11. Intensive care unit admission in patients following rapid response team activation: call factors, patient characteristics and hospital outcomes.

    Le Guen, M P; Tobin, A E; Reid, D


    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.

  12. Physical activity and physical activity cognitions are potential factors maintaining fatigue in patients with primary Sjogren's syndrome

    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

  13. Clinical and arthroscopic findings in recreationally active patients

    Fowler Elizabeth M


    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.

  14. Are hospitals also for relatives? A survey of hospitals' activities regarding relatives of cardiac patients

    Nissen, Nina Konstantin; Madsen, Mette; Kjøller, Mette;


    AIM: Patients and their close relatives both feel the burden of cardiovascular disease. Relatives of heart patients experience lower quality of life and increased mortality than the general population and relatives of patients with other diseases. Nevertheless, knowledge on health services aimed ...... of resources, lack of interest and knowledge among staff, and practical and psychological barriers among patients and relatives. More research is needed on health services concerning relatives of cardiac patients, regarding both the prevalence of activities and barriers to these....

  15. Impact of negative emotion on the neural correlates of long-term recognition in younger and older adults

    Grégoria eKalpouzos


    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

  16. The relationship between disease activity and radiologic progression in patients with rheumatoid arthritis: a longitudinal analysis.

    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


    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

  17. Decreased salivary sulphotransferase activity correlated with inflammation and autoimmunity parameters in Sjogren's syndrome patients

    Castro, Isabel; Aguilera, Sergio; Brockhausen, Inka;


    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. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity

    Alexander Tallner


    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.

  19. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity.

    Tallner, Alexander; Waschbisch, Anne; Hentschke, Christian; Pfeifer, Klaus; Mäurer, Mathias


    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.

  20. Prediction of remission and low disease activity in disease-modifying anti-rheumatic drug-refractory patients with rheumatoid arthritis treated with golimumab

    Kutzbach, Abraham Garcia; Amital, Howard; Pavelka, Karel; Lazaro, María Alicia; Moots, Robert J.; Wollenhaupt, Jürgen; Zerbini, Cristiano A. F.; Louw, Ingrid; Combe, Bernard; Beaulieu, Andre; Schulze-Koops, Hendrik; Dasgupta, Bhaskar; Fu, Bo; Huyck, Susan; Weng, Haoling H.; Govoni, Marinella; Durez, Patrick


    Objective. To create a tool to predict probability of remission and low disease activity (LDA) in patients with RA being considered for anti-TNF treatment in clinical practice. Methods. We analysed data from GO-MORE, an open-label, multinational, prospective study in biologic-naïve patients with active RA (DAS28-ESR ⩾3.2) despite DMARD therapy. Patients received 50 mg s.c. golimumab (GLM) once monthly for 6 months. In secondary analyses, regression models were used to determine the best set of baseline factors to predict remission (DAS28-ESR <2.6) at month 6 and LDA (DAS28-ESR ⩽3.2) at month 1. Results. In 3280 efficacy-evaluable patients, of 12 factors included in initial regression models predicting remission or LDA, six were retained in final multivariable models. Greater likelihood of LDA and remission was associated with being male; younger age; lower HAQ, ESR (or CRP) and tender joint count (or swollen joint count) scores; and absence of comorbidities. In models predicting 1-, 3- and 6-month LDA or remission, area under the receiver operating curve was 0.648–0.809 (R2 = 0.0397–0.1078). The models also predicted 6-month HAQ and EuroQoL-5-dimension scores. A series of matrices were developed to easily show predicted rates of remission and LDA. Conclusion. A matrix tool was developed to show predicted GLM treatment outcomes in patients with RA, based on a combination of six baseline characteristics. The tool could help provide practical guidance in selection of candidates for anti-TNF therapy. PMID:27114562

  1. Development and evaluation of a hospital-based peer support group for younger individuals with stroke.

    Muller, Melissa; Toth-Cohen, Susan; Mulcahey, M J


    The incidence of stroke in younger individuals is rising, producing unique challenges due to loss of productive roles and long-term impact in the survivor's life. This paper reports the results of a hospital-based program based on occupational therapy principles that was designed to provide support and education for 13 younger individuals (<65) with stroke. Participants demonstrated improved socialization, healthy coping, and role attainment as measured by the Stroke Impact Scale (SIS), the Community Integration Questionnaire (CIQ), and a member satisfaction questionnaire. Key factors for successful implementation and considerations for future programs to meet the needs of younger adults with stroke are discussed.

  2. Normal reference value of forced vital capacity of Chinese younger women and geographical factors


    Objective To supply a scientific basis for standardizing the normal reference value of forced vital capacity(FVC)of Chinese younger women.Methods We studied the relationship between the normal reference value of 21767 samples of FVC of younger women and eight geographical factors in 157 areas in China.Results It was found that the correlation between geographical factors and the normal reference value of FVC of younger women was quite significant(F=5.884,P=0.000).By adopting the method of mathematical regre...

  3. Consensus Recommendations for Advancing Breast Cancer: Risk Identification and Screening in Ethnically Diverse Younger Women

    Alexander Stojadinovic, Thomas A Summers, John Eberhardt, Albert Cerussi, Warren Grundfest, Charles M. Peterson, Michael Brazaitis, Elizabeth Krupinski, Harold Freeman


    Full Text Available A need exists for a breast cancer risk identification paradigm that utilizes relevant demographic, clinical, and other readily obtainable patient-specific data in order to provide individualized cancer risk assessment, direct screening efforts, and detect breast cancer at an early disease stage in historically underserved populations, such as younger women (under age 40 and minority populations, who represent a disproportionate number of military beneficiaries. Recognizing this unique need for military beneficiaries, a consensus panel was convened by the USA TATRC to review available evidence for individualized breast cancer risk assessment and screening in young (< 40, ethnically diverse women with an overall goal of improving care for military beneficiaries. In the process of review and discussion, it was determined to publish our findings as the panel believes that our recommendations have the potential to reduce health disparities in risk assessment, health promotion, disease prevention, and early cancer detection within and in other underserved populations outside of the military. This paper aims to provide clinicians with an overview of the clinical factors, evidence and recommendations that are being used to advance risk assessment and screening for breast cancer in the military.

  4. Incidence and survival differences of differentiated thyroid cancer among younger women

    Boltz MM


    Full Text Available Melissa M Boltz,1 Laura M Enomoto,1,2 Rollyn M Ornstein,3 Brian D Saunders,1,4 Christopher S Hollenbeak1,2,51Department of Surgery, 2Division of Outcomes Research and Quality, The Pennsylvania State University, College of Medicine, 3Department of Pediatrics, Division of Adolescent Medicine and Eating Disorders, The Pennsylvania State University, Hershey Children’s Hospital, 4Division of General Surgery Specialties and Surgical Oncology, 5Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USAAbstract: Differentiated thyroid cancer is the most common endocrine malignancy, with an estimated 60,220 new cases diagnosed in the United States in 2013. For reasons that are unclear, differentiated thyroid cancer is three times more common in females than in males. However, among adolescent and young adult females between ages 15–39 years, differentiated thyroid cancer remains under-recognized. The disparity in cancer incidence and outcomes in this population may be secondary to the tumor's biology, and risk factors unique to women. This review summarizes the incidence and survival rates of thyroid cancer in women younger than 45 years of age, as well as the pathophysiology, etiology, risk factors, prognosis, and current and emerging treatment options for this patient population.Keywords: differentiated thyroid cancer, young adult women, adolescents, incidence, risk factors, treatment

  5. The investigation of Adenosine Deaminase activity in patients with Mycosis Fungoides

    Yılmaz Ulaş


    Full Text Available Aim: Mycosis fungoides (MF is a cutaneous T cell lymphoma. The clinical and histophological diagnosis of early mycosis fungoides is usually diffucult. There is no special laboratory method for the diagnosis of MF disease and this is the most important problem in diagnosis and also follow up the effectiveness of treatment. Adenosine deaminase (ADA activity is a non-specific marker of T cell activation. In the present study, we aimed to investigate the levels of plasma and tissue ADA in patients with mycosis fungoides and to determine if ADA is an activation criteria for this disease. Materials and Medhods: The levels of ADA activities in both plasma and tissues were spectrophotometrically measured in 40 patients with MF and compared to those of 33 healthy subjects. Moreover, a subgroup analysis regarding ADA activities was performed in 17 patients who achieved complete remission after different kinds of treatments. Results: Patients with MF had more significantly elevated plasma and tissue ADA activity levels than those of control groups (respectively p0.05; MF patients in remission were found to have higher plasma levels of ADA activities than those of controls (p<0.001. Conclusion: These findings of the current study may provide an important clinical support for showing the roles of plasma and tissue ADA activity levels to predict disease activity in MF patients. In addition, levels of ADA activity measurements might be a marker to follow up in MF patients.

  6. MBM12 A Younger Version of the TW Hydrae Association?

    Wolk, S J; Jayawardhana, R; Hearty, T J; Wolk, Scott J.; Cover, Rebecca T.; Jayawardhana, Ray; Hearty, Thomas J.


    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.

  7. Telomere shortening and telomerase activity in ischaemic cardiomyopathy patients

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


    BACKGROUND: Implantable cardioverter defibrillators (ICDs) reduce mortality in patients with ischaemic cardiomyopathy at high risk of ventricular arrhythmias (VA). However, the current indication for ICD prescription needs improvement. Telomere and telomerase in leucocytes have been shown to asso...

  8. Clinicians' and Patients' Assessment of Activity Overuse and Underuse and Its Relation to Physical Capacity

    de Jong, Annemieke Bonny; Preuper, Henrica R. Schiphorst; Reneman, Michiel F.


    To explore clinicians' and patients' (self)-assessment of activity overuse and underuse, and its relationship with physical capacity in patients with chronic musculoskeletal pain (CMP). Study design was cross-sectional. Participants included patients with CMP, admitted to a multidisciplinary outpatient pain rehabilitation program. The main…

  9. Barriers, motivators, and facilitators of physical activity in dementia patients : A systematic review

    van Alphen, Helena J. M.; Hortobagyi, Tibor; van Heuvelen, Marieke J. G.


    Purpose: Physical activity (PA) has the potential to slow the progression of dementia patients' cognitive and physical decline. A better understanding of the factors that facilitate or hamper dementia patients' PA participation will increase the success rate of implementing PA in dementia patients'

  10. Physical Activity of Depressed Patients and Their Motivation to Exercise: Nordic Walking in Family Practice

    Suija, Kadri; Pechter, Ulle; Kalda, Ruth; Tahepold, Heli; Maaroos, Jaak; Maaroos, Heidi-Ingrid


    The objectives of this study were to find out how motivated depressed patients are to exercise regularly, to measure the physical activity of depressed patients and to find out how regular Nordic Walking affects the mood and physical fitness of depressed patients. A cross-sectional study was carried out. Three years after the Prediction of Primary…

  11. 75 FR 16912 - Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request


    ... AFFAIRS Proposed Information Collection (Dental Patient Satisfaction Survey) Activity: Comment Request... measure patients' satisfaction with VA's dental services. DATES: Written comments and recommendations on..., Dental Patient Satisfaction Survey, VA Form 10-0503. OMB Control Number: 2900-New (VA Form 10-0503)....

  12. 78 FR 79079 - Agency Information Collection (Dental Patient Satisfaction Survey); Activities under OMB Review


    ... AFFAIRS Agency Information Collection (Dental Patient Satisfaction Survey); Activities under OMB Review... . Please refer to ``OMB Control No. 2900- 0764 (Dental Patient Satisfaction Survey)'' in any . Please refer to ``OMB Control No. 2900-0764 (Dental Patient Satisfaction Survey)'' in...

  13. Engagement and satisfaction with an Internet-based physical activity intervention in patients with rheumatoid arthritis.

    Berg, M.H. van den; Ronday, H.K.; Peeters, A.J.M.; Voogt-van der Harst, E.M.; Munneke, M.; Breedveld, F.C.; Vliet Vlieland, T.P.M.


    OBJECTIVE: To assess the engagement in and satisfaction with an Internet-mediated physical activity intervention with individual supervision in patients with rheumatoid arthritis (RA). METHODS: The intervention studied was one of the two strategies aimed at enhancing physical activity in RA patients

  14. Persistent Inflammation and Endothelial Activation in HIV-1 Infected Patients after 12 Years of Antiretroviral Therapy

    Rönsholt, Frederikke F; Ullum, Henrik; Katzenstein, Terese L;


    The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART).......The study investigated markers of inflammation and endothelial activation in HIV infected patients after 12 years of successful combination antiretroviral treatment (cART)....

  15. Physical Activity and Vascular Events and Mortality in Patients with Vascular Disease

    Boss, H. Myrthe; Kappelle, L. Jaap; Van der Graaf, Yolanda; Kooistra, Minke; Visseren, Frank L. J.; Geerlings, Mirjam I.


    Introduction: In patients with CAD, moderate levels of leisure time physical activity are associated with lower risk of mortality. However, less is known about the effects in patients with vascular disease other than CAD. In this study, we examined the association between physical activity and risk

  16. Interacting Patients: The construction of active patientship in quality improvement initiatives

    F.D. Vennik (Femke)


    markdownabstractThe promotion of active patient participation in healthcare quality improvement projects is an important policy goal in the Netherlands and other Western countries. Healthcare quality improvement is no longer perceived to be an exclusive professional activity; patients, who may be ab

  17. [Successful patient-activated help call for a doctor during in-hospital stay].

    Hansen, Mette Mejlby; Hasselkvist, Birgith; Thordal, Sofie; Riiskjær, Erik; Kelsen, Jens


    Department of Medicine, Randers Regional Hospital, conducted a study of patient-activated help call, involving 1,050 patients with nearly 3,700 days in-hospital stay. Patients were encou-raged to bypass traditional clinical hierarchy of communication when they felt, that their concern was not met by the staff. Three help calls were related to the management of pain. In two cases it resulted in a surgical procedure. A survey including 104 patients revealed that one third reported that patient safety was improved by the initiative and nearly three quarters re-ported that they would be willing to activate the call.

  18. Prevalence of HHV-6 in cerebrospinal fluid of children younger than 2 years of age with febrile convulsion.

    Setareh Mamishi


    Full Text Available Febrile convulsion is a common disorder in children. Viral infections such as human herpes virus 6 (HHV-6 which results in roseola infantum may contribute to developing seizure. The objective of this study was to determine the prevalence of HHV-6 by detecting DNA in cerebrospinal fluid (CSF of children with febrile convulsion and without any rash of roseola infantum.In this descriptive cross-sectional study, CSF of 100 children younger than 2 years of age with febrile convulsion was evaluated for detecting HHV-6 DNA by PCR. All of them were referred to emergency ward in Pediatric Medical Center from March 2010 to March 2011. General information, clinical manifestations, laboratory tests and outcomes were collected in the questionnaires.One hundred children including 59 males and 41 females were evaluated. HHV-6 was detected from CSF in six patients (6% by PCR. Mean age was 8 months old. All children were younger than 12 months old. The most common primary manifestation was fever alone. None of them had rash. Majority of cases occurred in winter. All patients recovered without any encephalitis.These findings showed that primary infection with HHV-6 is frequently associated with febrile convulsion in infants which may be at risk for subsequent development of epilepsy.

  19. Using the Pharmacist Interaction Tracking Tool for Capturing Student-Patient Interactions in Direct and Simulated Patient Care Activities.

    Hall, Deanne L; Schonder, Kristine S; Pater, Karen S; McGivney, Melissa S; Meyer, Susan M


    Objective. To create and implement a standardized data collection tool for capturing student-patient interactions in direct and simulated patient care activities. Design. Faculty members and students determined key elements, design, and an implementation plan for the tool, which was to be used by students across professional years to quantify numbers and types of interactions with patients for tracking student progression toward achievement of curricular outcomes. Assessment. During the 2013-2014 academic year, 27 778 entries were completed, with 17 767 (64%) advanced pharmacy practice experiences, 7272 (26%) introductory pharmacy practice experiences, and 2739 (10%) simulation. Direct patient care interactions occurred with 11 090 patients and 10 983 providers, with 14 252 drug-related problems identified. Data was used by students for their professional portfolios, by administrators for curricular assessment, and to student impact on patient care. Conclusion. The PITT Form enabled the collection of data from actual and simulated patient care activities, allowed for curricular assessment of activities across years, and was used by individual students.

  20. Low levels of physical activity in patients with severe mental illness

    Nyboe, Lene; Lund, H


    Background: Physical inactivity is an independent risk factor for cardiovascular diseases and Type 2 diabetes, both being highly prevalent in patients with severe mental illness. Though physical activity has become an important issue in psychiatric treatment and rehabilitation in the past decade......, systematic evaluations of physical activity level in psychiatric populations could be more disseminated. Aim: The primary aim of the study was to investigate the physical activity level of psychiatric patients in comparison with healthy controls. Methods: Patients with severe mental illness (n =47......) and a group of healthy controls (n =28) matched on sex and age reported their physical activity level using the Physical Activity Scale (PAS). PAS was administered as an interview in relation to patients and as a questionnaire in relation to healthy controls. Results: Patients had statistically significant...

  1. Physical activity and anomalous bodily experiences in patients with first-episode schizophrenia

    Nyboe, Lene; Moeller, Marianne K; Vestergaard, Claus H


    were obtained from medical records of all patients. RESULTS: Physical activity and aerobic fitness was significantly lower in patients with FES compared with healthy controls (p fitness. Patients with more severe....... AIM: The purpose of the study was to compare physical activity in patients with FES with healthy controls; to investigate changes in physical activity over 1 year of follow-up; and to explore the correlations of physical activity and anomalous bodily experiences reported by patients with FES. METHODS......: Both physical activity and aerobic fitness were measured. Anomalous bodily experiences were measured by selected items from the Examination of Anomalous Self-Experience and The Body Awareness Scale. Psychopathological data comprising negative and positive symptoms and data on psychotropic medication...

  2. Decision-making quality of younger and older adults in familiar and unfamiliar domains.

    Wayde, Ernest N; Black, Sheila R; Gilpin, Ansley


    Age-related differences in purchasing decisions were examined as a function of age and familiarity. On each trial, participants received purchasing options which varied in quality but ultimately cost the same amount of money. On half the trials, participants made decisions about items familiar to younger adults and on the other half of the trials, participants made decisions about products familiar to older adults. The participants' task was to choose the option that provided the best value for the money. We were particularly interested in participants' performance when inferencing was required to select the optimal option from the two choices. Younger adults outperformed older adults in unfamiliar but not familiar domains. It appeared that both younger and older adults used inferencing and elaborative processing to make the best decision in familiar domains but that only younger adults used inferencing and elaborative processing in unfamiliar domains.

  3. Influence of broadcasting on Aggressive Behaviour of Younger School-Aged Children

    RAJNOVÁ, Zuzana


    The thesis is aimed at influence of broadcasting on the level of aggressive behaviour of younger school-aged children. The basic concepts are explained in general terms; the basic way aggressive behaviour and mass media can be divided is given; psyche of a younger school-aged child is explained; television violence, its forms and both negative and positive effects and health consequences of excessive television-watching are described and prevention of adverse ffects of TV programmes on childr...

  4. Soluble urokinase plasminogen activator receptor is a marker of dysmetabolism in HIV-infected patients receiving highly active antiretroviral therapy

    Andersen, Ove; Eugen-Olsen, Jesper; Kofoed, Kristian;


    Circulating soluble urokinase plasminogen activator receptor (suPAR) reflects the immune and pro-inflammatory status of the HIV-infected patient. Highly active antiretroviral therapy (HAART) suppresses suPAR. Independent of the immune response to HAART, suPAR remains elevated in some HIV-infected...

  5. Predictors of sexual debut at age 16 or younger.

    Cavazos-Rehg, Patricia A; Spitznagel, Edward L; Bucholz, Kathleen K; Nurnberger, John; Edenberg, Howard J; Kramer, John R; Kuperman, Samuel; Hesselbrock, Victor; Bierut, Laura Jean


    The present study examined the extent to which variables within the self system (i.e., symptoms of alcohol dependence and conduct disorder, gender, race, and metropolitan status) and the familial system (i.e., having an alcohol dependent biological parent or second-degree relative, religious background, educational background of parents, and being born to a teenage mother) were associated with sexual debut at 16 years old or earlier. Participants were 1,054 biological relatives, aged 18-25 years, of alcohol dependent probands who participated in the Collaborative Study on the Genetics of Alcoholism project. Comparison participants (N = 234) without alcohol dependent biological parents were also evaluated. Clinical and sociodemographic variables were assessed by structured, personal interviews. Parental history of alcohol dependence was evaluated by direct interview of parents in most cases and family history in uninterviewed parents. In a multivariate survival analysis, increased risk of becoming sexually active at 16 years of age or earlier was significantly associated with 6 of the 10 predictor variables, including race, one or more alcohol dependence symptoms, and/or one or more conduct disorder symptoms. Having an alcohol dependent biological parent or second-degree relative (e.g., aunt, uncle, or grandparent), educational background of mother, and being born to a teenage mother were also significantly associated with increased risk. These results provide evidence that specific variables in the self and familial systems of influence are important in predicting sexual debut at 16 years old or earlier.

  6. Alteration in the phagocyte activity of crevicular leucocytes regarding diabetic patients with periodontal disease

    Colchado Carhuavilca, Jorge R.; Departamento Académico Medico quirúrgico. Facultad Odontología. UNMSM. Lima Perú.


    The goal of this investigation was to find out the alterations in the phagocyte activity of crevicular leucocytes regarding to diabetic patients with periodontal disease. For that reason, 56 patients with periodontal disease were selected: 42 of them with a diagnosis of Diabetes Mellitus - Type 2, and 14 patients without it (control group), from 35 to 74 years old. To performed the study, crevicular fluid of the mentioned patients was analyzed. By means of sequential washings the samples were...

  7. Physical activity and the association with fatigue and sleep in Danish patients with rheumatoid arthritis

    Loppenthin, K.; Esbensen, B. A.; Østergaard, M.;


    . An inverse univariate association was found between moderate to vigorous physical activity, and fatigue (MFI mental, MFI activity, MFI physical and MFI general), sleep, diabetes, depression, pain, patient global assessment, HAQ and disease activity. The multivariate prediction model demonstrated that fatigue......The aim of this study was to examine physical activity behavior in patients with rheumatoid arthritis and to identify potential correlates of regular physical activity including fatigue, sleep, pain, physical function and disease activity. A total of 443 patients were recruited from a rheumatology...... outpatient clinic and included in this cross-sectional study. Physical activity was assessed by a four-class questionnaire, in addition to the Physical Activity Scale. Other instruments included the Multidimensional Fatigue Inventory (MFI), the Pittsburgh Sleep Quality Index and the Health Assessment...

  8. Actigraphy correctly predicts sleep behavior in infants who are younger than six months, when compared with polysomnography.

