What Works Clearinghouse, 2013
"Scott Foresman-Addison Wesley Elementary Mathematics" is a core mathematics curriculum for students in prekindergarten through grade 6. The program aims to improve students' understanding of key math concepts through problem-solving instruction, hands-on activities, and math problems that involve reading and writing. The curriculum…
What Works Clearinghouse, 2010
"Scott Foresman-Addison Wesley Elementary Mathematics" is a core curriculum for students at all ability levels in prekindergarten through grade 6. The program supports students' understanding of key math concepts and skills and covers a range of mathematical content across grades. The What Works Clearinghouse (WWC) reviewed 12 studies on…
Skinner, Daniel; Schneider, Adam
This article uses a reading of John Wesley's Primitive Physic, or An Easy and Natural Method of Curing Most Diseases (1747) to resist the common rejection-often as "quackery"-of Wesley's treatments for common maladies. We engage Wesley not because he was right but because his approach offers useful moments of pause in light of contemporary medical epistemology. Wesley's recommendations were primarily oriented towards the categories of personal responsibility and capability, but he also sought to empower individuals-especially the poor-with the knowledge to safely and affordably treat maladies of their own. We leverage Primitive Physic to rethink contemporary medical knowledge production, especially as sanctioned by randomized clinical trials and legitimate views of experience and contemporary institutions such as the AMA. Ultimately, we suggest that the medical humanities has a key role to play in mining the discarded and dismissed for what they can tell scholars about medical knowledge.
... your blood pressure and water and salt balance. Addison disease happens if the adrenal glands don't make ... A problem with your immune system usually causes Addison disease. The immune system mistakenly attacks your own tissues, ...
Symptoms of Addison disease include: Chronic diarrhea, nausea, and vomiting Darkening of the skin in some places Dehydration Dizziness when standing up Low-grade fever Extreme weakness , fatigue , and slow, sluggish movement Darker ...
The clinical signs and symptoms of primary adrenal insufficiency are unspecific often causing a delayed diagnosis or even misdiagnosis. In the diagnostic work-up the short synacthen test is regarded as the gold standard. Hydrocortisone and fludrocortisone are the preferred therapy for Addison's disease. The management and surveillance of therapy requires experience and several aspects need to be followed to prevent side effects which might occur due to overtreatment or undertreatment. Very important aspects in therapy are the repeated teaching of the patient and relatives, the issuing of an emergency steroid card and the prescription of a glucocorticoid emergency set. Acute adrenal failure (adrenal crisis), which might be the first manifestation of adrenal insufficiency, is a life-threatening situation requiring immediate glucocorticoid administration and fluid substitution. The most common causes for an adrenal crisis are gastrointestinal infections and fever and discontinuation of glucocorticoid therapy. This article gives an up-to-date overview of diagnostic and therapeutic aspects of Addison's disease.
Addison's disease Diagnosis Your doctor will talk to you first about your medical history and your signs and ... If your doctor thinks that you may have Addison's disease, you may undergo some of the following tests: ...
Mor, F; Green, P; Wysenbeek, A J
Since the first description of primary adrenocortical insufficiency by Thomas Addison in 1855 several large series of patients with Addison's disease have been published. The common signs and symptoms include: weakness, hyperpigmentation, weight loss, gastrointestinal complaints, and hypotension. It is rare for patients with Addison's disease to present with musculoskeletal symptoms including flexion contractures, hyperkalaemic neuromyopathy, Guillain-Barré syndrome, migratory myalgia, sciati...
Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria. ... wall hernia who had operative intervention and other postoperative management. ... elective in 23 patients (21%) who had spontaneous reduction while awaiting surgery.
Afroz, S; Bain, S
Adrenal insufficiency is a rare disease, but is life threatening when overlooked. Addison's disease may be an acquired form of adrenal insufficiency due to the destruction or dysfunction of the adrenal cortex. It affects both glucocorticoid and mineralocorticoid function. Main presenting symptoms of Addison's disease such as fatigue, anorexia, vomiting and convulsion often mimics central nervous system (CNS) infections. We describe a case of Addison's disease who was initially misdiagnosed as a case of meningo-encephalitis subsequently renal tubular acidosis and finally Addison's disease. Addison's disease can remain unrecognized until acute crisis and sometimes it may be misdiagnosed.
Endine NATO vägede ülemjuhataja Euroopas Wesley Clark pidas USA välispoliitikanõukogus kõne, milles tegi ettepaneku sõlmida uus Atlandi harta ning võrdles USA suhteid Euroopa riikidega raudeesriide-aegse olukorraga
Takahashi, Kentaro; Kagami, Shin-Ichiro; Kawashima, Hirotoshi; Kashiwakuma, Daisuke; Suzuki, Yoshio; Iwamoto, Itsuo
We herein describe a second Japanese case of sarcoidosis presenting Addison's disease. A 52-year-old man was diagnosed with sarcoidosis based on clinical and laboratory findings, including bilateral hilar lymphadenopathy and elevated levels of serum angiotensin-converting enzyme and lysozyme, as well as the presence of noncaseating epithelioid granulomas. The patient also exhibited general fatigue, pigmentation, weight loss, hypotension and hyponatremia, suggestive of chronic adrenocortical insufficiency. An endocrine examination confirmed primary adrenocortical insufficiency. This case suggests the direct involvement of sarcoid granuloma in the adrenal glands.
Napier, Catherine; Pearce, Simon H S
Addison's disease is a rare autoimmune disorder. In the developed world, autoimmune adrenalitis is the commonest cause of primary adrenal insufficiency, where the majority of patients have circulating antibodies against the key steroidogenic enzyme 21-hydroxylase. A complex interplay of genetic, immunological and environmental factors culminates in symptomatic adrenocortical insufficiency, with symptoms typically developing over months to years. Biochemical evaluation and further targeted investigations must confirm primary adrenal failure and establish the underlying aetiology. The diagnosis of adrenocortical insufficiency will necessitate lifelong glucocorticoid and mineralocorticoid replacement therapy, aiming to emulate physiological patterns of hormone secretion to achieve well-being and good quality of life. Education of patients and healthcare professionals is essential to minimise the risk of a life-threatening adrenal crisis, which must be promptly recognised and aggressively managed when it does occur. This article provides an overview of our current understanding of the natural history and underlying genetic and immunological basis of this condition. Future research may reveal novel therapeutic strategies for patient management. Until then, optimisation of pharmacological intervention and continued emphasis on education and empowerment of patients should underpin the management of individuals with autoimmune Addison's disease. Copyright © 2012. Published by Elsevier Masson SAS.
Puttanna, Amar; Cunningham, Alana Rosaleen; Dainty, Philip
Addison's disease is a relatively rare endocrine condition resulting from adrenal insufficiency due to various causes. Weight loss is a common feature; however, patients may be seen by a variety of specialists, even requiring acute admission before the diagnosis is made. Addison's disease is commonly associated with other autoimmune diseases. In some cases such as autoimmune polyendocrine syndromes (APS) types 1 and 2, these associations are more commonly found. We present a case of one such ...
that every possible channel of communication will be utilized to ascertain the whereabouts of your son. The personal effects of 2nd. Lieut. Charles W...AIR UNIVERSITY AIR FORCE RESEARCH INSTITUTE Letters of Second Lieutenant Charles Wesley Chapman, Jr. December 19, 1894–May 3, 1918 Air Force...in-Publication Data Chapman, Charles Wesley, Jr., 1894–1918. Letters of Second Lieutenant Charles Wesley Chapman, Jr., December 19, 1894–May 3, 1918
D'Souza, Malcolm J; Kroen, William K; Stephens, Charlene B; Kashmar, Richard J
Church-related small private liberal arts baccalaureate minority-serving institutions like Wesley College have modest endowments, are heavily tuition-dependent, and have large numbers of financially-challenged students. In order to sustain the level of academic excellence and to continue to build student demographic diversity in its accessible robust Science and Mathematics (STEM) programs, the faculty sought federal and state funds to implement a coordinated program of curriculum enhancements and student support programs that will increase the number of students choosing STEM majors, increase their academic success, and improve retention.
Puttanna, Amar; Cunningham, Alana Rosaleen; Dainty, Philip
Addison's disease is a relatively rare endocrine condition resulting from adrenal insufficiency due to various causes. Weight loss is a common feature; however, patients may be seen by a variety of specialists, even requiring acute admission before the diagnosis is made. Addison's disease is commonly associated with other autoimmune diseases. In some cases such as autoimmune polyendocrine syndromes (APS) types 1 and 2, these associations are more commonly found. We present a case of one such patient who presented to the acute medical team having been referred to the gastrointestinal services in the previous year for persistent vomiting and weight loss. On review of history, the cause of vomiting and weight loss was questioned and combined with subsequent biochemical testing a diagnosis of Addison's disease was made. The patient was also noted to have other associated endocrine and autoimmune conditions.
Jul 17, 2013 ... Case Study: An unusual coexistence of Addison's disease and phaeochromocytoma. 164 ... strongly positive. ... Department of Endocrinology and Metabolism, Ondokuz Mayis University Medical School, Samsun, Turkey.
... common in particular ethnic groups? Genetic Changes The cause of autoimmune Addison disease is complex and not completely understood. A combination ... is not caused by an autoimmune reaction. Other causes include infections that ... adrenal glands. Addison disease can also be one of several features of ...
Cosimo, Caterina; Franco, Ciro
Addisonian crises, a rare but life-threatening event in pregnant women, may accompany stressful conditions such as labor, puerperium, infection, hyperemesis gravidarum or surgery. A 36-year-old woman, primigravida, with Addison's disease, diagnosed when she was 10 year-old and treated with cortisone and fludrocortisone. The therapy was regulated to avoid adrenal crisis during pregnancy. The woman underwent to caesarean section at 38th week and gave birth to a normal baby. The successful management of pregnant women with Addison's disease, regarding her state and that of the foetus, reassures those women that nowadays Addison's disease and pregnancy are not incompatible when proper monitoring and management is provided.
Napier, Catherine; Pearce, Simon H S
The purpose of this article is to review the current therapy of Addison's disease and to highlight recent developments in this field. Conventional steroid replacement for Addison's disease consists of twice or three-times daily oral hydrocortisone and once-daily fludrocortisone; however, new treatment modalities such as modified-released hydrocortisone and continuous subcutaneous hydrocortisone infusion have recently been developed. These offer the potential for closer simulation of the physiological serum cortisol rhythm. Two studies have also looked at modifying the natural history of adrenal failure using adrenocorticotropic hormone (ACTH) stimulation and immunomodulatory therapies, leading to the concept of residual adrenal function in some Addison's disease patients. Following more than 60 years with no significant innovation in the management of Addison's disease, these new approaches hold promise for improved patient health and better quality of life in the future.
Winters, Stephen J; Vitaz, Todd; Nowacki, Michael R; Craddock, Durrett C; Silverman, Craig
A 60-year-old man with Addison's disease, primary hypothyroidism and type 2 diabetes mellitus who was treated with stable doses of hydrocortisone and fludrocortisone developed increasing skin pigmentation and a bitemporal hemianopia. The plasma ACTH level was 14,464 pg/mL, and an invasive pituitary macroadenoma with suprasellar extension was found on magnetic resonance imaging leading to transnasal-transsphenoidal adenomectomy. The tumor demonstrated features of an eosinophilic adenoma and stained uniformly for ACTH. Residual tumor was treated with stereotactic radiotherapy. This case and the 13 cases published previously indicate that primary adrenal failure may predispose to corticotroph hyperplasia, and in some patients to the development of an invasive corticotroph adenoma. The ACTH level should be measured, and a pituitary magnetic resonance imaging is indicated when skin pigmentation increases in a patient with primary adrenal failure who is receiving customary treatment with glucocorticoids and mineralocorticoids.
D'Souza, Malcolm J.; Shuman, Kevin E.; Wentzien, Derald E.; Roeske, Kristopher P.
Wesley College secured a five-year National Science Foundation (NSF) S-STEM (scholarships in science, technology, engineering, and mathematics) grant (1355554) to provide affordability and access to its robust STEM programs. With these funds, the college initiated a freshman to senior level, mixed-cohort, Cannon Scholar (CS) learning community…
Calculus and Analytic Geometry, 7th ed. (Reading, MA: Addison-Wesley Publishing Company) A-47. 9 Diagram drawn by author based on: Fleisch, A Student’s...Publishing, Inc., 1998. 17 Thomas, George B. Jr and Ross L. Finney. Calculus and Analytic Geometry, 7th ed. Reading, MA: Addison-Wesley Publishing Company...first two, we have to account for the energy lost in the space between the radar and the target due to atmospheric absorption and geometric spreading
Oliveira, Diana; Lages, Adriana; Paiva, Sandra; Carrilho, Francisco
Addison's disease, or primary adrenocortical insufficiency, is a long-term, potentially severe, rare endocrine disorder. In pregnancy, it is even rarer. We report the case of a 30-year-old pregnant patient with Addison's disease, referred to Obstetrics-Endocrinology specialty consult at 14 weeks gestation. She had been to the emergency department of her local hospital various times during the first trimester presenting with a clinical scenario suggestive of glucocorticoid under-replacement (nausea, persistent vomiting and hypotension), but this was interpreted as normal pregnancy symptoms. Hydrocortisone dose was adjusted, and the patient maintained regular follow-up. No complications were reported for the remainder of gestation and delivery. Pregnant patients with Addison's disease should be monitored during gestation and in the peripartum period by multidisciplinary teams. Adjustments in glucocorticoid and mineralocorticoid replacement therapy are often necessary, and monitoring should be based mainly on clinical findings, which becomes increasingly difficult during pregnancy. Patient education and specialized monitoring are key to avoiding complications from under- or over-replacement therapy in this period. An increase in glucocorticoid replacement dose is expected to be necessary during pregnancy in a woman with Addison's disease.Patient education regarding steroid cover and symptoms of acute adrenal crisis are fundamental.Monitoring in this period is challenging and remains mainly clinical.The increase in hydrocortisone dose often obviates the need to increase fludrocortisone dose.
Perry, M.C.; Eason, R.J.; Croxson, M.S.
The important contribution computerised tomography played in the diagnosis of tuberculous Addison's disease is described. While conventional radiographic methods of demonstrating this disease are often unhelpful, C.T. is an excellent technique for demonstrating the morphology of normal and abnormal adrenal glands
Bhattacharjee, Rana; Sharma, A; Rays, A; Thakur, I; Sarkar, D; Mandal, B; Mookerjee, S K; Chatterjee, S K; Chowdhury, Pradip Roy
Primary hypoadrenalism has various causes and protean manifestation. We report a young female patient who presented with severe muscle spasm as her primary complaint. On evaluation she was found to be a case of Addison's disease secondary to adrenal tuberculosis. Her muscle spasm disappeared rapidly with replacement dose of glucocorticoid.
Sun, Zhong-Hua; Nomura, Kaoru; Toraya, Shohzoh; Ujihara, Makoto; Horiba, Nobuo; Suda, Toshihiro; Tsushima, Toshio; Demura, Hiroshi; Kono, Atsushi
Adrenal computed tomographic (CT) scanning was conducted in twelve patients with Addison's disease during the clinical course. In tuberculous Addison's disease (n=8), three of four patients examined during the first two years after disease onset had bilaterally enlarged adrenals, while one of four had a unilaterally enlarged one. At least one adrenal gland was enlarged after onset in all six patients examined during the first four years. Thereafter, the adrenal glands was atrophied bilaterally, in contrast to adrenal glands in idiopathic Addison's disease which was atrophied bilaterally from disease onset (n=2). Adrenal calcification was a less sensitive clue in tracing pathogenesis, i.e., adrenal calcification was observed in five of eight patients with tuberculous Addison's disease, but not idiopathic patients. Thus, adrenal CT scanning could show the etiology of Addison's disease (infection or autoimmunity) and the phase of Addison's disease secondary to tuberculosis, which may be clinically important for initiating antituberculous treatment. (author)
Chaudhuri, Sayani; Rao, Karthik N; Patil, Navin; Ommurugan, Balaji; Varghese, George
Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison's disease. Adrenal insufficiency (Addison's disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison's disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis.
Ross, A H; Haider, S; Bailey, C C
To report three cases of Nonarteritic anterior ischaemic optic neuropathy (NAAION) in patients with Addison's disease. We present a retrospective review of patients presenting with NAAION with underlying Addison's disease. Three eyes of two young patients presented with NAAION. Both patients had underlying Addison's disease with episodes of prolonged hypotension. To our knowledge, this is the first published report of NAAION associated with Addison's disease. As hypotension may be one of the few situations, in which NAAION may be treatable and the visual loss reversible, it is important to recognize and treat sustained episodes of hypotension in these individuals.
Royo Gómez, M; Olmos Jiménez, M J; Rodríguez Arnao, M D; Roldán Martín, M B
Addison's disease or primary adrenal insufficiency is a rare disease in children. The signs and symptoms at diagnosis are frequently non-specific and insidious. Since adrenal crisis represents an emergency, it is important to be aware and to have a high degree of suspicion of the disorder in order to achieve an early diagnosis and treatment. We present a retrospective study describing the epidemiological, clinical and etiological data at diagnosis of five patients with Addison's disease followed up in our hospital. Dehydration, hyponatremia and skin hyperpigmentation were the most prevalent signs and symptoms at onset of the disease. The patients had low serum cortisol levels and positive adrenal antibodies. One patient with negative antibodies presented with a polyglandular syndrome. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier España, S.L. All rights reserved.
Full Text Available Abstract Background Addison's disease, also known as hypoadrenocorticism, has been reported in many individual dogs, although some breeds exhibit a greater incidence than the population as a whole. Addison's is presumed to be an autoimmune mediated hereditary defect but the mode of inheritance remains unclear. In particular, the heritability and mode of inheritance have not been defined for the Portuguese Water Dog although Addison's is known to be prevalent in the breed. Results The analyses present clear evidence that establishes Addison's disease as an inherited disorder in the Portuguese Water Dog with an estimate of heritability of 0.49 (± 0.16; there were no differences in risk for disease across sexes (p > 0.49. Further, the complex segregation analysis provides suggestive evidence that Addison's disease in the Portuguese Water Dog is inherited under the control of a single, autosomal recessive locus. Conclusion The high heritability and mode of inheritance of Addison's disease in the Portuguese Water Dog should enable the detection of segregating markers in a genome-wide scan and the identification of a locus linked to Addison's. Though the confirmation of Addison's disease as an autosomal recessive disorder must wait until the gene is identified, breeders of these dogs may wish to keep the present findings in mind as they plan their breeding programs to select against producing affected dogs.
Lambacher, Bianca; Wittek, Thomas
A 4.75-year old Simmental cow was presented with symptoms of colic and ileus. The clinical signs and blood analysis resulted in the diagnosis of suspected primary hypoadrenocorticism (Addison's disease). Although Addison's disease has been frequently described in other domestic mammals, to our knowledge, this disease has not previously been reported in cattle.
Oberbauer, A M; Bell, J S; Belanger, J M; Famula, T R
Addison's disease, also known as hypoadrenocorticism, has been reported in many individual dogs, although some breeds exhibit a greater incidence than the population as a whole. Addison's is presumed to be an autoimmune mediated hereditary defect but the mode of inheritance remains unclear. In particular, the heritability and mode of inheritance have not been defined for the Portuguese Water Dog although Addison's is known to be prevalent in the breed. The analyses present clear evidence that establishes Addison's disease as an inherited disorder in the Portuguese Water Dog with an estimate of heritability of 0.49 (+/- 0.16); there were no differences in risk for disease across sexes (p > 0.49). Further, the complex segregation analysis provides suggestive evidence that Addison's disease in the Portuguese Water Dog is inherited under the control of a single, autosomal recessive locus. The high heritability and mode of inheritance of Addison's disease in the Portuguese Water Dog should enable the detection of segregating markers in a genome-wide scan and the identification of a locus linked to Addison's. Though the confirmation of Addison's disease as an autosomal recessive disorder must wait until the gene is identified, breeders of these dogs may wish to keep the present findings in mind as they plan their breeding programs to select against producing affected dogs.
The prevalence of Addison's disease in South Africa is lower than in Western countries. This is concerning, since patients could be dying, undiagnosed. Enhanced awareness of this highly treatable condition is warranted. The epidemiology, aetiology, clinical presentation, screening and management of Addison's disease ...
Yamauchi, Teiyu; Yashiro, Naofumi; Iio, Masahiro
The computed tomography (CT) findings of the adrenal glands were described in six patients with Addison's disease. Three of four patients due to tuberculosis showed calcification in bilateral adrenal glands. In all three, non-calcified portions of left adrenal glands were identified by CT. One showed bilaterally enlarged adrenal glands. Bilateral adrenal glands were small in a patient with idiopatic Addison's disease. One patient of metastatic infiltration of the adrenal glands showed nodular masses in bilateral adrenal beds. CT findings were useful to clarify the etiology of Addison's patients. (author)
Chronic adrenal insufficiency, known as Addison's disease, presents with a constellation of symptoms and signs. The neuropsychiatric aspect of this condition is not fully understood and not much has been documented about it in the English literature. This article presents a case of a 41-year old male patient who presented initially with depression after a recent life stressor. After his condition escalated and therapy continued to fail, the medical team revised its diagnosis to Addison's disease. Neuropsychiatric symptoms could be the first presentation of Addison's disease, and thus should be kept in mind whenever such a case presents to the physician.
Husebye, Eystein S; Løvås, Kristian
Autoimmune Addison's disease and autoimmune ovarian insufficiency are caused by selective targeting by T and B lymphocytes to the steroidogenic apparatus in these organs. Autoantibodies toward 21-hydroxylase are a clinically useful marker for autoimmune Addison's disease. Autoantibodies to 21-hydroxylase are found in premature ovarian insufficiency, but others also can be present, notably antibodies against side-chain cleavage enzyme. The autoimmune response primarily targets the theca cells, yielding elevated concentrations of inhibin, which is emerging as a useful diagnostic marker for autoimmune etiology of ovarian insufficiency. Little is known about its immunogenetics, but in contrast to Addison's disease, several experimental models of autoimmune premature ovarian insufficiency are available for study.
Bratland, Eirik; Husebye, Eystein S
Autoimmune adrenocortical failure, or Addison's disease, is a prototypical organ-specific autoimmune disorder. In common with related autoimmune endocrinopathies, Addison's disease is only manageable to a certain extent with replacement therapy being the only treatment option. Unfortunately, the available therapy does not restore the physiological hormone levels and biorhythm. The key to progress in treating and preventing autoimmune Addison's disease lies in improving our understanding of the predisposing factors, the mechanisms responsible for the progression of the disease, and the interactions between adrenal antigens and effector cells and molecules of the immune system. The aim of the present review is to summarize the current knowledge on the role of T cells and cellular immunity in the pathogenesis of autoimmune Addison's disease. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Vermont Center for Geographic Information — (Link to Metadata) This metadata applies to the following collection area(s): Addison County 2012 1.6m and related SLOPE datasets. Created using ArcGIS "SLOPE"...
Vermont Center for Geographic Information — (Link to Metadata) This metadata applies to the following collection area(s): Addison County 2012 1.6m and related ASPECT datasets. This metadata complies with the...
concerned 16 BuzzeUl, Robert D., John A. Quelch, and Christopher Bartlett, Global Marketing Management, Cases and Readings, (Reading, Massachusetts...Christopher Bartlett. 1992. Global Marketing Management, Cases and Readings. Reading, Massachusetts: Addison-Wesley Publishing Company. Byrne, John A
Addison's disease is a rare condition. Its onset of symptoms most often is nonspecific contributing to a diagnostic and therapeutic delay. Acute renal failure can be the first manifestation of this disease. We report the case of a patient with Addison's disease who was initially treated for acute renal failure due to multiple myeloma and whose diagnosis was adjusted thereafter. Patient's condition dramatically improved after treatment with intravenous rehydration; injectable hydrocortisone.
Srinivasan, B; Patel, M; Ethunandan, M; Ilankovan, V
Melanoma accounts for 5% of all skin cancers. The risk of metastasis is related to the thickness of the tumour, and can affect local, regional and distant sites. Adrenal metastasis from melanoma of the head and neck is uncommon and often asymptomatic. Addison's disease as a presentation of metastatic melanoma is extremely rare and we are unaware of previous reports in the world literature. We report a case of a patient with metastatic melanoma presenting with signs and symptoms of Addison's disease.
Erichsen, Martina M; Husebye, Eystein S; Michelsen, Trond M; Dahl, Alv A; Løvås, Kristian
Females with primary adrenal insufficiency (Addison's disease) have reduced levels of circulating androgens, which are allegedly important for sexual functioning. The aim was to determine peripheral androgen status, sexual functioning, and birth rates in Addison's disease females. In a postal survey, all 269 females in the Norwegian Addison's registry were invited to complete the Sexual Activity Questionnaire (SAQ) and registration of childbirths. Blood samples were analyzed for 5alpha-androstane-3alpha,17beta-diol-3-glucuronide (3alpha-Diol-G) and compared with blood donor levels. The SAQ scores were compared with 740 age-matched controls from the general population and 234 women subjected to risk-reducing salpingo-oophorectomy. Fertility was estimated as standardized incidence ratio for birth; the expected number of births was estimated from population statistics. The SAQ was completed by 174 (65%) of the Addison's patients. Those not taking DHEA had significantly lower 3alpha-Diol-G levels than blood donors (mean, 0.53 vs. 2.2 ng/ml; P Addison's disease females were equally sexually active as the controls, but they reported significantly higher pleasure and less discomfort. They reported lower pleasure but less discomfort than the risk-reducing salpingo-oophorectomy women. The fertility was significantly reduced in females with Addison's disease; 54 children were born to mothers with established diagnosis (87.5 expected), yielding a standardized incidence ratio for birth of 0.69 (confidence interval, 0.52-0.86). Despite androgen depletion, females with Addison's disease do not report impaired sexuality. The fertility is reduced after the diagnosis is made; the reasons for this remain unknown.
INTRODUCTION: Corticoid therapy is well-known to improve the symptoms of psoriasis. Addison's disease is an autoimmune disease which leads to a loss of cortisol production in the adrenal glands. This case report describes a patient with wide-spread psoriasis for 34 years who was cured when Addison's disease was detected and substitution to reach normal biological cortisol levels was introduced. CASE REPORT: A 59-year-old man was diagnosed with Addison's disease. He had been tired for several years and had had difficulties in continuing his work. His brother had Addison's disease and recommended him to make a screen for the disease. Synacthen test diagnosed Addison's disease with a clear deficiency of cortisol production. After substitution with hydrocortisone the patient's constitution improved rapidly and he felt no longer tired during work. At the same time, all skin lesions of psoriasis disappeared as well as aches in several joints, both symptoms having been present for a couple of decades. Previously, salves of cortisol had been used to reduce the symptoms of psoriasis, but now, 1-2 years later, after the treatment of Addison's disease, no symptoms in the skin or joints have reoccurred. CONCLUSIONS: This report illustrates that Addison's disease, although a rare condition, should be kept in mind before treatment of psoriasis is started. Especially if other symptoms such as fatigue are present, a screening test of serum cortisol in the morning should be liberally made. The report also illustrates a need of examining corticoid levels in patients with psoriasis compared to the general population.
Clark, Wesley K
NATO Euroopa liitlasvägede endine juhataja, USA erukindral 2004. aasta presidendivalimistest USA-s, võimalikust kandideerimisest presidendiks 2008. aasta valimistel, demokraatide võimalustest järgmised presidendivalimised võita, oma seisukohtadest Iraagi sõja küsimuses, diplomaatiliste vahendite kasutamisest sõjaliste konfliktide lahendamisel, NATO laienemisest ja organisatsiooni sõjalisest suutlikkusest ning intsidendist Vene hävitajaga. Lisa: Wesley K. Clark
Zhang, Zhuo-li; Wang, Yu; Zhou, Wei; Hao, Yan-jie
Addison's disease is an autoimmune process. However, Addison's disease associated with connective tissue diseases (CTD) is only occasionally reported. Here, we report six cases of Addison's disease secondary to a variety of CTD, which include systemic lupus erythematosus, Takayasu arteritis, systemic sclerosis, ankylosing spondylitis (AS) and antiphospholipid antibody syndrome. The association of Addison's disease with Takayasu arteritis and AS is reported for the first time. We also found high prevalence of hypothyroidism as concomitant autoimmune disorder. Our case series highlight the autoimmune features of Addison's disease. Therefore, we suggest considering adrenal dysfunction in patients with CTD.
White, K G
Jane Austen's letters describe a two-year deterioration into bed-ridden exhaustion, with unusual colouring, bilious attacks and rheumatic pains. In 1964, Zachary Cope postulated tubercular Addison's to explain her symptoms and her relatively pain-free illness. Literary scholars later countered this posthumous diagnosis on grounds that are not well substantiated, while medical authors supported his conclusion. Important symptoms reported by contemporary Addison's patients-mental confusion, generalised pain and suffering, weight loss and anorexia-are absent from Jane Austen's letters. Thus, by listening to the patient's perspective, we can conclude it is unlikely that Addison's disease caused Jane Austen's demise. Disseminated bovine tuberculosis would offer a coherent explanation for her symptoms, so that Cope's original suggestion of infective tuberculosis as the cause of her illness may have been correct.
Rodrigo Antonio Brandão Neto
Full Text Available CONTEXT: Erythema induratum of Bazin (EIB is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.
Full Text Available A 28-year-old man diagnosed with primary adrenal insufficiency (Addison's disease in 2002. Following diagnosis, replacement therapy with hydrocortisone and fludrocortisone was indicated. Hydrocortisone replacement therapy was unsuccessful, and increased ACTH levels as high as 996 pg/dl were observed on outpatient follow-up. A pituitary MRI revealed a pituitary microadenoma. These findings raised three possibilities: (1 treatment is insufficient; (2 there is no relationship between Addison's disease and pituitary microadenoma; and (3 the microadenoma is similar to Nelson's syndrome. This latter is the most satisfactory explanation of this patient's clinical picture.
Choudhary, Sandeep; Alam, Anwer; Dewan, Vivek; Yadav, Dinesh; Dubey, N K
Addison's disease is most commonly due to autoimmune adrenalitis and tuberculosis and refers to primary hypoadrenalism caused by a total or near total destruction or dysfunction of both adrenal cortices. Usual manifestations involve chronic fatigue, muscle weakness, loss of appetite, nausea, vomiting, diarrhea, hypotension and hyperpigmentation of skin. We herein report a case of primary adrenal insufficiency presenting with fever and seizures in an 11-yr-old boy. His symptoms resolved after starting specific therapy. This kind of presentation of Addison's disease is rather unusual.
Bøe Wolff, A S; Oftedal, B; Johansson, S
Autoimmune Addison's disease (AAD) is often associated with other components in autoimmune polyendocrine syndromes (APS). Whereas APS I is caused by mutations in the AIRE gene, the susceptibility genes for AAD and APS II are unclear. In the present study, we investigated whether polymorphisms...
Sowden, J. M.; Borsey, D. Q.
A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison's disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis. PMID:2594601
Eriksson, D.; Bianchi, Matteo; Landegren, Nils; Nordin, Jessika; Dalin, Frida; Mathioudaki, Argyri; Eriksson, G. N.; Hultin-Rosenberg, Lina; Dahlqvist, Johanna; Zetterqvist, H.; Karlsson, Andreas; Hallgren, Anna; Farias, F. H. G.; Murén, Eva; Ahlgren, Kerstin M.
BackgroundAutoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addisons disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology. MethodsTo understand the genetic background of Addisons disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected se...
Anna A. Kasperlik-Zaluska
Full Text Available This study aimed at comparing two groups of patients with Addison's disease: A, including 180 patients described in 1991 and B, consisting of 138 patients registered since 1991. The incidence of coexisting autoimmune disorders was evaluated and etiological factors were analyzed. Immunological and imaging studies (computed tomography in group B were performed. Adrenal autoantibodies were examined by an indirect immunofluorescence technique in group A, and by the assay measuring autoantibodies against steroid 21-hydroxylase in group B. Adrenal autoantibodies were revealed in 37% of patients examined by the immunofluorescence method and in 63% investigated by the modern technique. Tuberculosis was found in 52 patients in the group A and in two patients in the group B; metastatic infiltrations of the adrenals in CT were detected in 16 patients. Probable autoimmune Addison's disease was diagnosed in 125/180 patients (69% in the group A and in 116/138 patients (84% in the group B.
Kasperlik-Zaluska, Anna A.; Czarnocka, Barbara; Jeske, Wojciech; Papierska, Lucyna
This study aimed at comparing two groups of patients with Addison's disease: A, including 180 patients described in 1991 and B, consisting of 138 patients registered since 1991. The incidence of coexisting autoimmune disorders was evaluated and etiological factors were analyzed. Immunological and imaging studies (computed tomography in group B) were performed. Adrenal autoantibodies were examined by an indirect immunofluorescence technique in group A, and by the assay measuring autoantibodies against steroid 21-hydroxylase in group B. Adrenal autoantibodies were revealed in 37% of patients examined by the immunofluorescence method and in 63% investigated by the modern technique. Tuberculosis was found in 52 patients in the group A and in two patients in the group B; metastatic infiltrations of the adrenals in CT were detected in 16 patients. Probable autoimmune Addison's disease was diagnosed in 125/180 patients (69%) in the group A and in 116/138 patients (84%) in the group B. PMID:21188237
Meyer, G; Hackemann, A; Penna-Martinez, M; Badenhoop, K
Several studies have shown a reduced quality of life in patients with Addison's disease, but little is known about the potential influences. We determined the quality of life in 200 patients with Addison's disease using an Addison's disease-specific quality-of-life questionnaire. Data about first symptoms, time to diagnosis and current medication were collected by questionnaires. With increasing latency between first symptoms and diagnosis of adrenal insufficiency, the quality of life decreased in highly significant manner (pdisease (p=0.05), atrophic gastritis (p=0.01) and primary ovarian failure (p=0.01) were highly correlated with reduced scores. Quality of life was significantly lower in female patients and in those with manifestation at older ages. With more autoimmune comorbidities, the quality of life scores dropped. The most important factor, however, was latency between first symptoms and diagnosis that affected patients' quality of life even years after manifestation of the disease. These results confirm and extend previous observations and emphasize the importance of a timely diagnosis. Therefore, medical awareness for this rare but easily treatable disorder needs to be sharpened. © Georg Thieme Verlag KG Stuttgart · New York.
Mozolevska, Viktoriya; Schwartz, Anna; Cheung, David; Shaikh, Bilal; Bhagirath, Kapil M; Jassal, Davinder S
Addison's disease is often accompanied by a number of cardiovascular manifestations. We report the case of a 30-year-old man who presented with a new onset dilated cardiomyopathy due to Addison's disease. The clinical presentation, treatment, and outcomes of this rare hormone mediated cardiac disorder are reviewed.
Likhari, Taruna; Magzoub, Saeed; Griffiths, Melanie J; Buch, Harit N
Background Addison's disease may present with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus. There are no data, however, on the prevalence of Addison's disease presenting with recurrent hypoglycaemia in patients with diabetes mellitus. Methods Three year retrospective study of diabetic patients with “unexplained” recurrent hypoglycaemia investigated with a short Synacthen test to exclude adrenocortical insufficiency. Results 95 patients with type 1 diabetes mellitus were studied. Addison's disease was identified as the cause of recurrent hypoglycaemia in one patient with type 1 diabetes mellitus. Conclusion Addison's disease is a relatively rare but remedial cause of recurrent hypoglycaemia in patients with type 1 diabetes mellitus. A low threshold for investigating patients with type 1 diabetes mellitus and recurrent hypoglycaemia to detect Addison's disease is therefore suggested. PMID:17551075
Likhari, Taruna; Magzoub, Saeed; Griffiths, Melanie J; Buch, Harit N; Gama, R
Addison's disease may present with recurrent hypoglycaemia in subjects with type 1 diabetes mellitus. There are no data, however, on the prevalence of Addison's disease presenting with recurrent hypoglycaemia in patients with diabetes mellitus. Three year retrospective study of diabetic patients with "unexplained" recurrent hypoglycaemia investigated with a short Synacthen test to exclude adrenocortical insufficiency. 95 patients with type 1 diabetes mellitus were studied. Addison's disease was identified as the cause of recurrent hypoglycaemia in one patient with type 1 diabetes mellitus. Addison's disease is a relatively rare but remedial cause of recurrent hypoglycaemia in patients with type 1 diabetes mellitus. A low threshold for investigating patients with type 1 diabetes mellitus and recurrent hypoglycaemia to detect Addison's disease is therefore suggested.
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schemata be distributed? To solve this problem, we defined a user- callable function: distribution-function. This function identifies who the "potential...Artificial Intelligence, Volume 4. Addison-Wesley Publishing Company, Massachusetts, 1989.  Bond , A.H., and Gasser, L. Readings in Distributed
Eriksson, D; Bianchi, M; Landegren, N; Nordin, J; Dalin, F; Mathioudaki, A; Eriksson, G N; Hultin-Rosenberg, L; Dahlqvist, J; Zetterqvist, H; Karlsson, Å; Hallgren, Å; Farias, F H G; Murén, E; Ahlgren, K M; Lobell, A; Andersson, G; Tandre, K; Dahlqvist, S R; Söderkvist, P; Rönnblom, L; Hulting, A-L; Wahlberg, J; Ekwall, O; Dahlqvist, P; Meadows, J R S; Bensing, S; Lindblad-Toh, K; Kämpe, O; Pielberg, G R
Autoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addison's disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology. To understand the genetic background of Addison's disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected set of 1853 genes and their potential regulatory elements, for the purpose of sequencing 479 patients with Addison's disease and 1394 controls. We identified BACH2 (rs62408233-A, OR = 2.01 (1.71-2.37), P = 1.66 × 10 -15 , MAF 0.46/0.29 in cases/controls) as a novel gene associated with Addison's disease development. We also confirmed the previously known associations with the HLA complex. Whilst BACH2 has been previously reported to associate with organ-specific autoimmune diseases co-inherited with Addison's disease, we have identified BACH2 as a major risk locus in Addison's disease, independent of concomitant autoimmune diseases. Our results may enable future research towards preventive disease treatment. © 2016 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.
Biagi, Federico; Campanella, Jonia; Soriani, Alessandra; Vailati, Alberto; Corazza, Gino R
It is well known that coeliac disease is associated with autoimmune endocrine diseases, such as autoimmune thyroid disease and insulin-dependent diabetes mellitus. Recently, coeliac disease has been shown in approximately 10% of patients with autoimmune Addison's disease. Addison's disease is the most common cause of primary adrenocortical insufficiency and it shares several clinical features with coeliac disease. Although hyperpigmentation and hypotension are the most specific signs, gastrointestinal symptoms are common and can be the first complaints of the patients. The aim of our study was to investigate the prevalence of coeliac disease in Italian patients with Addison's disease. Seventeen consecutive patients affected by Addison's disease (14 F, mean age 53.9 years, range 26-79 years) were enrolled in the study. Eleven of them were affected by Addison's disease associated with autoimmune thyroid disease and/or insulin-dependent diabetes mellitus; the other 6 patients were suffering from isolated Addison's disease. Diagnosis had been performed at the age of 40.5 years (range 23-55). Steroid treatment had already been started in 16 of the patients. Endomysial antibodies were tested in all of them and a duodenal biopsy was taken in those found to be positive for antiendomysial antibody (EMA). One out of 17 patients was found to be EMA positive. Duodenal biopsy confirmed the diagnosis of coeliac disease by showing subtotal villous atrophy. Although we studied only a small sample, our preliminary results confirmed that Addison's disease is associated with coeliac disease, being present in 5.9% of patients with Addison's disease. Since the symptoms can be similar and treatment of Addison's disease can mask coeliac disease, this association should always be actively investigated.
Cronin, C C
Acute adrenal crisis in patients with unrecognized chronic adrenocortical failure is difficult to diagnose and potentially fatal. We describe 2 patients with acute adrenal crisis whose diagnoses were hindered because of concomitant glucocorticoid treatment. Acute adrenal insufficiency is primarily a state of mineralocorticoid deficiency. Prednisolone and prednisone, the most frequently prescribed anti-inflammatory corticosteroid agents, have minimal mineralocorticoid activity. Several conditions that may be treated with pharmacological glucocorticoids are associated with an increased risk of Addison disease. An acute adrenal crisis, against which concurrent glucocorticoid therapy does not confer adequate protection, may develop in such patients.
Renner, F.; Graninger, W.
One of the major causes of chronic adrenal insufficiency (Addison's disease) is tuberculous adrenalopathy. Since sonography and computed tomography have become generally available in recent years and are of potential help in the diagnosis of this disease the merits of these methods are discussed in the light of 2 cases of adrenal tuberculosis, followed by a review of the literature. Adrenal calcification is the most significant, although not specific sign of adrenal insufficiency due to tuberculosis. Computed tomography has proven to be the method of choice in the non-invasive diagnosis of tuberculous adrenalopathy and in the monitoring of tuberculostatic treatment in this disease. Sonography is helpful as a preliminary investigation. (Author)
Brandão Neto, Rodrigo Antonio; de Carvalho, Jozélio Freire
Autoimmune adrenalitis, or autoimmune Addison disease (AAD), is the most prevalent cause of primary adrenal insufficiency in the developed world. AAD is rare and can easily be misdiagnosed as other conditions. The diagnosis depends on demonstrating inappropriately low cortisol production and the presence of high titers of adrenal cortex autoantibodies (ACAs), along with excluding other causes of adrenal failure using other tests as necessary. The treatment corticosteroid replacement, and the prognosis following the treatment is the same as the normal population. Spontaneous recovery of adrenal function has been described but is rare. Copyright © 2014 Elsevier B.V. All rights reserved.
Namikawa, Hiroki; Takemoto, Yasuhiko; Kainuma, Shigeto; Umeda, Sakurako; Makuuchi, Ayako; Fukumoto, Kazuo; Kobayashi, Masanori; Kinuhata, Shigeki; Isaka, Yoshihiro; Toyoda, Hiromitsu; Kamata, Noriko; Tochino, Yoshihiro; Hiura, Yoshikazu; Morimura, Mina; Shuto, Taichi
We herein report a case of Addison's disease caused by tuberculosis characterized by atypical hyperpigmentation, noted as exacerbation of the pigmentation of freckles and the occurrence of new freckles, that was diagnosed in the presence of active pulmonary tuberculosis. The clinical condition of the patient was markedly ameliorated by the administration of hydrocortisone and anti-tuberculosis agents. When exacerbation of the pigmentation of the freckles and/or the occurrence of new freckles are noted, Addison's disease should be considered as part of the differential diagnosis. In addition, the presence of active tuberculosis needs to be assumed whenever we treat patients with Addison's disease caused by tuberculosis, despite its rarity.
