Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe.

LENUS (Irish Health Repository)

Conway, D I

2010-02-01

In the European Union, there are 180,000 new cases of upper aerodigestive tract (UADT) cancer cases per year--more than half of whom will die of the disease. Socioeconomic inequalities in UADT cancer incidence are recognised across Europe. We aimed to assess the components of socioeconomic risk both independently and through their influence on the known behavioural risk factors of smoking, alcohol consumption and diet.

The aetiology of upper aerodigestive tract cancers among young adults in Europe: the ARCAGE study.

LENUS (Irish Health Repository)

Macfarlane, Tatiana V

2010-12-01

The incidence of cancers of the upper aerodigestive tract (UADT) is increasing throughout the world. To date the increases have been proportionally greatest among young people. Several reports have suggested that they often do not have a history of tobacco smoking or heavy alcohol consumption.

Upper aerodigestive tract burn: a case report of firework injury.

Science.gov (United States)

Kerekhanjanarong, V; Supiyaphun, P; Saengpanich, S

2001-02-01

The case of a 46 year-old German man with upper aerodigestive burn by firework was reported. He presented with the symptoms and signs of upper airway obstruction. Tracheostomy was done and direct laryngoscopy with microscopic examination revealed swelling and denudation of the mucosa of the oral cavity and supraglottic area. Intravenous steroids and antibiotics were administrated for treatment. It is suggested that proper management needs an understanding of the mechanism and effect of the corrosive agent. Careful airway management resulted in a good outcome in this patient.

Kasiinomeistri Playtechi omanikud müüvad aktsiaid 240 miljoni dollari eest

Index Scriptorium Estoniae

2006-01-01

Iisraeli ärilehe Globes andmeil müüvad internetikasiinode arendamise ja haldamisega tegeleva Playtechi omanikud esmase avaliku müügi käigus aktsiaid 240 milj. USA dollari eest. Lisa: Kasumlik äritegevus

Anti-apoptotic effects of pan-caspase inhibitor (Z-VAD), SOD or catalase on antimycin A-induced HeLa cell death.

Science.gov (United States)

Han, Yong Hwan; Kim, Suhn Hee; Kim, Sung Zoo; Park, Woo Hyun

2009-01-01

Antimycin A (AMA) is an inhibitor of the electron transport chain in mitochondria. In this study, we investigated the anti-apoptotic effects of pan-caspase inhibitor (Z-VAD), superoxide dismutase (SOD) or catalase on AMA-induced HeLa cell death in relation to the cell cycle. Treatment with Z-VAD, SOD or catalase rescued some HeLa cells from AMA-induced apoptosis, but did not prevent the growth inhibition of HeLa cells by AMA. DNA flow cytometric analysis indicated that treatment with AMA significantly induced an S-phase arrest of the cell cycle at 72 h. Interestingly, Z-VAD, SOD and catalase intensified S-phase arrest in AMA-treated cells. In conclusion, treatment with Z-VAD, SOD or catalase decreased apoptotic levels in AMA-treated cells, which was associated with the enhancement of the S-phase arrest of the cell cycle in these cells.

Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma

NARCIS (Netherlands)

Digonnet, Antoine; Hamoir, Marc; Andry, Guy; Vander Poorten, Vincent; Haigentz, Missak; Langendijk, Johannes A.; de Bree, Remco; Hinni, Michael L.; Mendenhall, William M.; Paleri, Vinidh; Rinaldo, Alessandra; Werner, Jochen A.; Takes, Robert P.; Ferlito, Alfio

Post-therapy follow-up for patients with head and neck cancer other than upper aerodigestive tract squamous cell carcinoma should meet several objectives: to detect both local, regional or distant recurrences, to evaluate acute and long-term treatment-related side effects, to guide the

A sex-specific association between a 15q25 variant and upper aerodigestive tract cancers.

LENUS (Irish Health Repository)

Chen, Dan

2011-04-01

Sequence variants located at 15q25 have been associated with lung cancer and propensity to smoke. We recently reported an association between rs16969968 and risk of upper aerodigestive tract (UADT) cancers (oral cavity, oropharynx, hypopharynx, larynx, and esophagus) in women (OR = 1.24, P = 0.003) with little effect in men (OR = 1.04, P = 0.35).

The Use of Fluid Mechanics to Predict Regions of Microscopic Thrombus Formation in Pulsatile VADs.

Science.gov (United States)

Topper, Stephen R; Navitsky, Michael A; Medvitz, Richard B; Paterson, Eric G; Siedlecki, Christopher A; Slattery, Margaret J; Deutsch, Steven; Rosenberg, Gerson; Manning, Keefe B

2014-03-01

We compare the velocity and shear obtained from particle image velocimetry (PIV) and computational fluid dynamics (CFD) in a pulsatile ventricular assist device (VAD) to further test our thrombus predictive methodology using microscopy data from an explanted VAD. To mimic physiological conditions in vitro , a mock circulatory loop is used with a blood analog that matched blood's viscoelastic behavior at 40% hematocrit. Under normal physiologic pressures and for a heart rate of 75 bpm, PIV data is acquired and wall shear maps are produced. The resolution of the PIV shear rate calculations are tested using the CFD and found to be in the same range. A bovine study, using a model of the 50 cc Penn State V-2 VAD, for 30 days at a constant beat rate of 75 beats per minute (bpm) provides the microscopic data whereby after the 30 days, the device is explanted and the sac surface analyzed using scanning electron microscopy (SEM) and, after immunofluorescent labeling for platelets and fibrin, confocal microscopy. Areas are examined based on PIV measurements and CFD, with special attention to low shear regions where platelet and fibrin deposition are most likely to occur. Data collected within the outlet port in a direction normal to the front wall of the VAD shows that some regions experience wall shear rates less than 500 s -1 , which increases the likelihood of platelet and fibrin deposition. Despite only one animal study, correlations between PIV, CFD, and in vivo data show promise. Deposition probability is quantified by the thrombus susceptibility potential, a calculation to correlate low shear and time of shear with deposition.

Button battery injuries in the pediatric aerodigestive tract.

Science.gov (United States)

Ettyreddy, Abhinav R; Georg, Matthew W; Chi, David H; Gaines, Barbara A; Simons, Jeffrey P

2015-12-01

Children with a button battery impaction present with nonspecific symptoms that may account for a delay in medical care. We conducted a retrospective study of the clinical presentation, management, and complications associated with button battery ingestion in the pediatric aerodigestive tract and to evaluate the associated long-term morbidity. We reviewed the medical records of 23 patients who were treated for button battery impaction at our tertiary care children's hospital from Jan. 1, 2000, through July 31, 2013. This population was made up of 14 boys and 9 girls, aged 7 days to 12 years (mean: 4 yr). Patients were divided into three groups based on the site of impaction; there were 9 impactions in the esophagus and 7 each in the nasal cavity and stomach. We compiled information on the type and size of each battery, the duration of the impaction, presenting symptoms, treatment, and outcomes. The mean duration of battery impaction was 40.6, 30.7, and 21.0 hours in the esophagus, nasal cavity, and stomach, respectively. We were able to identify the specific type of battery in 13 cases; 11 of these cases (85%) involved a 3-V 20-mm lithium ion battery, including all cases of esophageal impaction in which the type of battery was identified. The most common presenting signs and symptoms were vomiting (n = 7 [30%]), difficulty feeding (n = 5 [22%]), cough (n = 5), and bloody nasal discharge (n = 5); none of the presenting signs and symptoms predicted the severity of the injury or the outcome. The median length of hospital stay was far greater in the esophageal group (12 days) than in the nasal and stomach groups (1 day each; p = 0.006). Battery impaction in the esophagus for more than 15 hours was associated with a significantly longer postoperative hospital stay than impaction for less than 15 hours (p = 0.04). Esophageal complications included strictures (n = 5), perforation (n = 3), and tracheoesophageal fistula formation (n = 2). Clinicians should consider battery

Role of medical history and medication use in the aetiology of upper aerodigestive tract cancers in Europe: the ARCAGE study.

LENUS (Irish Health Repository)

Macfarlane, T V

2012-04-01

The study aimed to investigate the role of medical history (skin warts, Candida albicans, herpetic lesions, heartburn, regurgitation) and medication use (for heartburn; for regurgitation; aspirin) in the aetiology of upper aerodigestive tract (UADT) cancer.

Vadītāja darbība izglītības iestādes demokrātiskas vides veidošnā.

OpenAIRE

Ķepule, Inga

2009-01-01

Maģistra darba temats „Vadītāja darbība izglītības iestādes demokrātiskas vides veidošanā”. Zinātniskais vadītājs: Profesors, Dr. Phys., Andris Grīnfelds. Maģistra darba mērķis ir izstrādāt priekšlikums vadītāja efektīvai darbībai demokrātiskas vides aspektā. Maģistra darbā ir raksturoti teorētiskie aspekti par iestādes demokrātiskas vides jēdzienu, ietverot visus ietekmējošos faktorus, kā vadības stilu, motivāciju, un citus elementus. Maģistra darbā veiktā pētījuma rezultātā ir i...

Bodipy-VAD-Fmk, a useful tool to study yeast peptide N-glycanase activity

NARCIS (Netherlands)

Witte, Martin D.; Descals, Carlos V.; Lavoir, Sebastiaan V.P. de; Florea, Bogdan I.; Marel, Gijsbert A. van der; Overkleeft, Herman S.

2007-01-01

In this paper the development of a fluorescent activity based probe, Bodipy-VAD-Fmk, for visualization of yeast peptide N-glycanase is described. The activity based probe is used to assess the efficacy of known and new chitobiose-based electrophilic traps to bind yeast peptide N-glycanase.

Vadīšanas funkciju izpildes analīze Viļakas novada pašvaldībā.

OpenAIRE

Cibule, Rūta

2016-01-01

Bakalaura darba tēma ir “Vadīšanas funkciju izpildes analīze Viļakas novada pašvaldībā”. Darbā ir apskatītas vadīšanas funkcijas – organizēšana, plānošana, motivēšana, koordinēšana un kontrole, fokusējoties uz pirmajām trim minētajām. Bakalaura darba mērķis ir izanalizēt vadīšanas funkciju izpildi Viļakas novada domes administrācijā, pievēršot pastiprinātu uzmanību organizēšanai, motivēšanai un plānošanai. Lai šo mērķi izpildītu, pirmajā daļā autore izpētīja dažādus teorijas avotus, otrajā da...

SIA "Baltegle" naudas plūsmas analīze un vadīšana

OpenAIRE

Jegorova, Valērija

2011-01-01

Vairākiem Latvijas uzņēmumiem ir aktuālas stabilizēšanas problēmas, kuras ietekmēja naudas plūsmas neefektīva vadīšana. Diplomdarba mērķis ir novērtēt SIA „Baltegle” naudas plūsmu un izstrādāt priekšlikumus tās optimizācijai. Pirmajā diplomdarba nodaļā apskatīta naudas plūsmas būtība, otrajā nodaļā - naudas plūsmas pārskata sagatavošanas īpatnības, trešajā nodaļā - analīzes un vadīšanas aspekti. Ceturtajā nodaļā pētīta SIA „Baltegle” saimnieciskā darbība. Piektajā nodaļā veikta uzņēmuma...

Cyclin D1 gene polymorphism as a risk factor for squamous cell carcinoma of the upper aerodigestive system in non-alcoholics

DEFF Research Database (Denmark)

Nishimoto, Ines Nobuko; Pinheiro, Nidia Alice; Rogatto, Silvia Regina

2004-01-01

Squamous cell carcinoma of the upper aerodigestive tract (UADT) is associated with environmental factors, especially tobacco and alcohol consumption. Genetic factors, including cyclin D1 (CCND1) polymorphism have been suggested to play an important role in tumorigenesis and progression of UADT...

Ainult võltsid jäävad ellu = Only phonies will survive / Anders Härm

Index Scriptorium Estoniae

Härm, Anders, 1977-

2009-01-01

Punkansamblite tekkest Ameerikas ja Inglismaal, ansamblist "Sex pistols" ning pungi fenomenist, transgressioonist ja selle rituaalidest performance'ikunstis. Ka Von Krahli Teatris lavastatud etendusest "Ainult võltsid jäävad ellu", mis kajastab punkansambli Sex Pistols tekkelugu ja võtmestseene, lavastaja Marko Raat

"Oftast du vet själv vad är det rätta" : Högstadieelevers sociala mediavanor och regelperception i onlinesammanhang

OpenAIRE

Bergman, Mikael

2018-01-01

Sammanfattning: Sociala medier spelar en allt större roll i hur vi kommunicerar och uttrycker oss. Denna studie är ämnad att utveckla och koppla ihop den redan existerande forskningen om ungdomars sociala mediavanor på Snapchat och Instagram, och forskning om vad sociala mediaanvändare upplever vad man kan och får publicera på dessa sociala medier. Denna studie utforskar detta genom tre fokusgruppsintervjuer med 15 åriga niondeklassare. Resultatet analyseras genom dramaturgi som till stor del...

Personāla vadīšana Valsts ieņēmumu dienesta Rīgas muitas reģionālajā iestādē

OpenAIRE

Beinerte, Inga

2009-01-01

Lai veiksmīgi uzsāktu uzņēmuma vadīšanu ir nepieciešami noteikti resursi, uz ko balstīt uzņēmumu. Visneprognozējamākie un grūtāk vadāmie no šiem resursiem ir cilvēkresursi. Bez cilvēkresursiem nav iedomājama uzņēmējdarbība, jo tie izgudro un ražo preces, sniedz pakalpojumus, vada un kontrolē procesu darbību, kā arī kontrolē to kvalitāti. Maģistra darba „Personāla vadīšana Valsts ieņēmumu dienesta Rīgas muitas reģionālajā iestādē” mērķis ir izpētīt personāla vadību, tās būtību un izanalizē...

Beyond the VAD: Human Factors Engineering for Mechanically Assisted Circulation in the 21st Century.

Science.gov (United States)

Throckmorton, Amy L; Patel-Raman, Sonna M; Fox, Carson S; Bass, Ellen J

2016-06-01

Thousands of ventricular assist devices (VADs) currently provide circulatory support to patients worldwide, and dozens of heart pump designs for adults and pediatric patients are under various stages of development in preparation for translation to clinical use. The successful bench-to-bedside development of a VAD involves a structured evaluation of possible system states, including human interaction with the device and auxiliary component usage in the hospital or home environment. In this study, we review the literature and present the current landscape of preclinical design and assessment, decision support tools and procedures, and patient-centered therapy. Gaps of knowledge are identified. The study findings support the need for more attention to user-centered design approaches for medical devices, such as mechanical circulatory assist systems, that specifically involve detailed qualitative and quantitative assessments of human-device interaction to mitigate risk and failure. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

"Isa kuhu need värvid jäävad ..." : [luuletused] / Jaan Kaplinski

Index Scriptorium Estoniae

Kaplinski, Jaan, 1941-

2002-01-01

Sisu: "Isa kuhu need värvid jäävad ..." ; Lume ootamine ; "Oh sina paha peavalu ..." ; "Märg on vihmal märg on kastel ..." ; "Peet kisub peeti ..." ; "Küllap väikestel mustadel ..." ; "Mart haigutab ..." ; Kuu ; Teremees Tõnu ; Jalgrataste talveuni ; Kitsu ja kätsu ; Siret siret siterkuuti ; Suve soe silmadesse ; Iirimaal on ilmalapsed ; Miks ; Sügisel ; Täis ; Mis algab ; Aeg ; "Ma koiduajal ärkasin ..."

Klientu attiecību sociālās vadības ietekme uz klientu lojalitāti; sociālā tīkla Facebook piemērs

OpenAIRE

Avotiņa, Lelde

2015-01-01

Maģistra darba “Klientu attiecību sociālās vadības ietekme uz klientu lojalitāti; sociālā tīkla Facebook piemērs” mērķis ir noteikt un analizēt faktorus, kas ietekmē lojālo klientu piesaistīšanu un noturēšanu sociālo mediju vidē klientu attiecību sociālās vadības kontekstā. Maģistra darba pirmajā nodaļā tiek aplūkoti jautājumi, kas skar klientu lojalitāti, klientu attiecību vadību, klientu lomu sociālo mediju kontekstā un klientu attiecību sociālo vadību. Šī teorētiskā apkopojuma rezultātā...

Emerging and established global life-style risk factors for cancer of the upper aero-digestive tract.

Science.gov (United States)

Gupta, Bhawna; Johnson, Newell W

2014-01-01

Upper aero-digestive tract cancer is a multidimensional problem, international trends showing complex rises and falls in incidence and mortality across the globe, with variation across different cultural and socio-economic groups. This paper seeks some explanations and identifies some research and policy needs. The literature illustrates the multifactorial nature of carcinogenesis. At the cellular level, it is viewed as a multistep process involving multiple mutations and selection for cells with progressively increasing capacity for proliferation, survival, invasion, and metastasis. Established and emerging risk factors, in addition to changes in incidence and prevalence of cancers of the upper aero-digestive tract, were identified. Exposure to tobacco and alcohol, as well as diets inadequate in fresh fruits and vegetables, remain the major risk factors, with persistent infection by particular so-called "high risk" genotypes of human papillomavirus increasingly recognised as also playing an important role in a subset of cases, particularly for the oropharynx. Chronic trauma to oral mucosa from poor restorations and prostheses, in addition to poor oral hygiene with a consequent heavy microbial load in the mouth, are also emerging as significant risk factors. Understanding and quantifying the impact of individual risk factors for these cancers is vital for health decision-making, planning and prevention. National policies and programmes should be designed and implemented to control exposure to environmental risks, by legislation if necessary, and to raise awareness so that people are provided with the information and support they need to adopt healthy lifestyles.

Latvijas sabiedrisko attiecību aģentūru prakse plānotas krīzes komunikācijas vadīšanā

OpenAIRE

Štokmane, Linda

2014-01-01

Darba nosaukums ir „Latvijas sabiedrisko attiecību aģentūru prakse plānotas krīzes komunikācijas vadīšanā”. Pētījuma problēma - vai krīzes situācijām iespējams sagatavoties un kā iepriekš plānota un sagatavota komunikācija spēj palīdzēt efektīvāk vadīt krīzes situācijas? Bakalaura darba mērķis ir izpētīt, kāda ir Latvijas sab iedrisko attiecību aģentūru prakse un pieredze krīzes komunikācijas plānošanā un vadīšanā. Darba teorētiskā bāze, galvenokārt, balstīta uz situatīvo krīzes komunikāci...

Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE).

NARCIS (Netherlands)

Nagel, Gabriele; Stafoggia, Massimo; Pedersen, Marie; Andersen, Zorana J; Galassi, Claudia; Munkenast, Jule; Jaensch, Andrea; Sommar, Johan; Forsberg, Bertil; Olsson, David; Oftedal, Bente; Krog, Norun H; Aamodt, Geir; Pyko, Andrei; Pershagen, Göran; Korek, Michal; De Faire, Ulf; Pedersen, Nancy L; Östenson, Claes-Göran; Fratiglioni, Laura; Sørensen, Mette; Tjønneland, Anne; Peeters, Petra H; Bueno-de-Mesquita, Bas; Vermeulen, Roel; Eeftens, Marloes; Plusquin, Michelle; Key, Timothy J; Concin, Hans; Lang, Alois; Wang, Meng; Tsai, Ming-Yi; Grioni, Sara; Marcon, Alessandro; Krogh, Vittorio; Ricceri, Fulvio; Sacerdote, Carlotta; Ranzi, Andrea; Cesaroni, Giulia; Forastiere, Francesco; Tamayo-Uria, Ibon; Amiano, Pilar; Dorronsoro, Miren; de Hoogh, Kees; Beelen, Rob; Vineis, Paolo; Brunekreef, Bert; Hoek, Gerard; Raaschou-Nielsen, Ole; Weinmayr, Gudrun

2018-01-01

Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer

Determining the Velocity Fine Structure by a Laser Anemometer in VAD operation

DEFF Research Database (Denmark)

Kristensen, Leif; Kirkegaard, Peter; Mikkelsen, Torben

. Then it is necessary to “create” a mean wind by turning the laser beam. Since the instrument is not moved the beam will describe a cone which could be a VAD-scanning. In any case the measured velocity components will not be parallel and this implies that the measured structure function will contain a term which...... is proportional to the total variance. The theoretical expression for the line-filtered structure function is derived in two equivalent ways, one in physical space and one in wave-number space, of which the last can be reliably evaluated by numerical integration. Also a practical approximate equation, derived...

Pretreatment with Pancaspase Inhibitor (Z-VAD-FMK Delays but Does Not Prevent Intraperitoneal Heat-Killed Group B Streptococcus-Induced Preterm Delivery in a Pregnant Mouse Model

Directory of Open Access Journals (Sweden)

Ozlem Equils

2009-01-01

Full Text Available Caspases and apoptosis are thought to play a role in infection-associated preterm-delivery. We have shown that in vitro treatment with pancaspase inhibitor Z-VAD-FMK protects trophoblasts from microbial antigen-induced apoptosis. Objective. To examine whether in vivo administration of Z-VAD-FMK would prevent infection-induced preterm-delivery. Methods. We injected 14.5 day-pregnant-mice with heat-killed group B streptococcus (HK-GBS. Apoptosis within placentas and membranes was assessed by TUNEL staining. Calpain expression and caspase-3 activation were assessed by immunohistochemistry. Preterm-delivery was defined as expulsion of a fetus within 48 hours after injection. Results. Intrauterine (i.u. or intraperitoneal (i.p. HK-GBS injection led to preterm-delivery and induced apoptosis in placentas and membranes at 14 hours. The expression of calpain, a caspase-independent inducer of apoptosis, was increased in placenta. Treatment with the specific caspase inhibitor Z-VAD-FMK (i.p. prior to HK-GBS (i.p. delayed but did not prevent preterm-delivery. Conclusion. Caspase-dependent apoptosis appears to play a role in the timing but not the occurrence of GBS-induced preterm delivery in the mouse.

Inverse association between toothbrushing and upper aerodigestive tract cancer risk in a Japanese population.

Science.gov (United States)

Sato, Fumihito; Oze, Isao; Kawakita, Daisuke; Yamamoto, Noriyuki; Ito, Hidemi; Hosono, Satoyo; Suzuki, Takeshi; Kawase, Takakazu; Furue, Hiroki; Watanabe, Miki; Hatooka, Shunzo; Yatabe, Yasushi; Hasegawa, Yasuhisa; Shinoda, Masayuki; Ueda, Minoru; Tajima, Kazuo; Tanaka, Hideo; Matsuo, Keitaro

2011-11-01

Oral hygiene is attracting increasing attention as a potential risk factor for cancers. To investigate the association between toothbrushing frequency and upper aerodigestive tract (UADT) cancer, the authors conducted a large-scale case-control study. A total of 856 UADT cancer case participants and 2696 age- and sex-matched control subjects without cancer were included. Edentulous or participants with unknown frequency of toothbrushing or number of remaining teeth were excluded. Associations were assessed by odds ratios and 95% confidence intervals in logistic regression models with adjustment for potential confounders. Compared with toothbrushing once per day, the adjusted odds ratio for brushing twice or more was 0.82 (95% confidence interval: 0.68, 0.99) whereas that for not brushing was 1.79 (0.79, 4.05). This association was observed especially in subjects who had a history of heavy smoking or drinking. The authors suggest that toothbrushing could have a protective effect for UADT cancer. Copyright © 2010 Wiley Periodicals, Inc.

Suppression of human T cell proliferation by the caspase inhibitors, z-VAD-FMK and z-IETD-FMK is independent of their caspase inhibition properties

Energy Technology Data Exchange (ETDEWEB)

Lawrence, C.P. [Medical Research Council Toxicology Unit, Hodgkin Building, Lancaster Road, University of Leicester, Leicester LE1 9HN (United Kingdom); Chow, S.C., E-mail: chow.sek.chuen@monash.edu [School of Science, Monash University Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, 46150 Selangor Darul Ehsan (Malaysia)

2012-11-15

The caspase inhibitors, benzyloxycarbony (Cbz)-l-Val-Ala-Asp (OMe)-fluoromethylketone (z-VAD-FMK) and benzyloxycarbonyl (Cbz)-Ile-Glu (OMe)-Thr-Asp (OMe)-FMK (z-IETD-FMK) at non-toxic doses were found to be immunosuppressive and inhibit human T cell proliferation induced by mitogens and IL-2 in vitro. Both caspase inhibitors were shown to block NF-κB in activated primary T cells, but have little inhibitory effect on the secretion of IL-2 and IFN-γ during T cell activation. However, the expression of IL-2 receptor α-chain (CD25) in activated T cells was inhibited by both z-VAD-FMK and z-IETD-FMK, whereas the expression of the early activated T cell marker, CD69 was unaffected. During primary T cell activation via the antigen receptor, both caspase-8 and caspase-3 were activated and processed to their respective subunits, but neither caspase inhibitors had any effect on the processing of these two caspases. In sharp contrast both caspase inhibitors readily blocked apoptosis and the activation of caspases during FasL-induced apoptosis in activated primary T cells and Jurkat T cells. Collectively, the results demonstrate that both z-VAD-FMK and z-IETD-FMK are immunosuppressive in vitro and inhibit T cell proliferation without blocking the processing of caspase-8 and caspase-3. -- Highlights: ► Caspase-8 and caspase-3 were activated during T cell activation and proliferation. ► T cell proliferation was blocked by caspase inhibitors. ► Caspase activation during T cell proliferation was not block by caspase inhibitors.

Hyaluronic Acid: Perspectives in Upper Aero-Digestive Tract. A Systematic Review.

Directory of Open Access Journals (Sweden)

Manuele Casale

Full Text Available To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper aerodigestive tract (UADT. The use of topical drugs, which are able to reduce mucosal inflammation and to improve healing tissues, can represent a relevant therapeutic advance. Topical sodium hyaluronate (SH has recently been recognized as adjuvant treatment in the chronic inflammatory disease of the UADT.The aim of our work was to review the published literature regarding all the potential therapeutic effects of SH in the chronic inflammatory disease of UADT.Relevant published studies were searched in Pubmed, Google Scholar, Ovid using keywords ("sodium hyaluronate" and "upper airways" or Medical Subject Headings.At the end of our selection process, sixteen publications have been included. Six of them in the post-operative period of nasal-sinus surgery, 2 of them in pediatric patients affected by recurrent upper respiratory tract infections, 4 of them in reducing symptoms and preventing exacerbations of chronic upper airways in adult population, 4 of them in patients with chronic inflammatory disease of UADT, including gastro-esophageal reflux disease (GERD.Topical administration of SH plays a pivotkey role in the postoperative phase of patients undergoing FESS and nasal surgery, and positive results are generally observed in all the patients suffering from UADT chronic inflammatory disease.

Curcumin induces apoptosis of upper aerodigestive tract cancer cells by targeting multiple pathways.

Directory of Open Access Journals (Sweden)

A R M Ruhul Amin

Full Text Available Curcumin, a natural compound isolated from the Indian spice "Haldi" or "curry powder", has been used for centuries as a traditional remedy for many ailments. Recently, the potential use of curcumin in cancer prevention and therapy urges studies to uncover the molecular mechanisms associated with its anti-tumor effects. In the current manuscript, we investigated the mechanism of curcumin-induced apoptosis in upper aerodigestive tract cancer cell lines and showed that curcumin-induced apoptosis is mediated by the modulation of multiple pathways such as induction of p73, and inhibition of p-AKT and Bcl-2. Treatment of cells with curcumin induced both p53 and the related protein p73 in head and neck and lung cancer cell lines. Inactivation of p73 by dominant negative p73 significantly protected cells from curcumin-induced apoptosis, whereas ablation of p53 by shRNA had no effect. Curcumin treatment also strongly inhibited p-AKT and Bcl-2 and overexpression of constitutively active AKT or Bcl-2 significantly inhibited curcumin-induced apoptosis. Taken together, our findings suggest that curcumin-induced apoptosis is mediated via activating tumor suppressor p73 and inhibiting p-AKT and Bcl-2.

Early or Up-Front Radiotherapy Improved Survival of Localized Extranodal NK/T-Cell Lymphoma, Nasal-Type in the Upper Aerodigestive Tract

International Nuclear Information System (INIS)

Huang Meijuan; Jiang Yu; Liu Weiping; Li Zhiping; Li Mei; Zhou Lin; Xu Yong; Yu Chunhua; Li Qiu; Peng Feng; Liu Jiyan; Luo Feng; Lu You

2008-01-01

Purpose: To investigate the role of early or up-front radiotherapy (RT), the optimal RT dose required to achieve appropriate treatment outcome and prognostic factors for patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. Methods and Materials: Eighty-two patients were reviewed. Eight patients were treated with chemotherapy (CT) alone, 9 patients received RT alone, and 65 patients were given combined modality treatment of CT and RT (CMT). Of those 74 patients receiving RT, 31 patients were given up-front RT, whereas CT was the initial therapy for 43 patients and 41 of those 43 patients received early RT. Results: Five-year overall survival (OS) and disease-free survival (DFS) were 52.3% and 39.2%, respectively. RT was the only independent prognostic factor for both OS and DFS at both the univariate and multivariate level. The 5-year OS and DFS were better in patients receiving ≥54 Gy of RT as compared with that of <54 Gy (5-year OS 75.5% vs. 46.1%, p = 0.019; 5-year DFS 60.3% vs. 33.4%, p = 0.004). Up-front RT presented better survival in Stage I patients when compared with that of initial CT followed by early RT (5-year OS 90.0% vs. 48.9%, p = 0.012; 5-year DFS 78.7% vs. 39.9%, p = 0.021). Conclusion: Early or up-front RT had an essential role in improved OS and DFS in patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. The recommended tumor dose was at least 54 Gy. Up-front RT may yield more benefits on survival in patients with Stage I disease

Late xerostomia after intensity-modulated conformational radiotherapy of upper aero-digestive tract cancers: study 2004-03 by the head and neck oncology and radiotherapy Group (Gortec)

International Nuclear Information System (INIS)

Toledano, I.; Lapeyre, M.; Graff, P.; Serre, C.; Bensadoun, R.J.; Bensadoun, R.J.; Ortholan, C.; Calais, G.; Alfonsi, M.; Giraud, P.; Racadot, S.

2010-01-01

The authors report a retrospective assessment of late xerostomia according to the RTOG (Radiation Therapy Oncology Group) classification of the European Organization for Research and Treatment of Cancer (EORTC) among patients treated by intensity-modulated conformational radiotherapy (IMRT) and suffering from upper aero-digestive tract carcinomas of different stages. Some of these patients have bee operated, and some have been treated by chemotherapy. It appears that the IMRT results in a reduction of late xerostomia, and even in an absence of salivary toxicity. Short communication

Informatīva uzņēmuma vadības sistēma

OpenAIRE

Salzemnieks, Aldis

2009-01-01

Informatīva uzņēmuma vadības sistēma piedāvā ērti un ātri pārlūkot informāciju par darbiniekiem, klientiem un finansiālajām attiecībām pret klientiem, kontrolēt uzņēmuma darbinieku veiktās darbības un veiksmīgi sadalīt darbus starp darbiniekiem. Sistēmu iespējams uzstādīt tā, lai piekļuve tai caur pārlūkprogrammu būtu gan no iekšējā datortīklā, gan arī tīmeklī. Tas nodrošina ātru, kvalitatīvu un organizētu darba izpildi, kā arī ietaupa laiku. Sistēmā iespējams izveidot lietotājus ar dažādiem ...

Long term forecasts to 2050 for the forestry and forest-based industries as seen by the students at the 'Ecole superieure du bois'

International Nuclear Information System (INIS)

Groutel, Emmanuel

2013-01-01

Some of the engineering students in their 3. year at the Nantes Ecole superieure du bois acquire knowledge through the 'World Forestry Exchanges' scheme. These students - Brazilians, Latvians, Taiwanese, Chines, Tunisian, ... French - learn about forestry flows, wood marketing and product trends. It is against this multi-cultural background that is open and seeks to awaken the students curiosity that their feedback is requested in the form of their own vision of the products and services that should be on offer in the future in many forest-based industries. The diversity of their responses and the originality and relevance of some of these inspired the author to write this article which classifies and summarises these thoughts. This is a cooperative approach which aims at being of educational, academic and practical value. (authors)

Genetic polymorphisms of alcohol dehydrogense-1B and aldehyde dehydrogenase-2, alcohol flushing, mean corpuscular volume, and aerodigestive tract neoplasia in Japanese drinkers.

Science.gov (United States)

Yokoyama, Akira; Mizukami, Takeshi; Yokoyama, Tetsuji

2015-01-01

Genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) modulate exposure levels to ethanol/acetaldehyde. Endoscopic screening of 6,014 Japanese alcoholics yielded high detection rates of esophageal squamous cell carcinoma (SCC; 4.1%) and head and neck SCC (1.0%). The risks of upper aerodigestive tract SCC/dysplasia, especially of multiple SCC/dysplasia, were increased in a multiplicative fashion by the presence of a combination of slow-metabolizing ADH1B*1/*1 and inactive heterozygous ALDH2*1/*2 because of prolonged exposure to higher concentrations of ethanol/acetaldehyde. A questionnaire asking about current and past facial flushing after drinking a glass (≈180 mL) of beer is a reliable tool for detecting the presence of inactive ALDH2. We invented a health-risk appraisal (HRA) model including the flushing questionnaire and drinking, smoking, and dietary habits. Esophageal SCC was detected at a high rate by endoscopic mass-screening in high HRA score persons. A total of 5.0% of 4,879 alcoholics had a history of (4.0%) or newly diagnosed (1.0%) gastric cancer. Their high frequency of a history of gastric cancer is partly explained by gastrectomy being a risk factor for alcoholism because of altered ethanol metabolism, e.g., by blood ethanol level overshooting. The combination of H. pylori-associated atrophic gastritis and ALDH2*1/*2 showed the greatest risk of gastric cancer in alcoholics. High detection rates of advanced colorectal adenoma/carcinoma were found in alcoholics, 15.7% of 744 immunochemical fecal occult blood test (IFOBT)-negative alcoholics and 31.5% of the 393 IFOBT-positive alcoholics. Macrocytosis with an MCV≥106 fl increased the risk of neoplasia in the entire aerodigestive tract of alcoholics, suggesting that poor nutrition as well as ethanol/acetaldehyde exposure plays an important role in neoplasia.

Diet and upper-aerodigestive tract cancer in Europe: the ARCAGE study.

LENUS (Irish Health Repository)

Lagiou, Pagona

2009-06-01

There is suggestive, but inconclusive, evidence that dietary factors may affect risk of cancers of the upper aerodigestive tract (UADT). In the context of the alcohol-related cancers and genetic susceptibility in Europe study, we have examined the association of dietary factors with UADT cancer risk. We have analyzed data from 2,304 patients with UADT cancer and 2,227 control subjects recruited in 14 centers in 10 European countries. Dietary data were collected through a semi-quantitative food frequency questionnaire that also assessed preferred temperature of hot beverages. Statistical analyses were conducted through multiple logistic regression controlling for potential confounding variables, including alcohol intake and smoking habits. Consumption of red meat (OR per increasing tertile = 1.14, 95% CI: 1.05-1.25), but not poultry, was significantly associated with increased UADT cancer risk and the association was somewhat stronger for esophageal cancer. Consumption of fruits (OR per increasing tertile = 0.68, 95% CI: 0.62-0.75) and vegetables (OR per increasing tertile = 0.73, 95% CI: 0.66-0.81) as well as of olive oil (OR for above versus below median = 0.78, 95% CI 0.67-0.90) and tea (OR for above versus below median = 0.83, 95% CI 0.69-0.98) were significantly associated with reduced risk of UADT cancer. There was no indication that an increase in tea or coffee temperature was associated with increased risk of UADT overall or cancer of the esophagus; in fact, the association was, if anything, inverse. In conclusion, the results of this large multicentric study indicate that diet plays an important role in the etiology of UADT cancer.

Population attributable risk of tobacco and alcohol for upper aerodigestive tract cancer.

LENUS (Irish Health Repository)

Anantharaman, Devasena

2011-08-01

Tobacco and alcohol are major risk factors for upper aerodigestive tract (UADT) cancer and significant variation is observed in UADT cancer rates across Europe. We have estimated the proportion of UADT cancer burden explained by tobacco and alcohol and how this varies with the incidence rates across Europe, cancer sub-site, gender and age. This should help estimate the minimum residual burden of other risk factors to UADT cancer, including human papillomavirus. We analysed 1981 UADT cancer cases and 1993 controls from the ARCAGE multicentre study. We estimated the population attributable risk (PAR) of tobacco alone, alcohol alone and their joint effect. Tobacco and alcohol together explained 73% of UADT cancer burden of which nearly 29% was explained by smoking alone, less than 1% due to alcohol on its own and 44% by the joint effect of tobacco and alcohol. Tobacco and alcohol together explained a larger proportion of hypopharyngeal\\/laryngeal cancer (PAR=85%) than oropharyngeal (PAR=74%), esophageal (PAR=67%) and oral cancer (PAR=61%). Tobacco and alcohol together explain only about half of the total UADT cancer burden among women. Geographically, tobacco and alcohol explained a larger proportion of UADT cancer in central (PAR=84%) than southern (PAR=72%) and western Europe (PAR=67%). While the majority of the UADT cancers in Europe are due to tobacco or the joint effect of tobacco and alcohol, our results support a significant role for other risk factors in particular, for oral and oropharyngeal cancers and also for UADT cancers in southern and western Europe.

Life course social mobility and risk of upper aerodigestive tract cancer in men.

LENUS (Irish Health Repository)

Schmeisser, N

2010-03-01

The aim of this study was to explore associations between social mobility and tumours of the upper aero-digestive tract (UADT), focussing on life-course transitions in social prestige (SP) based on occupational history. 1,796 cases diagnosed between 1993 and 2005 in ten European countries were compared with 1585 controls. SP was classified by the Standard International Occupational Prestige Scale (SIOPS) based on job histories. SIOPS was categorised in high (H), medium (M) and low (L). Time weighted average achieved and transitions between SP with nine trajectories: H --> H, H --> M, H --> L, M --> H, M --> M, M --> L, L --> H, L --> M and L --> L were analysed. Odds ratios (ORs) and 95%-confidence intervals [95%-CIs] were estimated with logistic regression models including age, consumption of fruits\\/vegetables, study centre, smoking and alcohol consumption. The adjusted OR for the lowest versus the highest of three categories (time weighted average of SP) was 1.28 [1.04-1.56]. The distance of SP widened between cases and controls during working life. The downward trajectory H --> L gave an OR of 1.71 [0.75-3.87] as compared to H --> H. Subjects with M --> M and L --> L trajectories ORs were also elevated relative to subjects with H --> H trajectories. The association between SP and UADT is not fully explained by confounding factors. Downward social trajectory during the life course may be an independent risk factor for UADT cancers.

Site Specific Effect of Tobacco Addiction in Upper Aerodigestive Tract Tumors: A Retrospective Clinicopathological Study

Directory of Open Access Journals (Sweden)

Ashok Kumar

2014-01-01

Full Text Available An institutional study was carried out in 102 patients to investigate the site specific effect of addictions, that is, tobacco smoking and tobacco chewing (smokeless, both independently and synergistically in development of malignancies in upper aerodigestive tract through retrograde questionnaire. The histopathologically proven cases were interviewed regarding different forms of addictions followed by clinical examination and investigations for grading (according to Modified Broadmann’s method and TNM staging (according to UICC according to the tumor site. Statistical analysis was done by Pearson test. Out of all proven cases of cancers, 29.4% were only tobacco chewers (smokeless, 25.5% were only smokers, 42.2% were having both types of tobacco addictions (smoke and smokeless, and only 2.9% were having no addiction. Out of only tobacco chewers (smokeless, 83.3% were of oral cavity cancers, 6.7% were of oro- and hypopharynx and the rest were of others. Among only smokers, 69.2% cases were of laryngeal and oro- and hypopharynx as compared to 11.5% of oral cavity cancers (nearly 6 times. Tobacco (smokeless chewing is associated with oral cancers whereas tobacco smoking is associated with laryngeal and hypopharyngeal carcinoma. Both smoking and smokeless tobacco act in synergy with each other.

Occupation and risk of upper aerodigestive tract cancer: the ARCAGE study.

LENUS (Irish Health Repository)

Richiardi, Lorenzo

2012-05-15

We investigated the association between occupational history and upper aerodigestive tract (UADT) cancer risk in the ARCAGE European case-control study. The study included 1,851 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1,949 controls. We estimated odds ratios (OR) and 95% confidence intervals (CI) for ever employment in 283 occupations and 172 industries, adjusting for smoking and alcohol. Men (1,457 cases) and women (394 cases) were analyzed separately and we incorporated a semi-Bayes adjustment approach for multiple comparisons. Among men, we found increased risks for occupational categories previously reported to be associated with at least one type of UADT cancer, including painters (OR = 1.74, 95% CI: 1.01-3.00), bricklayers (1.58, 1.05-2.37), workers employed in the erection of roofs and frames (2.62, 1.08-6.36), reinforced concreters (3.46, 1.11-10.8), dockers (2.91, 1.05-8.05) and workers employed in the construction of roads (3.03, 1.23-7.46), general construction of buildings (1.44, 1.12-1.85) and cargo handling (2.60, 1.17-5.75). With the exception of the first three categories, risks both increased when restricting to long duration of employment and remained elevated after semi-Bayes adjustment. Increased risks were also found for loggers (3.56, 1.20-10.5) and cattle and dairy farming (3.60, 1.15-11.2). Among women, there was no clear evidence of increased risks of UADT cancer in association with occupations or industrial activities. This study provides evidence of an association between some occupational categories and UADT cancer risk among men. The most consistent findings, also supported by previous studies, were obtained for specific workers employed in the construction industry.

Retrospective study of the evolution of nutritional, inflammatory and bacteriological profiles of patients suffering from inoperable aero-digestive duct tumour during sequential or concomitant chemo-radiotherapy

International Nuclear Information System (INIS)

Martin, L.; Brocard, C.; Coudray, C.; Pavlovitch, J.M.

2010-01-01

The authors report a retrospective study which aimed at analysing a cohort of consecutive patients in terms of clinic and biological aspects reflecting their nutritional and inflammatory status as well as the status of their buccal bacterial flora during a sequential or concomitant chemo-radiotherapy. The objective was to detect a possible difference between these both therapeutic modalities, and a possible relationship with toxicity. Several data have been collected for patients suffering from inoperable aero-digestive tract tumour: weight, body mass index, prealbumin, albumin, orosomucoid, C-reactive protein, PINI index, and buccal bacterial flora. The evolution of these nutritional biological criteria appears to depend on the treatment modality. Short communication

Vad och hur gör de? − att synliggöra lärande i grundskolans slöjdpraktik via videoetnografi och mikroanalys

Directory of Open Access Journals (Sweden)

Marléne Johansson

2011-11-01

Full Text Available Artikeln bygger på resultat och erfarenheter av etnografiskt insamlade videoinspelningar från grundskolans slöjdundervisning utgående från tre studier; dels vid ett projekt med förstudier under slutet av 1990-talet (Johansson, 1996, dels vid avhandlingsprojektet Slöjdpraktik i skolan (Johansson, 2002 och dels inom forskningsprojektet Kommunikation och lärande i slöjdpraktiker, (”Komolär-projektet”, under 2005−2010 (Lindström, Borg, Johansson & Lindberg, 2003.Att insamla empiri i autentiska slöjdmiljöer är av intresse då lärandesituationer kan synliggöras när elever med hjälp av material och redskap arbetar med att tillverka artefakter. Utifrån detaljerade analyser av slöjdaktiviteter går det att upptäcka det som utspelar sig och möjligheter ges att uppfatta något annat jämfört med vad man kan tro känna väl eller ha förenklade och till och med felaktiga uppfattningar om. Videoobservationer möjliggör att antaganden istället görs på empiriskt grundat datamaterial. Med risk att videofilma och analysera det man tror sig veta och söka har forskningsprojektens insamlingar mer förutsättningslöst arbetat efter vad och hur elever och lärare gör i slöjdpraktik och vad man får veta när slöjdaktiviteter analyseras mer ingående. Videomaterialen har analyserats både på en mer övergripande nivå och detaljerat med hjälp av mikroanalyser. Därefter har lärandet synliggjorts och beskrivits bland annat i teman för att visa hur personerna är resurser för varandra och hur lärandet utvecklas genom olika språkanvändning och med slöjdpraktikens fysiska redskap och material.Sökord: metod, slöjd, klassrumsforskning, videoetnografi, mikroanalysURN:NBN:no-29955

Karlstads universitet - Ut i skogen, vad ska jag dit och göra? : En rapport om skapandet av ett unikt monterkoncept

OpenAIRE

Bergman, Karin; Jernberg, Jonna

2012-01-01

Sammanfattning Mässor förekom som fenomen redan under medeltiden och har allt sedan dess använts som en kanal för försäljning och marknadsföring. Idag tävlar företag och organisationer om mässbesökares uppmärksamhet genom att skapa attraktiva montrar med vinnande koncept som ska locka människor och få dem att lägga företagsnamnet på minnet. Detta är vad Karlstads universitet haft i åtanke då de utformat beskrivningen till detta projekt. Bakgrunden till projektet är att universitetet finns r...

Human Papillomavirus and Upper Aerodigestive Tract Neoplasm: A Review Literature from Mexico and Colombia / Virus del papiloma humano y el cáncer de cabeza y cuello: revisión de la literatura desde México y Colombia

OpenAIRE

Rocha Buelvas, Anderson; Grupo de Gestión del Conocimiento de Observatorios, Registros y Sistemas de Información, Dirección de Epidemiología y Demografía, Ministerio de Salud y Protección Social, Bogotá; Bologna Molina, Ronell; Escuela de Odontología, Universidad Juárez del Estado de Durango; Rocha Buelvas, Cristian; Universidad Nacional de Colombia sede Bogotá

2013-01-01

Background: Papillomavirus or papilovirus is considered the most prevalent group of virusesthat cause tumors of head and neck associated with infection with human papillomavirus (HPV). Purpose: Carry out a systematic review of literature on HPV as causal agentof upper aerodigestive tract neoplasm (UADTN), according to epidemiological and clinicaldata. Methods: Pertinent biomedical literature was searched in several databases such asMedline, Proquest, Science Direct, Ovid and Cochrane, as well...

Noliktavu vadības sistēmas (WMS) ieviešana un ieviešanas rezultātu analīze loģistikas uzņēmumā AS ,,Dominante Loģistikas Sistēma

OpenAIRE

Morozovs, Gļebs

2010-01-01

Darbā „Noliktavu vadības sistēmas (WMS) ieviešana un ieviešanas rezultātu analīze loģistikas uzņēmumā AS „Dominante Loģistikas Sistēma„ tiek pētīta noliktavu vadības sistēmas ievešanas ietekme uz loģistikas uzņēmumu. Darbā izpētīts loģistikas saturs un funkcionālās sfēra, aplūkoti noliktavu un transporta loģistika pamatprincipi un mijiedarbība, analizētas loģistikas attīstības tendences un loma Latvijas tautsaimniecība. Izpētīti noliktavu un transporta loģistikas instrumenti, raksturota infor...

Inverse association between yoghurt intake and upper aerodigestive tract cancer risk in a Japanese population.

Science.gov (United States)

Kawakita, Daisuke; Sato, Fumihito; Hosono, Satoyo; Ito, Hidemi; Oze, Isao; Watanabe, Miki; Hanai, Nobuhiro; Hatooka, Shunzo; Hasegawa, Yasuhisa; Shinoda, Masayuki; Tajima, Kazuo; Murakami, Shingo; Tanaka, Hideo; Matsuo, Keitaro

2012-09-01

Although the combination of tobacco smoking and alcohol drinking account for approximately 80% of upper aerodigestive tract (UADT) cancer risk, the role of dietary factors, including dairy products, in the risk of these cancers remains controversial. We aimed to evaluate the association between dairy product intake and UADT cancer risk in a Japanese population. We conducted a case-control study in 959 patients with UADT cancer and 2877 sex- and age-matched noncancer control subjects who visited the Aichi Cancer Center in Nagoya, Japan. Data on lifestyle factors, including diet, were obtained by self-administered questionnaire. Associations were assessed by multivariate logistic regression models that considered potential confounders. We found a significant inverse association between yoghurt intake and UADT cancer risk with multivariate-adjusted odds ratios and 95% confidence intervals for <1 time/week, ≥ 1 time/week and <1 time/day, and ≥ 1 time/day consumption of yoghurt of 0.70 (95% confidence interval: 0.54-0.91), 0.67 (0.54-0.84), and 0.73 (0.55-0.95) relative to nonconsumers (P trend=0.005). When stratified by primary tumor site, this association was significant among patients with hypopharyngeal, laryngeal, and esophageal cancer. However, we saw no significant association between milk or butter intake and UADT cancer risk. In this study, we found that a high intake of yoghurt may lower the risk of developing UADT cancer in a Japanese population. Further investigation of this association is warranted.

Augmentation of Radiation Response by Panitumumab in Models of Upper Aerodigestive Tract Cancer

International Nuclear Information System (INIS)

Kruser, Tim J.; Armstrong, Eric A.; Ghia, Amol J.; Huang Shyhmin; Wheeler, Deric L.; Radinsky, Robert; Freeman, Daniel J.; Harari, Paul M.

2008-01-01

Purpose: To examine the interaction between panitumumab, a fully human anti-epidermal growth factor receptor monoclonal antibody, and radiation in head-and-neck squamous cell carcinoma and non-small-cell lung cancer cell lines and xenografts. Methods and Materials: The head-and-neck squamous cell carcinoma lines UM-SCC1 and SCC-1483, as well as the non-small-cell lung cancer line H226, were studied. Tumor xenografts in athymic nude mice were used to assess the in vivo activity of panitumumab alone and combined with radiation. In vitro assays were performed to assess the effect of panitumumab on radiation-induced cell signaling, apoptosis, and DNA damage. Results: Panitumumab increased the radiosensitivity as measured by the clonogenic survival assay. Radiation-induced epidermal growth factor receptor phosphorylation and downstream signaling through mitogen-activated protein kinase (MAPK) and signal transducer and activator of transcription 3 (STAT3) was inhibited by panitumumab. Panitumumab augmented radiation-induced DNA damage by 1.2-1.6-fold in each of the cell lines studied as assessed by residual γ-H 2 AX foci after radiation. Radiation-induced apoptosis was increased 1.4-1.9-fold by panitumumab, as evidenced by Annexin V-fluorescein isothiocyanate staining and flow cytometry. In vivo, the combination therapy of panitumumab and radiation was superior to panitumumab or radiation alone in the H226 xenografts (p = 0.01) and showed a similar trend in the SCC-1483 xenografts (p = 0.08). In vivo, immunohistochemistry demonstrated the ability of panitumumab to augment the antiproliferative and antiangiogenic effects of radiation. Conclusion: These studies have identified a favorable interaction in the combination of radiation and panitumumab in upper aerodigestive tract tumor models, both in vitro and in vivo. These data suggest that clinical investigations examining the combination of radiation and panitumumab in the treatment of epithelial tumors warrant

Quantification of tumor infiltrating Foxp3+ regulatory T cells enables the identification of high-risk patients for developing synchronous cancers over upper aerodigestive tract.

Science.gov (United States)

Wang, Wen-Lun; Chang, Wei-Lun; Yang, Hsiao-Bai; Chang, I-Wei; Lee, Ching-Tai; Chang, Chi-Yang; Lin, Jaw-Town; Sheu, Bor-Shyang

2015-07-01

Patients with squamous cell carcinomas (SCC) of upper aerodigestive tract, either over head and neck (HNSCC) or esophagus (ESCC), frequently developed synchronous multiple cancers, leading to worse prognosis. This study validated whether suppression of host cancer immunosurveillance mediated by regulatory T cells (Treg) may predispose to the development of synchronous cancers. Tumor tissues of 200 patients (100 ESCC only, 50 HNSCC only, and 50 synchronous SCCs) were quantitatively accessed for the tumor infiltrating Treg by immunohistochemistry. The density of Treg was also correlated to the level of Treg-associated inhibitory cytokines (IL-10, IL-35 and TGF-β1), and chemokine (CCL22). The density of tumor infiltrating Treg in the index tumor (i.e. the first malignancy diagnosed) of synchronous SCC group was higher than those of HNSCC or ESCC only (prisk of synchronous cancer development to initiate a proper surveillance program. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lifetime risk of distinct upper aerodigestive tract cancers and consumption of alcohol, betel and cigarette.

Science.gov (United States)

Hsu, Wan-Lun; Chien, Yin-Chu; Chiang, Chun-Ju; Yang, Hwai-I; Lou, Pei-Jen; Wang, Cheng-Ping; Yu, Kelly J; You, San-Lin; Wang, Li-Yu; Chen, Shu-Yuan; Yang, Czau-Siung; Chen, Chien-Jen

2014-09-15

The cancer of upper aerodigestive tract (UADT) is a common cancers in the world. However, its lifetime risk by consumption of alcohol, betel and cigarettes remain to be elucidated. This study aimed to estimate lifetime risk of distinct UADT cancers and assess their associations with alcohol, betel and cigarette consumption. Three cohorts of 25,611 men were enrolled in 1982-1992 in Taiwan. The history of alcohol, betel and cigarette consumption was enquired through questionnaire interview. Newly developed UADT cancers were ascertained through computerized linkage with national cancer registry profile. Lifetime (30-80 years old) risk and multivariate-adjusted hazard ratio (HRadj) of distinct UADT cancers by alcohol, betel and cigarette consumption were estimated. A total of 269 pathologically confirmed cases of UADT cancers were newly-diagnosed during 472,096 person-years of follow-up. The lifetime risk of UADT cancer was 9.42 and 1.65% for betel chewers and nonchewers, 3.22 and 1.21% for cigarette smokers and nonsmokers and 4.77 and 1.85% for alcohol drinkers and nondrinkers. The HRadj (95% confidence interval) of developing UADT cancer was 3.36 (2.51-4.49), 2.02 (1.43-2.84), 1.90 (1.46-2.49), respectively, for the consumption of betel, cigarette and alcohol. Alcohol, betel and cigarette had different effect on cancers at various anatomical sites of UADT. The cancer risk from the mouth, pharynx, esophagus to larynx increased for alcohol and cigarette consumption, but decreased for betel consumption. Alcohol, betel and cigarette consumption are independent risk predictors for distinct UADT cancers. © 2014 UICC.

A genome-wide association study of upper aerodigestive tract cancers conducted within the INHANCE consortium.

LENUS (Irish Health Repository)

McKay, James D

2011-03-01

Genome-wide association studies (GWAS) have been successful in identifying common genetic variation involved in susceptibility to etiologically complex disease. We conducted a GWAS to identify common genetic variation involved in susceptibility to upper aero-digestive tract (UADT) cancers. Genome-wide genotyping was carried out using the Illumina HumanHap300 beadchips in 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls. The 19 top-ranked variants were investigated further in an additional 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies participating in the INHANCE consortium. Five common variants presented evidence for significant association in the combined analysis (p ≤ 5 × 10⁻⁷). Two novel variants were identified, a 4q21 variant (rs1494961, p = 1×10⁻⁸) located near DNA repair related genes HEL308 and FAM175A (or Abraxas) and a 12q24 variant (rs4767364, p =2 × 10⁻⁸) located in an extended linkage disequilibrium region that contains multiple genes including the aldehyde dehydrogenase 2 (ALDH2) gene. Three remaining variants are located in the ADH gene cluster and were identified previously in a candidate gene study involving some of these samples. The association between these three variants and UADT cancers was independently replicated in 5,092 UADT cancer cases and 6,794 controls non-overlapping samples presented here (rs1573496-ADH7, p = 5 × 10⁻⁸); rs1229984-ADH1B, p = 7 × 10⁻⁹; and rs698-ADH1C, p = 0.02). These results implicate two variants at 4q21 and 12q24 and further highlight three ADH variants in UADT cancer susceptibility.

A genome-wide association study of upper aerodigestive tract cancers conducted within the INHANCE consortium.

Directory of Open Access Journals (Sweden)

James D McKay

2011-03-01

Full Text Available Genome-wide association studies (GWAS have been successful in identifying common genetic variation involved in susceptibility to etiologically complex disease. We conducted a GWAS to identify common genetic variation involved in susceptibility to upper aero-digestive tract (UADT cancers. Genome-wide genotyping was carried out using the Illumina HumanHap300 beadchips in 2,091 UADT cancer cases and 3,513 controls from two large European multi-centre UADT cancer studies, as well as 4,821 generic controls. The 19 top-ranked variants were investigated further in an additional 6,514 UADT cancer cases and 7,892 controls of European descent from an additional 13 UADT cancer studies participating in the INHANCE consortium. Five common variants presented evidence for significant association in the combined analysis (p ≤ 5 × 10⁻⁷. Two novel variants were identified, a 4q21 variant (rs1494961, p = 1×10⁻⁸ located near DNA repair related genes HEL308 and FAM175A (or Abraxas and a 12q24 variant (rs4767364, p =2 × 10⁻⁸ located in an extended linkage disequilibrium region that contains multiple genes including the aldehyde dehydrogenase 2 (ALDH2 gene. Three remaining variants are located in the ADH gene cluster and were identified previously in a candidate gene study involving some of these samples. The association between these three variants and UADT cancers was independently replicated in 5,092 UADT cancer cases and 6,794 controls non-overlapping samples presented here (rs1573496-ADH7, p = 5 × 10⁻⁸; rs1229984-ADH1B, p = 7 × 10⁻⁹; and rs698-ADH1C, p = 0.02. These results implicate two variants at 4q21 and 12q24 and further highlight three ADH variants in UADT cancer susceptibility.

Association of sugary beverages with survival among patients with cancers of the upper aerodigestive tract

Science.gov (United States)

Miles, Fayth L.; Chang, Shen-Chih; Morgenstern, Hal; Tashkin, Donald; Rao, Jian-Yu; Cozen, Wendy; Mack, Thomas; Lu, Qing-Yi

2017-01-01

Purpose The role of consumption of added sugars in cancers of the upper aerodigestive tract (UADT) is unclear. We examined associations between sugary beverages and susceptibility to UADT cancer as well as overall survival among UADT cancer patients. Methods The association between dietary added sugar and susceptibility to UADT cancers or overall survival among 601 UADT cancer cases was evaluated using data from a population-based case–control study conducted in Los Angeles County. Unconditional logistic regression was used to estimate odds ratios and 95 % confidence intervals (CI) for cancer susceptibility, and Cox regression was used to estimate hazards ratios (HRs) with 95 % CIs for survival, adjusting for relevant confounders. Results A total of 248 deaths were observed during follow-up (median 12.1 years). A positive association was observed with consumption of grams of sugar from beverages, including soft drinks and fruit juices, and poorer survival among UADT cancer cases (aHR, Q4 vs. Q1:1.88; 95 % CI 1.29, 2.72; p for trend = 0.002), as well as servings of sugary beverages (aHR, Q4 vs. Q1: 95 % CI 1.97, 95 % CI 1.32–2.93). This was due largely to consumption of sugars from soft drinks. Particularly, high consumption of sugary beverages was associated with poorer survival among esophageal cancer cases, driven by squamous cancers. No association was observed between sugary beverages and cancer susceptibility. Conclusion These findings suggest that consumption of sugary beverages may decrease survival associated with UADT cancers. Additional studies should be conducted to examine survival among cancer patients consuming high amounts of added or refined sugars. Such studies may highlight prognostic factors for UADT cancers. PMID:27539643

Alpha-Synuclein Pathology in Sensory Nerve Terminals of the Upper Aerodigestive Tract of Parkinson's Disease Patients.

Science.gov (United States)

Mu, Liancai; Chen, Jingming; Sobotka, Stanislaw; Nyirenda, Themba; Benson, Brian; Gupta, Fiona; Sanders, Ira; Adler, Charles H; Caviness, John N; Shill, Holly A; Sabbagh, Marwan; Samanta, Johan E; Sue, Lucia I; Beach, Thomas G

2015-08-01

Dysphagia is common in Parkinson's disease (PD) and causes significant morbidity and mortality. PD dysphagia has usually been explained as dysfunction of central motor control, much like other motor symptoms that are characteristic of the disease. However, PD dysphagia does not correlate with severity of motor symptoms nor does it respond to motor therapies. It is known that PD patients have sensory deficits in the pharynx, and that impaired sensation may contribute to dysphagia. However, the underlying cause of the pharyngeal sensory deficits in PD is not known. We hypothesized that PD dysphagia with sensory deficits may be due to degeneration of the sensory nerve terminals in the upper aerodigestive tract (UAT). We have previously shown that Lewy-type synucleinopathy (LTS) is present in the main pharyngeal sensory nerves of PD patients, but not in controls. In this study, the sensory terminals in UAT mucosa were studied to discern the presence and distribution of LTS. Whole-mount specimens (tongue-pharynx-larynx-upper esophagus) were obtained from 10 deceased human subjects with clinically diagnosed and neuropathologically confirmed PD (five with dysphagia and five without) and four age-matched healthy controls. Samples were taken from six sites and immunostained for phosphorylated α-synuclein (PAS). The results showed the presence of PAS-immunoreactive (PAS-ir) axons in all the PD subjects and in none of the controls. Notably, PD patients with dysphagia had more PAS-ir axons in the regions that are critical for initiating the swallowing reflex. These findings suggest that Lewy pathology affects mucosal sensory axons in specific regions of the UAT and may be related to PD dysphagia.

SFRO booklets - The radiotherapy of cancers: of anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder for a better understanding of radiotherapy, sarcoma radiotherapy - To better understand your treatment

International Nuclear Information System (INIS)

Leroy, Thomas; Mornex, Francoise; Peiffert, Didier; Thariat, Juliette; Faivre, Jean-Christophe; Huguet, Florence; Vendrely, Veronique; Barillot, Isabelle; Janoray, Guillaume; Bibault, Jean-Emmanuel; Antoni, Delphine; Crehange, Gilles; Meillan, Nicolas; Pichon, Baptiste; Biau, Julian; Pointreau, Yoann; Mirabel, Xavier; Leysalle, Axel; Claren, Audrey; Cartier, Lysian; Chand, Mari-Eve; Jacob, Julian; Renard-Oldrini, Sophie; Le Pechoux, Cecile; Ducassou, Anne; Moureau-Zabotto, Laurence; Lagrange, Jean Leon; Molina, Sarah

2016-07-01

This document gathers several booklets which, for different types of cancers, propose information regarding the anatomy and location of the cancer, its diagnosis, possible treatments, secondary effects during treatment, some practical advices, issues related to the post-treatment period, associations and other resources which can be useful for patient information, and a glossary of the main terms used for this cancer and its treatment. Cancer types are anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder cancers

Toys in the upper aerodigestive tract: evidence on their risk as emerging from the ESFBI study.

Science.gov (United States)

Foltran, Francesca; Gregori, Dario; Passàli, Desiderio; Bellussi, Luisa; Caruso, Giuseppe; Passàli, Francesco Maria; Passàli, Giulio Cesare

2011-10-01

Foreign body inhalation/aspiration or ingestion is a relatively common event in young children and, despite many efforts made in several Countries to reach acceptable safety levels for products devoted to children, small toys or toy parts are frequently mentioned among risky foreign bodies. The aim of the present study is to characterize the risk of complications and prolonged hospitalization due to toys inhalation/aspiration or ingestion according to age and gender of patients, FB characteristics and FB location, circumstances of the accident, as emerging from the ESFBI study. A retrospective study in major hospitals of 19 European Countries was realized on children aged 0-14 having inhaled/aspired or ingested a toy, with regard to the characteristics of the child and the FB (shape, volume, consistency), the FB location, the hospitalization's details and the occurrence of complications. In the years 2000-2003 a total of 2094 FB injuries occurred in children aged 0-14 years. Among them 121 (5.8%) were due to toys (mainly parts of toys) and 95 (4.5%) occurred in the lower/upper aero-digestive tract. 58 children needed hospitalization. The first determinant of a damage requiring hospitalization is the rigid consistence of the object. Almost 27% of toys related injuries happened under adults' supervision. Despite the adoption of preventive strategies, including products modification by manufacturers, has resulted in a decrease of children's mortality rate for choking in the last decades, our results seem to testify that preventive strategies imposing a regulation of industrial production, even if fundamental, are not sufficient and need to be integrated with other preventive intervention addressed to improve parents ability to be conscious of FB injuries and attentive toward a proper surveillance of children. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Alpha-Synuclein Pathology in Sensory Nerve Terminals of the Upper Aerodigestive Tract of Parkinson’s Disease Patients

Science.gov (United States)

Mu, Liancai; Chen, Jingming; Sobotka, Stanislaw; Nyirenda, Themba; Benson, Brian; Gupta, Fiona; Sanders, Ira; Adler, Charles H.; Caviness, John N.; Shill, Holly A.; Sabbagh, Marwan; Samanta, Johan E.; Sue, Lucia I.; Beach, Thomas G.