    So, Kevin; Buckley, Pat; Adamson, T Michael; Horne, Rosemary S C


    Actigraphy has been widely used in adults and children. In infants, validation of actigraphy has typically used a comparison with behaviorally determined sleep state classification rather than polysomnography (PSG). This study validated actigraphy against PSG for determining sleep and waking states in infants who were younger than 6 mo. Twenty-two healthy infants, 13 term and 9 preterm, were studied at three different matched postconceptional ages. Actigraph data were compared with PSG recordings in 1-min epochs. Agreement rate (AR), predictive value for sleep, predictive value for wake, sensitivity. and specificity were calculated and compared between activity thresholds and across ages with two-way ANOVA for repeated measures. Thirty-two validation studies were analyzed. Overall AR with PSG of 93.7 +/- 1.3 and 91.6 +/- 1.8 were obtained at 2-4 wk and 5-6 mo, respectively, at the low activity threshold setting, whereas the auto activity threshold gave the best agreement with PSG at 2-4 mo (AR 89.3 +/- 1.3%). Sensitivity values of 96.2 +/- 1.1% at 2-4 wk, 91.2 +/- 1.5% at 2-4 mo, and 94.0 +/- 1.9% were obtained at these same settings. There was no difference across ages in AR or sensitivity. PVW and specificity values were low in this study. We conclude that actigraphy is a valid method for monitoring sleep in infants who are younger than 6 mo.

  9. Focused and divided attention in a simulated cocktail-party situation: ERP evidence from younger and older adults.

    Getzmann, Stephan; Golob, Edward J; Wascher, Edmund


    Speech perception under complex listening conditions usually decreases in aging. This is especially true for listening conditions requiring divided attention among 2 and more relevant speakers. Using a speech perception task and event-related potential measures, we studied the ability of younger and older adults to attend to speech information from a single-target speaker (focused attention) or from 2 different (alternative) target speakers (divided attention). The focused and divided attention conditions were presented either in silence or in the presence of 3 concurrent speakers. In the presence of concurrent speakers, older participants showed worse performance with divided versus focused attention. In contrast, there was no effect of attention condition for the younger adults. Relative to the young, event-related potential analysis in older subjects indicated a decline in preparatory activity for the critical speech information (a delayed and smaller contingent negative variation), and delayed attentional control (indicated by a longer P2 latency). Standardized low-resolution brain electromagnetic tomography revealed that the age-related decline in preparatory activity was associated with reduced activation of medial and superior frontal gyrus and anterior cingulate gyrus. The results suggest that age-related differences in these prefrontal brain areas reflect declines in preparatory attention and gating of subsequent task-related speech information, especially under conditions of divided attention. These findings may reflect mechanisms relating to impaired speech perception by older people in "cocktail-party" listening situations.

  10. Performance of activities of daily living among hospitalized cancer patients

    Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen;


    Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). RESULTS: All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results...... differed between women and men. There was significant overlap between problems identified using the COPM and the ADL-Q instruments. RESULTS from the COPM showed that 65% of problems were related to self-care, 25% to leisure, and 19% to productivity. Using both instruments identified more ADL problems than...


    Liu Huirong; Liang Feng; Zhang Weifang; Zheng Zhenqun


    Objective: To identify whether the level of anticomplementary activity in serum is different between lung cancer patients and normal subjects. Method: With a sensitive immune haemolytic assay, the anticomplementary activity in the sera of 50 normal subjects and 61lung cancer patients were demonstrated. Results: It was found that all samples contained complement-inhibition activity, although some were of low degree. Increased anticomplementary activity was found to be associated significantly with lung cancer. With the progression of cancer the anticomplementary activity in sera increased in different lung cancer patients. Conclusion: Such a higher anticomplementary activity in sera of lung cancer patients might be one of the immunosuppressive contents induced by the tumor cells.

  12. [Patients on the move: validated methods to quantify physical activity

    Bakker, E.A.; Eijsvogels, T.M.H.; Vegt, F. de; Busser, G.S.; Hopman, M.T.E.; Verbeek, A.L.M.


    - Physical activity is an important component in the maintenance and improvement of general health; physical inactivity is, however, an increasing problem in the Netherlands.- Requests for advice on physical activity are increasing within the healthcare. - Assessment of an individual's physical acti

  13. Progress in paediatric parasitology: a preface to a topic focusing on ever younger subjects.

    Stothard, J Russell; Chiodini, Peter; Booth, Mark


    Without realizing it perhaps, the research activities of many parasitologists are often focused upon the study of parasites most commonly found in children. Though there is little recognition of paediatric parasitology as a separate topic within medical parasitology, with the global interest in promotion of maternal and child health, alleviation of diseases associated with poverty and requirements of 'child-sized' medicines, a more formal consideration is now timely. Recent research, for example, has highlighted that defining precisely the 'first-age' at which parasites interfere with a child's health, or normal developmental processes, is being revised. Attention is now drawn towards ever younger subjects, for parasites have the capacity to also influence the health of the foetus within the in utero environment, altering immune-development. These subtle, yet evolutionary profound interactions perhaps manifest themselves as to why some children are more prone to infection(s), develop overt disease and sadly die while others do not. Here, we address the growing importance of paediatric parasitology and its applications within disease control strategies as highlighted in the 2010 Autumn Symposium of the British Society of Parasitology.

  14. Cholecystokinin-like activity in the duodenal mucosa of duodenal ulcer patients.

    Kataoka, S


    Cholecystokinin-like activity in the duodenal mucosa was measured by the bioassay method described by Ljungberg to elucidate its significance in 14 duodenal ulcer patients as well as in 13 normal subjects with no evidence of gastrointestinal diseases. The stage of duodenal ulceration was determined endoscopically according to the criterion of the Japanese Gastroenterological Endoscopic Society. The cholecystokinin-like activity in the duodenal mucosa of duodenal ulcer patients in active stage...

  15. Active patient participation in the development of an online intervention.

    Bruinessen, I.R. van; Weel-Baumgarten, E.M. van; Snippe, H.W.; Gouw, H.; Zijlstra, J.M.; Dulmen, S. van


    Background: An important and challenging part of living with cancer relates to the repeated visits to the hospital. Since how patients cope between these post-diagnostic visits depends partly on the information and support received from their physician during the visits, it is important to make the

  16. A comparative study of oxidant-antioxidant status in stable and active vitiligo patients.

    Ines, Dammak; Sonia, Boudaya; Riadh, Ben Mansour; Amel, El Gaied; Slaheddine, Marrekchi; Hamida, Turki; Hamadi, Attia; Basma, Hentati


    The pathogenetic mechanisms in vitiligo have not been completely clarified. One of the major hypotheses in the pathogenesis of vitiligo is the oxidative stress hypothesis. The active or stable phase of vitiligo is defined on the basis of the progression or appearance of new lesions in the last 3 months and the absence of new lesions or their progression in the last 6 months, respectively. Eighteen patients with active vitiligo, 18 patients with stable vitiligo, and 40 controls were included in this study. We examined serum levels of malondialdehyde, selenium, vitamin E and A, and the erythrocyte activities of glutathione peroxidase, superoxide dismutase, and catalase. Our results revealed a significantly higher level of serum malondialdehyde, selenium in patients with active disease compared with the controls. Significant higher increase in erythrocytes superoxide dismutase activities was observed in active vitiligo group, erythrocyte glutathione peroxidase activity was decreased significantly in active disease, whereas erythrocyte catalase activity and plasma vitamin E and A levels were not different in vitiligo patients as compared with controls. Our study shows that oxidative stress is involved in the pathophysiology of both active and stable vitiligo but increased imbalance of antioxidants was observed in the blood of active vitiligo patients.

  17. Influence of major pulmonary resection on postoperative daily ambulatory activity of the patients.

    Novoa, Nuria; Varela, Gonzalo; Jiménez, Marcelo F; Aranda, Jose Luis


    To describe and compare the daily ambulatory activity of the patients before and one month after major lung resection. Daily activity was measured using a pedometer (OMROM Walking Style PRO) given preoperatively in a prospective way to a series of 21 consecutive cases scheduled for lobectomy or pneumonectomy. Analyzed variables were age, pulmonary function, mean number of total and aerobic steps per day, walked distance and mean daily time of aerobic activity. Activity variables were analyzed individually and as a new differential variable DELTA. Wilcoxon and Mann-Whitney nonparametric tests were used for comparison between groups. General series data: 19 male. Age: 63+/-10.9 years. FEV(1)%: 88.4+/-22.7. DLCO: 86.2+/-21.6. Eleven cases had COPD criteria. Type of surgery: 3 pneumonectomy/18 lobectomy. Activity data: all patients showed a global decrease of their activity one month after surgery but, patients in the pneumonectomy group are unable to keep aerobic activity meanwhile patients that undergone lobectomy showed only a 25% reduction in the measured variables. Major pulmonary resection decreases the time and the quality of the daily ambulatory activity of the patients during the first postoperative month. Despite limitations, the chosen pedometer OMRON Walking Style Pro is an efficient tool to evaluate the perioperative daily ambulatory activity of patients.

  18. Basal and exercise-induced neuroendocrine activation in patients with heart failure and in normal subjects

    Kjaer, Andreas; Appel, Jon; Hildebrandt, Per;


    looked at activation during maximal exercise, whereas we believe that activation at a submaximal level might be more pathophysiologically relevant. AIM: To compare exercise-induced neurohormonal activation between CHF patients and normal subjects using the same relative and submaximal workload. Subjects......: Twenty-three newly-diagnosed CHF patients and 18 age- and gender-matched healthy subjects were exercised at two workloads, which were calculated to correspond to 50 and 75% of each individual's heart rate response. RESULTS: In CHF patients, baseline levels of ANP, BNP, AVP, PRA and ET-1 were elevated...... compared to healthy subjects. Exercise induced an increase in ANP, A and NA in both CHF patients and in normal subjects, however BNP was only increased in CHF patients and not in normal subjects. CONCLUSION: When CHF patients exercise at the same relative and submaximal level as age-matched healthy...

  19. Mediation analysis of the relationship between institutional research activity and patient survival

    Rochon, Justine; du Bois, Andreas; Lange, Theis


    BACKGROUND: Recent studies have suggested that patients treated in research-active institutions have better outcomes than patients treated in research-inactive institutions. However, little attention has been paid to explaining such effects, probably because techniques for mediation analysis...... existing so far have not been applicable to survival data. METHODS: We investigated the underlying mechanisms using a recently developed method for mediation analysis of survival data. Our analysis of the effect of research activity on patient survival was based on 352 patients who had been diagnosed...... as potential mediators of the effect of hospital research activity on patient survival. RESULTS: The 219 patients treated in hospitals participating in clinical trials had more complete surgical debulking, were more likely to receive the recommended platinum-taxane combination, and had better survival than...

  20. Patient Mood and Instrumental Activities of Daily Living in Alzheimer Disease: Relationship Between Patient and Caregiver Reports.

    Votruba, Kristen L; Persad, Carol; Giordani, Bruno


    This retrospective study investigated the relationship between self-reports and caregiver perceptions of patients' depressive symptoms and the respective ability of these reports to predict instrumental activities of daily living (IADLs) beyond what is accounted for by cognitive abilities in 71 patients with mild Alzheimer disease. Patients completed the Geriatric Depression Scale-Short Form, and caregivers completed the Behavior Rating Scale for Dementia assessing their perception of patients' depressive symptoms. Caregivers also completed IADL items from the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory. Cognitive measures included the Mini-Mental State Examination, Logical Memory from the Wechsler Memory Scale III, and Trail Making Test, Part B. The relationship between self-reported depressive symptoms and caregiver report of patients' depressive symptoms showed a trend toward significance (r = .22, P = .06). Measures of depressive symptoms significantly predicted 12.5% of the variance in IADLs performance, beyond that accounted for by patient demographics and cognitive functioning. Interestingly, patients' reports, rather than caregivers', were particularly useful in this prediction.

  1. Motor imagery evokes increased somatosensory activity in Parkinson's disease patients with tremor.

    Helmich, Rick C; Bloem, Bastiaan R; Toni, Ivan


    Parkinson's disease (PD) is surprisingly heterogeneous: some patients have a prominent resting tremor, while others never develop this symptom. Here we investigate whether the functional organization of the voluntary motor system differs between PD patients with and without resting tremor, and whether these differences relate to the cerebral circuit producing tremor. We compared 18 PD patients with marked tremor, 20 PD patients without tremor, and 19 healthy controls. Subjects performed a controlled motor imagery task during fMRI scanning. We quantified imagery-related cerebral activity by contrasting imagery of biomechanically difficult and easy movements. Tremor-related activity was identified by relating cerebral activity to fluctuations in tremor amplitude, using electromyography during scanning. PD patients with tremor had better behavioral performance than PD patients without tremor. Furthermore, tremulous PD patients showed increased imagery-related activity in somatosensory area 3a, as compared with both healthy controls and to nontremor PD patients. This effect was independent from tremor-related activity, which was localized to the motor cortex, cerebellum, and thalamic ventral intermediate nucleus (VIM). The VIM, with known projections to area 3a, was unique in showing both tremor- and imagery-related responses. We conclude that parkinsonian tremor influences motor imagery by modulating central somatosensory processing through the VIM. This mechanism may explain clinical differences between PD patients with and without tremor.

  2. Continuous reduction of plasma paraoxonase activity with increasing dialysis vintage in hemodialysis patients.

    Henning, Bernhard F; Holzhausen, Helge; Tepel, Martin


    Plasma paraoxonase (PON) is an enzyme that hydrolyzes organic phosphate and aromatic carboxylic acid esters. Reduced activity is associated with early events of atherogenesis. The relevance of PON phenotypes is not well characterized in hemodialysis patients. In a cross-sectional study we measured PON activity in 377 hemodialysis patients photometrically using the substrates 4-nitrophenylacetate and phenylacetate. The PON ratio was calculated from 4-nitrophenylacetate-derived activity divided by phenylacetate-derived activity. Frequency distribution of the PON ratio showed three different PON phenotypes. 74% of hemodialysis patients showed PON phenotype 1, 21% PON phenotype 2, and 5% PON phenotype 3. Compared to hemodialysis patients with PON 1, patients with PON 2 or 3 showed higher conversion rates for 4-nitrophenylacetate. We observed a significant reduction of PON ratio with increasing dialysis vintage (Pvintage. In conclusion, plasma PON ratio significantly declines with increasing dialysis vintage.

  3. Serum YKL-40 concentrations in patients with rheumatoid arthritis: relation to disease activity

    Johansen, J S; Stoltenberg, M; Hansen, M


    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 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

  4. Before Anesthesia: The Patient's Active Role Makes a Difference

    ... anesthesia, a candidate must have a four-year bachelor of science degree in nursing or other appropriate ... can—and should—take an active role in these preparations by communicating and cooperating with your anesthesia ...

  5. Factors influencing quality of life in patients with active tuberculosis

    Cox Victoria C; Marra Fawziah; Marra Carlo A; Palepu Anita; FitzGerald J Mark


    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 T...

  6. Physical activity patterns in patients with early and late age-related macular degeneration

    Subhi, Yousif; Sørensen, Torben Lykke


    best-corrected visual acuity in the best-seeing and the worse-seeing eye was associated with less engagement in physical activities that would work up sweat and a lower number of steps taken daily. Patients with bilateral vision loss from late AMD engaged in physical activities that were more......INTRODUCTION: Age-related macular degeneration (AMD) leads to visual impairment that affects visual functioning and thereby the ability to be physically active. We investigated physical activity patterns in patients with AMD. METHODS: Patients with early and late AMD and elderly controls were...... recruited for this hospital-based cross-sectional study. All participants had their best-corrected visual acuity measured and were interviewed about their physical activity based on questions that covered regular physical activity, physical activity that would work up sweat, climbing the stairs and time...

  7. Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences

    Klompstra L


    Full Text Available Leonie Klompstra,1 Tiny Jaarsma,1 Anna Strömberg2,31Department of Social and Welfare Studies, Faculty of Health Sciences, 2Department of Medical and Health Sciences, Division of Nursing, 3Department of Cardiology, Linköping University, Linköping, SwedenBackground: Adherence to recommendations for physical activity is low in both male and female patients with heart failure (HF. Men are more physically active than women. In order to successfully promote physical activity, it is therefore essential to explore how much and why HF patients are physically active and if this is related to sex. The aim of this study was therefore to evaluate physical activity in HF patients, to describe the factors related to physical activity, and to examine potential barriers and motivations to physical activity with special focus on sex differences.Methods: The study had a cross-sectional survey design. HF patients living at home received a questionnaire during May–July 2014, with questions on physical activity (from the Short Form-International Physical Activity Questionnaire, and potential barriers and motivations to physical activity.Results: A total of 154 HF patients, 27% women, with a mean age of 70±10 were included. In total, 23% of the patients reported a high level of physical activity, 46% a moderate level, and 34% a low level. Higher education, self-efficacy, and motivation were significantly associated with a higher amount of physical activity. Symptoms or severity of the disease were not related to physical activity. All the potential barriers to exercise were reported to be of importance. Psychological motivations were most frequently rated as being the most important motivation (41% to be physically active. Physical motivations (33% and social motivations were rated as the least important ones (22%. Women had significantly higher total motivation to be physically active. These differences were found in social, physical, and psychological

  8. Computerized monitoring of physical activity and sleep in postoperative abdominal surgery patients

    Bisgaard, T; Kjaersgaard, M; Bernhard, A;


    OBJECTIVE: Assessment of early postoperative activity is important in the documentation of improvements of peri-operative care. This study was designed to validate computerized activity-based monitoring of physical activity and sleep (actigraphy) in patients after abdominal surgery. METHODS...... physical activity and sleep-wake cycles after major abdominal surgery.......: The study included twelve hospitalized patients after major abdominal surgery studied on day 2 to 4 after operation and twelve unhospitalized healthy volunteers. Measurements were performed for 24 consecutive hours. The actigraphy measurements were compared with self-reported activity- and sleep...

  9. Prevalence of vertebral fractures in a disease activity steered cohort of patients with early active rheumatoid arthritis

    Dirven Linda


    Full Text Available Abstract Objective To determine the prevalence of vertebral fractures (VFs after 5 years of disease activity score (DAS-steered treatment in patients with early rheumatoid arthritis (RA and to investigate the association of VFs with disease activity, functional ability and bone mineral density (BMD over time. Methods Five-year radiographs of the spine of 275 patients in the BeSt study, a randomized trial comparing four treatment strategies, were used. Treatment was DAS-steered (DAS ≤ 2.4. A height reduction >20% in one vertebra was defined a vertebral fracture. With linear mixed models, DAS and Health Assessment Questionnaire (HAQ scores over 5 years were compared for patients with and without VFs. With generalized estimating equations the association between BMD and VFs was determined. Results VFs were observed in 41/275 patients (15%. No difference in prevalence was found when stratified for gender, prednisone use and menopausal status. Disease activity over time was higher in patients with VFs, mean difference 0.20 (95% CI: 0.05-0.36, and also HAQ scores were higher, independent of disease activity, with a mean difference of 0.12 (95% CI: 0.02-0.2. Age was associated with VFs (OR 1.06, 95% CI: 1.02-1.09, mean BMD in spine and hip over time were not (OR 95% CI, 0.99: 0.78-1.25 and 0.94: 0.65-1.36, respectively. Conclusion After 5 years of DAS-steered treatment, 15% of these RA patients had VFs. Higher age was associated with the presence of VFs, mean BMD in hip and spine were not. Patients with VFs have greater functional disability over time and a higher disease activity, suggesting that VFs may be prevented by optimal disease activity suppression.

  10. Cerebral Activity Changes in Different Traditional Chinese Medicine Patterns of Psychogenic Erectile Dysfunction Patients

    Qi Liu


    Full Text Available Background. Pattern differentiation is the foundation of traditional Chinese medicine (TCM treatment for erectile dysfunction (ED. This study aims to investigate the differences in cerebral activity in ED patients with different TCM patterns. Methods. 27 psychogenic ED patients and 27 healthy subjects (HS were enrolled in this study. Each participant underwent an fMRI scan in resting state. The fractional amplitude of low-frequency fluctuation (fALFF was used to detect the brain activity changes in ED patients with different patterns. Results. Compared to HS, ED patients showed an increased cerebral activity in bilateral cerebellum, insula, globus pallidus, parahippocampal gyrus, orbitofrontal cortex (OFC, and middle cingulate cortex (MCC. Compared to the patients with liver-qi stagnation and spleen deficiency pattern (LSSDP, the patients with kidney-yang deficiency pattern (KDP showed an increased activity in bilateral brainstem, cerebellum, hippocampus, and the right insula, thalamus, MCC, and a decreased activity in bilateral putamen, medial frontal gyrus, temporal pole, and the right caudate nucleus, OFC, anterior cingulate cortex, and posterior cingulate cortex (P<0.005. Conclusions. The ED patients with different TCM patterns showed different brain activities. The differences in cerebral activity between LSSDP and KDP were mainly in the emotion-related regions, including prefrontal cortex and cingulated cortex.

  11. Relationship between disease activity and hearing impairment in patients with rheumatoid arthritis compared with controls.

    Yildirim, Adem; Surucu, Gulseren; Dogan, Sedat; Karabiber, Mehmet


    The characteristics of hearing impairment (HI) in rheumatoid arthritis (RA) are still poorly understood, and their association with disease activity is based on conflicting information. This study compared HI between RA patients and controls and between active and remission RA groups using multi-frequency audiometry. This study enrolled 88 RA patients and 50 controls. The pure-tone hearing thresholds at 500 to 4000 Hz for air (AC) and bone (BC) conduction were compared between RA and controls as well as between active and remission RA patients using DAS28-CRP scores. The pure-tone hearing thresholds for AC and BC were significantly higher at high frequencies (2000 and 4000 Hz) in the RA group for both ears compared with controls. In addition, the BC threshold at 1000 Hz for the right ear was higher in the RA group than controls. When active and remission RA patients were compared, the thresholds were higher only at 4000 Hz for both ears for AC and BC in patients with active RA. The air-bone gap differed significantly at 2000 and 4000 Hz in both ears. This study demonstrated that patients with RA have a heightened risk of HI, and disease activity increases this risk, particularly at high frequencies. Clinicians who manage RA should be aware of HI and consider performing audiological evaluations in RA patients with active disease in particular.

  12. Physical Activity and Reported Barriers to Activity Among Type 2 Diabetic Patients in the United Arab Emirates

    Al-Kaabi, Juma; Al-Maskari, Fatma; Afandi, Bachar; Parkar, Hasratali; Nagelkerke, Nicolaas


    OBJECTIVES: This study was designed to assess the physical activity practice among type 2 diabetic patients in the United Arab Emirates (UAE). METHODS: This is a cross-sectional study of type 2 diabetic patients who participated in the outpatient clinics in Al-Ain District, during 2006. The patients completed an interviewer-administered questionnaire, and measurements of blood pressure, body mass index, body fat, abdominal circumference, glycemic control (HbA1c), and fasting lipid profile. RESULTS: Of the 390 patients recruited, only 25% reported an increase in their physical activity levels following the diagnosis of diabetes, and only 3% reported physical activity levels that meet the recommended guidelines. More than half of the study subjects had uncontrolled hypertension (53%) and unacceptable lipid profiles; 71% had a high low-density lipoprotein (LDL), 73% had low high-density lipoprotein (HDL), and 59% had hypertriglyceridemia. Forty-four percent were obese and a further 34% were overweight. Abdominal obesity was also common (59%). Only 32% had an acceptable glycemic control. CONCLUSIONS: The physical activity practice of type 2 diabetic patients in the UAE is largely inadequate to meet the recommended level necessary to prevent or ameliorate diabetic complications. Interventions aiming at overcoming the barriers to physical activity are urgently needed. PMID:20043039

  13. Self-reported physical activity and major adverse events in patients with atrial fibrillation

    Proietti, Marco; Boriani, Giuseppe; Laroche, Cécile;


    patients taking regular exercise were associated with a lower risk of all-cause death, even when we considered various subgroups, including gender, elderly age, symptomatic status, and stroke risk class. Efforts to increase physical activity among AF patients may improve outcomes in these patients.......AIMS: Physical activity is protective against cardiovascular (CV) events, both in general population and in high-risk CV cohorts. However, the relationship between physical activity with major adverse outcomes in atrial fibrillation (AF) is not well-established. Our aim was to analyse...... this relationship in a 'real-world' AF population. Second, we investigated the influence of physical activity on arrhythmia progression. METHODS AND RESULTS: We studied all patients enrolled in the EURObservational Research Programme on AF (EORP-AF) Pilot Survey. Physical activity was defined as 'none', 'occasional...