Objective: To examine the relationship between illness representations, coping behaviour and adaptive outcome in patients with Addison's disease (AD). Design: Cross-sectional. Following Leventhal's self-regulation model (Leventhal, Meyer & Nerenz, 1980), it was hypothesized that illness
Lee, Paul; Greenfield, Jerry R
Addison's disease is associated with low bone mineral density and increased risk of hip fractures. Causes are multifactorial, contributed by underlying adrenocortical hormonal deficiency, associated autoimmune endocrinopathies, electrolyte disturbances and, in some patients, supraphysiologic glucocorticoid replacement. Recent realization of physiologic cortisol production rate has revised downwards glucocorticoid replacement dosages. Meanwhile, new research has emerged suggesting complex interplay between sodium and calcium homoeostasis under the influence of mineralocorticoid and parathyroid hormone that may impact bone health. As the prevalence of Addison's disease is rising, and osteoporosis and fractures are associated with significant morbidity and increased mortality, attention to bone preservation in Addison's disease is of clinical relevance and importance. We suggest an approach to bone health in Addison's disease integrating physiologic adrenocortical hormonal replacement with electrolyte and mineral homoeostasis optimization. © 2015 John Wiley & Sons Ltd.
Smans, L.; Lentjes, E.G.W.M.; Hermus, A.R.; Zelissen, P.M.J.
OBJECTIVE: Patients with Addison's disease require lifelong treatment with glucocorticoids. At present, no glucocorticoid replacement therapy (GRT) can exactly mimic normal physiology. As a consequence, under- and especially overtreatment can occur. Suboptimal GRT may lead to various side effects.
Vermont Center for Geographic Information — (Link to Metadata) This metadata applies to the following collection area(s): Addison County 2012 1.6m and related "normalized" Digital Surface Model (nDSM). Created...
Objective: To examine the relationship between illness representations, coping behaviour and adaptive outcome in patients with Addison's disease (AD). Design: Cross-sectional. Following Leventhal's self-regulation model (Leventhal, Meyer & Nerenz, 1980), it was hypothesized that illness representations are directly associated with coping and, via coping, with adaptive outcome. Method: The illness representations held by 63 patients with a diagnosis of Addison's disease were explored using a q...
Pozzi Mucelli, R.S.; Pozzi Mucelli, F.; Muner, G.
Addison's disease of the adrenal glands presents with different pathological findings depending on the stage. In the acute phase the adrenal glands are bilaterally enlarged while in the chronic phase the glands are small and calcified. A case of Addison's disease with follow-up over a period of a year by CT is reported. CT showed the evolution of the adrenal glands from bilateral masses to small calcified glands. The differential diagnostic problems in the acute phase are also discussed. (orig.)
Horn, Morten A; Erichsen, Martina M; Wolff, Anette S B; Månsson, Jan-Eric; Husebye, Eystein S; Tallaksen, Chantal M E; Skjeldal, Ola H
X-linked adrenoleukodystrophy is an important cause of Addison's disease in boys, but less is known about its contribution to Addison's disease in adult men. After surveying all known cases of X-linked adrenoleukodystrophy in Norway in a separate study, we aimed to look for any missed cases among the population of adult men with nonautoimmune Addison's disease. Among 153 adult men identified in a National Registry for Addison's Disease (75% of identified male cases of Addison's disease in Norway), those with negative indices for 21-hydroxylase autoantibodies were selected. Additionally, cases with low autoantibody indices (48-200) were selected. Sera from subjects included were analysed for levels of very long-chain fatty acids, which are diagnostic for X-linked adrenoleukodystrophy in men. Eighteen subjects had negative indices and 17 had low indices for 21-hydroxylase autoantibodies. None of those with low indices and only one of those with negative indices were found to have X-linked adrenoleukodystrophy; this subject had already been diagnosed because of the neurological symptoms. Cases of Addison's disease proved to be caused by X-linked adrenoleukodystrophy constitute 1·5% of all adult male cases in Norway; the proportion among nonautoimmune cases was 15%. We found X-linked adrenoleukodystrophy to be an uncommon cause of Addison's disease in adult men. However, this aetiological diagnosis has far-reaching consequences both for the patient and for his extended family. We therefore recommend that all adult men with nonautoimmune Addison's disease be analysed for levels of very long-chain fatty acids. © 2013 John Wiley & Sons Ltd.
Rodrigo Antonio Brandão Neto
Full Text Available CONTEXT: Erythema induratum of Bazin (EIB is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum. CASE REPORT: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. The diagnosis was obtained through the clinical picture, positive tuberculin test and positive BCG (bacillus Calmette-Guérin test on the histological sample. Anti-tuberculosis drugs and glucocorticoid replacement led to disappearance of the signs and symptoms. CONCLUSIONS: This is the first description of an association between EIB and Addison's disease. It should be borne in mind that tuberculosis is an important etiological factor for Addison's disease.CONTEXTO: O eritema indurado de Bazin (EIB é considerado uma reação tuberculoide e consiste de nódulos dolorosos recorrentes. O diagnóstico diferencial inclui doenças como vasculite nodular, perniose, poliarterite nodosa e eritema nodoso. RELATO DE CASO: Nós reportamos o caso de uma mulher com EIB que desenvolveu doença de Addison durante tratamento com drogas tuberculostáticas e com boa resposta com reposição de glicocorticoide. O diagnóstico foi realizado pela apresentação clínica, teste tuberculínico positivo e positividade para BCG (bacilo Calmette-Guérin no espécime histológico. A reposição de glicocorticoides e drogas tuberculostáticas levou ao desaparecimento dos sinais e sintomas. CONCLUSÕES: Este é o primeiro caso reportando a associação entre EIB e doença de Addison. Tuberculose é um importante agente etiológico da doença de Addison.
Chen, Xiaoyan; Chen, Zhiye; Huang, Dehui; Liu, Xiaofeng; Gui, Qiuping; Yu, Shengyuan
We described a 38-year-old woman of rapidly progressive dementia with white matter encephalopathy and death. She had Addison's disease but the adrenal glands were hyperplastic. Brain magnetic resonance imaging revealed diffuse white matter lesion predominantly in the frontal lobe with band-like contrast enhancement. l-Methyl-11C-methionine positron emission tomography revealed accumulation of tracer in bilateral frontal lobes. Stereotactic biopsy demonstrated demyelination changes. A number of urinary organic acids were elevated. Adrenoleukodystrophy was diagnosed by elevated plasma very long chain fatty acid and ABCD1 gene mutation (C1544C/T). Adrenoleukodystrophy should be considered as a differential diagnosis in women with rapidly progressive white matter encephalopathy. Copyright © 2014 Elsevier B.V. All rights reserved.
Bayrak, Z; Turan, V; Demirtaş, G; Erdoğan, M; Aşkar, N
Primer adrenal yetmezlik nadir görülen bir endokrinolojik hastalıktır. Çoğu idiopatiktir. Tip 1 diabetes mellitus, hipertiroidizm, hipotiroidizm, pernisiyöz anemi gibi otoimmun hastalıklarla ilişkilidir. Yirmi sekiz yaşında 18 yıldır Addison hastalığı nedeni ile tedavi gören ve gebelik istemi olan olguyu gebeliğin ilk haftalarından doğuma ve puerperal döneme kadar takip ettik. Endokrinoloji kliniği ile birlikte takip ettiğimiz hastada kortikosteroid tedavisi ile antenatal ve postnatal dönemde...
Mascarenhas, Janice V; Jude, Edward B
Addison's disease accounts for the majority of cases of adrenal failure that are detected during hospital admissions. Unfortunately, prompt diagnosis of this condition is often delayed due to varied atypical manifestations and inadequate assessment at the time of presentation. We report a case of a 52-year-old woman who was detected to have hypotension during routine colonoscopy for evaluation of anaemia and progressive weight loss. During admission for evaluation of hypotension, she was also detected to have hyponatremia. Hyponatremia and hypotension failed to improve despite fluid resuscitation. Our endocrinological opinion was sought for and on further evaluation she was diagnosed with primary adrenal insufficiency. Glucocorticoid and mineralocorticoid replacement therapy were eventually instituted, which was followed by restoration of blood pressure and normalisation of serum sodium levels. 2014 BMJ Publishing Group Ltd.
Hellesen, Alexander; Bratland, Eirik; Husebye, Eystein S
Autoimmunity against the adrenal cortex is the leading cause of Addison's disease in industrialized countries, with prevalence estimates ranging from 93-220 per million in Europe. The immune-mediated attack on adrenocortical cells cripples their ability to synthesize vital steroid hormones and necessitates life-long hormone replacement therapy. The autoimmune disease etiology is multifactorial involving variants in immune genes and environmental factors. Recently, we have come to appreciate that the adrenocortical cell itself is an active player in the autoimmune process. Here we summarize the complex interplay between the immune system and the adrenal cortex and highlight unanswered questions and gaps in our current understanding of the disease. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Erichsen, Martina M; Løvås, Kristian; Fougner, Kristian J; Svartberg, Johan; Hauge, Erik R; Bollerslev, Jens; Berg, Jens P; Mella, Bjarne; Husebye, Eystein S
Primary adrenal insufficiency (Addison's disease) is a rare autoimmune disease. Until recently, life expectancy in Addison's disease patients was considered normal. To determine the mortality rate in Addison's disease patients. i) Patients registered with Addison's disease in Norway during 1943-2005 were identified through search in hospital diagnosis registries. Scrutiny of the medical records provided diagnostic accuracy and age at diagnosis. ii) The patients who had died were identified from the National Directory of Residents. iii) Background mortality data were obtained from Statistics Norway, and standard mortality rate (SMR) calculated. iv) Death diagnoses were obtained from the Norwegian Death Cause Registry. Totally 811 patients with Addison's disease were identified, of whom 147 were deceased. Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). Acute adrenal failure was a major cause of death; infection and sudden death were more common than in the general population. The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. Addison's disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison's disease.
van der Valk, Eline S.; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H.; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J
BACKGROUND: Health related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to
Valk, E.S. Van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M de; Backx, F.J.; Hermus, A.R.M.M.; Zelissen, P.M.J.
BACKGROUND: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. OBJECTIVE: The aim of this study was to
Valk, E.S. van der; Smans, L.C.C.J.; Hofstetter, H.; Stubbe, J.H.; Vries, M. de; Backx, F.J.G.; Hermus, A.R.M.M.; Zelissen, P.M.J.
Background: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. Objective: The aim of this study was to
Full Text Available MeCab user dictionary for science technology term Addison-Biermer貧血 名詞 サ変接続 * * * * 悪性貧血... アクセイヒンケツ アクセイヒンケツ Thesaurus2015 200906044106165134 C LS51 UNKNOWN_2 Addison - Biermer 貧血
Dantas, Thinali Sousa; Nascimento, Isabelly Vidal do; Verde, Maria Elisa Quezado Lima; Alves, Ana Paula Negreiros Nunes; Sousa, Fabrício Bitu; Mota, Mário Rogério Lima
Oral melanoacanthoma is a mucocutaneous, pigmented, rare, benign, and probably reactive lesion. This paper reports for the first time in the literature a case of multifocal oral melanoacanthoma in a patient diagnosed with Addison's disease and concomitant Graves' disease with hyperthyroidism. The patient presented with oral pigmented lesions, which were hypothesized to be mucosal pigmentation associated with Addison's disease. Due to their unusual clinical pattern, these oral lesions were biopsied and diagnosed as oral melanoacanthoma on histopathology and immunohistochemistry for HMB-45. At the moment of this report, the patient was being treated for her systemic conditions, but the lesions had not regressed. Reactive hyperpigmentation of the skin and mucous membranes may be found in Addison's disease and hyperthyroidism. This case reinforces the hypothesis of a reactive nature for oral melanoacanthoma and highlights the need for investigation of endocrine disorders in patients with multifocal oral melanoacanthoma.
Henry, Michelle; Thomas, Kevin G F; Ross, Ian L
Patients with Addison's disease frequently self-report memory and attention difficulties, even when on standard replacement therapy. However, few published studies examine, using objective measures and assessing across multiple domains, the cognitive functioning of Addison's disease patients relative to healthy controls. The primary aim of this study was to investigate whether the previously reported subjective cognitive deficits in Addison's disease are confirmed by objective measures. Conducting comprehensive neuropsychological assessments of patients with relatively rare clinical disorders, such as Addison's disease, is challenging because access to those patients is often limited, and because their medical condition might prevent extended testing sessions. Brief telephonic cognitive assessments are a useful tool in such circumstances. Hence, we administered the Brief Test of Adult Cognition by Telephone to 27 Addison's disease patients and 27 matched healthy controls. The instrument provides objective assessment of episodic memory, working memory, executive functioning, reasoning, and speed of processing. Statistical analyses confirmed that, as expected, patients performed significantly more poorly than controls on the episodic memory subtest. There were, however, no significant between-group differences on the attention, executive functioning, reasoning, and speed of processing subtests. Furthermore, patients with a longer duration of illness performed more poorly across all domains of cognition. We conclude that, for Addison's disease patients, previously reported subjective cognitive deficits are matched by objective impairment, but only in the domain of episodic memory. Future research might investigate (a) whether these memory deficits are material-specific (i.e., whether non-verbal memory is also affected), and (b) the neurobiological mechanisms underlying these deficits.
Løvås, Kristian; Curran, Suzanne; Oksnes, Marianne; Husebye, Eystein S; Huppert, Felicia A; Chatterjee, V Krishna K
Patients with Addison's disease reproducibly self-report impairment in specific dimensions of general well-being questionnaires, suggesting particular deficiencies in health-related quality-of-life (HRQoL). We sought to develop an Addison's disease-specific questionnaire (AddiQoL) that could better quantify altered well-being and treatment effects. Design, Setting, Patients, Intervention, and Outcomes: We reviewed the literature to identify HRQoL issues in Addison's disease and interviewed patients and their partners in-depth to explore various symptom domains. A list of items was generated, and nine expert clinicians and five expert patients assessed the list for impact and clarity. A preliminary questionnaire was presented to 100 Addison's outpatients; the number of items was reduced after analysis of the distribution of the responses. The final questionnaire responses were assessed by Cronbach's alpha and Rasch analysis. Published studies of HRQoL in Addison's disease indicated reduced vitality and general health perception and limitations in physical and emotional functioning. In-depth interviews of 14 patients and seven partners emphasized the impact of the disease on the emotional domain. Seventy HRQoL items were generated; after the expert consultation process and pretesting in 100 patients, the number of items was reduced to 36. Eighty-six patients completed the final questionnaire; the responses showed high internal consistency with Cronbach's alpha 0.95 and Person Separation Index 0.94 (Rasch analysis). We envisage AddiQoL having utility in trials of hormone replacement and management of patients with Addison's disease, analogous to similar questionnaires in GH deficiency (AGHDA) and acromegaly (AcroQoL).
Gan, Earn H; Pearce, Simon H
The treatment for autoimmune Addison's disease (AAD) has remained virtually unchanged in the last 60 years. Most patients have symptoms that are relatively well controlled with exogenous steroid replacement, but there may be persistent symptoms, recurrent adrenal crisis and poor quality of life, despite good compliance with optimal current treatments. Treatment with conventional exogenous steroid therapy is also associated with premature mortality, increased cardiovascular risk and complications related to excessive steroid replacement. Hence, novel therapeutic approaches have emerged in the last decade attempting to improve the long-term outcome and quality of life of patients with AAD. This review discusses the recent developments in treatment innovations for AAD, including the novel exogenous steroid formulations with the intention of mimicking the physiological biorhythm of cortisol secretion. Our group has also carried out a few studies attempting to restore endogenous glucocorticoid production via immunomodulatory and regenerative medicine approaches. The recent advances in the understanding of adrenocortical stem cell biology, and adrenal plasticity will also be discussed to help comprehend the science behind the therapeutic approaches adopted. © 2017 European Society of Endocrinology.
Wolff, A S B; Mitchell, A L; Cordell, H J; Short, A; Skinningsrud, B; Ollier, W; Badenhoop, K; Meyer, G; Falorni, A; Kampe, O; Undlien, D; Pearce, S H S; Husebye, E S
In common with several other autoimmune diseases, autoimmune Addison's disease (AAD) is thought to be caused by a combination of deleterious susceptibility polymorphisms in several genes, together with undefined environmental factors and stochastic events. To date, the strongest genomic association with AAD has been with alleles at the HLA locus, DR3-DQ2 and DR4. The contribution of other genetic variants has been inconsistent. We have studied the association of 16 single-nucleotide polymorphisms (SNPs) within the CD28-CTLA-4-ICOS genomic locus, in a cohort comprising 691 AAD patients of Norwegian and UK origin with matched controls. We have also performed a meta-analysis including 1002 patients from European countries. The G-allele of SNP rs231775 in CTLA-4 is associated with AAD in Norwegian patients (odds ratio (OR)=1.35 (confidence interval (CI) 1.10-1.66), P=0.004), but not in UK patients. The same allele is associated with AAD in the total European population (OR=1.37 (CI 1.13-1.66), P=0.002). A three-marker haplotype, comprising PROMOTER_1661, rs231726 and rs1896286 was found to be associated with AAD in the Norwegian cohort only (OR 2.43 (CI 1.68-3.51), P=0.00013). This study points to the CTLA-4 gene as a susceptibility locus for the development of AAD, and refines its mapping within the wider genomic locus.
Godswill, Okwuonu Chimezie; Odigie, Ojeh-Oziegbe
Coexistence of Addison's disease and systemic lupus erythematosus (SLE) is a rare occurrence with only few reported cases in the literature. We describe a 29-year-old woman who presented to us with clinical features of acute Addisonian crisis and SLE. Laboratory investigations were confirmatory of Addison's disease in a background of SLE. The patient made remarkable improvement on administration of steroids as replacement therapy for adrenal insufficiency and treatment of SLE. Clinicians need to have a high-index of suspicion of this possible coexistence in order to avoid the associated deleterious hemodynamic and metabolic consequences.
Hasik, J.; Kozal, H.; Kosowicz, J.; Hansz, J.
Radioimmunoassay of gastrin level in the blood was performed in 20 controls, 12 patients with duodenal ulcer, 13 patients with atrophic gastritis and 14 patients with Addison-Biermer's disease. Gastrin level in the serum of the patients with duodenal ulcer did not differ significantly from that of controls. In atrophic gastritis and particularly in Addison-Biermer's disease gastrin level was found to be several times higher. This is probably a result of chronic gastrin secretion stimulation which is normally inhibited by gastric juice. (author)
van der Valk, Eline S; Smans, Lisanne C C J; Hofstetter, Hedwig; Stubbe, Janine H; de Vries, Marieke; Backx, Frank J G; Hermus, Ad R M M; Zelissen, Pierre M J
Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd.
Passanisi, Stefano; Timpanaro, Tiziana; Lo Presti, Donatella; Caruso-Nicoletti, Manuela
Primary adrenocortical insufficiency or Addison's disease is caused by a progressive destruction of the adrenal cortex, resulting into a reduction of glucocorticoids, mineralocorticoids, and androgens. Autoimmune Addison's disease is the most common etiological form, accounting for about 80% of all cases. We describe the case of a 16-year-old Caucasian boy affected by type-1 diabetes mellitus and autoimmune thyroiditis, who experienced recurrent hypoglycaemia as presenting symptom of Addison's disease. Hypoglycaemia is not a common presenting feature of Addison's disease, both in patients with type-1 diabetes mellitus and in non-diabetic patients. However, hypoglycaemia may occur in association with primary and secondary glucocorticoid deficiency as a result of an enhanced insulin sensitivity. Hypoglycaemia is the most common acute complication of insulin therapy in patients with type-1 diabetes mellitus. Addison's disease has been described in approximately 0.5% of patients with type-1 diabetes mellitus, being more frequent in females and occurring in middle-aged patients. An association among type-1 diabetes mellitus, autoimmune thyroiditis, and Addison's disease is found in the "Schmidt's syndrome", a rare disorder that may occur in the paediatric age. Our case suggests that the presence of Addison's disease should be taken into consideration in patients with type-1 diabetes mellitus and frequent episodes of hypoglycaemia. We wish to highlight that there are no specific indications to screen for the association between Addison's disease and type-1 diabetes mellitus, although an early diagnosis of Addison's disease in diabetic patients would prevent the morbidity and potential mortality of this association.
Wulffraat, N. M.; Drexhage, H. A.; Bottazzo, G. F.; Wiersinga, W. M.; Jeucken, P.; van der Gaag, R.
The presence of serum immunoglobulins (Ig) blocking ACTH-induced adrenal DNA synthesis and/or cortisol production was studied in 25 patients with idiopathic Addison's disease. For this purpose guinea pig adrenal segments kept in organ culture were exposed to ACTH and graded concentrations of patient
Wilms, G.; Tits, J.; Vanstraelen, D.; Marchal, G.; Rigauts, H.; Baert, A.L.
In a patient with Addison's disease, who gave a history of a severe car accident, CT showed bilateral enlargement of the adrenal glands. MRI, by demonstrating paramagnetic T1 shortening due to methaemoglobin and haemosiderin on T2-weighted images, confirmed the haemorrhagic nature of the lesions. (orig.)
Betterle, Corrado; Garelli, Silvia; Presotto, Fabio; Furmaniak, Jadwiga
Recent progress in the immunopathology field has greatly improved our understanding of the natural history of autoimmune diseases, particularly of Addison's disease. Addison's disease is known to be a chronic illness characterized by adrenocortical gland insufficiency that develops following a long and mainly asymptomatic period, characterized by the presence of circulating autoantibodies directed to adrenal cortex antigens. In this chapter we describe the groups of subjects at risk of developing Addison's disease, together with the diagnostic tests considered the most appropriate for evaluating adrenal function: determination of basal plasma adrenocorticotropic hormone (ACTH) levels, plasma renin activity, plasma aldosterone and cortisol levels, and cortisol levels after intravenous stimulation with ACTH (ACTH test). The employment of specific clinical, immunological and functional criteria in the subjects with autoantibodies to the adrenal cortex allows identifying those at risk of developing overt disease. The independent risk factors for the progression to adrenal failure have also been identified and they contribute to different risks of developing clinical Addison's disease. Based on the risk level, the subjects should be monitored over time to observe early signs of adrenal dysfunction, and start substitutive treatment as soon as possible. For patients presenting with high risk, prevention strategies and trials might be available. © 2016 S. Karger AG, Basel.
Jagannath, A.; Brill, P.W.; Winchester, P.
A 13-year-old girl developed Addison's disease during antituberculous therapy for presumed tuberculous ventriculitis. CT of the abdomen showed diffusely enlarged hypodense adrenals and a hypodense lesion in the lower pole of the left kidney. Biopsy of the renal lesion revealed caseating and noncaseating granolomas. (orig.)
Gan, Earn H; MacArthur, Katie; Mitchell, Anna L; Hughes, Beverly A; Perros, Petros; Ball, Stephen G; James, R Andrew; Quinton, Richard; Chen, Shu; Furmaniak, Jadwiga; Arlt, Wiebke; Pearce, Simon H S
Despite lifelong steroid hormone replacement, there is excess morbidity and mortality associated with autoimmune Addison's disease. In health, adrenocortical cells undergo continuous self-renewal from a population of subcapsular progenitor cells, under the influence of ACTH, suggesting a therapeutic possibility. We aimed to determine whether tetracosactide (synthetic ACTH1-24) could revive adrenal steroidogenic function in autoimmune Addison's disease. Thirteen patients (aged 16-65 y) with established autoimmune Addison's disease for more than 1 year were recruited at the Newcastle University Clinical Research Facility. The intervention included a 20-week study of regular sc tetracosactide (ACTH1-24) therapy. Serum and urine corticosteroids were measured during medication withdrawal at baseline and every 5 weeks during the study. Serum cortisol levels remained less than 100 nmol/L in 11 of 13 participants throughout the study. However, two women achieved peak serum cortisol concentrations greater than 400 nmol/L after 10 and 29 weeks of tetracosactide therapy, respectively, allowing withdrawal of corticosteroid replacement. Concurrently, urine glucocorticoid and mineralocorticoid metabolite excretion increased from subnormal to above the median of healthy controls. One of these responders remains well with improving peak serum cortisol (672 nmol/L) 28 months after stopping all treatments. The other responder showed a gradual reduction in serum cortisol and aldosterone over time, and steroid therapy was recommenced after a 28-week period without glucocorticoid replacement. This is the first study to demonstrate that established autoimmune Addison's disease is amenable to a regenerative medicine therapy approach.
Kocyigit, Ismail; Unal, Aydin; Tanriverdi, Fatih; Hayri Sipahioglu, Murat; Tokgoz, Bulent; Oymak, Oktay; Utas, Cengiz
Addison's disease is a rare disorder in patients with end-stage renal disease (ESRD). In patients, the diagnosis of Addison's disease is difficult in clinical practice because most of the clinical findings of this disease are similar to those of the renal failure. We present a 51-year-old male patient, who underwent hemodialysis therapy for 8 years, diagnosed with Addison's disease after having myalgia, skin hyperpigmentation, weight loss, sweating, and nausea for the past few weeks. The physical examination was completely normal except for muscle weakness, hyperpigmentation on labial mucosa and skin in a patient. The laboratory tests revealed anemia and hypoglycemia. Serum cortisol, adrenocorticotropic hormone (ACTH) levels, and ACTH stimulation test results were consistent with Addison's disease. Adrenal computerized tomography revealed bilateral atrophic glands. Additionally, it was found that elevated serum thyroid stimulating hormone levels and antithyroid peroxidase antibody titer were positive. Our purpose is to emphasize that physicians should be alert to the potential for additional different conditions particularly in terms of adrenal failure in patients with ESRD.
Printha, K.; Hulathduwa, S. R.; Samarasinghe, K.; Suh, Y. H.; De Silva, K. R. D.
Background: Stress and depression shows possible links to neuronal death in hippocampus. Subiculum plays a prominent role in limbic stress integration and direct effect of corticosteroids on subicular neurons needs to be defined to assess its subsequent impact on hippocampal plasticity. Aim: This study was intended to assess apoptosis in subicular neurons of a young depressed suicide victim, where presumably stress induced excess of corticosteroids and a case of young Addison's disease with low level of corticosteroids. Materials and Method: Both bilateral adrenal glands (Addison's) and subiculum (both cases) were initially stained with hematoxylin and eosin; subicular neurons of both cases were examined for the degree of apoptosis using ‘ApopTag Kit’. Apoptotic cell counts were expressed as average number of labeled cells/mm2 and the results were analysed statistically using a non-parametric Mann–Whitney U test. Result: Apoptotic neurons were detected in the subicular region of both suicide and Addison victims, and it is statistically significant in both right and left between the cases (P Addison disease where the number of neuronal cell death between right and left was statistically insignificant (P > 0.05). Conclusion: The present study confirms the vulnerability of the subicular neurons to apoptosis, possibly due to corticosteroids in both ends of spectrum. PMID:20048453
caused by autoimmune destruction of adrenal gland cortex. Those with Addisons disease have a deficiency of cortisol and aldostreone. These deficiencies are accompanied by adrenal androgen depletion. A case report of 43 year old female is hereby reported. The patient presented with hyperpigmentation of nipples, ...
Hinz, Laura E; Kline, Gregory A; Dias, Valerian C
To present a case of symptomatic autoimmune adrenal insufficiency with initially normal serum cortisol and to caution about limitations of the current diagnostic algorithm for adrenal insufficiency, which does not reflect the pathophysiology of early disease. We describe the clinical presentation and relevant investigations of a patient ultimately found to have Addison's disease, which is followed by a focused review of the literature. A 41-year-old Caucasian woman with autoimmune hypothyroidism, premature ovarian failure, and microscopic colitis presented with nausea, salt craving, increased skin pigmentation, and postural hypotension. Initial bloodwork revealed a normal morning cortisol of level of 19.2 μg/dL (normal, 7.2 to 25 μg/dL) but an adrenocorticotropic hormone (ACTH) level 10 times normal, at 513.6 pg/mL (normal, <52.5 pg/mL). Her potassium was normal, but her aldosterone level was 4.12 ng/dL (normal, 12.3 to 62.5 ng/dL) and her renin activity was increased (23.0 mg/dL/hour; normal, <6.0 mg/dL/hour). Six weeks after initial presentation, she was found to have anti-adrenal antibodies. It was not until 10 weeks after her initial symptomatic presentation that her morning cortisol level was found to be subnormal and a formal diagnosis of adrenal insufficiency was made. The present case and literature review reveal that common diagnostic approaches will miss patients with (possibly symptomatic) early adrenal insufficiency. We suggest that serum ACTH level testing or tests of mineralocorticoid function be included in the initial step of investigation for suspected primary adrenal insufficiency.
Baxter, M; Gorick, S; Swords, F M
Summary Addison's disease is a condition characterised by immune-mediated destruction of the adrenal glands leading to a requirement of lifelong replacement therapy with mineralocorticoid and glucocorticoid. We present a case of a 53-year-old man who presented at the age of 37 years with nausea, fatigue and dizziness. He was found to have postural hypotension and buccal pigmentation. His presenting cortisol level was 43 nmol/l with no response to Synacthen testing. He made an excellent response to conventional replacement therapy with hydrocortisone and fludrocortisone and then remained well for 16 years. On registering with a new endocrinologist, his hydrocortisone dose was revised downwards and pre- and post-dose serum cortisol levels were assessed. His pre-dose cortisol was surprisingly elevated, and so his dose was further reduced. Subsequent Synacthen testing was normal and has remained so for further 12 months. He is now asymptomatic without glucocorticoid therapy, although he continues on fludrocortisone 50 μg daily. His adrenal antibodies are positive, although his ACTH and renin levels remain elevated after treatment. Addison's disease is generally deemed to lead to irreversible cell-mediated immune destruction of the adrenal glands. For this reason, patients receive detailed counselling and education on the need for lifelong replacement therapy. To our knowledge, this is the third reported case of spontaneous recovery of the adrenal axis in Addison's disease. Recovery may therefore be more common than previously appreciated, which may have major implications for the treatment and monitoring of this condition, and for the education given to patients at diagnosis. Learning points Partial recovery from Addison's disease is possible although uncommon.Patients with long-term endocrine conditions on replacement therapy still benefit from regular clinical and biochemical assessment, to revisit optimal management.As further reports of adrenal axis recovery
Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K; Vivekanandan, Muthupillai
Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations.
Baxter, M; Gorick, S; Swords, F M
Addison's disease is a condition characterised by immune-mediated destruction of the adrenal glands leading to a requirement of lifelong replacement therapy with mineralocorticoid and glucocorticoid. We present a case of a 53-year-old man who presented at the age of 37 years with nausea, fatigue and dizziness. He was found to have postural hypotension and buccal pigmentation. His presenting cortisol level was 43 nmol/l with no response to Synacthen testing. He made an excellent response to conventional replacement therapy with hydrocortisone and fludrocortisone and then remained well for 16 years. On registering with a new endocrinologist, his hydrocortisone dose was revised downwards and pre- and post-dose serum cortisol levels were assessed. His pre-dose cortisol was surprisingly elevated, and so his dose was further reduced. Subsequent Synacthen testing was normal and has remained so for further 12 months. He is now asymptomatic without glucocorticoid therapy, although he continues on fludrocortisone 50 μg daily. His adrenal antibodies are positive, although his ACTH and renin levels remain elevated after treatment. Addison's disease is generally deemed to lead to irreversible cell-mediated immune destruction of the adrenal glands. For this reason, patients receive detailed counselling and education on the need for lifelong replacement therapy. To our knowledge, this is the third reported case of spontaneous recovery of the adrenal axis in Addison's disease. Recovery may therefore be more common than previously appreciated, which may have major implications for the treatment and monitoring of this condition, and for the education given to patients at diagnosis. Partial recovery from Addison's disease is possible although uncommon.Patients with long-term endocrine conditions on replacement therapy still benefit from regular clinical and biochemical assessment, to revisit optimal management.As further reports of adrenal axis recovery emerge, this may
Sahoo, Jaya Prakash; Selviambigapathy, Jayakumar; Kamalanathan, Sadishkumar; Nagarajan, K.; Vivekanandan, Muthupillai
Background: Steroid replacement without thyroxine supplementation normalizes thyroid function test (TFT) in some but not all Addison's disease patients with primary hypothyroidism. Both autoimmune and nonautoimmune mechanisms contribute to this improvement in TFT. However, the documentation of the change in thyroid autoimmunity after cortisol replacement is very limited in the literature. The aim of this study was to determine the effect of steroid replacement on TFT and anti-thyroid peroxidase antibody (anti-TPO-Ab) titer in Addison's disease with primary hypothyroidism. Materials and Methods: This observational study was conducted in a tertiary care center in South India. Six Addison's disease patients with primary hypothyroidism, who were only on steroid replacement, were included in the study. Low serum cortisol (22 pmol/L) and/or hyperpigmentation of skin/mucous membranes was considered as the diagnostic criteria for Addison's disease. Primary hypothyroidism (both overt and subclinical) was defined as high thyroid stimulating hormone (TSH) with/without low free thyroxine (fT4). TFT and anti-TPO-Ab were performed before and after steroid replacement in all of them. Results: Poststeroid replacement, there was a normalization of TSH in all but one subjects. In overt hypothyroidism patients, fT4 also normalized. The improvement in TFT was not associated with decreasing titer of the anti-TPO-Ab in all six patients. However, there was a significant difference in TSH after steroid replacement compared to the baseline status. Conclusions: The concept of normalization of primary hypothyroidism with cortisol replacement in patients with Addison's disease should be recognized to avoid iatrogenic thyrotoxicosis caused by thyroxine replacement. Both autoimmune and nonautoimmune mechanisms contribute to these alterations. PMID:27042409
Elebrashy, Ibrahim; Yousief, Elham; Saif, Aasem
We report a case of Addison's disease presenting with recurrent deep venous thrombosis and thrombocytopenia and proved to have primary anti-phospholipid antibody syndrome. The case report highlights the shared autoimmune nature of both diseases.
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Day, Richard R.
"Teaching Reading" uncovers the interactive processes that happen when people learn to read and translates them into a comprehensive easy-to-follow guide on how to teach reading. Richard Day's revelations on the nature of reading, reading strategies, reading fluency, reading comprehension, and reading objectives make fascinating…
Paulo S.M. Esperon
Full Text Available OBJETIVO: alertar sobre a importância de distúrbio hidroeletrolítico grave devido a doença crônica não previamente diagnosticada. MÉTODO: relato de um caso de coma hiponatrêmico devido a crise adrenal em criança portadora de doença de Addison não diagnosticada previamente, apesar de história clínica sugestiva desta doença há cerca de quatro anos. RESULTADO: Após atendimento inicial à emergência, com correção da hiponatremia grave com hipovolemia discreta, hipernatriúria e hiperpotassemia, o diagnóstico diferencial deste distúrbio hidroeletrolítico revelou tratar-se de uma crise adrenal secundária a uma insuficiência adrenal primária crônica. O tratamento com hidrocortisona oral possibilitou alta hospitalar com correção total dos distúrbios metabólicos. CONCLUSÃO: é importante manter um alto grau de suspeita de doença de Addison para evitar as graves conseqüências de seu diagnóstico tardio, como distúrbios hidroeletrolíticos graves, além de atraso de crescimento e desenvolvimento.OBJECTIVE: To show the importance of severe hydroelectrolytic disorder as a consequence of previously undiagnosed chronic disease. DESCRIPTION: Case report of hyponatremic coma caused by adrenal crisis in a child with previously undiagnosed Addison's disease despite suggestive clinical findings of this disease in the last four years. After correction of severe hyponatremia, mild hypovolemia, hypernatriuria and hyperkalemia, the differential diagnosis of this hydroelectrolytic disorder revealed an adrenal crisis resulting from a primary chronic adrenal insufficiency. Oral treatment with hydrocortisone was efficient in correcting the metabolic disorder and the patient was then discharged. COMMENTS: It is very important to highly suspect of Addison's disease in order to avoid the dangerous consequences of late diagnosis such as severe hydroelectrolytic disorders and retarded growth and development.
Maki, Sara; Kramarz, Caroline; Maria Heister, Paula; Pasha, Kamran
Addison's disease is a rare endocrine disorder that frequently presents with non-specific symptoms, but may deteriorate rapidly into life-threatening Addisonian crisis if left untreated. Diagnosis can be difficult in patients without a suggestive medical history. We describe a case of a 37-year-old man who was admitted with acute kidney injury and hyperkalaemia, resistant to treatment with insulin/dextrose and calcium gluconate. On clinical examination, he was found to be hyperpigmented; a subsequent random serum cortisol of 49 nmol/L affirmed the preliminary diagnosis of Addison's disease. The patient's hyperkalaemia improved on treatment with hydrocortisone, and a follow-up morning adrenocorticotropic hormone of 1051 ng/L confirmed the diagnosis. 2016 BMJ Publishing Group Ltd.
John G. Skedros
Full Text Available This report describes a patient who had a series of daily interscalene nerve blocks to treat pain following a shoulder manipulation for postsurgical stiffness. She experienced acute respiratory compromise that persisted for many weeks. All typical and unusual causes of these symptoms were ruled out. Her treating pulmonologist theorized that the ipsilateral carotid body had been injured. However, it was subsequently determined that the constellation of symptoms and their prolonged duration were best explained by a poor stress response from Addison's disease coupled with exacerbation of early onset myasthenia gravis. This patient's case is not a typical reaction to interscalene nerve blocks, and thus preoperative testing would not be recommended for myasthenia gravis or Addison's disease without underlying suspicion. We describe this report to inform physicians to consider a workup for these diagnoses if a typical workup rules out all usual causes of complications from an interscalene block.
Skedros, John G; Kiser, Casey J; Mendenhall, Shaun D
This report describes a patient who had a series of daily interscalene nerve blocks to treat pain following a shoulder manipulation for postsurgical stiffness. She experienced acute respiratory compromise that persisted for many weeks. All typical and unusual causes of these symptoms were ruled out. Her treating pulmonologist theorized that the ipsilateral carotid body had been injured. However, it was subsequently determined that the constellation of symptoms and their prolonged duration were best explained by a poor stress response from Addison's disease coupled with exacerbation of early onset myasthenia gravis. This patient's case is not a typical reaction to interscalene nerve blocks, and thus preoperative testing would not be recommended for myasthenia gravis or Addison's disease without underlying suspicion. We describe this report to inform physicians to consider a workup for these diagnoses if a typical workup rules out all usual causes of complications from an interscalene block.
Discussão: A doença de Addison é uma patologia rara em idade pediátrica e o seu diagnóstico requer um elevado grau de suspeição, dada a inespecificidade da sintomatologia inicial. Os autores pretendem alertar para a suspeição necessária perante uma clínica de hiponatrémia associada a sintomas constitucionais e gastrointestinais.
Ross, I L; Levitt, N S; Blom, D J; Haarburger, D
Hypogonadism may complicate Addison's disease (primary hypoadrenalism), but prevalence and metabolic sequelae of hypogonadism in Addison's disease are poorly described. We recruited patients from the South African Addison's disease national registry who received stable replacement doses of hydrocortisone and had no acute illness. Male biochemical testosterone deficiency was defined as an early morning basal testosterone10 or 12 IU/l). Testosterone deficiency did not correlate with age, disease duration or hydrocortisone dose. Untreated male hypogonadal subjects had a higher (mean ± standard deviation) BMI compared to eugonadal subjects 29.2 ± 4.9 kg/m(2) vs. 24.7 ± 3.4 kg/m(2) (p=0.01) and a higher median (interquartile range) high-sensitive-CRP 6.4 (2.5-14.0) mg/l vs. 1.45 (0.6-2.8) mg/l (p=0.002). There were no differences between the 2 groups in lipids, lipoproteins and fasting glucose. The median (interquartile range) DHEAS was lower in the hypogonadal 0.31 (0.27-0.37) μmol/l, compared with the eugonadal group 0.75 (0.50-1.51) μmol/l (p=0.005). POF was documented in 11% of female patients. Male testosterone deficiency was highly prevalent in this cohort and was primarily due to secondary hypogonadism. Only BMI and hs-CRP were increased in untreated male hypogonadal subjects. Male and female hypogonadism appears to be a common complication of Addison's disease and may contribute to its morbidity. © Georg Thieme Verlag KG Stuttgart · New York.
Ian Louis Ross
Full Text Available BACKGROUND: Addison's disease is a potentially life-threatening disorder, and prompt diagnosis, and introduction of steroid replacement has resulted in near normal life-expectancy. There are limited data describing the clinical presentation of Addison's disease in South Africa. It is hypothesised that patients may present in advanced state of ill-health, compared to Western countries. PATIENTS: A national database of patients was compiled from primary care, referral centres and private practices. 148 patients were enrolled (97 white, 34 mixed ancestry, 5 Asian and 12 black. METHODS: Demographic and clinical data were elicited using questionnaires. Biochemical data were obtained from folder reviews and laboratory archived results. RESULTS: The majority of the cohort was women (62%. The median and inter-quartile age range (IQR of patients at enrolment was 46.0 (32.0-61.0 years, with a wide range from 2.8-88.0 years. The median and IQR age at initial diagnosis was 34.0 (20.0-45.0 years (range 0.02-77.0 years, indicating that at the time of enrolment, the patients, on average, were diagnosed with Addison's disease 12 years previously. Hyperpigmentation was observed in 76%, nausea and vomiting occurred in more than 40%, and weight loss was noted in 25%. Loss of consciousness as a presenting feature was recorded in 20%. with a 95% confidence interval [CI] of (14-28% and shock occurred in 5% CI (1.5-8.5%. Case-finding was recorded at 3.1 per million. CONCLUSIONS: The usual constellation of hyperpigmentation, nausea, vomiting and weight loss suggests Addison's disease, but a significant proportion present with an advanced state of ill-health and Addisonian crises. A lower prevalence rate, compared to Western countries is suggested.
Ma Ensen; Yang Zhigang; Li Yuan; Guo Yingkun; Deng Yuping; Zhang Xiaochun
Objective: To determine the characteristics of tuberculous Addison's disease on the axial and multiplanar reformatted (MPR) images of the multidetector-row computed tomography (MDCT). Materials and methods: The unenhanced and contrast-enhanced MDCT features in 19 patients with tuberculous Addison's disease were retrospectively assessed for the location, contour, size, calcification, attenuation, and enhancement patterns. The correlation between the duration of Addison's disease and the percentage of calcification presence was evaluated. Results: The adrenal glands were infected bilaterally in all of the 19 cases (100%, 38 glands). Enlargement of the glands appeared in 18 cases (94.7%, 36 glands) and the remaining one case (5.3%, two glands) showed atrophy bilaterally. Of the 36 enlarged adrenals, 13 (36.1%) had preserved contours, and the other 23 (63.9%) were mass-like. The size of the adrenals ranged from 0.6 to 4.8cm (mean 1.92+/-0.96cm). Calcification was revealed in 16 adrenals (16/38, 42.1%), increasing in incidence with disease progression. Fourteen of the 36 (38.9%) enlarged adrenals showed peripheral enhancement while the remaining 22 (61.1%) demonstrated heterogeneous enhancement. The ΔCT value, the attenuation measurement of mass-like lesions, was less in the central area (7+/-4HU) than that in the peripheral area (32+/-14HU) (P<0.01) between the unenhanced and contrast-enhanced scan. Conclusion: MDCT can reveal the characteristic morphology and CT attenuation in the tuberculous Addison's disease. Combined with its clinical presentations and biochemical findings, we can diagnose and stage adrenal tuberculosis with high specificity and accuracy on MDCT
Jyothi, K S; George, Cyriac; Shaji, K S
Adrenoleukodystrophy (ALD) is an X-linked disorder with diverse clinical presentations. A 30-year-old male, previously diagnosed with Addison's disease, on steroid supplementation for 18 years, presented to us with manic symptoms for 4 years. He was found to have white matter hypodensities in computed tomography head and had white matter signal changes in magnetic resonance imaging, and therefore a diagnosis of ALD was made.