2015-01-01

Dysphagia is common in Parkinson’s disease (PD) and causes significant morbidity and mortality. PD dysphagia has usually been explained as dysfunction of central motor control, much like other motor symptoms that are characteristic of the disease. However, PD dysphagia does not correlate with severity of motor symptoms nor does it respond to motor therapies. It is known that PD patients have sensory deficits in the pharynx, and that impaired sensation may contribute to dysphagia. However, the underlying cause of the pharyngeal sensory deficits in PD is not known. We hypothesized that PD dysphagia with sensory deficits may be due to degeneration of the sensory nerve terminals in the upper aerodigestive tract (UAT). We have previously shown that Lewy-type synucleinopathy (LTS) is present in the main pharyngeal sensory nerves of PD patients, but not in controls. In this study, the sensory terminals in UAT mucosa were studied to discern the presence and distribution of LTS. Whole-mount specimens (tongue-pharynx-larynx-upper esophagus) were obtained from 10 deceased human subjects with clinically diagnosed and neuropathologically confirmed PD (five with dysphagia and five without) and four age-matched healthy controls. Samples were taken from six sites and immunostained for phosphorylated α-synuclein (PAS). The results showed the presence of PAS-immunoreactive (PAS-ir) axons in all the PD subjects and in none of the controls. Notably, PD patients with dysphagia had more PAS-ir axons in the regions that are critical for initiating the swallowing reflex. These findings suggest that Lewy pathology affects mucosal sensory axons in specific regions of the UAT and may be related to PD dysphagia. PMID:26041249

Solid state processing of massive uranium mononitride, using uranium and uranium higher nitride powders as starting materials (1962); Preparation a l'etat solide de mononitrure d'uranium massif a partir de poudres d'uranium et de nitrures superieurs d'uranium (1962)

Energy Technology Data Exchange (ETDEWEB)

Molinari, J [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1960-12-15

The mechanism and the optimum conditions for preparing uranium mononitride have been studied. The results have been used for hot pressing (250 kg/cm{sup 2}, 1000 deg. C, under vacuum) a mixture of powders of uranium and uranium higher nitrides. The products obtained have been identified by X-ray measurements and may be - at will and depending upon the stoichiometry - either UN, or a cermet a U{sub {alpha}}-UN. As revealed by the curved shape of grain boundaries, the sinters obtained here do not easily evolve towards physico-chemical equilibrium when submitted to heat treatment. This behaviour is quite different from the one observed with uranium monocarbide prepared by a similar method. This fact may be ascribed to the insolubility in the matrix UN of particles of UO{sub 2} being present as impurities. The density, hardness and thermal conductivity of these products are higher than those measured on uranium nitride or cermets U-UN obtained by other methods. (author) [French] Apres une etude prealable du mecanisme et des conditions optimales de nitruration de l'uranium, on a montre qu'il est possible de preparer par frittage sous charge (250 kg/cm{sup 2}, 1000 deg. C sous vide) d'un melange de poudres d'uranium et de nitrures superieurs d'uranium, un produit qui a ete identifie par diffraction de rayons X. On peut ainsi obtenir a volonte, soit le monocarbure UN, soit un cermet U{sub {alpha}}-UN dans le cas de compositions sous-stoechiometriques. Au contraire du monocarbure d'uranium prepare dans des conditions analogues, les produits obtenus ici, soumis a un traitement thermique, n'evoluent pas facilement vers un etat d'equilibre physico-chimique caracterise par l'existence de joints de grains rectilignes. On attribue ce phenomene a l'insolubilite de l'impurete UO{sub 2} dans UN. La densite, la durete, la conductibilite thermique de ces produits se revelent superieures a celles des nitrures d'uranium ou des cermets U-UN obtenus par les autres methodes. (auteur)

Risk of upper aerodigestive tract cancer and type of alcoholic beverage: a European multicenter case-control study.

LENUS (Irish Health Repository)

Marron, Manuela

2012-07-01

The general relationship between cancers of the upper aerodigestive tract (UADT) and alcohol drinking is established. Nevertheless, it is uncertain whether different types of alcoholic beverages (wine, beer and liquor) carry different UADT cancer risks. Our study included 2,001 UADT cancer cases and 2,125 controls from 14 centres in 10 European countries. All cases were histologically or cytologically confirmed squamous cell carcinomas. Controls were frequency matched by sex, age and centre. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 %CI) adjusted for age, sex, centre, education level, vegetable and fruit intake, tobacco smoking and alcohol drinking, where appropriate. Risk of beverage-specific alcohol consumption were calculated among \\'pure drinker\\' who consumed one beverage type exclusively, among \\'predominant drinkers\\' who consumed one beverage type to more than 66 % and among \\'mixed drinkers\\' who consumed more than one beverage type to similar proportions. Compared to never drinkers and adjusted for cumulative alcohol consumption, the OR and 95 %CI for wine, beer and liquor drinking, respectively, were 1.24 (0.86, 1.78), 1.54 (1.05, 2.27) and 0.94 (0.53, 1.64) among \\'pure drinkers\\' (p value for heterogeneity across beverage types = 0.306), 1.05 (0.76,1.47), 1.25 (0.87,1.79) and 1.43 (0.95, 2.16) among \\'predominant drinkers\\' (p value = 0.456), and 1.09 (0.79, 1.50), 1.20 (0.88, 1.63) and 1.12 (0.82, 1.53) among \\'mixed drinkers\\' (p value = 0.889). Risk of UADT cancer increased with increasing consumption of all three alcohol beverage types. Our findings underscore the strong and comparable carcinogenic effect of ethanol in wine, beer and liquor on organs of the UADT.

Immunophenotypic and Clinical Differences Between the Nasal and Extranasal Subtypes of Upper Aerodigestive Tract Natural Killer/T-Cell Lymphoma

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Liu, Qing-Feng; Wang, Wei-Hu; Wang, Shu-Lian; Liu, Yue-Ping [Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Huang, Wen-Ting; Lu, Ning [Department of Pathology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Zhou, Li-Qiang [Department of Medical Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Ouyang, Han [Department of Radiology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Jin, Jing [Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China); Li, Ye-Xiong, E-mail: yexiong@yahoo.com [Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (China)

2014-03-15

Purpose: To investigate, in a large cohort of patients, the immunophenotypic and clinical differences of nasal and extranasal extranodal nasal-type natural killer/T-cell lymphoma of the upper aerodigestive tract (UADT-NKTCL) and examine the relevance of the immunophenotype on the clinical behavior, prognosis, and treatment. Methods and Materials: A total of 231 patients with UADT-NKTCL were recruited. One hundred eighty-one patients had primary location in the nasal cavity (nasal UADT-NKTCL), and 50 patients had primary extranasal UADT-NKTCL. Results: Patients with extranasal UADT-NKTCL had more adverse clinical features, including advanced-stage disease, regional lymph node involvement, B symptoms, and poor performance status, than patients with nasal UADT-NKTCL. In addition, CD56 and granzyme B were less frequently expressed in extranasal UADT-NKTCL. The 5-year overall survival rate was 74.1% for the entire group and 76.0% for early-stage disease. The 5-year overall survival rate for extranasal UADT-NKTCL was similar or superior to that of nasal UADT-NKTCL for all disease stages (76.9% vs 73.4%, P=.465), stage I disease (75.9% vs 79.2%, P=.786), and stage II disease (83.3% vs 50.3%, P=.018). CD56 expression and a Ki-67 proliferation rate ≥50% predicted poorer survival for extranasal UADT-NKTCL but not for nasal UADT-NKTCL. Conclusions: Patients with nasal and extranasal UADT-NKTCL have significantly different clinical features, immunophenotypes, and prognosis. Extranasal UADT-NKTCL should be considered as a distinct subgroup apart from the most commonly diagnosed prototype of nasal UADT-NKTCL.

Analysis of the role of the gene coding the Amyloid-Precursor Protein Binding Protein 1 (APP-BP1) in the radio-sensitivity of epidermoid carcinomas of the upper aero-digestive tract infected by the human papillomavirus

International Nuclear Information System (INIS)

Guihard, S.; Altmeyer, A.; Ramolu, L.; Macabre, C.; Abecassis, J.; Noel, G.; Jung, A.C.

2010-01-01

As the human papillomavirus (HPV) is at the origin of 25% of upper aero-digestive tract cancers, and as these tumours present an increased radio-sensitivity compared to other tumours, probably due to a greater transcriptional activity of p53, the authors report the study on the influence of a decrease of the expression of the APP-BP1 in these tumours which could favour a radio-induced apoptosis. By using a reverse transcriptase polymerase chain reaction (RT-PCR), they assessed the APP-BP1 expression levels as well as expression levels of transcriptions coding onco-proteins known to be over-expressed in HPV+ tumours. They compared the radio-sensitivities of HPV+ and HPV- cells, the first one appearing to be greater than the second one. Short communication

Plasmodium falciparum metacaspase PfMCA-1 triggers a z-VAD-fmk inhibitable protease to promote cell death.

Directory of Open Access Journals (Sweden)

Benoît Meslin

Full Text Available Activation of proteolytic cell death pathways may circumvent drug resistance in deadly protozoan parasites such as Plasmodium falciparum and Leishmania. To this end, it is important to define the cell death pathway(s in parasites and thus characterize proteases such as metacaspases (MCA, which have been reported to induce cell death in plants and Leishmania parasites. We, therefore, investigated whether the cell death function of MCA is conserved in different protozoan parasite species such as Plasmodium falciparum and Leishmania major, focusing on the substrate specificity and functional role in cell survival as compared to Saccharomyces cerevisae. Our results show that, similarly to Leishmania, Plasmodium MCA exhibits a calcium-dependent, arginine-specific protease activity and its expression in yeast induced growth inhibition as well as an 82% increase in cell death under oxidative stress, a situation encountered by parasites during the host or when exposed to drugs such as artemisins. Furthermore, we show that MCA cell death pathways in both Plasmodium and Leishmania, involve a z-VAD-fmk inhibitable protease. Our data provide evidence that MCA from both Leishmania and Plasmodium falciparum is able to induce cell death in stress conditions, where it specifically activates a downstream enzyme as part of a cell death pathway. This enzymatic activity is also induced by the antimalarial drug chloroquine in erythrocytic stages of Plasmodium falciparum. Interestingly, we found that blocking parasite cell death influences their drug sensitivity, a result which could be used to create therapeutic strategies that by-pass drug resistance mechanisms by acting directly on the innate pathways of protozoan cell death.

Treatment modalities of oral mucositis after radiation of head and neck cancers; Prise en charge des mucites apres radiotherapie des cancers des voies aerodigestives superieures

Energy Technology Data Exchange (ETDEWEB)

Lapeyre, M.; Charra-Brunaud, C.; Kaminsky, M.C.; Geoffrois, L.; Dolivet, G.; Pourel, N.; Marchal, C.; Bey, P.; Maire, F.; Simon, M. [Centre Alexis-Vautrin, 54 - Vandoeuvre-les-Nancy (France); Toussaint, B. [Hopital Central, Service de Chirurgie ORL, 54 - Nancy (France)

2001-11-01

Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and anti-fungal, local GM-CSF, Glutamide, Low-energy laser, corticosteroids). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or anti-fungal topical (bicarbonates, Amphotericine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal sparing block, conformal radiotherapy and intensity modulated radiation therapy). (authors)

Genetic associations of 115 polymorphisms with cancers of the upper aerodigestive tract across 10 European countries: the ARCAGE project.

LENUS (Irish Health Repository)

Canova, Cristina

2009-04-01

Cancers of the upper aerodigestive tract (UADT) include malignant tumors of the oral cavity, pharynx, larynx, and esophagus and account for 6.4% of all new cancers in Europe. In the context of a multicenter case-control study conducted in 14 centers within 10 European countries and comprising 1,511 cases and 1,457 controls (ARCAGE study), 115 single nucleotide polymorphisms (SNP) from 62 a priori-selected genes were studied in relation to UADT cancer. We found 11 SNPs that were statistically associated with UADT cancers overall (5.75 expected). Considering the possibility of false-positive results, we focused on SNPs in CYP2A6, MDM2, tumor necrosis factor (TNF), and gene amplified in squamous cell carcinoma 1 (GASC1), for which low P values for trend (P trend<0.01) were observed in the main effects analyses of UADT cancer overall or by subsite. The rare variant of CYP2A6 -47A>C (rs28399433), a phase I metabolism gene, was associated with reduced UADT cancer risk (P trend=0.01). Three SNPs in the MDM2 gene, involved in cell cycle control, were associated with UADT cancer. MDM2 IVS5+1285A>G (rs3730536) showed a strong codominant effect (P trend=0.007). The rare variants of two SNPs in the TNF gene were associated with a decreased risk; for TNF IVS1+123G>A (rs1800610), the P trend was 0.007. Variants in two SNPs of GASC1 were found to be strongly associated with increased UADT cancer risk (for both, P trend=0.008). This study is the largest genetic epidemiologic study on UADT cancers in Europe. Our analysis points to potentially relevant genes in various pathways.

Prevention of upper aerodigestive tract cancer in zinc-deficient rodents: Inefficacy of genetic or pharmacological disruption of COX-2

Science.gov (United States)

Fong, Louise Y.Y.; Jiang, Yubao; Riley, Maurisa; Liu, Xianglan; Smalley, Karl J.; Guttridge, Denis C.; Farber, John L.

2009-01-01

Zinc deficiency in humans is associated with an increased risk of upper aerodigestive tract (UADT) cancer. In rodents, zinc deficiency predisposes to carcinogenesis by causing proliferation and alterations in gene expression. We examined whether in zinc-deficient rodents, targeted disruption of the cyclooxygenase (COX)-2 pathway by the COX-2 selective inhibitor celecoxib or by genetic deletion prevent UADT carcinogenesis. Tongue cancer prevention studies were conducted in zinc-deficient rats previously exposed to a tongue carcinogen by celecoxib treatment with or without zinc replenishment, or by zinc replenishment alone. The ability of genetic COX-2 deletion to protect against chemically-induced for-estomach tumorigenesis was examined in mice on zinc-deficient versus zinc-sufficient diet. The expression of 3 predictive bio-markers COX-2, nuclear factor (NF)-κ B p65 and leukotriene A4 hydrolase (LTA4H) was examined by immunohistochemistry. In zinc-deficient rats, celecoxib without zinc replenishment reduced lingual tumor multiplicity but not progression to malignancy. Celecoxib with zinc replenishment or zinc replenishment alone significantly lowered lingual squamous cell carcinoma incidence, as well as tumor multiplicity. Celecoxib alone reduced overexpression of the 3 biomarkers in tumors slightly, compared with intervention with zinc replenishment. Instead of being protected, zinc-deficient COX-2 null mice developed significantly greater tumor multiplicity and forestomach carcinoma incidence than wild-type controls. Additionally, zinc-deficient COX-2−/− forestomachs displayed strong LTA4H immunostaining, indicating activation of an alter-native pathway under zinc deficiency when the COX-2 pathway is blocked. Thus, targeting only the COX-2 pathway in zinc-deficient animals did not prevent UADT carcinogenesis. Our data suggest zinc supplementation should be more thoroughly explored in human prevention clinical trials for UADT cancer. PMID:17985342

How Social Reactions to Alcohol-Related Facial Flushing Are Affected by Gender, Relationship, and Drinking Purposes: Implications for Education to Reduce Aerodigestive Cancer Risks.

Science.gov (United States)

Newman, Ian M; Ding, Lanyan; Shell, Duane F; Lin, Lida

2017-06-09

Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university students identified gender, friendship, and drinking purpose as important variables related to whether someone would encourage a person who flushes when drinking alcohol to stop or reduce their drinking. A questionnaire was developed that incorporated these variables into 24 drinking scenarios in which someone flushed while drinking. Students responded whether they would (a) encourage the flusher to stop or drink less; (b) do nothing while wishing they could; or (c) do nothing because there was no need. Analysis of survey responses from 2912 university students showed a three-way interaction of the variables and implied that the probability students will intervene when a drinker flushes was highest when the flusher was a female, a close friend, and the drinking purpose was for fun and lowest if the flusher was a male, the friendship was general, and the drinking purpose was risky. The results provide important details about the social factors affecting how other people respond to a person who flushes when drinking alcohol. This information is useful for those considering ways to reduce and prevent aerodigestive cancers through education and information programs.

The association between change in body mass index and upper aerodigestive tract cancers in the ARCAGE project: multicenter case-control study.

LENUS (Irish Health Repository)

Park, Sungshim Lani

2011-03-15

Previous studies reported an inverse relationship between body mass index (BMI) and upper aerodigestive tract (UADT) cancers. Examining change in BMI over time may clarify these previous observations. We used data from 2,048 cases and 2,173 hospital- and population-based controls from ten European countries (alcohol-related cancers and genetic susceptibility in Europe study) to investigate the relationship with BMI and adult change in BMI on UADT cancer risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between BMI at three time intervals and BMI change on UADT cancer development, adjusting for center, age, sex, education, fruit and vegetable intake, smoking and alcohol consumption. We found an inverse relationship between UADT cancers and BMI at time of interview and 2 years before interview. No association was found with BMI at 30 years of age. Regarding BMI change between age 30 and 2 years before interview, BMI decrease (BMI change <-5%) vs. BMI stability (-5% ≤ BMI change <5%) showed no overall association with UADT cancers (OR = 1.15; 95% CI = 0.89, 1.49). An increase in BMI (BMI change ≥+5%) was inversely associated with UADT cancers (OR = 0.74; 95% CI = 0.62, 0.89). BMI gain remained inversely associated across all subsites except for esophageal cancer. When stratified by smoking or by drinking, association with BMI gain was detected only in drinkers and smokers. In conclusion, BMI gain is inversely associated with UADT cancers. These findings may be influenced by smoking and\\/or drinking behaviors and\\/or the development of preclinical UADT cancers and should be corroborated in studies of a prospective nature.

Prenatal vitamin A deficiency impairs adaptive immune responses to pentavalent rotavirus vaccine (RotaTeq®) in a neonatal gnotobiotic pig model.

Science.gov (United States)

Kandasamy, Sukumar; Chattha, Kuldeep S; Vlasova, Anastasia N; Saif, Linda J

2014-02-07

Vitamin A deficiency (VAD) is associated with increased childhood mortality and morbidity in impoverished Asian and African countries, but the impact of VAD on rotavirus (RV) vaccine or infection is poorly understood. We assessed effects of gestational and dietary induced pre- and post-natal VAD and vitamin A supplementation on immune responses to a pentavalent rotavirus vaccine, RotaTeq(®) in a neonatal gnotobiotic pig model. Vaccine efficacy was assessed against virulent G1P[8] human rotavirus (HRV) challenge. VAD and vitamin A sufficient (VAS) piglets were derived from dietary VAD and VAS sows, respectively. VAD piglets had significantly lower levels of hepatic vitamin A compared to that of VAS piglets. RotaTeq(®)-vaccinated VAD piglets had 350-fold higher fecal virus shedding titers compared to vaccinated VAS piglets post-challenge. Only 25% of vaccinated non-vitamin A supplemented VAD piglets were protected against diarrhea compared with 100% protection rate in vaccinated non-supplemented VAS piglets post-challenge. Intestinal HRV specific immune responses were compromised in VAD piglets. Vaccinated VAD piglets had significantly lower ileal HRV IgG antibody secreting cell (ASC) responses (pre-challenge) and duodenal HRV IgA ASC responses (post-challenge) compared to vaccinated VAS piglets. Also, intestinal HRV IgA antibody titers were 11-fold lower in vaccinated VAD compared to vaccinated VAS piglets post-challenge. Persistently elevated levels of IL-8, a pro-inflammatory mediator, and lower IL-10 responses (anti-inflammatory) in vaccinated VAD compared to VAS piglets suggest more severe inflammatory responses in VAD piglets post-challenge. Moreover higher IFN-γ responses pre-challenge were observed in VAD compared to VAS piglets. The impaired vaccine-specific intestinal antibody responses and decreased immunoregulatory cytokine responses coincided with reduced protective efficacy of the RV vaccine against virulent HRV challenge in VAD piglets. In

EU:s nya varumärkesdefinition : En utredning av vad borttagandet av kravet på grafisk återgivning kommer att innebära för möjligheten att registrera okonventionella varumärken

OpenAIRE

Fredriksson, Mathilda; Petersson, Frida

2017-01-01

Sedan det första steget togs mot en harmoniserad varumärkesrätt inom EU har grafisk återgivning varit ett krav vid registrering av varumärken, men kravet på grafisk återgivning försvinner i och med EU:s nya varumärkesreform. Syftet med denna uppsats är att belysa och utreda vad detta kommer att innebära för möjligheten att registrera okonventionella varumärken. Utredningen är inriktad på följande okonventionella varumärken: doftmärken, smakmärken, ljudmärken, känselmärken, rörelsemärken och h...

Ventricular assist device elicits serum natural IgG that correlates with the development of primary graft dysfunction following heart transplantation.

Science.gov (United States)

See, Sarah B; Clerkin, Kevin J; Kennel, Peter J; Zhang, Feifan; Weber, Matthew P; Rogers, Kortney J; Chatterjee, Debanjana; Vasilescu, Elena R; Vlad, George; Naka, Yoshifumi; Restaino, Susan W; Farr, Maryjane A; Topkara, Veli K; Colombo, Paolo C; Mancini, Donna M; Schulze, P Christian; Levin, Bruce; Zorn, Emmanuel

2017-08-01

Pre-transplant sensitization is a limiting factor in solid-organ transplantation. In heart transplants, ventricular assist device (VAD) implantation has been associated with sensitization to human leukocyte antigens (HLA). The effect of VAD on non-HLA antibodies is unclear. We have previously shown that polyreactive natural antibodies (Nabs) contribute to pre-sensitization in kidney allograft recipients. Here we assessed generation of Nabs after VAD implantation in pre-transplant sera and examined their contribution to cardiac allograft outcome. IgM and IgG Nabs were tested in pre-transplant serum samples collected from 206 orthotopic heart transplant recipients, including 128 patients with VAD (VAD patients) and 78 patients without VAD (no-VAD patients). Nabs were assessed by testing serum reactivity to apoptotic cells by flow cytometry and to the generic oxidized epitope, malondialdehyde, by enzyme-linked immunosorbent assay. No difference was observed in serum levels of IgM Nabs between VAD and no-VAD patients. However, serum IgG Nabs levels were significantly increased in VAD compared with no-VAD patients. This increase was likely due to the presence of the VAD, as revealed by lower serum IgG Nabs levels before implantation. Elevated pre-transplant IgG Nabs level was associated with development of primary graft dysfunction (PGD). Our study demonstrates that VAD support elicits IgG Nabs reactive to apoptotic cells and oxidized epitopes. These findings further support broad and non-specific B-cell activation by VAD, resulting in IgG sensitization. Moreover, the association of serum IgG Nabs levels with development of PGD suggests a possible role for these antibodies in the inflammatory reaction accompanying this complication. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Single-center experience of the bridge-to-bridge strategy using the Nipro paracorporeal ventricular assist device.

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Yoshitake, Shuichi; Kinoshita, Osamu; Nawata, Kan; Hoshino, Yasuhiro; Itoda, Yoshifumi; Kimura, Mitsutoshi; Yamauchi, Haruo; Ono, Minoru

2018-06-25

Currently, we use the Nipro paracorporeal VAD (p-VAD) for initial short-term ventricular support, as a bridge to decision (BTD) or a bridge to candidacy (BTC) treatment, in Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1 and 2 patients. However, it is possible that compared to patients with primary implantable-VADs (P-iVAD), the bridge-to-bridge (BTB) patients are more likely to develop complications. This retrospective study used data from 24 consecutive BTB patients who were initially implanted with Nipro p-VAD as BTD or BTC treatments between April 2011 and March 2016, and subsequently underwent conversion to an i-VAD. The data from 72 patients who underwent a primary i-VAD (P-iVAD) procedure were used for comparison. Between the two groups, there was no significant difference in the incidence of infectious events (p = 0.72) or stroke (p = 0.44). Orthotropic heart transplantation was performed in 6 of the 24 patients in the BTB group and in 21 of the 72 patients in the P-iVAD group. The 1- and 2-year survival rates were 95.8% and 95.8% in the BTB group and 91% and 85.8% in the P-iVAD group; these values were not significantly different between groups (p = 0.91). Based on these results we conclude that BTB using Nipro p-VAD is a reasonable strategy for treating patients with severe decompensated end-stage heart failure.

Vad är den främst avgörande faktorn vid privatkundens val av marginalbank? : en studie om hur demografiska skillnader påverkar privatkunders val av marginalbank samt se hur deras val kan användas vid segmentering

OpenAIRE

Lindh, Jenni; Persson, Frida

2012-01-01

Syfte: Syftet med detta examensarbete är att förklara vad som är den främst avgörande faktorn vid privatkundens val av marginalbank, genom att jämföra med demografiska variabler samt hur deras val kan användas vid segmentering. Dessutom vill vi titta på vilka typer av banker privatkunder har. Metod: För att nå fram till resultat för analysen har ett positivistiskt angreppssätt och en deduktiv ansats använts. Det empiriska materialet är baserat på en enkätundersökning gjord på personer i Hässl...

Impact of ventricular assist device placement on longitudinal renal function in children with end-stage heart failure.

Science.gov (United States)

May, Lindsay J; Montez-Rath, Maria E; Yeh, Justin; Axelrod, David M; Chen, Sharon; Maeda, Katsuhide; Almond, Christopher S D; Rosenthal, David N; Hollander, Seth A; Sutherland, Scott M

2016-04-01

Although ventricular assist devices (VADs) restore hemodynamics in those with heart failure, reversibility of end-organ dysfunction with VAD support is not well characterized. Renal function often improves in adults after VAD placement, but this has not been comprehensively explored in children. Sixty-three children on VAD support were studied. Acute kidney injury (AKI) was defined by Kidney Disease: Improving Global Outcomes criteria. Estimated glomerular filtration rate (eGFR) was determined by the Schwartz method. Generalized linear mixed-effects models compared the pre-VAD and post-VAD eGFR for the cohort and sub-groups with and without pre-VAD renal dysfunction (pre-VAD eGFR renal dysfunction. AKI affected 60.3% (38 of 63), with similar rates in those with and without pre-existing renal dysfunction. Within the cohort, the nadir eGFR occurred 1 day post-operatively (62.9 ml/min/1.73 m(2); IQR, 51.2-88.9 ml/min/1.73 m(2); p renal dysfunction experienced the greatest improvement in the eGFR (β = 0.0051 vs β = 0.0013, p Renal dysfunction is prevalent in children with heart failure undergoing VAD placement. Although peri-operative AKI is common, renal function improves substantially in the first post-operative week and for months thereafter. This is particularly pronounced in those with pre-VAD renal impairment, suggesting that VADs may facilitate recovery and maintenance of kidney function in children with advanced heart failure. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Discovery of Acupoints and Combinations with Potential to Treat Vascular Dementia: A Data Mining Analysis

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Shuwei Feng

2015-01-01

Full Text Available The prevalence of vascular dementia (VaD is high among the elderly. Acupuncture, a popular therapeutic method in China, can improve memory, orientation, calculation, and self-managing ability in VaD patients. However, in clinical acupuncture and acupuncture research, the selection of acupoints to treat VaD remains challenging. This study aimed to discover acupoints and acupoint combinations with potential for VaD based on data mining. After database searching and screening for articles on clinical trials evaluating the effects of acupuncture on VaD, 238 acupuncture prescriptions were included for further analysis. Baihui (GV 20, Sishencong (EX-HN 1, Fengchi (GB 20, Shuigou (GV 26, and Shenting (GV 24 appeared most frequently in the modern literature and are potential acupoints for VaD. Combinations between Baihui (GV 20, Sishencong (EX-HN 1, Fengchi (GB 20, Shenting (GV 24, Shuigou (GV 26, and Zusanli (ST 36 were most frequent and represent potential combinations for VaD treatment. These results provide a reference for the selection and combination of acupoints to treat VaD in clinical acupuncture and acupuncture research.

Vad behöver eleverna undervisning i för att utveckla sitt skrivande? Förväntningsnormer och didaktiska beslut i svensklärares bedömningssamtal

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Per Blomqvist

2016-04-01

Full Text Available I studien samtalar tre lärargrupper om elevers skrivande och skrivundervisning i ämnet svenska på gymnasiet. Det teoretiska perspektiv som läggs på dessa samtal är didaktiskt och inriktas på hur lärare formulerar och använder bedömningsinformation om elevers skrivande för beslut om skrivundervisningens innehåll. Resultatet visar att lärares bedömningar av elevers skrivande behandlar fler och delvis andra aspekter av skrivförmåga än vad deras didaktiska beslut sedan omfattar. De kvalitetsuppfattningar och förväntningsnormer som lärarna uttrycker i sina bedömningar av elevers skrivande inriktas huvudsakligen på texters kommunikativa kvaliteter, den stilistiska utformningen och textuppbyggnaden, följt av ämnesinnehåll och källanvändning. De didaktiska beslut som fattas utifrån bedömningen av elevers texter inriktas däremot i stort sett enbart på att eleverna behöver skrivundervisning i att disponera text och att använda källor. Detta gör att överensstämmelsen är låg mellan lärarnas beslut om skrivundervisningens inriktning och deras förväntningar på vad eleverna ska kunna. De didaktiska besluten omfattar i begränsad utsträckning den bedömningsinformation som lärarna själva har formulerat.Nyckelord: Skrivbedömning, kvalitetsuppfattningar, förväntningsnormer, didaktiska beslut, formativ bedömning, svenskämnets didaktik, svenska på gymnasietAbstractThis article presents an analysis of teacher group discussions about students’ writing in the subject of Swedish in upper secondary school. The study adopts a pedagogical perspective on these discussions and focuses on examining teachers’ expressed assessment criteria and relating them to their pedagogical decision-making. The results reveal that the teachers’ assessments of students’ writing focus on much more, and partly other, criteria than their pedagogical decisions. The quality standards that teachers express in the discussions about

Magnetic suspension of the rotor of a ventricular assist device of mixed flow type.

Science.gov (United States)

Horikawa, Oswaldo; de Andrade, Aron José Pazin; da Silva, Isaías; Bock, Eduardo Guy Perpetuo

2008-04-01

This work presents results of preliminary studies concerning application of magnetic bearing in a ventricular assist device (VAD) being developed by Dante Pazzanese Institute of Cardiology-IDPC (São Paulo, Brazil). The VAD-IDPC has a novel architecture that distinguishes from other known VADs. In this, the rotor has a conical geometry with spiral impellers, showing characteristics that are intermediate between a centrifugal VAD and an axial VAD. The effectiveness of this new type of blood pumping principle was showed by tests and by using it in heart surgery for external blood circulation. However, the developed VAD uses a combination of ball bearings and mechanical seals, limiting the life for some 10 h, making impossible its long-term use or its use as an implantable VAD. As a part of development of an implantable VAD, this work aims at the replacement of ball bearings by a magnetic bearing. The most important magnetic bearing principles are studied and the magnetic bearing developed by Escola Politécnica of São Paulo University (EPUSP-MB) is elected because of its very simple architecture. Besides presenting the principle of the EPUSP-MB, this work presents one possible alternative for applying the EPUSP-MB in the IDPC-VAD.

Outcomes of ventricular assist device implantation in children and young adults: the Melbourne experience.

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Shi, William Y; Marasco, Silvana F; Saxena, Pankaj; d'Udekem, Yves; Yong, Matthew S; Mitnovetski, Sergei; Brizard, Christian P; McGiffin, David C; Weintraub, Robert G; Konstantinov, Igor E

2016-12-01

We evaluated our experience with ventricular assist device (VAD) implantation in children and young adults. A total of 64 patients underwent VAD implantation in two centres. The mean age was 15 ± 7.2 years. Thirty-five (55%) patients were under 18 years of age. Devices implanted included the Thoratec Paracorporeal in 30 (47%) patients, Berlin Heart EXCOR in 11 (17%) and VentrAssist in 14 (22%). The diagnosis was cardiomyopathy in 53, congenital heart disease in 11, and graft failure in four patients. There were 10 (16%) in-hospital deaths. Mortality was higher in patients <18 years of age (26% compared with 3.4% for those ≥18 years, P = 0.02). The use of extracorporeal membrane oxygenation prior to VAD implantation was associated with higher mortality (P = 0.006). Seventeen (27%) patients experienced stroke. Nine patients (14%) required change of VAD because of thrombosis. Transplantation was performed in 44 patients after a mean of 131 ± 141 days on VAD, 11 patients died without transplantation and three patients currently await transplantation. The VAD was explanted in six patients because of recovery. Overall survival from VAD implantation was 69% and 61% at 5 and 10 years, respectively. The 5-year post-transplant survival for those bridged with VAD support was 91% and was comparable with a cohort of patients who did not receive a pre-transplant VAD. Children requiring pre-transplant VAD support have a higher mortality and morbidity compared with young adults. Survival after heart transplantation those supported with VADs was similar to patients of similar age who did not require pre-transplant support. © 2015 Royal Australasian College of Surgeons.

Cost-Effectiveness of Ventricular Assist Device Destination Therapy for Advanced Heart Failure in Duchenne Muscular Dystrophy.

Science.gov (United States)

Magnetta, Defne A; Kang, JaHyun; Wearden, Peter D; Smith, Kenneth J; Feingold, Brian

2018-05-17

Destination ventricular assist device therapy (DT-VAD) is well accepted in select adults with medically refractory heart failure (HF) who are not transplant candidates; however, its use in younger patients with progressive diseases is unclear. We sought to evaluate the cost-effectiveness of DT-VAD in Duchenne muscular dystrophy (DMD) patients with advanced HF. We created a Markov-state transition model (5-year horizon) to compare survival, costs, and quality of life (QOL) between medical management and DT-VAD in DMD with advanced HF. Model input parameters were derived from the literature. We used sensitivity analyses to explore uncertainty around model assumptions. DT-VAD had higher costs ($435,602 vs. $125,696), survival (3.13 vs. 0.60 years), and quality-adjusted survival (1.99 vs. 0.26 years) than medical management. The incremental cost-effectiveness ratio (ICER) for DT-VAD was $179,086 per quality-adjusted life year (QALY). In sensitivity analyses that were widely varied to account for uncertainty in model assumptions, the DT-VAD strategy generally remained more costly and effective than medical management. Only when VAD implantation costs were <$113,142 did the DT-VAD strategy fall below the $100,000/QALY willingness-to-pay threshold commonly considered to be "cost-effective." In this exploratory analysis, DT-VAD for patients with DMD and advanced HF exceeded societal expectations for cost-effectiveness but had an ICER similar to the accepted practice of DT-VAD in adult HF patients. While more experience and research in this population is needed, our analysis suggests that DT-VAD for advanced HF in DMD should not be dismissed solely based on cost.

Sociālo tīklu izmantošana pusaudžu vecumā un to vadīšanas iespējas interešu izglītībā

OpenAIRE

Biezais, Artūrs

2015-01-01

Pētījuma nosaukums ir „Sociālo tīklu izmantošana pusaudžu vecumā un to vadīšanas iespējas interešu izglītībā”. Dažādos pētījumos ir pierādīts, ka tieši pusaudžu vecumposms ir tas, kurā bērni visvairāk laika pavada sociālajos tīklos. Viņi tiem piekļūst ar datoru, ar viedtālruņu un planšetdatoru palīdzību. Neskatoties uz to, ka bērni sociālos tīklus ļoti aktīvi izmanto ārpus skolas, viņi tos izmanto arī skolā un pat mācību stundās. Tā ir mūsdienu realitāte, kas visnotaļ, atkarībā no sociālo med...

An Estimate of Attributable Cases of Alzheimer Disease and Vascular Dementia due to Modifiable Risk Factors: The Impact of Primary Prevention in Europe and in Italy

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Flavia Mayer

2018-02-01

Full Text Available Background: Up to 53.7% of all cases of dementia are assumed to be due to Alzheimer disease (AD, while 15.8% are considered to be due to vascular dementia (VaD. In Europe, about 3 million cases of AD could be due to 7 potentially modifiable risk factors: diabetes, midlife hypertension and/or obesity, physical inactivity, depression, smoking, and low educational level. Aims: To estimate the number of VaD cases in Europe and the number of AD and VaD cases in Italy attributable to these 7 potentially modifiable risk factors. Methods: Assuming the nonindependence of the 7 risk factors, the adjusted combined population attributable risk (PAR was estimated for AD and VaD. Results: In Europe, adjusted combined PAR was 31.4% for AD and 37.8% for VaD. The total number of attributable cases was 3,033,000 for AD and 873,000 for VaD. In Italy, assuming a 20% reduction of the prevalence of each risk factor, adjusted combined PAR decreased from 45.2 to 38.9% for AD and from 53.1 to 46.6% for VaD, implying a 6.4 and 6.5% reduction in the prevalence of AD and VaD, respectively. Conclusion: A relevant reduction of AD and VaD cases in Europe and Italy could be obtained through primary prevention.

An Estimate of Attributable Cases of Alzheimer Disease and Vascular Dementia due to Modifiable Risk Factors: The Impact of Primary Prevention in Europe and in Italy.

Science.gov (United States)

Mayer, Flavia; Di Pucchio, Alessandra; Lacorte, Eleonora; Bacigalupo, Ilaria; Marzolini, Fabrizio; Ferrante, Gianluigi; Minardi, Valentina; Masocco, Maria; Canevelli, Marco; Di Fiandra, Teresa; Vanacore, Nicola

2018-01-01

Up to 53.7% of all cases of dementia are assumed to be due to Alzheimer disease (AD), while 15.8% are considered to be due to vascular dementia (VaD). In Europe, about 3 million cases of AD could be due to 7 potentially modifiable risk factors: diabetes, midlife hypertension and/or obesity, physical inactivity, depression, smoking, and low educational level. To estimate the number of VaD cases in Europe and the number of AD and VaD cases in Italy attributable to these 7 potentially modifiable risk factors. Assuming the nonindependence of the 7 risk factors, the adjusted combined population attributable risk (PAR) was estimated for AD and VaD. In Europe, adjusted combined PAR was 31.4% for AD and 37.8% for VaD. The total number of attributable cases was 3,033,000 for AD and 873,000 for VaD. In Italy, assuming a 20% reduction of the prevalence of each risk factor, adjusted combined PAR decreased from 45.2 to 38.9% for AD and from 53.1 to 46.6% for VaD, implying a 6.4 and 6.5% reduction in the prevalence of AD and VaD, respectively. A relevant reduction of AD and VaD cases in Europe and Italy could be obtained through primary prevention.

How the factoid of wind turbines causing 'vibroacoustic disease' came to be 'irrefutably demonstrated'.

Science.gov (United States)

Chapman, Simon; St George, Alexis

2013-06-01

In recent years, claims have proliferated in cyberspace that wind turbines cause a large variety of symptoms and diseases. One of these, "vibroacoustic disease" (VAD) is frequently mentioned. The aim of this study is to examine the quality of the evidence on how VAD came to be associated with wind turbine exposure by wind farm opponents. Searches of the web (Google advanced) and major research databases for papers on VAD and wind turbines. Self-citation analysis of research papers on VAD. Google returned 24,700 hits for VAD and wind turbines. Thirty-five research papers on VAD were found, none reporting any association between VAD and wind turbines. Of the 35 papers, 34 had a first author from a single Portuguese research group. Seventy-four per cent of citations to these papers were self-citations by the group. Median self-citation rates in science are around 7%. Two unpublished case reports presented at conferences were found asserting that VAD was "irrefutably demonstrated" to be caused by wind turbines. The quality of these reports was abject. VAD has received virtually no scientific recognition beyond the group who coined and promoted the concept. There is no evidence of even rudimentary quality that vibroacoustic disease is associated with or caused by wind turbines. The claim that wind turbines cause VAD is a factoid that has gone 'viral' in cyberspace and may be contributing to nocebo effects among those living near turbines. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Post-transplant outcomes in pediatric ventricular assist device patients: A PediMACS-Pediatric Heart Transplant Study linkage analysis.

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Sutcliffe, David L; Pruitt, Elizabeth; Cantor, Ryan S; Godown, Justin; Lane, John; Turrentine, Mark W; Law, Sabrina P; Lantz, Jodie L; Kirklin, James K; Bernstein, Daniel; Blume, Elizabeth D

2017-12-13

Pediatric ventricular assist device (VAD) support as bridge to transplant has improved waitlist survival, but the effects of pre-implant status and VAD-related events on post-transplant outcomes have not been assessed. This study is a linkage analysis between the PediMACS and Pediatric Heart Transplant Study databases to determine the effects of VAD course on post-transplant outcomes. Database linkage between October 1, 2012 and December 31, 2015 identified 147 transplanted VAD patients, the primary study group. The comparison cohort was composed of 630 PHTS patients without pre-transplant VAD support. The primary outcome was post-transplant survival, with secondary outcomes of post-transplant length of stay, freedom from infection and freedom from rejection. At implant, the VAD cohort was INTERMACS Profile 1 in 33 (23%), Profile 2 in 89 (63%) and Profile 3 in 14 (10%) patients. The VAD cohort was older, larger, and less likely to have congenital heart disease (p < 0.0001). However, they had greater requirements for inotrope and ventilator support and increased liver and renal dysfunction (p < 0.0001), both of which normalized at transplant after device support. Importantly, there were no differences in 1-year post-transplant survival (96% vs 93%, p = 0.3), freedom from infection (81% vs 79%, p = 0.9) or freedom from rejection (71% vs 74%, p = 0.87) between cohorts. Pediatric VAD patients have post-transplant outcomes equal to that of medically supported patients, despite greater pre-implant illness severity. Post-transplant survival, hospital length of stay, infection and rejection were not affected by patient acuity at VAD implantation or VAD-related complications. Therefore, VAD as bridge to transplant mitigates severity of illness in children. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Prevalence and factors associated with vitamin A deficiency in children and adolescents

Directory of Open Access Journals (Sweden)

Rita de Cássia Ribeiro-Silva

2014-09-01

Full Text Available Objective: To identify the prevalence and factors associated with vitamin A deficiency (VAD in children and adolescents. Methods: This was a cross-sectional study involving 546 schoolchildren, aged between 7 and 14 years, of both genders, enrolled in public elementary schools. Blood was collected for measurement of serum retinol. The retinol concentration in the samples was determined by high performance liquid chromatography (HPLC. Data were collected on anthropometrics, dietary, demographic, and socioeconomic factors. Polytomous logistic regression was used to evaluate the associations of interest. Results: Approximately 27.5% of the students had retinol values < 30 μg/dL. The multivariate analysis showed, after the appropriate adjustments, a positive and statistically significant association of moderate/severe VAD (OR = 2.19; 95% CI 1.17 to 4.10 and marginal VAD (OR = 2.34; 95% CI 1.47 to 3.73 with age < 10 years. There was also association of VAD moderate/severe (OR = 2.01; 95% CI 1.01 to 5.05 and borderline VAD (OR = 2.14; 95% CI: 1.08 to 4.21 with the anthropometric status of underweight. Lower intake of retinol was detected among those with severe VAD. Conclusion: VAD is a health concern among children and adolescents. Lower weight and younger schoolchildren had greater vulnerability to VAD.

High pulmonary vascular resistance in addition to low right ventricular stroke work index effectively predicts biventricular assist device requirement.

Science.gov (United States)

Imamura, Teruhiko; Kinugawa, Koichiro; Kinoshita, Osamu; Nawata, Kan; Ono, Minoru

2016-03-01

Although the right ventricular stroke work index (RVSWI) is a good index for RV function, a low RVSWI is not necessarily an indicator for the need for a right ventricular assist device at the time of left VAD implantation. We here aimed to determine a more precise indicator for the need for a biventricular assist device (BiVAD). In total, 116 patients (mean age, 38 ± 14 years), who underwent hemodynamic assessments preoperatively including 12 BiVAD patients, and had been followed at our institute from 2003 to 2015, were included. Multivariate logistic regression analysis indicated that RVSWI and pulmonary vascular resistance (PVR) were independent predictors of BiVAD requirement (P 5 g/m, PVR 5, PVR > 3.7), (3) RV failure (RVSWI 3.7), and examined. Most of the patients in Group 4 (75 %), with acutely depressed hemodynamics and inflammatory responses in the myocardium, required BiVAD. Overall, patients with BiVAD had a worse survival rate as compared with those with LVAD alone. In conclusion, high PVR in addition to low RVSWI effectively predicts BiVAD requirement.

Air pollution and incidence of cancers of the stomach and the upper aerodigestive tract in the European Study of Cohorts for Air Pollution Effects (ESCAPE).

Science.gov (United States)

Nagel, Gabriele; Stafoggia, Massimo; Pedersen, Marie; Andersen, Zorana J; Galassi, Claudia; Munkenast, Jule; Jaensch, Andrea; Sommar, Johan; Forsberg, Bertil; Olsson, David; Oftedal, Bente; Krog, Norun H; Aamodt, Geir; Pyko, Andrei; Pershagen, Göran; Korek, Michal; De Faire, Ulf; Pedersen, Nancy L; Östenson, Claes-Göran; Fratiglioni, Laura; Sørensen, Mette; Tjønneland, Anne; Peeters, Petra H; Bueno-de-Mesquita, Bas; Vermeulen, Roel; Eeftens, Marloes; Plusquin, Michelle; Key, Timothy J; Concin, Hans; Lang, Alois; Wang, Meng; Tsai, Ming-Yi; Grioni, Sara; Marcon, Alessandro; Krogh, Vittorio; Ricceri, Fulvio; Sacerdote, Carlotta; Ranzi, Andrea; Cesaroni, Giulia; Forastiere, Francesco; Tamayo-Uria, Ibon; Amiano, Pilar; Dorronsoro, Miren; de Hoogh, Kees; Beelen, Rob; Vineis, Paolo; Brunekreef, Bert; Hoek, Gerard; Raaschou-Nielsen, Ole; Weinmayr, Gudrun

2018-04-26

Air pollution has been classified as carcinogenic to humans. However, to date little is known about the relevance for cancers of the stomach and upper aerodigestive tract (UADT). We investigated the association of long-term exposure to ambient air pollution with incidence of gastric and UADT cancer in 11 European cohorts. Air pollution exposure was assigned by land-use regression models for particulate matter (PM) below 10 µm (PM 10 ), below 2.5 µm (PM 2.5 ), between 2.5 and 10 µm (PM coarse ), PM 2.5 absorbance and nitrogen oxides (NO 2 and NO X ) as well as approximated by traffic indicators. Cox regression models with adjustment for potential confounders were used for cohort-specific analyses. Combined estimates were determined with random effects meta-analyses. During average follow-up of 14.1 years of 305 551 individuals, 744 incident cases of gastric cancer and 933 of UADT cancer occurred. The hazard ratio for an increase of 5 µg/m 3 of PM 2.5 was 1.38 (95%-CI 0.99;1.92) for gastric and 1.05 (95%-CI 0.62;1.77) for UADT cancers. No associations were found for any of the other exposures considered. Adjustment for additional confounders and restriction to study participants with stable addresses did not influence markedly the effect estimate for PM 2.5 and gastric cancer. Higher estimated risks of gastric cancer associated with PM 2.5 was found in men (HR 1.98 (1.30;3.01)) as compared to women (HR 0.85 (0.5;1.45)). This large multicentre cohort study shows an association between long-term exposure to PM 2.5 and gastric cancer, but not UADT cancers, suggesting that air pollution may contribute to gastric cancer risk. This article is protected by copyright. All rights reserved. © 2018 UICC.

Vitamin A deficiency impairs adaptive B and T cell responses to a prototype monovalent attenuated human rotavirus vaccine and virulent human rotavirus challenge in a gnotobiotic piglet model.

Directory of Open Access Journals (Sweden)

Kuldeep S Chattha

Full Text Available Rotaviruses (RV are a major cause of gastroenteritis in children. Widespread vitamin A deficiency is associated with reduced efficacy of vaccines and higher incidence of diarrheal infections in children in developing countries. We established a vitamin A deficient (VAD gnotobiotic piglet model that mimics subclinical vitamin A deficiency in children to study its effects on an oral human rotavirus (HRV vaccine and virulent HRV challenge. Piglets derived from VAD and vitamin A sufficient (VAS sows were orally vaccinated with attenuated HRV or mock, with/without supplemental vitamin A and challenged with virulent HRV. Unvaccinated VAD control piglets had significantly lower hepatic vitamin A, higher severity and duration of diarrhea and HRV fecal shedding post-challenge as compared to VAS control pigs. Reduced protection coincided with significantly higher innate (IFNα cytokine and CD8 T cell frequencies in the blood and intestinal tissues, higher pro-inflammatory (IL12 and 2-3 fold lower anti-inflammatory (IL10 cytokines, in VAD compared to VAS control pigs. Vaccinated VAD pigs had higher diarrhea severity scores compared to vaccinated VAS pigs, which coincided with lower serum IgA HRV antibody titers and significantly lower intestinal IgA antibody secreting cells post-challenge in the former groups suggesting lower anamnestic responses. A trend for higher serum HRV IgG antibodies was observed in VAD vs VAS vaccinated groups post-challenge. The vaccinated VAD (non-vitamin A supplemented pigs had significantly higher serum IL12 (PID2 and IFNγ (PID6 compared to vaccinated VAS groups suggesting higher Th1 responses in VAD conditions. Furthermore, regulatory T-cell responses were compromised in VAD pigs. Supplemental vitamin A in VAD pigs did not fully restore the dysregulated immune responses to AttHRV vaccine or moderate virulent HRV diarrhea. Our findings suggest that that VAD in children in developing countries may partially contribute to more

Herbal Medicine for the Treatment of Vascular Dementia: An Overview of Scientific Evidence

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Dennis Chang

2016-01-01

Full Text Available Dementia is a leading cause of mental and physical disability. Vascular dementia (VaD is the second most common cause of dementia after Alzheimer’s disease (AD constituting 10–15% of the dementia population. Currently there are no approved pharmaceutical options for VaD and the conventional anti-AD therapies provide only modest, short-term relief of symptoms associated with VaD. Herbal medicines have been used for the management of dementia-like symptoms for centuries and may provide viable therapies for VaD due to their multicomponent and multitarget approach. This review is designed to provide an updated overview on the current status of herbal medicine research, with an emphasis on Chinese herbal medicine, for the treatment of VaD or dementia. A case study is also provided to demonstrate the development process of a novel standardized complex herbal formulation for VaD. The article reveals some preliminary evidence to support the use of single and complex herbal preparations for VaD and dementia. Multiple issues in relation to clinical and preclinical research have been identified and future research directions are discussed.

The pharmacotherapy implications of ventricular assist device in the patient with end-stage heart failure.

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Von Ruden, Serena A S; Murray, Margaret A; Grice, Jennifer L; Proebstle, Amy K; Kopacek, Karen J

2012-04-01

Advances in mechanical circulatory support, such as the use of ventricular assist devices (VADs), have become a means for prolonging survival in end-stage heart failure (HF). VADs decrease the symptoms of HF and improve quality of life by replacing some of the work of a failing heart. They unload the ventricle to provide improved cardiac output and end-organ perfusion, resulting in improvement in cardiorenal syndromes and New York Heart Association functional class rating. VADs are currently used asa bridge to heart transplantation, a bridge to recovery of cardiac function, or as destination therapy. Complications of VAD include bleeding, infections, arrhythmias, multiple organ failure, right ventricular failure, and neurological dysfunction. Patients with VAD have unique pharmacotherapeutic requirements in terms of anticoagulation, appropriate antibiotic selection, and continuation of HF medications. Pharmacists in acute care and community settings are well prepared to care for the patient with VAD. These patients require thorough counseling and follow-up with regard to prevention and treatment of infections, appropriate levels of anticoagulation, and maintenance of fluid balance. A basic understanding of this unique therapy can assist pharmacists in attending to the needs of patients with VAD.

Target volume delineation for head and neck cancer intensity-modulated radiotherapy; Delineation des volumes cibles des cancers des voies aerodigestives superieures en radiotherapie conformationnelle avec modulation d'intensite

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Lapeyre, M.; Toledano, I.; Bourry, N. [Departement de radiotherapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1 (France); Bailly, C. [Unite de radiodiagnostic, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1 (France); Cachin, F. [Unite de medecine nucleaire, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1 (France)

2011-10-15

This article describes the determination and the delineation of the target volumes for head-and-neck cancers treated with intensity-modulated radiotherapy (IMRT). The delineation of the clinical target volumes (CTV) on the computerized tomography scanner (CT scan) requires a rigorous methodology due to the complexity of head-and-neck anatomy. The clinical examination with a sketch of pretreatment tumour extension, the surgical and pathological reports and the adequate images (CT scan, magnetic resonance imaging and fluorodeoxyglucose positron emission tomography) are necessary for the delineation. The target volumes depend on the overall strategy: sequential IMRT or simultaneous integrated boost-IMRT (SIB-IMRT). The concept of selectivity of the potential subclinical disease near the primary tumor and the selection of neck nodal targets are described according to the recommendations and the literature. The planing target volume (PTV), mainly reflecting setup errors (random and systematic), results from a uniform 4-5 mm expansion around the CTV. We propose the successive delineation of: (1) the gross volume tumour (GTV); (2) the 'high risk' CTV1 around the GTV or including the postoperative tumour bed in case of positive margins or nodal extra-capsular spread (65-70 Gy in 30-35 fractions); (3) the CTV2 'intermediate risk' around the CTV1 for SIB-IMRT (59-63 Gy in 30-35 fractions); (4) the 'low-risk' CTV3 (54-56 Gy in 30-35 fractions); (5) the PTVs. (authors)

Squamous cell carcinoma of the esophagus and multiple primary tumors of the upper aerodigestive tract Carcinoma epidermoide do esôfago e múltiplos tumores primários do trato aerodigestivo alto

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Ulysses RIBEIRO Jr.

1999-12-01

Full Text Available Squamous cell carcinoma of the esophagus is frequently associated with other, synchronous or metachronous tumors, in the upper aerodigestive tract. All 264 patients with squamous cell carcinoma of the esophagus, treated in the Gastrointestinal Surgery, Esophagus section, of the "Hospital das Clínicas" (São Paulo University Medical School, Brazil, between 1979 and 1989 were analyzed retrospectively with regards to the occurrence of multiple primary tumors in the upper aerodigestive tract. Multiple primary tumors were encountered in 10 (3.8% patients. All patients were male and the mean age at the time of the first primary was 52.2 years. Tobacco smoke and alcohol were the principal carcinogens in these patients (n = 10. The sites of the tumors were: larynx (n = 4, tongue (n = 4, lung (n = 2, and oral cavity (n = 1. Two simultaneous, three synchronous and five metachronous multiple primary carcinomas were detected. The esophagus was the second primary tumor in nine patients. The mean overall survival after the diagnosis of the second primary was 2.8 months (SD = 0.89. Inquiry regarding other malignancies, associated with panendoscopy should be carry out prior to the treatment of the first primary to diagnose simultaneous or synchronous primary tumors, and careful follow-up should be performed after treatment of the first primary to detect new tumors in these high-risk patients.Carcinoma epidermóide do esôfago está freqüentemente associado a outros, sincrônicos ou metacrônicos tumores do trato aerodigestivo alto. Foram analisados, retrospectivamente, 264 pacientes com carcinoma de esôfago tratados na Disciplina de Cirurgia do Aparelho Digestivo, Divisão de Cirurgia do Esôfago, do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, entre 1979 e 1989, com o intuito de se observar a ocorrência de múltiplos tumores primários do trato aerodigestivo alto. Observaram-se 10 (3.8% pacientes com múltiplos tumores

Graph theoretical analysis of EEG effective connectivity in vascular dementia patients during a visual oddball task.

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Wang, Chao; Xu, Jin; Zhao, Songzhen; Lou, Wutao

2016-01-01

The study was dedicated to investigating the change in information processing in brain networks of vascular dementia (VaD) patients during the process of decision making. EEG was recorded from 18 VaD patients and 19 healthy controls when subjects were performing a visual oddball task. The whole task was divided into several stages by using global field power analysis. In the stage related to the decision-making process, graph theoretical analysis was applied to the binary directed network derived from EEG signals at nine electrodes in the frontal, central, and parietal regions in δ (0.5-3.5Hz), θ (4-7Hz), α1 (8-10Hz), α2 (11-13Hz), and β (14-30Hz) frequency bands based on directed transfer function. A weakened outgoing information flow, a decrease in out-degree, and an increase in in-degree were found in the parietal region in VaD patients, compared to healthy controls. In VaD patients, the parietal region may also lose its hub status in brain networks. In addition, the clustering coefficient was significantly lower in VaD patients. Impairment might be present in the parietal region or its connections with other regions, and it may serve as one of the causes for cognitive decline in VaD patients. The brain networks of VaD patients were significantly altered toward random networks. The present study extended our understanding of VaD from the perspective of brain functional networks, and it provided possible interpretations for cognitive deficits in VaD patients. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

The temporal requirement for vitamin A in the developing eye: mechanism of action in optic fissure closure and new roles for the vitamin in regulating cell proliferation and adhesion in the embryonic retina.

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See, Angela Wai-Man; Clagett-Dame, Margaret

2009-01-01

Mammalian eye development requires vitamin A (retinol, ROL). The role of vitamin A at specific times during eye development was studied in rat fetuses made vitamin A deficient (VAD) after embryonic day (E) 10.5 (late VAD). The optic fissure does not close in late VAD embryos, and severe folding and collapse of the retina is observed at E18.5. Pitx2, a gene required for normal optic fissure closure, is dramatically downregulated in the periocular mesenchyme in late VAD embryos, and dissolution of the basal lamina does not occur at the optic fissure margin. The addition of ROL to late VAD embryos by E12.5 restores Pitx2 expression, supports dissolution of the basal lamina, and prevents coloboma, whereas supplementation at E13.5 does not. Surprisingly, ROL given as late as E13.5 completely prevents folding of the retina despite the presence of an open fetal fissure, showing that coloboma and retinal folding represent distinct VAD-dependent defects. Retinal folding due to VAD is preceded by an overall reduction in the percentage of cyclin D1 positive cells in the developing retina, (initially resulting in retinal thinning), as well as a dramatic reduction in the cell adhesion-related molecules, N-cadherin and beta-catenin. Reduction of retinal cell number combined with a loss of the normal cell-cell adhesion proteins may contribute to the collapse and folding of the retina that occurs in late VAD fetuses.

The Effect of a Voice Activity Detector on the Speech Enhancement

DEFF Research Database (Denmark)

Dau, Torsten; Catic, Jasmina; Buchholz, Jörg

2010-01-01

A multimicrophone speech enhancement algorithm for binaural hearing aids that preserves interaural time delays was proposed recently. The algorithm is based on multichannel Wiener filtering and relies on a voice activity detector (VAD) for estimation of second-order statistics. Here, the effect...... of a VAD on the speech enhancement of this algorithm was evaluated using an envelopebased VAD, and the performance was compared to that achieved using an ideal error-free VAD. The performance was considered for stationary directional noise and nonstationary diffuse noise interferers at input SNRs from −10...

Vitamin A deficiency alters the pulmonary parenchymal elastic modulus and elastic fiber concentration in rats

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Holmes Amey J

2005-07-01

Full Text Available Abstract Background Bronchial hyperreactivity is influenced by properties of the conducting airways and the surrounding pulmonary parenchyma, which is tethered to the conducting airways. Vitamin A deficiency (VAD is associated with an increase in airway hyperreactivity in rats and a decrease in the volume density of alveoli and alveolar ducts. To better define the effects of VAD on the mechanical properties of the pulmonary parenchyma, we have studied the elastic modulus, elastic fibers and elastin gene-expression in rats with VAD, which were supplemented with retinoic acid (RA or remained unsupplemented. Methods Parenchymal mechanics were assessed before and after the administration of carbamylcholine (CCh by determining the bulk and shear moduli of lungs that that had been removed from rats which were vitamin A deficient or received a control diet. Elastin mRNA and insoluble elastin were quantified and elastic fibers were enumerated using morphometric methods. Additional morphometric studies were performed to assess airway contraction and alveolar distortion. Results VAD produced an approximately 2-fold augmentation in the CCh-mediated increase of the bulk modulus and a significant dampening of the increase in shear modulus after CCh, compared to vitamin A sufficient (VAS rats. RA-supplementation for up to 21 days did not reverse the effects of VAD on the elastic modulus. VAD was also associated with a decrease in the concentration of parenchymal elastic fibers, which was restored and was accompanied by an increase in tropoelastin mRNA after 12 days of RA-treatment. Lung elastin, which was resistant to 0.1 N NaOH at 98°, decreased in VAD and was not restored after 21 days of RA-treatment. Conclusion Alterations in parenchymal mechanics and structure contribute to bronchial hyperreactivity in VAD but they are not reversed by RA-treatment, in contrast to the VAD-related alterations in the airways.

The effect of Scutellaria baicalensis stem-leaf flavonoids on spatial learning and memory in chronic cerebral ischemia-induced vascular dementia of rats.

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Cao, Yanjing; Liang, Lizhen; Xu, Jian; Wu, Jiali; Yan, Yongxing; Lin, Ping; Chen, Qiang; Zheng, Fengming; Wang, Qin; Ren, Qian; Gou, Zengmei; Du, Yifeng

2016-05-01

Flavonoids have been shown to improve cognitive function and delay the dementia progression. However, the underlying mechanisms remain elusive. In the present study, we examined the effect of Scutellaria baicalensis stem-leaf total flavonoids (SSTFs) extracted from S. baicalensis Georgi on spatial learning and memory in a vascular dementia (VaD) rat model and explored its molecular mechanisms. The VaD rats were developed by permanent bilateral occlusion of the common carotid artery. Seven days after recovery, the VaD rats were treated with either 50 or 100 mg/kg of SSTF for 60 days. The spatial learning and memory was evaluated in the Morris water maze (MWM) test. The tau hyperphosphorylation and the levels of the related protein kinases or phosphatases were examined by western blot analysis. In VaD rats, SSTF treatment at 100 mg/kg significantly reduced the escape latency in training trial in MWM test. In the probe trial, SSTF treatment increased the searching time and travel distance in the target quadrant. SSTF treatment inhibited the tau phosphorylation in both cortex and hippocampus in VaD rats. Meanwhile, SSTF reduced the activity of glycogen synthase kinase 3β and cyclin-dependent kinase 5 in VaD rats. In contrast, SSTF treatment increased the level of the protein phosphatase 2A subunit B in VaD rats. SSTF treatment significantly improved the spatial cognition in VaD rats. Our results suggest that SSTF may alleviate tau-hyperphosphorylation-induced neurotoxicity through coordinating the activity of kinases and phosphatase after a stroke. SSTF may be developed into promising novel therapeutics for VaD. © The Author 2016. Published by ABBS Editorial Office in association with Oxford University Press on behalf of the Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences.

Neuropsychiatric profiles in patients with Alzheimer′s disease and vascular dementia

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Tushar Kanti Bandyopadhyay

2014-01-01

Full Text Available Background/Aims: The aim of the following study is to compare the behavioral and psychological symptoms of dementia (BPSD in patients of Alzheimer disease (AD and vascular dementia (VaD. Materials and Methods: We used National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer′s Disease and Related Disorders Association criteria for diagnosing AD and National Institute of Neurological Disorders and Stroke-Association International pour la Recherche et l′Enseignement en Neurosciences Criteria for diagnosing VaD. VaD cohort was further subcategorized into small vessel and large vessel disease. The severity of cognitive impairment and the BPSD were studied by means of the Clinical Dementia Rating Scale (CDR and the Neuropsychiatric Inventory respectively. Results: We studied 50 AD and 50 VaD patients of whom 38 were small vessels and 12 were large vessels VaD. The severity of dementia was comparable in both groups. The agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, irritability, aberrant motor behavior, appetite and eating behavior and night-time behaviors occurred significantly more frequently in patients with VaD than AD. We found a weak positive correlation between the CDR score and the number of neuropsychiatric symptoms per patient in both cohorts. Elation/euphoria, agitation/aggression was significantly more frequent in patients with large vessel in comparison to small vessel VaD. Conclusions: BPSD are common in both types of dementia and they are more severe in VaD than AD when the groups have similar levels of cognitive impairment.

A Semi-Continuous State-Transition Probability HMM-Based Voice Activity Detector

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H. Othman

2007-02-01

Full Text Available We introduce an efficient hidden Markov model-based voice activity detection (VAD algorithm with time-variant state-transition probabilities in the underlying Markov chain. The transition probabilities vary in an exponential charge/discharge scheme and are softly merged with state conditional likelihood into a final VAD decision. Working in the domain of ITU-T G.729 parameters, with no additional cost for feature extraction, the proposed algorithm significantly outperforms G.729 Annex B VAD while providing a balanced tradeoff between clipping and false detection errors. The performance compares very favorably with the adaptive multirate VAD, option 2 (AMR2.

A Semi-Continuous State-Transition Probability HMM-Based Voice Activity Detector

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Othman H

2007-01-01

Full Text Available We introduce an efficient hidden Markov model-based voice activity detection (VAD algorithm with time-variant state-transition probabilities in the underlying Markov chain. The transition probabilities vary in an exponential charge/discharge scheme and are softly merged with state conditional likelihood into a final VAD decision. Working in the domain of ITU-T G.729 parameters, with no additional cost for feature extraction, the proposed algorithm significantly outperforms G.729 Annex B VAD while providing a balanced tradeoff between clipping and false detection errors. The performance compares very favorably with the adaptive multirate VAD, option 2 (AMR2.

Relationship between vitamin A deficiency and the thyroid axis in clinically stable patients with liver cirrhosis related to hepatitis C virus.

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El-Eshmawy, Mervat M; Arafa, Mona M; Elzehery, Rasha R; Elhelaly, Rania M; Elrakhawy, Mohamed M; El-Baiomy, Azza A

2016-09-01

Vitamin A deficiency (VAD) and altered thyroid function are commonly encountered in patients with liver cirrhosis. The link between vitamin A metabolism and thyroid function has been previously identified. The aim of this study was to explore the association between VAD and the thyroid axis in clinically stable patients with cirrhosis related to hepatitis C virus (HCV). One hundred and twelve patients with clinically stable HCV-related cirrhosis and 56 healthy controls matched for age, sex, and socioeconomic status were recruited for this study. Vitamin A status, liver function, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), reverse triiodothyronine (rT3), anti-thyroid peroxidase antibodies (anti-TPO), and thyroid volume were evaluated. The prevalence of VAD among patients with HCV-related cirrhosis was 62.5% compared with 5.4% among controls (P vitamin A status: VAD and normal vitamin A. Patients with VAD had significantly lower vitamin A intake and serum albumin and higher serum bilirubin, FT4, FT3, and TSH than patients with normal vitamin A status. Multiple logistic regression analysis revealed that VAD was associated with Child-Pugh score (β = 0.11, P = 0.05) and TSH (β = -1.63, P = 0.02) independently of confounding variables. We conclude that VAD may be linked to central hyperthyroidism in patients with clinically stable HCV-related liver cirrhosis.

Systemic and Disease-Specific Risk Factors in Vascular Dementia: Diagnosis and Prevention

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Efraim Jaul

2017-10-01

Full Text Available In order to prevent the onset of vascular dementia (VaD in aging individuals, it is critical to detect clinically relevant vascular and systemic pathophysiological changes to signal the onset of its preceding prodromal stages. Identifying behavioral and neurobiological markers that are highly sensitive to VaD classification vs. other dementias is likely to assist in developing novel preventive treatment strategies that could delay the onset of disruptive psychomotor symptoms, decrease hospitalizations, and increase the quality of life in clinically-high-risk aging individuals. In light of empirical diagnostic and clinical findings associated with VaD pathophysiology, the current investigation will suggest a few clinically-validated biomarker measures of prodromal VaD cognitive impairments that are correlated with vascular symptomology, and VaD endophenotypes in non-demented aging people. In prodromal VaD individuals, distinguishing VaD from other dementias (e.g., Alzheimer's disease could facilitate specific early preventive interventions that significantly delay more severe cognitive deterioration or indirectly suppress the onset of dementia with vascular etiology. Importantly, the authors conclude that primary prevention strategies should examine aging individuals by employing comprehensive geriatric assessment approach, taking into account their medical history, and longitudinally noting their vascular, systemic, cognitive, behavioral, and clinical functional status. Secondary prevention strategies may include monitoring chronic medication as well as promoting programs that facilitate social interaction and every-day activities.

MAQUETTE ORL Décembre 2004

African Journals Online (AJOL)

le cancer des VADS ainsi que ses thérapies, la recherche ... les cancers des VADS, il faut commencer très précocement avant même ... support should always be preferred. ... D'une manière générale, la tumeur se développe quelque .... patients pris en charge en ORL pour cancer des VADS .... Evaluation nutritionnelle.