  14. Serum paraoxonase activity, total thiols levels, and oxidative status in patients with acute brucellosis.

    Esen, Ramazan; Aslan, Mehmet; Kucukoglu, Mehmet Emin; Cıkman, Aytekin; Yakan, Umit; Sunnetcioglu, Mahmut; Selek, Sahbettin


    It is well known that paraoxonase-1 (PON1) activity may decrease during the course of infection and inflammation. The aim of this study was to investigate serum PON1 activity, oxidative status, and thiols levels in patients with acute brucellosis. In addition, we investigated the PON1 phenotype in patients with acute brucellosis. Thirty patients with acute brucellosis and 35 healthy controls were enrolled. Serum paraoxonase and arylesterase activities, thiols levels, lipid hydroperoxide levels, total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) were determined. Serum basal and salt-stimulated paraoxonase-arylesterase activities, TAC levels and thiols levels were significantly lower in patients with acute brucellosis than controls (for all, p brucellosis. These results indicate that lower PON1 activity is associated with oxidant-antioxidant imbalance.

  15. The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease

    Gimeno-Santos, Elena; Raste, Yogini; Demeyer, Heleen; Louvaris, Zafeiris; de Jong, Corina; Rabinovich, Roberto A.; Hopkinson, Nicholas S.; Polkey, Michael I.; Vogiatzis, Ioannis; Tabberer, Maggie; Dobbels, Fabienne; Ivanoff, Nathalie; de Boer, Willem I.; van der Molen, Thys; Kulich, Karoly; Serra, Ignasi; Basagana, Xavier; Troosters, Thierry; Puhan, Milo A.; Karlsson, Niklas; Garcia-Aymerich, Judith


    No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD. Physical activity was assessed in a 6-week, randomised,

  16. Evaluation of von Willebrand factor-cleaving protease activity in patients with thrombotic thrombocytopenic purpura

    高维强; 苏健; 白霞; 王兆钺; 阮长耿


    Background Thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy. In this study we investigated the von Willebrand factor-cleaving protease (vWF-cp) activity deficiency in patients with TTP.Methods The plasma or serum vWF-cp activity was measured using a sensitive enzyme-linked immunosorbent assay (ELISA) by detecting the residual collagen binding activity (R-CBA) of von Willebrand factor (vWF) before and after digestion by vWF-cp. Multimers of vWF in plasma of patients with TTP were also analyzed by SDS-agarose electrophoresis. Moreover, the serum vWF-cp activities were compared between the patients with TTP and those with tumors.Results The coefficient of variation for intra-batch and inter-batch of the assay were 3.60% and 8.35%. The plasma and serum vWF-cp activity in healthy individuals were (78.79±9.17)% (n=30) and (79.47±10.78)% (n=53), respectively, while the plasma vWF-cp activity in 5 patients with TTP was markedly decreased [(21.83±19.98)%, P<0.001]. The unusually large vWF multimers were observed in two plasma samples of the patients with TTP. Although the vWF-cp activities in patients with benign and malignant tumors were also decreased (P<0.03 and P<0.001, respectively), they were relatively high in comparison with that of TTP patients (P<0.001).Conclusion Measurement of the vWF-cp activity using R-CBA is a simple and rapid method for diagnosing TTP. The vWF-cp activity in patients with TTP was markedly lower than those of patients with tumors.

  17. Serum YKL-40, a potential new marker of disease activity in patients with inflammatory bowel disease

    Vind, Ida; Johansen, J S; Price, P A;


    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...

  18. Femoro-acetabulaer impingement: årsag til lyskesmerter og tidlig hofteslidgigt hos yngre patienter

    Jacobsen, Steffen; Winge, Søren


    important, often subtle, malformations of the hip joint which are thought to play an important role pathogenetically for the development of hip osteoarthritis and hip pain especially in younger, active patients. The common denominator for these malformations is that they cause femoro-acetabular impingement...

  19. iNOS-dependent sweating and eNOS-dependent cutaneous vasodilation are evident in younger adults, but are diminished in older adults exercising in the heat.

    Fujii, Naoto; Meade, Robert D; Alexander, Lacy M; Akbari, Pegah; Foudil-Bey, Imane; Louie, Jeffrey C; Boulay, Pierre; Kenny, Glen P


    Nitric oxide synthase (NOS) contributes to sweating and cutaneous vasodilation during exercise in younger adults. We hypothesized that endothelial NOS (eNOS) and neuronal NOS (nNOS) mediate NOS-dependent sweating, whereas eNOS induces NOS-dependent cutaneous vasodilation in younger adults exercising in the heat. Further, aging may upregulate inducible NOS (iNOS), which may attenuate sweating and cutaneous vasodilator responses. We hypothesized that iNOS inhibition would augment sweating and cutaneous vasodilation in exercising older adults. Physically active younger (n = 12, 23 ± 4 yr) and older (n = 12, 60 ± 6 yr) adults performed two 30-min bouts of cycling at a fixed rate of metabolic heat production (400 W) in the heat (35°C). Sweat rate and cutaneous vascular conductance (CVC) were evaluated at four intradermal microdialysis sites with: 1) lactated Ringer (control), 2) nNOS inhibitor (nNOS-I, NPLA), 3) iNOS inhibitor (iNOS-I, 1400W), or 4) eNOS inhibitor (eNOS-I, LNAA). In younger adults during both exercise bouts, all inhibitors decreased sweating relative to control, albeit a lower sweat rate was observed at iNOS-I compared with eNOS-I and nNOS-I sites (all P 0.05). We show that iNOS and eNOS are the main contributors to NOS-dependent sweating and cutaneous vasodilation, respectively, in physically active younger adults exercising in the heat, and that iNOS inhibition does not alter sweating or cutaneous vasodilation in exercising physically active older adults.

  20. Thyroid Disease in the Older Patient

    ... a brother, sister or child of the patient. HYPERTHYROIDISM IN THE OLDER PATIENT As in all hyperthyroid ... and family. TREATMENT OF THE OLDER PATIENT WITH HYPERTHYROIDISM As with younger patients, treatment of hyperthyroidism in ...

  1. Medical student stories of participation in patient care-related activities: the construction of relational identity.

    Warmington, Sally; McColl, Geoffrey


    Professional identity formation is acknowledged as one of the fundamental tasks of contemporary medical education. Identity is a social phenomenon, constructed through participation in everyday activities and an integral part of every learning interaction. In this paper we report from an Australian ethnographic study into how medical students and patients use narrative to construct their identities. The dialogic narrative analysis employed focused on the production of meaning through the use of language devices in a given context, and the juxtaposition of multiple perspectives. Two stories told by students about their participation in patient care-related activities reveal how identities are constructed in this context through depictions of the relationships between medical students, patients and clinical teachers. These students use the rhetorical functions of stories to characterise doctors and patients in certain ways, and position themselves in relation to them. They defend common practices that circumvent valid consent processes, justified by the imperative to maximise students' participation in patient care-related activities. In doing so, they identify patients as their adversaries, and doctors as allies. Both students are influenced by others' expectations but one reveals the active nature of identity work, describing subtle acts of resistance. These stories illustrate how practices for securing students' access to patients can influence students' emerging identities, with implications for their future disclosure and consent practices. We argue that more collaborative ways of involving medical students in patient care-related activities will be facilitated if students and clinical teachers develop insight into the relational nature of identity work.

  2. Creatine kinase activity in patients with diabetes mellitus type I and type II.

    Jevrić-Causević, Adlija; Malenica, Maja; Dujić, Tanja


    Diabetes mellitus can be looked upon as an array of diseases, all of which exhibit common symptoms. While pathogenesis of IDDM (insulin dependant diabetes mellitus) is well understood, the same is not true for diabetes mellitus type II. In the latter case, relative contribution of the two factors (insulin resistance or decreased insulin secretion) varies individually, being highly increased in peripheral tissues and strictly dependant on insulin for glucose uptake. Moreover, in patients with diabetes mellitus type II, disbalance at the level of regulation of glucose metabolism as well as lipid metabolism has been noted in skeletal muscles. It is normal to assume that in this type of diabetes, these changes are reflected at the level of total activity of enzyme creatine kinase. This experimental work was performed on a group of 80 regular patients of Sarajevo General Hospital. Forty of those patients were classified as patients with diabetes type I and forty as patients with diabetes type II. Each group of patients was carefully chosen and constituted of equal number of males and females. The same was applied for adequate controls. Concentration of glucose was determined for each patient with GOD method, while activity of creatine kinase was determined with CK-NAC activated kit. Statistical analysis of the results was performed with SPSS software for Windows. Obtained results point out highly expressed differences in enzyme activity between two populations examined. Changes in enzyme activity are more expressed in patients with diabetes type II. Positive correlation between concentration of glucose and serum activity of the enzyme is seen in both categories of diabetic patients which is not the case for the patients in control group. At the same time, correlation between age and type of diabetes does exist . This is not followed at the level of enzyme activity or concentration of glucose.

  3. Palbociclib Isethionate in Treating Younger Patients With Recurrent, Progressive, or Refractory Central Nervous System Tumors


    Childhood Choroid Plexus Tumor; Childhood Ependymoblastoma; Childhood Grade III Meningioma; Childhood High-grade Cerebellar Astrocytoma; Childhood High-grade Cerebral Astrocytoma; Childhood Medulloepithelioma; Recurrent Childhood Anaplastic Astrocytoma; Recurrent Childhood Anaplastic Oligoastrocytoma; Recurrent Childhood Anaplastic Oligodendroglioma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Giant Cell Glioblastoma; Recurrent Childhood Glioblastoma; Recurrent Childhood Gliomatosis Cerebri; Recurrent Childhood Gliosarcoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor

  4. Imetelstat Sodium in Treating Younger Patients With Relapsed or Refractory Solid Tumors


    Childhood Hepatoblastoma; Previously Treated Childhood Rhabdomyosarcoma; Recurrent Childhood Liver Cancer; Recurrent Childhood Rhabdomyosarcoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Neuroblastoma; Recurrent Osteosarcoma

  5. Veliparib, Radiation Therapy, and Temozolomide in Treating Younger Patients With Newly Diagnosed Diffuse Pontine Gliomas


    Childhood Mixed Glioma; Untreated Childhood Anaplastic Astrocytoma; Untreated Childhood Brain Stem Glioma; Untreated Childhood Fibrillary Astrocytoma; Untreated Childhood Giant Cell Glioblastoma; Untreated Childhood Glioblastoma; Untreated Childhood Gliosarcoma

  6. Talazoparib and Temozolomide in Treating Younger Patients With Refractory or Recurrent Malignancies


    Adult Solid Neoplasm; Childhood Solid Neoplasm; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Central Nervous System Neoplasm; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Refractory Central Nervous System Neoplasm

  7. DNA Analysis in Samples From Younger Patients With Germ Cell Tumors and Their Parents or Siblings


    Childhood Malignant Ovarian Germ Cell Tumor; Childhood Malignant Testicular Germ Cell Tumor; Ovarian Choriocarcinoma; Ovarian Embryonal Carcinoma; Ovarian Mixed Germ Cell Tumor; Ovarian Teratoma; Ovarian Yolk Sac Tumor; Testicular Choriocarcinoma; Testicular Embryonal Carcinoma; Testicular Seminoma; Testicular Teratoma; Testicular Yolk Sac Tumor

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

    Kåreholt Ingemar; Ahacic Kozma; Trygged Sven


    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 registe...

  9. p28 in Treating Younger Patients With Recurrent or Progressive Central Nervous System Tumors


    Teratoid Tumor, Atypical; Choroid Plexus Neoplasms; Anaplastic Astrocytoma; Anaplastic Oligodendroglioma; Brainstem Tumors; Giant Cell Glioblastoma; Glioblastoma; Gliosarcoma; Medulloblastoma; Neuroectodermal Tumor, Primitive

  10. Promotion and support of physical activity in elderly patients on hemodialysis: a case study

    Shiota, Kotomi; Hashimoto, Toshihiko


    [Purpose] The aim of this study was to ascertain the optimum strategy for implementing a physical activity intervention in patients on hemodialysis by investigating the physical characteristics of elderly patients on hemodialysis, and their attitude to physical activity and level of daily activity. [Subjects] The Subject were 10 elderly patients on hemodialysis. [Methods] They wore a physical activity monitor for 1 week. Data obtained were analyzed for hemodialysis and non- hemodialysis days, and two-way analysis of variance was used to compare the number of steps and activity levels. A questionnaire was administered to investigate the stage of psychological preparedness for exercise and attitudes toward/awareness of exercise. [Results] There was no significant difference in the number of steps or exercise levels on hemodialysis and non- hemodialysis days. However, on both types of days, subjects spent long periods not engaged in any activity. Most of their activity was either inactivity or sedentary behavior. [Conclusion] Patients on hemodialysis with low physical activity levels are considered to have poor physical function and exercise tolerance. To maintain and improve the physical function of patients on hemodialysis, it will be necessary to reduce their time spent in inactive, and comprehensive care that covers psychosocial aspects should be provided to promote the proactive improvement of physical activity and their attitudes to exercise. PMID:27190487

  11. Impact of thermal processing and the Maillard reaction on the basophil activation of hazelnut allergic patients.

    Cucu, Tatiana; De Meulenaer, Bruno; Bridts, Chris; Devreese, Bart; Ebo, Didier


    Food allergy, an abnormal immunological response due to sensitization to a food component, has become an important health problem, especially in industrialized countries. The aim of this study was to investigate the impact of thermal processing and glycation on the basophil activation by hazelnut proteins using a basophil activation test. Patients with systemic allergic reactions (SR; n=6) to hazelnut as well as patients with an isolated oral allergy syndrome (OAS; n=4) were investigated. Thermal processing of hazelnut proteins either in the presence or absence of wheat proteins did not result in major changes in the stimulatory activity of the basophils for patients with SR or OAS. For the patients with OAS, incubation of hazelnut proteins with glucose led to complete depletion of the stimulatory activity of the basophils. An increase in stimulatory activity of the basophils for two out of six patients with SR was observed. For the other four patients slight or complete abolition of the stimulatory activity was observed. These results indicate that some patients with SR to hazelnut are at risk when exposed to hazelnut proteins, even in processed foods.

  12. Fibromyalgia in patients with axial spondyloarthritis: epidemiological profile and effect on measures of disease activity.

    Salaffi, Fausto; De Angelis, Rossella; Carotti, Marina; Gutierrez, Marwin; Sarzi-Puttini, Piercarlo; Atzeni, Fabiola


    To determine the prevalence of fibromyalgia (FM) in patients with ankylosing spondylitis (AS) or psoriatic arthritis (PsA) characterized by axial involvement (axial-PsA), and to assess the discriminative ability of different versions of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) in measuring disease activity in three different cohorts of patients with axial spondyloarthritis (axial-SpA), FM, or both (axial-SpA + FM), this study was divided into two phases: (1) 402 patients with definite AS or axial-PsA were examined to diagnose FM and estimate its prevalence; and (2) 419 patients (111 with axial-SpA, 248 with FM, and 60 with aSpA + FM) were evaluated using the different versions of the ASDAS and BASDAI to assess the effect on disease activity. The overall prevalence of FM in the axial-SpA population was 14.9 %, significantly higher among women (p axial-PsA was 17.2 %. Although the BASDAI scores correlated with those of ASDAS-C-reactive protein (CRP) and ASDAS-erythrocyte sedimentation rate (ESR) (p axial-SpA and more prevalent in female patients. Our findings suggest that ASDAS is better than BASDAI in distinguishing patients with disease activity from those with functional impairment. The use of ASDAS may be very useful in clinical practice as it allows treating patients with the most appropriate therapy.

  13. Altered Error-Related Activity in Patients with Schizophrenia

    Koch, Kathrin; Wagner, Gerd; Schultz, Christoph; Schachtzabel, Claudia; Nenadic, Igor; Axer, Martina; Reichenbach, Jurgen R.; Sauer, Heinrich; Schlosser, Ralf G. M.


    Deficits in working memory (WM) and executive cognitive control are core features of schizophrenia. However, findings regarding functional activation strengths are heterogeneous, partly due to differences in task demands and behavioral performance. Previous investigators proposed integrating these heterogeneous findings into a comprehensive model…

  14. Hematologic and surgical management of the dental patient with plasminogen activator deficiency.

    Scheitler, L E; Hart, N; Phillips, G; Weinberg, J B


    Anticoagulation therapy is used to treat patients with a variety of hemostatic disorders in an attempt to prevent thrombus formation. A thorough understanding of the patient's medical history is essential before dental treatment that may require alteration of this anticoagulation therapy. Alteration of anticoagulation therapy should be undertaken only after consultation with the patient's physician because some patients are at greater risk than others for thrombus formation or hemorrhage. This case of a 29-year-old man with plasminogen activator deficiency illustrates how consultation can result in a coordinated treatment plan for medical and dental management formulated to help ensure safe surgical treatment for these medically compromised patients.

  15. Active middle ear implantation for patients with sensorineural hearing loss and external otitis: long-term outcome in patient satisfaction

    Zwartenkot, J.W.; Hashemi, J.; Cremers, C.W.R.J.; Mulder, J.J.S.; Snik, A.F.M.


    OBJECTIVE: To study long-term subjective benefit of patients with sensorineural hearing loss and chronic external otitis who use active middle ear implants. DESIGN: Single-subject repeated measures in a preintervention and postintervention design with multiple postintervention measurements (question

  16. Younger is not always better: development of locomotor adaptation from childhood to adulthood.

    Vasudevan, Erin V L; Torres-Oviedo, Gelsy; Morton, Susanne M; Yang, Jaynie F; Bastian, Amy J


    New walking patterns can be learned over short timescales (i.e., adapted in minutes) using a split-belt treadmill that controls the speed of each leg independently. This leads to storage of a modified spatial and temporal motor pattern that is expressed as an aftereffect in regular walking conditions. Because split-belt walking is a novel task for adults and children alike, we used it to investigate how motor adaptation matures during human development. We also asked whether the immature pattern resembles that of people with cerebellar dysfunction, because we know that this adaptation depends on cerebellar integrity. Healthy children (3-18 years old) and adults, and individuals with cerebellar damage were adapted while walking on split belts (1:2 speed ratio). Adaptation and de-adaptation rates were quantified separately for temporal and spatial parameters. All healthy children and adults tested could learn the new timing at the same rate and showed significant aftereffects. However, children younger than 6 years old were unable to learn the new spatial coordination. Furthermore, children as old as age 11 years old showed slower rates of adaptation and de-adaptation of spatial parameters of walking. Young children showed patterns similar to cerebellar patients, with greater deficits in spatial versus temporal adaptation. Thus, although walking is a well-practiced, refined motor skill by late childhood (i.e., 11 years of age), the processes underlying learning new spatial relationships between the legs are still developing. The maturation of locomotor adaptation follows at least two time courses, which we propose is determined by the developmental state of the cerebellum.

  17. Successful Interferon Therapy Reverses Enhanced Hepatic Progenitor Cell Activation in Patients with Chronic Hepatitis C.

    Noritake, Hidenao; Kobayashi, Yoshimasa; Ooba, Yukimasa; Matsunaga, Erika; Ohta, Kazuyoshi; Shimoyama, Shin; Yamazaki, Satoru; Chida, Takeshi; Kawata, Kazuhito; Sakaguchi, Takanori; Suda, Takafumi


    The enhanced accumulation of hepatic progenitor cells (HPCs) is related to the risk of progression to hepatocellular carcinoma (HCC). Interferon (IFN) treatment reduces HCC risk in patients with chronic hepatitis C virus (HCV) infection. However, the underlying mechanisms remain unclear. The aim of this study was to examine the effects of IFN treatment on HPC activation in HCV patients. Immunohistochemical detection and computer-assisted quantitative image analyses of cytokeratin 7 (CK7) were performed to evaluate HPC activation in paired pre- and post-treatment liver biopsies from 18 HCV patients with sustained virological response (SVR) to IFN-based therapy and from 23 patients without SVR, as well as normal liver tissues obtained from surgical resection specimens of 10 patients. Pretreatment HCV livers showed increased CK7 immunoreactivity, compared with normal livers (HCV: median, 1.38%; normal: median, 0.69%, P=0.006). IFN treatment reduced hepatic CK7 immunoreactivity (median, 1.57% pre-IFN vs. 0.69% post-IFN, P=0.006) in SVR patients, but not in non-SVR patients. The development of HCC following IFN treatment was encountered in 3 non-SVR patients who showed high post-IFN treatment CK7 immunoreactivity (>4%). Successful IFN therapy can reverse enhanced HPC activation in HCV patients, which may contribute to the reduced risk of HCC development in these patients.

  18. Pioglitazone is equally effective for diabetes prevention in older versus younger adults with impaired glucose tolerance.

    Espinoza, Sara E; Wang, Chen-Pin; Tripathy, Devjit; Clement, Stephen C; Schwenke, Dawn C; Banerji, Mary Ann; Bray, George A; Buchanan, Thomas A; Henry, Robert R; Kitabchi, Abbas E; Mudaliar, Sunder; Stentz, Frankie B; Reaven, Peter D; DeFronzo, Ralph A; Musi, Nicolas


    To determine the efficacy of pioglitazone to prevent type 2 diabetes in older compared to younger adults with pre-diabetes. Six hundred two participants with impaired glucose tolerance (IGT) were randomized in double blind fashion to placebo or pioglitazone for diabetes prevention in the ACT NOW study (NEJM 364:1104-1115, 2011). Cox proportional hazard regression was used to compare time to development of diabetes over a mean of 2 years between older (≥61 years) and younger participants. We compared effects of pioglitazone versus placebo on metabolic profiles, inflammatory markers, adipokines, β cell function (disposition index), insulin sensitivity (Matsuda index), and body composition by ANOVA. Diabetes incidence was reduced by 85 % in older and 69 % in younger subjects (p = 0.41). β cell function (disposition index) increased by 35.0 % in the older and 26.7 % in younger subjects (p = 0.83). Insulin sensitivity (Matsuda index) increased by 3.07 (5.2-fold) in older and by 2.54 (3.8-fold) in younger participants (p = 0.58). Pioglitazone more effectively increased adiponectin in older versus younger subjects (22.9 ± 3.2 μg/mL [2.7-fold] vs. 12.7 ± 1.4 μg/mL [2.2-fold], respectively; p = 0.04). Younger subjects tended to have a greater increase in whole body fat mass compared to older subjects (3.6 vs. 3.1 kg; p = 0.061). Younger and older subjects had similar decreases in bone mineral density (0.018 ± 0.0071 vs. 0.0138 ± 0.021 g/cm(2)). Younger and older pre-diabetic adults taking pioglitazone had similar reductions in conversion to diabetes and older adults had similar or greater improvements in metabolic risk factors, demonstrating that pioglitazone is useful in preventing diabetes in older adults.