Pearce, Simon H S; Mitchell, Anna L; Bennett, Stuart; King, Phil; Chandran, Sukesh; Nag, Sath; Chen, Shu; Smith, Bernard Rees; Isaacs, John D; Vaidya, Bijay
A diagnosis of Addison's disease means lifelong dependence on daily glucocorticoid and mineralocorticoid therapy and is associated with increased morbidity and mortality as well as a risk of unexpected adrenal crisis. The objective of the study was to determine whether immunomodulatory therapy at an early stage of autoimmune Addison's disease could lead to preservation or improvement in adrenal steroidogenesis. This was an open-label, pilot study of B lymphocyte depletion therapy in new-onset idiopathic primary adrenal failure. Doses of iv rituximab (1 g) were given on d 1 and 15, after pretreatment with 125 mg iv methylprednisolone. Six patients (aged 17-47 yr; four females) were treated within 4 wk of the first diagnosis of idiopathic primary adrenal failure. Dynamic testing of adrenal function was performed every 3 months for at least 12 months. Serum cortisol levels declined rapidly and were less than 100 nmol/liter (3.6 μg/dl) in all patients by 3 months after B lymphocyte depletion. Serum cortisol and aldosterone concentrations remained low in five of the six patients throughout the follow-up period. However, a single patient had sustained improvement in both serum cortisol [peak 434 nmol/liter (15.7 μg/dl)] and aldosterone [peak 434 pmol/liter (15.7 ng/dl)] secretion. This patient was able to discontinue steroid medications 15 months after therapy and remains well, with improving serum cortisol levels 27 months after therapy. New-onset autoimmune Addison's disease should be considered as a potentially reversible condition in some patients. Future studies of immunomodulation in autoimmune Addison's disease may be warranted.
Ross, Ian Louis; Levitt, Naomi S
Addison's disease is a potentially life-threatening disorder, and prompt diagnosis, and introduction of steroid replacement has resulted in near normal life-expectancy. There are limited data describing the clinical presentation of Addison's disease in South Africa. It is hypothesised that patients may present in advanced state of ill-health, compared to Western countries. A national database of patients was compiled from primary care, referral centres and private practices. 148 patients were enrolled (97 white, 34 mixed ancestry, 5 Asian and 12 black). Demographic and clinical data were elicited using questionnaires. Biochemical data were obtained from folder reviews and laboratory archived results. The majority of the cohort was women (62%). The median and inter-quartile age range (IQR) of patients at enrolment was 46.0 (32.0-61.0) years, with a wide range from 2.8-88.0 years. The median and IQR age at initial diagnosis was 34.0 (20.0-45.0) years (range 0.02-77.0) years, indicating that at the time of enrolment, the patients, on average, were diagnosed with Addison's disease 12 years previously. Hyperpigmentation was observed in 76%, nausea and vomiting occurred in more than 40%, and weight loss was noted in 25%. Loss of consciousness as a presenting feature was recorded in 20%. with a 95% confidence interval [CI] of (14-28%) and shock occurred in 5% CI (1.5-8.5%). Case-finding was recorded at 3.1 per million. The usual constellation of hyperpigmentation, nausea, vomiting and weight loss suggests Addison's disease, but a significant proportion present with an advanced state of ill-health and Addisonian crises. A lower prevalence rate, compared to Western countries is suggested.
Smans, Lisanne; Lentjes, Eef; Hermus, Ad; Zelissen, Pierre
Patients with Addison's disease require lifelong treatment with glucocorticoids. At present, no glucocorticoid replacement therapy (GRT) can exactly mimic normal physiology. As a consequence, under- and especially overtreatment can occur. Suboptimal GRT may lead to various side effects. The aim of this study was to investigate the use of salivary cortisol day curves (SCDC) in the individual adjustment of GRT in order to approach normal cortisol levels as closely as possible, reduce over- and underreplacement and study the short-term effects on quality of life (QoL). Twenty patients with Addison's disease were included in this prospective study. A SCDC was obtained and compared to normal controls; general and disease specific QoL-questionnaires were completed. Based on SCDC assessment of over- and undertreatment (calculated as duration (h) × magnitude (nmol/L) at different time points, glucocorticoid dose and regime were adjusted. After 4 weeks SCDC and QoL assessment were repeated and the effect of adjusting GRT was analysed. At baseline, underreplacement was present in 3 and overreplacement in 18 patients; total calculated overreplacement was 32.8 h.nmol/L. Overreplacement decreased significantly to 13.3 h. nmol/L (p =0.005) after adjustment of GRT. Overreplacement was found particularly in the afternoon and evening. After reducing overreplacement in the evening, complaints about sleep disturbances significantly decreased. Individual adjustment of GRT based on SCDC to approach normal cortisol concentrations during the day can reduce overreplacement, especially in the evening. This can lead to a reduction of sleep disturbances and fatigue in patients with Addison's disease. A SCDC is a simple and patient-friendly tool for adjusting GRT and can be useful in the follow-up of patients with Addison's disease.
David L. Browman
Full Text Available This volume contains a short 6 page history of the contributions ofWesley Robert Hurt, Jr., to Americanist archaeology,along with a 4 page 'selected' list of his publications. The review starts with his career in the Southwest, traces the shift in his research to the Plains, and especially South Dakota, and then turns to his later change of interest to South America (especially Colombia, Brazil and Uruguay. Hurt was born September 20, 1 9 1 7 in New Mexico, and got into archaeology through his cousin, Reginald Fisher, who was working for Dr. Edgar L. Heweu. Hurt started out taking Heweu's Chaco Canyon Field School, and began working on the Jemez Archaeological project as a high school student in the 1930s. After graduating from the University of New Mexico in 1938, he worked from 1938 to 1940 as a WPAArchaeology Project supervisor on Southwest projects, and in 1941 served as the National Park Service archaeologist at Canyon de Chelly National Monument.
White, Katherine; Arlt, Wiebke
Adrenal crisis is a life-threatening event that occurs regularly in Addison's patients receiving standard replacement therapy. Patient reports suggest that it is an underestimated and under-managed event. To assess the frequency of adrenal crisis in diagnosed patients and to understand the factors contributing to the risks of adrenal crisis. We conducted a postal survey of Addison's patients in four countries, UK (n=485), Canada (n=148), Australia (n=123) and New Zealand (n=85) in 2003, asking about patients' experiences of adrenal crisis and their demographic characteristics. In 2006, a shorter follow-up survey was conducted in the UK (n=261). The frequency and causes of adrenal crisis were compared across both surveys. Demographic data from the 2003 survey were analysed to establish the main variables associated with an elevated risk of crisis. Around 8% of diagnosed cases can be expected to need hospital treatment for adrenal crisis annually. Exposure to gastric infection is the single most important factor predicting the likelihood of adrenal crisis. Concomitant diabetes and/or asthma increase the frequency of adrenal crises reported by patients. The endocrinologist has a responsibility to ensure that Addison's patients have adequate access to life-saving emergency injection materials and repeated, practical training sessions in how to use them, while the general practitioner plays a vital role as in arranging prompt emergency admissions.
Thompson, Michael D; Kalmar, Eileen; Bowden, Sasigarn A
We present a case of rapidly progressing Addison's disease in adrenal crisis with severe hyponatraemia and absence of hyperkalaemia in a 10-year-old girl. She presented with 2 weeks of vomiting, fatigue and weight loss. Her serum electrolytes obtained 1 week prior to presentation were normal, except for mild hyponatraemia at 131 mmol/L, which dropped to 112 mmol/L on admission. She had normal serum potassium, low-serum osmolality, with elevated urine sodium and osmolality, indistinguishable from syndrome of inappropriate antidiuretic hormone (SIADH). Subsequently, Addison's disease was diagnosed on the basis of gingival hyperpigmentation and undetectable cortisol on adrenocorticotropic hormone stimulation test. She rapidly responded to stress dose hydrocortisone, followed by hydrocortisone and fludrocortisone replacement therapy. The absence of hyperkalaemia in the presence of severe hyponatraemia cannot rule out Addison's disease in children. The mechanism of hypo-osmolar hyponatraemia in primary adrenal insufficiency and clinical clues to differentiate it from SIADH are discussed. 2015 BMJ Publishing Group Ltd.
Inder, Warrick J; Meyer, Caroline; Hunt, Penny J
Addison's disease may be complicated by hypertension and less commonly by heart failure. We review the pathophysiology of the renin-angiotensin-aldosterone axis in Addison's disease and how this is altered in the setting of hypertension and heart failure. An essential first step in management in both conditions is optimizing glucocorticoid replacement and considering dose reduction if excessive. Following this, if a patient with Addison's disease remains hypertensive, the fludrocortisone dose should be reviewed and reduced if there are clinical and/or biochemical signs of mineralocorticoid excess. In the absence of such signs, where the renin is towards the upper end of the normal range or elevated, an angiotensin II (AII) receptor antagonist or angiotensin converting enzyme (ACE) inhibitor is the treatment of choice, and the fludrocortisone dose should remain unchanged. Dihydropyridine calcium channel blockers are clinically useful as second line agents, but diuretics should be avoided. In the setting of heart failure, there is an increase in total body sodium and water; therefore, it is appropriate to reduce and rarely consider ceasing the fludrocortisone. Loop diuretics may be used, but not aldosterone antagonists such as spironolactone or eplerenone. Standard treatment with ACE inhibitors, or as an alternative, AII receptor antagonists, are appropriate. Measurements of renin are no longer helpful in heart failure to determine the volume status but plasma levels of brain natriuretic peptide (BNP/proBNP) may help guide therapy. © 2014 John Wiley & Sons Ltd.
Smans, L C C J; Zelissen, P M J
To our knowledge, no case of remission in autoimmune Addison's disease has previously been reported. We describe a patient with primary adrenal insufficiency caused by autoimmune adrenalitis in whom partial remission was observed after 7 yr. A 39-yr-old male was referred because of extreme fatigue, weight loss, anorexia, nausea, and bouts of fever. During physical examination hyperpigmentation was seen. Laboratory tests showed a plasma cortisol of 0.02 micromol/l (08:30 h). Cortisol failed to increase during the ACTH stimulation test (0.02 to 0.03 micromol/l) and ACTH was markedly elevated (920 pmol/l). Adrenal auto-antibodies were weakly positive. A CT-scan showed no evidence of calcifications or other abnormalities of the adrenal glands. The diagnosis of autoimmune Addison's disease was made and replacement therapy with hydrocortisone and fludrocortisone was started. During the following years the dose of hydrocortisone was gradually decreased. Eventually, the patient decided to stop his medication completely. A repeated ACTH-stimulation test revealed a basal cortisol of 0.25 micromol/l and a peak cortisol of 0.30 micromol/l with a basal ACTH of 178 pmol/l. The patient did not have any complaints. Recovery of adrenal insufficiency, due to causes other than autoimmune adrenalitis, has been reported in the past. If our case of partial recovery of autoimmune adrenalitis is not unique this could have profound effects on treatment and follow-up of Addison's disease.
Full Text Available Abstract Introduction Idiopathic intracranial hypertension can rarely be associated with an underlying endocrine disorder such as Cushing's syndrome, hyperthyroidism, or with administration of thyroxine or growth hormone. Though cases of idiopathic intracranial hypertension associated with Addison's disease in children have been reported, there is only one documented case report of this association in adults. We describe a case of an acute adrenal insufficiency precipitated by idiopathic intracranial hypertension in a Caucasian female. Case presentation A 24-year-old Caucasian woman was acutely unwell with a background of several months of generalised fatigue and intermittent headaches. She had unremarkable neurological and systemic examination with a normal computerised tomography and magnetic resonance imaging of the brain. Normal cerebrospinal fluid but increased opening pressure at lumbar puncture suggested intracranial hypertension. A flat short synacthen test and raised level of adrenocorticotrophic hormone were consistent with primary adrenal failure. Conclusion Addison's disease can remain unrecognised until precipitated by acute stress. This case suggests that idiopathic intracranial hypertension can rarely be associated with Addison's disease and present as an acute illness. Idiopathic intracranial hypertension is possibly related to an increase in the levels of arginine vasopressin peptide in serum and cerebrospinal fluid secondary to a glucocorticoid deficient state.
Full Text Available This article describes the visual nature of the reading process as it relates to reading speed. It points out that there is a physical limit on normal reading speed and beyond this limit the reading process will be different from normal reading where almost every word is attended to. The article describes a range of activities for developing reading fluency, and suggests how the development of fluency can become part of a reading programme.
Berardelli, R; Karamouzis, I; D'Angelo, V; Fussotto, B; Minetto, M A; Ghigo, E; Giordano, R; Arvat, E
Mineralocorticoid receptors (MR) in the hippocampus display an important role in the control of hypothalamic-pituitary-adrenal (HPA) axis, mediating the ''proactive'' feedback of glucocorticoids (GC). Fludrocortisone (FC), a potent MR agonist, has been shown to decrease HPA activity through a hippocampal mechanism. Since it has been demonstrated that FC shows a significant inhibition of the HPA axis response to hCRH stimulus in normal subjects, also at doses usually administered as replacement therapy in patients with Addison's disease, an FC effect at MRs in human pituitary or a GR-pituitary agonism stronger than believed until now has been postulated. Ten patients affected by autoimmune Addison's disease received: (1) placebo p.o. + placebo i.v., (2) hydrocortisone (H) 10 mg p.o. + placebo i.v., (3) FC 0.1 mg p.o. + placebo i.v., (4) FC 0.1 mg and H 10 mg p.o. + placebo i.v. to verify a possible GR FC-mediated effect that might display a repercussion on the GC-replacement therapy. H reduced ACTH (p < 0.01) and increased cortisol levels (p < 0.01) with respect to the placebo session, while FC did not affect either ACTH or cortisol levels compared to placebo, and higher ACTH and lower cortisol levels (p < 0.03 and p < 0.01) were observed compared with the H session; furthermore the co-administration of FC + H showed ACTH and cortisol profiles similar to that observed during H alone. Our study showed a lack of FC effect on corticotrope secretion in Addison's disease, thus making unlikely the hypothesis of its GR pituitary agonism and the risk of glucocorticoid excess in primary adrenal insufficiency.
Full Text Available Adrenocortical autoantibodies (ACA, present in 60-80% of patients with idiopathic Addison's disease, are conventionally detected by indirect immunofluorescence (IIF on frozen sections of adrenal glands. The large-scale use of IIF is limited in part by the need for a fluorescence microscope and the fact that histological sections cannot be stored for long periods of time. To circumvent these restrictions we developed a novel peroxidase-labelled protein A (PLPA technique for the detection of ACA in patients with Addison's disease and compared the results with those obtained with the classical IIF assay. We studied serum samples from 90 healthy control subjects and 22 patients with Addison's disease, who had been clinically classified into two groups: idiopathic (N = 13 and granulomatous (N = 9. ACA-PLPA were detected in 10/22 (45% patients: 9/13 (69% with the idiopathic form and 1/9 (11% with the granulomatous form, whereas ACA-IIF were detected in 11/22 patients (50%: 10/13 (77% with the idiopathic form and 1/9 (11% with the granulomatous form. Twelve of the 13 idiopathic addisonians (92% were positive for either ACA-PLPA or ACA-IIF, but only 7 were positive by both methods. In contrast, none of 90 healthy subjects was found to be positive for ACA. Thus, our study shows that the PLPA-based technique is useful, has technical advantages over the IIF method (by not requiring the use of a fluorescence microscope and by permitting section storage for long periods of time. However, since it is only 60% concordant with the ACA-IIF method, it should be considered complementary instead of an alternative method to IIF for the detection of ACA in human sera.
Lee, Li-Chik; Fujita, Naohisa; Ohba, Yachiyo
A 62-year-old woman was admitted to our hospital with complaints of general malaise and hyperpigmentation. We diagnosed her case as primary adrenocortical insufficiency (Addison's disease) by endocrinological studies. CT demonstrated dense calcification in both adrenal beds without evidence of normal glandular remnants. Calcified adrenal is not specific to tuberculosis, but some points of CT findings are useful for pathogenetic approach. Recently, there have been several reports that ACTH producing pituitary tumors develop in patients treated with conventional corticosteroid replacement. Corticosteroid should be administered by monitoring of plasma cortisol and ACTH concentrations. (author)
Mudawi, Hatim M.; Baraka, Omer Z.; El-Hassan, Ahmed M.; El-Amin, Elwaleed M.
Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, both disseminated histoplasmosis and symptomatic adrenal histoplasmosis are rare. Herein, we describe the case of a 50-year-old gentleman residing in western Sudan who presented with 7-month history of generalized body weakness, easy fatigue and frequent attacks of vomiting and diarrhea. Physical examination and laboratory investigations confirmed the diagnosis of Addison's disease due to histoplasma capsulatum var duboisii infection of the adrenal glands. He was treated with intravenous hydrocortisone, followed by oral prednisolone and itraconazole. (author)
Hangaard, J; Andersen, M; Grodum, E
The physiological and pathophysiological role of cortisol in pulsatile LH release was investigated in 14 patients (5 men, 6 premenopausal women, and 3 postmenopausal women) with Addison's disease. The explicit effect of cortisol in relation to the effect of corticotropin-releasing factor (CRF......), ACTH, and opioids was ensured by hypo-, normo-, and hypercortisolism. Hypocortisolism was obtained by 24-h discontinuation of hydrocortisone (HC) followed by 23-h saline infusion. Eucortisolism was secured by infusion of HC (0.5 mg/kg) over 23 h. Stress-appropriate hypercortisolism was obtained...
Wagner, H.; Degenhardt, G.; Wenning, N.
The findings obtained before suggest that plasma ACTH determination is another valuable parameter supplementing the determination of plasma corticoids in the diagnosis of Addison's disease. In the assessment of the success of the treatment, plasma ACTH measurement is superior to the determination of plasma corticoids. (orig./AK) [de
Ozturk, Hakan; Karaaslan, Serap
Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histo-pathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.
Guo Yingkun; Yang Zhigang; Li Yuan; Ma Ensen; Deng Yuping; Min Pengqiu; Yin Longlin; Hu Jian; Zhang Xiaochun; Chen Tianwu
Purpose: To describe CT morphology of untreated adrenal tuberculosis during the different stages of the natural history of the disease and to evaluate the diagnostic implications of CT features. Materials and methods: We retrospectively evaluated CT features in 42 patients with documented adrenal tuberculosis for the location, size, morphology, and enhancement patterns shown on CT images. The clinical duration were correlated with the CT features. Results: Of the 42 patients with untreated adrenal tuberculosis, bilaterally enlarged adrenal glands were revealed in 38 cases (91%), unilaterally enlarged in 3 cases (7%), and normal size in 1 case (2%). Of the 41 cases (98%) with enlargement, mass-like enlargement was seen in 20 cases (49%) and enlargement with preserved contours in 21 cases (51%). Peripheral rim enhancement presented in 22 cases (52%) on contrast-enhanced CT. Non-enhanced CT scan revealed calcification in 21 cases (50%). As the duration of Addison's disease increased, the presence of calcification and contour preservation increased concomitantly (p < 0.001), whereas peripheral rim enhancement and mass-like enlargement decreased concomitantly on CT images (p < 0.001). Conclusion: CT may be helpful in diagnosing adrenal tuberculosis when clinically suspected, and CT features are correlated to the clinical duration of Addison's disease
Annemarie Wennekers; Frank Huysmans; Jos de Haan
Original title: Lees:Tijd The amount of time that Dutch people spend reading has been declining steadily since the 1950s. This decline in reading time contrasts starkly with the positive personal and social benefits that can be derived from reading, according to lots of research. The Reading:
Tilley, Carol L.
Many adults, even librarians who willingly add comics to their collections, often dismiss the importance of comics. Compared to reading "real" books, reading comics appears to be a simple task and compared to reading no books, reading comics might be preferable. After all, comics do have words, but the plentiful pictures seem to carry most of the…
Ross, I L; Levitt, N S; Van der Walt, J S; Schatz, D A; Johannsson, G; Haarburger, D H; Pillay, T S
Using salivary cortisol (SC) measurements, cortisol exposure in Addison's disease patients on hydrocortisone replacement was determined and compared with healthy controls. Cortisol pharmacokinetics was assessed in 31 patients with Addison's disease on replacement hydrocortisone doses (median daily dose 20 mg; range 5-50 mg) and 30 healthy control subjects. Saliva samples (n=16) were collected between 08:00 and 00:00 h in 1 day, using a passive drool technique. Cortisol exposure was evaluated by noncompartmental approach. In the patients, cortisol exposure was significantly higher than in controls: median inter-quartile range (IQR) peak cortisol (C(max)) 174.5 (59.3-837.0) vs. 6.50 (4.7-19.3) nmol/l, p=0.0001; area under the curve (AUC) 390.1 (177.1-928.9) vs. 21.4 (14.6-28.4) minutes*nmol/l, p=0.0001, trough cortisol level (C(min)) 0.49 (0.49-0.96) vs. 0.49 (0.49-0.49) nmol/l, p=0.02, occurring at 480.0 (0.1-660.0) vs. 405.0 (180.0-570.0) min, p=0.56. First peak cortisol was 174.5 (53.0-754.7) vs. 6.27 (3.90-8.47) nmol/l, p=0.0001 and second peak cortisol 18.90 (5.22-76.9) vs. 3.12 (1.76-4.79) nmol/l, p=0.0001. The time to first peak cortisol differed between the 2 groups, 30 (30-75) vs. 0.1 (0.1-30) minutes; p=0.0001. At doses studied, hydrocortisone replacement therapy results in cortisol pharmacokinetics being markedly different from endogenous cortisol profiles in healthy control subjects. Addison's disease patients had significantly higher SC levels compared to healthy control subjects. © Georg Thieme Verlag KG Stuttgart · New York.
Zurawek, Magdalena; Fichna, Marta; Kazimierska, Marta; Fichna, Piotr; Dzikiewicz-Krawczyk, Agnieszka; Przybylski, Grzegorz; Ruchala, Marek; Nowak, Jerzy
Mitochondrial antiviral signaling (MAVS) protein is an intracellular adaptor molecule, downstream of viral sensors, retinoid acid-inducible gene I (RIG-I)-like receptors (RLRs). Impaired antiviral cell signaling might contribute to autoimmunity. Studies have recently shown variations in genes encoding RLRs as risk factors for autoimmune diseases. We investigated whether MAVS coding polymorphisms are associated with Addison's disease (AD) and type 1 diabetes (T1D) in Polish population. We genotyped 140 AD, 532 T1D patients and 600 healthy controls for MAVS rs17857295, rs7262903, rs45437096 and rs7269320. Genotyping was performed by TaqMan assays. Distribution of the MAVS genotypes and alleles did not reveal significant differences between patients and controls (p > 0.05). This analysis did not indicate the association of the MAVS locus with susceptibility to AD and T1D.
Full Text Available This report describes a case of West Nile virus (WNV meningoencephalitis in a child who presented with fever, headache, seizures, and altered mental status, as well as hyponatremia and bronzing of the skin. Findings that led to the diagnosis of WNV included plasma-cell pleocytosis of the cerebrospinal fluid (CSF and linear chorioretinitis on ophthalmologic exam. The diagnosis was confirmed by a positive serum and CSF WNV IgM. The acute WNV infection triggered an adrenal crisis which uncovered a new diagnosis of underlying Addison's disease. This is the first case report of severe neuroinvasive WNV disease in a pediatric patient with primary adrenal insufficiency. Neuroinvasive WNV disease is uncommon in children, but may have a more severe presentation in those with certain underlying medical conditions.
Bjanesoy, Trine E; Andreassen, Bettina Kulle; Bratland, Eirik; Reiner, Andrew; Islam, Shahinul; Husebye, Eystein S; Bakke, Marit
Autoimmune Addison's Disease (AAD) is an endocrine and immunological disease of uncertain pathogenesis resulting from the immune system's destruction of the hormone producing cells of the adrenal cortex. The underlying molecular mechanisms are largely unknown, but it is commonly accepted that a combination of genetic susceptibility and environmental impact is critical. In the present study, we identified multiple hypomethylated gene promoter regions in patients with isolated AAD using DNA isolated from CD4+ T cells. The identified differentially methylated regions were distributed evenly across the 10.5-kb-promoter regions covered by the array, and a substantial number localized to promoters of genes involved in immune regulation and autoimmunity. This study reveals a hypomethylated status in CD4+ T cells from AAD patients and indicates differential methylation of promoters of key genes involved in immune responses. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Colucci, Randall; Jimenez, Rafael E; Farrar, William; Malgor, Ramiro; Kohn, Leonard; Schwartz, Frank L
A 56-year-old woman presented with an incidental adrenal adenoma and physical examination findings that included moderate obesity, a slight cervicothoracic fat pad ("buffalo hump"), increased supraclavicular fat pads, and white abdominal striae. Biochemical workup revealed elevated levels of 24-hour urinary free cortisol but normal serum morning cortisol and suppressed levels of corticotropin, suggestive of adrenal-dependent Cushing syndrome. The resected adrenal gland revealed macronodular cortical hyperplasia with a dominant nodule. Other findings included an absent cortisol response to corticotropin stimulation, presence of serum anti-21-hydroxylase antibodies, and mononuclear cell infiltration--consistent with adrenalitis. The findings represent, to the authors' knowledge, the first known case of a patient with coexistent functional cortisol-secreting macronodular adrenal tumor resulting in Cushing syndrome and immune-mediated adrenalitis resulting in Addison disease.
Lewandowski, Krzysztof C; Malicka, Katarzyna; Dąbrowska, Katarzyna; Lewiński, Andrzej
A 36-year-old woman was found to have a low morning ACTH concentration despite a history of Addison's disease. Past medical history: At the age of 23 years the subject developed Graves's disease, which was treated with radioiodine. At about the same time, she claimed to have two episodes of pancreatitis treated with cholecystectomy. About seven months later she was euthyroid on L-thyroxine (TSH 1.51 mIU/mL) but was admitted with hypotension, hyponatraemia (sodium 109 mmol/L), and low morning cortisol (119 nmol/L). Further investigations confirmed primary adrenal failure with ACTH concentration of 779 pg/mL (ref. range 0-60) prior to the dose of hydrocortisone. About nine years later she complained about tiredness. Clinically she was normotensive and not pigmented. BMI 22.3 kg/m². Periods were regular. ACTH concentration was surprisingly low (ACTH 8.53 pg/mL, ref. range 0-46), despite very low cortisol (3.37 nmol/L). She was admitted for further assessment. Pituitary MRI scan was unremarkable. An insulin tolerance test was performed and showed a clear increase of ACTH (from 15.2 to 165 pg/mL). There was, however, hardly any increase of ACTH after CRH stimulation (from 6.05 pg/mL to 10.2 pg/mL), thus demonstrating central CRH resistance. In summary, this patient developed secondary adrenal failure in the setting of previous Addison's disease. Interestingly, hypoglycaemia (but not CRH) provided a stimulus for ACTH release, thus demonstrating CRH resistance. The case confirms that besides CRH, other factors are responsible for stimulation of the ACTH-cortisol axis during insulin tolerance test.
Vrkljan, Ana Marija; Pašalić, Ante; Strinović, Mateja; Perić, Božidar; Kruljac, Ivan; Miroševć, Gorana
A case of autoimmune polyglandular syndrome (APS) is presented. A 45-year-old man was admitted due to fatigue, malaise and inappetence. He had a history of primary hypothyroidism and was on levothyroxine substitution therapy. One year before, he was diagnosed with normocytic anemia and vitamin B12 deficiency, which was treated with vitamin B12 substitution therapy. Physical examination revealed hypotension and marked hyperpigmentation. Laboratory testing showed hyponatremia, hyperkaliemia and severe normocytic anemia. Endocrinological evaluation disclosed low morning cortisol and increased adrenocorticotropic hormone levels. Hence, the diagnosis of Addison's disease was established. Additional laboratory workup showed positive parietal cell antibodies. However, his vitamin B12 levels were increased due to vitamin B12 supplementation therapy, which was initiated earlier. Gastroscopy and histopathology of gastric mucosa confirmed atrophic gastritis. Based on prior low serum vitamin B12 levels, positive parietal cell antibodies and atrophic gastritis, the patient was diagnosed with pernicious anemia. Hydrocortisone supplementation therapy was administered and titrated according to urinary-free cortisol levels. Electrolyte disbalance and red blood cell count were normalized. This case report demonstrates rather unique features of pernicious anemia in a patient with Addison's disease. It also highlights the link between type II and type III APS. Not only do they share the same etiological factors, but also overlap in pathophysiological and clinical characteristics. This case report favors older classification of APS, which consolidates all endocrine and other organ-specific autoimmune diseases into one category. This is important since it might help avoid pitfalls in the diagnosis and treatment of patients with APS.
Baker, Peter R.; Nanduri, Priyaanka; Gottlieb, Peter A.; Yu, Liping; Klingensmith, Georgeanna J.; Eisenbarth, George S.; Barker, Jennifer M.
Summary Context Autoantibodies to 21-hydroxylase (21OH-AA) precede onset of autoimmune Addison's disease (AD). Progression to AD can take months to years, and early detection of metabolic decompensation may prevent morbidity and mortality. Objective To define optimal methods of predicting progression to overt AD (defined by subnormal peak cortisol response to Cosyntropin) in 21OH-AA+ individuals. Design, Setting and Participants Individuals were screened for 21OH-AA at the Barbara Davis Center from 1993 to 2011. Subjects positive for 21OH-AA (n = 87) were tested, and the majority prospectively followed for the development of Addison's disease, including seven diagnosed with AD upon 21OH-AA discovery (discovered), seven who progressed to AD (progressors) and 73 nonprogressors. Main Outcome Measured Plasma renin activity (PRA), ACTH, baseline cortisol, peak cortisol and 21OH-AA were measured at various time points relative to diagnosis of AD or last AD-free follow-up. Results Compared with nonprogressors, in the time period 2 months–2 years prior to the onset of AD, progressors were significantly more likely to have elevated ACTH (11–22 pm, P < 1E-4), with no significant differences in mean PRA (P = 0·07) or baseline cortisol (P = 0·08), and significant but less distinct differences seen with 21OH-AA levels (P < 1E-4) and poststimulation cortisol levels (P = 6E-3). Conclusion Moderately elevated ACTH is a more useful early indicator of impending AD than 21OH-AA, PRA or peak cortisol, in the 2 months–2 years preceding the onset of AD. PMID:22066755
Multicultural reading advocates believe in the power of literature to transform and to change people's lives. They take seriously the arguments that racism and prejudice can be lessened through multicultural reading, and also that children from undervalued societal groups who read books that depict people like themselves in a positive light will…
A 30-year-old female with a history of anxiety, cannabis use, and Avoidant/Restrictive Food Intake Disorder presented for residential treatment of a Cannabis Use Disorder. Upon arrival, she had not eaten for two days and was found to be hypotensive with electrolyte disturbances. She was admitted to a nearby hospital, where the Internist diagnosed her with Addison's disease. She was treated with corticosteroid therapy, with rapid normalization of her electrolytes, eating, and anxiety. This is the first published case of undiagnosed Addison's disease presenting as an eating disorder, with cannabis use likely contributing to symptoms. This case elucidates the importance of ruling out other biologic and psychologic causes of clinical presentations before an eating disorder diagnosis can be made.
Winqvist, O; Gustafsson, J; Rorsman, F; Karlsson, F A; Kämpe, O
Autoimmune polyendocrine syndrome type I (APS I) and idiopathic Addison's disease are both disorders with adrenal insufficiency but with differences in genetic background, clinical presentation, and extent of extraadrenal manifestations. In this study the major adrenal autoantigen identified with sera from patients with APS I was characterized by analyses using indirect immunofluorescence, Western blots of adrenal subcellular fractions and of recombinant proteins, immunoprecipitations of [35S...
Dawoodji, Amina; Chen, Ji-Li; Shepherd, Dawn; Dalin, Frida; Tarlton, Andrea; Alimohammadi, Mohammad; Penna-Martinez, Marissa; Meyer, Gesine; Mitchell, Anna L; Gan, Earn H; Bratland, Eirik; Bensing, Sophie; Husebye, Eystein S; Pearce, Simon H; Badenhoop, Klaus; Kämpe, Olle; Cerundolo, Vincenzo
The mechanisms behind destruction of the adrenal glands in autoimmune Addison's disease remain unclear. Autoantibodies against steroid 21-hydroxylase, an intracellular key enzyme of the adrenal cortex, are found in >90% of patients, but these autoantibodies are not thought to mediate the disease. In this article, we demonstrate highly frequent 21-hydroxylase-specific T cells detectable in 20 patients with Addison's disease. Using overlapping 18-aa peptides spanning the full length of 21-hydroxylase, we identified immunodominant CD8(+) and CD4(+) T cell responses in a large proportion of Addison's patients both ex vivo and after in vitro culture of PBLs ≤20 y after diagnosis. In a large proportion of patients, CD8(+) and CD4(+) 21-hydroxylase-specific T cells were very abundant and detectable in ex vivo assays. HLA class I tetramer-guided isolation of 21-hydroxylase-specific CD8(+) T cells showed their ability to lyse 21-hydroxylase-positive target cells, consistent with a potential mechanism for disease pathogenesis. These data indicate that strong CTL responses to 21-hydroxylase often occur in vivo, and that reactive CTLs have substantial proliferative and cytolytic potential. These results have implications for earlier diagnosis of adrenal failure and ultimately a potential target for therapeutic intervention and induction of immunity against adrenal cortex cancer. Copyright © 2014 by The American Association of Immunologists, Inc.
Meyer, Gesine; Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus
Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days. In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.
... of potassium and low levels of sodium. What causes Addison’s disease? Addison’s disease is caused by injury to your ... example, a problem with your pituitary gland can cause secondary Addison’s disease. Or, you may develop Addison’s disease if you ...
Kraus, A U; Penna-Martinez, M; Meyer, G; Badenhoop, K
Addison's disease is a rare autoimmune disorder leading to adrenal insufficiency and life-long glucocorticoid dependency. Vitamin D receptor (VDR) polymorphisms and vitamin D deficiency predispose to Addison's disease. Aim of the current study was, to investigate potential anti-inflammatory vitamin D effects on monocytes in Addison's disease, focusing on inflammatory CCL-2 and IL6, as well on monocyte CD14 markers. Addison's disease is genetically linked to distinct HLA susceptibility alleles. Therefore we analyzed, whether HLA genotypes differed for vitamin D effects on monocyte markers. CD14 + monocytes were isolated from Addison's disease patients (AD, n=13) and healthy controls (HC, n=15) and stimulated with 1,25-dihydroxyvitamin D 3 and IL1β as an inflammatory stimulant. Cells were processed for mRNA expression of CCL-2, IL6 and CD14 and DNA samples were genotyped for major histocompatibility class (MHC) class II-encoded HLA- DQA1-DQB1 haplotypes. We found a downregulation of CCL-2 after vitamin D treatment in IL1β-stimulated monocytes both from AD patients and HC (AD p<0.001; HC p<0.0001). CD14 expression however, was upregulated in both HC and AD patients after vitamin D treatment (p<0.001, respectively). HC showed higher CD14 transcription level than AD patients after vitamin D treatment (p=0.04). Compared to IL1β-induced inflammation, HC have increased CD14 levels after vitamin D treatment (p<0.001), whereas the IL1β-induced CD14 expression of AD patients' monocytes did not change after vitamin D treatment (p=0.8). AD patients carrying HLA high-risk haplotypes showed an increased CCL-2 expression after IL1β-induced inflammation compared to intermediate-risk HLA carriers (p=0.05). Also HC monocytes' CD14 transcription after IL1β and vitamin D co-stimulation differed according to HLA risk profile. We show that vitamin D can exert anti-inflammatory effects on AD patients' monocytes which may be modulated by HLA risk genotypes. Copyright © 2017 Elsevier
Petersen, Kristina S; Rushworth, R Louise; Clifton, Peter M; Torpy, David J
Addison's disease, or primary adrenal insufficiency, is often associated with reduced well-being and fatigue despite use of currently recommended adrenal hormone replacement. Hypoglycaemia is a known manifestation of glucocorticoid deficiency, but is generally considered rare in adults and not relevant to troubling ongoing symptoms in patients with Addison's disease. A 43 year old woman with a three year history of Addison's disease complained of severe morning fatigue and headaches, despite standard glucocorticoid replacement therapy in the form of thrice daily hydrocortisone and mineralocorticoid replacement with fludrocortisone. Alternative glucocorticoid replacement regimens and the addition of dehydroepiandrosterone replacement therapy had no effect. Nocturnal hypoglycaemia was suspected and a 4-day continuous glucose monitor system (CGMS) revealed hypoglycaemia (interstitial glucose < 2.2 mmol/L) between 0200-0400 h on 3 of 4 days. The patient was counselled to take an evening snack designed to ensure slow absorption of ingested carbohydrates. Nocturnal hypoglycaemia was then absent on follow up CGMS assessment. The patient noted a marked symptomatic improvement in morning symptoms, but with persistent fatigue during the day. Currently, the best strategy for control of non-specific symptoms in treated Addison's disease is unknown, but it may be that investigation for hypoglycaemia and treatment, where necessary, could assist some sufferers to achieve improved wellbeing. A systematic study of this phenomenon in Addison's disease is required.
Camozzi, Valentina; Betterle, Corrado; Frigo, Anna Chiara; Zaccariotto, Veronica; Zaninotto, Martina; De Caneva, Erica; Lucato, Paola; Gomiero, Walter; Garelli, Silvia; Sabbadin, Chiara; Salvà, Monica; Costa, Miriam Dalla; Boscaro, Marco; Luisetto, Giovanni
to assess bone damage and metabolic abnormalities in patients with Addison's disease given replacement doses of glucocorticoids and mineralocorticoids. A total of 87 patients and 81 age-matched and sex-matched healthy controls were studied. The following parameters were measured: urinary cortisol, serum calcium, phosphorus, creatinine, 24-h urinary calcium excretion, bone alkaline phosphatase, parathyroid hormone, serum CrossLaps, 25 hydroxyvitamin D, and 1,25 dihydroxyvitamin D. Clear vertebral images were obtained with dual-energy X-ray absorptiometry in 61 Addison's disease patients and 47 controls and assessed using Genant's classification. Nineteen Addison's disease patients (31.1%) had at least one morphometric vertebral fracture, as opposed to six controls (12.8%, odds ratio 3.09, 95% confidence interval 1.12-8.52). There were no significant differences in bone mineral density parameters at any site between patients and controls. In Addison's disease patients, there was a positive correlation between urinary cortisol and urinary calcium excretion. Patients with fractures had a longer history of disease than those without fractures. Patients taking fludrocortisone had a higher bone mineral density than untreated patients at all sites except the lumbar spine. Addison's disease patients have more fragile bones irrespective of any decrease in bone mineral density. Supra-physiological doses of glucocorticoids and longer-standing disease (with a consequently higher glucocorticoid intake) might be the main causes behind patients' increased bone fragility. Associated mineralocorticoid treatment seems to have a protective effect on bone mineral density.
Gagliardi, Lucia; Nenke, Marni A; Thynne, Tilenka R J; von der Borch, Jenny; Rankin, Wayne A; Henley, David E; Sorbello, Jane; Inder, Warrick J; Torpy, David J
Patients with Addison's disease (AD) report impaired subjective health status (SHS). Since cortisol exhibits a robust circadian cycle that entrains other biological clocks, impaired SHS may be due to the noncircadian cortisol profile achieved with conventional glucocorticoid replacement. Continuous subcutaneous hydrocortisone infusion (CSHI) reproduces a circadian cortisol profile, but its effects on SHS have not been objectively evaluated. The aim of this study was to determine the effect of CSHI on SHS in AD. This was a multicentre, double-blind, placebo-controlled trial of CSHI vs oral glucocorticoid therapy. Participants received in random order 4 weeks of: CSHI and oral placebo, and subcutaneous placebo and oral hydrocortisone, separated by a 2-week washout period. SHS was assessed using the Short-Form 36 (SF-36), General Health Questionnaire (GHQ-28), Fatigue Scale (FS), Gastrointestinal Symptom Rating Scale (GSRS); and Addison's Quality of Life Questionnaire (AddiQoL). Participants were asked their (blinded) treatment preference. Twenty-four hour urine free cortisol (UFC) and diurnal salivary cortisol collections compared cortisol exposure during each treatment. Ten participants completed the study. Baseline SHS scores (mean ± SE) were consistent with mild impairment: SF-36 physical component summary 48.4 (± 2.4), mental component summary 53.3 (± 3.0); GHQ-28 18.1 (± 3.3); GSRS 3.7 (± 1.6), and AddiQoL 94.7 (± 3.7). FS was similar to other AD cohorts 13.5 (± 1.0) (P = 0.82). UFC between treatments was not different (P = 0.87). The salivary cortisol at 0800 h was higher during CSHI (P = 0.03), but not at any other time points measured. There was no difference between the treatments in the SHS assessments. Five participants preferred CSHI, four oral hydrocortisone, and one was uncertain. Biochemical measurements indicate similar cortisol exposure during each treatment period, although a more circadian pattern was evident during CSHI. CSHI does not
Campean, Radu; Hasun, Matthias; Stöllberger, Claudia; Bucher, Johannes; Finsterer, Josef; Schnack, Christoph; Weidinger, Franz
Reversible left ventricular dysfunction, also termed Takotsubo cardiomyopathy, is rarely reported in Addison's disease after initiation of hormone replacement therapy. The pathogenesis of this cardiomyopathy is unknown. A 41-year-old white woman with a history of autoimmune Hashimoto thyroiditis diagnosed 3 years earlier and acute adrenal insufficiency diagnosed 3 weeks earlier presented with new onset of heart failure New York Heart Association class IV, which had started shortly after initiation of hormone replacement therapy with hydrocortisone 20 mg/day and fludrocortisone 0.3 mg/day. Nine days before admission she had collapsed because of dizziness and had a cerebral concussion and open fracture of her nasal bone, however, no further investigations were carried out at that time. A physical examination revealed leg edema, tachycardia, tachypnea, bilateral basal crepitations, and blood pressure 110/70 mmHg. An electrocardiogram showed sinus tachycardia, low voltage, negative T-waves in V 5 and V 6 and a corrected QT interval of 590 ms. Echocardiography revealed a reduced left ventricular systolic function with an ejection fraction of 30 %, and septal, apical, and anterior wall akinesia. Cardiac magnetic resonance imaging showed relative enhancement of gadolinium, indicating hyperemia and capillary leakage, and no myocardial scars. Because of the improvement in her cardiac function, lack of cardiovascular risk factors, and lack of signs for ischemia on magnetic resonance imaging, no coronary angiography was carried out. The results of sellar and renal magnetic resonance imaging were normal. Her troponin T was slightly elevated. Bisoprolol and ramipril were started. Her fludrocortisone dose was reduced to 0.05 mg/day. Her electrocardiogram and systolic function, documented by echocardiography and magnetic resonance imaging, normalized within 6 months. Although we could not exclude coronary artery disease by coronary angiography, her clinical course and
Fagan, W. T.