Soil-Transmitted Helminthiasis and Vitamin A Deficiency: Two Problems, One Policy.

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Strunz, Eric C; Suchdev, Parminder S; Addiss, David G

2016-01-01

Vitamin A deficiency (VAD) and soil-transmitted helminthiasis (STH) represent two widely prevalent and often overlapping global health problems. Approximately 75% of countries with moderate or severe VAD are coendemic for STH. We reviewed the literature on the complex relationship between STH and VAD. Treatment for STH significantly increases provitamin A (e.g., β-carotene) levels but is associated with minimal increases in preformed vitamin A (retinol). Interpretation of the data is complicated by variations in STH infection intensity and limitations of vitamin A biomarkers. Despite these challenges, increased coordination of STH and VAD interventions represents an important public health opportunity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Outcomes of pediatric patients supported with continuous-flow ventricular assist devices: A report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS).

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Rossano, Joseph W; Lorts, Angela; VanderPluym, Christina J; Jeewa, Aamir; Guleserian, Kristine J; Bleiweis, Mark S; Reinhartz, Olaf; Blume, Elizabeth D; Rosenthal, David N; Naftel, David C; Cantor, Ryan S; Kirklin, James K

2016-05-01

Continuous-flow (CF) ventricular assist devices (VADs) have largely replaced pulsatile-flow VADs in adult patients. However, there are few data on CF VADs among pediatric patients. In this study we aimed to describe the overall use, patients' characteristics and outcomes of CF VADs in this population. The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a national registry for U.S. Food and Drug Adminstration (FDA)-approved VADs in patients <19 years of age. Patients undergoing placement of durable CF VADs between September 2012 and June 2015 were included and outcomes were compared with those of adults from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). CF VADs were implanted in 109 patients at 35 hospitals. The median age at implantation was 15 years (2.8 to 18.9 years) and median weight was 62 kg (range 16 to 141 kg). The underlying disease was cardiomyopathy in 89 (82%) patients. The INTERMACS level at time of implant was Level 1 in 20 (19%), Level 2 in 64 (61%) and Levels 3 to 7 in 21 (20%) patients. Most were implanted as LVADs (n = 102, 94%). Median duration of support was 2.3 months (range <1 day to 28 months). Serious adverse event rates were low, including neurologic dysfunction (early event rate 4.1 per 100 patient-months with 2 late events). Competing outcomes analysis at 6 months post-implant indicated 61% transplanted, 31% alive with device in place and 8% death before transplant. These outcomes compared favorably with the 3,894 adults supported with CF VADs as a bridge to transplant. CF VADs are commonly utilized in older children and adolescents, with excellent survival rates. Further study is needed to understand impact of patient and device characteristics on outcomes in pediatric patients. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Exercise physiology with a left ventricular assist device: Analysis of heart-pump interaction with a computational simulator.

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Fresiello, Libera; Rademakers, Frank; Claus, Piet; Ferrari, Gianfranco; Di Molfetta, Arianna; Meyns, Bart

2017-01-01

Patients with a Ventricular Assist Device (VAD) are hemodynamically stable but show an impaired exercise capacity. Aim of this work is to identify and to describe the limiting factors of exercise physiology with a VAD. We searched for data concerning exercise in heart failure condition and after VAD implantation from the literature. Data were analyzed by using a cardiorespiratory simulator that worked as a collector of inputs coming from different papers. As a preliminary step the simulator was used to reproduce the evolution of hemodynamics from rest to peak exercise (ergometer cycling) in heart failure condition. Results evidence an increase of cardiac output of +2.8 l/min and a heart rate increase to 67% of the expected value. Then, we simulated the effect of a continuous-flow VAD at both rest and exercise. Total cardiac output increases of +3.0 l/min (+0.9 l/min due to the VAD and +2.1 l/min to the native ventricle). Since the left ventricle works in a non-linear portion of the diastolic stiffness line, we observed a consistent increase of pulmonary capillary wedge pressure (from 14 to 20 mmHg) for a relatively small increase of end-diastolic volume (from 182 to 189 cm3). We finally increased VAD speed during exercise to the maximum possible value and we observed a reduction of wedge pressure (-4.5 mmHg), a slight improvement of cardiac output (8.0 l/min) and a complete unloading of the native ventricle. The VAD can assure a proper hemodynamics at rest, but provides an insufficient unloading of the left ventricle and does not prevent wedge pressure from rising during exercise. Neither the VAD provides major benefits during exercise in terms of total cardiac output, which increases to a similar extend to an unassisted heart failure condition. VAD speed modulation can contribute to better unload the ventricle but the maximal flow reachable with the current devices is below the cardiac output observed in a healthy heart.

Efficacy Of Rivastigmine And Donepezil On Cognitive Impairment Of Vascular Dementia - Some Preliminary Observations

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Jha S

2004-01-01

Full Text Available Background: Vascular Dementia (VaD is common, global, disabling and a rather neglected, age related dementia. It is important to identify and treat it since cognitive impairment produces dysfunction in occupational and social life. Moreso, due to increase in geriatric population, incidence and prevalence of VaD is also increasing. Aim: We share our observations on efficacy of Rivastigmine and Donepezil (drugs advocated for improving cognition in dementia in patients of VaD. Material and Method: This was a non-randomized study based on clinical evaluation. We selected 53 patients suffering from VaD (as per clinical and radiological criteria. Their age range was 55-78 years (mean 65.3 + 6.2 yrs. Clinical, biochemical and radiological (Cranial CT and MRI evaluation was done to establish etiology. Cognition was measured using modified Mini Mental State Examination (MMSE which was repeated 2 times, at interval of 3 months. We observed the role of Rivastigmine in 14 and Donepezil in 19 patients of VaD. The change in MMSE score was compared with 20 control patients of VaD. The associated risk factors like hypertension, diabetes, hyperlipidemia etc. were managed. Acetyl Salicylic Acid (ASA in dose of 150mg/day was given as an antiplatelet agent to all 53 patients in this study. Results: At end of study, no statistically significant improvement was observed in MMSE score in any of the 53 patients. Improvement in MMSE score (though statistically insignificant was observed with Rivastigmine in 11 and with Donepezil in 14 patients. Progressive decline in MMSE score was observed in 14 (70% control patients of VaD who did not receive rivastigmine or donepezil. Conclusion - Rivastigmine and Donepezil are beneficial in halting deterioration of dementia in patients suffering from VaD.

Use of Ventricular Assist Device in Univentricular Physiology: The Role of Lumped Parameter Models.

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Di Molfetta, Arianna; Ferrari, Gianfranco; Filippelli, Sergio; Fresiello, Libera; Iacobelli, Roberta; Gagliardi, Maria G; Amodeo, Antonio

2016-05-01

Failing single-ventricle (SV) patients might benefit from ventricular assist devices (VADs) as a bridge to heart transplantation. Considering the complex physiopathology of SV patients and the lack of established experience, the aim of this work was to realize and test a lumped parameter model of the cardiovascular system, able to simulate SV hemodynamics and VAD implantation effects. Data of 30 SV patients (10 Norwood, 10 Glenn, and 10 Fontan) were retrospectively collected and used to simulate patients' baseline. Then, the effects of VAD implantation were simulated. Additionally, both the effects of ventricular assistance and cavopulmonary assistance were simulated in different pathologic conditions on Fontan patients, including systolic dysfunction, diastolic dysfunction, and pulmonary vascular resistance increment. The model can reproduce patients' baseline well. Simulation results suggest that the implantation of VAD: (i) increases the cardiac output (CO) in all the three palliation conditions (Norwood 77.2%, Glenn 38.6%, and Fontan 17.2%); (ii) decreases the SV external work (SVEW) (Norwood 55%, Glenn 35.6%, and Fontan 41%); (iii) increases the mean pulmonary arterial pressure (Pap) (Norwood 39.7%, Glenn 12.1%, and Fontan 3%). In Fontan circulation, with systolic dysfunction, the left VAD (LVAD) increases CO (35%), while the right VAD (RVAD) determines a decrement of inferior vena cava pressure (Pvci) (39%) with 34% increment of CO. With diastolic dysfunction, the LVAD increases CO (42%) and the RVAD decreases the Pvci. With pulmonary vascular resistance increment, the RVAD allows the highest CO (50%) increment with the highest decrement of Pvci (53%). The single ventricular external work (SVEW) increases (decreases) increasing the VAD speed in cavopulmonary (ventricular) assistance. Numeric models could be helpful in this challenging and innovative field to support patients and VAD selection to optimize the clinical outcome and personalize the therapy

Features and selection of vascular access devices.

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Sansivero, Gail Egan

2010-05-01

To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

Occult pneumomediastinum in blunt chest trauma: clinical significance.

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Rezende-Neto, J B; Hoffmann, J; Al Mahroos, M; Tien, H; Hsee, L C; Spencer Netto, F; Speers, V; Rizoli, S B

2010-01-01

Thoracic injuries are potentially responsible for 25% of all trauma deaths. Chest X-ray is commonly used to screen patients with chest injury. However, the use of computed tomography (CT) scan for primary screening is increasing, particularly for blunt trauma. CT scans are more sensitive than chest X-ray in detecting intra-thoracic abnormalities such as pneumothoraces and pneumomediastinums. Pneumomediastinum detected by chest X-ray or "overt pneumomediastinum", raises the concern of possible aerodigestive tract injuries. In contrast, there is scarce information on the clinical significance of pneumomediastinum diagnosed by CT scan only or "occult pneumomediastinum". Therefore we investigated the clinical consequences of occult pneumomediastinum in our blunt trauma population. A 2-year retrospective chart review of all blunt chest trauma patients with initial chest CT scan admitted to a level I trauma centre. Data extracted from the medical records include; demographics, occult, overt, or no pneumomediastinum, the presence of intra-thoracic aerodigestive tract injuries (trachea, bronchus, and/or esophagus), mechanism and severity of injury, endotracheal intubation, chest thoracostomy, operations and radiological reports by an attending radiologist. All patients with intra-thoracic aerodigestive tract injuries from 1994 to 2004 were also investigated. Of 897 patients who met the inclusion criteria 839 (93.5%) had no pneumomediastinum. Five patients (0.6%) had overt pneumomediastinum and 53 patients (5.9%) had occult pneumomediastinum. Patients with occult pneumomediastinum had significantly higher ISS and AIS chest (pchest thoracostomy tube was more common (ppneumothorax. None of the patients with occult pneumomediastinum had aerodigestive tract injuries (95%CI 0-0.06). Follow up CT scan of patients with occult pneumomediastinum showed complete resolution in all cases, in average 3 h after the initial exam. Occult pneumomediastinum occurred in approximately 6% of

Vascular dementia: Facts and controversies

Directory of Open Access Journals (Sweden)

Pavlović Aleksandra

2013-01-01

Full Text Available Vascular dementia (VaD is the second most frequent dementia after Alzheimer’s disease, and is diagnosed during lifetime in 20% of demented patients. Five­year survival rate in VaD is 39%, while it is estimated to be 75% in healthy persons of the same age. It is therefore important to make correct diagnosis of VaD early in the course of the disease. Risk factors for VaD are identical to stroke risk factors, and there are significant possibilities for the prevention of vascular cognitive decline. Cognitive decline develops acutely or step­by­step within three months after stroke, but more gradual progression of intellectual decline is also possible. Neurological examination can reveal pyramidal and extrapyramidal signs, pseudobulbar palsy, gait disturbance and urinary incontinence. Neuropsychological profile comprises the loss of cognitive set shifting, decline in word fluency, verbal learning difficulties, perseverations, difficulties in complex figure copying, and in patients with cortically located lesions also problems with speech and praxia. The basis of the diagnosis is, besides history, neurological examination and neuropsychological assessment, computed tomography and/ or magnetic resonance brain imaging. Vascular risk factors control is the most important measure in VaD prevention. Modern guidelines for the treatment of cognitive decline in VaD emphasize that donepezil can be useful in the improvement of cognitive status at the level of Class IIa recommendation at the level of evidence A, while memantine may be useful in patients with mixed VaD and Alzheimer’s disease dementia. [Projekat Ministarstva nauke Republike Srbije, br. 175022 i br. 175033

The Ventricular Assist Device in the Life of the Child: A Phenomenological Pediatric Study.

Science.gov (United States)

van Manen, Michael A

2017-05-01

What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy. While the mechanical-technical operation of the VAD is well understood, the clinical-technical aspects of young people living with this device are largely unexplored. Drawing on interviews of school-aged children, the aim of this phenomenological study is to explore how a VAD may structure or condition a child's meaningful experience of their world outside the hospital. The driveline of an implanted VAD is the peripheral attachment, extruding through the skin to connect the controller-power supply. The materiality of the device may be interruptive, restrictive, and disturbing to the psycho-physical being and sense of self-identity of the child as a child. And while a child equipped with a VAD is not necessarily conspicuous among other children, the child may experience the device as an exposing presence, while living with the worry of a caregiver who takes on the role not simply of parent but of watchful health professional. A phenomenological understanding of the VAD should assist parents and caregiving health professionals knowing how to deal with specific issues arising in the life of the VAD child.

Experience With a Long-term Pulsatile Ventricular Assist Device as a Bridge to Heart Transplant in Adults.

Science.gov (United States)

Gómez Bueno, Manuel; Segovia Cubero, Javier; Serrano Fiz, Santiago; Ugarte Basterrechea, Juan; Hernández Pérez, Francisco José; Goirigolzarri Artaza, Josebe; Castedo Mejuto, Evaristo; Burgos Lázaro, Raúl; García Montero, Carlos; Moñivas Palomero, Vanessa; Mingo Santos, Susana; González Román, Ana Isabel; Álvarez Avelló, José Manuel; Vidal Fernández, Mercedes; Forteza Gil, Alberto; Alonso-Pulpón, Luis

2017-09-01

Most long-term ventricular assist devices (VADs) that are currently implanted are intracorporeal continuous-flow devices. Their main limitations include their high cost and inability to provide biventricular support. The aim of this study was to describe the results of using paracorporeal pulsatile-flow VADs as a bridge to transplant (BTT) in adult patients. Retrospective analysis of the characteristics, complications, and outcomes of a single-center case series of consecutive patients treated with the EXCOR VAD as BTT between 2009 and 2015. During the study period, 25 VADs were implanted, 6 of them biventricular. Ventricular assist devices were indicated directly as a BTT in 12 patients and as a bridge to decision in 13 due to the presence of potentially reversible contraindications or chance of heart function recovery. Twenty patients (80%) were successfully bridged to heart transplant after a median of 112 days (range, 8-239). The main complications included infectious (52% of patients), neurological events (32%, half of them fatal), bleeding (28%), and VAD malfunction requiring component replacement (28%). Eighty percent of patients with the EXCOR VAD as BTT achieved the goal after an average of almost 4 months of support. The most frequent complications were infectious, and the most severe were neurological. In our enivonment, the use of these pulsatile-flow VAD as BTT is a feasible strategy that obtains similar outcomes to those of intracorporeal continuous-flow devices. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Simulation of Ventricular, Cavo-Pulmonary, and Biventricular Ventricular Assist Devices in Failing Fontan.

Science.gov (United States)

Di Molfetta, Arianna; Amodeo, Antonio; Fresiello, Libera; Trivella, Maria Giovanna; Iacobelli, Roberta; Pilati, Mara; Ferrari, Gianfranco

2015-07-01

Considering the lack of donors, ventricular assist devices (VADs) could be an alternative to heart transplantation for failing Fontan patients, in spite of the lack of experience and the complex anatomy and physiopathology of these patients. Considering the high number of variables that play an important role such as type of Fontan failure, type of VAD connection, and setting (right VAD [RVAD], left VAD [LVAD], or biventricular VAD [BIVAD]), a numerical model could be useful to support clinical decisions. The aim of this article is to develop and test a lumped parameter model of the cardiovascular system simulating and comparing the VAD effects on failing Fontan. Hemodynamic and echocardiographic data of 10 Fontan patients were used to simulate the baseline patients' condition using a dedicated lumped parameter model. Starting from the simulated baseline and for each patient, a systolic dysfunction, a diastolic dysfunction, and an increment of the pulmonary vascular resistance were simulated. Then, for each patient and for each pathology, the RVAD, LVAD, and BIVAD implantations were simulated. The model can reproduce patients' baseline well. In the case of systolic dysfunction, the LVAD unloads the single ventricle and increases the cardiac output (CO) (35%) and the arterial systemic pressure (Pas) (25%). With RVAD, a decrement of inferior vena cava pressure (Pvci) (39%) was observed with 34% increment of CO, but an increment of the single ventricle external work (SVEW). With the BIVAD, an increment of Pas (29%) and CO (37%) was observed. In the case of diastolic dysfunction, the LVAD increases CO (42%) and the RVAD decreases the Pvci, while both increase the SVEW. In the case of pulmonary vascular resistance increment, the highest CO (50%) and Pas (28%) increment is obtained with an RVAD with the highest decrement of Pvci (53%) and an increment of the SVEW but with the lowest VAD power consumption. The use of numerical models could be helpful in this innovative

Bridge to recovery in two cases of dilated cardiomyopathy after long-term mechanical circulatory support

OpenAIRE

Pacholewicz, Jerzy; Zakliczy?ski, Micha?; Kowalik, Violetta; Nadziakiewicz, Pawe?; Kowalski, Oskar; Kalarus, Zbigniew; Zembala, Marian

2014-01-01

Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. Achieving the potential for recovery of native heart function using VADs is an established form of treatment in a selected group of patients with HF. We report two cases of VAD patients with different types of pump used for mechanical circulatory support, a continuous flow pump (Heart-Ware?) and a pulsatile pump (POLVAD MEV?), which allow regeneration of the native heart....

Left ventricular assist device (lvad design features: literature review

Directory of Open Access Journals (Sweden)

Yu. V. Bogdanova

2014-01-01

Full Text Available More than 8 million people in our country suffer from heart failure. About one million of these people die each year [1]. The problem of ventricular assist device creating - a mechanical device used for partial or complete replacement of heart function - is investigated for a long time (according to [2] just in our country since the 1970s. Today plenty of encouraging results are received. There is a number of VAD models which are successfully applied to patients with heart failure. After implantation, patients conduct a way of life that is normal in many respects: they are in the family, often they have an opportunity to work in their former specialty. Some of them live with the device about 8 years [3].According to [4] for 2010 the estimated total number of long-term devices implanted in the United States per year is over 1,700 (the population of the U.S. is 305 million, compared with over 430 per year in Europe (the population of Europe is 731 million. Unfortunately, people who need a heart transplant are much more.The principle of VAD is that being connected to the left ventricle with one cannula and to the ascending aorta with the other cannula the pump fully or partially replaces the function of the natural heart. This scheme allows the use of VAD in two ways: as a "bridge to transplantation" when the device is used temporarily until the donor heart is found, and a "bridge to recovery", when through the use of VAD the function of the heart muscle is recovered.VAD system can be divided into three subsystems: blood pump, power supply system and control system (Fig. 1.Each subsystem can be the subject of separate study. Special role in the development of VAD plays medical side of the issue. Successful research and development require interaction with qualified professionals in this field. The development of VAD is a multidisciplinary problem which demands fulfilment of a number of requirements.One of the most active programs in implantation of

Imaging of muscarinic acetylcholine receptors using (+)N-[11C]methyl-3-piperidyl benzilate (11C-3NMPB) in vascular dementia and Alzheimer's disease

International Nuclear Information System (INIS)

Saito, Hirohiko

2006-01-01

In order to clarify the integrity of muscarinic acetylcholine receptor (mAChR) in vascular dementia (VaD) and Alzheimer's disease (AD), PET imaging with (+) N-[ 11 C]methyl-3-piperidyl benzilate ( 11 C-3NMPB) was performed in 12 patients with VaD, 11 patients with AD, and 7 normal controls (NC group). The mAChR binding was compared by the ratios compared with the cerebellum which were calculated from the regions of interest (ROI), and by three-dimensional statistic analysis. Compared with the NC group, mAChR was not significantly reduced in any ROI in AD patients. In those with VaD due to cortical lesions, mAChR was reduced in the infarcted areas. On the other hand, mAChR was significantly reduced in the thalamus and anterior cingulated gyrus, but not in other cerebral cortices in patients with VaD due to subcortical lesions. Accordingly, it is suggested that the mAChR is preserved in the cerebral cortices in patients with VaD due to subcortical lesions as well as in AD patients. (author)

Euthanasia and surgeons: an overview of the Victorian Voluntary Assisted Dying Act 2017 and its relevance to surgical practice in Australia.

Science.gov (United States)

Beardsley, Christian; Brown, Kilian; Sandroussi, Charbel

2018-05-14

Surgeons play a significant role in the treatment of patients with many types of cancer, including the management of advanced and recurrent disease after long periods of apparent remission. The recently introduced Victorian Voluntary Assisted Dying (VAD) Act represents a shift in paradigm in Australian medical practice. To be eligible for VAD, the new legislation requires patient assessment by a physician with at least 5 years post-fellowship experience and relevant expertise in the patient's condition. Given many specialist surgeons' experience in managing advanced and often incurable malignancy, it is likely that many will receive referrals for assessment for VAD. It is foreseeable that other states and territories in Australia will follow suit with similar legislation. It is imperative that surgeons receiving referrals to assess patients seeking access to VAD are familiar with the legislation and assessment process. This article summarizes the current regulation of VAD in Australia, including the patient application and assessment process, briefly reviews world-wide assisted dying practices and discusses the relevance to surgeons practicing in Australia. © 2018 Royal Australasian College of Surgeons.

Multi-Infarct Dementia: A Historical Perspective

Directory of Open Access Journals (Sweden)

Erin McKay

2017-05-01

Full Text Available Background: Multi-infarct dementia (MID, a prominent subtype of vascular dementia (VaD, has only achieved recognition in the last 4 decades. Since its original description, the characterization, etiological understanding, and therapeutic direction of MID and other VaD subtypes has progressed at an astounding rate. Summary: This paper divides the landmark discoveries and emergence of new research strategies for MID into decade-defining patterns so that a condensed picture of the total history of MID and its eventual inclusion as a VaD subtype emerges. This paper follows the first descriptive decade, a shift to a preventative focus, a renewed interest coinciding with timely advances in research technology, and a hopeful return to treatment possibilities for VaD. Key Message: Concisely tracing the historical lineage of the modern understanding of MID, both as a singular entity and as part of the VaD con­stellation of disorders, provides a novel perspective on the foundation upon which future advances in combating vascular contributions to dementia will be based.

Vehicle Awareness Device Data from Leesburg, Virginia

Data.gov (United States)

Department of Transportation — The files in this data environment were produced using the Vehicle Awareness Device (VAD) installed on one test vehicle over a two month period. The VAD installed in...

Assessment of free and cued recall in Alzheimer's disease and vascular and frontotemporal dementia with 24-item Grober and Buschke test.

Science.gov (United States)

Cerciello, Milena; Isella, Valeria; Proserpi, Alice; Papagno, Costanza

2017-01-01

Alzheimer's disease (AD), vascular dementia (VaD) and frontotemporal dementia (FTD) are the most common forms of dementia. It is well known that memory deficits in AD are different from those in VaD and FTD, especially with respect to cued recall. The aim of this clinical study was to compare the memory performance in 15 AD, 10 VaD and 9 FTD patients and 20 normal controls by means of a 24-item Grober-Buschke test [8]. The patients' groups were comparable in terms of severity of dementia. We considered free and total recall (free plus cued) both in immediate and delayed recall and computed an Index of Sensitivity to Cueing (ISC) [8] for immediate and delayed trials. We assessed whether cued recall predicted the subsequent free recall across our patients' groups. We found that AD patients recalled fewer items from the beginning and were less sensitive to cueing supporting the hypothesis that memory disorders in AD depend on encoding and storage deficit. In immediate recall VaD and FTD showed a similar memory performance and a stronger sensitivity to cueing than AD, suggesting that memory disorders in these patients are due to a difficulty in spontaneously implementing efficient retrieval strategies. However, we found a lower ISC in the delayed recall compared to the immediate trials in VaD than FTD due to a higher forgetting in VaD.

Relationship between the Nutritional Status of Vitamin A per Trimester of Pregnancy with Maternal Anthropometry and Anemia after Roux-en-Y Gastric Bypass.

Science.gov (United States)

Cruz, Sabrina; Matos, Andréa; da Cruz, Suelem Pereira; Pereira, Silvia; Saboya, Carlos; Ramalho, Andréa

2017-09-08

The aim of this study was to compare the nutritional status of vitamin A per trimester of pregnancy, as well as to assess its influence on pre-pregnancy BMI, total gestational weight gain (TGWG) and presence of anemia in women who had previously undergone Roux-en-Y gastric bypass (RYGB). An analytical, longitudinal and retrospective study comprising 30 pregnant women who had previously undergone RYGB was undertaken. In all trimesters of pregnancy, the serum concentrations of retinol, β-carotene, stages of vitamin A deficiency (VAD), night blindness (NB), anemia and anthropometric variables were assessed. VAD in pregnancy affected 90% of women, 86.7% developed NB and 82.8% had mild VAD. TGWG above/below the recommended range was related to the low serum concentrations of β-carotene ( p = 0.045) in the second trimester and women with TGWG above the recommended range showed 100% of inadequacy of this nutrient in the third trimester. Among the pregnant women with anemia, 90.9% had VAD and 86.4% had NB. This study highlights the importance of monitoring the nutritional status of vitamin A in prenatal care, due to its relationship with TGWG and the high percentage of VAD and NB found since the beginning of pregnancy. It also reaffirms the use of the cut-off <1.05 μmol/L for determining VAD.

Expediting Clinician Adoption of Safety Practices: The UCSF Venous Access Patient Safety Interdisciplinary Education Project

National Research Council Canada - National Science Library

Donaldson, Nancy E; Plank, Rosemary K; Williamson, Ann; Pearl, Jeffrey; Kellogg, Jerry; Ryder, Marcia

2005-01-01

...) Venous Access Device (VAD) Patient Safety Interdisciplinary Education Project was to develop a 30-hour/one clinical academic unit VAD patient safety course with the aim of expediting clinician adoption of critical concepts...

The Ventricular Assist Device in the Life of the Child: A Phenomenological Pediatric Study

Science.gov (United States)

van Manen, Michael A.

2017-01-01

What is it like for a child to live with an artificial heart? The use of some medical therapies in children requires developmental considerations, is associated with psychosocial consequences, and calls for ethical sensitivities. A critical case is the ventricular assist device (VAD), a mechanical pump used to support the functioning of a failing heart. As a pediatric therapy, the device can be used as a temporary solution for poor heart function, a bridge to transplantation or recovery, or as a destination therapy. While the mechanical-technical operation of the VAD is well understood, the clinical-technical aspects of young people living with this device are largely unexplored. Drawing on interviews of school-aged children, the aim of this phenomenological study is to explore how a VAD may structure or condition a child’s meaningful experience of their world outside the hospital. The driveline of an implanted VAD is the peripheral attachment, extruding through the skin to connect the controller-power supply. The materiality of the device may be interruptive, restrictive, and disturbing to the psycho-physical being and sense of self-identity of the child as a child. And while a child equipped with a VAD is not necessarily conspicuous among other children, the child may experience the device as an exposing presence, while living with the worry of a caregiver who takes on the role not simply of parent but of watchful health professional. A phenomenological understanding of the VAD should assist parents and caregiving health professionals knowing how to deal with specific issues arising in the life of the VAD child. PMID:28682718

Voice Activity Detection. Fundamentals and Speech Recognition System Robustness

OpenAIRE

Ramirez, J.; Gorriz, J. M.; Segura, J. C.

2007-01-01

This chapter has shown an overview of the main challenges in robust speech detection and a review of the state of the art and applications. VADs are frequently used in a number of applications including speech coding, speech enhancement and speech recognition. A precise VAD extracts a set of discriminative speech features from the noisy speech and formulates the decision in terms of well defined rule. The chapter has summarized three robust VAD methods that yield high speech/non-speech discri...

Comparison of Alzheimer's disease with vascular dementia and non-dementia using specific voxel-based Z score maps

International Nuclear Information System (INIS)

Ishii, Shirou; Shishido, Fumio; Miyajima, Masayuki; Sakuma, Koutarou; Shigihara, Takeshi; Tameta, Tadanobu; Miyazaki, Makoto; Kuroda, Hiroshi

2009-01-01

We investigated the ability to discriminate between Alzheimer's disease (AD) and vascular dementia (VaD), and between AD and non-dementia using the program ''easy Z score imaging system'' (eZIS) developed by Matsuda et al., for the diagnosis of very early AD. Of 201 patients, we investigated 12 patients with AD, 10 with VaD, and 9 with non-dementia, who underwent brain perfusion single-photon emission computed tomography by technetium-99m ethyl cysteinate dimer ( 99m Tc-ECD) between February 2005 and September 2006. The sensitivity and specificity of the indicators of specific volume of interest (VOI) analysis, namely, severity, extent, and ratio were evaluated for the distinction of AD from VaD and non-dementia. There was a significant difference in all the criteria for severity, extent, and ratio between AD and non-dementia cases and in the ratio between AD and VaD. Between AD and non-dementia, the sensitivity and specificity of severity were 100% and 45%, respectively, using the cutoff value of 1.19. When using the cutoff value of 14.2 for extent, the sensitivity and specificity were both 100%. Using the cutoff value of 2.22 for ratio, the sensitivity of 42% and specificity of 100% were demonstrated. When comparing AD with VaD, using the cutoff value of 2.22 for ratio, the sensitivity and specificity were 42% and 100%, respectively. Using the cutoff value of 1.5 for ratio, the sensitivity and specificity between AD and VaD were 92% and 80%, respectively, thereby showing the best results. The specific VOI analysis program of AD using specific voxel-based Z score maps is not influenced by interobserver differences among radiologists and is useful to discriminate AD from VaD and non-dementia. However, the setting of the cutoff value at each institution and comparison with original and eZIS images are suggested to distinguish better AD from VaD. (author)

Multichannel linear descriptors analysis for event-related EEG of vascular dementia patients during visual detection task.

Science.gov (United States)

Lou, Wutao; Xu, Jin; Sheng, Hengsong; Zhao, Songzhen

2011-11-01

Multichannel EEG recorded in a task condition could contain more information about cognition. However, that has not been widely investigated in the vascular-dementia (VaD)- related studies. The purpose of this study was to explore the differences of brain functional states between VaD patients and normal controls while performing a detection task. Three multichannel linear descriptors, i.e. spatial complexity (Ω), field strength (Σ) and frequency of field changes (Φ), were applied to analyse four frequency bands (delta, theta, alpha and beta) of multichannel event-related EEG signals for 12 VaD patients (mean age ± SD: 69.25 ± 10.56 years ; MMSE score ± SD: 22.58 ± 4.42) and 12 age-matched healthy subjects (mean age ± SD: 67.17 ± 5.97 years ; MMSE score ± SD: 29.08 ± 0.9). The correlations between the three measures and MMSE scores were also analysed. VaD patients showed a significant higher Ω value in the delta (p = 0.013) and theta (p = 0.021) frequency bands, a lower Σ value (p = 0.011) and a higher Φ (p = 0.008) value in the delta frequency band compared with normal controls. The MMSE scores were negatively correlated with the Ω (r = -0.52, p = 0.01) and Φ (r = -0.47, p = 0.02) values in the delta frequency band. The results indicated the VaD patients presented a reduction of synchronization in the slow frequency band during target detection, and suggested more neurons might be activated in VaD patients compared with normal controls. The Ω and Φ measures in the delta frequency band might be used to evaluate the degree of cognitive dysfunction. The multichannel linear descriptors are promising measures to reveal the differences in brain functions between VaD patients and normal subjects, and could potentially be used to evaluate the degree of cognitive dysfunction in VaD patients. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Bridge to transplantation using paracorporeal biventricular assist devices or the syncardia temporary total artificial heart: is there a difference?

Science.gov (United States)

Nguyen, A; Pozzi, M; Mastroianni, C; Léger, P; Loisance, D; Pavie, A; Leprince, P; Kirsch, M

2015-06-01

Biventricular support can be achieved using paracorporeal ventricular assist devices (p-BiVAD) or the Syncardia temporary total artificial heart (t-TAH). The purpose of the present study was to compare survival and morbidity between these devices. Data from 2 French neighboring hospitals were reviewed. Between 1996 and 2009, 148 patients (67 p-BiVADs and 81 t-TAH) underwent primary, planned biventricular support. There were 128 (86%) males aged 44±13 years. Preoperatively, p-BiVAD recipients had significantly lower systolic and diastolic blood pressures, more severe hepatic cytolysis and higher white blood cell counts than t-TAH recipients. In contrast, t-TAH patients had significantly higher rates of pre-implant ECLS and hemofiltration. Mean support duration was 79±100 days for the p-BiVAD group and 71±92 for t-TAH group (P=0.6). Forty two (63%) p-BiVAD recipients were bridged to transplantation (39, 58%) or recovery (3, 5%), whereas 51 (63%) patients underwent transplantation in the t-TAH group. Death on support was similar between groups (p-BiVAD, 26 (39%); t-TAH, 30 (37%); P=0.87). Survival while on device was not significantly different between patient groups and multivariate analysis showed that only preimplant diastolic blood pressure and alanine amino-transferase levels were significant predictors of death. Post-transplant survival in the p-BiVAD group was 76±7%, 70±8%, and 58±9% at 1, 3, and 5 years after transplantation, respectively, and was similar to that of the t-TAH group (77±6%, 72±6%, and 70±7%, P=0.60). Survival while on support and up to 5 years after heart transplantation was not significantly different in patients supported by p-BiVADs or t-TAH. Multivariate analysis revealed that survival while on transplantation was not affected by the type of device implanted.

Using medical imaging for the detection of adverse events ("incidents") during the utilization of left ventricular assist devices in adult patients with advanced heart failure.

Science.gov (United States)

Kaufmann, Friedrich; Krabatsch, Thomas

2016-05-01

Ventricular assist devices (VAD) are used for mechanical support of the terminally failing heart. Failure of these life supporting systems can be fatal. Early and reliable detection of any upcoming problems is mandatory and is crucial for the outcome. Medical imaging methods are described within this review, which are not only essential for diagnosis of typically VAD-related complications but also for the detection or verification of technical issues. Within this review the utilization of medical imaging equipment for the diagnosis of technical malfunctions or damages of implanted system components is discussed. A newly developed specialized acoustic imaging method for pump thrombosis detection will also be described along with the most common VAD-related medical complications and their respective imaging methods and the limitations induced by the use of the VAD-system.

Hemodynamic Aspects of the Berlin Ventricle Assist Device

National Research Council Canada - National Science Library

Avrahami, I

2001-01-01

.... A 3D numerical model was constructed to simulate the VAD pump and a time-dependent CFD analysis with moving walls was performed to predict the flow field inside the VAD during the cardiac cycle...

Ethical Analysis of Withdrawing Ventricular Assist Device Support

OpenAIRE

Mueller, Paul S.; Swetz, Keith M.; Freeman, Monica R.; Carter, Kari A.; Crowley, Mary Eliot; Severson, Cathy J. Anderson; Park, Soon J.; Sulmasy, Daniel P.

2010-01-01

OBJECTIVE: To describe a series of patients with heart failure supported with a ventricular assist device (VAD) who requested (or whose surrogates requested) withdrawal of VAD support and the legal and ethical aspects pertaining to these requests.

Comparison of total artificial heart and biventricular assist device support as bridge-to-transplantation.

Science.gov (United States)

Cheng, Allen; Trivedi, Jaimin R; Van Berkel, Victor H; Massey, H Todd; Slaughter, Mark S

2016-10-01

The use of left ventricular assist devices (LVAD) has increased significantly in the last decade. However, right heart dysfunction remains a problem despite the improved outcomes with continuous-flow LVADs. Surgical options for bridge to transplantation (BTT) in patients with biventricular failure are total artificial heart (TAH) or biventricular support (BiVAD). This study examines the differences in pre- and post-transplantation outcomes and survival in patients with TAH or BiVAD support as BTT. The United Network of Organ Sharing database was retrospectively queried from January 2005 to December 2014 to identify adult patients undergoing heart transplantation (n = 17,022). Patients supported with either TAH (n = 212) or BiVAD (n = 366) at the time of transplantation were evaluated. Pre- and post-transplantation Kaplan-Meier survival curves were examined. Cox regression model was used to study the hazard ratios of the association between TAH versus BiVAD support and post-transplant survival. The median age of the study groups was 49.8 ± 12.9 (TAH) and 47.2 ± 13.9 (BiVAD) years (range 18-74 years). There were more men, 87% versus 74%, in the TAH group (p < 0.0001) with greater body mass index, 27.3 ± 5.2 versus 25.6 ± 4.7 (p < 0.0001), compared to those with BiVADs. Creatinine was higher, 1.7 + 1.2 versus 1.3 + 0.8 mg/dL (p < 0.0001), in the TAH group before transplant. The 30-day, one-, and three-year post-transplantation survival was 88%, 78%, and 67%, respectively, for patients with TAH support versus 93%, 83%, and 73% (p = 0.06) for patients with BiVAD support. Cox regression model shows pre-transplant creatinine (HR = 1.21, p = 0.008) is associated with a lower post-transplant survival. TAH is not associated with a worse post-transplant survival (p = 0.1). There was no difference in wait-list survival in patients supported with TAH or BiVAD (p = 0.8). Although there has been a recent

Mechanical circulatory support is associated with loss of platelet receptors glycoprotein Ibα and glycoprotein VI.

Science.gov (United States)

Lukito, P; Wong, A; Jing, J; Arthur, J F; Marasco, S F; Murphy, D A; Bergin, P J; Shaw, J A; Collecutt, M; Andrews, R K; Gardiner, E E; Davis, A K

2016-11-01

Essentials Relationship of acquired von Willebrand disease (VWD) and platelet dysfunction is explored. Patients with ventricular assist devices and on extracorporeal membrane oxygenation are investigated. Acquired VWD and platelet receptor shedding is demonstrated in the majority of patients. Loss of platelet adhesion receptors glycoprotein (GP) Ibα and GPVI may increase bleeding risk. Background Ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO) are associated with bleeding that is not fully explained by anticoagulant or antiplatelet use. Exposure of platelets to elevated shear in vitro leads to increased shedding. Objectives To investigate whether loss of platelet receptors occurs in vivo, and the relationship with acquired von Willebrand syndrome (AVWS). Methods Platelet counts, coagulation tests and von Willebrand factor (VWF) analyses were performed on samples from 21 continuous flow VAD (CF-VAD), 20 ECMO, 12 heart failure and seven aortic stenosis patients. Levels of platelet receptors were measured by flow cytometry or ELISA. Results The loss of high molecular weight VWF multimers was observed in 18 of 19 CF-VAD and 14 of 20 ECMO patients, consistent with AVWS. Platelet receptor shedding was demonstrated by elevated soluble glycoprotein (GP) VI levels in plasma and significantly reduced surface GPIbα and GPVI levels in CF-VAD and ECMO patients as compared with healthy donors. Platelet receptor levels were also significantly reduced in heart failure patients. Conclusions These data link AVWS and increased platelet receptor shedding in patients with CF-VADs or ECMO for the first time. Loss of the platelet surface receptors GPIbα and GPVI in heart failure, CF-VAD and ECMO patients may contribute to ablated platelet adhesion/activation, and limit thrombus formation under high/pathologic shear conditions. © 2016 International Society on Thrombosis and Haemostasis.

Therapeutic Mechanisms of Vernonia amygdalina Delile in the Treatment of Prostate Cancer

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William Johnson

2017-09-01

Full Text Available Prostate cancer patients have been suffering from limited treatment options due to late diagnosis, poor drug tolerance, and multi-drug resistance to almost all the current drug treatments. Therefore, it is important to seek a new alternative therapeutic medicine that can effectively prevent the disease and even eradicate the progression and metastasis of prostate cancer. Vernonia amygdalina Delile (VAD is a common edible vegetable in Cameroon that has been used as a traditional medicine for some human diseases. However, to the best of our knowledge, no previous reports have explored its therapeutic efficacy against human prostate cancer. The objective of the present study was to assess the anticancer activities of VAD methanolic extracts in the prevention and treatment of prostate cancer using human androgen-independent prostate cancer (PC-3 cells as a test model. To achieve our objective, PC-3 cells were treated with various doses of VAD for 48 h. Data generated from the trypan blue test and MTT assay demonstrated that VAD extracts exhibited significant growth-inhibitory effects on PC-3 cells. Collectively, we established for the first time the antiproliferative effects of VAD on PC-3 cells, with an IC50 value of about 196.6 µg/mL. Further experiments, including cell morphology, lipid peroxidation and comet assays, and apoptosis analysis showed that VAD caused growth-inhibitory effects on PC-3 cells through the induction of cell growth arrest, DNA damage, apoptosis, and necrosis in vitro and may provide protection from oxidative stress diseases as a result of its high antioxidant content. These results provide useful data on the anticancer activities of VAD for prostate cancer and demonstrate the novel possibilities of this medicinal plant for developing prostate cancer therapies.

Low serum insulin-like growth factor-I (IGF-I) level is associated with increased risk of vascular dementia.

Science.gov (United States)

Quinlan, Patrick; Horvath, Alexandra; Nordlund, Arto; Wallin, Anders; Svensson, Johan

2017-12-01

Insulin-like growth factor-I (IGF-I) is important for the adult brain, but little is known of the role of IGF-I in Alzheimeŕs disease (AD) or vascular dementia (VaD). A prospective study of 342 patients with subjective or objective mild cognitive impairment recruited at a single memory clinic. We determined whether serum IGF-I concentrations at baseline were associated with the risk of all-cause dementia, AD, or VaD. Patients developing mixed forms of AD and VaD were defined as suffering from VaD. The statistical analyses included Cox proportional hazards regression analysis. During the follow-up (mean 3.6 years), 95 (28%) of the patients developed all-cause dementia [AD, n=37 (11%) and VaD, n=42 (12%)]. Low as well as high serum IGF-I (quartile 1 or 4 vs. quartiles 2-3) did not associate with all-cause dementia [crude hazard ratio (HR) 1.30, 95% confidence interval (CI): 0.81-2.08 and crude HR 1.05, 95% CI: 0.63-1.75, respectively] or AD (crude HR 0.79, 95% CI: 0.35-1.79 and crude HR 0.94, 95% CI: 0.43-2.06, respectively]. In contrast, low serum IGF-I concentrations were associated with increased risk of VaD (quartile 1 vs. quartiles 2-3, crude HR 2.22, 95% CI: 1.13-4.36). The latter association remained significant also after adjustment for multiple covariates. In a memory clinic population, low serum IGF-I was a risk marker for subsequent VaD whereas low IGF-I did not associate with the risk of AD. High serum IGF-I was not related to the risk of conversion to dementia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Shift of graft-versus-host-disease target organ tropism by dietary vitamin A.

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Christian Koenecke

Full Text Available Gut-homing of donor T cells is causative for the development of intestinal GvHD in recipients of allogeneic hematopoietic stem cell transplantation (HSCT. Expression of the gut-specific homing receptors integrin-α4β7 and chemokine receptor CCR9 on T cells is imprinted in gut-associated lymphoid tissues (GALT under the influence of the vitamin A metabolite retinoic acid. Here we addressed the role of vitamin A deficiency in HSCT-recipients for donor T cell migration in the course of experimental GvHD. Vitamin A-deficient (VAD mice were prepared by feeding them a vitamin A-depleted diet. Experiments were performed in a C57BL/6 into BALB/c model of acute GvHD. We found that expression of integrin-α4β7 and CCR9 in GALT was reduced in VAD recipients after HSCT. Competitive in vivo homing assays showed that allogeneic T cells primed in VAD mice did not home as efficiently to the intestine as T cells primed in mice fed with standard diet (STD. The course of GvHD was ameliorated in VAD HSCT-recipients and, consequently, their survival was prolonged compared to recipients receiving STD. However, VAD-recipients were not protected and died of clinical GvHD. We found reduced numbers of donor T cells in the intestine but increased cell counts and tissue damage in other organs of VAD-recipients. Furthermore, we observed high IFN-γ(+CD4(+ and low FoxP3(+CD4(+ frequencies of total donor CD4(+ T cells in VAD as compared to STD recipients. Taken together, these results indicate that dietary vitamin A deficiency in HSCT-recipients changed target organ tropism in GvHD but also resulted in fatal inflammation after HSCT.

Neuroradiological findings in vascular dementia

Energy Technology Data Exchange (ETDEWEB)

Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

2007-01-15

There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

Lack of association between PRNP 1368 polymorphism and Alzheimer's disease or vascular dementia

Directory of Open Access Journals (Sweden)

Jeong Byung-Hoon

2009-04-01

Full Text Available Abstract Background Polymorphisms of the prion protein gene (PRNP at codons 129 and 219 play an important role in the susceptibility to Creutzfeldt-Jakob disease (CJD, and might be associated with other neurodegenerative disorders. Several recent reports indicate that polymorphisms outside the coding region of PRNP modulate the expression of prion protein and are associated with sporadic CJD, although other studies failed to show an association. These reports involved the polymorphism PRNP 1368 which is located upstream from PRNP exon 1. In a case-controlled protocol, we assessed the possible association between the PRNP 1368 polymorphism and either Alzheimer's disease (AD or vascular dementia (VaD. Methods To investigate whether the PRNP 1368 polymorphism is associated with the occurrence of AD or VaD in the Korean population, we compared the genotype, allele, and haplotype frequencies of the PRNP 1368 polymorphism in 152 AD patients and 192 VaD patients with frequencies in 268 healthy Koreans. Results and conclusion Significant differences in genotype, allele and haplotype frequencies of PRNP 1368 polymorphism were not observed between AD and normal controls. There were no significant differences in the genotype and allele frequencies of the PRNP 1368 polymorphism between Korean VaD patients and normal controls. However, in the haplotype analysis, haplotype Ht5 was significantly over-represented in Korean VaD patients. This was the first genetic association study of a polymorphism outside the coding region of PRNP in relation to AD and VaD.

Lack of retinoic acid leads to increased langerin-expressing dendritic cells in gut-associated lymphoid tissues.

Science.gov (United States)

Chang, Sun-Young; Cha, Hye-Ran; Chang, Jae-Hoon; Ko, Hyun-Jeong; Yang, Hyungjun; Malissen, Bernard; Iwata, Makoto; Kweon, Mi-Na

2010-04-01

Retinoic acid (RA) is a crucial factor for maintaining homeostasis in the gut, including lymphocyte homing, immunoglobulin (Ig) A production, and T regulatory cells (Treg) and T helper cell 17 (T(H)17) generation. Until now, most attention has focused on the function of dendritic cells (DCs) to initiate adaptive immunity including T and B lymphocytes through RA. To investigate the effects of RA on DCs of gut-associated lymphoid tissue (GALT), we analyzed the phenotype and function of DC subsets from GALT of vitamin A-deficient (VAD) mice. VAD mice were prepared by feeding them a VAD diet over 12 weeks from gestational days 10-14. Here, we report that tremendous increase of langerin(+) DCs occurred in the mesenteric lymph nodes (MLNs) and gut lamina propria of VAD mice dependent on CCR7 signaling. Langerin(+) DCs have phenotypes more similar to those of bone marrow-derived dermal langerin(+) DCs than epidermal Langerhans cells. Moreover, RA receptor antagonists enhance the differentiation of langerin(+) DCs from mouse and human precursors of bone marrow and peripheral blood. Langerin(+) DCs were highly differentiated but less inflammatory than langerin(-) DCs of MLNs of VAD mice. Moreover, tolerance to orally delivered antigen was completely abrogated by depletion of langerin(+) DCs in the VAD mice. These results suggest that generation of langerin(+) DCs in the GALT is tightly regulated by RA and that the microenvironment of tissues determines the phenotype of DCs. 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

General surgical complications associated with the use of long-term mechanical circulatory support devices: are we 'under-reporting' problems?

Science.gov (United States)

Tchantchaleishvili, Vakhtang; Umakanthan, Ramanan; Karp, Seth; Stulak, John M; Keebler, Mary E; Maltais, Simon

2013-05-01

Multiple complications are associated with use of ventricular assist devices (VADs). Cardiac-related complications and infections are most frequently reported. VADs, however, can also lead to a number of general surgical complications equally significant in terms of morbidity and mortality. The authors performed a systematic literature search to review current data that specifically relate general surgical complications to patients who undergo left VAD implantation. The review provides a relatively clear understanding of the spectrum of general surgical complications and shows that they contribute significantly to morbidity and mortality in these patients.

A new approach to heart valve tissue engineering

DEFF Research Database (Denmark)

Kaasi, Andreas; Cestari, Idágene A.; Stolf, Noedir A G.

2011-01-01

The 'biomimetic' approach to tissue engineering usually involves the use of a bioreactor mimicking physiological parameters whilst supplying nutrients to the developing tissue. Here we present a new heart valve bioreactor, having as its centrepiece a ventricular assist device (VAD), which exposes...... chamber. Subsequently, applied vacuum to the pneumatic chamber causes the blood chamber to fill. A mechanical heart valve was placed in the VAD's inflow position. The tissue engineered (TE) valve was placed in the outflow position. The VAD was coupled in series with a Windkessel compliance chamber...

Factors associated with anti-human leukocyte antigen antibodies in patients supported with continuous-flow devices and effect on probability of transplant and post-transplant outcomes

DEFF Research Database (Denmark)

Alba, Ana C; Tinckam, Kathryn; Foroutan, Farid

2015-01-01

BACKGROUND: One major disadvantage of ventricular assist device (VAD) therapy is the development of human-leukocyte antigen (HLA) antibodies. We aimed to identify factors associated with HLA antibodies during continuous flow (CF)-VAD support and assess the effect on transplant probability...

Pathology in patients with ventricular assist devices: a study of 21 autopsies, 24 ventricular apical core biopsies and 24 explanted hearts.

Science.gov (United States)

Rose, Alan G; Park, Soon J

2005-01-01

Ventricular assist devices (VADs) are used as a bridge to cardiac transplantation or as a permanent or sometimes temporary treatment for end stage heart failure. Our autopsy and surgical pathology experience with VADs prior to August 2002 was reviewed. Noted were patient's age, sex, underlying (UCOD) and proximate causes of death (PCOD), duration of VAD implantation, presence of native or prosthetic valvar disease and organ complications. Myocardium from biopsies and explanted hearts were blindly assessed for coagulative necrosis (CN), contraction bands (CB), myocytolysis (MC), increased eosinophilia (IE), myocyte waviness (MW) and fibrosis (F). Each was graded as either mild (score 1), moderate (score 2) or severe (score 3). Autopsy patients: Twenty-one patients, with mean age 55 years (range 10-73), comprised 10 women and 11 men. UCOD was ischemic disease in 16 patients, dilated cardiomyopathy in 4 and aortic valve disease in 1. The mean duration of VAD implantation was 125.7 days (range 1-1095 days, S.D.=253.6). Five patients had biventricular VADs, and 16 had LVAD only. Acquired aortic valve fusion was noted in three patients. PCOD was VAD related in six, donor heart problem in four, cerebrovascular accident in four, miscellaneous in three, pulmonary hypertension in two and aortic disease in two patients. Morbidity: local liver necrosis in seven, acquired aortic valve disease in four, gut infarction in three, abdominal aortic aneurysm in two and host cell assault against VAD porcine aortic valves in one case. Biopsies and explanted hearts: Twenty-four patients had a mean age of 53 years (range 38-68, S.D.=8.6). VADs were implanted for 177.8 days (range 7-593 days, S.D.=151.1). Comparison of histologic scores of biopsies with explanted hearts showed the following: CN 1.33 (S.D.=1.4)/0.21 (S.D.=0.66; P<.001); CB: 2.1 (S.D.=0.93)/0.83 (S.D.=0.28; NS); MC: 0.88 (S.D.=1.19)/0.13 (S.D.=0.34; P<.01); IE: 1.71 (S.D.=1.27)/0.38 (S.D.=0.65; NS); fibrosis: 1.08 (S.D.=1

Hemodynamic Effects of Ventricular Assist Device Implantation on Norwood, Glenn, and Fontan Circulation: A Simulation Study.

Science.gov (United States)

Di Molfetta, Arianna; Amodeo, Antonio; Gagliardi, Maria G; Trivella, Maria G; Fresiello, Libera; Filippelli, Sergio; Toscano, Alessandra; Ferrari, Gianfranco

2016-01-01

The growing population of failing single-ventricle (SV) patients might benefit from ventricular assist device (VAD) support as a bridge to heart transplantation. However, the documented experience is limited to isolated case reports. Considering the complex and different physiopathology of Norwood, Glenn, and Fontan patients and the lack of established experience, the aim of this work is to realize and test a lumped parameter model of the cardiovascular system able to simulate SV hemodynamics and VAD implantation effects to support clinical decision. Hemodynamic and echocardiographic data of 30 SV patients (10 Norwood, 10 Glenn, and 10 Fontan) were retrospectively collected and used to simulate patients' baseline. Then, the effects of VAD implantation were simulated. Simulation results suggest that the implantation of VAD: (i) increases the cardiac output and the mean arterial systemic pressure in all the three palliation conditions (Norwood 77.2 and 19.7%, Glenn 38.6 and 32.2%, and Fontan 17.2 and 14.2%); (ii) decreases the SV external work (Norwood 55%, Glenn 35.6%, and Fontan 41%); (iii) decreases the pressure pulsatility index (Norwood 65.2%, Glenn 81.3%, and Fontan 64.8%); (iv) increases the pulmonary arterial pressure in particular in the Norwood circulation (Norwood 39.7%, Glenn 12.1% and Fontan 3%); and (v) decreases the atrial pressure (Norwood 2%, Glenn 10.6%, and Fontan 8.6%). Finally, the VAD work is lower in the Norwood circulation (30.4 mL·mm Hg) in comparison with Fontan (40.3 mL·mm Hg) and to Glenn (64.5 mL·mm Hg) circulations. The use of VAD in SV physiology could be helpful to bridge patients to heart transplantations by increasing the CO and unloading the SV with a decrement of the atrial pressure and the SV external work. The regulation of the pulmonary flow is challenging because the Pap is increased by the presence of VAD. The hemodynamic changes are different in the different SV palliation step. The use of numerical models

Determinants of vitamin a deficiency in children between 6 months and 2 years of age in Guinea-Bissau

DEFF Research Database (Denmark)

Danneskiold-Samsøe, Niels; Fisker, Ane Bærent; Jørgensen, Mathias Jul

2013-01-01

The World Health Organization (WHO) classifies Guinea-Bissau as having severe vitamin A deficiency (VAD). To date, no national survey has been conducted. We assessed vitamin A status among children in rural Guinea-Bissau to assess status and identify risk factors for VAD....

Interactions of vitamin A and iodine deficiencies: effects on the pituitary-thyroid axis

NARCIS (Netherlands)

Zimmermann, M.B.

2007-01-01

Vitamin A (VA) deficiency (VAD) and the iodine deficiency disorders (IDD) affect > 30% of the global population and these deficiencies often coexist in vulnerable groups. VAD has multiple effects on the pituitary-thyroid axis; VA status modulates thyroid gland metabolism, peripheral metabolism of

The Total Artificial Heart in End-Stage Congenital Heart Disease.

Science.gov (United States)

Villa, Chet R; Morales, David L S

2017-01-01

The development of durable ventricular assist devices (VADs) has improved mortality rates and quality of life in patients with end stage heart failure. While the use of VADs has increased dramatically in recent years, there is limited experience with VAD implantation in patients with complex congenital heart disease (CHD), despite the fact that the number of patients with end stage CHD has grown due to improvements in surgical and medical care. VAD use has been limited in patients with CHD and end stage heart failure due to anatomic (systemic right ventricle, single ventricle, surgically altered anatomy, valve dysfunction, etc.) and physiologic constraints (diastolic dysfunction). The total artificial heart (TAH), which has right and left sided pumps that can be arranged in a variety of orientations, can accommodate the anatomic variation present in CHD patients. This review provides an overview of the potential use of the TAH in patients with CHD.

Big data and data repurposing - using existing data to answer new questions in vascular dementia research.

Science.gov (United States)

Doubal, Fergus N; Ali, Myzoon; Batty, G David; Charidimou, Andreas; Eriksdotter, Maria; Hofmann-Apitius, Martin; Kim, Yun-Hee; Levine, Deborah A; Mead, Gillian; Mucke, Hermann A M; Ritchie, Craig W; Roberts, Charlotte J; Russ, Tom C; Stewart, Robert; Whiteley, William; Quinn, Terence J

2017-04-17

Traditional approaches to clinical research have, as yet, failed to provide effective treatments for vascular dementia (VaD). Novel approaches to collation and synthesis of data may allow for time and cost efficient hypothesis generating and testing. These approaches may have particular utility in helping us understand and treat a complex condition such as VaD. We present an overview of new uses for existing data to progress VaD research. The overview is the result of consultation with various stakeholders, focused literature review and learning from the group's experience of successful approaches to data repurposing. In particular, we benefitted from the expert discussion and input of delegates at the 9 th International Congress on Vascular Dementia (Ljubljana, 16-18 th October 2015). We agreed on key areas that could be of relevance to VaD research: systematic review of existing studies; individual patient level analyses of existing trials and cohorts and linking electronic health record data to other datasets. We illustrated each theme with a case-study of an existing project that has utilised this approach. There are many opportunities for the VaD research community to make better use of existing data. The volume of potentially available data is increasing and the opportunities for using these resources to progress the VaD research agenda are exciting. Of course, these approaches come with inherent limitations and biases, as bigger datasets are not necessarily better datasets and maintaining rigour and critical analysis will be key to optimising data use.

Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age

NARCIS (Netherlands)

Imdad, Aamer; Herzer, Kurt; Mayo-Wilson, Evan; Yakoob, Mohammad Yawar; Bhutta, Zulfiqar A.

2010-01-01

Background Vitamin A deficiency (VAD) is a major public health problem in low and middle income countries affecting 190 million children under 5. VAD can lead to many adverse health consequences, including death. Objectives To evaluate the effect of vitamin A supplementation (VAS) for preventing

Voice acoustic patterns of patients diagnosed with vibroacoustic disease

Directory of Open Access Journals (Sweden)

Ana Mendes

2006-07-01

Full Text Available Background: Long-term low frequency noise exposure (LFN (≤ 500 Hz, including infrasound may lead to the development of vibroacoustic disease (VAD, a systemic pathology characterized by the abnormal growth of extra-cellular matrices. The respiratory system is a target for LFN. Fibrosis of the respiratory tract epithelia was observed in VAD patients through biopsy, and confirmed in animal models exposed to LFN. Voice acoustic analysis can detect vocal fold variations of mass, tension, muscular and neural activity. Frequency perturbation (jitter, amplitude perturbation (shimmer and harmonicto- noise ratio (HNR are used in the evaluation of the vocal function, and can be indicators of the presence and degree of severity of vocal pathology. Since the respiratory system is the energy source of the phonation process, this raises questions about the effects of VAD on voice production. The purpose of this study was to determine if voice acoustic parameters of VAD patients are different from normative data. Methods: Nine individuals (5 males and 4 females diagnosed with VAD were recorded performing spoken and sung tasks. The spoken tasks included sustaining vowels and fricatives. The sung tasks consisted of maximum phonational frequency range (MPFR. Voice acoustic parameters analysed were: fundamental frequency (F0, jitter, shimmer, HNR and temporal measures. Results: Compared with normative data, both males and females diagnosed with VAD exhibited increased F0, shimmer and HNR. Jitter, MPFR and one temporal measure were reduced. Conclusions: VAD individuals presented voice acoustic parameter differences in spectral, temporal and perturbation measures, which may be indicative of small morphological changes in the phonatory system. Resumo: Enquadramento: A exposição crónica ao ruído de baixa frequência (RBF (≤ 500 Hz, incluindo infra-sons pode conduzir ao desenvolvimento da doença vibroacústica (VAD �

Padrões acústicos da voz em indivíduos com a doença vibroacústica

Directory of Open Access Journals (Sweden)

Ana Mendes

2006-07-01

Full Text Available Resumo: Enquadramento: A exposição crónica ao ruído de baixa frequência (RBF (≤ 500 Hz, incluindo infra-sons pode conduzir ao desenvolvimento da doença vibroacústica (VAD – vibroacoustic disease, uma patologia sistémica caracterizada pela proliferação anormal das matrizes extracelulares. O aparelho respiratório é alvo do RBF, como foi observado em doentes com VAD através de biópsia e confirmado com modelos animais expostos a RBF, sendo um dos aspectos mais evidentes a fibrose intersticial da traqueia. A análise acústica vocal pode detectar pequenas variações na massa, tensão, actividade muscular e neuronal das pregas vocais através de parâmetros como frequência fundamental (F0, jitter, shimmer e índice harmónico-ruído (H/R. Dado que o sistema respiratório é a fonte de energia do processo fonatório, e sabendo das alterações morfológicas na traqueia dos doentes com VAD, pode perguntar-se quais os efeitos destas alterações na voz.O objectivo deste estudo foi determinar se os parâmetros acústicos dos doentes com VAD diferem dos dados normativos. Métodos: Nove indivíduos diagnosticados com a VAD (5 homens e 4 mulheres foram gravados durante a produção de tarefas fonatórias e foram efectuadas as análises acústicas vocais. Resultados: Os doentes com a VAD apresentaram valores elevados de F0, shimmer e H/R e valores reduzidos de jitter e extensão máxima de frequência vocal. Conclusões: Os doentes com a VAD, quando comparados com dados normativos, apresentaram diferentes parâmetros acústicos vocais, espectrais e de perturbação, podendo indicar alterações morfológicas no sistema fonatório.Rev Port Pneumol 2006; XII (4: 375-382 Abstract: Background: Long-term low frequency noise exposure (LFN (≤ 500 Hz, including infrasound may lead to the development of vibroacoustic disease

Ventricular assist device use in single ventricle congenital heart disease.

Science.gov (United States)

Carlo, Waldemar F; Villa, Chet R; Lal, Ashwin K; Morales, David L

2017-11-01

As VAD have become an effective therapy for end-stage heart failure, their application in congenital heart disease has increased. Single ventricle congenital heart disease introduces unique physiologic challenges for VAD use. However, with regard to the mixed clinical results presented within this review, we suggest that patient selection, timing of implant, and center experience are all important contributors to outcome. This review focuses on the published experience of VAD use in single ventricle patients and details physiologic challenges and novel approaches in this growing pediatric and adult population. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of Lactobacillus plantarum TWK10-Fermented Soymilk on Deoxycorticosterone Acetate-Salt-Induced Hypertension and Associated Dementia in Rats

Directory of Open Access Journals (Sweden)

Te-Hua Liu

2016-05-01

Full Text Available Oxidative stress resulting from excessive production of reactive oxygen species is the major mediator of neuronal cell degeneration observed in neurodegenerative diseases, such as Alzheimer’s disease (AD and vascular dementia (VaD. Additionally, hypertension has been shown to be a positive risk factor for VaD. Therefore, the objective of this study was to investigate the effects of Lactobacillus plantarum strain TWK10 (TWK10-fermented soymilk on the protection of PC-12 cells in H2O2-, oxygen-glucose deprivation (OGD- and deoxycorticosterone acetate (DOCA-salt-induced rat models of VaD. Notably, the viabilities of H2O2-treated PC-12 cells and OGD model were significantly increased by treatment with TWK10-fermented soymilk ethanol extract (p < 0.05. In addition, oral administration of TWK10-fermented soymilk extract in DOCA-salt hypertension-induced VaD rats resulted in a significant decrease in blood pressure (p < 0.05, which was regulated by inhibiting ACE activity and promoting NO production, in addition to decreased escape latency and increased target crossing (p < 0.05. In conclusion, these results demonstrated that TWK10-fermented soymilk extract could improve learning and memory in DOCA-salt hypertension-induced VaD rats by acting as a blood pressure-lowering and neuroprotective agent.

Vitamin A Repletion in rats with concurrent vitamin A and iodine deficiency affects pituitary THS {beta} gene expression and reduces thyroid hyperstimulation and thyroid size

NARCIS (Netherlands)

Biebinger, R.; Arnold, M.; Langhans, W.; Hurrell, R.F.; Zimmermann, M.B.

2007-01-01

Concurrent vitamin A (VA) deficiency (VAD) and iodine deficiency (ID) are common in developing countries. VAD has effects on thyroid metabolism that may be dependent on iodine status. The aim of this study was to investigate the effect of VA supplementation (VAS) and/or dietary iodine repletion,

Cardiovascular risk factors in cognitively impaired nursing home patients: A relationship with pain?

NARCIS (Netherlands)

Achterberg, W.P.; Scherder, E.J.A.; Pot, A.M.; Ribbe, M.W.

2007-01-01

Cardiovascular risk factors (CRF) such as hypertension and diabetes mellitus favour the development of both vascular dementia (VaD) and Alzheimer’s disease (AD). The resulting deafferentation may increase the experience of pain in VaD and in AD. The goal of the present study was to examine the

76 FR 36548 - Circulatory System Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting

Science.gov (United States)

2011-06-22

... information related to the humanitarian device exemption for the Berlin Heart EXCOR Pediatric Ventricular Assist Device (VAD) sponsored by Berlin Heart, Inc. The Berlin Heart EXCOR Pediatric VAD device is a..., please contact AnnMarie Williams, Conference Management Staff, at 301-796-5966, at least 7 days in...

Vascular dementia | Connor | African Journal of Psychiatry

African Journals Online (AJOL)

Vascular dementia (VaD) is a common but heterogeneous condition in which there is a clear temporal relationship between the dementia and vascular disease. It may result from multiple large or small vessel strokes or a single strategic stroke. Subcortical ischaemic VaD includes multiple lacunes and subcortical ...

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Indian Academy of Sciences (India)

- ford University, USA, Claude Cohen-Tannoudji of College de France and Ecole. Normale Superieure, France and William D Phillips of the National Institute of. Standards and Technology, Maryland, USA for development of methods to cool.

Social withdrawal of persons with vascular dementia associated with disturbance of basic daily activities, apathy, and impaired social judgment.