  19. Younger Cousin



    虫虫:Welcome back!大家假期过得怎么样啊?一定都很快乐,都玩出了新花样吧!不过,新学期到来了,大家还是收收心,将精力投入到学习中去吧。瞧瞧今天又轮到谁上台展示自我了?哦,原来是来自青海的俞鸿霄同学啊。有请——

  20. Computed tomography angiography in patients with active gastrointestinal bleeding

    Reis, Fatima Regina Silva; D' Ippolito, Giuseppe, E-mail: [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Cardia, P.P. [Hospital Vera Cruz, Campinas, SP (Brazil)


    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding. (author)

  1. Interleukin 27 is up-regulated in patients with active inflammatory bowel disease.

    Furuzawa Carballeda, Janette; Fonseca Camarillo, Gabriela; Yamamoto-Furusho, Jesús K


    The aim of the study was to characterize and quantify tissue gene and protein expression of IL-27 in ulcerative colitis (UC) and Crohn's disease (CD) patients. This is an observational and cross-sectional study. Fifty-four patients with IBD were studied: 27 active UC, 12 inactive UC, 10 active CD, and 5 inactive CD. All patients belonged to the Inflammatory Bowel Disease Clinic at the Instituto Nacional de Ciencias Médicas y Nutrición. We found that IL-27 gene expression was significantly higher in active UC versus inactive UC group (P = 0.015). The IL-27 mRNA expression was increased in patients with active CD compared with inactive CD disease (P = 0.035). The percentage of IL-27 immunoreactive cells was higher in active UC versus active CD patients and non-inflamed tissue controls. The IL-27 was significantly elevated in active UC and CD patients, and it was associated with disease severity.

  2. Time perspective and social preference in older and younger adults: Effects of self-regulatory fatigue.

    Segerstrom, Suzanne C; Geiger, Paul J; Combs, Hannah L; Boggero, Ian A


    Socioemotional selectivity theory predicts that when perceived time in life is limited, people will prefer emotionally close social partners over less emotionally rewarding partners. Regulating social choices with regard to time perspective can make the best use of time with regard to well-being. However, doing so may depend on the self-regulatory capacity of the individual. Two studies, 1 with younger adults (N = 101) and 1 with younger (N = 42) and older (N = 39) adults, experimentally tested the effects of time perspective and self-regulatory fatigue on preferences for emotionally close partners and knowledgeable partners. In both studies and across younger and older adults, when self-regulatory fatigue was low, the perception of limited time resulted in a greater preference for close social partners relative to knowledgeable social partners. However, this shift was eliminated by self-regulatory fatigue. In Study 2, when fatigued, younger adults preferred close social partners to knowledgeable partners across time perspectives; older adults preferred close and knowledgeable partners more equally across time perspectives. These findings have implications for social decision-making and satisfaction among people who experience chronic self-regulatory fatigue. They also contradict previous suggestions that only younger adults are susceptible to self-regulatory fatigue. (PsycINFO Database Record

  3. Understanding the gap in primary care access and use between teens and younger children.

    Burns, Marguerite E; Leininger, Lindsey Jeanne


    Primary health care use among teenagers falls short of clinical recommendations and consistently lags behind that of younger children. Using the Medical Expenditure Panel Survey, the authors explore three explanations for this age-related gap: family composition, parental awareness of children's health care needs, and the relative role of predisposing, enabling, and need-based factors for teens and younger children. Teenagers are 64% more likely to have no usual source of care and 25% more likely to have had no health care visit in the prior year relative to younger children. The gap narrows in families with children from both age-groups and among children with special health care needs. The largest disparity in primary care access exists between teens in families with no younger sibling(s) and younger children in families with no teen(s). A resolution to the age-related access gap will likely require understanding of, and intervention into, family-level determinants of poor access.

  4. Activation capacity of the alternative and classic complement pathways in patients operated on for colorectal cancer

    Zimmermann-Nielsen, Erik; Iversen, Lene H; Svehag, Sven-Erik;


    . Significant differences in C3 activation capacities were observed between cancer patients that were related to Dukes stage and in patients with and without buffy coat-depleted red cells suspended in saline, adenine, glucose, and mannitol transfusion, infectious events, and deep venous thromboembolism......PURPOSE: Tumor cells may suppress activation of the host's complement system, and the functional state of the complement system may be a prognostic marker of outcome in patients with malignancies. Serial plasma samples from patients undergoing intended curative surgery for colorectal cancer were...... analyzed for complement factor C3 activation capacity. METHODS: Samples were collected from 91 patients with colorectal cancer and 13 with benign colorectal diseases before surgery and 1, 2, and 7 days after surgery, between 8 and 13 days after surgery, and 3, 6, 12, 18, 24, 36, 48, and 60 months after...

  5. Xanthine oxidase activity and free radical generation in patients with sepsis syndrome

    Galley, H F; Davies, Michael Jonathan; Webster, N R


    OBJECTIVE: To determine xanthine oxidase activity, free radical concentrations, and lipid peroxidation in patients with sepsis syndrome compared with noninfected critically ill patients. DESIGN: A prospective observational study. SETTING: A nine-bed intensive care unit in a university teaching......). CONCLUSIONS: Patients with sepsis have xanthine oxidase activation, high free-radical concentrations, and evidence of free radical damage. The finding that xanthine oxidase activity was lower in those patients who died, coupled with increased lactate concentrations implies more severe ischemia with incomplete...... to the Acute Physiology and Chronic Health Evaluation (APACHE) II score or to the presence of organ dysfunction. The mean ascorbyl radical concentration (arbitrary units) determined by electron paramagnetic resonance following spin trapping was increased in patients compared with healthy subjects (p

  6. Patient activation in Europe: an international comparison of psychometric properties and patients’ scores on the short form Patient Activation Measure (PAM-13)

    Rademakers, J.; Terkildsen Maindal, H.; Steinsbekk, A.; Gensichen, J.; Brenk-Franz, K.; Hendriks, M.


    Background: To allow better assessment of patients’ individual competencies for self-management, the Patient Activation Measure (PAM) has been developed in the USA. Because the American studies have shown the PAM to be a valuable tool, several European countries have translated the instrument into t

  7. Over-optimistic patient expectations of recovery and leisure activities after arthroscopic meniscus surgery

    Pihl, Kenneth; Roos, Ewa M; Nissen, Nis;


    Background and purpose - Patients' expectations of outcomes following arthroscopic meniscus surgery are largely unknown. We investigated patients' expectations concerning recovery and participation in leisure-time activities after arthroscopic meniscus surgery and the postoperative fulfillment...... their expectations of recovery time and postoperative participation in leisure activities. 3 months after surgery, the patients completed questionnaires on their actual level of leisure activity and their degree of satisfaction with their current knee function. We analyzed differences between the expected outcome...... meniscus surgery were too optimistic regarding their recovery time and postoperative participation in leisure activities. This highlights the need for shared decision making which should include giving the patient information on realistic expectations of recovery time and regarding participation in leisure...

  8. Decreased renal vitamin K-dependent γ-glutamyl carboxylase activity in calcium oxalate calculi patients

    陈俊汇; 刘继红; 章咏裳; 叶章群; 王少刚


    Objective To study the activity of vitamin K-dependent γ-glutamyl carboxylase in patients with calcium oxalate (CaOx) urolithiasis compared with healthy individuals and to assess its relationship to the renal calcium oxalate urolithiasis. Methods Renal parenchymas were harvested from urolithic patients and renal tumor patients undergoing nephrectomy. The renal carboxylase activity was evaluated as the radioactivity of [14C] labeled sodium bicarbonate in carboxylic reactions in vitro using β-liquid scintillation counting. Results Significantly reduced activity of renal vitamin K-dependent γ-glutamyl carboxylase was observed in the urolithic group as compared with normal controls (P<0.01). Conclusion It suggests that the reduced carboxylase activity observed in the urolithic patients may play an important role in the course of renal calcium oxalate urolithiasis.

  9. Daily energy expenditure, physical activity, and weight loss in Parkinson's disease patients

    Patients with Parkinson's disease (PD) commonly exhibit weight loss (WL) which investigators attribute to various factors, including elevated energy expenditure. We tested the hypothesis that daily energy expenditure (DEE) and its components, resting energy expenditure (REE) and physical activity (P...

  10. Promotion of physical activity and fitness in sedentary patients with Parkinson's disease : randomised controlled trial

    van Nimwegen, Marlies; Speelman, Arlene D.; Overeem, Sebastiaan; van de Warrenburg, Bart P.; Smulders, Katrijn; Dontje, Manon L.; Borm, George F.; Backx, Frank J. G.; Bloem, Bastiaan R.; Munneke, Marten


    Objective To evaluate whether a multifaceted behavioural change programme increases physical activities in patients with Parkinson's disease. Design Multicentre randomised controlled trial. Setting 32 community hospitals in the Netherlands, collaborating in a nationwide network (ParkinsonNet). Parti

  11. Telomerase Activity in Peripheral Blood Mononuclear Cells from Senile Patients with Pneumonia

    LIU Jian; ZHOU Zhen; LIU Xiaoqing


    To investigate the changes of the activity of telomerase in peripheral blood mononuclear cells (PBMCs) from senile patients with pneumonia, the telomerase activity was examined before and after the stimulation of phytohemagglutinin-M (PHA-M) in PBMCs from 10 control subjects (group A), 12 non-senile patients with pneumonia (group B) and 9 senile patients with pneumonia (group C). Also observed was the proliferative response of these PBMCs to PHA-M. The results showed that, both with or without the stimulation of PHA-M, the values of telomerase activity in PBMCs from group C patients (A values: pre-stimulation, 0.43±0.04; post-stimulation, 0.63±0.03) were significantly lower than those in PBMCs from both group A patients (A values: prestimulation, 0.65±0.05;post-stimulation, 1.26±0.13;P<0.001, respectively) and group B patients (A values: pre-stimulation, 0.63±0.03; post-stimulation, 0.93±0.03;P<0.05, respectively). The results of MTT test showed that the proliferative activity of PBMCs in group C patients (A value: 0.35±0.03) was also significantly lower than that in group A patients (A value:0. 55±0.04; P<0.05) and group B patients (A value: 0.46±0.03;P<0.05). These results indicate that the telomerase activity decreases in senile patients with pneumonia, which may be one of the mechanisms for the weakened immune function in those patients.

  12. Abnormal atrial activation in young patients with lone atrial fibrillation

    Holmqvist, Fredrik; Olesen, Morten S; Tveit, Arnljot;


    using signal-averaged P-wave analysis. Echocardiography was performed in association with the ECG recording. Heart rate (67 ± 13 vs. 65 ± 7 b.p.m., P = 0.800) and PQ-interval (163 ± 16 vs. 164 ± 23 ms, P = 0.629) were similar in AF cases and controls, as was P-wave duration (136 ± 13 vs. 129 ± 13 ms, P...... hearts. Methods and results Thirty-six patients with lone AF were included before the age of 40 years (34 ± 4 years, 34 men) and compared with age- and gender-matched control subjects. Standard 12-lead electrocardiogram (ECG) was recorded for at least 10 s. P-wave morphology and duration were estimated...

  13. Positive effects of electronic patient records on three clinical activities

    Hertzum, Morten; Simonsen, Jesper


     Purpose: To investigate the effects of a fully functional electronic patient record (EPR) system on clinicians' work during team conferences, ward rounds, and nursing handovers. Method: In collaboration with clinicians an EPR system was configured for a stroke unit and in trial use for five days...... records prior to the trial period. The data comprise measurements from 11 team conferences, 7 ward rounds, and 10 nursing handovers. Results: During team conferences the clinicians experienced a reduction on five of six subscales of mental workload, and the physicians experienced an overall reduction...... in mental workload. The physician in charge also experienced increased clarity about the importance of and responsibilities for work tasks, and reduced mental workload during ward rounds. During nursing handovers the nurses experienced fewer missing pieces of information and fewer messages to pass on after...

  14. Erectile Dysfunction Among HIV Patients Undergoing Highly Active Antiretroviral Therapy: Dyslipidemia as a Main Risk Factor

    Gustavo Romero‐Velez, MD


    Conclusions: ED is highly prevalent in HIV patients. Dyslipidemia should be considered as a risk factor for ED in HIV patients. Romero‐Velez G, Lisker‐Cervantes A, Villeda‐Sandoval CI, Sotomayor de Zavaleta M, Olvera‐Posada D, Sierra‐Madero JG, Arreguin‐Camacho LO, and Castillejos‐Molina RA. Erectile dysfunction among HIV patients undergoing highly active antiretroviral therapy: Dyslipidemia as a main risk factor. Sex Med 2014;2:24–30.

  15. Increased serum YKL-40 in patients with pulmonary sarcoidosis--a potential marker of disease activity?

    Johansen, Julia S; Milman, Nils; Hansen, Michael


    YKL-40, a growth factor for fibroblasts and vascular endothelial cells, is secreted by macrophages and neutrophils. Elevated serum YKL-40 is found in patients with diseases characterized by inflammation, tissue remodelling and ongoing fibrosis. The aim was to evaluate whether macrophages and giant...... cells in the granulomatous sarcoid lesions of patients with pulmonary sarcoidosis produce YKL-40 and to determine whether serum YKL-40 in these patients were associated with disease activity....

  16. The effect of percutaneous coronary intervention on habitual physical activity in older patients

    Charman, Sarah J.; Vincent T van Hees; Quinn, Louise; Dunford, Joseph R.; Bawamia, Bilal; Veerasamy, Murugapathy; Michael I Trenell; Jakovljevic, Djordje G.; Kunadian, Vijay


    Background Given the ongoing burden of cardiovascular disease and an ageing population, physical activity in patients with coronary artery disease needs to be emphasized. This study assessed whether sedentary behaviour and physical activity levels differed among older patients (≥75 years) following percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) consisting of ST-segment elevation myocardial infarction (STEMI) and non STEMI (NSTEMI) versus an elective admission contr...

  17. Web-Based Self-Management in Chronic Care: A Study of Change in Patient Activation

    Solomon, Michael R.


    Web-based self-management interventions (W-SMIs) are designed to help a large number of chronically ill people become more actively engaged in their health care. Despite the potential to engage more patients in self-managing their health, the use of W-SMIs by patients and their clinicians is low. Using a self-management conceptual model based on…

  18. Evaluation of Instrumental Activities of Daily Living in Greek Patients with Advanced Cancer

    Mystakidou, Kyriaki; Parpa, Efi; Tsilika, Eleni; Panagiotoua, Irene; Roumeliotou, Anna; Symeonidi, Matina; Galanos, Antonis; Kouvaris, Ioannis


    Translation of the instrumental activities of daily living (IADL) was carried out and its psychometric properties were assessed in a Greek sample of patients with advanced cancer. The scale was translated with the forward-backward procedure into the Greek language. It was initially administered to 136 advanced cancer patients. To assess…


    刘长安; 管增伟; 孙武; 邵玉霞; 李卓; 贾廷珍


    Objective To study on the expression and clinical significance of T lymphocyte subset and NK cell activity (NKA) in patients with colorectal cancer. Methods Fifty-seven cancer patients and 33 healthy controls were enrolled in this study. T lymphocyte subset was measured by SAP technique and NKA by LDH release assay based on K562 cells, which served as target cells.

  20. Telemetry Option in the Measurement of Physical Activity for Patients with Heart Failure

    Melczer, Csaba; Melczer, László; Oláh, András; Sélleyné-Gyúró, Mónika; Welker, Zsanett; Ács, Pongrác


    Measurement of physical activity among patients with heart failure typically requires a special approach due to the patients' physical status. Nowadays, a technology is already available that can measure the kinematic movements in 3-D by a pacemaker and implantable defibrillator giving an assessment on software. The telemetry data can be…

  1. Increased muscle activity to stabilise mobile bearing knees in patients with rheumatoid arthritis

    Garling, E.H.; Eck, M; Wedding, T.; Veeger, H.E.J.; Valstar, E.R.; Nelissen, R.G.H.H.


    The aim of this study was to assess the differences in muscle activity (surface EMG) between a posterior stabilised (PS) total knee design and a mobile bearing (MB) posterior cruciate ligament retaining design in rheumatoid arthritis (RA) patients during a step-up task. Four patients with a PS total

  2. Physical Activity Measured With Implanted Devices Predicts Patient Outcome in Chronic Heart Failure

    Conraads, Viviane M.; Spruit, Martijn A.; Braunschweig, Frieder; Cowie, Martin R.; Tavazzi, Luigi; Borggrefe, Martin; Hill, Michael R. S.; Jacobs, Sandra; Gerritse, Bart; van Veldhuisen, Dirk J.


    Background- Physical activity (PA) predicts cardiovascular mortality in the population at large. Less is known about its prognostic value in patients with chronic heart failure (HF). Methods and Results- Data from 836 patients with implantable cardioverter defibrillator without or with cardiac resyn

  3. Interrogation of Patient Smartphone Activity Tracker to Assist Arrhythmia Management.

    Rudner, Joshua; McDougall, Carol; Sailam, Vivek; Smith, Monika; Sacchetti, Alfred


    A 42-year-old man presented to the emergency department (ED) with newly diagnosed atrial fibrillation of unknown duration. Interrogation of the patient's wrist-worn activity tracker and smartphone application identified the onset of the arrhythmia as within the previous 3 hours, permitting electrocardioversion and discharge of the patient from the ED.

  4. Exercise and limitations in physical activity levels among new dialysis patients in the United States: an epidemiologic study.

    Stack, Austin G


    Epidemiologic studies of physical activity among patients with end-stage renal disease (ESRD) are lacking. The aim of this study was to describe the patterns of physical activity among new dialysis patients in the United States.

  5. Comparing urban form correlations of the travel patterns of older and younger adults

    Meza, Maria Josefina Figueroa; Nielsen, Thomas Alexander Sick; Siren, Anu Kristiina


    Using disaggregated data from the Danish National Travel Survey conducted between 2006 - 2011, this study compares the travel patterns of older (65 – 84 years of age) and younger (18 – 64 years of age) adults regarding land use, socio-economic conditions and urban structures. The results highlight...... significant differences between travel patterns and their urban form correlates for the older and younger adult populations. Spatial variables such as density and regional accessibility have different and potentially reverse associations with travel among older adults. The car use of older adults...... is not substituted by other modes in high-density settings, as is the case for younger adults. Older adults do not respond to high regional accessibility by reducing distance traveled, but travel longer and are also more likely to continue using a car in high-access conditions. Spatial structural conditions have...

  6. Enhanced sea-ice export from the Arctic during the Younger Dryas.

    Not, Christelle; Hillaire-Marcel, Claude


    The Younger Dryas cold spell of the last deglaciation and related slowing of the Atlantic meridional overturning circulation have been linked to a large array of processes, notably an influx of fresh water into the North Atlantic related to partial drainage of glacial Lake Agassiz. Here we observe a major drainage event, in marine sediment cores raised from the Lomonosov Ridge, in the central Arctic Ocean marked by a pulse in detrital dolomitic-limestones. This points to an Arctic-Canadian sediment source area with about fivefold higher Younger Dryas ice-rafting deposition rate, in comparison with the Holocene. Our findings thus support the hypothesis of a glacial drainage event in the Canadian Arctic area, at the onset of the Younger Dryas, enhancing sea-ice production and drifting through the Arctic, then export through Fram Strait, towards Atlantic meridional overturning circulation sites of the northern North Atlantic.

  7. Cardiovascular reactivity of younger and older adults to positive-, negative-, and mixed-emotion cognitive challenge.

    Hogan, Michael J; James, Jack E; McCabe, Tadhg R; Kilmartin, Liam; Howard, Siobhán; Noone, Chris


    Although aging is associated with progressive increases in blood pressure level, previous research has been inconsistent as to whether older adults show greater or lesser cardiovascular reactivity (CVR) to emotion than do younger adults. There is reason to believe that these inconsistencies could be clarified by examining age-related differences in hemodynamic profile revealed by measuring the pattern of cardiac output and total peripheral resistance associated with changes in blood pressure reactivity. Accordingly, the present study examined the performance, CVR, and hemodynamic profile of younger and older adults during encoding and recognition of word pairs involving four valence types: positive, negative, mixed (positive/negative), and neutral word pairs. Results revealed higher baseline blood pressure, increased CVR characterized by a vascular hemodynamic profile, and more rapid recovery (especially during encoding) for older than for younger participants. Results are discussed in light of research and theory on the relationship between aging and cardiovascular health.

  8. A fall-off in cervical screening coverage of younger women in developed countries

    Lancucki, L; Fender, M; Koukari, A;


    OBJECTIVES: To analyse cervical screening coverage data by age over time in a number of developed countries throughout the world, with specific emphasis on trends for younger women and on age differentials between younger and older women. METHODS: Routinely collected cervical screening statistics...... that generally the gap between coverage of younger women and coverage of older women increased, sometimes dramatically, between the mid-1990s and the mid-2000s. CONCLUSIONS: There is a general trend in developed countries towards lower coverage in young women (25-29 years old). No common underlying cause has...... and survey data were collected on the proportion of women who have undergone cervical screening with cytology in seven countries in the period 1995 to 2005. RESULTS: Data for the 25-29 age group were examined. Coverage fell in most countries, in three by more than 5 percentage points. In two countries while...

  9. Gradual onset and recovery of the Younger Dryas abrupt climate event in the tropics.

    Partin, J W; Quinn, T M; Shen, C-C; Okumura, Y; Cardenas, M B; Siringan, F P; Banner, J L; Lin, K; Hu, H-M; Taylor, F W


    Proxy records of temperature from the Atlantic clearly show that the Younger Dryas was an abrupt climate change event during the last deglaciation, but records of hydroclimate are underutilized in defining the event. Here we combine a new hydroclimate record from Palawan, Philippines, in the tropical Pacific, with previously published records to highlight a difference between hydroclimate and temperature responses to the Younger Dryas. Although the onset and termination are synchronous across the records, tropical hydroclimate changes are more gradual (>100 years) than the abrupt (10-100 years) temperature changes in the northern Atlantic Ocean. The abrupt recovery of Greenland temperatures likely reflects changes in regional sea ice extent. Proxy data and transient climate model simulations support the hypothesis that freshwater forced a reduction in the Atlantic meridional overturning circulation, thereby causing the Younger Dryas. However, changes in ocean overturning may not produce the same effects globally as in Greenland.

  10. Effects of context expectation on prospective memory performance among older and younger adults.

    Kominsky, Terrence K; Reese-Melancon, Celinda


    This experiment examined the impact of context expectation on prospective memory (PM) performance among older and younger adults. Participants responded to PM target words embedded in an ongoing lexical decision task (LDT). Older and younger adults performed similarly on the PM task. Regardless of age, PM was significantly better for participants in the correct context expectation condition and significantly worse in the incorrect context expectation condition relative to participants who held no expectations about the context in which targets would appear. Participants' LDT response latencies were used to assess cost of the PM task to the ongoing task. Latencies were discernibly longer in the LDT block where the PM targets were expected compared to the block where they were not expected. The findings provide new information about how context can be used to support PM aging and suggest that contextual information can be equally beneficial for older and younger adults.