The Canadian Institute for Research in Behavioral and Social Sciences of Calgary was awarded a contract by the Provincial Government of Alberta to assess student skills and knowledge in reading and written composition. Here evaluation is defined and the use of standardized and criterion referenced tests for evaluating reading performance are…
Richard L. ALLINGTON
Full Text Available Long overlooked, reading volume is actually central to the development of reading proficiencies, especially in the development of fluent reading proficiency. Generally no one in schools monitors the actual volume of reading that children engage in. We know that the commonly used commercial core reading programs provide only material that requires about 15 minutes of reading activity daily. The remaining 75 minute of reading lessons is filled with many other activities such as completing workbook pages or responding to low-level literal questions about what has been read. Studies designed to enhance the volume of reading that children do during their reading lessons demonstrate one way to enhance reading development. Repeated readings have been widely used in fostering reading fluency but wide reading options seem to work faster and more broadly in developing reading proficiencies, including oral reading fluency.
The thesis titled Promoting preschool reading consists of a theoretiral and an empirical part. In the theoretical part I wrote about reading, the importance of reading, types of reading, about reading motivation, promoting reading motivation, internal and external motivation, influence of reading motivation on the child's reading activity, reading and familial literacy, the role of adults in promotion reading literacy, reading to a child and promoting reading in pre-school years, where I ...
Full Text Available Abstract Background Addison's disease (AD is caused by an autoimmune destruction of the adrenal cortex. The pathogenesis is multi-factorial, involving genetic components and hitherto unknown environmental factors. The aim of the present study was to investigate if gene dosage in the form of copy number variation (CNV could add to the repertoire of genetic susceptibility to autoimmune AD. Methods A genome-wide study using the Affymetrix GeneChip® Genome-Wide Human SNP Array 6.0 was conducted in 26 patients with AD. CNVs in selected genes were further investigated in a larger material of patients with autoimmune AD (n = 352 and healthy controls (n = 353 by duplex Taqman real-time polymerase chain reaction assays. Results We found that low copy number of UGT2B28 was significantly more frequent in AD patients compared to controls; conversely high copy number of ADAM3A was associated with AD. Conclusions We have identified two novel CNV associations to ADAM3A and UGT2B28 in AD. The mechanism by which this susceptibility is conferred is at present unclear, but may involve steroid inactivation (UGT2B28 and T cell maturation (ADAM3A. Characterization of these proteins may unravel novel information on the pathogenesis of autoimmunity.
Miconi, Francesco; Savarese, Emanuela; Miconi, Giovanni; Cabiati, Gabriele; Rapaccini, Valentina; Principi, Nicola; Esposito, Susanna
Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison's disease (AD) and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.
Full Text Available Abstract Background Polymorphisms within the insulin gene can influence insulin expression in the pancreas and especially in the thymus, where self-antigens are processed, shaping the T cell repertoire into selftolerance, a process that protects from β-cell autoimmunity. Methods We investigated the role of the -2221Msp(C/T and -23HphI(A/T polymorphisms within the insulin gene in patients with a monoglandular autoimmune endocrine disease [patients with isolated type 1 diabetes (T1D, n = 317, Addison's disease (AD, n = 107 or Hashimoto's thyroiditis (HT, n = 61], those with a polyglandular autoimmune syndrome type II (combination of T1D and/or AD with HT or GD, n = 62 as well as in healthy controls (HC, n = 275. Results T1D patients carried significantly more often the homozygous genotype "CC" -2221Msp(C/T and "AA" -23HphI(A/T polymorphisms than the HC (78.5% vs. 66.2%, p = 0.0027 and 75.4% vs. 52.4%, p = 3.7 × 10-8, respectively. The distribution of insulin gene polymorphisms did not show significant differences between patients with AD, HT, or APS-II and HC. Conclusion We demonstrate that the allele "C" of the -2221Msp(C/T and "A" -23HphI(A/T insulin gene polymorphisms confer susceptibility to T1D but not to isolated AD, HT or as a part of the APS-II.
Ammini, A.C.; Gupta, R.; Mukopadhyay, C.; Shah, P.; Sandhu, M.S.; Vijayaraghavan, M.; Berry, M.
To study the morphology of the adrenal glands of patients with Addison's disease an ultrasound and a computed tomographic scan of the adrenal glands were performed in 28 patients. Thirteen patients had bilateral, asymmetric adrenal enlargement. In six of these patients, areas of necrosis and calcification were also seen. Six patients had atrophic glands with calcification and nine patients had normal/atrophic glands without calcification. After instituting appropriate treatment, computed tomography (CT) was repeated between 6 months and 3 years later in 10 of the 13 patients with adrenal enlargement. A reduction in gland size was noted in all patients and one had functional recovery. It is concluded that the appearance of the adrenal glands on CT depends not only on the nature of the underlying disease but also on the duration of the illness and the type of treatment. The results highlighted the importance of studying adrenal morphology during the initial evaluation of patients with adrenal insufficiency. 11 refs., 4 tabs., 4 figs
Background Addison's disease (AD) is caused by an autoimmune destruction of the adrenal cortex. The pathogenesis is multi-factorial, involving genetic components and hitherto unknown environmental factors. The aim of the present study was to investigate if gene dosage in the form of copy number variation (CNV) could add to the repertoire of genetic susceptibility to autoimmune AD. Methods A genome-wide study using the Affymetrix GeneChip® Genome-Wide Human SNP Array 6.0 was conducted in 26 patients with AD. CNVs in selected genes were further investigated in a larger material of patients with autoimmune AD (n = 352) and healthy controls (n = 353) by duplex Taqman real-time polymerase chain reaction assays. Results We found that low copy number of UGT2B28 was significantly more frequent in AD patients compared to controls; conversely high copy number of ADAM3A was associated with AD. Conclusions We have identified two novel CNV associations to ADAM3A and UGT2B28 in AD. The mechanism by which this susceptibility is conferred is at present unclear, but may involve steroid inactivation (UGT2B28) and T cell maturation (ADAM3A). Characterization of these proteins may unravel novel information on the pathogenesis of autoimmunity. PMID:21851588
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Giorgis, Cyndi; Johnson, Nancy J.
Offers brief descriptions of 34 children's books that are excellent for reading aloud: some of them for inviting interaction, for laughing out loud, for prompting discussion, for living vicariously, for lingering over language, and for making curricular connections. (SR)
Anna L Mitchell
Full Text Available Autoimmune Addison's disease (AAD is a rare, highly heritable autoimmune endocrinopathy. It is possible that there may be some highly penetrant variants which confer disease susceptibility that have yet to be discovered.DNA samples from 23 multiplex AAD pedigrees from the UK and Norway (50 cases, 67 controls were genotyped on the Affymetrix SNP 6.0 array. Linkage analysis was performed using Merlin. EMMAX was used to carry out a genome-wide association analysis comparing the familial AAD cases to 2706 UK WTCCC controls. To explore some of the linkage findings further, a replication study was performed by genotyping 64 SNPs in two of the four linked regions (chromosomes 7 and 18, on the Sequenom iPlex platform in three European AAD case-control cohorts (1097 cases, 1117 controls. The data were analysed using a meta-analysis approach.In a parametric analysis, applying a rare dominant model, loci on chromosomes 7, 9 and 18 had LOD scores >2.8. In a non-parametric analysis, a locus corresponding to the HLA region on chromosome 6, known to be associated with AAD, had a LOD score >3.0. In the genome-wide association analysis, a SNP cluster on chromosome 2 and a pair of SNPs on chromosome 6 were associated with AAD (P <5x10-7. A meta-analysis of the replication study data demonstrated that three chromosome 18 SNPs were associated with AAD, including a non-synonymous variant in the NFATC1 gene.This linkage study has implicated a number of novel chromosomal regions in the pathogenesis of AAD in multiplex AAD families and adds further support to the role of HLA in AAD. The genome-wide association analysis has also identified a region of interest on chromosome 2. A replication study has demonstrated that the NFATC1 gene is worthy of future investigation, however each of the regions identified require further, systematic analysis.
Meyer, Gesine; Koch, Maike; Herrmann, Eva; Bojunga, Jörg; Badenhoop, Klaus
Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months. AC was defined if at least two of the following symptoms were reported: (a) hypotension, (b) nausea or vomiting, (c) severe fatigue, (d) documented hyponatremia, hyperkalemia, or hypoglycemia, and subsequent parenteral glucocorticoid administration was carried out. Prevalence of AC was 10.9/100 patient years. AddiQoL scores in patients with AC showed a trend (p = 0,08) to a wider fluctuation over time. Subjective precrises not meeting the criteria for AC were reported by 31 patients who had significantly lower AddiQoL scores (p = 0,018). These are the first data showing the course of QoL during a period of ten months in patients with AD. Incidence of AC exceeds previous data. Our data show, that subjective precrises in AD associate with lower QoL. AC, as well as precrises affect intraindividual AddiQol-scores over time with a trend to a stronger fluctuation. Longitudinal AddiQol scores and self-reporting of precrises via patient diaries are additional clinical tools to identify higher risk for critical events.
Edvardsen, Kine; Hellesen, Alexander; Husebye, Eystein S; Bratland, Eirik
Autoimmune Addison's disease (AAD) is caused by multiple genetic and environmental factors. Variants of genes encoding immunologically important proteins such as the HLA molecules are strongly associated with AAD, but any environmental risk factors have yet to be defined. We hypothesized that primary or reactivating infections with cytomegalovirus (CMV) could represent an environmental risk factor in AAD, and that CMV specific CD8(+) T cell responses may be dysregulated, possibly leading to a suboptimal control of CMV. In particular, the objective was to assess the HLA-B8 restricted CD8(+) T cell response to CMV since this HLA class I variant is a genetic risk factor for AAD. To examine the CD8(+) T cell response in detail, we analyzed the HLA-A2 and HLA-B8 restricted responses in AAD patients and healthy controls seropositive for CMV antibodies using HLA multimer technology, IFN-γ ELISpot and a CD107a based degranulation assay. No differences between patients and controls were found in functions or frequencies of CMV-specific T cells, regardless if the analyses were performed ex vivo or after in vitro stimulation and expansion. However, individual patients showed signs of reactivating CMV infection correlating with poor CD8(+) T cell responses to the virus, and a concomitant upregulation of interferon regulated genes in peripheral blood cells. Several recently diagnosed AAD patients also showed serological signs of ongoing primary CMV infection. CMV infection does not appear to be a major environmental risk factor in AAD, but may represent a precipitating factor in individual patients.
Pazderska, Agnieszka; Fichna, Marta; Mitchell, Anna L; Napier, Catherine M; Gan, Earn; Ruchała, Marek; Santibanez-Koref, Mauro; Pearce, Simon H
The pathogenesis of autoimmune Addison's disease (AAD) is thought to be due to interplay of genetic, immune, and environmental factors. A month-of-birth effect, with increased risk for those born in autumn/winter months, has been described in autoimmune conditions such as type 1 diabetes and autoimmune thyroid disease. Month-of-birth effect was investigated in 2 independent cohorts of AAD subjects. The monthly distribution of birth in AAD patients was compared with that of the general population using the cosinor test. A total of 415 AAD subjects from the United Kingdom cohort were compared with 8 180 180 United Kingdom births, and 231 AAD subjects from the Polish cohort were compared with 2 421 384 Polish births. Association between month of birth and the susceptibility to AAD. In the entire cohort of AAD subjects, month-of-birth distribution analysis showed significant periodicity with peak of births in December and trough in May (P = .028). Analysis of the odds ratio distribution based on month of birth in 2 cohorts of patients with AAD versus the general population revealed a December peak and May trough, and January peak and July trough, in the United Kingdom and Polish cohorts, respectively. For the first time, we demonstrate that month of birth exerts an effect on the risk of developing AAD, with excess risk in individuals born in winter months and a protective effect when born in the summer. Exposure to seasonal viral infections in the perinatal period, coupled with vitamin D deficiency, could lead to dysregulation of innate immunity affecting the risk of developing AAD.
Brozzetti, Annalisa; Alimohammadi, Mohammad; Morelli, Silvia; Minarelli, Viviana; Hallgren, Åsa; Giordano, Roberta; De Bellis, Annamaria; Perniola, Roberto; Kämpe, Olle; Falorni, Alberto
NACHT leucine-rich-repeat protein 5 (NALP5)/maternal antigen that embryo requires (MATER) is an autoantigen in hypoparathyroidism associated with autoimmune polyendocrine syndrome type 1 (APS1) but is also expressed in the ovary. Mater is an autoantigen in experimental autoimmune oophoritis. The objectives of the study were to determine the frequency of NALP5/MATER autoantibodies (NALP5/MATER-Ab) in women with premature ovarian insufficiency (POI) and in patients with autoimmune Addison's disease (AAD) and to evaluate whether inhibin chains are a target for autoantibodies in POI. Autoantibodies against NALP5/MATER and inhibin chains-α and -βA were determined by radiobinding assays in 172 patients with AAD without clinical signs of gonadal insufficiency, 41 women with both AAD and autoimmune POI [steroidogenic cell autoimmune POI (SCA-POI)], 119 women with idiopathic POI, 19 patients with APS1, and 211 healthy control subjects. NALP5/MATER-Ab were detected in 11 of 19 (58%) sera from APS1 patients, 12 of 172 (7%) AAD sera, 5 of 41 (12%) SCA-POI sera, 0 of 119 idiopathic POI sera and 1 of 211 healthy control sera (P < .001). None of 160 POI sera, including 41 sera from women with SCA-POI and 119 women with idiopathic POI, and none of 211 healthy control sera were positive for inhibin chain-α/βA autoantibodies. NALP5/MATER-Ab are associated with hypoparathyroidism in APS1 but are present also in patients with AAD and in women with SCA-POI without hypoparathyroidism. Inhibin chains do not appear to be likely candidate targets of autoantibodies in human POI.
Napier, C; Mitchell, A L; Gan, E; Wilson, I; Pearce, S H S
Autoimmune endocrinopathies demonstrate a profound gender bias, but the reasons for this remain obscure. The 1000 genes on the X chromosome are likely to be implicated in this inherent susceptibility; various theories, including skewed X chromosome inactivation and fetal microchimerism, have been proposed. GPR174 is an Xq21 putative purinergic receptor that is widely expressed in lymphoid tissues. A single-nucleotide polymorphism, rs3827440, encoding Ser162Pro, has recently been associated with Graves' disease in Chinese and Polish populations, suggesting a role of this X chromosome gene in autoimmune disease. We investigated the role of rs3827440 in a UK cohort of patients with autoimmune Addison's disease (AAD). Samples from 286 AAD cases and 288 healthy controls were genotyped using TaqMan single-nucleotide polymorphism genotyping assays (C_25954273_10) on the Applied Biosystems 7900HT Fast real-time PCR system. Using a dominant (present/absent) model, the serine-encoding T allele of rs3827440 was present in 189 of 286 AAD patients (66%) compared with 132 of 288 unaffected controls (46%) [P = .010, odds ratio 1.80 (5%-95% confidence interval 1.22-2.67)]. An allele dosage model found a significant excess of the T allele in AAD patients compared with controls [P = .03, odds ratio 1.34 (5%-95% confidence interval 1.07-1.67)]. We have demonstrated a significant association of this X chromosome-encoded immunoreceptor with AAD for the first time. This X-linked gene could have a more generalized role in autoimmunity pathogenesis: G protein-coupled receptors are promising drugable targets, and further work to elucidate the functional role of GPR174 is now warranted.
Chantzichristos, Dimitrios; Persson, Anders; Eliasson, Björn; Miftaraj, Mervete; Franzén, Stefan; Bergthorsdottir, Ragnhildur; Gudbjörnsdottir, Soffia; Svensson, Ann-Marie; Johannsson, Gudmundur
Our hypothesis was that patients with diabetes mellitus obtain an additional risk of death if they develop Addison's disease (AD). Nationwide, matched, observational cohort study cross-referencing the Swedish National Diabetes Register with Inpatient, Cancer and Cause of Death Registers in patients with diabetes (type 1 and 2) and AD and matched controls with diabetes. Clinical characteristics at baseline, overall, and cause-specific mortality were assessed. The relative risk of death was assessed using a Cox proportional hazards regression model. Between January 1996 and December 2012, 226 patients with diabetes and AD were identified and matched with 1129 controls with diabetes. Median (interquartile range) follow-up was 5.9 (2.7-8.6) years. When patients with diabetes were diagnosed with AD, they had an increased frequency of diabetes complications, but both medical history of cancer and coronary heart disease did not differ compared with controls. Sixty-four of the 226 patients with diabetes and AD (28%) died, while 112 of the 1129 controls (10%) died. The estimated relative risk increase (hazard ratio) in overall mortality in the diabetes and AD group was 3.89 (95% confidence interval 2.84-5.32) compared with controls with diabetes. The most common cause of death was cardiovascular in both groups, but patients with diabetes and AD showed an increased death rate from diabetes complications, infectious diseases and unknown causes. Patients with the rare combination of diabetes and AD showed a markedly increased mortality and died more frequently from infections and unknown causes than patients with diabetes alone. Improved strategy for the management of this combination of metabolic disorders is needed. © 2017 European Society of Endocrinology.
Mitchell, Anna L; Bøe Wolff, Anette; MacArthur, Katie; Weaver, Jolanta U; Vaidya, Bijay; Erichsen, Martina M; Darlay, Rebecca; Husebye, Eystein S; Cordell, Heather J; Pearce, Simon H S
Autoimmune Addison's disease (AAD) is a rare, highly heritable autoimmune endocrinopathy. It is possible that there may be some highly penetrant variants which confer disease susceptibility that have yet to be discovered. DNA samples from 23 multiplex AAD pedigrees from the UK and Norway (50 cases, 67 controls) were genotyped on the Affymetrix SNP 6.0 array. Linkage analysis was performed using Merlin. EMMAX was used to carry out a genome-wide association analysis comparing the familial AAD cases to 2706 UK WTCCC controls. To explore some of the linkage findings further, a replication study was performed by genotyping 64 SNPs in two of the four linked regions (chromosomes 7 and 18), on the Sequenom iPlex platform in three European AAD case-control cohorts (1097 cases, 1117 controls). The data were analysed using a meta-analysis approach. In a parametric analysis, applying a rare dominant model, loci on chromosomes 7, 9 and 18 had LOD scores >2.8. In a non-parametric analysis, a locus corresponding to the HLA region on chromosome 6, known to be associated with AAD, had a LOD score >3.0. In the genome-wide association analysis, a SNP cluster on chromosome 2 and a pair of SNPs on chromosome 6 were associated with AAD (P <5x10-7). A meta-analysis of the replication study data demonstrated that three chromosome 18 SNPs were associated with AAD, including a non-synonymous variant in the NFATC1 gene. This linkage study has implicated a number of novel chromosomal regions in the pathogenesis of AAD in multiplex AAD families and adds further support to the role of HLA in AAD. The genome-wide association analysis has also identified a region of interest on chromosome 2. A replication study has demonstrated that the NFATC1 gene is worthy of future investigation, however each of the regions identified require further, systematic analysis.
Saevik, Å B; Åkerman, A-K; Grønning, K; Nermoen, I; Valland, S F; Finnes, T E; Isaksson, M; Dahlqvist, P; Bergthorsdottir, R; Ekwall, O; Skov, J; Nedrebø, B G; Hulting, A-L; Wahlberg, J; Svartberg, J; Höybye, C; Bleskestad, I H; Jørgensen, A P; Kämpe, O; Øksnes, M; Bensing, S; Husebye, E S
Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce. Perform a retrospective audit of patient records with the aim of identifying biochemical markers for early diagnosis of AAD. A multicentre retrospective study including 272 patients diagnosed with AAD at hospitals in Norway and Sweden during 1978-2016. Scrutiny of medical records provided patient data and laboratory values. Low sodium occurred in 207 of 247 (84%), but only one-third had elevated potassium. Other common nonendocrine tests were largely normal. TSH was elevated in 79 of 153 patients, and hypoglycaemia was found in 10%. Thirty-three per cent were diagnosed subsequent to adrenal crisis, in whom electrolyte disturbances were significantly more pronounced (P < 0.001). Serum cortisol was consistently decreased (median 62 nmol L -1 [1-668]) and significantly lower in individuals with adrenal crisis (38 nmol L -1 [2-442]) than in those without (81 nmol L -1 [1-668], P < 0.001). The most consistent biochemical finding of untreated AAD was low sodium independent of the degree of glucocorticoid deficiency. Half of the patients had elevated TSH levels. Only a minority presented with marked hyperkalaemia or other nonhormonal abnormalities. Thus, unexplained low sodium and/or elevated TSH should prompt consideration of an undiagnosed AAD, and on clinical suspicion bring about assay of cortisol and ACTH. Presence of 21-hydroxylase autoantibodies confirms autoimmune aetiology. Anticipating additional abnormalities in routine blood tests may delay diagnosis. © 2017 The Association for the Publication of the Journal of Internal Medicine.
Henry, Michelle; Ross, Ian Louis; Wolf, Pedro Sofio Abril; Thomas, Kevin Garth Flusk
Standard replacement therapy for Addison's disease (AD) does not restore a normal circadian rhythm. Periods of sub- and supra- physiological cortisol levels experienced by patients with AD likely induce disrupted sleep. Given that healthy sleep plays an important role in memory consolidation, the novelty of the current study was to characterise, using objective measures, the relationship between sleep and memory in patients with AD, and to examine the hypothesis that poor sleep is a biological mechanism underlying memory impairment in those patients. We used a within-subjects design. Ten patients with AD and 10 matched healthy controls completed standardised neuropsychological tests assessing declarative memory (Rey Auditory Verbal Learning Test) and procedural memory (Finger Tapping Task) before and after a period of actigraphy-measured sleep, and before and after a period of waking. Relative to healthy controls, patients with AD experienced disrupted sleep characterised by poorer sleep efficiency and more time spent awake. Patients also showed impaired verbal learning and memory relative to healthy controls (p=0.007). Furthermore, whereas healthy controls' declarative memory performance benefited from a period of sleep compared to waking (p=0.032), patients with AD derived no such benefit from sleep (p=0.448). Regarding the procedural memory task, analyses detected no significant between-group differences (all p's<0.065), and neither group showed significant sleep-enhanced performance. We demonstrated, using actigraphy and standardized measures of memory performance, an association between sleep disturbances and cognitive deficits in patients with AD. These results suggest that, in patients with AD, the source of memory deficits is, at least to some extent, disrupted sleep patterns that interfere with optimal consolidation of previously-learned declarative information. Hence, treating the sleep disturbances that are frequently experienced by patients with AD may
Gan, Earn H; MacArthur, Katie; Mitchell, Anna L; Pearce, Simon H S
Background Autoimmune Addison's disease (AAD) is a rare condition with a complex genetic basis. A panel of rare and functionally defective genetic variants in the sialic acid acetylesterase (SIAE) gene has recently been implicated in several common autoimmune conditions. We performed a case–control study to determine whether these rare variants are associated with a rarer condition, AAD. Method We analysed nine SIAE gene variants (W48X, M89V, C196F, C226G, R230W, T312M, Y349C, F404S and R479C) in a United Kingdom cohort of 378 AAD subjects and 387 healthy controls. All samples were genotyped using Sequenom iPlex chemistry to characterise primer extension products. Results A heterozygous rare allele at codon 312 (312*M) was found in one AAD patient (0.13%) but was not detected in the healthy controls. The commoner, functionally recessive variant at codon 89 (89*V) was found to be homozygous in two AAD patients but was only found in the heterozygous state in controls. Taking into account all nine alleles examined, 4/378 (1.06%) AAD patients and 1/387 (0.25%) healthy controls carried the defective SIAE alleles, with a calculated odds ratio of 4.13 (95% CI 0.44–97.45, two-tailed P value 0.212, NS). Conclusion We demonstrated the presence of 89*V homozygotes and the 312*M rare allele in the AAD cohort, but overall, our analysis does not support a role for rare variants in SIAE in the pathogenesis of AAD. However, the relatively small collection of AAD patients limits the power to exclude a small effect. PMID:23011869
Dalla Costa, M; Bonanni, G; Masiero, S; Faggian, D; Chen, S; Furmaniak, J; Rees Smith, B; Perniola, R; Radetti, G; Garelli, S; Chiarelli, S; Albergoni, M P; Plebani, M; Betterle, C
Steroidogenic enzyme autoantibodies (SEAbs) are frequently present and are markers of autoimmune premature ovarian failure (POF) in females with autoimmune Addison's disease (AAD). The prevalence and significance of SEAbs in males with AAD have not yet been defined. We studied the prevalence of SEAbs in a large cohort of males with AAD and assessed the relationship between SEAbs positivity and testicular function. A total of 154 males with AAD (mean age 34 years) were studied. SEAbs included autoantibodies to steroid-producing cells (StCA), detected by immunofluorescence, and steroid 17α-hydroxylase (17α-OHAbs) and side chain cleavage enzyme (SCCAbs) measured by immunoprecipitation assays. Gonadal function was evaluated by measuring follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHGB), anti-müllerian hormone (AMH) and inhibin-B (I-B). Twenty-six males, 10 SEAbs((+)) and 16 SEAbs((-)), were followed-up for a mean period of 7·6 years to assess the behaviour of SEAbs and testicular function. SEAbs were found in 24·7% of males with AAD, with the highest frequency in patients with autoimmune polyendocrine syndrome type 1 (APS-1). The levels of reproductive hormones in 30 SEAbs((+)) males were in the normal range according to age and were not significantly different compared to 55 SEAbs((-)) males (P > 0·05). During follow-up, both SEAbs((+)) and SEAbs((-)) patients maintained normal testicular function. SEAbs were found with high frequency in males with AAD; however, they were not associated with testicular failure. This study suggests that the diagnostic value of SEAbs in males with AAD differs compared to females, and this may be related to the immunoprivileged status of the testis. © 2014 British Society for Immunology.
2JDS Uniphase Corporation, 625 Industrial Way, Eatontown, NJ 07724, USA ..... the Swedish funding agency VINNOVA for financing this project. VA, PS ...  B D Cullity, Introduction to magnetic materials (Addison-Wesley Publishing Co.) p.
Genetic algorithms (GAs) are computational optimisation schemes with an ... The algorithms solve optimisation problems ..... Genetic Algorithms in Search, Optimisation and Machine. Learning, Addison-Wesley Publishing Company, Inc. 1989.
pared to spherical ones. The red shift is attributed to strain induced changes in internal pressure inside the ..... Shape control can also induce anisotropy and thus modify the coercivity of these ... ppines: Addison-Wesley Publishing Company).
May 15, 2012 ... to diseases and insects and reduction in fertility of flowering plants ..... soaking duration was noticed to cause the treated seeds to give low height .... Addison-. Wesley, London. Stadler J, Phillips RL, Leonard M (1989).Mitotic ...
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In our everyday life we constantly encounter a diversity of reading matters, including display types on traffic signage, printed text in novels, newspaper headlines, or our own writing on a computer screen. All these conditions place different demands on the typefaces applied. The book discusses...
Reading Rembrandt: Beyond the Word-Image Opposition explores the potential for an interdisciplinary methodology between visual art and literature. In a series of close analyses of works by "Rembrandt" - works as we see them today, through all the ways of seeing and commenting that precede - and
Heald, Adrian H; Walther, Andreas; Davis, Julian R E; Moreno, Gabriela Y C; Kane, John; Livingston, Mark; Fowler, Helen L
Patients with Addison's disease have relatively high rates of depression and anxiety symptoms compared with population-based reference samples. Addison's disease results in deficiency of dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S). There is considerable debate about the specific effects of DHEA deficiency on energy level and mood. We measured emotional well-being in 16 patients with Addison's disease and a group of 16 hospital attendees with type 2 diabetes. Participants completed the General Health Questionnaire-28 (GHQ-28), the Hospital Anxiety and Depression Scale (HADS), the World Health Organization's quality of life assessment (WHOQOL-BREF) and the Holmes-Rahe life event scale. DHEA-S was low in Addison's patients (Addison's men: 0.5 ± 0.1 μmol/l [normal range: 2.1-10.8] compared with diabetes men: 3.2 ± 1.2 μmol/l; Addison's women: 0.4 ± 0.01 μmol/l [normal range: 1.0-11.5] compared with diabetes women: 2.2 ± 0.71 μmol/l). Testosterone levels were similar in both groups studied. There were no differences in emotional well-being and quality of life (QOL) between patients with Addison's disease and Type 2 Diabetes Mellitus as measured by GHQ-28 (Addison's: 22.4 ± 2.6, Diabetes: 19.6 ± 2.7), HADS Depression (Addison's: 5.4 ± 0.9, Diabetes: 4.5 ± 1.4), HADS Anxiety and WHOQOL-BREF. There were no gender differences in affective symptomatology within the Addison's group. Life event scores were above average in both groups (Addison's: 195 ± 39.6, Diabetes: 131 ± 43.8), but not significant for difference between groups as was GHQ-28 total score. Both groups scored highly on the GHQ-28 and the life event scale, indicative of poorer health perceptions than the general population. This could be due to the chronicity of both disorders. We have not identified any specific effects of DHEA-S deficiency on mood or QOL.
9 Labor force participation rate equates to the labor force divided by the population. 10 Ehrenberg and Smith, “Modern Labor Economics .” 27...Econometrica 66 (1998): 249. 12 Ehrenbrg, Ronald G. and Robert S. Smith. “Modern Labor Economics : Theory and Public Policy.” Addison Wesley...whs.osd.mil/mid/military/miltop.htm> Ehrenbrg, Ronald G. and Robert S. Smith. “Modern Labor Economics : Theory and Public Policy.” Addison Wesley
Research has shown a wide range of learning benefits accruing from extensive reading. Not only is there improvement in reading, but also in a wide range of language uses and areas of language knowledge. However, few research studies have examined reading speed. The existing literature on reading speed focused on students' reading speed without…
Anna L Mitchell
Full Text Available Gene variants known to contribute to Autoimmune Addison's disease (AAD susceptibility include those at the MHC, MICA, CIITA, CTLA4, PTPN22, CYP27B1, NLRP-1 and CD274 loci. The majority of the genetic component to disease susceptibility has yet to be accounted for.To investigate the role of 19 candidate genes in AAD susceptibility in six European case-control cohorts.A sequential association study design was employed with genotyping using Sequenom iPlex technology. In phase one, 85 SNPs in 19 genes were genotyped in UK and Norwegian AAD cohorts (691 AAD, 715 controls. In phase two, 21 SNPs in 11 genes were genotyped in German, Swedish, Italian and Polish cohorts (1264 AAD, 1221 controls. In phase three, to explore association of GATA3 polymorphisms with AAD and to determine if this association extended to other autoimmune conditions, 15 SNPs in GATA3 were studied in UK and Norwegian AAD cohorts, 1195 type 1 diabetes patients from Norway, 650 rheumatoid arthritis patients from New Zealand and in 283 UK Graves' disease patients. Meta-analysis was used to compare genotype frequencies between the participating centres, allowing for heterogeneity.We report significant association with alleles of two STAT4 markers in AAD cohorts (rs4274624: P = 0.00016; rs10931481: P = 0.0007. In addition, nominal association of AAD with alleles at GATA3 was found in 3 patient cohorts and supported by meta-analysis. Association of AAD with CYP27B1 alleles was also confirmed, which replicates previous published data. Finally, nominal association was found at SNPs in both the NF-κB1 and IL23A genes in the UK and Italian cohorts respectively.Variants in the STAT4 gene, previously associated with other autoimmune conditions, confer susceptibility to AAD. Additionally, we report association of GATA3 variants with AAD: this adds to the recent report of association of GATA3 variants with rheumatoid arthritis.
Methlie, Paal; Hustad, Steinar; Kellman, Ralf; Almås, Bjørg; Erichsen, Martina M; Husebye, Eystein S; Løvås, Kristian
Objective Liquid chromatography–tandem mass spectrometry (LC–MS/MS) offers superior analytical specificity compared with immunoassays, but it is not available in many regions and hospitals due to expensive instrumentation and tedious sample preparation. Thus, we developed an automated, high-throughput LC–MS/MS assay for simultaneous quantification of ten endogenous and synthetic steroids targeting diseases of the hypothalamic–pituitary–adrenal axis and gonads. Methods Deuterated internal standards were added to 85 μl serum and processed by liquid–liquid extraction. Cortisol, cortisone, prednisolone, prednisone, 11-deoxycortisol, dexamethasone, testosterone, androstenedione and progesterone were resolved by ultra-high-pressure chromatography on a reversed-phase column in 6.1 min and detected by triple-quadrupole mass spectrometry. The method was used to assess steroid profiles in women with Addison's disease (AD, n=156) and blood donors (BDs, n=102). Results Precisions ranged from 4.5 to 10.1% relative standard deviations (RSD), accuracies from 95 to 108% and extraction recoveries from 60 to 84%. The method was practically free of matrix effects and robust to individual differences in serum composition. Most postmenopausal AD women had extremely low androstenedione concentrations, below 0.14 nmol/l, and median testosterone concentrations of 0.15 nmol/l (interquartile range 0.00–0.41), considerably lower than those of postmenopausal BDs (1.28 nmol/l (0.96–1.64) and 0.65 nmol/l (0.56–1.10) respectively). AD women in fertile years had androstenedione concentrations of 1.18 nmol/l (0.71–1.76) and testosterone concentrations of 0.44 nmol/l (0.22–0.63), approximately half of those found in BDs of corresponding age. Conclusion This LC–MS/MS assay provides highly sensitive and specific assessments of glucocorticoids and androgens with low sample volumes and is suitable for endocrine laboratories and research. Its utility has been
Castillo, Víctor; Ortemberg, L.
La enfermedad de Addison (EA), la hiperplasia adrenal congénita (HAC) por déficit de 21 αhidroxilasa adrenal y el hipoparatiroidismo (HoPTH) son de diagnóstico poco frecuente, representando el 3% (EA) y 0,5% (tanto HAC como HoPTH) de las enfermedades endócrinas atendidas. Se describen 1 caso de EA congénito (collie de 6 meses de edad), 2 casos de HAC (una caniche toy y una labradora, ambas de 2 años) y 2 de HoPTH (cocker spaniel de 11 meses y una mestiza de 7 años). Por la signología clínica ...
De Bellis, Annamaria; Bellastella, Giuseppe; Falorni, Alberto; Aitella, Ernesto; Barrasso, Mariluce; Maiorino, Maria Ida; Bizzarro, Elio; Bellastella, Antonio; Giugliano, Dario; Esposito, Katherine
Women with autoimmune Addison's disease with normal ovulatory cycles but positive for steroid cell antibodies (StCA) have been considered at risk of premature ovarian insufficiency (POI). Thirty-three women younger than 40 years, with subclinical-clinical autoimmune Addison's disease but with normally ovulatory menses, were followed up for 10 years to evaluate the long-term time-related variations of StCA, ovarian function and follicular reserve. All patients and 27 control women were investigated at the start and every year for the presence and titre of StCA (by indirect immunofluorescence), serum concentrations of anti-Mullerian hormone (AMH) and ovarian function at four consecutive menses every year. At the start of the study StCA were present in 16 women (group 1), at low/middle titres (≤1:32) in seven of them (43.8%, group 1A), at high titres (>1:32) in the remaining nine patients (group 1B, 56.2%), while they were absent from 17 patients (group 2). During the follow-up period, all women in group 1A remained StCA-positive at low/middle titres with normal ovulatory menses and normal gonadotrophin and AMH levels, while all patients in group 1B showed a further increase of StCA titres (1:128-1:256) and progressed through three stages of ovarian function. None of the patients in group 2 and controls showed the appearance of StCA or ovarian dysfunction during the follow-up. The presence of StCA at high titres can be considered a good predictive marker of subsequent development of autoimmune POI. To single out the stages of autoimmune POI may allow a timely therapeutic choice in the subclinical and early clinical stages. © 2017 European Society of Endocrinology.
Badley, K. Jo-Ann; Badley, Ken
The medieval monastic movement preserved and developed reading practices--lectio--from ancient Greek pedagogy as a slow, mindful approach to reading for formation. This ancient way of reading, now better known as lectio divina, challenges the fast, pragmatic reading so characteristic of our time. We propose that the present moment may be ripe for…
Reading is a fundamental activity of our society and is present in all areas of a person’s life. Authors who deal with reading define reading with different definitions, some of them I also presented in my master’s degree thesis. The ways of reading, typology of readers and knowledge of different reading models are only some of the important theoretical facts that serve as a basis for the research and defining reading. Reading motivation is an important motivational factor, which encourages a...
Giordano, Roberta; Marzotti, Stefania; Berardelli, Rita; Karamouzis, Ioannis; Brozzetti, Annalisa; D'Angelo, Valentina; Mengozzi, Giulio; Mandrile, Giorgia; Giachino, Daniela; Migliaretti, Giuseppe; Bini, Vittorio; Falorni, Alberto; Ghigo, Ezio; Arvat, Emanuela
Although glucocorticoids are essential for health, several studies have shown that glucocorticoids replacement in Addison's disease might be involved in anthropometric and metabolic impairment, with increased cardiovascular risk, namely if conventional doses are used. As the effects of glucocorticoids are mediated by the glucocorticoid receptor, encoded by NR3C1 gene, different polymorphisms in the NR3C1 gene have been linked to altered glucocorticoid sensitivity in general population as well as in patients with obesity or metabolic syndrome. We investigated the impact of glucocorticoid receptor gene polymorphisms, including the BclI, N363S and ER22/23EK variants, on anthropometric parameters (BMI and waist circumference), metabolic profile (HOMA, OGTT and serum lipids) and ACTH levels in 50 patients with Addison's disease (34 women and 16 men, age 20-82 year) under glucocorticoids replacement. Neither N363S nor ER22/23EK variants were significantly associated with anthropometric, metabolic or hormonal parameters, while patients carrying the homozygous BclI polymorphism GG (n = 4) showed higher (P Addison's disease and may contribute, along with other factors, to the increase in central adiposity, impaired glucose metabolism and dyslipidaemia. © 2012 Blackwell Publishing Ltd.
Sridhar, M. S.
Discusses the importance and ways of inculcating reading habit in children at the right age, describes the five reading phases in children along with interest and the material to satiate the need, explains how four deterministic factors affect the reading habit of children, enlists motivations that are behind the reading process with tips to improve reading habit of children.
Jacobs, George M.
How can teachers motivate students to read extensively in a second language? One strategy is for teachers to read aloud to students to promote the joys of reading generally, to build students' language skills and to introduce students to specific authors, book series, genres, websites, etc. This article begins by discussing why teachers might want…
Abstract. The current study explores the feasibility of an extensive reading programme in the context of a low-income country (Mozambique), as well as the influence of extensive reading on academic reading. The programme took over 4 months and was conducted among 30 students majoring in Journalism at the Eduardo ...
Ross, I L; Lacerda, M; Pillay, T S; Blom, D J; Johannsson, G; Dave, J A; Levitt, N S; Haarburger, D; van der Walt, J-S
Salivary cortisol has been used to monitor hydrocortisone replacement in patients with Addison's disease (AD). Since salivary cortisol is metabolised to salivary cortisone, it may be an adjunctive analyte to assess adequacy of hydrocortisone replacement in patients with AD. We aimed to characterise the exposure of salivary cortisol and cortisone in patients and healthy controls. We measured salivary cortisol and cortisone by liquid chromatography-tandem mass spectrometry and constructed a day curve (08:00 until 24:00 h) with 16 time points in 25 AD patients taking their usual hydrocortisone dose and in 26 healthy controls. The median (interquartile range) area under the curve (AUC) for cortisol was not different for patients, compared with controls [55.63 (32.91-151.07) nmol*min*l -1 vs. 37.49 (27.41-52.00) nmol*min*l -1 ; p=0.098, respectively], whereas the peak cortisol C max was higher in patients [32.61 (5.75-146.19) nmol/l vs. 8.96 (6.96-12.23) nmol/l; p=0.013], compared with controls. The AUC for cortisone [23.65 (6.10-54.76) nmol*min*l -1 vs. 227.73 (200.10-280.52) nmol*min*l -1 ; p≤ 0.001, respectively], and peak cortisone C max was lower in patients than in controls [11.11 (2.91-35.85) nmol/l vs. 33.12 (25.97-39.95) nmol/l; p=0.002]. The AUC for salivary cortisol and salivary cortisone were not correlated with any measures of hydrocortisone dose. The time-course and AUC of salivary cortisol were similar between Addison's patients and healthy controls. Patients had substantially lower salivary cortisone AUC, compared to healthy controls. Salivary cortisol AUC and pharmacokinetics were not related to hydrocortisone dose and thus are not likely useful markers for the adequacy of hydrocortisone replacement. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Abstract Background Three genes have been confirmed as major joint susceptibility genes for endocrine autoimmune disease:human leukocyte antigen class II, cytotoxic T-lymphocyte antigen 4 and protein tyrosine phosphatase non-receptor type 22. Recent studies showed that a genetic variation within the interferon induced helicase domain 1 (IFIH1 locus (rs1990760 polymorphism is an additional risk factor in type 1 diabetes and Graves' disease (GD. Methods The aim of the present study was to investigate the role of the rs1990760 polymorphism within the IFIH1 gene in German patients with GD (n = 258, Hashimoto's thyroiditis (HT, n = 106, Addison's disease (AD, n = 195 and healthy controls (HC, n = 227 as well as in 55 GD families (165 individuals, German and 100 HT families (300 individuals, Italian. Furthermore, the interaction between rs1990760 polymorphism with human leukocyte antigen (HLA risk haplotype DQ2(DQA*0501-DQB*0201, the risk haplotypes DQ2/DQ8 (DQA*0301-DQB*0302 and the status of thyroglobulin antibody (TgAb, thyroid peroxidase antibody (TPOAb and TSH receptor antibody (TRAb in patients and families were analysed. Results No significant differences were found between the allele and genotype frequencies for rs1990760 IFIH1 polymorphism in patients with GD, HT, AD and HC. Also no differences were observed when stratifying the IFIH1 rs1990760 polymorphism for gender, presence or absence of thyroid antibodies (GD:TRAb and HT:TPOAb/TgAb and HLA risk haplotypes (DQ2:for GD and HT, DQ2/DQ8:for AD. Furthermore the transmission analysis in GD and HT families revealed no differences in alleles transmission for rs1990760 IFIH1 from parents with or without HLA risk haplotype DQ2 to the affected offspring. In contrast, by dividing the HT parents according to the presence or absence of thyroid Ab titers, mothers and fathers both positive for TPOAb/TgAb overtransmitted the allele A of IFIH1 rs1990760 to their HT affected offspring (61.8% vs 38.2%;p = 0
De Nardo Pasquale
Full Text Available Abstract Introduction Prosthetic joint infection due to Mycobacterium tuberculosis is occasionally encountered in clinical practice. To the best of our knowledge, this is the first report of a prosthetic joint infection due to Mycobacterium tuberculosis complicated by psoas abscesses and secondary Addison disease. Case presentation A 67-year-old immunocompetent Caucasian woman underwent total left hip arthroplasty because of osteoarthritis. After 18 months, she underwent arthroplasty revision for a possible prosthetic infection. Periprosthetic tissue specimens for bacteria were negative, and empirical antibiotic therapy was unsuccessful. She was then admitted to our department because of complications arising 22 months after arthroplasty. A physical examination revealed a sinus tract overlying her left hip and skin and mucosal pigmentation. Her levels of C-reactive protein, basal cortisol, adrenocorticotropic hormone, and sodium were out of normal range. Results of the tuberculin skin test and QuantiFERON-TB Gold test were positive. Computed tomography revealed a periprosthetic abscess and the inclusion of the left psoas muscle. Results of microbiological tests were negative, but polymerase chain reaction of a specimen taken from the hip fistula was positive for Mycobacterium tuberculosis. Our patient's condition was diagnosed as prosthetic joint infection and muscle psoas abscess due to Mycobacterium tuberculosis and secondary Addison disease. She underwent standard treatment with rifampicin, ethambutol, isoniazid, and pyrazinamide associated with hydrocortisone and fludrocortisone. At 15 months from the beginning of therapy, she was in good clinical condition and free of symptoms. Conclusions Prosthetic joint infection with Mycobacterium tuberculosis is uncommon. A differential diagnosis of tuberculosis should be considered when dealing with prosthetic joint infection, especially when repeated smears and histology examination from infected
Henry, Michelle; Wolf, Pedro S A; Ross, Ian L; Thomas, Kevin G F
Standard replacement therapy for Addison's disease (AD) does not restore a normal circadian rhythm. In fact, hydrocortisone replacement in AD patients likely induces disrupted sleep. Given that healthy sleep plays an important role in improving quality of life, optimizing cognition, and ensuring affect regulation, the aim of this study was to investigate whether poor quality of life, mood alterations, and memory complaints reported by AD patients are associated with their disrupted sleep patterns. Sixty patients with AD and 60 matched healthy controls completed a battery of self-report questionnaires assessing perceived physical and mental health (Short-Form 36), mood (Beck Depression Inventory-II), sleep quality (Pittsburgh Sleep Quality Index), and cognition (Cognitive Failures Questionnaire). A latent variable model revealed that although AD had a significant direct effect on quality of life, the indirect effect of sleep was significantly greater. Furthermore, although AD had no direct effect on cognitive functioning, the indirect effect of sleep was significant. The overall model showed a good fit (comparative fit index = 0.91, root mean square of approximation = 0.09, and standardized root mean square residual = 0.05). Our findings suggest that disrupted sleep, and not the disease per se, may induce poor quality of life, memory impairment, and affect dysregulation in patients with AD. We think that improving sleep architecture may improve cognitive, affective, and physical functioning. Copyright © 2015 Elsevier Inc. All rights reserved.