Science.gov (United States)

Honda, Yukiko; Meguro, Kenichi; Meguro, Mitsue; Akanuma, Kyoko

2013-01-01

Patients with vascular dementia (VaD) are often isolated, withdrawn from society because of negative symptoms and functional disabilities. The aim of this study was to detect factors associated with social withdrawal in patients with VaD. The participants were 36 institutionalized patients with VaD. Social withdrawal was assessed with the social withdrawal of the Multidimensional Observation Scale for Elderly Subjects (MOSES). Possible explanatory variables were the MOSES items depression and self-care, Cognitive Abilities Screening Instrument (CASI), apathy evaluation scale (AES), and Behavioral Pathology in Alzheimer's Disease Frequency-Weighted Severity Scale (BEHAVE-AD-FW). Multiple regression analyses were conducted for two groups: Analysis 1 was performed in all patients (N = 36) and Analysis 2 was performed in the patients with the ability to move by themselves (i.e., independent walking or independent movement with a cane or a wheelchair; n = 28). In Analysis 1, MOSES item social withdrawal was correlated with AES and MOSES item self-care. In Analysis 2, MOSES item social withdrawal was correlated with AES and CASI domain abstraction and judgment. Decreased social activities of VaD were not related to general cognitive function or depression. Disturbed activities of daily living (ADLs) for self-care may involve decreased frontal lobe function, indicating that comprehensive rehabilitation for both ADL and dementia are needed to improve the social activities of patients with VaD.

Vitamin D status and vascular dementia due to cerebral small vessel disease in the elderly Asian Indian population.

Science.gov (United States)

Prabhakar, Puttachandra; Chandra, Sadanandavalli Retnaswami; Supriya, Manjunath; Issac, Thomas Gregor; Prasad, Chandrajit; Christopher, Rita

2015-12-15

Vitamin D plays vital roles in human health and recent studies have shown its beneficial effect on brain functioning. The present study was designed to evaluate the association of vitamin D with vascular dementia (VaD) due to cerebral small vessel disease (SVD) in Asian Indian population. 140 VaD patients aged ≥ 60 years with neuroimaging evidence of SVD, and 132 age and gender-matched controls, were investigated. Vitamin D status was estimated by measuring serum 25-hydroxy vitamin D. Logistic regression model revealed that deficient levels of vitamin D (vitamin D deficiency and insufficiency (12-20 ng/ml), the odds were increased to 31.6-fold and 14.4-fold, respectively. However, in hypertensives with vitamin D sufficiency (>20 ng/ml), the odds of VaD were increased by 3.8-fold only. Pearson correlation showed that serum vitamin D was inversely associated with systolic and diastolic blood pressure (r=-0.401 and -0.411, pvitamin D-deficient subjects. Since the combined presence of hypertension and vitamin D deficiency increases the probability of developing VaD, screening for vitamin D status in addition to regular monitoring of blood pressure, could reduce the risk of VaD associated with cerebral SVD in the elderly Asian Indian subjects. Copyright © 2015 Elsevier B.V. All rights reserved.

Neuroprotective Effects of Clostridium butyricum against Vascular Dementia in Mice via Metabolic Butyrate

Directory of Open Access Journals (Sweden)

Jiaming Liu

2015-01-01

Full Text Available Probiotics actively participate in neuropsychiatric disorders. However, the role of gut microbiota in brain disorders and vascular dementia (VaD remains unclear. We used a mouse model of VaD induced by a permanent right unilateral common carotid arteries occlusion (rUCCAO to investigate the neuroprotective effects and possible underlying mechanisms of Clostridium butyricum. Following rUCCAO, C. butyricum was intragastrically administered for 6 successive weeks. Cognitive function was estimated. Morphological examination was performed by electron microscopy and hematoxylin-eosin (H&E staining. The BDNF-PI3K/Akt pathway-related proteins were assessed by western blot and immunohistochemistry. The diversity of gut microbiota and the levels of butyrate in the feces and the brains were determined. The results showed that C. butyricum significantly attenuated the cognitive dysfunction and histopathological changes in VaD mice. C. butyricum not only increased the levels of BDNF and Bcl-2 and decreased level of Bax but also induced Akt phosphorylation (p-Akt and ultimately reduced neuronal apoptosis. Moreover, C. butyricum could regulate the gut microbiota and restore the butyrate content in the feces and the brains. These results suggest that C. butyricum might be effective in the treatment of VaD by regulating the gut-brain axis and that it can be considered a new therapeutic strategy against VaD.

Vitamin A Deficiency Due to Selective Eating as a Cause of Blindness in a High-Income Setting.

Science.gov (United States)

Martini, Silvia; Rizzello, Angela; Corsini, Ilaria; Romanin, Benedetta; Fiorentino, Michelangelo; Grandi, Sara; Bergamaschi, Rosalba

2018-04-01

Vitamin A is a fat-soluble micronutrient involved in the regulation of several physiologic functions, such as visual acuity, epithelial tissue integrity, immune response, and gene expression, thus playing a crucial role in childhood growth and development. Although vitamin A deficiency (VAD) in resource-limited settings is still an actual issue and represents the leading cause of preventable childhood blindness, its occurrence in high-income countries is rare, although possibly underdiagnosed because of its nonspecific early manifestations. A good awareness of VAD symptoms and risk factors could aid its early diagnosis, which is fundamental to undertake a prompt treatment and to prevent ocular complications. Nevertheless, the role of restrictive dietary habits, increasingly common in developed countries, is often overlooked in infants and children. We present a case of VAD with permanent ocular sequelae in a 5-year-old girl from a high-income country. In the case described, VAD ensued from a highly restricted diet, mainly limited to oat milk, which had been followed for more than 2 years. This child presented with ocular symptoms, opportunistic infection, anemia, poor growth, and a diffuse squamous metaplasia of the bladder; after commencing retinol supplementation, a gradual healing of clinical VAD manifestations occurred, with the exception of the ocular sequelae, which resulted in irreversible visual loss. Copyright © 2018 by the American Academy of Pediatrics.

Experience of a patient with an extracorporeal ventricular assist system who participated in a sleepover program.

Science.gov (United States)

Gon, Shigeyoshi; Suematsu, Yoshihito; Morizumi, Sei; Shimizu, Tsuyoshi

2011-09-01

A 19-year-old woman suffered fulminant myocarditis owing to a mycoplasma infection and was inserted with an intra-aortic balloon pump and a percutaneous cardiopulmonary support. Antibiotics and gamma globulin were administered, however, the patient's cardiac function did not recover, and the TOYOBO ventricular assist device (VAD) was implanted. She had rehabilitation training such as maintaining a standing position at the bedside and walking in the hospital, and a hospital outing program to a family restaurant was conducted two times with the VAD. The patient wished to attend the coming-of-age ceremony in Tachikawa city, which is 3 h away from our hospital by car. Therefore, we planned the program including a night stay at her home. The patient and her family fully understood the risks and wished to participate in the sleepover program. In preparing for the sleepover, the patient and her family learned to operate the VAD, and she was able to move to the lavatory and through the house with the help of only her family. A physician and a clinical engineer stayed at her house for infusion of antibiotics and management of sudden changes. There was no adverse event. In Japan, the community support of patients with VAD is not yet established, and we hope that our experience becomes a help to support return to society for patients with VAD.

Dynamics of micromechanisms controlling the mechanical ...

Indian Academy of Sciences (India)

R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

Nickel base superalloys are meant for applications requiring high strength and high temper- .... To enter this channel the matrix mobile dislocation ..... Thesis,. Paris Ecole Sup`erieure des Mines, Paris. Benyoucef M, Clement N, Coujou A 1995 ...

p-Adic valuation of the Morgan–Voyce sequence and p-regularity

Indian Academy of Sciences (India)

Adic valuation of ... USTHB/Faculty of Mathematics, LATN Laboratory, DG-RSDT, BP 32, El Alia, 16111, Bab Ezzouar, Algiers, Algeria; Ecole nationale Superieure d Informatique (ESI), BP 68M Oued Smar, 16270, El Harrach, Algiers, Algeria ...

Investigation of a potential scintigraphic marker of apoptosis: radioiodinated Z-Val-Ala-DL-Asp(O-methyl)-fluoromethyl ketone

Energy Technology Data Exchange (ETDEWEB)

Haberkorn, Uwe E-mail: uwe_haberkorn@med.uni-heidelberg.de; Kinscherf, Ralf; Krammer, Peter H.; Mier, Walter; Eisenhut, Michael

2001-10-01

The imaging of apoptosis represents an attractive diagnostic goal in the area of tumor therapy, degenerative diseases and organ transplantation. Since caspases play a key role during the early period of the intracellular signal cascade of cells undergoing apoptosis we considered benzyloxycarbonyl-Val-Ala-DL-Asp(O-methyl)-fluoromethyl ketone [Z-VAD-fmk], a pan-caspase inhibitor, as a potential apoptosis imaging agent. Applying the Tl(TFA){sub 3}/[{sup 131}I]iodide method Z-VAD-fmk was successfully labeled at the benzyloxycarbonyl protecting group. The success of radioiodination, however, depended on the presence of carrier iodide resulting in specific radioactivities of 2.6 GBq/{mu}mol and the formation of a mixture of the 2- and 4-iodophenyl derivative (61%) which could not be separated by HPLC. Uptake measurements were performed with Morris hepatoma cells (MH3924Atk8) which showed expression of the Herpes Simplex Virus thymidine kinase (HSVtk) gene. Apoptosis was induced by treatment of the cells with 25 {mu}M ganciclovir. The TUNEL assay revealed 1.3{+-}0.3 and 23{+-}1.1% apoptotic cells immediately and 24 h after therapy, respectively. A two-fold increase of [{sup 131}I]IZ-VAD-fmk uptake was found at the end of treatment with the HSVtk/suicide system which constantly remained elevated for the following 4 hours. The slow cellular influx and lack of uptake saturation of [{sup 131}I]IZ-VAD-fmk are evidence for simple diffusion as transport mechanism. In addition, the absolute cellular uptake of [{sup 131}I]IZ-VAD-fmk was found to be low. This quality was related to the rather high lipophilicity of [{sup 131}I]IZ-VAD-fmk causing unspecific binding to macromolecules in the medium. Instead of using an inhibitor, synthetic caspase substrates are currently investigated which may accumulate in the apoptotic cell by metabolic trapping thereby enhancing the imaging signal.

Cancers of the lung, head and neck on the rise: perspectives on the genotoxicity of air pollution

Science.gov (United States)

Wong, Ian Chi Kei; Ng, Yuen-Keng; Lui, Vivian Wai Yan

2014-01-01

Outdoor air pollution has been recently classified as a class I human carcinogen by the World Health Organization (WHO). Cumulative evidence from across the globe shows that polluted air is associated with increased risk of lung, head and neck, and nasopharyngeal cancers—all of which affect the upper aerodigestive tract. Importantly, these cancers have been previously linked to smoking. In this article, we review epidemiologic and experimental evidence of the genotoxic and mutagenic effects of air pollution on DNA, purportedly a key mechanism for cancer development. The alarming increase in cancers of the upper aerodigestive tract in Asia suggests a need to focus government efforts and research on reducing air pollution, promoting clean energy, and investigating the carcinogenic effects of air pollution on humans. PMID:25011457

Biznesa efektivitātes uzlabošanas iespējas uzņēmumā SIA "3K MANAGEMENT"

OpenAIRE

Penēze, Aija

2015-01-01

Aizvien lielāka nozīmē mūsdienās tiek pievērsta atšķirībai starp uzņēmumu vadīšanu un efektīvu uzņēmumu vadīšanu. Uzņēmēji organizācijas vadīšanā savu uzmanību koncentrē uz to, kā uzņēmums preces un pakalpojumus piedāvā, kāds ir tā tēls, kā tiek organizēta uzņēmuma darbība un kultūra. Uzņēmumi arvien vairāk vērš uzmanību uz uzņēmumu vadīšanu ar pievienoto vērtību, tas ir, efektivitātes uzlabošanu. Aijas Penēzes maģistra darba tēma ir „Biznesa efektivitātes uzlabošanas iespējas uzņēmumā SI...

Is Alzheimer's disease a homogeneous disease entity?

Science.gov (United States)

Korczyn, Amos D

2013-10-01

The epidemic proportions of dementia in old age are a cause of great concern for the medical profession and the society at large. It is customary to consider Alzheimer's disease (AD) as the most common cause of dementia, and vascular dementia (VaD) as being the second. This dichotomous view of a primary neurodegenerative disease as opposed to a disorder where extrinsic factors cause brain damage led to separate lines of research in these two entities. New biomarkers, particularly the introduction of modern neuroimaging and cerebrospinal fluid changes, have, in recent years, helped to identify anatomical and chemical changes of VaD and of AD. Nevertheless, there is a substantial difference between the two entities. While it is clear that VaD is a heterogeneous entity, AD is supposed to be a single disorder. Nobody attempts to use CADASIL as a template to develops treatment for sporadic VaD. On the other hand, early-onset AD is used to develop therapy for sporadic AD. This paper will discuss the problems relating to this false concept and its consequences.

Recanalisation of spontaneously occluded vertebral artery dissection after subarachnoid haemorrhage.

Science.gov (United States)

Akiyama, Takenori; Onozuka, Satoshi; Horiguchi, Takashi; Yoshida, Kazunari

2012-10-01

Spontaneous occlusion is a rare manifestation of ruptured vertebral artery dissection (VAD). Its natural history and treatment strategy have yet to be established due to its rarity. Here, we report five lesions involving spontaneous occlusion of VAD after subarachnoid haemorrhage, among which three lesions showed recanalisation. Based on our experience and previous reports, spontaneous occlusion of ruptured VAD can be classified into two groups-one group with occlusion in the acute stage with a high incidence of recanalisation and another group with occlusion in the chronic stage with a relatively low incidence of recanalisation. The underlying mechanism is likely different in each group, and treatment strategies should also be tailored depending on the pathophysiology.

Clinical effectiveness and cost-effectiveness of second- and third-generation left ventricular assist devices as either bridge to transplant or alternative to transplant for adults eligible for heart transplantation: systematic review and cost-effectiveness model.

Science.gov (United States)

Sutcliffe, P; Connock, M; Pulikottil-Jacob, R; Kandala, N-B; Suri, G; Gurung, T; Grove, A; Shyangdan, D; Briscoe, S; Maheswaran, H; Clarke, A

2013-11-01

Advanced heart failure (HF) is a debilitating condition for which heart transplant (HT) offers the best treatment option. However, the supply of donor hearts is diminishing and demand greatly exceeds supply. Ventricular assist devices (VADs) are surgically implanted pumps used as an alternative to transplant (ATT) or as a bridge to transplant (BTT) while a patient awaits a donor heart. Surgery and VADs are costly. For the NHS to allocate and deliver such services in a cost-effective way the relative costs and benefits of these alternative treatments need to be estimated. To investigate for patients aged ≥ 16 years with advanced HF eligible for HT: (1) the clinical effectiveness and cost-effectiveness of second- and third-generation VADs used as BTT compared with medical management (MM); and (2) the clinical effectiveness and cost-effectiveness of second- and third-generation VADs used as an ATT in comparison with their use as BTT therapy. Searches for clinical effectiveness studies covered years from 2003 to March 2012 and included the following data bases: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), HTA databases [NHS Centre for Reviews and Dissemination (CRD)], Science Citation Index and Conference Proceedings (Web of Science), UK Clinical Research Network (UKCRN) Portfolio Database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and National Library of Medicine (NLM) Gateway, Cochrane Central Register of Controlled Trials (CENTRAL), Current Controlled Trials and ClinicalTrials.gov. Reference lists of relevant articles were checked, and VAD manufacturers' websites interrogated. For economic analyses we made use of individual patient data (IPD) held in the UK Blood and Transplant Database (BTDB). Systematic reviews of evidence on clinical effectiveness and cost

Vitamin A deficiency and anemia among children 12-71 months old in Honduras

Directory of Open Access Journals (Sweden)

Penelope Nestel

1999-07-01

Full Text Available Vitamin A deficiency (VAD and iron deficiency anemia (IDA have been recognized as public health problems in Honduras for over 30 years. This paper, based on the 1996 National Micro nutrient Survey on 1 678 children 12–71 months of age, presents the results for vitamin A status and anemia prevalence, as well as the level of vitamin A in sugar at the household level. The results showed that 14% of the children were subclinically vitamin A deficient (plasma retinol < 20 µg/dL and 32% were at risk of VAD (plasma retinol 20–30 µg/dL. These data indicate that VAD is a moderate public health problem in Honduras. Logistic regression analysis showed that children 12–23 months old living in areas other than the rural south of the country were at greatest risk of subclinical VAD. Infection, indicated by an elevated alpha-1-acid-glycoprotein level, increased the risk of subclinical VAD more than three-fold. Children from households that obtained water from a river, stream, or lake were at twice the risk of subclinical VAD compared with other children. That same doubled risk was found for children from a household with an outside toilet. VAD can be controlled by fortifying sugar. Retinol levels in sugar at the household level were about 50% of those mandated by Honduran law. There appears to be significant leakage of unfortified sugar into the market. This is particularly true in the rural north, where 33% of samples contained no retinol. Overall, 30% of children were anemic (Hb < 11 g/dL. Logistic regression analysis showed that children whose fathers lived with them but who had not attended at least grade 4 of primary school were at 33% greater risk of being anemic. Infection and being underweight increased the risk of being anemic by 51% and 21%, respectively. Many of the anemic children had not been given iron supplements, suggesting health care providers may not be aware that anemia is widespread among young children and/or know how to diagnose it.

Association between air pollutants and dementia risk in the elderly.

Science.gov (United States)

Wu, Yun-Chun; Lin, Yuan-Chien; Yu, Hwa-Lung; Chen, Jen-Hau; Chen, Ta-Fu; Sun, Yu; Wen, Li-Li; Yip, Ping-Keung; Chu, Yi-Min; Chen, Yen-Ching

2015-06-01

The aging rate in Taiwan is the second highest in the world. As the population ages quickly, the prevalence of dementia increases rapidly. There are some studies that have explored the association between air pollution and cognitive decline, but the association between air pollution and dementia has not been directly evaluated. This was a case-control study comprising 249 Alzheimer's disease (AD) patients, 125 vascular dementia (VaD) patients, and 497 controls from three teaching hospitals in northern Taiwan from 2007 to 2010. Data of particulate matter Bayesian maximum entropy was used to estimate the individual exposure level of air pollutants, which was then tertiled for analysis. Conditional logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals between the association of PM10 and ozone exposure with AD and VaD risk. The highest tertile of PM10 (≥49.23 μg/m(3)) or ozone (≥21.56 ppb) exposure was associated with increased AD risk (highest vs. lowest tertile of PM10: AOR = 4.17; highest vs. lowest tertile of ozone: AOR = 2.00). Similar finding was observed for VaD. The association with AD and VaD risk remained for the highest tertile PM10 exposure after stratification by APOE ɛ4 status and gender. Long-term exposure to the highest tertile of PM10 or ozone was significantly associated with an increased risk of AD and VaD.

Isolation of Antidiabetic Principle from Fruit Rinds of Punica granatum

Directory of Open Access Journals (Sweden)

Vishal Jain

2012-01-01

Full Text Available Present study was aimed to isolate and evaluate the antidiabetic activity of phytoconstituents from fruit rinds of Punica granatum. With the above objectives Valoneic acid dilactone (VAD was isolated from methanolic fruit rind extracts of Punica granatum (MEPG and confirmed by 1H-NMR, 13C-NMR, and mass spectral data. Antidiabetic activity was evaluated by Aldose reductase, α-amylase and PTP1B inhibition assays in in vitro and Alloxan-induced diabetes in rats was used as an in vivo model. In bioactivity studies, MEPG and VAD have showed potent antidiabetic activity in α-amylase, aldose reductase, and PTP1B inhibition assays with IC50 values of 1.02, 2.050, 26.25 μg/mL and 0.284, 0.788, 12.41 μg/mL, respectively. Furthermore, in alloxan-induced diabetes model MEPG (200 and 400 mg/kg, p.o. and VAD (10, 25, and 50 mg/kg, p.o. have showed significant and dose dependent antidiabetic activity by maintaining the blood glucose levels within the normal limits. Inline with the biochemical findings histopathology of MEPG (200 and 400 mg/kg, p.o., VAD (10, 25, and 50 mg/kg, p.o., and glibenclamide (10 mg/kg, p.o. treated animals showed significant protection against alloxan-induced pancreatic tissue damage. These findings suggest that MEPG and VAD possess significant antidiabetic activity in both in vitro and in vivo models.

[Prevalence of vitamin a deficiency and anemia in children under five years of age in Peru].

Science.gov (United States)

Pajuelo, Jaime; Miranda, Marianella; Zamora, Rosa

2015-01-01

To determine the prevalence of vitamin A deficiency (VAD) and nutritional anemia (NA) in children under five in Peru. Cross-sectional study with a stratified and multi-staged probabilistic sample conducted between November 2007 and April 2010.2,736 children were included for NA and 1,465 children for VAD. NA was defined as Hb<11 g/dL.VAD was identified by serum retinol levels <20 µg/dL. Sociodemographic variables related to the child and the mother were studied in addition to their participation in growth control and development programs, integrated nutrition program and supplementation with iron and vitamin A. Analysis of complex samples was performed, descriptive statistics and logistic regression with 95% confidence intervals and a significance level of p<0.05 were calculated. The prevalence of VAD was 11.7% (95% CI: 9.4 to 14.4). The highest prevalences were in children under five months (44.6%) and those living in rural areas (19.5%). The prevalence of NA was 33% (95% CI: 29.9 to 36.1) and was higher in children under 11 months (68.2%) and children of mothers aged 13-19 years old (55.4 %). VAD is a public health problem that remains, with the most affected children living in rural areas and in the jungle. The prevalence of NA shows a slight improvement. It is necessary to improve the efficiency and impact of programs that include supplementation of vitamin A and iron.

Vitamin D, Homocysteine, and Folate in Subcortical Vascular Dementia and Alzheimer Dementia.

Science.gov (United States)

Moretti, Rita; Caruso, Paola; Dal Ben, Matteo; Conti, Corrado; Gazzin, Silvia; Tiribelli, Claudio

2017-01-01

Dementia is a worldwide health problem which affects millions of patients; Alzheimer's disease (AD) and subcortical vascular dementia (sVAD) are the two most frequent forms of its presentation. As no definite therapeutic options have been discovered, different risk factors for cognitive impairment have been searched for potential therapies. This report focuses on the possible evidence that vitamin D deficiency and hyper-homocysteinemia can be considered as two important factors for the development or the progression of neurodegenerative or vascular pathologies. To this end, we assessed: the difference in vascular risk factors and vitamin D-OH25 levels among groups of sVAD, AD, and healthy age-matched controls; the association of folate, B12, homocysteine, and vitamin D with sVAD/AD and whether a deficiency of vitamin D and an increment in homocysteine levels may be related to neurodegenerative or vessel damages. The commonly-considered vascular risk factors were collected in 543 patients and compared with those obtained from a healthy old volunteer population. ANOVA group comparison showed that vitamin D deficiency was present in demented cases, as well as low levels of folate and high levels of homocysteine, more pronounced in sVAD cases. The statistical models we employed, with regression models built, and adjustments for biochemical, demographic and neuropsychiatric scores, confirmed the association between the three measures (folate decrease, hyperhomocysteinemia and vitamin D decrease) and dementia, more pronounced in sVAD than in AD.

Isolation of Antidiabetic Principle from Fruit Rinds of Punica granatum

Science.gov (United States)

Jain, Vishal; Viswanatha, G. L.; Manohar, D.; Shivaprasad, H. N.

2012-01-01

Present study was aimed to isolate and evaluate the antidiabetic activity of phytoconstituents from fruit rinds of Punica granatum. With the above objectives Valoneic acid dilactone (VAD) was isolated from methanolic fruit rind extracts of Punica granatum (MEPG) and confirmed by 1H-NMR, 13C-NMR, and mass spectral data. Antidiabetic activity was evaluated by Aldose reductase, α-amylase and PTP1B inhibition assays in in vitro and Alloxan-induced diabetes in rats was used as an in vivo model. In bioactivity studies, MEPG and VAD have showed potent antidiabetic activity in α-amylase, aldose reductase, and PTP1B inhibition assays with IC50 values of 1.02, 2.050, 26.25 μg/mL and 0.284, 0.788, 12.41 μg/mL, respectively. Furthermore, in alloxan-induced diabetes model MEPG (200 and 400 mg/kg, p.o.) and VAD (10, 25, and 50 mg/kg, p.o.) have showed significant and dose dependent antidiabetic activity by maintaining the blood glucose levels within the normal limits. Inline with the biochemical findings histopathology of MEPG (200 and 400 mg/kg, p.o.), VAD (10, 25, and 50 mg/kg, p.o.), and glibenclamide (10 mg/kg, p.o.) treated animals showed significant protection against alloxan-induced pancreatic tissue damage. These findings suggest that MEPG and VAD possess significant antidiabetic activity in both in vitro and in vivo models. PMID:22919408

Quality of Life, Depression, and Anxiety in Ventricular Assist Device Therapy: Longitudinal Outcomes for Patients and Family Caregivers.

Science.gov (United States)

Bidwell, Julie T; Lyons, Karen S; Mudd, James O; Gelow, Jill M; Chien, Christopher V; Hiatt, Shirin O; Grady, Kathleen L; Lee, Christopher S

Patients who receive ventricular assist device (VAD) therapy typically rely on informal caregivers (family members or friends) to assist them in managing their device. The purpose of this study is to characterize changes in person-oriented outcomes (quality of life [QOL], depression, and anxiety) for VAD patients and their caregivers together from pre-implantation to 3 months post-implantation. This was a formal interim analysis from an ongoing prospective study of VAD patients and caregivers (n = 41 dyads). Data on person-oriented outcomes (QOL: EuroQol 5 Dimensions Visual Analog Scale; depression: Patient Health Questionnaire-8; anxiety: Brief Symptom Inventory) were collected at 3 time points (just prior to implantation and at 1 and 3 months post-implantation). Trajectories of change for patients and caregivers on each measure were estimated using latent growth modeling with parallel processes. Patients' QOL improved significantly over time, whereas caregiver QOL worsened. Depression and anxiety also improved significantly among patients but did not change among caregivers. There was substantial variability in change on all outcomes for both patients and their caregivers. This is the first quantitative study of VAD patient-caregiver dyads in modern devices that describes change in person-oriented outcomes from pre-implantation to post-implantation. This work supports the need for future studies that account for the inherent relationships between patient and caregiver outcomes and examine variability in patient and caregiver responses to VAD therapy.

International Journal of Medicine and Health Development - Vol 7 ...

African Journals Online (AJOL)

... Through The Upper Aerodigestive Tract In A Home Accident- A Case Report. ... Design and Construction of Strain Gauge Interface Pressure Transducer for ... Cautionary case of Double Carcinoma Presenting as Acute Abdominal Pain ...

Teaching with "Voix et Images de France"

Science.gov (United States)

Marrow, G. D.

1970-01-01

A report on the classroom use of Voix et Images de France," the French text prepared by the Centre de Recherche et d'Etude pourla Diffusion du Francais (CREDIF) at the Ecole Normale Superieure de Saint-Cloud in France. (FB)

Magkänslans anatomi

DEFF Research Database (Denmark)

Ahlström, Kristoffer

Varför dog 1500 personer i onödan i biltrafiken efter den 11 september 2001? Vad har FBI-agenter gemensamt med barn till alkoholister? Och vad fick författaren George Orwell att börja utöva svart magi? Magkänslans anatomi är en fascinerande kartläggning av de psykologiska mekanismer som ligger...

'A very valuable fusion of classes': British professional and volunteer nurses of the First World War.

Science.gov (United States)

Hallett, Christine E

2014-06-01

Public perceptions of the work of nurses and VAD-volunteers in the First World War have been heavily influenced by a small number of VAD-writings. The work of trained, professional nurses in supporting and supervised the work of VADs has been largely overlooked. This paper examines several of the writings of both volunteers and professionals, and emphasises the overlooked supervisory, managerial and clinical work of trained nurses. In this centenary year of the First World War's opening months, the paper also explores the ways in which the British mass-media--notably the BBC--have chosen to cling to a romantic image of the untrained nurse, whilst at the same time acknowledging the significance of trained, professional nursing. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mechanical circulatory support in pediatrics.

Science.gov (United States)

Steffen, Robert J; Miletic, Kyle G; Schraufnagel, Dean P; Vargo, Patrick R; Fukamachi, Kiyotaka; Stewart, Robert D; Moazami, Nader

2016-05-01

End-stage heart failure affects thousands of children yearly and mechanical circulatory support is used at many points in their care. Extracorporeal membrane oxygenation supports both the failing heart and lungs, which has led to its use as an adjunct to cardiopulmonary resuscitation as well as in post-operative cardiogenic shock. Continuous-flow ventricular assist devices (VAD) have replaced pulsatile-flow devices in adults and early studies have shown promising results in children. The Berlin paracorporeal pulsatile VAD recently gained U.S. Food and Drug Administration approval and remains the only VAD approved in pediatrics. Failing univentricular hearts and other congenitally corrected lesions are new areas for mechanical support. Finding novel uses, improving durability, and minimizing complications are areas of growth in pediatric mechanical circulatory support.

CASE REPORT

African Journals Online (AJOL)

neck just lateral to the vertebral body of cervical spine 3 and 4. (Figure 1, lower part). The patient remained haemodynamically and neurologically stable during his ... definitive management if vascular or aerodigestive injuries were present.

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African Journals Online (AJOL)

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chudiokani@yahoo.com. ABSTRACT. Background:Occult cervical lymph node metastasis is a relatively rare oncologic disease presenting as a neck lump without an obvious mucosal lesion. Most cases arise from the upper aerodigestive tract and.

A cross-sectional study on thyroid status in North Indian elderly outpatients with dementia

Directory of Open Access Journals (Sweden)

Rachna Agarwal

2013-01-01

Full Text Available Background: Several population based studies have demonstrated an association between hypo-or hyperthyroidism and dementia in last two decades. As a consequence, thyroid stimulating hormone has become part of the screening laboratory test for dementia. Aim: The aim of the present study was to evaluate the association between thyroid function and Alzheimer′s disease (AD and vascular dementia (VaD and to determine the risk of AD and VaD in clinically euthyroid patients. Materials and Methods: A cross-sectional hospital based study was carried out in subjects diagnosed with AD/VaD and were assessed for thyroid status as routine screening test. Results: Free T3, free T4 and TSH were studied in 114 AD patients (mean age: 65 years, 35 VaD patients (mean age: 62 years and 105 control subjects (mean age: 62 years. In AD group, TSH levels were significantly lower than controls (P = 0.00 and for each unit increase in TSH level, the odds of having dementia decreased by 37.1%. No such relation was seen in VaD. Conclusion: The results suggest a consistent association of subclinical hyperthyroidism and AD.

Leisure activities, apolipoprotein E e4 status, and the risk of dementia.

Science.gov (United States)

Yang, Sheng-Ying; Weng, Pei-Hsuan; Chen, Jen-Hau; Chiou, Jeng-Min; Lew-Ting, Chih-Yin; Chen, Ta-Fu; Sun, Yu; Wen, Li-Li; Yip, Ping-Keung; Chu, Yi-Min; Chen, Yen-Ching

2015-12-01

Leisure activities have been associated with a decreased risk of dementia. However, to date, no study has explored how apolipoprotein E (ApoE) e4 status or vascular risk factors modified the association between leisure activities and dementia risks. This case-control study recruited patients (age ≥ 60 years) with Alzheimer's disease (AD; n = 292) and vascular dementia (VaD; n = 144) and healthy controls (n = 506) from three teaching hospitals in Taiwan between 2007 and 2010. Information on patient's leisure activities were obtained through a questionnaire. Conditional logistic regression models were used to assess the association of leisure activities and ApoE e4 status with the risk of dementia. High-frequency physical activity was associated with a decreased risk of AD [adjusted odds ratio (AOR) = 0.45], and the results become more evident among ApoE e4 carriers with AD (AOR = 0.30) and VaD (AOR = 0.26). Similar findings were observed for cognitive (AOR = 0.42) and social activities (AOR = 0.55) for AD. High-frequency physical, cognitive, and social activities were associated with a decreased risk of VaD (AOR = 0.29-0.60). Physical and social activities significantly interacted with each other on the risk of VaD (pinteraction = 0.04). Physical activity consistently protects against AD and VaD. Significant interactions were identified across different types of leisure activities in lowering dementia risk. Copyright © 2014. Published by Elsevier B.V.

Complications related to the use of an intraventricular access device for the treatment of leptomeningeal metastases from solid tumor: a single centre experience in 112 patients.

Science.gov (United States)

Zairi, Fahed; Le Rhun, Emilie; Bertrand, Nicolas; Boulanger, Thomas; Taillibert, Sophie; Aboukais, Rabih; Assaker, Richard; Chamberlain, Marc C

2015-09-01

Ventricular access devices (VAD) offer several advantages compared to intralumbar injections for the administration of intra-CSF agents in the treatment of leptomeningeal metastases (LM). However, there are few prospective studies reporting on complications with the use of VADs. All complications were prospectively collected that pertained to the implantation and use of a VAD in consecutive patients with solid tumor-related LM from June 2006 to December 2013. Clinical follow-up was every 2 weeks during the initial 2 months of treatment and then once monthly. Complete neuraxis MRI was performed at baseline and then every 2-3 months. A total of 112 patients (88 women) with a mean age of 51.1 years (range 26-73) were included. Primary cancers included breast (79 patients), lung (12) and melanoma (6). All patients were treated with intra-CSF liposomal cytarabine. 72 % of the patients received concomitant systemic and intra-CSF chemotherapy. The placement of the VAD was performed under local anesthesia in all cases. The mean operative time was 15 min and no perioperative complications were reported. The mean number of intraventricular injections per patient was 9.34 (range 1-47). A total of 11 complications in 11 patients were seen including 7 infections, 1 intracranial hemorrhage, 2 instances of symptomatic leukoencephalopathy and 1 catheter malpositioning. 8 complications required an operation and 1 complication was fatal. The use of a VAD is safe and may improve patients' comfort and compliance with LM-directed therapy.

Potential latitudinal variation in orodigestive tract cancers in Africa

African Journals Online (AJOL)

A latitudinal relationship has been found between the ... Africa should be focused in terms of regional variations to make best use of the fiscal allocation ..... Squamous cell carcinoma of the upper aerodigestive tract: Precursors and problematic.

A Novel Voice Sensor for the Detection of Speech Signals

Directory of Open Access Journals (Sweden)

Kun-Ching Wang

2013-12-01

Full Text Available In order to develop a novel voice sensor to detect human voices, the use of features which are more robust to noise is an important issue. Voice sensor is also called voice activity detection (VAD. Due to that the inherent nature of the formant structure only occurred on the speech spectrogram (well-known as voiceprint, Wu et al. were the first to use band-spectral entropy (BSE to describe the characteristics of voiceprints. However, the performance of VAD based on BSE feature was degraded in colored noise (or voiceprint-like noise environments. In order to solve this problem, we propose the two-dimensional part-band energy entropy (TD-PBEE parameter based on two variables: part-band partition number upon frequency index and long-term window size upon time index to further improve the BSE-based VAD algorithm. The two variables can efficiently represent the characteristics of voiceprints on each critical frequency band and use long-term information for noisy speech spectrograms, respectively. The TD-PBEE parameter can be regarded as a PBEE parameter over time. First, the strength of voiceprints can be partly enhanced by using four entropies applied to four part-bands. We can use the four part-band energy entropies for describing the voiceprints in detail. Due to the characteristics of non-stationary for speech and various noises, we will then use long-term information processing to refine the PBEE, so the voice-like noise can be distinguished from noisy speech through the concept of PBEE with long-term information. Our experiments show that the proposed feature extraction with the TD-PBEE parameter is quite insensitive to background noise. The proposed TD-PBEE-based VAD algorithm is evaluated for four types of noises and five signal-to-noise ratio (SNR levels. We find that the accuracy of the proposed TD-PBEE-based VAD algorithm averaged over all noises and all SNR levels is better than that of other considered VAD algorithms.

Day-to-Day Blood Pressure Variability and Risk of Dementia in a General Japanese Elderly Population: The Hisayama Study.

Science.gov (United States)

Oishi, Emi; Ohara, Tomoyuki; Sakata, Satoko; Fukuhara, Masayo; Hata, Jun; Yoshida, Daigo; Shibata, Mao; Ohtsubo, Toshio; Kitazono, Takanari; Kiyohara, Yutaka; Ninomiya, Toshiharu

2017-08-08

Several observational studies have reported that higher visit-to-visit blood pressure variability is a risk factor for cognitive impairment and dementia. However, no studies have investigated the association of day-to-day blood pressure variability assessed by home blood pressure measurement with the development of dementia. A total of 1674 community-dwelling Japanese elderly without dementia, ≥60 years of age, were followed up for 5 years (2007-2012). Home blood pressure was measured 3 times every morning for a median of 28 days. Day-to-day systolic (SBP) and diastolic blood pressure variabilities, calculated as coefficients of variation (CoV) of home SBP and diastolic blood pressure, were categorized into quartiles. The hazard ratios and their 95% confidence intervals of the CoV levels of home blood pressure on the development of all-cause dementia, vascular dementia (VaD), and Alzheimer disease (AD) were computed with a Cox proportional hazards model. During the follow-up, 194 subjects developed all-cause dementia; of these, 47 had VaD and 134 had AD. The age- and sex-adjusted incidences of all-cause dementia, VaD, and AD increased significantly with increasing CoV levels of home SBP (all P for trend dementia, VaD, and AD were significantly higher in those in the fourth quartile (hazard ratio=2.27, 95% confidence interval=1.45-3.55, P dementia; hazard ratio=2.79, 95% confidence interval=1.04-7.51, P =0.03 for VaD; hazard ratio=2.22, 95% confidence interval=1.31-3.75, P dementia and AD. There was no interaction between home SBP levels and CoV levels of home SBP on the risk of each subtype of dementia. Our findings suggest that increased day-to-day blood pressure variability is, independently of average home blood pressure, a significant risk factor for the development of all-cause dementia, VaD, and AD in the general elderly Japanese population. © 2017 The Authors.

Far-Field Voice Activity Detection and Its Applications in Adverse Acoustic Environments

DEFF Research Database (Denmark)

Petsatodis, Theodoros

2012-01-01

-sided Gamma distribution. The increased adaptability of the system along with the encapsulated adaptive threshold allows the system to perform remarkably under adverse complex phenomena. Following recent technological trends, of incorporating microphone arrays in numerous commercial applications (eg. mobile...... phones, VOIP terminals) and research environments (smart rooms), a multiple microphone VAD is also considered. The system processes signals captured by far-field sensors in order to integrate spatial information in addition to the frequency content available at a single sensor. The core of the system......-modality of speech production, a simple visual-VAD is also developed to examine performance enhancement when fusing audio and video information. In the final part of the work, applications of VAD in the context of integration with other signal processing systems are also considered. Performance benefits of combining...

Gastroesophageal Reflux Disease and Aerodigestive Disorders.

Science.gov (United States)

Maqbool, Asim; Ryan, Matthew J

2018-03-01

This relationship between gastroesophageal reflux and airway disorders is complex, possibly bidirectional, and not clearly defined. The tools used to investigate gastroesophageal reflux are mostly informative about involvement of gastroesophageal reflux within the gastrointestinal tract, although they are often utilized to study the relationship between gastroesophageal reflux and airway issues with are suspected to occur in relation to reflux. These modalities often lack specificity for reflux-related airway disorders. Co-incidence of gastroesophageal reflux and airway disorders does not necessarily infer causality. While much of our focus has been on managing acidity, controlling refluxate is an area that has not been traditionally aggressively pursued. Our management approach is based on some of the evidence presented, but also often from a lack of adequate study to provide further guidance. Copyright © 2018 Mosby, Inc. All rights reserved.

The pathology and pathophysiology of vascular dementia.

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Kalaria, Raj N

2017-12-19

Vascular dementia (VaD) is widely recognised as the second most common type of dementia. Consensus and accurate diagnosis of clinically suspected VaD relies on wide-ranging clinical, neuropsychological and neuroimaging measures in life but more importantly pathological confirmation. Factors defining subtypes of VaD include the nature and extent of vascular pathologies, degree of involvement of extra and intracranial vessels and the anatomical location of tissue changes as well as time after the initial vascular event. Atherosclerotic and cardioembolic diseases combined appear the most common subtypes of vascular brain injury. In recent years, cerebral small vessel disease (SVD) has gained prominence worldwide as an important substrate of cognitive impairment. SVD is characterised by arteriolosclerosis, lacunar infarcts and cortical and subcortical microinfarcts and diffuse white matter changes, which involve myelin loss and axonal abnormalities. Global brain atrophy and focal degeneration of the cerebrum including medial temporal lobe atrophy are also features of VaD similar to Alzheimer's disease. Hereditary arteriopathies have provided insights into the mechanisms of dementia particularly how arteriolosclerosis, a major contributor of SVD promotes cognitive impairment. Recently developed and validated neuropathology guidelines indicated that the best predictors of vascular cognitive impairment were small or lacunar infarcts, microinfarcts, perivascular space dilation, myelin loss, arteriolosclerosis and leptomeningeal cerebral amyloid angiopathy. While these substrates do not suggest high specificity, VaD is likely defined by key neuronal and dendro-synaptic changes resulting in executive dysfunction and related cognitive deficits. Greater understanding of the molecular pathology is needed to clearly define microvascular disease and vascular substrates of dementia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bee Venom Ameliorates Cognitive Dysfunction Caused by Neuroinflammation in an Animal Model of Vascular Dementia.

Science.gov (United States)

Cai, Mudan; Lee, Jun Hwan; Yang, Eun Jin

2017-10-01

Vascular dementia (VaD) is caused by the reduction of blood supply by vessel occlusion and is characterized by progressive cognitive decline. VaD incidence has been growing due to the aging population, placing greater strain on social and economic resources. However, the pathological mechanisms underlying VaD remain unclear. Many studies have used the bilateral common carotid artery occlusion (BCCAO) animal model to investigate potential therapeutics for VaD. In this study, we investigated whether bee venom (BV) improves cognitive function and reduces neuroinflammation in the hippocampus of BCCAO animals. Animals were randomly divided into three groups: a sham group (n = 15), BCCAO control group (n = 15), and BV-treated BCCAO group (n = 15). BCCAO animals were treated with 0.1 μg/g BV at ST36 ("Joksamli" acupoint) four times every other day. In order to investigate the effect of BV treatment on cognitive function, we performed a Y-maze test. In order to uncover any potential relationship between these results and neuroinflammation, we also performed Western blotting in the BCCAO group. Animals that had been treated with BV showed an improved cognitive function and a reduced expression of neuroinflammatory proteins in the hippocampus, including Iba-1, TLR4, CD14, and TNF-α. Furthermore, we demonstrated that BV treatment increased pERK and BDNF in the hippocampus. The present study thus underlines the neuroprotective effect of BV treatment against BCCAO-induced cognitive impairment and neuroinflammation. Our findings suggest that BV may be an effective complementary treatment for VaD, as it may improve cognitive function and attenuate neuroinflammation associated with dementia.

Ventricular Assist Device implant (AB 5000 prototype cannula: In vitro assessment of MRI issues at 3-Tesla

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Valencerina Samuel

2008-05-01

Full Text Available Abstract Purpose To evaluate MRI issues at 3-Tesla for a ventricular assist device (VAD. Methods The AB5000 Ventricle with a prototype Nitinol wire-reinforced In-Flow Cannula and Out-Flow Cannula attached (Abiomed, Inc., Danvers, MA was evaluated for magnetic field interactions, heating, and artifacts at 3-Tesla. MRI-related heating was assessed with the device in a gelled-saline-filled, head/torso phantom using a transmit/received RF body coil while performing MRI at a whole body averaged SAR of 3-W/kg for 15-min. Artifacts were assessed for the main metallic component of this VAD (atrial cannula using T1-weighted, spin echo and gradient echo pulse sequences. Results The AB5000 Ventricle with the prototype In-Flow Cannula and Out-Flow Cannula attached showed relatively minor magnetic field interactions that will not cause movement in situ. Heating was not excessive (highest temperature change, +0.8°C. Artifacts may create issues for diagnostic imaging if the area of interest is in the same area or close to the implanted metallic component of this VAD (i.e., the venous cannula. Conclusion The results of this investigation demonstrated that it would be acceptable for a patient with this VAD (AB5000 Ventricle with a prototype Nitinol wire-reinforced In-Flow Cannula and Out-Flow Cannula attached to undergo MRI at 3-Tesla or less. Notably, it is likely that the operation console for this device requires positioning a suitable distance (beyond the 100 Gauss line or in the MR control room from the 3-Tesla MR system to ensure proper function of the VAD.

Association of Dietary Proportions of Macronutrients with Visceral Adiposity Index: Non-Substitution and Iso-Energetic Substitution Models in a Prospective Study.

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Moslehi, Nazanin; Ehsani, Behnaz; Mirmiran, Parvin; Hojjat, Parvane; Azizi, Fereidoun

2015-10-26

We aimed to investigate associations between dietary macronutrient proportions and prospective visceral adiposity index changes (ΔVAI). The study included 1254 adults (18-74 years), from the Tehran Lipid and Glucose Study (TLGS), who were followed for three years. Dietary intakes were assessed twice using food frequency questionnaires. Associations of dietary macronutrient with ΔVAI and risk of visceral adiposity dysfunction (VAD) after three years were investigated. The percentage of energy intake from protein in the total population, and from fat in women, were associated with higher increases in VAI. A 5% higher energy intake from protein substituted for carbohydrate, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) was associated with higher ΔVAI. Higher energy intake from animal protein substituted for PUFAs was positively associated with ΔVAI. Substituting protein and PUFAs with MUFAs were related to higher ΔVAI. The associations were similar in men and women, but reached significance mostly among women. Risk of VAD was increased when 1% of energy from protein was replaced with MUFAs. Substituting protein for carbohydrate and fat, and fat for carbohydrate, resulted in increased risk of VAD in women. Higher dietary proportions of protein and animal-derived MUFA may be positively associated with ΔVAI and risk of VAD.

CSF/serum albumin ratio in dementias: a cross-sectional study on 1861 patients.

Science.gov (United States)

Skillbäck, Tobias; Delsing, Louise; Synnergren, Jane; Mattsson, Niklas; Janelidze, Shorena; Nägga, Katarina; Kilander, Lena; Hicks, Ryan; Wimo, Anders; Winblad, Bengt; Hansson, Oskar; Blennow, Kaj; Eriksdotter, Maria; Zetterberg, Henrik

2017-11-01

A connection between dementias and blood-brain barrier (BBB) dysfunction has been suggested, but previous studies have yielded conflicting results. We examined cerebrospinal fluid (CSF)/serum albumin ratio in a large cohort of patients diagnosed with Alzheimer's disease (AD, early onset [EAD, n = 130], late onset AD [LAD, n = 666]), vascular dementia (VaD, n = 255), mixed AD and VaD (MIX, n = 362), Lewy body dementia (DLB, n = 50), frontotemporal dementia (FTD, n = 56), Parkinson's disease dementia (PDD, n = 23), other dementias (other, n = 48), and dementia not otherwise specified (NOS, n = 271). We compared CSF/serum albumin ratio to 2 healthy control groups (n = 292, n = 20), between dementia diagnoses, and tested biomarker associations. Patients in DLB, LAD, VaD, MIX, other, and NOS groups had higher CSF/serum albumin ratio than controls. CSF/serum albumin ratio correlated with CSF neurofilament light in LAD, MIX, VaD, and other groups but not with AD biomarkers. Our data show that BBB leakage is common in dementias. The lack of association between CSF/serum albumin ratio and AD biomarkers suggests that BBB dysfunction is not inherent to AD but might represent concomitant cerebrovascular pathology. Copyright © 2017 Elsevier Inc. All rights reserved.

Ionizing radiation induces apoptosis in hematopoietic stem and progenitor cells

International Nuclear Information System (INIS)

Meng, A.; Zhou, D.; Geiger, H.; Zant, G.V.

2003-01-01

The aims of this study was to determine if ionizing radiation (IR) induces apoptosis in hematopoietic stem (HSC) and progenitor cells. Lin-cells were isolated from mouse bone marrow (BM) and pretreated with vehicle or 100 μM z-VAD 1 h prior to exposure to 4 Gy IR. The apoptotic and/or necrotic responses of these cells to IR were analyzed by measuring the annexin V and/or 7-AAD staining in HSC and progenitor populations using flow cytometry, and hematopoietic function of these cells was determined by CAFC assay. Exposure of Lin-cells to IR selectively decreased the numbers of HSC and progenitors in association with an increase in apoptosis in a time-dependent manner. Pretreatment of Lin- cells with z-VAD significantly inhibited IR-induced apoptosis and the decrease in the numbers of HSC and progenitors. However, IR alone or in combination with z-VAD did not lead to a significant increase in necrotic cell death in either HSC or progenitors. In addition, pretreatment of BM cells with z-VAD significantly attenuated IR-induced reduction in the frequencies of day-7, -28 and -35 CAFC. Exposure of HSC and progenitors to IR induces apoptosis. The induction of HSC and progenitor apoptosis contributes to IR-induced suppression of their hematopoietic function

Development of ventricular assist devices in China: present status, opportunities and challenges.

Science.gov (United States)

Gu, Kaiyun; Chang, Yu; Gao, Bin; Wan, Feng; Loisance, Daniel; Zeng, Yi

2014-08-01

The growing number of heart failure patients and the scarcity of organ donors account for the huge need for the development of mechanical circulatory systems, including ventricular assist devices (VADs) and artificial hearts, in China. Several research programmes on blood pumps have been under way for the last three decades. However, unlike in other countries, the development of VADs has been extremely slow, and no system is currently approved and available for clinical application. There are many reasons for this situation. This article provides an overview of the present development of experimental and clinical research on VADs in China. In addition, the challenges for the clinical development of mechanical circulatory support in China are discussed. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Incidental findings of thyroid tissue in cervical lymph nodes: old controversy not yet resolved?

NARCIS (Netherlands)

Triantafyllou, A.; Williams, M.D.; Angelos, P.; Shah, J.P.; Westra, W.H.; Hunt, J.L.; Devaney, K.O.; Rinaldo, A.; Slootweg, P.J.; Gnepp, D.R.; Silver, C.; Ferlito, A.

2016-01-01

The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over

Vertebral artery dissection in weightlifter with performance enhancing drug use

OpenAIRE

Low, Andrew; Dovey, Julie; Ash-Miles, Janice

2011-01-01

This case report describes a transient ischaemic attack secondary to vertebral artery dissection (VAD) in a young male body builder. This occurred following weight training with weights across the back and shoulders. The patient was also known to take multiple performance enhancing agents including anabolic steroids, slimming agents, stimulants and human growth hormone. Cases of VAD have been described with cervical manipulation in the past and an association between the use of anabolic stero...

Urmo Raus : "Maalimine on mäluline protsess" / Urmo Raus ; interv. Reet Varblane

Index Scriptorium Estoniae

Raus, Urmo, 1969-

2003-01-01

Tallinna Kunstihoones Urmo Rausi maalinäituse avamise puhul intervjuu kunstnikuga, kes on õppinud Eesti Kunstiakadeemias, Pariisi Ecole Nationale Superieure des Beaux-Arts'is, on teinud näitusi Prantsusmaal, Itaalias, Venemaal, Eestis, elab Haagis. U. Raus kunstiõpetusest Pariisis ja EKA maaliosakonnas, kaasaegsest vitraažikunstist, oma maalikunstist

Nonparametric condence intervals for tail dependence based on ...

African Journals Online (AJOL)

Ce papier presente des intervalles de conance asymptotiques pour les coe- cients de dependance de queue inferieure et superieure. Ces derniers sont obtenus de facon nonparametrique a partir de bandes de conance presque sures obtenues pour la fonction copule elle meme et basees sur des estimateurs a noyau.

Study of diffusion tensor imaging in subcortical ischemic vascular cognitive impairment

Directory of Open Access Journals (Sweden)

Hui-ying GUO

2014-04-01

Full Text Available Objective Using diffusion tensor imaging (DTI to explore the microstructure changes of white matter in subcortical ischemic vascular cognitive impairment (SIVCI and its correlation with cognitive function.  Methods Forty-nine patients with subcortical ischemic cerebrovascular diseases were collected. By using Clinical Dementia Rating Scale (CDR, they were classified into 10 cases of vascular dementia (VaD group, 20 cases of vascular cognitive impairment-no dementia (VCIND group and 19 cases of normal cognitive function (control group. Conventional MRI and DTI were performed in all cases. Based on the DTI data, voxel-based analysis was used to assess the whole brain region. Correlation analysis was applied to illustrate the relationship between DTI parameters and cognitive scale in VaD patients.  Results Compared with the control group, fractional anisotropy (FA values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes, right temporal lobe and bilateral orbitofrontal lobes (P = 0.000, for all, and FA values of patients in VCIND group decreased in right inferior frontal gyrus, right hippocampus and bilateral precuneus (P = 0.000, for all. Compared with VCIND group, FA values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate, corpus callosum, bilateral parietal lobes and right temporal lobe (P = 0.000, for all. Compared with the control group, mean diffusivity (MD values in VaD group increased in medial prefrontal cortex, corpus callosum, bilateral parietal lobes, bilateral temporal lobes and anterior cingulate (P = 0.000, for all, while in VCIND group increased in bilateral precuneus and right hippocampus (P = 0.000, for all. Compared with VCIND group, MD values in VaD group increased in right medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes and bilateral temporal lobes (P = 0

Survey of Navy Funded Marine Mammal Research and Studies FY 00-01

Science.gov (United States)

2001-05-10

A.L., Bergemann, A.D., Reidenberg, J.S., and Laitman, J.T. (2000) A molecular exploration of the branchial arches: Implications for understanding...insights into the development of the aerodigestive tract: Molecular relationships among branchial arches. Assoc. Res. Otolaryngol. Abstr. Vol. 23:249

Late swallowing dysfunction and dysphagia after radiotherapy for pharynx cancer: frequency, intensity and correlation with dose and volume parameters

DEFF Research Database (Denmark)

Jensen, Kenneth; Lambertsen, Karin; Grau, Cai

2007-01-01

BACKGROUND AND PURPOSE: Dysphagia and swallowing problems are common in pharynx cancer patients treated with radiotherapy. Dysfunction of the upper aerodigestive tract may lead to reduced quality of life, malnutrition and aspiration pneumonia. The aim of the current study was to describe swallowi...

Cost-effectiveness of "golden mustard" for treating vitamin A deficiency in India.

Directory of Open Access Journals (Sweden)

Jeffrey Chow

Full Text Available BACKGROUND: Vitamin A deficiency (VAD is an important nutritional problem in India, resulting in an increased risk of severe morbidity and mortality. Periodic, high-dose vitamin A supplementation is the WHO-recommended method to prevent VAD, since a single dose can compensate for reduced dietary intake or increased need over a period of several months. However, in India only 34 percent of targeted children currently receive the two doses per year, and new strategies are urgently needed. METHODOLOGY: Recent advancements in biotechnology permit alternative strategies for increasing the vitamin A content of common foods. Mustard (Brassica juncea, which is consumed widely in the form of oil by VAD populations, can be genetically modified to express high levels of beta-carotene, a precursor to vitamin A. Using estimates for consumption, we compare predicted costs and benefits of genetically modified (GM fortification of mustard seed with high-dose vitamin A supplementation and industrial fortification of mustard oil during processing to alleviate VAD by calculating the avertable health burden in terms of disability-adjusted life years (DALY. PRINCIPAL FINDINGS: We found that all three interventions potentially avert significant numbers of DALYs and deaths. Expanding vitamin A supplementation to all areas was the least costly intervention, at $23-$50 per DALY averted and $1,000-$6,100 per death averted, though cost-effectiveness varied with prevailing health subcenter coverage. GM fortification could avert 5 million-6 million more DALYs and 8,000-46,000 more deaths, mainly because it would benefit the entire population and not just children. However, the costs associated with GM fortification were nearly five times those of supplementation. Industrial fortification was dominated by both GM fortification and supplementation. The cost-effectiveness ratio of each intervention decreased with the prevalence of VAD and was sensitive to the efficacy rate of

Stroke prevention by endovascular treatment of carotid and vertebral artery dissections.

Science.gov (United States)

Moon, Karam; Albuquerque, Felipe C; Cole, Tyler; Gross, Bradley A; McDougall, Cameron G

2017-10-01

Endovascular intervention for cervical carotid artery dissection (CAD) and vertebral artery dissection (VAD) may be indicated in specific circumstances. To review our institutional experience with endovascular treatment of cervical dissections over the past 20 years to examine indications for treatment, interventional methods, and outcomes. Retrospective review of a prospectively maintained database to identify patients with extracranial dissection who underwent endovascular intervention between January 1996 and January 2016. Demographic data and details of procedures, outcomes, and complications were extracted. Of 116 patients [93 CAD, 23 VAD; mean age 44.9 years (range 5-76 years)], 104 underwent stent placement; 11, coil occlusion of the parent artery; and 1, stenting with contralateral vessel occlusion. The cohorts were well matched for age, sex, dissection etiology, and admission and follow-up modified Rankin Scale (mRS) scores. Patients with CAD had significantly more stent placements (p<0.001), failure of medical therapy (p=0.004), and interventions for enlarging pseudoaneurysms (p=0.01) or thromboembolic events (p=0.004). Patients with VAD had significantly more interventions for traumatic occlusion with recanalization (p<0.001). Dissections were spontaneous (n=67), traumatic (n=36), or iatrogenic (n=13). Traumatic dissections in patients with CAD were associated with poor admission mRS scores (p=0.01). Six of 67 (9.0%) patients with spontaneous dissection reported recent chiropractic manipulation. Mean follow-up was 3.5 years (range 1-146 months). Permanent morbidity/mortality was 3.4%, including two deaths. Over a follow-up period of 364 patient-years, 1 stroke occurred (0.27% per year). At last follow-up, 41 previously disabled patients [CAD, 31/93 (33.3%); VAD, 10/23 (43.5%)] were no longer disabled; no patient reported worsened disability. Patients with CAD and VAD differ significantly in presentation, indications for treatment, and treatment

Prevalence Of Vitamin A And Vitamin D Deficiency Amongst Children Under Five Years And Women Of Reproductive Age In Madhya Pradesh

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Supreet Kaur

2015-12-01

Full Text Available Introduction: Vitamin A deficiency (VAD and vitamin D deficiency (VDD are major nutritional concern in lower income countries. Staple food fortification is an effective complementary strategy to reduce micronutrient malnutrition at population level. Rationale: The present study was conducted to determine the burden of vitamin A and D deficiencies in Madhya Pradesh prior to the introduction of vitamin A and D fortified vegetable oil in the market. Objectives: To determine the prevalence of VAD and VDD in children under five years of age and women of reproductive age. Methods: A multistage stratified cross-sectional survey was conducted between October-November 2013 in Indore, Gwalior and Betul. Venous blood was available for 577 women of reproductive age and 561 children 6-59 months of age in the urban strata. Serum retinol concentration corrected for inflammation (CRP <0.70 umol/L and 25-hydroxyvitamin D (25(OHD concentration <20 ng/ml were used to define VAD and VDD, respectively. Standard procedure was followed for collection, storage and estimations. Results: VDD was prevalent among 74.6% (n=560 women, mean age of 26.7±3.3 years, and among 52.0% (n=577 of children (2.9 ± 1.3 years. It was estimated that, 16.9% (n=561 of women and 13.4% (n=574 of children had sub-clinical VAD. The prevalence of VDD among children in Gwalior and Betul was lower (43-49% compared to Indore (64% (p=0.000; but these district-wise VDD differences were not apparent among women in Indore (78%, Gwalior (78%, and Betul (71%. In contrast, VAD was substantially lower among women (8% and children (3% in Betul compared to Gwalior (18% of women; 21% of children and Indore (25% of women and 19% of children (p=0.000. Conclusion: Prevalence of both VAD and VDD in Madhya Pradesh is high, marking it as major public health problem. Increased coverage of micronutrient fortified foods at the population level will be an important strategy to mitigate the burden of

Incidence of traumatic carotid and vertebral artery dissections: results of cervical vessel computed tomography angiogram as a mandatory scan component in severely injured patients

Directory of Open Access Journals (Sweden)

Schicho A

2018-01-01

Full Text Available Andreas Schicho,1 Lukas Luerken,1 Ramona Meier,1 Antonio Ernstberger,2 Christian Stroszczynski,1 Andreas Schreyer,1 Lena-Marie Dendl,1 Stephan Schleder1 1Department of Radiology, 2Department of Trauma Surgery, University Medical Center, Regensburg, Germany Purpose: The aim of this study was to evaluate the true incidence of cervical artery dissections (CeADs in trauma patients with an Injury Severity Score (ISS of ≥16, since head-and-neck computed tomography angiogram (CTA is not a compulsory component of whole-body trauma computed tomography (CT protocols. Patients and methods: A total of 230 consecutive trauma patients with an ISS of ≥16 admitted to our Level I trauma center during a 24-month period were prospectively included. Standardized whole-body CT in a 256-detector row scanner included a head-and-neck CTA. Incidence, mortality, patient and trauma characteristics, and concomitant injuries were recorded and analyzed retrospectively in patients with carotid artery dissection (CAD and vertebral artery dissection (VAD. Results: Of the 230 patients included, 6.5% had a CeAD, 5.2% had a CAD, and 1.7% had a VAD. One patient had both CAD and VAD. For both, CAD and VAD, mortality is 25%. One death was caused by fatal cerebral ischemia due to high-grade CAD. A total of 41.6% of the patients with traumatic CAD and 25% of the patients with VAD had neurological sequelae. Conclusion: Mandatory head-and-neck CTA yields higher CeAD incidence than reported before. We highly recommend the compulsory inclusion of a head-and-neck CTA to whole-body CT routines for severely injured patients. Keywords: polytrauma, carotid artery, vertebral artery, dissection, blunt trauma, computed tomography angiogram

[Treatment of vascular dementia by Chinese herbal medicine: a systematic review of randomized controlled trials of clinical studies].

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Jian, Wen-Jia; Shi, Jing; Tian, Jin-Zhou; Ni, Jing-Nian

2015-01-01

Chinese herbal medicine has been extensively used in the treatment of vascular dementia (VaD), but lacked systematic review on its efficacy and safety. So we conducted a systematic review to assess the efficacy and safety of Chinese herbal medicine in treating VaD. CNKI, CBM, PubMed, and Wiley Online Library were retrieved for randomized trials (RCTs) on Chinese herbal medicine treating VaD patients. Randomized parallel control trials by taking Chinese herbal medicine as one treatment method and placebos/cholinesterase inhibitors/Memantine hydrochloride as the control were included. Quality rating and data extraction were performed. RevMan5.2.0 Software was used for meta-analysis. Standardized mean difference (SMD) at 95% confidence interval (CI) was used to indicate effect indicators of results. Seven RCTs met the inclusive criteria. Totally 677 VaD patients were randomly assigned to the treatment group and the control group. Descriptive analyses were performed in inclusive trials. The cognitive function was assessed in all trials. Results showed Mini-Mental state examination (MMSE) score was better in the Chinese herbal medicine group than in the placebo group, but with no significant difference when compared with the donepezil group (P > 0.05). Adverse reactions were mainly manifested as gastrointestinal symptoms such as abdominal pain in the Chinese herbal medicine group. But they occurred more in the donepezil group than in the Chinese herbal medicine group. The methodological quality of included trials was poor with less samples. Results of different trials were lack of consistency. Present evidence is not sufficient to prove or disapprove the role of Chinese herbal medicine in improving clinical symptoms and outcome indicators of VaD patients. Their clinical efficacy and safety need to be supported by more higher quality RCTs.

The Effects of Anti-Dementia and Nootropic Treatments on the Mortality of Patients with Dementia: A Population-Based Cohort Study in Taiwan.

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Chen-Yi Wu

Full Text Available Few studies have examined the contribution of treatment on the mortality of dementia based on a population-based study.To investigate the effects of anti-dementia and nootropic treatments on the mortality of dementia using a population-based cohort study.12,193 incident dementia patients were found from 2000 to 2010. Their data were compared with 12,193 age- and sex-matched non-dementia controls that were randomly selected from the same database. Dementia was classified into vascular (VaD and degenerative dementia. Mortality incidence and hazard ratios (HRs were calculated.The median survival time was 3.39 years (95% confidence interval [CI]: 2.88-3.79 for VaD without medication, 6.62 years (95% CI: 6.24-7.21 for VaD with nootropics, 3.01 years (95% CI: 2.85-3.21 for degenerative dementia without medication, 8.11 years (95% CI: 6.30-8.55 for degenerative dementia with anti-dementia medication, 6.00 years (95% CI: 5.73-6.17 for degenerative dementia with nootropics, and 9.03 years (95% CI: 8.02-9.87 for degenerative dementia with both anti-dementia and nootropic medications. Compared to the non-dementia group, the HRs among individuals with degenerative dementia were 2.69 (95% CI: 2.55-2.83 without medication, 1.46 (95% CI: 1.39-1.54 with nootropics, 1.05 (95% CI: 0.82-1.34 with anti-dementia medication, and 0.92 (95% CI: 0.80-1.05 with both nootropic and anti-dementia medications. VaD with nootropics had a lower mortality (HR: 1.25, 95% CI: 1.15-1.37 than VaD without medication (HR: 2.46, 95% CI: 2.22-2.72.Pharmacological treatments have beneficial effects for patients with dementia in prolonging their survival.

The Effects of Anti-Dementia and Nootropic Treatments on the Mortality of Patients with Dementia: A Population-Based Cohort Study in Taiwan.

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Wu, Chen-Yi; Hu, Hsiao-Yun; Chow, Lok-Hi; Chou, Yiing-Jenq; Huang, Nicole; Wang, Pei-Ning; Li, Chung-Pin

2015-01-01

Few studies have examined the contribution of treatment on the mortality of dementia based on a population-based study. To investigate the effects of anti-dementia and nootropic treatments on the mortality of dementia using a population-based cohort study. 12,193 incident dementia patients were found from 2000 to 2010. Their data were compared with 12,193 age- and sex-matched non-dementia controls that were randomly selected from the same database. Dementia was classified into vascular (VaD) and degenerative dementia. Mortality incidence and hazard ratios (HRs) were calculated. The median survival time was 3.39 years (95% confidence interval [CI]: 2.88-3.79) for VaD without medication, 6.62 years (95% CI: 6.24-7.21) for VaD with nootropics, 3.01 years (95% CI: 2.85-3.21) for degenerative dementia without medication, 8.11 years (95% CI: 6.30-8.55) for degenerative dementia with anti-dementia medication, 6.00 years (95% CI: 5.73-6.17) for degenerative dementia with nootropics, and 9.03 years (95% CI: 8.02-9.87) for degenerative dementia with both anti-dementia and nootropic medications. Compared to the non-dementia group, the HRs among individuals with degenerative dementia were 2.69 (95% CI: 2.55-2.83) without medication, 1.46 (95% CI: 1.39-1.54) with nootropics, 1.05 (95% CI: 0.82-1.34) with anti-dementia medication, and 0.92 (95% CI: 0.80-1.05) with both nootropic and anti-dementia medications. VaD with nootropics had a lower mortality (HR: 1.25, 95% CI: 1.15-1.37) than VaD without medication (HR: 2.46, 95% CI: 2.22-2.72). Pharmacological treatments have beneficial effects for patients with dementia in prolonging their survival.