  11. [The contribution of Web 2.0 technologies to the empowerment of active patients].

    Oliver-Mora, Martí; Iñiguez-Rueda, Lupicinio


    The Spanish health system has recently been marked by the emergence of more active patients who are characterized as being better informed about their disease, having a more participatory attitude, wanting to have a greater influence in making decisions about their health and asserting their rights as patients. Therefore, this article aims to report on how the introduction of Web 2.0 technologies can contribute to the empowering of more active patients. To achieve this, 14 semi-structured interviews were conducted with patients and representatives of patient associations who have used Web 2.0 technologies to interact with other patients or to communicate with health professionals. From the results obtained, we highlight the fact that Web 2.0 technologies provide greater access to health-related information, improve communication between patients and health professionals, and enable the creation of new spaces of interaction among patients. All of the facts above contribute to the formation of a more active role on the part of patients.

  12. High versus low radioiodine activity in patients with differentiated thyroid cancer - A meta-analysis

    Valachis, Antonis [Dept. of Oncology, Maelarsjukhuset., Eskilstuna (Sweden); Univ. of Uppsala,, (Sweden)], e-mail:,; Nearchou, Andreas [Dept, of Oncology, Maelarsjukhuset., Eskilstuna (Sweden); Univ. of Uppsala., Uppsala (Sweden)


    Background: The purpose of the meta-analysis was to estimate the effectiveness and toxicity of low activity radioiodine ablation versus high activity in patients with differentiated thyroid cancer (DTC). Design: A systematic review and meta-analysis was performed by including all randomized trials of low activity versus high activity radioiodine ablation after thyroidectomy. Standard meta-analytic procedures were used to analyze the study outcomes. Results: Ten trials were considered eligible and were further analyzed. The pooled risk ratio (RR) of having a successful ablation for an activity of 1100 MBq versus 3700 MBq (seven trials, 1772 patients) was 0.94 (95% CI 0.85 - 1.04, p-value 0.21). The RR for successful ablation when only thyroid hormone withdrawal was used (five trials, 1116 patients) was 0.87 (95% CI 0.72 - 1.06, p-value 0.17) and it was comparable to RR when only recombinant-human TSH (rec-hTSH) (two trials, 812 patients) was used (1.00, 95% CI 0.93 - 1.07, p-value 0.92). Salivary dysfunction, nausea, and neck pain were significantly more frequent among patients with higher dose for ablation. Conclusion: Our meta-analysis provides some evidence from randomized trials that a lower activity of radioiodine ablation is as effective as higher dose after surgery in patients with DTC with lower toxicity.

  13. Relationship between serum leptin level and disease activity in patients with systemic sclerosis.

    Budulgan, Mahmut; Dilek, Banu; Dağ, Şevin Buluttekin; Batmaz, Ibrahim; Yıldız, İsmail; Sarıyıldız, Mustafa Akif; Çevik, Remzi; Nas, Kemal


    To determine the relationship between serum leptin levels and disease activity in systemic sclerosis (SSc). A total of 60 subjects (30 controls and 30 patients) were included. The inflammatory markers and leptin levels were evaluated and body mass index (BMI) was measured for both groups. The assessment of the skin involvement was performed based on the modified Rodnan skin score (mRSS). Disease activity was evaluated according to the Valentini scleroderma disease activity index. There was a significant difference between the patient and control groups in terms of BMI (p 0.05). Valentini scores and mRSS were determined to be significantly higher in active patients (n = 14) than in inactive patients (n = 16) (p 0.05). However, leptin levels were significantly lower in active patients than in inactive patients (p < 0.05). We found a significant positive correlation between serum leptin and BMI (p < 0.05), and leptin and serum C3 levels (p < 0.05); no relationship was detected between leptin and other parameters. Leptin can be used as an activity marker in SSc. Further studies, including larger series, should be carried out to clarify this relationship.

  14. Altered Activities of Antioxidant Enzymes in Patients with Metabolic Syndrome

    Lucie Vávrová


    Full Text Available Objective: In the pathogenesis of the metabolic syndrome (MetS, an increase of oxidative stress could play an important role which is closely linked with insulin resistance, endothelial dysfunction, and chronic inflammation. The aim of our study was to assess several parameters of the antioxidant status in MetS. Methods: 40 subjects with MetS and 40 age- and sex-matched volunteers without MetS were examined for activities of superoxide dismutase (CuZnSOD, catalase (CAT, glutathione peroxidase 1 (GPX1, glutathione reductase (GR, paraoxonase1 (PON1, concentrations of reduced glutathione (GSH, and conjugated dienes in low-density lipoprotein (CD-LDL. Results: Subjects with MetS had higher activities of CuZnSOD (p Conclusions: Our results implicated an increased oxidative stress in MetS and a decreased antioxidative defense that correlated with some laboratory (triglycerides, high-density lipoprotein cholesterol (HDL-C and clinical (waist circumference, blood pressure components of MetS.

  15. Functional magnetic resonance imaging evaluation of visual cortex activation in patients with anterior visual pathway lesions

    Xiufeng Song; Guohua Wang; Tong Zhang; Lei Feng; Peng An; Yueli Zhu


    The aim of this study was to examine the secondary visual cortex functional disorder in patients with glaucoma and large pituitary adenoma by functional magnetic resonance imaging, and to determine the correlation between visual field defect and primary visual cortex activation. Results showed that single eye stimulation resulted in bilateral visual cortex activation in patients with glaucoma or large pituitary adenoma. Compared with the normal control group, the extent and intensity of visual cortex activation was decreased after left and right eye stimulation, and functional magnetic resonance imaging revealed a correlation between visual field defects and visual cortex activation in patients with glaucoma and large pituitary adenoma. These functional magnetic resonance imaging data suggest that anterior optic pathway lesions can cause secondary functional disorder of the visual cortex, and that visual defects are correlated with visual cortex activation.

  16. Recurrence or rebound of clinical relapses after discontinuation of natalizumab therapy in highly active MS patients

    Sorensen, Per Soelberg; Koch-Henriksen, Nils; Petersen, Thor;


    A number of studies have reported flare-up of multiple sclerosis (MS) disease activity after cessation of natalizumab, increasing to a level beyond the pre-natalizumab treatment level. Our aim was to describe the development in clinical disease activity following cessation of natalizumab therapy...... in a large unselected cohort of highly active patients. We studied 375 highly active patients who had suffered at least two significant relapses within 1 year or three relapses within 2 years, or had been treated with mitoxantrone for highly active disease. All patients had discontinued therapy...... with natalizumab after at least 24 weeks on therapy, and had been followed 3-12 months (mean 8.9 months) after cessation of natalizumab therapy. The annualised relapse rate before start of natalizumab therapy was 0.94 (95 % confidence interval [CI] 0.88-1.00), 0.47 (95 % CI 0.43-0.52) during natalizumab therapy, 0...

  17. Privileging Younger Children's Voices in Research: Use of Drawings and a Co-Construction Process

    Joanna Tay-Lim PhD Student


    Full Text Available The growing acknowledgement of the value of listening to children's views and experiences in social research, popularly termed as “listening to their voices,” brings with it methodological consequences. Regarding children as expert informants about their own lives carries with it the simultaneous call for researchers to be experts in developing and employing appropriate strategies that can effectively elicit the insights that children can bring to a research topic. With younger children, the use of participatory methodologies has been foregrounded as the key to unlocking their potential to contribute rich and useful perspectives to inform research into their lives. This article explores the usefulness of employing preschoolers' drawings within the context of a co-construction process to facilitate the children's construction of ideas and reinforce their voices in research. The case is made that the quality of the dialogical engagement is as important as the drawing itself, and both visual images and the verbal exchanges are central to the children's meaning-making process. In the co-construction process, both adult and child are (ideally equal players and the resulting dialogical process plays a major role in the constitution of the phenomena. The role of the researcher as the co-constructor can be a challenging one because it entails engaging and supporting children's views and the expression of these views. The discussion and illustrations from the first author's research projects contribute to the literature base on positioning preschool children as valid social actors in their communities. We operate through an ethos of empowerment of all participants, and aim for participatory research practice which has at its heart an active involvement in promoting the rights of children as citizens with voice and power. (Pascal & Bertram, 2009, p. 249

  18. Imaging Striatal Microglial Activation in Patients with Parkinson's Disease.

    Yuko Koshimori

    Full Text Available This study investigated whether the second-generation translocator protein 18kDa (TSPO radioligand, [18F]-FEPPA, could be used in neurodegenerative parkinsonian disorders as a biomarker for detecting neuroinflammation in the striatum. Neuroinflammation has been implicated as a potential mechanism for the progression of Parkinson's disease (PD. Positron Emission Tomography (PET radioligand targeting for TSPO allows for the quantification of neuroinflammation in vivo. Based on genotype of the rs6791 polymorphism in the TSPO gene, 16 mixed-affinity binders (MABs (8 PD and age-matched 8 healthy controls (HCs, 16 high-affinity binders (HABs (8 PD and age-matched 8 HCs and 4 low-affinity binders (LABs (3 PD and 1 HCs were identified. Total distribution volume (VT values in the striatum were derived from a two-tissue compartment model with arterial plasma as an input function. There was a significant main effect of genotype on [18F]-FEPPA VT values in the caudate nucleus (p = 0.001 and putamen (p < 0.001, but no main effect of disease or disease x genotype interaction in either ROI. In the HAB group, the percentage difference between PD and HC was 16% in both caudate nucleus and putamen; in the MAB group, it was -8% and 3%, respectively. While this PET study showed no evidence of increased striatal TSPO expression in PD patients, the current findings provide some insights on the possible interactions between rs6791 polymorphism and neuroinflammation in PD.

  19. The Younger Siblings of Teenage Mothers: A Follow-Up of Their Pregnancy Risk

    East, Patricia L.; Jacobson, Leanne J.


    This study followed 243 younger brothers and younger sisters of parenting teens and nonparenting teens across a 1.5-year period. The average age of siblings was 13.6 years at Time 1 and 15 years at Time 2. Relative to other youths, the sisters of parenting teens exhibited a sharp increase in drug and alcohol use and partying behavior across time and had the highest pregnancy rate at Time 2 (15%). The siblings of parenting teens spent 10 hr a week caring for their sisters’ children, and, for g...

  20. Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

    Thomas, Kali S; Keohane, Laura; Mor, Vincent


    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

  1. Cross-cultural validity of the animated activity questionnaire (AAQ) that assesses activity limitations in patients with hip or knee osteoarthritis

    Peter, W. F.; De Vet, R.; Boers, M.


    Background: The Animated Activity Questionnaire (AAQ) measures activity limitations in hip and knee osteoarthritis (HKOA), and demonstrated good validity and reliability [1]. The AAQ shows stylized video animations of different levels of activity performance. Patients are asked to choose which...

  2. Younger women's experiences of deciding against delayed breast reconstruction post-mastectomy following breast cancer: An interpretative phenomenological analysis.

    Holland, Fiona; Archer, Stephanie; Montague, Jane


    Most women do not reconstruct their breast(s) post-mastectomy. The experiences of younger women who maintain this decision, although important to understand, are largely absent in the research literature. This interview-based study uses interpretative phenomenological analysis to explore the experiences of six women, diagnosed with primary breast cancer in their 30s/40s, who decided against delayed reconstruction. Findings reported here focus on one superordinate theme (decision-making) from a larger analysis, illustrating that the women's drive to survive clearly influenced their initial decision-making process. Their tenacity in maintaining their decision is highlighted, despite non-reconstruction sometimes being presented negatively by medical teams. Patient-centred support recommendations are made.

  3. Subjective experiences of occupational performance of activities of daily living in patients with mild stroke

    Kristensen, Hanne Kaae; Post, A; Poulsen, T.E.;


    and risk of accidents. Conclusion: It is important to view the patients with mild stroke as heterogeneous, and consider post-stroke fatigue and emotional reactions when evaluating rehabilitation needs. Therefore, it is important to look further into structured tools, which examine how well the participant......Aim: To investigate the subjective experiences of occupational performance of activities of daily living (ADL) in patients with mild stroke. Methodology: Data was generated from January – December 2011 and consisted of 41 individual ADL-I interviews with patients in hospital and another 41...... performs daily activities and how this is perceived, to understand fully the patient’s rehabilitation needs....

  4. Correlation between rest-activity rhythm and survival in cancer patients experiencing pain.

    Chang, Wen-Pei; Lin, Chia-Chin


    The purpose of this study was to investigate the influence of rest-activity rhythm on the survival of cancer patients. This study collected data related to cancer patients experiencing pain who had been hospitalized for treatment between August 2006 and October 2007. Data included the Karnofsky Performance Status Index as a representation of functional condition as well as the Brief Pain Inventory and the Pittsburgh Sleep Quality Index. Actigraphic methods were used to record the dichotomy index (I rest-activity rhythms over periods of three consecutive days. Patients were closely followed until 31 July 2013. Results were analyzed using Kaplan-Meier survival analysis, log-rank testing and Cox proportional hazards regression analysis to evaluate whether alterations in the rest-activity rhythm affected the survival rate of the patients. Of the 68 hospitalized cancer patients experiencing pain at the time of admission, 51 subsequently died within the study period. A significant difference was observed in the survival curves between the regular I rest-activity rhythm were negatively correlated with the survival of hospitalized cancer patients experiencing pain. Effects were particularly pronounced in cancer patients with poor performance status.

  5. Continuous reduction of plasma paraoxonase activity with increasing dialysis vintage in hemodialysis patients

    Henning, Bernhard F; Holzhausen, Helge; Tepel, Martin


    Plasma paraoxonase (PON) is an enzyme that hydrolyzes organic phosphate and aromatic carboxylic acid esters. Reduced activity is associated with early events of atherogenesis. The relevance of PON phenotypes is not well characterized in hemodialysis patients. In a cross-sectional study we measured...... phenotypes. 74% of hemodialysis patients showed PON phenotype 1, 21% PON phenotype 2, and 5% PON phenotype 3. Compared to hemodialysis patients with PON 1, patients with PON 2 or 3 showed higher conversion rates for 4-nitrophenylacetate. We observed a significant reduction of PON ratio with increasing...

  6. Decreased levels of serum platelet-activating factor acetylhydrolase in patients with rheumatic diseases

    P. Vergne


    Full Text Available PAF is a potent inflammatory compound known to stimulate the release of various cytokines involved in rheumatic diseases. Elevated blood PAF levels are reported in these patients. We report that serum PAF acetylhydrolase activity (AHA levels are decreased in patients with rheumatoid arthritis or osteoarthritis as compared to healthy controls. Serum and synovial fluid AHA levels were correlated in these patients. The present study suggests the potential role of AHA in controling systemic and/or local PAF levels in patients with rheumatic diseases.

  7. The changing face(book) of psychiatry: can we justify 'following' patients' social media activity?

    Cox-George, Chantal


    Individuals with mental health issues may post information on social networking sites that can provide an insight into their mental health status. It could be argued that doctors (and specifically psychiatrists) should understand the way in which social media is used by their patients to gain a better insight into their illnesses. However, choosing to actively monitor a patient's social media activity raises important questions about the way in which medical students, qualified clinicians and other healthcare professionals obtain information about patients. While this may be framed as a mere form of 'collateral history-taking', there are obvious practical and ethical problems with doing so. Here, a case is made against monitoring the social media activity of patients involved with psychiatric services.

  8. Emotional words induce enhanced brain activity in schizophrenic patients with auditory hallucinations.

    Sanjuan, Julio; Lull, Juan J; Aguilar, Eduardo J; Martí-Bonmatí, Luis; Moratal, David; Gonzalez, José C; Robles, Montserrat; Keshavan, Matcheri S


    Neuroimaging studies of emotional response in schizophrenia have mainly used visual (faces) paradigms and shown globally reduced brain activity. None of these studies have used an auditory paradigm. Our principal aim is to evaluate the emotional response of patients with schizophrenia to neutral and emotional words. An auditory emotional paradigm based on the most frequent words heard by psychotic patients with auditory hallucinations was designed. This paradigm was applied to evaluate cerebral activation with functional magnetic resonance imaging (fMRI) in 11 patients with schizophrenia with persistent hallucinations and 10 healthy subjects. We found a clear enhanced activity of the frontal lobe, temporal cortex, insula, cingulate, and amygdala (mainly right side) in patients when hearing emotional words in comparison with controls. Our findings are consistent with other studies suggesting a relevant role for emotional response in the pathogenesis and treatment of auditory hallucinations.


    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.

    into that the heart endures physical activity. In addition to serving as physical guidance, exercise-based cardiac rehabilitation offers valuable mental support. The patients find help to overcome an initial anxiety and move forward towards a physically active life featuring a feeling of improved health and new......Purpose. Patients face demanding and challenging processes when they experience cardiac problems. Exercise-based cardiac rehabilitation is established to enable these patients to move forward to lead a satisfying life. It is recognised that patients fail to join all sessions of the rehabilitation......, and it seems to be crucial to further emphasise the individuals lived experiences when exercise-based cardiac rehabilitation is followed. Hence this study aims to investigate how patients experience exercise-based cardiac rehabilitation in a hospital setting. Methods. This study, which included nine men...

  10. Activities of daily living and lesion position among multiple sclerosis patients by Bayes network

    Zhifang Pan; Hongtao Lu; Qi Cheng


    Magnetic resonance imaging is a highly sensitive approach for diagnosis of multiple sclerosis, and T2-weighted images can reveal lesions in the cerebral white matter, gray matter, and spinal cord. However, the lesions have a poor correlation with measurable clinical disability. In this study, we performed a large-scale epidemiological survey of 238 patients with multiple sclerosis in eleven districts by network member hospitals in Shanghai, China within 1 year. The involved patients were scanned for position and size of lesions by MRI. Results showed that lesions in the cerebrum, spinal cord, or supratentorial position had an impact on the activities of daily living in multiple sclerosis patients, as assessed by the Bayes network. On the other hand, brainstem lesions were very unlikely to influence the activities of daily living, and were not associated with the position of lesion, patient's gender, and patient's living place.

  11. Very low levels of physical activity in older patients during hospitalization at an acute geriatric ward

    Villumsen, Morten; Jørgensen, Martin; Andreasen, Jane;


    Lack of activity during hospitalization may contribute to functional decline. The purpose of this study was to investigate (1) the time spent walking during hospitalization by geriatric patients referred to physical and/or occupational therapy and (2) the development in time spent walking during......; nonetheless, the physical activity level increased significantly during hospitalization....

  12. Intestinal Disaccharidase Activity in Patients with Autism: Effect of Age, Gender, and Intestinal Inflammation

    Kushak, Rafail I.; Lauwers, Gregory Y.; Winter, Harland S.; Buie, Timothy M.


    Intestinal disaccharidase activities were measured in 199 individuals with autism to determine the frequency of enzyme deficiency. All patients had duodenal biopsies that were evaluated morphologically and assayed for lactase, sucrase, and maltase activity. Frequency of lactase deficiency was 58% in autistic children less than or equal to 5 years…

  13. Upper trapezius muscle activation patterns in neck–shoulder pain patients and healthy controls

    Voerman, G.E.; Vollenbroek-Hutten, M.M.R.; Hermens, H.J.


    This study aimed at investigating whether patients with neck–shoulder complaints from different aetiologies (work-related musculo-skeletal disorders, WMSD; whiplash associated disorders, WAD) show comparable muscle activation patterns, characterised by higher activation and lower relaxation levels o

  14. Physical Activity Participation Among Patients After Total Hip and Knee Arthroplasty

    Stevens, Martin; Reininga, Inge H. F.; Bulstra, Sjoerd K.; Wagenmakers, Robert; van den Akker-Scheek, Inge


    Total hip (THA) and knee arthroplasty (TKA) are successful operative interventions, yet little is known about the physical activity behavior of patients after THA/TKA. For older adults, there are beneficial effects of regular physical activity after THA/TKA. The objective of this paper is to review

  15. Effects of intensive exercise on patients with active rheumatoid arthritis: a randomised clinical trial.

    Ende, C.H.M. van den; Breedveld, F.C.; Cessie, S. le; Dijkmans, B.A.C.; Mug, A.W. de


    Objectives: To investigate the effects of a dynamic, intensive exercise regimen on pain, disease activity, and physical functioning in active rheumatoid arthritis (RA). Methods: 64 patients with RA with a mean age of 60 (13) years and mean disease duration of 8 (8) years, admitted to hospital becaus

  16. The association between immune activation and manic symptoms in patients with a depressive disorder

    Becking, K.; Boschloo, L.; Vogelzangs, N.; Haarman, B. C. M.; Riemersma-van der Lek, R.; Penninx, B. W. J. H.; Schoevers, R. A.


    Although recent studies have shown that immunological processes play an important role in the pathophysiology of mood disorders, immune activation may only be present in specific subgroups of patients. Our study aimed to examine whether immune activation was associated with (a) the presence of manic

  17. Beta-Carotene, Vitamin E, MDA, Glutathione Reductase and Arylesterase Activity Levels in Patients with Active Rheumatoid Arthritis

    N Aryaeian


    Full Text Available "nBackground: Many studies have investigated the possible role of reactive oxygen species in the etiology and patho­gene­sis of Rheumatoid Arthritis (RA. The aim of this study was to investigate the activities of some antioxidants in RA patients."nMethods: In this case-control study, 59 RA patients and 60 healthy sex and age-matched controls were selected. Vitamin E and Beta-carotene were determined using HPLC. Erythrocytes glutathione reductase (GR activity was meas­ured spec­trophotometrically, and malondialdehyde (MDA was determined by colorimetric method. Aryles­terase activity (AEA was measured by Phenylacetate. The clinical data were determined by a rheumatologist, medical history and filling the questionnaire by interview. Statistical analyses were carried out using the SPSS software."nResults: In patients with RA, serum MDA level was significantly higher and plasma concentration of vitamin E, Beta-carotene and GR activity, were significantly lower than healthy control (P<0.001. AEA activity differences between two groups were non-significant."nConclusions: Oxidative stress may play an important role in the inflammation and pathogenesis of RA.  