Daniels, Jo; Sheils, Elizabeth
Addison's disease (AD) is a rare chronic illness caused by adrenocortical insufficiency. Due to the pivotal role of the regulating hormone cortisol in AD, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety in endocrinological disorders, however there is a paucity of research examining the complex interplay between AD and anxiety. This paper describes a single case study of a patient with severe health anxiety and co-morbid AD. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in AD can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. A single case design was used, with pre- and post-measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment. This preliminary study provides a sound rationale for further research into AD complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of AD, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.
Manso, Jacopo; Pezzani, Raffaele; Scarpa, Riccardo; Gallo, Nicoletta; Betterle, Corrado
Autoimmune Addison's disease (AAD) is the most frequent cause of adrenocortical insufficiency. The natural history of AAD usually comprises five consecutive stages with the first stage characterized by the increase of plasma renin consistent with the impairment of pars glomerulosa, which is usually the first affected layer of the adrenal cortex. We describe a 19-year-old female with Hashimoto's thyroiditis (HT) who underwent an autoantibody screening due to having the personal and family history of other autoimmune diseases in the absence of relevant clinical manifestations. She was positive for adrenal cortex autoantibodies (ACA) and steroid 21-hydroxylase autoantibodies (21-OH Ab) at high titers. She had increased basal levels of ACTH with normal basal cortisol not responding to ACTH stimulation, reduced levels of dehydroepiandrosterone-sulfate but normal levels of orthostatic renin and aldosterone. This scenario was consistent with a subclinical AAD presenting with first impairments in pars fasciculata and reticularis and conserved pars glomerulosa function. Only subsequently, progressive deficiency in pars glomerulosa function has become evident. Review of the literature showed that there was only one case, reported to date, with a similar atypical natural history of AAD. The strategies for screening for ACA/21-OH Ab in patients with HT are discussed.
Bergthorsdottir, Ragnhildur; Ragnarsson, Oskar; Skrtic, Stanko; Glad, Camilla A M; Nilsson, Staffan; Ross, Ian Louis; Leonsson-Zachrisson, Maria; Johannsson, Gudmundur
Patients with Addison's disease (AD) have increased cardiovascular mortality. To study visceral fat and conventional and exploratory cardiovascular risk factors in patients with AD. A cross-sectional, single-center, case-control study. Patients (n = 76; n = 51 women) with AD and 76 healthy control subjects were matched for sex, age, body mass index (BMI), and smoking habits. The primary outcome variable was visceral abdominal adipose tissue (VAT) measured using computed tomography. Secondary outcome variables were prevalence of metabolic syndrome (MetS) and 92 biomarkers of cardiovascular disease. The mean ± standard deviation age of all subjects was 53 ± 14 years; mean BMI, 25 ± 4 kg/m2; and mean duration of AD, 17 ± 12 years. The median (range) daily hydrocortisone dose was 30 mg (10 to 50 mg). Median (interquartile range) 24-hour urinary free cortisol excretion was increased in patients vs controls [359 nmol (193 to 601 nmol) vs 175 nmol (140 to 244 nmol); P 1] and vasodilatory protective marker was decreased (FC, <1). Twenty-six patients (34%) vs 12 control subjects (16%) fulfilled the criteria for MetS (P = 0.01). Despite higher cortisol exposure, VAT was not increased in patients with AD. The prevalence of MetS was increased and several biomarkers of cardiovascular disease were adversely affected in patients with AD. Copyright © 2017 Endocrine Society
Volpato, M; Prentice, L; Chen, S; Betterle, C; Rees Smith, B; Furmaniak, J
Steroid 21-hydroxylase (21-OH) autoantibodies are found in patients with autoimmune Addison's disease (AAD), either isolated or associated with autoimmune polyglandular syndrome (APS) type I and II and in adrenal-cortex autoantibody (ACA)-positive patients without AAD. In order to assess any differences in the 21-OH autoantibodies in these different patient groups, we have studied their reactivity with different epitopes on 21-OH using full length and modified 35S-labelled 21-OH proteins produced in an in vitro transcription/translation system. There were no major differences in the pattern of autoantibody reactivity with the different modified 21-OH proteins in patients with isolated AAD or with APS types I and II, and in 21-OH autoantibody-positive patients with clinical AAD, subclinical AAD and those maintaining a normal adrenal function. Our studies also indicate that the main epitopes for 21-OH autoantibodies in patients with different forms of autoimmune adrenal disease are located in the C-terminal end and in a central region of 21-OH. PMID:9486414
Hellesen, A; Edvardsen, K; Breivik, L; Husebye, E S; Bratland, E
Autoimmune Addison's disease (AAD) is caused by selective destruction of the hormone-producing cells of the adrenal cortex. As yet, little is known about the potential role played by environmental factors in this process. Type I and/or type III interferons (IFNs) are signature responses to virus infections, and have also been implicated in the pathogenesis of autoimmune endocrine disorders such as type 1 diabetes and autoimmune thyroiditis. Transient development of AAD and exacerbation of established or subclinical disease, as well as the induction of autoantibodies associated with AAD, have been reported following therapeutic administration of type I IFNs. We therefore hypothesize that exposure to such IFNs could render the adrenal cortex susceptible to autoimmune attack in genetically predisposed individuals. In this study, we investigated possible immunopathological effects of type I and type III IFNs on adrenocortical cells in relation to AAD. Both types I and III IFNs exerted significant cytotoxicity on NCI-H295R adrenocortical carcinoma cells and potentiated IFN-γ- and polyinosine-polycytidylic acid [poly (I : C)]-induced chemokine secretion. Furthermore, we observed increased expression of human leucocyte antigen (HLA) class I molecules and up-regulation of 21-hydroxylase, the primary antigenic target in AAD. We propose that these combined effects could serve to initiate or aggravate an ongoing autoimmune response against the adrenal cortex in AAD. © 2014 British Society for Immunology.
Full Text Available El título de este trabajo pretende, además de consignar su objetivo, señalar una insuficiencia: la de la patología psicosomática, impregnada, desde su origen, por conceptos psicoanalíticos que han dado lugar a explicaciones demasiado subjetivistas y alejadas de las ideas fisiopatológicas no superadas, al menos clínicamente, por la moderna versión norteamericana de las antiguas y equilibradas doctrinas socráticas de integración. Perseguimos en esta comunicación dos propósitos: contrastrar las concepciones psicosomáticas y fisiopatológicas del Basedow y de la insuficiencia suprarrenal, en el intento de poner de manifiesto la insuficiencia del criterio psicosomático; y, estudiar la fisiopatología de los principales síntomas del Basedow y del Addison que se expresan por la doble vertiente somatopsíquica. Estos síntomas serán, en el hipertiroidismo, la hiperemotividad y, singularmente, la prisa; y en la insuficiencia suprarrenal, la astenia.
Bøe Wolff, A S; Oftedal, B; Johansson, S; Bruland, O; Løvås, K; Meager, A; Pedersen, C; Husebye, E S; Knappskog, P M
Autoimmune Addison's disease (AAD) is often associated with other components in autoimmune polyendocrine syndromes (APS). Whereas APS I is caused by mutations in the AIRE gene, the susceptibility genes for AAD and APS II are unclear. In the present study, we investigated whether polymorphisms or copy number variations in the AIRE gene were associated with AAD and APS II. First, nine SNPs in the AIRE gene were analyzed in 311 patients with AAD and APS II and 521 healthy controls, identifying no associated risk. Second, in a subgroup of 25 of these patients, AIRE sequencing revealed three novel polymorphisms. Finally, the AIRE copy number was determined by duplex quantitative PCR in 14 patients with APS I, 161 patients with AAD and APS II and in 39 healthy subjects. In two Scandinavian APS I patients previously reported to be homozygous for common AIRE mutations, we identified large deletions of the AIRE gene covering at least exon 2 to exon 8. We conclude that polymorphisms in the AIRE gene are not associated with AAD and APS II. We further suggest that DNA analysis of the parents of patients found to be homozygous for mutations in AIRE, always should be performed.
Jund, Suzanne, Ed.
This journal issue concentrates on the theme "Parents and Reading." It presents articles on sharing books with young children, using public relations in a reading program, guiding preschool learning, assessing language readiness, working with reading problems, and teaching reading readiness in Wisconsin kindergartens. Resources and a review of…
Davis, Frederick B.
This review of psychometric research in reading analyzes the factors which seem related to reading comprehension skills. Experimental analysis of reading comprehension by L. E. Thorndike revealed two major components: knowledge of word meanings and verbal reasoning abilities. Subsequent analysis of experimental studies of reading comprehension…
This updated edition offers the most extensive and varied practice for all types of questions students might face on standardized and in-class tests. With this guide, students will learn to develop expert reading strategies, understand how to read faster and with greater comprehension, overcome reading anxiety, and increase appreciation of reading for pleasure. This book's step-by-step approach provides graduated coverage that moves from the basics to more advanced reading.
Baleva, Marta P; Mihaylova, Snejina; Yankova, Petja; Atanasova, Iliana; Nikolova-Vlahova, Milena; Naumova, Elissaveta
Selective IgA deficiency (IgAD) is the most prevalent type of primary immune deficiencies, but partial IgA deficiency is even more common. Addison's disease is a rare condition associated with primary adrenal insufficiency due to infection or autoimmune destruction of the adrenals. The association between IgA deficiency and Addison's disease is very rare. We observed a 22-year-old male patient with marked darkening of the skin, especially on the palms and areolae, jaundice on the skin and sclera, astheno-adynamia, hypotension (80/50 mm Hg), and pain in the right hypochondrium. The laboratory investigations revealed increased serum levels of total and indirect bilirubin, AST, ALT, GGT and LDH, negative HBsAg, anti-HBc IgM, anti-HCV and anti-HAV IgM, very low serum IgA levels (0.16 g/l) with normal IgG and IgM, negative ANA, ANCA, AMA, LKM-1, anti-GAD-60, anti-IA-2, anti-thyroglobulin antibodies, a mild increase in anti-TPO antibodies titer, a marked increase in IgG anti-tissue transglutaminase antibodies, with no typical changes in cellular immunity, negative T-SPOT-TB test, HLA - A*01; B*08; DRB1*03; DQB1*02, karyotype - 46, XY. We present a rare case of partial IgA deficiency with Addison's disease, hepatitis, thyroiditis and positive anti-tissue transglutaminase antibodies. IgAD and some autoimmune disorders share several predisposing HLA genes, thus explaining the increased prevalence of IgAD in certain patient groups.
Children experience difficulties in reading either because they fail to decode the words and thus are unable to comprehend the text or simply fail to comprehend the text even if they are able to decode the words and read them out. Failure in word decoding results from a failure in phonological coding of written information, whereas reading…
Mol, Suzanne Elizabeth
There is a widely held belief that reading (story)books makes us smarter and helps promote success in life. Does scientific evidence support this notion? The three meta-analyses in this thesis comprise 146 studies between 1988 and 2010 (N=10,308 participants) that addressed the role of book reading
Brønstad, Ingeborg; Skinningsrud, Beate; Bratland, Eirik; Løvås, Kristian; Undlien, Dag; Sverre Husebye, Eystein; Wolff, Anette Susanne Bøe
Steroid 21-hydroxylase, encoded by CYP21A2, is the major autoantigen in autoimmune Addison's disease (AAD). CYP21A2 is located in the region of the HLA complex on chromosome 6p21.3, which harbours several risk alleles for AAD. The objective was to investigate whether CYP21A2 gene variants confer risk of AAD independently of other risk alleles in the HLA loci. DNA samples from 381 Norwegian patients with AAD and 340 healthy controls (HC) previously genotyped for the HLA-A, -B, -DRB1, and -DQB1 and MICA loci were used for genotyping of CYP21A2. Genotyping of CYP21A2 was carried out by direct sequencing. Linkage of CYP21A2 to the HLA loci was assessed using UNPHASED version 3.0.10 and PHASE version 2.1. Heterozygotes of the single-nucleotide polymorphisms (SNPs) rs397515394, rs6467, rs6474, rs76565726 and rs6473 were detected significantly more frequently in AAD patients compared with HC (P<0.005), but all SNPs were in a linkage disequilibrium (LD) with high-risk HLA-DRB1 haplotypes. rs6472C protected against AAD (odds ratio=0.15, 95% CI (0.08-0.30), P=3.8×10(-10)). This SNP was not in an LD with HLA loci (P=0.02), but did not increase protection when considering the effect of HLA-DRB1 alleles. Mutations causing congenital adrenal hyperplasia were found in heterozygosity in <1.5% of the cases in both groups. Genetic variants of CYP21A2 associated to AAD are in LD with the main AAD risk locus HLA-DRB1, and CYP21A2 does not constitute an independent susceptibility locus. © 2014 European Society of Endocrinology.
Skov, Jakob; Höijer, Jonas; Magnusson, Patrik K E; Ludvigsson, Jonas F; Kämpe, Olle; Bensing, Sophie
The pathophysiology behind autoimmune Addison's disease (AAD) is poorly understood, and the relative influence of genetic and environmental factors remains unclear. In this study, we examined the heritability of AAD and explored disease-associated autoimmune comorbidity among Swedish twins. A population-based longitudinal cohort of 112,100 Swedish twins was used to calculate the heritability of AAD, and to explore co-occurrence of 10 organ-specific autoimmune disorders in twin pairs with AAD. Diagnoses were collected 1964-2012 through linkage to the Swedish National Patient Register. The Swedish Prescribed Drug Register was used for additional diagnostic precision. When available, biobank serum samples were used to ascertain the AAD diagnosis through identification of 21-hydroxylase autoantibodies. We identified 29 twins with AAD. Five out of nine (5/9) monozygotic pairs and zero out of fifteen (0/15) dizygotic pairs were concordant for AAD. The probandwise concordance for monozygotic twins was 0.71 (95% CI 0.40-0.90) and the heritability 0.97 (95% CI 0.88-99). Autoimmune disease patterns of monozygotic twin pairs affected by AAD displayed a higher degree of similarity than those of dizygotic twins, with an incidence rate ratio of 15 (95% CI 1.8-116) on the number of shared autoimmune diagnoses within pairs. The heritability of AAD appears to be very high, emphasizing the need for further research on the genetic etiology of the disease. Monozygotic twin concordance for multiple autoimmune manifestations suggests strong genetic influence on disease specificity in organ-specific autoimmunity.
Boag, Alisdair M; Christie, Michael R; McLaughlin, Kerry A; Syme, Harriet M; Graham, Peter; Catchpole, Brian
Canine hypoadrenocorticism likely arises from immune-mediated destruction of adrenocortical tissue, leading to glucocorticoid and mineralocorticoid deficiency. In humans with autoimmune Addison's disease (AAD) or autoimmune polyendocrine syndrome (APS), circulating autoantibodies have been demonstrated against enzymes associated with adrenal steroid synthesis. The current study investigates autoantibodies against steroid synthesis enzymes in dogs with spontaneous hypoadrenocorticism. Coding regions of canine CYP21A2 (21-hydroxylase; 21-OH), CYP17A1 (17-hydroxylase; 17-OH), CYP11A1 (P450 side-chain cleavage enzyme; P450scc) and HSD3B2 (3β hydroxysteroid dehydrogenase; 3βHSD) were amplified, cloned and expressed as 35S-methionine radiolabelled recombinant protein. In a pilot study, serum samples from 20 dogs with hypoadrenocorticism and four unaffected control dogs were screened by radio-immunoprecipitation assay. There was no evidence of reactivity against 21-OH, 17-OH or 3βHSD, but five dogs with hypoadrenocorticism showed immunoreactivity to P450scc compared with controls. Serum samples were subsequently obtained from 213 dogs diagnosed with hypoadrenocorticism and 110 dogs from a hospital control population. Thirty control dogs were randomly selected to establish a threshold for antibody positivity (mean + 3 × standard deviation). Dogs with hypoadrenocorticism were more likely to be P450scc autoantibody positive than hospital controls (24% vs. 1.2%, respectively; p = 0.0016). Sex was significantly associated with the presence of P450scc autoantibodies in the case population, with 30% of females testing positive compared with 17% of males (p = 0.037). Significant associations with breed (p = 0.015) and DLA-type (DQA1*006:01 allele; p = 0.017) were also found. This cross-sectional study indicates that P450scc autoantibodies are present in a proportion of dogs affected with hypoadrenocorticism.
Alisdair M Boag
Full Text Available Canine hypoadrenocorticism likely arises from immune-mediated destruction of adrenocortical tissue, leading to glucocorticoid and mineralocorticoid deficiency. In humans with autoimmune Addison's disease (AAD or autoimmune polyendocrine syndrome (APS, circulating autoantibodies have been demonstrated against enzymes associated with adrenal steroid synthesis. The current study investigates autoantibodies against steroid synthesis enzymes in dogs with spontaneous hypoadrenocorticism. Coding regions of canine CYP21A2 (21-hydroxylase; 21-OH, CYP17A1 (17-hydroxylase; 17-OH, CYP11A1 (P450 side-chain cleavage enzyme; P450scc and HSD3B2 (3β hydroxysteroid dehydrogenase; 3βHSD were amplified, cloned and expressed as 35S-methionine radiolabelled recombinant protein. In a pilot study, serum samples from 20 dogs with hypoadrenocorticism and four unaffected control dogs were screened by radio-immunoprecipitation assay. There was no evidence of reactivity against 21-OH, 17-OH or 3βHSD, but five dogs with hypoadrenocorticism showed immunoreactivity to P450scc compared with controls. Serum samples were subsequently obtained from 213 dogs diagnosed with hypoadrenocorticism and 110 dogs from a hospital control population. Thirty control dogs were randomly selected to establish a threshold for antibody positivity (mean + 3 × standard deviation. Dogs with hypoadrenocorticism were more likely to be P450scc autoantibody positive than hospital controls (24% vs. 1.2%, respectively; p = 0.0016. Sex was significantly associated with the presence of P450scc autoantibodies in the case population, with 30% of females testing positive compared with 17% of males (p = 0.037. Significant associations with breed (p = 0.015 and DLA-type (DQA1*006:01 allele; p = 0.017 were also found. This cross-sectional study indicates that P450scc autoantibodies are present in a proportion of dogs affected with hypoadrenocorticism.
Ian Louis Ross
Full Text Available BACKGROUND: Addison's disease (AD has been associated with an increased risk of cardiovascular disease. Glucocorticoid receptor polymorphisms that alter glucocorticoid sensitivity may influence metabolic and cardiovascular risk factors in patients with AD. The 9β polymorphism of the glucocorticoid receptor gene is associated with relative glucocorticoid resistance and has been reported to increase the risk of myocardial infarction in the elderly. We explored the impact of this polymorphism in patients with AD. MATERIALS AND METHODS: 147 patients with AD and 147 age, gender and ethnicity matched healthy controls were recruited. Blood was taken in a non-fasted state for plasma lipid determination, measurement of cardiovascular risk factors and DNA extraction. RESULTS: Genotype data for the 9β polymorphism was available for 139 patients and 146 controls. AD patients had a more atherogenic lipid profile characterized by an increase in the prevalence of small dense LDL (p = 0.003, increased triglycerides (p = 0.002, reduced HDLC (p<0.001 an elevated highly sensitive C-reactive protein (p = 0.01, compared with controls. The 9β polymorphism (at least one G allele was found in 28% of patients and controls respectively. After adjusting for age, gender, ethnicity, BMI and hydrocortisone dose per metre square of body surface area in patients, there were no significant metabolic associations with this polymorphism and hydrocortisone doses were not higher in patients with the polymorphism. CONCLUSIONS: This study did not identify any associations between the 9β polymorphism and cardiovascular risk factors or hydrocortisone dose and determination of this polymorphism is therefore unlikely to be of clinical benefit in the management of patients with AD.
Granata, Antonio; Tirabassi, Giacomo; Pugni, Valeria; Arnaldi, Giorgio; Boscaro, Marco; Carani, Cesare; Balercia, Giancarlo
There is evidence suggesting that autoimmune Addison's disease (AD) could be associated with sexual dysfunctions probably caused by gluco- and mineralocorticoid deficiency; however, no study has yet treated this subject in males. To evaluate male sexuality and psychological correlates in autoimmune AD before and after gluco- and mineralocorticoid replacement therapy. Twelve subjects with a first diagnosis of autoimmune AD were studied before (baseline) and 2 months after (recovery phase) initiating hormone replacement therapy. Erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), overall satisfaction (OS), depression, and anxiety were studied using a number of questionnaires (International Index of Erectile Function, Beck Depression Inventory, and Spielberger State-Trait Anxiety Inventory); clinical, biochemical, and hormone data were included in the analysis. At baseline, low values were found for EF, OF, SD, IS, and OS and high values for depression and anxiety; all of these parameters improved significantly in the recovery phase compared with baseline. EF variation between the two phases correlated significantly and positively with the variation of serum cortisol, urinary free cortisol, systolic blood pressure, and diastolic blood pressure and inversely with that of upright plasma renin activity. Multiple linear regression analysis using EF variation as dependent variable confirmed the relationship of the latter with variation of serum cortisol, urinary free cortisol, and upright plasma renin activity but not with variation of systolic and diastolic blood pressure. Our study showed that onset of autoimmune AD in males is associated with a number of sexual dysfunctions, all reversible after initiating replacement hormone therapy; cortisol and aldosterone deficiency seems to play an important role in the genesis of erectile dysfunction although the mechanism of their activity is not clear. © 2012 International Society
Jane Austen is typically described as having excellent health until the age of 40 and the onset of a mysterious and fatal illness, initially identified by Sir Zachary Cope in 1964 as Addison's disease. Her biographers, deceived both by Cassandra Austen's destruction of letters containing medical detail, and the cheerful high spirits of the existing letters, have seriously underestimated the extent to which illness affected Austen's life. A medical history reveals that she was particularly susceptible to infection, and suffered unusually severe infective illnesses, as well as a chronic conjunctivitis that impeded her ability to write. There is evidence that Austen was already suffering from an immune deficiency and fatal lymphoma in January 1813, when her second and most popular novel, Pride and Prejudice, was published. Four more novels would follow, written or revised in the shadow of her increasing illness and debility. Whilst it is impossible now to conclusively establish the cause of her death, the existing medical evidence tends to exclude Addison's disease, and suggests there is a high possibility that Jane Austen's fatal illness was Hodgkin's disease, a form of lymphoma.
Hauptman, Allyson L.
The purpose of this study was to determine the relationship between Guided Reading and student motivation to read across fourth, fifth, and sixth grades. The study defined literacy motivation as: (a) task value; (b) self-perceived competence; (c) students' perceptions of the Guided Reading format. Factor analysis and repeated measures ANOVAs were…
Wright, Benjamin D.; Stenner, A. Jackson
This document discusses the measurement of reading ability and the readability of books by application of the Lexile framework. It begins by stating the importance of uniform measures. It then discusses the history of reading ability testing, based on the assumption that no researcher has been able to measure more than one kind of reading ability.…
McCreary, John J.; Marchant, Gregory J.
The relationship between reading and empathy was explored. Controlling for GPA and gender, reading variables were hypothesized as related to empathy; the relationship was expected to differ for males and females. For the complete sample, affective components were related to GPA but not reading. Perspective taking was related to reading…
In high school students get tied up in extracurricular activities and have little time for pleasure reading. It is true that with rigorous academic schedules they have little time for pleasure reading. Thus began a conversation with a sophomore English teacher at the author's high school. As they were discussing the plight of free reading he was…
An exploration of the increasingly important role of linguistics in literacy research and instruction reviews literature on reading comprehension, written language, orthography, metalinguistics, classroom language use, reading disabilities, native tongues, nonstandard dialects, bilingual education, adult literacy, and second-language reading. (86…
The use of traditional stories in American Indian language programs connects students' reading to their lives and familiarizes learners with the rhythms of the oral language. Puppet performances are one way of connecting reading programs to the Native oral tradition. A high school reading lesson in a first-year Hupa language class uses many…
... occurs when there is not enough cortisol) Addison disease (adrenal glands do not produce enough cortisol) Hypopituitarism (pituitary gland ... A.M. Editorial team. Addison Disease Read more Adrenal Gland Disorders Read more Pituitary Disorders Read more A.D. ...
Muijselaar, M.M.L.; Swart, N.M.; Steenbeek-Planting, E.G.; Droop, W.; Verhoeven, L.T.W.; Jong, P.F. de
We examined the developmental relations between knowledge of reading strategies and reading comprehension in a longitudinal study of 312 Dutch children from the beginning of fourth grade to the end of fifth grade. Measures for reading comprehension, reading strategies, reading fluency, vocabulary, and working memory were administered. A structural equation model was constructed to estimate the unique relations between reading strategies and reading comprehension, while controlling for reading...
Full Text Available The academic success of the university students greatly depends on the mastery of an academic reading skill. However, students as well as teachers, take the learning of this skill for granted, as they tend to presuppose that reading skill is acquired as a part of their secondary education. As a result, most first-year students employ non university strategies to read academic texts, which leads to a surface approach to reading and prevents students from a better understanding of the material. This paper will discuss the strategies that involve students in taking a deep approach to reading academic texts.
Laísa Cristina dos Santos Guilherme; Rodrigo Ferreira Daverni
Abstract: Reading in preschool is a time of awakening the taste and pleasure in reading, it is also a source of reflection, discovery and learn to listen. It is then necessary that the contact with the reading start from pre-school, with a variety of texts and the teacher also has the habit of reading in their daily lives. Therefore, this study aimed to investigate the benefits of daily reading in the classroom pre-school life of a student, which the characteristics of a player and teacher re...
Veenendaal, N.J.; Groen, M.A.; Verhoeven, L.T.W.
Text reading fluency – the ability to read quickly, accurately and with a natural intonation – has been proposed as a predictor of reading comprehension. In the current study, we examined the role of oral text reading fluency, defined as text reading rate and text reading prosody, as a contributor
Pazderska, Agnieszka; Oftedal, Bergithe E; Napier, Catherine M; Ainsworth, Holly F; Husebye, Eystein S; Cordell, Heather J; Pearce, Simon H S; Mitchell, Anna L
Autoimmune Addison's disease (AAD) is a rare but highly heritable condition. The BACH2 protein plays a crucial role in T lymphocyte maturation, and allelic variation in its gene has been associated with a number of autoimmune conditions. We aimed to determine whether alleles of the rs3757247 single nucleotide polymorphism (SNP) in the BACH2 gene are associated with AAD. This case-control association study was performed in two phases using Taqman chemistry. In the first phase, the rs3757247 SNP was genotyped in 358 UK AAD subjects and 166 local control subjects. Genotype data were also available from 5154 healthy UK controls from the Wellcome Trust (WTCCC2) for comparison. In the second phase, the SNP was genotyped in a validation cohort comprising 317 Norwegian AAD subjects and 365 controls. The frequency of the minor T allele was significantly higher in subjects with AAD from the United Kingdom compared to both the local and WTCCC2 control cohorts (58% vs 45 and 48%, respectively) (local controls, P = 1.1 × 10 -4 ; odds ratio [OR], 1.68; 95% confidence interval [CI], 1.29-2.18; WTCCC2 controls, P = 1.4 × 10 -6 ; OR, 1.44; 95% CI, 1.23-1.69). This finding was replicated in the Norwegian validation cohort (P = .0015; OR, 1.41; 95% CI, 1.14-1.75). Subgroup analysis showed that this association is present in subjects with both isolated AAD (OR, 1.53; 95% CI, 1.22-1.92) and autoimmune polyglandular syndrome type 2 (OR, 1.37; 95% CI, 1.12-1.69) in the UK cohort, and with autoimmune polyglandular syndrome type 2 in the Norwegian cohort (OR, 1.58; 95% CI, 1.22-2.06). We have demonstrated, for the first time, that allelic variability at the BACH2 locus is associated with susceptibility to AAD. Given its association with multiple autoimmune conditions, BACH2 can be considered a "universal" autoimmune susceptibility locus.
Fichna, Marta; Żurawek, Magdalena; Bratland, Eirik; Husebye, Eystein S; Kasperlik-Załuska, Anna; Czarnocka, Barbara; Januszkiewicz-Lewandowska, Danuta; Nowak, Jerzy
Autoimmune Addison's disease (AAD) results from T cell-mediated destruction of the adrenal cortex, commonly accompanied by autoantibodies to 21-hydroxylase (21OH). In order to gain insight into the obscure aetiology of this disease, we investigated the roles of the IL2 and IL2RA genes, encoding interleukin-2 and subunit alpha of its receptor (IL2Ra), respectively. The association of AAD with IL2 and IL2RA polymorphisms (rs6822844, rs2069762, rs3136534, rs11594656, rs3118470 and rs2104286) was tested in 223 patients and 672 healthy controls. Functional studies consisted of gene expression analysis in cultured PBMCs exposed to 21OH and evaluation of serum interleukin by ELISA assays. The frequency of the minor C allele of rs3136534 was significantly decreased in AAD subjects compared to controls (OR 0.71; 95%CI 0.561-0.887; p = 0.003). Only AAD cells responded to 21OH with an elevated IL2 and IL2RA mRNA synthesis (p = 0.004 and p = 0.009 versus controls, respectively), paralleled by increased supernatant levels of both cytokines (p = 0.031 and p = 0.001 versus controls). IL2 mRNA level in 21OH-stimulated AAD PBMCs correlated negatively with age (p = 0.036) and positively with serum antibodies to 21OH (p = 0.006). Carriers of the rs2104286 AA genotype demonstrated higher IL2RA mRNA (p = 0.022) and soluble IL2Ra secretion (p = 0.029) upon 21OH stimulation. Serum interleukin-2 in AAD subjects was significantly higher compared to controls (4.61 ± 4.3 versus 1.71 ± 3.2 pg/mL, p < 0.001), whereas sIL2Ra levels remained similar in both groups (p = 0.885). In conclusion, the study reveals an association between AAD and IL2 locus. It confirms specific 21OH-directed reactivity of the peripheral AAD lymphocytes, which display increased synthesis of interleukin-2 and sIL2Ra.
Chantzichristos, Dimitrios; Persson, Anders; Eliasson, Björn; Miftaraj, Mervete; Franzén, Stefan; Svensson, Ann-Marie; Johannsson, Gudmundur
We determined the incidence and prevalence of Addison's disease (AD) among persons with or without type 1 diabetes mellitus (T1DM) in nationwide, matched cohort studies. Persons with T1DM were identified from the Swedish National Diabetes Register and each was matched for age, sex, year and county to five controls randomly selected from the general population. Persons with AD were identified from the Swedish National Inpatient Register. Baseline demographics and seasonal onset variation of AD were presented by descriptive statistics. Prevalence and incidence were estimated by proportions and incidence rates, respectively. Times to AD were analyzed using the Cox proportional hazard model. Between 1998 and 2013, 66 persons with T1DM were diagnosed with AD at a mean age (s.d.) of 36.4 (13.0) years among 36 514 persons with T1DM, while 32 were diagnosed with AD at a mean age of 42.7 (15.2) years among 182 570 controls. The difference in mean age at diagnosis of AD between the groups was 6.3 years ( P value = 0.036). The incidence of AD for a person with or without T1DM was therefore 193 and 18 per million person-years, respectively. The adjusted relative risk increase of developing AD in T1DM was 10.8 (95% CI: 7.1-16.5). The highest incidence of AD was observed during February-March and September-October. The prevalence of AD in persons with or without T1DM in December 2012 was 3410 and 208 per million, respectively. The odds ratio for AD in persons with T1DM vs controls was 16.5 (95% CI: 11.1-24.5). The risk to develop AD among persons with T1DM is more than 10 times higher than in persons without T1DM. Persons with T1DM develop AD at a younger age. The incidence of AD may have a seasonal pattern. © 2018 European Society of Endocrinology.
Ian Louis Ross
Full Text Available BACKGROUND: Patients with Addison's disease (AD in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD. Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. METHODS: In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP and adiponectin were studied. RESULTS: All patients were Caucasian and the majority were women N = 36 (65.5%. Mean (standard deviation; SD ages of the Swedish and South African patients were 52.9 (13.0 and 52.6 (14.4 years and BMI 25.3 (3.2 and 25.8 (4.1 kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1 versus 24.3 (8.0 mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR triglycerides (TG [1.59 (1.1-2.46 versus 0.96 (0.74-1.6 mmol/l; p<0.001], total cholesterol (TC [6.02(1.50 versus 5.13 (0.87 mmol/l; p<0.001], LDL-C [4.43 (1.44 versus 2.75 (0.80 mmol/l; p<0.001] and median hs-CRP [2.15 (0.93-5.45 versus 0.99 (0.57-2.10 mg/L; p<0.003] and lower HDL-C [0.80 (0.40 versus 1.86 (0.46 mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. CONCLUSIONS: South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors.
Penna-Martinez, Marissa; Filmann, Natalie; Bogdanou, Dimitra; Shoghi, Firouzeh; Huenecke, Sabine; Schubert, Ralf; Herrmann, Eva; Koehl, Ulrike; Husebye, Eystein S; Badenhoop, Klaus
On the basis of the immunomodulatory actions of vitamin D (VD), we investigated the effects of high-dose VD therapy over a 3 mo period on the immune response in patients with Addison's disease (AD). This randomized, controlled, crossover trial included 13 patients with AD who received either cholecalciferol (4000 IU/d) for 3 mo followed by 3 mo placebo oil or the sequential alternative placebo followed by verum. Glucocorticoid replacement doses remained stable. The primary outcome measures were changes in 25-hydroxyvitamin D3 (25(OH)D 3 ) levels and immune cells including T helper cells (Th; CD3 + CD4 + ), late-activated Th cells (CD3 + CD4 + HLA-DR + ), regulatory T cells (CD3 + CD4 + CD25 bright CD127 dim/neg ), cytotoxic T cells (Tc; CD3 + CD8 + ), late-activated Tc cells (CD3 + CD8 + HLA-DR + ), and monocytes. The explorative analysis included the correlation of changes with VD-related gene polymorphisms and 21-hydroxylase antibody titers. Ten of 13 patients (77%) were VD deficient. Median 25(OH)D 3 concentrations increased significantly to 41.5 ng/ml (median changes: 19.95 ng/ml; P = 0.0005) after 3 mo of cholecalciferol treatment. Within the T-cells, only the late-activated Th (median changes: 1.6%; P = 0.02) and late-activated Tc cells (median changes: 4.05%; P = 0.03) decreased, whereas monocytes (median changes: 1.05%; P = 0.008) increased after VD therapy. T-cell changes were associated with two polymorphisms (CYP27B1-rs108770012 and VDR-rs10735810), but no changes in the 21-hydroxylase antibody titers were observed. Three months of treatment with cholecalciferol achieved sufficient 25(OH)D 3 levels and can regulate late-activated T-cells and monocytes in patients with AD. Explorative analysis revealed potential genetic contributions. This pilot trial provides novel insights about immunomodulation in AD. Copyright © 2017 Elsevier Inc. All rights reserved.
Ross, I L; Babu, S; Armstrong, T; Zhang, L; Schatz, D; Pugliese, A; Eisenbarth, G; Baker Ii, P
Genetic similarities between patients from the United States and South African (SA) Addison's Disease (AD) strengthen evidence for genetic association. SA-AD (n = 73), SA healthy controls (N = 78), and US-AD patients (N = 83) were genotyped for DQA1, DQB1, DRB1, and HLA-B alleles. Serum was tested for the quantity of 21OH-AA and IFNα-AA at the Barbara Davis Center. Although not as profound as in US-AD, in SA-AD 21OH-AA + subjects the predominantly associated risk haplotypes were DRB1*0301-DQB1*0201 (DR3), DRB1*04xx-DQB1*0302 (DR4), and the combined DR3/4 genotype. DQB1*0302 associated DRB1*04xx haplotypes conferred higher risk than those DRB1*04xx haplotypes associated with other DQB1 alleles. We found negative association in 21OH-AA + SA-AD for DQA1*0201-DQB1*0202 and DQA1*0101-DQB1*0501 vs SA controls, and positive association for DQA1*0401-DQB1*0402 vs US-AD. Apart from the class II DR3 haplotype, HLA-B8 did not have an independent effect; however together DR3 and HLA-B8 conferred the highest risk vs 21OH-AA negative SA-AD and SA-controls. HLA-B7 (often with DR4) conferred novel risk in 21OH-AA + SA-AD vs controls. This study represents the first comparison between South African and United States AD populations utilizing genotyping and serology performed at the same center. SA-AD and US-AD 21OH-AA + patients share common HLA risk haplotypes including DR4 (with HLA-B7) and DR3 (with HLA-B8), strengthening previously described HLA associations and implicating similar genetic etiology. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Fichna, Marta; Rogowicz-Frontczak, Anita; Żurawek, Magdalena; Fichna, Piotr; Gryczyńska, Maria; Zozulińska-Ziółkiewicz, Dorota; Ruchała, Marek
Autoimmune Addison's disease (AAD) associates with exceptional susceptibility to develop other autoimmune conditions, including type 1 diabetes (T1D), marked by positive serum autoantibodies to insulin (IAA), glutamic acid decarboxylase (GADA) and insulinoma-associated protein 2 (IA-2A). Zinc transporter 8 (ZnT8) is a new T1D autoantigen, encoded by the SLC30A8 gene. Its polymorphic variant rs13266634C/T seems associated with the occurrence of serum ZnT8 antibodies (ZnT8A). This study was designed to determine the prevalence of serum ZnT8A and their clinical implication in 140 AAD patients. Other beta cell and thyroid-specific autoantibodies were also investigated, and ZnT8A results were confronted with the rs13266634 genotype. ZnT8A were detectable in 8.5 %, GADA in 20.7 %, IA-2A in 5.7 %, IAA in 1.6 % and various anti-thyroid antibodies in 7.1-67.8 % individuals. Type 1 diabetes was found in 10 % AAD patients. ZnT8A were positive in 57.1 % of T1D patients and 3.4 % non-diabetic AAD. Analysis of ZnT8A enabled to identify autoimmunity in two (14.3 %) T1D individuals previously classified as autoantibody-negative. ZnT8A-positive patients revealed significantly higher number of autoimmune conditions (p < 0.001), increased prevalence of T1D (p < 0.001) and other beta cell-specific autoantibodies. Carriers of the rs13266634 T-allele displayed increased frequency (p = 0.006) and higher titres of ZnT8A (p = 0.002). Our study demonstrates high incidence of ZnT8A in AAD patients. ZnT8A are associated with coexisting T1D and predictive of T1D in non-diabetic subjects. Moreover, positive ZnT8A in AAD indicate elevated risk for additional autoimmune conditions. Autoantibodies to beta cell antigens, comprising ZnT8, could be included in routine screening panels in AAD.
Ross, Ian Louis; Bergthorsdottir, Ragnhildur; Levitt, Naomi; Dave, Joel Alex; Schatz, Desmond; Marais, David; Johannsson, Gudmundur
Background Patients with Addison's disease (AD) in Scandinavia have an increased risk for premature death due to cardiovascular disease (CVD). Serum lipids are important risk factors for CVD and vascular mortality. Replacement doses of hydrocortisone have historically been higher in Sweden than South Africa. The primary aim was to study the lipid profiles in a large group of patients with AD with the hypothesis that the lipid profile in patients in Sweden would be worse than in South Africa. Methods In a cross-sectional study, 110 patients with AD (55 from South Africa, 55 from Sweden) matched for age, gender, ethnicity and BMI were studied. Anthropometric measures, blood pressure, lipids, highly sensitive C-reactive protein (hs-CRP) and adiponectin were studied. Results All patients were Caucasian and the majority were women N = 36 (65.5%). Mean (standard deviation; SD) ages of the Swedish and South African patients were 52.9 (13.0) and 52.6 (14.4) years and BMI 25.3 (3.2) and 25.8 (4.1) kg/m2, respectively. The mean total daily hydrocortisone dose was greater in the Swedish patients than the South African patients, [33.0 (8.1) versus 24.3 (8.0) mg; p<0.0001]. South African patients had higher median (interquartilerange; IQR) triglycerides (TG) [1.59 (1.1–2.46) versus 0.96 (0.74–1.6) mmol/l; p<0.001], total cholesterol (TC) [6.02(1.50) versus 5.13 (0.87) mmol/l; p<0.001], LDL-C [4.43 (1.44) versus 2.75 (0.80) mmol/l; p<0.001] and median hs-CRP [2.15 (0.93–5.45) versus 0.99 (0.57–2.10) mg/L; p<0.003] and lower HDL-C [0.80 (0.40) versus 1.86 (0.46) mmol/l; p<0.001] than the Swedish patients. Approximately 20% of the patients in both cohorts had hypertension and diabetes mellitus. Conclusions South African patients with AD have worse lipid profiles and higher hs-CRP compared to their matched Swedish patients, despite lower doses of hydrocortisone. It is uncertain at this time whether these are due to genetic or environmental factors. PMID:24603607
Schneiderman, M; Czuzoj-Shulman, N; Spence, A R; Abenhaim, H A
To assess if pregnancies among women with Addison's disease (AD) are at higher risk of adverse maternal and neonatal outcomes. Population-based retrospective cohort study. All births in the United States' Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2011. Baseline characteristics were compared between women with AD and those without, and prevalence over time was measured. Logistic regression was used to estimate the effect of AD on maternal and neonatal outcomes by calculating the crude and adjusted odds ratios (OR) and corresponding 95% confidence intervals (95% CI). We calculated a prevalence of AD in pregnancy of 5.5/100 000, increasing from 5.6 to 9.6/100 000 (P = 0.0001) over the 9-year study period. Compared with women without AD, women with AD were more likely to deliver preterm (OR 1.50, 95% CI 1.16-1.95), deliver by caesarean section (OR 1.32, 95% CI 1.08-1.61), have impaired wound healing (OR 4.28, 95% CI 2.55-7.18), develop infections (OR 2.44, 95% CI 1.66-3.58) and develop thromboembolism (OR 5.21, 95% CI 2.15-12.63), require transfusions (OR 6.69, 95% CI 4.69-9.54), and have prolonged postpartum hospital admissions (OR 5.71, 95% CI 4.37-7.47). Maternal mortality was significantly higher than in the comparison group (OR 22.30, 95% CI 6.82-72.96). Congenital anomalies (OR 3.62, 95% CI 2.05-6.39) and small-for-gestational age infants (OR 1.78, 95% CI 1.15-2.75) were more likely in these pregnancies. Addison's disease significantly increases the risk of severe adverse maternal and neonatal outcomes, so pregnant women with AD are best managed in tertiary-care centres. Pregnancies complicated by Addison's disease have an increased risk of adverse maternal and neonatal outcomes. © 2016 Royal College of Obstetricians and Gynaecologists.