Stroke Risk and Mortality in Patients With Ventricular Assist Devices.

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Parikh, Neal S; Cool, Joséphine; Karas, Maria G; Boehme, Amelia K; Kamel, Hooman

2016-11-01

Ventricular assist devices (VADs) have advanced the management of end-stage heart failure. However, these devices are associated with hemorrhagic and thrombotic complications, including stroke. We assessed the incidence, risk factors, and outcomes of ischemic and hemorrhagic stroke after VAD placement. Using administrative claims data from acute care hospitals in California, Florida, and New York from 2005 to 2013, we identified patients who underwent VAD placement, defined by the International Classification of Diseases, Ninth Revision, Clinical Modification code 37.66. Ischemic and hemorrhagic strokes were identified by previously validated coding algorithms. We used survival statistics to determine the incidence rates and Cox proportional hazard analyses to examine the associations. Among 1813 patients, we identified 201 ischemic strokes and 116 hemorrhagic strokes during 3.4 (±2.0) years of follow-up after implantation of a VAD. The incidence of stroke was 8.7% per year (95% confidence interval [CI], 7.7-9.7). The annual incidence of ischemic stroke (5.5%; 95% CI, 4.8-6.4) was nearly double that of hemorrhagic stroke (3.1%; 95% CI, 2.6-3.8). Women faced a higher hazard of stroke than men (hazard ratio, 1.6; 95% CI, 1.2-2.1), particularly hemorrhagic stroke (hazard ratio, 2.2; 95% CI, 1.4-3.4). Stroke was strongly associated with subsequent in-hospital mortality (hazard ratio, 6.1; 95% CI, 4.6-7.9). The incidence of stroke after VAD implantation was 8.7% per year, and incident stroke was strongly associated with subsequent in-hospital mortality. Notably, ischemic stroke occurred at nearly twice the rate of hemorrhagic stroke. Women seemed to face a higher risk for hemorrhagic stroke than men. © 2016 American Heart Association, Inc.

Soft, fortified ice-cream for head and neck cancer patients: a useful first step in nutritional and swallowing difficulties associated with multi-modal management.

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Trinidade, Aaron; Martinelli, Katrina; Andreou, Zenon; Kothari, Prasad

2012-04-01

Patients with head and neck cancer have complex swallowing and nutritional concerns. Most patients are malnourished, and treatment modalities within the aerodigestive tract have profound effects on future swallowing and nutrition. The objective of this study is to investigate whether the introduction of fortified soft ice-cream to post-operative head and neck cancer patients would increase compliance with oral-feeding regimes. Using a questionnaire study, an ice-cream machine that produces fortified soft ice-cream was introduced onto our ward, and 30 patients were asked to fill out questionnaires based on their experience in addition to their oral-feeding regime. Results indicate that overall patient satisfaction and compliance with oral-feeding regimes increased: 77% felt that the taste was excellent and also felt that it was easy to eat; 60% felt that it eased the symptoms associated with their symptoms, in particular its cold temperature. We conclude from the results that the inability of patients undergoing multi-modal treatment for upper aerodigestive tract cancer to enjoy normal foods and its effects on their quality of life is underestimated. Providing a food to that is palatable, familiar and acceptable as it is safe and nutritionally sound can increase compliance with oral-feeding regimes. The ice-cream was safe to use in the early post-operative period, especially soothing in patients undergoing upper aerodigestive radiotherapy and high in protein and calorific content. Our practice may have wider benefits, including patients with oral and oropharyngeal infections, the elderly and patients with neurological dysphagia resulting from stroke.

P53-dependent ceramide generation in response ro ionizing irradiation is caspase-dependent

International Nuclear Information System (INIS)

Dbaibo, G.; El-Assaad, W.

2000-01-01

Full text.We have previously reported that p53-dependent apoptosis is accompanied by ceramide accumulation. Lack of p53 prevents ceramide accumulation in response to induces such as ionizing irradiation. The mechanisms of ceramide accumulation have not been explored. P53 has been reported to function by inducing the death receptors Fas and DR5 both of which function by initiating a caspase cascade that results in apoptosis. We decided to examine the role of caspases in the elevation of cellular ceramide levels. We treated Molt-4 cells with 5Gy of ionizing irradiation and examined the effects of co-treatment with the general caspase inhibitor z-VAD-fmk at concentration of 50 and 100μM. We found that z-VAD blocked apoptosis induced by irradiation without interfering with p53 accumulation indicating that it was not functioning upstream of p53. However, z-VAD treatment resulted in a significant decrease in ceramide accumulation. Additionally, z-VAD partially blocked the loss of glutathione in response to irradiation. This was important since glutathione has been described as an inhibitor of neutral sphindomyelinase, a major source of cellular ceramide via sphingomyelin hydrolysis. These studies indicate that p53 induces ceramide accumulation in a caspase-dependent manner and that the regulation of cellular glutathione by caspases may be a mechanism by which they regulate ceramide accumulation

Vitamin A deficiency during pregnancy of HIV infected and non-infected women in tropical settings of Northwest Ethiopia

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Bekele Assegedech

2011-07-01

Full Text Available Abstract Background Vitamin A deficiency (VAD is known to be a major public health problem among women of reproductive age in South East Asia and Africa. In Ethiopia, there are no studies conducted on serum vitamin A status of HIV-infected pregnant women. Therefore, the present study was aimed at determining the level of serum vitamin A and VAD among pregnant women with and without HIV infection in tropical settings of Northwest Ethiopia. Methods In this cross-sectional study, blood samples were collected from 423 pregnant women and from 55 healthy volunteers who visited the University of Gondar Hospital. Serum concentration of vitamin A was measured by high performance liquid chromatography. Results After controlling for total serum protein, albumin and demographic variables, the mean ± SD serum vitamin A in HIV seropositive pregnant women (0.96 ± 0.42 μmol/L was significantly lower than that in pregnant women without HIV infection (1.10 ± 0.45 μmol/L, P Conclusion The present study shows that VAD is a major public health problem among pregnant women in the tropical settings of Northwest Ethiopia. Considering the possible implications of VAD during pregnancy, we recommend multivitamin (which has a lower level of vitamin A supplementation in the care and management of pregnant women with or without HIV infection.

Development of a Voice Activity Controlled Noise Canceller

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Abid Noor, Ali O.; Samad, Salina Abdul; Hussain, Aini

2012-01-01

In this paper, a variable threshold voice activity detector (VAD) is developed to control the operation of a two-sensor adaptive noise canceller (ANC). The VAD prohibits the reference input of the ANC from containing some strength of actual speech signal during adaptation periods. The novelty of this approach resides in using the residual output from the noise canceller to control the decisions made by the VAD. Thresholds of full-band energy and zero-crossing features are adjusted according to the residual output of the adaptive filter. Performance evaluation of the proposed approach is quoted in terms of signal to noise ratio improvements as well mean square error (MSE) convergence of the ANC. The new approach showed an improved noise cancellation performance when tested under several types of environmental noise. Furthermore, the computational power of the adaptive process is reduced since the output of the adaptive filter is efficiently calculated only during non-speech periods. PMID:22778667

Role of neuropsychological assessment in the differential diagnosis of Alzheimer's disease and vascular dementia

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Érica Maria Lima Pimentel

Full Text Available Abstract The prevalence of dementia increases significantly from the age of 65 years, doubling every five years thereafter. Alzheimer's disease (AD and vascular dementia (VaD constitute the two main dementia types. Differentiating them encompasses anamnesis, neurological examination, laboratory and neuroimaging exams and neuropsychological assessment. Neuropsychological assessment produces different findings for each dementia type, and reveals those areas most impaired as well as those most preserved. The aim of the present article was to describe the role of neuropsychology in diagnosing dementia and achieving a differential diagnosis between AD and VaD. A general overview follows of the most widely known instruments used to assess cognitive function in dementia, and the cognitive changes seen in AD and VaD. The conclusion drawn was that there is significant overlap in cognitive changes between both these dementia types, while each type has its own specific characteristics which are identifiable and quantifiable on neuropsychological assessments and provide the basis for reaching a differential diagnosis.

Development of a Voice Activity Controlled Noise Canceller

Directory of Open Access Journals (Sweden)

Aini Hussain

2012-05-01

Full Text Available In this paper, a variable threshold voice activity detector (VAD is developed to control the operation of a two-sensor adaptive noise canceller (ANC. The VAD prohibits the reference input of the ANC from containing some strength of actual speech signal during adaptation periods. The novelty of this approach resides in using the residual output from the noise canceller to control the decisions made by the VAD. Thresholds of full-band energy and zero-crossing features are adjusted according to the residual output of the adaptive filter. Performance evaluation of the proposed approach is quoted in terms of signal to noise ratio improvements as well mean square error (MSE convergence of the ANC. The new approach showed an improved noise cancellation performance when tested under several types of environmental noise. Furthermore, the computational power of the adaptive process is reduced since the output of the adaptive filter is efficiently calculated only during non-speech periods.

Conceptual Integration of Hybridization by Algerian Students Intending to Teach Physical Sciences

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Salah, Hazzi; Dumon, Alain

2011-01-01

This work aims to assess the difficulties encountered by students of the Ecole Normale Superieure of Kouba (Algeria) intending to teach physical science in the integration of the hybridization of atomic orbitals. It is a concept that they should use in describing the formation of molecular orbitals ([sigma] and [pi]) in organic chemistry and gaps…

Une Exception Francaise: Les Grandes Ecoles (A French Exception: The Great Schools).

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Kimmel, Alain

1996-01-01

Examines the role of exceptional schools in France that have produced famous personages such as Charles de Gaulle and Jean-Paul Sartre. The schools reviewed include L'Ecole Nationale d'Administration, L'Ecole Polytechnique, L'Ecole Normale Superieure, L'Ecole des Hautes Etudes Commerciales, Saint-Cyr, and L'Institut d'Etudes Politiques de Paris.…

What is unburned carbon?; Vad aer ofoerbraent?

Energy Technology Data Exchange (ETDEWEB)

Bjurstroem, Henrik [AaF-Process AB, Stockholm (Sweden); Suer, Pascal [Swedish Geotechnical Inst., Linkoeping (Sweden)

2006-01-15

Different methods to determine unburned carbon in an ash yield different results, which raises the question of what actually is unburned. Using knowledge on the chemistry of ashes, one can identify which processes that contribute to the results from a method of analysis, but it is not possible to quantify these contributions. The project that is reported here aimed at clarifying what the results from the different methods mean using practical examples. Approximately twenty ash samples have been collected and their content of unburned carbon determined using loss on ignition at different temperatures, instrumental analysis of TOC and wet oxidation (the so-called colorimetric method). In order to identify the processes contributing to the results the samples have been investigated using a thermobalance instrumented with DTA and mass spectrometry for the species released when the samples are heated in air. The results can be grouped according to the type of ash: bottom ash, ESP ashes or baghouse filter ashes. They each have their specific fingerprints. Although the same processes contribute to the LOI, the proportions differ. In the case of bottom ashes, LOI and TOC yield results close to each other. A large part of the LOI is TOC, but not all. TOC is dominated by charred fuel (elementar carbon) and organic is a minor part. In the case of fly ashes, LOI and TOC yield results that differ from each other. As for bottom ashes, a large part of the LOI at 550 deg C is TOC, dominated by char or elemental carbon. The LOI at higher temperatures is often at least double and includes much more. Igniting ESP and baghouse filter ash samples at ca 1000 deg C leads to losses of volatile salts, e g chlorides. The colorimetric method takes some of the TOC, not only organic matter. The TOC methods should be preferred to it. The LOI methods yield values that are generally too high. As they are easy to implement their use will be continued. We recommend that: Ash is not ignited at temperatures higher than necessary; The temperature at which LOI was determined is reported; The result of LOI is reported as LOI and not as organic content in ash.

Intensity-modulated radiation therapy for head and neck cancers with bilateral irradiation of the neck: preliminary results; Radiotherapie conformationnelle avec modulation d'intensite des cancers des voies aerodigestives superieures avec irradiation bilaterale du cou: resultats preliminaires

Energy Technology Data Exchange (ETDEWEB)

Lapeyre, M.; Mege, A.; Mege, P.; Racadot, S.; Marchal, C. [Centre Alexis-Vautrin, Dept. de radiotherapie, avenue de Bourgogne, Unite de radiotherapie externe, 54 - Vandoeuvre-les-Nancy (France); Marchesi, V.; Aletti, P.; Noel, A. [Centre Alexis-Vautrin, Dept. de radiotherapie, avenue de Bourgogne, Unite de radiophysique, 54 - Vandoeuvre-les-Nancy (France); Noel, A.; Marchal, C. [Institut National Polytechnique de Lorraine, Universite Henri-Poincare, Centre de Recherche en Automatique de Nancy, UMR CNRS 7039 Nancy-I, 54 - Vandoeuvre-les-Nancy (France)

2004-06-01

Purpose. - To report preliminary results of a prospective study of intensity-modulated radiotherapy (IMRT) for head and neck squamous cell carcinoma (HNC) with bilateral irradiation of the neck. Patients and methods. - At the Alexis Vautrin Cancer Center, 23 patients have been treated with IMRT for HNC since January 2002-August 2003. The first 10 patients with a minimum follow-up of 3 months were analyzed. All tumors were oropharyngeal. There were four females and six males, with a mean age of 50 years (range 39-66). Stages were I-II in eight and III-IV in two. CTV1 was microscopic disease and N0 neck (prescribed dose: 50 Gy) and CTV2 was macroscopic disease and the volume at risk (prescribed dose: 66-70 Gy). PTV were CTV + 5 mm. Patient's immobilization consisted of a five-point head neck shoulder thermoplastic mask. Set-up verifications were done by semi-automatically matching portal images and digitized reconstructed radiographs. IMRT used dynamic multi-leaf collimation. Five patients (group A) received 50 Gy IMRT (two post-operative and three with a brachytherapy boost with a mean dose: 27.5 Gy), and five patients (group B) received 66-70 Gy IMRT (four post-operative). Acute and late normal tissue effects were graded according to the RTOG-EORTC radiation morbidity scoring criteria. Results. - With a median follow-up of 7.4 months (range 3-18.5), no patient died or had loco-regional relapse. The displacements were <4 mm in 98% cases. CTV1 and 2 received 95% of the prescribed dose in 100% of the volume. On average the mean dose to the contralateral parotid was 25.5 Gy for group A vs. 31 Gy for group B (P = 0.09). Mean doses <26 Gy were obtained in three of five patients in group A vs. zero of five patients in group B (P = 0.04). Acute skin toxicities were grade 1 in five patients, grade 2 in four and grade 3 in one. Acute mucositis cases were grade 1 in three patients, grade 2 in five and localized grade 3 in two. At 3 months, 50% of the patients had a grade 0-1 late xerostomia. Conclusion. - The 26 Gy dose limit constraint to the contralateral parotid was easier to satisfy when IMRT was prescribed at a maximum dose of 50 Gy. Acute toxicity is low. The displacements in the mask indicate that it is possible to define the PTV as CTV + 4 mm. This reduction should decrease the mean dose to the parotids. At 3 months, a 50% rate of grade 0-1 late xerostomia encourages the hope of a very low rate at 2 years. (authors)

Management of single-ventricle patients with Berlin Heart EXCOR Ventricular Assist Device: single-center experience.

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Mackling, Tracey; Shah, Tejas; Dimas, Vivian; Guleserian, Kristine; Sharma, Mahesh; Forbess, Joseph; Ardura, Monica; Gross-Toalson, Jami; Lee, Ying; Journeycake, Janna; Barnes, Aliessa

2012-06-01

There are minimal data regarding chronic management of single-ventricle ventricular assist device (VAD) patients. This study aims to describe our center's multidisciplinary team management of single-ventricle patients supported long term with the Berlin Heart EXCOR Pediatric VAD. Patient #1 was a 4-year-old with double-outlet right ventricle with aortic atresia, L-looped ventricles, and heart block who developed heart failure 1 year after Fontan. She initially required extracorporeal membrane oxygenation support and was transitioned to Berlin Heart systemic VAD. She was supported for 363 days (cardiac intensive care unit [CICU] 335 days, floor 28 days). The postoperative course was complicated by intermittent infection including methicillin-resistant Staphylococcus aureus, intermittent hepatic and renal insufficiencies, and transient antithrombin, protein C, and protein S deficiencies resulting in multiple thrombi. She had a total of five pump changes over 10 months. Long-term medical management included anticoagulation with enoxaparin, platelet inhibition with aspirin and dipyridamole, and antibiotic prophylaxis using trimethoprim/sulfamethoxazole. She developed sepsis of unknown etiology and subsequently died from multiorgan failure. Patient #2 was a 4-year-old with hypoplastic left heart syndrome who developed heart failure 2 years after bidirectional Glenn shunt. At systemic VAD implantation, he was intubated with renal insufficiency. Post-VAD implantation, his renal insufficiency resolved, and he was successfully extubated to daytime nasal cannula and biphasic positive airway pressure at night. He was supported for 270 days (CICU 143 days, floor 127 days). The pump was upsized to a 50-mL pump in May 2011 for increased central venous pressures (29 mm Hg). Long-term medical management included anticoagulation with warfarin and single-agent platelet inhibition using dipyridamole due to aspirin resistance. He developed increased work of breathing requiring

Extracorporeal Life Support Bridge to Ventricular Assist Device: The Double Bridge Strategy.

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Marasco, Silvana F; Lo, Casey; Murphy, Deirdre; Summerhayes, Robyn; Quayle, Margaret; Zimmet, Adam; Bailey, Michael

2016-01-01

In patients requiring left ventricular assist device (LVAD) support, it can be difficult to ascertain suitability for long-term mechanical support with LVAD and eventual transplantation. LVAD implantation in a shocked patient is associated with increased morbidity and mortality. Interest is growing in the utilization of extracorporeal life support (ECLS) as a bridge-to-bridge support for these critically unwell patients. Here, we reviewed our experience with ECLS double bridging. We hypothesized that ECLS double bridging would stabilize end-organ dysfunction and reduce ventricular assist device (VAD) implant perioperative mortality. We conducted a retrospective review of prospectively collected data for 58 consecutive patients implanted with a continuous-flow LVAD between January 2010 and December 2013 at The Alfred Hospital, Melbourne, Victoria, Australia. Twenty-three patients required ECLS support pre-LVAD while 35 patients underwent LVAD implantation without an ECLS bridge. Preoperative morbidity in the ECLS bridge group was reflected by increased postoperative intensive care duration, blood loss, blood product use, and postoperative renal failure, but without negative impact upon survival when compared with the no ECLS group. ECLS stabilization improved end-organ function pre-VAD implant with significant improvements in hepatic and renal dysfunction. This series demonstrates that the use of ECLS bridge to VAD stabilizes end-organ dysfunction and reduces VAD implant perioperative mortality from that traditionally reported in these "crash and burn" patients. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Developing an Anti-Xa-Based Anticoagulation Protocol for Patients with Percutaneous Ventricular Assist Devices.

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Sieg, Adam; Mardis, B Andrew; Mardis, Caitlin R; Huber, Michelle R; New, James P; Meadows, Holly B; Cook, Jennifer L; Toole, J Matthew; Uber, Walter E

2015-01-01

Because of the complexities associated with anticoagulation in temporary percutaneous ventricular assist device (pVAD) recipients, a lack of standardization exists in their management. This retrospective analysis evaluates current anticoagulation practices at a single center with the aim of identifying an optimal anticoagulation strategy and protocol. Patients were divided into two cohorts based on pVAD implanted (CentriMag (Thoratec; Pleasanton, CA) / TandemHeart (CardiacAssist; Pittsburgh, PA) or Impella (Abiomed, Danvers, MA)), with each group individually analyzed for bleeding and thrombotic complications. Patients in the CentriMag/TandemHeart cohort were subdivided based on the anticoagulation monitoring strategy (activated partial thromboplastin time (aPTT) or antifactor Xa unfractionated heparin (anti-Xa) values). In the CentriMag/TandemHeart cohort, there were five patients with anticoagulation titrated based on anti-Xa values; one patient developed a device thrombosis and a major bleed, whereas another patient experienced major bleeding. Eight patients received an Impella pVAD. Seven total major bleeds in three patients and no thrombotic events were detected. Based on distinct differences between the devices, anti-Xa values, and outcomes, two protocols were created to guide anticoagulation adjustments. However, anticoagulation in patients who require pVAD support is complex with constantly evolving anticoagulation goals. The ideal level of anticoagulation should be individually determined using several coagulation laboratory parameters in concert with hemodynamic changes in the patient's clinical status, the device, and the device cannulation.

Prevention of Hippocampal Neuronal Damage and Cognitive Function Deficits in Vascular Dementia by Dextromethorphan.

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Xu, Xiaofeng; Zhang, Bin; Lu, Kaili; Deng, Jiangshan; Zhao, Fei; Zhao, Bing-Qiao; Zhao, Yuwu

2016-07-01

Dextromethorphan (DM) is a non-competitive antagonist of NMDA receptors and a widely used component of cough medicine. Recently, its indication has been extended experimentally to a wide range of disorders including inflammation-mediated central nervous system disorders such as Parkinson disease (PD) and multiple sclerosis (MS). In this study, we investigate whether DM treatment has protective effects on the hippocampal neuron damage induced by bilateral occlusion of the common carotid arteries (two-vessel occlusion [2VO]), an animal model of vascular dementia (VaD). Sprague-Dawley (SD) (10 weeks of age) rats were subjected to the 2VO, and DM was injected intraperitoneally once per day for 37 days. Neuron death, glial activation, and cognitive function were assessed at 37 days after 2VO (0.2 mg/kg, i.p., "DM-0.2" and 2 mg/kg, i.p., "DM-2"). DM-2 treatment provided protection against neuronal death and glial activation in the hippocampal CA1 subfield and reduced cognitive impairment induced by 2VO in rats. The study also demonstrates that activation of the Nrf2-HO-1 pathway and upregulation of superoxide dismutase (SOD) play important roles in these effects. These results suggest that DM is effective in treating VaD and protecting against oxidative stress, which is strongly implicated in the pathogenesis of VaD. Therefore, the present study suggests that DM treatment may represent a new and promising protective strategy for treating VaD.

Neuropsychiatric Symptoms in Alzheimer Disease, Vascular Dementia, and Mixed Dementia.

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Anor, Cassandra J; O'Connor, Sean; Saund, Amardeep; Tang-Wai, David F; Keren, Ron; Tartaglia, Maria Carmela

2017-01-01

Neuropsychiatric symptoms (NPS) are common in Alzheimer disease (AD) and vascular dementia (VaD), and are distressful to patients and caregivers. NPS are likely related to the underlying pathology. Previous studies suggest that frontal lobe lesions and vascular changes such as white matter hyperintensities (WMH) have a significant association with specific NPS. The current study aimed to compare NPS in patients with AD, VaD, and mixed AD/VaD, and to evaluate the differences in the prevalence of NPS in relation to frontal WMH volume. In total, 180 patients with NPS and MRI data (92 probable AD, 51%; 34 probable VaD, 19%; and 54 probable mixed AD/VaD, 30%) were included in the study. Regression analyses were performed to determine the relationships between NPS prevalence and diagnosis, and between NPS and frontal WMH. VaD patients had significantly more agitation (p < 0.05; 40 vs. 14%) and sleep disturbances (p < 0.05; 57 vs. 32%) than AD patients, and significantly more depression (p < 0.05; 48 vs. 20%) and aberrant motor behaviors (p < 0.05; 31 vs. 13%) than mixed AD/VaD patients. AD patients with delusions had significantly greater right frontal WMH volumes than those without (p < 0.05; delusions 1/0 = 314.8/112.6 mm3). Differences in NPS prevalence are likely related to the underlying pathology and warrant further study as they have implications for treatment. © 2017 S. Karger AG, Basel.

Human papillomavirus DNA in aerodigestive squamous carcinomas ...

African Journals Online (AJOL)

A series of 10 oesophageal and 10 laryngeal squamous carcinomas was examined by means of immuno cytochemistry and in situ DNA hybridisation to demonstrate human papillomavirus (HPV) infection. Changes in the epithelium adjacent to the carcinoma were found in 5 of 10 oesophageal and 7 of 10 laryngeal ...

Klubbhusverksamheten - Betydelse av dagligt arbete

OpenAIRE

Niskanen, Karolina

2011-01-01

Syftet med undersökningen är att beskriva klubbhusmedlemmarnas uppfattning om det dagliga arbetet och dess betydelse för välmående i vardagen. Undersökningen utfördes i form av kvalitativa intervjuer med fem medlemmar av klubbhuset Pelaren i Mariehamn. Forskningsfrågorna som skulle besvaras var hur klubbhusmedlemmarna uppfattar arbete, vad arbete har för betydelse för deras hälsa, vilka aktiviteter de upplever som betydelsefulla i klubbhusverksamheten samt vad i klubbhusmiljön som stöder dem ...

Estimating Turbulence Statistics and Parameters from Lidar Measurements. Remote Sensing Summer School

DEFF Research Database (Denmark)

Sathe, Ameya

This report is prepared as a written contribution to the Remote Sensing Summer School, that is organized by the Department of Wind Energy, Technical University of Denmark. It provides an overview of the state-of-the-art with regards to estimating turbulence statistics from lidar measurements...... configuration. The so-called velocity Azimuth Display (VAD) and the Doppler Beam Swinging (DBS) methods of post processing the lidar data are investigated in greater details, partly due to their wide use in commercial lidars. It is demonstrated that the VAD or DBS techniques result in introducing significant...

Budgetering och budgeteringsprocessen inom ekonomiförvaltningen

OpenAIRE

Finnström, Anders

2013-01-01

Syftet med undersökningen är att ge en bild av vad budgetering är och budgeteringsprocessen inom ekonomiförvaltningen. Forskningsproblemet är att ta reda på vilken kritiken är mot budgetering, hur man kan förbättra budgetarbetet och få fram vilka de alternativa metoderna är till budgetering. I lärdomsprovets teoretiska del behandlas vad en budget är, syften med en budget, huvud- och delbudgetar, budgeteringsprocessen, kritik och alternativa metoder till budgeteringen. I den empiriska delen ha...

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African Journals Online (AJOL)

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warts, oral or vulvar papilloma, keratoacanthoma, epidermoplasia verruciformis etc. In the head and neck region, the commonly affected sites are the skin, oral mucosa and upper aerodigestive tract. (Wang et al., 2009). Ear canal papillomas are relatively rare and are gen- erally associated with low-risk HPV types 6 and 11.

Serum Retinol Levels in Pregnant Adolescents and Their Relationship with Habitual Food Intake, Infection and Obstetric, Nutritional and Socioeconomic Variables.

Science.gov (United States)

Spíndola Garcêz, Laís; de Sousa Paz Lima, Geania; de Azevedo Paiva, Adriana; Maria Rebêlo Sampaio da Paz, Suzana; Lázaro Gomes, Erica Ivana; Nunes, Valéria Sutti; Cotta de Faria, Eliana; de Barros-Mazon, Sílvia

2016-10-25

Globally, vitamin A deficiency (VAD) affects about 19.1 million pregnant women. Its occurrence is classically associated with inadequate food intake and may also be associated with socioeconomic factors and the presence of infection. The aim of this study was to determine the factors related to serum retinol levels among pregnant teenagers. The sample consisted of 89 pregnant adolescents, from whom socioeconomic, obstetric, anthropometric, and food consumption data were collected. Serum concentrations of retinol and the supposed presence of infection were determined by high-performance liquid chromatography and C-reactive protein quantification, respectively. The serum retinol concentrations were classified according to the criteria of the World Health Organization. We adopted a 5% significance level for all statistical tests. Serum retinol levels were significantly and positively associated with sanitation ( p = 0.008) and pre-gestational nutritional status ( p = 0.002), and negatively with the trimester ( p = 0.001). The appropriate sanitation conditions and pre-pregnancy body mass index (BMI) were shown to have a protective effect against VAD. Conversely, serum retinol levels were reduced with trimester progression, favoring VAD occurrence.

Outflow monitoring of a pneumatic ventricular assist device using external pressure sensors.

Science.gov (United States)

Kang, Seong Min; Her, Keun; Choi, Seong Wook

2016-08-25

In this study, a new algorithm was developed for estimating the pump outflow of a pneumatic ventricular assist device (p-VAD). The pump outflow estimation algorithm was derived from the ideal gas equation and determined the change in blood-sac volume of a p-VAD using two external pressure sensors. Based on in vitro experiments, the algorithm was revised to consider the effects of structural compliance caused by volume changes in an implanted unit, an air driveline, and the pressure difference between the sensors and the implanted unit. In animal experiments, p-VADs were connected to the left ventricles and the descending aorta of three calves (70-100 kg). Their outflows were estimated using the new algorithm and compared to the results obtained using an ultrasonic blood flow meter (UBF) (TS-410, Transonic Systems Inc., Ithaca, NY, USA). The estimated and measured values had a Pearson's correlation coefficient of 0.864. The pressure sensors were installed at the external controller and connected to the air driveline on the same side as the external actuator, which made the sensors easy to manage.

Mechanism underlying the suppressor activity of retinoic acid on IL4-induced IgE synthesis and its physiological implication.

Science.gov (United States)

Seo, Goo-Young; Lee, Jeong-Min; Jang, Young-Saeng; Kang, Seung Goo; Yoon, Sung-Il; Ko, Hyun-Jeong; Lee, Geun-Shik; Park, Seok-Rae; Nagler, Cathryn R; Kim, Pyeung-Hyeun

2017-12-01

The present study extends an earlier report that retinoic acid (RA) down-regulates IgE Ab synthesis in vitro. Here, we show the suppressive activity of RA on IgE production in vivo and its underlying mechanisms. We found that RA down-regulated IgE class switching recombination (CSR) mainly through RA receptor α (RARα). Additionally, RA inhibited histone acetylation of germ-line ε (GL ε) promoter, leading to suppression of IgE CSR. Consistently, serum IgE levels were substantially elevated in vitamin A-deficient (VAD) mice and this was more dramatic in VAD-lecithin:retinol acyltransferase deficient (LRAT -/- ) mice. Further, serum mouse mast cell protease-1 (mMCP-1) level was elevated while frequency of intestinal regulatory T cells (Tregs) were diminished in VAD LRAT -/- mice, reflecting that deprivation of RA leads to allergic immune response. Taken together, our results reveal that RA has an IgE-repressive activity in vivo, which may ameliorate IgE-mediated allergic disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevalence of dementia and major subtypes in Europe

DEFF Research Database (Denmark)

Lobo, A; Launer, L J; Fratiglioni, L

2000-01-01

The last comparison of prevalence figures of dementia across European studies was 10 years ago. Using studies conducted in the 1990s, the authors compare the age- and sex-specific prevalence of dementia, AD, and vascular dementia (VaD) across European population-based studies of persons 65 years...... and older. Data from these studies were also pooled to obtain stable estimates of age- and sex-specific prevalence. A total of 2346 cases of mild to severe dementia were identified in 11 cohorts. Age-standardized prevalence was 6.4% for dementia (all causes), 4.4% for AD, and 1.6% for VaD. The prevalence...... of dementia increased continuously with age and was 0.8% in the group age 65 to 69 years and 28.5% at age 90 years and older. The corresponding figures for AD (53.7% of cases) were 0.6% and 22.2%, and for VaD (15.8% of cases), 0.3% and 5.2%. Variation of AD prevalence across studies was greatest for men...

Arroz Dorado, cultivos dorados, perspectivas doradas

Directory of Open Access Journals (Sweden)

Jorge E Mayer Cabrera

2007-01-01

Full Text Available Golden Rice is probably the best known second-generation—nutrition quality enhanced—transgenic  crop, but several others are following suit. Golden Rice was developed to deal with the problem of vitamin A deficiency (VAD, which affects millions of people all over the world, especially small children in developing countries. VAD not only causes blindness and increased morbidity, but a hitherto almost ignored increase in mortality. While ongoing supplementation and fortification programs are helping to reduce the burden, there is a strong need to develop biofortified crops capable of sustainably providing various micronutrients to target populations. Green biotechnology and progress in the biochemical understanding of the mechanisms of biosynthesis and accumulation pathways of micronutrients have not only paved the way to address VAD but also deficiency of the micronutrients iron, zinc, vitamin E, folate, and essential amino acids. Here I provide an overview of the progress and the political environment of the Golden Rice Project as well as the status of a number of related projects in biofortification. Key words: Biofortification, micronutrient deficiency, vitamin A deficiency, carotenoids, beta-carotene, nutrigenomics

Short fusion

CERN Multimedia

2002-01-01

French and UK researchers are perfecting a particle accelerator technique that could aid the quest for fusion energy or make X-rays that are safer and produce higher-resolution images. Led by Dr Victor Malka from the Ecole Nationale Superieure des Techniques Avancees in Paris, the team has developed a better way of accelerating electrons over short distances (1 page).

Contribution a l'etude de la flore lichenique dans la zeenaie de ...

African Journals Online (AJOL)

situe dans l'etage bioclimatique subhumide caracterise par un hiver doux et humide et un ete chaud et sec. ... que si le subsfrat est humide OU meme impregnes d'eau). La plupart des lichens foliaces et presque tous ..... soufre S02 superieure a 30 µI m3 d'air [18]. Le lichen pulmonaire est un excellent indicateur d'une forte ...

Symposium at CERN in honour of Maurice Jacob on 27th March 1998

CERN Multimedia

Patrice Loïez

1998-01-01

The Jacobfest at CERN was prefaced by a talk by Maurice Jacob's longtime colleague Claude Cohen-Tannoudji of the College de France and Ecole Normale Superieure, who shared the 1997 Nobel Prize with Steven Chu of Stanford and William D. Phillips, of the US National Institute of Standards and Technology, for their development of methods to cool and trap atoms with laser light.

Problematique de l'utilisation des tic dans l'enseignement superieur ...

African Journals Online (AJOL)

Mots clés : Technologies de l'Information et de la Communication (TIC), Internet, enseignants chercheurs, étudiants, université. Communication and Information Technologies (TIC) plays today an important part in the sectors of the life. Appearing as a means of supplementing the traditional educational techniques they make ...

Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment.

Science.gov (United States)

Chen, Hui-Mei; Lin, Hsiu-Fen; Huang, Mei-Feng; Chang, Chun-Wei; Yeh, Yi-Chun; Lo, Yi-Ching; Yen, Cheng-Fang; Chen, Cheng-Sheng

2016-01-01

Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants' reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), for vascular cognitive impairment (VCI) by examining its psychometric properties and diagnostic accuracy. Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD), 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE), Lawton-IADL and Barthel Index (BI), were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined. Cronbach's alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = -0.587, p cognitive domain of Lawton IADL (r = -0.663) than with physical domain of Lawton IADL (r = -0.541). The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812-0.965) to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%. The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD.

The pathophysiology of the aqueduct stroke volume in normal pressure hydrocephalus: can co-morbidity with other forms of dementia be excluded?

International Nuclear Information System (INIS)

Bateman, Grant A.; Levi, Christopher R.; Wang, Yang; Lovett, Elizabeth C.; Schofield, Peter

2005-01-01

Variable results are obtained from the treatment of normal pressure hydrocephalus (NPH) by shunt insertion. There is a high correlation between NPH and the pathology of Alzheimer's disease (AD) on brain biopsy. There is an overlap between AD and vascular dementia (VaD), suggesting that a correlation exists between NPH and other forms of dementia. This study seeks to (1) understand the physiological factors behind, and (2) define the ability of, the aqueduct stroke volume to exclude dementia co-morbidity. Twenty-four patients from a dementia clinic were classified as having either early AD or VaD on the basis of clinical features, Hachinski score and neuropsychological testing. They were compared with 16 subjects with classical clinical findings of NPH and 12 aged-matched non-cognitively impaired subjects. MRI flow quantification was used to measure aqueduct stroke volume and arterial pulse volume. An arterio-cerebral compliance ratio was calculated from the two volumes in each patient. The aqueduct stroke volume was elevated in all three forms of dementia, with no significant difference noted between the groups. The arterial pulse volume was elevated by 24% in VaD and reduced by 35% in NPH, compared to normal (P=0.05 and P=0.002, respectively), and was normal in AD. There was a spectrum of relative compliance with normal compliance in VaD and reduced compliance in AD and NPH. The aqueduct stroke volume depends on the arterial pulse volume and the relative compliance between the arterial tree and brain. The aqueduct stroke volume cannot exclude significant co-morbidity in NPH. (orig.)

The pathophysiology of the aqueduct stroke volume in normal pressure hydrocephalus: can co-morbidity with other forms of dementia be excluded?

Energy Technology Data Exchange (ETDEWEB)

Bateman, Grant A. [John Hunter Hospital, Department of Medical Imaging, Newcastle (Australia); Levi, Christopher R.; Wang, Yang; Lovett, Elizabeth C. [Hunter Medical Research Institute, Clinical Neurosciences Program, Newcastle (Australia); Schofield, Peter [James Fletcher Hospital, Neuropsychiatry Unit, Newcastle (Australia)

2005-10-01

Variable results are obtained from the treatment of normal pressure hydrocephalus (NPH) by shunt insertion. There is a high correlation between NPH and the pathology of Alzheimer's disease (AD) on brain biopsy. There is an overlap between AD and vascular dementia (VaD), suggesting that a correlation exists between NPH and other forms of dementia. This study seeks to (1) understand the physiological factors behind, and (2) define the ability of, the aqueduct stroke volume to exclude dementia co-morbidity. Twenty-four patients from a dementia clinic were classified as having either early AD or VaD on the basis of clinical features, Hachinski score and neuropsychological testing. They were compared with 16 subjects with classical clinical findings of NPH and 12 aged-matched non-cognitively impaired subjects. MRI flow quantification was used to measure aqueduct stroke volume and arterial pulse volume. An arterio-cerebral compliance ratio was calculated from the two volumes in each patient. The aqueduct stroke volume was elevated in all three forms of dementia, with no significant difference noted between the groups. The arterial pulse volume was elevated by 24% in VaD and reduced by 35% in NPH, compared to normal (P=0.05 and P=0.002, respectively), and was normal in AD. There was a spectrum of relative compliance with normal compliance in VaD and reduced compliance in AD and NPH. The aqueduct stroke volume depends on the arterial pulse volume and the relative compliance between the arterial tree and brain. The aqueduct stroke volume cannot exclude significant co-morbidity in NPH. (orig.)

Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency

Directory of Open Access Journals (Sweden)

James P. Wirth

2017-02-01

Full Text Available Vitamin A supplementation (VAS programs targeted at children aged 6–59 months are implemented in many countries. By improving immune function, vitamin A (VA reduces mortality associated with measles, diarrhea, and other illnesses. There is currently a debate regarding the relevance of VAS, but amidst the debate, researchers acknowledge that the majority of nationally-representative data on VA status is outdated. To address this data gap and contribute to the debate, we examined data from 82 countries implementing VAS programs, identified other VA programs, and assessed the recentness of national VA deficiency (VAD data. We found that two-thirds of the countries explored either have no VAD data or data that were >10 years old (i.e., measured before 2006, which included twenty countries with VAS coverage ≥70%. Fifty-one VAS programs were implemented in parallel with at least one other VA intervention, and of these, 27 countries either had no VAD data or data collected in 2005 or earlier. To fill these gaps in VAD data, countries implementing VAS and other VA interventions should measure VA status in children at least every 10 years. At the same time, the coverage of VA interventions can also be measured. We identified three countries that have scaled down VAS, but given the lack of VA deficiency data, this would be a premature undertaking in most countries without appropriate status assessment. While the global debate about VAS is important, more attention should be directed towards individual countries where programmatic decisions are made.

Penetrating and blunt trauma to the neck: clinical presentation, assessment and emergency management.

Science.gov (United States)

Perdonck, P; de Schoutheets, J C; Monsieurs, K G; Van Laer, C; Vander Poorten, V; Vanderveken, O

Penetrating and blunt trauma to the neck: clinical presentation, assessment ana emergency management. In Belgium, and even in Western Europe, penetrating and blunt injury to the neck is relatively uncommon in both the civilian and military populations. Pre-hospital and emergency assessment and management will therefore always prove challenging, as individual exposure to this specific type of injury remains low. Historically, the neck has been divided into three anatomical zones with specific landmarks to guide the diagnostic and therapeutic approach to penetrating neck injuries. Most penetrating injuries need to be explored surgically, although with the advent of multi-detector computed tomographic angiography (MDCTA), which yields high diagnostic sensitivity, this inflexible approach has recently changed to a more targeted management, based on clinical, radiographic and, if deemed necessary, endoscopic findings. However, some authors have addressed their concern about this novel, 'no-zone' approach, since the risk of missing less apparent aerodigestive tract injuries may increase. It is recommended, therefore, that all patients with penetrating neck injuries be closely observed, irrespective of the initial findings. The incidence of blunt neck injury is much lower, and this makes risk assessment and management even more difficult in comparison with penetrating injuries. Again, MDCTA is most often the first diagnostic tool if a blunt neck injury is suspected, due to its good sensitivity for blunt cerebrovascular injuries (BCVI) as well as for aerodigestive tract injuries. Specific patterns of injury and unexpected neurological and neuro-radiological findings in trauma patients should always warrant further investigation. Despite ongoing debate, systemic anticoagulation is recommended for most BCVI, sometimes combined with endovascular treatment. Aerodigestive tract injuries may present dramatically, but are often more subtle, making the diagnosis more difficult

Second primary tumours in oral cancer

NARCIS (Netherlands)

van der Waal, I.; de Bree, R.

2010-01-01

Second primary tumours in patients treated for oral cancer occur at a rate of 3% to 7% per year. The majority of these tumours show up at least six months after the detection of the primary and are often located in the upper aerodigestive tract. Cessation of smoking habits may reduce the risk of the

Implicaciones Fisiológicas en la Vía Aérea Difícil

OpenAIRE

Martínez Hurtado, Eugenio; Sánchez Merchante, Miriam; Mariscal Flores, Marisa; Paz Martín, Daniel; López Coloma, Rafael

2016-01-01

La Vía Aérea Difícil (VAD) continúa siendo la primera causa de morbi-mortalidad anestésica, e incluye diferentes situaciones, como la ventilación difícil con mascarilla facial (VDMF), laringoscopia difícil (LD), intubación difícil (ID) y la ventilación e intubación imposible (escenario No intubable /No ventilable). Aunque sigue sin existir actualmente en la literatura consenso en la definición de VAD, la ASA define la ID como aquella situación en la que, con la cabeza en posición neutra y ...

Anàlisi i tècniques de processat del senyal per a la generació de mapes eòlics

OpenAIRE

Martínez Domingo, Carme

2009-01-01

L'emplaçament del projecte es situa a un parc eòlic marítim, on es vol observar el vent a través del radar VAD, Velocity Azimuth Display, per poder controlar la velocitat de rotació dels aerogeneradors, i poder substituir els actuals anemòmetres. No ens centrarem en el control d'aquest, sinó que l'objectiu principal d'aquest projecte és analitzar el funcionament i processat de dades del VAD. Es proposaran, simularan i estudiaran noves tècniques d'estimació espectral per obtenir una millora im...

Does CPAP Affect Patient-Reported Voice Outcomes?

Science.gov (United States)

Hartke, Vance; Gillespie, Amanda; Smith, Libby J; Soose, Ryan J

2018-04-01

Upper aerodigestive tract symptoms are common in patients with obstructive sleep apnea (OSA). It remains unclear whether continuous positive airway pressure (CPAP) improves or worsens these otolaryngology symptoms. As therapy-related side effects limit CPAP adherence, this study aimed to determine if CPAP negatively affects voice, sinonasal, and reflux symptoms of the upper airway. Case series with planned data collection was performed at an academic otolaryngology sleep center. Newly diagnosed patients with OSA were evaluated before and 6 months after initiating CPAP therapy. Data collected included CPAP data download, Reflux Symptom Index (RSI), Epworth Sleepiness Scale (ESS), Voice Handicap Index 10 (VHI-10), Sino-Nasal Questionnaire (SNQ), and oral dryness visual analog scale (VAS). For the 11 CPAP-adherent participants, the RSI significantly improved with CPAP (mean RSI, 22.0-9.5; P = .002); however, the VAS, VHI-10, and SNQ did not change after 6 months of CPAP therapy. In a small sample size, patient-reported voice outcomes (VHI-10) and other upper aerodigestive tract symptoms did not worsen with CPAP; rather, CPAP therapy was associated with a reduction in reflux symptoms.

Study of superconductors of the second type in the lead-thallium system; Etude des supraconducteurs de la deuxieme espece du systeme plomb-thallium

Energy Technology Data Exchange (ETDEWEB)

Bon Mardion, G [Commissariat a l' Energie Atomique, Grenoble (France). Centre d' Etudes Nucleaires

1965-07-01

The author has shown by magnetization measurements on lead-thallium alloys having from 5 to 70 atom per cent of thallium, that superconductors of the second type definitively exist. The results obtained, in particular on the upper critical field H{sub C2} are in good agreement with the models of Ginzburg, Landau, Abrikosov, Gorkov and Goodman. Finally resistivity measurements have confirmed the occurrence of a fourth upper critical field, the existence of which has been theoretically predicted by St James and de Gennes. (author) [French] L'auteur par des mesures d'aimantation sur les alliages plomb-thallium, de composition variant de 5 pour cent a 70 pour cent At. de thallium, a montre qu'il fallait admettre definitivement l'existence des supraconducteurs de la deuxieme espece. Les resultats obtenus, en particulier sur le champ critique superieur H{sub c2} sont en bon accord avec les modeles de Ginzburg, Landau, Abrikosov, Gorkov et Goodman. Enfin des mesures de resistivite ont confirme l'existence d'un quatrieme champ critique superieur H{sub c3}, existence prevue theoriquement par St James et de Gennes. (auteur)

Molecular Simulation of the Vapor-Liquid Phase Behavior of Lennard-Jones Mixtures in Porous Solids

Science.gov (United States)

2006-09-01

sur la Catalyse, Centre National de la Recherche Scientifique, Group de Chimie Theorique, 2 Avenue Albert Einstein, 69626 Villeurbanne Cedex, France...and Group de Chimie Theorique, Ecole Normale Superieure de Lyon, 46 Allee d’Italie, 69364 Lyon, Cedex 07, France 14. ABSTRACT We present vapor...Scientifique, Group de Chimie Theorique, 2 Avenue Albert Einstein, 69626 Villeurbanne Cedex, France and Group de Chimie Theorique, Ecole Normale

Involvement of central airways in vibroacoustic disease patients

Directory of Open Access Journals (Sweden)

José Reis Ferreira

2006-03-01

Full Text Available Introduction. Vibroacoustic disease (VAD is the whole-body pathology caused by excessive exposure to LFN. For the past 25 years, it has been know that low frequency noise (LFN, <500 Hz, including infrasound targets the respiratory system. In LFN-exposed rodents, the morphological changes of respiratory tract tissue partially explained some respiratory symptoms reported by VAD patients. However, many questions remain unanswered. Recently, some volunteer VAD patients underwent bronchoscopy in order to ascertain possible damage that could be associated with their respiratory complaints. Methods. Fourteen fully-informed and volunteer VAD patients were submitted to bronchoscopy, and biopsies were removed for analysis. Results. All patients exhibited small submucosal vascular-like lesions near the spurs, consisting of increased collagen and elastin fibres. Histology disclosed cilliary abnormalities, basal membrane hyperplasia, and thickening of vessel walls. In five patients, collagen bundles appeared degenerative and disrupted. No inflammatory process was ever identified, and no differences were seen between smokers and non-smokers. Discussion. Data is in accordance with what was observed in LFN-exposed animal models and also in 8 VAD patients who developed lung tumours. Collagen disruption and degeneration was also observed in electron microscopy images of the respiratory tract of LFN-exposed rodents. Thickened blood and lymphatic vessel walls have been consistently seen in images of VAD patients and of LFN-exposed rodents. During bronchoscopy performed by other reasons, this sort of structural aspects is not frequently seen. Taken together, it is strongly suggested that these findings could be VAD-specific. Resumo: Nos últimos vinte cinco anos constatou-se que o aparelho respiratório constitui um alvo do ruído de baixa frequência (RFB <500Hz, incluindo infra-sons. Denomina-se doença vibroacústica (VAD a patologia sistémica causada pela

Evaluating the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo.

Science.gov (United States)

Li, Wenxian; Feng, Youzhen; Lu, Weibiao; Xie, Xie; Xiong, Zhilin; Jing, Zhen; Cai, Xiangran; Huang, Li'an

2016-11-15

To determine the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo (UIV) patients using 320-detector row computed tomography (CT). A total of 150 patients who underwent CT angiography (CTA) and CT perfusion (CTP) imaging were divided into UIV group and benign paroxysmal positional vertigo (BPPV) group. Sixty individuals with sex- and age-matched without vertigo and cerebral diseases served as the control. The morphological changes of intracranial arteries, perfusion parameters and vascular risk factors (VRFs) were analyzed, calculated and compared. In UIV patients, hypertension (HT), hyperlipidemia and number of VRFs≥3 occurred more commonly (P<0.0125, respectively). The incidence of vertebral artery dominance (VAD), vertebral artery stenosis (VAS) and basilar artery curvature (BAC) were significantly higher (P<0.0125, respectively). HT was an independent risk predictor of non-VAD (OR: 5.411, 95%CI: 1.401; 20.900, P=0.014). HT and VAD associated with BAC served as risk predictors (OR: 4.081, 95%CI: 1.056;15.775, P=0.041 and OR: 6.284, 95%CI: 1.848; 21.365, P=0.003, respectively). The absolute difference in relative values of CTP parameters from cerebellum and brainstem were significantly different (P<0.05), and hypoperfusion was found in the territories of the non-VAD side and the BAC cohort (P<0.05, respectively). On the basis of multiple VRFs, morphological changes of vertebrobasilar artery (VBA) and the unilateral hypoperfusion of the cerebellum and brainstem, that acts as a herald for IV occurrence, which should be paid cautious attention to UIV patients. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL, a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment.

Directory of Open Access Journals (Sweden)

Hui-Mei Chen

Full Text Available Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants' reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL, for vascular cognitive impairment (VCI by examining its psychometric properties and diagnostic accuracy.Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD, 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE, Lawton-IADL and Barthel Index (BI, were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined.Cronbach's alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = -0.587, p <0.01. Notably, the TPIADL had a higher correlation coefficient with the cognitive domain of Lawton IADL (r = -0.663 than with physical domain of Lawton IADL (r = -0.541. The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812-0.965 to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%.The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD.

Taking a positive spin: preserved initiative and performance of everyday activities across mild Alzheimer's, vascular and mixed dementia.

Science.gov (United States)

Giebel, Clarissa M; Burns, Alistair; Challis, David

2017-09-01

The literature commonly evaluates those daily activities which are impaired in dementia. However, in the mild stages, people with dementia (PwD) are still able to initiate and perform many of those tasks. With a lack of research exploring variations between different dementia diagnoses, this study sought to investigate those daily activities with modest impairments in the mild stages and how these compare between Alzheimer's disease (AD), vascular dementia (VaD) and mixed dementia. Staff from memory assessment services from nine National Health Service trusts across England identified and approached informal carers of people with mild dementia. Carers completed the newly revised Interview for Deteriorations in Daily Living Activities in Dementia 2 assessing the PwD's initiative and performance of instrumental activities of daily living (IADLs). Data were analysed using analysis of variance and Chi-square tests to compare the maintenance of IADL functioning across AD, VaD, and mixed dementia. A total of 160 carers returned the Interview for Deteriorations in Daily Living Activities in Dementia 2, of which 109, 21, and 30 cared for someone with AD, VaD, and mixed dementia, respectively. There were significant variations across subtypes, with AD showing better preserved initiative and performance than VaD for several IADLs. Overall, PwD showed greater preservation of performance than initiative, with tasks such as preparing a hot drink and dressing being best maintained. Findings can help classify dementia better into subtypes in order to receive bespoke support. It suggests that interventions should primarily address initiative to improve overall functioning. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Efficacy, safety and tolerability of rivastigmine capsules in patients with probable vascular dementia: the VantagE study.

Science.gov (United States)

Ballard, C; Sauter, M; Scheltens, P; He, Y; Barkhof, F; van Straaten, E C W; van der Flier, W M; Hsu, C; Wu, S; Lane, R

2008-09-01

The aim was to evaluate the efficacy, safety and tolerability of rivastigmine capsules in patients diagnosed with probable vascular dementia (VaD). VantagE (Vascular Dementia trial studying Exelon) was a 24-week, multicentre, double-blind study. VaD patients aged 50-85 years were randomized to rivastigmine capsules (3-12 mg/day) or placebo. Efficacy assessments included global and cognitive performances, activities of daily living and neuropsychiatric symptoms. Adverse events were recorded. Additional exploratory analyses determined whether heterogeneity in pathologies and symptoms extended to differential treatment effects. NCT00099216. 710 patients were randomized. Rivastigmine demonstrated superiority over placebo on three measures of cognitive performance (Vascular Dementia Assessment Scale, Alzheimer's Disease Assessment Scale cognitive subscale, Mini-Mental State Examination; all p or =75 years old), assumed more likely to also have Alzheimer's disease (AD) pathology, demonstrated significant cognitive responses to rivastigmine and a safety profile similar to that seen in AD patients. Younger patients, assumed less likely to have concomitant AD pathology, showed no efficacy response and were associated with slight elevations of blood pressure, cerebrovascular accidents and mortality. Rivastigmine-placebo differences in patients with, versus those without, medial temporal atrophy (also suggestive of concomitant AD) showed a numerical difference similar to that seen between the older versus younger patients, but did not attain statistical significance. Consistent with trials evaluating other cholinesterase inhibitors, rivastigmine did not provide consistent efficacy in probable VaD. The efficacy apparent on cognitive outcomes was derived from effects in older patients likely to have concomitant Alzheimer pathology. This is supportive of an existing argument that the putative cholinergic deficit in VaD reflects the presence of concomitant Alzheimer pathology.

Analysis of Electrochemical Porosity of Phosphatized Coatings on Galvanized Steel Substrate

Directory of Open Access Journals (Sweden)

Ponte Haroldo de Araújo

2002-01-01

Full Text Available This work refers to the application of a Voltammetric Anodic Dissolution (VAD Technique in the analysis of coating discontinuities, focusing on pores and cracks that exposed the substrate. An evaluation was made of the influence of several parameters, such as the concentration of the passivation solution and sweep rate (SR, on the substrate passivation process and on the porosity indexes of tricationic phosphate coatings of Fe/Zn/Mn. The phosphatization process used was a commercial tricationic Fe/Zn/Mn phosphate bath applied on a galvanized steel (GS substrate. Once the best experimental conditions for the use of the VAD technique had been defined, the grain size and layer weight were related to porosity indexes. The porosity was found to show a tendency to decrease with increasing grain size. The VAD technique consists of the anodic polarization of the substrate/coating system and measurement of the charge density involved in the substrate passivation process. A quantitative porosity index was obtained by comparing the passivation charge density of the substrate without coating (standard passivation charge density and the passivation charge of the coated substrate.

Voice Activity Detection Using Fuzzy Entropy and Support Vector Machine

Directory of Open Access Journals (Sweden)

R. Johny Elton

2016-08-01

Full Text Available This paper proposes support vector machine (SVM based voice activity detection using FuzzyEn to improve detection performance under noisy conditions. The proposed voice activity detection (VAD uses fuzzy entropy (FuzzyEn as a feature extracted from noise-reduced speech signals to train an SVM model for speech/non-speech classification. The proposed VAD method was tested by conducting various experiments by adding real background noises of different signal-to-noise ratios (SNR ranging from −10 dB to 10 dB to actual speech signals collected from the TIMIT database. The analysis proves that FuzzyEn feature shows better results in discriminating noise and corrupted noisy speech. The efficacy of the SVM classifier was validated using 10-fold cross validation. Furthermore, the results obtained by the proposed method was compared with those of previous standardized VAD algorithms as well as recently developed methods. Performance comparison suggests that the proposed method is proven to be more efficient in detecting speech under various noisy environments with an accuracy of 93.29%, and the FuzzyEn feature detects speech efficiently even at low SNR levels.

A durability study of a paracorporeal pulsatile electro-mechanical pneumatic biventricular assist device.

Science.gov (United States)

Choi, Hyuk; Lee, Heung-Man; Nam, Kyoung Won; Choi, Jaesoon; Lee, Jung-Joo; Kim, Ho Chul; Song, Seung Joon; Ahn, Chi Bum; Son, Ho Sung; Lim, Choon Hak; Son, Kuk Hui; Park, Yong Doo; Jeong, Gi Seok; Sun, Kyung

2011-06-01

In 2002, the paracorporeal pulsatile electro-mechanical pneumatic ventricular assist device (VAD) began to be developed by the Korea Artificial Organ Center at Korea University under a Health & Medical Technology Research and Development program which finished in 2008. In vitro durability testing was conducted on the paracorporeal pulsatile pneumatic VAD to determine device durability and to evaluate device failures. The 1- and 2-year reliability of the paracorporeal pulsatile pneumatic VAD was shown to be 91.2% and 54.9%, respectively, with an 80% confidence level. Failure modes were analyzed using fault tree analysis, with customized software continuously acquiring data during the test period. After this period, 21 in vivo animal tests were done, with 14 cases of left atrium to left ventricle (LV) inflow cannulation (36Fr)/outflow grafting to descending aorta, and seven cases of apex cannulation of LV to descending aorta (12 mm). The longest postoperative day (182 days) in Korea was recently recorded in in vivo animal testing (bovine, 90 kg, male, 3.5-4.0 L/min flow rate, and 55 bpm). © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Qualitative aspects of learning, recall, and recognition in dementia

Directory of Open Access Journals (Sweden)

Ranjith Neelima

2010-01-01

Full Text Available Objective: To determine whether learning and serial position effect (SPE differs qualitatively and quantitatively among different types of dementia and between dementia patients and controls; we also wished to find out whether interference affects it. Materials and Methods: We administered the Malayalam version of the Rey Auditory Verbal Learning Test (RAVLT to 30 cognitively unimpaired controls and 80 dementia patients [30 with Alzheimer′s disease (AD, 30 with vascular dementia (VaD, and 20 with frontotemporal dementia (FTD] with mild severity on the Clinical Dementia Rating Scale. Results: All groups were comparable on education and age, except the FTD group, who were younger. Qualitatively, the learning pattern and SPE (with primacy and recency being superior to intermediate was retained in the AD, VaD, and control groups. On SPE in free recall, recency was superior to intermediate in the FTD group (P < 0.01 using Bonferroni correction. On recognition, the AD and VaD groups had more misses (P < 0.01, while the FTD group had more false positives (P < 0.01. Conclusion: Quantitative learning is affected by dementia. The pattern of qualitative learning remains unaltered in dementia in the early stages.

Synergy of first principles modelling with predictive control for a biventricular assist device: In silico evaluation study.

Science.gov (United States)

Koh, Vivian C A; Yong Kuen Ho; Stevens, Michael C; Salamonsen, Robert F; Lovell, Nigel H; Lim, Einly

2017-07-01

Control for dual rotary left ventricular assist devices (LVADs) used as a biventricular assist device (BiVAD) is challenging. If the control system fails, flow imbalance between the systemic and the pulmonary circulations would result, subsequently leading to ventricular suction or pulmonary congestion. With the expectation that advanced control approaches such as model predictive control could address the challenges naturally and effectively, we developed a synergistic first principles model predictive controller (MPC) for the BiVAD. The internal model of the MPC is a simplified state-space model that has been developed and validated in a previous study. A single Frank-Starling (FS) control curve was used to define the target pump flow corresponding to the preload on each side of the heart. The MPC was evaluated in a validated numerical model using three clinical scenarios: blood loss, myocardial recovery, and exercise. Simulation results showed that the MPC was effective in adapting to changes in physiological states without causing ventricular suction or pulmonary congestion. The use of MPC for a BiVAD eliminates the need for two controllers of dual LVADs thus making the task of controller tuning easier.

Protective coating of inner surface of steel tubes via vacuum arc deposition

Energy Technology Data Exchange (ETDEWEB)

Maile, K.; Roos, E.; Lyutovich, A.; Boese, J.; Itskov, M. [Stuttgart Univ. (DE). Materialpruefungsanstalt (MPA); Ashurov, Kh.; Mirkarimov, A.; Kazantsev, S.; Kadirov, Kh. [Uzbek Academy of Science, Tashkent (Uzbekistan). Arifov Inst. of Electronics

2010-07-01

The Vacuum Arc Deposition (VAD) technique based on sputtering a chosen electrode material and its deposition via plasma allows highly-productive technology for creating a wide class of protecting coatings on complex structures. In this work, VAD was applied as a method for the protection of the inner surface of tubes for power-plant boilers against steam oxidation. For this aim, a source cathode of an alloy with high chromium and nickel content was employed in two different VAD treatment systems: a horizontal vacuum chamber (MPA) and a vertical system where the work-piece of the tubes to be protected served as a vacuum changer (Arifov Institute of Electronics). Surface coating with variation of deposition parameters and layer thickness was performed. Characterisation of coated tubes has shown that the method realised in this work allows attainment of material transfer from the cathode to the inner surface with nearly equal chemical composition. It was demonstrated that the initial martensitic structure of the tubes was kept after the vacuum-arc treatment which can provide for both the high mechanical robustness and the corrosion-resistance of the final material. (orig.)

Hüvad ärritunud pedagoogilised daamid / Vaapo Vaher

Index Scriptorium Estoniae

Vaher, Vaapo, 1945-

2003-01-01

Arvustus: XX sajandi vene kirjandus. I, Luule / [koostanud Katrin Kalamees ja Maritsa Lens. Tallinn] : Avita, 2002; XX sajandi vene kirjandus. II, Proosa / [koostanud Katrin Kalamees ja Maritsa Lens. Tallinn] : Avita, 2002. Vastuseks Vaapo Vaheri arvustusele "Vene kirjanduse õpik lõhestab kirjanikud headeks ja pahadeks", Eesti Päevaleht : Arkaadia, 25. apr. 2003: Kalamees, Katrin; Lens, Maritsa. Vastuseid Vaapo Vaheri küsimistele, Eesti Päevaleht, 2. mai, lk. 17; Vt. ka vastukajad: Tuch, Boris. Dva toma oshibok // Estonija (2002) 28. apr., lk. 9

Nyexaminerade lärares första tid i yrket : En studie om nyttan av utbilningens teoretiska moment

OpenAIRE

Kreuger, Julia; Kylén-Wengman, Karin

2007-01-01

Sammanfattning Syftet med vår undersökning var att få syn på vad som utmärkte nyexaminerade lärares beskrivning av vad och hur de använder lärarutbildningen i sin profession, med fokus på de teoretiska momenten. Den dominerande bilden i tidigare forskning är att nyblivna lärare upplever många svårigheter under den första tiden i yrket. I det nya Lärarprogrammet från 2001 fanns en strävan efter att utbildningen skulle bli mer vetenskaplig och akademisk. Vi undersökte om lärare, examinerade frå...

Vertebral Artery Dissection Associated with Generalized Convulsive Seizures: A Case Report

Directory of Open Access Journals (Sweden)

Faisal Mohammad Amin

2013-07-01

Full Text Available A 46-year-old male with juvenile myoclonic epilepsy was admitted to the neurological department for convulsive seizures just after lamotrigine was discontinued. On admission he was awake but had a right-sided hemiparesis with Babinski sign and ataxic finger-nose test on the left side. An MR scan showed a left-sided pontine infarction, an infarct in the left cerebellar hemisphere and a right vertebral artery dissection (VAD. The patient was treated with heparin and an oral anticoagulant for 6 months. Recovery of neurologic function was excellent. In patients with symptoms of disturbances of posterior circulation after epileptic seizures, VAD should be considered.

Du kan, men du gör inget. : En studie av utvecklingssamtal på ett gymnasium.

OpenAIRE

Måhl, Anna

2007-01-01

Mitt syfte med denna uppsats är att studera tre elevvårdskonferenser för att först se om deras innehåll överensstämmer med vad Cilla Lindblom Larsson skriver om utvecklings-samtal på grundskolan, att de handlar om pojkarnas skolbeteende och de råd och anvis-ningar pojkarna får där är moraliserande och tillrättavisande, och sedan undersöka hur samtalsstrukturen ser ut i dessa konferenser. I arbetets första del undersöker jag vad dessa elevvårdskonferenser handlar om och kommer fram till att de...

"Att slänga sig ut i det okända..." : En utredning av utmaningen att skapa en föreställning utgående ifrån improvisation

OpenAIRE

Krusberg, Catrine

2014-01-01

Syftet med detta examensarbete är att undersöka nyckelelementen i att skapa en föreställning med improvisation som utgångspunkt. Forskningen fokuserar på skapandeprocessen av monologpjäsen Gillar, gillar inte, med frågeställningen: hur skapar jag en fungerande föreställning utan en befintlig dramaturgisk text som referens? Vad händer på scengolvet då jag som skådespelare har enbart de ramar som temat medför? Vad är för- och nackdelarna med att utgå ifrån detta slag av fri impro...

A TAD better for myeloma therapy?

Science.gov (United States)

Giralt, Sergio

2010-02-11

In this issue of Blood, Lokhorst and colleagues report on the results of HOVON-50, a phase 3 randomized trial designed to evaluate the effects of thalidomide during induction treatment and as maintenance in patients with multiple myeloma. There were 556 patients randomly assigned either to 3 cycles of VAD or to TAD. All patients were to receive high-dose melphalan with autologous stem cell support followed by maintenance with interferon for the VAD arm or thalidomide for the TAD arm.(1) This study together with other randomized and nonrandomized trials establish a definitive role for thalidomide as induction therapy in conjunction with dexamethasone, anthracyclines, and alkylating agents.

Kinky sex till salu : En semiotisk analys om hur sexualiserat våld används vid framställningen av kvinnor i sex stycken reklambilder

OpenAIRE

Isaksson, Elin

2018-01-01

Forskning visar på en lång historia av sexualisering och objektifiering av kvinnor i reklam. Vad forskning inte fokuserat på är sexualiserat våld i reklambilder. Den här studien är en sammanfogning av forskningsfälten genus och våld i reklam. Vad studien vill ta reda på är om sexualiserat våld används vid framställningen av kvinnor i reklambilderna samt den manliga blickens perspektiv. Studien använder sig av kvalitativ semiotisk analys för att undersöka om sexualiserat våld existerar i sex s...