  18. Quantification of disease activity in patients undergoing leucocyte scintigraphy for suspected inflammatory bowel disease

    Cheow, Heok K.; Voutnis, Demetrius D.; Evans, John W.; Szczepura, Katy R.; Swift, E. Anna; Bird, Nicholas J.; Ruparelia, Prina; Solanki, Chandra K.; Ballinger, James R.; Chilvers, Edwin R.; Peters, A. Michael [Addenbrooke' s Hospital, Department of Nuclear Medicine, Cambridge (United Kingdom); Middleton, Stephen J. [Addenbrooke' s Hospital, Department of Gastroenterology, Cambridge (United Kingdom)


    Whole-body gamma camera counting is an alternative to faecal {sup 111}In collection for quantifying disease activity in inflammatory bowel disease (IBD) but requires administration of imaging activities of {sup 111}In. The aim of this study was to explore a dedicated whole-body counter which requires 20-fold less activity than gamma camera counting. Thirty patients with known or suspected IBD received {sup 99m}Tc-granulocytes ({proportional_to}200 MBq) and {sup 111}In-granulocytes ({proportional_to}0.5 MBq). The {sup 99m}Tc-cells were injected 45 min after the {sup 111}In-cells and immediately after a baseline {sup 111}In whole-body count. The decay-corrected count at 120 h was expressed as a fraction of baseline to give whole-body {sup 111}In retention (WBR). One patient was excluded as the injected cells were non-viable. Median 45-min intravascular {sup 111}In recovery was 35% in patients compared with 43% in six normal volunteers (p<0.05). WBR in normals ranged from 91% to 93% and in 11 patients with negative {sup 99m}Tc imaging from 87% to 96%. Only one of 11 patients with negative imaging had WBR <90% while 11/12 patients with WBR <90% had abnormal imaging. Ten of 13 patients with Crohn's disease (CD) had abnormal imaging. The lowest WBR in these ten was 77% and six had values of >90%. There was a significant association between WBR and {sup 99m}Tc image grade (R{sub s}=0.73, p<0.002) in 16 patients without CD, but not in 13 patients with CD (R{sub s}=0.54, p>0.05). Dedicated whole-body counting is able to quantify disease activity in IBD but may give normal values in active CD. (orig.)

  19. Increased interleukin-23 is associated with increased disease activity in patients with rheumatoid arthritis

    GUO Ying-ying; WANG Nai-zhi; ZHAO Shuai; HOU Lin-xin; XU Yan-bing; ZHANG Ning


    Background Interleukin-23 (IL-23) is a pro-inflammatory cytokine that is thought to be central to the development of autoimmune diseases.This study was conducted to determine whether or not the serum concentration of IL-23 is elevated in patients with rheumatoid arthritis (RA),and to determine the relationship between the IL-23 level and disease activity in RA patients.Methods Serum samples were obtained from 59 patients with RA and 30 healthy controls.The clinical parameters of disease activity were determined,including the 28-joint disease activity score (DAS28),C-reactive protein (CRP),rheumatoid factor (RF) levels,and the degree of bony erosions based on X-rays.The levels of IL-23 and IL-17 were determined by enzyme-linked immunosorbent assay (ELISA).The correlations between the serum levels of IL-23 and disease activity parameters of patients with RA were determined.Results The serum IL-23 level was significantly elevated in patients with RA compared to healthy controls.The serum IL-23 levels in the RA patients correlated with IL-17 and CRP levels,and the DAS28.The levels of IL-23 based on X-ray classification phase Ⅰ,Ⅱ,Ⅲ,and Ⅳ were gradually elevated in RA patients.Conclusions The levels of serum IL-23 in RA patients were higher than in healthy controls.Thus,elevated serum IL-23 levels may be useful markers to detect active RA.In addition,IL-23 is involved in disease progression and bony erosions in patients with RA.

  20. Activity of Matrix Metalloproteinase in Airway Epithelial Cells of COPD Patients


    To examine the mRNA expression of matrix metalloproteinase 9 (MMP-9) and the gelatinase activity of its inhibitor, tissue inhibitor of matrix metalloproteinase 1 (TIMP-1) in the primary epithelial cells of patients with COPD, airway epithelial cells were taken from 15 COPD patients and cultured in vitro. The patients were divided into three groups, COPD group, normal smoking control group and non-smoking control group, with 5 subjects in each group, on basis of the smoking history and lung function. The semi-qualitative RT-PCR was employed to determine the mRNA levels of MMP 9 and TIMP-1 and SDS PAGE was used for the determination of the gelatinase activity of MMP-9 and TIMP-1. Our result showed that the mRNA of MMP-9 and TIMP-1 in epithelial cells of the non-smoking subjects was at a low level The mRNA of MMP 9 and TIMP-1 in COPD patients and smokers was significantly higher than that in non-smokers (P<0.05). No significant difference was found in the levels of MMP-9 and TIMP-1 in epithelial cells between the COPD patients and smokers. The MMP-9/TIMP-1 ratios in COPD patients and smokers were significantly lower than that of non-smokers (P<0.05). The gelatinase activity in the epithelial cells of both COPD patients and normal smokers was increased (P<0.05), but no difference existed in the gelatinase activity in the epithelial cells between COPD patients and normal smokers. It is concluded that the transcription of MMP-9 and TIMP-1 and the gelatinase activity of MMP-9 and MMP-2 in the epithelial cells in COPD patients were increased, which resulted in an imbalance of MMP-9/TIMP-1, thereby causing pulmonary fibrosis. These factors play important roles in the pathogenesis of COPD.

  1. Benefit of a Tiered-Trauma Activation System for Triaging Dead-on-Arrival Patients

    Omar K. Danner


    Full Text Available Introduction: Although national guidelines have been published for the management of critically injured traumatic cardiopulmonary arrest (TCPA patients, many hospital systems have not implemented in-hospital triage guidelines. The objective of this study was to determine if hospital resources could be preserved by implementation of an in-hospital tiered triage system for patients in TCPA with prolonged resuscitation who would likely be declared dead on arrival (DOA.Method: We conducted a retrospective analysis of 4,618 severely injured patients, admitted to our Level I trauma center from December 2000 to December 2008 for evaluation. All of the identified patients had sustained life-threatening penetrating and blunt injuries with pre-hospital TCPA. Patients who received cardiopulmonary resuscitation (CPR for 10 minutes were assessed for survival rate, neurologic outcome, and charge-for-activation (COA for our hospital trauma system.Results: We evaluated 4,618 charts, which consisted of patients seen by the MSM trauma service from December 2001 through December 2008. We identified 140 patients with severe, life-threatening traumatic injuries,who sustained pre-hospitalTCPArequiring prolongedCPRin the field andwere brought to the emergency department (ED.Group I was comprised of 108 patients sustaining TCPA (53 blunt, 55penetrating, who died after receiving, 45 minutes of ACLS after arrival. Group II, which consisted of 32 patients (25 blunt, 7 penetrating, had resuscitative efforts in the EDlasting.45 minutes, but all ultimately died prior to discharge. Estimated hospital charge-for-activation for Group I was approximately $540,000, based on standard charges of $5000 per full-scale trauma system activation (TSA.Conclusion: Full-scale trauma system activation for patients sustaining greater than 10 minutes of prehospital TCPA in the field is futile and economically depleting. [West J Emerg Med. 2012;13(3:225–229.

  2. Brain bioelectrical activity changes in patients with poststroke depression and apathy

    I. V. Kichuk


    Full Text Available Objective: to study the specific features of brain bioelectrical activity in patents with poststroke apathy and depressive disorders.Patients and methods. The investigation enrolled 175 patients (84 men and 91 women with new-onset cerebral stroke at different sites. A total of 107 (61% patients of them were observed to have depressive disorders (n=41 (38% and apathy (n=66 (62% within a year after disease onset. A control group included 68 (39% patients without poststroke affective disorders. The mean age of the study group patients was 66±10 years and that of the control patients was 68±11 years. The severity and magnitude of neurological deficit were evaluated using the U.S. National Institutes of Health Stroke Scale (NIHSS. The patients underwent electroencephalography (EEG, brain computed tomography and magnetic resonance imaging. The investigators used diagnostic and statistical manual of mental disorders (DSM-IV criteria to diagnose depression and the Hamilton depression rating scale (HAM-D and the mini-mental status examination (MMSE to evaluate the mental status. The basic rhythmic power indices in the affected and unaffected hemispheres were calculated, as well as anteroposterior alpha rhythm distribution coefficient and interhemispheric asymmetry coefficient. Results and discussion. The computer EEG analysis was shown to identify the hallmark characteristics of brain bioelectric activity in patients with different types of affective disorders in the acute, early and late recovery periods of stroke. The patients with affective disorders were found to have brain bioelectrical activity changes predominantly in the rapid frequency sub-band on EEG, suggesting midbrain structural dysfunction. In the patients with poststroke depression, depressive disorder scale scores were related to the power of bioelectric activity in the slow and alpha frequency bands manly in the acute stroke period whereas those were correlated with the EEG

  3. Catalase, carbonic anhydrase and xanthine oxidase activities in patients with mycosis fungoides.

    Cengiz, Fatma Pelin; Beyaztas, Serap; Gokce, Basak; Arslan, Oktay; Guler, Ozen Ozensoy


    Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma. In several studies the relationship between catalase (CAT), human cytosolic carbonic anhydrases (CA; hCA-I and hCA-II) and xanthine oxidase (XO) enzyme activities have been investigated in various types of cancers but carbonic anhydrase, catalase and xanthine oxidase activities in patients with MF have not been previously reported. Therefore, in this preliminary study we aim to investigate CAT, CA and XO activities in patients with MF. This study enrolled 32 patients with MF and 26 healthy controls. According to the results, CA and CAT activities were significantly lower in patients with mycosis fungoides than controls (p < 0.001) (p < 0.001). There was no significant difference in XO activity between patient and control group (p = 0.601). Within these findings, we believe these enzyme activity levels might be a potentially important finding as an additional diagnostic biochemical tool for MF.

  4. Detection value of Th17 related indexes and platelet activation indexes in patients with liver cancer

    Pai-Qiang Chen; Qiao-Li Jiang; Jun Li; Jing Zhang


    Objective:To study the detection value of Th17 related indexes and platelet activation indexes in the patients with liver cancer.Methods: A total of 59 patients with liver cancer in our hospital from July 2015 to June 2016 were selected as the observation group, 59 healthy persons of the same ages with physical examination were selected as the control group, then the serum Th17 related indexes and platelet activation indexes levels of two groups were detected and compared, then the serum Th17 related indexes and platelet activation indexes levels of observation group with different stages and types of liver cancer were compared too. Results:The serum Th17 related indexes and platelet activation indexes levels of observation group were all higher than those of control group, the serum Th17 related indexes and platelet activation indexes levels of observation group with different stages and types of liver cancer had obvious differences (allP<0.05).Conclusions: The Th17 related indexes and platelet activation indexes of patients with liver cancer show higher expression state, and the expression levels of patients with different stages and types of liver cancer have obvious differences too, so the clinical detection value of those indexes in the patients with liver cancer are higher.

  5. Fluoxetine modulates motor performance and cerebral activation of patients recovering from stroke.

    Pariente, J; Loubinoux, I; Carel, C; Albucher, J F; Leger, A; Manelfe, C; Rascol, O; Chollet, F


    In order to determine the influence of a single dose of fluoxetine on the cerebral motor activation of lacunar stroke patients in the early phase of recovery, we conducted a prospective, double-blind, crossover, placebo-controlled study on 8 patients with pure motor hemiparesia. Each patient underwent two functional magnetic resonance imaging (fMRI) examinations: one under fluoxetine and one under placebo. The first was performed 2 weeks after stroke onset and the second a week later. During the two fMRI examinations, patients performed an active controlled motor task with the affected hand and a passive one conducted by the examiner with the same hand. Motor performance was evaluated by motor tests under placebo and under fluoxetine immediately before the examinations to investigate the effect of fluoxetine on motor function. Under fluoxetine, during the active motor task, hyperactivation in the ipsilesional primary motor cortex was found. Moreover, fluoxetine significantly improved motor skills of the affected side. We found that a single dose of fluoxetine was enough to modulate cerebral sensory-motor activation in patients. This redistribution of activation toward the motor cortex output activation was associated with an enhancement of motor performance.

  6. Leisure time activities of Iranian patients with multiple sclerosis: a qualitative study

    Seyed Mohammad Sadegh Hosseini


    Conclusion: The results represented the range and heterogeneity of leisure activities amongst the MS patients. Considering participation in spiritual/religious and social activities as leisure time undertaking might reflect cultural diversity in the perception and use of time for recreation. For mental health promotion purposes, paying special attention to the types of activities that people of different socio-cultural background choose for their refreshment could help health care providers in giving tailored advice for patients with MS and other chronic debilitating disease.

  7. Strategies to encourage physical activity in patients with Parkinson's disease: improving quality of life

    Barksdale H


    Full Text Available Heather Barksdale,1 Odinachi Oguh,21Department of Rehabilitation, University of Florida College of Medicine, Jacksonville, FL, USA; 2Department of Neurology, University of Florida, Jacksonville, FL, USA Abstract: The purpose of this article is to discuss strategies to encourage physical activity in patients with Parkinson's disease (PD, to consider the effect that physical activity and exercise has on the quality of life in individuals with PD, identify types of physical activity and exercise most recently and best supported by research, and to explore ways to customize physical exercise to PD patients based on stage and severity. Through research, recommendations are made to encourage physical activity and overcome barriers that may hinder participation in physical activity and exercise across different stages of PD. Keywords: Parkinson's disease, physical activity, barriers, exercise, quality of life

  8. Plasma drug activity assay for treatment optimization in tuberculosis patients.

    Heysell, Scott K; Mtabho, Charles; Mpagama, Stellah; Mwaigwisya, Solomon; Pholwat, Suporn; Ndusilo, Norah; Gratz, Jean; Aarnoutse, Rob E; Kibiki, Gibson S; Houpt, Eric R


    Low antituberculosis (TB) drug levels are common, but their clinical significance remains unclear, and methods of measurement are resource intensive. Subjects initiating treatment for sputum smear-positive pulmonary TB were enrolled from Kibong'oto National TB Hospital, Tanzania, and levels of isoniazid, rifampin, ethambutol, and pyrazinamide were measured at the time of typical peak plasma concentration (C(2 h)). To evaluate the significance of the effect of observed drug levels on Mycobacterium tuberculosis growth, a plasma TB drug activity (TDA) assay was developed using the Bactec MGIT system. Time to detection of plasma-cocultured M. tuberculosis versus time to detection of control growth was defined as a TDA ratio. TDA assays were later performed using the subject's own M. tuberculosis isolate and C(2 h) plasma from the Tanzanian cohort and compared to drug levels and clinical outcomes. Sixteen subjects with a mean age of 37.8 years ± 10.7 were enrolled. Fourteen (88%) had C(2 h) rifampin levels and 11 (69%) had isoniazid levels below 90% of the lower limit of the expected range. Plasma spiked with various concentrations of antituberculosis medications found TDA assay results to be unaffected by ethambutol or pyrazinamide. Yet with a range of isoniazid and rifampin concentrations, TDA exhibited a statistically significant correlation with drug level and drug MIC, and a TDA of ~1.0 indicated the presence of multidrug-resistant TB. In Tanzania, low (≤ 2.0) TDA was significantly associated with both lower isoniazid and rifampin C(2 h) levels, and very low (≤ 1.5) TDA corresponded to a trend toward lack of cure. Study of TDA compared to additional clinical outcomes and as a therapeutic management tool is warranted.

  9. Increased γ-secretase activity in idiopathic normal pressure hydrocephalus patients with β-amyloid pathology.

    Tiina Laiterä

    Full Text Available The potential similarity between the brain pathology of idiopathic normal pressure hydrocephalus (iNPH and Alzheimer disease (AD is intriguing and thus further studies focusing on the underlying molecular mechanisms may offer valuable information for differential diagnostics and the development of treatments for iNPH. Here, we investigated β- and γ-secretase activities in relation to amyloid-β (Aβ pathology in the brain tissue samples collected from iNPH and AD patients. β- and γ-secretase activities were measured from the frontal cortical biopsies of 26 patients with suspected iNPH as well as post-mortem tissue samples from the inferior temporal cortex of 74 AD patients and eight subjects without neurofibrillary pathology. In iNPH samples with detectable Aβ plaques, γ-secretase activity was significantly increased (∼ 1.6-fold when compared to iNPH samples without Aβ plaques (p = 0.009. In the AD samples, statistically significant differences in the γ-secretase activity were not observed with respect to disease severity (mild, moderate and severe AD according to neurofibrillary pathology. Conversely, β-secretase activity was unaltered in iNPH samples with or without Aβ plaques, while it was significantly increased in relation to disease severity in the AD patients. These results show for the first time increased γ-secretase but not β-secretase activity in the biopsy samples from the frontal cortex of iNPH patients with AD-like Aβ pathology. Conversely, the opposite was observed in these secretase activities in AD patients with respect to neurofibrillary pathology. Despite the resemblances in the Aβ pathology, iNPH and AD patients appear to have marked differences in the cellular mechanisms responsible for the production of Aβ.

  10. Skill set or mind set? Associations between health literacy, patient activation and health.

    Samuel G Smith

    Full Text Available OBJECTIVE: There is ongoing debate on whether health literacy represents a skill-based construct for health self-management, or if it also more broadly captures personal 'activation' or motivation to manage health. This research examines 1 the association between patient activation and health literacy as they are most commonly measured and 2 the independent and combined associations of patient activation and health literacy skills with physical and mental health. METHODS: A secondary analysis of baseline cross-sectional data from the LitCog cohort of older adults was used. Participants (n = 697 were recruited from multiple US-based health centers. During structured face-to-face interviews, participants completed the Test of Functional Health Literacy in Adults (TOFHLA, the Patient Activation Measure (PAM, the SF-36 physical health summary subscale, and Patient Reported Outcomes Measurement Information Service (PROMIS short form subscales for depression and anxiety. RESULTS: The relationship between health literacy and patient activation was weak, but significant (r = 0.11, p<0.01. In models adjusted for participant characteristics, lower health literacy was associated with worse physical health (β = 0.13, p<0.001 and depression (β = -0.16, p<0.001. Lower patient activation was associated with worse physical health (β = 0.19, p<0.001, depression (β = -0.27, p<0.001 and anxiety (β-0.24, p<0.001. CONCLUSIONS: The most common measures of health literacy and patient activation are weakly correlated with each other, but also independently correlated with health outcomes. This suggests health literacy represents a distinct skill-based construct, supporting the Institute of Medicine's definition. Deficits in either construct could be useful targets for behavioral intervention.

  11. The ontogeny of human point following in dogs: When younger dogs outperform older.

    Zaine, Isabela; Domeniconi, Camila; Wynne, Clive D L


    We investigated puppies' responsiveness to hand points differing in salience. Experiment 1 compared performance of younger (8 weeks old) and older (12 weeks) shelter pups in following pointing gestures. We hypothesized that older puppies would show better performance. Both groups followed the easy and moderate but not the difficult pointing cues. Surprisingly, the younger pups outperformed the older ones in following the moderate and difficult points. Investigation of subjects' backgrounds revealed that significantly more younger pups had experience living in human homes than did the older pups. Thus, we conducted a second experiment to isolate the variable experience. We collected additional data from older pet pups living in human homes on the same three point types and compared their performance with the shelter pups from Experiment 1. The pups living in homes accurately followed all three pointing cues. When comparing both experienced groups, the older pet pups outperformed the younger shelter ones, as predicted. When comparing the two same-age groups differing in background experience, the pups living in homes outperformed the shelter pups. A significant correlation between experience with humans and success in following less salient cues was found. The importance of ontogenetic learning in puppies' responsiveness to certain human social cues is discussed.

  12. The effects of emotional television advertising on older and younger adults

    M.J. van der Goot; E.A. van Reijmersdal; M. Kleemans


    Understanding older adults’ responses to advertising is vital for the industry because older adults constitute a large and lucrative market: The world population is aging (United Nations, 2012) and consumers of 50 years and older have more disposable income than younger consumers (e.g., Ahmad, 2003;

  13. The effects of emotional television advertising on older and younger adults

    Goot, M.J. van der; Reijmersdal, E.A. van; Kleemans, M.


    Understanding older adults' responses to advertising is vital for the industry because older adults constitute a large and lucrative market: The world population is aging (United Nations, 2012) and consumers of 50 years and older have more disposable income than younger consumers (e.g., Ahmad, 2003;

  14. Comparable modulation of the late positive potential by emotion regulation in younger and older adults

    S.J.E. Langeslag (Sandra); J.W. van Strien (Jan)


    textabstractIt has been suggested that emotion regulation improves with aging. Here, we investigated age differences in emotion regulation by studying modulation of the late positive potential (LPP) by emotion regulation instructions. The electroencephalogram of younger (18-26 years) and older (60-7

  15. Immigrant Girls as Caregivers to Younger Siblings: A Transnational Feminist Analysis

    Lee, Jo-Anne; Pacini-Ketchabaw, Veronica


    This article employs a transnational feminist lens to examine the experiences of racialised immigrant girls who provide care for their younger siblings. The article draws on findings from a participatory action research study in Victoria, British Columbia, Canada to examine the role that immigrant girls' caregiving practices play in transnational…

  16. Predicting Spanking of Younger and Older Children by Mothers and Fathers.

    Day, Randal D.; Peterson, Gary W.; McCracken, Coleen


    Parents' characteristics that influence the incidence of spanking are investigated. Differences between boys and girls, mothers and fathers, older and younger children, Black and White, and married versus single women, as well as attributes of the child, the parent, and the social context are explored using multiple regression analysis. Profiles…

  17. Mistakes as Stepping Stones: Effects of Errors on Episodic Memory among Younger and Older Adults

    Cyr, Andrée-Ann; Anderson, Nicole D.


    The memorial costs and benefits of trial-and-error learning have clear pedagogical implications for students, and increasing evidence shows that generating errors during episodic learning can improve memory among younger adults. Conversely, the aging literature has found that errors impair memory among healthy older adults and has advocated for…

  18. Motivating Millennials: Improving Practices in Recruiting, Retaining, and Motivating Younger Library Staff

    Smith, Sara D.; Galbraith, Quinn


    Working with younger staff and student employees can be a challenge for library supervisors in a multigenerational workplace. Because members of the Millennial Generation have different work expectations, managers need to adjust to best meet their needs. By surveying its five hundred student employees, Brigham Young University's Harold B. Lee…

  19. The Changing Construct of Computer Anxiety for Younger and Older Adults.

    Dyck, Jennifer L.; Gee, Nancy R.; Smither, Janan Al-Awar


    A revalidation of a previously developed computer anxiety scale indicated changes in the factor structure for younger and older adults. Two factors emerged--"Direct Involvement" and "Indirect Involvement" with computers--as compared with the previous "General Computer Anxiety" and "Equipment Anxiety" factors, suggesting that the construct of…

  20. Longitudinal Links between Older Sibling Features and Younger Siblings' Academic Adjustment during Early Adolescence

    Bouchey, Heather A.; Shoulberg, Erin K.; Jodl, Kathleen M.; Eccles, Jacquelynne S.


    This study investigated prospective relations between older siblings' support and academic engagement and younger siblings' academic adjustment from 7th to post-8th grade. The study was unique in that it incorporated a sample of both African American and European American adolescents. Also investigated was the extent to which the gender…

  1. Family and Friend Relationships among Older and Younger Adults: Interaction Motivation, Mood, and Quality.

    O'Connor, Brian P.