McGeown, Sarah P.; Duncan, Lynne G.; Griffiths, Yvonne M.; Stothard, Sue E.
The present study examines the extent to which adolescents' reading affect (reading motivation) and behaviour (reading habits) predict different components of reading (word reading, comprehension, summarisation and text reading speed) and also adds to the limited research examining group differences (gender, age, ability) in adolescents' reading…
Starrfelt, Randi; Klargaard, Solja K; Petersen, Anders
exposure durations (targeting the word superiority effect), and d) text reading. RESULTS: Participants with developmental prosopagnosia performed strikingly similar to controls across the four reading tasks. Formal analysis revealed a significant dissociation between word and face recognition......, that is, impaired reading in developmental prosopagnosia. METHOD: We tested 10 adults with developmental prosopagnosia and 20 matched controls. All participants completed the Cambridge Face Memory Test, the Cambridge Face Perception test and a Face recognition questionnaire used to quantify everyday face...... recognition experience. Reading was measured in four experimental tasks, testing different levels of letter, word, and text reading: (a) single word reading with words of varying length,(b) vocal response times in single letter and short word naming, (c) recognition of single letters and short words at brief...
Full Text Available The purpose of this study is to examine the relationship between interest and reading motivation based on literature review. The concept of the interest portrayed as a psychological state that occurs during interaction between individual and specific topic, object or activity including process of willingness, increased attention, concentration and positive feeling to the topic, object or activity. Meanwhile reading motivation emphasized to mental readiness, willingness and refers to beliefs and perception of individual to engage in reading activity. Some researchers were identified factors that influenced reading motivation such as intrinsic and extrinsic factors, self-concept and value of reading, and interest. In general, the literature review described that have positive relationship between interest and reading motivation.
Full Text Available In this study I will present some ideas on today’s educational practice for motivation, the realization of the meaningful reading. There is a special place for the methodical ranking of the reading process, starting in school. Main requests of this reading, consist of the deep meaning of the subject, exploration of the idea, and other elements of the subject, implementation of the technique’s rules of the expressive reading, such as breathing, voice, diction, intonation, spelling, stoppages, logical emphasizes, emotional expressions, temper, timber, gesticulations, and mimic. There is also highlighted the fact that the used method comes from the pupils’ results and depends on the capability and level of the teacher, from the programming’s scale, the tools that are put into disposition, the age and the level of the pupils, and from the environment that the teacher creates during courses. At the end there are some practical guidelines for the realization of the expressive reading in the literature subject.
Help your students discover the practical solution to their reading frustrations, with Improve Your Reading. Written by bestselling author and education advocate Ron Fry, this book avoids gimmicks and tricks in favor of proven strategies that will help your students better retain and comprehend what they've read in any textbook, in any course, at any academic level. Endlessly adaptable to each student's individual learning needs, the text focuses on fundamental skills students can carry beyond the classroom.
Hulme, Charles; Snowling, Margaret J
We review current knowledge about the nature of reading development and disorders, distinguishing between the processes involved in learning to decode print, and the processes involved in reading comprehension. Children with decoding difficulties/dyslexia experience deficits in phoneme awareness, letter-sound knowledge and rapid automatized naming in the preschool years and beyond. These phonological/language difficulties appear to be proximal causes of the problems in learning to decode print in dyslexia. We review data from a prospective study of children at high risk of dyslexia to show that being at family risk of dyslexia is a primary risk factor for poor reading and children with persistent language difficulties at school entry are more likely to develop reading problems. Early oral language difficulties are strong predictors of later difficulties in reading comprehension. There are two distinct forms of reading disorder in children: dyslexia (a difficulty in learning to translate print into speech) and reading comprehension impairment. Both forms of reading problem appear to be predominantly caused by deficits in underlying oral language skills. Implications for screening and for the delivery of robust interventions for language and reading are discussed.
Tzoufi, Meropi; Makis, Alexandros; Chaliasos, Nikolaos; Nakou, Iliada; Siomou, Ekaterini; Tsatsoulis, Agathoklis; Zikou, Anastasia; Argyropoulou, Maria; Bonnefont, Jean Paul; Siamopoulou, Antigone
Kearns-Sayre syndrome (KSS) is a rare mitochondrial DNA deletion syndrome defined as the presence of ophthalmoplegia, pigmentary retinopathy, onset less than age 20 years, and one of the following: cardiac conduction defects, cerebellar syndrome, or cerebrospinal fluid protein above 100 mg/dl. KSS may affect many organ systems causing endocrinopathies, encephalomyopathy, sensorineural hearing loss, and renal tubulopathy. Clinical presentation at diagnosis is quite heterogeneous and, usually, few organs are affected with progression to generalized disease early in adulthood. We present the case of a boy with KSS presenting at the age of 5 years with myopathy, Addison's disease, primary hypoparathyroidism, and Fanconi syndrome. The proper replacement treatment along with the administration of mitochondrial metabolism-improving agents had a brief ameliorating effect, but gradual severe multisystemic deterioration was inevitable over the next 5 years. This report highlights the fact that in case of simultaneous presentation of polyendocrinopathies and renal disease early in childhood, KSS should be considered.
Bush, Lisabeth A; Ruess, Lynne; Jack, Tom; Person, Donald A
A young Marshallese woman presented with the insidious development of fever, cough, fatigue, profound weakness, massive weight loss, cachexia, alopecia, amenorrhea, and periumbilical hyperpigmentation. Limited laboratory studies revealed anemia, leukocytosis, and hyponatremia. Imaging studies, as well as digital photographs, transmitted over the Internet, using the secure Pacific Island Health Care Project (PIHCP), store-and-forward telemedicine system, suggested the diagnosis of disseminated tuberculosis, and antimycobacterial antibiotics were begun. Sputum cultures eventually grew Mycobacterium tuberculosis. Based on the constellation of clinical signs and symptoms, the transmitted images, and limited laboratory data, adrenal tuberculosis (Addison's disease) with adrenal insufficiency was diagnosed and corticosteroids were initiated. The patient responded dramatically This case underscores the utility of telemedicine in the diagnosis and treatment of patients with unusual conditions, rarely seen today in the United States, from remote sites in the Developing World.
Muijselaar, M.; Swart, N.M.; Steenbeek-Planting, E.G,.; Droop, M.; Verhoeven, L.; de Jong, P.F.
We examined the developmental relations between knowledge of reading strategies and reading comprehension in a longitudinal study of 312 Dutch children from the beginning of fourth grade to the end of fifth grade. Measures for reading comprehension, reading strategies, reading fluency, vocabulary,
Molnár, Ágnes; Kövesdi, Annamária; Szücs, Nikolette; Tóth, Miklós; Igaz, Péter; Rácz, Károly; Patócs, Attila
Glucocorticoid substitution is essential in patients with chronic primary adrenocortical insufficiency (Addison's disease) and both over-treatment and inadequate dosage have deleterious effects. Individual sensitivity to glucocorticoids is partly genetically determined. To test the hypothesis whether the well-characterized SNPs of the GR and HSD11B1 genes may modulate the individual sensitivity to exogenous glucocorticoids and may influence clinical and/or laboratory parameters and the glucocorticoid substitution dosage in patients with Addison's disease. 68 patients with primary adrenocortical insufficiency were involved. Clinical and laboratory data, as well as the dosage of the hormone replacement therapy were collected. Peripheral blood DNA was isolated, and the GR and HSD11B1 SNPs were examined using allele-specific PCR or Taqman assay on Real Time PCR. The allele frequency of the GR N363S polymorphism was higher in patients compared to the control group and the disease appeared significantly earlier in patients harbouring the GR A3669G compared to noncarriers. These patients had higher ACTH level measured at the time of diagnosis. Homozygous BclI carriers had higher body mass index (BMI) and lower total hydrocortisone equivalent supplementation dose needed than heterozygous or noncarriers. The BMI and weight gain during hormone replacement therapy were also higher in carriers of the HSD11B1 rs4844880 treated with glucocorticoids other than dexamethasone. The BclI polymorphism of the GR gene and the rs4844880 of the HSD11B1 gene may contribute to weight gain and may affect the individual need of glucocorticoid substitution dose in these patients. © 2016 John Wiley & Sons Ltd.
Bernecker, C; Halim, F; Haase, M; Willenberg, H S; Ehlers, M; Schott, M
Autoimmune Addison's disease (AD) is a rare but potentially life threatening disease. The exact etiology of the immune response to the adrenal gland is still unknown. MicroRNAs (miRNAs) critically control gene-expression and play an important role in regulating the immune response. The aim of this study was to determine key immunoregulatory miRNAs influencing autoimmune adrenal insufficiency. For this purpose selected miRNAs were amplified by a semiquantitative SYBR Green PCR from blood mononuclear cells and after purification from CD4+ and CD 8+ cells of 6 patients with autoimmune adrenal insufficiency and 10 healthy controls. In CD4+ T-cells miRNA 181a*_1 (18.02 in AD vs. 11.99 in CG, p=0.0047) is significantly increased whereas miRNA 200a_1 (12.48 in AD vs. 19.40 in CG, p=0.0003) and miRNA 200a_2* (8.59 in AD vs. 17.94 in CG, p=0.0160) are significantly decreased. miRNA 200a_1 (12.37 in AD group vs. 18.12 in control group, p=0.001) and miRNA 200a_2* (10.72 in AD group vs. 17.84 in control group, p=0.022) are also significantly decreased in CD8+ T-cells. This study could show for the first time a significant change of three defined miRNAs in PBMCs, CD4+, and CD8+ T-cells of autoimmune AD patients in vivo. These data may help to better understand the cause of the autoimmune processes leading to autoimmune AD. They extend our very limited knowledge concerning miRNAs in autoimmune Addison's disease. © Georg Thieme Verlag KG Stuttgart · New York.
Ross, Ian; Boulle, Andrew; Soule, Steven; Levitt, Naomi; Pirie, Fraser; Karlsson, Anders; Mienie, Japie; Yang, Ping; Wang, Hongjie; She, Jin-Xiong; Winter, William; Schatz, Desmond
We sought to determine whether autoimmunity is the predominant cause of Addison's disease in South Africa and whether human leucocyte antigen (HLA) DQ association exists. We compiled a national registry of patients from primary care, referral centres and private practices. A total of 144 patients, 94 of European descent, 34 Mixed Ancestry, 5 Asian and 11 Black Africans (mean age 45.9 years, range 2.7-88 years; mean duration of disease 13.1 years, range 0-50 years) and controls were matched for gender and ethnicity. All potential causes were investigated. Fifty one per cent of cases (74 patients) were autoimmune in aetiology. Either 21-hydroxylase autoantibodies (72 patients, 50% of entire patient group) or adrenocortical autoantibodies (35 patients, 24%) were present, while 23% of patients had both. None of the Asian (n = 5) or Black (n = 11) patients had evidence of autoimmune disease. Overall 8% of patients had tuberculosis, 4% adrenoleucodystrophy, 1% adrenocorticotrophic hormone resistance syndrome and 6% X-linked adrenal hypoplasia. In those with autoimmune disease primary hypothyroidism (47%), premature ovarian failure (8%) and type 1 diabetes (7%) were the most prevalent accompanying autoimmune conditions. HLA DQB1*0201 alleles predominated in the autoimmune group (DQB1*0201: 65%vs 43% of controls P = 0.017) with the *0201/*0302 heterozygous genotype being the most prevalent (28%vs 8%P = 0.02). While autoimmunity accounts for at least half of patients with Addison's disease in South Africa and is associated with HLA DQB1*0201, none of the Black Africans or Asians in this cohort had adrenal autoantibodies. Moreover, 21-hydroxylase autoantibodies were detectable in a higher proportion than adrenocortical autoantibodies, especially in those patients with a long history after disease onset.
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Modern life is changing the way people read April 23 was the 16th World Book and Copyright Day,also known as the World Book Day.Reading-related problems have once again attracted people’s attention.Today,living a life with an increasingly rapid pace,most people are
MANGRUM, CHARLES T.
SIGNIFICANT RESEARCH ON THE PHYSIOLOGICAL AND FUNCTIONAL ASPECTS OF VISION AND READING DISABILITY IS SURVEYED. CONCLUSIONS BASED ON THE LITERATURE IN THE FIELD ARE DISCUSSED. A BIBLIOGRAPHY OF 70 REFERENCES AND A GLOSSARY OF TERMS ARE APPENDED. A TABLE SUMMARIZING REFRACTIVE ERRORS AND EYE DEFECTS CONTRIBUTING TO READING DISABILITY IS INCLUDED.…
Outlines the concept of working memory, with particular reference to a hypothetical subcomponent, the articulatory loop. Discusses the role of the loop in fluent adult reading, then examines the reading performance of adults with deficits in auditory verbal memory, showing that a capacity to articulate is not necessary for the effective…
Recent research shows that reading comprehension relies heavily on prior knowledge. Far more than generic "reading skills" like drawing inferences, making predictions, and knowing the function of subheads, how well students learn from a nonfiction text depends on their background knowledge of the text's subject matter. And in a cyclical…
Zigo, Diane; Moore, Michael T.
Science fiction deserves a greater respect, serious and critical reading and a better place in high school literature classes. Some of the science fiction books by Isaac Asimov, Alfred Bester, Ray Bradbury and Octavia L. Butler and various activities for incorporating science fiction into the English language arts instruction classroom are…
Henny Uswatun Hasanah
Full Text Available Teaching is a process of communication. It has to be created through the way of teaching and exchanging the message or information by every teacher and student. The message can be knowledge, skills, ideas, experiences, and many others. Through the process of communication, the people can receive the message or information. To avoid misunderstanding in the process of communication, media are needed in the process of teaching. Magazine can be other alternative as reading material in the classroom. Magazine as reading material has appeal for the students. To make the students get information from magazine, the teacher can ask the students to observe table of content and giving the students training to use it. Like, what is done on text book. Distinguishing informative reading material with fictive reading, important to know students in reading magazine. Like analyzing advertisements to detect propaganda.
Chen, Chih-Ming; Wang, Jung-Ying; Chen, Yong-Ting; Wu, Jhih-Hao
To reduce effectively the reading anxiety of learners while reading English articles, a C4.5 decision tree, a widely used data mining technique, was used to develop a personalized reading anxiety prediction model (PRAPM) based on individual learners' reading annotation behavior in a collaborative digital reading annotation system (CDRAS). In…
Full Text Available ABSTRACTPurpose: The aim of the article is to research reading habits in Slovenia in the period between 16th and 19th century and to find similarities with Austria and other European countries of that time.Methodology/approach: For the purpose of the analysis different resources were used – study books, catechisms, prayer books and manuals. We were focused on introductions in which readers are advised how to read, explaining to whom the work is intended and emphasizing the importance of meditation on the texts.Results: Historically the laud reading was prefered, as to continue the folk tradition. However, the 16th century texts were transmitted by women while the folk tradition was narrated by males. In the 18th century the higher level of literacy and greater book production and availability caused that the books were not a privilege of a few. At that time more texts were intended for silent, individual reading. Interestingly, the authors emphasized the importance of meditation on the texts, too. It was also advised when to read – it wasrecommedend to read in leisure time on Sundays, and on holidays. The role of books was also to breakaway with the reality and to forget everyday problems. Due to the overproduction of books in the 17th centrury it was concerned that books are misleading the crowds. The church considered the reading of books as inappropriate, and criticized fiction, novels and adventure stories mostly read by women.Research limitation: The study is based on Slovenian texts only, although the foreign literature, especially in German, was generally available, too.Originality/practical implications: The study is fullfiling the gap in the history of reading in Slovenia.
Kuzmičová, Anežka; Dias, Patrícia; Vogrinčič Čepič, Ana
in the environment where one engages in individual silent reading. The primary goal of the study was to explore the role and possible associations of a number of variables (text type, purpose, device) in selecting generic (e.g. indoors vs outdoors) as well as specific (e.g. home vs library) reading environments....... Across all six samples included in the study, participants spontaneously attested to varied, and partly surprising, forms of sensitivity to company and social space in their daily efforts to align body with mind for reading. The article reports these emergent trends and discusses their potential...
... Venous Thromboembolism Aortic Aneurysm More Understanding Blood Pressure Readings Updated:Jun 1,2018 What do your blood ... and Live Our Interactive Cardiovascular Library has detailed animations and illustrations to help you learn about conditions, ...
Therkelsen, Anette; Sørensen, Anders
of information sought, amount of information read and level of involvement displayed, indicating a three-pronged typology of guidebook readers. The guidebook reader typology thus constructed may be regarded as a first step in understanding the effect of guidebooks on tourists’ behaviour and their experience......This article investigates tourists’ ways of reading their guidebooks on the basis of qualitative interviews with tourists visiting Copenhagen, Denmark. Tourist guidebooks have only been dealt with sporadically by tourism scholars. The relatively few studies that focus on guidebooks either present...... a historical perspective on the guidebook or centre on content analyses of place representation, whereas virtually no research exists on the way in which tourists read and use their guidebooks. This study reveals that tourists read the same guidebooks in a number of different ways regarding types...
... and language-based learning disabilities are commonly called dyslexia . These disorders are present from a young age ... information about these problems. Types of Reading Disorders Dyslexia is a brain-based type of learning disability ...
Hopkins, Charles R.; Kim, Paul Y.
Since the reading abilities of general business students vary from one individual to the next, the author's report on the readability of three general business textbooks to guide business teachers in their selection of textbooks. (AG)
U.S. Department of Health & Human Services — The Sequence Read Archive (SRA) stores raw sequencing data from the next generation of sequencing platforms including Roche 454 GS System®, Illumina Genome...
Kravitz, Richard; Shapiro, Marvin
The physical education department of the Pennsylvania Advancement School of Philadelphia has established a reading and communication skill project that uses the appeal of sports to help students improve their basic skills. (Author)
Koh, Kim H.; Paris, Scott G.
Effective reading instruction and intervention are rooted in effective assessments of children's developing skills in reading. The article aims to describe the development of new reading assessments to help promote beginning reading in Singapore primary schools. We begin with an introduction to the educational landscape and policies before…
Hudson, Alida K.; Williams, Joan A.
This article details one teacher's implementation of reading workshop in her second grade classroom. She provided a framework for authentic reading using the five components of reading workshop: time, choice, response, community, and structure. She found that reading workshop is a highly effective practice for not only increasing students'…
Boakye, Naomi A. N. Y.
There have been a number of studies on reading interventions to improve students' reading proficiency, yet the majority of these interventions are undertaken with the assumption that students' reading challenges are obvious and generic in nature. The interventions do not take into consideration the diversity in students' reading backgrounds and…
Divoll, Kent; Browning, Sandra
Students do not always read what is expected in college courses (Berry, Cook, Hill, & Stevens, 2010; Phillips & Phillips, 2007; Sikorski et al., 2002) or they read to cram for an exam or quiz (Clump, Bauer, & Bradley, 2004). The Reading Retention Strategy (RRS) is designed to motivate students to read and assist students in…
Full Text Available Poor reading achievement of children in elementary schools has been one of the major concerns in education. The aim of this study is to examine the effectiveness of a child-centered reading intervention in eliminating the reading problems of a student with poor reading achievement. The research was conducted with a student having difficulty in reading. A reading intervention was designed that targeted multiple areas of reading and aimed to improve reading skills through the use of multiple strategies. This intervention is child-centered and includes visual aids, talking, dictating, reading and writing stages. The study was performed in 35 sessions consisting of stages of a single sentence (5 sessions, two sentences (5 sessions, three sentences (20 sessions and the text stage (5 sessions. The intervention sessions were audio-taped. These recordings and the written responses to the reading comprehension questions provided the data for analysis. The findings on the reading intervention revealed positive outcomes. The student exhibited certain improvements at the levels of reading, reading rate and reading comprehension. These results were discussed in the literature and the findings suggest that child-centered reading strategies such as talking, dictating and writing should be the main focus of instruction for students with low reading literacy achievement to enable these students to meet the demands of the curriculum.
Full Text Available Abstract: The challenges of reading are indeed apparent in most teaching and learning processes in ESL classrooms. As a result, this study is conducted to resolve the issues of students who seem to find reading to be unbearable. Many of them have limited ability to read well and hence, possess insufficient reading habits to become competent readers, particularly out-of-school context. Besides, poor home literacy environments also contribute to their shortcomings in reading. The main objectives of this study are to identify the students’ reasons for reading as well as to find out their home reading environments (reading backgrounds and habits; reading attitudes and motivation; reading exposure and supports. To identify these, questionnaires were distributed to 120 secondary school students (Form 4: 16 years old from one of the urban schools in Sarawak, Malaysia. The findings indicate that the students read to gain information and knowledge though many chose reading as a hobby as their last choice in explaining their motives of reading. Besides, they preferred non-academic reading materials, mainly lighter forms reading materials such as comics, story books and magazines. Though the students acknowledged the importance of reading in their daily lives, their average reading habits, attitude, motivation, exposure and support within the home domain had suggested otherwise. They mainly read for instrumental purposes while reading for pleasure seemed not to be given priority. Besides, the respondents acknowledge that their parents and themselves did not read much at home. As an implication, it is vital for students to improve their reading perceptions, abilities and practices to achieve personal, societal and national progress. On a final note, parents’ early and continuous efforts to be involved in their children’s literacy events in an out-of-school context are believed to be vital to inculcate positive reading environments, habits and culture
Full Text Available Abstract: The present study, entitled Improving Students’ Reading Comprehension through Interactive Read-Aloud, attempts to unlock problems found in teaching and reading comprehension through interactive read-aloud in a Senior High School of Sport (SMAN Olah Raga Lampung, in Metro. The findings revealed that students’ reading comprehension improved through interactive read-aloud. The improvement can be seen from the increase of test results, meaning construction, and motivation. The process of reading activities showed that the teacher’s gesture and body language, 20 questions, explain and guess activities were proven to help the students construct meaning from the given texts. In addition, interactive read-aloud is effective to boost students’ motivation to comprehend the texts. Key words: Reading comprehension, interactive read-aloud.
Baron, Naomi S.
The many advantages of reading digitally also bring with them implications for how we learn differently when we read differently. The author suggests that new contemporary technologies are changing the very notion of what it means to read. Even millennials acknowledge that their attention is more focused when they read print rather than online.…
Polk, Cindy L. Howes; Goldstein, David
Indicated that early readers are more likely to be advanced in cognitive development than are nonearly-reading peers. After one year of formal reading instruction, early readers maintained their advantage in reading achievement. Measures of concrete operations were found to predict reading achievement for early and nonearly readers. (Author/DB)
Franc, Lillian H.; Hildebrandt, Jeannette
Concludes, among other things, that fluent oral reading is an important step toward reading for meaning and independent silent reading and that silent reading should be encouraged from the beginning of reading instruction. (FL)
Madhavi Gayathri Raman
Full Text Available This paper captures the design of a comprehensive curriculum incorporating the four skills based exclusively on the use of parallel audio-visual and written texts. We discuss the use of authentic materials to teach English to Indian undergraduates aged 18 to 20 years. Specifically, we talk about the use of parallel reading (screen-play and audio-visual texts (Shawshank Redemption, and Life is Beautiful, A Few Good Men and Lion King drawn from popular culture in the classroom as an effective teaching medium. Students were gradually introduced to films based on novels with extracts from the original texts (Schindler’s List, Beautiful Mind for extended reading and writing practice. We found that students began to pay more attention to aspects such as pronunciation, intonational variations, discourse markers and vocabulary items (phrasal verbs, synonyms, homophones, and puns. Keywords: Reading, films, popular culture, ESL classroom, language skills
Bassou, L; Granié, M; Pugh, A K; Morucci, J P
Is there an effect on binocular coordination during reading of oculomotor imbalance (heterophoria, strabismus and inadequate convergence) and of functional lateral characteristics (eye preference and perceptually privileged visual laterality)? Recordings of the binocular eye-movements of ten-year-old children show that oculomotor imbalances occur most often among children whose left visual perceptual channel is privileged, and that these subjects can present optomotor dissociation and manifest lack of motor coordination. Close binocular motor coordination is far from being the norm in reading. The faster reader displays saccades of differing spatial amplitude and the slower reader an oculomotor hyperactivity, especially during fixations. The recording of binocular movements in reading appears to be an excellent means of diagnosing difficulties related to visual laterality and to problems associated with oculomotor imbalance.
Mohammad Mehdi Yazdani
Full Text Available Investigating the efficiencies and deficiencies of reading strategies is one of the noticeable issues in the related theory and research in reading comprehension instruction. This study was to examine the impact of Directed Reading Thinking Activity (DRTA and Guided Reading (GR on reading comprehension. Sixty three Iranian students of grade one in Shahed high school in the city of Bojnourd took part in the study. They were assigned in three groups, one control and two experimental groups. The instruction lasted for ten weeks. This study utilized a pretest posttest control group in quantitative quasi- experimental design. The same reading comprehension test was administered as pre-test and post-test. The results were twofold: First, the instruction of learning strategies could foster reading comprehension skill. Second, while the explicit instruction of both strategies could improve the students' reading comprehension skill, Directed Reading Thinking Activity had a more significant positive effect than Guided Reading.
Reviewed by Yavuz Akbulut
Full Text Available The book demonstrates the best and most conservative ways to decipher and critique research reports particularly for social science researchers. In addition, new editions of the book are always better organized, effectively structured and meticulously updated in line with the developments in the field of research statistics. Even the most trivial issues are revisited and updated in new editions. For instance, purchaser of the previous editions might check the interpretation of skewness and kurtosis indices in the third edition (p. 34 and in the fifth edition (p.29 to see how the author revisits every single detail. Theory and practice always go hand in hand in all editions of the book. Re-reading previous editions (e.g. third edition before reading the fifth edition gives the impression that the author never stops ameliorating his instructional text writing methods. In brief, “Reading Statistics and Research” is among the best sources showing research consumers how to understand and critically assess the statistical information and research results contained in technical research reports. In this respect, the review written by Mirko Savić in Panoeconomicus (2008, 2, pp. 249-252 will help the readers to get a more detailed overview of each chapters. I cordially urge the beginning researchers to pick a highlighter to conduct a detailed reading with the book. A thorough reading of the source will make the researchers quite selective in appreciating the harmony between the data analysis, results and discussion sections of typical journal articles. If interested, beginning researchers might begin with this book to grasp the basics of research statistics, and prop up their critical research reading skills with some statistics package applications through the help of Dr. Andy Field’s book, Discovering Statistics using SPSS (second edition published by Sage in 2005.
Balling, Laura Winther
Most research on cognates has focused on words presented in isolation that are easily defined as cognate between L1 and L2. In contrast, this study investigates what counts as cognate in authentic texts and how such cognates are read. Participants with L1 Danish read news articles in their highly...... proficient L2, English, while their eye-movements were monitored. The experiment shows a cognate advantage for morphologically simple words, but only when cognateness is defined relative to translation equivalents that are appropriate in the context. For morphologically complex words, a cognate disadvantage...... word predictability indexed by the conditional probability of each word....
Edvardsen, Kine; Bjånesøy, Trine; Hellesen, Alexander; Breivik, Lars; Bakke, Marit; Husebye, Eystein S; Bratland, Eirik
Autoimmune Addison's disease (AAD) is a disorder caused by an immunological attack on the adrenal cortex. The interferon (IFN)-inducible chemokine CXCL10 is elevated in serum of AAD patients, suggesting a peripheral IFN signature. However, CXCL10 can also be induced in adrenocortical cells stimulated with IFNs, cytokines, or microbial components. We therefore investigated whether peripheral blood mononuclear cells (PBMCs) from AAD patients display an enhanced propensity to produce CXCL10 and the related chemokine CXCL9, after stimulation with type I or II IFNs or the IFN inducer poly (I:C). Although serum levels of CXCL10 and CXCL9 were significantly elevated in patients compared with controls, IFN stimulated patient PBMC produced significantly less CXCL10/CXCL9 than control PBMC. Low CXCL10 production was not significantly associated with medication, disease duration, or comorbidities, but the low production of poly (I:C)-induced CXCL10 among patients was associated with an AAD risk allele in the phosphatase nonreceptor type 22 (PTPN22) gene. PBMC levels of total STAT1 and -2, and IFN-induced phosphorylated STAT1 and -2, were not significantly different between patients and controls. We conclude that PBMC from patients with AAD are deficient in their response to IFNs, and that the adrenal cortex itself may be responsible for the increased serum levels of CXCL10.
Bjånesøy, Trine; Hellesen, Alexander; Breivik, Lars; Bakke, Marit; Husebye, Eystein S.; Bratland, Eirik
Autoimmune Addison's disease (AAD) is a disorder caused by an immunological attack on the adrenal cortex. The interferon (IFN)-inducible chemokine CXCL10 is elevated in serum of AAD patients, suggesting a peripheral IFN signature. However, CXCL10 can also be induced in adrenocortical cells stimulated with IFNs, cytokines, or microbial components. We therefore investigated whether peripheral blood mononuclear cells (PBMCs) from AAD patients display an enhanced propensity to produce CXCL10 and the related chemokine CXCL9, after stimulation with type I or II IFNs or the IFN inducer poly (I:C). Although serum levels of CXCL10 and CXCL9 were significantly elevated in patients compared with controls, IFN stimulated patient PBMC produced significantly less CXCL10/CXCL9 than control PBMC. Low CXCL10 production was not significantly associated with medication, disease duration, or comorbidities, but the low production of poly (I:C)-induced CXCL10 among patients was associated with an AAD risk allele in the phosphatase nonreceptor type 22 (PTPN22) gene. PBMC levels of total STAT1 and -2, and IFN-induced phosphorylated STAT1 and -2, were not significantly different between patients and controls. We conclude that PBMC from patients with AAD are deficient in their response to IFNs, and that the adrenal cortex itself may be responsible for the increased serum levels of CXCL10. PMID:25978633
Leton, Donald A.
In recent years, coding and decoding have been claimed to be the processes for converting one language form to another. But there has been little effort to locate these processes in the human learner or to identify the nature of the internal codes. Computer simulation of reading is useful because the similarities in the human reception and…
Glickman, Theodore S; Gough, Michael
... from Resources for the Future are distributed worldwide by The Johns Hopkins University Press. Library of Congress Cataloging-in-Publication Data Readings in risk I Theodore S. Glickman and Michael Gough, editors. p. cm. Includes bibliographical references. ISBN 0-915707-55-1 (alk. paper) 1. Technology-Risk assessment. 2. Health risk assessment....
Over the last 50 years, certain ideas have become dominant that make learning to read different than it once was than the ideas that children are neurologically "wired" to use language "competently" in certain ways. Noam Chomsky has promoted the idea that there are certain "syntactic structures" hard-wired in the human brain. That view, the author…
Jenkins, Jacquelyn W.; Shaul, Nancy Pera
The program described in this paper was based upon the premise that the activity of cooking in the classroom is an excellent way of integrating all areas of learning and a very useful reading vehicle. Through cooking activities and related field trips, children can add to both their knowledge in basic subject areas and their motor skills as well…
Jones, EdD, Darolyn "Lyn"
Reading comprehension gets easier as students learn what kind of reader they are, discover how to keep facts in their head, and much more. Bonus Online Component: includes additional games, including Beat the Clock, a line match game, and a word scramble.
Duane, Drake D., Ed.; Rawson, Margaret B., Ed.
The nine papers in this book discuss aspects of language processing that contribute to reading difficulty. After a summary of the 1974 World Congress on Dyslexia, at which these papers were presented, the following subjects are examined: historical background and educational treatment of dyslexia; the structure of language; neuroanatomy underlying…
Phi Delta Kappan, 1992
Advises administrators to use their summers to relax and recharge their intellectual batteries. Reading suggestions include Edith Wharton's "House of Mirth," Charlotte Perkins Gilman's "The Yellow Wallpaper," Amy Tan's "Joy Luck Club," China Achebe's "Things Fall Apart," Paule Marshall's "The Chosen…
The digital age is rendering books more common, not less. It is true that there is nothing new about "furniture books": The trade in reading material has long been dwarfed by the market for coffee-table books, books that steakhouse chains buy by the yard, empty bindings that interior decorators use to accessorize the upholstery. As coffee-table…
Given the strong sense of passing time which seems to be wired into human beings, it is only natural that the Year 2000, or Y2K in contemporary jargon, should lead to serious speculation about the future. Reading and literacy, old skills relatively speaking, continue rightly to figure in those predictions (along with the technologically advanced…
Kellman, Steven G.
It is hard to imagine a world without books. Reading represents a mode of thinking and being that may be overshadowed in a contemporary world of web sites, movies, TV shows, CDs and video games. Ultimately, the author concludes that the percentage of serious readers has probably not changed significantly during the past century: what has changed…
North, Michael J. [Argonne National Lab. (ANL), Argonne, IL (United States)
SchemaOnRead provides tools for implementing schema-on-read including a single function call (e.g., schemaOnRead("filename")) that reads text (TXT), comma separated value (CSV), raster image (BMP, PNG, GIF, TIFF, and JPG), R data (RDS), HDF5, NetCDF, spreadsheet (XLS, XLSX, ODS, and DIF), Weka Attribute-Relation File Format (ARFF), Epi Info (REC), Pajek network (PAJ), R network (NET), Hypertext Markup Language (HTML), SPSS (SAV), Systat (SYS), and Stata (DTA) files. It also recursively reads folders (e.g., schemaOnRead("folder")), returning a nested list of the contained elements.
Ladd, Megan; Martin-Chang, Sandra; Levesque, Kyle
Teacher reading-related knowledge (phonological awareness and phonics knowledge) predicts student reading, however little is known about the reading-related knowledge of parents. Participants comprised 70 dyads (children from kindergarten and grade 1 and their parents). Parents were administered a questionnaire tapping into reading-related knowledge, print exposure, storybook reading, and general cultural knowledge. Children were tested on measures of letter-word knowledge, sound awareness, receptive vocabulary, oral expression, and mathematical skill. Parent reading-related knowledge showed significant positive links with child letter-word knowledge and sound awareness, but showed no correlations with child measures of mathematical skill or vocabulary. Furthermore, parent reading-related knowledge was not associated with parents' own print exposure or cultural knowledge, indicating that knowledge about English word structure may be separate from other cognitive skills. Implications are discussed in terms of improving parent reading-related knowledge to promote child literacy.
The aim of this article is to place the focus on teachers’ beliefs about reading and reading strategies to the purpose of emphasizing the im portance of reading strategies in the reading process. The method of study is analytic analysis of teachers’ beliefs obtained through ques tionnaires delivered to 18 English language teachers of elementary, secondary and high level education in the region of Saranda in lbania. The results of the study pointed to a great concordance between teach ers’ bel...
Donham van Deusen, Jean; Langhorne, Mary Jo
Describes the Community Reading Month (CRM) initiative in Iowa City, Iowa; its goals are to promote the value of reading and to build a sense of community. Topics include the development of CRM, increased reading scores of Iowa City's elementary school students, activities for people of all ages, and planning and evaluation. (AEF)
Ahmadi, Mohammad Reza; Ismail, Hairul Nizam; Abdullah, Muhammad Kamarul Kabilan
Metacognitive reading strategy awareness plays a significant role in reading comprehension and educational process. In spite of its importance, metacognitive strategy has long been the ignored skill in English language teaching, research, learning, and assessment. This lack of good metacognitive reading strategy skill is exacerbated by the central…
There are many environmental and personal factors that contribute to reading success. Reading comprehension is a complex interaction of language, sensory perception, memory, and motivational aspects. However, most existing assessment tools have not adequately reflected the complex nature of reading comprehension. Good assessment requires a…
Ven, M.A.M. van de; Leeuw, L.C. de; Weerdenburg, M.W.C. van; Steenbeek-Planting, E.G.
This study examined the effects of an intervention with a multicomponent reading game on the development of reading skills in 60 Dutch primary school children with special educational needs. The game contains evidence-based reading exercises and is based on principles of applied gaming. Using a
Ring, Jeremiah J.; Barefoot, Lexie C.; Avrit, Karen J.; Brown, Sasha A.; Black, Jeffrey L.
The important role of reading fluency in the comprehension and motivation of readers is well documented. Two reading rate intervention programs were compared in a cluster-randomized clinical trial of students who were considered at-risk for reading failure. One program focused instruction at the word level; the second program focused instruction…
van den Boer, M.
Being able to read is very important in our literate society. Many studies, therefore, have examined children’s reading skills to improve our understanding of reading development. In general, there have been two types of studies. On the one hand, there is a line of research that focuses on the
van de Ven, M.; de Leeuw, L.; van Weerdenburg, M.; Steenbeek-Planting, E. G.
This study examined the effects of an intervention with a multicomponent reading game on the development of reading skills in 60 Dutch primary school children with special educational needs. The game contains evidence-based reading exercises and is based on principles of applied gaming. Using a multiple baseline approach, we tested children's…
Kim, Young-Suk Grace
The primary goal was to expand our understanding of text reading fluency (efficiency or automaticity)—how its relation to other constructs (e.g., word reading fluency and reading comprehension) changes over time and how it is different from word reading fluency and reading comprehension. We examined (1) developmentally changing relations among word reading fluency, listening comprehension, text reading fluency, and reading comprehension; (2) the relation of reading comprehension to text readi...
Describes computer software, including "The Electronic Bookshelf" and "Return to Reading," which provides motivation for recreational reading in various ways, including: quizzes, games based on books, and whole language activities for children's literature and young adult fiction. (MM)
Mertens, Thomas R.; Robinson, Sandra K.
Describes different sources of readings for understanding issues and concepts of genetic engineering. Broad categories of reading materials are: concerns about genetic engineering; its background; procedures; and social, ethical and legal issues. References are listed. (PS)
Meisinger, Elizabeth B.; Schwanenflugel, Paula J.; Bradley, Barbara A.; Stahl, Steven A.
The influence of social relationships, positive interdependence, and teacher structure on the quality of partner reading interactions was examined. Partner reading, a scripted cooperative learning strategy, is often used in classrooms to promote the development of fluent and automatic reading skills. Forty-three pairs of second grade children were observed during partner reading sessions taking place in 12 classrooms. The degree to which the partners displayed social cooperation (instrumental...
Carreteiro, Rui Manuel; Justo, João Manuel; Figueira, Ana Paula
Home literacy environment explains between 12 and 18.5% of the variance of children's language skills. Although most authors agree that children whose parents encourage them to read tend to develop better and earlier reading skills, some authors consider that the impact of family environment in reading skills is overvalued. Probably, other…
Geoffrion, Leo D.; Bergeron, R. Daniel
The Computer Animated Reading Instruction System (CARIS) was developed to introduce reading to children with varied sensory, cognitive, and physical handicaps. CARIS employs an exploratory learning approach which encourages children to experiment with the reading and writing of words and sentences. Brief computer-animated cartoons provide the…
Discusses the need to place a greater emphasis on the subject of reading in library and information science (LIS) education and research. Topics include literacy studies, print culture history, reader-response theory, ethnography of reading, genre fiction and cultural studies, information versus reading, and access to information versus content of…
South Carolina State Dept. of Education, Columbia. Office of Vocational Education.
This handbook on teaching reading in vocational education is designed to provide vocational education teachers with a resource to use in helping students to develop sound reading skills. Provided in the handbook are information sheets, self-checks, practice activities, and suggestions for further reading dealing with the following topics:…
Shepherd, Mary D.
It is generally agreed that the ability to read mathematics is an important skill--one that few of our students possess. A number of people have published some suggestions for helping students learn to read their mathematics textbooks. What these have in common is suggestions for getting students more active while reading. Using these resources as…
Murray, Laura L; Rutledge, Stefanie
Although individuals with Parkinson's disease (PD) self-report reading problems and experience difficulties in cognitive-linguistic functions that support discourse-level reading, prior research has primarily focused on sentence-level processing and auditory comprehension. Accordingly, the authors investigated the presence and nature of reading comprehension in PD, hypothesizing that (a) individuals with PD would display impaired accuracy and/or speed on reading comprehension tests and (b) reading performances would be correlated with cognitive test results. Eleven adults with PD and 9 age- and education-matched control participants completed tests that evaluated reading comprehension; general language and cognitive abilities; and aspects of attention, memory, and executive functioning. The PD group obtained significantly lower scores on several, but not all, reading comprehension, language, and cognitive measures. Memory, language, and disease severity were significantly correlated with reading comprehension for the PD group. Individuals in the early stages of PD without dementia or broad cognitive deficits can display reading comprehension difficulties, particularly for high- versus basic-level reading tasks. These reading difficulties are most closely related to memory, high-level language, and PD symptom severity status. The findings warrant additional research to delineate further the types and nature of reading comprehension impairments experienced by individuals with PD.
Hagaman, Jessica L.; Luschen, Kati; Reid, Robert
Reading problems are one of the most frequent reasons students are referred for special education services and the disparity between students with reading difficulties and those who read successfully appears to be increasing. As a result, there is now an emphasis on early intervention programs such as RTI. In many cases, early intervention in…
Kern, Richard P.; And Others
This paper presents data describing large differences between the reading difficulty levels of printed materials used in certain military occupational specialties (MOSs) and the relatively lower reading ability levels of men assigned to these MOSs. Initial data explore the relationship between reading ability and utilization of printed materials…
This invention is a direct reading dosimeter which is light, small enough to be worn on a person, and measures both dose rates and total dose. It is based on a semiconductor sensor. The gate threshold voltage change rather than absolute value is measured and displayed as a direct reading of the dose rate. This is effected by continuously switching the gate of an MOS transistor from positive to negative bias. The output can directly drive a digital readout or trigger an audible alarm. The sensor device can be a MOSFET, bipolar transistor, or MOSFET capacitor which has its electrical characteristics change due to the trapped charge in the insulating layer of the device
What is reading? What is writing? What connects the two? These questions have been the fertile ground for many literary and philosophical theories, from New Criticism to Deconstruction. This essay does not pretend answering to these two questions, but rather to question the question themselves...... and try to shed a different light of this essential problematic. Choosing not to consider literature as a stable concept, but rather as an ontologically impermanent one, I try to reflect upon the terms that condition our approach of works and of the creation of these works. In a large perspective......, the notions of “reading” and “writing” are examined through the prism of their incarnations as “works”, and the consequences of this identity have on our critical discourse. In order to read critically, one must thus recognize this immanent instability of our notions and definitions, and begin from...