Vasalund preschool

OpenAIRE

Wettervik, Erik

2016-01-01

När jag började projektet pratade jag med flertalet förskolepedagoger i min bekantskapskrets och sökte upp så mycket information jag kunde om förskoleverksamhet i allmänhet och vad som är önskvärt i en förskolemiljö. Utifrån det listade jag ett antal punkter på vad som vore önskvärt i och omkring min byggnad som jag hela tiden förhållit mig till. Förskolans volym och riktning anpassar sig till de omkring liggande villorna med den sammansatta volymen, utblickar och de olika takhöjderna. Taket...

Effects of Delay Duration on the WMS Logical Memory Performance of Older Adults with Probable Alzheimer's Disease, Probable Vascular Dementia, and Normal Cognition.

Science.gov (United States)

Montgomery, Valencia; Harris, Katie; Stabler, Anthony; Lu, Lisa H

2017-05-01

To examine how the duration of time delay between Wechsler Memory Scale (WMS) Logical Memory I and Logical Memory II (LM) affected participants' recall performance. There are 46,146 total Logical Memory administrations to participants diagnosed with either Alzheimer's disease (AD), vascular dementia (VaD), or normal cognition in the National Alzheimer's Disease Coordinating Center's Uniform Data Set. Only 50% of the sample was administered the standard 20-35 min of delay as specified by WMS-R and WMS-III. We found a significant effect of delay time duration on proportion of information retained for the VaD group compared to its control group, which remained after adding LMI raw score as a covariate. There was poorer retention of information with longer delay for this group. This association was not as strong for the AD and cognitively normal groups. A 24.5-min delay was most optimal for differentiating AD from VaD participants (47.7% classification accuracy), an 18.5-min delay was most optimal for differentiating AD versus normal participants (51.7% classification accuracy), and a 22.5-min delay was most optimal for differentiating VaD versus normal participants (52.9% classification accuracy). Considering diagnostic implications, our findings suggest that test administration should incorporate precise tracking of delay periods. We recommend a 20-min delay with 18-25-min range. Poor classification accuracy based on LM data alone is a reminder that story memory performance is only one piece of data that contributes to complex clinical decisions. However, strict adherence to the recommended range yields optimal data for diagnostic decisions. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Arsenic toxicity induced endothelial dysfunction and dementia: Pharmacological interdiction by histone deacetylase and inducible nitric oxide synthase inhibitors

Energy Technology Data Exchange (ETDEWEB)

Sharma, Bhupesh, E-mail: drbhupeshresearch@gmail.com; Sharma, P.M.

2013-11-15

Arsenic toxicity has been reported to damage all the major organs including the brain and vasculature. Dementia including Alzheimer's disease (AD) and vascular dementia (VaD) are posing greater risk to the world population as it is now increasing at a faster rate. We have investigated the role of sodium butyrate, a selective histone deacetylase (HDAC) inhibitor and aminoguanidine, a selective inducible nitric oxide synthase (iNOS) inhibitor in pharmacological interdiction of arsenic toxicity induced vascular endothelial dysfunction and dementia in rats. Arsenic toxicity was done by administering arsenic drinking water to rats. Morris water-maze (MWM) test was used for assessment of learning and memory. Endothelial function was assessed using student physiograph. Oxidative stress (aortic superoxide anion, serum and brain thiobarbituric acid reactive species, brain glutathione) and nitric oxide levels (serum nitrite/nitrate) were also measured. Arsenic treated rats have shown impairment of endothelial function, learning and memory, reduction in serum nitrite/nitrate and brain GSH levels along with increase in serum and brain TBARS. Sodium butyrate as well as aminoguanidine significantly convalesce arsenic induced impairment of learning, memory, endothelial function, and alterations in various biochemical parameters. It may be concluded that arsenic induces endothelial dysfunction and dementia, whereas, sodium butyrate, a HDAC inhibitor as well as aminoguanidine, a selective iNOS inhibitor may be considered as potential agents for the management of arsenic induced endothelial dysfunction and dementia. - Highlights: • As has induced endothelial dysfunction (Edf) and vascular dementia (VaD). • As has increased oxidative stress, AChE activity and decreased serum NO. • Inhibitors of HDAC and iNOS have attenuated As induced Edf and VaD. • Both the inhibitors have attenuated As induced biochemical changes. • Inhibitor of HDAC and iNOS has shown good potential

A 20-year multicentre outcome analysis of salvage mechanical circulatory support for refractory cardiogenic shock after cardiac surgery

Directory of Open Access Journals (Sweden)

Maziar Khorsandi

2016-11-01

Full Text Available Abstract Background Refractory post-cardiotomy cardiogenic shock (PCCS is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS, namely extra-corporeal membrane oxygenation (ECMO or ventricular assist devices (VAD. In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period. Methods The data was obtained through the Edinburgh, Glasgow and Aberdeen cardiac surgery databases. Our inclusion criteria included any adult patient from April 1995 to April 2015 who had received salvage VA ECMO or VAD for PCCS refractory to intra-aortic balloon pump (IABP and maximal inotropic support following adult cardiac surgery. Results A total of 27 patients met the inclusion criteria. Age range was 34–83 years (median 51 years. There was a large male predominance (n = 23, 85 %. Overall 23 patients (85 % received VA ECMO of which 14 (61 % had central ECMO and 9 (39 % had peripheral ECMO. Four patients (15 % were treated with short-term VAD (BiVAD = 1, RVAD = 1 and LVAD = 2. The most common procedure-related complication was major haemorrhage (n = 10. Renal failure requiring renal replacement therapy (n = 7, fatal stroke (n = 5, septic shock (n = 2, and a pseudo-aneurysm at the femoral artery cannulation site (n = 1 were also observed. Overall survival to hospital discharge was 40.7 %. All survivors were NYHA class I-II at 12 months’ follow-up. Conclusion AMCS for refractory PCCS carries a survival benefit and achieves acceptable functional recovery despite a significant complication rate.

Totally implantable total artificial heart and ventricular assist device with multipurpose miniature electromechanical energy system.

Science.gov (United States)

Takatani, S; Orime, Y; Tasai, K; Ohara, Y; Naito, K; Mizuguchi, K; Makinouchi, K; Damm, G; Glueck, J; Ling, J

1994-01-01

A multipurpose miniature electromechanical energy system has been developed to yield a compact, efficient, durable, and biocompatible total artificial heart (TAH) and ventricular assist device (VAD). Associated controller-driver electronics were recently miniaturized and converted into hybrid circuits. The hybrid controller consists of a microprocessor and controller, motor driver, Hall sensor, and commutation circuit hybrids. The sizing study demonstrated that all these components can be incorporated in the pumping unit of the TAH and VAD, particularly in the centerpiece of the TAH and the motor housing of the VAD. Both TAH and VAD pumping units will start when their power line is connected to either the internal power pack or the external battery unit. As a redundant driving and diagnostic port, an emergency port was newly added and will be placed in subcutaneous location. In case of system failure, the skin will be cut down, and an external motor drive or a pneumatic driver will be connected to this port to run the TAH. This will minimize the circulatory arrest time. Overall efficiency of the TAH without the transcutaneous energy transmission system was 14-18% to deliver pump outputs of 4-9 L/min against the right and left afterload pressures of 25 and 100 mm Hg. The internal power requirement ranged from 6 to 13 W. The rechargeable batteries such as NiCd or NiMH with 1 AH capacity can run the TAH for 30-45 min. The external power requirement, when TETS efficiency of 75% was assumed, ranged from 8 to 18 W. The accelerated endurance test in the 42 degrees C saline bath demonstrated stable performance over 4 months. Long-term endurance and chronic animal studies will continue toward a system with 5 years durability by the year 2000.

Systematic Design of a Magnetically Levitated Brushless DC Motor for a Reversible Rotary Intra-Aortic Blood Pump.

Science.gov (United States)

Wang, Yaxin; Logan, Thomas G; Smith, P Alex; Hsu, Po-Lin; Cohn, William E; Xu, Liping; McMahon, Richard A

2017-10-01

The IntraVAD is a miniature intra-aortic ventricular assist device (VAD) designed to work in series with the compromised left ventricle. A reverse-rotation control (RRc) mode has been developed to increase myocardial perfusion and reduce ventricular volume. The RRc mode includes forward rotation in systole and reverse rotation in diastole, which requires the IntraVAD to periodically reverse its rotational direction in synchrony with the cardiac cycle. This periodic reversal leads to changes in pressure force over the impeller, which makes the entire system less stable. To eliminate the mechanical wear of a contact bearing and provide active control over the axial position of the rotor, a miniature magnetically levitated bearing (i.e., the PM-Coil module) composed of two concentric permanent magnetic (PM) rings and a pair of coils-one on each side-was proposed to provide passive radial and active axial rotor stabilization. In the early design stage, the numerical finite element method (FEM) was used to optimize the geometry of the brushless DC (BLDC) motor and the maglev module, but constructing a new model each time certain design parameters were adjusted required substantial computation time. Because the design criteria for the module had to be modified to account for the magnetic force produced by the motor and for the hemodynamic changes associated with pump operation, a simplified analytic expression was derived for the expected magnetic forces. Suitable bearings could then be designed capable of overcoming these forces without repeating the complicated FEM simulation for the motor. Using this method at the initial design stage can inform the design of the miniature maglev BLDC motor for the proposed pulsatile axial-flow VAD. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Arsenic toxicity induced endothelial dysfunction and dementia: Pharmacological interdiction by histone deacetylase and inducible nitric oxide synthase inhibitors

International Nuclear Information System (INIS)

Sharma, Bhupesh; Sharma, P.M.

2013-01-01

Arsenic toxicity has been reported to damage all the major organs including the brain and vasculature. Dementia including Alzheimer's disease (AD) and vascular dementia (VaD) are posing greater risk to the world population as it is now increasing at a faster rate. We have investigated the role of sodium butyrate, a selective histone deacetylase (HDAC) inhibitor and aminoguanidine, a selective inducible nitric oxide synthase (iNOS) inhibitor in pharmacological interdiction of arsenic toxicity induced vascular endothelial dysfunction and dementia in rats. Arsenic toxicity was done by administering arsenic drinking water to rats. Morris water-maze (MWM) test was used for assessment of learning and memory. Endothelial function was assessed using student physiograph. Oxidative stress (aortic superoxide anion, serum and brain thiobarbituric acid reactive species, brain glutathione) and nitric oxide levels (serum nitrite/nitrate) were also measured. Arsenic treated rats have shown impairment of endothelial function, learning and memory, reduction in serum nitrite/nitrate and brain GSH levels along with increase in serum and brain TBARS. Sodium butyrate as well as aminoguanidine significantly convalesce arsenic induced impairment of learning, memory, endothelial function, and alterations in various biochemical parameters. It may be concluded that arsenic induces endothelial dysfunction and dementia, whereas, sodium butyrate, a HDAC inhibitor as well as aminoguanidine, a selective iNOS inhibitor may be considered as potential agents for the management of arsenic induced endothelial dysfunction and dementia. - Highlights: • As has induced endothelial dysfunction (Edf) and vascular dementia (VaD). • As has increased oxidative stress, AChE activity and decreased serum NO. • Inhibitors of HDAC and iNOS have attenuated As induced Edf and VaD. • Both the inhibitors have attenuated As induced biochemical changes. • Inhibitor of HDAC and iNOS has shown good potential in

Comparison of swallowing outcomes of laryngotracheal separation versus total laryngectomy in a validated ovine model of profound oropharyngeal dysphagia.

Science.gov (United States)

Venkatesan, N N; Johnson, C M; Siddiqui, M T; Cates, D J; Kuhn, M A; Postma, G N; Belafsky, P C

2017-04-01

To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre- and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model. Mean pre-intervention Penetration Aspiration Scale and National Institutes of Health Swallow Safety Scale scores were 8 ± 0 and 6 ± 0 respectively in sheep and human cadavers, with 100 per cent intra- and inter-species reproducibility. These scores improved to 1 ± 0 and 2 ± 0 post-laryngohyoid suspension (p < 0.01). Aerodigestive tract residue was 18.6 ± 2.4 ml at baseline, 15.4 ± 3.8 ml after laryngotracheal separation and 3.0 ± 0.7 ml after total laryngectomy (p < 0.001). The ovine model displayed perfect intra- and inter- species reliability for the Penetration Aspiration Scale and Swallow Safety Scale. Less aerodigestive tract residue after narrow-field laryngectomy suggests that swallowing outcomes after total laryngectomy are superior to those after laryngotracheal separation.

Varumärket IKEA : en studie om identitet och image vid företagets etablering i Karlstad

OpenAIRE

Almqvist, Jessica; Reinholdsson, Åsa

2007-01-01

IKEA är i nuläget ett av Sveriges och världens starkaste varumärken och under sommaren 2007 kommer IKEA att etablera sig i Karlstad. För att ett varumärke ska kunna anses vara starkt krävs det att företagets identitet och image stämmer överens. Identitet är de signaler som företaget sänder ut till kunden och image är den uppfattning som uppstår i kundens medvetande om själva företaget. Intresset i nuläget var att se till vad IKEA har för identitet och vad boende i Karlstad med omnejd har för ...

Nuclear medicine in otolaryngology

International Nuclear Information System (INIS)

Watkinson, J.C.

1991-01-01

Otolaryngology is concerned with the diagnosis and treatment of diseases which affect the mucosal structures of the upper aerodigestive tract and adnexial organs. This editorial outlines the current rate of nuclear medicine in otolaryngology with particular reference to diseases of the thyroid, the parathyroid, the salivary glands, the lacrimal glands, bones of the head and neck, tumours of the head and neck and CSF leaks. (UK)

Surgical approach to end-stage heart failure.

Science.gov (United States)

Klotz, Stefan; Scheld, Hans H

2011-02-01

End-stage heart failure is a challenging disease with growing incidence. With decreasing heart transplant rates worldwide organ preserving therapies become, again, of interest. The purpose of the present review is to examine the potential challenges of surgical therapies in patients with end-stage heart failure. The gold-standard for end-stage heart failure is and will be cardiac transplantation. However, due to organ shortage this therapy is limited to a few patients. Therefore implantation of ventricular assist devices (VADs) or long-term minimal-invasive partial support devices will increase. Improvements in device design with smaller devices, easier implantation techniques, and modified anticoagulation outcome and long-term success will likely improve. In addition, good quality of life as destination therapy is almost available. Organ conservation surgery (coronary artery bypass grafting and surgical ventricular restoration or surgical repair of mitral valve regurgitation) in end-stage heart failure patients could not prove the expected results. Transcatheter or minimal-invasive approaches of these therapies might become routine in the near future. Due to the overwhelming outcome rates, cardiac transplantation is the most established surgical therapy for end-stage heart failure. VAD therapy is increasing and minimized VADs might further open the market for destination therapy/permanent support.

Validation of the Addenbrooke's cognitive examination for detecting early Alzheimer's disease and mild vascular dementia in a German population.

Science.gov (United States)

Alexopoulos, P; Greim, B; Nadler, K; Martens, U; Krecklow, B; Domes, G; Herpertz, S; Kurz, A

2006-01-01

We assessed the diagnostic accuracy of the German version of the Addenbrooke's Cognitive Examination (ACE) in identifying early Alzheimer's disease (AD) and mild vascular dementia (VaD) in comparison with the conventional Mini-Mental State Examination (MMSE). The study refers to 50 patients with mild dementia of AD, 26 patients with mild dementia of vascular etiology and to 54 cognitively normal subjects. The ACE and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic workup. Statistical analysis was performed using the receiver operator characteristics method. The optimal cut-off score for the ACE for detecting dementia in patients with early AD was 85/86, which had a sensitivity of 93% and a specificity of 86%. The optimal cut-off for the ACE for the identification of dementia in patients with mild VaD was also 85/86 and it had a sensitivity of 93% and a specificity of 100%. The kappa values imply a substantial agreement between the diagnoses made by the ACE and the MMSE. The German version of the ACE is a short and practical but accurate test battery for the identification of AD and VaD, assessing a broad range of cognitive functions and providing a wide profile of cognitive functions/dysfunctions.

Blinde alfabet: ʼn Moedswillige Willem Boshoff reken af met meerderwaardigheid – ʼn neo-Marxistiese interpretasie

OpenAIRE

Swanepoel, Rita

2013-01-01

In heelwat van sy taalgebaseerde konseptuele installasies moedig die kunstenaar Willem Boshoff aanskouers van sy werke tot gesprekvoering aan. Die doel van die gesprekke is hoofsaaklik om die dominasie van sogenaamde meerderwaardiges as "superieur" en die "norm" te ondermyn. Hy doen dit deur die bemagtiging van die "afwykendes" of "abnormales" om die betekenis van die kunswerk aan die "meerderwaardiges" te verduidelik. Hierdie aanslag van Boshoff ondersoek en illustreer ek in hierdie artikel ...

Participação das vias aéreas centrais na doença vibroacústica

Directory of Open Access Journals (Sweden)

José Reis Ferreira

2006-03-01

Full Text Available Resumo: Nos últimos vinte cinco anos constatou-se que o aparelho respiratório constitui um alvo do ruído de baixa frequência (RFB <500Hz, incluindo infra-sons. Denomina-se doença vibroacústica (VAD a patologia sistémica causada pela exposição excessiva a RBF. Em ratos Wistar expostos a RBF, as alterações morfológicas observadas nos tecidos das vias aéreas centrais explicam, parcialmente, os sintomas apresentados pelos doentes com a VAD. Apesar disso, muitas perguntas permanecem por responder. Recentemente, voluntários com a doença vibroacústica submeteram-se a exames broncos cópicos para esclarecer e, se possível, demonstrar possíveis lesões das vias aéreas centrais que estariam associadas com as queixas respiratórias. Treze doentes voluntários, exaustivamente esclarecidos sobre este exame, submeteram-se a broncoscopias, durante as quais se colheram fragmentos para exame histológico e ultra-estrutural. Em todos os indivíduos se observaram lesões de tipo vascular na submucosa próximas das bifurcações das vias aéreas. Estas lesões caracterizavam-se por numerosos pequenos vasos com paredes espessadas, mergulhados em feixes de colagénio e algumas fibras de elastina. Em cinco indivíduos as lesões evidenciavam degenerescência e ruptura do colagénio. Histologicamente, na mucosa normal observaram-se alterações ciliares, hiperplasia da membrana basal e espessamento dos vasos sanguíneos. Em nenhum caso se observaram infiltrados celulares de natureza inflamatória. O estudo da ultra-estrutura revelou numerosos axonemas (de dois a oito contidos numa membrana ciliar comum, algumas vesículas emanando dos cílios, imagens de apoptose com reforço do citosqueleto celular e das ligações intercelulares. Não se observaram diferenças entre fumadores e não fumadores. Estes dados estão de acordo com o que já fora observado nas vias aéreas centrais de oito doentes com carcinoma pavimento-celular do pulmão e também com

Ecstasy, kanep või "valge hiinlane" - klassivennalt võid osta kõike / Kärt Anvelt

Index Scriptorium Estoniae

Anvelt, Kärt, 1973-

2008-01-01

Narkokuritegevusest ja narkootikumidega kaubitsemisest Eestis. Lisatud: narkomuulad jäävad vahele varem või hiljem ; Eesti Venezuela-aukonsuli Arne Roostna kommentaar: tavaliselt jäädakse siin vahele

Investor interest returning as economies start to stabilize

Index Scriptorium Estoniae

2009-01-01

Praegu on õige aeg Baltimaadesse investeerimiseks, kuna ka sealne majandus on stabiliseerumas. Võimalik, et Baltimaade valitsused müüvad veel riigivara. East Capital Groupi osalused Baltimaade ettevõtetes

Piimandus: laenukarid, ikaldused ja hinnaralli tõid kriisi / Ain Alvela ; kommenteerinud Tiit Tuuleveski, Urmas Põlluaas ja Tõnu Post

Index Scriptorium Estoniae

Alvela, Ain, 1967-

2009-01-01

Kuigi piimatootmisega tegelevad ettevõtted vajaksid tegevuse arendamiseks hädasti investeeringuid, jäävad enamiku rahastamisplaanid paremaid aegu ootama. Diagramm. Kommenteerivad Tiit Tuuleveski, Urmas Põlluaas ja Tõnu Post

Machine for controlling band-type 'essuimatic' hand towels (1962); Machine a controler les essuie-mains en bande du type essuimatic (1962)

Energy Technology Data Exchange (ETDEWEB)

Cottignies, S; Ortiz, J [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

1962-07-01

This machine is designed to control the band-towels in the form of 40 meters bands equipping the 'Essuimatic' distributors. It controls automatically the {alpha} and {beta}-{gamma} activity. The towel is driven by motors and passes under Geiger-Muller counters and then between zinc sulphide scintillators in conjunction with photomultipliers. Two distinct counting systems measure the total activity deposited on the cloth and, in order to give an idea of the distribution of this activity, count also the number of marks, that is, the number of times that the counting rate of the probes is above a certain value. After the passage of the cloth it is thus possible to know whether the count corresponding to the whole band is greater than that due to just the counter movement, and also whether this counting rate has not occasionally been greater than the average rate; it is thus possible to detect weak local contamination which could have been missed in an overall measurement of the cloth. (authors) [French] Cette machine est destinee a controler les linges essuie-mains sous forme de bande de 40 metres de longueur equipant les distributeurs 'ESSUIMATIC'. Elle effectue automatiquement un controle en {alpha} et en {beta}-{gamma}. Le linge entraine par un moteur passe. sous des compteurs Geiger-Muller, puis entre des scintillateurs au sulfure de zinc associes a des photomultiplicateurs. Deux chaines de comptage distinctes comptent l'activite totale deposee sur le linge et, en outre, pour donner une idee de la repartition de cette activite, elles comptent le nombre de taches, c'est-a-dire le nombre de fois que le taux de comptage des sondes est superieur a une certaine valeur. A la fin du passage du linge, il est donc possible de connaitre si le comptage correspondant a toute la bande est superieur a celui du au mouvement propre seul des compteurs et egalement de savoir si parfois ce taux de comptage n'a pas ete superieur au taux de comptage moyen, ce qui permet de detecter de

Sällskapsdjurens betydelse för de äldres välbefinnande

OpenAIRE

Gäddnäs, Emma

2016-01-01

Denna studie undersöker sällskapsdjurens betydelse för de äldres välbefinnande. Syftet med studien är att diskutera vad sällskapsdjur betyder för de äldres välbefinnande och vad djur kan betyda för de äldre som bor på äldreboende. Frågeställningarna i studien lyder ”Vilken betydelse har sällskapsdjur för de äldres välbefinnande och deras känsla av delaktighet?” och ”Vilken betydelse har sällskapsdjur inom äldreomsorgen?” Metoden som används för att svara på frågeställningarna är både tidigare...

Kognitiv beteendeterapi i skolan

OpenAIRE

Nummelin, Maria; Almetun Englund, Britt

2008-01-01

Syftet med studien var att få en ökad förståelse och insyn i vad kognitiv beteendeterapi- KBT är, och ta reda på om den stökiga skolmiljön som ofta förekommer, kan förbättras med hjälp av KBT. Våra forskningsfrågor behandlar: Vad är kognitiv beteendeterapi? Vilka förutsättningar krävs bland personalen för att arbeta med KBT vid en skola? När kan det vara lämpligt att pedagogerna i skolan använder sig av KBT? Hur använder pedagogerna KBT i skolan. Studien har genomförts genom bearbetning av re...

Mumin : Varumärkets image vs varumärkets personlighet

OpenAIRE

Sandell, Saara

2015-01-01

Undersökningen gjordes för att jämföra vad de som följer Mumin på sociala medier och via e-post anser att Mumin som varumärke står för jämfört med vad All Things Commerce och Moomin Characters vill att det ska stå för. För att få en bild på hur varumärkets personlighet uppfattas. Som modell för undersökningen användes Jennifer Aakers modell för varumärkets personlighet. Metoden som användes var en webbenkät som lades ut via sociala medier och via e-post. Sammanlagt blev det en population på k...

CCR 20th anniversary commentary: Preclinical study of proteasome inhibitor bortezomib in head and neck cancer.

Science.gov (United States)

Allen, Clint T; Conley, Barbara; Sunwoo, John B; Van Waes, Carter

2015-03-01

In a study published in the May 1, 2001, issue of Clinical Cancer Research, Sunwoo and colleagues provided evidence for proteasome inhibition of NF-κB and tumorigenesis, supporting early-phase clinical trials in solid malignancies of the upper aerodigestive tract. Subsequent clinical studies uncovered a dichotomy of responses in patients with hematopoietic and solid malignancies, and the mechanisms of resistance. ©2015 American Association for Cancer Research.

AGARD/SMP Review Damage Tolerance for Engine Structures. 2. Defects and Quantitative Materials Behaviour

Science.gov (United States)

1988-10-01

ROUES DE TURBINE COULEES MONOBLOC par D. FOURNIER TURBOMECA BORDES 64320 BIZANOS FRANCE 1. INTRODUCTION La conception d’une piece aeronautique...Lycoming LTS 101 - Turbomeca ARRIEL 1A. Les avantages et les inconvenients de cette technologie sont resumes dans le tableau ci-dessous : AVANTAGES... tableau de la figure 6. 5. DEFAUTS Aucun defaut superieur a 0,2 nun n’a ete detecte sur I’une des 250 coupes diame- trales de roues examinees

Organisatsiooniliste muutuste võimalikud probleemid ja ohud avalikus sektoris : Ettevõtluse Arendamise Sihtasutuse näitel / Tõnu Roolaht

Index Scriptorium Estoniae

Roolaht, Tõnu, 1972-

2005-01-01

Kuigi avalike organisatsioonide muutused jäävad ka edaspidi seotuks poliitiliste arengutega, leiab autor, et selles protsessis on siiski vajalik otsida teid ka organisatsiooni sisemiste arenguseaduspärasustega arvestamiseks. Skeem

Kuhu jäävad pisarad, naine? / Kaivo Kopli

Index Scriptorium Estoniae

Kopli, Kaivo

2004-01-01

Autor näeb sarnasusi kahe naisvälisministri, Makiko Tanaka ja Kristiina Ojulandi tegevuses ning selle kriitikas. Erinevalt mitmest naispoliitikust, kes eri põhjustel on tagasi astunud, on välisminister Kristiina Ojuland autori sõnul kauakestvale rünnakule vastu pidanud.

E-mobbning : En studie om vad det är

OpenAIRE

Moberg, Oskar

2014-01-01

The purpose of this work is to investigate what students in grades 4 to 6 at a school in southern Värmland know about cyber bullying. It also aims to find out whether there is or has been any cyber bullying in grades 4-6 at the school. The issues at work are what do cyber bullying? Is there a difference between cyber bullying in the different grades? (4-6 grades) Are their differences in cyber bullying when it comes to sex? And there is no connection between the mental bullying and cyber bull...

Ettevaatust, bussid jäävad seisma! / Peep Peterson

Index Scriptorium Estoniae

Peterson, Peep, 1975-

2004-01-01

Ilmunud ka: Severnoje Poberezhje, 23. okt. 2004, lk. 2; Narva Postiljon, 23. okt. 2004, lk. 5; Narvskaja Gazeta, 23. okt. 2004, lk. 4; Sakala, 26. okt. 2004, lk. 2; Võrumaa Teataja, 26. okt. 2004, lk. 2; Vooremaa, 26. okt. 2004, lk. 2; Meie Maa, 26. okt. 2004, lk. 2; Harjumaa, 26. okt. 2004, lk. 2; Järva Teataja, 28. okt. 2004, lk. 2; Hiiu Leht, 29. okt. 2004, lk. 2; Pärnu Postimees, 29. okt. 2004, lk. 15; Linnaleht : Pärnu, 29. okt. 2004, lk. A4; Valgamaalane, 6. nov. 2004, lk. 2. Transpordi ametiühing andis autoettevõtete liidule üle nõudmise, milles taotleb kõigile bussijuhtidele lisatasudeta Eesti keskmist palka. Kokkuleppele tuleb jõuda enne 2005. aasta 1. jaanuari

Evaluation of Factors Associated with Hypermetabolism and Hypometabolism in Critically Ill AKI Patients

Directory of Open Access Journals (Sweden)

Cassiana R. de Góes

2018-04-01

Full Text Available Acute kidney injury (AKI is a frequent and serious condition with high mortality. The presence of hypermetabolism may be a factor related to poorer prognosis. This study evaluated the resting energy expenditure (REE of intensive care unit (ICU patients with severe AKI using indirect calorimetry (IC and identified factors associated with metabolism categories. Patients were evaluated through measurement of REE and estimation of basal energy expenditure (BEE using the Harris–Benedict equation. Metabolism categories were as follows: hypermetabolism (REE/BEE > 1.3 and hypometabolism (REE/BEE < 0.9. The metabolism categories were compared using ANOVA and the chi-square test. Variables were analyzed by multiple logistic regression tests. Also, survivors and non-survivors were compared using Student’s t-tests along with Cox regression tests. Kaplan–Meier survival curves were also performed. We evaluated 124 patients with a mean age of 61.08 ± 16.6 years. Sixty-four patients were hypermetabolic (62% and 18 were hypometabolic (14%. Vasoactive drug (VAD dose and younger age were independently associated with hypermetabolism. The survival analysis was not associated with metabolism categorization. In conclusion, patients with severe AKI are mostly hypermetabolic and hypermetabolic patients of a lower age receiving treatment with higher VAD doses. The only factors associated with death were protein intake and VAD dose.

Effects of fisetin on hyperhomocysteinemia-induced experimental endothelial dysfunction and vascular dementia.

Science.gov (United States)

Hemanth Kumar, Boyina; Arun Reddy, Ravula; Mahesh Kumar, Jerald; Dinesh Kumar, B; Diwan, Prakash V

2017-01-01

This study was designed to investigate the effects of fisetin (FST) on hyperhomocysteinemia (HHcy)-induced experimental endothelial dysfunction (ED) and vascular dementia (VaD) in rats. Wistar rats were randomly divided into 8 groups: control, vehicle control, l-methionine, FST (5, 10, and 25 mg/kg, p.o.), FST-per se (25 mg/kg, p.o.), and donepezil (0.1 mg/kg, p.o.). l-Methionine administration (1.7 g/kg, p.o.) for 32 days induced HHcy. ED and VaD induced by HHcy were determined by vascular reactivity measurements, behavioral analysis using Morris water maze and Y-maze, along with a biochemical and histological evaluation of thoracic aorta and brain tissues. Administration of l-methionine developed behavioral deficits; triggered brain lipid peroxidation (LPO); compromised brain acetylcholinesterase activity (AChE); and reduced the levels of brain superoxide dismutase (SOD), brain catalase (CAT), brain reduced glutathione (GSH), and serum nitrite; and increased serum homocysteine and cholesterol levels. These effects were accompanied by decreased vascular NO bioavailability, marked intimal thickening of the aorta, and multiple necrotic foci in brain cortex. HHcy-induced alterations in the activities of SOD, CAT, GSH, AChE, LPO, behavioral deficits, ED, and histological aberrations were significantly attenuated by treatment with fisetin in a dose-dependent manner. Collectively, our results indicate that fisetin exerts endothelial and neuroprotective effects against HHcy-induced ED and VaD.

The medical physics of ventricular assist devices

International Nuclear Information System (INIS)

Wood, Houston G; Throckmorton, Amy L; Untaroiu, Alexandrina; Song Xinwei

2005-01-01

Millions of patients, from infants to adults, are diagnosed with congestive heart failure each year all over the world. A limited number of donor hearts available for these patients results in a tremendous demand for alternative, supplemental circulatory support in the form of artificial heart pumps or ventricular assist devices (VADs). The development procedure for such a device requires careful consideration of biophysical factors, such as biocompatibility, haemolysis, thrombosis, implantability, physiologic control feasibility and pump performance. Conventional pump design equations based on Newton's law and computational fluid dynamics (CFD) are readily used for the initial design of VADs. In particular, CFD can be employed to predict the pressure-flow performance, hydraulic efficiencies, flow profile through the pump, stress levels and biophysical factors, such as possible blood cell damage. These computational flow simulations may involve comprehensive steady and transient flow analyses. The transient simulations involve time-varying boundary conditions and virtual modelling of the impeller rotation in the blood pumps. After prototype manufacture, laser flow measurements with sophisticated optics and mock circulatory flow loop testing assist with validation of pump design and identification of irregular flow patterns for optimization. Additionally, acute and chronic animal implants illustrate the blood pump's ability to support life physiologically. These extensive design techniques, coupled with fundamental principles of physics, ensure a reliable and effective VAD for thousands of heart failure patients each year

An Implantable Intravascular Pressure Sensor for a Ventricular Assist Device

Directory of Open Access Journals (Sweden)

Luigi Brancato

2016-08-01

Full Text Available The aim of this study is to investigate the intravascular application of a micro-electro-mechanical system (MEMS pressure sensor to directly measure the hemodynamic characteristics of a ventricular assist device (VAD. A bio- and hemo-compatible packaging strategy is implemented, based on a ceramic thick film process. A commercial sub-millimeter piezoresistive sensor is attached to an alumina substrate, and a double coating of polydimethylsiloxane (PDMS and parylene-C is applied. The final size of the packaged device is 2.6 mm by 3.6 mm by 1.8 mm. A prototype electronic circuit for conditioning and read-out of the pressure signal is developed, satisfying the VAD-specific requirements of low power consumption (less than 14.5 mW in continuous mode and small form factor. The packaged sensor has been submitted to extensive in vitro tests. The device displayed a temperature-independent sensitivity (12 μ V/V/mmHg and good in vitro stability when exposed to the continuous flow of saline solution (less than 0.05 mmHg/day drift after 50 h. During in vivo validation, the transducer has been successfully used to record the arterial pressure waveform of a female sheep. A small, intravascular sensor to continuously register the blood pressure at the inflow and the outflow of a VAD is developed and successfully validated in vivo.

Protective effect of NSA on intestinal epithelial cells in a necroptosis model.

Science.gov (United States)

Dong, Wei; Zhang, Min; Zhu, Yaxi; Chen, Yuanhan; Zhao, Xingchen; Li, Ruizhao; Zhang, Li; Ye, Zhiming; Liang, Xingling

2017-10-17

This study aimed to investigate the protective effect of the necroptosis inhibitor necrosulfonamide (NSA) on intestinal epithelial cells using a novel in vitro necroptosis model that mimics inflammatory bowel disease (IBD). 2,4,6-trinitrobenzenesulfonic acid (TNBS) was perfused into the rectum of BALB/c mice to established a colitis model. Pathologic injury and cell death were evaluated. A novel in vitro model of necroptosis was established in Caco-2 cells using TNF- α and Z-VAD-fmk, and the cells were treated with or without NSA. Morphologic changes, manner of cell death and the levels of phosphorylation of receptor-interacting protein kinase 3 (p-RIPK3) and mixed-lineage kinase domain-like (p-MLKL) were detected. In the TNBS-induced colitis in mice, TUNEL-positive and caspase-3-negative cells were observed in the intestinal mucosa, and p-RIPK3 was found to be elevated. Under the stimulation of TNF- α and Z-VAD-fmk, the morphologic damage in the Caco-2 cells was aggravated, the proportion of necrosis was increased, and the level of p-RIPK3 and p-MLKL were increased, confirming that the regulated cell death was necroptosis. NSA reversed the morphological abnormalities and reduced necrotic cell death induced by TNF- α and Z-VAD-fmk. NSA can inhibit necroptosis in intestinal epithelial cells in vitro and might confer a potential protective effect against IBD.

The Role of Narrow Band Imaging in the Detection of Recurrent Laryngeal and Hypopharyngeal Cancer after Curative Radiotherapy

Directory of Open Access Journals (Sweden)

Michal Zabrodsky

2014-01-01

Full Text Available Narrow band imaging is considered a significant improvement in the possibility of detecting early mucosal lesion of the upper aerodigestive tract. Early detection of mucosal neoplastic lesions is of utmost importance for patients survival. There is evidence that, especially in patients previously treated by means of curative radiotherapy or chemoradiotherapy, the early detection rate of recurrent disease is quite low. The aim of this study was to prove whether the videoendoscopy coupled with NBI might help detect recurrent or secondary tumors of the upper aerodigestive tract. 66 patients previously treated by means of RT or CRT with curative intent were enrolled in the study. All patients underwent transnasal flexible videoendoscopy with NBI mode under local anesthesia. When a suspicious lesion was identified in an ambulatory setting, its nature was proved histologically. Many of these changes were not identifiable by means of conventional white light (WL endoscopy. The accuracy, sensitivity, specificity, and positive and negative predictive value of the method are very high (88%, 92%, 76%, 96%, and 91%, resp.. Results demonstrate that outpatient transnasal endoscopy with NBI is an excellent method for the follow-up of patients with carcinomas of the larynx and the hypopharynx primarily treated with radiotherapy.

Florida DOT Orlando ITS World Congress Vehicle Awareness Device

Data.gov (United States)

Department of Transportation — Florida DOT (FDOT) installed Vehicle Awareness Devices (VADs) on a set of Lynx transit buses as part of a demonstration for the ITS World Congress held in Orlando in...

Prediction of the external work of the native heart from the dynamic H-Q curves of the rotary blood pumps during left heart bypass.

Science.gov (United States)

Yokoyama, Yoshimasa; Kawaguchi, Osamu; Kitao, Takashi; Kimura, Taro; Steinseifer, Ulrich; Takatani, Setsuo

2010-09-01

The ventricular performance is dependent on the drainage effect of rotary blood pumps (RBPs) and the performance of RBPs is affected by the ventricular pulsation. In this study, the interaction between the ventricle and RBPs was examined using the pressure-volume (P-V) diagram of the ventricle and dynamic head pressure-bypass flow (H-Q) curves (H, head pressure: arterial pressure minus ventricular pressure vs. Q, bypass flow) of the RBPs. We first investigated the relationships in a mock loop with a passive fill ventricle, followed by validation in ex vivo animal experiments. An apical drainage cannula with a micro-pressure sensor was especially fabricated to obtain ventricular pressure, while three pairs of ultrasonic crystals placed on the heart wall were used to derive ventricular volume. The mock loop-configured ventricular apical-descending aorta bypass revealed that the external work of the ventricle expressed by the area inside the P-V diagrams (EW(Heart) ) correlated strongly with the area inside dynamic H-Q curves (EW(VAD)), with the coefficients of correlation being R² = 0.869 ∼ 0.961. The results in the mock loop were verified in the ex vivo studies using three Shiba goats (10-25 kg in body weight), showing the correlation coefficients of R² = 0.802 ∼ 0.817. The linear regression analysis indicated that the increase in the bypass flow reduced pulsatility in the ventricle expressed in EW(Heart) as well as in EW(VAD) . Experimental results, both mock loop and animal studies, showed that the interaction between cardiac external work and H-Q performance of RBPs can be expressed by the relationships "EW(Heart) versus EW(VAD) ." The pulsatile nature of the native heart can be expressed in the area underneath the H-Q curves of RBPs EW(VAD) during left heart bypass indicating the status of the level of assistance by RBPs and the native heart function. © 2010, Copyright the Authors. Artificial Organs © 2010, International Center for Artificial Organs and

Smoking is associated with an increased risk of dementia: a meta-analysis of prospective cohort studies with investigation of potential effect modifiers.

Directory of Open Access Journals (Sweden)

Guochao Zhong

Full Text Available Previous studies showed inconsistent results on the association of smoking with all-cause dementia and vascular dementia (VaD, and are limited by inclusion of a small number of studies and unexplained heterogeneity. Our review aimed to assess the risk of all-cause dementia, Alzheimer's disease (AD and VaD associated with smoking, and to identify potential effect modifiers.The PubMed, Embase, Cochrane Library and Psychinfo databases were searched to identify studies that provided risk estimates on smoking and incidence of dementia. A random-effects model was used to yield pooled results. Thirty-seven studies were included. Compared with never smokers, current smokers showed an increased risk of all-cause dementia (risk ratio (RR 1.30, 95% confidence interval (CI 1.18-1.45, AD (RR 1.40, 95% CI 1.13-1.73 and VaD (RR 1.38, 95% CI 1.15-1.66. For all-cause dementia, the risk increased by 34% for every 20 cigarettes per day (RR 1.34, 95% CI 1.25-1.43. Former smokers did not show an increased risk of all-cause dementia (RR 1.01, 95% CI 0.96-1.06, AD (RR 1.04, 95% CI 0.96-1.13 and VaD (RR 0.97, 95% CI 0.83-1.13. Subgroup analyses indicated that (1 the significantly increased risk of AD from current smoking was seen only in apolipoprotein E ε4 noncarriers; (2 current smokers aged 65 to 75 years at baseline showed increased risk of all-cause dementia and AD compared to those aged over 75 or under 65 years; and (3 sex, race, study location and diagnostic criteria difference in risk of dementia was not found.Smokers show an increased risk of dementia, and smoking cessation decreases the risk to that of never smokers. The increased risk of AD from smoking is more pronounced in apolipoprotein E ε4 noncarriers. Survival bias and competing risk reduce the risk of dementia from smoking at extreme age.

Konkurentideta lennukokad / Martin Hanson

Index Scriptorium Estoniae

Hanson, Martin, 1984-

2008-01-01

Airo Catering Services toodab lennukitel toitlustamiseks umbes kaks miljonit söögikorda aastas. Vt. samas: Äriklassile kaetakse rikkalikum toidulaud; Piloot ja kapten söövad eri toitu. Diagramm: Airo Cateringi majandustulemused

Profile of clinically-diagnosed dementias in a neuropsychiatric ...

African Journals Online (AJOL)

morbidities included hypertension, diabetes mellitus, parkinsonism and ... eating habits and schizophreniform/paranoid psychosis.10-. 12 BPSD constitute a ..... and VaD compared to populations of similar genetic stock but with lower burden of ...

Ilse Leetaru graafika Kadriorus / Anne Lõugas

Index Scriptorium Estoniae

Lõugas, Anne, 1951-

1999-01-01

Kastellaanimajas 1. juulist avatud New Yorgis elava kunstniku Ilse Leetaru graafika näitusel eksponeeritakse töid Eesti Kunstimuuseumi kogust ja uusi teoseid, mis jäävad kingituseks Tallinna ja Tartu kunstimuuseumile

An orthodontic bracket embedded in the medial pterygoid surface: a case report.

Science.gov (United States)

Wilmott, Sheryl E; Ikeagwuani, Okechukwu; McLeod, Niall M H

2016-03-01

There is a potential risk that orthodontic brackets can become dislodged into the aerodigestive tract. This case illustrates the management of an orthodontic bracket, which became embedded in the deep tissues of the oropharynx. We aim to highlight the potential risk misplaced dental instruments and materials pose, including that they may become embedded in the soft tissues of the throat and suggest that that this possibility should be considered when they cannot be localized.

Prevalence of Oral Human Papilloma Virus in Healthy Individuals in East Azerbaijan Province of Iran

OpenAIRE

SEIFI, Sharareh; ASVADI KERMANI, Iraj; DOLATKHAH, Roya; ASVADI KERMANI, Atabak; SAKHINIA, Ebrahim; ASGARZADEH, Mohammad; DASTGIRI, Saeed; EBRAHIMI, Ayoub; ASGHARI HAGGI, Arezou; NADRI, Mahsa; ASVADI KERMANI, Touraj

2013-01-01

Background: Human papilloma virus causes benign and malignant abnormalities in different part of the body. The link between high risk types of HPV and some anogenital and aerodigestive tract cancer is well established. Oral HPV infection plays a role in developing oropharyngeal squamous cell carcinoma. We studied the prevalence of oral HPV in healthy individuals and its relative risk factors. Methods: Saliva samples of 114 healthy subjects were collected for HPV DNA analysis. Volunteers compl...

Metsaomanikud vaidlevad Natura-alade vastu / Silvia Paluoja

Index Scriptorium Estoniae

Paluoja, Silvia, 1956-

2004-01-01

Pärnumaa keskkonnateenistusse jõudis 97 avaldust kinnistute omanikelt, kelle maad jäävad ohustatud või haruldaste taimede ja loomade ning nende elupaikade kaitseks moodustatavasse üleeuroopalisse hoiualade ehk Natura 2000 võrgustikku

Utilisation of sulfites by animals; Utilisation des sulfites par l'animal superieur

Energy Technology Data Exchange (ETDEWEB)

Fromageot, P; Chapeville, F [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1955-07-01

It studied the uptake of radioactive sulfates and sulfites in sulfinic cysteine acid, taurine and cystine in animal organism. The experiments are conducted on rabbits. The experimental procedures are described: one experiment is to sterilize intestines of the animal before to inject it radioactive sulfites or sulfates, the rabbit is sacrificed 28 hours after and its organs analysed. The other experiment is to inject radioactive sulfites or sulfates in an eviscerated rabbit and sacrificed it 30 minutes after. Sulfinic cysteine acid is mainly found in liver extracts after 30 minutes and only after injection of radioactive sulfites, whereas cystine is found after 28 hours in a majority of organ extracts. It showed that sulfur used for the synthesis of sulfinic cysteine acid comes from sulfites intake and that sulfinic cysteine acid is a precursor of taurine and cystine. (M.P.)

Seadusemuudatus võib jätta head algatused rahata / Ishtvan Ban

Index Scriptorium Estoniae

Ban, Ishtvan

2003-01-01

Ilmunud ka: Severnoje Poberezhje 17. juuli lk. 5. Ida-Virumaal jäävad rajamata mitmed laste mänguväljakud või toetuseta andekad noored, kui rahandusminister Tõnis Paltsi kavandatud riigiettevõtete sponsorabi keelustatakse

Täienes Kunstimuuseumi graafikakogu / Anne Lõugas

Index Scriptorium Estoniae

Lõugas, Anne, 1951-

1998-01-01

Tallinna XI graafikatriennaali premeeritud tööd jäävad enamikus Eesti Kunstimuuseumi. Omandatud töödest, pikemalt muuseumi ostupreemia pälvinud inglise kunstniku Wendy Swallowi (s. 1974) kolmest tööst.

East and Central African Journal of Surgery http://www.bioline.org.br ...

African Journals Online (AJOL)

Patrick

3Department of surgery, Faculty of Medicine, Addis Ababa University (AAU), Addis ... In animal study, VAD decreased thyroidal iodine uptake and impaired thyroglobulin (Tg) ..... group A and 12/95 in group B; small were vitamin A deficient.

Bazex Syndrome with Hypoalbuminemia and Severe Ascites

OpenAIRE

Matsui, Hidetoshi; Iwae, Shigemichi; Hirayama, Yuji; Yonezawa, Koichiro; Shigeji, Jun

2016-01-01

Bazex syndrome is a rare paraneoplastic dermatosis. The underlying malignancy frequently is squamous cell carcinoma of the upper aerodigestive tract or cervical lymph nodes from an unknown primary site. We report a 63-year-old man with squamous cell carcinoma of cervical lymph nodes from an unknown primary site. He developed a mass on the right side of his neck, cutaneous lesions diagnosed as Bazex syndrome, hypoalbuminemia, and severe ascites. Right neck dissection was performed. After neck ...

Use of the direct puncture technique in management of capillaro-venous malformations: case report

Directory of Open Access Journals (Sweden)

Tyagi Isha

2002-03-01

Full Text Available Abstract Background Preoperative devascularization of the capillaro-venous malformations located in the aero-digestive tract is important for surgeons, to minimize blood loss during surgical excision of malformations. Case presentation Here we present two cases of capillaro-venous malformation in which we could successfully achieve preoperative devascularization, by directly injecting n-butyl cyano acrylate into the capillaro-venous bed. This technique is relatively easy, safe and cheap, and can be carried out immediately before surgery.

An Unusual Neck Mass: Ingested Chicken Bone

OpenAIRE

Demirhan, Erhan; İber, Metin; Yağız, Özlem; Kandoğan, Tolga; Çukurova, İbrahim

2016-01-01

Background: Foreign bodies in the upper aerodigestive tract are frequently seen in otolaryngological practice, but migration of an ingested foreign body to the neck is a very rare condition. Case Report: We present a 66-year-old woman admitted to our outpatient department with a painful neck mass. She had a history of emergency department admission 4 months prior with odynophagia after eating chicken meal. A physical examination revealed a painful and hyperemic mass on the left neck. Ant...

Peri-stent aneurysm formation following a stent implant for stenotic intracranial vertebral artery dissection: a technical report of two cases successfully treated with coil embolization.

Science.gov (United States)

Ishimaru, Hideki; Nakashima, Kazuaki; Takahata, Hideaki; Matsuoka, Yohjiro

2013-02-01

Although stenting for stenotic vertebral artery dissection (VAD) improves compromised blood flow, subsequent peri-stent aneurysm (PSA) formation is not well-known. We report two cases with PSA successfully treated with coil embolization. Three patients with stenotic intracranial VAD underwent endovascular angioplasty at our institution because they had acute infarction in posterior circulation territory and clinical evidence of hemodynamic insufficiency. In two of three patients balloon angioplasty at first session failed to relieve the stenosis, and a coronary stent was implanted. Angiography immediately after stenting showed no abnormality in case 1 and minimal slit-like projection at proximal portion of the stent in case 2. Angiography obtained 16 months after the stenting revealed PSA in case 1. In case 2, angiography performed 3 months later showed that the projection at proximal portion enlarged and formed an aneurysm outside the stent. Because follow-up angiographies showed growth of the aneurysm in both cases, endovascular aneurysmal embolization was performed. We advanced a microcatheter into the aneurysm through the strut of existing stent and delivered detachable coils into the aneurysm lumen successfully in both cases. The post-procedural course was uneventful, and complete obliteration of aneurysm was confirmed on angiography in both cases. Stenting for stenotic intracranial VAD may result in delayed PSA; therefore, follow-up angiographies would be necessary after stenting for stenotic intracranial arterial dissection. Coil embolization through the stent strut would be a solution for enlarging PSA.

Construction and Antiapoptosis Activities of Recombinant Adenoviral Expression Vector Carrying EBV Latent Membrane Protein 2A

Directory of Open Access Journals (Sweden)

Xishuang Liu

2011-01-01

Full Text Available To evaluate the possible effects of LMP2A (EBV latent membrane protein 2A on human gastric cancer cell line SGC-7901, LMP2A coding gene was subcloned into shuttle plasmid pAdTrackCMV to form transfer plasmid pAdTrackCMV-2A, which was linearized with PmeI and cotransformed into E.coli BJ5183 with adenovirus genomic plasmid of pAdeasy-1. The identified recombinant adenovirus plasmid DNA was digested with PacI and transfected into 293 cells to package recombinant adenovirus particles named vAd-2A. Then the expression and antiapoptosis activities of LMP2A on SGC-7901 infected with vAd-2A were analyzed. The vAd-2A was successfully constructed and identified by PCR, restriction digestion, and sequencing. LMP2A expression in SGC was identified by strong green fluorescence expression with fluorescence microscopic photograph and Southern blotting. The growth of LMP2A expressing SGC cells was apparently improved. Both cyclin E expression and S phase ratio in LMP2A expressing SGC cells were upregulated by cell cycle analysis and confocal microscopic analysis respectively. The replication-deficient recombinant adenovirus vector can express LMP2A antigen in SGC cells and inhibit their apoptosis. The results indicate that LMP2A might play an important role in pathogenesis of EBV-associated gastric cancer (EBVaGC. This study establishes a foundation for further study on EBVaGC and its gene therapy.

Brief screening for mild cognitive impairment in subcortical ischemic vascular disease: a comparison study of the Montreal Cognitive Assessment with the Mini-Mental State Examination.

Science.gov (United States)

Xu, Qun; Cao, Wen-wei; Mi, Jian-hua; Yu, Ling; Lin, Yan; Li, Yan-sheng

2014-01-01

To assess the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in the detection of vascular mild cognitive impairment (VaMCI) in patients with subcortical ischemic vascular disease (SIVD). Among 102 SIVD patients, both cutoff scores of the MMSE and MoCA for differentiating VaMCI from no cognitive impairment (NCI) or differentiating VaMCI from vascular dementia (VaD) were determined by the receiver operator characteristic (ROC) analysis. Optimal sensitivity with specificity of cutoff scores was obtained after the raw scores were adjusted for education. After adjusting for education, the MoCA cutoff score for differentiating VaMCI from NCI was at 24/25 and that for differentiating VaMCI from VaD was at 18/19. After applying the adjusted MoCA scores from 19 to 24 to identify VaMCI in all SIVD patients, sensitivity was at 76.7% and specificity was at 81.4% (κ = 0.579). The adjusted cutoff score of the MMSE for differentiating VaMCI from NCI was at 28/29 and that for differentiating VaMCI from VaD was at 25/26. The sensitivity and specificity of the adjusted MMSE was at 58.1 and 71.2%, respectively, when using the score from 26 to 28 to identify VaMCI in SIVD patients (κ = 0.294). The MoCA detected subcortical VaMCI better than the MMSE. © 2013 S. Karger AG, Basel.

VITAMIN A DEFICIENCY IN BRAZILIAN CHILDREN AND ASSOCIATED VARIABLES.

Science.gov (United States)

Lima, Daniela Braga; Damiani, Lucas Petri; Fujimori, Elizabeth

2018-03-29

To analyze the variables associated with vitamin A deficiency (VAD) in Brazilian children aged 6 to 59 months, considering a hierarchical model of determination. This is part of the National Survey on Demography and Health of Women and Children, held in 2006. Data analysis included 3,417 children aged from six to 59 months with retinol data. Vitamin A deficiency was defined as serum retinol Poisson regression analysis were performed, with significance level set at 5%, using a hierarchical model of determination that considered three conglomerates of variables: those linked to the structural processes of community (socioeconomic-demographic variables); to the immediate environment of the child (maternal variables, safety and food consumption); and individual features (biological characteristics of the child). Data were expressed in prevalence ratio (PR). After adjustment for confounding variables, the following remained associated with VAD: living in the Southeast [PR=1,59; 95%CI 1,19-2,17] and Northeast [PR=1,56; 95%CI 1,16-2,15]; in urban area [RP=1,31; 95%CI 1,02-1,72]; and mother aged ≥36 years [RP=2,28; 95%CI 1,37-3,98], the consumption of meat at least once in the last seven days was a protective factor [PR=0,24; 95%CI 0,13-0,42]. The main variables associated with VAD in the country are related to structural processes of society and to the immediate, but not individual, environment of the child.

Roppus ja raev murdsid saali, kuid pungi sisu jäi kaugeks / Margit Tõnson

Index Scriptorium Estoniae

Tõnson, Margit, 1978-

2004-01-01

7. okt. Von Krahli Teatris esietendunud punkansambli Sex Pistolsi tekkelugu ja võtmestseene kujutavast etendusest "Ainult võltsid jäävad ellu", lavastaja M. Raat. Lisatud ka punkari V. Tamme ja psühhoterrori laulja Freddy kommentaar

Acceptance of a complementary food prepared with yellow ...

African Journals Online (AJOL)

2014-06-13

Jun 13, 2014 ... Dietetics and Human Nutrition, University of KwaZulu-Natal. Derera J, PhD ... decrease in the national prevalence of VAD in children aged five years and ..... With nutritional education and proper marketing strategies, the ...

VITAMIN A DEFICIENCY IN NIGERIAN CHILDREN

African Journals Online (AJOL)

Dr Olaleye

Vitamin A deficiency (VAD) is a global problem of public health significance in many ... It is therefore important to know Vitamin A status of. Nigerian ..... Ph D thesis University of Ibadan. Ajaiyeoba AI (1994). Childhood blindness in Nigeria.

Paula Stradiņa veselības un sociālās aprūpes koledžai pieejamie resursi un to izmantošana medicīnas speciālistu sagatavošanas procesā

OpenAIRE

Oliņa, Agnese

2007-01-01

Veselības nozares nodrošināšana ar pietiekamiem cilvēkresursiem. Mērķis, izpētīt koledžas pieejamos resursus un to izmantošanu, atklāt pozitīvos momentus un trūkumus, kā arī izstrādāt priekšlikumus. Analīzes rezultāti, nepietiekams finanšu resurss telpu un iekārtu nodrošināsanai jaunajām studiju programmām, resursu vadīšanas procesam nepieciešami papildus darbinieki un zināšanas. Darbā analizēti vispārējie resursi un to atšķirības veselības izglītības jomā, vadīšanas process un kvalit...

ASA klientide vara sulas peenrahaks / Anne Oja

Index Scriptorium Estoniae

Oja, Anne, 1970-

2007-01-01

Sajad ASA Kindlustuse kliendid saavad pankrotist vähem raha kui kulub pangaülekandeks, summad jäävad 2 ja 30 krooni vahele. Vt. samas: Klientide saadav raha ASA Kindlustuse pankrotipesast; Apananski süüst priiks

Kunstnik kavatseb maalidest jaanitule teha / Erika Prave

Index Scriptorium Estoniae

Prave, Erika, 1970-

2005-01-01

Andrus Older teeb jaanitule oma piltidest, mis jäävad ostmata oksjonil, mille ta korraldab päev enne Sillamäe lähedal Orava talus. Harrastuskunstnik paneb müüki umbes 50 maali. Kunstniku kommentaarid

Shock wave air dissociation and ionization; Dissociation et ionisation de l'air par une onde de choc

Energy Technology Data Exchange (ETDEWEB)

Thouvenin, J. [Commissariat a l' energie atomique et aux energies alternatives - CEA (France)

1959-07-01

The composition and internal energy of air are computed for a range of temperature from 3 500 up to 11500 deg. K and a range of density from 4 up to 12 times normal density. In another connection, the increase of internal energy of air by a shock wave traveling through it is evaluated in terms of the same parameters. By adjusting both expressions of energy, a relation between the temperature T and the ratio of molecular volumes V{sub 0}/V ahead and behind the shock front is obtained. The others physical variables, pressure, front velocity, material velocity, degree of ionization, can be then computed if either of parameters T or V{sub 0}/V is known. Conversely, measurement of any one physical variable makes it possible to get values of all the others. Present calculations show the oxygen to be completely dissociated by strong shock waves (velocities above 7000 m/s), the nitrogen by a rate of 50 % higher, and the concentration of free electrons to be over 0,1 %. Reprint of a paper published in 'Le journal de physique et le radium', Tome 19, July 1958, p. 639-648 [French] La composition de l'air et la valeur de son energie interne sont calculees pour des temperatures allant de 3 500 a 11 500 deg. K et des densites de 4 a 12 fois superieures a la densite normale. D'autre part, on determine, en fonction des memes parametres, l'augmentation d'energie interne de l'air due au passage d'une onde de choc. En egalant les deux expressions de l'energie, on obtient une relation entre la temperature T et le rapport des volumes moleculaires V{sub 0}/ V devant et derriere le front de choc. Les valeurs des autres grandeurs physiques, pression, vitesse du front, vitesse d'ecoulement, taux d'ionisation dans le front, sont alors determinees si l'on connait l'un des parametres T ou V{sub 0}/ V. Inversement, la mesure de l'une quelconque de ces grandeurs physiques permet de fixer la valeur de toutes les autres. Le calcul montre que pour des chocs intenses (vitesses superieures a 7000 m

A new detector for the measurement of neutron flux in nuclear reactors; Nouvelle methode de mesure des flux de neutrons dans les reacteurs atomiques

Energy Technology Data Exchange (ETDEWEB)

Koch, L; Labeyrie, J; Tarassenko, S [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1958-07-01

The detector described is designed for the instantaneous measurement of thermal neutron fluxes, in the presence of high {gamma} ray activity; this detector can withstand temperatures as high as 500 deg. C. It is based on the following principle: radioactive atoms resulting from heavy-nucleus fission are carried by a gas flow to a detector recording their {beta} and {gamma} disintegration. Thermal neutron fluxes as low as few neutrons per cm{sup 2} per second can be measured. This detector may be used to control a nuclear reactor, to plot the thermal flux distribution with an excellent definition (1 mm{sup 2}) for fluxes higher than 10{sup 8} n/cm{sup 2}/s. The time response of the system to a sharp variation of flux is limited, in case of large fluxes, to the transit time of the gas flow between the fission product emitter and the detector; of the order of one tenth of a sec per meter of piping. The detector may also be applied for spectroscopy of fission products eider than 0,1 s. (author)Fren. [French] On decrit un appareil permettant la mesure instantanee des flux de neutrons thermiques accompagnes de flux intenses de rayons {gamma} et situes dans des enceintes pouvant etre portees a des temperatures superieures a 500 deg. C. On utilise la radioactivite des atomes resultant de la fission des noyaux lourds; ces atomes sont entraines par un courant gazeux vers un detecteur de radioactivite qui enregistre leurs desintegrations {beta} et {gamma}. On peut mesurer des flux partir de quelques neutrons thermiques par cm{sup 2} et par seconde. L'appareil permet de suivre la puissance d'un reacteur atomique, de tracer des cartes de densite de neutrons avec une tres bonne definition (1 mm{sup 2}) dans le cas de flux superieurs a 10{sup 8} cm{sup 2}/s. Le temps de reponse du systeme a une variation du flux de neutrons est limite, poes flux importants, par le temps de transit du gaz entre l'emetteur de produits de fission et le detecteur: soit quelques dizaines de

Contribution to the study of radio toxicity of aromatic and medicinal plants using solid state nuclear track detectors; Contribution a l etude de la radio toxicite des plantes aromatiques et medicinales au moyen des detecteurs solides de traces nucleaires

Energy Technology Data Exchange (ETDEWEB)

Mortassim, A; Misdaq, M A; Naaman, A

2009-07-01

The concentrations of uranium (238 U), thorium (232 Th), radon (222 Rn) and thoron (220 Rn) were measured in twenty aromatic and medicinal plants in {sup f}ind a new method based on using solid state nuclear track detectors type Cr-39 and Rs-115. He emerges from this study that the verbena and salvia have higher levels of uranium (radon) higher than that of other plants while the leaves of olive and saturja have concentrations of thorium (thoron) higher than other plants therefore radio toxicity of these plants is higher than that of others and may pose a radiological hazard if the masses are incorporated by consumers high. [French] Les concentrations en uranium (238U), thorium (232Th), radon (222Rn), et thoron (220Rn) ont ete mesurees dans vingt plantes aromatiques et medicinales en utilsant une nouvelle methode basee sur l utilisation des detecteurs solides de traces nucleaires de types CR-39 et LR-115. Il en sort de cette etude que la verveine et la salvia presentent des teneurs en uranium (radon) superieurs a celle des autres plantes alors que les feuilles d olivier et la saturja presentent des concentrations en thorium (thoron) plus elevee que celles des autres plantes par consequent la radio toxicite de ces plantes est superieure a celles des autres et peuvent presenter un risque radiologique si les masses incorporees par les consommateurs sont elevees.

Transoral laser surgery for laryngeal carcinoma: has Steiner achieved a genuine paradigm shift in oncological surgery?

Science.gov (United States)

Harris, A T; Tanyi, A; Hart, R D; Trites, J; Rigby, M H; Lancaster, J; Nicolaides, A; Taylor, S M

2018-01-01

Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO 2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predominantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase 'paradigm shift' in his groundbreaking book The Structure of Scientific Revolutions. He argued that the arrival of the new and often incompatible idea forms the core of a new paradigm, the birth of an entirely new way of thinking. This article discusses whether Steiner and colleagues truly brought about a paradigm shift in oncological surgery. By rejecting the principle of en block resection and by replacing it with the belief that not only is it oncologically safe to cut through the substance of the tumour but in doing so one can actually achieve better results, Steiner was able to truly revolutionise the management of laryngeal cancer. Even though within this article the repercussions of his insight are limited to the upper aerodigestive tract oncological surgery, his willingness to question other peoples' dogma makes his contribution truly a genuine paradigm shift.

Olemise ja unustamise vahel : World Press Photo '98 / Ants Juske

Index Scriptorium Estoniae

Juske, Ants, 1956-2016

1998-01-01

Parimate pressifotode rändnäitusest. Konkursil osales 3627 fotograafi, Eestist Tiit Räis ja Viktor Vesterinen. Aasta parimaks tunnistati alžeeria fotograafi Hocine pilt naisest massimõrva ohvrite haigla juures. Paremini müüvad fotod katastroofidest

Kalle Klandorf: politseinikud tuleb taas tuua tänavale : Tallinna abilinnapea leiab, et munitsipaalpolitsei vajab seadusega antud suuremaid volitusi / interv. Andrus Allika

Index Scriptorium Estoniae

Klandorf, Kalle, 1956-

2011-01-01

Kalle Klandorf leiab, et kuritegevuse vähenemisega, nagu väidab statistika, pole Eestis küll põhjust hoobelda. Kuritegusid registreeritakse lihtsalt vähem – inimesed ei tule politsei juurde, nad löövad käega

Eesti kõrgmood uues võtmes / Anne Vetik

Index Scriptorium Estoniae

Vetik, Anne

2010-01-01

ReUse Republic disainilaat Kristiine Keskuses (Tallinn) 3.-7. veebruarini 2010. Ürituse raames loovad noored disainerid tuntud moebrändide laojääkidest originaalesemeid ning müüvad neid. Disainilaada patrooniks ja modelliks on laulja Marten Kuningas

German troops to stay in Lithuania until security situation changes

Index Scriptorium Estoniae

2017-01-01

NATO pataljoni kuuluvad Saksa sõdurid jäävad Leetu kuni julgeolekuolukorra paranemiseni. Saksamaa ja Leedu sõjaline koostöö on viimastel aastatel kasvanud: Leedu on Saksamaalt ostnud märkimisväärsel hulgal relvastust ja sõjatehnikat

Mis muutub Eesti Kunstimuuseumi elus, rollis ja tähenduses, kui Kumu valmis on saanud? / Marika Valk

Index Scriptorium Estoniae

Valk, Marika

2004-01-01

EKMi filiaalidest jäävad edasi tegutsema Kadrioru lossi väliskunstimuuseum (koos Mikkeli muuseumiga), Niguliste muuseum, Adamson-Ericu muuseum, Kristjan Raua majamuuseum, juurde tuleb Kumu, tegevuse lõpetavad Rüütelkonna hoone ja kunstimuuseumi näitusepind Rotermanni soolalaos

Turumajandus on käkitegu, aga püüdke demokraatiat ehitada! / Lauri Linnamäe

Index Scriptorium Estoniae

Linnamäe, Lauri

2008-01-01

Postkommunistlike riikide vastu huvi tundva majandusteadlase Anders Aslundi raamatust "How capitalism was built", mis annab põhjaliku ja süstemaatilise ülevaate ajast ja protsessidest, mis jäävad Nõukogude Liidu lagunemise ja tänapäeva vahele

Impact of fixed pulmonary hypertension on post-heart transplant outcomes in bridge-to-transplant patients

DEFF Research Database (Denmark)

Alba, Ana Carolina; Rao, Vivek; Ross, Heather J

2010-01-01

Fixed pulmonary hypertension (FPH) is considered a contraindication to cardiac transplantation. Ventricular assist device (VAD) therapy through prolonged left ventricular unloading may reverse FPH. Our aim was to assess post-transplant outcomes and survival in patients with and without FPH...