    In a study of relationships and life satisfaction, 82 independently-living older adults and 91 younger adults completed measures of their relationships with family and friends. For elderly people, the quality of relationships with their friends was more important than the quality of relationships with their children. The discussion focuses on how…

  2. With Eyes of Equality: Older and Younger Students Learn in a Community College Senior Program.

    Heinrich, June Sark

    In contrast to many senior education programs, the senior program at Triton College (TC) has as one of its aims bringing together younger and older students in both noncredit and credit courses without neglecting the need and desire of many older adults to learn in their own age group. The term "older students" is loosely defined at the college,…

  3. Connecting Younger Second-Language Learners and Older Bilinguals: Interconnectedness and Social Inclusion

    Clyne, Michael; Cordella, Marisa; Schüpbach, Doris; Maher, Brigid


    This article reports on an inter-generational inter-cultural pilot project carried out in suburban Melbourne which supports the second-language acquisition of younger people and enhances the social inclusion of older people of migrant background. The article begins with an outline of the multilingual context in which the project is based. The…

  4. Feelings towards Older vs. Younger Adults: Results from the European Social Survey

    Ayalon, Liat


    The study evaluated the association of modernization (at the macro/societal-level) and modernity (at the micro/individual-level) with feelings towards older vs. younger adults. Analysis was based on the fourth wave of the European Social Survey, which includes a rotated module on ageism. The sample consisted of 28 countries and a total of 54,988…

  5. TLR activation of tumor-associated macrophages from ovarian cancer patients triggers cytolytic activity of NK cells.

    Bellora, Francesca; Castriconi, Roberta; Dondero, Alessandra; Pessino, Anna; Nencioni, Alessio; Liggieri, Giovanni; Moretta, Lorenzo; Mantovani, Alberto; Moretta, Alessandro; Bottino, Cristina


    We analyzed the functional outcome of the interaction between tumor-associated macrophages (TAMs) and natural killer (NK) cells. TAMs from ascites of ovarian cancer patients displayed an alternatively activated functional phenotype (M2) characterized by a remarkably high frequency and surface density of membrane-bound IL-18. Upon TLR engagement, TAMs acquired a classically activated functional phenotype (M1), released immunostimulatory cytokines (IL-12, soluble IL-18), and efficiently triggered the cytolytic activity of NK cells. TAMs also induced the release of IFN-γ from NK cells, which however was significantly lower compared with that induced by in vitro-polarized M2 cells. Most tumor-associated NK cells displayed a CD56(bright) , CD16(neg) or CD56(bright) , CD16(dim) phenotype, and very poor cytolytic activities, despite an increased expression of the activation marker CD69. They also showed downregulation of DNAM-1, 2B4, and NTB-A activating receptors, and an altered chemokine receptor repertoire. Importantly however, when appropriately stimulated, NK cells from the patients, including those cells isolated from ascites, efficiently killed autologous TAMs that expressed low, "nonprotective" levels of HLA class I molecules. Overall, our data show the existence of a complex tumor microenvironment in which poorly cytolytic/immature NK cells deal with immunosuppressive tumor-educated macrophages.

  6. Altered cortical activation during action observation in amyotrophic lateral sclerosis patients: a parametric functional MRI study

    Li, Haiqing; Li, Yuxin; Yin, Bo; Tang, Weijun; Yu, Xiangrong; Geng, Daoying [Huashan Hospital, Department of Radiology, Fudan University, Shanghai (China); Chen, Yan [Fudan University, Department of Neurology, Huashan Hospital, Shanghai (China); Huang, Weiyuan [People' s Hospital of Hainan Province, Department of Radiology, Haikou, Hainan Province (China); Zhang, Biyun [Nanjing University of Traditional Chinese Medicine, Department of radiotherapy, Affiliated Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing (China)


    To investigate functional cerebral abnormalities in patients with amyotrophic lateral sclerosis (ALS) using functional magnetic resonance imaging (fMRI) during action observation. Thirty patients with ALS and 30 matched healthy controls underwent fMRI with an experimental paradigm while observing a video of repetitive flexion-extension of the fingers at three frequency levels or three complexity levels, alternated with periods of a static hand. A parametric analysis was applied to determine the effects of each of the two factors. Action observation activated similar neural networks as the research on execution of action in the ALS patients and healthy subjects in several brain regions related to the mirror-neuron system (MNS). In the ALS patients, in particular, the dorsal lateral premotor cortex (dPMC), inferior parietal gyrus (IPG), and SMA, were more activated compared with the activation in the controls. Increased activation within the primary motor cortex (M1), dPMC, inferior frontal gyrus (IFG), and superior parietal gyrus (SPG) mainly correlated with hand movement frequency/complexity in the videos in the patients compared with controls. The findings indicated an ongoing compensatory process occurring within the higher order motor-processing system of ALS patients, likely to overcome the loss of function. (orig.)

  7. Impact of acetazolamide and CPAP on cortical activity in obstructive sleep apnea patients.

    Katrin Stadelmann

    Full Text Available STUDY OBJECTIVES: 1 To investigate the impact of acetazolamide, a drug commonly prescribed for altitude sickness, on cortical oscillations in patients with obstructive sleep apnea syndrome (OSAS. 2 To examine alterations in the sleep EEG after short-term discontinuation of continuous positive airway pressure (CPAP therapy. DESIGN: Data from two double-blind, placebo-controlled randomized cross-over design studies were analyzed. SETTING: Polysomnographic recordings in sleep laboratory at 490 m and at moderate altitudes in the Swiss Alps: 1630 or 1860 m and 2590 m. PATIENTS: Study 1: 39 OSAS patients. Study 2: 41 OSAS patients. INTERVENTIONS: Study 1: OSAS patients withdrawn from treatment with CPAP. Study 2: OSAS patients treated with autoCPAP. Treatment with acetazolamide (500-750 mg or placebo at moderate altitudes. MEASUREMENTS AND RESULTS: An evening dose of 500 mg acetazolamide reduced slow-wave activity (SWA; approximately 10% and increased spindle activity (approximately 10% during non-REM sleep. In addition, alpha activity during wake after lights out was increased. An evening dose of 250 mg did not affect these cortical oscillations. Discontinuation of CPAP therapy revealed a reduction in SWA (5-10% and increase in beta activity (approximately 25%. CONCLUSIONS: The higher evening dose of 500 mg acetazolamide showed the "spectral fingerprint" of Benzodiazepines, while 250 mg acetazolamide had no impact on cortical oscillations. However, both doses had beneficial effects on oxygen saturation and sleep quality.

  8. Category learning strategies in younger and older adults: Rule abstraction and memorization.

    Wahlheim, Christopher N; McDaniel, Mark A; Little, Jeri L


    Despite the fundamental role of category learning in cognition, few studies have examined how this ability differs between younger and older adults. The present experiment examined possible age differences in category learning strategies and their effects on learning. Participants were trained on a category determined by a disjunctive rule applied to relational features. The utilization of rule- and exemplar-based strategies was indexed by self-reports and transfer performance. Based on self-reported strategies, the frequencies of rule- and exemplar-based learners were not significantly different between age groups, but there was a significantly higher frequency of intermediate learners (i.e., learners not identifying with a reliance on either rule- or exemplar-based strategies) in the older than younger adult group. Training performance was higher for younger than older adults regardless of the strategy utilized, showing that older adults were impaired in their ability to learn the correct rule or to remember exemplar-label associations. Transfer performance converged with strategy reports in showing higher fidelity category representations for younger adults. Younger adults with high working memory capacity were more likely to use an exemplar-based strategy, and older adults with high working memory capacity showed better training performance. Age groups did not differ in their self-reported memory beliefs, and these beliefs did not predict training strategies or performance. Overall, the present results contradict earlier findings that older adults prefer rule- to exemplar-based learning strategies, presumably to compensate for memory deficits. (PsycINFO Database Record

  9. A Younger Dryas plateau icefield in the Monadhliath, Scotland, and implications for regional palaeoclimate

    Boston, Clare M.; Lukas, Sven; Carr, Simon J.


    A record of Younger Dryas glaciation in Scotland is well established. However, the role of the Monadhliath, a significant plateau area extending over 840 km2 in central Scotland, has never been investigated systematically. We present the first systematic glacial geomorphological mapping across the whole region, which has led to the identification of hitherto-unrecorded glacial and associated landforms. The spatial distribution of these landforms indicates that the last phase of glaciation in the area was that of a local plateau icefield. In addition, a clear morphostratigraphical signature provides a strong indication that the icefield dates to the Younger Dryas (12.9-11.7 ka), which is supported by numerical ages in the southeast of the study area. Based on the geomorphological evidence and 2D glacier surface profile modelling, a 280 km2 icefield is reconstructed. A novel approach is introduced to quantify plateau icefield thickness for equilibrium line altitude (ELA) and palaeoprecipitation calculations, resulting in greater overall data confidence compared to traditional reconstruction methods. The ELA for the whole icefield is calculated to be 714 ± 25 m, whilst the ELAs of individual outlet glaciers range from 560 m in the west to 816 m in the east, demonstrating a significant W-E precipitation gradient across the region during the Younger Dryas. These ELAs compare well with those calculated for Younger Dryas ice masses reconstructed in neighbouring regions and are in good agreement with overall precipitation patterns suggested for Scotland during this time. Whilst the total amount of precipitation calculated from these ELAs is highly dependent on the method used, irrespective of this, the study suggests a more arid Younger Dryas climate in the region compared to the present day.

  10. Impaired NADPH oxidase activity in peripheral blood lymphocytes of galactosemia patients.

    Al-Essa, Mazen; Dhaunsi, Gursev S; Al-Qabandi, Wafa'a; Khan, Islam


    Galactosemia is an autosomal recessive disorder with a wide range of clinical abnormalities. Cellular oxidative stress is considered as one of the pathogenic mechanisms of galactosemia. In this study, we examined the activity of NADPH oxidase (NOX), a major superoxide-generating enzyme system, in peripheral blood lymphocytes (PBL) from galactosemia patients. PBL were isolated from galactosemia patients and healthy control subjects and used for cell culture studies and biochemical assays. PBL were cultured in the presence or absence of galactose or galactose-1-phosphate (Gal-1-P), and enzyme activities and/or gene expression of NOX, catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPx) were measured in the cell homogenates. PBL isolated from galactosemia patients showed significantly reduced (P Galactosemia patients were found to have significantly (P galactosemia patients; however, Western blotting revealed that NOX-1 protein was not significantly altered. Interestingly, levels of NOX activity in lymphocytes isolated from galactosemia patients significantly increased but remained subnormal when cultured in galactose-deficient medium for two weeks, indicating a galactose-mediated inhibition of NOX. Lymphocytes isolated from control subjects were found to have significantly (P galactosemia patients.

  11. Cnages in activity limitations and predictors of functional outcome of patients with spinal cord injury following in patient rehabilitation

    C. Joseph


    Full Text Available The purpose of this study was to investigate the changes in the activity limitations of patients following in-patient rehabilitation and the factors influencing functional ability as measured by the Spinal Cord independence measure III (SCIM III. A longitudinal study design was utilised to study the change in functional abilities of patients with spinal cord injury between admission and discharge. A convenient sampling strategy was employed, in which every consecutive patient admitted to the rehabilitation centre within a three-month period was eligible for the study. Demographic-, medical, and process of rehabilitation data were collected and collated from the patients’ medical records using a data gathering sheet that was validated and tested for reliability. functional abilities were measured by the SCIM III. Seventy-six patients met the inclusion criteria, consisting of 58 paraplegics and 18 tetraplegics. The mean age of this cohort was 34.14 years. A significant difference (p<0.001 in functional ability was detected for the total sample, with only 12.5% of patients independent in walking ability and 28.12% in stair management. four (4 factors were found to be predictors of functional outcomes on bivariate analysis, but when considered together in a multiple regression model, only functional status on admission remained correlated to functional outcomes. Conclusion and implication for practice: Significant improvement in functional abilities of persons with spinal cord injury following in-patient rehabilitation was observed. however, mobility and stair-management limitations were the most prevalent at discharge. lastly, a lower functional status should be better targeted to optimise functional ability in the future. future research should be directed towards illuminating whether personal factors or rehabilitation inefficiencies are responsible for the limitations observed at discharge.

  12. Abnormal activation of the occipital lobes during emotion picture processing in major depressive disorder patients

    Jianying Li; Cheng Xu; Xiaohua Cao; Qiang Gao; Yan Wang; Yanfang Wang; Juyi Peng; Kerang Zhang


    A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe, temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for

  13. Abnormal activation of the occipital lobes during emotion picture processing in major depressive disorder patients.

    Li, Jianying; Xu, Cheng; Cao, Xiaohua; Gao, Qiang; Wang, Yan; Wang, Yanfang; Peng, Juyi; Zhang, Kerang


    A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe, temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for

  14. Clinical feature and treatment outcome of active ocular toxoplasmosis in immunocompetent patients

    Mohammad Nassaji; Gholamreza Daraie; Raheb Ghorbani


    Objective:To investigate clinical features, ocular findings, management and follow-up data in a series of immunocompetent patients with active ocular toxoplasmosis. Methods:A prospective study of 25 immunocompetent patients with first attack of active ocular toxoplasmosis. Age, gender, clinical presentation and ophthalmic examination finding were recorded. The diagnosis was based on typical finding in ophthalmic examination. Systemic antimicrobials and corticosteroids were given to all patients. The treatment outcome and side-effects of drugs were observed. Results: Thirteen (52%) patients were male and 12(48%) were female. The mean±SD age at presentation was (26.8±11.1) years. Eye involvement was unilateral in 92%of patients and bilateral only in 8%. Lesions were located at the peripheral retina in 48%, at the macula retina in 28%, and at the macula and peripheral retina in 24%of the patients. The most common presenting symptom was blurred vision (96%), followed by eye pain (28%). All patients received antimicrobials treatment. Systemic corticosteroids were used in 48%of the patients. Clinical response were observed in 44%2 weeks before and in 56%2 weeks after. Vision was improved with treatment except in two cases. No recurrences occurred during one year follow up. Conclusions:Our study shows that active ocular toxoplasmosis has no gender predilection and affects young individuals. Unilateral involvement is more common in our study. Response to treatment is good in patients and no recurrences occur during one year follow-up. It may have implications in favor of treatment of active ocular toxoplasmosis.

  15. Neuronal activation by mucosal biopsy supernatants from irritable bowel syndrome patients is linked to visceral sensitivity.

    Buhner, Sabine; Braak, Breg; Li, Qin; Kugler, Eva Maria; Klooker, Tamira; Wouters, Mira; Donovan, Jemma; Vignali, Sheila; Mazzuoli-Weber, Gemma; Grundy, David; Boeckxstaens, Guy; Schemann, Michael


    Based on the discomfort/pain threshold during rectal distension, irritable bowel syndrome (IBS) patients may be subtyped as normo- or hypersensitive. We previously showed that mucosal biopsy supernatants from IBS patients activated enteric and visceral afferent neurons. We tested the hypothesis that visceral sensitivity is linked to the degree of neuronal activation. Normo- and hypersensitive IBS patients were distinguished by their discomfort/pain threshold to rectal balloon distension with a barostat. Using potentiometric and Ca(2+) dye imaging, we recorded the response of guinea-pig enteric submucous and mouse dorsal root ganglion (DRG) neurons, respectively, to mucosal biopsy supernatants from normosensitive (n = 12 tested in enteric neurons, n = 9 tested in DRG) and hypersensitive IBS patients (n = 9, tested in both types of neurons). In addition, we analysed the association between neuronal activation and individual discomfort/pain pressure thresholds. The IBS supernatants evoked Ca(2+) transients in DRG neurons and spike discharge in submucous neurons. Submucous and DRG neurons showed significantly stronger responses to supernatants from hypersensitive IBS patients as reflected by higher spike frequency or stronger [Ca(2+)]i transients in a larger proportion of neurons. The neuroindex as a product of spike frequency or [Ca(2+)]i transients and proportion of responding neurons correlated significantly with the individual discomfort/pain thresholds of the IBS patients. Supernatants from hypersensitive IBS patients caused stronger activation of enteric and DRG neurons. The level of activation correlated with the individual discomfort/pain threshold pressure values. These findings support our hypothesis that visceral sensitivity is linked to activation of peripheral neurons by biopsy supernatants.

  16. Elevated erythrocyte adenosine deaminase activity in a patient with primary acquired sideroblastic anemia.

    Kanno, H; Fujii, H; Tani, K; Morisaki, T; Takahashi, K; Horiuchi, N; Kizaki, M; Ogawa, T; Miwa, S


    We report a case of primary acquired sideroblastic anemia (PASA) associated with elevated erythrocyte adenosine deaminase (ADA) activity. The patient was an 85-year-old Japanese male. Analysis of the peripheral blood revealed pancytopenia, and the bone marrow findings showed marked ringed sideroblasts and chromosomal deletion (46XY, 11q-). The erythrocyte ADA activity was 17 times higher than that of normal control, the leukocyte ADA activity was within the normal range, and the plasma ADA activity was 2 times higher than the normal mean. The adenine nucleotides in the patient's erythrocytes were within normal range. According to starch gel electrophoresis, ADA isozyme of the patient was ADA 1. Western blotting showed an increased amount of ADA protein in the patient's erythrocytes. Southern blotting revealed no gene amplification or large structural change. Dot blot analysis of the reticulocyte mRNA showed no increase in the amount of ADA mRNA in the patient's reticulocytes compared with those of reticulocyte-rich controls. We considered that the mechanism of elevated ADA activity in this acquired defect was similar to that found in hereditary hemolytic anemia associated with ADA overproduction.

  17. Evaluation of physical activity habits in patients with posttraumatic stress disorder

    Marcio Antonio de Assis


    Full Text Available OBJECTIVE: In this study, we present data from a survey that aimed to assess the physical activity habits of adult Brazilian patients with Posttraumatic Stress Disorder. METHOD: Fifty male and female patients with Posttraumatic Stress Disorder participated in this study. The mean age at onset was 37±12 years, and the mean time between diagnosis and follow-up was 3.6±4.2 years. RESULTS: Substantial changes in physical activity habits were observed following the onset of PTSD. While more than half of the patients participated in physical activities prior to Posttraumatic Stress Disorder onset, there was a significant reduction in their participation afterwards. The justifications for stopping physical activities or sport participation were lack of time and lack of motivation. DISCUSSION: Several studies have shown that physical exercise decreases reverts symptoms of psychiatric disorders such as depression, anxiety and social isolation. We could therefore hypothesize that patients with Posttraumatic Stress Disorder who exercise should experience the same benefits. CONCLUSION: Our findings demonstrated that patients with Posttraumatic Stress Disorder have low levels of participation in sports or physical activities.

  18. Patient satisfaction´s level with the nursing activities timetable.

    Laura Carretero Cortes


    Full Text Available The assessment of patient satisfaction allows one the one hand to identify deficient areas from the point of view of the patient and on the other hand to evaluate the care outcomes.Patient´s opinion is an essential component in the assessment of the service. If patients are dissatisfied, care is far away from what it should be, no matter how high quality can be assesed through clinical indicators.The objective was to determine the patient satisfaction´s level with the schedule established in the hospital. Thus, a descriptive study that using simple random sampling the elements of the random sample were chosen directly in one step, assign each person hospitalized in a hospital in Toledo BZH a number and through a mechanical means (balls in a bag we get random items that will be part of the sample (50 patients in the Hospital of Toledo BZH, so that each element in the population had an equal chance of being selected. The survey provides a closed, compilation, anonymous and voluntary.Results points to a certain degree of dissatisfaction among users, strict schedules and adapted to the "rotation" of health personnel, not patients.Analyzing the results in the development of activity schedules nursing activities: hygiene, feeding, etc ... we can see a big difference being a high percentage of patients who would prefer to change some schedules.

  19. Actively paranoid patients with schizophrenia over attribute anger to neutral faces.

    Pinkham, Amy E; Brensinger, Colleen; Kohler, Christian; Gur, Raquel E; Gur, Ruben C


    Previous investigations of the influence of paranoia on facial affect recognition in schizophrenia have been inconclusive as some studies demonstrate better performance for paranoid relative to non-paranoid patients and others show that paranoid patients display greater impairments. These studies have been limited by small sample sizes and inconsistencies in the criteria used to define groups. Here, we utilized an established emotion recognition task and a large sample to examine differential performance in emotion recognition ability between patients who were actively paranoid (AP) and those who were not actively paranoid (NAP). Accuracy and error patterns on the Penn Emotion Recognition test (ER40) were examined in 132 patients (64 NAP and 68 AP). Groups were defined based on the presence of paranoid ideation at the time of testing rather than diagnostic subtype. AP and NAP patients did not differ in overall task accuracy; however, an emotion by group interaction indicated that AP patients were significantly worse than NAP patients at correctly labeling neutral faces. A comparison of error patterns on neutral stimuli revealed that the groups differed only in misattributions of anger expressions, with AP patients being significantly more likely to misidentify a neutral expression as angry. The present findings suggest that paranoia is associated with a tendency to over attribute threat to ambiguous stimuli and also lend support to emerging hypotheses of amygdala hyperactivation as a potential neural mechanism for paranoid ideation.

  20. Relationship between insulinase activity of erythrocytes and insulin resistance in patients with type 2 diabetes mellitus

    LI Chen-zhong; ZHANG Su-hua; QIU Hong-xin; WANG Ding-nian


    To investigate the relationship between insulinase activity of erythrocytes (EIA) and insulin resistance in patients with type 2 diabetes mellitus. Methods: EIA was determined with the method of radioassay of enzyme activity in 65 healthy subjects, and 109 patients with type 2 diabetes mellitus divided into 3 subgroups according to their therapy and plasma glucose control. Fasting plasma insulin (FINS) and other related indices were also measured in all the subjects. Moreover, insulin sensitive index (lSI) was calculated for estimation of insulin sensitivity. Results: EIA and FINS are increased in two subgroups of diabetic patients on hypoglycemics (subgroup A and subgroup B), and especially higher in the poor controlled subgroup of patients ( subgroup A). EIA and FINS are normal in subgroup of patients without medication (subgroup C). Moreover, ISI is decreased in all the subgroups of patients as compared with normal subjects. Correlation analysis show that EIA is inversely correlated with ISI in all subgroups of patients and normal subjects, and positively correlated with FINS in normal subjects. Conclusions:The rate of insulin degradation in erythrocytes is increased in patients with type 2 diabetes, and increased insulin degradation may result in their insulin- resistant state. Moreover, EIA may be used as one of the indices for estimation of insulin sensitivity.