Pirandola, Stefano; Braunstein, Samuel L; Lupo, Cosmo; Mancini, Stefano; Giovannetti, Vittorio
The readout of a classical memory can be modelled as a problem of quantum channel discrimination, where a decoder retrieves information by distinguishing the different quantum channels encoded in each cell of the memory (Pirandola 2011 Phys. Rev. Lett. 106 090504). In the case of optical memories, such as CDs and DVDs, this discrimination involves lossy bosonic channels and can be remarkably boosted by the use of nonclassical light (quantum reading). Here we generalize these concepts by extending the model of memory from single-cell to multi-cell encoding. In general, information is stored in a block of cells by using a channel-codeword, i.e. a sequence of channels chosen according to a classical code. Correspondingly, the readout of data is realized by a process of ‘parallel’ channel discrimination, where the entire block of cells is probed simultaneously and decoded via an optimal collective measurement. In the limit of a large block we define the quantum reading capacity of the memory, quantifying the maximum number of readable bits per cell. This notion of capacity is nontrivial when we suitably constrain the physical resources of the decoder. For optical memories (encoding bosonic channels), such a constraint is energetic and corresponds to fixing the mean total number of photons per cell. In this case, we are able to prove a separation between the quantum reading capacity and the maximum information rate achievable by classical transmitters, i.e. arbitrary classical mixtures of coherent states. In fact, we can easily construct nonclassical transmitters that are able to outperform any classical transmitter, thus showing that the advantages of quantum reading persist in the optimal multi-cell scenario. (paper)
Zitniak, J.; Pargac, M.
In the Slovak Environmental Agency during relative short time originated the first version of software product using of GPS technology for monitoring of negative phenomena in nature. It was denominated as readShape and its primary goal is to minister for conservator of environment geographically strictly to observe endangered territories as are, for example, fire, fish kill, impact of motor vehicle accident or dangerous objects as are illegal stock-piles, wastes and other. Process of monitoring is described
This paper focuses on fan fiction as a literary experience and especially on fan fiction readers’ receptive strategies. Methodologically, its approach is at the intersection of literary theory, theory of popular culture, and qualitative research into practices of communication within online communities. It presents a general characterization of fan fiction as a type of contemporary reading and writing, drawing upon the influential works by H. Jenkins, A. Dericho, K. Tosenberger, and others. T...
guidelines. 9 Kanban is a technique for managing workflow originating from the lean engineering methods pioneered by Toyota. [Reinertsen 2009...Cockburn, Alistair, & Pols, Andy. Patterns for Effective Use Cas- es. Addison-Wesley, 2002. Anderson, David. Kanban . Blue Hole Press, 2010. CMU/SEI-2013
will help make such decisions. A further approach growing in use is the workflow-oriented Kanban method of limiting work in progress and... Kanban , Blue Hole Press, 2010. 18. K.. Beck, Extreme Programming Explained, Addison Wesley, 1999. Contract Number: H98230-08-D-0171 TO 0031, RT
Therefore, managing job stress with various coping strategies in an organization such as Oyo ... level of relationship between job stressors and coping strategies. ..... Behavior. 2nd(Ed). Addison-Wesley Publishing Company, Inc. pp295-31. ... Lietal, Y. X., Yang, X., &Shen, J. L. (2007). The relationship between teachers'.
capacity of what can be accomplished - but at a price. Brod [Ref. 25: pp. 16-171 uses the term " technostress " to describe the inability to cope with...T., Structured Analysis and System Sr~cifcatonYourdon, Inc. , 1S/9. 25. Brod, C. , Technostress , Addison-Wesley, 1984. 26. Brod, C. Technostress
Jul 6, 2016 ... 1. Introduction. The violation of the action and reaction principle in classical .... ering that the moving m possesses an electric dipole moment d = c−1 v × m. ..... man lectures on physics (Addison-Wesley, New York, 1964). Vol. 2.
results in lower change traffic and defect incidence. • KSS: Incremental SE, with some design up-front and design continuing throughout development...Boston: Addison-Wesley.  Morgan, James M, and Jeffrey K Liker. (2006). The Toyota Product Development System: Integrating People, Process, and
Mishkin , Frederic S. and Stanley G. Eakins. Financial Markets + Institutions . Boston, MA: Addison Wesley. 2003... Financial Markets , Federal Reserve Bank of New York, 1998. Mishkin , Frederic S. and Eakins, Stanley G., Financial Markets + Institutions , Fourth...discussion of the industry would be complete without an understanding of the concept of moral hazard in the financial markets . According to Mishkin
Programming Software Engineering Strong Typing Tasking Audene . Computer Scientists Terbook(s): Barnes, J. Programming in Ada, 3rd ed. Addison-Wesley...Ada. Concept: Abstract Data Types Management Overview Package Real-Time Programming Tasking Audene Computer Scientists Textbook(s): Barnes, J
quantities are found to satisfy the empirical ideal gas law, that is. m m. m m m. PV. N k T ... forces1,2 and theoretically developed general equation of state for gases as 3,4,5 ..... Theory and Statistical Thermodynamics, 3rd Ed. Addison-Wesley ...
Groebner Bases Moss Sweedler ...................................................... 699 Using Macsyma in a Generalized Harmonic Balance Method for a Problem...Doing Mathiematics by Comnputer, Addison-Wesley Publishing Company, 1988. 698 Groebner Bases GROEBNER BASES Moss Sweedler Mathematical Sciences...Institute Cornell University Ithaca NY 14853 ABSTRACT Groebner bases are remarkable sets of polynomials which permit effec- tive manipulation of multivariate
Reinhold, Fran; Vernot, Dave
Describes four online information service packages developed for schools: (1) Dialog's Classroom Instruction Program; (2) Addison-Wesley's Einstein; (3) WNET's Learning Link; and (4) McGraw-Hill's Information Exchange (MIX). Databases offered in each service are described, as well as accompanying curriculum materials, and costs for the services…
Full Text Available Donald, Forensic Analysis of the Contents of Nokia Mobile Phones, 2006, Pp 1-4.  W.G. Kruse and J.G. Heiser, Computer Forensics, Incident response essentials, Addison-Wesley, Boston, 2001.  M. Kohn, J.H.P. Eloff, M. Olivier, Framework for a Digital...
Control of Dynamic Systems Addison-Wesley Publishing Company, 1961. 7. Karadimas , C., Design and Analysis of Discrete Lateral Autogilots for BTT...GREECE 8. LT Karadimas , Christos H.N 1 Kolokotroni 156 Piraeus GREECE ’-- 138 ............-.... *9. LT Karadimt trf s, Antont os HRN 201 Glenwood Circle
Kwon, Heekyung; Linderholm, Tracy
We hypothesised that college students take reading speed into consideration when evaluating their own reading skill, even if reading speed does not reliably predict actual reading skill. To test this hypothesis, we measured self-perception of reading skill, self-perception of reading speed, actual reading skill and actual reading speed to…
Sonia Maria Gomes Ferreira
Full Text Available Arising at a time of unprecedented growth of interest in fostering critical thinking, Introducing Reading offers a clear introduction and thorough account of contemporary developments in the field of reading. While overtly focusing on the special demands of social and human aspects of the reading practice, the issues raised have crucial resonance in the sphere of critical reading. Explicitly addressed to teachers of mother tongue and foreign language contexts, the book claims to elaborate on aspects of reading which have received meager attention to date: individual readers engaged in different real-world reading tasks, the social contexts where such readers engage and interact with texts, and the nature and variety of texts, here regarded as “participants” in the interaction between reader and writer. To this extent, the book successfully reaches the ambitious aim of “socializing and humanizing reading and the teaching of reading” (p. xi. Arising at a time of unprecedented growth of interest in fostering critical thinking, Introducing Reading offers a clear introduction and thorough account of contemporary developments in the field of reading. While overtly focusing on the special demands of social and human aspects of the reading practice, the issues raised have crucial resonance in the sphere of critical reading. Explicitly addressed to teachers of mother tongue and foreign language contexts, the book claims to elaborate on aspects of reading which have received meager attention to date: individual readers engaged in different real-world reading tasks, the social contexts where such readers engage and interact with texts, and the nature and variety of texts, here regarded as “participants” in the interaction between reader and writer. To this extent, the book successfully reaches the ambitious aim of “socializing and humanizing reading and the teaching of reading” (p. xi.
Full Text Available Reading act is performed by connected physiological, psychological and cognitive processes. The operations taking place in these processes are expected to continue for life by being developed with certain strategies. A lot of information is gained with reading skill in education life. Therefore, basic concepts that constitute reading education in teaching and improving reading are important for teachers. The aim of this study is to submit information compiled from the literature about reading education process and which basic concepts are used in reading education. While teaching reading from part to whole, from whole to part and interactional approaches are used. From part to whole approach is at the forefront. Then with interactional approach strategies, both code solving and making sense is improved. Teachers should know the characteristics of bouncing, stopping, turning back, and scanning movements of the eye both in code solving and making sense. The teacher should configure the teaching for the students to gain fluid reading elements by making use of reading out and reading silently. After reading act is acquired; good reader characteristics should be gained by improving asking questions, guessing, summarizing, interpretation skills in integrated readings. Reading skill is improved by studies on the text. Therefore, the students should come across texts that are suitable to their levels, textuality and readability criteria. The vocabulary of children should be improved in a planned way with text-based word and meaning studies. Fluid reading, making sense and interpretation skills of children should be pursued with different evaluation types. In the long term, work should be done to make reading a habit for them.
Dalton, Russell W.
This article reflects on the vivid images of reading presented in several popular fantasy novels, including "The Spiderwick Chronicles," "The Great Good Thing," and "The Neverending Story." It suggests that these images can be used to help children, youth, and adults reflect on the nature of reading and the potential power of reading sacred texts.…
O'Connor, Rollanda E.
The goal of improving reading rate and fluency is to positively impact reading comprehension; however, it is unclear how fast students with learning disabilities (LD) need to read to reap this benefit. The purpose of this research was to identify the point of diminishing return for students who were dysfluent readers. Participants included 337…
The use of book clubs in college developmental reading classes is an effective way to encourage reluctant readers to build and strengthen reading skills, foster reading enjoyment, and engage students. In addition, book clubs build a sense of community within the classroom as the students converse and share their interpretations of the reading…
Several empirical studies and syntheses of extensive reading have concluded that extensive reading has positive impacts on language learning in second- and foreign-language settings. However, many of the studies contained methodological or curricular limitations, raising questions about the asserted positive effects of extensive reading. The…
Jiang, Xiangying; Sawaki, Yasuyo; Sabatini, John
This study examined the relationship among word reading efficiency, text reading fluency, and reading comprehension for adult English as a Foreign Language (EFL) learners. Data from 185 adult Chinese EFL learners preparing to take the Test-of-English-as-a-Foreign-Language[TM] (TOEFL[R]) were analyzed in this study. The participants completed a…
Poulsen, Mads; Nielsen, Anne-Mette Veber; Juul, Holger
Early screening for reading difficulties before the onset of instruction is desirable because it allows intervention that is targeted at prevention rather than remediation of reading difficulties. However, early screening may be too inaccurate to effectively allocate resources to those who need...... them. The present study compared the accuracy of early screening before the onset of formal reading instruction with late screening six months into the first year of instruction. The study followed 164 Danish students from the end of Grade 0 to the end of Grade 2. Early screening included measures...... of phonemic awareness, rapid naming, letter knowledge, paired associate learning, and reading. Late screening included only reading. Results indicated that reading measures improved substantially as predictors over the first six months of Grade 1, to the point where late reading measures alone provided...
Giordano, Roberta; Guaraldi, Federica; Marinazzo, Elisa; Fumarola, Federica; Rampino, Alessia; Berardelli, Rita; Karamouzis, Ioannis; Lucchiari, Manuela; Manetta, Tilde; Mengozzi, Giulio; Arvat, Emanuela; Ghigo, Ezio
In patients with Addison's disease (AD), a dual-release preparation of hydrocortisone (Plenadren, PLEN) has been demonstrated to maintain cortisol levels in a more physiological range than conventional glucocorticoid therapy, and to exert positive effects. This study aimed to assess variations of anthropometric, metabolic, and hormonal parameters in patients with AD after switching from conventional hydrocortisone (HC) treatment to PLEN. In nineteen AD patients (15 F and 4 M, age 27-65 years) treated with HC 20 mg/day thrice daily, body weight, BMI, waist circumference, fasting glucose, HbA1c, serum lipids, plasma renin activity, electrolytes, and blood pressure were evaluated at baseline, and 1, 3, 6, and 12 months after switching from HC to PLEN. At baseline, and after 1 and 12 months of PLEN, blood ACTH and cortisol (at 0800 h at fasting, and 30, 60, 90, 120, and 240 min after drug ingestion), and health-related quality of life (HRQoL), using 30-AddiQoL questionnaire, were evaluated. During PLEN, waist and serum lipid progressively decreased. After 12 months of PLEN, a significant difference was observed in waist circumference (P = 0.007), HbA1c (P = 0.002), total and LDL-cholesterol levels (P < 0.05). ACTH levels at 240 min and the area under the curve (AUC) were lower (P < 0.05) during PLEN than HC, while cortisol peaks and AUC were similar. 30-AddiQoL total score also improved (P = 0.04) during PLEN. In AD patients, PLEN reduces central adiposity, and improves glucose and metabolism parameters and HRQoL.
Circadian hormone profiles and insulin sensitivity in patients with Addison's disease: a comparison of continuous subcutaneous hydrocortisone infusion with conventional glucocorticoid replacement therapy.
Björnsdottir, Sigridur; Øksnes, Marianne; Isaksson, Magnus; Methlie, Paal; Nilsen, Roy M; Hustad, Steinar; Kämpe, Olle; Hulting, Anna-Lena; Husebye, Eystein S; Løvås, Kristian; Nyström, Thomas; Bensing, Sophie
Conventional glucocorticoid replacement therapy in patients with Addison's disease (AD) is unphysiological with possible adverse effects on mortality, morbidity and quality of life. The diurnal cortisol profile can likely be restored by continuous subcutaneous hydrocortisone infusion (CSHI). The aim of this study was to compare circadian hormone rhythms and insulin sensitivity in conventional thrice-daily regimen of glucocorticoid replacement therapy with CSHI treatment in patients with AD. An open, randomized, two-period, 12-week crossover multicentre trial in Norway and Sweden. Ten Norwegian patients were admitted for 24-h sampling of hormone profiles. Fifteen Swedish patients underwent euglycaemic-hyperinsulinaemic clamp. Thrice-daily regimen of oral hydrocortisone (OHC) and CSHI treatment. We measured the circadian rhythm of cortisol, adrenocorticotropic hormone (ACTH), growth hormone (GH), insulin-like growth factor-1, (IGF-1), IGF-binding protein-3 (IGFBP-3), glucose, insulin and triglycerides during OHC and CSHI treatment. Euglycaemic-hyperinsulinaemic clamp was used to assess insulin sensitivity. Continuous subcutaneous hydrocortisone infusion provided a more physiological circadian cortisol curve including a late-night cortisol surge. ACTH levels showed a near normal circadian variation for CSHI. CSHI prevented a continuous decrease in glucose during the night. No difference in insulin sensitivity was observed between the two treatment arms. Continuous subcutaneous hydrocortisone infusion replacement re-established a circadian cortisol rhythm and normalized the ACTH levels. Patients with CSHI replacement had a more stable night-time glucose level compared with OHC without compromising insulin sensitivity. Thus, restoring night-time cortisol levels might be advantageous for patients with AD. © 2015 John Wiley & Sons Ltd.
The radiological features that accompany measles are reviewed. Changes due to viral infection may be complicated by those secondary to bacterial superinfection. The syndrome of relapsing pulmonary infection after measles is discussed, and studies on the pathogenesis are presented. S. Afr. Med. J., 48, 1001 (1974) ...
Sixty-two black children were prospectively followed up for 1 - 7 years after pneumonia contracted at a median age of 17 months. In 55% of cases the pneumonia was measles-associated and 27% had serological evidence of Infection with other respiratory viruses. Recurrence of cough or wheeze for more than 6 months ...
Van Den Boer, Madelon; van Bergen, Elsje; de Jong, Peter F.
Many studies have examined reading and reading development. The majority of these studies, however, focused on oral reading rather than on the more dominant silent reading mode. Similarly, it is common practice to assess oral reading abilities rather than silent reading abilities in schools and in
This paper gives a short analysis of reading abilities and reading strategies. Much research has been done to investigate the nature of reading, though it's had to exactly define reading abilities and strategies. Different kinds of readings are discussed in this paper and distinctions are made between first language reading and second or foreign…
Broeder, Peter; Stokmans, Mia
While reading behaviour of adolescents is a frequent object of research, most studies in this field are restricted to a single country. This study investigates reading as a leisure-time activity across social groups from three regions differing in reading tradition as well as in the facilities available for reading. The authors analyse the reading behaviour of a total of 2,173 adolescents in the Netherlands, in Beijing (China), and in Cape Town (South Africa). Taking Icek Ajzen's Theory of Planned Behaviour as a starting point, the authors adjusted it to model the three most important determinants of reading behaviour, namely (1) reading attitude; (2) subjective norms (implicit and explicit social pressure to read); and (3) perceived behavioural control, which includes reading proficiency and appropriateness of the available books (book supply). While they found the adjusted model to fit the Dutch and Beijing situation quite well, it appeared to be inappropriate for the Cape Town situation. Despite considerable cultural and situational differences between the Netherlands and Beijing, the results show a similar pattern for these two environments. The most important determinants turn out to be: the hedonic reading attitude, the implicit norm of family and friends, the attractiveness of the available choice of books, and the perceived reading proficiency.
Minh Ha, Thien; Niggeler, Dieter; Bunke, Horst; Clarinval, Jose
Although giro forms are used by many people in daily life for money remittance in Switzerland, the processing of these forms at banks and post offices is only partly automated. We describe an ongoing project for building an automatic system that is able to recognize various items printed or written on a giro form. The system comprises three main components, namely, an automatic form feeder, a camera system, and a computer. These components are connected in such a way that the system is able to process a bunch of forms without any human interactions. We present two real applications of our system in the field of payment services, which require the reading of both machine printed and handwritten information that may appear on a giro form. One particular feature of giro forms is their flexible layout, i.e., information items are located differently from one form to another, thus requiring an additional analysis step to localize them before recognition. A commercial optical character recognition software package is used for recognition of machine-printed information, whereas handwritten information is read by our own algorithms, the details of which are presented. The system is implemented by using a client/server architecture providing a high degree of flexibility to change. Preliminary results are reported supporting our claim that the system is usable in practice.
Albrechtslund, Anne-Mette Bech
The increasing use of social media along with the rapidly developing digitization of the book has led to a range of new circumstances for writing, publishing and reading books, resulting in transformations in reading culture and practices. The social aspect of reading is emphasized when readers...... relations in the network of writers, publishers, readers, and reviewers. Similarly, the increasing use of electronic reading devices plays a key role in the acceleration of a culture in which the audience engages with cultural works in new ways. The print book has an “easy materiality” (Marshall, 2010, p....... 17), but with the electronic book, the materiality of reading becomes more ambiguous and malleable as the book as technology is being radically reconstructed. The purpose of this paper is to explore these changes through an investigation into the technology relations (Ihde, 1990) in fiction reading...
Full Text Available In this research we start from the assumption that teachers act as mediators of reading practices in school and problematise their practices, meanings and representations of reading. We have investigated meanings constructed by a group of teachers of Physics, Chemistry and Biology, working at a federal technical school. Having French discourse analysis as our theoretical-methodological framework, we considered that meanings, concepts and conceptions of reading are built historically through discourses, which produce meanings that determine ideological practices. Our results show that, for that group of teachers, there were no opportunities during either initial training or on-going education for reflecting upon the role of reading in science teaching and learning. Moreover, there seems to be an association between the type of discourse and modes of reading, so that unique meanings are attributed to scientific texts and their reading are linked to search and assimilation of information.
Veenendaal, Nathalie J.; Groen, Margriet A.; Verhoeven, Ludo
Background: Text reading prosody has been associated with reading comprehension. However, text reading prosody is a reading-dependent measure that relies heavily on decoding skills. Investigation of the contribution of speech prosody--which is independent from reading skills--in addition to text reading prosody, to reading comprehension could…
The objective was to ensure ourselves and the general public that the workers in the Nuclear Materials Processing Department (NMPD) could read, follow, and understand procedures. Procedures were randomly selected and analyzed for reading levels. A tenth grade reading level was established as the standard for all NMPD employees. Employees were tested to determine reading levels and approximately 12% could not read at the target level. A Procedure Walk-Through Evaluation was administered to each person not reaching tenth grade reading level. This was a job performance measure given to ensure that the worker was competent in his/her present job, and should remain there while completing reading training. A mandatory Reading Training Program utilizing Computer Based Training was established. This program is self-paced, individualized instruction and provided to the worker on Company time. Results of the CBT Program have been very good. Instruction is supplemented with test-taking skills seminars, practice exams, individual conferences with their own reading specialist, and some self-directed study books. This paper describes the program at Savannah River Site
Kim, Young-Suk Grace
The primary goal was to expand our understanding of text reading fluency (efficiency or automaticity)-how its relation to other constructs (e.g., word reading fluency and reading comprehension) changes over time and how it is different from word reading fluency and reading comprehension. We examined (1) developmentally changing relations among word reading fluency, listening comprehension, text reading fluency, and reading comprehension; (2) the relation of reading comprehension to text reading fluency; (3) unique emergent literacy predictors (i.e., phonological awareness, orthographic awareness, morphological awareness, letter name knowledge, vocabulary) of text reading fluency vs. word reading fluency; and (4) unique language and cognitive predictors (e.g., vocabulary, grammatical knowledge, theory of mind) of text reading fluency vs. reading comprehension. These questions were addressed using longitudinal data (two timepoints; Mean age = 5;24 & 6;08) from Korean-speaking children ( N = 143). Results showed that listening comprehension was related to text reading fluency at time 2, but not at time 1. At both times text reading fluency was related to reading comprehension, and reading comprehension was related to text reading fluency over and above word reading fluency and listening comprehension. Orthographic awareness was related to text reading fluency over and above other emergent literacy skills and word reading fluency. Vocabulary and grammatical knowledge were independently related to text reading fluency and reading comprehension whereas theory of mind was related to reading comprehension, but not text reading fluency. These results reveal developmental nature of relations and mechanism of text reading fluency in reading development.
Perfetti, Charles A; Tan, Li-Hai
Do differences in writing systems translate into differences in the brain's reading network? Or is this network universal, relatively impervious to variation in writing systems? A new study adds intriguing evidence to these questions by showing that reading handwritten words activates a pre-motor area across writing systems. Copyright © 2012 Elsevier Ltd. All rights reserved.
This paper is the findings from existing literature on the mechanics of using book talks and story books to inculcate reading and the steps to develop good reading culture in children. This work is an ongoing action research work in selected private and public schools in Lagos Mainland. It has so far been established that the ...
Kendall, Elizabeth L.; Chenoweth, Roberta
This activity guide is one of four supplements to be used with "Do You Read Me? Prevocational-Vocational Reading Development Activities" (ED 210 454). Each supplement deals with a different occupational category. Games, puzzles, and other activities are offered to aid in developing the word recognition, vocabulary, and comprehension…
It has been found that motivation is very important to children's reading competence. This paper intended to study intrinsic and extrinsic motivation and find their relationship with children's reading competence. In order to do so, previous investigations about intrinsic and extrinsic motivation were critically reviewed, and their results were discussed in this paper.
Chou, Mei-Ju; Cheng, Jui-Ching; Cheng, Ya-Wen
This research aims to explore how preschool educators understand about raising children's reading motivation through operating classroom aesthetic reading environment. With one year qualitative research, sixteen 4-6 years old young were observed and interviewed. The first stage interviews were undergone with environmental guidance. After the…
Online reading requires traditional and new comprehension skills and strategies, and these skills and strategies will have to be taught and supported, especially for young beginning readers. But how do elementary teachers go about doing this? Much of the research regarding teaching and supporting online reading comprehension has focused on older…
Full Text Available Derived from the project with the same name, the work was published into a book by the Ministry of Culture and Tourism, Directorate General of Libraries and Publications, the project coordinator. Goal of the project is defined as follows: "specifying the solutions to problems faced directly or indirectly in accessing information, making suggestions to related corporations and persons, determining the perception of libraries in the society, raising the quality of services provided at public libraries and children's libraries affiliated with the Ministry, diversifying these libraries and designating the road map for the future." Carried out with the "method of face-to-face surveys" with 6.212 people in 26 cities, the research revealed the society's habits of reading and library usage.
Hooper, G.; Williams, C.C.P.; Ezra, D.
The Parliamentary Under-Secretary at the Department of Energy introduced the second reading of the Electricity Bill which provides for the restructuring and privatisation of the electricity supply industry throughout Great Britain. Three features at the heart of the Government's proposals are mentioned - first that the proposals will promote competition in electricity generation and supply of electricity so there will be a downward pressure on costs and prices, second is a new deal for customers and third is the security of electricity supply which will be ensured by the diversity of suppliers. The benefits of the scheme are outlined and then specific details of the Bill are considered. The debate which followed lasted six hours and is reported verbatim. The issues raised included environmental effects, efficiency, energy conservation, research and development and investment. (UK)
The exact role that phonological coding (the recoding of written, orthographic information into a sound based code) plays during silent reading has been extensively studied for more than a century. Despite the large body of research surrounding the topic, varying theories as to the time course and function of this recoding still exist. The present review synthesizes this body of research, addressing the topics of time course and function in tandem. The varying theories surrounding the function of phonological coding (e.g., that phonological codes aid lexical access, that phonological codes aid comprehension and bolster short-term memory, or that phonological codes are largely epiphenomenal in skilled readers) are first outlined, and the time courses that each maps onto (e.g., that phonological codes come online early [prelexical] or that phonological codes come online late [postlexical]) are discussed. Next the research relevant to each of these proposed functions is reviewed, discussing the varying methodologies that have been used to investigate phonological coding (e.g., response time methods, reading while eye-tracking or recording EEG and MEG, concurrent articulation) and highlighting the advantages and limitations of each with respect to the study of phonological coding. In response to the view that phonological coding is largely epiphenomenal in skilled readers, research on the use of phonological codes in prelingually, profoundly deaf readers is reviewed. Finally, implications for current models of word identification (activation-verification model, Van Orden, 1987; dual-route model, e.g., M. Coltheart, Rastle, Perry, Langdon, & Ziegler, 2001; parallel distributed processing model, Seidenberg & McClelland, 1989) are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Kluger, Nicolas; Matikainen, Niina; Sintonen, Harri; Ranki, Annamari; Roine, Risto P; Schalin-Jäntti, Camilla
Patients with Addison's disease (AD) on conventional replacement therapy have impaired health-related quality of life (HRQoL). It is possible that lower hydrocortisone (HC) doses recommended by current guidelines could restore HRQoL. We compared HRQoL in AD patients treated according to current HC recommendations to that of the age- and gender-standardized general population. We assessed HRQoL in a cross-sectional setting with the 15D instrument in a Finnish AD cohort (n = 107) and compared the results with those of a large sample of general population (n = 5671). We examined possible predictors of HRQoL in AD. Within the patient group, HRQoL was also assessed by SF-36. Mean HC dose was 22 mg/d, corresponding to 12 ± 4 mg/m2. HRQoL was impaired in AD compared with the general population (15D score; 0·853 vs 0·918, P < 0·001). Within single 15D dimensions, discomfort and symptoms, vitality and sexual activity were most affected. Stepwise regression analysis demonstrated that Patient's Association membership (P = 0·02), female gender (P < 0·01), presence of other autoimmune or inflammatory comorbidity (P < 0·02), lower education (P < 0·02) and longer disease duration (P < 0·05) independently predicted impaired HRQoL, whereas replacement regimens, autoimmune-related comorbidities, total number of comorbidities or level of healthcare follow-up did not. In AD, HRQoL was impaired also as assessed by SF-36. HRQoL is significantly impaired in AD compared with the general population despite use of recommended HC doses. Patient's Association membership was the most significant predictor of impaired HRQoL. This finding should be explored in more detail in the future. © 2014 John Wiley & Sons Ltd.
Reading difficulties are experienced by children either because they fail to decode the words and thus are unable to comprehend the text or simply fail to comprehend the text even if they are able to decode the words and read them out. Failure in word decoding results from a failure in phonological coding of written information, whereas, reading…
McDonald Connor, Carol
The best way to teach children how to read has been debated for more than a century. Accumulating research now shows that there is no one best way to teach reading. The effect of various types of instruction depends on the constellation of skills learners bring to the classroom. In this article, we discuss the idea of…
Joseph, Jane; Noble, Kimberly; Eden, Guinevere
This paper reviews studies using positron emission tomography and functional magnetic resonance imaging in adults to study the reading process and notes that general networks of regions seem to be uniquely associated with different components of the reading process. Findings are evaluated in light of technical and experimental limitations and…
Ngandu, Kathleen M.
This handbook contains advice for the teacher in diagnosing dyslexia and developing an individualized program for overcoming severe reading problems. Observable characteristics of dyslexia are listed as an aid to the teacher's diagnosis, but it is emphasized that cooperation between the teacher and a reading specialist is of great importance in…
Due to a medical condition I temporarily lost the ability to read and write. As an academic researcher specialised in understanding the reading process, I can benefit from this terrible experience by explaining – on a scientific level – what happened to me, and hence draw the lines to existing re...
McCreary, John J.
For this study, empathy was defined as not only understanding and sharing another's mental state, but also responding from a perspective more closely resembling the observed rather than the observer. Based on evidence suggesting relationships between reading and empathy, between empathy and gender, and between reading and gender, the current study…
Suárez-Coalla, Paz; Álvarez-Cañizo, Marta; Martínez, Cristina; García, Noemí; Cuetos, Fernando
Reading becomes expressive when word and text reading are quick, accurate and automatic. Recent studies have reported that skilled readers use greater pitch changes and fewer irrelevant pauses than poor readers. Given that developmental dyslexics have difficulty acquiring and automating the alphabetic code and developing orthographic…
Hohenstein, Sven; Kliegl, Reinhold
Word features in parafoveal vision influence eye movements during reading. The question of whether readers extract semantic information from parafoveal words was studied in 3 experiments by using a gaze-contingent display change technique. Subjects read German sentences containing 1 of several preview words that were replaced by a target word…
Reading is a multileveled, interactive, and hypothesis-generating process in which readers construct a meaningful representation of text by using their knowledge of the world and of language. If reading involves grasping the significance of an input depending on the reader's mental cognitive-perceptual situation, then there is a form of background…
Reading groups or book clubs have become increasingly popular in recent years, with many libraries, bookshops and workplaces hosting meetings, while a wealth of support is available online. They provide a chance to read, share opinions, chat and have fun--each one will be unique in how it works. Discussing books can help to reinforce, change or…
Presents a collection of quotes by famous people about reading for enjoyment and personal development. The collection was assembled from a lifetime of fond association with books and reading by the rare-book librarian at the State Library in Berlin, who after Hitler's rise, relocated to the United States and founded the Bettmann Archive in New…
Christensen, Mette Vedsgaard
-home literacy-intervention throughout a school year. The children in the intervention group (1500 children in year 2 and 3) received reading materials and their parents were informed about how to talk about texts, language and knowledge with their children through specially developed tools such as “reading...
Ingerslev, Gitte Holten
the reading of literature is respectively supported and hindered in literature lessons in upper secondary school. The aim is to investigate the relation between the teacher's conception of learning and knowledge within the subject combined with the student's conception of learning and of reading...
Examined how reading attitudes of Year 6 boys in British primary schools were influenced by gender issues, peers, and peer group culture. Found that confidence and experience shown in private reading was at odds with boys' public attitudes in discussion with peers. Suggests that siblings and adults might provide more positive role models for…
Scholastic Inc., 2015
This report presents the 5th Edition of Scholastic's biannual study of children's and parents' attitudes and behaviors about reading. The latest research touches on reading aloud to children of all ages, the impact of reading independently for fun at school and at home, the importance of frequent reading, and the books children want most to read.…
Desy Olivia Riani
Full Text Available This collaborative action research is aimed to find out whether or not the implementation of Collaborative Strategic Reading (CSR improves students' reading comprehension and also to identify students' attitude towards the implementation of CSR. CSR is reading strategy that employs four strategies namely Preview, Click and Clunk, Get the Gist and Wrap Up during students’ cooperative learning. A class of eleventh grade students of a public senior high school in Majalengka, West Java, Indonesia is participated as the participant of the study. The required data were collected through the use of questionnaire, observation checklist, and reading test. The data from the questionnaire indicated that 82% students had positive attitude toward the implementation of CSR. They feel that CSR improves their motivation in learning English and CSR brings more fun to the process of learning. Moreover, it was found from observation data that the students were actively participated during CSR implementation and they were motivated when comprehending a text by means CSR strategy. Finally, the study proved that CSR improved students’ reading comprehension. Students’ mean score of reading test in the beginning of the study was 67, meanwhile, after applying CSR as reading strategy, their mean scores improved to 88.
Ana María Montes-Salas
Full Text Available In the NMS has been relevant to investigate the notion of reading and how reading comprehension skills are developed as they are the basis of learning. According to Frida Diaz Barriga and Hernandez (2002 critical and reflective understanding of the composition of texts written are nodal activities in the construction of meanings. We now know that the skills of reading and typesetting apprentices develop in subjects strategically and self-regulated, thanks to this research. Promote the development of communication skills contributes to the foundation of the curriculum consists of educating for students to acquire skills that allow them to face problems collaboratively and competently.
Reading is extremely important for pupils and their development. The pupil with reading habits riches his vocabulary and gaining knowledge. On the other hand the pupil through reading entry into the world of imagination and stories. Major role in motivating students to read have parents and teachers. In this graduation thesis I was interested in how third grade teachers motivate their pupils to read. In doing so, I was focused mainly to reading for required reading and The Reading Badge. ...
Courtin, E.; Grund, K.; Traub, S.; Zeeb, H.
The peak reading detector circuit serves for picking up the instants during which peaks of a given polarity occur in sequences of signals in which the extreme values, their time intervals, and the curve shape of the signals vary. The signal sequences appear in measuring the foetal heart beat frequence from amplitude-modulated ultrasonic, electrocardiagram, and blood pressure signals. In order to prevent undesired emission of output signals from, e. g., disturbing intermediate extreme values, the circuit consists of the series connections of a circuit to simulate an ideal diode, a strong unit, a discriminator for the direction of charging current, a time-delay circuit, and an electronic switch lying in the decharging circuit of the storage unit. The time-delay circuit thereby causes storing of a preliminary maximum value being used only after a certain time delay for the emission of the output signal. If a larger extreme value occurs during the delay time the preliminary maximum value is cleared and the delay time starts running anew. (DG/PB) [de
Wilson, Jo-Anne R.
An elementary school reading teacher describes how she restructured her teaching methods by encouraging children to read and write as part of an integrated process, rather than teaching reading alone as a set of fragmented steps. (GC)
Nisakorn Charumanee believes that a reading teacher has an active role in cultivating reading culture or reading habit and in activating students to "want" to read. One way to do this is to integrate extensive reading into the classroom (Day and Bamford, 1998; Bamford and Day, 2004) where extensive reading can be enhanced if the teacher…
Fink, Katherine T.; Devine, Thomas G.
Less competent adult readers have not developed the habit of reading. Ways to cultivate adult reading habits include relevant material, environment saturated with reading material, reading aloud to adults, having them read to children, sustained silent reading, modeling, book sharing, author conferences, and recognition. (SK)
Seok, Soonhwa; DaCosta, Boaventura
This research investigated oral reading fluency as a predictor of silent reading fluency at the secondary and postsecondary levels. Several measures were used, including the Gray Oral Reading Test, the Test of Silent Word Reading Fluency, the Test of Silent Contextual Reading Fluency, and the Reading Observation Scale. A total of 223 students…
Manning, Maryann; Manning, Gary
Presents elementary school teachers with 13 ideas on how to achieve a balanced "diet" in their primary and intermediate reading and writing programs using 5 different genres--artistic, personal, narrative, expository, and procedural. (BB)
Sonja Pečjak; Nataša Bucik
Reading motivation is one of the crucial factors of reading and consequently also learning efficiency of students. The purpose of the contribution is to establish the connection between dimensions of reading motivation and reading achievement in elementary school students. Participating in the study were 1073 third-grade and 1282 seventh-grade students. We used the questionnaire of reading motivation which consists of two factors: the reading competence factor and the interest and perceived r...
Full Text Available Besides achieving secure communication between two spatially-separated parties,another important issue in modern cryptography is related to secure communication intime, i.e., the possibility to confidentially store information on a memory for later retrieval.Here we explore this possibility in the setting of quantum reading, which exploits quantumentanglement to efficiently read data from a memory whereas classical strategies (e.g., basedon coherent states or their mixtures cannot retrieve any information. From this point ofview, the technique of quantum reading can provide a new form of technological security fordata storage.
Ghelani, Karen; Sidhu, Robindra; Jain, Umesh; Tannock, Rosemary
Reading comprehension is a very complex task that requires different cognitive processes and reading abilities over the life span. There are fewer studies of reading comprehension relative to investigations of word reading abilities. Reading comprehension difficulties, however, have been identified in two common and frequently overlapping childhood disorders: reading disability (RD) and attention-deficit/hyperactivity disorder (ADHD). The nature of reading comprehension difficulties in these groups remains unclear. The performance of four groups of adolescents (RD, ADHD, comorbid ADHD and RD, and normal controls) was compared on reading comprehension tasks as well as on reading rate and accuracy tasks. Adolescents with RD showed difficulties across most reading tasks, although their comprehension scores were average. Adolescents with ADHD exhibited adequate single word reading abilities. Subtle difficulties were observed, however, on measures of text reading rate and accuracy as well as on silent reading comprehension, but scores remained in the average range. The comorbid group demonstrated similar difficulties to the RD group on word reading accuracy and on reading rate but experienced problems on only silent reading comprehension. Implications for reading interventions are outlined, as well as the clinical relevance for diagnosis.
Full Text Available In the paper we set the aim to determine whether phonological awareness and short-term verbal memory are indicators of a subsequent reading acquisition. The sample consisted of 194 first graders from two primary schools in Belgrade. The results of our research showed that the most significant indicator of the subsequent (unsuccessful reading was phonological awareness. The short-term verbal memory is, to a lesser extent, an indicator of the subsequent reading acquisition defined by the time needed for reading the text and by the text comprehension. Our findings offer basis for proposing that the phonological awareness assessment should be implemented into the regular procedure of assessing child's readiness for school. In this way children in need for preventive stimulation within the inclusive programme in primary schools could be identified.
U.S. Department of Health & Human Services — The CDRH FOIA electronic reading room contains frequently requested information via the Freedom of Information Act from the Center for Devices and Radiological Health.
Loni Kreis Taglieber
Full Text Available The purpose of this paper is to provide, for L1 and L2 reading and writing teachers, a brief overview of the literature about critical reading and higher level thinking skills. The teaching of these skills is still neglected in some language classes in Brazil, be it in L1 or in L2 classes. Thus, this paper may also serve as a resource guide for L1 and/or L2 reading and writing teachers who want to incorporate critical reading and thinking into their classes. In modern society, even in everyday life people frequently need to deal with complicated public and political issues, make decisions, and solve problems. In order to do this efficiently and effectively, citizens must be able to evaluate critically what they see, hear, and read. Also, with the huge amount of printed material available in all areas in this age of “information explosion” it is easy to feel overwhelmed. But often the information piled up on people’s desks and in their minds is of no use due to the enormous amount of it. The purpose of this paper is to provide, for L1 and L2 reading and writing teachers, a brief overview of the literature about critical reading and higher level thinking skills. The teaching of these skills is still neglected in some language classes in Brazil, be it in L1 or in L2 classes. Thus, this paper may also serve as a resource guide for L1 and/or L2 reading and writing teachers who want to incorporate critical reading and thinking into their classes. In modern society, even in everyday life people frequently need to deal with complicated public and political issues, make decisions, and solve problems. In order to do this efficiently and effectively, citizens must be able to evaluate critically what they see, hear, and read. Also, with the huge amount of printed material available in all areas in this age of “information explosion” it is easy to feel overwhelmed. But often the information piled up on people’s desks and in their minds is of
Carreteiro, Rui Manuel; Justo, João Manuel; Figueira, Ana Paula
Home literacy environment explains between 12 and 18.5 % of the variance of children's language skills. Although most authors agree that children whose parents encourage them to read tend to develop better and earlier reading skills, some authors consider that the impact of family environment in reading skills is overvalued. Probably, other variables of parent-child relationship, like parenting styles, might be relevant for this field. Nevertheless, no previous studies on the effect of parenting styles in literacy have been found. To analyze the role of parenting styles in the reading processes of children. Children's perceptions of parenting styles contribute significantly to the explanation of statistical variance of children's reading processes. 110 children (67 boys and 43 girls), aged between 7 and 11 years (M [Formula: see text] 9.22 and SD [Formula: see text] 1.14) from Portuguese schools answered to a socio-demographic questionnaire. To assess reading processes it was administered the Portuguese adaptation (Figueira et al. in press) of Bateria de Avaliação dos Processos Leitores-Revista (PROLEC-R). To assess the parenting styles Egna Minnen av Barndoms Uppfostran-parents (EMBU-P) and EMBU-C (children version) were administered. According to multiple hierarchical linear regressions, individual factors contribute to explain all reading tests of PROLEC-R, while family factors contribute to explain most of these tests. Regarding parenting styles, results evidence the explanatory power about grammatical structures, sentence comprehension and listening. Parenting styles have an important role in the explanation of higher reading processes (syntactic and semantic) but not in lexical processes, focused by main theories concerning dyslexia.
Pirozzolo, Francis J
Neuropsychological and Cognitive Processes in Reading explores reading and reading disabilities within the context of cognitive psychology and neuropsychology. Emphasis is on the roles of brain mechanisms in reading and reading disturbances. In the areas of perception and cognition, theoretical models of the reading process are used to highlight the various psychological processes involved in the act of skilled reading. Comprised of 12 chapters, this volume begins with an introduction to the fundamental processes of reading, giving particular attention to a psychological theory that builds on two concepts: that the basic processes of reading are few in number, and that they are separable from one another. A useful and testable information-processing model of reading that consists of three separable, fundamental processes - decoding, word meaning, and sentence comprehension - is described. Subsequent chapters deal with some of the external and internal factors involved in reading; a model of disorders of readi...