Cost-effectiveness analysis of treating transplant-eligible multiple myeloma patients in Macedonia

Directory of Open Access Journals (Sweden)

Qerimi V

2018-06-01

Full Text Available Vjollca Qerimi,1,2 Aleksandra Kapedanovska Nestorovska,1 Zoran Sterjev,1 Sonja Genadieva-Stavric,3 Ljubica Suturkova1 1Faculty of Pharmacy, Ss. Cyril and Methodius University in Skopje, Skopje, Macedonia; 2Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria; 3Medical Faculty, University Hematology Clinic, Skopje, Macedonia Purpose: A decision-analytic model was developed to study the impact of induction regimens vincristine, adriamycin, dexamethasone (VAD; thalidomide, dexamethasone (TD; and bortezomib, dexamethasone (BorD, followed by autologous stem cell transplantation (ASCT for treating multiple myeloma (MM patients in Macedonia. Additionally, a cost-effectiveness analysis (CEA of treatment sequences to predict health effects and costs of different treatment sequences was performed.Methods: Model strategies were based on a previously published study for treating patients with MM in Macedonia. The data on disease progression and treatment effectiveness were obtained from the published reports of randomized clinical trials (GIMEMA M-B02005, IFM 2005-01. Utility parameters were extracted from the literature. To compare treatment combinations, a decision tree model was developed. Additionally, a cost analysis for one-time per-protocol costs was performed from a Macedonian national health care perspective. The incremental cost-effectiveness ratios (ICERs/quality-adjusted life years (QALYs gained for 1-, 10-, and 20-year time horizons were determined. Costs and health outcomes were discounted to evaluate the effects of time in the model.Results: The one-time costs of BorD (EUR 5,656 were higher compared to VAD (EUR 303 and TD (EUR 329, increasing the overall costs for BorD. Thus, the BorD combination dominated in the baseline

Nee omingud, päävad ja õhtad / Enda Naaber

Index Scriptorium Estoniae

Naaber, Enda, 1938-

2006-01-01

Järvesalu, Irma. Nänne kink oo nee õhtad : murdeluulet / toimetaja Kadri Tüür ; illustratsioonid: Viire Jagomägi ; kujundanud Riina Uisk. Tupenurme : I. Järvesalu, 2006. Sisaldab katkendeid luuletustest "Nänne kink", "Me jõudsime mere juure", "Kuoruke" ja "Meri"

Eesti kukeseeni söövad prantsuse gurmaanid / Signe Kalberg

Index Scriptorium Estoniae

Kalberg, Signe, 1959-

2005-01-01

Wilberg Food OÜ ostab kokku seeni, 95% värsketest kukeseentest eksporditakse välismaale. Astelpajumarju kokku ostva OÜ Berry Farmingu hinnangul oleks astelpajumarjade välismaale turustamiseks vaja suurendada kokkuostu kaks korda. Vt. samas: Kodumaist köögivilja napib

Hodnocení povrchových vad optických ploch

Czech Academy of Sciences Publication Activity Database

Procháska, František; Špína, Michal; Matoušek, Ondřej; Melich, Radek

2015-01-01

Roč. 60, č. 2 (2015), s. 73-76 ISSN 0447-6441 R&D Projects: GA TA ČR(CZ) TA03010843; GA MŠk(CZ) LO1206 Institutional support: RVO:61389021 Keywords : surface imperfection * scratch and dig analysis Subject RIV: JS - Reliability ; Quality Management, Testing http://jmo.fzu.cz/

Tornid, millest pilved jäävad allapoole / Eda Post

Index Scriptorium Estoniae

Post, Eda, 1983-

2008-01-01

Maailma kõrgeimatest hoonetest alates Frank Lloyd Wrighti kavandatud tornist The Illinois. Burj Dubai ja Al Burj Araabia Ühendemiraatides, Abraj Al Bait Saudi Araabias, Chicago Spire (arhitekt Santiago Calatrava) ja Moskva rahvusvahelise ärikeksuse torn (Briti arhitektuuribüroo Foster and Partners)

Eurovolinikud GMO pärast vastamisi / Nastja Pertsjonok

Index Scriptorium Estoniae

Pertsjonok, Nastja

2006-01-01

ELi keskkonnavolinik Stavros Dimas väitis 6. aprillil Viinis peetud üleeuroopalisel konverentsil "Vaba valik", et Euroopa põllumehed ei hakka GMOsid kasvatama. Põllumajandusvolinik Mariann Fischer Boeli hinnangul GMOd on ja jäävad ning eurooplastel oleks parem nendega harjuda

The effect of ventricular assist devices on cerebral blood flow and blood pressure fractality

International Nuclear Information System (INIS)

Bellapart, Judith; Fraser, John F; Chan, Gregory S H; Tzeng, Yu-Chieh; Ainslie, Philip N; Dunster, Kimble R; Barnett, Adrian G; Boots, Rob

2011-01-01

Biological signals often exhibit self-similar or fractal scaling characteristics which may reflect intrinsic adaptability to their underlying physiological system. This study analysed fractal dynamics of cerebral blood flow in patients supported with ventricular assist devices (VAD) to ascertain if sustained modifications of blood pressure waveform affect cerebral blood flow fractality. Simultaneous recordings of arterial blood pressure and cerebral blood flow velocity using transcranial Doppler were obtained from five cardiogenic shock patients supported by VAD, five matched control patients and five healthy subjects. Computation of a fractal scaling exponent (α) at the low-frequency time scale by detrended fluctuation analysis showed that cerebral blood flow velocity exhibited 1/f fractal scaling in both patient groups (α = 0.95 ± 0.09 and 0.97 ± 0.12, respectively) as well as in the healthy subjects (α = 0.86 ± 0.07). In contrast, fluctuation in blood pressure was similar to non-fractal white noise in both patient groups (α = 0.53 ± 0.11 and 0.52 ± 0.09, respectively) but exhibited 1/f scaling in the healthy subjects (α = 0.87 ± 0.04, P < 0.05 compared with the patient groups). The preservation of fractality in cerebral blood flow of VAD patients suggests that normal cardiac pulsation and central perfusion pressure changes are not the integral sources of cerebral blood flow fractality and that intrinsic vascular properties such as cerebral autoregulation may be involved. However, there is a clear difference in the fractal scaling properties of arterial blood pressure between the cardiogenic shock patients and the healthy subjects

Daily rhythms of catalase and glutathione peroxidase expression and activity are endogenously driven in the hippocampus and are modified by a vitamin A-free diet.

Science.gov (United States)

Navigatore-Fonzo, Lorena S; Delgado, Silvia M; Gimenez, Maria Sofia; Anzulovich, Ana C

2014-01-01

Alterations in enzymatic antioxidant defense systems lead to a deficit of cognitive functions and altered hippocampal synaptic plasticity. The objectives of this study were to investigate endogenous rhythms of catalase (CAT) and glutathione peroxidase (GPx) expression and activity, as well as CREB1 mRNA, in the rat hippocampus, and to evaluate to which extent the vitamin A deficiency could affect those temporal patterns. Rats from control and vitamin A-deficient (VAD) groups received a diet containing 4000 IU of vitamin A/kg diet, or the same diet devoid of vitamin A, respectively, during 3 months. Rats were maintained under 12-hour-dark conditions, during 10 days before the sacrifice. Circadian rhythms of CAT, GPx, RXRγ, and CREB1 mRNA levels were determined by reverse transcriptrase polymerase chain reaction in hippocampus samples isolated every 4 hours during a 24-hour period. CAT and GPx enzymatic activities were also determined by kinetic assays. Regulatory regions of clock and antioxidant enzymes genes were scanned for E-box, RXRE, and CRE sites. E-box, RXRE, and CRE sites were found on regulatory regions of GPx and CAT genes, which display a circadian expression in the rat hippocampus. VAD phase shifted CAT, GPx, and RXRγ endogenous rhythms without affecting circadian expression of CREB1. CAT and GPx expression and enzymatic activity are circadian in the rat hippocampus. The VAD affected the temporal patterns antioxidant genes expression, probably by altering circadian rhythms of its RXR receptors and clock factors; thus, it would impair the temporal orchestration of hippocampal daily cognitive performance.

Disorders of "taste cognition" are associated with insular involvement in patients with Alzheimer's disease and vascular dementia: "memory of food is impaired in dementia and responsible for poor diet".

Science.gov (United States)

Suto, Teiko; Meguro, Kenichi; Nakatsuka, Masahiro; Kato, Yuriko; Tezuka, Kimihiro; Yamaguchi, Satoshi; Tashiro, Manabu

2014-07-01

In dementia patients, dietary intake problems may occur despite the absence of swallowing problems. We investigated cognitive functions on food and taste in Alzheimer's disease (AD) and vascular dementia (VaD) patients. Participants included 15 healthy controls (HC), 30 AD and 20 VaD patients. Food Cognition Test: Replicas of three popular foods in Japan with no odors were presented visually to each participant, with the instruction to respond with the name of each food. Replicas of food materials were subsequently presented to ask whether they were included in these foods. Taste Cognition Test: Replicas of 12 kinds of foods were presented to describe their expected tastes. The AD/VaD groups exhibited significantly lower scores on Food/Taste Cognition Tests compared with the HC group. These scores correlated inversely with Mini-Mental State Examination (MMSE) scores in the AD group. Decreased dietary intake was observed in 12 of the 50 patients; 8 of the 12 exhibited decreased Taste Cognition Test scores, higher than that of the normal-intake patients. There was no difference in the filter paper taste disc test between HC/AD/VaD groups. To test the hypothesis that the insula is associated with taste cognition, two MMSE-matched AD subgroups (n = 10 vs. 10) underwent positron emission tomography. Glucose metabolism in the right insula was lower in the low taste cognition subgroup. The VaD patients with insular lesions exhibited impaired Taste Cognition Test findings. It is important to consider the cognitive aspect of dietary intake when we care for dementia patients.

Sun-dried cowpeas and amaranth leaves recipe improves β-carotene and retinol levels in serum and hemoglobin concentration among preschool children.

Science.gov (United States)

Nawiri, Mildred P; Nyambaka, Hudson; Murungi, Jane I

2013-03-01

Vitamin A deficiency (VAD) and anemia are major challenges among children and expecting and lactating mothers in developing countries. Intervention with locally available dark green leafy vegetables (DGLV) is more sustainable to eradicate VAD, being cost-effective and readily adaptable to local communities. DGLV contain high levels of iron and β-carotene (BC) and therefore useful in fighting VAD and anemia. Since DGLVs are season-dependent sun-drying enables their availability during low seasons. However, their contribution to the bioavailability of BC and the improvement of hemoglobin are not well understood. The study therefore investigated the effect of consuming cooked recipe consisting of sun-dried amaranth and cowpea leaves on the levels of BC, retinol, and hemoglobin in preschool children from Machakos District, a semiarid region in Kenya. Vegetables were purchased from local vegetable market, with some sun-dried in an open shade. Levels of BC and retinol in serum and BC in fresh and processed vegetables were determined by a HPLC method and hemoglobin using a portable Hemocue Analyzer. All-trans-BC levels in uncooked fresh cowpea and amaranth leaves were 806.0 μg/g and 599.0 μg/g dry matter, respectively, while the dehydration and cooking processes retained the β-carotene levels at over 60 %. Consumption of the dehydrated vegetables significantly improved both serum BC and retinol levels (p < 0.05), while the baseline hemoglobin levels improved by 4.6 %. The study has shown that intervention with locally available sun-dried vegetables improves the bioavailability of BC, retinol, and hemoglobin levels among preschool children.

The venous manifestations of pulse wave encephalopathy: windkessel dysfunction in normal aging and senile dementia

Energy Technology Data Exchange (ETDEWEB)

Bateman, Grant A. [Locked Bag 1, Newcastle Region Mail Center, Department of Medical Imaging, John Hunter Hospital, Newcastle (Australia); Levi, Christopher R.; Wang, Yang; Lovett, Elizabeth C. [Hunter Medical Research Institute, Clinical Neurosciences Program, Newcastle (Australia); Schofield, Peter [James Fletcher Hospital, Neuropsychiatry Unit, Newcastle (Australia)

2008-06-15

Cerebral arterial, venous and cerebrospinal fluid (CSF) pulsations are closely coupled and this produces pulsation dampening or the windkessel effect. Normal pressure hydrocephalus is a manifestation of the breakdown of this windkessel effect with altered CSF and venous pulsations being noted. The aim of this study was to show that dysfunction of the windkessel mechanism is also a component of normal aging and senile dementia. The study group comprised 24 patients classified as either early senile dementia of Alzheimer's type (SDAT) or vascular dementia (VaD). The patients with dementia were compared with 12 age-matched non-cognitively impaired subjects, and 12 normal young individuals were compared with the normal aging group. MRI flow quantification was used to measure the nonpulsatile and pulsatile components of blood flow as well as the pulsation at the tentorial incisura. With normal aging blood flow decreased but arterial pulsations increased in volume by 49% (P = 0.003). The CSF vented via the tentorial incisura does not change significantly with age and therefore increased venous pulsation is necessary. In patients with VaD the arterial pulse volume was higher by 24% and the straight sinus pulsation was higher by 57% than in normal aging subjects (P = 0.05 and P = 0.03, respectively). In patients with SDAT the total venous pulsation volumes were similar to those in normal aging subjects but there was less basal sinus pulsation. Normal aging, SDAT and VaD are associated with alterations in venous pulsation due to a breakdown of the windkessel effect. (orig.)

Bridge to recovery in two cases of dilated cardiomyopathy after long-term mechanical circulatory support.

Science.gov (United States)

Pacholewicz, Jerzy; Zakliczyński, Michał; Kowalik, Violetta; Nadziakiewicz, Paweł; Kowalski, Oskar; Kalarus, Zbigniew; Zembala, Marian

2014-06-01

Ventricular assist devices (VADs) have become an established therapeutic option for patients with end-stage heart failure. Achieving the potential for recovery of native heart function using VADs is an established form of treatment in a selected group of patients with HF. We report two cases of VAD patients with different types of pump used for mechanical circulatory support, a continuous flow pump (Heart-Ware(®)) and a pulsatile pump (POLVAD MEV(®)), which allow regeneration of the native heart. Patients were qualified as INTERMACS level 3-4 for elective implantation of an LVAD. Implantations were performed without complications. The postoperative course was uncomplicated. In the HeartWare patient the follow-up was complicated by episodes of epistaxis and recurrent GIB as well as driveline infection. The follow-up of the POLVAD MEV patient was uneventful. Recurrent GIB forced us to withdraw aspirin and warfarin therapy and maintain only clopidogrel in the HeartWare patient.. In mid-February 2013 the patient was admitted due to dysfunction of the centrifugal pump with a continuous low-flow alarm and increase power consumption. Under close monitoring of the patient a decision was made to stop the pump immediately and evaluate cardiac function. The serial echocardiography studies showed significant improvement in LVEF up to 45% and no significant valvular pathology. In February 2013 LVAD explant was performed by left thoracotomy without complications. At six-month follow-up the patient was in a good clinical condition, in NYHA class I/II, and on pharmacological treatment.

Complications and sequelae of the treatment of upper aerodigestive tumors

Directory of Open Access Journals (Sweden)

Ángel MUÑOZ-HERRERA

2018-05-01

Full Text Available Head and neck cancer treatment related dusphagia: clinical casesWe explain some clinical cases of patients with the diagnose of head and neck cáncer treated in our hospital with different treatment option. The first two cases are related to patiens with surgical aproachment, with or without flap reconstruction. Third and four ones are cases with non surgical treatment (chemo and/or radiotherapy

PEDAGOGIE PAR PROJET: UNE ÉTUDE DE CAS DANS L'ENSEIGNEMENT SUPERIEUR TECHNOLOGIQUE

Directory of Open Access Journals (Sweden)

Ngo van Thien

Full Text Available Cet article rapporte les résultats d'un questionnaire proposé aux étudiants d'une formation d'enseignement supérieur technologique en génie électrique et informatique industrielle. L'objectif de ce questionnaire est d'évaluer le profit que les étudiants ont retiré d'un enseignement des techniques de gestion de projet, et l'utilisation qu'ils en ont fait, d'une part au cours d'une série de travaux pratiques utilisant la pédagogie par projet, d'autre part au cours de leur stage de fin d'études en entreprise.

Oma brändi kaubad muudavad tootjate ja jaemüüjate jõuvahekordi / Erik Aru, Aavo Kokk

Index Scriptorium Estoniae

Aru, Erik

2006-01-01

Poeketid müüvad oma kaubamärgiga kaupu, mis on märksa odavamad kui analoogtooted. Autorid vaatlevad, mis sunnib tootjaid valmistama kaupa (pealegi odavamalt), mis nende omaga konkureerib. Lisad: Eristumine: Target müüb odavat luksust; Toidupoodides samad hinnad. Tabel: Võrdlusmoment

Gaz - almaz / Jekaterina Rodina

Index Scriptorium Estoniae

Rodina, Jekaterina

2008-01-01

Venemaa Energiapoliitika Instituudi arvutuste kohaselt võib maagaasi tootmise ja nõudluse vahe ulatuda 2010. aastaks 100 miljardi kuupmeetrini, Kui maagaasi tarned Eestisse ära jäävad, saab meie riik omal jõul hakkama kõige rohkem kuu aega. Vt. samas: Gaas arvudes

Trajectories of cognitive decline in different types of dementia

NARCIS (Netherlands)

Smits, L.L.; van Harten, A.C.; Pijnenburg, Y.A.L.; Koedam, E.L.G.E.; Bouwman, F.H.; Sistermans, N.; Reuling, I.E.W.; Prins, N.D.; Lemstra, A.W.; Scheltens, P.; van der Flier, W.M.

2015-01-01

Background. To investigate trajectories of cognitive decline in patients with different types of dementia compared to controls in a longitudinal study. Method. In 199 patients with Alzheimer's disease (AD), 10 with vascular dementia (VaD), 26 with dementia with Lewy bodies (DLB), 20 with behavioural

Red palm oil bean-stew improved serum vitamin A and ...

African Journals Online (AJOL)

Vitamin A deficiency (VAD), anaemia, and parasitic infections are among the major nutritional and health problems confronting Ghanaian school children. This study assessed the impact of red palm oil bean-stew consumption on serum retinol and haemoglobin concentrations of Ghanaian school children in a ...

Vabadussamba autorid võitlevad Tšehhi klaasivabriku kehva töö vastu / Tarmo Vahter

Index Scriptorium Estoniae

Vahter, Tarmo, 1970-

2008-01-01

Tallinnasse Vabadussõja võidusamba püstitamisest. Tšehhi klaasitehases Sans Souci valmistatud monumendi klaaspaneelid kinnitatakse poltidega, mille otsad jäävad nähtavale. Monumendi püstitamise ajagraafikust, maksumusest. Kommenteerivad Rainer Sternfeld, Martin Chab, Veiko Pärlin. Artiklile lisatud samba joonis

Distribution of corded ware in the areas north of the Gulf of Finland - an update/ Kerkko Nordqvist, Piritta Häkälä

Index Scriptorium Estoniae

Nordqvist, Kerkko

2014-01-01

Artiklis käsitletakse nöörkeraamika leiukohti Soomes ja Loode-Venemaal. Leiukohad jagatakse kolme peamisse rühma: matuse- ja asulakohad ning venekirveste juhuleiukohad. Soome lahest põhja poole jäävad alad paistavad silma rohkete asulakohtade ja väheste kalmistutega

Paradoxical embolisation and cerebral white matter lesions in dementia.

NARCIS (Netherlands)

Purandare, N.; Oude Voshaar, R.C.; McCollum, C.; Jackson, A.; Burns, A.

2008-01-01

The study aimed to examine the relationship between spontaneous cerebral emboli (SCE), patent foramen ovale (PFO) and white matter hyperintensities (WMH) on cerebral MRI in patients with Alzheimer's disease (AD) and vascular dementia (VaD). SCE were identified by transcranial Doppler of the middle

Juhtimissüsteemide selgroog. Lean ning ISO - terviklahendused tootmise haldamiseks / Anton Ovsjankin

Index Scriptorium Estoniae

Ovsjankin, Anton

2011-01-01

Kasvanud on juurutatavate Lean ja ISO süsteemide arv, kuid on kasvanud ka nende juurutamise ja arendamisega seotud ebaõnnestumiste arv. Põhjustest, miks jäävad paljud Leani ja ISO juurutanud ettevõtted ilma lubatud tulemusteta. Leani ja ISO haldamiseks vajalikest teguritest

Kolmas vaatus Euroopa võlakriisis - Portugal. Oht Portugali mainel / Sirje Rank

Index Scriptorium Estoniae

Rank, Sirje, 1966-

2011-01-01

Portugal kavatseb läbi viia riigivõlakirjade emissiooni, samas müüvad teisedki riigid lähiajal võlakirju, mille riskiaste on väiksem. Portugal eitab väidet, nagu oleks Saksamaa ja Prantsusmaa survestanud teda Euroopa kriisifondist abi küsima

Thalidomide in induction treatment increases the very good partial response rate before and after high-dose therapy in previously untreated multiple myeloma.

NARCIS (Netherlands)

Lokhorst, H.M.; Schmidt-Wolf, I.; Sonneveld, P.; Holt, B. van der; Martin, H.; Barge, R.; Bertsch, U.; Schlenzka, J.; Bos, G.M.; Croockewit, S.; Zweegman, S.; Breitkreutz, I.; Joosten, P.; Scheid, C.; Marwijk-Kooy, M. van; Salwender, H.J.; Oers, M.H. van; Schaafsma, R.; Naumann, R.; Sinnige, H.A.M.; Blau, I.; Delforge, M.; Weerdt, O. de; Wijermans, P.W.; Wittebol, S.; Duersen, U.; Vellenga, E.; Goldschmidt, H.

2008-01-01

In the prospective phase 3 HOVON-50/GMMG-HD3 trial, patients randomized to TAD (thalidomide, doxorubicin, dexamethasone) had a significantly higher response rate (at least PR) after induction compared with patients randomized to VAD (vincristine, adriamycin, dexamethasone, 72% vs. 54%, p<0.001).

Neurological signs in relation to type of cerebrovascular disease in vascular dementia

NARCIS (Netherlands)

Staekenborg, S.S.; van der Flier, W.M.; van Straaten, E.C.W.; Lane, R.; Barkhof, F.; Scheltens, P.

2008-01-01

BACKGROUND AND PURPOSE - The aim of this study was to describe the prevalence of a number of neurological signs in a large population of patients with vascular dementia (VaD) and to compare the relative frequency of specific neurological signs dependent on type of cerebrovascular disease. METHODS -

Kodumaine mood kolib kaubanduskeskustesse / Karilin Engelbrecht

Index Scriptorium Estoniae

Engelbrecht, Karilin

2010-01-01

Tallinnas Stockmanni kaubamajas müüakse kuu aja jooksul eesti moekunstnike rõivakollektsioone. Projekti juhib Oksana Tandit. Kristiine keskuse Moetäikal müüvad eesti disainerid taaskasutatud riideid ning ReUse Republicu disainilaadal vanadest laoülejääkidest õmmeldud rõivaid

Vitamin A deficiency among Moroccan women and children | Nasri ...

African Journals Online (AJOL)

Background: Vitamin A deficiency (VAD), attributable to an inadequate food intake, constitutes a problem in developing countries. The determination of plasma vitamin A (VA) is a reliable method for assessing VA status of the population. In this context, high performance liquid chromatography (HPLC) has become the ...

Evaluation of three lidar scanning strategies for turbulence measurements

DEFF Research Database (Denmark)

Newman, Jennifer F.; Klein, Petra M.; Wharton, Sonia

2016-01-01

Several errors occur when a traditional Doppler beam swinging (DBS) or velocity-azimuth display (VAD) strategy is used to measure turbulence with a lidar. To mitigate some of these errors, a scanning strategy was recently developed which employs six beam positions to independently estimate the u,...

Just nagu mustkunst: võlgades firmad haihtusid politseinike ja maksuametnike silme all / Marta Jaakson ; kommenteerinud Marie Rosin

Index Scriptorium Estoniae

Jaakson, Marta

2017-01-01

Maksuvõlgadega firmad Lõuna Ehitus OÜ, EBG OÜ, Lõuna Ehitus Grupp OÜ, Joy Grupp OÜ, Caramira Pet Trade OÜ, Väike-Ameerika 2 OÜ, Legal & Business Solutions OÜ ühinesid Verones OÜ-ga ning kustutati äriregistrist ja võlad jäävad likvideerijate mureks

CORRELATION ANATOMO-SCANNOGRAPHIQUE DANS LE ...

African Journals Online (AJOL)

ensemble des cancers des vAdS (1). L'imagerie est devenue indispensable au diagnostic de ces cancers et à la décision thérapeutique. Elle permet une définition parfaite des extensions et des volumes tumoraux. La. TdM est à ...

The diabetic brain and cognition

DEFF Research Database (Denmark)

Riederer, Peter; Korczyn, Amos D; Ali, Sameh S

2017-01-01

The prevalence of both Alzheimer's disease (AD) and vascular dementia (VaD) is increasing with the aging of the population. Studies from the last several years have shown that people with diabetes have an increased risk for dementia and cognitive impairment. Therefore, the authors of this consensus...

Adaptive cognitive testing in cerebrovascular disease and vascular dementia

NARCIS (Netherlands)

Wouters, Hans; de Koning, Inge; Zwinderman, Aeilko H; van Gool, Willem A; Schmand, Ben; Buiter, Maarten; Lindeboom, Robert

2009-01-01

BACKGROUND/AIMS: To examine whether brevity can be combined with precision in measuring global cognitive ability in patients with cerebrovascular disease (CVD) or vascular dementia (VaD). Longer tests (e.g. the CAMCOG) are precise but inefficient, whereas brief tests (e.g. the MMSE) are efficient

Functional Neuroimaging in Dementia

NARCIS (Netherlands)

J.M. Papma (Janne)

2012-01-01

textabstractDementia refers to a clinical syndrome of cognitive deterioration and difficulty in the performance of activities of daily living. The most common cause of dementia is Alzheimer’s disease (AD), followed by vascular dementia (VaD) at old age and frontotemporal dementia (FTD) at young

Automüüjatel suve ei olnud / Tõnu Ojala

Index Scriptorium Estoniae

Ojala, Tõnu, 1969-

2006-01-01

2006. aasta esimese poolaasta automüügi tulemused. Tabelid: ARKis esmakordselt registreeritud sõiduautode TOP 12; Sõiduautode müük; Populaarseimad mudelid; Tarbesõidukite müük. Lisad: Tööautod müüvad hästi; Sakslased valitsevad second-hand-turgu

Possible involvement of caspase-6 and -7 but not caspase-3 in the regulation of hypoxia-induced apoptosis in tube-forming endothelial cells

International Nuclear Information System (INIS)

Eguchi, Ryoji; Tone, Shigenobu; Suzuki, Akio; Fujimori, Yoshihiro; Nakano, Takashi; Kaji, Kazuhiko; Ohta, Toshiro

2009-01-01

We recently reported that a broad-spectrum caspase inhibitor zVAD-fmk failed, while p38 inhibitor SB203580 succeeded, to prevent chromatin condensation and nuclear fragmentation induced by hypoxia in tube-forming HUVECs. In this study, we investigated the reasons for zVAD-fmk's inability to inhibit these morphological changes at the molecular level. The inhibitor effectively inhibited DNA ladder formation and activation of caspase-3 and -6, but it surprisingly failed to inhibit caspase-7 activation. On the other hand, SB203580 successfully inhibited all of these molecular events. When zLEHD-fmk, which specifically inhibits initiator caspase-9 upstream of caspase-3, was used, it inhibited caspase-3 activation but failed to inhibit caspase-6 and -7 activation. It also failed to inhibit hypoxia-induced chromatin condensation, nuclear fragmentation and DNA ladder formation. Taken together, our results indicate that, during hypoxia, caspase-7 is responsible for chromatin condensation and nuclear fragmentation while caspase-6 is responsible for DNA ladder formation

Risk of Dementia Associated with Elevated Plasma Homocysteine in a Latin American Population

Directory of Open Access Journals (Sweden)

Inara J. Chacón

2009-01-01

Full Text Available The relationship between total homocysteine (tHcy and dementia risk remains controversial, as the association varies among populations and dementia subtypes. We studied a Venezuelan population that has high prevalence of both elevated tHcy and dementia. We tested the hypotheses that (1 elevated tHcy is associated with increased dementia risk, (2 the risk is greater for vascular dementia (VaD than for Alzheimer's disease (AD, and (3 a history of stroke may partly explain this association. 2100 participants (≥55 years old of the Maracaibo Aging Study underwent standardized neurological, neuropsychiatric, and cardiovascular assessments. Elevated tHcy was significantly associated with dementia, primarily VaD. When history of stroke and other confounding factors were taken into account, elevated tHcy remained a significant risk factor in older (>66 years, but not in younger (55–66 years subjects. Ongoing studies of this population may provide insight into the mechanism by which tHcy increases risk for dementia.

Starptautiskas kompānijas franšīze Latvijā - ,,McDonald's"

OpenAIRE

Sīle, Līga

2012-01-01

Bakalaura darbā tiek apskatīta stratēģiskā vadīšana un produktu diferencēšanas stratēģija, kā arī franšīze kā uzņēmējdarbības forma. Tiek analizēts uzņēmums McDonald’s un tā darbība dažādu valstu tirgos diferencēšanas stratēģijas ietvaros, veikta konkurentu analīze Latvijā, izvirzīti secinājumi un izteikti priekšlikumi. Pirmajā nodaļā tiek aprakstīta stratēģiskā vadīšana, tās būtība un līmeņi, kā arī tuvāk aplūkota diferencēšanas stratēģija. Otrajā nodaļā apskatīta franšīzes būtība un veid...

A new communication approach for customer relationship management in the hotel industry

OpenAIRE

Heiden, Sandra Marianne

2014-01-01

“Visas uzņēmējdarbības pamatā ir attiecības. Uzņēmumam tikai tās saviem klientiem jāpadara uztveramas un jēgpilnas - ar nosacījumu, ka klienti to vēlas” (Grönroos 2007, 24 lpp.). Uzņēmuma spēja palielināt apgrozījumu, izmantojot efektīvu vadību attiecībās ar klientiem ir ļoti svarīga, lai pārvarētu ekonomisko nenoteiktību visā pasaulē. Jaunās digitālo mediju īpašības kopā ar milzīgu alternatīvo paņēmienu klāstu saziņai ar klientiem ir radījušas vadītājiem un akadēmiķiem gan iespējas, gan prob...

Jaunā komunikācijas pieeja klientu attiecību pārvaldībai viesnīcu nozarē

OpenAIRE

Sandra Marianne Heiden

2014-01-01

ANOTĀCIJA “Visas uzņēmējdarbības pamatā ir attiecības. Uzņēmumam tikai tās saviem klientiem jāpadara uztveramas un jēgpilnas - ar nosacījumu, ka klienti to vēlas” (Grönroos 2007, 24 lpp.). Uzņēmuma spēja palielināt apgrozījumu, izmantojot efektīvu vadību attiecībās ar klientiem ir ļoti svarīga, lai pārvarētu ekonomisko nenoteiktību visā pasaulē. Jaunās digitālo mediju īpašības kopā ar milzīgu alternatīvo paņēmienu klāstu saziņai ar klientiem ir radījušas vadītājiem un akadēmiķiem gan iespē...

Incidence of dementia and major subtypes in Europe

DEFF Research Database (Denmark)

Fratiglioni, L; Launer, L J; Andersen, K

2000-01-01

The authors examined the association of incident dementia and subtypes with age, sex, and geographic area in Europe. Incidence data from eight population-based studies carried out in seven European countries were compared and pooled. The pooled data included 835 mild to severe dementia cases and 42......,996 person-years of follow-up. In all studies a higher proportion of cases were diagnosed with AD (60 to 70% of all demented cases) than vascular dementia (VaD). The incidence of dementia and AD continued to increase with age up to age 85 years, after which rates increased in women but not men....... There was a large variation in VaD incidence across studies. In the pooled analysis, the incidence rates increased with age without any substantial difference between men and women. Surprisingly, higher incidence rates of dementia and AD were found in the very old in northwest countries than in southern countries...

Inhibitors of cysteine cathepsin and calpain do not prevent ultraviolet-B-induced apoptosis in human keratinocytes and HeLa cells

DEFF Research Database (Denmark)

Bang, Bo; Baadsgaard, Ole; Skov, Lone

2004-01-01

been demonstrated to play a role in the execution of programmed cell death induced by other stimuli, e.g. TNF-alpha. The purpose of the present study was therefore to investigate whether inhibitors of cysteine cathepsins and calpains could prevent UVB-induced apoptosis in HeLa cells and keratinocytes....... This was done by investigating the effect of the irreversible cysteine protease inhibitor zFA-fmk, the cathepsin B inhibitor CA-074-Me and the calpain inhibitor ALLN on the viability of UVB-irradiated human keratinocytes and HeLa cells. At concentrations of 10 microM and above zVAD-fmk conferred partial dose......-dependent protection against UVB-induced apoptosis in HeLa cells and keratinocytes. Moreover, caspase-3 activity was completely blocked at zVAD-fmk concentrations of 1 microM in HeLa cells. This indicates that caspase-independent mechanisms could be involved in UVB-induced apoptosis. However, the protease inhibitors z...

Constructing memory through artistic practices

International Nuclear Information System (INIS)

Massart, Cecile

2015-01-01

Cecile Massart is a visual artist who lives and works in Brussels, Belgium. Her teaching career includes Academy of Ixelles, Ecole Superieure des Arts Plastiques et Visuels in Mons, and Ecole Nationale Superieure des Arts Visuels La Cambre in Brussels. Cecile Massart has presented her extensive artistic research at numerous international conferences. Her works are featured in private and public collections. Since 1994, Cecile Massart has been investigating international sites for radioactive waste storage, exploring how this 21. century archaeological stratum is being inscribed in the landscape. Researching radioactive waste sites around the world for over 20 years, her main focus has become their identification in the landscape. Her ideas are communicated through her visual research and writings that aim to raise the awareness of radioactive disposal sites and to study their life within their surroundings for future generations. Her drawings, films, books and exhibitions investigate a new kind of architecture of the sites that become research platforms. Her first graphic research, edited under the title Un site archive pour Alpha, Beta, Gamma, helps in revealing their true nature. Her photographs, silk-screen prints, installations and pictures testify to the need to preserve the memory and knowledge of such sites across generations ensuring the safety of the living world. With this objective in mind, to build a memory, she has developed an architectural vocabulary functioning as warning sculptures to identify the nuclear repositories in the landscape: markers or archi-sculptures. In the following sections, Cecile Massart describes her work in her own words. For more details on her work, see www.cecilemassart.com

Head and neck computed tomography virtual endoscopy: evaluation of a new imaging technique.

Science.gov (United States)

Gallivan, R P; Nguyen, T H; Armstrong, W B

1999-10-01

To evaluate a new radiographic imaging technique: computed tomography virtual endoscopy (CTVE) for head and neck tumors. Twenty-one patients presenting with head and neck masses who underwent axial computed tomography (CT) scan with contrast were evaluated by CTVE. Comparisons were made with video-recorded images and operative records to evaluate the potential utility of this new imaging technique. Twenty-one patients with aerodigestive head and neck tumors were evaluated by CTVE. One patient had a nasal cylindrical cell papilloma; the remainder, squamous cell carcinomas distributed throughout the upper aerodigestive tract. Patients underwent complete head and neck examination, flexible laryngoscopy, axial CT with contrast, CTVE, and in most cases, operative endoscopy. Available clinical and radiographic evaluations were compared and correlated to CTVE findings. CTVE accurately demonstrated abnormalities caused by intraluminal tumor, but where there was apposition of normal tissue against tumor, inaccurate depictions of surface contour occurred. Contour resolution was limited, and mucosal irregularity could not be defined. There was very good overall correlation between virtual images, flexible laryngoscopic findings, rigid endoscopy, and operative evaluation in cases where oncological resections were performed. CTVE appears to be most accurate in evaluation of subglottic and nasopharyngeal anatomy in our series of patients. CTVE is a new radiographic technique that provides surface-contour details. The technique is undergoing rapid technical evolution, and although the image quality is limited in situations where there is apposition of tissue folds, there are a number of potential applications for this new imaging technique.

Ühepäevaliblika lend üle valgete laikude / Sven Karja

Index Scriptorium Estoniae

Karja, Sven, 1968-

2000-01-01

Teatrikriitika olukorrast - kiirtempo, esietenduse põhjal arvustamine, väikelinnateatrite keskmised lavastused jäävad kajastuseta. Vaadeldakse hooaja kolme "mahavaikitud " lavastust - Akos Kertészi "Lesed" Eili Neuhausi lavastuses Rakvere Teatris, Mario Fratti "Ohver" Madis Kalmeti lavastuses Pärnu Endlas ja David Williamsoni "Sõbrad ja raha" Viljandi Ugalas.

Liimpuidu konkurentsitihedal turul jääb ellu vaid tugevaim / Annely Allik

Index Scriptorium Estoniae

Allik, Annely

2005-01-01

Võrumaa ettevõtete TOP 50 3. koht. Liimpuitu tootva ettevõtte GM Panels OÜ juhataja Urmas Lillepalu sõnul jäävad tiheda konkurentsi tingimustes ellu vaid need, kes suudavad efektiivselt toota. Diagramm: GM Panelsi kasum suurenes üheksa korda. Vt. samas: Roland Luks. Edu aluseks õiged otsused

Hääleta oma ostukorviga

Index Scriptorium Estoniae

2011-01-01

Kakaouba kasvatav Kavokiva kooperatiiv Elevandiluurannikul on Fairtrade'i lisatasu eest saanud maksta oma liikmetele aastapreemiaid ning investeerida hariduse ja meditsiini kättesaadavuse parandamisse. Põhja-Vietnami Nam Lanh'i küla elanikud, kes müüvad õiglase kaubanduse tingimustel teed, on saadud lisatasude eest ehitanud kooli

Individual Difference Relations in Psychometric and Experimental Cognitive Tasks

Science.gov (United States)

1980-04-01

underrepresented in the factor-analytic and correlational studies done to date. One such process is what is commonly called encoding (the process REPFRM de...IL 61820 Eugene OR 97403 1 ERIC Facility-Acquisitions 1 Dr. Barbara Hayes-Roth 41833 Rugby Avenue The Rand Corporation Bethesda, VAD 20014 1700 Main

Profile of clinically-diagnosed dementias in a neuropsychiatric ...

African Journals Online (AJOL)

Alzheimer's disease (AD) and Vascular dementia (VaD) were the predominant phenotypes seen in 62 (57.4%) and 18 (16.7%) subjects respectively. Others include mixed dementia (4 cases), frontotemporal dementia (4 cases), Lewy body dementia (3 cases), alcohol-related dementia (3 cases), PD dementia (1 case) and ...

Eigenvalue Problems.

Science.gov (United States)

1987-06-01

11.55), we get (11.56) 1 bu(u - ZhU)dx < bull - hUi{ !s Ch2V(a), where C = C(aOa 1lbo,blV 0 (a),X). Next we consider I(S-Sh)uIL and Ij(T-Th)uaL2 It is...Math. Ann. 97, 711-736. Courant, R. [1943]: Variational methods for the solution of prob- .-lems of equilibrium and vibrations, Bull . Amer. Math. Soc...fournir des bornes superieures ou inferieures, C.R. Acad. Sci., Paris 235, 995-997. .V Prodi, G. (1962]: Theoremi di tipo locale per il sistema de Navier

CONTRIBUTION À L’ÉTUDE DES LIPIDES TISSULAIRES ET PLASMATIQUES CHEZ LE RAT WISTAR MÂLE SOUS RÉGIME HYPERGRAS

OpenAIRE

BENSALAH, Meryem

2012-01-01

De nos jours, les pathologies associées aux accumulations lipidiques dans l’organisme humain, telle l’obésité, prennent une importance croissante dans les questions de santé. Ces maladies sont consécutives à des apports caloriques superieurs à la dépense énergétique aboutissant à un surplus de stockage des graisses. L’objectif principal de cette étude était d’évaluer l’impact d’un régime hyperlipidique hypercalorique administré pour une période de 8 semaines chez le rat male Wistar (que nous ...

A rare case of a sharp foreign body on the vocal cord

Directory of Open Access Journals (Sweden)

Khairunnisak Misron

2017-08-01

Full Text Available A foreign body (FB in the upper aerodigestive tract is a common clinical problem that presents as as acute emergency. Sharp FB, such as fish bone or chicken bone, commonly lodges in the tonsil, base of tongue, vallecula or pyriform fossa. Dislodgement of a FB into the laryngopharynx is very rare and specifically onto the vocal cord is extremely uncommon. This case report illustrates a rare case of a sharp FB that was dislodged into the airway and stuck on to the right vocal cord, which was removed under local anaesthesia.

An elderly man with acute anterior neck pain and odynophagia after a meal

Directory of Open Access Journals (Sweden)

Irfan Mohamad

2013-12-01

Full Text Available The upper aerodigestive tract, specifically the cricopharyngeal area, is the most common site of foreign body impaction. Anatomically, this area is the first constriction of the oesophagus. Fish bones, one of the most common foreign bodies encountered in the throat, tend to get stuck in this area. The movement of this sharp-edged foreign body upon swallowing will induce odynophagia and an acute onset of neck pain. We report a case of a healthy elderly man who complained of sudden anterior neck pain and odynophagia after eating yellowtail scad fish.

The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study.

Science.gov (United States)

Rossetti, Francesca; Pittiruti, Mauro; Lamperti, Massimo; Graziano, Ugo; Celentano, Davide; Capozzoli, Giuseppe

2015-01-01

The Italian Group for Venous Access Devices (GAVeCeLT) has carried out a multicenter study investigating the safety and accuracy of intracavitary electrocardiography (IC-ECG) in pediatric patients. We enrolled 309 patients (age 1 month-18 years) candidate to different central venous access devices (VAD) - 56 peripherally inserted central catheters (PICC), 178 short term centrally inserted central catheters (CICC), 65 long term VADs, 10 VADs for dialysis - in five Italian Hospitals. Three age groups were considered: A (ECG was applicable in 307 cases. The increase of the P wave on IC-ECG was detected in all cases but two. The tip of the catheter was positioned at the cavo-atrial junction (CAJ) (i.e., at the maximal height of the P wave on IC-ECG) and the position was checked during the procedure by fluoroscopy or chest x-ray, considering the CAJ at 1-2 cm (group A), 1.5-3 cm (group B), or 2-4 cm (group C) below the carina. There were no complications related to IC-ECG. The overall match between IC-ECG and x-ray was 95.8% (96.2% in group A, 95% in group B, and 96.8% in group C). In 95 cases, the IC-ECG was performed with a dedicated ECG monitor, specifically designed for IC-ECG (Nautilus, Romedex): in this group, the match between IC-ECG and x-ray was 98.8%. We conclude that the IC-ECG method is safe and accurate in the pediatric patients. The applicability of the method is 99.4% and its feasibility is 99.4%. The accuracy is 95.8% and even higher (98.8%) when using a dedicated ECG monitor.

Headache characteristics of uncomplicated intracranial vertebral artery dissection and validation of ICHD-3 beta diagnostic criteria for headache attributed to intracranial artery dissection.

Science.gov (United States)

Kim, Jae-Gyum; Choi, Jeong-Yoon; Kim, Sung Un; Jung, Jin-Man; Kwon, Do-Young; Park, Moon Ho; Oh, Kyungmi

2015-05-01

Headache may be a warning sign of subsequent stroke in patients with vertebral artery dissection (VAD). Even though the headache characteristics of VAD have been described predominantly in patients with extracranial VAD and neurological complications, headache semiology is not well known in patients with uncomplicated intracranial vertebral artery dissection (ICVAD). In the present study, we attempt to identify the headache semiology that characterizes ICVAD and validate the revised version of the International Classification of Headache Disorders (ICHD-3 beta) criteria for headache attributed to intracranial artery dissection. Six patients with neurologically uncomplicated ICVAD presented at a participating medical center, and eight similar patients were reviewed in the literature. Combining these data, we analyzed headache characteristics of patients with uncomplicated ICVAD according to their pain onset and duration, nature, intensity, location, aggravating and relieving factors, associated symptoms, response to medication, and prognosis. Headache in uncomplicated ICVAD usually has an acute mode of onset (11/14) and persistent (10/14) temporal feature. Pain that has a throbbing quality (nine of 14) and severe intensity (13/14) on the ipsilesional (10/14) and occipitonuchal area (12/14) is a headache prototype in ICVAD. Additionally, headache was intensified by head flexion and rotation (three of six), and relieved by head extension and supine positioning (five of six). Headache of all patients in the present study fulfilled the ICHD-3 beta criteria. Headache semiology of uncomplicated ICVAD is mostly homogenous in the present study. These characteristics may be helpful in the diagnosis of uncomplicated ICVAD. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Innovative Free-range Resonant Electrical Energy Delivery system (FREE-D System) for a ventricular assist device using wireless power.

Science.gov (United States)

Waters, Benjamin H; Smith, Joshua R; Bonde, Pramod

2014-01-01

Technological innovation of a smaller, single moving part has an advantage over earlier large pulsatile ventricular assist devices (VADs) prone to mechanical failure. Drivelines limit the potential for extended patient survival durations with newer pumps and act as source for infection, increased morbidity, rehospitalizations, and reduced quality of life. The Free-range Resonant Electrical Energy Delivery (FREE-D) wireless power system uses magnetically coupled resonators to efficiently transfer power. We demonstrate the efficiency over distance of this system. The experimental setup consists of an radiofrequency amplifier and control board which drives the transmit resonator coil, and a receiver unit consisting of a resonant coil attached to a radiofrequency rectifier and power management module. The power management module supplies power to the axial pump, which was set at 9,600 rpm. To achieve a seamless wireless delivery in any room size, we introduced a third relay coil. This relay coil can be installed throughout a room, whereas a single relay coil could be built into a jacket worn by the patient, which would always be within range of the receive coil implanted in the patient's body. The power was delivered over a meter distance without interruptions or fluctuations with coil, rectifier, and regulator efficiency more than 80% and overall system efficiency of 61%. The axial pump worked well throughout the 8 hours of continuous operation. Having same setup on the opposite side can double the distance. A tether-free operation of a VAD can be achieved by FREE-D system in room-size distances. It has the potential to make the VAD therapy more acceptable from the patient perspective.

Development of a compact wearable pneumatic drive unit for a ventricular assist device.

Science.gov (United States)

Homma, Akihiko; Taenaka, Yoshiyuki; Tatsumi, Eisuke; Akagawa, Eiki; Lee, Hwansung; Nishinaka, Tomohiro; Takewa, Yoshiaki; Mizuno, Toshihide; Tsukiya, Tomonori; Kakuta, Yukihide; Katagiri, Nobumasa; Shimosaki, Isao; Hamada, Shigeru; Mukaibayashi, Hiroshi; Iwaoka, Wataru

2008-01-01

The purpose of this study was to develop a compact wearable pneumatic drive unit for a ventricular assist device (VAD). This newly developed drive unit, 20 x 8.5 x 20 cm in size and weighing approximately 1.8 kg, consists of a brushless DC motor, noncircular gears, a crankshaft, a cylinder-piston, and air pressure regulation valves. The driving air pressure is generated by the reciprocating motion of the piston and is controlled by the air pressure regulation valves. The systolic ratio is determined by the noncircular gears, and so is fixed for a given configuration. As a result of an overflow-type mock circulation test, a drive unit with a 44% systolic ratio connected to a Toyobo VAD blood pump with a 70-ml stroke volume achieved a pump output of more than 7 l/min at 100 bpm against a 120 mmHg afterload. Long-term animal tests were also performed using drive units with systolic ratios of 45% and 53% in two Holstein calves weighing 62 kg and 74 kg; the tests were terminated on days 30 and 39, respectively, without any malfunction. The mean aortic pressure, bypass flow, and power consumption for the first calf were maintained at 90 x 13 mmHg, 3.9 x 0.9 l/min, and 12 x 1 W, and those for the second calf were maintained at 88 x 13 mmHg, 5.0 x 0.5 l/min, and 16 x 2 W, respectively. These results indicate that the newly developed drive unit may be used as a wearable pneumatic drive unit for the Toyobo VAD blood pump.

A multivariate model for predicting segmental body composition.

Science.gov (United States)

Tian, Simiao; Mioche, Laurence; Denis, Jean-Baptiste; Morio, Béatrice

2013-12-01

The aims of the present study were to propose a multivariate model for predicting simultaneously body, trunk and appendicular fat and lean masses from easily measured variables and to compare its predictive capacity with that of the available univariate models that predict body fat percentage (BF%). The dual-energy X-ray absorptiometry (DXA) dataset (52% men and 48% women) with White, Black and Hispanic ethnicities (1999-2004, National Health and Nutrition Examination Survey) was randomly divided into three sub-datasets: a training dataset (TRD), a test dataset (TED); a validation dataset (VAD), comprising 3835, 1917 and 1917 subjects. For each sex, several multivariate prediction models were fitted from the TRD using age, weight, height and possibly waist circumference. The most accurate model was selected from the TED and then applied to the VAD and a French DXA dataset (French DB) (526 men and 529 women) to assess the prediction accuracy in comparison with that of five published univariate models, for which adjusted formulas were re-estimated using the TRD. Waist circumference was found to improve the prediction accuracy, especially in men. For BF%, the standard error of prediction (SEP) values were 3.26 (3.75) % for men and 3.47 (3.95)% for women in the VAD (French DB), as good as those of the adjusted univariate models. Moreover, the SEP values for the prediction of body and appendicular lean masses ranged from 1.39 to 2.75 kg for both the sexes. The prediction accuracy was best for age < 65 years, BMI < 30 kg/m2 and the Hispanic ethnicity. The application of our multivariate model to large populations could be useful to address various public health issues.

Prevalence and predictors of vitamin a deficiency among infants in ...

African Journals Online (AJOL)

Vitamin A (VA) deficiency (VAD) is a major nutritional public health problem among children under-5-years-old in the developing world including Kenya. A community-based cross-sectional survey among 1,630 children (aged 6-23 mos) was undertaken in Western Kenya. A questionnaire was administered to collect ...

Nõrkushoogudes vaevelnud dollar hakkab kosuma / Lauri Matsulevitsh, Liis Kängsepp

Index Scriptorium Estoniae

Matsulevitsh, Lauri

2005-01-01

Viimastel aastatel langustrendis püsinud USA dollar on näitamas tugevnemise märke. Vt. samas: Euroopas jäävad intressid stabiilseks; Bensiin võib kallineda järgmise nädala alguses; Tekstiilitöösturid soovivad nõrka dollarit; Kalatööstused rõõmustavad

Благодаря лекциям одной минуты наука стала ближе / Айри Илиссон-Круз ; интервьюировала Ада Мальцева

Index Scriptorium Estoniae

Илиссон-Круз, Айри, 1980-

2014-01-01

Tallinna Ülikooli loengute sarjast, mille idee autor ja konsultant on Balti Filmi- ja Meediakooli õppejõud Indrek Treufeldt, kaasa löövad Tallinna Ülikooli turundus- ja kommunikatsiooniosakond, produtsent Airi Ilisson-Cruz ja e-õppekeskus, operaatorid-monteerijad Kristjan Madalvee ja Tarmo Lehari. Intervjuu loengusarja produtsendi Airi Ilisson-Cruziga

Ühe minuti loengute abil jõuavad väärt teadmised kiiresti ja mugavalt huvilisteni / Airi Ilisson-Cruz ; intervjueerinud Ada Maltseva

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Ilisson-Cruz, Airi, 1980-

2014-01-01

Tallinna Ülikooli loengute sarjast, mille idee autor ja konsultant on Balti Filmi- ja Meediakooli õppejõud Indrek Treufeldt, kaasa löövad Tallinna Ülikooli turundus- ja kommunikatsiooniosakond, produtsent Airi Ilisson-Cruz ja e-õppekeskus, operaatorid-monteerijad Kristjan Madalvee ja Tarmo Lehari. Intervjuu loengusarja produtsendi Airi Ilisson-Cruziga

Island otsib sõjalisi kaitseingleid / Allan Espenberg

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Espenberg, Allan

2007-01-01

Islandil toimuvatel parlamendivalimistel peaks arvamusküsitluste kohaselt enam kui 40% valijatest toetama Iseseisvusparteid, teisele kohale jäävad sotsiaaldemokraadid 23,5% ning neile järgnevad rohelised 17,6 ja Progressiivne Partei 10%-ga. Ka Islandi-Norra kahepoolsest lepingust, mis tihendab kaitse- ja julgeolekualast koostööd

Herman Simm põhjendab reetmist KGB minevikuga / Risto Berendson, Rasmus Kagge

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Berendson, Risto, 1975-

2008-01-01

Riigireetmises uurimise all viibiva Herman Simmi väidetel langes ta KGB šantaaži ohvriks. Vt. samas: Indrek Jürjo. KGB lähiajalugu Eestis püsib ähmasena; Vladimir Jushkin. Agentide nimed jäävad igaveseks saladuseks; Hardo Aasmäe. Agentuuritoimikud viidi Eestist minema

Vaesed kambodzhalased riisuvad muistiseid / Mai Loog

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Loog, Mai, 1960-

2004-01-01

Siem Riepis asuvast UNESCO maailmapärandina registreeritud Angkor Vati templikompleksist. Ülemaailmse antiigikaubanduse mustal turul ringleb üha enam dzhunglitemplitest pärit iidse khmeeride tsivilisatsiooni muistiseid, mida kambodzhalased müüvad ebaseaduslikele ülesostjaile. Viimasel ajal on eriti hinnas Kambodzha Angkori-eelsest ajastust pärinevad muistised

Töötajate vigastused söövad majanduskasvu / Tõnis Arnover

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Arnover, Tõnis, 1952-

2001-01-01

Eestis juhtub inimestega kolm korda rohkem õnnetusi kui Põhjamaades ja seeläbi tekkiv kahju ulatub viimastel aastatel 1,6 miljardi kroonini, mis on 2% SKT-st. Ilmunud ka: Delovõje Vedomosti, 25. apr. 2001, lk. 10

Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition

Science.gov (United States)

World Health Organization (WHO) guidelines recommend for children with severe acute malnutrition (SAM), high-dose vitamin A (VA) supplements be given on day 1 of admission, and on days 2 and 14 in the case of clinical signs of vitamin A deficiency (VAD). Daily low-dose VA follows, delivered in a pre...

Versija Hermana Simma : menja shantazhirovali / Risto Berendson, Rasmus Kagge

Index Scriptorium Estoniae

Berendson, Risto, 1975-

2008-01-01

Riigireetmises uurimise all viibiva Herman Simmi väidetel langes ta KGB šantaaži ohvriks. Vt. samas: Indrek Jürjo. KGB lähiajalugu Eestis püsib ähmasena; Vladimir Jushkin. Agentide nimed jäävad igaveseks saladuseks; Hardo Aasmäe. Agentuuritoimikud viidi Eestist minema; Herman Simmi arreteerimine

Att tänka socialpsykologiskt

DEFF Research Database (Denmark)

Bo, Inger Glavind

Att tänka socialpsykoloskt är en introduktion till socialpsykologi. Syftet är att ge en introduktion till vad det innebär att tänka sociologisk om olika problemställningar. Boken tar upp olika tanketraditioner som vardagslivsteori, fenomenologi och symbolsk interaktionism, men hämtar också inspir...

Kuulsused võitlevad õiglase kaubanduse eest / Tiiu Laks

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Laks, Tiiu, 1984-

2006-01-01

Arenenud riigid ekspordivad oma põllumajandusülejääke arengumaadesse, müües neid seal odavama hinnaga kui kohalikud põllumehed oma toodangut, nii jäävad kohalikud farmerid rahata. Mitmed maailmakuulsad näitlejad ja lauljad osalevad õiglase kaubanduse liikumises. Lisa: Make Trade Fair üritab ohjeldada heaoluriike

La Arqueología de la Construcción. Un laboratorio para el análisis de la arquitectura de época romana

Directory of Open Access Journals (Sweden)

Pizzo, Antonio

2009-12-01

Full Text Available This paper deals with the results recently obtained within the studies of roman architecture and, mainly, within the analysis of building, management and organization processes. A summary of the contents and primary results presented to the Seminary of Archaeology of Construction organized by the Instituto de Arqueología of Mérida, the Università of Siena and the Ecole Normale Superieure of Paris is here exposed. Some issues and aims are obtained from these seminaries, showing the peculiarity of some themes related to the knowledge of building dynamics. Among the mains aspects, material elements linked with building project, different building phases, building techniques and technological solutions are highlighted.El articulo trata de los alcances obtenidos recientemente en los estudios de arquitectura romana y, concretamente, en el análisis de los procesos de construcción, gestión y organización de una obra. Se presenta un resumen de los contenidos y los primeros resultados conseguidos en los Seminarios de Arqueología de la Construcción organizados por el Instituto de Arqueología-Mérida, la Università di Siena y la École Normale Superieure de Paris. A raíz de estos seminarios se extraen una serie de problemáticas y de objetivos específicos que evidencian la peculiaridad de las temáticas relativas al reconocimiento de las dinámicas constructivas. Entre los principales aspectos tratados se documentan los elementos materiales relativos al proyecto arquitectónico, a las distintas etapas de la construcción, a las distintas técnicas constructivas y soluciones tecnológicas empleadas.

Edaravone injection reverses learning and memory deficits in a rat model of vascular dementia.

Science.gov (United States)

Li, Xu; Lu, Fen; Li, Wei; Qin, Lingzhi; Yao, Yong; Ge, Xuerong; Yu, Qingkai; Liang, Xinliang; Zhao, Dongmei; Li, Xiaohong; Zhang, Jiewen

2017-01-01

Edaravone is a novel free radical scavenger that exerts neuroprotective effects by inhibiting endothelial injury and by ameliorating neuronal damage in brain ischemia. Recently, it was reported that edaravone could alleviate the pathology and cognitive deficits of Alzheimer's disease patients. However, its relevance to vascular dementia (VaD) is not clear. In this study, we partially occluded the bilateral carotid arteries of rats surgically to induce chronic cerebral hypoperfusion (CCH), a well-known rat model of VaD. Water maze and step-down inhibitory test were used to evaluate the memory deficit. The activities of superoxide dismutase (SOD) and lactate dehydrogenase (LDH), the content of malondialdehyde (MDA) and total reactive oxygen species were measured to evaluate the oxidative stress level. Western blot analysis was used to evaluate the synaptic protein expression. It was found that treatment with edaravone for a 5-week period was able to reverse both spatial and fear-memory deficits in rats with CCH. Edaravone significantly reduced the level of oxidative stress in the brains of rats with CCH by increasing SOD activity and decreasing the content of MDA, LDH, and total reactive oxygen species. Furthermore, edaravone treatment also restored the levels of multiple synaptic proteins in the hippocampi of rats with CCH. Our data provide direct evidence supporting the neuroprotective effects of edaravone in VaD. We propose that the alleviation of oxidative stress and restoration of synaptic proteins play important roles in neuroprotection. © The Author 2016. Published by Oxford University Press on behalf of the Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Transcranial magnetic stimulation and transcranial direct current stimulation: treatments for cognitive and neuropsychiatric symptoms in the neurodegenerative dementias?

Science.gov (United States)

2014-01-01

Introduction Two methods of non-invasive brain stimulation, transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have demonstrable positive effects on cognition and can ameliorate neuropsychiatric symptoms such as depression. Less is known about the efficacy of these approaches in common neurodegenerative diseases. In this review, we evaluate the effects of TMS and tDCS upon cognitive and neuropsychiatric symptoms in the major dementias, including Alzheimer’s disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), Parkinson’s disease with dementia (PDD), and frontotemporal dementia (FTD), as well as the potential pre-dementia states of Mild Cognitive Impairment (MCI) and Parkinson’s disease (PD). Methods PubMed (until 7 February 2014) and PsycINFO (from 1967 to January Week 3 2014) databases were searched in a semi-systematic manner in order to identify relevant treatment studies. A total of 762 studies were identified and 32 studies (18 in the dementias and 14 in PD populations) were included. Results No studies were identified in patients with PDD, FTD or VaD. Of the dementias, 13 studies were conducted in patients with AD, one in DLB, and four in MCI. A total of 16 of the 18 studies showed improvements in at least one cognitive or neuropsychiatric outcome measure. Cognitive or neuropsychiatric improvements were observed in 12 of the 14 studies conducted in patients with PD. Conclusions Both TMS and tDCS may have potential as interventions for the treatment of symptoms associated with dementia and PD. These results are promising; however, available data were limited, particularly within VaD, PDD and FTD, and major challenges exist in order to maximise the efficacy and clinical utility of both techniques. In particular, stimulation parameters vary considerably between studies and are likely to subsequently impact upon treatment efficacy. PMID:25478032

The Potential of Integrating Provitamin A-Biofortified Maize in Smallholder Farming Systems to Reduce Malnourishment in South Africa

Directory of Open Access Journals (Sweden)

Mthokozisi K. Zuma

2018-04-01

Full Text Available Biofortification interventions have the potential to combat malnutrition. This review explored the use of provitamin A-biofortified maize (PVABM as a vitamin A deficiency (VAD reduction agricultural-based strategy. Maize has been identified as one of the key staple crops for biofortification to reduce hidden hunger in Africa. Most nutrition interventions have not been successful in reducing hunger because rural communities, who mainly rely on agriculture, have been indirectly excluded. The biofortification intervention proposed here aims to be an inclusive strategy, based on smallholder farming systems. Vitamin A is a micronutrient essential for growth, immune function, reproduction and vision, and its deficiency results in VAD. VAD is estimated to affect more than 250 million children in developing countries. In Africa, especially sub-Saharan Africa, maize is a staple food for rural communities, consumed by most household members. Due to carotenoids, PVABM presents an orange color. This color has been reported to lead to negative perceptions about PVABM varieties. The perceived agronomic traits of this maize by smallholder farmers have not been explored. Adoption and utilization of PVABM varieties relies on both acceptable consumer attributes and agronomic traits, including nutritional value. It is therefore important to assess farmers’ perceptions of and willingness to adopt the varieties, and the potential markets for PVABM maize. It is essential to establish on-farm trials and experiments to evaluate the response of PVABM under different climatic conditions, fertilizer levels and soils, and its overall agronomic potential. For the better integration of PVABM with smallholder farming systems, farmer training and workshops about PVABM should be part of any intervention. A holistic approach would enhance farmers’ knowledge about PVABM varieties and that their benefits out-compete other existing maize varieties.

Dementia in Qatar

International Nuclear Information System (INIS)

Hamad, Ahmad I.; Ibrahim, Mohammed A.; Sulaiti, Essa M.

2004-01-01

Dementia is the major public health problem among the elderly in developed countries and a growing problem in the underdeveloped countries. There are no published data on dementia in any of the Arab countries. The aim of this study was to determine the different subtypes of dementia among Qataris. A retrospective and prospective ongoing hospital based study in which all medical records of the patients with diagnosis of dementia seen at the Hamad General Hospital, Doha, Qatar, between June 1997 and June 2003, whether inpatient and outpatient were reviewed. Dementia was defined according to diagnostic and statistical manual (DSM) IV criteria. Those who had dementia were evaluated by a psychologist, psychiatrist, neurologist and a geriatrician. All had brain computerized tomography, magnetic resonance imaging or both and routine blood test. Finally, they were classified into sub-types according to the cause of dementia. One of 300 patients, 134 fulfilled the inclusion criteria, most of them were illiterate, married and non-smokers. Among those dementia sub-types were: Alzheimer disease (AD) 39 (29%), vascular dementia (VaD) 30 (22%), mixed AD and VaD 20 (15%) and Parkinson's disease with dementia due to other medical conditions. Our stidy showed that AD is more prevalent than VaD. It also showed that patients and their families seek medical help late due to to the general belief among the public that forgetfulness and other associated cognitive impairment are part of normal aging process. The emergence of new drugs and advancement in prevention of cerebrovascular diseases make early diagnosis of dementia sub-type important. A community based study to show the real prevalence and incidence of sub-types of dementia is highly indicated. These data are necessory for planning and setting up community services and health care programs for demented patients. (author)

Adolescent health in rural Ghana: A cross-sectional study on the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors

Science.gov (United States)

Alicke, Marie; Boakye-Appiah, Justice K.; Abdul-Jalil, Inusah; Henze, Andrea; van der Giet, Markus; Schulze, Matthias B.; Schweigert, Florian J.; Mockenhaupt, Frank P.; Bedu-Addo, George

2017-01-01

In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95% CIs were calculated for the associations with socio-demographic factors. In this Ghanaian population (age range, 14.4–15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38–52%), for malnutrition 50% (43–57%) and for CRFs 16% (11–21%). Infectious diseases and malnutrition frequently co-existed (28%; 21–34%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6%; 2–9%) or with malnutrition (7%; 3–11%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted. PMID:28727775

Kõrgtehnoloogia paine / Jeremy Rifkin

Index Scriptorium Estoniae

Rifkin, Jeremy

2006-01-01

Ameerikas välja antud uuringust selgub, et inimestevaheline lähisuhtlus on kahekümne aastaga vähenenud kolmandiku. Lapsed upuvad virtuaalmaailma ja jäävad seetõttu ilma emotsionaalsest sidemest, mis lähisuhtluses tekib. Tundmusliku arvutitehnoloogiaga tegelevad infotehnoloogid murravad pead, et luua arvuti, mis oleks võimeline tundeid avaldama

Первый сорт со второй попытки

Index Scriptorium Estoniae

2010-01-01

ReUse Republic disainilaadast Kristiine Keskuses Tallinnas 3.-7. veebruaril 2010. Ürituse raames loovad noored disainerid tuntud moebrändide laojääkidest originaalesemeid ning müüvad neid. Taaskasutust propageeriva konkursi Uus-ReUse parimate tööde tutvustus. Võidutööks osutus Laura Toomsalu kilekottidest valmistatud valgusti

Use of bitot's spot in screening for Vitamin A deficiency in Nigerian ...

African Journals Online (AJOL)

A total of 2,905 children between 6 and 71 months of age were selected using a 2 stage stratified sampling method and screened for xerophthalmia using World Health Organisation (WHO) criteria and vitamin a deficiency (VAD) using serum retinol < 20 ìg/dl (low/marginal). Only 33 cases of xerophthalmia were seen ...

FAA Air Traffic Activity: FY 1990. Addendum.