  1. Disease activity patterns over time in patients with SLE: analysis of the Hopkins Lupus Cohort

    Györi, Noémi; Giannakou, Ioanna; Chatzidionysiou, Katerina; Magder, Laurence; van Vollenhoven, Ronald F; Petri, Michelle


    Objective To describe SLE disease activity patterns in the Hopkins Lupus Cohort. Methods Disease activity was studied in 1886 patients followed-up for 1–28 years. Disease activity patterns were defined using (1) Physician Global Assessment (PGA) and (2) modified SLE Disease Activity Index (M-SLEDAI) as follows: long quiescent (LQ), M-SLEDAI=0/PGA=0 at all visits; relapsing-remitting (RR), periods of activity (M-SLEDAI>0/PGA>0) interspersed with inactivity (M-SLEDAI=0/PGA=0); chronic active (CA), M-SLEDAI>0/PGA>0 at all visits. The pattern of first 3 consecutive follow-up years was determined in 916 patients as: persistent LQ (pLQ), persistent RR (pRR) and persistent CA (pCA), LQ, RR and CA pattern in each of the 3 years, respectively; mixed, at least two different pattern types were identified. Results The RR pattern accounted for the greatest proportion of follow-up time both by M-SLEDAI and PGA, representing 53.8% and 49.9% of total patient-years, respectively. The second most frequent pattern was LQ based on M-SLEDAI (30.7%) and CA based on PGA (40.4%). For the first 3-year intervals, the mixed pattern type was the most common (56.6%). The pRR was the second most frequent (M-SLEDAI 33.3%, PGA 26.5%), while pLQ (M-SLEDAI 6.4%, PGA 0.7%) and pCA were less frequent (M-SLEDAI 3.7%, PGA 16.3%). Conclusions The RR pattern was the most prevalent pattern. LQ was achieved in a subset of patients, using the M-SLEDAI. However, the PGA captured mild activity missed on the M-SLEDAI in these patients. Over a 3-year perspective, less than half of patients maintained their original pattern. PMID:28243457

  2. Effects of alprazolam on cortical activity and tremors in patients with essential tremor.

    Jaime Ibáñez

    Full Text Available BACKGROUND: Essential tremor (ET is characterised by postural and action tremors with a frequency of 4-12 Hz. Previous studies suggest that the tremor activity originates in the cerebello-thalamocortical pathways. Alprazolam is a short-acting benzodiazepine that attenuates tremors in ET. The mechanisms that mediate the therapeutic action of alprazolam are unknown; however, in healthy subjects, benzodiazepines increase cortical beta activity. In this study, we investigated the effect of alprazolam both on beta and tremor-related cortical activity and on alterations in tremor presentation in ET patients. Therefore, we characterised the dynamics of tremor and cortical activity in ET patients after alprazolam intake. METHODS: We recorded hand tremors and contralateral cortical activity in four recordings before and after a single dose of alprazolam. We then computed the changes in tremors, cortico-muscular coherence, and cortical activity at the tremor frequency and in the beta band. RESULTS: Alprazolam significantly attenuated tremors (EMG: 76.2 ± 22.68%, decreased cortical activity in the tremor frequency range and increased cortical beta activity in all patients (P<0.05. At the same time, the cortico-muscular coherence at the tremor frequency became non-significant (P<0.05. We also found a significant correlation (r = 0.757, P<0.001 between the reduction in tremor severity and the increased ratio of cortical activity in the beta band to the activity observed in the tremor frequency range. CONCLUSIONS: This study provides the first quantitative analysis of tremor reduction following alprazolam intake. We observed that the tremor severity decreased in association with an increased ratio of beta to tremor-related cortical activity. We hypothesise that the increase in cortical beta activity may act as a blocking mechanism and may dampen the pathological oscillatory activity, which in turn attenuates the observed tremor.

  3. Quantification of muscle activity during sleep for patients with neurodegenerative diseases

    Hanif, Umaer; Trap, Lotte; Jennum, Poul;


    Idiopathic REM sleep behavior disorder (iRBD) is a very strong predictor for later development of Parkinson's disease (PD), and is characterized by REM sleep without atonia (RSWA), resulting in increased muscle activity during REM sleep. Abundant studies have shown the loss of atonia during REM...... sleep, but our aim was to investigate whether iRBD and PD patients have increased muscle activity in both REM and NREM sleep compared to healthy controls. This was achieved by developing a semi-automatic algorithm for quantification of mean muscle activity per second during all sleep stages...... to the different sleep stages and muscle activity beyond the threshold was counted. The results were evaluated statistically using the two-sided Mann-Whitney U-test. The results suggested that iRBD patients also exhibit distinctive muscle activity characteristics in NREM sleep, however not as evident as in REM...

  4. Telemetry Option in the Measurement of Physical Activity for Patients with Heart Failure

    Melczer Csaba


    Full Text Available Measurement of physical activity among patients with heart failure typically requires a special approach due to the patients’ physical status. Nowadays, a technology is already available that can measure the kinematic movements in 3-D by a pacemaker and implantable defibrillator giving an assessment on software. The telemetry data can be transmitted to a central system. The research aims to elaborate the methods that help to compare of the data concerning physical activity both built-in an accelerometer in Cardiac Resychrinisation Therapy (CRT devices and data obtained from an external Actigraph GT3XE-Plus Triaxial Activity Monitor. 5 persons participated in the pilot study (n=5; mean age: 57+- 13.37; BMI: 90.6+- 7.63. The Actigraph data from CRT device were examined in a 6-day-interval, between February 28 and March 5, 2014. The investigation started conducting a 6-minute walking test and continued with the measurement of daily physical activity. For data analysis descriptive statistics and linear regression analysis were used. It is clear from the data obtained from Actigraph that the MET values (mean: 1.17 ± 0.096 of the patients in the sample were extremely low due to their disease. However, some patients with higher physical activity than average (1.26; 1.28 seemed to be noteworthy, but they showed lower performance than healthy people. The physical activity of the patients during the 6-minute walking test corresponded to 1.9-2.48 MET. The physical activity of patients was found typically in the “light or moderate range” classifying the physical activity by Actigraph. Data from Actigraph are accurate and detailed making the physical activity of the patients measurable and appreciable. The results of the 6-minute walking test were in the category from moderate to very vigorous for individualized moderate physical performance based on Actigraph. It indicates the individual performance differences among patients. However, the daily

  5. Detection of gelatinase B activity in serum of gastric cancer patients

    Vesna V Dragutinovi(c); Neboj(s)a S Radovanovi(c); Lidija T Izrael-(Z)ivkovi(c); Miroslav M Vrvi(c)


    AIM: To determine the proteolytic activity and expression of gelatinase B in serum of gastric cancer patients and their correlation with the stage of the tumor.METHODS: Sera from 23 patients who underwent surgery for primary gastric cancer as the experimental group and from 11 as the control group were used to determine the proteolytic activity and its inhibition by EDTA and 1,10-phenanthroline. Gelatinase B activity was detected by SDS polyacrylamide gel electrophoresis (SDS-PAGE) and SDS-PAGE zymography.RESULTS: Proteolytic enzyme activity was increased in gastric cancer patients when compared to the control group (P<0.05). The proteinases were determined to be metalloproteinases upon inhibition test with specific metalloproteinase inhibitors 1,10-phenanthroline (P<0.05) and EDTA (P<0.01). SDS-PAGE and SDS-PAGE zymography revealed gelatinase B (proMMP-9) activity and its molecular mass of 92 ku.CONCLUSION: Proteinase activity is overexpressed in serum of gastric cancer patients. Gelatinase B in serum plays an important role in the progression of gastric cancer. ProMMP-9 can be used as a marker for invasiveness of gastric cancer.

  6. WHO disability grade does not influence physical activity in Brazilian leprosy patients.

    Do Prado, Glauber Dias; Prado, Renata Bilion Ruiz; Marciano, Lúcia Helena Soares Camargo; Nardi, Susilene Maria Tonelli; Cordeiro, José Antonio; Monteiro, Henrique Luiz


    Disability caused by leprosy may be associated with stigma. The aim of this work is to describe the degree of disability, quality of life and level of physical activity of individuals with leprosy and to identify possible correlations between these factors. Ninety-seven patients from two referral centres were studied. A complete medical history was taken and the World Health Organization degree of physical disability classification (WHO-DG), the International Physical Activity Questionnaire (IPAQ) and the Medical Outcome Study 36-item Short-form health Survey (SF36) were applied. The mean age of patients was 51 +/- 14.9 years old; participants were predominantly men, married, unemployed, had concluded treatment and had had lepromatous leprosy. The WHO-DG and the level of physical activity (P-value = 0.36) were not correlated. The WHO-DG showed that 72.2% of patients had disabilities, 37.1% of whom performed vigorous physical activities. No significant association was observed between the WHO-DG and the domains of the QoL SF-36 except for functional capacity (P-value = 0.02); the physical capacity is generally 'very good' when individuals have no disabilities and 'bad' with severe disabilities. In conclusion, the WHO-DG of leprosy patients does not affect the level of physica activities or quality of life except functional capacity. There is no significan association between physical activities and quality of life in these individuals.

  7. Analysis of scapular muscle EMG activity in patients with idiopathic neck pain: a systematic review.

    Castelein, Birgit; Cools, Ann; Bostyn, Emma; Delemarre, Jolien; Lemahieu, Trees; Cagnie, Barbara


    It is proposed that altered scapular muscle function can contribute to abnormal loading of the cervical spine. However, it is not clear if patients with idiopathic neck pain show altered activity of the scapular muscles. The aim of this paper was to systematically review the literature regarding the differences or similarities in scapular muscle activity, measured by electromyography ( = EMG), between patients with chronic idiopathic neck pain compared to pain-free controls. Case-control (neck pain/healthy) studies investigating scapular muscle EMG activity (amplitude, timing and fatigue parameters) were searched in Pubmed and Web of Science. 25 articles were included in the systematic review. During rest and activities below shoulder height, no clear differences in mean Upper Trapezius ( = UT) EMG activity exist between patients with idiopathic neck pain and a healthy control group. During overhead activities, no conclusion for scapular EMG amplitude can be drawn as a large variation of results were reported. Adaptation strategies during overhead tasks are not the same between studies. Only one study investigated timing of the scapular muscles and found a delayed onset and shorter duration of the SA during elevation in patients with idiopathic neck pain. For scapular muscle fatigue, no definite conclusions can be made as a wide variation and conflicting results are reported. Further high quality EMG research on scapular muscles (broader than the UT) is necessary to understand/draw conclusions on how scapular muscles react in the presence of idiopathic neck pain.

  8. Computerized monitoring of physical activity and sleep in postoperative abdominal surgery patients

    Bisgaard, T; Kjaersgaard, M; Bernhard, A


    .15). In both study groups, all correlation coefficients between actigraphy measurements and self-reported activity data were statistically significant (r, values for patients 0.4 to 0.8 and volunteers 0.6 to 0.9). A higher mean agreement between automated actigraphy sleep detection and self-reported sleep...... registration were found in the volunteers (85%, SD 15%) compared with the patients (77%, SD 11%) (p value awake was higher in the volunteers than in the patients (p ...: The study included twelve hospitalized patients after major abdominal surgery studied on day 2 to 4 after operation and twelve unhospitalized healthy volunteers. Measurements were performed for 24 consecutive hours. The actigraphy measurements were compared with self-reported activity- and sleep...

  9. [The changes of basal brain electric activity in patients with epilepsy after callosotomy].

    Beĭn, B N; Dravert, N E; Tatarenko, S A


    Short-term and long-term outcomes of basal brain activity were estimated in 20 epileptic patients with a medical history of callosotomy. Patients with malignant courses selected for callosotomy retained the high capacity of cerebral electric activity after surgery. In spite of limitations of bilateral synchronized irradiation of electric discharges in the brain, patients had the high power of cerebral electric genesis. A clinical study revealed the decrease of the number of seizures and their severity in patients who underwent the surgery. Thus, callosotomy plays only a palliative role in epileptic processes. Of primary importance is individual selection of anti-epileptic drugs to support cell mechanisms of epilepsy and improvement of treatment outcomes.

  10. Irisin levels are not affected by physical activity in patients with anorexia nervosa

    Tobias eHofmann


    Full Text Available Irisin was recently identified as muscle-derived hormone that increases energy expenditure. Studies in normal weight and obese subjects reported an increased irisin expression following physical activity, although inconsistent results were observed. Increased physical activity in a subgroup of patients with anorexia nervosa (AN complicates the course of the disease. Since irisin could account for differences in clinical outcomes, we investigated irisin levels in anorexic patients with high and moderate physical activity to evaluate whether irisin differs with increasing physical activity. Hospitalized female anorexic patients (n=39 were included. Plasma irisin measured by ELISA and locomotor activity were assessed at the same time. Patients were separated into two groups (n=19/group; median excluded: moderate and high activity (6331±423 vs. 13743±1047 steps/day, p0.05, whereas body weight-adjusted total energy expenditure (46.0±1.4 vs. 41.1±1.1 kcal/kg/d, metabolic equivalents (METs, 1.9±0.1 vs. 1.7±0.1 METs/d, body weight-adjusted exercise activity thermogenesis (EAT, 1.8±0.5 vs. 0.6±0.3 kcal/kg/d, duration of exercise (18.6±4.7 vs. 6.2±3.1 min/d and body weight-adjusted non-exercise activity thermogenesis (21.6±1.0 vs. 18.8±0.8 kcal/kg/d were higher in the high activity compared to the moderate activity group (p0.05. In conclusion, the current data do not support the concept of irisin being induced by exercise, at least not under conditions of severely reduced body weight like AN.

  11. Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians

    Zupanc Andrea


    Full Text Available Abstract Background Hospital physicians' time is a critical resource in medical care. Two aspects are of interest. First, the time spent in direct patient contact – a key principle of effective medical care. Second, simultaneous task performance ('multitasking' which may contribute to medical error, impaired safety behaviour, and stress. There is a call for instruments to assess these aspects. A preliminary study to gain insight into activity patterns, time allocation and simultaneous activities of hospital physicians was carried out. Therefore an observation instrument for time-motion-studies in hospital settings was developed and tested. Methods 35 participant observations of internists and surgeons of a German municipal 300-bed hospital were conducted. Complete day shifts of hospital physicians on wards, emergency ward, intensive care unit, and operating room were continuously observed. Assessed variables of interest were time allocation, share of direct patient contact, and simultaneous activities. Inter-rater agreement of Kappa = .71 points to good reliability of the instrument. Results Hospital physicians spent 25.5% of their time at work in direct contact with patients. Most time was allocated to documentation and conversation with colleagues and nursing staff. Physicians performed parallel simultaneous activities for 17–20% of their work time. Communication with patients, documentation, and conversation with colleagues and nursing staff were the most frequently observed simultaneous activities. Applying logit-linear analyses, specific primary activities increase the probability of particular simultaneous activities. Conclusion Patient-related working time in hospitals is limited. The potential detrimental effects of frequently observed simultaneous activities on performance outcomes need further consideration.

  12. Activation of the contact system and inflammation after thrombolytic therapy in patients with acute myocardial infarction.

    Merlini, Piera Angelica; Cugno, Massimo; Rossi, Marco L; Agricola, Pietro; Repetto, Alessandra; Fetiveau, Raffaella; Diotallevi, Paolo; Canosi, Umberto; Mannucci, Pier Mannuccio; Ardissino, Diego


    Thrombolytic therapy activates the contact system, and factor XII activation may activate the coagulation cascade and inflammation. It is not known whether an early inflammatory response is induced by thrombolytic therapy in patients with acute myocardial infarction (AMI). We prospectively measured the plasma levels of activated factor XII, cleaved kininogen, prothrombin fragment 1 + 2 (as indexes of the contact phase and coagulation activation), and interleukin-6 and C-reactive protein (CRP) (as indexes of inflammation) in 39 patients hospitalized for AMI within 12 hours of symptom onset: 26 receiving thrombolytic therapy and 13 heparin alone. Blood samples were collected at baseline and after 90 minutes and 24 hours. Patients undergoing thrombolysis had a significant early increase in activated factor XII (from 2.2 ng/ml at baseline to 4.7 ng/ml after 90 minutes; p = 0.0001), cleaved kininogen (from 26% to 37%; p = 0.001), and fragment 1 + 2 (from 1.4 to 2.1 nmol/L; p = 0.0001), whereas the 24-hour levels were similar to baseline levels. The levels of interleukin-6 significantly increased during the first 90 minutes (from 3.9 to 6.3 microg/ml; p = 0.001), and were even higher after 24 hours (11.9 ng/ml, p = 0.0001). CRP levels increased only after 24 hours (p = 0.0001). There were no changes in these parameters in patients receiving heparin alone, except for a 24-hour increase in interleukin-6 and CRP levels. Thus, in patients with AMI receiving thrombolytic therapy, early activation of inflammation parallels the activation of the contact system and the coagulation cascade, which might contribute to microvascular obstruction and reperfusion injury.

  13. Correction of coronal plane deformities around the knee using a tension band plate in children younger than 10 years

    Ruta M Kulkarni


    Full Text Available Background: Guided growth through temporary hemiepiphysiodesis has gained acceptance as the preferred primary treatment in treating pediatric lower limb deformities as it is minimally invasive with a lesser morbidity than the traditional osteotomy. The tension band plate is the most recent development in implants used for temporary hemiepiphysiodesis. Our aim was to determine its safety and efficacy in correcting coronal plane deformities around the knee in children younger than 10 years. Materials and Methods: A total of 24 children under the age of 10 were operated for coronal plane deformities around the knee with a single extra periosteal tension band plate and two nonlocking screws. All the children had a pathological deformity for which a detailed preoperative work-up was carried out to ascertain the cause of the deformity and rule out physiological ones. The average age at hemiepiphysiodesis was 5 years 3 months (range: 2 years to 9 years 1 month. Results: The plates were inserted for an average of 15.625 months (range: 7 months to 29 months. All the patients showed improvement in the mechanical axis. Two patients showed partial correction. Two cases of screw loosening were observed. In the genu valgum group, the tibiofemoral angle improved from a preoperative mean of 19.89° valgus (range: 10° valgus to 40° valgus to 5.72° valgus (range: 2° varus to 10° valgus. In patients with genu varum the tibiofemoral angle improved from a mean of 28.27° varus (range: 13° varus to 41° varus to 1.59° valgus (range: 0-8° valgus. Conclusion: Temporary hemiepiphysiodesis through the application of the tension band plate is an effective method to correct coronal plane deformities around the knee with minimal complications. Its ease and accuracy of insertion has extended the indication of temporary hemiepiphysiodesis to patients younger than 10 years and across a wide variety of diagnosis including pathological physis, which were traditionally

  14. Substance use, dental hygiene, and physical activity in adult patients with single ventricle physiology

    Overgaard, Dorthe; Schrader, Anne-Marie; Lisby, Karen H


    OBJECTIVES: The study aims to describe substance use, dental hygiene, and physical activity in adult survivors with single ventricle physiology (SVP) and to compare the behaviors with matched controls, while the patients are particularly at risk for general health problems. DESIGN: The present...... differences in overall health behaviors between SVP patients and controls, SVP patients are less physically active and are less likely to binge drink........596); 20% have had no dental visits during the last year (25% in controls; OR = 1.07; P = 0.684); 46% are not flossing their teeth (32% in controls; OR = 1.32; P = 0.239); and 39% are not physically active (24% in controls; OR = 1.63; P = 0.069). CONCLUSIONS: While in general there was no significant...

  15. Quality of sleep, physical activity and fatigue in patients with rheumatoid arthritis

    Løppenthin, Katrine; Esbensen, Bente Appel; Jennum, Poul Jørgen;


    to Physical Activity (PA) and fatigue. Understanding PA, fatigue and the impact on sleep disturbances could illuminate ways to promote sufficient sleep in RA patients. Thus, the aim of this study was to examine the association between sleep disturbance, PA, and fatigue. Methods A total of 500 RA patients from...... a rheumatology outpatient clinic were recruited consecutively to participate in an observational cross-sectional study. The self-administered questionnaire covered the Health Assessment Questionnaire (HAQ), Visual Analogue Scale (VAS) for pain and fatigue, Physical Activity Scale (PAS), Multidimensional Fatigue...... of 58 years), and 80% were women. The mean disease duration was 14 years and mean DAS score was 2.7. The prevalence of poor sleep quality was 61 %. Higher level of general fatigue, mental fatigue, physical fatigue, reduced activity and reduced motivation was reported in patients with poor sleep quality...

  16. Suppression of ventilatory muscle activity in healthy subjects and COPD patients with negative pressure ventilation.

    Gigliotti, F; Duranti, R; Fabiani, A; Schiavina, M; Scano, G


    We evaluated the ability of NPV to suppress EMGd and EMGint in seven patients with severe COPD and five normal subjects. Subjects were studied either without (A) or with mouthpiece and nose clip (B). Electromyographic suppression was assessed comparing EMG activity during NPV with the control activity without a mouthpiece and prior to the initiation of the NPV run. In normal subjects, in A, NPV resulted in a partial suppression of EMGd; in B, prior to NPV, EMGd rose compared with A prior to NPV. In patients, in A, NPV resulted in a suppression of both EMGd and EMGint. In B, prior to NPV, both EMGd and EMGint rose compared with A prior to NPV. Thus, it seems that NPV is able to produce a consistent reduction in inspiratory muscle EMG activity. This variable NPV ability would have to be assessed for better selection criteria for patient candidates in a rehabilitation program.

  17. Activation of blood T-cells in HIV/HCV co-infected patients

    Matsiyeuskaya Natallia V


    Full Text Available Expression of HLA-DR which is immune response activation marker on T-cells and their subpopulations (CD4+ and CD8+ lymphocytes and number of CD4 /CD25 cells with immune suppression properties in blood of HIV/HCV coinfected patients depending on HIV viral load, AIDS and receiving of antiretroviral therapy were studied. It was detected that HLA-DR expression on T-cells was significantly higher in patients with detectable HIV viral load, AIDS, and in patients not receiving antiretroviral therapy. Antiretroviral therapy leads to significant reduction of immune system activation markers expression, though it doesn’t allow to reach the level of healthy individuals. Number of CD4+/CD25+ cells had inverse correlation with activated CD3+ and CD3+CD8+ lymphocytes and HIV viral load.

  18. QT dispersion in patients with systemic lupus erythematosus: the impact of disease activity

    Kojuri Javad


    Full Text Available Abstract Background Patients with systemic lupus erythematosus (SLE have increased cardiovascular morbidity and mortality. Although autopsy studies have documented that the heart is affected in most SLE patients, clinical manifestations occur in less than 10%. QT dispersion is a new parameter that can be used to assess homogeneity of cardiac repolarization and autonomic function. We compared the increase in QT dispersion in SLE patients with high disease activity and mild or moderate disease activity. Methods and Results One hundred twenty-four patients with SLE were enrolled in the study. Complete history and physical exam, ECG, echocardiography, exercise test and SLE disease activity index (SLEDAI were recorded. Twenty patients were excluded on the basis of our exclusion criteria. The patients were divided to two groups based on SLEDAI: 54 in the high-score group (SLEDAI > 10 and 50 in the low-score group (SLEDAI QT dispersion was significantly higher in high-score group (58.31 ± 18.66 vs. 47.90 ± 17.41 respectively; P P = 0.45 or corticosteroids (53.58 ± 19.16 vs. 50.40 + 11.59, P = 0.47. There was a statistically significant correlation between abnormal echocardiographic findings (abnormalities of pericardial effusion, pericarditis, pulmonary hypertension and Libman-Sacks endocarditis and SLEADI (P Conclusions QT dispersion can be a useful, simple noninvasive method for the early detection of cardiac involvement in SLE patients with active disease. Concerning high chance of cardiac involvement, cardiovascular evaluation for every SLE patient with a SLEDAI higher than 10 may be recommended. Trial registration registration NCT01031797

  19. Highly active antiretroviral therapy and changing spectrum of liver diseases in HIV infected patients

    Kavita S. Joshi; Rohit R. Shriwastav


    Background: HIV is now considered as chronic disease than a fatal disease. HIV infected individual is having normal life expectancy post highly active antiretroviral therapy (HAART) era. Liver disease is the major cause of morbidity and mortality in HIV infected patients. The objective was to study the prevalence, clinical profile of various liver diseases in HIV infected individuals on HAART and also to study aetiologies of liver involvement in HIV patients. Methods: It was a cross secti...

  20. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain


    [Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per ...