Holly Warzecha, M.A. TESOL
Full Text Available The purpose of the following paper is to take a closer look at the benefits of incidental learning through reading, with a specific focus on vocabulary acquisition. The teaching of vocabulary has traditionally been an explicit process where the target vocabulary is taken out of context and taught separately. However, this kind of explicit teaching and learning may only take into account a form-meaning connection. Therefore, this paper explores research on incidental learning and specifically looks at what it takes to acquire new vocabulary incidentally through reading while considering the coverage rates of texts, how many words must be known already from the text, how many repetitions it takes to learn a word, types of texts that promote learning, and the effects of pairing students‘ reading with learner tasks. After reviewing many studies, it can be concluded that more reading is better. More specifically, extensive reading of chosen novels at an appropriate level and interest to the students showed important gains in vocabulary. In addition, readings that were supplemented with additional activities that focused on both form and meaning showed an even higher increase in word retention.
Yong, Keir X X; Rajdev, Kishan; Shakespeare, Timothy J; Leff, Alexander P; Crutch, Sebastian J
We report (1) the quantitative investigation of text reading in posterior cortical atrophy (PCA), and (2) the effects of 2 novel software-based reading aids that result in dramatic improvements in the reading ability of patients with PCA. Reading performance, eye movements, and fixations were assessed in patients with PCA and typical Alzheimer disease and in healthy controls (experiment 1). Two reading aids (single- and double-word) were evaluated based on the notion that reducing the spatial and oculomotor demands of text reading might support reading in PCA (experiment 2). Mean reading accuracy in patients with PCA was significantly worse (57%) compared with both patients with typical Alzheimer disease (98%) and healthy controls (99%); spatial aspects of passages were the primary determinants of text reading ability in PCA. Both aids led to considerable gains in reading accuracy (PCA mean reading accuracy: single-word reading aid = 96%; individual patient improvement range: 6%-270%) and self-rated measures of reading. Data suggest a greater efficiency of fixations and eye movements under the single-word reading aid in patients with PCA. These findings demonstrate how neurologic characterization of a neurodegenerative syndrome (PCA) and detailed cognitive analysis of an important everyday skill (reading) can combine to yield aids capable of supporting important everyday functional abilities. This study provides Class III evidence that for patients with PCA, 2 software-based reading aids (single-word and double-word) improve reading accuracy. © 2015 American Academy of Neurology.
Full Text Available Reading motivation is one of the crucial factors of reading and consequently also learning efficiency of students. The purpose of the contribution is to establish the connection between dimensions of reading motivation and reading achievement in elementary school students. Participating in the study were 1073 third-grade and 1282 seventh-grade students. We used the questionnaire of reading motivation which consists of two factors: the reading competence factor and the interest and perceived reading importance factor. The findings of the study are the following: third-graders are more competent and more interested in reading compared to seventh-graders. The same is true for girls in both educational levels. Reading competence , interest and perceived reading importance reflect also in the actual reading behaviour of students – students who are more competent and more interested in reading read more frequently, for longer periods and more often autonomously decide to read compared to their less motivated peers. Higher reading motivation has implications also for higher reading efficiency. Namely, good readers are more competent, show higher interest and perceive reading as more important compared to average and bad readers.
Rajdev, Kishan; Shakespeare, Timothy J.; Leff, Alexander P.; Crutch, Sebastian J.
Objective: We report (1) the quantitative investigation of text reading in posterior cortical atrophy (PCA), and (2) the effects of 2 novel software-based reading aids that result in dramatic improvements in the reading ability of patients with PCA. Methods: Reading performance, eye movements, and fixations were assessed in patients with PCA and typical Alzheimer disease and in healthy controls (experiment 1). Two reading aids (single- and double-word) were evaluated based on the notion that reducing the spatial and oculomotor demands of text reading might support reading in PCA (experiment 2). Results: Mean reading accuracy in patients with PCA was significantly worse (57%) compared with both patients with typical Alzheimer disease (98%) and healthy controls (99%); spatial aspects of passages were the primary determinants of text reading ability in PCA. Both aids led to considerable gains in reading accuracy (PCA mean reading accuracy: single-word reading aid = 96%; individual patient improvement range: 6%–270%) and self-rated measures of reading. Data suggest a greater efficiency of fixations and eye movements under the single-word reading aid in patients with PCA. Conclusions: These findings demonstrate how neurologic characterization of a neurodegenerative syndrome (PCA) and detailed cognitive analysis of an important everyday skill (reading) can combine to yield aids capable of supporting important everyday functional abilities. Classification of evidence: This study provides Class III evidence that for patients with PCA, 2 software-based reading aids (single-word and double-word) improve reading accuracy. PMID:26138948
Full Text Available The present study explored the interrelations between foreign language (FL reading anxiety, FL reading strategy use and their interactive effect on FL reading comprehension performance at the tertiary level in China. Analyses of the survey data collected from 1702 university students yielded the following results: (a Both Foreign Language Reading Anxiety Scale (FLRAS and Foreign Language Reading Strategy Use Scale (FLRSUS had important subcomponents, (b more than half of the students generally did not feel anxious when reading English, and were confident in and satisfied with their English reading proficiency. Meanwhile, (c more than half of them moderately used different types of reading strategies such as planning, checking and confirming, predicting and assessing, when reading English, (d compared with their female peers, male students felt significantly more anxious when facing reading activities, less satisfied with their English reading proficiency, and used specific analyzing and planning strategies significantly less often during a reading activity, (e FLRAS was significantly inversely related to FLRSUS, and both were significantly correlated with the students’ FL reading comprehension performance, and (f FLRAS (overall FL reading anxiety, FLRAS1 (general anxiety about FL reading, and FLRSUS2 (predicting strategies were good predictors of FL reading comprehension performance. Based on the findings, some implications are discussed.
This study investigates the relationship between strategic reading instruction, the process of learning second language-based reading strategies and English reading achievement for Thai university students of science and technology. In a course in reading general English texts for 16?weeks, 82 students were taught using a strategies-based approach…
Pedersen, Niels C; Brucker, Lynn; Tessier, Natalie Green; Liu, Hongwei; Penedo, Maria Cecilia T; Hughes, Shayne; Oberbauer, Anita; Sacks, Ben
Sebaceous adenitis (SA) and Addison's disease (AD) increased rapidly in incidence among Standard Poodles after the mid-twentieth century. Previous attempts to identify specific genetic causes using genome wide association studies and interrogation of the dog leukocyte antigen (DLA) region have been non-productive. However, such studies led us to hypothesize that positive selection for desired phenotypic traits that arose in the mid-twentieth century led to intense inbreeding and the inadvertent amplification of AD and SA associated traits. This hypothesis was tested with genetic studies of 761 Standard, Miniature, and Miniature/Standard Poodle crosses from the USA, Canada and Europe, coupled with extensive pedigree analysis of thousands more dogs. Genome-wide diversity across the world-wide population was measured using a panel of 33 short tandem repeat (STR) loci. Allele frequency data were also used to determine the internal relatedness of individual dogs within the population as a whole. Assays based on linkage between STR genomic loci and DLA genes were used to identify class I and II haplotypes and disease associations. Genetic diversity statistics based on genomic STR markers indicated that Standard Poodles from North America and Europe were closely related and reasonably diverse across the breed. However, genetic diversity statistics, internal relatedness, principal coordinate analysis, and DLA haplotype frequencies showed a marked imbalance with 30 % of the diversity in 70 % of the dogs. Standard Poodles with SA and AD were strongly linked to this inbred population, with dogs suffering with SA being the most inbred. No single strong association was found between STR defined DLA class I or II haplotypes and SA or AD in the breed as a whole, although certain haplotypes present in a minority of the population appeared to confer moderate degrees of risk or protection against either or both diseases. Dogs possessing minor DLA class I haplotypes were half as
Messman, Anne M; Walker, Ian
Textbook reading plays a foundational role in a resident's knowledge base. Many residency programs place residents on identical reading schedules, regardless of the clinical work or rotation the resident is doing. We sought to develop a reading curriculum that takes into account the clinical work a resident is doing so their reading curriculum corresponds with their clinical work. Preliminary data suggests an increased amount of resident reading and an increased interest in reading as a result of this change to their reading curriculum.
Zhongshe Lu; Meihua Liu
The present study explored the interrelations between foreign language (FL) reading anxiety, FL reading strategy use and their interactive effect on FL reading comprehension performance at the tertiary level in China. Analyses of the survey data collected from 1702 university students yielded the following results: (a) Both Foreign Language Reading Anxiety Scale (FLRAS) and Foreign Language Reading Strategy Use Scale (FLRSUS) had important subcomponents, (b) more than half of the stu...
Gompel, Marjolein; van Bon, Wim H. J.; Schreuder, Robert
This study of the reading of text found that despite their lower reading speed on a reading-comprehension task, the children with low vision comprehended texts at least as well as did the sighted children. Children with low vision need more time to read and comprehend a text, but they seem to use this time with enough efficiency to process the…
Dix, Suzanne Liacos
As advocates for reading, librarians cannot help but love a reading program. In this article, the author talks about the Battle of the Books, a reading enrichment program that had been in place since 1996. Battle of the Books promotes reading among middle school students by offering interesting books and a trivia-type competition. The author…
Historically, political debates have broken out over how to teach reading in primary schools and infant classrooms. These debates and "reading wars" have often resulted from public concerns and media reportage of a fall in reading standards. They also reflect the importance placed on learning to read by parents, teachers, employers, and…
Reading skills are vital to student success, and those skills could be practiced with Shakespeare "if students are taught reading skills in the classroom." The problem is that many teachers of English do not consider themselves reading specialists and do not teach reading skills to their students. Fred L. Hamel notes that teachers in a recent…
Reading is an indispensable tool of learning. Every course of study is accomplished partly through reading. Lecturers in the University usually have high expectations of a students‟ ability to cope with the demands of reading. However, reading as a practice and an art has tended to diminish. The general expectations of ...
You have young preschool children. You think ahead to when they will begin school, and wonder what you might do to make it easy for your children to learn to read. This article offers some hints for parents and caregivers about learning to read: (1) Reading can begin at birth; (2) When reading aloud to an infant, make the experience a warm, loving…
Based on the results of Phase I of a reading skills project in 2000 (SAJHE 16(3) 2002), Phase II was undertaken to set up a reading intervention programme on a voluntary basis for students enrolled in a mathematics access module, to determine whether explicit attention given to reading would improve their reading skills ...
Full Text Available This research takes an action research aimed at promoting critical reading (“thinking” while reading skills using authentic materials among the students. This research also aims to reveal the students perception on using critical reading skills in reading activities. Nineteen English Education Department students who took Reading IV class, participated in this project. There were three cycles with three different critical reading strategies were applied. Meanwhile, the authentic materials were taken from newspaper and internet articles. The result revealed that the use of critical reading strategies along with the use of authentic materials has improved students’ critical reading skills as seen from the improvement of each cycle - the students critical reading skill was 54% (fair in the cycle 1 improved to 68% (average in cycle 2, and 82% (good in cycle 3.. In addition, based on the critical reading skill criteria, the students’ critical reading skill has improved from 40% (nearly meet to 80% (exceed. Meanwhile, from the students’ perception questionnaire, it was shown that 63% students agreed the critical reading activity using authentic text could improve critical thinking and 58% students agreed that doing critical reading activity could improve reading comprehension. The result had the implication that the use of authentic texts could improve students’ critical reading skills if it was taught by performing not lecturing them. Selectively choosing various strategies and materials can trigger students’ activeness in responding to a text, that eventually shape their critical reading skills.
Irish, Christy K.; Parsons, Seth A.
Sharing reading techniques with families is an important responsibility of teachers. Dialogic reading is one way to improve young students' expressive vocabulary skills, which are important for later reading success. Dialogic reading also supports students' understanding of story structure and content. This well researched technique has not been…
Shaw, Donita Massengill
The purpose of this manuscript was to describe information about an animal-assisted therapy, specifically the Reading Education Assistance Dog (R.E.A.D.) program. In this manuscript I provide information about R.E.A.D. programs in general. Next, I share perspectives solicited from R.E.A.D. participants, specifically teachers, parents, students and…
Davis, Marcia H.; Tonks, Stephen M.; Hock, Michael; Wang, Wenhao; Rodriguez, Aldo
Reading motivation is a critical contributor to reading achievement and has the potential to influence its development. Educators, researchers, and evaluators need to select the best reading motivation scales for their research and classroom. The goals of this review were to identify a set of reading motivation student self-report scales used in…
This paper reports on an investigation into students' attitudes to and motivations for reading. These socio-affective factors relating to students' reading abilities have been largely ignored in L1 and L2 reading research, especially in L2 contexts. Yet, L2 students tend to display differing motivations and attitudes for L2 reading ...
Karstadt, Roberta; Rey, Victoria M.
Newspapers are an effective educational and motivational tool in developmental reading classes. However, many students are unfamiliar with newspapers and read them infrequently. In order to foster newspaper reading and familiarize the college freshmen enrolled in their developmental reading classes with newspapers, the writers of this article…
Catts, Hugh W.; Nielsen, Diane Corcoran; Bridges, Mindy Sittner; Liu, Yi-Syuan
Most research on early identification of reading disabilities has focused on word reading problems and little attention has been given to reading comprehension difficulties. In this study, we investigated whether measures of language ability and/or response to language intervention in kindergarten uniquely predicted reading comprehension…
Daniela Blagoj Dimitrova-Radojichikj
Full Text Available A comparison reading performance was done between 8 students who are using Braille and 14 students who are using enlarged print to read. Reading performance was determined using reading rate (words per minute, wpm. Reading rate results showed no significant difference (p>0.05 between those using the Braille (16.62±11.61 wpm and those using the enlarged print (27.21±24.89 wpm. This study has shown that Braille reader students read at lower reading rate compared to print reader students with visual impairment.
Banales, Erin; Kohnen, Saskia; McArthur, Genevieve
The aim of the current study was to determine whether poor verbal working memory is associated with poor word reading accuracy because the former causes the latter, or the latter causes the former. To this end, we tested whether (a) verbal working memory training improves poor verbal working memory or poor word reading accuracy, and whether (b) reading training improves poor reading accuracy or verbal working memory in a case series of four children with poor word reading accuracy and verbal working memory. Each child completed 8 weeks of verbal working memory training and 8 weeks of reading training. Verbal working memory training improved verbal working memory in two of the four children, but did not improve their reading accuracy. Similarly, reading training improved word reading accuracy in all children, but did not improve their verbal working memory. These results suggest that the causal links between verbal working memory and reading accuracy may not be as direct as has been assumed.
Levy, B A; Newell, S; Snyder, J; Timmins, K
Five experiments examined changes in the processing of a text across reading encounters. Experiment 1 showed that reading speed increased systematically across encounters, with no loss in the extensiveness of analyses of the printed text, as indicated by the ability to detect nonword errors embedded within that passage. Experiment 2 replicated this improved reading fluency with experience and showed that it occurred even with typescript changes across trials, thus indicating that a primed visual operations explanation cannot account for the effect. The third and fourth experiments then extended the study of the familiarity effect to higher level processing, as indicated by the detection of word errors. Familiarity facilitated the detection of these violations at the syntactic-semantic levels. Finally, Experiment 5 showed that these higher level violations continued to be well detected over a series of reading encounters with the same text. The results indicate that prior experience improves reading speed, with no attenuation of analysis of the printed words or of the passage's message.
Full Text Available Reading Comprehension has been determined (by the Director of First Common Year Program to be one of the core subjects for the first year IPB students, either in semester one or two. With the objective of being able to read English texts effectively and efficiently, the teaching of reading for these undergraduate programs are basically confined to skills that can develop reading speed and improve students‘ comprehension and reasoning abilities. Thus, skills like finding both general and specific ideas, guessing unknown words, finding meanings from English-English dictionary, predicting, ad nfinding inferences are those need to be covered. Such kind of teaching, however, can sometimes become a demanding task when dealing with certain classroom conditions and with certain targets. It is, therefore, a challenge for all English teachers in my university to be able to carry out the task well so as to achieve the above teaching objectives. Meanwhile, students‘ evaluation reveals that 3 semesters ago, teachers obtained various scores in their teaching evaluation, ranging from 2 to 3.7 out of the 1-4 scale. This paper, accordingly, is written to find out the teaching method and strategies used by those obtaining relatively good scores (3.2 and above in order to disseminate them as better insights for the teaching of reading not only in my university but also other schools or colleges.
Sfafi'i, Muhammad Lukman
Reading as one of language skills plays significant roles in the teaching English as a foreign language. Since the teacher still uses the conventional way to teach reading, students‘ ability in reading comprehension seems still unsatisfactory yet. So, teacher should explore and develop new strategies. One of strategies in reading comprehension that can trigger our students to attain that purpose is SMART (Self Monitoring Approach for Reading and Thinking) strategy. ...
Huang, Jiuhan; Nisbet, Deanna
This article explores the relationship between reading strategy use and reading proficiency among 121 adult ESL learners. Reading strategy use was measured by the SORS, and reading proficiency was determined by the CASAS Reading Test and BEST Literacy Test. Findings of the study reveal that (a) adult ESL learners are active strategies users; (b)…
Mendez, Linda M. Raffaele; Pelzmann, Catherine A.; Frank, Michael J.
In this study, we piloted a Tier 2 intervention designed to improve reading skills among struggling early readers using an intervention that included SRA Reading Mastery, listening-while-reading activities, strategies to increase motivation and engagement in reading, and parent involvement in reading homework. The study included 6 students in…
Snellings, Patrick; van der Leij, Aryan; de Jong, Peter F.; Blok, Henk
Breznitz (2006) demonstrated that Hebrew-speaking adults with reading disabilities benefited from a training in which reading rate was experimentally manipulated. In the present study, the authors examine whether silent reading training enhances the sentence reading rate and comprehension of children with reading disabilities and whether results…
Reading is one of the most significant skills, particularly for EFL students. Many students today do not have the reading skills needed to do effective work in their courses. This paper explores reading for pleasure, its importance and impact on reading comprehension. Pleasure reading helps students to communicate, listen and, most importantly, to…
This study investigated the metacognitive awareness and reading strategies use of high school-aged English language learners (ELLs) and the relationship between ELL reading strategy use and reading proficiency as measured by a standardized reading test and self-rated reading proficiency. Results reveal that participants reported moderate use of…
Small, Ruth V.
In education, it is possible to find dozens of examples of "forced" reading incentive programs that categorize student reading levels, provide limited reading lists coordinated with those reading levels, assess student reading through computer-based tests, and award tangible prizes when they pass the test. Those who perform best get the most…
Long, Deanna; Szabo, Susan
This quasi-experimental mixed methods study examined the use of e-readers during guided reading instruction and its impact on 5th grade students' reading motivation, attitude toward reading, and reading comprehension. For 10 weeks, 19 students received guided reading instruction by means of the traditional paper/text format, while 16 students…
Kirnan, Jean; Siminerio, Steven; Wong, Zachary
An existing school program in which therapy dogs are integrated into the reading curriculum was analyzed to determine the effect on student reading. Previous literature suggests an improvement in both reading skills and attitudes towards reading when students read in the presence of a therapy dog. Using a mixed method model, the researchers…
Maurer, Trent W.; Longfield, Judith
This study compared students' daily in-class reading quiz scores in an introductory Child Development course across five conditions: control, reading guide only, reading guide and on-line practice quiz, reading guide and on-line graded quiz, and reading guide and both types of on-line quizzes. At the beginning of class, students completed a 5-item…
The purpose of this study was to examine the associations between reading motivation and inference generation while reading. Undergraduate participants (N = 69) read two science articles while thinking aloud, completed a standardized reading comprehension assessment, and self reported their habitual reading motivation. Findings indicate that…
Veenendaal, Nathalie J; Groen, Margriet A; Verhoeven, Ludo
Text reading prosody has been associated with reading comprehension. However, text reading prosody is a reading-dependent measure that relies heavily on decoding skills. Investigation of the contribution of speech prosody - which is independent from reading skills - in addition to text reading prosody, to reading comprehension could provide more insight into the general role of prosody in reading comprehension. The current study investigates how much variance in reading comprehension scores is explained by speech prosody and text reading prosody, after controlling for decoding, vocabulary, and syntactic awareness. A battery of reading and language assessments was performed by 106 Dutch fourth-grade primary school children. Speech prosody was assessed using a storytelling task and text reading prosody by oral text reading performance. Decoding skills, vocabulary, syntactic awareness, and reading comprehension were assessed using standardized tests. Hierarchical regression analyses showed that text reading prosody explained 6% of variance and that speech prosody explained 8% of variance in reading comprehension scores, after controlling for decoding, vocabulary, and syntactic awareness. Phrasing was the significant factor in both speech and text reading. When added in consecutive order, phrasing in speech added 5% variance to phrasing in reading. In contrast, phrasing in reading added only 3% variance to phrasing in speech. The variance that speech prosody explained in reading comprehension scores should not be neglected. Speech prosody seems to facilitate the construction of meaning in written language. © 2014 The British Psychological Society.
Ready, Rebecca E.; Chaudhry, Maheen F.; Schatz, Kelly C.; Strazzullo, Sarah
There are few tests that assess reading comprehension in adults, but these tests are needed for a comprehensive assessment of reading disorders (RD). "The Nelson-Denny Reading Test" (NDRT) has a long-passage reading comprehension component that can be used with adolescents and adults. A problem with the NDRT is that reading comprehension…
Meniado, Joel C.
Metacognitive reading strategies and reading motivation play a significant role in enhancing reading comprehension. In an attempt to prove the foregoing claim in a context where there is no strong culture for reading, this study tries to find out if there is indeed a relationship between and among metacognitive reading strategies, reading…
Buari, Noor Halilah; Chen, Ai-Hong; Musa, Nuraini
A reading chart that resembles real reading conditions is important to evaluate the quality of life in terms of reading performance. The purpose of this study was to compare the reading speed of UiTM Malay related words (UiTM-Mrw) reading chart with MNread Acuity Chart and Colenbrander Reading Chart. Fifty subjects with normal sight were randomly recruited through randomized sampling in this study (mean age=22.98±1.65 years). Subjects were asked to read three different near charts aloud and as quickly as possible at random sequence. The charts were the UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart, respectively. The time taken to read each chart was recorded and any errors while reading were noted. Reading performance was quantified in terms of reading speed as words per minute (wpm). The mean reading speed for UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart was 200±30wpm, 196±28wpm and 194±31wpm, respectively. Comparison of reading speed between UiTM-Mrw Reading Chart and MNread Acuity Chart showed no significant difference (t=-0.73, p=0.72). The same happened with the reading speed between UiTM-Mrw Reading Chart and Colenbrander Reading Chart (t=-0.97, p=0.55). Bland and Altman plot showed good agreement between reading speed of UiTM-Mrw Reading Chart with MNread Acuity Chart with the Colenbrander Reading Chart. UiTM-Mrw Reading Chart in Malay language is highly comparable with standardized charts and can be used for evaluating reading speed. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.
Lynch, Tai E.
Educational leaders are charged with making informed decisions regarding various aspects of schooling that affect the overall achievement of students. Numerous legislative ideas, funding initiatives, programming standards, and practicing guidelines for early childhood education programs have been introduced (Buyssee & Wesley, 2006). Early care…
Pulzer, A; Burger-Stritt, S; Hahner, S
Adrenal insufficiency, a rare disorder which is characterized by the inadequate production or absence of adrenal hormones, may be classified as primary adrenal insufficiency in case of direct affection of the adrenal glands or secondary adrenal insufficiency, which is mostly due to pituitary or hypothalamic disease. Primary adrenal insufficiency affects 11 of 100,000 individuals. Clinical symptoms are mainly nonspecific and include fatigue, weight loss, and hypotension. The diagnostic test of choice is dynamic testing with synthetic ACTH. Patients suffering from chronic adrenal insufficiency require lifelong hormone supplementation. Education in dose adaption during physical and mental stress or emergency situations is essential to prevent life-threatening adrenal crises. Patients with adrenal insufficiency should carry an emergency card and emergency kit with them.
Baranski Lamback, Elisa; Morandi, Grazia; Rapti, Eleni; Christov, Georgi; Brogan, Paul A; Hindmarsh, Peter
Polyglandular autoimmune syndrome (PGA) and eosinophilic granulomatosis with polyangiitis (EGPA) do not seem to represent a coincidental association. A case of a 15-year-old boy is reported who presented with severe systemic inflammation, perimyocarditis and cardiogenic shock, in whom EGPA was initially suspected and later diagnosed with autoimmune adrenalitis with PGA. The severity of the systemic inflammation and perimyocarditis suggests a more widespread autoimmune-mediated process. Autoimmune adrenal insufficiency should be considered in all cases of pericarditis and perimyocarditis, especially when the severity of clinical manifestations exceeds the expected for the severity of the cardiac findings, as timely identification and prompt treatment may be life-saving.
Wolf, Jutta Manuela
Die Psychoneuroimmunologie beschäftigt sich unter anderem mit der Frage, ob und unter welchen Bedingungen psychosozialer Stress krank macht. Humanstudien, die dieser Frage nachgehen, können dabei meist nur korrelative Zusammenhänge aufdecken. Um trotzdem Aussagen zu Mechanismen, Ursache-Wirkungsbeziehungen und klinische Relevanz treffen zu können, muss z.B. auf Befunde aus der Tierforschung oder aus in vitro-Studien zurückgegriffen werden. Ziel der vorliegenden Arbeit war es, eine Methode zu ...
... These conditions can lead to an adrenal crisis. Pregnancy Women with adrenal insufficiency who become pregnant are ... can benefit from following a diet rich in sodium. A health care provider or a dietitian can ...
Posner, M.; Abdullaev, Y.
What happens in our brain when we read isolated words? Are some particular areas of cortex stimulated when these words make sense? Does the reading practice induce others areas? And what about the new senses research? Some studies carried out for a century show that two regions of the left cerebral hemisphere: the Broca and the Wernicke areas are involved. By visualizing in vivo an elementary thought as what is for instance the function of a hammer, the functional cerebral imagery (positron computed tomography, NMR imaging, electro-encephalography) allows to deepen and to explain the analysis. It reveals an areas network called semantic, in the right hemisphere too. Their activation would take place according to a very fast sequence in order to direct the eye movements during the reading. (O.M.)
Full Text Available In today’s economy, it is more crucial than ever to focus our educational efforts on increasing financial literacy. Many young people are unskilled in managing their personal finances, yet this critical life skill will greatly affect their future economic well-being. Reading Makes Cents, developed by Penn State University, is an excellent resource to address this need. A reviewed and recommended curriculum by National 4-H, this complete, easy to use curriculum targets youth in grades 3-5 with a combination of financial literacy and reading. The curriculum explores basic money concepts such as spending, saving, and sharing money. Lessons incorporate hands-on activities and children’s literature to reinforce lesson objectives. With evaluation questions and family activities included, Reading Makes Cents is a perfect guide for educators to easily pick up and teach.
Arseny A Sokolov
Full Text Available Body motion is a rich source of information for social cognition. However, gender effects in body language reading are largely unknown. Here we investigated whether, and, if so, how recognition of emotional expressions revealed by body motion is gender dependent. To this end, females and males were presented with point-light displays portraying knocking at a door performed with different emotional expressions. The findings show that gender affects accuracy rather than speed of body language reading. This effect, however, is modulated by emotional content of actions: males surpass in recognition accuracy of happy actions, whereas females tend to excel in recognition of hostile angry knocking. Advantage of women in recognition accuracy of neutral actions suggests that females are better tuned to the lack of emotional content in body actions. The study provides novel insights into understanding of gender effects in body language reading, and helps to shed light on gender vulnerability to neuropsychiatric impairments in visual social cognition.
Full Text Available The teaching of literature even when focused on reading is often overlooked in the face of other classroom needs. The teaching of reading, without well-defined object, is emphasized by performing as a concern of all areas and not only in mother-tongue classes. However, a closer look reveals that this is exactly the reading of literary texts that provides answers to questions from other spheres (LAJOLO, 1982; 1993; COSSON, 2006. In this article, taking as a basis, the intertextuality, one of the constituent elements of literary texts (MAINGUENEAU, 2004, we propose some reflections on the role of literary literacy by presenting suggestions for activities, based on the concept of teacher as mediator of the dialogues constituted in the literary text and other derivatives of these dialogues in the classroom.
Kingsnorth, Alec; Wolffsohn, James S
To validate the accuracy and repeatability of a mobile app reading speed test compared with the traditional paper version. Twenty-one subjects wearing their full refractive correction glasses read 14 sentences of decreasing print size between 1.0 and -0.1 logMAR, each consisting of 14 words (Radner reading speed test) at 40 cm with a paper-based chart and twice on iPad charts. Time duration was recorded with a stop watch for the paper chart and on the App itself for the mobile chart allowing critical print size (CPS) and optimal reading speed (ORS) to be derived objectively. The ORS was higher for the mobile app charts (194±29 wpm; 195±25 wpm) compared with the paper chart (166±20 wpm; F=57.000, pmobile app charts (0.17±0.20 logMAR; 0.18±0.17 logMAR) compared with the paper chart (0.25±0.17 logMAR; F=5.406, p=0.009). The mobile app test had a mean difference repeatability of 0.30±22.5 wpm, r=0.917 for ORS, and a CPS of 0.0±0.2 logMAR, r=0.769. Repeatability of the app reading speed test is as good (ORS) or better (CPS) than previous studies on the paper test. While the results are not interchangeable with paper-based charts, mobile app tablet-based tests of reading speed are reliable and rapid to perform, with the potential to capture functional visual ability in research studies and clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Bonham, Scott W.
An important aspect of science education involves helping students learn to read and communicate scientific information and arguments. In this note, I would like to share a resource that I have come across which I have found to be a useful tool for helping students improve those skills, learn content material, and acquaint them with a great scientist. Specifically, this is having non-science college students in my course Light, Color and Vision read and discuss a letter by James Clerk Maxwell entitled "On the Theory of Colours in Relation to Colour-Blindness" (see Fig. 1).
Giselda Maria Dutra Bandoli
Full Text Available This work conducts a reflection on the notions of hypertext from a few updated views of Vidas Secas by Graciliano Ramos. Our purpose is to carry out the reading of an art object, dissociating hypertext from the idea of a device enabled only by electronic media. Thus, we show that hypertext is also manifested in printed texts, and postulate that literary language can be a manifestation of hypertextuality. Finally, we perform an intertextual reading of the book, seeking to highlight the dialogue between this and other works by representative Brazilian authors.
Students' minds today are attracted to entertainment and all things social. To engage the reading attitudes of this generation, educators need to adapt some old tricks and add new tricks to their bag to meet these Digital Natives where they live--the world of social interaction and social technology. This article discusses the three R's necessary…
Wolf, Maryanne; Ullman-Shade, Catherine; Gottwald, Stephanie
This essay is about the improbable emergence of written language six millennia ago that gave rise to the even more improbable, highly sophisticated reading brain of the twenty-first century. How it emerged and what it comprises--both in its most basic iteration in the very young reader and in its most elaborated iteration in the expert reader--is…
Carroll, Julia M; Fox, Amy C
The relationship between cognitive skills and reading has been well-established. However, the role of motivational factors such as self-efficacy in reading progress is less clear. In particular, it is not clear how self-efficacy relates to word level reading versus comprehension, and whether this differs in boys and girls. This study examines the relationship between self-efficacy, word reading and reading comprehension across the range of reading abilities after controlling for reading-related cognitive factors. One hundred and seventy nine children (86 males and 93 females) between 8 and 11 years old completed a self-report measure of reading self-efficacy together with measures of reading comprehension and word reading, working memory, auditory short-term memory, phonological awareness, and vocabulary. Boys and girls showed similar levels of attainment and reading self-efficacy. Reading self-efficacy was associated with word reading, but not with reading comprehension in either boys or girls. It is argued that this may reflect important differences between reading self-efficacy and more general measures of reading motivation and engagement. Reading self-efficacy is an element of reading motivation that is closely associated with a child's perceived attainments in reading and is less susceptible to the gender differences seen in broader measures.
Carroll, Julia M.; Fox, Amy C.
The relationship between cognitive skills and reading has been well-established. However, the role of motivational factors such as self-efficacy in reading progress is less clear. In particular, it is not clear how self-efficacy relates to word level reading versus comprehension, and whether this differs in boys and girls. This study examines the relationship between self-efficacy, word reading and reading comprehension across the range of reading abilities after controlling for reading-related cognitive factors. One hundred and seventy nine children (86 males and 93 females) between 8 and 11 years old completed a self-report measure of reading self-efficacy together with measures of reading comprehension and word reading, working memory, auditory short-term memory, phonological awareness, and vocabulary. Boys and girls showed similar levels of attainment and reading self-efficacy. Reading self-efficacy was associated with word reading, but not with reading comprehension in either boys or girls. It is argued that this may reflect important differences between reading self-efficacy and more general measures of reading motivation and engagement. Reading self-efficacy is an element of reading motivation that is closely associated with a child’s perceived attainments in reading and is less susceptible to the gender differences seen in broader measures. PMID:28144223
Abstract The study examines reading programmes with the reference to the teaching/learning of reading to school beginners. The teaching of reading at the early stages is important because it is the quality of the experiences that children get that affect or lay the foundation for reading development (Chall, 1996).Therefore, the phenomenon, “teaching of reading to school beginners” studied is of great importance. The theoretical background used includes reading and its importance, Languag...
Valderrama, Jose O.
Describes an activity in which undergraduate students read an international publication to help them have a broader vision of the subject being studied, encourage constructive criticism, promote discussion, and stimulate efforts toward better oral and written communication in the students' native language. (JN)
Jackson, Mark D.; McClelland, James L.
Two groups of undergraduates differing in reading ability were tested on a number of reaction-time tasks designed to determine the speed of encoding visual information at several different levels, tests of sensory functions, verbal and quantitative reasoning ability, short-term auditory memory span, and ability to comprehend spoken text.…
Cowles, Kathleen Letcher, Comp.; And Others
These readings provide basic background information on urban integrated pest management and the development of Integrated Pest Management (IPM) programs for the control of rodents, cockroaches, and head lice. IPM is a decision-making process for deciding if pest supprssion treatments are needed, when they should be initiated, where they should be…
McGraw-Hill Companies, New York, NY. Educational and Professional Publishing Group.
This publication tells the stories of eight schools from around the nation that have used the Open Court Reading program, describing the history of the schools, the challenges they faced, and their attempts to meet those challenges. The schools are located in California, Florida, Texas, and New York. Each of the school stories includes a focus on…
In this reading list, I share thoughts on scholars and journalists from which the Sublime Imperfections project takes its inspiration. The authors of the texts that I clustered ponder the nexus between the imperfect and the sublime, they rethink repair and breakdown, they critically interrogate and
Fisher, Douglas; Frey, Nancy
12 teachers were interviewed and observed as they engaged students in close reading. We analyzed their responses and instruction to determine the scaffolds that were used as well as the contingency teaching plans they implemented when students were unable to understand the text.
Johnson, Amy Carpenter; Halas, Joannie
For the past six years in Winnipeg, Canada, young people from diverse Aboriginal backgrounds have been volunteering their time, energy, and talents to develop and deliver after-school physical activity, nutrition, and education programs for children in their school's neighbourhood. Known as "Rec and Read," the after-school activities are…
It has frequently been found that profoundly deaf children with conventional hearing aids have difficulties with the comprehension of written text. Cochlear Implants (CIs) were expected to enhance the reading comprehension of these profoundly deaf children because they provide auditory access to
Harris, Albert J.
There are three main reasons why reading research has not had a stronger influence on what goes on in schools. The first reason is the powerful impact of social forces such as the bandwagon effect, the pendulum swing, and the prevailing climate of opinion. These factors determine to an unfortunately large degree whether or not particular research…
Elena Hernández Sandoica
Full Text Available During the final decades of the 20th century, the reading of the works of E.P. Thompson was a necessary exercise for many historians. The object of these reflections, starting from the changes occurred in historiography, is to assert its force as a historian and to reiterate its status of “classic”.
Twenty years after its publication, Culture and Imperialism continues to be seen as part of the defining moment of postcolonial readings of our contemporary world. The anniversary marks an opportunity to revisit the landscape of culture and imperialism as envisaged by Edward Said, but also to dis...
Vaish, Viniti; Subhan, Aidil
Using translanguaging as a theoretical foundation, this paper analyses findings from a Grade 2 reading class for low achieving students, where Malay was used as a scaffold to teach English. Data come from one class in one school in Singapore and its Learning Support Programme (LSP), which is part of a larger research project on biliteracy. The LSP…
Full Text Available This paper deals mainly with three issues: how people interact with linguistically codified messages in everyday life? How this affects people’s behaviour? And how does this thing relates to practicing philosophy? These three issues are faced with the help two concepts: “affective reading” regards the first two of them, while “strategic hermeneutics” regards the last one. This paper thus starts with the analysis of the meaning of affective reading and tries to show how this way of reading is practiced on everyday basis to organize our actions. Then the focus turns to philosophical applications of the affective reading to show how much it affects our discipline. Strategic hermeneutics takes here its place on the stage. Indeed, this concept is the application of affective reading as a philosophical tool and method. Hence, it’s shown how to use this kind of tool with a theoretical analysis and an example given. At the end of the paper I’ve tried to display how this philosophical method affects the foundation and development of the philosopher’s ego under the prospective of Lacan’s theory of Oedipus’ complex.
Three flaws found in commercial reading materials, such as workbooks and kits, are discussed in this paper, and examples of the flaws are taken from specific materials. The first problem noted is that illustrations frequently provide the information that the learner is supposed to supply through phonetic or structural analysis; the illustrations…
Do school librarians play a role in teaching students to read? Yes, they do, and librarians should embrace that role if they want school administrators and politicians to recognize them as central to fostering literate kids, according to several people who took part in the literacy challenge group. The question of how and what school librarians…
O'Brien, David; Voss, Scott
Technological changes and the proliferation of digital devices have created new reading experiences for students. The rapid transition from print to digital texts is evident in the movement toward the adoption of an e-book standard, increasing sales of e-book readers and tablet devices, and projections that universities and public schools may use…
McGraw, Amanda; Mason, Mary
The teaching of reading provokes heated discussion, particularly when the reputations of governments and institutions rest on what students do and achieve. This paper focuses on the first two years of a three year project where the researchers worked in communities of practice with secondary school English teachers in state, Catholic and…
Halladay, Juliet L.; Neumann, Maureen D.
Recent years have witnessed a growing interest in interdisciplinary teaching and learning in the elementary grades. Teachers are increasingly looking for ways to help their students integrate literacy instruction with content area learning. This article highlights some of the similarities between reading comprehension and mathematical…
The term "close reading" is problematic for English teachers, yet a heightened awareness of the role that language plays in mediating experience and social relationships is fundamental to an informed and critically engaged citizenry. This essay finds that a focus on abstracted ideological content of literary texts comes at the cost of…
Meisinger, Elizabeth B; Bloom, Juliana S; Hynd, George W
The current investigation explored the diagnostic utility of reading fluency measures in the identification of children with reading disabilities. Participants were 50 children referred to a university-based clinic because of suspected reading problems and/or a prior diagnosis of dyslexia, where children completed a battery of standardized intellectual, reading achievement, and processing measures. Within this clinical sample, a group of children were identified that exhibited specific deficits in their reading fluency skills with concurrent deficits in rapid naming speed and reading comprehension. This group of children would not have been identified as having a reading disability according to assessment of single word reading skills alone, suggesting that it is essential to assess reading fluency in addition to word reading because failure to do so may result in the under-identification of children with reading disabilities.
Kasemsap, Bharani; Lee, Hugo Yu-Hsiu
This study aims to explore the application of reading strategies to the reading of English texts by Thai vocational college students. Data were collected via questionnaire surveys, think-aloud experiments and semi-structured interviews. The research results reveal different typologies of reading strategies adopted by lower and higher level English…
Pedersen, Henriette Folkmann; Fusaroli, Riccardo; Lauridsen, Lene Louise; Parrila, Rauno
The purpose of this study was to examine the quality of oral reading and how it relates to reading comprehension in students with dyslexia. A group of Danish university students with dyslexia (n = 16) and a comparison group of students with no history of reading problems (n = 16) were assessed on their oral reading performance when reading a complex text. Along with reading speed, we measured not only the number and quality of reading errors but also the extent and semantic nature of the self-corrections during reading. The reading comprehension was measured through aided text retellings. The results showed that, as a group, the dyslexics performed poorer on most measures, but there were notable within-group differences in the reading behaviours and little association between how well university students with dyslexia read aloud and comprehended the text. These findings suggest that many dyslexics in higher education tend to focus their attention on one subcomponent of the reading process, for example, decoding or comprehension, because engaging in both simultaneously may be too demanding for them. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Weisberg, Renee; Balajthy, Ernest
Examines and evaluates microcomputer software designed to assist in diagnosing students' reading abilities and making instructional decisions. Claims that existing software shows valuable potential when used sensibly and critically by trained reading clinicians. (MM)
Reading for national development: Catching them young. ... It also discussed the impact of illiteracy and inefficient use of reading skills in an era of world's advanced technology. Some agencies that ... AJOL African Journals Online. HOW TO ...
National Aeronautics and Space Administration — Overview: ReADS can analyze text reports, such as aviation reports and problem or maintenance records. ReADS uses text clustering algorithms to group loosely related...
... them. If you read nothing else on managing people, read these articles. We've combed through hundreds of Harvard Business Review articles and selected the most important ones to help you maximize your employee's performance...
Reading, a complex and multi-faceted skill, is essential for life and academic success. While its mysteries still baffle first-language research, the nature of reading in a foreign language presents an even greater puzzle. However, given reading's importance for EFL students who study their specializations in English, and whose future employment may depend on their competence in it, researchers must continue to investigate foreign language reading and devise ways of improving students' capaci...
Teachers often report that their A-level pupils are unwilling to read physics-related material. What is it about physics texts that deters pupils from reading them? Are they just too difficult for 16 - 18 year olds, or is it that pupils lack specific reading skills? This article describes some of the results from my research into pupils' reading of physics-related texts and tries to clarify the situation.
Presented diploma thesis is focused on reading problems of people with hearing impairment. The theoretical part deals a hearing impairment, process of acquisition of reading skills of healthy people and deaf people as well. The practical part efforts to clarify preparations, process and results of the research. I am presenting my own reading comprehension test, which was compiled on purpose due to the research. The goal of my diploma thesis is to determine when the level of reading acquiremen...
Lyons, Wanda; Thompson, Scott Anthony
Teachers in inclusive classrooms are challenged to provide reading instruction for students with a wide range of instructional levels. This article reports on the implementation of guided reading in four middle years inclusive classrooms, the impact on student engagement and reading progress, and teacher perspectives on the guided reading…
Annamma, Subini; Eppolito, Amy; Klingner, Janette; Boele, Amy; Boardman, Alison; Stillman-Spisak, Stephanie J.
The authors interviewed 17 middle school reading and language arts teachers as part of a larger study on an evidence-based intervention called Collaborative Strategic Reading (CSR). CSR is a multi-component reading instructional model combined with cooperative grouping and peer discussion. We show from the teacher interviews that CSR has benefits…
Lee, Ho Cheung
This article discusses the significance of inferencing in reading comprehension and addresses theoretical and practical issues related to teaching inferencing in English classrooms. The author explains the nature of inferencing in reading and, drawing on previous research findings and his own reflections on teaching reading to English as a second…
Georgiou, George K.; Das, J. P.
The present study aimed to examine the nature of the working memory and general cognitive ability deficits experienced by university students with a specific reading comprehension deficit. A total of 32 university students with poor reading comprehension but average word-reading skills and 60 age-word-matched controls with no comprehension…