Science.gov (United States)

1990-01-01

381 0 2 379 0 TIFTON .......................................................................... GA N 1 VAD 23 0 0 23 0 TIMS AIRPARK...Aviation Military GEORGIA-Continued TIFTON ............................................................................... (TMA) GA 23 1 0 0 23 0...ordering purposes. ATLANTA, GA KANSAS CITY, MO Room 100, Federal Building, 275 Peachtree Street, NE, P.O. Box 120 Bannister Mail, 5600 E. Bannister Road

Behavioral and Psychologic Symptoms in Different Types of Dementia

Directory of Open Access Journals (Sweden)

Ming-Jang Chiu

2006-01-01

Conclusion: A strategy of targeting type-specific BPSD may be beneficial, such as environmental stimulus control for DLB patients who are prone to have hallucinations, design of a pacing path for patients with FTD who need support for symptoms of wandering and emotional support for patients with VaD who are susceptible to depression.

Value of the post-operative CT in predicting delayed flap failures following head and neck cancer surgery

International Nuclear Information System (INIS)

Kim, Bitna; Yoon, Dae Young; Seo, Young Lan; Park, Min Woo; Kwon, Kee Hwan; Rho, Young Soo; Chung, Chul Hoon

2017-01-01

To identify post-operative computed tomography (CT) findings associated with delayed flap failures following head and neck cancer surgery. We retrospectively reviewed 60 patients who underwent flap reconstruction after head and neck cancer surgery and post-operative (3–14 days) contrast-enhanced CT scans for suspected complications. Patients were divided into two groups: delayed flap failure patients (patients required flap revision) (n = 18) and flap success patients (n = 42). Clinical data (age, sex, T-stage, type of flap, and time interval between reconstruction surgery and CT) and post-operative CT findings of flap status (maximum dimension of the flap, intra- or peri-flap fluid collection and intra- or peri-flap air collection, fat infiltration within the flap, fistula to adjacent aerodigestive tract or skin, and enhanced vascular pedicle) were assessed and compared between the two groups. CT findings showed that the following flap anomalies were observed more frequently in the delayed flap failure group than in the flap success group: intra- or peri-flap fluid collection > 4 cm (61.1% vs. 23.8%, p 2 cm (61.1% vs. 2.4%, p < 0.001), and fistula to adjacent aerodigestive tract or skin (44.4% vs. 0%, p < 0.001). The maximum dimension of the flap, fat infiltration within the flap, and enhanced vascular pedicle were not associated with delayed flap failures. A large amount of fluid or air collection and fistula are the CT findings that were associated with delayed flap failures in patients with suspected post-operative complications after head and neck cancer surgery

Radiation Doses to Structures Within and Adjacent to the Larynx are Correlated With Long-Term Diet- and Speech-Related Quality of Life

International Nuclear Information System (INIS)

Dornfeld, Ken; Simmons, Joel R.; Karnell, Lucy; Karnell, Michael; Funk, Gerry; Yao Min; Wacha, Judith; Zimmerman, Bridget; Buatti, John M.

2007-01-01

Purpose: To test the hypothesis that radiation dose to key sites in the upper aerodigestive tract is associated with long-term functional outcome after (chemo)radiotherapy for head-and-neck cancers. Methods and Materials: This study examined the outcome for 27 patients treated with intensity-modulated radiotherapy for definitive management of their head-and-neck cancer who were disease free for at least 1 year after treatment. Head-and-neck cancer-specific quality of life (QoL) was assessed before treatment and at 1 year after treatment. Type of diet tolerated, presence of a feeding tube, and degree of weight loss 1 year after treatment were also used as outcome measures. Radiation doses delivered to various points along the upper aerodigestive tract, including base of tongue, lateral pharyngeal walls, and laryngeal structures, were determined from each treatment plan. Radiation doses for each of these points were tested for correlation with outcome measures. Results: Higher doses delivered to the aryepiglottic folds, false vocal cords, and lateral pharyngeal walls near the false cords correlated with a more restrictive diet, and higher doses to the aryepiglottic folds correlated with greater weight loss (p < 0.05) 1 year after therapy. Better posttreatment speech QoL scores were associated with lower doses delivered to structures within and surrounding the larynx. Conclusion: Our data show an inverse relationship between radiation dose delivered to laryngeal structures and speech and diet and QoL outcomes after definitive (chemo)radiation treatment. These findings suggest that efforts to deliver lower doses to laryngeal structures may improve outcomes after definitive (chemo)radiation therapy

Kompanijas „ADIDAS” iekšējās un ārējās vides analīze

OpenAIRE

Kraiņeva, Jūlija

2013-01-01

,,Kompānijas “Adidas” iekšējās un ārējās vides analīze”. Autore – Jūlija Kraiņeva. Darba vadītāja – lektore Irina Rezepina. Darbs „Sociālo zinātņu bakalaurs vadībzinātnē” akadēmiskā grāda iegūšanai: 69 lapas, 8 attēli, 15 tabulas, 41 izmantotās literatūras un citi informācijas avoti. Pētījuma mērķis ir аnаlizēt kompānijas „Аdidas” ārējo un iеkšējo vidi, izstrādāt рriеkšlikumus tо рilnvеidоšаnаi un izvirzīt rekomendācijas, kuras palīdzēs uzlabot kompānijas darbības efektivitāti. Darba tē...

Bcl-2 and Bcl-xL overexpression inhibits cytochrome c release, activation of multiple caspases, and virus release following coxsackievirus B3 infection

International Nuclear Information System (INIS)

Carthy, Christopher M.; Yanagawa, Bobby; Luo Honglin; Granville, David J.; Yang, Decheng; Cheung, Paul; Cheung, Caroline; Esfandiarei, Mitra; Rudin, Charles M.; Thompson, Craig B.; Hunt, David W.C.; McManus, Bruce M.

2003-01-01

Coxsackievirus B3, a cytopathic virus in the family Picornaviridae, induces degenerative changes in host cell morphology. Here we demonstrate cytochrome c release and caspases-2, -3, -6, -7, -8, and -9 processing. Enforced Bcl-2 and Bcl-xL expression markedly reduced release of cytochrome c, presentation of the mitochondrial epitope 7A6, and depressed caspase activation following infection. In comparison, cell death using TRAIL ligand caused caspase-8 processing prior to cytochrome c release and executioner caspases and cell death was only partially rescued by Bcl-2 and Bcl-xL overexpression. Disruption of the mitochondrial inner membrane potential following CVB3 infection was not inhibited by zVAD.fmk treatment. Bcl-2 or Bcl-xL overexpression or zVAD.fmk treatment delayed the loss of host cell viability and decreased progeny virus release following infection. Our data suggest that mitochondrial release of cytochrome c may be an important early event in caspase activation in CVB3 infection, and, as such, may contribute to the loss of host-cell viability and progeny virus release

Speech enhancement via Mel-scale Wiener filtering with a frequency-wise voice activity detector

International Nuclear Information System (INIS)

Kim, Han Jun; Kim, Hwa Soo; Cho, Young Man

2007-01-01

This paper presents a speech enhancement system that enables a comfortable communication inside an automobile. A couple of novel concepts are proposed in an effort to improve two major building blocks in the existing speech enhancement systems: a voice activity detector (VAD) and a noise filtering algorithm. The proposed VAD classifies a given data frame as speech or noise at each frequency, enabling the frequency-wise updates of noise statistics and thereby improving the effectiveness of the noise filtering algorithms by providing more up-to-date noise statistics. The celebrated Wiener filter is adopted in this paper as the accompanying noise filtering algorithm, which results in significant noise suppression. Yet, the musical noise present in most Wiener filter-based systems prompts the idea of applying the Wiener filter in the Mel-scale in which the human auditory system responds to the external stimulation. It turns out that the Mel-scale Wiener filter creates some masking effects and thereby reduces musical noise significantly, leading to smooth transition between data frames

Serum Brain-Derived Neurotrophic Factor Levels in Different Neurological Diseases

Directory of Open Access Journals (Sweden)

Mariacarla Ventriglia

2013-01-01

Full Text Available Consistent evidence indicates the involvement of the brain-derived neurotrophic factor (BDNF in neurodegenerative disorders such as Alzheimer's disease (AD and Parkinson’s disease (PD. In the present study, we compared serum BDNF in 624 subjects: 266 patients affected by AD, 28 by frontotemporal dementia (FTD, 40 by Lewy body dementia (LBD, 91 by vascular dementia (VAD, 30 by PD, and 169 controls. Our results evidenced lower BDNF serum levels in AD, FTD, LBD, and VAD patients (P<0.001 and a higher BDNF concentration in patients affected by PD (P=0.045. Analyses of effects of pharmacological treatments suggested significantly higher BDNF serum levels in patients taking mood stabilizers/antiepileptics (P=0.009 and L-DOPA (P<0.001 and significant reductions in patients taking benzodiazepines (P=0.020. In conclusion, our results support the role of BDNF alterations in neurodegenerative mechanisms common to different forms of neurological disorders and underline the importance of including drug treatment in the analyses to avoid confounding effects.

Simvastatin induces caspase-independent apoptosis in LPS-activated RAW264.7 macrophage cells

International Nuclear Information System (INIS)

Kim, Yong Chan; Song, Seok Bean; Lee, Mi Hee; Kang, Kwang Il; Lee, Hayyoung; Paik, Sang-Gi; Kim, Kyoon Eon; Kim, Young Sang

2006-01-01

Macrophages participate in several inflammatory pathologies such as sepsis and arthritis. We examined the effect of simvastatin on the LPS-induced proinflammatory macrophage RAW264.7 cells. Co-treatment of LPS and a non-toxic dose of simvastatin induced cell death in RAW264.7 cells. The cell death was accompanied by disruption of mitochondrial membrane potential (MMP), genomic DNA fragmentation, and caspase-3 activation. Surprisingly, despite caspase-dependent apoptotic cascade being completely blocked by Z-VAD-fmk, a pan-caspase inhibitor, the cell death was only partially repressed. In the presence of Z-VAD-fmk, DNA fragmentation was blocked, but DNA condensation, disruption of MMP, and nuclear translocation of apoptosis inducing factor were obvious. The cell death by simvastatin and LPS was effectively decreased by both the FPP and GGPP treatments as well as mevalonate. Our findings indicate that simvastatin triggers the cell death of LPS-treated RAW264.7 cells through both caspase-dependent and -independent apoptotic pathways, suggesting a novel mechanism of statins for the severe inflammatory disease therapy

DYNAMIC MODELLING OF VIBRATIONS ASSISTED DRILLING

Directory of Open Access Journals (Sweden)

Mathieu LADONNE

2015-05-01

Full Text Available The number of multi-materials staking configurations for aeronautical structures is increasing, with the evolution of composite and metallic materials. For drilling the fastening holes, the processes of Vibration Assisted Drilling (VAD expand rapidly, as it permits to improve reliability of drilling operations on multilayer structures. Among these processes of VAD, the solution with forced vibrations added to conventional feed to create a discontinuous cutting is the more developed in industry. The back and forth movement allows to improve the evacuation of chips by breaking it. This technology introduces two new operating parameters, the frequency and the amplitude of the oscillation. To optimize the process, the choice of those parameters requires first to model precisely the operation cutting and dynamics. In this paper, a kinematic modelling of the process is firstly proposed. The limits of the model are analysed through comparison between simulations and measurements. The proposed model is used to develop a cutting force model that allows foreseeing the operating conditions which ensure good chips breaking and tool life improvement.

New method of determining the thermal utilization factor of a cell; Nouvelle methode de determination du facteur d'utilisation thermique d'une cellule

Energy Technology Data Exchange (ETDEWEB)

Amouyal, A; Benoist, P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1956-07-01

A new formula for the thermal utilization factor is derived, which, while comparable in simplicity to the formula given by elementary diffusion theory, furnishes much more precise results. This is clearly brought out by comparison with the results given by the S{sub n} and spherical harmonics methods. (author) [French] Une nouvelle expression du facteur d'utilisation thermique, d'une simplicite comparable a celle de Ia theorie elementaire, est etablie. La comparaison avec les resultats fournis par la methode S{sub n} et les methodes d'harmoniques spheriques montre que la precision obtenue par cette formule est tres superieure a celle que donne la theorie elementaire. (auteur)

Extramedullary plasmacytoma of small bowel mesentery in associated with cecal cancer: a case report

International Nuclear Information System (INIS)

Kim, Sung Kyu; Kim, Yong Soo; Kim, Young Sun; Cho, On Koo; Koh, Byung Hee; Rhim, Hyun Chul; Park, Choog Ki; Park, Dong Woo; Park, Yong Wook; Oh, Young Ha

2005-01-01

Extramedullary plasmacytoma is a rare disease that is histopathologically defined as a solitary tumor composed of a monoclonal proliferation of cells with plasmacytic differentiation in an extramedullary site. Most of these tumors occur in the submucosa of the upper aerodigestive tract, and they rarely occur in the small bowel mesentery. We report here on a case of extramedullary plasmacytoma of the small bowel mesentery that was in association with a cecal cancer. Abdominal ultrasound and CT revealed a lobulated soft tissue mass with a cystic portion and peripheral calcification. In this case, the preoperative radiological diagnosis was difficult due to accompanying cecal cancer

Extramedullary plasmacytoma of small bowel mesentery in associated with cecal cancer: a case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Sung Kyu; Kim, Yong Soo; Kim, Young Sun; Cho, On Koo; Koh, Byung Hee; Rhim, Hyun Chul; Park, Choog Ki; Park, Dong Woo [Hanyang University College of Medicine, Seoul (Korea, Republic of); Park, Yong Wook; Oh, Young Ha [Hanyang University Guri Hospital, Guri (Korea, Republic of)

2005-07-15

Extramedullary plasmacytoma is a rare disease that is histopathologically defined as a solitary tumor composed of a monoclonal proliferation of cells with plasmacytic differentiation in an extramedullary site. Most of these tumors occur in the submucosa of the upper aerodigestive tract, and they rarely occur in the small bowel mesentery. We report here on a case of extramedullary plasmacytoma of the small bowel mesentery that was in association with a cecal cancer. Abdominal ultrasound and CT revealed a lobulated soft tissue mass with a cystic portion and peripheral calcification. In this case, the preoperative radiological diagnosis was difficult due to accompanying cecal cancer.

[TNM 2010. What's new?].

Science.gov (United States)

Wittekind, C

2010-10-01

In the seventh edition of the TNM Classification of Malignant Tumours there are several entirely new classifications: upper aerodigestive mucosal melanoma, gastrointestinal stromal tumour, gastrointestinal carcinoid (neuroendocrine tumour), intrahepatic cholangiocarcinoma, Merkel cell carcinoma, uterine sarcomas, and adrenal cortical carcinoma. Significant modifications concern carcinomas of the oesophagus, oesophagogastric junction, stomach, appendix, biliary tract, lung, skin, prostate and ophthalmic tumours, which will be not addressed in this article. For several tumour entities only minor changes were introduced which might be of importance in daily practice. The new classifications and changes will be commented on without going into details.

A Rare Incidental Finding of a Foreign Body in the Nasopharynx during Adenotonsillectomy

Directory of Open Access Journals (Sweden)

Waleed M. Alshehri

2018-01-01

Full Text Available Diverse foreign bodies may become lodged in the aerodigestive tract, and the discovery of such foreign bodies is an expected scenario for health-care practitioners. The foreign body insertion may be accidental or deliberate, and the object may be organic or inorganic. Most accidental foreign body aspirations occur in children, and some such cases are potential threats that go unnoticed. Very few cases of foreign bodies in the nasopharynx have been reported. Herein, we describe an unusual case in which a foreign body in a child’s nasopharynx went unnoticed for 1 year and was detected intraoperatively.

GLEN ehk Eesti noored Aafrikaga tutvust tegemas / Annika Räim

Index Scriptorium Estoniae

Räim, Annika

2008-01-01

GLEN (Global Education for the Young Europeans) on programm, kus löövad kaasa Euroopa Liidu 12 liikmesmaa mittetulundusühingud ning mis lähetab noori eurooplasi projektide raames kolmeks kuuks arengumaadesse. Artiklis jagavad oma muljeid GLEN-projektis osalenud Kadri Runnel Gruusiast, Kadri Aavik Lõuna-Aafrika Vabariigist, Birgit Rosenberg Sambiast ja Mari Nuga Kamerunist

Tuumaenergiat tuleb Eestil oodata veel aastakümneid / Endel Lippmaa ; interv. Tanel Raig

Index Scriptorium Estoniae

Lippmaa, Endel, 1930-2015

2008-01-01

Akadeemiku arvates põhineb Eesti energiatootmine järgmised 25 aastat jätkuvalt põlevkivitööstusel, tuuleenergia ja hüdroenergia osa jäävad väikeseks, tuumaenergiat hakatakse arendama tulevikus. Diagramm: Põhiosa elektrienergiast tuleb soojuselektrijaamadelt. Lisa: Eesti energiamajanduse rahuldamise vahendid. Kommenteerib Riigikogu liige Marek Strandberg: talumaja peab muutuma oma energiavarustuselt sõltumatuks

Usbeki lastest ja tarbija moraalist / Margit Keller

Index Scriptorium Estoniae

Keller, Margit, 1971-

2007-01-01

Usbekistanis väidetavalt lapstööjõu kasutamisega seoses ütleb autor, et tavaliselt jäävad toodete üle maailma ulatuvad valmistamisahelad tarbija silmale nähtamatuks. Oleks hea, kui tekiks diskussioon, mis ärgitaks kohalikku tarbijat tajuma ja mõtestama oma rolli nii üleilmses kui ka Eesti majanduse ja kultuuriruumi kontekstis

Arctic Sea tallinlased - piraadid, ökoloogid, võlanõudjad või palgatud kinnikukkujad? / Janar Filippov

Index Scriptorium Estoniae

Filippov, Janar, 1976-

2009-01-01

Autor avaldab arvamust, et täit tõde kaubalaeva Arctic Sea 2-nädalase kadumise kohta ei saa avalikkus ilmselt kunagi teada ning esialgu jäävad õhku küsimused, kas kaheksa "piraati" läksid laevale omal initsiatiivil, mõne kuritegeliku grupeeringu või Venemaa võimude tellimusel. Vt. samas: Tavalised kriminaalid

Metsas mekib söök hoopis teistmoodi / Ada Maltseva

Index Scriptorium Estoniae

Maltseva, Ada, 1970-

2007-01-01

Vt. ka Linnaleht : Pärnu, Linnaleht : Tartu 8. juuni, lk. B4-B5. Looduses matkajaid abistavad mitmesugused nutikad köögiriistad ja kuivtoidud, mis teevad vabas looduses söögitegemise ja söömise lihtsaks ning nauditavaks. Vt. samas: Mida sõjaväelased väliõppustel söövad?

La ciclooxigenasa-2 (COX-2 y el factor de crecimiento epidérmico (EFG en lesiones epiteliales orales premalignas Cyclooxygenase-2 (COX-2 and epidermal growth factor (EGF in oral premalignant epithelial lesions

Directory of Open Access Journals (Sweden)

S. Díaz Prado

2009-06-01

Full Text Available Las lesiones premalignas orales incluyen eritroplasias (manchas rojas y leucoplasias (manchas blancas, las cuales se desarrollan a lo largo de superficies epiteliales. Estas lesiones son considerados marcadores en la "carcinogénesis de campo" ya que pacientes con lesiones premalignas orales pueden desarrollar carcinoma de células escamosas (CCS en el sitio de las lesiones, así como en otros lugares de tracto aerodigestivo superior. Se está haciendo un gran esfuerzo para identificar nuevos biomarcadores SEBs (surrogate endpoint biomarkers para el carcinoma de células escamosas de cabeza y cuello. Los SEBs candidatos para el carcinoma de células escamosas invasivo en el trato aerodigestivo superior deben ser detectables con los cambios moleculares celulares y tisulares que tienen lugar durante la formación del tumor. Entre los diferentes marcadores que se han propuesto hasta la actualidad, la ciclooxigenasa- 2 (COX-2 y el receptor del factor de crecimiento epidérmico (EGFR parecen ser los más prometedores. COX-2 se sobre expresa durante el proceso tumoral, desde hiperplasia temprana a enfermedad metastásica. EGFR también está anormalmente activado en tumores epiteliales, pues las células de casi todas estas neoplasias expresan altos niveles de este receptor, una característica asociada con un peor pronóstico clínico. En este sentido el tracto aerodigestivo superior proporciona un sistema o modelo único para el estudio de CCS y para la investigación de nuevos candidatos SEBs.Oral premalignant lesions include leukoplakia (white patch and erythroplakia (red patch, which develop on epithelial surfaces. These lesions are markers for field cancerization because patients with oral premalignancy can develop squamous cell carcinoma at the site of the lesion(s and at other sites in the upper aerodigestive tract. An effort is being made to identify surrogate endpoint biomarkers (SEBs for head and neck squamous cell carcinoma (HNSCC

FIAT-i juht : maailma jääb alles vaid kuus suurt autotootjat / Erik Aru

Index Scriptorium Estoniae

Aru, Erik

2008-01-01

FIAT-i tegevjuhi Sergio Marchionne hinnangul jääb kriisi lõpuks alles üks Ameerika, üks Saksa, üks Prantsuse, üks Hiina ja üks võimalik üleeuroopaline autotootja. Analüütik Jürgen Pieperi hinnangul on kõige haavatavamad FIAT, BMW ja PSA/Peugeot-Citroen, alles jäävad VW, Renault-Nissan ja Daimler

USA väärtpaberi järelevalve murrab ilma hellitamiseta miljardäre / Mikk Salu

Index Scriptorium Estoniae

Salu, Mikk, 1975-

2006-01-01

USA väärtpaberijärelevalve amet (SEC) on aegade jooksul kohtu ette saatnud tuntud teletähti ja miljardäre. LHV endiste töötajate Oliver Peegi ja Kristjan Lepikuga seotud juhtumi hetkeseisust. Advokaatide Üllar Talviste ja Marti Hääle kommentaare. Lisad: SEC versus maailm; Rikkad jäävad rikasteks...; Security and Exchange Commission

Value of the post-operative CT in predicting delayed flap failures following head and neck cancer surgery

Energy Technology Data Exchange (ETDEWEB)

Kim, Bitna; Yoon, Dae Young; Seo, Young Lan; Park, Min Woo; Kwon, Kee Hwan; Rho, Young Soo; Chung, Chul Hoon [Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

2017-06-15

To identify post-operative computed tomography (CT) findings associated with delayed flap failures following head and neck cancer surgery. We retrospectively reviewed 60 patients who underwent flap reconstruction after head and neck cancer surgery and post-operative (3–14 days) contrast-enhanced CT scans for suspected complications. Patients were divided into two groups: delayed flap failure patients (patients required flap revision) (n = 18) and flap success patients (n = 42). Clinical data (age, sex, T-stage, type of flap, and time interval between reconstruction surgery and CT) and post-operative CT findings of flap status (maximum dimension of the flap, intra- or peri-flap fluid collection and intra- or peri-flap air collection, fat infiltration within the flap, fistula to adjacent aerodigestive tract or skin, and enhanced vascular pedicle) were assessed and compared between the two groups. CT findings showed that the following flap anomalies were observed more frequently in the delayed flap failure group than in the flap success group: intra- or peri-flap fluid collection > 4 cm (61.1% vs. 23.8%, p < 0.05), intra- or peri-flap air collection > 2 cm (61.1% vs. 2.4%, p < 0.001), and fistula to adjacent aerodigestive tract or skin (44.4% vs. 0%, p < 0.001). The maximum dimension of the flap, fat infiltration within the flap, and enhanced vascular pedicle were not associated with delayed flap failures. A large amount of fluid or air collection and fistula are the CT findings that were associated with delayed flap failures in patients with suspected post-operative complications after head and neck cancer surgery.

Moskva ärimehed müüvad Narva ettevõtte / Ilja Smirnov

Index Scriptorium Estoniae

Smirnov, Ilja

2006-01-01

Ilmunud ka: Severnoje Poberezhje 18. aug. lk. 4. Moskva omanikele kuuluva ja kangaste viimistlemisega tegeleva Narva ettevõtte, AS-i Polytex.ee.Printing töö on täielikult peatatud ning algab massiline koondamine

Pensionärid jäävad hätta / Jaan Kundla

Index Scriptorium Estoniae

Kundla, Jaan, 1937-

2007-01-01

Ilmunud ka: Põhjarannik, 5. okt. 2007, lk. 2; Severnoje Poberezhje, 5. okt. 2007, lk. 2; Koit, 6. okt. 2007, lk. 6; Järva Teataja, 9. okt. 2007, lk. 2; Meie Maa, 8. okt. 2007, lk. 2; Vooremaa, 9. okt. 2007, lk. 2; Vali Uudised, 12. okt. 2007, lk. 2; Kesknädal, 17. okt. 2007, lk. 4; Lõunaleht, 18. okt. 2007, lk. 2. Autori sõnul põhjustavad hinnatõusud hüperinflatsiooni, samas pöörab valitsus lubamatult vähe tähelepanu puuetega inimestele

Energideklaration- Vad är det och hur ska det hanteras i fastighetsbranschen?

OpenAIRE

Gustafsson, Bert

2006-01-01

Abstract The Energy Declaration is a law that will come into effect October 1: Th 2006. This report has Värnamo municipality as principal and shall clarify what the estate owner in general and Värnamo municipality in particular need to know about this law. Another part that is going to be dealt with is how large the future need for energy experts in this field will be, and which competence that will be demanded for them. The work will in general deal with simplified energy declarations for ap...

Linnugripp ja salmonella löövad valusalt Talleggi / Toivo Tänavsuu

Index Scriptorium Estoniae

Tänavsuu, Toivo

2005-01-01

Talleggi kahjum oli 2004. aastal 10,7 miljonit, võitlus salmonellabakteriga on suurendanud hüppeliselt kulusid ning seetõttu võib selle aasta kahjum olla veelgi suurem. Tallegg on kaotanud turgu Leedu ettevõtte toodangule, mida turustatakse Eestis Rannamõisa kaubamärgi all

Vad ersätter företagets avbrottsförsäkring?

OpenAIRE

Rosenqvist, Felix

2010-01-01

I arbetet redogörs för hur en avbrottsförsäkring är uppbyggd och hur ersättningen räknas ut i praktiken. I teoridelen behandlas försäkringshistoria, de frivilliga skadeförsäkringarna och mera djupgående avbrottsförsäkringen. Skadehanteringsprocessen beskrivs också i teoridelen. För att åskådliggöra ämnet har själva resultatredovisnigen förverkligats genom en fiktiv fallstudie. Detta för att göra det enklare för läsaren att förstå hur avbrottsförsäkringen fungerar i praktiken...

From "Ecoles Superieures de Commerce" to "Management Schools": Transformations and Continuity in French Business Schools

Science.gov (United States)

Blanchard, Marianne

2009-01-01

Part of the national system of grandes Ecoles, French Business schools have known radical changes since the 1980s, notably in size, and have become more attractive to students both at a national and an international level. As a consequence, the French elitist system has been questioned by the competition of foreign--especially Anglo-Saxon--models.…

Solidification of residual fission-product solutions; laboratory studies; Solidification de solutions residuaires concentrees de produits de fission: etudes de laboratoire

Energy Technology Data Exchange (ETDEWEB)

Boniaud, R; Cohen, P; Sombret, C [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

1961-07-01

This paper describes the results obtained, at laboratory scale, during the study of the incorporation of fission products into glasses and synthetic micas. The rate of leaching of fission products from the glass and their volatility during firing were measured. A hot cell was built to complete these results. (author) [French] Ce rapport resume le resultat des etudes faites en laboratoire (activite de l'ordre du millicurie) sur l'incorporation des produits de fission dans des verres et micas synthetiques. On a mesure le taux de lixiviation des produits de fission et leur volatilisation au cours de la cuisson. Une cellule chaude a ete installee pour completer ces resultats au moyen d'essais realises avec une activite superieure. (auteur)

NuMA and nuclear lamins are cleaved during viral infection - inhibition of caspase activity prevents cleavage and rescues HeLa cells from measles virus-induced but not from rhinovirus 1B-induced cell death

International Nuclear Information System (INIS)

Taimen, Pekka; Berghaell, Heidi; Vainionpaeae, Raija; Kallajoki, Markku

2004-01-01

Nuclear matrix is a structural framework of important nuclear processes. We studied the effect of two different types of viral infections on nuclear matrix. HeLa cells were infected with human rhinovirus 1B (HRV 1B) or measles virus (MV), and Nuclear Mitotic Apparatus protein (NuMA) and lamins A/C and B were used as markers for internal nuclear matrix and peripheral nuclear lamina, respectively. We show that NuMA, lamins, and poly(ADP-ribose) polymerase-1 are cleaved during viral infection in a virus family-specific manner suggesting that these viruses activate different sets of proteases. Morphologically, NuMA was excluded from the condensed chromatin, lamins showed a folded distribution, and both proteins finally remained around the nuclear fragments. A general caspase inhibitor benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (z-VAD-FMK) prevented the nuclear disintegration and the cleavage of the proteins studied. Interestingly, z-VAD-FMK rescued MV-infected but not HRV 1B-infected cells from cell death. These results show for the first time that NuMA and lamins are specific target proteins during virus-induced programmed cell death

Isolation of lactobacillus reuteri from Peyer's patches and their effects on sIgA production and gut microbiota diversity.

Science.gov (United States)

Wang, Panpan; Li, Ya; Xiao, Hang; Shi, Yonghui; Le, Guo-Wei; Sun, Jin

2016-09-01

We previously reported that specific Lactobacillus reuteri colonized within mouse Peyer's patches (PP) effectively prevented high fat diet induced obesity and low-grade chronic inflammation. We further investigated the role of PP Lactobacillus reuteri on sIgA production in rats in this study. Lactobacilli were isolated from rat PP. All isolates were L. reuteri and belonged to three phenotypes according to amplified fragment length polymorphism analysis. Typical strains of two main clusters, PP1 and PP2, were used to treat control and vitamin A deficient (VAD) rats, respectively. The feeding of PP1 and PP2 affected sIgA and Lactobacillus diversity by strain-specific manner. Free sIgA was significantly increased by PP1 (p = 0.069) and PP2 (p Lactobacillus diversity in the control rats (p Lactobacillus diversity in both control and VAD rats. Fecal sIgA was correlated with PP Lactobacillus diversity (R(2) = 0.7958, p = 0.011). Modulation of sIgA production by PP L. reuteri of rat is dependent on vitamin A and change of Lactobacillus diversity in PP. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Systematic Review on the Efficacy and Safety of Herbal Medicines for Vascular Dementia

Directory of Open Access Journals (Sweden)

Sui Cheung Man

2012-01-01

Full Text Available We present a systematic review of existing research that aims to assess the efficacy and safety of herbal medications (HM, as either monotherapy or adjunct to orthodox medications (OM, mainly comprised of cholinesterase inhibitors, for vascular dementia (VaD. We included 47 studies conducted in mainland China, each testing different HM. Of 43 HM monotherapy studies, 37 reported HM to be significantly better than OM or placebo; six reported similar efficacy between HM and OM. All four HM adjuvant studies reported significant efficacy. No major adverse events for HM were reported. Heterogeneity in diagnostic criteria, interventions and outcome measures hindered comprehensive data analysis. Studies suggested that HM can be a safe and effective treatment for VaD, either alone or in conjunction with OM. However, methodological flaws in the design of the studies limited the extent to which the results could be interpreted. Thirty most commonly used herbal constituents, including Rhizoma Chuanxiong (Chuanxiong in Chinese, Radix Polygoni Multiflori (Heshouwu in Chinese and Radix Astragali (Huangqi in Chinese. were ranked. Further multi-center trials with large sample sizes, high methodological quality and standardized HM ingredients are necessary for clinical recommendations to be made.

Esophageal Foreign Body: A Case Report of a Refractory Croup in a 20-Month-Old Boy

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sevil Nasirmohtaram

2016-11-01

Full Text Available Introduction: Foreign body ingestion is common among children and more common in boys and in children under the age of 3. It can present with a wide variety of symptoms like dysphagia and drooling or symptoms related to the upper aerodigestive tract.   Case Report: A 20-month-old male presented with refractory croup and poor feeding since 2 weeks. Bronchoscopy and esophagoscopy was performed due to suspicious history of eating loquat. The core of the fruit was found in the esophagus.   Conclusion:  Physicians should be aware of the variability of esophageal foreign body presentations to prevent serious complications due to delay in diagnosis.

Mandibulotomy in the irradiated patient

International Nuclear Information System (INIS)

Davidson, J.; Freeman, J.; Birt, D.

1989-01-01

Though the mandibular swing, as an approach to certain upper aerodigestive tract malignancies, has been gaining popularity in recent years, there has been little reported as to the feasibility of this procedure in subjects who have received radical preoperative radiotherapy. We have recently reported the results of 23 such patients, and we now present an update. The results presented are of a retrospective analysis of 44 patients, 50% of whom received radical preoperative radiotherapy to fields including the osteotomy site. As in the previous study, there were no statistically significant differences between the complication rates in the irradiated and nonirradiated patient populations. All the patients were orally rehabilitated

Eesti jäämurdekontseptsioon / Carol Kirss, Tarmo Kõuts

Index Scriptorium Estoniae

Kirss, Carol

2005-01-01

Autorite arvates on Eestis olemas risk, et sadamad jäävad külmadel talvedel piisava jäämurdevõimsuse juures blokeerituks. Võimalikest jäämurdekontseptsioonidest Eestis. Diagrammid: Kaubavedu Eesti sadamate kaudu; Eesti sadamate laevakülastused. Tabelid: Talvesadmate osatähtsus; Jäämurdjate optimaalse arvu selgitamine; Soome ja Liivi lahe erinevate jäämurdesüsteemide versioonide maksumus

A ginseng saponin metabolite-induced apoptosis in HepG2 cells involves a mitochondria-mediated pathway and its downstream caspase-8 activation and Bid cleavage

International Nuclear Information System (INIS)

Oh, Seon-Hee; Lee, Byung-Hoon

2004-01-01

20-O-(β-D-Glucopyranosyl)-20(S)-protopanaxadiol (IH901), an intestinal bacterial metabolite of ginseng saponin formed from ginsenosides Rb1, Rb2, and Rc, is suggested to be a potential chemopreventive agent. Here, we show that IH901 induces apoptosis in human hepatoblastoma HepG2 cells. IH901 led to an early activation of procaspase-3 (12 h posttreatment), and the activation of caspase-8 became evident only later (18 h posttreatment). Caspase activation was a necessary requirement for apoptosis because caspase inhibitors significantly inhibited cell death by IH901. Treatment of HepG2 cells with IH901 also induced the cleavage of cytosolic factors such as Bid and Bax and translocation of truncated Bid (tBid) to mitochondria. A time-dependent release of cytochrome c from mitochondria was observed, which was accompanied by activation of caspase-9. A broad-spectrum caspase inhibitor, N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (zVAD-fmk), and a specific inhibitor for caspase-8, N-benzyloxycarbonyl-Ile-Glu-Thr-Asp-fluoromethylketone (zIETD-fmk), abrogated Bid processing and translocation, and caspase-3 activation. Cytochrome c release was inhibited by zVAD-fmk, however, the inhibition by zIETD-fmk was not complete. The activation of caspase-8 was inhibited not only by zIETD-fmk but also by zVAD-fmk. The results, together with the kinetic change of caspase activation, indicate that activation of caspase-8 occurred downstream of caspase-3 and -9. Our data suggest that the activation of caspase-8 after early caspase-3 activation might act as an amplification loop necessary for successful apoptosis. Primary hepatocytes isolated from normal Sprague-Dawley rats were not affected by IH901 (0-60 μM). The very low toxicity in normal hepatocytes and high activity in hepatoblastoma HepG2 cells suggest that IH901 is a promising experimental cancer chemopreventive agent

MRI of intracranial vertebral artery dissection: evaluation of intramural haematoma using a black blood, variable-flip-angle 3D turbo spin-echo sequence

Energy Technology Data Exchange (ETDEWEB)

Takano, Koichi; Yamashita, Shinnichi; Kuwabara, Yasuo; Yoshimitsu, Kengo [Fukuoka University, Department of Radiology, Faculty of Medicine, Fukuoka-shi, Fukuoka (Japan); Takemoto, Koichiro; Inoue, Tooru [Fukuoka University, Department of Neurosurgery, Faculty of Medicine, Fukuoka (Japan)

2013-07-15

We investigated the efficacy of three-dimensional black blood T1-weighted imaging (3D-BB-T1WI) using a variable refocusing flip angle turbo spin-echo sequence in the diagnosis of intracranial vertebral artery dissection (VAD). Sixteen consecutive patients diagnosed with intracranial VAD underwent magnetic resonance imaging that included 3D time-of-flight-MRA, axial spin-echo T1-weighted images (SE-T1WI) and oblique coronal 3D-BB-T1WI sequences. The visualization, morphology and extent of intramural haematomas were assessed and compared among the sequences. Results obtained by digital subtraction angiography (DSA), 3D-angiography and/or 3D-CT angiography (CTA) were used as standards of reference. 3D-BB-T1WI revealed intramural haematomas in all cases, whereas SE-T1WI and magnetic resonance angiography (MRA) failed to reveal a haematoma in one case and three cases, respectively. The mean visualization grading score for the intramural haematoma was the highest for 3D-BB-T1WI, and there was a statistically significant difference among the sequences (p < 0.001). At least a portion of the intramural haematoma was distinguishable from the lumen on 3D-BB-T1WI, whereas the haematomas were entirely indistinguishable from intraluminal signals on MRA in two cases (12.5 %) and on SE-T1WI in one case (6.3 %). 3D-BB-T1WI revealed the characteristic crescent shape of the intramural haematoma in 14 cases (87.5 %), whereas SE-T1WI and MRA revealed a crescent shape in only 7 cases (43.8 %) and 8 cases (50 %), respectively. In a consensus reading, 3D-BB-T1WI was considered the most consistent sequence in representing the extent and morphology of the lesion in 14 cases (87.5 %), compared to DSA and CTA. 3D-BB-T1WI is a promising method to evaluate intramural haematoma in patients with suspected intracranial VAD. (orig.)

The Spanish version of the Addenbrooke's Cognitive Examination - Revised (ACE-R) in subcortical ischemic vascular dementia.

Science.gov (United States)

Raimondi, Catalina; Gleichgerrcht, Ezequiel; Richly, Pablo; Torralva, Teresa; Roca, María; Camino, Julieta; Manes, Facundo

2012-11-15

Vascular dementia (VaD) is one of the most prevalent causes of dementia, and it is frequently misdiagnosed and undertreated in clinical practice. Because neuropsychological outcome depends, among other factors, on the size and location of the vascular brain injury, characterizing the cognitive profile of VaD has been especially challenging. Yet, there has been sufficient evidence to show a marked impairment of attention and executive functions, in particular in relation to Alzheimer disease. Being able to detect these deficits at bedside is crucial for everyday clinical practice, and yet, brief cognitive screening toots such as the Mini-Mental Sate Examination (MMSE) may overlook at cognitive deficits typical of patients with VaD. The Addenbrooke's Cognitive Examination Revised (ACE-R) is also a brief cognitive screening tool designed to incorporate the items of the MMSE and further extend the test to assess orientation, attention, verbal fluency, memory, language, and visuospatial abilities. In this study, we investigated the ability of the Spanish version of the ACE-R to detect the cognitive impairment showed in patients with subcortical ischemic vascular dementia, and we compared its usefulness to that of the MMSE in this population. Scores on these tests were compared to those of patients with Alzheimer disease and matched healthy controls. The 88-point cut-off proposed for the ACE-R was associated with a sensitivity of 100% and a specificity of 100% for the detection of cognitive impairment, demonstrating a stronger capacity than the MMSE (sensitivity of 42% with its 23-point cut-off score). We also found that the verbal fluency subtest of the ACE-R may be potentially useful in discriminating patients with subcortical ischemic vascular dementia from patients with AD. We discuss the utility of these findings in the context of everyday clinical practice and we propose that future studies should evaluate the potential usefulness of combining the ACE-R with a

Automatic Artifact Removal in EEG of Normal and Demented Individuals Using ICA–WT during Working Memory Tasks

Directory of Open Access Journals (Sweden)

Noor Kamal Al-Qazzaz

2017-06-01

Full Text Available Characterizing dementia is a global challenge in supporting personalized health care. The electroencephalogram (EEG is a promising tool to support the diagnosis and evaluation of abnormalities in the human brain. The EEG sensors record the brain activity directly with excellent time resolution. In this study, EEG sensor with 19 electrodes were used to test the background activities of the brains of five vascular dementia (VaD, 15 stroke-related patients with mild cognitive impairment (MCI, and 15 healthy subjects during a working memory (WM task. The objective of this study is twofold. First, it aims to enhance the recorded EEG signals using a novel technique that combines automatic independent component analysis (AICA and wavelet transform (WT, that is, the AICA–WT technique; second, it aims to extract and investigate the spectral features that characterize the post-stroke dementia patients compared to the control subjects. The proposed AICA–WT technique is a four-stage approach. In the first stage, the independent components (ICs were estimated. In the second stage, three-step artifact identification metrics were applied to detect the artifactual components. The components identified as artifacts were marked as critical and denoised through DWT in the third stage. In the fourth stage, the corrected ICs were reconstructed to obtain artifact-free EEG signals. The performance of the proposed AICA–WT technique was compared with those of two other techniques based on AICA and WT denoising methods using cross-correlation X C o r r and peak signal to noise ratio ( P S N R (ANOVA, p ˂ 0.05. The AICA–WT technique exhibited the best artifact removal performance. The assumption that there would be a deceleration of EEG dominant frequencies in VaD and MCI patients compared with control subjects was assessed with AICA–WT (ANOVA, p ˂ 0.05. Therefore, this study may provide information on post-stroke dementia particularly VaD and stroke

Diagnostic accuracy of indirect laryngoscopy and x-ray neck in the diagnosis of fish bone impaction in upper aero digestive tract

International Nuclear Information System (INIS)

Kundi, N.; Mehmood, T.

2015-01-01

This study was aimed at finding the validity of indirect laryngoscopy (IDL) and neck X-Rays in the diagnosis of fish bone impaction. Study Design: Validation study. Place and Duration of Study: CMH Nowshera from August 2012 to February 2013. Material and Methods: A total of 50 patients were selected by consecutive sampling presenting with history of fishbone impaction in aerodigestive tract. IDL examination and neck X-rays were performed and findings were recorded. Those with no fishbone on both the investigations were discharged from hospital with follow up after 03 days. Those with fishbone detected on either of investigations underwent removal. Fishbone easily approachable were removed under local anaesthesia with foreceps and in others Endoscopy (Direct laryngoscopy or Oesophagoscopy) was performed under General Anaesthesia. Sensitivities and specificities of both the modalities were calculated using standard 2/2 Table. ROC curve analysis was carried out and significance level p < 0.05 was taken as significant. Results: In 20 patients no fishbone was found, 26 patients were diagnosed on IDL and in 04 patients fishbone was detected by neck X-Rays. Most common site for fishbone impaction was pharyngeal tonsil. In 22 patients fishbone was removed with foreceps and in 08 patients endoscopy was performed. Diagnostic accuracy for IDL 86% and Neck X-Rays 48% was calculated. ROC curve analysis revealed AUC for IDL 0.933 and Significance level (P) as <0.0001. ROC curve analysis for X-ray gives AUC of 0.567 and Significance level (p) 0.4132. Conclusion: IDL shows higher diagnostic accuracy than neck X-Rays for detection of fishbone in upper aerodigestive tract. Neck X-rays are more useful for impacted foreign bodies in oesophagus. (author)

Intraoperative assessment of laryngeal pathologies with optical coherence tomography integrated into a surgical microscope.

Science.gov (United States)

Englhard, Anna S; Betz, Tom; Volgger, Veronika; Lankenau, Eva; Ledderose, Georg J; Stepp, Herbert; Homann, Christian; Betz, Christian S

2017-07-01

Endoscopic examination followed by tissue biopsy is the gold standard in the evaluation of lesions of the upper aerodigestive tract. However, it can be difficult to distinguish between healthy mucosa, dysplasia, and invasive carcinoma. Optical coherence tomography (OCT) is a non-invasive technique which acquires high-resolution, cross-sectional images of tissue in vivo. Integrated into a surgical microscope, it allows the intraoperative evaluation of lesions simultaneously with microscopic visualization. In a prospective case series, we evaluated the use of OCT integrated into a surgical microscope during microlaryngoscopy to help differentiating various laryngeal pathologies. 33 patients with laryngeal pathologies were examined with an OCT- microscope (OPMedT iOCT-camera, HS Hi-R 1000G-microscope, Haag-Streit Surgical GmbH, Wedel, Germany) during microlaryngoscopy. The suspected intraoperative diagnoses were compared to the histopathological reports of subsequent tissue biopsies. Hands-free non-contact OCT revealed high-resolution images of the larynx with a varying penetration depth of up to 1.2 mm and an average of 0.6 mm. Picture quality was variable. OCT showed disorders of horizontal tissue layering in dysplasias with a disruption of the basement membrane in carcinomas. When comparing the suspected diagnosis during OCT-supported microlaryngoscopy with histology, 79% of the laryngeal lesions could be correctly identified. Premalignant lesions were difficult to diagnose and falsely classified as carcinoma. OCT integrated into a surgical microscope seems to be a promising adjunct tool to discriminate pathologies of the upper aerodigestive tract intraoperatively. However, picture quality and penetration depth were variable. Although premalignant lesions were difficult to diagnose, the system proved overall helpful for the intraoperative discrimination of benign and malignant tumors. Further studies will be necessary to define its value in the future. Lasers

Exercise guidelines for inpatients following ventricular assist device placement: a systematic review of the literature.

Science.gov (United States)

Scheiderer, Rachel; Belden, Courtney; Schwab, Darla; Haney, Casey; Paz, Jaime

2013-06-01

For patients with end-stage heart failure awaiting transplantation, lack of donor organs has created an increased need for alternatives such as left ventricular assist device (LVAD) implantation. The purpose of this study is to determine safe and effective exercise parameters for physical therapy in the acute care setting. A systematic literature review was conducted according to PRISMA guidelines using Sackett's Levels of Evidence to rate the evidence. Multiple databases were searched with inclusion criteria of: available in English, inpatient care up to 6 months postoperatively, description of intervention type and exercise parameters. no defined exercise parameters, outpatient treatment, infection post VAD, or palliative or hospice care post VAD. Six studies out of 1,291 articles met inclusion criteria. Common exercise parameters used were the Borg Rating of Perceived Exertion scale 11-13 (6-20 scale) or > 4 (0-10 scale), Dyspnea scale > 2 (0-4 scale) and > 5 (0-10 scale), mean arterial pressure (MAP) 70-95 mmHg, and LVAD flow > 3L/min. Levels of evidence ranged from case controlled to expert opinion. Current evidence on inpatient exercise parameters for patient's status post LVAD implantation is not sufficient to suggest definitive guidelines; however, these exercise parameters provide a reference for patient care.

Vitamin A and feeding statuses modulate the insulin-regulated gene expression in Zucker lean and fatty primary rat hepatocytes.

Directory of Open Access Journals (Sweden)

Wei Chen

Full Text Available Unattended hepatic insulin resistance predisposes individuals to dyslipidemia, type 2 diabetes and many other metabolic complications. The mechanism of hepatic insulin resistance at the gene expression level remains unrevealed. To examine the effects of vitamin A (VA, total energy intake and feeding conditions on the insulin-regulated gene expression in primary hepatocytes of Zucker lean (ZL and fatty (ZF rats, we analyze the expression levels of hepatic model genes in response to the treatments of insulin and retinoic acid (RA. We report that the insulin- and RA-regulated glucokinase, sterol regulatory element-binding protein-1c and cytosolic form of phosphoenolpyruvate carboxykinase expressions are impaired in hepatocytes of ZF rats fed chow or a VA sufficient (VAS diet ad libitum. The impairments are partially corrected when ZF rats are fed a VA deficient (VAD diet ad libitum or pair-fed a VAS diet to the intake of their VAD counterparts in non-fasting conditions. Interestingly in the pair-fed ZL and ZF rats, transient overeating on the last day of pair-feeding regimen changes the expression levels of some VA catabolic genes, and impairs the insulin- and RA-regulated gene expression in hepatocytes. These results demonstrate that VA and feeding statuses modulate the hepatic insulin sensitivity at the gene expression level.

Clinical utility of FDG-PET for the differential diagnosis among the main forms of dementia.

Science.gov (United States)

Nestor, Peter J; Altomare, Daniele; Festari, Cristina; Drzezga, Alexander; Rivolta, Jasmine; Walker, Zuzana; Bouwman, Femke; Orini, Stefania; Law, Ian; Agosta, Federica; Arbizu, Javier; Boccardi, Marina; Nobili, Flavio; Frisoni, Giovanni Battista

2018-05-07

To assess the clinical utility of FDG-PET as a diagnostic aid for differentiating Alzheimer's disease (AD; both typical and atypical forms), dementia with Lewy bodies (DLB), frontotemporal lobar degeneration (FTLD), vascular dementia (VaD) and non-degenerative pseudodementia. A comprehensive literature search was conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted on six different diagnostic scenarios using the Delphi method. The level of empirical study evidence for the use of FDG-PET was considered good for the discrimination of DLB and AD; fair for discriminating FTLD from AD; poor for atypical AD; and lacking for discriminating DLB from FTLD, AD from VaD, and for pseudodementia. Delphi voting led to consensus in all scenarios within two iterations. Panellists supported the use of FDG-PET for all PICOs-including those where study evidence was poor or lacking-based on its negative predictive value and on the assistance it provides when typical patterns of hypometabolism for a given diagnosis are observed. Although there is an overall lack of evidence on which to base strong recommendations, it was generally concluded that FDG-PET has a diagnostic role in all scenarios. Prospective studies targeting diagnostically uncertain patients for assessing the added value of FDG-PET would be highly desirable.

Efficacy of cognitive stimulation therapy for older adults with vascular dementia

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Federica Piras

Full Text Available ABSTRACT. Background: Cognitive stimulation therapy (CST is an evidence-based psychosocial intervention for people with mild-to-moderate dementia due to various etiological factors. Objective: The aim of the present study was to assess the efficacy of the CST program, Italian adaptation -CST-IT-, in individuals who have vascular dementia (VaD. Methods: Older adults with mild-to-moderate VaD (N = 35 were assigned to one of two programs: one group (N = 21 attended the 14 sessions of the CST-IT program, while the other, active control group (N = 14 took part in alternative activities. The following domains were examined: cognitive functioning, quality of life, mood, behavior, functional activities of daily living. Results: Compared with the active controls, the CST-IT group showed a greater improvement in general cognitive functioning after the intervention (i.e. score increase on the Mini-Mental State Examination and decrease on the Alzheimer's Disease Assessment Scale – Cognitive subscale. A trend towards improvement was also identified in short-term/working memory – the backward digit span task- and perceived quality of life (Quality of Life – Alzheimer's Disease scale. No significant differences emerged between the two groups for the other domains considered. Conclusion: The present results support the efficacy of CST in people with vascular dementia.

Particle Filter with Integrated Voice Activity Detection for Acoustic Source Tracking

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Anders M. Johansson

2007-01-01

Full Text Available In noisy and reverberant environments, the problem of acoustic source localisation and tracking (ASLT using an array of microphones presents a number of challenging difficulties. One of the main issues when considering real-world situations involving human speakers is the temporally discontinuous nature of speech signals: the presence of silence gaps in the speech can easily misguide the tracking algorithm, even in practical environments with low to moderate noise and reverberation levels. A natural extension of currently available sound source tracking algorithms is the integration of a voice activity detection (VAD scheme. We describe a new ASLT algorithm based on a particle filtering (PF approach, where VAD measurements are fused within the statistical framework of the PF implementation. Tracking accuracy results for the proposed method is presented on the basis of synthetic audio samples generated with the image method, whereas performance results obtained with a real-time implementation of the algorithm, and using real audio data recorded in a reverberant room, are published elsewhere. Compared to a previously proposed PF algorithm, the experimental results demonstrate the improved robustness of the method described in this work when tracking sources emitting real-world speech signals, which typically involve significant silence gaps between utterances.

Patient with a total artificial heart maintained on outpatient dialysis while listed for combined organ transplant, a single center experience.

Science.gov (United States)

Hanna, Ramy M; Hasnain, Huma; Kamgar, Mohammad; Hanna, Mina; Minasian, Raffi; Wilson, James

2017-10-01

Advanced mechanical circulatory support is increasingly being used with more sophisticated devices that can deliver pulsatile rather than continuous flow. These devices are more portable as well, allowing patients to await cardiac transplantation in an outpatient setting. It is known that patients with renal failure are at increased risk for developing worsening acute kidney injury during implantation of a ventricular assist device (VAD) or more advanced modalities like a total artificial heart (TAH). Dealing with patients who have an implanted TAH who develop renal failure has been a challenge with the majority of such patients having to await a combined cardiac and renal transplant prior to transition to outpatient care. Protocols do exist for VAD implanted patients to be transitioned to outpatient dialysis care, but there are no reported cases of TAH patients with end stage renal disease (ESRD) being successfully transitioned to outpatient dialysis care. In this report, we identify a patient with a TAH and ESRD transitioned successfully to outpatient hemodialysis and maintained for more than 2 years, though he did not survive to transplant. It is hoped that this report will raise awareness of this possibility, and assist in the development of protocols for similar patients to be successfully transitioned to outpatient dialysis care. © 2017 International Society for Hemodialysis.

MP3-e leiutajatele jäävad näpud / Patrick Jenkins

Index Scriptorium Estoniae

Jenkins, Patrick

2005-01-01

Tänu MP3-mängija iPod edukale müügile suurenes Apple Computeri I kvartali kasum 368% ning oli 295 miljonit dollarit. MP3 tehnoloogia leiutati Saksamaal peaaegu 20 aastat tagasi, kuid tookord ei saadud tehnoloogia rakendamiseks Euroopas tuge. Lisa: MPEG Layer 3 kodeerimine

Scratch and Dig analýza povrchových vad pro zrcadla Metis

Czech Academy of Sciences Publication Activity Database

Špína, Michal; Procháska, František; Melich, Radek

2017-01-01

Roč. 62, č. 1 (2017), s. 11-13 ISSN 0447-6441 R&D Projects: GA MŠk(CZ) LO1206 Institutional support: RVO:61389021 Keywords : Surface imperfection * Scratch and dig analysis * optical surface evaluation Subject RIV: JS - Reliability ; Quality Management, Testing OBOR OECD: Audio engineering, reliability analysis

Avaliação do desempenho hemodinâmico do dispositivo de assistência ventricular InCor como substituto do coração esquerdo Analysis of the hemodynamic performance of the InCor ventricular assist device as a substitute for the left heart

Directory of Open Access Journals (Sweden)

Anderson BENÍCIO

1999-07-01

dispositivo foi melhor quanto maior o nível de vácuo no sistema de drenagem e com a utilização de cânula ventricular.BACKGROUND: The mechanical circulatory assistance is a therapeutic option in cases of cardiogenic shock refractory to the pharmacological treatment, and is frequently used as a bridge for heart transplantation. OBJECTIVE: To evaluate the action of the Ventricular Assist Device (VAD developed by the Bioengineering Division of the Instituto do Coração, implanted as a substitute of the left heart. PATIENTS AND METHODS: Ten Girolando calves with medium weight of 73 kg were studied. The VAD-InCor implant was accomplished with the drainage cannula positioned in the left atrium (LA or in the apex of the left ventricle and the replacement cannula implanted in the descending thoracic aorta. The pressures of the right and left heart, cardiac output and the flow of VAD were determined before and after the pharmacological induction of myocardial failure, at different levels of vacuum of the drainage system. RESULTS: Values of the flow of VAD with the drainage in LA were of 2.2 ± 0.5 l/min without vacuum, of 3.7 ± 0.4 with vacuum of 10 mmHg, of 4.3 ± 0.4 with vacuum of 20 mmHg and of 4.8 ± 0.6 with vacuum of 30 mmHg. The values of the pressure of LA were: 11.7 ± 6; 9.8 ± 5.3; 8.5 ± 4.4 and 5.6 ± 3.3 mmHg under the same conditions, respectively. With the ventricular cannula, the VAD flow was 4.2 ± 0.6 without vacuum and of 4.4 ± 0.7 with vacuum of 10 mmHg, with of LA pressure of 11.1 ± 2 and 10.3 ± 3.5 mmHg in the two conditions. Those results were observed in similar hemodynamic conditions, with the VAD flow responsible for a greater percentile of the total cardiac output according to the level of vacuum. That percentile was of 86 ± 13% with the atrial cannula and vacuum of 30 mmHg and of 97 ± 3% with the ventricular drainage and vacuum of 10 mmHg. CONCLUSIONS: The VAD-InCor demonstrated its effectiveness as a substitute of the left heart. The

Skrivande om skrivande

DEFF Research Database (Denmark)

Vad har skrivande för roll i vår forskning? Hur kan vi använda skrivande som ett sätt att tänka, lära, förstå och samtala? Kan skrivande vara metod? I Skrivande om skrivande möter du skribenter med bakgrund såväl i akademin som i skönlitteratur, poesi och journalistik. Här delar de med sig av sina...

Lühiajaline. Suuremõõtmeline / Indrek Grigor

Index Scriptorium Estoniae

Grigor, Indrek

2010-01-01

3. septembril 2010 avati Eesti Rahva Muuseumi Raadi mõisapargis skulptuurinäitus töödest, mis valmisid rahvusvahelise skulptuurisümpoosioni "Lühiajaline. Suuremõõtmeline" (25. 08.-03. 09. 2010) käigus ja mis jäävad parki aastaks. Sümpoosioni peakorraldajad: Jevgeni Zolotko ja Bruno Kadak, osalesid: Uwe Schloen (Saksamaa), Csilla Nagy (Ungari), Gleb Netšvolodov (Inglismaa), Ahti Seppet, Eike Eplik ja Jevgeni Zolotko (Eesti)

Moskva mängis end naabritega tülitsedes nurka / Heiki Suurkask

Index Scriptorium Estoniae

Suurkask, Heiki, 1972-

2007-01-01

USA välisministri Condoleezza Rice'i Venemaa-visiidi eesmärk oli vähendada Venemaa vastuseisu Tšehhi ja Poola laiendatavale raketitõrjekilbile ja Kosovo iseseisvusele, kuid lepiti kokku vaid selles, et retoorikat tuleb pehmendada. Moskvas viibis ka Saksa välisminister Frank-Walter Steinmeier, EL-i ja Venemaa tippkohtumise eel jäävad peaaegu kõik poliitilised tüliküsimused püsima. Lisa: Usaldamatuse saareke

Vitamin D, Homocysteine, and Folate in Subcortical Vascular Dementia and Alzheimer Dementia

OpenAIRE

Moretti, Rita; Caruso, Paola; Dal Ben, Matteo; Conti, Corrado; Gazzin, Silvia; Tiribelli, Claudio

2017-01-01

Dementia is a worldwide health problem which affects millions of patients; Alzheimer's disease (AD) and subcortical vascular dementia (sVAD) are the two most frequent forms of its presentation. As no definite therapeutic options have been discovered, different risk factors for cognitive impairment have been searched for potential therapies. This report focuses on the possible evidence that vitamin D deficiency and hyper-homocysteinemia can be considered as two important factors for the develo...

Herrens röst

DEFF Research Database (Denmark)

Rösing, Lilian Munk

2015-01-01

Om språket är gränsen mellan djur och människor, vad innebär det när hundar talar? I filmen Upp pratar de animerade hundarna, men med sin husses röst. Lilian Munk Rösing ser filmen i sällskap av bland andra Jacques Lacan, Slavoj Žižek och Renata Salecl och finner en röst utan kropp, en kropp besj...

Carcinomas epidermóides do pulmão na doença vibroacústica Respiratory squamous cell carcinomas in vibroacoustic disease

Directory of Open Access Journals (Sweden)

José Reis Ferreira

2006-09-01

Full Text Available Enquadramento: Em 1987, observou-se durante a autópsia de um doente com doença vibroacústica (VAD dois tumores: Um carcinoma de células renais e um glioma maligno cerebral. Desde 1987, tem-se vigiado o aparecimento de tumores em doentes com a VAD. Até à data, num universo de 945 indivíduos, há 46 casos de tumores malignos, dos quais 11 são múltiplos. Dos 11 casos de tumores do aparelho respiratório, todos eram carcinomas epidermóides (CE. O presente estudo aborda as características morfológicas destes tumores. Métodos: Foram recolhidos fragmentos destes tumores (biópsia endoscópica ou cirúrgica de 11 doentes do sexo masculino (idade média: 58±9 anos, 3 não fumadores: 2 na glote e 9 no pulmão. Dos 3 não fumadores, 2 tinham tumores do pulmão e 1 tinha tumor da glote. Todos eram trabalhadores ou reformados da indústria aeronáutica, pilotos militares ou de linhas comerciais. Foram fixados fragmentos para microscopia óptica e electrónica. Para os estudos imuno-histoquímicos usou-se coloração com cromagranina e sinaptofisina. Resultados: Todos os tumores pulmonares se localizaram no brônquio do lobo superior direito, e a sua histologia era de tumores epidermóides pouco diferenciados. A pesquisa com marcadores neuroendócrinos foi negativa. Nove doentes faleceram. Os 2 sobreviventes são grandes fumadores (> 2 maços/dia. A média de idade de aparecimento do tumor em pilotos de helicóptero estava abaixo dos 50 anos, enquanto para os outros dois grupos profissionais era superior a 50. Os hábitos tabágicos não tiveram influência na progressão e desfecho dos casos. Conclusões: O CE constitui aproximadamente 40% dos tumores pulmonares na população em geral. Face aos actuais resultados, torna-se muito importante especificar o tipo histológico exacto do tumor em todos os estudos estatísticos. Não surpreende a idade mais jovem de início dos tumores em pilotos de helicóptero, atendendo aos resultados dos estudos

Effects of bile acids on human airway epithelial cells: implications for aerodigestive diseases

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Adil Aldhahrani

2017-03-01

Full Text Available Gastro-oesophageal reflux and aspiration have been associated with chronic and end-stage lung disease and with allograft injury following lung transplantation. This raises the possibility that bile acids may cause lung injury by damaging airway epithelium. The aim of this study was to investigate the effect of bile acid challenge using the immortalised human bronchial epithelial cell line (BEAS-2B. The immortalised human bronchial epithelial cell line (BEAS-2B was cultured. A 48-h challenge evaluated the effect of individual primary and secondary bile acids. Post-challenge concentrations of interleukin (IL-8, IL-6 and granulocyte−macrophage colony-stimulating factor were measured using commercial ELISA kits. The viability of the BEAS-2B cells was measured using CellTiter-Blue and MTT assays. Lithocholic acid, deoxycholic acid, chenodeoxycholic acid and cholic acid were successfully used to stimulate cultured BEAS-2B cells at different concentrations. A concentration of lithocholic acid above 10 μmol·L−1 causes cell death, whereas deoxycholic acid, chenodeoxycholic acid and cholic acid above 30 μmol·L−1 was required for cell death. Challenge with bile acids at physiological levels also led to a significant increase in the release of IL-8 and IL6 from BEAS-2B. Aspiration of bile acids could potentially cause cell damage, cell death and inflammation in vivo. This is relevant to an integrated gastrointestinal and lung physiological paradigm of chronic lung disease, where reflux and aspiration are described in both chronic lung diseases and allograft injury.

Review of the safety and efficacy of vitamin A supplementation in the treatment of children with severe acute malnutrition.

Science.gov (United States)

Iannotti, Lora L; Trehan, Indi; Manary, Mark J

2013-09-12

World Health Organization (WHO) guidelines recommend for children with severe acute malnutrition (SAM), high-dose vitamin A (VA) supplements be given on day 1 of admission, and on days 2 and 14 in the case of clinical signs of vitamin A deficiency (VAD). Daily low-dose VA follows, delivered in a premix added to F-75 and F-100. This study aimed to systematically review the evidence for safety and effectiveness of high-dose VA supplementation (VAS) in treatment of children with SAM. A comprehensive literature review was undertaken for all relevant randomized controlled trials (RCT) and observational studies from 1950 to 2012. Studies identified for full review were evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology using a set of pre-defined criteria: indirectness; inconsistency; imprecision; and study limitations. A quality rating of high, moderate, or low was then assigned to each study, and only those attaining moderate to high were considered in making recommendations. Of the 2072 abstracts screened, 38 met criteria for full review, and 20 were rated moderate to high quality. Only one study replicated the WHO VA protocol in children with SAM. Indirectness was a critical limitation, as studies were not exclusive to children with SAM. There was inconsistency across trials for definitions of malnutrition, morbidities, and ages studied; and imprecision arising from sub-group analyses and small sample sizes. Evidence showed improved outcomes associated with low-dose compared to high-dose VAS, except in cases presenting with signs of VAD, measles, and severe diarrhea or shigellosis. Adverse outcomes related to respiratory infection, diarrhea, and growth were associated with high-dose VAS in children who were predominantly adequately nourished. No adverse effects of the high dose were found in children with SAM in the trial that replicated the WHO VA guideline. This is the first systematic review of the safety and

Inhibition of HIV-1 entry by extracts derived from traditional Chinese medicinal herbal plants

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Song Xinming

2009-08-01

Full Text Available Abstract Background Highly active anti-retroviral therapy (HAART is the current HIV/AIDS treatment modality. Despite the fact that HAART is very effective in suppressing HIV-1 replication and reducing the mortality of HIV/AIDS patients, it has become increasingly clear that HAART does not offer an ultimate cure to HIV/AIDS. The high cost of the HAART regimen has impeded its delivery to over 90% of the HIV/AIDS population in the world. This reality has urgently called for the need to develop inexpensive alternative anti-HIV/AIDS therapy. This need has further manifested by recent clinical trial failures in anti-HIV-1 vaccines and microbicides. In the current study, we characterized a panel of extracts of traditional Chinese medicinal herbal plants for their activities against HIV-1 replication. Methods Crude and fractionated extracts were prepared from various parts of nine traditional Chinese medicinal herbal plants in Hainan Island, China. These extracts were first screened for their anti-HIV activity and cytotoxicity in human CD4+ Jurkat cells. Then, a single-round pseudotyped HIV-luciferase reporter virus system (HIV-Luc was used to identify potential anti-HIV mechanisms of these extracts. Results Two extracts, one from Euphorbiaceae, Trigonostema xyphophylloides (TXE and one from Dipterocarpaceae, Vatica astrotricha (VAD inhibited HIV-1 replication and syncytia formation in CD4+ Jurkat cells, and had little adverse effects on host cell proliferation and survival. TXE and VAD did not show any direct inhibitory effects on the HIV-1 RT enzymatic activity. Treatment of these two extracts during the infection significantly blocked infection of the reporter virus. However, pre-treatment of the reporter virus with the extracts and treatment of the extracts post-infection had little effects on the infectivity or gene expression of the reporter virus. Conclusion These results demonstrate that TXE and VAD inhibit HIV-1 replication likely by blocking